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Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R, Lavorgna M, Colao A, Di Somma C. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne) 2023; 14:1231580. [PMID: 37693364 PMCID: PMC10484397 DOI: 10.3389/fendo.2023.1231580] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body's capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.
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Affiliation(s)
- Fiammetta Romano
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Serpico
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Antonella Di Sarno
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Carmine Dalia
- Internal Medicine S. Maria Della Pietà Hospital Nola, Nola, Italy
| | - Rossana Arianna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Colao
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
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Menzinger S, Saurat JH, Kaya G. Morphological Analysis of Dermatoporosis by in vivo Reflectance Confocal Microscopy and Ultrasonography. Dermatopathology (Basel) 2020; 6:279-287. [PMID: 32309277 PMCID: PMC7154283 DOI: 10.1159/000505990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Dermatoporosis is defined as a chronic cutaneous fragility and insufficiency syndrome. It results from chronological aging, long-term and unprotected sun exposure, genetic factors, or the chronic use of topical and systemic corticosteroids. There is currently a lack of noninvasive tools for the evaluation and quantification of dermatoporosis. Objectives The aim of this study was to define the dermal-epidermal modifications which characterize dermatoporosis using noninvasive methods such as in vivo reflectance confocal microscopy (RCM) and ultrasound (US). Subjects and Methods Seventeen patients with stage I dermatoporosis and 14 healthy volunteers were included in the study. The posterior surface of the right forearm was analyzed in all subjects, and stellate pseudoscars and senile purpura in patients with dermatoporosis were analyzed when possible. We used a commercially available reflectance confocal microscope and measured different histometric parameters (thickness of the epidermis and its different layers, cellular architecture, aspect of the dermal-epidermal junction and the dermis). We also used a commercially available US skin system to define the dermal-epidermal thickness (DET) in all subjects. Results The DET measured with the US skin system was significantly different between the two groups: mean value 1.19 mm (volunteers group) versus 0.81 mm (patient group). The significant differences measured with RCM were (1) epidermal thickness, (2) number of dermal papillae, and (3) thickness of solar elastosis. Stellate pseudoscars are also characterized by a modified dermis, with a linear organization of the collagen bundles. Conclusion US and in vivo RCM are useful tools for the diagnosis of dermatoporosis. Dermal-epidermal atrophy, reduction of dermal papillae/area, and the thickness of dermal elastosis seem to be the major histometric parameters which characterize dermatoporosis.
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Affiliation(s)
- Sébastien Menzinger
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
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Affiliation(s)
- G Kaya
- Department of Dermatology, University of Geneva, Geneva, Switzerland
| | - A Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - O Sorg
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - J-H Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
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Kaya G, Kaya A, Sorg O, Saurat J. Dermatoporosis, a prevalent skin condition affecting the elderly: current situation and potential treatments. Clin Dermatol 2019; 37:346-50. [DOI: 10.1016/j.clindermatol.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Dermatoporosis is a chronic skin fragility syndrome, caused by age and environmental factors. People with dermatoporosis have skin whose protective mechanical function is reduced and which has a decreased tolerance for friction and shearing forces. Skin tears are another clinical consequence of age-associated skin vulnerability and people with dermatoporosis are at increased risk of skin tears. Dermatoporosis may also delay the healing of skin tears, making it vital that healthcare professionals are aware of this condition. Skin tears have profound effects on the health and well-being of older people, and these kinds of injuries are being seen more frequently in clinical practice as the average age of the population increases. The treatment of skin tears in three older people with dermatoporosis is discussed and the clinical decisions made in each case.
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Affiliation(s)
| | - Elena Toma
- Wound care, independent tissue viability consultant, Rome, Italy
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Kluger N, Impivaara S. Prevalence of and risk factors for dermatoporosis: a prospective observational study of dermatology outpatients in a Finnish tertiary care hospital. J Eur Acad Dermatol Venereol 2018; 33:447-450. [DOI: 10.1111/jdv.15240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 08/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- N. Kluger
- Department of Dermatology, Allergology and Venereology; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - S. Impivaara
- Department of Dermatology, Allergology and Venereology; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
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Saurat JH, Mengeaud V, Georgescu V, Coutanceau C, Ezzedine K, Taïeb C. A simple self-diagnosis tool to assess the prevalence of dermatoporosis in France. J Eur Acad Dermatol Venereol 2017; 31:1380-1386. [DOI: 10.1111/jdv.14240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | - V. Mengeaud
- Département Exploration Cutanée; Centre de Recherche sur la Peau; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - V. Georgescu
- Medical Department; Laboratoires Dermatologiques Avène; Lavaur France
| | - C. Coutanceau
- Medical Department; Laboratoires Dermatologiques Avène; Lavaur France
| | - K. Ezzedine
- Department of Dermatology; Hôpital Henri Mondor EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques) EA 7379; UPEC-Université Paris-Est Créteil; Créteil France
| | - C. Taïeb
- Public Health; European Market Maintenance Assessment-EMMA; Vincennes France
- Public Health; Hôpital Necker-Enfants Malades; Maladies Rares en Dermatologie; Paris France
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Teye K, Numata S, Ishii N, Krol RP, Tsuchisaka A, Hamada T, Koga H, Karashima T, Ohata C, Tsuruta D, Saya H, Haftek M, Hashimoto T. Isolation of All CD44 Transcripts in Human Epidermis and Regulation of Their Expression by Various Agents. PLoS One 2016; 11:e0160952. [PMID: 27505250 PMCID: PMC4978388 DOI: 10.1371/journal.pone.0160952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 07/27/2016] [Indexed: 01/06/2023] Open
Abstract
CD44, a cell surface proteoglycan, is involved in many biological events. CD44 transcripts undergo complex alternative splicing, resulting in many functionally distinct isoforms. To date, however, the nature of these isoforms in human epidermis has not been adequately determined. In this study, we isolated all CD44 transcripts from normal human epidermis, and studied how their expressions are regulated. By RT-PCR, we found that a number of different CD44 transcripts were expressed in human epidermis, and we obtained all these transcripts from DNA bands in agarose and acrylamide gels by cloning. Detailed sequence analysis revealed 18 CD44 transcripts, 3 of which were novel. Next, we examined effects of 10 different agents on the expression of CD44 transcripts in cultured human keratinocytes, and found that several agents, particularly epidermal growth factor, hydrogen peroxide, phorbol 12-myristate 13-acetate, retinoic acid, calcium and fetal calf serum differently regulated their expressions in various patterns. Furthermore, normal and malignant keratinocytes were found to produce different CD44 transcripts upon serum stimulation and subsequent starvation, suggesting that specific CD44 isoforms are involved in tumorigenesis via different CD44-mediated biological pathways.
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Affiliation(s)
- Kwesi Teye
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Sanae Numata
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Rafal P Krol
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Atsunari Tsuchisaka
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Tadashi Karashima
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Chika Ohata
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hideyuki Saya
- Division of Gene Regulation, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Marek Haftek
- University of Lyon 1, EA 4169 and CNRS, Lyon, France
| | - Takashi Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, 830-0011, Japan
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Abstract
INTRODUCTION Glucocorticoids represent the standard therapy for reducing inflammation and immune activation in various diseases. However, as with any potent medication, they are not without side effects. Glucocorticoid-associated side effects may involve most major organ systems. Musculoskeletal, gastrointestinal, cardiovascular, endocrine, neuropsychiatric, dermatologic, ocular, and immunologic side effects are all possible. AREAS COVERED This article analyzes English-language literature and provides an update on the most recent literature regarding side effects of systemic glucocorticoid treatment. EXPERT OPINION The risk/benefit ratio of glucocorticoid therapy can be improved by proper use. Careful monitoring and using appropriate preventive strategies can potentially minimize side effects.
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Affiliation(s)
- Merih Oray
- a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.,b Ocular Immunology and Uveitis Foundation , Waltham , MA , USA.,c Istanbul Faculty of Medicine, Department of Ophthalmology , Istanbul University , Istanbul , Turkey
| | - Khawla Abu Samra
- a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.,b Ocular Immunology and Uveitis Foundation , Waltham , MA , USA
| | - Nazanin Ebrahimiadib
- a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.,b Ocular Immunology and Uveitis Foundation , Waltham , MA , USA
| | - Halea Meese
- a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.,b Ocular Immunology and Uveitis Foundation , Waltham , MA , USA
| | - C Stephen Foster
- a Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.,b Ocular Immunology and Uveitis Foundation , Waltham , MA , USA.,d Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
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Affiliation(s)
- R. Rayner
- School of Nursing and Midwifery, Curtin University and Silver Chain Group, Western Australia
| | - K. Carville
- School of Nursing and Midwifery, Curtin University and Silver Chain Group, Western Australia
| | - G. Leslie
- School of Nursing and Midwifery, Curtin University, Western Australia
| | - P. Roberts
- School of Nursing and Midwifery, Curtin University, Western Australia
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Abstract
The relatively new term dermatoporosis refers to chronic deficiencies in the skin's functions in the elderly population due to aging. This syndrome is marked by chronic cutaneous fragility clinically represented by skin atrophy, senile purpura, stellate pseudoscars, skin laceration, and dissecting hematoma of the skin. In this paper, we report three cases of sacral pressure ulcers presenting primary dermatoporosis on the forearms. Case 1 was a 74-year-old male who presented with a stage IV sacral pressure ulcer. The signs of dermatoporosis appeared on the forearms. Histopathology of the lesions revealed epidermal thinning with loss of rete ridges. Azan and Elastica van Gieson staining demonstrated the degeneration of the dermal collagen fibers and elastic fibers, respectively. In spite of 6 months of treatment, the ulcer failed to heal sufficiently. Case 2 was a 74-year-old male and Case 3 was a 97-year-old female. Both cases presented with a stage II sacral pressure ulcer and dermatoporosis on the forearms. Histopathological examinations and the clinical course of the wound could not be ascertained in Cases 2 and 3. None of the patients had previously used corticosteroids. The presence of a primary dermatoporosis on the forearms in these cases may be associated with the increased risk of pressure ulcer development.
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Affiliation(s)
- Yuta Kurashige
- Department of Dermatology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
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