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Zhu T, Yang S, Mauro TM, Man MQ. Association of Epidermal Biophysical Properties with Obesity and Its Implications. Skin Pharmacol Physiol 2023; 36:165-173. [PMID: 37640014 DOI: 10.1159/000533587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obesity is a condition defined by an excess amount of body fat, with body mass index (BMI) of 30 and higher. It is associated with a number of other medical conditions, including insulin resistance, diabetes mellitus, and cardiovascular diseases, as well as dyslipidemia, and it is also associated with several cutaneous disorders such as atopic dermatitis, psoriasis, intertriginous dermatitis, acanthosis nigricans and skin infections. SUMMARY Evidence suggests a link between obesity and epidermal dysfunction. Generally, individuals with obesity display higher transepidermal water loss rate and lower stratum corneum hydration levels, although no association of obesity with epidermal dysfunction has been documented. Results of skin surface pH are controversial. But study demonstrated a positive correlation of BMI with skin surface pH on both the forearm and the shin in males, suggesting that the changes in epidermal function vary with gender in individuals with obesity. KEY MESSAGES This review summarizes the association between obesity and epidermal function, and discusses possible underlying mechanisms. Individuals with obesity exhibit poor epidermal permeability barrier and lower stratum corneum hydration levels. Because of the pathogenic role of compromised epidermal function in inflammation, which is also linked to obesity, improvement in epidermal function could benefit individuals with obesity, particularly those with abnormalities in epidermal function.
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Affiliation(s)
- Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People's Hospital of Baoshan, Baoshan, China
| | - Theodora M Mauro
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
| | - Mao-Qiang Man
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
- Dermatology Hospital, Southern Medical University, Guangzhou, China
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Hebert AA. Oxidative stress as a treatment target in atopic dermatitis: The role of furfuryl palmitate in mild-to-moderate atopic dermatitis. Int J Womens Dermatol 2020; 6:331-333. [PMID: 33015298 PMCID: PMC7522904 DOI: 10.1016/j.ijwd.2020.03.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 03/18/2020] [Indexed: 11/25/2022] Open
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Berekméri A, Tiganescu A, Alase AA, Vital E, Stacey M, Wittmann M. Non-invasive Approaches for the Diagnosis of Autoimmune/Autoinflammatory Skin Diseases-A Focus on Psoriasis and Lupus erythematosus. Front Immunol 2019; 10:1931. [PMID: 31497014 PMCID: PMC6712514 DOI: 10.3389/fimmu.2019.01931] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/30/2019] [Indexed: 12/27/2022] Open
Abstract
The traditional diagnostic gold standard for inflammatory skin lesions of unclear etiology is dermato-histopathology. As this approach requires an invasive skin biopsy, biopsy processing and analysis by specialized histologists, it is a resource intensive approach requiring trained healthcare professionals. In many health care settings access to this diagnostic approach can be difficult and outside emergency cases will usually take several weeks. This scenario leads to delayed or inappropriate treatment given to patients. With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to "measure" samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation-they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin diseases.
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Affiliation(s)
- Anna Berekméri
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Ana Tiganescu
- Faculty of Medicine and Health, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Adewonuola A. Alase
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Edward Vital
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Martin Stacey
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Miriam Wittmann
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
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Chow S, Seow CS, Dizon MV, Godse K, Foong H, Chan V, Khang TH, Xiang L, Hidayat S, Listiawan MY, Triwahyudi D, Gondokaryono SP, Sutedja E, Diana IA, Suwarsa O, Dharmadji HP, Siswati AS, Danarti R, Soebaryo R, Budianti WK. A clinician's reference guide for the management of atopic dermatitis in Asians. Asia Pac Allergy 2018; 8:e41. [PMID: 30402408 PMCID: PMC6209602 DOI: 10.5415/apallergy.2018.8.e41] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/24/2018] [Indexed: 01/08/2023] Open
Abstract
Background Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD. Objective The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians. Methods Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017. Results The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included. Conclusion The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.
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Affiliation(s)
| | | | | | - Kiran Godse
- DY Patil School of Medicine, Nerul, Navi Mumbai, India
| | - Henry Foong
- Foong Skin Specialist Clinic, Ipoh, Malaysia
| | - Vicheth Chan
- Cadau Skin and Laser Clinic, Pnomh Penh, Cambodia
| | | | | | - Syarief Hidayat
- League of ASEAN Dermatologic Societies, Kuala Lumpur, Malaysia
| | | | | | | | | | | | - Oki Suwarsa
- Univerity of Padjadjaran, Bandung, Indonesia
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Pigatto PD, Diani M. Beneficial Effects of Antioxidant Furfuryl Palmitate in Non-pharmacologic Treatments (Prescription Emollient Devices, PEDs) for Atopic Dermatitis and Related Skin Disorders. Dermatol Ther (Heidelb) 2018; 8:339-347. [PMID: 29790104 PMCID: PMC6109026 DOI: 10.1007/s13555-018-0239-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Indexed: 12/23/2022] Open
Abstract
Introduction Atopic dermatitis (AD) is a common chronic inflammatory skin disease; it requires long-term treatments focused on symptomatic relief. Current first-line treatments include moisturizers and topical corticosteroids. Recently, topical antioxidants have been added to moisturizer formulations to alleviate mild-to-moderate AD. The aim of this review was to evaluate the efficacy and tolerability of furfuryl palmitate, a new antioxidant molecule, and furfuryl derivatives. Methods A PubMed/Google Scholar search was conducted using the term “furfuryl palmitate” (and its derivatives, including AR-GG27®) combined with “skin,” “atopic dermatitis,” and “atopic eczema.” Existing trials including adult and pediatric patients with AD and related skin disorders were evaluated. The treatment indication(s), number of subjects, treatment protocols, results, and side effects were recorded. Results Effective treatments with furfuryl palmitate and furfuryl derivatives have been reported for the following conditions: atopic, seborrheic, irritative, and allergic contact dermatitis, eczema, xerosis, and cutaneous inflammatory pathologies. All the products tested showed a good tolerability profile. Conclusion Studies performed up to now showed that furfuryl derivatives can efficaciously contrast signs and symptoms of mild-to-moderate AD, erythema, and widespread diffuse cutaneous pathologies in both adult and pediatric patients, representing a real alternative to steroids and a valid aid in the treatment of skin disorders, with no side effects and without requiring precautions in use. Funding Relife S.r.l. - Menarini Group. Plain Language Summary Plain language summary available for this article.
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Affiliation(s)
- Paolo Daniele Pigatto
- Dipartimento di Scienze biomediche, chirurgiche e odontoiatriche, Clinica Dermatologica, Università degli Studi di Milano, Milan, Italy.
| | - Marco Diani
- Dipartimento di Scienze biomediche, chirurgiche e odontoiatriche, Clinica Dermatologica, Università degli Studi di Milano, Milan, Italy
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Tsai MT, Tsai TY, Shen SC, Ng CY, Lee YJ, Lee JD, Yang CH. Evaluation of Laser-Assisted Trans-Nail Drug Delivery with Optical Coherence Tomography. SENSORS (BASEL, SWITZERLAND) 2016; 16:E2111. [PMID: 27973451 PMCID: PMC5191091 DOI: 10.3390/s16122111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 01/08/2023]
Abstract
The nail provides a functional protection to the fingertips and surrounding tissue from external injuries. The nail plate consists of three layers including dorsal, intermediate, and ventral layers. The dorsal layer consists of compact, hard keratins, limiting topical drug delivery through the nail. In this study, we investigate the application of fractional CO₂ laser that produces arrays of microthermal ablation zones (MAZs) to facilitate drug delivery in the nails. We utilized optical coherence tomography (OCT) for real-time monitoring of the laser-skin tissue interaction, sparing the patient from an invasive surgical sampling procedure. The time-dependent OCT intensity variance was used to observe drug diffusion through an induced MAZ array. Subsequently, nails were treated with cream and liquid topical drugs to investigate the feasibility and diffusion efficacy of laser-assisted drug delivery. Our results show that fractional CO₂ laser improves the effectiveness of topical drug delivery in the nail plate and that OCT could potentially be used for in vivo monitoring of the depth of laser penetration as well as real-time observations of drug delivery.
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Affiliation(s)
- Meng-Tsan Tsai
- Department of Electrical Engineering, Chang Gung University, Taoyuan 33302, Taiwan.
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan.
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
| | - Ting-Yen Tsai
- Department of Electrical Engineering, Chang Gung University, Taoyuan 33302, Taiwan.
| | - Su-Chin Shen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
| | - Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
| | - Ya-Ju Lee
- Institute of Electro-Optical Science and Technology, National Taiwan Normal University, Taipei 11677, Taiwan.
| | - Jiann-Der Lee
- Department of Electrical Engineering, Chang Gung University, Taoyuan 33302, Taiwan.
- Department of Neurosurgery, Chang Gung Memorial Hospital, LinKou 33305, Taiwan.
| | - Chih-Hsun Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
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Lee CH. Immune regulation in pathophysiology and targeted therapy for itch in atopic dermatitis. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2015.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Qin R, Lampel HP. Review of Occupational Contact Dermatitis—Top Allergens, Best Avoidance Measures. CURRENT TREATMENT OPTIONS IN ALLERGY 2015. [DOI: 10.1007/s40521-015-0063-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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