Bad air gets under your skin

Oroxylin A ameliorates ultraviolet radiation-induced premature skin aging by regulating oxidative stress via the Sirt1 pathway

Skin is susceptible to premature aging in response to ultraviolet (UV) radiation-induced oxidative stress, which can ultimately result in aberrant aging or age-related disorders. Accordingly, strategies that can be adopted to mitigate oxidative stress may contribute to protecting skin from induced aging-related damage, thereby offering promising approaches for the treatment of skin diseases and disorders. In this regard, oroxylin A (OA), a natural flavonoid isolated from certain plants used in traditional Chinese medicine, is considered to have notable antioxidant, anti-inflammatory, and anti-apoptotic properties, and is often used to treat certain inflammatory diseases. To date, however, there has been comparatively little research on the effects of OA with respect skin aging. In this study, we utilized UV radiation-induced mouse and cellular models of aging to assess the efficacy of OA in protecting against skin aging. Subsequently, to elucidate the potential mechanisms underlying the protective effect of OA on skin aging, we performed molecular docking analysis to investigate the involvement of the anti-aging gene Sirt1, which was further confirmed on the basis of Sirt1 gene silencing. We accordingly demonstrated that by promoting an increase in the expression of Sirt1, OA can contribute to suppressing UV-induced skin photo-aging in cells/mice by reducing oxidative stress. Furthermore, we established that by activating Sirt1, OA can also promote the dissociation of Nrf2 from Keap1 and its subsequent nuclear translocation. Collectively, our findings in this study reveal OA to be an effective natural compound that can be administered to delay the aging of skin triggered by UV, both in vivo and in vitro, by binding to Sirt1 to promote the deacetylation and nuclear translocation of Nrf2, thereby contributing to a reduction in oxidative stress. These findings may this provide a therapeutic target for the prevention of skin aging or aging-induced skin diseases.

Promoting New Approach Methodologies (NAMs) for research on skin color changes in response to environmental stress factors: tobacco and air pollution

Aging is one of the most dynamic biological processes in the human body and is known to carry significant impacts on individuals' self-esteem. Skin pigmentation is a highly heritable trait made possible by complex, strictly controlled cellular and molecular mechanisms. Genetic, environmental and endocrine factors contribute to the modulation of melanin's amount, type and distribution in the skin layers. One of the hallmarks of extrinsic skin aging induced by environmental stress factors is the alteration of the constitutive pigmentation pattern clinically defined as senile lentigines and/or melasma or other pigmentary dyschromias. The complexity of pollutants and tobacco smoke as environmental stress factors warrants a thorough understanding of the mechanisms by which they impact skin pigmentation through repeated and long-term exposure. Pre-clinical and clinical studies demonstrated that pollutants are known to induce reactive oxygen species (ROS) or inflammatory events that lead directly or indirectly to skin hyperpigmentation. Another mechanistic direction is provided by Aryl hydrocarbon Receptors (AhR) which were shown to mediate processes leading to skin hyperpigmentation in response to pollutants by regulation of melanogenic enzymes and transcription factors involved in melanin biosynthesis pathway. In this context, we will discuss a diverse range of New Approach Methodologies (NAMs) capable to provide mechanistic insights of the cellular and molecular pathways involved in the action of environmental stress factors on skin pigmentation and to support the design of raw ingredients and formulations intended to counter their impact and of any subsequently needed clinical studies.

Environmental Air Pollutants Affecting Skin Functions with Systemic Implications

The increase in air pollution worldwide represents an environmental risk factor that has global implications for the health of humans worldwide. The skin of billions of people is exposed to a mixture of harmful air pollutants, which can affect its physiology and are responsible for cutaneous damage. Some polycyclic aromatic hydrocarbons are photoreactive and could be activated by ultraviolet radiation (UVR). Therefore, such UVR exposure would enhance their deleterious effects on the skin. Air pollution also affects vitamin D synthesis by reducing UVB radiation, which is essential for the production of vitamin D3, tachysterol, and lumisterol derivatives. Ambient air pollutants, photopollution, blue-light pollution, and cigarette smoke compromise cutaneous structural integrity, can interact with human skin microbiota, and trigger or exacerbate a range of skin diseases through various mechanisms. Generally, air pollution elicits an oxidative stress response on the skin that can activate the inflammatory responses. The aryl hydrocarbon receptor (AhR) can act as a sensor for small molecules such as air pollutants and plays a crucial role in responses to (photo)pollution. On the other hand, targeting AhR/Nrf2 is emerging as a novel treatment option for air pollutants that induce or exacerbate inflammatory skin diseases. Therefore, AhR with downstream regulatory pathways would represent a crucial signaling system regulating the skin phenotype in a Yin and Yang fashion defined by the chemical nature of the activating factor and the cellular and tissue context.

Dermatological Management of Aged Skin

The subject of the work concerns the dermatological management of patients mainly with aged skin. The purpose of the work was to present the basic techniques and preparations which are performed by dermatologists in the treatment of aged skin. There are dermatological treatments related to the treatment of skin diseases and cosmetic treatments which are mainly related to skin care. In this work, the method of literature research was applied. On the basis of books and journal articles on dermatological and cosmetic procedures for aged skin, an analysis of treatment types was made. Then, the results of this analysis were presented in the paper under discussion. The paper presents information on the skin and its properties. The structure and functions of the skin, aging processes and characteristics of aged skin were discussed. Then, the possibilities of reducing the visible signs of skin aging through the use of invasive and non-invasive dermatological and cosmetological treatments were given, and the most important components of preparations used supportively in combating skin aging processes were discussed.

The impact of airborne ultrafine particulate matter on human keratinocyte stem cells

OBJECTIVE

Air pollution is today fully acknowledged to be a significant public health problem. Rapid urbanization exposed us to a variety of unhealthy ambient air pollutants at high concentrations. The emergence of airborne ultrafine particles has added an additional dimension to this already complex problem of air pollution. The skin has different functions, one of them being the protection against the deleterious effect of external agents. The aim of this study is to evaluate the impact of airborne ultrafine particles (UFP) pollution on skin aging and on keratinocyte differentiation.

METHODS

Ex vivo human skin biopsies and cultured keratinocytes stem cells (KSC) were submitted to diesel exhaust-derived UFP. Reactive oxygen species (ROS) production was assessed with the MitoSOX™ probe. Keratinocyte stemness potential was evaluated by the immunodetection of keratin 15 (K15) and p63 (∆N isoforms). Effect of UFP on the epithelial niche maintenance was evaluated by immunodetection of Sox9. Reconstructed epidermis model was used to assess the impact of UFP on keratinocyte differentiation and aging.

RESULTS

UFP exposure induced ROS production and disturbed K15, ∆Np63 and Sox9 expression in KSC or ex vivo skin. Finally, investigations on reconstructed epidermis revealed a phenotype marked by impaired keratinocyte differentiation.

CONCLUSION

These results indicate that UFP pollution is a potent extrinsic factor of skin aging, affecting the keratinocyte stem cell potential and the skin renewal process.

Present and future: infectious tropical travel rashes and the impact of climate change

In this article, we discuss pertinent cutaneous findings with which patients may present after travel to tropical destinations. We address arthropod-borne infectious diseases such as cutaneous leishmaniasis, Chagas disease, cutaneous larva migrans, and myiasis. We discuss other relevant diseases with cutaneous signs such as monkey pox and severe acute respiratory syndrome coronavirus 2. We provide clinicians with information regarding the background, diagnosis, treatment, and prevention of these tropical rashes. In addition, we address the impact that climate change will have on the temporal and geographic incidence of these rashes. Viral, fungal, and vector-borne diseases have seen a geographic expansion into more northern latitudes. Among these are tick-borne Lyme disease, aquatic snail-related seabather's eruption, and atopic dermatitis. As these diseases spread, we believe that the updated information within this article is significant to the practicing physician in today's warming world.

Skin Health Promoting Effects of Natural Polysaccharides and Their Potential Application in the Cosmetic Industry

Skincare is one of the most profitable product categories today. Consumers’ demand for skin-friendly products has stimulated the development of natural-ingredient-based cosmeceutical preparations over synthetic chemicals. Thus, natural polysaccharides have gained much attention since the promising potent efficacy in wound healing, moisturizing, antiaging, and whitening. The challenge is to raise awareness of polysaccharides with excellent bioactivities from natural sources and consequently incorporate them in novel and safer cosmetics. This review highlights the benefits of natural polysaccharides from plants, algae, and fungi on skin health, and points out some obstacles in the application of natural polysaccharides.

Organophosphorus Flame Retardant TCPP Induces Cellular Senescence in Normal Human Skin Keratinocytes: Implication for Skin Aging

Tris (1-chloro-2-propyl) phosphate (TCPP) is one of the most frequently detected organophosphorus flames in the environment. Continuous daily exposure to TCPP may harm human skin. However, little is known about the adverse effects of TCPP on human skin. In this study, we first evaluated the detrimental effects and tried to uncover the underlying mechanisms of TCPP on human skin keratinocytes (HaCaT) after 24 h exposure. We found that TCPP caused a concentration-dependent decrease in HaCaT cell viability after exposure to 1.56-400 μg/mL for 24 h, with an IC₅₀ of 275 μg/mL. TCPP also promoted the generation of intracellular reactive oxygen species (ROS) and triggered DNA damage, evidenced by an increase of phosphorylated histone H2A.X (γH2A.X) in the nucleus. Furthermore, the cell cycle was arrested at the G1 phase at 100 μg/mL by upregulation of the mRNA expression of p53 and p21 and downregulation of cyclin D1 and CDK4 expression. Additionally, both the senescence-associated-β-galactosidase activity and related proinflammatory cytokine IL-1β and IL-6 were elevated, indicating that TCPP exposure caused cellular senescence may be through the p53-dependent DNA damage signal pathway in HaCaT cells. Taken together, our data suggest that flame-retardant exposure may be a key precipitating factor for human skin aging.

Anti-Wrinkle Effect of BB-1000: A Double-Blind, Randomized Controlled Study

Skin aging usually results from intrinsic or extrinsic stress. Photodamage promotes skin damage and stimulates the skin, manifesting as wrinkles, dryness, roughness, and loss of elasticity. We have previously found that blackberry (Rubus fruticosus B) fermented by Lactobacillus plantarum JBMI F5, designated BB-1000, showed an in vitro and in vivo anti-skin-aging activity. In the present study, we have further evaluated the anti-aging effect of BB-1000 via a randomized, double-blind, and placebo-controlled clinical trial. The trial included 102 volunteers aged 35 to 59 years who have dry skin and wrinkles. Subjects took BB-1000 or a placebo orally at 800 mg/day for 12 weeks. Skin hydration and degree of wrinkles around the eyes were measured at weeks 6 and 12. Skin hydration had no significant effect in both groups at weeks 6 and 12. Otherwise, volunteers in the BB-1000 group had a significant reduction in eye wrinkle grade at week 12. These findings suggest that BB-1000 may be considered a candidate anti-aging agent for preventing skin wrinkles as a nutricosmetic agent.

Association Between Short-term Exposure to Environmental Air Pollution and Psoriasis Flare

IMPORTANCE

Psoriasis is a chronic inflammatory disease with a relapsing-remitting course. Selected environmental factors such as infections, stressful life events, or drugs may trigger disease flares. Whether air pollution could trigger psoriasis flares is still unknown.

OBJECTIVE

To investigate whether short-term exposure to environmental air pollution is associated with psoriasis flares.

DESIGN, SETTING, AND PARTICIPANTS

This observational study with both case-crossover and cross-sectional design retrospectively analyzed longitudinal data from September 2013 to January 2020 from patients with chronic plaque psoriasis consecutively attending the outpatient dermatologic clinic of the University Hospital of Verona. For the case-crossover analysis, patients were included who had at least 1 disease flare, defined as Psoriasis Area and Severity Index (PASI) increase of 5 or greater between 2 consecutive assessments in a time frame of 3 to 4 months. For the cross-sectional analysis, patients were included who received any systemic treatment for 6 or more months, with grade 2 or higher consecutive PASI assessment.

MAIN OUTCOMES AND MEASURES

We compared the mean and cumulative (area under the curve) concentrations of several air pollutants (carbon monoxide, nitrogen dioxide, other nitrogen oxides, benzene, coarse particulate matter [PM; 2.5-10.0 μm in diameter, PM10] and fine PM [<2.5 μm in diameter, PM2.5]) in the 60 days preceding the psoriasis flare and the control visits.

RESULTS

A total of 957 patients with plaque psoriasis with 4398 follow-up visits were included in the study. Patients had a mean (SD) age of 61 (15) years and 602 (62.9%) were men. More than 15 000 measurements of air pollutant concentration from the official, open-source bulletin of the Italian Institute for Environmental Protection and Research (ISPRA) were retrieved. Among the overall cohort, 369 (38.6%) patients with psoriasis flare were included in the case-crossover study. We found that concentrations of all pollutants were significantly higher in the 60 days before psoriasis flare (median PASI at the flare 12; IQR, 9-18) compared with the control visit (median PASI 1; IQR, 1-3, P < .001). In the cross-sectional analysis, exposure to mean PM10 over 20 μg/m3 and mean PM2.5 over 15 μg/m3 in the 60 days before assessment were associated with a higher risk of PASI 5 or greater point worsening (adjusted odds ratio [aOR], 1.55; 95% CI, 1.21-1.99; and aOR, 1.25; 95% CI, 1.0-1.57, respectively). Sensitivity analyses that stratified for trimester of evaluation, with various lag of exposure and adjusting for type of treatment, yielded similar results.

CONCLUSIONS AND RELEVANCE

The findings of this case-crossover and cross-sectional study suggest that air pollution may be a trigger factor for psoriasis flare.

Protective Role of Melatonin and Its Metabolites in Skin Aging

The skin, being the largest organ in the human body, is exposed to the environment and suffers from both intrinsic and extrinsic aging factors. The skin aging process is characterized by several clinical features such as wrinkling, loss of elasticity, and rough-textured appearance. This complex process is accompanied with phenotypic and functional changes in cutaneous and immune cells, as well as structural and functional disturbances in extracellular matrix components such as collagens and elastin. Because skin health is considered one of the principal factors representing overall “well-being” and the perception of “health” in humans, several anti-aging strategies have recently been developed. Thus, while the fundamental mechanisms regarding skin aging are known, new substances should be considered for introduction into dermatological treatments. Herein, we describe melatonin and its metabolites as potential “aging neutralizers”. Melatonin, an evolutionarily ancient derivative of serotonin with hormonal properties, is the main neuroendocrine secretory product of the pineal gland. It regulates circadian rhythmicity and also exerts anti-oxidative, anti-inflammatory, immunomodulatory, and anti-tumor capacities. The intention of this review is to summarize changes within skin aging, research advances on the molecular mechanisms leading to these changes, and the impact of the melatoninergic anti-oxidative system controlled by melatonin and its metabolites, targeting the prevention or reversal of skin aging.

Structural and Functional Changes and Possible Molecular Mechanisms in Aged Skin

Skin aging is a complex process influenced by intrinsic and extrinsic factors. Together, these factors affect the structure and function of the epidermis and dermis. Histologically, aging skin typically shows epidermal atrophy due to decreased cell numbers. The dermis of aged skin shows decreased numbers of mast cells and fibroblasts. Fibroblast senescence contributes to skin aging by secreting a senescence-associated secretory phenotype, which decreases proliferation by impairing the release of essential growth factors and enhancing degradation of the extracellular matrix through activation of matrix metalloproteinases (MMPs). Several molecular mechanisms affect skin aging including telomere shortening, oxidative stress and MMP, cytokines, autophagic control, microRNAs, and the microbiome. Accumulating evidence on the molecular mechanisms of skin aging has provided clinicians with a wide range of therapeutic targets for treating aging skin.

Amino acid complex (AAComplex) benefits in cosmetic products: In vitro and in vivo clinical studies

Background

Amino acids are major components of skin's natural moisturizing factors and play a role in regulating skin hydration and skin pH.

Objective

This research examines a proprietary amino acid complex technology (AAComplex) designed to help reduce skin irritation and repair skin damage.

Methods

In‐ vitro Scratch Assay

HaCaT cells are scratched, and the wounds are imaged at different time points until the closure of the scratch wound is detected.

Results

In‐ vitro Scratch Assay

The AAComplex demonstrated a strong cell renewal benefit in the HaCaT (human) cells scratch assay.

Conclusion

The in vitro and in vivo clinical studies demonstrated that the AAComplex technology formulated in the commercially available Skin Recovery System effectively reduced skin irritation and redness as well as accelerating the skin repair process.

The Impact of Vitamin D on Skin Aging

The active metabolites of vitamin D₃ (D₃) and lumisterol (L₃) exert a variety of antiaging and photoprotective effects on the skin. These are achieved through immunomodulation and include anti-inflammatory actions, regulation of keratinocytes proliferation, and differentiation programs to build the epidermal barrier necessary for maintaining skin homeostasis. In addition, they induce antioxidative responses, inhibit DNA damage and induce DNA repair mechanisms to attenuate premature skin aging and cancerogenesis. The mechanism of action would involve interaction with multiple nuclear receptors including VDR, AhR, LXR, reverse agonism on RORα and -γ, and nongenomic actions through 1,25D₃-MARRS receptor and interaction with the nongenomic binding site of the VDR. Therefore, active forms of vitamin D₃ including its canonical (1,25(OH)₂D₃) and noncanonical (CYP11A1-intitated) D₃ derivatives as well as L₃ derivatives are promising agents for the prevention, attenuation, or treatment of premature skin aging. They could be administrated orally and/or topically. Other forms of parenteral application of vitamin D₃ precursor should be considered to avoid its predominant metabolism to 25(OH)D₃ that is not recognized by CYP11A1 enzyme. The efficacy of topically applied vitamin D₃ and L₃ derivatives needs further clinical evaluation in future trials.

Vitamin C prevents epidermal damage induced by PM-associated pollutants and UVA1 combined exposure

Particulate matter is suspected to be substantially involved in pollution-induced health concerns. In fact, ultrafine particles (UFPs) contain polycyclic aromatic hydrocarbons (PAHs) known as mutagenic, cytotoxic and sometimes phototoxic. Since UFPs reach blood circulation from lung alveoli, deep skin is very likely contaminated by PAHs coming from either skin surface or blood. As photoreactive, benzo(a)pyrene (BaP) or indenopyrene (IcdP) is involved in the interplay between pollution and sunlight. In order to better characterize this process, experiments were carried out on reconstructed human epidermis (RHE) in a protocol mimicking realistic exposure. Concentrations of PAHs comparable to those generally reported in blood were used together with chronic irradiation to low dose UVA1. On a histological level, damaged cells mainly accumulated in a suprabasal situation, thus reducing living epidermis thickness. Stress markers such as IL1-α or MMP3 secretion increased, and surprisingly, the histological position of Transglutaminase-1 within epidermis was disturbed, whereas position of other differentiation markers (keratin-10, filaggrin, loricrin) remained unchanged. When vitamin C was added in culture medium, a very significant protection involving all markers was noticed. In conclusion, we provide here a model of interest to understand the epidermal deleterious consequences of pollution and to select efficient protective compounds.

Climate change and dermatology: An introduction to a special topic, for this special issue

Anthropogenic global climate change is a well-documented phenomenon that has led to average global temperatures climbing to approximately 1 °C above preindustrial (1850-1900) levels, with even higher regional deviations in some areas and significantly increased average warming in densely populated urban centers. In 2018, the United Nations Intergovernmental Panel on Climate Change set a threshold of 1.5 °C of average warming (above the preindustrial baseline), beyond which our planet will become significantly less hospitable to human life. However, adverse human health impacts are already occurring due to current levels of global climate change, as summarized by publications such as The Lancet's annual "Countdown on Health and Climate Change," initiated in 2016. The human health impacts of climate change are truly cross-disciplinary, with nearly every medical specialty either already facing or set to face effects. The field of dermatology is not immune to these risks. This special issue of the International Journal of Women's Dermatology is dedicated to the cross section of dermatology and climate change. This initial article will serve as an overview to introduce readers to the topic and to lay the groundwork for the rest of the issue. We are delighted to work with the Women's Dermatological Society and welcome their support for this dedicated issue. Herein, you will read from up-and-coming stars in the field and established experts, including articles on the following key areas: infectious diseases, environmentally friendly office practices, sunscreens and the environment, refugee health, heat-related illness, the effect of air pollution on the skin, the impact of climate change on pediatric dermatology, implications for skin cancer, and skin issues related to flooding and extreme weather events.

Air pollution and skin disorders

Air pollution is being shown to play an increasing causation role in our most common skin diseases. Acne, hyperpigmentation, atopic dermatitis, and psoriasis have been shown to be influenced by air pollution. It is important for pollution to be added as a risk factor for these skin disorders, and thus we must discuss mitigating its negative affects with patients. Air pollution is the contamination of outdoor (ambient) and indoor (household) environments by any chemical, physical, or biological agent that modifies the natural characteristics of the atmosphere. Nearly all (90%) of the world's population experience daily pollution. In 2019, air pollution was considered by the World Health Organization to be the biggest environmental health risk to humans, responsible for killing more than 7 million people prematurely every year. Preliminary studies link air pollution to COVID-19 deaths, as there were high death tolls in some of the most globally polluted areas. Air pollution affects many organ systems such as cardiovascular, pulmonary, central nervous, reproductive, and integumentary systems. In this study, we detail the current evidence linking specific skin and health disorders to air pollution.

The influence of climate change on skin cancer incidence - A review of the evidence

BACKGROUND

Climate change is broadly affecting human health, with grave concern that continued warming of the earth's atmosphere will result is serious harm. Since the mid-20th century, skin cancer incidence rates have risen at an alarming rate worldwide.

OBJECTIVE

This review examines the relationship between climate change and cutaneous carcinogenesis.

METHODS

A literature review used the National Institutes of Health databases (PubMed and Medline), the Surveillance, Epidemiology, and End Results and International Agency for Research on Cancer registries, and published reports by federal and international agencies and consortia, including the Australian Institute of Health and Welfare, Climate and Clean Air Coalition, U.S. Environmental Protection Agency, Intergovernmental Panel on Climate Change, National Aeronautics and Space Administration, National Oceanic and Atmospheric Administration, United Nations Environment Programme, World Health Organization, and World Meteorological Organization.

RESULTS

Skin cancer risk is determined by multiple factors, with exposure to ultraviolet radiation being the most important. Strong circumstantial evidence supports the hypothesis that factors related to climate change, including stratospheric ozone depletion, global warming, and ambient air pollution, have likely contributed to the increasing incidence of cutaneous malignancy globally and will continue to impose a negative on influence skin cancer incidence for many decades to come.

CONCLUSION

Because much of the data are based on animal studies and computer simulations, establishing a direct and definitive link remains challenging. More epidemiologic studies are needed to prove causality in skin cancer, but the evidence for overall harm to human health as a direct result of climate change is clear. Global action to mitigate these negative impacts to humans and the environment is imperative.

A novel skin brightening topical technology

Background

Effective skin lightening remains an unmet need in over‐the‐counter formulations.

Aims

This research examined a topical facial formulation containing hexylresorcinol, silymarin, 20% vitamin C, and 5% vitamin E in a proprietary anhydrous vehicle in skin explants for UVB photoprotective effects and clinical benefits.

Patients/Method

In vitro investigation examined 12 skin explants to assess the test product and vehicle. Six skin explants received 10 μL of the study product, and six skin explants received the 10 μL of the vehicle. After 96 hours, half the skin samples were exposed to 250 mJ/cm² of UVB radiation while the other half unexposed.

Clinically, 42 female subjects with normal or dry skin 35‐55 years with skin types I‐VI were enrolled possessing discoloration, uneven skin tone, and fine lines. The dermatologist investigator evaluated brightening, evenness, fine lines, wrinkles, and global appearance.

Results

Explants treated with the study product experienced no significant change in gene marker expression of pro‐collagen and pro‐inflammatory gene markers upon UVB exposure. In contrast, skin explants treated with the vehicle experienced significant decreases in pro‐collagen expression and significant increases in pro‐inflammatory gene marker expression. Clinically, the greatest improvement as compared to baseline was seen at week 12 (P < .001) with 45% improvement in brightening, 27% improvement in evenness, 25% improvement in lines, and 25% improvement in global facial appearance.

Conclusion

Hexylresorcinol, silymarin, 20% vitamin C, and 5% vitamin E in a proprietary anhydrous vehicle are effective in decreasing UVB‐induced photodamage in skin explants while clinically producing skin brightness improvement.

Climate Change and Inpatient Dermatology

Purpose of Review

Climate change represents a major existential threat facing the global community, and it has already begun to affect human health in a multitude of ways. This review highlights and discusses the implications that climate change has already had and is expected to have for inpatient dermatologists.

Recent Findings

There are a variety of conditions affected by climate changes. The distribution and frequencies of infectious diseases and their vectors are changing in line with variations in climate conditions. Increased temperatures have already been associated with exacerbation of existing skin conditions, such as atopic dermatitis, and recent evidence suggests that higher temperatures will also magnify the effects of harmful ultraviolet radiation. Extreme weather events that result from climate change are followed by an array of dermatologic conditions that may be unusual for the given location. Inpatient dermatologists should be prepared to manage these potentially unfamiliar dermatologic consequences of climate change.

Summary

Climate change will have widespread effects on the medical field, and inpatient dermatologists will be faced with their own unique set of challenges and practice variations. Practitioners should be familiar with the ongoing and predicted effects of climate change in their locations so that they can readily identify and treat associated conditions, and they should adjust their practice to reduce their carbon footprint and serve as a model for patients to do the same.

Climate change and pediatric skin health

Children are known to disproportionately bear the health impacts of climate change, particularly children living in impoverished areas. Owing to their developing physiology and immature metabolism, distinct exposure behaviors, and reliance on adults for care and protection, children are uniquely susceptible to the adverse effects of our warming planet. Herein, we summarize the known impacts of climate change on pediatric skin health, including its effects on atopic dermatitis, vector-borne and other infectious diseases, nutritional deficiencies, and psychodermatoses.

Biomarkers, oxidative stress and autophagy in skin aging

Aging is a major cause of many degenerative diseases. The most intuitive consequence of aging is mainly manifested on the skin, resulting in cumulative changes in skin structure, function and appearance, such as increased wrinkles, laxity, elastosis, telangiectasia, and aberrant pigmentation of the skin. Unlike other organs of the human body, skin is not only inevitably affected by the intrinsic aging process, but also affected by various extrinsic environmental factors to accelerate aging, especially ultraviolet (UV) radiation. Skin aging is a highly complex and not fully understood process, and the lack of universal biomarkers for the definitive detection and evaluation of aging is also a major research challenge. Oxidative stress induced by the accumulation of reactive oxygen species (ROS) can lead to lipid, protein, nucleic acid and organelle damage, thus leading to the occurrence of cellular senescence, which is one of the core mechanisms mediating skin aging. Autophagy can maintain cellular homeostasis when faced with different stress conditions and is one of the survival mechanisms of cell resistance to intrinsic and extrinsic stress. Autophagy and aging have many features in common and may be associated with skin aging mediated by different factors. Here, we summarize the changes and biomarkers of skin aging, and discuss the effects of oxidative stress and autophagy on skin aging.

Individual and combined effects of the infrared, visible, and ultraviolet light components of solar radiation on damage biomarkers in human skin cells

The ability of solar ultraviolet (UV) to induce skin cancer and photoaging is well recognized. The effect of the infrared (IR) and visible light (Vis) components of solar radiation on skin and their interaction with UV is less well known. This study compared the effects of physiologically relevant doses of complete (UV + Vis + IR) solar-simulated light and its individual components on matched primary dermal fibroblasts and epidermal keratinocytes from human donors on three biomarkers of cellular damage (reactive oxygen species (ROS) generation, mitochondrial DNA (mtDNA), and nuclear DNA (nDNA) damage). There was a greater induction of ROS, mtDNA, and nDNA damage with the inclusion of the visible and IR components of solar-simulated light in primary fibroblast cells compared to primary keratinocytes (P < .001). Experiments using exposure to specific components of solar light alone or in combination showed that the UV, Vis, and IR components of solar light synergistically increased ROS generation in primary fibroblasts but not primary keratinocytes (P < .001). Skin cell lines were used to confirm these findings. These observations have important implications for different skin cell type responses to the individual and interacting components of solar light and therefore photodamage mechanisms and photoprotection interventions.

Study of the responses of two biomonitor plant species (Datura alba & Ricinus communis) to roadside air pollution

Various physiological and biochemical responses of two good biomonitor plant species i.e. Datura alba and Ricinus communis were studied along two roads in the Punjab, Pakistan. Chlorophyll a, b, total chlorophylls, carotenoids, total free amino acids, total soluble proteins, total antioxidant activity, stomatal conductance, photosynthetic rate, internal CO₂ concentration, transpiration rate, and water use efficiency of D. alba and R. communis were examined at different sites along both roads. Photosynthetic rate of both plant species was found to be affected. Reduced transpiration rate and stomatal conductance were also noted. However, elevated internal CO₂ concentration and water use efficiency were recorded. Total soluble proteins got reduced, but, we found a tremendous increase in total antioxidant activity and total free amino acids in both plant species. D. alba was found to be more affected by the adverse effects of roadside air borne pollutants. Although R. communis was also affected but it showed minimal variation in all parameters compared to the control. Hence, our results suggest that R. communis is more resistant to urban roadside air pollution compared to D. alba and would be a good choice as phytoremediator of traffic borne pollutants, whereas, D. alba could be a better biomonitoring plant.

A variety of processes that affect the perception of skin aging

The purpose of this paper is to discuss the most important factors affecting perceived age. Aging is an unavoidable and irreversible process, but perceived age is a modifiable psychosocial factor. Our exterior has become one of the determinants of our social position, the key to success in our professional and personal lives. Today, we see people through their appearance, we judge after the first impression. With the help of aesthetic medicine, we can change the perceived age, but we cannot stop aging. This article discusses factors affecting the perceived age, such as hair color, skin color, general appearance and environmental factors. Many cannot be avoided, but we can make changes in life to look younger and more well-groomed. Indeed, we can change our habits for the benefit of the whole body, not only for the skin.

Involvement of 4-hydroxy-2-nonenal in pollution-induced skin damage

The effects of environmental insults on human health are a major global concern. Some of the most noxious pollutants that humans are exposed to include ozone (O₃ ), particulate matter (PM), and cigarette smoke (CS). Since the skin is the first line of defense against environmental insults, it is considered one of the main target organs for the harmful insults of air pollution. Thus, there is solid evidence that skin pathologies such as premature aging, atopic dermatitis (AD), and psoriasis are associated with pollutant exposure; all of these skin conditions are also associated with an altered redox status. Therefore, although the mechanisms of action and concentrations of O₃ , PM, and CS that we are exposed to differ, exposure to all of these pollutants is associated with the development of similar skin conditions due to the fact that all of these pollutants alter redox homeostasis, increasing reactive oxygen species production and oxidative stress. A main product of oxidative stress, induced by exposure to the aforementioned pollutants, is 4-hydroxy-2-nonenal (HNE), which derives from the oxidation of ω-6 polyunsaturated fatty acids. HNE is a highly reactive compound that can form adducts with cellular proteins and even DNA; it is also an efficient cell signaling molecule able to regulate mitogen-activated protein kinase pathways and the activity of redox-sensitive transcription factors such as Nrf2, AP1, and NFκB. Therefore, increased levels of HNE in the skin, in response to pollutants, likely accelerates skin aging and exacerbates existing skin inflammatory conditions; thus, targeting HNE formation could be an innovative cosmeceutical approach for topical applications.

Mitochondria's Role in Skin Ageing

Skin ageing is the result of a loss of cellular function, which can be further accelerated by external factors. Mitochondria have important roles in skin function, and mitochondrial damage has been found to accumulate with age in skin cells, but also in response to solar light and pollution. There is increasing evidence that mitochondrial dysfunction and oxidative stress are key features in all ageing tissues, including skin. This is directly linked to skin ageing phenotypes: wrinkle formation, hair greying and loss, uneven pigmentation and decreased wound healing. The loss of barrier function during skin ageing increases susceptibility to infection and affects wound healing. Therefore, an understanding of the mechanisms involved is important clinically and also for the development of antiageing skin care products.

The impact of airborne pollution on skin

Indoor and outdoor airborne pollutants modify our environment and represent a growing threat to human health worldwide. Airborne pollution effects on respiratory and cardiac health and diseases have been well established, but its impact on skin remains poorly described. Nonetheless, the skin is one of the main targets of pollutants, which reach the superficial and deeper skin layers by transcutaneous and systemic routes. In this review, we report the outcomes of basic and clinical research studies monitoring pollutant levels in human tissues including the skin and hair. We present a current understanding of the biochemical and biophysical effects of pollutants on skin metabolism, inflammatory processes and oxidative stress, with a focus on polyaromatic hydrocarbons and ground-level ozone that are widespread outdoor pollutants whose effects are mostly studied. We reviewed the literature to report the clinical effects of pollutants on skin health and skin ageing and their impact on some chronic inflammatory skin diseases. We also discuss the potential interactions of airborne pollutants with either ultraviolet radiation or human skin microbiota and their specific impact on skin health.

Autophagy Activation by Crepidiastrum Denticulatum Extract Attenuates Environmental Pollutant-Induced Damage in Dermal Fibroblasts

Pollution-induced skin damage results in oxidative stress; cellular toxicity; inflammation; and, ultimately, premature skin aging. Previous studies suggest that the activation of autophagy can protect oxidation-induced cellular damage and aging-like changes in skin. In order to develop new anti-pollution ingredients, this study screened various kinds of natural extracts to measure their autophagy activation efficacy in cultured dermal fibroblast. The stimulation of autophagy flux by the selected extracts was further confirmed both by the expression of proteins associated with the autophagy signals and by electron microscope. Crepidiastrum denticulatum (CD) extract treated cells showed the highest autophagic vacuole formation in the non-cytotoxic range. The phosphorylation of adenosine monophosphate kinase (AMPK), but not the inhibition of mammalian target of rapamycin (mTOR), was observed by CD-extract treatment. Its anti-pollution effects were further evaluated with model compounds, benzo[a]pyrene (BaP) and cadmium chloride (CdCl₂), and a CD extract treatment resulted in both the protection of cytotoxicity and a reduction of proinflammatory cytokines. These results suggest that the autophagy activators can be a new protection regimen for anti-pollution. Therefore, CD extract can be used for anti-inflammatory and anti-pollution cosmetic ingredients.