Cutaneous Sensation Research Articles

Structural mechanism of TRPV3 channel inhibition by the plant-derived coumarin osthole.

TRPV3, a representative of the vanilloid subfamily of TRP channels, is predominantly expressed in skin keratinocytes and has been implicated in cutaneous sensation and associated with numerous skin pathologies and cancers. TRPV3 is inhibited by the natural coumarin derivative osthole, an active ingredient of Cnidium monnieri, which has been used in traditional Chinese medicine for the treatment of a variety of human diseases. However, the structural basis of channel inhibition by osthole has remained elusive. Here we present cryo-EM structures of TRPV3 in complex with osthole, revealing two types of osthole binding sites in the transmembrane region of TRPV3 that coincide with the binding sites of agonist 2-APB. Osthole binding converts the channel pore into a previously unidentified conformation with a widely open selectivity filter and closed intracellular gate. Our structures provide insight into competitive inhibition of TRPV3 by osthole and can serve as a template for the design of osthole chemistry-inspired drugs targeting TRPV3-associated diseases.

Erythropoietic protoporphyria: time to prodrome, the warning signal to exit sun exposure without pain—a patient-reported outcome efficacy measure

PurposePatients with erythropoietic protoporphyria (EPP), a severe painful photodermatosis, experience prodromal sensations when exposed to sunlight, which are the “warning signals” to exit the sun, as prolonged exposure causes an excruciatingly painful phototoxic attack. The unique prodromal cutaneous sensations are reversible and differ from the severe burning pain attack lasting 2–7 days. Previously, afamelanotide treatment was studied using time to pain or time outside as primary outcome measures. Since patients have an ingrained fear of sunlight, these measures did not capture the full treatment effect. We retrospectively characterized and evaluated time to prodrome (TTP) as a safer, patient-reported outcome (PRO) measure in afamelanotide-treated patients. MethodsStructured interviews recorded TTP before and during afamelanotide treatment in retrospective US and Dutch cohort studies. ResultsThirty-one US and 58 Dutch EPP patients participated. Before afamelanotide treatment, 54.8% US and 39.7% Dutch patients reported TTP onset <10 minutes in direct sunlight. In both studies, patients’ TTP’s were significantly longer during afamelanotide treatment (p < 0.0001). All US patients’ TTP increased; no TTP was <10 minutes. Among Dutch patients 81% improved; only 10.3% reported TTPs < 10 minutes. ConclusionEPP patients reported substantial improvements in TTP during afamelanotide treatment. TTP could provide a safer, PRO-based efficacy endpoint for assessing future EPP treatments.

Electronic Skin With Embedded Carbon Nanotubes Proximity Sensors

We present an electronic skin with proximity sensing capabilities. Through a simple and cheap fabrication process, we integrate carbon nanotube forests, which serve as the sensing element, into soft, flexible, and transparent artificial skin. Numerical simulations demonstrate the operational principle of the electronic skin proximity sensors. Experimental characterization reveals excellent repeatability and performance of the electronic skin proximity sensors, which are unaffected by the applied strain. Mounting the electronic skin on experimenter's finger further demonstrates its high performance, variability, and potential to interface with humans. Thus, the cheap and simple fabrication process of this electronic skin, together with its straightforward operation, high reliability, and excellent performance under large deformations and different working conditions, set the stage for the development of a new generation of high-end flexible sensory electronic skin, which is attractive in a wide range of engineering fields, such as autonomous soft robotics, biomedicine, and the Internet of Things.

Interest in Micellar Solution to Reduce Unpleasant Skin Sensations.

IntroductionThe results from the “Objectifs Peau” project showed that approximately 30% of the French population complains of an unpleasant skin sensation at least once a day. Itching was the most frequent complaint (32%), followed by tingling (18.9%) and burning sensation (5.6%), which impact an individual’s daily life. These sensations could be identified, as they were either isolated or associated with each other. The aim of this study was to evaluate the use of micellar solution to reduce these sensations, especially on sensitive skin.MethodologyA questionnaire was administered at Day 0 (D0), D2, D14, and D28 using a mobile phone application to individuals applying micellar solution (Sensibio H2O, Laboratoire Bioderma, NAOS) who spontaneously used micellar solution for sensitive skin and/or spontaneously consulted a health professional. Itching, tightness, tingling and burning sensations were evaluated by means of frequencies (never, rarely, sometimes, often or constantly) at D0, D2, D14 and D28. Responses from the questionnaire were rated (never=0, rarely=1, sometimes=2, often=3 or constantly=4) and allowed us to obtain an overall “unpleasant sensations” score, where a higher score corresponded to a higher degree of unpleasant sensations.ResultsIn total, 400 evaluable individuals participated in the study (97% female, average age 38.5±13 years, 82% reported sensitive skin). The “unpleasant sensations” score improved from D2 and continued significantly on D14 and D28. The improvement rates were 47.7%, 57.9% and 62.7% at D2, D14 and D28, respectively, compared to D0. The percentages of improvement at D2, D14 and D28 were 83.2% (95% CI: 79.26; 87.21), 87.54% (95% CI: 84.01; 91.06) and 90% (95% CI: 87.06; 92.94), respectively, compared to D0.ConclusionThe improvement in the reduction of unpleasant sensations was observed as early as 2 days after using micellar solution and increased over time. The use of this type of micellar solution, especially on sensitive skin, and the guidance of health professionals (dermatologists and pharmacists) may help to reduce the impact of unpleasant skin sensations.

Effects of low-intensity exercise on local skin and whole-body thermal sensation in hypothermic young males

Thermal sensation, a key component of behavioral thermoregulation, is modulated by the changes in both skin and core temperatures. Although cutaneous thermal sensation to local cold is blunted during exercise as compared to rest in normothermic humans, it remains to be determined whether this holds true during core cooling. Furthermore, when local skin thermal sensation is diminished during exercise, it remains unclear whether whole-body thermal sensation is also attenuated. We therefore tested whether low-intensity exercise (VO2: ~1300 ml min−1) attenuates local skin and/or whole-body thermal sensation in hypothermic young males. Eleven healthy young males (24 ± 2 years) were cooled through cold water immersion (18 °C) up to their lower abdomen while resting (rest trial) and during low-intensity cycling (30–60 W, 30 rpm) (exercise trial). Body temperature, cardiorespiratory variables, and whole-body (9-point scale: 0, unbearably cold; 4, neutral; 8, unbearably hot) and local skin thermal sensation were measured at baseline on land and before the esophageal temperature (Tes) began to decrease (defined as -0.0 Tes) and after 0.5 and 1.0 °C decrements in Tes from baseline during the immersion period. Local skin thermal sensation was measured using a thermostimulator with Peltier element that was attached to the chest. The temperature of the probe was initially equilibrated to the chest skin temperature, then gradually decreased at a constant rate (0.1 °C s -1) until the participants felt coolness. The difference between the initial skin temperature and the local skin temperature that felt cool was assessed as an index of local skin thermal sensation. Throughout the immersions, esophageal and mean skin temperatures did not differ between the rest and exercise trials. Local skin thermal sensation also did not differ between the two trials or at any core temperature level. By contrast, the whole-body thermal sensation score was higher (participants felt less cold) in the exercise than in the rest trial at esophageal temperature of -1.0 °C (1.25 ± 0.46 vs. 0.63 ± 0.35 units, P = 0.035). These results suggest that local skin thermal sensation during low-intensity exercise is not affected by a decrease in core temperature. However, whole-body thermal sensation mediated by a decrease in core temperature (-1.0 °C) is blunted by low-intensity exercise during cold water immersion.

Establishment of a Model for Evaluating Shelf Life of Pseudosciaena crocea in Simulated Logistics and Storage

Cold chain logistics is a common way of fresh-keeping transportation at present, but in the actual transportation and storage process, temperature control is often not accurate, which leads to shortened shelf life. We evaluated the changes in the quality of yellow croaker (Pseudosciaena crocea) at different temperatures during transportation. Specimens of P. crocea were immersed in slurry ice for 20 min and stored at 22, 4, or -1°C for 4 days. During this period, the development of rancidity of P. crocea was measured by sensory (odor, skin, color, and flesh appearance) and biochemical (total number of colonies, total volatile basic nitrogen, and K value) analyses. A combination of sensory and biochemical parameters and the Arrhenius equation were used to predict the shelf life of P. crocea during storage. After verification under different storage temperatures, the relative error between the predicted and the measured values was found to be within 15%. The present work provides theoretical guidance for the quality control of P. crocea during transportation and storage.

Traumatic Spinal Cord Injury at T12 Causing Complete Paraplegia for 12-Years Duration Treated with Autologous Telomerase Positive Stem Cells

A 36-year-old paraplegic female presented to the clinic for bi-monthly pain management below thoracic level, T12. She was absent of cutaneous sensation below level of T12, absent of bladder/rectum function, absent genital function, and could not move around without the use of a wheelchair. She displayed anxiety, depression, and decreased feeling of self-worth. Her intense pain was due to a traumatic spinal cord crush injury from a car accident 12 years previously. To date, no effective pharmacological or regenerative treatment has been developed to treat chronic spinal cord injuries. Advances in stem cell technologies (e.g., embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), neural stem cells (NSCs), NSCs induced from either iPSCs or ESCs, mesenchymal stem cells, medicinal signaling cells, etc.), biomaterials, immune engineering, and nanotechnologies have been applied to regenerative therapies following subacute spinal cord injuries. Although these therapies have proven safe for subacute spinal cord injury in animal models, their efficacy in clinical trials to date has not been demonstrated. The participant was presented with opportunity to join a clinical trial using autologous adult-derived telomerase positive stem cells for amelioration of her neurogenic problems. She agreed to the trial because she wanted to walk. Her first autologous stem cell transplant did not ameliorate any of her symptoms. In retrospect, this was due to the anesthetic having a 100% kill ratio for telomerase positive stem cells. Switching to an anesthetic with a 0% kill ratio allowed the telomerase positive stem cells the potential to restore neurogenic function as previously noted for Parkinson disease, age-related dry macular degeneration, and Alzheimer’s disease. Following two telomerase positive stem cell treatments there was restoration of sensation from below her umbilicus to just proximal to her knee joints and restoration of function of her urinary bladder and rectum. Due to the limited time frame following her treatments (e.g., four months), no sustained voluntary control was seen in the musculature of her lower extremities. Her inability to walk following two telomerase positive stem cell treatments prompted her to drop out of the study. Due to restoration of function to damaged structures of the central and peripheral nervous system after following telomerase positive stem cell transplants in this chronic spinal cord injured patient, suggest that TSCs, PSCs, and MesoSCs might have been involved in this restorative process. Since no adverse events were reported during her study, autologous telomerase positive stem cells appeared to be safe for administration. And with restoration of the neurogenic activities during the limited time frame of treatment, administration of telomerase positive stem cells appears to be efficacious in their activities to restore neurogenic function to the tissues absent of those activities for 12 years duration.

Transdermal Application of Anesthetic Preparations Is Effective in Increasing Mechanical Nociceptive Threshold at Perineural Injection Sites in Horses

Perineural anaesthesia is an essential part of lameness investigation in horses. Painful reactions to injections imply a high risk of accidents for veterinarians. To evaluate the efficacy of two topical anaesthetic creams on desensitization of the skin at two perineural injection sites and to evaluate the effects these formulations may have on pain perception distally to the application sites. Randomized, blind, prospective study. 14 healthy horses were randomly divided in two groups of 7 horses each, one treated with EMLA and one with PLIAGLIS preparations. The mechanical nociceptive threshold (MNT) was recorded via pressure algometer at the baseline and one hour after application (T1) on palmar and palmar digital nerve blocks sites. Skin sensation was also assessed on the distal limb, recording MNT on the coronary band and on both bulbs of the heels. Data were compared with a 3-way ANOVA statistical analyses. No significant difference was encountered in the MNT values between baseline records and records at T1 at the control sites. A significant difference of MNT values was detected between the two time points in the treated limbs. The significant sources of variation in our study were the time and the presence of anaesthetic cream. The type of treatment did not determine any differences. Furthermore, no significant difference of MNT values at sites distal to treatment was recorded between the two time points, both in the treated limb and control limbs. Both formulations are effective to obtain superficial skin desensitization

Ambiently and Mechanically Stable Ionogels for Soft Ionotronics

AbstractStretchable ionic conductors such as hydrogels and ionic‐liquid‐based gels (aka ionogels) have garnered great attention as they enable the development of soft ionotronics. Notably, soft ionotronic devices inevitably operate in humid environments or under mechanical loads. However, many previously reported hydrogels and ionogels, however, are unstable in environments with varying humidity levels owing to hydrophilicity, and their liquid components (i.e., ionic liquid, water) may leak easily from polymer matrices under mechanical loads, causing deterioration of device performance. This work presents novel hydrophobic ionogels with strong ionic liquid retention capability. The ionogels are ambiently and mechanically stable, capable of not absorbing moisture in environments with high relative humidity and almost not losing liquid components during long periods of mechanical loading. Moreover, the ionogels exhibit desirable conductivity (10−4–10−5 S cm−1), large rupturing strain (&gt;2000%), moderate fractocohesive length (0.51–1.03 mm), and wide working temperature range (−60 to 200 °C). An ionic skin is further designed by integrating the concept of sensory artificial skins and triboelectric nanogenerators, which can convert multiple stimuli into various types of signals, including resistance, capacitance, short‐circuit current, and open‐circuit voltage. This work may open new avenues for the development of soft ionotronics with stable performance.

Non-ambulatory measures of lower extremity sensorimotor function are associated with walking function in Multiple Sclerosis

BackgroundDisease progression of multiple sclerosis (MS) is often monitored by ambulatory measures, but how non-ambulatory sensorimotor measures differentially associate to walking measures in MS subtypes is unknown. We determined whether there are characteristic differences between relapsing-remitting MS (RRMS), progressive MS (PMS), and non-MS controls in lower extremity sensorimotor function and clinical walking tasks and the sensorimotor associations with walking function in each group. Methods18 RRMS, 13 PMS and 28 non-MS control participants were evaluated in their plantar cutaneous sensitivity (vibration perception threshold, Volts), proprioception during ankle joint position-matching (|∆°| in dorsiflexion), motor coordination (rapid foot-tap count/10 s), and walking function with three tests: Timed 25-foot walk (T25FW) at preferred and fast speeds (s), and timed-up-and-go (TUG, s). ResultsFoot-tapping (p = 0.039, Mean difference (MD)= 5.65 taps) and plantar cutaneous sensation (p = 0.026, MD= -10.30 V) differed between the MS subtypes. For the RRMS group faster walking was related to better proprioceptive function (preferred T25FW: p = 0.019, Root mean square error (RMSE)=1.94; fast T25FW: p = 0.004, RMSE=1.65; TUG: p = 0.001, RMSE=2.12) and foot-tap performance (preferred T25FW: p = 0.033, RMSE = 2.74; fast T25FW: p = 0.010, RMSE=2.02). These associations were not observed in the PMS group. ConclusionsFoot-tap performance and plantar cutaneous sensitivity but not ankle proprioception differed between MS subtypes. Lower walking performance was associated with lower foot-tapping and plantar cutaneous sensitivity in the RRMS but not the PMS group. This result suggests a change in the relationship of lower extremity sensorimotor function to walking performance in the PMS subtype.

A Clinical Evaluation of Minimally Invasive Ponto Surgery With a Modified Drill System for Inserting Bone-Anchored Hearing Implants.

Objective:To compare 6-months outcomes of the modified minimally invasive Ponto surgery (m-MIPS) to both the linear incision technique with soft tissue preservation (LIT-TP), and original MIPS (o-MIPS) for inserting bone-anchored hearing implants (BAHIs).Study design:Exploratory pilot study with one test group and two historical control groups.Setting:Tertiary referral center.Patients:In the test group, 24 patients (25 implants) were prospectively included. Each control group comprised 25 patients (25 implants) who participated in previously conducted clinical trials.Interventions:The test group received a BAHI using m-MIPS. The two control groups underwent surgery using the LIT-TP and o-MIPS, respectively.Main outcome measures:Implant survival, implant stability, and surgery-related variables were compared between the test and control groups. Soft tissue status, skin sensibility, and subjective numbness were compared between m-MIPS and LIT-TP only.Results:Implant survival was comparable between m-MIPS and LIT-TP, whereas implant stability measurements were slightly lower for m-MIPS. M-MIPS resulted in comparable adverse skin reactions and skin sensibility, significantly reduced surgical time and slightly improved subjective numbness, compared with LIT-TP. Between m-MIPS and o-MIPS, no statistically significant differences in implant survival, implant stability and surgical time were observed.Conclusions:A trend toward lower implant loss rates after m-MIPS was observed, when compared with o-MIPS. M-MIPS seems to be a good alternative to LIT-TP for inserting BAHIs, since most clinical outcomes were either comparable or slightly better for m-MIPS. Upon deciding on which technique to use, larger studies on implant survival should be performed. Furthermore, other aspects such as costs, training aspects and surgical experience should be evaluated.

Self-Powered, Stretchable, and Wearable Ion Gel Mechanoreceptor Sensors.

Mechanoreceptors in human skin are important and efficient cutaneous sensors that are highly sensitive, selective, and adaptive to the environment. Among these, Merkel disk (MD) and cilia are capable of sensing an external mechanical force through a receptor with a sharp pillar-like structure at its end. Then, the signal of the action potential is generated by pumping Na+ ions through ion channels. In this study, a self-powered, stretchable, and wearable gel mechanoreceptor sensor is developed inspired by the structural features of the MD and cilia with sharp tips and the signaling characteristics of mechanoreceptor ion migration. Poly(vinylidene fluoride-co-trifluoroethylene) gel is used to implement a self-powered system, and polyvinylchloride-based elastic gel is utilized to detect sensing signals based on charge transfer and distribution. The surface of all gels is that of a conical structure to achieve high sensor sensitivity and conformal contact with a target surface. In addition, using the developed sensors, various biological signals related to pressure/strain occurring in the human body (e.g., blood pressure (BP), muscle movement, and motion) are acquired. Furthermore, the behavior of arterial BP was investigated during the contraction and relaxation of the muscles.

Body temperature and esthesia in individuals with stroke

Patients with sequelae of stroke commonly report somatosensory losses. It is believed that body temperature may be associated with tactile sensibility and sensorimotor recovery of these patients. Demonstrate the associations among tactile sensibility, cutaneous temperature, subjective temperature perception, and sensorimotor recovery of patients with stroke sequelae. 86 patients with stroke sequelae were included. Patients had standardized regions of interest (ROIs) assessed with infrared thermography (FLIR T650SC) and monofilaments esthesiometry, and global motor recovery was evaluated with Fugl-Meyer Assessment (FMA). The presence of self-reported perception of temperature difference was used to divide the participants into two groups of 43 patients, and correlation tests were applied to establish correlations among variables. There is no clinically relevant association between tactile sensibility and cutaneous temperature of the foot, regardless of the subjective sensation of temperature changes. Sensorimotor recovery evaluated by FMA is associated with the difference of sensibility between both sides of the body (p < 0.001), as well as with the difference of tactile sensibility (p < 0.001). A clinically significant association between the difference of cutaneous temperature and tactile sensibility was not found, regardless of the presence or absence of subjective perception of such temperature difference. However, sensorimotor recovery is correlated with cutaneous temperature differences and tactile sensibility.

Identification of Environmental and Experimental Factors Influencing Human Perception of DC and AC Electric Fields.

As part of the energy transition in Germany, high-voltage direct current (HVDC) lines producing DC electric fields (EF) are in planning. Since the human perception of DC EF was rarely investigated in the past, we aimed to identify environmental and experimental factors influencing the human perception of direct current (DC) EF, alternating current (AC) EF, and the co-exposure of DC EF and AC EF (hybrid EF) under whole-body exposure. Additionally, first estimates of DC EF and AC EF perception thresholdsas well as differences in human perception of DC EF and AC EF concerning the type of sensation experienced and the affected body part were evaluated. A highly sophisticated exposure lab was built to expose participants to various EF strengths and ask for their assessment concerning the presence of an EF. To estimate the individual perception thresholds of 11 participants, the signal detection theory as well as the single-interval-adjustment matrix procedure were applied. Relative humidity could be identified as an environmental factor influencing the perception of AC EF and DC EF in different ways. An appropriate ramp slope and an exposure duration for future studies could be elaborated. Additionally, perception thresholds were lower under hybrid EF exposure than under DC EF or AC EF exposure alone. Cutaneous sensations evoked under DC EF and AC EF exposure were individually different and attributed to various parts of the body. Several environmental and experimental factors influencing the human perception of EF could be identified and provide an essential basis for a large-scale study. © 2021 Bioelectromagnetics Society.

Efficacy and tolerability of a detergent and care component for rosacea patients: A split-face, vehicle-controlled, randomized trial.

The treatment of facial erythema and subjective symptoms of rosacea patients remains challenging in clinical practice. Cosmeceuticals, care components containing active ingredients such as phytochemicals, play a growing role in treatment plans. However, well-designed studies on their efficacy and limitations are widely missing. A foam and a cream for rosacea patients were assessed based on objective and subjective methodology. The tolerability of skin and eyes was evaluated. A randomized, double-blinded, split-face, and vehicle-controlled trial was conducted. At baseline and after four weeks of product use, dermatological and ophthalmological investigations were performed, employing image analysis of facial erythema, clinical assessments, and questionnaires. The patient cohort comprised 33 females with persistent facial erythema due to rosacea. No significant differences were found between the vehicle and the verum. According to the analysis of facial erythema, a "less pronounced" or "much less pronounced" appearance was seen in two thirds of patients comparing V1 to V0. Especially, the dryness of the skin improved by the use of the vehicle and the verum. Adverse subjective skin sensations decreased by 61.3% for the verum side and by 58.6% for the vehicle side. Subjective and objective analysis of ocular manifestation differed, with subjective manifestations reported more frequently, thus highlighting underdiagnosis of ocular rosacea. As no clear differences between the verum and the vehicle were found, an optimal skin care regime itself seems to have a superior effect in the relief of facial erythema and foremost of subjective symptoms, rather than certain active ingredients.

Exercise induced neuropathic lower leg pain due to a tibial bone exostosis

ABSTRACT Objectives: The differential diagnosis of chronic exercise induced lower leg pain in sporters includes compartment syndrome and medial tibial stress syndrome. However, severe discomfort may also be caused by nerve entrapment. Methods: Here we present a marathon runner who reports pain day and night in the lower leg. Deep palpation suggested the presence of a bony tumor deep in the calf musculature, and digital pressure on the soleal sling was painful and elicited paresthesias in the foot. A swab test indicated a hypo-esthetic sole of the foot. Imaging revealed the presence of a tibial exostosis that was hypothesized to narrow the soleal tunnel and irritate the tibial nerve. Results: Via a medial infragenual approach, the soleal tunnel was opened. A bony prominence was found in direct contact to the tibial nerve. Resection of the exostosis with tibial nerve neurolysis completely abolished all of his symptoms. Conclusion: An awkward lower leg discomfort that is present at night and worsens during exercise combined with altered foot sole skin sensation in the presence of a tibial bone exostosis may suggest tibial nerve neuropathy. If conservative therapies fail, resection and neurolysis is advised.

Clinical Outcomes and Patient Satisfaction After Corneal Neurotization.

The aim of this study was to assess clinical outcomes of corneal neurotization (CN) and determine patient perception of postoperative results. This was a retrospective study involving 29 eyes in 28 patients who underwent CN. Chart review data included demographic and clinical history; ophthalmic examination including visual acuity, ocular surface quality, and corneal sensation; surgical technique; and postoperative course. Subjective self-reported patient outcomes of surgical success were also assessed. Only eyes with at least 6 months of follow-up were included in the statistical analysis. A total of 24 eyes and 23 patients were included in statistical analyses. The median postoperative follow-up time was 12.2 months (interquartile range 10.9-18.5 mo). Twenty-three eyes (92%) achieved improvement in ocular surface quality. Eleven of 13 (85%) demonstrated healing of persistent epithelial defects at their last follow-up. Patients gained a median of 2.3 cm in Cochet-Bonnet esthesiometry measurements of sensation. No significant difference was found between preoperative and postoperative visual acuity. All 17 patients who provided self-assessment of their surgical outcome indicated they would undergo CN again if given the choice. Most of the patients reported that the postoperative pain was tolerable, with a median pain score of 3.0 on a 10-point scale (interquartile range 0.0-4.0). Sixteen patients (94%) reported full or partial return of skin sensation along the donor nerve distribution. CN provides improvement in corneal health and sensibility, with high patient satisfaction and minimal postoperative pain and morbidity.

89% Vichy mineralizing water with hyaluronic acid is a well-tolerated adjunct treatment that helps restore skin barrier function in dry skin-related inflammatory dermatoses and post-procedure skin care: A Canadian study.

Minéral 89 (M89), comprised of 89% Vichy mineralizing water and hyaluronic acid, has been formulated to help strengthen and restore skin barrier. Assess tolerance and efficacy of M89 in post-esthetic procedures and dry skin-related facial dermatoses. Adults post-esthetic procedure or presenting with inflammatory dermatoses (47 subjects; mean age 40.9±13.2years; any Fitzpatrick or skin phototype), applied M89 for 4weeks, once or twice daily, as an adjuvant treatment. Information on clinical signs and subject-reported symptoms, skin characteristics, tolerance, and subject and investigator satisfaction were collected. Following 4weeks of M89 use, significant decreases with complete resolution of erythema (27.6%), desquamation (29.8%), irritation (32%), and skin dehydration (35.8%), as compared to baseline signs and symptoms, were observed. Overall grading improvements for erythema (84.8%; p<0.001), desquamation (91.7%; %; p<0.003), irritation (91.7%; %; p<0.015), and skin hydration (46.2%; p<0.015) were noted. There was no significant improvement in papules and pustules. Evaluation of subjective signs demonstrated significant decreases in skin sensations such as burning (-73%; p<0.0001), itching (-71%; p<0.0001), stinging-tingling (-66.7%; p<0.0001), as well as in skin dryness (-60%; p<0.0001). M89 texture was rated very pleasant by 90% of patients. Investigators assessed M89 tolerance to be either good or very good (93%), and satisfactory or highly satisfactory impact on patient's skin (91.5%). M89 is a highly tolerable adjuvant treatment that significantly improved clinical signs and symptoms related to a compromised skin barrier in various facial dermatoses and post-aesthetic procedures.

Тромбоз кавернозного синуса, ассоциированный с COVID-19

This paper describes a case of cavernous sinus thrombosis The condition developed in a patient who had been treated for confirmed COVID-19 Left eye examination findings were as follows: amaurosis;absence of periorbital skin sensation;signs of orbital cellulitis;ptosis;chemosis;total ophthalmoplegia;exophthalmos;decreased corneal sensation;widened pupil;and absence of pupil light reflex In addition, ophthalmoscopy showed diffused retinal and optic disc edema The patient had an atypical clinical course which could not be clearly identified as septic or aseptic, and his elevated D-dimer level could indicate a potential relationship between this condition and COVID-19 © Oripov O I , Bilalov E N , 2021

Cutaneous sensation of electrical stimulation waveforms

BackgroundSkin sensation is the primary factor limiting the intensity of transcranial electrical stimulation (tES). It is well established that different waveforms generate different sensations, yet transcranial stimulation has been limited to a relatively small number of prototypical waveforms. ObjectiveWe explore whether alternative stimulation waveforms could substantially reduce skin sensation and thus allow for stronger intensities in tES. MethodsWe systematically tested a range of waveforms in a series of 6 exploratory experiments stimulating human adults on the forearm and in one instance on the head. Subjects were asked to rate skin sensation level on a numerical scale from “none” to “extreme”. ResultsHigh frequency (>1 kHz) monophasic square wave stimulation was found to decrease in sensation with increasing duty cycle, baseline, and frequency, but the sensation was never lower than for constant current stimulation. For the purpose of injecting a net direct current (DC), a constant current is optimal. For stimulation with alternating current (AC), sensation decreased with increasing frequency, consistent with previous reports. Amplitude modulation did not reduce sensation below stimulation with constant AC amplitude, and biphasic square waveforms produced higher sensation levels than biphasic sinusoidal waveforms. Furthermore, for DC stimulation, sensation levels on the arm were similar to those reported on the head. ConclusionOur comparisons of various waveforms for monophasic and biphasic stimulation indicate that conventional DC and AC waveforms may provide the lowest skin sensations levels for transcutaneous electrical stimulation. These results are likely generalizable to tES applications.