Skin Pharmacology and Physiology最新文献

Introduction: Identifying subgroups of patients with primary hyperhidrosis (PHH) can improve the understanding of the disease pathophysiology. The study objective was to determine the naturally occurring subgroups of patients with PHH based on clinical characteristics.

Methods: In this retrospective cohort study, data were collected from participants included in a clinical trial. The data were collected between January 2020 and June 2021 from outpatients with PHH attending a dermatologic department in Denmark. Overall, 84 patients with PHH were screened for inclusion in the clinical trial. Of these, 41 met the eligibility criteria. Four participants were excluded because of missing data. The main outcome was the identification of subgroups of patients with PHH using an unsupervised hierarchical cluster analysis.

Results: Overall, 37 patients were included {28 (76.7%) females; median age at inclusion 28.0 (interquartile range [IQR] 24.0-38.3); median body mass index 24.9 (IQR 20.9-27.4); median age of onset 13.0 (IQR 9.5-18.5); and 26 (70.3%) had a familial disposition toward PHH}. Two clusters of 18 and 17 patients were identified. The first cluster had, when compared to the second, a younger age of onset (median age 11.0 [IQR 0-13.0] vs. 17.0 [IQR 15.0-21.0], p = 0.003) and higher sweat rates on gravimetry (median 175.0 [IQR 121.2-252.5] vs. 40.0 [IQR 20.0-60.0] milligrams of sweat/5 min, p < 0.001) and transepidermal water loss (median 93.7 [IQR 91.2-97.8] vs. 59.0 [IQR 44.4-73.2] g/m2/h, p < 0.001). No differences were observed for the other variables.

Conclusions: This study identifies 2 subgroups of patients with PHH. The patients with an onset of PHH during childhood had a substantially higher sweat and evaporation rate in adulthood than those with an onset during adolescence. These findings may imply a changed understanding of the pathophysiology of PHH, by indicating that an early disease onset can lead to a worse disease course.

Introduction: Disinfectants play a critical role in reducing healthcare-associated infections by eliminating microorganisms on surfaces. However, prolonged use of disinfectants may adversely affect the skin microflora, essential for skin health and infection prevention. This study investigates the impact of disinfection on the skin microbiota and metabolites of medical personnel in operating rooms, aiming to provide a scientific foundation for safeguarding their skin health.

Methods: We conducted 16S sequencing and metabolomic analysis to assess the effects of disinfection on the skin microbiota and metabolites of medical personnel. Samples were collected from operating room personnel after disinfectant exposure to identify changes in microbial communities and metabolite profiles.

Results: Our analysis revealed that prolonged use of disinfectants led to alterations in skin microbial communities and microbial metabolites. These alterations included the production of harmful metabolites that could potentially promote skin infections and other health issues among medical personnel.

Conclusion: The findings underscore the importance of minimizing disruptions to skin microbiota and metabolites caused by long-term disinfectant use to preserve the overall health of medical personnel. This study provides valuable insights into the relationship between disinfectant use, skin microbiota, and metabolites, highlighting the necessity for further research in this area.

Introduction: Three interrelated skin water assessments include stratum corneum hydration (SCH) via electrical measurements, skin water using tissue dielectric constant (TDC) measurements, and transepidermal water loss (TEWL). These are differentially used for skin physiology research, clinical assessments of dermatological conditions and to assess skin water in diabetes and lymphedema. Often volar forearm skin is used for assessments done at various times of day (TOD). The present goal was to assess the extent of intraday variability in SCH, TDC, and TEWL.

Methods: Twelve medical students self-measured SCH, TDC, and TEWL on their forearm every 2 h from 08:00 to 24:00 h on 2 consecutive days. All participants were well trained and pre-certified in all procedures. Tests for parameter differences among TOD were via the nonparametric Friedman test.

Results: No significant differences in SCH or TEWL were found among TOD over the 16-h interval for either day or combined. Contrastingly, TDC decreased slightly but significantly from morning through evening. There was no evidence of a diurnal pattern. Interestingly, a significant nonlinear relationship between TEWL and SCH was detected.

Conclusion: Findings indicate only minor intraday variations with TOD trend except for TDC which decreases slightly from morning through evening. The clinical relevance relates to the confidence now gained associated with the parameter estimates when measured at different TOD during normal clinic hours or beyond. This should help in estimating the potential importance of small differences if measured at a different TOD. From a physiological viewpoint, the findings uncover and describe an interesting nonlinear relationship between TEWL and SCH which may serve to propel further investigations that might better characterize this process.

Introduction: Non-invasive measurement of the stratum corneum hydration (SCH) with capacitance-based instrumentation is established in dermatological and cosmetic studies. We wanted to test the reliability of non-invasive self-measurements for SCH performed under real-life conditions by volunteers with a Bluetooth-based (wireless) probe Corneometer® (CM 825i) transmitting the data via a smartphone application to a central server. Probes and smartphones communicated using Bluetooth Low Energy. Data from the smartphone were securely transferred to a remote server in a different country with TLS encryption using HTTPS protocols. CM 825i values were correlated with the established CM 825 under laboratory conditions. The primary endpoint was the correlation of the two probes. Secondary endpoints were the coefficient of variation (CV) and delta values (before and after treatment).

Methods: Eighteen healthy volunteers (f: 8; m: 10) participated in the prospective observational study. The real-world home use of the wireless CM 825i was performed before and after treatments with base cream DAC for 7 days.

Results: Both instruments showed a significant and relevant correlation (p < 0.0001; Spearman coefficient of r = 0.8647). CM 825i and CM 825 differentiate significantly between normal and high SCH. Both devices showed comparable robustness in repeated measurements with a CV between 5.6% and 9.2%.

Conclusion: We could show a significant correlation between both devices and a comparable differentiation between low and high SCH and comparable CVs. The real-life use demonstrated adequate acquiring and transmitting of in vivo data to a smartphone and subsequently transmitting to the secure server with low numbers of missed transmissions (<0.2%) and missed measurements (<5%).

Introduction: Dermatofluoroscopy is an optical noninvasive method of melanoma/nevus differentiation that has shown 89% sensitivity and 45% specificity in clinical trials, but long measurement duration hinders clinical use. An intelligent algorithm was developed to shorten the measurement time without compromising its diagnostic accuracy. It uses dermoscopic images of the skin lesions to be measured to select measurement points based on the assessment of color values.

Methods: 27 patients with a total of 29 lesions suggestive of cutaneous melanoma were included in a clinical study and measured with both methods, conventional dermatofluoroscopy and the newly developed intelligent algorithm. The results were compared to the independent findings of two histopathologists to evaluate diagnostic accuracy and time saved.

Results: There was a median reduction of measurement points from 265 to 158 (40%). Meanwhile, the intelligent algorithm showed a higher diagnostic accuracy than conventional dermatofluoroscopy (area under the curve of 72% vs. 63%).

Conclusion: The intelligent algorithm did not perform inferior to the conventional method while saving 40% of time. However, measurement times remain long compared to other noninvasive methods of diagnosing malignant melanoma. Further studies are needed to evaluate clinical suitability.

Introduction: Dermatofluoroscopy is an optical noninvasive method of melanoma/nevus differentiation that has shown 89% sensitivity and 45% specificity in clinical trials, but long measurement duration hinders clinical use. An intelligent algorithm was developed to shorten the measurement time without compromising its diagnostic accuracy. It uses dermoscopic images of the skin lesions to be measured to select measurement points based on the assessment of color values.

Methods: 27 patients with a total of 29 lesions suggestive of cutaneous melanoma were included in a clinical study and measured with both methods, conventional dermatofluoroscopy and the newly developed intelligent algorithm. The results were compared to the independent findings of two histopathologists to evaluate diagnostic accuracy and time saved.

Results: There was a median reduction of measurement points from 265 to 158 (40%). Meanwhile, the intelligent algorithm showed a higher diagnostic accuracy than conventional dermatofluoroscopy (area under the curve of 72% vs. 63%).

Conclusion: The intelligent algorithm did not perform inferior to the conventional method while saving 40% of time. However, measurement times remain long compared to other noninvasive methods of diagnosing malignant melanoma. Further studies are needed to evaluate clinical suitability.