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Blume-Peytavi U, Tan J, Tennstedt D, Boralevi F, Fabbrocini G, Torrelo A, Soares-Oliveira R, Haftek M, Rossi AB, Thouvenin MD, Mangold J, Galliano MF, Hernandez-Pigeon H, Aries MF, Rouvrais C, Bessou-Touya S, Duplan H, Castex-Rizzi N, Mengeaud V, Ferret PJ, Clouet E, Saint Aroman M, Carrasco C, Coutanceau C, Guiraud B, Boyal S, Herman A, Delga H, Biniek K, Dauskardt R. Fragility of epidermis in newborns, children and adolescents. J Eur Acad Dermatol Venereol 2016; 30 Suppl 4:3-56. [PMID: 27062556 DOI: 10.1111/jdv.13636] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/10/2016] [Accepted: 02/17/2016] [Indexed: 12/18/2022]
Abstract
Within their first days of life, newborns' skin undergoes various adaptation processes needed to accommodate the transition from the wet uterine environment to the dry atmosphere. The skin of newborns and infants is considered as a physiological fragile skin, a skin with lower resistance to aggressions. Fragile skin is divided into four categories up to its origin: physiological fragile skin (age, location), pathological fragile skin (acute and chronic), circumstantial fragile skin (due to environmental extrinsic factors or intrinsic factors such as stress) and iatrogenic fragile skin. Extensive research of the past 10 years have proven evidence that at birth albeit showing a nearly perfect appearance, newborn skin is structurally and functionally immature compared to adult skin undergoing a physiological maturation process after birth at least throughout the first year of life. This article is an overview of all known data about fragility of epidermis in 'fragile populations': newborns, children and adolescents. It includes the recent pathological, pathophysiological and clinical data about fragility of epidermis in various dermatological diseases, such as atopic dermatitis, acne, rosacea, contact dermatitis, irritative dermatitis and focus on UV protection.
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Affiliation(s)
- U Blume-Peytavi
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin, Berlin, Germany
| | - J Tan
- Department of Medicine, Faculty of Medicine, Schulich School of Medicine and Dentistry, Western University, Windsor campus, Windsor, ON, Canada.,Windsor Clinical Research Inc., Windsor campus, Windsor, ON, Canada
| | - D Tennstedt
- Department of Dermatology, Saint-Luc University Clinics, Brussels, Belgium
| | - F Boralevi
- Pediatric Dermatology, Pellegrin Hospital, Bordeaux, France
| | - G Fabbrocini
- Department of Dermatology, University Hospital of Naples, Naples, Italy
| | - A Torrelo
- Pediatric Dermatology, Hospital del Niño Jesús, Madrid, Spain
| | | | - M Haftek
- University Lyon 1, Lyon, France.,University Lyon 1, EA4169, "Fundamental, clinical and therapeutic aspects of the skin barrier function", Lyon, France
| | - A B Rossi
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Department of Dermatology, Toulouse University hospital, France
| | - M D Thouvenin
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - J Mangold
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - M F Galliano
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - H Hernandez-Pigeon
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - M F Aries
- Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - C Rouvrais
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - S Bessou-Touya
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Medical Department, Pierre Fabre Research and Laboratoires Dermatologiques A-Derma, Lavaur, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - H Duplan
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - N Castex-Rizzi
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - V Mengeaud
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France
| | - P J Ferret
- Pierre Fabre Dermo-Cosmétique Research & Development, Toxicology Division, Vigoulet-Auzil, France.,Pierre Fabre Dermo-Cosmétique Research & Developement Center, Toxicology division, Vigoulet, France
| | - E Clouet
- Pierre Fabre Dermo-Cosmétique Research & Development, Toxicology Division, Vigoulet-Auzil, France.,Pierre Fabre Dermo-Cosmétique Research & Developement Center, Toxicology division, Vigoulet, France
| | | | - C Carrasco
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - C Coutanceau
- Medical Department, Pierre Fabre Research and Laboratoires Dermatologiques A-Derma, Lavaur, France
| | - B Guiraud
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - S Boyal
- Windsor Clinical Research Inc., Windsor campus, Windsor, ON, Canada
| | - A Herman
- Department of Dermatology, Saint-Luc University Clinics, Brussels, Belgium
| | - H Delga
- Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - K Biniek
- Department of Materials Science and Engineering, Stanford University hospital, Stanford, CA, USA
| | - R Dauskardt
- Department of Materials Science and Engineering, Stanford University hospital, Stanford, CA, USA
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Adjadj L, Debelmas A, Franois-Fiquet C, Diner PA, Buis J, Franchi G, Chrétien-Marquet B, Vazquez MP, Picard A, Kadlub N. [Orbital congenital nevi: Principles of treatment about 51 cases]. ANN CHIR PLAST ESTH 2014; 61:29-38. [PMID: 25524448 DOI: 10.1016/j.anplas.2014.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/08/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The incidence of congenital nevi is one over 20,000 newborns per year, 14 % of them are located in the head and neck area. Nevi of the orbital region are particularly difficult to handle on the aesthetic and functional side. The objectives of this study were to conduct an analysis of different clinical presentations of congenital nevi of the eyelid orbital region in children to establish a treatment algorithm. MATERIEL AND METHODS We realised a bi-centric retrospective study including 51 children with orbito-palpebral congenital nevi. We analysed the different clinical presentations, their treatments and their results. RESULTS Nineteen underwent direct suture excision; three a total skin graft; 15 a combination of treatments, among them four underwent tissular expansion and 14 patients were not operated and clinically followed-up. The average follow-up time was 6.6 years. In 33 cases residual nevic area was still present. The postoperative sequelae were: dyschromia (n=17), anatomical deformation of the eye (n=10), nevi outbreaks (n=8), internal canthus deformation (n=5) and ectropion (n=1). CONCLUSION The results of our study show that therapeutic abstention is preferred when the aesthetic wrong is accepted by the patient and when there is not a higher risk of malignant degeneration. In order to minimise the risk of postoperative sequelae, we propose a therapeutic algorithm for the management of congenital orbital nevi.
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Affiliation(s)
- L Adjadj
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - A Debelmas
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - C Franois-Fiquet
- Service de chirurgie plastique, CHU de Reims, 51000 Reims, France; UFR de médecine, université de Reims-Champagne-Ardennes, 51000 Reims, France
| | - P-A Diner
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - J Buis
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - G Franchi
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - B Chrétien-Marquet
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - M-P Vazquez
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France
| | - A Picard
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France
| | - N Kadlub
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France.
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