FASEB J. 2009 Jul 29; Salem MM, Shalbaf M, Gibbons NC, Chavan B, Thornton JM, Schallreuter KUVitiligo is characterized by a patchy loss of inherited skin color affecting approximately 0.5% of individuals of all races. Despite the absence of the protecting pigment and the overwhelming evidence for hydrogen peroxide (H2O2)-induced oxidative stress in the entire epidermis of these patients, there is neither increased photodamage/skin aging nor a higher incidence for sun-induced nonmelanoma skin cancer. Here we demonstrate for the first time increased DNA damage via 8-oxoguanine in the skin and plasma in association with epidermal up-regulated phosphorylated/acetylated p53 and high levels of the p53 antagonist p76(MDM2). Short-patch base-excision repair via hOgg1, APE1, and polymerasebeta DNA repair is up-regulated. Overexpression of Bcl-2 and low caspase 3 and cytochrome c levels argue against increased apoptosis in this disease. Moreover, we show the presence of high epidermal peroxynitrite (ONOO(-)) levels via nitrotyrosine together with high nitrated p53 levels. We demonstrate by EMSA that nitration of p53 by ONOO(-) (300x10(-6) M) abrogates DNA binding, while H2O2-oxidized p53 (10(-3) M) enhances DNA binding capacity and prevents ONOO(-)-induced abrogation of DNA binding. Taken together, we add a novel reactive oxygen species to the list of oxidative stress inducers in vitiligo. Moreover, we propose up-regulated wild-type p53 together with p76(MDM2) as major players in the control of DNA damage/repair and prevention of photodamage and nonmelanoma skin cancer in vitiligo.-Salem, M. M. A. E. L., Shalbaf, M., Gibbons, N. C. J., Chavan, B., Thornton, J. M., Schallreuter, K. U. Enhanced DNA binding capacity on up-regulated epidermal wild-type p53 in vitiligo by H2O2-mediated oxidation: a possible repair mechanism for DNA damage.

Consult Pharm. 2009 Jun; 24 Suppl B: 5-10Drab SROBJECTIVES: To identify the incidence and symptoms of type 2 diabetes in older adult patients, review appropriate glycemic targets for older adults with type 2 diabetes, and consider the rationale for managing hyperglycemia in this patient population. DATA SOURCES: Live symposium presentation based on clinical practice and research, medical literature, and studies published between January 1993 and November 2008 on managing diabetes in older adults, government statistics, and medical society guidelines. STUDY SELECTION: Thirty-five articles were identified from various data sources and were evaluated. The following search terms were used: Complications, Diabetes, Glucose Tolerance, Goals, Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS), Long-term Care, Management, Obesity, Prevalence, Risk Factors, Screening, Senior, and Symptoms. All information deemed relevant to recognizing the rising impact of diabetes in seniors and its implications for management were included. DATA EXTRACTION: Data were extracted independently of the author by the librarians of the University of Pittsburgh. DATA SYNTHESIS: As a result of the aging of the U.S. population, the increasing prevalence of diabetes, and the considerable impact of this disease among older adults, it is only logical to assume that the number of older individuals with diabetes and its impact on older adults will continue to rise. Uncontrolled diabetes has significant risks in the elderly beyond the typical microvascular and macrovascular complications commonly associated with diabetes: cognitive impairment, depression, excessive skin problems, and an increased risk of falls. However, glycemic control reduces the development of these complications and can lead to improvements in dementia, memory, energy, physical activity, mood, and quality of life. CONCLUSION: Because many older adults may benefit from intensive, long-term glycemic control, consultant pharmacists should understand the importance of individualizing glycemic targets, management strategies, and pharmacotherapy in older adults.

J Drugs Dermatol. 2009 Jul; 8(7 Suppl): s3Weinkle SH, Tiesman JP

J Drugs Dermatol. 2009 Jul; 8(7 Suppl): s4-7Osborne R, Mullins LA, Jarrold BBGlobal gene expression profiling provides a useful means to identify key aspects of the skin aging process, and provides information to help develop new skin technologies. Important aspects of skin aging that can be addressed include skin hydration, barrier, matrix, pigmentation and antioxidant capacity. Human skin equivalent cultures allow topical application of test compounds, combinations and products to their stratum corneum surface and measurement of predictive biomarkers. Using this in vitro biomarker approach, it is possible to detect skin barrier enhancement in response to the compounds niacinamide and hexamidine, matrix effects to the peptides Pal-KT and Pal-KTTKS, and hydration and matrix responses to niacinamide and N-acetylglucosamine.

J Drugs Dermatol. 2009 Jul; 8(7 Suppl): s15-8Kaczvinsky JR, Grimes PESkin aging integrates the impact of extrinsic skin insults (e.g., ultraviolet [UV] light, etc.) with chronological, genetically programmed decreases in cellular function. A genomic study of aged skin highlighted the mechanistic importance of skin barrier function, exfoliation, control of reactive oxygen species and maintenance of extracellular matrix to the aging process. A set of topical products designed to address these mechanistic themes was developed and clinically tested. The individual products improved skin barrier function, hydration and skin turnover, as well as the smoothness and depth of periorbital wrinkles. Treatment with a regimen of these products improved the appearance of facial wrinkles after eight weeks. Changes in treated subjects' stratum corneum protein biomarker levels were consistent with the mechanistic pathways identified in the genomic work. Thus, leveraging a genomic understanding of skin aging led to the development of a clinically efficacious, aesthetically pleasing cosmetic regimen that improved the appearance of aged skin.

J Drugs Dermatol. 2009 Jul; 8(7 Suppl): s8-11Robinson MK, Binder RL, Griffiths CELike all tissues, the skin ages due to the passage of time (chronologic aging). However, skin is also exposed to external insults, such as sunlight. Aging due to chronic sun exposure (photoaging) is characterized clinically by wrinkling, dyspigmentation and other changes. Chronologic and photoaging of skin have been distinguished at the structural, cellular and molecular levels. However, many underlying mechanisms remain a mystery. Recent sequencing of the human genome and development of genome-wide microarray platforms now permit analysis of skin aging at the level of gene expression. Analysis of gene expression differences between young and older sun-protected and sun-exposed skin showed that photoaging produces many similar (but more severe) changes in gene expression versus chronologic aging. However, some changes are unique to one form of aging or the other. Bioinformatics tools also enable an integrated analysis of gene expression themes and pathways, which may provide new insights into the mechanisms of skin aging and possible interventions.

J Cosmet Laser Ther. 2009 Jul 22; 1-5Chiba C, Usui A, Hara H, Ishi YBackground: The long-pulse Nd:YAG laser is a versatile, effective and safe treatment modality for skin rejuvenation, in addition to the treatments of telangiectasia and laser hair removal. Objective: To evaluate the clinical efficacy and safety of a long-pulse Nd:YAG laser for skin rejuvenation in Japanese patients. Methods: A total of 19 female Japanese patients with Fitzpatrick skin types III or IV were treated for improving their wrinkles, skin texture, and skin laxity with a repetitive painting motion technique. Results: Of 19 patients, 10 showed good or superior results in their faces with minimal discomfort after two to seven treatments every 3-4 weeks. Improvement was also observed in wrinkles and skin laxity as well as skin texture and fine lines. An increase in the density of collagen fibers in the papillary dermis was observed histopathologically. Conclusion: The long-pulse Nd:YAG laser with a minimal down time technique should be considered as a treatment modality in Asian women. Further studies are necessary to determine more optimal treatment parameters, without compromising patients' comfort.

J Med Food. 2009 Jun; 12(3): 601-7Shim JS, Choi EJ, Lee CW, Kim HS, Hwang JKMatrix metalloproteinase (MMP)-1 is a superfamily of zinc-dependent endopeptidases that are capable of degrading all components of the extracellular matrix. Kaempferia pandurata extract (0.01-0.5 microg/mL) significantly reduced the expression of MMP-1 and induced the expression of type 1 procollagen at the protein and mRNA levels in a dose-dependent manner. Ultraviolet (UV)-induced MMP-1 initiates cleavage of fibrillar collagen. Once cleaved by MMP-1, collagen can be further degraded by elevated levels of MMP-3 and MMP-9. It was found that increased MMP-1 expression due to UV irradiation was mediated by activation of mitogen-activated protein kinases such as extracellular-regulated kinase (ERK), Jun N-terminal kinase (JNK), and p38 kinase. Treatment of K. pandurata extract in the range of 0.01-0.5 microg/mL inhibited the UV-induced phosphorylations of ERK, JNK, and p38, respectively. Moreover, inhibition of phosphorylated ERK, JNK, and p38 by K. pandurata extract resulted in decreased c-Fos expression and c-Jun phosphorylation induced by UV light. The results strongly suggest that K. pandurata is potentially useful for the prevention and treatment of skin aging.

Skin Res Technol. 2009 Aug; 15(3): 357-63Koehler MJ, Preller A, Kindler N, Elsner P, König K, Bückle R, Kaatz MBACKGROUND: Skin aging is accelerated by extrinsic factors, particularly actinic damage. Over the last decades, both clinical and pathological differences between intrinsic and actinic aging have been characterized. In this work, we aimed at quantifying skin aging by non-invasive in vivo methods. METHODS: Young healthy volunteers using indoor tanning facilities and aged people were compared with appropriate controls by measurements of skin elasticity with the Cutometer and the Reviscometer and by semi-quantitative evaluation of the dermal matrix composition by the multiphoton laser tomograph DermaInspect. RESULTS: We found differences between the sun-protected volar forearm and the dorsal side as well as between young and old test persons with all three methods. No significant differences were found between the skin of indoor-tanned test persons and control. Also, gender had no influence on the severity of skin aging. CONCLUSION: The most consistent results were obtained with the DermaInspect. The considerable inter-individual variation due to the cross-sectional design of the study may have disguised the factual skin damage caused by tanning beds.

Int J Cosmet Sci. 2009 Jul 17; Fujimura T, Sugata K, Haketa K, Hotta MSynopsis Visual scoring has been used to evaluate ethnic differences in skin wrinkling, but it is not sufficient to fully evaluate those differences in wrinkles. We examined whether both the roughness analysis of the skin and visual scoring are sufficient to characterize ethnic differences in wrinkles in Japanese, Chinese and German women. One hundred and five Japanese, 96 Chinese and 90 German age-matched women participated in this study. The severity of their wrinkles in the skin at two sites at the periphery of the eye was evaluated by visual scoring using a photoscale and by roughness values obtained from three-dimensional analysis of skin replicas. Slight but significant differences were scarcely observed between Japanese and Chinese women as well as between Japanese and German women at the same age group using the visual scoring method. However, significant and clearer differences among those ethnic groups were observed using the roughness analysis of skin replicas. Below the eye, significant differences among those ethnic groups were observed using both visual wrinkle scoring and roughness analysis. However, the extent of increased roughness values with age was relatively small compared with the increased wrinkle scores. These results show that roughness analysis is more sensitive than the visual scoring method when comparing ethnic differences in wrinkles. We conclude that roughness analysis of the skin is an important secondary evaluation criterion to visual scoring necessary to evaluate ethnic differences of wrinkles.

Skin Res Technol. 2009 Aug; 15(3): 306-13Querleux B, Baldeweck T, Diridollou S, de Rigal J, Huguet E, Leroy F, Holloway Barbosa VBACKGROUND: Ethnic differences in skin structural features have not been thoroughly investigated, and the few reported studies are contradictory. Thus, we have carried out a set of in vivo measurements on the skin of about 400 volunteers from various ethnic origins living in the same environment. METHODS: Female subjects were distributed into four ethnic groups: African Americans, Mexicans, Caucasians, and Chinese. Inter- and intra-ethnic skin structural differences, according to age and anatomic site, were investigated using three non-invasive skin-imaging methods: ultrasound (US) at 25 and 150 MHz, and optical coherence tomography (OCT). RESULTS: The thickness of the skin is higher on the cheek compared with the dorsal and ventral forearm, with no ethnic or age-related specificity. We confirm that the sub-epidermal non-echogenic band is a sensitive marker of skin aging, and reveal for the first time that it is less pronounced in African Americans. From OCT images, we bring out evidence that the thickness of the dermal-epidermal junction (DEJ) decreased with age, and was higher in African Americans than in Caucasians. Finally, by comparing US images at 150 MHz with OCT images, we show that papillary dermis thickness can be measured and appears to be quite constant irrespective of age or ethnic group. CONCLUSION: Our study confirms that skin imaging is very attractive to further our knowledge of the morphology of skin from various ethnic origins. Regarding age effects, quantitative parameters have shown that they would be delayed in African Americans compared with all other ethnic populations.

J Biomed Mater Res B Appl Biomater. 2009 Jul 23; Eleni PN, Krokida MK, Polyzois GL, Gettleman LStatement of Problem: Facial prostheses deteriorate in a service environment primary due to exposition to various environmental factors, including sebaceous oils (sebum) and perspiration. Purpose: This study investigated the physical properties of an experimental, facial prosthetic after immersion for 6 months in simulated sebum, and perspiration at 37 degrees C. Material and Methods: Chlorinated polyethylene (CPE) specimens were immersed in simulated perspiration as well as in sebum. Compression tests were conducted on a Zwick testing machine. Shore A hardness measurements were carried out in a CV digital Shore A durometer. Melting and glass transition temperatures were evaluated with a differential scanning calorimeter. Weight changes were measured and color changes were determined in the CIE LAB system using a MiniScan XE spectrophotometer. Simple mathematical models were developed to correlate the measured properties with immersion time. The data were also subjected to analyses of variance (ANOVA) and the Tukey multiple range tests at a level of alpha = 0.05. Results: Specimens immersed in perspiration became harder due to facilitation of the propagation of cross-linking reaction that probably occurred during aging of the CPE samples. Some weight increase was observed for the specimens immersed into the aqueous solutions, whereas for those immersed in sebum, weight loss was recorded, probably because of extraction of some compounds. The color change was higher for the specimens immersed in sebum than that corresponding to simulated perspiration. Conclusions: The chlorinated polyethylene specimens aged for a period, which simulates 1.5 years of clinical service1, showed significant deformations in their physical properties. (c) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009.

Skin Res Technol. 2009 Aug; 15(3): 299-305Ezure T, Hosoi J, Amano S, Tsuchiya TBACKGROUND/PURPOSE: Facial sagging is associated with aging, although the mechanism remains unclear. The aim of this study was to investigate the mechanism of facial sagging by examining the relationship of sagging severity to changes of skin elasticity, fat mass and facial muscle function at the cheek. METHODS: Faces of 108 healthy Japanese female volunteers, aged 20-60 years were photographed at an angle of 45 degrees . Standard scores of sagging severity were established by analyzing the photographs. We examined the correlations of scored sagging levels with skin elasticity measured with a Cutometer MPA 580, fat content estimated by bioelectrical impedance analysis and facial muscle function (lip sealing force and occlusal force) in middle-aged female volunteers (30-40 years) with a wide range of sagging scores. RESULTS: Because the upper, lower and lateral areas in the cheek may show severe sagging, a six-grade score of sagging severity was separately established for each area. Each score was significantly correlated positively with age (20-60 years). In middle-aged volunteers, the sagging scores in all three areas of the cheek were significantly and negatively associated with skin elasticity. Body fat percentage was significantly and positively correlated with the sagging scores in the lower and lateral areas, although the correlation was only weakly positive in the upper area. Mimetic muscle function, measured in terms of lip sealing pressure, was significantly and negatively correlated with the sagging score only at the upper area of the cheek, but masticatory muscle function, measured in terms of occlusal force pressure, was not associated with the sagging score. CONCLUSIONS: Sagging may be associated with the reduction of skin elasticity and mimetic muscle function and increase of fat mass, but the relationships are different in different areas of the cheek.

Ann Dermatol Venereol. 2009 May; 136 Suppl 4: S61-6Trevidic P, Cauchois R, Ingallina FThe muscular topographic anatomy of the face has long been known. The functional anatomy of the face has been studied by many neurologists, with Duchenne of Boulogne one of the first. The possibility of correcting not only wrinkles, but also certain regional balances gives botulinum toxin a certain number of advantages as well as limitations that should be well known by future injectors as well as the more experienced of practitioners who seek to treat the most difficult zones.

Ann Dermatol Venereol. 2009 May; 136 Suppl 4: S146-51Gassia VBotulinum toxin serotype A injections used in treating dynamic wrinkles is one of the least invasive cosmetic procedures. High patient satisfaction and low onset of always moderate side effects contribute to the growing popularity of botulinum toxin injections in cosmetic treatment over the past few years. Years of experience and use, in therapeutics [1,2] and esthetics (20 years) have proven the efficacy and the safety of this wrinkle treatment. Today, no severe or long-term side effects have been reported in esthetics. This article discusses only the most frequent locoregional effects. They are rare, moderate, transitory, and totally reversible. Properly informing and selecting patients will contribute to successfully preventing and managing these effects.

Aesthet Surg J. 2009 May-Jun; 29(3): 174-9Lambros VBACKGROUND: Aging eyes often are treated by excision of apparent excess skin and fat and, in some instances, by elevation of the brow. The result of these traditional approaches is increased definition of the orbit, which is not of benefit for all patients. In some cases, the addition of volume in the periorbital area may provide a better-looking result than traditional surgical alternatives. OBJECTIVE: The author describes the use of hyaluronic acid (HA) fillers for improvement of the periorbital region. METHODS: Using local anesthetic, patients are provided with a preview of the aesthetic result of treatment with HA fillers to add volume to the brow. Most treatments are performed using HA fillers, which have the benefit of results that are both reversible and long-lasting. The author uses a fanning technique to inject small quantities of material. RESULTS: The use of these techniques results in a high degree of patient satisfaction. Occasional minor irregularities may occur, but these can be smoothed out by massage or blended by further injection. Results lasting two years are common and we have observed longevity of three years or more in some patients. Some brow configurations that falsely project emotional states, such as anxiety, may also be corrected. CONCLUSIONS: As in other types of cosmetic surgery, patient selection is key. In properly selected patients, increased fullness of the upper lids is preferable to the greater definition of the lids resulting from traditional surgical techniques. The longevity of treatment and reversibility of changes to the upper lids with HA fillers render this approach both cost-effective and safe.

Ann Dermatol Venereol. 2009 May; 136 Suppl 4: S111-8Gassia V, Beylot C, Béchaux S, Michaud TAlthough correction of the dynamic wrinkles of the upper part of the face is the major indication for botulinum toxin, there are also many possibilities for the middle and lower thirds of the face and neck. However, these injections are more delicate and require an experienced operator who has excellent knowledge of the muscles of these regions, their functions, the antagonist actions exercised on other muscles, particularly in terms of the complex equilibrium of the mouth. An excessive dose, an inappropriate injection point, or a centering mistake can all easily be responsible for undesirable side effects. However, the results obtained, often with lower doses than in the superior part of the face, can be highly satisfactory, notably in erasing bunny lines, improvement of marionette lines, peau d'orange chin, attenuation of peribuccal lines, melomental folds, correction of a gummy smile, and facial asymmetries. In the neck it is possible to reduce platysmal bands, horizontal lines, and diagonal lines of the neck and décolleté. The face contours can also be improved by the Nefertiti lift. In the mid and lower regions of the face, botulinum toxin is often a complement to other esthetic techniques, particularly filling procedures.

Ann Dermatol Venereol. 2009 May; 136 Suppl 4: S67-72Le Louarn CCutaneous ageing is responsible for the increasingly creased appearance of the skin, pores opening, skin dyschromia, while the ageing of the structures of the face is attributed primarily to the effect of gravity on the tissues. The theory expounded below sets out to prove that the main and initial cause of this ageing is the repeated contractions of the mimic muscles. This concept attributes only a secondary role to gravity in the ageing process, which is initially brought about by muscular contractions. An MRI study recently made it possible to demonstrate the anterior convexity curve of the mimic muscles in the young subject. This curve is due to the existence of a deep fat pad at the back of these muscles. While this mass of fat is effectively a mechanical sliding plane, its convexity constitutes the founding principle behind this new ageing theory. In the young subject, the extent of its convexity and its location give a specific, youthful character to the movements, in terms of direction and amplitude, of the facial muscles. With age, the muscle gradually straightens and shortens, due to the repeated contractions that expel the underlying fat and increase the tonus at rest. The structural ageing becomes visible and with time, the expression of the subject is consequently more rigid.

J Ethnopharmacol. 2009 Jul 17; Hsu MF, Chiang BHETHNOPHARMACOLOGICAL RELEVANCE: Radix astragali, a well-known Chinese herb, which has been traditionally used for skincare, and microbial fermentation is one of the conventional methods for processing Chinese herbs. AIM OF STUDY: This research studied the effects of non-fermented (HQNB) and fermented preparations (HQB) of Radix astragali on hyaluronic acid (HA) production in primary human skin cells. MATERIALS AND METHODS: HQB and HQNB were prepared and added to the cultures of primary human skin cells. Hyaluronic acid content was determined using ELISA. Real time RT-PCR was used to evaluate hyaluronan synthase gene expression. The bioactive compounds were analyzed by HPLC. RESULTS: The growth-stimulating effect of HQNB on both of keratinocytes and fibroblasts were significantly higher than that of HQB. Conversely, HQB, but not HQNB significantly stimulated HA production in both cultured primary human epidermal keratinocytes and human dermal fibroblasts in dose-dependent manners. In addition, HQB markedly and dose-dependently increased the expression of hyaluronan synthase 3 and hyaluronan synthase 2 mRNA in HaCaT cells and human fibroblasts, respectively. Therefore, HQB might be a promising candidate for preventing the age-dependent loss of HA content in aged human skin, and its effect on the enhancement of HA synthesis in skin cells is highly related to its effect on the expression of hyaluronan synthase genes. The three major active isoflavonoids in R. astragali were identified as ononin, calycosin, and formononetin. After fermentation, all of these three compounds in HQB were significantly reduced. However, HQB still had significantly higher enhancement effect on the production of HA than HQNB. It appeared that isoflavonoid aglycones or other metabolites, converted from their primary isoflavones during fermentation, might be responsible for the skincare functions found in this study. CONCLUSION: This study demonstrated the low toxicity and the stimulating effects of HQB on HA synthesis, and suggests that HQB may play a promising role in anti-aging cosmetic applications.

J Struct Biol. 2009 Jul 15; Robach JS, Stock SR, Veis AMicrostructure of the teeth of the sea urchin Lytechinusvariegatus was investigated using optical microscopy, SEM (scanning electron microscopy) and SIMS (secondary ion mass spectroscopy). The study focused on the internal structure of the first-stage mineral structures of high Mg calcite (primary, secondary and carinar process plates; prisms) and on morphology of the columns of second-stage mineral (very high Mg calcite) that cement the first-stage material together. Optical micrographs under polarized light revealed contrast in the centers (midlines) of carinar process plates and in prisms in polished sections; staining of primary and carinar process plates revealed significant dye uptake at the plate centers. Demineralization with and without fixation revealed that the midlines of primary and carinar process plates (but not secondary plates) and the centers of prisms differed from the rest of the plate or prism, and SIMS showed proteins concentrated in these plate centers. SEM was used to study the morphology of columns, the fracture surfaces of mature teeth and the 3D morphology of prisms. These observations of internal structures in plates and prisms offer new insight into the mineralization process and suggest an important role for protein inclusions within the first-stage mineral. Some of the 3D structures not reported previously, such as twisted prisms and stacks of carinar process plates with nested wrinkles, may represent structural strengthening strategies.

Regul Toxicol Pharmacol. 2009 Jul 15; Colerangle JBPhotosafety testing has become a necessary component of drug development. Phototoxic effects to human skin can range from sunburn, premature skin aging, to life threatening skin cancer while phototoxic effects to the human eye can range from blurred vision to transient or permanent blindness. Phototoxic liabilities should be recognized early to avoid delays in drug development as they can have a strong impact on the safety and overall commercial success of a new drug product. Current guidance from the FDA and EMEA for photosafety testing varies widely among these regulatory agencies. While both guidance agree that only drug products that absorb light within the 290-700 nm range and distribute to the skin and/or eyes need to be tested, they do not specify what levels of either the drug product concentration in the skin/eyes or what molar absorbance would necessitate photosafety testing and when. The EMEA Concept paper published in 2008 does not provide any specific criteria for deciding whether photosafety testing is needed. Due to the lack of specified timing as to when photosafety testing should be conducted and what testing strategy should be pursued, the pharmaceutical companies should engage in dialogue with the regulatory agencies early in drug development to reach a consensus on these issues to avoid delays during drug development. This paper proposes a testing strategy that attempts to merge the testing proposals recommended by both regulatory agencies into a common strategy that meets the requirements of both regulatory agencies.

Neurogastroenterol Motil. 2009 Jul 10; de Iorio F, Malagelada C, Azpiroz F, Maluenda M, Violanti C, Igual L, Vitrià J, Malagelada JRAbstract A programme for evaluation of intestinal motility has been recently developed based on endoluminal image analysis using computer vision methodology and machine learning techniques. Our aim was to determine the effect of intestinal muscle inhibition on wall motion, dynamics of luminal content and transit in the small bowel. Fourteen healthy subjects ingested the endoscopic capsule (Pillcam, Given Imaging) in fasting conditions. Seven of them received glucagon (4.8 mug kg(-1) bolus followed by a 9.6 mug kg(-1) h(-1) infusion during 1 h) and in the other seven, fasting activity was recorded, as controls. This dose of glucagon has previously shown to inhibit both tonic and phasic intestinal motor activity. Endoluminal image and displacement was analyzed by means of a computer vision programme specifically developed for the evaluation of muscular activity (contractile and non-contractile patterns), intestinal contents, endoluminal motion and transit. Thirty-minute periods before, during and after glucagon infusion were analyzed and compared with equivalent periods in controls. No differences were found in the parameters measured during the baseline (pretest) periods when comparing glucagon and control experiments. During glucagon infusion, there was a significant reduction in contractile activity (0.2 +/- 0.1 vs 4.2 +/- 0.9 luminal closures per min, P < 0.05; 0.4 +/- 0.1 vs 3.4 +/- 1.2% of images with radial wrinkles, P < 0.05) and a significant reduction of endoluminal motion (82 +/- 9 vs 21 +/- 10% of static images, P < 0.05). Endoluminal image analysis, by means of computer vision and machine learning techniques, can reliably detect reduced intestinal muscle activity and motion.

Semin Cutan Med Surg. 2009 Jun; 28(2): 115-29Talakoub L, Wesley NOThe United States has become progressively more multicultural, with the ethnic population growing at record rates. The US Census Bureau projects that, by the year 2056, greater than 50% of the US population will be of non-Caucasian descent. Ethnic patients have different cosmetic concerns and natural features that are unique. The cosmetic concerns of ethnic patients also differ as the result of differences in skin pathophysiology, mechanisms of aging, and unique anatomic structure. There is no longer a single standard of beauty. We must now adapt to the more diverse population and understand how to accommodate the diversity of beauty in the United States. Ethnic patients do not necessarily want a Westernized look because what constitutes beauty is determined by racial, cultural, and environmental influences. We as leaders in skin care must understand these differences and adapt our practices accordingly. This article will focus on the differences in aging in different ethnic populations and highlight procedures unique to skin of color.

Aesthet Surg J. 2009 May-Jun; 29(3): 199-206; discussion 206-8Sajjadian A, Guyuron BNasal tip ptosis ("drooping" or long nose) occurs when the tip of the nose is more caudal than what is deemed ideal. Intrinsic factors, such as elongated or caudally-rotated lower lateral cartilages, can lead to nasal tip ptosis. Extrinsic factors, such as elongated upper lateral cartilages or excessive caudal anterior septum and heavy nasal skin, can push the nasal tip caudally and lead to drooping of the nasal tip. The loss of maxillary or nasal spine support may enhance the potential for tip ptosis. In addition, a hyperactive depressor nasi septi could, as a result of continuous pull on the tip, result in tip ptosis. Aging or previous nasal procedures (such as the Goldman-type tip surgery) where the continuity of the lateral and medial crura of the lower lateral cartilages have been violated may cause a weakening of the tip-supporting mechanisms and de-rotation of the nasal tip. Correction of this deformity is challenging and rewarding; it can resolve both the cosmetic deformity and nasal obstruction symptoms related to this entity. The goal of this article is to present our current principles of diagnosis and treatment of nasal tip ptosis, as well as to introduce and algorithm of preferred methods and techniques for its reliable and stable correction. RESULTS: Correction of the nasal tip ptosis requires accurate diagnosis, a recognition of the interplay between various anatomic components, specific strategy planning, and a correction of anatomic abnormalities.

Acta Dermatovenerol Croat. 2009; 17(2): 99-102Matanis E, Munder H, Ullmann Y, Miskin R, Gilhar ACaloric restriction (CR) extends the lifespan of diverse animal species and is currently the only therapeutic intervention known to attenuate aging and increase longevity in laboratory animals. The effect of CR on intrinsic skin aging is not well understood. To study this issue, we took advantage of transgenic alphaMUPA mice that spontaneously eat less (20-30%) when fed ad libitum and live longer compared to their wild type (WT) FVB/N control mice. Herein we determined morphometric skin parameters in young (6-7 months) and aged (17-18 months) alphaMUPA and WT mice. In addition, we transplanted skin grafts excised from the aged or young alphaMUPA and WT mice into both types of young mice, to test whether the systemic environments of alphaMUPA and WT mice could affect the grafts differently. The results have shown that the mean epidermal thickness, number of hair follicles and number of dermal blood vessels were similar in all four groups regardless of age or mouse type. In addition, the post-graft specimens of all four groups exhibited increase in all parameters measured, in particular a remarkable 6-7 fold increase in epidermal thickness. However, no significant differences were detected in the post-graft samples between the four experimental groups. Our findings indicate that, at least in FVB/N mice, parameters measured in normal or grafted skin depend primarily on the intrinsic cutaneous capacity rather than on circulating factors as determined by age or reduced calories.

Nippon Rinsho. 2009 Jul; 67(7): 1277-82Katsuya T, Morishita RWerner's syndrome is a typical progeroid syndrome with many specific features of aging early in life. Clinical features of Werner's syndrome closely resemble accelerated aging, such as cataract, scleroderma skin, diabetes and tumorigenesis. The causative gene of this syndrome is denoted as WRN, which encodes a homolog of the E. coli RecQ DNA helicase and is located on chromosome 8p2-p11.2. WRN is not only a helicase but also an exonuclease and ATPase. WRN protein plays a key role in genome stability, particularly during DNA replication and telomere metabolism. In this review, we introduce the clinical characteristics of Werner's syndrome and recent topics concerning WRN in comparison with other progeroid syndromes.

Biomed Chromatogr. 2009 Jul 9; Lopes LB, Reed RTopical application of lycopene is a convenient way to restore antioxidants depleted from the skin by UV radiation and achieve protection against premature aging and cancer. In this study, a simple, rapid and reproducible method to quantify lycopene in different skin layers was developed, validated and employed to assess this compound after skin penetration studies. Lycopene was extracted from the stratum corneum (SC) and viable epidermis and dermis (ED) by vortex homogenization and bath sonication in a mixture of acetonitrile and methanol (52:48, v/v). Lycopene was assayed by HPLC using a C(18) column, and acetonitrile:methanol (52:48, v/v) as mobile phase. The quantification limit of lycopene in samples of SC and ED was 35 ng/mL and the assay was linear from 35 to 2000 ng/mL. Within-day and between-days assays coefficients of variation and relative errors (indicative of precision and accuracy) were less than 15% (or 20% for the limit of quantification). Lycopene recovery from SC and ED was dependent on the spiked concentration: for 50 ng/mL, recoveries were 88.3 and 90.5%; for 100-1000 ng/mL, recoveries were 68.6-74.9%. This method has a potential application for lycopene quantification during formulation development and evaluation in the dermatological field. Copyright (c) 2009 John Wiley & Sons, Ltd.

J Drugs Dermatol. 2009 Jul; 8(7): 674-7Bergstrom KGIn contrast to youthful skin, mature skin undergoes well-established clinical and microscopic changes, particularly after menopause. In particular, dermal thinning, loss of dermal collagen and decreased lipid production are complicated by the effects of life-long sun exposure. These changes manifest as wrinkling, loss of elasticity, dryness and textural changes that characterize mature skin. To effectively combat these age- and sun-related changes, a multifaceted approach is required. Any treatment for mature skin must address the many causes of skin changes, that is, collagen production, lipid balance and epidermal texture. Several currently available compounds have scientifically-established effects on skin, and are anticipated to be even more effective in combination. Women worldwide struggle with coming to terms with their aging skin, and seek ways to preserve its youthful appearance. While dermatologists' offices may offer tretinoin cream (Renova and related products), laser resurfacing approaches, volume fillers and Botox, demand also exists for topical products that preserve and improve skin tone. With the push toward "natural," "organic" and "herbal" products, public and private research has never generated more evidence for complementary therapy. During skin aging, and particularly menopause, characteristic changes occur. Topical compounds can target many aspects of the aging process. The following is a review of topical compounds that may help with particular parts of this process. How can different problems be approached? In addition to prescription approaches and physical modalities, several topical compounds, many available over the counter, show evidence for helping aged and photo-damaged skin. Clinical data exist for many of these compounds, and is divided by mechanism of action.

Int J Cosmet Sci. 2009 Jun; 31(3): 225-35

J Invest Dermatol. 2009 Jul 9; Barolet D, Roberge CJ, Auger FA, Boucher A, Germain LIt has been reported that skin aging is associated with a downregulation in collagen synthesis and an elevation in matrix metalloproteinase (MMP) expression. This study investigated the potential of light-emitting diode (LED) treatments with a 660 nm sequentially pulsed illumination formula in the photobiomodulation of these molecules. Histological and biochemical changes were first evaluated in a tissue-engineered Human Reconstructed Skin (HRS) model after 11 sham or LED light treatments. LED effects were then assessed in aged/photoaged individuals in a split-face single-blinded study. Results yielded a mean percent difference between LED-treated and non-LED-treated HRS of 31% in levels of type-1 procollagen and of -18% in MMP-1. No histological changes were observed. Furthermore, profilometry quantification revealed that more than 90% of individuals showed a reduction in rhytid depth and surface roughness, and, via a blinded clinical assessment, that 87% experienced a reduction in the Fitzpatrick wrinkling severity score after 12 LED treatments. No adverse events or downtime were reported. Our study showed that LED therapy reversed collagen downregulation and MMP-1 upregulation. This could explain the improvements in skin appearance observed in LED-treated individuals. These findings suggest that LED at 660 nm is a safe and effective collagen-enhancement strategy.Journal of Investigative Dermatology advance online publication, 9 July 2009; doi:10.1038/jid.2009.186.

Dis Mon. 2009 Apr; 55(4): 223-35Friedman S, Lippitz J

Diabetes Technol Ther. 2009 Jul; 11(7): 461-7Petrofsky JS, McLellan KAbstract Background: Aging and diabetes are both associated with impaired vascular endothelial function. This causes a reduction in the resting blood flow and the blood flow response to autonomic stressors. Further, skin moisture and the ability to sweat are also reduced with aging and diabetes. The present investigation was undertaken to determine if the extent of damage from aging and diabetes could be accurately assessed by simply examining the electrodermal skin response (galvanic skin resistance) to a thermal stress. Study Design: Forty-five subjects whose average age was 31.2 +/- 8.3 years (younger group), 62.4 +/- 9.6 years (older group), and 61.8 +/- 11.3 years (diabetes group) were divided into three groups of 15 subjects. Subjects were exposed to environmental temperatures of 15 degrees C, 23 degrees C, or 32 degrees C for 30 min. During this period of time, sweat rate, skin blood flow, the electrodermal skin response, and skin moisture were measured. Results: There were significant impairments in skin moisture, sweat, skin blood flow, and the galvanic skin response at any of the three environmental temperatures in subjects with diabetes compared to older subjects compared to younger subjects (analysis of variance, P < 0.01). Both a reduction in skin blood flow and impaired sweating contributed to the higher galvanic skin resistance seen in subjects with diabetes. The greatest contributor was impaired sweating. Conclusions: The results show that galvanic skin resistance, at any environmental temperature, may be a good means of assessing vascular damage and impaired sweat response in people with diabetes.

EuroIntervention. 2009 May; 5(1): 157-65Basalus MW, Ankone MJ, van Houwelingen GK, de Man FH, von Birgelen CAims: To classify and quantify post-expansion irregularities in durable polymer-based coatings of drug-eluting stents (DES). Methods and results: Taxus Liberté, Endeavor Sprint, Endeavor Resolute and Xience V DES (three samples of each) were explored by light microscopy and scanning electron microscopy (SEM) following expansion at 14 atm in water. Incidence and size of irregularities were measured during thorough quantitative examinations of a 360 SEM images. DES types examined showed a significant difference in the incidence of irregularities (p

Phytomedicine. 2009 Jul 3; Sumiyoshi M, Kimura YTurmeric (the rhizomes of Curcuma longa L., Zingiberacease) is widely used as a dietary pigment and spice, and has been traditionally used for the treatment of inflammation, skin wounds and hepatic disorders in Ayurvedic, Unani and Chinese medicine. Although the topical application or oral administration of turmeric is used to improve skin trouble, there is no evidence to support this effect. The aim of this study was to clarify whether turmeric prevents chronic ultraviolet B (UVB)-irradiated skin damage. We examined the effects of a turmeric extract on skin damage including changes in skin thickness and elasticity, pigmentation and wrinkling caused by long-term, low-dose ultraviolet B irradiation in melanin-possessing hairless mice. The extract (at 300 or 1000mg/kg, twice daily) prevented an increase in skin thickness and a reduction in skin elasticity induced by chronic UVB exposure. It also prevented the formation of wrinkles and melanin (at 1000mg/kg, twice daily) as well as increases in the diameter and length of skin blood vessels and in the expression of matrix metalloproteinase-2 (MMP-2). Prevention of UVB-induced skin aging by turmeric may be due to the inhibition of increases in MMP-2 expression caused by chronic irradiation.

Am J Hum Genet. 2009 Jul 1; Guernsey DL, Jiang H, Evans SC, Ferguson M, Matsuoka M, Nightingale M, Rideout AL, Provost S, Bedard K, Orr A, Dubé MP, Ludman M, Samuels MEAutosomal-recessive cutis laxa type 2 (ARCL2) is a multisystem disorder characterized by the appearance of premature aging, wrinkled and lax skin, joint laxity, and a general developmental delay. Cutis laxa includes a family of clinically overlapping conditions with confusing nomenclature, generally requiring molecular analyses for definitive diagnosis. Six genes are currently known to mutate to yield one of these related conditions. We ascertained a cohort of typical ARCL2 patients from a subpopulation isolate within eastern Canada. Homozygosity mapping with high-density SNP genotyping excluded all six known genes, and instead identified a single homozygous region near the telomere of chromosome 17, shared identically by state by all genotyped affected individuals from the families. A putative pathogenic variant was identified by direct DNA sequencing of genes within the region. The single nucleotide change leads to a missense mutation adjacent to a splice junction in the gene encoding pyrroline-5-carboxylate reductase 1 (PYCR1). Bioinformatic analysis predicted a pathogenic effect of the variant on splice donor site function. Skipping of the associated exon was confirmed in RNA from blood lymphocytes of affected homozygotes and heterozygous mutation carriers. Exon skipping leads to deletion of the reductase functional domain-coding region and an obligatory downstream frameshift. PYCR1 plays a critical role in proline biosynthesis. Pathogenicity of the genetic variant in PYCR1 is likely, given that a similar clinical phenotype has been documented for mutation carriers of another proline biosynthetic enzyme, pyrroline-5-carboxylate synthase. Our results support a significant role for proline in normal development.

Cell Stem Cell. 2009 Jul 2; 5(1): 64-75Su X, Paris M, Gi YJ, Tsai KY, Cho MS, Lin YL, Biernaskie JA, Sinha S, Prives C, Pevny LH, Miller FD, Flores ERThe cellular mechanisms that regulate the maintenance of adult tissue stem cells are still largely unknown. We show here that the p53 family member, TAp63, is essential for maintenance of epidermal and dermal precursors and that, in its absence, these precursors senesce and skin ages prematurely. Specifically, we have developed a TAp63 conditional knockout mouse and used it to ablate TAp63 in the germline (TAp63(-/-)) or in K14-expressing cells in the basal layer of the epidermis (TAp63(fl/fl);K14cre+). TAp63(-/-) mice age prematurely and develop blisters, skin ulcerations, senescence of hair follicle-associated dermal and epidermal cells, and decreased hair morphogenesis. These phenotypes are likely due to loss of TAp63 in dermal and epidermal precursors since both cell types show defective proliferation, early senescence, and genomic instability. These data indicate that TAp63 serves to maintain adult skin stem cells by regulating cellular senescence and genomic stability, thereby preventing premature tissue aging.

Int J Cosmet Sci. 2009 Jun 30; Udompataikul M, Sripiroj P, Palungwachira PVarious nutraceuticals (dietary supplements) are claimed to have cutaneous antiageing properties, however, there are a limited number of research studies supporting these claims. The objective of this research was to study the effectiveness of an oral nutraceutical containing antioxidants, minerals and glycosaminoglycans on cutaneous ageing. In this double-blind, placebo-controlled trial, 60 women aged 35-60 years were randomized to receive oral dietary supplement (n = 30) or placebo (n = 30), once daily for 12 weeks. The depth of skin roughness and fine wrinkles were measured using surface evaluation of skin parameters for living skin (Visioscan) at baseline, and at the 4, 8 and 12 weeks of treatment. Surface evaluation using a replica film (Visiometer) at baseline and at the 12th week of treatment was also carried out. Statistical differences in objective skin improvement were assessed by the independent t-test. The volunteers' satisfaction was tested using the chi-squared test. The baseline depth of skin roughness and fine wrinkles in the treatment group and the placebo group were 100.5 and 100 mum, respectively. At the end of the study, the depth of skin roughness and fine wrinkles in the treatment group showed a 21.2% improvement, whereas improvement in the control group was 1.7%. This difference was statistically significant (P < 0.001). With regard to the volunteers' satisfaction, there was no statistically significant decrease in the homogenization of skin colour, however, a statistically significant reduction in pore size and depth of skin roughness and fine wrinkles were observed (P < 0.05). No side effects were noted throughout the study. The oral dietary supplement containing antioxidants, minerals and glycosaminoglycans improved skin roughness and fine wrinkles but did not affect skin colour change in female volunteers.

Am J Physiol Regul Integr Comp Physiol. 2009 Jul 1; Hodges GJ, Jackson DN, Mattar L, Johnson JM, Shoemaker JKNeuropeptide Y (NPY) is a ubiquitous peptide with multiple effects on energy metabolism, reproduction, neurogenesis, and emotion. In addition, NPY is an important sympathetic neurotransmitter involved in neurovascular regulation. While early studies suggested that the vasoactive effects of NPY were limited to periods of high stress, there is growing evidence for the involvement of NPY on baseline vasomotor tone and sympathetically evoked vasoconstriction in vivo in both skeletal muscle and the cutaneous circulation. In Sprague-Dawley rat skeletal muscle, Y1-receptor activation appears to play an important role in the regulation of basal vascular conductance and this effect is similar in magnitude to the alpha1-receptor contribution. Furthermore, under baseline conditions, agonist and receptor-based mechanisms for Y1-receptor dependent control of vascular conductance in skeletal muscle are greater in male than female rats. In skin, there is Y1-receptor-mediated vasoconstriction during whole-body, but not local, cooling. As with the NPY system in muscle, this neural effect in skin differs between males and females and in addition, declines with aging. Intriguingly, skin vasodilation to local heating also requires NPY, and is currently thought to be acting via a nitric oxide pathway. These studies are establishing further interest in the role of NPY as an important vasoactive agent in muscle and skin, adding to the complexity of neurovascular regulation in these tissues. In this review, we focus on the role of NPY on baseline vasomotor tone in skeletal muscle and skin and how NPY modulates vasomotor tone in response to stress, with the aim of compiling what is currently known while highlighting some of the more pertinent questions yet to be answered. Key words: skeletal muscle blood flow, Skin blood flow, blood flow control, BIBP3226.

Acta Reumatol Port. 2009 Apr-Jun; 34(2A): 228-34Azevedo VF, Müller Cde S, Rinaldi L, Bredt MC, Giovanni K, Pereira MA, Volaco FCINTRODUCTION: Systemic Sclerosis (SSc) is an inflammatory disease that decreases functional capacity through muscular atrophy, skin sclerosis and loss of joint function. Scleroderma patients suffer from movement's restriction. In addition, the disease affects the nutritional status, compromising the quality of life in varying degrees. The gastrointestinal involvement appears to be the main responsible for the nutritional impairment. OBJECTIVE: To evaluate the physical and nutritional status of patients with SSc. METHODS: We conducted a cross-sectional and descriptive study in 20 patients with SSc. All patients were evaluated in Physioteraphy Clinic of the Catholic University of Paraná, from July 2003 to April 2004. The evaluation was performed by Bioimpedance Body (BIA), the questionnaires Nutritional Risk Assessment (Determine), Mini Nutritional Assessment of Aging and Health Assessment Questionnaire (HAQ) and Visual Analogue Scale (VAS) for pain. The work muscle ability was assessed by measuring the peak torque of flexor and extensor muscles of the elbow in the isokinetic dynamometer Cybex Norm model 7000. We have calculated the mean and standard deviation for each variable analyzed, in addition to the percentage of peak torque deficit. RESULTS: The values of the VAS ranged from zero to 97.8 mm (mean: 48.9 +/- 32.9 mm). The HAQ scores ranged from zero to 2.75 (average: 0.95 +/- 0.8). The average BMI was 22.4 +/- 3.9 kg / m2. The average deficit of mass was: 1.3 +/- 2.1 kg. Ten patients had high nutritional risk. 1 patient was malnourished and 15 were at high risk for malnutrition. The average peak torque to the muscle groups of elbows was 19.2 +/- 5 N / m to the flexor and 21.9 +/-6.6 N/m for the extensors, with an average deficit of 17% and 13% for the both groups. CONCLUSIONS: We found that SSc patients were in poor nutritional status and had decreased functional and physical capacity by the weakening of the muscles of the elbow demonstrated by the isokinetic evaluation. We concluded that our SSc patients were at high risk for malnutrition and this may indicate that scleroderma patients need a better nutritional orientation. We do consider that SSc patients also must be included in physical activity programs in order to achieve better physical performance.

Dermatol Surg. 2009 May; 35(5): 875-7Acikel C, Karagoz H, Kucukodaci Z

Plast Surg Nurs. 2008 Jul-Sep; 28(3): 123-8; quiz 129-30Bello JSSun-damaged skin is one of the most common complaints of patients presenting to a plastic surgery or dermatology practice. Baby boomers and many others who chose to sunbathe in their adolescent years previously thought little of the potential damaging effects on their skin and are now "paying the price" (P. Kurtzweil, 1998).

Cutis. 2008 Oct; 82(4): 285-90Gerstner G, Matarasso AThere has been an increase in nonsurgical interventions for facial rejuvenation since 2001, which can be attributed to an increase in the use of injectable fillers, volumizers, and biostimulators for soft tissue augmentation. The efficacy and duration of these products depend on their mode of operation, site of injection, and composition. Semipermanent devices offer a compromise between short-term and long-term results.

Surgical procedures for tissues damaged by radiation are fraught with the possibility of multiple and serious complications. A knowledge of the altered pathophysiology of such tissues (chiefly diminished blood supply, fibrosis, and direct cellular reparative potential) is necessary for the surgeon to make a proper judgment. Recognition of the pathognomic signs in the skin is important.

The possibility of malignant change must be kept in mind. Surgical treatment must include the excision of radiated tissues back to good blood supply, and then proper and adequate coverage by the simplest and best means.

If the surrounding local tissues are so altered that they are unsuitable for coverage, structures from a distance must be used. Prior planning of the coverage before the excision pays dividends by preventing disastrous complications.


"Surgical problems in the excision and repair of radiated tissue"
Robinson DW
Plast Reconstr Surg. 1975 Jan ; 55(1): 41-9 (Hubmed.org)


Highlight :
Diamond Microdermabrasion Treatments | Microdermabrasion Equipment | Susan Lucci Microdermabrasion Treatment | Microdermabrasion Kits

J Cutan Med Surg. 2008 Nov-Dec; 12(6): 288-94Housman TS, Berg D, Most SP, Odland PB, Stoddard EBACKGROUND: Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome. OBJECTIVE: This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone. CONCLUSION: The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.

Indian J Dermatol Venereol Leprol. 2008 Nov-Dec; 74(6): 622-4Kachhawa D, Kalla GBACKGROUND: Various surgical procedures for correcting stable vitiligo exist but these have their own limitations. Autologous, non-cultured, non-trypsinized, melanocyte plus keratinocyte grafting is a new and simple method of vitiligo surgery. OBJECTIVE: The study aimed to evaluate efficacy of a new grafting technique in vitiligo patches. METHODS: Eighteen vitiligo patches underwent this procedure. The upper layer of epidermis was removed by superficial dermabrasion using a dermabrader micromotor until the epidermis appeared wet and shiny. Then, antibiotic ointment was applied and dermabrasion was continued up to the whitish area of the upper dermis. The paste-like material (ointment with entangled epidermal particles) was collected and spread over the dermabraded recipient site. RESULTS: Pigmentation usually started at 4-6 weeks. Complete uniform pigmentation took 16-20 weeks. CONCLUSION: For smaller vitiligo patches this method gives cosmetically acceptable results. It is easy to perform and does not require specific laboratory setup.

Curr Opin Ophthalmol. 2009 Jun 24; Lewis CD, Perry JDPURPOSE OF REVIEW: In the last several years, surgeons have increasingly realized the importance of volume loss as a central mechanism of facial aging. New, innovative techniques incorporate volume augmentation, or inflation, to improve cosmetic outcomes. RECENT FINDINGS: Previous rejuvenative facial surgical techniques focused on the removal of excess, lax tissues. In addition to tissue laxity and descent, volume loss significantly contributes to the appearance of facial aging in most patients. Volume loss, or deflation, affects all facial layers, including the skin, deep soft tissue, and bone. A variety of new, innovative surgical and nonsurgical techniques specifically address volume deficiencies in the brow, periorbita, and midface. Volume augmentation directly counteracts volume loss, a key feature of facial aging, and offers surgeons a powerful tool to improve cosmetic results. SUMMARY: In addition to the excision or repositioning of lax or prolapsed tissues, surgeons must assess and treat facial volume loss to optimize cosmetic outcomes.

Current options for treating the aging hand include microdermabrasion, fractional thermolysis, chemical peeling, intense light sources and laser therapy (such as pigment lasers and ablative resurfacing), as well as injectable fillers and volumizers to correct soft tissue atrophy.

OBJECTIVE:
This article reviews the latest technologies in hand rejuvenation and provides data from three clinical practices using injectable poly-l-lactic acid (PLLA) for soft tissue augmentation.

METHODS:
Patient data from three clinical practices were retrospectively collected and tabulated. This included baseline patient data, the number of injections and vials of product used, and adverse events.

RESULTS:
PLLA was used to improve volume loss in the hand to the satisfaction of a majority of patients. The most commonly reported adverse events, such as bruising, swelling and pain, were injection-related and resolved within a few days of treatment. No papules or nodules were reported in any patients and there were no serious adverse events.

CONCLUSION:
The overall results from the three clinics presented here show that patients were very satisfied with the results of PLLA treatment for the hands, and experienced only minor and short-term injection-related adverse events.

"Addressing volume loss in hand rejuvenation: a report of clinical experience"
Sadick NS, Anderson D, Werschler WP
J Cosmet Laser Ther. 2008 Dec ; 10(4): 237-41 (Hubmed.org)


Highlight :
Diamond Microdermabrasion Treatments | Microdermabrasion Equipment | Susan Lucci Microdermabrasion Treatment | Microdermabrasion Kits

Int J Cosmet Sci. 2009 Jun; 31(3): 240Cho HR, Ryou JH, Lee JW, Lee MHSynopsis Human placental extract is used in the treatment of skin wrinkles and wounds. To date, no studies have evaluated the effects of placental extract on dermal fibroblast proliferation. To investigate the effects of placental extract vs. ascorbic acid on fibroblast proliferation and transforming growth factor (TGF)-beta1 expression, cultured human fibroblasts were treated with placental extract (0%, 0.08%, 0.16%, 0.32%, and 0.64%) or L-ascorbic acid-2-phosphate magnesium (0, 0.01, 0.1, 1.0, and 10 mmol L(-1)). Fibroblast proliferation was determined by MTT assay, and TGF-beta1 protein expression was analyzed by ELISA. The proliferation of fibroblasts increased significantly after treatment with placental extract at concentrations of 0.32% and 0.64% and with L-ascorbic acid-2-phosphate magnesium at concentrations of 1.0 and 10 mmol L(-1). Placental extract demonstrated no significant effects on TGF-beta1 expression; however, TGF-beta1 expression significantly increased after treatment with ascorbic acid at concentrations of 1.0 and 10 mmol L(-1). Placental extract and ascorbic acid had similar effects on fibroblast proliferation; however, placental extract did not significantly increase TGF-beta1 protein expression.

Adverse physiologic and biochemical changes in the aging skin are aggravated by unprotected, continuous or repeated exposure to the harmful rays of the sun. Waning hormonal activity contributes to these changes.

The associated clinical entities are skin dryness, accentuation of facial lines and wrinkles, hyperpigmentation, and multiple benign or malignant growths. The skin should be protected by sunscreening and sunblocking agents.

Overexposure to the sun must be avoided. Repeated applications of moisturizing creams, vegetable oils, and appropriate hormonal cosmetics may be helpful in hydrating the skin and thus improving its external appearance.

Chemosurgery (peeling) and dermabrasion may reduce hyperpigmentation and fine facial lines and wrinkles. New growths can be removed by various surgical methods. Biopsy should be performed to determine the presence of a malignant lesion requiring additional x-ray therapy.


"Treatment of the aging skin by dermatologic methods"
Lubowe II
J Am Geriatr Soc. 1976 Jan ; 24(1): 25-8 (Hubmed.org)


Highlight :
Diamond Microdermabrasion Treatments | Microdermabrasion Equipment | Susan Lucci Microdermabrasion Treatment | Microdermabrasion Kits

A study was made of pigment freckles which recur after skin abrasion of spotted grouped pigmented nevi, according to the lapse of time, chiefly by means of the fluorescence method of Falck and Hillarp.

The mechanism of recurrence is summarized as follows. Nearly simultaneously with the epidermal regeneration, dendritic melanin-producing cells derived from hair follicles and eccrine sweat ducts appear in the basal and prickle-cell layers of epidermis.

These cells then create junction activity in the basal layer of epidermis, in the hair follicles and in the eccrine sweat duct walls. Finally, these nevus cells drop off into the underlying layer of scar tissue along the epidermal appendages.

The dendritic melanin-producing cells seen in the early regenerative pigment freckles were thought to be incompletely differentiated nevus cells in the pre-stage of junction nevus formation.

Appearance of dendritic melanin-producing cells and formation of junction activity in the eccrine sweat duct walls suggest the following possibilities. (1) In the cases of spotted grouped pigmented nevus which we studied, nevus cell proliferation also occurred eccrine-centrically on pathogenesis. (2) An important role is played by the eccrine sweat ducts in the recurrence of ordinary pigmented nevi after incomplete removal. (3) Eccrine-centered nevus cells are derived from nevoblasts in the eccrine sweat duct walls.


"Mechanism of recurrence of pigmented nevi following dermabrasion"
Imagawa I, Endo M, Morishima T
Acta Derm Venereol. 1976; 56(5): 353-9 (Hubmed.org)


Highlight :
Diamond Microdermabrasion Treatments | Microdermabrasion Equipment | Susan Lucci Microdermabrasion Treatment | Microdermabrasion Kits

Int J Cosmet Sci. 2009 Jun; 31(3): 237Oba A, Sato C, Takahashi K, Futagawa MThe organs and tissues of the human body function together, and many women know that facial skin quality can be influenced by the condition of other areas. From the perspective of esthetics, the condition of other tissues and organs can have significant impact on facial skin. In our lives, increasing numbers of people experience pain and discomfort in the neck and shoulder region; this study investigates the effects of neck/shoulder pain and discomfort on facial beauty, and demonstrates that facial beauty can be improved by alleviating this pain and discomfort. Shoulder pain and discomfort are correlated to increased shoulder muscle stiffness, increased tension in the frontalis muscle (a muscle of facial expression in the forehead, and forehead wrinkling. We show that body massage aimed at alleviating muscle tension in the neck and upper back alleviate frontalis muscle tension and improve forehead wrinkles. Since other non-facial factors are likely to affect facial beauty, our results show that measures to make the face beautiful and healthy-looking involve the entire body. Keywords: facial beauty, non-facial factors, entire body, neck/shoulder pain and discomfort, shoulder muscle stiffness, frontalis muscle tension, forehead wrinkles, body massage aimed at alleviating muscle tension.

J Drugs Dermatol. 2009 May; 8(5 Suppl Skin Rejuenation): 4-13Sundaram H, Mehta RC, Norine JA, Kircik L, Cook-Bolden FE, Atkin DH, Werschler PW, Fitzpatrick RESynergistic interaction of multiple growth factors (GF) in skin controls the processes that promote skin repair. GFs have been shown to affect different pathways of skin repair and rejuvenation with many GFs working in close cooperation with one another and with other endogenous agents. Intrinsic and extrinsic aging of skin reduces both the levels of natural GFs and the number and activity of fibroblasts. Supplementing skin's endogenous GFs may enhance natural repair processes and accelerate the reversal of damage caused by intrinsic and extrinsic skin aging. In spite of their large molecular weight, evidence suggests that a small fraction of topically applied GFs penetrating into superficial epidermis can elicit a fibroblast-mediated response in the dermis. GF mixture secreted by human fibroblasts grown in conditions resembling the physiological condition of dermis, and present at high concentrations in a stable formula is most likely to provide an ideal cosmeceutical product. This naturally balanced mixture is also likely to contain other important, but as yet unidentified, substances that affect skin healing. Such a complex mixture cannot be reproduced using synthetic substances. Clinical studies have shown that topical application of products containing high concentrations of a physiologically balanced mixture of GF appears to reverse the signs of skin aging. A synergistic combination of antioxidants, matrix building agents and skin conditioners with physiologically balanced GF provides a novel and comprehensive paradigm of skin rejuvenation.

J Dtsch Dermatol Ges. 2009 Apr 24; Brod C, Schippert W, Breuninger HA 58-year-old man presented in 2001 with dysplastic nevus syndrome with at least 300 nevi and about 100 clinically highly atypical nevi. Three melanomas had been excised by a private dermatologist within the past year. We then removed two additional melanomas. Between 2002 and 2003, 117 nevi which were atypical on dermatoscopy were removed; most by horizontal (shave) excision. Adequate clinical and dermatoscopic control was not feasible due to the large number of atypical nevi. In order to reduce the number of nevus cells, we treated test sites with both dermabrasion and split-thickness excision. The latter proved to be more efficient and was used to completely excise the skin of the back, as well as parts of the arms and chest in two sessions under general anesthesia. Wound healing was uneventful. Following these procedures, adequate clinical and dermatoscopic monitoring of the remaining nevi was possible and only a few had to be removed. No more melanomas appeared in the treated areas.