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Soto‐Moreno A, Montero‐Vilchez T, Diaz‐Calvillo P, Molina‐Leyva A, Arias‐Santiago S. The impact of photodynamic therapy on skin homeostasis in patients with actinic keratosis: A prospective observational study. Skin Res Technol 2023; 29:e13493. [PMID: 38017667 PMCID: PMC10684974 DOI: 10.1111/srt.13493] [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: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AKs), but there is little information on how PDT affects skin barrier function. The objectives of this study are: To compare skin barrier function between skin with AKs and healthy skin and to evaluate the impact of PDT on skin homeostasis in patients with AKs. METHODS A prospective observational study was conducted in patients with AKs to evaluate epidermal barrier function and skin homeostasis before and 1 ek after receiving PDT. RESULTS A total of 21 subjects were included in the study, male/female ratio was 17:4, mean age was 75.86 years. The number of AKS observed before starting treatment was reduced with respect to those diagnosed 1 month after starting PDT (14.83 vs. 1.91, p < 0.0001). Application of PDT for treating AKs modifies epidermal barrier function. Immediately after the first session temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total antioxidant capacity (TAC) increased while pH decreased on lesional skin. After 1-month follow-up, the only remained change was the increased in SCH. Higher increases in temperature were observed when using occlusive PDT compared to mixed modality. 5-ALA and M-ALA seem to have a similar impact on skin barrier. CONCLUSIONS PDT can improve skin barrier function in patients with AKs. Skin homeostasis parameters can be used to assess efficacy and optimize dosing.
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Affiliation(s)
- Alberto Soto‐Moreno
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Trinidad Montero‐Vilchez
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Pablo Diaz‐Calvillo
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Alejandro Molina‐Leyva
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Salvador Arias‐Santiago
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
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SIRT5 reduces the inflammatory response and barrier dysfunction in IL-17A-induced epidermal keratinocytes. Allergol Immunopathol (Madr) 2023; 51:30-36. [PMID: 36617819 DOI: 10.15586/aei.v51i1.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 01/04/2023]
Abstract
Psoriasis is a chronic multisystemic inflammatory disease with inflammatory cell infiltration, hyperproliferation of keratinocytes in skin lesions, and epidermal barrier dysfunction. Normal human epidermal keratinocytes (NHEKs) were stimulated with interleukin 17A (IL-17A). The expression levels of sirtuin-5 (SIRT5) were analyzed by RT-qPCR and western blot assay. The proliferation levels of NHEKs were assessed by EdU staining. The expression of ELOVL1 and ELOVL4 was analyzed by RT-Qpcr, and the expression levels of filaggrin, loricrin, and aquaporin-3 were analyzed by RT-qPCR and western blot. Extracellular signal-regulated kinase 1/2 (ERK1/2) activator t-butylhydroquinone was used to activate ERK1/2. Here, we show that SIRT5 overexpression reduces cell viability and cell proliferation, and improves barrier dysfunction in IL-17A-treated human epidermal keratinocytes, this effect of which is significantly blunted by the ERK1/2 activator. In epidermal keratinocytes, SIRT5 decreases cell proliferation and inflammation and improves barrier dysfunction via ERK/STAT3. This study reveals the role of SIRT5 in the pathogenesis of psoriasis, epidermal hyperplasia, keratinocyte-mediated inflammatory responses, and barrier dysfunction, the role of which is mediated by ERK/STAT3.
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Yao YZ, Liao ZK, Jiang S, Dong BQ, Luo LF, Miao F, Lei TC. Uncoupling melanogenesis from proliferation in epidermal melanocytes responding to stimulation with psoriasis-related proinflammatory cytokines. J Dermatol Sci 2022; 108:98-108. [PMID: 36577564 DOI: 10.1016/j.jdermsci.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Few studies have addressed the impact of the psoriasis-related proinflammatory cytokines on the proliferation and melanogenesis of melanocytes (MCs) in lesional psoriatic skin. OBJECTIVE We investigated the effects of TNFα, IL17A, and IL8 on the proliferation and melanin synthesis of MCs. METHODS Skin specimens were biopsied from patients with psoriasis vulgaris at the active stage, or from the tail skin of Dct-LacZ mice with imiquimod (IMQ)-induced psoriasiform dermatitis. Cultured keratinocytes (KCs), MCs, and human skin explants were used in this study. The numbers of MCs were measured via β-galactosidase staining, EdU incorporation and HMB45 immunohistochemical staining. The expression of human β-defensin 3 (hBD3) in KCs was silenced by siRNA, the conditioned medium (CM) from siRNA-transfected KCs was used to treat MCs, then followed by αMSH stimulation. The melanogenesis-related genes were examined by using qRT-PCR and western blotting. RESULTS The increased number of MCs and decreased melanin content were highly relevant to the enhanced expression of IL8 and BD3 both in human psoriatic skin and in IMQ-treated mouse tail skin. IL8 expression in KCs and CXCR2 expression in MCs was significantly increased by IL17A and TNFα, the αMSH-induced upregulations of microphthalmia-associated transcription factor (MITF) and tyrosinase in MCs were abrogated by the CM from hBD3-unsilenced KCs, but not from hBD3-silenced KCs. CONCLUSION Our results suggest the roles of IL8-CXCR2 activation in promoting MC proliferation and of BD3 upregulation in reducing melanogenesis. These findings have been implicated in the underlying mechanism that active psoriasis prefers hypopigmentation despite chronic inflammation.
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Affiliation(s)
- Yun-Zhu Yao
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhi-Kai Liao
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shan Jiang
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bing-Qi Dong
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Long-Fei Luo
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fang Miao
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tie-Chi Lei
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, China.
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Rizzetto G, Molinelli E, Radi G, Cirioni O, Brescini L, Giacometti A, Offidani A, Simonetti O. MRSA and Skin Infections in Psoriatic Patients: Therapeutic Options and New Perspectives. Antibiotics (Basel) 2022; 11:1504. [PMID: 36358159 PMCID: PMC9686594 DOI: 10.3390/antibiotics11111504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 09/29/2023] Open
Abstract
Psoriatic patients present various infectious risk factors, but there are few studies in the literature evaluating the actual impact of psoriasis in severe staphylococcal skin infections. Our narrative review of the literature suggests that psoriatic patients are at increased risk of both colonization and severe infection, during hospitalization, by S. aureus. The latter also appears to play a role in the pathogenesis of psoriasis through the production of exotoxins. Hospitalized psoriatic patients are also at increased risk of MRSA skin infections. For this reason, new molecules are needed that could both overcome bacterial resistance and inhibit exotoxin production. In our opinion, in the near future, topical quorum sensing inhibitors in combination with current anti-MRSA therapies will be able to overcome the increasing resistance and block exotoxin production. Supplementation with Vitamin E (VE) or derivatives could also enhance the effect of anti-MRSA antibiotics, considering that psoriatic patients with metabolic comorbidities show a low intake of VE and low serum levels, making VE supplementation an interesting new perspective.
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Affiliation(s)
- Giulio Rizzetto
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Elisa Molinelli
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Giulia Radi
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Oscar Cirioni
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Lucia Brescini
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Andrea Giacometti
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Annamaria Offidani
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Oriana Simonetti
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
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Seo JI, Ham HI, Baek JH, Shin MK. An objective skin-type classification based on non-invasive biophysical parameters. J Eur Acad Dermatol Venereol 2021; 36:444-452. [PMID: 34747517 DOI: 10.1111/jdv.17793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite the invention of various non-invasive bioengineering tools, skin-type analysis has largely been based on subjective assessments. However, advancements in the functional cosmetic industry and artificial intelligence-assisted dermatology are creating a greater demand for an objective skin-type classification system. OBJECTIVES To propose an objective skin-type classification system solely based on non-invasive, bioengineering devices; provide reference values applicable to the Korean population; and compare our reference values with those of published studies. METHODS Biophysical parameter measurements were obtained from the 2018 International Skin Characteristics Data Bank Project conducted by the Foundation of Korea Cosmetic Industry Institute. The participants were 434 healthy South Korean adults. Each participant was assessed using eight bioengineering devices (Tewameter® , pH-meter® , Corneometer® , Sebumeter® , Cutometer® , Spectrophotometer® , PRIMOS® lite, and Janus® ). The measurements were divided into tertiles to determine reference points. RESULTS Our objective skin-type classification consists of five main categories (sensitivity, hydration, oiliness, elasticity, and skin tone) and five corresponding subcategories (erythema, roughness, pores, wrinkles, and pigmentation, respectively). Each skin type was assigned based on the reference point of the biophysical parameter, which was established as the tertile value associated with 'unfavourable' skin characteristics. Individuals were categorized as having sensitive skin when the TEWL scores were over 18.0 g/m2 /h or the pH was over 5.45; dehydrated skin when the corneometric value measured below 47.17 A.U.; oily skin when the sebumetric value exceeded 70 μg/cm2 ; and loose skin when the cutometric R2 value was below 0.68 E/mm. CONCLUSIONS This study is the first to provide a comprehensive skin-type classification system based solely on non-invasive biophysical parameters. As measurement data accumulate, the reference points will progress to become more accurate, and they will be subdivided according to gender, age, and ethnic group. Therefore, our classification system serves as a basis for artificial intelligence-based skin-type analysis.
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Affiliation(s)
- J I Seo
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - H I Ham
- Dermapro Skin Research Center, DERMAPRO Ltd., Seoul, Republic of Korea
| | - J H Baek
- Dermapro Skin Research Center, DERMAPRO Ltd., Seoul, Republic of Korea
| | - M K Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
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Montero-Vilchez T, Martinez-Lopez A, Sierra-Sanchez A, Soler-Gongora M, Jimenez-Mejias E, Molina-Leyva A, Buendia-Eisman A, Arias-Santiago S. Erythema Increase Predicts Psoriasis Improvement after Phototherapy. J Clin Med 2021; 10:jcm10173897. [PMID: 34501344 PMCID: PMC8432224 DOI: 10.3390/jcm10173897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/01/2021] [Accepted: 08/26/2021] [Indexed: 01/07/2023] Open
Abstract
Psoriasis is a major global health problem. There is a need to develop techniques to help physicians select the most appropriate cost-effective therapy for each patient. The main objectives of this study are (1) to evaluate changes in epidermal barrier function and skin homeostasis after phototherapy and (2) to explore potentially predictive values in epidermal barrier function and skin homeostasis to assess clinical improvement after fifteen sessions of phototherapy. A total of 76 subjects, 38 patients with plaque-type psoriasis and 38 gender- and age-matched healthy volunteers, were included in the study. Erythema, transepidermal water loss (TEWL), temperature, stratum corneum hydration (SCH), pH, sebum, and antioxidant capacity were measured before and after the first and fifteenth phototherapy session. Erythema (401.09 vs. 291.12 vs. 284.52 AU, p < 0.001) and TEWL (18.23 vs. 11.44 vs. 11.41 g·m-2·h-1, p < 0.001) were significantly higher at psoriatic plaques than in uninvolved psoriatic skin and healthy volunteers, respectively, while SCH was lower (9.71 vs. 44.64 vs. 40.00 AU, p < 0.001). After fifteen phototherapy sessions, TEWL (-5.19 g·m-2·h-1, p = 0.016) decreased while SCH (+7.01 AU, p = 0.013) and erythema (+30.82 AU, p = 0.083) increased at psoriatic plaques. An erythema increase exceeding 53.23 AU after the first phototherapy session, with a sensitivity of 71.4% and specificity of 84.2%, indicates that a patient may improve Psoriasis Area and Severity Index (PASI) by ≥3 points after fifteen phototherapy sessions. In conclusion, phototherapy improves epidermal barrier function in psoriatic patients and the erythema increase after one phototherapy session could help doctors select psoriasis patients who are more likely to respond to phototherapy.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
| | - Antonio Martinez-Lopez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
- Correspondence: ; Tel.: +34-958-023-422
| | | | - Miguel Soler-Gongora
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain; (M.S.-G.); (A.B.-E.)
| | - Eladio Jimenez-Mejias
- Epidemiology and Public Health Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain;
| | - Alejandro Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
| | - Agustin Buendia-Eisman
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain; (M.S.-G.); (A.B.-E.)
| | - Salvador Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain; (M.S.-G.); (A.B.-E.)
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Maroto-Morales D, Montero-Vilchez T, Arias-Santiago S. Study of Skin Barrier Function in Psoriasis: The Impact of Emollients. Life (Basel) 2021; 11:life11070651. [PMID: 34357023 PMCID: PMC8304041 DOI: 10.3390/life11070651] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
Psoriasis is a chronic multi-systemic inflammatory disease that affects the epidermal barrier. Emollients can be used as a coadjutant therapy for psoriasis management, but little is known about how the epidermal barrier function in psoriatic patients is modified by moisturizers. The objective of this study is to evaluate the effect of Vaseline jelly and a water-based formula on epidermal barrier function in psoriatic patients. Thirty-one patients with plaque-type psoriasis and thirty-one gender and age-matched healthy controls were enrolled in the study. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity and the erythema index were measured using non-invasive tools before and after applying Vaseline jelly and a water-based formula. TEWL was higher in psoriatic plaques than uninvolved psoriatic skin (13.23 vs. 8.54 g·m-2·h-1; p < 0.001). SCH was lower in psoriatic plaques than uninvolved psoriatic skin and healthy skin (13.44 vs. 30.55 vs. 30.90 arbitrary units (AU), p < 0.001). In psoriatic plaques, TEWL decreased by 5.59 g·m-2·h-1 (p = 0.001) after applying Vaseline Jelly, while it increased by 3.60 g·m-2·h-1 (p = 0.006) after applying the water-based formula. SCH increased by 9.44 AU after applying the water-based formula (p = 0.003). The use of emollients may improve epidermal barrier function in psoriatic patients. TEWL is decreased by using Vaseline, and SCH is increased by using the water-based formula.
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Affiliation(s)
- Daniel Maroto-Morales
- Dermatology Department, Faculty of Medicine, University of Granada, 18071 Granada, Spain; (D.M.-M.); (S.A.-S.)
| | - Trinidad Montero-Vilchez
- Department of Dermatology at Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence: ; Tel.: +34-958-023-422
| | - Salvador Arias-Santiago
- Dermatology Department, Faculty of Medicine, University of Granada, 18071 Granada, Spain; (D.M.-M.); (S.A.-S.)
- Department of Dermatology at Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Serrano-Serra JP, Montero-Vilchez T, Buendia-Eisman A, Arias-Santiago S. Epidermal Barrier Function and Skin Homeostasis in Skin with Permanent and Adhesive Tattoos: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10040888. [PMID: 33671713 PMCID: PMC7926473 DOI: 10.3390/jcm10040888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022] Open
Abstract
Tattoos are a current trend, but their impact on skin homeostasis and epidermal barrier function is not well known. So, the aims of this study are (1) to investigate epidermal barrier function and skin homeostasis in skin with permanent tattoos, adhesive temporary tattoos and non-tattooed skin, and (2) to analyze the effect of petrolatum on skin with permanent and adhesive tattoos. In total, 67 tattoos were enrolled (34 permanent tattoos and 33 adhesive tattoos). Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), erythema and total antioxidant capacity (TAC) were measured in skin with permanent tattoos, adhesive tattoos and non-tattooed skin before and after petrolatum application. The temperature was lower (30.47 °C vs. 31.01 °C; p = 0.001) on skin with permanent tattoos than non-tattooed skin, while SCH (48.24 Arbitrary Units (AU) vs. 44.15 AU; p = 0.008) was higher. Skin with adhesive tattoos showed lower temperature, SCH (21.19 AU vs. 41.31 AU; p < 0.001) and TAC (1.27 microcoulombs (uC) vs. 3.48 uC; p < 0.001), and higher TEWL (8.65 g/h/m2 vs. 6.99 g/h/m2; p = 0.003), than non-tattooed skin. After petrolatum application, the temperature decreased on skin with permanent tattoos, and TEWL and SCH decreased on skin with adhesive tattoos. Adhesive tattoos may affect skin barrier function, while permanent tattoos may have a lower impact. Tattooed and non-tattooed skin responds in different ways to moisturizers.
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Affiliation(s)
- Jose-Pablo Serrano-Serra
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
| | - Trinidad Montero-Vilchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
- Correspondence: or ; Tel.: +34-958023259
| | - Agustin Buendia-Eisman
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
| | - Salvador Arias-Santiago
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
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