The distribution of melanin in skin determined in vivo

Melanometry for objective evaluation of skin pigmentation in pulse oximetry studies

Pulse oximetry enables real-time, noninvasive monitoring of arterial blood oxygen levels. However, results can vary with skin color, thus detecting disparities during clinical validation studies requires an accurate measure of skin pigmentation. Recent clinical studies have used subjective methods such as self-reported color, race/ethnicity to categorize skin. Melanometers based on optical reflectance may offer a more effective, objective approach to assess pigmentation. Here, we review melanometry approaches and assess evidence supporting their use as clinical research tools. We compare performance data, including repeatability, robustness to confounders, and compare devices to each other, to subjective methods, and high-quality references. Finally, we propose best practices for evaluating melanometers and discuss alternate optical approaches that may improve accuracy. Whilst evidence indicates that melanometers can provide superior performance to subjective approaches, we encourage additional research and standardization efforts, as these are needed to ensure consistent and reliable results in clinical studies.

Clinical effect of Pediococcus acidilactici PMC48 on hyperpigmented skin

BACKGROUND

The excessive production and accumulation of melanin in the epidermal skin layer can result in skin hyperpigmentation and darkening. Current technologies for regulating melanin are based on inhibiting melanin biosynthesis. They have low effectiveness and safety issues.

AIMS

This study aimed to evaluate the potential role of Pediococcus acidilactici PMC48 as a probiotic strain in medicines and cosmetics for skin treatment.

MATERIALS AND METHODS

Meanwhile, our research team has reported that P. acidilactici PMC48 strain isolated from sesame leaf kimchi can directly decompose the already synthesized melanin. It can also inhibit melanin biosynthesis. In the present study, we investigated the skin-whitening effect of this strain by arranging an 8-week clinical trial with 22 participants. PMC48 was applied to each participant's artificially UV-induced tanned skin in the clinical trial. Its whitening effect was investigated based on visual evaluation, skin brightness, and melanin index.

RESULTS

PMC48 showed a significant effect on the artificially induced pigmented skin. The color intensity of the tanned skin was decreased by 47.647%, and skin brightness was increased by 8.098% after the treatment period. PMC48 also significantly decreased the melanin index by 11.818%, indicating its tyrosinase inhibition capacity. Also, PMC48 improved skin moisture content level by 20.943%. Additionally, 16S rRNA-based amplicon sequencing analysis showed a distinct increase in Lactobacillaceae in the skin by up to 11.2% at the family level without affecting other skin microbiota. Furthermore, it showed no toxicity in in vitro or in vivo analyses.

DISCUSSION

These results indicate that P. acidilactici PMC48 is a promising probiotic strain that can be used to develop medicines and cosmetic products to solve skin-related problems.

CONCLUSIONS

These results demonstrate that P. acidilactici PMC48 can be a potential probiotic for the cosmetic industry against different skin disorders.

A randomized, double-blind, controlled study evaluating the effects of two facial serums on skin aging

BACKGROUND

Skin aging is a natural process that occurs because of oxidative stress. Facial skin aging is often concerning for individuals due to the exposure of the face.

OBJECTIVES

To assess and compare the effects of two anti-aging facial serums on the following characteristics associated with facial skin aging: fine lines/wrinkles, age spots, firmness, elasticity, texture, radiance, tone, lifting, clarity, and complexion.

METHODS

A 24-week, double-blind controlled study was conducted on 130 participants who were randomized into two groups: facial serum with Liposomal Blend and facial serum without Liposomal Blend. Clinical evaluations (Visual Analog Scale) and instrumental evaluations (Cutometer, SIAscope, and Clarity Pro image analysis) were performed at weeks 0 (baseline), 2, 4, 8, 12, and 24 to assess for changes in skin aging characteristics.

RESULTS

A total of 123 participants completed the study; participants that used the facial serum with Liposomal Blend had significantly greater improvements in skin aging characteristics compared to those that used the facial serum without Liposomal Blend. This study shows that Liposomal Blend is a vehicle with the ability to enhance the anti-aging properties of the ingredients within the facial serum by facilitating its delivery into the underlying layers of the skin. Higher concentration of ingredients at the site of action could potentially lead to greater damage repair and improvements in signs of facial skin aging.

CONCLUSION

By using Liposomal Blend, practitioners and pharmacists could potentially improve the delivery of the ingredients within their formulations into the skin, which may lead to increased treatment efficacy.

Effectiveness of high intensity laser therapy on pain, grip strength and median nerve conductivity in pregnant women with carpal tunnel syndrome: A randomized controlled trial

STUDY DESIGN

Single-blind randomized controlled trial.

INTRODUCTION

High-intensity laser therapy (HILT) was recently introduced to the physiotherapy field as a treatment option for patients with carpal tunnel syndrome (CTS). However, evidence about its effectiveness on pregnant women with CTS is sparse.

PURPOSE OF STUDY

To test the effectiveness of HILT combined with a conventional physical therapy program to reduce pain intensity, sensory and motor nerve distal latency, and increase grip strength in pregnant women with CTS compared with the physical therapy alone.

METHODS

Fifty-four pregnant women with mild to moderate CTS were randomized and further allocated into two groups. The HILT group (n = 27) received both HILT and conventional physical therapy, and the control group (n = 27) received only physical therapy, including nerve and tendon gliding exercises and the use of an orthotic device. Participants received the interventions at the University Hospital (omitted for review) three times per week for 5 weeks. An 11-points numerical pain rating scale, electromyography, and a handheld dynamometer were used for data collection before and after the treatment.

RESULTS

Participants from both groups presented significant improvement in the median nerve motor nerve distal latency (MNDL), sensory nerve distal latency, numerical pain rating scale, and handgrip strength after the intervention. The between-group difference showed more improvements in participants of the HILT group on reducing pain intensity, mean difference (MD) = -3.11 (-4.1 to 2.1), and sensory nerve distal latency, MD = -0.3 (-0.5 to -0.1) compared with the control group.

DISCUSSION

HILT produced greater improvement in outcomes of pregnant women with mild to moderate CTS whichsuggests that adding HILT to traditional CTS physical therapy protocol is beneficial and safe.

CONCLUSIONS

High-intensity laser therapy combined with a standard physical therapy program for CTS in pregnant women is better than the physical therapy program alone to improve pain intensity and median nerve sensory distal latency.

Skin Phototype and Disease: A Comprehensive Genetic Approach to Pigmentary Traits Pleiotropy Using PRS in the GCAT Cohort

Human pigmentation has largely been associated with different disease prevalence among populations, but most of these studies are observational and inconclusive. Known to be genetically determined, pigmentary traits have largely been studied by Genome-Wide Association Study (GWAS), mostly in Caucasian ancestry cohorts from North Europe, identifying robustly, several loci involved in many of the pigmentary traits. Here, we conduct a detailed analysis by GWAS and Polygenic Risk Score (PRS) of 13 pigmentary-related traits in a South European cohort of Caucasian ancestry (n = 20,000). We observed fair phototype strongly associated with non-melanoma skin cancer and other dermatoses and confirmed by PRS-approach the shared genetic basis with skin and eye diseases, such as melanoma (OR = 0.95), non-melanoma skin cancer (OR = 0.93), basal cell carcinoma (OR = 0.97) and darker phototype with vitiligo (OR = 1.02), cataracts (OR = 1.04). Detailed genetic analyses revealed 37 risk loci associated with 10 out of 13 analyzed traits, and 16 genes significantly associated with at least two pigmentary traits. Some of them have been widely reported, such as MC1R, HERC2, OCA2, TYR, TYRP1, SLC45A2, and some novel candidate genes C1QTNF3, LINC02876, and C1QTNF3-AMACR have not been reported in the GWAS Catalog, with regulatory potential. These results highlight the importance of the assess phototype as a genetic proxy of skin functionality and disease when evaluating open mixed populations.

Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color - Part I: Genetic, biologic, and structural differences in skin of color

Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC.

In vivo imaging with a fast large-area multiphoton exoscope (FLAME) captures the melanin distribution heterogeneity in human skin

Melanin plays a significant role in the regulation of epidermal homeostasis and photoprotection of human skin. The assessment of its epidermal distribution and overall content is of great interest due to its involvement in a wide range of physiological and pathological skin processes. Among several spectroscopic and optical imaging methods that have been reported for non-invasive quantification of melanin in human skin, the approach based on the detection of two-photon excited fluorescence lifetime distinguishes itself by enabling selective detection of melanin with sub-cellular resolution, thus facilitating its quantification while also resolving its depth-profile. A key limitation of prior studies on the melanin assessment based on this approach is their inability to account for the skin heterogeneity due to the reduced field of view of the images, which results in high dispersion of the measurement values. Pigmentation in both normal and pathological human skin is highly heterogeneous and its macroscopic quantification is critical for reliable measurements of the epidermal melanin distribution and for capturing melanin-related sensitive dynamic changes as a response to treatment. In this work, we employ a fast large-area multiphoton exoscope (FLAME), recently developed by our group for clinical skin imaging, that has the ability to evaluate the 3D distribution of epidermal melanin content in vivo macroscopically (millimeter scale) with microscopic resolution (sub-micron) and rapid acquisition rates (minutes). We demonstrate significant enhancement in the reliability of the melanin density and distribution measurements across Fitzpatrick skin types I to V by capturing the intra-subject pigmentation heterogeneity enabled by the large volumetric sampling. We also demonstrate the potential of this approach to provide consistent measurement results when imaging the same skin area at different times. These advances are critical for clinical and research applications related to monitoring pigment modulation as a response to therapies against pigmentary skin disorders, skin aging, as well as skin cancers.

In vivo volumetric monitoring of revascularization of traumatized skin using extended depth-of-field photoacoustic microscopy

Faster and better wound healing is a critical medical issue. Because the repair process of wounds is closely related to revascularization, accurate early assessment and postoperative monitoring are very important for establishing an optimal treatment plan. Herein, we present an extended depth-of-field photoacoustic microscopy system (E-DOF-PAM) that can achieve a constant spatial resolution and relatively uniform excitation efficiency over a long axial range. The superior performance of the system was verified by phantom and in vivo experiments. Furthermore, the system was applied to the imaging of normal and trauma sites of volunteers, and the experimental results accurately revealed the morphological differences between the normal and traumatized skin of the epidermis and dermis. These results demonstrated that the E-DOF-PAM is a powerful tool for observing and understanding the pathophysiology of cutaneous wound healing.

Is skin autofluorescence (SAF) representative of dermal advanced glycation endproducts (AGEs) in dark skin? A pilot study

Aims

Non-invasively assessed skin autofluorescence (SAF) measures advanced glycation endproducts (AGEs) in the dermis. SAF correlates with dermal AGEs in Caucasians and Asians, but studies in dark-skinned subjects are lacking. In this pilot we aimed to assess whether SAF signal is representative of intrinsic fluorescence (IF) and AGE accumulation in dark skin.

Methods

Skin biopsies were obtained in 12 dark-skinned subjects (6 healthy subjects, median age 22 years; 6 diabetes mellitus (DM) subjects, 65 years). SAF was measured with the AGE Reader, IF using confocal microscopy, and AGE distribution with specific antibodies. CML and MG-H1 were quantified with UPLC-MS/MS and pentosidine with HPLC and fluorescent detection.

Results

SAF correlated with IF from the dermis (405nm, r = 0.58, p < 0.05), but not with CML (r = 0.54, p = 0.07). CML correlated with IF from the dermis (405nm, r = 0.90, p < 0.01). UV reflectance and the coefficient of variation of SAF were negatively correlated (r = -0.80, p < 0.01). CML and MG-H1 were predominantly present around blood vessels, in collagen and fibroblasts in the dermis.

Conclusion

This proof of concept study is the first to compare non-invasive SAF with AGE levels measured in skin biopsies in dark-skinned subjects. SAF did not correlate with individual AGEs from biopsies, but was associated with IF. However, the intra-individual variance was high, limiting its application in dark-skinned subjects on an individual basis.

Melanin Bleaching and Melanogenesis Inhibition Effects of Pediococcus acidilactici PMC48 Isolated from Korean Perilla Leaf Kimchi

Overproduction and accumulation of melanin in the skin will darken the skin and cause skin disorders. So far, components that can inhibit tyrosinase, a melanin synthase of melanocytes, have been developed and used as ingredients of cosmetics or pharmaceutical products. However, most of existing substances can only inhibit the biosynthesis of melanin while melanin that is already synthesized and deposited is not directly decomposed. Thus, their effects in decreasing melanin concentration in the skin are weak. To overcome the limitation of existing therapeutic agents, we started to develop a substance that could directly biodegrade melanin. We screened traditional fermented food microorganisms for their abilities to direct biodegrade melanin. As a result, we found that a kimchi-derived Pediococcus acidilactici PMC48 had a direct melanin-degrading effect. This PMC48 strain is a new strain, different from P. acidilactici strains reported so far. It not only directly degrades melanin, but also has tyrosinase-inhibiting effect. It has a direct melanindecomposition effect. It exceeds existing melanin synthesis-inhibiting technology. It is expected to be of high value as a raw material for melanin degradation drugs and cosmetics.

The past, present, and prospective on UV-VIS-NIR skin photonics and spectroscopy-a wavelength guide

The study and applications of in vivo skin optics have been openly documented as early as the year 1954, or possibly earlier. To date, challenges in analyzing the complexities of this field remain, with wide scopes requiring more scrutiny. Recent advances in spectroscopic research and multivariate analytics allow a closer look into applications potentially for detecting or monitoring diseases. One of the challenges in this field is in establishing a reference for applications which correspond to certain bandwidths. This article reviews the scope on past research on skin spectroscopy, and the clinical aspects which have or may have applications on disease detection or enhancing diagnostics. A summary is supplied on the technicalities surrounding the measurements reported in literature, focused towards the wavelength-dependent applications in themes central to the respective research. Analytics on the topology of the papers' data cited in this work is also provided for a statistical perspective. In short, this paper strives to immediately inform the reader with possible applications via the spectroscopic devices at hand. Graphical Abstract .

A review of melanin sensor devices

Knowing how readily the skin produces melanin is invaluable in reducing photochemical and phototherapy overtreatment in dermatology and also in reducing the risk of actinic skin damage and skin cancer from excessive radiant light exposure. The commonly used Fitzpatrick skin type (FST) classification scale is often used to subjectively assess ultraviolet light sensitivity and susceptibility to sunburn following significant sunlight exposure. However, the FST scale falls short in the assessment of nonwhite skin types. Alternatively, commercially available melanin sensor devices, called melanometers, can be used to objectively quantify useful skin parameters such as the epidermal melanin concentration (EMC). This study reviews commercially available melanometers and their use in quantifying epidermal melanin concentration (EMC) and the individual maximum safe radiant exposure (IMSRE) for an individual in clinical, workplace and community settings.

Multidiameter single-fiber reflectance spectroscopy of heavily pigmented skin: modeling the inhomogeneous distribution of melanin

When analyzing multidiameter single-fiber reflectance (MDSFR) spectra, the inhomogeneous distribution of melanin pigments in skin tissue is usually not accounted for. Especially in heavily pigmented skins, this can result in bad fits and biased estimation of tissue optical properties. A model is introduced to account for the inhomogeneous distribution of melanin pigments in skin tissue. In vivo visible MDSFR measurements were performed on heavily pigmented skin of type IV to VI. Skin tissue optical properties and related physiological properties were extracted from the measured spectra using the introduced model. The absorption of melanin pigments described by the introduced model demonstrates a good correlation with the co-localized measurement of the well-known melanin index.

18F-Flortaucipir Binding in Choroid Plexus: Related to Race and Hippocampus Signal

BACKGROUND

On target 18F-Flortaucipir (FTP) binding of Alzheimer's disease tau aggregates and off-target binding of melanocytes have been demonstrated with autoradiography.

OBJECTIVE

We aimed to investigate the hypothesis that if binding in choroid plexus (CP) is due to melanocytes, the signal would be elevated in Black/African American (B/AA) compared to White (W) participants. In addition, we examined whether CP signal affects measurements in adjacent regions, and whether correcting for spill-in effects has an influence on associations between hippocampus (HC) FTP and amyloid or cognition.

METHODS

FTP race differences in 147 Harvard Aging Brain Study participants (23 B/AA, 124W) were examined in CP, HC, HC covaried for CP, amygdala, inferior temporal gyrus, entorhinal cortex, and fusiform regions. Associations between CP FTP and other regions-of-interest (ROIs) were probed to assess spill-in effects. A statistical regression approach to attenuate CP spill-in was tested by relating adjusted HC SUVR residuals and unadjusted HC SUVR to race, cognition and amyloid. All analyses were covaried for age, sex, education and amyloid deposition, and Bonferroni-corrected for multiple comparisons.

RESULTS

B/AA individuals had elevated CP and HC SUVR (p < 0.007), whereas other ROI SUVR and HC SUVR covaried for CP SUVR did not show race differences (p > 0.05). CP SUVR was associated with HC SUVR (p < 10-14), but with no other ROI SUVR (p > 0.05). When adjusting HC SUVR for CP SUVR, no race differences in residual HC SUVR were detected, and relationships with amyloid and memory became apparent.

CONCLUSION

Melanocyte FTP binding may account partially for high CP signal. This off-target binding affects mainly HC FTP measurements, which should be interpreted with caution.

Hair Color and Skin Color Together Influence Perceptions of Age, Health, and Attractiveness in Lightly-Pigmented, Young Women

OBJECTIVE

Research documents that even subtle changes in visible skin condition affect perceptions of age, health, and attractiveness. There is evidence that hair quality also affects the assessment of physical appearance, as variations in hair diameter, hair density, and hair style have systematic effects on perception. Here, we consider combined effects of hair color and skin color on the perception of female physical appearance.

METHODS

In two experiments, we digitally manipulated facial skin color of lightly-pigmented, young women, both between-subjects (Experiment 1) and within-subjects (Experiment 2), and investigated possible interactions with hair color in regard to age, health, and attractiveness perception.

RESULTS

In both experiments, we detected hair color and skin color interaction effects on men's and women's assessments. For between-subjects comparisons, participants with lighter hair color were judged to be younger than those with darker shades; this effect was more pronounced in women with light skin color. No such effect was observed for within-subjects variation in skin color. Both experiments showed that smaller perceived contrast between hair color and skin color resulted in more positive responses.

CONCLUSION

We conclude that hair color and facial skin color together have an effect on perceptions of female age, health, and attractiveness in young women, and we discuss these findings with reference to the literature on the role of hair and skin in the assessment of female physical appearance. This article is protected by copyright. All rights reserved.

Personalized skincare: from molecular basis to clinical and commercial applications

Individual responses of human skin to the environmental stress are determined by differences in the anatomy and physiology that are closely linked to the genetic characteristics such as pigmentation. Ethnic skin phenotypes can be distinguished based on defined genotypic traits, structural organization and compartmentalized sensitivity to distinct extrinsic aging factors. These differences are not only responsible for the variation in skin performance after exposure to damaging conditions, but can also affect the mechanisms of drug absorption, sensitization and other longer term effects. The unique characteristics of the individual skin function and, particularly, of the ethnic skin type are currently considered to shape the future of clinical and pharmacologic interventions as a basis for personalized skincare. Individual approaches to skincare render a novel and actively growing area with a range of biomedical and commercial applications within cosmetics industry. In this review, we summarize the aspects of the molecular and clinical manifestations of the environmental stress on human skin and proposed protective mechanisms that are linked to ethnic differences and pathophysiology of extrinsic skin aging. We subsequently discuss the possible applications and translation of this knowledge into personalized skincare.

Melanin fate in the human epidermis: a reassessment of how best to detect and analyse histologically

Melanin is the predominant pigment responsible for skin colour and is synthesized by the melanocyte in the basal layer of the epidermis and then transferred to surrounding keratinocytes. Despite its optical properties, melanin is barely detectable in unstained sections of human epidermis. However, identification and localization of melanin is of importance for the study of skin pigmentation in health and disease. Current methods for the histologic quantification of melanin are suboptimal and are associated with significant risk of misinterpretation. The aim of this study was to reassess the existing literature and to develop a more effective histological method of melanin quantification in human skin. Moreover, we confirm that Warthin-Starry (WS) stain provides a much more sensitive and more specific melanin detection method than the commonplace Fontana-Masson (FM) stain. For example, WS staining sensitivity allowed the visualization of melanin even in very pale Caucasian skin that was missed by FM or Von Kossa (VK) stains. From our reassessment of the histology-related literature, we conclude that so-called melanin dust is most likely an artifact of discoloration due to non-specific silver deposition in the stratum corneum. Unlike FM and VK, WS was not associated with this non-specific stratum corneum darkening, misinterpreted previously as 'degraded' melanin. Finally, WS melanin particle counts were largely similar to previously reported manual counts by transmission electron microscopy, in contrast to both FM and VK. Together these findings allow us to propose a new histology/Image J-informed method for the accurate and precise quantification of epidermal melanin in skin.

First application of a transcutaneous optical single-port glucose monitoring device in patients with type 1 diabetes mellitus

The combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion can be used to improve the treatment of patients with diabetes. The aim of this study was to advance an existing preclinical single-port system for clinical application by integrating the sensors of a phosphorescence based CGM system into a standard insulin infusion set. The extracorporeal optical phase fluorimeter was miniaturised and is now comparable with commercial CGM systems regarding size, weight and wear comfort. Sensor chemistry was adapted to improve the adhesion of the sensor elements on the insulin infusion set. In-vitro tests showed a linear correlation of R²=0.998 between sensor values and reference glucose values in the range of 0-300mg/dl. Electrical and cytotoxicity tests showed no negative impact on human health. Two single-port devices were tested in each of 12 patients with type 1 diabetes mellitus in a clinical set-up for 12h. Without additional data processing, the overall median absolute relative difference (median ARD) was 22.5%. For some of the used devices the median ARD was even well below 10%. The present results show that individual glucose sensors performance of the single-port system is comparable with commercial CGM systems but further improvements are needed. The new system offers a high extent of safety and usability by combining insulin infusion and continuous glucose measurement in a single-port system which could become a central element in an artificial pancreas for an improved treatment of patients with type 1 diabetes mellitus.

Human skin detection in the visible and near infrared

Skin detection is a well-studied area in color imagery and is useful in a number of scenarios to include search and rescue and computer vision. Most approaches focus on color imagery due to cost and availability. Many of the visible-based approaches do well at detecting skin (above 90%) but they tend to have relatively high false-alarm rates (8%-15%). This article presents a novel feature space for skin detection in visible and near infrared portions of the electromagnetic spectrum. The features are derived from known spectral absorption of skin constituents to include hemoglobin, melanin, and water as well as scattering properties of the dermis. Fitting a Gaussian mixture to skin and background distributions and using a likelihood ratio test detector, the features presented here show dominating performance when comparing receiver-operating characteristic curves (ROCs) and statistically significant improvement when comparing equal error rates and area under the ROC (AUC). A detection/false-alarm probability of 98.6%/1.1% is achieved for the averaged equal error rate (EER). EER values for the proposed feature space show a 5.6%-11.2% increase in detection probability with a 6.0%-11.6% decrease in false-alarm probability compared to well performing color-based features. The AUC shows a 0.034-0.173 increase in total area under the curve compared to well performing color-based features.

Tyrosinase Depletion Prevents the Maturation of Melanosomes in the Mouse Hair Follicle

The mechanisms that lead to variation in human skin and hair color are not fully understood. To better understand the molecular control of skin and hair color variation, we modulated the expression of Tyrosinase (Tyr), which controls the rate-limiting step of melanogenesis, by expressing a single-copy, tetracycline-inducible shRNA against Tyr in mice. Moderate depletion of TYR was sufficient to alter the appearance of the mouse coat in black, agouti, and yellow coat color backgrounds, even though TYR depletion did not significantly inhibit accumulation of melanin within the mouse hair. Ultra-structural studies revealed that the reduction of Tyr inhibited the accumulation of terminal melanosomes, and inhibited the expression of genes that regulate melanogenesis. These results indicate that color in skin and hair is determined not only by the total amount of melanin within the hair, but also by the relative accumulation of mature melanosomes.

Practical application of new technologies for melanoma diagnosis: Part I. Noninvasive approaches

Confirming a diagnosis of cutaneous melanoma requires obtaining a skin biopsy specimen. However, obtaining numerous biopsy specimens-which often happens in patients with increased melanoma risk-is associated with significant cost and morbidity. While some melanomas are easily recognized by the naked eye, many can be difficult to distinguish from nevi, and therefore there is a need and opportunity to develop new technologies that can facilitate clinical examination and melanoma diagnosis. In part I of this 2-part continuing medical education article, we will review the practical applications of emerging technologies for noninvasive melanoma diagnosis, including mobile (smartphone) applications, multispectral imaging (ie, MoleMate and MelaFind), and electrical impedance spectroscopy (Nevisense).

The Effect of Electroporation of a Lyotroic Liquid Crystal Genistein-Based Formulation in the Recovery of Murine Melanoma Lesions

A lamellar lyotropic liquid crystal genistein-based formulation (LLC-Gen) was prepared in order to increase the aqueous solubility of the lipophilic phytocompound genistein. The formulation was applied locally, in a murine model of melanoma, with or without electroporation. The results demonstrated that, when the formulation was applied by electroporation, the tumors appeared later. During the 21 days of the experiment, the LLC-Gen formulation decreased the tumor volume, the amount of melanin and the degree of erythema, but when electroporation was applied, all these parameters indicated a better prognosis even (lower tumor volume, amount of melanin and degree of erythema). Although hematoxylin-eosin (HE) staining confirmed the above events, application of the LLC-Gen formulation by electroporation did not lead to a significant effect in terms of the serum concentrations of the protein S100B and serum neuron specific enolase (NSE), or the tissue expression of the platelet-derived growth factor receptor β (PDGFRβ) antibody.

Optimized parametric skin modelling for diagnosis of skin abnormalities by combining light back-scatter and laser speckle imaging

BACKGROUND/PURPOSE

Optical and parametric skin imaging methods which can efficiently identify invisible sub-skin features or subtle changes in skin layers are very important for accurate optical skin modelling. In this study, a hybrid method is introduced that helps develop a parametric optical skin model by utilizing interdisciplinary techniques including light back-scatter analysis, laser speckle imaging, image-texture analysis and Bayesian inference methods. The model aims to detect subtle skin changes and hence very early signs of skin abnormalities/diseases.

METHODS

Light back-scatter and laser speckle image textural analysis are applied onto the normal and abnormal skin regions (lesions) to generate set of attributes/parameters. These are then optimized by Bayesian inference method in order to build an optimized parametric model.

RESULTS

The attributes selected by Bayesian inference method in the optimization stage were used to build an optimized model and then successfully verified. It was clearly proven that Bayesian inference based optimization process yields good results to build an optimized skin model.

CONCLUSION

The outcome of this study clearly shows the applicability of this hybrid method in the analysis of skin features and is therefore expected to lead development of non-invasive and low-cost instrument for early detection of skin changes.

Effect of the Isoflavone Genistein on Tumor Size, Metastasis Potential and Melanization in a B16 Mouse Model of Murine Melanoma

The isoflavonoid genistein, the aglycone of the heteroside genistin, possesses preventive effect on coronary heart disease and osteoporosis, antioxidant, anthelmintic, antineoplastic and anti-inflammatory properties. Much research has been undertaken regarding the action of genistein on cancer-preventing/treating effects, especially on breast and prostate cancer. The aim of this study was to analyze the effect of this compound in vivo by observing tumor size, metastasis potential and melanization in a mouse model of murine melanoma, employing the B164A5 melanoma cell line and C57BL/6J mice. Genistein decreased the tumor volume and weight by approximately 30%. Non-invasive measurements for both melanin and erythema showed that genistein reduced the quantity of melanin and the degree of erythema in direct proportion to the number of days of treatment. HE analysis diagnosed malignant melanoma in both groups, but no metastasis was recorded in the treated group compared with the liver metastasis in the untreated group after a period of 15 days of experiment at a dose of 15 mg/kg body weight of genistein. Genistein showed beneficial effects regarding tumor size, metastasis potential and melanization in a B16 mouse model of murine melanoma.

Update on techniques for the quantitation of facial skin characteristics

The purpose of this article is to review the strategies and methods for quantifying treatment outcomes, perhaps defined by the consumer/patient as a "decrease in perceived age." The demand for the rejuvenation of facial skin is expected to increase as the population ages and seeks optimal outcomes from the array of available treatment modalities. This information will be of value to the plastic surgeon in collaborating with patients on evaluation and treatment strategies.

Determination of chronological aging parameters in epidermal keratinocytes by in vivo harmonic generation microscopy

Skin aging is an important issue in geriatric and cosmetic dermatology. To quantitatively analyze changes in keratinocytes related to intrinsic aging, we exploited a 1230 nm-based in vivo harmonic generation microscopy, combining second- and third-harmonic generation modalities. 52 individuals (21 men and 31 women, age range 19-79) were examined on the sun-protected volar forearm. Through quantitative analysis by the standard algorithm provided, we found that the cellular and nuclear size of basal keratinocytes, but not that of granular cells, was significantly increased with advancing age. The cellular and nuclear areas, which have an increase of 0.51 μm(2) and 0.15 μm(2) per year, respectively, can serve as scoring indices for intrinsic skin aging.

A new morphometric technique for assessment of melanization in skin of guinea pigs

BACKGROUND

The degree of melanization is an important finding in many skin disorders. An objective measurement of melanin density is needed to achieve an accurate evaluation.

OBJECTIVES

The present work aims at translating the subjective increase of melanin particles after narrow band ultraviolet-B (NB-UVB) irradiation into objective numerical values ready for statistical analysis.

MATERIALS AND METHODS

This study had involved 18 guinea pigs that were exposed to biweekly sessions of NB-UVB radiation for 4 weeks to induce skin pigmentation. Two skin biopsies were obtained from each animal; the first before treatment and the second at the end of the study, using 5 mm punch and stained with hematoxylin and eosin and Masson-Fontana (MF) stains. Surface area of both the epidermis (ESA) and the melanin particles (MPSA) were measured in μm(2) using a software supplied with Olympus light microscope. The MPSA/ESA percentage was calculated for each biopsy. The results before and after NB-UVB exposure were compared and statistically analyzed.

RESULTS

In the MF-stained sections, the mean ± SD of the MPSA/ESA percentage were 0.24 μm(2) ± 0.09 and 6.21 μm(2) ± 2.45 at the start of the study and at its end, respectively, with a highly significant difference (P < 0.001).

CONCLUSION

This technique offers a new methodology for an accurate numerical evaluation of epidermal melanization.

Hybrid diffusion and two-flux approximation for multilayered tissue light propagation modeling

Accurate and rapid estimation of fluence, reflectance, and absorbance in multilayered biological media has been essential in many biophotonics applications that aim to diagnose, cure, or model in vivo tissue. The radiative transfer equation (RTE) rigorously models light transfer in absorbing and scattering media. However, analytical solutions to the RTE are limited even in simple homogeneous or plane media. Monte Carlo simulation has been used extensively to solve the RTE. However, Monte Carlo simulation is computationally intensive and may not be practical for applications that demand real-time results. Instead, the diffusion approximation has been shown to provide accurate estimates of light transport in strongly scattering tissue. The diffusion approximation is a greatly simplified model and produces analytical solutions for the reflectance and absorbance in tissue. However, the diffusion approximation breaks down if tissue is strongly absorbing, which is common in the visible part of the spectrum or in applications that involve darkly pigmented skin and/or high local volumes of blood such as port-wine stain therapy or reconstructive flap monitoring. In these cases, a model of light transfer that can accommodate both strongly and weakly absorbing regimes is required. Here we present a model of light transfer through layered biological media that represents skin with two strongly scattering and one strongly absorbing layer.

State of the art in non-invasive imaging of cutaneous melanoma

BACKGROUND

This review focuses on looking at recent developments in the non-invasive imaging of skin, in particular at how such imaging may be used at present or in the future to detect cutaneous melanoma.

METHODS

A MEDLINE search was performed for papers using imaging techniques to evaluate cutaneous melanoma, including melanoma metastasis.

RESULTS

Nine different techniques were found: dermoscopy, confocal laser scanning microscopy (including multiphoton microscopy), optical coherence tomography, high frequency ultrasound, positron emission tomography, magnetic resonance imaging, and Fourier, Raman, and photoacoustic spectroscopies. This review contrasts the effectiveness of these techniques when seeking to image melanomas in skin.

CONCLUSIONS

Despite the variety of techniques available for detecting melanoma, there remains a critical need for a high-resolution technique to answer the question of whether tumours have invaded through the basement membrane.

Visible skin condition and perception of human facial appearance

Evolutionary psychology suggests that certain human beauty standards have evolved to provide reliable cues of fertility and health. Hence, preferences for some physical characteristics of the face and body are thought to reflect adaptations for the promotion of mate choice. Studies that have investigated facial attractiveness have concentrated mainly on features such as symmetry, averageness and sex-typical traits, which are developed under the influence of sex steroids. Few studies, however, have addressed the effect of human skin condition on perception of facial appearance in this context, and possible implications for sexual selection. There is now accumulating evidence that skin pigmentation and skin surface topography cues, particularly in women, have a significant influence on attractiveness judgements, as they seem primarily to signal aspects of age and health. This article (i) reviews briefly some of the main determinants of visible skin condition, (ii) presents recent evidence on its signalling value in face perception and (iii) suggests areas for future research with reference to an evolutionary psychology framework.

Reduction in the appearance of facial hyperpigmentation after use of moisturizers with a combination of topical niacinamide and N-acetyl glucosamine: results of a randomized, double-blind, vehicle-controlled trial

BACKGROUND

Topical niacinamide and N-acetyl glucosamine (NAG) each individually inhibit epidermal pigmentation in cell culture. In small clinical studies, niacinamide-containing and NAG-containing formulations reduced the appearance of hyperpigmentation.

OBJECTIVES

To assess the effect of a combination of niacinamide and NAG in a topical moisturizing formulation on irregular facial pigmentation, including specific detection of changes in colour features associated with melanin.

METHODS

This was a 10-week, double-blind, vehicle-controlled, full-face, parallel-group clinical study conducted in women aged 40-60 years. After a 2-week washout period, subjects used a daily regimen of either a morning sun protection factor (SPF) 15 sunscreen moisturizing lotion and evening moisturizing cream each containing 4% niacinamide + 2% NAG (test formulation; n = 101) or the SPF 15 lotion and cream vehicles (vehicle control; n = 101). Product-induced changes in apparent pigmentation were assessed by capturing digital photographic images of the women after 0, 4, 6 and 8 weeks of product use and evaluating the images by algorithm-based computer image analysis for coloured spot area fraction, by expert visual grading, and by chromophore-specific image analysis based on noncontact SIAscopy for melanin spot area fraction and melanin chromophore evenness.

RESULTS

By all four measures, the niacinamide + NAG formulation regimen was significantly (P < 0.05) more effective than the vehicle control formulation regimen in reducing the detectable area of facial spots and the appearance of pigmentation.

CONCLUSIONS

A formulation containing the combination of niacinamide + NAG reduced the appearance of irregular pigmentation including hypermelaninization, providing an effect beyond that achieved with SPF 15 sunscreen.

Molecular genetics of human pigmentation diversity

The genetic basis underlying normal variation in the pigmentary traits of skin, hair and eye colour has been the subject of intense research directed at understanding the diversity seen both between and within human populations. A combination of approaches have been used including comparative genomics of candidate genes and the identification of regions of the human genome under positive selection, together with genome-wide and specific allele association studies. Independent selection for different pigmentation gene sets has been found between Asian, European and African populations. Several genome-wide association studies for pigmentation have now been conducted and identified single nucleotide polymorphism (SNP) markers in known, TYR, TYRP1, OCA2, SLC45A2, SLC24A5, MC1R, ASIP, KITLG and previously unknown SLC24A4, IRF4, TPCN2, candidate genes. The contribution of SNP polymorphisms present in populations from South Asia have been tested and alleles found at TYR, SLC45A2 and SLC24A5 can largely account for differences between those of darkest and lightest skin reflectance using a simple additive model. Skin and hair colour associations in Europeans are found within a range of pigmentation gene alleles, whereas blue-brown eye colour can be explained by a single SNP proposed to regulate OCA2 expression. Functional testing of variant alleles has begun to connect phenotype correlations with biological differences. Variant MC1R alleles show direct correlations between the biochemical signalling properties of the encoded receptor and the red-hair fair skin pigmentation phenotype. Direct testing of a range of clonal melanocyte cultures derived from donor skin tissue characterized for three causal SNPs within SLC45A2, SLC24A5 and OCA2 has assessed their impact on melanin content and tyrosinase enzyme activity. From a culmination of genetic and functional studies, it is apparent that a number of genes impacting melanosome biogenesis or the melanin biosynthetic pathway are candidates to explain the diversity seen in human pigmentation.

Remittance at a single wavelength of 390 nm to quantify epidermal melanin concentration

Objective quantification of epidermal melanin concentration (EMC) should be useful in laser dermatology to determine the individual maximum safe radiant exposure (IMSRE). We propose a single-wavelength remittance measurement at 390 nm as an alternative optical method to determine EMC and IMSRE. Remittance spectra (360 to 740 nm), melanin index (MI) measurements and the transient radiometric temperature increase, DeltaT(t), upon skin irradiation with an Alexandrite laser (755 nm, 3-ms pulse duration, 6 Jcm(2)) were measured on 749 skin spots (arm and calf) on 23 volunteers (skin phototypes I to IV). Due to the shallow penetration depth and independence of blood oxygen saturation (isosbestic point), remittance at 390 nm appears to provide better estimates for EMC and IMSRE than MI.