Dermal Thickness Research Articles

Multimodal management of more than 50% mixed deep dermal and full thickness burns in a child

IntroductionEarly tangential excision and wound coverage by autologous skin grafting is the mainstay of treatment for deep dermal and full-thickness burns. They are challenging in children with major burns involving more than 50% of the body surface area.AimThis article highlights a young boy who suffered from 52% mixed deep dermal and full-thickness burns after alleged thermal burns and we discuss his treatment strategies.Case studyA 10-year-old boy suffered 52% mixed deep dermal and full-thickness burns after alleged thermal burns. After initial resuscitation, pain relief and fluid replacement, he underwent an emergent escharotomy of bilateral lower limbs followed by a series of surgeries. His treatment was complicated by many hurdles such as graft failure, difficult intravenous access, nutritional support and local wound infection which were tackled aptly with a multidisciplinary approach.Results and discussionA sequential excision of eschar tissue and advocation of multiple modalities of burn wound coverage, including glycerol-preserved cadaveric allograft (GPCA) and MEEK micrografting. GPCA decreases the bacterial load and helps to re-establish the skin barrier, normalise the physiological state and promote capillary ingrowth into the wound. MEEK micrografting allows better re-epithelization and has a shorter operation time.ConclusionsVarious modalities can be used to achieve skin coverage such as GPCA and MEEK micrografting. Extensive burns need to be managed in a tertiary centre with a combination of skin coverage techniques such as GPCA and MEEK micrografting in order to overcome the unavailability of normal skin for conventional skin grafting.

Acellular Dermal Matrix Thickness and Outcomes in Prepectoral Implant-Based Breast Reconstruction

Acellular Dermal Matrix Thickness and Outcomes in Prepectoral Implant-Based Breast Reconstruction

Improved Quality of Healed Wounds with Topical Application of Eurycoma Longifolia Jack Root Extract Hydrogel

INTRODUCTION: Collagen is the key component of the extracellular matrix that plays a critical role in the strength and quality of the healed wound. Eurycoma longifolia Jack root extract (TA) has been documented as an anti-inflammatory, antioxidant, and antimicrobial agent that may improve the quality of healed wounds. The objective of this study is to investigate the effect of topical application of TA hydrogel on the quality of the healed skin in rats. MATERIALS AND METHODS: Twenty male Sprague Dawley rats were grouped into 4 groups: Negative control, Hydrocyn® aqua gel positive control, vehicle (Xanthan) hydrogel, and Eurycoma longifolia Jack (TA) hydrogel. Treatments were applied twice daily starting on wounding day until day 21. An excisional wound was created on the back of 20 rats. Tissue samples of the healed skin were collected for histological examination by measuring the epidermal and dermal thicknesses and evaluating the collagen fibre quality by VVG stain. RESULTS: The TA hydrogel group had the thickest newly formed epidermis compared with the other experimental groups. For the dermal thickness, compared with the vehicle (xanthan) hydrogel group, TA hydrogel, and Hydrocyn aqua® gel positive control groups showed significantly increased thickness with p values 0.020 and 0.045, respectively. Histologically TA hydrogel group showed a significant increase in mixed-oriented collagen fibres, and fascicular collagen bundles and showed profound collagen density. CONCLUSION: TA hydrogel improved the quality of healed skin by increasing the epidermal/dermal thicknesses and enhancing the quality of newly produced collagen fibres. It can be considered a promising and effective wound-healing agent.

Evaluation ofTopical Off-the-Shelf Therapies to Reduce the Need to Evacuate Battlefield-Injured Warfighters.

Immediate evacuation of burn casualties can be challenging in austere environments, and it is predicted to be even more difficult in future multi-domain battlespaces against near-peer foes. Therefore, a need exists to treat burn wounds at the point of injury to protect the exposed injury for an extended period. In this study, we compare two commercially available FDA-approved therapies to the current gold standard of care (GSOC), excisional debridement followed by the application of split-thickness skin graft, and the standard for prolonged field care, silver sulfadiazine (SSD) cream. The shelf-stable therapies evaluated were irradiated human skin (IHS) allograft and polylactic acid (PLA). Our objective was to study whether they have the potential capability to reduce the need for evacuation to a burn center for surgical intervention so that the combat power can be preserved in the field. Sixteen burns (50 cm2) were created on the dorsum of four anesthetized swine. All materials were sterile, but a sterile field was not utilized in order to simulate the prolonged field care setting. The wounds were then treated with PLA, IHS, and SSD cream, and the remaining wounds (designated GSOC) were also treated with SSD cream. On post-operative day (POD) 3, sterile surgical debridement and skin grafting (1:4) were performed on the GSOC wounds. Burn healing was followed for either PODs 10, 14, 21, or 28, wherein one animal was humanely euthanized at each time point; each represented a time point of the healing process. A full-thickness excisional biopsy was taken from each wound immediately after euthanasia to give a cross-section view of the wound edge to edge. Wound healing was determined by the histological analysis of wound re-epithelialization, epidermal thickness, rete ridges, and scar elevation index and macroscopically using noninvasive imaging systems. The PLA and IHS treatments did not need to be reapplied to the wounds during the course of the experiment, unlike SSD, which was reapplied at each assessment time point. In terms of re-epithelialization, on POD 10, IHS and SSD were similar to the GSOC; on POD 14, all treatments were similar; on POD 21, PLA and IHS were similar to SSD; finally, on POD 28, re-epithelialization was similar in all groups. On POD 28, scar elevation index and rete ridges/mm were similar to all groups, and epidermal and dermal thickness for PLA and IHS were similar to GSOC. This preclinical study demonstrated that the use of the PLA and the IHS dressings resulted in similar outcomes to the GSOC-treated burns in several key metrics of wound healing. These therapies represent a potentially useful tool in current and future battlespaces, where surgical intervention is not possible. The products are lightweight and, more importantly, stable at room temperature for their entire shelf lives. This would allow for easy storage and transport by medical practitioners in the field.

Adverse Events Relating to Radiation Therapy in Patients with Collagen Vascular Disorders

To evaluate treatment related toxicity in patients with collagen vascular disorder (CVD) undergoing contemporary radiotherapy. This is a retrospective cohort study of patients with CVD undergoing radiation therapy from 2005 to 2022 at a single institution. CVD evaluated included lupus, scleroderma, rheumatoid arthritis, and Sjogren's syndrome or other nonspecific CVD. Patient characteristics, diagnostic and treatment information were extracted from various institutional EMR systems. This study was designated the status of EXEMPT by the institutional IRB. A total of 40 patients undergoing 44 treatment courses with a minimum follow up of 3 months are included in this study. Among the 40 patients identified, 8 were male and 32 were female, with a median age of 62 (range, 17 to 88). Out of the 40 patients in our study, 30 were diagnosed with lupus, 6 with scleroderma, and 4 with other CVDs. In regard to treatments, 38 were performed for malignant conditions and 6 for benign conditions. Treatment locations included 10 to the head and neck region, 16 to the thorax, 6 to the pelvis, and 11 to the skin, soft tissue, or other locations. Treatment modalities were protons for 6 treatments, photons for 33 treatments, and electrons for 5 treatments. Ten patients also received chemotherapy concurrently. Median follow up time was 33.2 months. Table 1 illustrates the extent of skin and subcutaneous reaction by treatment region and radiation doses. One patient, who had Grade 3 radiation dermatitis, underwent a short break in RT due to severity of symptoms. Three patients experienced severe, painful lupus flares during the course of RT, but were managed by medication; however, one was hospitalized due to severe pain and blistering of the skin. Two patients experienced radiation related dermal thickening and fibrosis of the treatment area skin. Contemporary radiation techniques may allow for the treatment of patients with significant collagen vascular disorders. In general, the treatments are well tolerated with the most common side effects relating to skin and subcutaneous tissue or flare up in generalized symptoms. However, the time to resolution of these symptoms may be longer and requires diligent care. Caution should be used in treating patients with CVD.

Allometric scaling of skin weight and thickness to body weight in relation to taxonomic orders and habitats in mammals.

Skin is the largest organ in a mammal body, and it exhibits most significant range of adaptations to different habitats. It is a complex, biological composite structure, consisting of epidermis, dermis and subcutaneous tissues and is used for the therapeutic application of medical devices to improve healthcare. Extensive studies have been performed on the roles of the skin; however, little is known on its physiological characteristics in relation to body size among different species. The purpose of this study was therefore to evaluate the allometric scaling of skin weight (SW) and thickness (ST) to body weight (BW) in relation to genetics and habitats. Also analysed the relationship of BW to thicknesses of epidermis, dermis and subcutaneous tissues. This study used 249 adult animals of both sexes, belonging to 144 species, clustered in 18 taxonomic orders and five types of habitats. The animals were obtained from various sources in Japan. SW and BW were weighed, and ST was measured using a calliper followed by data analysis. Results showed that SW and ST were related to BW [log SW = 0.969 × logBW - 0636, adjust. R2 : 0.975]. The BW increased with increasing skin dermal thickness (y = 0.3916x + 1.5253, adjust. R2 : 0.6921), slightly with epidermal thickness (y = 0.2495x + 0.3984, adjust. R2 : 0.3402), but not all with the thickness of subcutaneous tissues (y = 0.1454x + 2.2437, adjust. R2 : 0.0752). The ratio of SW to BW (SW/BW) distributed over a large range from 0.06 to 0.64 values and varied among animal taxonomic orders and their dwelling habitats. Close relationship of BW to SW/BW was observed in species weighing ≥200 g but not in species weighing <200 g. In conclusion, SW and ST in mammals are determined by BW. The SW/BW varies based on BW, taxonomic orders and habitat and is large in small mammals weighing ≥200 g to provide a mechanism used for survival strategy.

Effects of 2,4-dichlorophenoxyacetic acid, α-naphthylacetic acid on the variant formation of Valentine Hoya (Hoya kerrii)

Valentine Hoya (Hoya kerrii) is favoured by many people for its richness in leaf shape, colour and flower fragrance. To increase the diversity and abundance of Hoya, leaf samples were transplanted into MS medium supplemented with 2,4-D and α-naphthylacetic acid (NAA) (concentration 4-7 mg/l) to create callus and induce mutations. Calli formation rate was observed at 100% after 15 days of culture in all treatments supplemented with growth regulators, while the control treatment showed no callus formation. The results of rapid callus multiplication showed that the callus-forming leaf sample obtained from the treatment of 5 mg/l 2,4-D gave the largest callus size (2.98 cm). The 45-day-old calli were transferred to MS + 1 mg/l IBA + 3.5 mg/l BAP regeneration medium, the time of shoot appearance for callus samples treated with NAA was 95 days after subculture with the highest regeneration rate of 66.67%, earlier than 2,4-D treated calli (225 days, 50% regeneration rate). The results of genetic divergence analysis using RAPD markers recorded a total of 330 DNA bands with molecular sizes ranging from 170 to 2700 bp. The polymorphism information content index was calculated in the 0.23-0.40 range. Samples treated with 5 mg/l NAA had the lowest similarity coefficient of 0.455, growth parameters such as petiole diameter, dermal tissue thickness, vascular bundle area, and a number of wood bundles recorded in samples treated with 5 mg/l NAA were superior to those of the control.Keywords:α-naphthylacetic acid, Hoya kerrii, polymorphisminformation content, variation, 2,4-D.Classification number:4.6

Intravenous immunoglobulins improve skin fibrosis in experimental models of systemic sclerosis

Systemic sclerosis (SSc) is the most severe systemic autoimmune disease with currently no cure. Intravenous immunoglobulins (IVIg) are an attractive candidate in this disease to counteract inflammation and fibrosis but data are scarce and conflicting. This study, assessed the effects of IVIg in a murine HOCl-induced model of SSc. We showed that IVIg prevented skin inflammation and fibrosis, by mitigating the immune cell infiltration (p = 0.04), proinflammatory cytokines gene overexpression (IL1β, p = 0.04; TNFα, p = 0.04; IL6, p = 0.05), skin and dermal thickening (p = 0.003 at d21 and p = 0.0003 at d42), the expression markers of fibrosis, such as αSMA (p = 0.031 for mRNA and p = 0.05 for protein), collagen (p = 0.05 for mRNA and p = 0.04 for protein, p = 0.05 for the hydroxyproline content) and fibronectin (p = 0.033 for mRNA). Moreover, IVIg prevented HOCl-induced alterations in splenic cell homeostasis. When administered in curative mode, despite their ability to reduce skin and dermal thickness (p < 0.0001 and p = 0.0002), IVIg showed partial or more mixed effects on skin inflammation and established fibrosis. These data favor further clinical trials in SSc patients on the potential efficiency of early and/or repeated IVIg administration.

Exosomes from human adipose–derived mesenchymal stem cells attenuate localized scleroderma fibrosis by the let-7a-5p/TGF-βR1/Smad axis

BackgroundInflammation and fibrosis of the skin are characteristics of localized scleroderma (LS). Emerging evidence has demonstrated that exosomes from human adipose tissue–derived mesenchymal stem cells (ADSC-Exo) could alleviate skin fibrosis. ObjectiveThe impact and potential mechanism of ADSC-Exo on LS fibrosis was examined. MethodsADSC-Exo was isolated and identified. The effects of ADSC-Exo on the abilities of proliferation and migration of LS-derived fibroblasts (LSFs) were assessed by CCK-8 and scratch assays, respectively. qRT-PCR, western blot, and immunofluorescence were conducted to detect LSFs stimulated with ADSC-Exo, ADSC-ExoAnti-let−7a−5p, let-7a-5p mimic/TGF-βR1 shRNA virus, and negative controls. The impact of ADSC-Exo on C57BL/6j LS mice was evaluated by photographic morphology, hematoxylin-eosin (H&E), Masson's trichrome, and immunohistochemical staining. ResultsThe verified ADSC-Exo limited the proliferation and migration of LSFs and reduced the expression of COL1, COL3, α-SMA, TGF-βR1, and p-Smad2/ 3 in vitro and in vivo. TGF-βR1 knockdown and let-7a-5p mimic in LSFs reduced the expression of COL1, COL3, α-SMA, and p-Smad2/3. However, compared with the ADSC-ExoNC group, the dermal thickness was increased, collagen arrangement was disordered, and α-SMA and TGF-βR1 levels were increased after exposure to ADSC-ExoAnti-let−7a−5p. ConclusionsIn this study, it might show that ADSC-Exo may successfully prevent LSF bioactivity, collagen deposition, and myofibroblast trans-differentiation. Additionally, we confirmed that let-7a-5p in ADSC-Exo could directly target TGF-R1 to control the Smad pathway and reduce fibrosis in LSFs. Our work offered a brand-new therapeutic approach and clarified the unique mechanism for the clinical management of LS.

Core mechanism and therapeutic methods of aging revealed by qi-collateral theory in traditional Chinese medicine

Abstract Aging, a complex and multisystem process, has increasingly become a hot issue of global concern. Traditional Chinese medicine has accumulated rich understanding of aging during thousands of years of development, which provides valuable references for the in-depth study of overall aging. According to the qi-collateral theory in traditional Chinese medicine, essence is the origin of life; qi is the driving force of life; and spirit is the embodiment of life. This theory interprets key scientific issues such as the formation of life, the driving force of life, the function of zang-fu organs, and the spirit and consciousness. Furthermore, it reveals the key mechanism of aging. That is, the deficiency of kidney essence is the root of aging; the loss of vitality is the key of aging; and the depletion of body and spirit is the manifestation of aging. Based on the experience of medical practitioners in the past dynasties, such as nourishing essence, black food tonifying the kidney, and supplementing essence with flesh-blood products, the treatment method of invigorating kidney and supplementing essence, harmonizing yin and yang, reinforcing the vitality, and nourishing the body and spirit was proposed. Furthermore, an innovative Chinese patent medicine, Bazi Bushen capsules, is developed, which exerts the antiaging effect by replenishing qi, invigorating the spirit, and nourishing the body and spirit. Pharmacological and clinical studies have confirmed that this preparation has antiaging effects and are effective in the prevention and treatment of age-related diseases. Experimental studies have shown that Bazi Bushen capsules can delay the overall aging, reduce the DNA methylation and extend the healthy life of naturally aging mice, mitigate the age-related cognitive dysfunction, improve neurological function, maintain redox homeostasis and telomere integrity, and inhibit apoptosis. Moreover, Bazi Bushen capsules can increase the dermal thickness and the collagen fiber and elastic fiber content to prevent skin aging. In addition, Bazi Bushen capsules can correct the lipid metabolism disorders and ameliorate multisystem age-related diseases such as osteoporosis in surgically induced menopausal rats. This article discusses the pathogenesis, treatment, and prescription of aging and the antiaging theory, aiming to provide a basis for delaying aging and preventing related diseases.

Impact of fermented lactobacilli acidophilus and antibiotics topically during the phase of re-epithelization in wound repair of rats.

Objective: To compare the topical effects of lactobacillus acidophilus strain and topical antibiotics during the phase of re-epithelization in wound repair. Study Design: Experimental Longitudinal study. Setting: Al-Tibri Medical College, Isra University Karachi. Period: June to November 2022. Material &amp; Methods: This longitudinal study took place in in which 45 Wistar rats were acquired and divided into three groups, Group A the control group in which normal saline was applied, Group B in which topical Lactobacillus acidophilus was applied, and Group C in which topical neomycin was applied on the 3rd, 7th, and 14th day of the study. A subcutaneous incision was given on all the rats of equal proportion, and on the 3rd, 7th, and 14th day of sampling a histological section was acquired. A micrometer was used to measure the thickness of the dermis and epidermis. Data was analyzed using SPSS, with the p-value set at &lt;0.05. Results: Significant difference was seen in the mean thickness of epidermis when Lactobacillus acidophilus groups was compared with both Group A and C on the 3rd, 7th, and 14th day of the study. Significant difference was also seen in the mean thickness of the dermis when Lactobacillus acidophilus was compared with both Group A and C on the 3rd, 7th, and 14th day of the study. Conclusion: Lactobacillus acidophilus plays a potent rote in repairing dermal tissue as it increased the thickness of dermis and epidermis.

TNF-like weak inducer of apoptosis inhibition is comparable to IL-13 blockade in ameliorating atopic dermatitis inflammation.

Targeting IL-13 is highly efficacious in patients with Th2-biased atopic dermatitis (AD), but inhibition of other inflammatory molecules might also limit disease. We investigated the importance of the TNF family cytokine TNF-like weak inducer of apoptosis (TWEAK; TNFSF12) to keratinocyte dysregulation and the pathogenesis of AD in mice and also tested if blocking TWEAK has a similar therapeutic effect as targeting IL-13. Conditional knockout mice lacking Fn14 (TNFRSF12A), the receptor for TWEAK, only in keratinocytes, were repetitively sensitized with house dust mite allergen and analyzed for AD-like skin inflammation. To determine the translational potential, wild-type mice with AD were therapeutically treated with anti-TWEAK and/or anti-IL-13 antibodies, and skin inflammation was assessed. Mice deficient in Fn14 in keratinocytes were resistant to developing maximal clinical features of AD, exhibiting reduced epidermal hyperplasia and dermal thickening, less skin infiltration of immune cells, and downregulated inflammatory gene expression. Moreover, therapeutic neutralization of TWEAK in wild-type mice with AD reduced all of the pathological features to a comparable extent as blocking IL-13. The activity of TWEAK in keratinocytes contributes to AD development, and neutralizing TWEAK represents a future potential therapeutic option in human AD similar to targeting IL-13.

Histological Comparison of Nanofat and Lipoconcentrate: Enhanced Effects of Lipoconcentrate on Adipogenesis and Angiogenesis.

Nanofat and lipoconcentrate contain adipose-derived stem cells and growth factors, and have wide clinical applications in the regenerative field. This study aimed to investigate the microenvironmental changes associated with nanofat and lipoconcentrate. Conventional fat, nanofat, or lipoconcentrate (0.2mL each, n = 5 per group) were injected subcutaneously into the dorsal flanks of athymic nude mice. The graft weights were measured at postoperative week 4; the grafts and their overlying skin were used for histological analyses. Weights of the lipoconcentrate grafts were significantly greater than those of the conventional fat (p < 0.05) and nanofat (p < 0.01) grafts. There was no significant difference in inflammation, oil cysts, and fibrosis between the conventional fat and nanofat groups. Histological examination of the lipoconcentrate grafts showed less macrophage infiltration and the formation of fibrosis and oil cysts. Additionally, adipogenesis and angiogenesis were induced more in the lipoconcentrate grafts than in the nanofat grafts (p < 0.01). Lipoconcentrate and nanofat improved dermal thickness (p < 0.001 and p < 0.01, respectively, versus the baseline). Lipoconcentrate grafts had greater volume and shape retention than conventional fat and nanofat grafts. They had better histological structure and acted as scaffolds for adipogenesis and angiogenesis. Both products showed regenerative effects on dermal thickness; however, only lipoconcentrate grafts had the required volume and regenerative effects, allowing it to serve as a novel adipose-free grafting method for facial rejuvenation and contouring. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An Open-Label, Uncontrolled, Single-Arm Clinical Trial of Tofacitinib, an Oral JAK1 and JAK3 Kinase Inhibitor, in Chinese Patients with Keloid

Background: The keloid treatment is still a thorny and complicated clinical problem, especially in multiple keloids induced by wound, severe burn, ethnic background or cultural behaviors, or unexplained skin healing. Mainstream treatments have limited efficacy in treating multiple keloids. As no oral treatment with painlessness and convenience is available, oral treatment strategies should be formulated. Objectives: This study aimed to investigate the efficacy and therapeutic mechanism of oral tofacitinib in keloid patients. Methods: We recruited the 7 patients with keloid scars and prescribed 5 mg of tofacitinib twice a day orally with a maximum follow-up of 12 weeks. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver scar scale (VSS), ANTERA 3D camera, and the DUB Skin Scanner 75 were used to assess the characteristics of the lesion. Immunohistochemistry was performed to evaluate collagen synthesis, proliferation, and relative molecular pathways. Moreover, the effects of tofacitinib were assessed on keloid fibroblast in vitro. Results: After 12 weeks of oral tofacitinib, significant improvement in POSAS, VSS, and Dermatology Life Quality Index (DLQI) scores was observed (p < 0.05). The volume, lesion height, and dermis thickness of the keloid decreased (p < 0.05). Moreover, significant decreases in the expression of collagen I, Ki67, p-STAT 3, and p-SMAD2 were observed after 12 weeks of administration. In vitro experiments suggested that tofacitinib treatment inhibits fibroblast proliferation and collagen I synthesis via suppression of STAT3 and SMAD2 pathway. Conclusion: Tofacitinib, a new candidate oral drug for keloid, could reduce keloid lesion volume by inhibiting collagen synthesis and inhibiting fibroblast proliferation, and alleviate itch and pain to obtain a better life quality.

Morphological, anatomical and histological studies on knob and beak characters of six goose breeds from China.

The knob serves as both a sexual indicator of a goose's maturity and a significant packaging attribute that garners consumer attention. However, studies regarding the morphological, anatomical and histological traits of different breeds and ages on the on knob in goose are lacking. In this study, six breeds with typical goose knob types were selected, and their knob size, morphological, anatomical and histological traits were characterized. The results showed that: Knob was more prominent in gander than in female goose, and the difference was the most obvious in Magang goose. Wanxi white goose and Shitou goose had the largest knob bulge, while Magang goose and Sichuan white goose were smaller. The total knob volume of Wanxi White goose and Shitou goose was significantly higher than that of other breeds, regardless of male or female (p < 0.05). The beak volume of Wanxi White goose and gander was significantly higher than that of other goose breeds (p < 0.05). Furthermore, the observation revealed that the "knob" primarily consisted of skin-derived tissue and bony protrusions. As age advances, the knob of both male and female geese undergoes synchronous development, with the knob of male geese typically surpassing that of their female counterparts during the same period. The growth rate of knob in male goose was the fastest from 70 to 120days of age, and slowed down from 300 to 500days of age. The growth rate of knob in female goose was slower than that in male goose. There were essential differences in the composition of Yangzhou goose knob and Magang goose knob. The subcutaneous tissue of Magang goose was rich, and the thickness of epidermis, dermis and various layers was significantly smaller than that of Yangzhou goose (p < 0.05). With the growth of goose knob, the cells of the epidermal spinous layer became denser and gradually condensed into an overall structure, and there was a clear boundary between the dermis and epidermis after adult. In adulthood, the fiber fascicle network was staggered and dense, with greater toughness and elasticity, and the stratum corneum, epidermis, reticular layer, dermis and other skin structural layers became thicker.

Ultra-High-Frequency Ultrasound as an Innovative Imaging Evaluation of Hyaluronic Acid Filler in Nasolabial Folds.

Dermal hyaluronic acid (HA) fillers are used for nasolabial fold correction, but no study is still available on the use of ultra-high-frequency ultrasound (UHFUS) with 70 MHz probes for the evaluation of HA distribution and wrinkle amelioration. We selected 13 patients who received HA filler, evaluated before (Time (T) 0) and after injection (T1), and after 24 weeks (T2). The dermal thickness and distribution of HA were registered, as well as the Wrinkle Severity Rating Scale (WSRS), Global Aesthetic Improvement Scale (GAIS), and wrinkle 3D fullness. The UHFUS dermal thickness was increased by 11% for both sides at T1 and by 7.4% and 6.8% for the right and left side, respectively, at T2 (p < 0.01). The 3D wrinkle fullness showed a T1 increase (+0.59 cc and +0.79 cc for the right and left side, respectively) with a T2 maintenance of 45% of the T1 fullness (p-value < 0.001). The only clinical score significantly modified was WSRS, with a reduction of 56% at T1 and of 47.1% at T2 (p-value < 0.001). Our study then demonstrated the efficacy of UHFUS in the assessment of nasolabial fold correction, representing also the first multi-modal evaluation of HA persistence and its visual subsequent aesthetic results.

The Role of Escin as a Topical Agent for Lymphedema Treatment in a Rat Model.

Escin, a naturally derived material isolated from horse chestnut, is used as an anti-inflammatory and anti-edema agent. This study aimed to evaluate its effects on lymphedema in a rat tail model. We divided the rats into five groups. The treatment groups received topical application of escin gel at concentrations of 20%, 10%, 2%, and 0.5% for 4 weeks. The fifth group served as a control. We performed volumetric (water displacement) tests, H&E staining, and LYVE-1 immunohistochemical staining, followed by statistical evaluation. All treatment groups showed significant volumetric reductions compared with the control group, but no significant differences were observed between the treatment groups. H&E staining showed a significant reduction in dermal thickness in the 20%, 10%, and 2% escin treatment groups compared to the control group. Within the treatment groups, the 2% escin group showed a significant difference compared with the 20% and 10% escin groups (p = 0.021 for both). LYVE-1 immunohistochemical staining revealed a significantly higher mean lymphatic vessel count in the 2% escin group compared with the 20%, 10%, and 0.5% escin-treated groups and the control group (p = 0.019, p = 0.025, p = 0.019, and p = 0.032 respectively). Topical escin applied to a rat tail model of acute lymphedema resulted in a significant reduction in tail volume, reduced dermal thickness, and increased lymphatic structures. The 2% escin concentration may be the optimal dose for improving lymphedema in this model. Further research is warranted to explore the clinical application of escin in patients with lymphedema.

Full-thickness skin columns: A method to reduce healing time and donor site morbidity in deep partial-thickness burns.

The current standard of care for the coverage of large wounds often involves split thickness skin grafts (STSGs) which have numerous limitations. One promising technique that has gained traction is fractional autologous skin grafting using full-thickness skin columns (FTSC). Harvesting occurs orthogonally by taking numerous individual skin columns containing the epidermis down through the dermis and transferring them to the wound bed. The purpose of this porcine study was to investigate the efficacy of implanting FTSCs directly into deep partial-thickness burn wounds, as well as examining donor site healing at the maximal harvest density. It was hypothesised that by utilising FTSCs, the rate of healing in deep partial thickness burns can be improved without incurring the donor morbidity seen in other methods of skin grafting. Deep partial-thickness burns were created on the dorsum of female red duroc swine, debrided 3 days later and FTSCs were implanted at varying expansion ratios directly into the burn wounds. At day 14, 1:50 expansion ratio showed significantly faster re-epithelialisation compared to the debrided burn control and 1:200. Donor sites (at 7%-10% harvest density) were 100% re-epithelialised by day 7. Additionally, the maximal harvest density was determined to be 28% in an ex vivo model, which then five donor sites were harvested at 28% density on a red duroc swine and compared to five STSG donor sites. At maximal harvest density, FTSC donor sites were significantly less hypopigmented compared to STSGs, but no significant differences were observed in re-epithelialisation, contraction, blood flow or dermal thickness. In conclusion, implantation directly into deep partial-thickness burns is a viable option for the application of FTSCs, favouring lower expansion ratios like 1:50 or lower. Little difference in donor site morbidity was observed between FTSC at a maximal harvest density of 28% and STSGs, exceeding the optimal harvest density.

Recurrent lymphangioma circumscriptum: Treated with microneedling radiofrequency and topical sirolimus

Abstract Introduction: Lymphangioma circumscriptum is a “microcytic” lymphatic malformation. Different treatments have been tried with varying success. We report here a case of recurrent lymphangioma circumscriptum who was treated with microneedling radiofrequency (MNRF) and topical preparation or sirolimus cream with good improvement. Case Report: A 14-year-old girl presented to outpatient department with a cluster of small asymptomatic blisters over the unilateral inguinal area which on histopathology was confirmed to be lymphangioma circumscriptum. The patient had similar lesions 3 years back which she got surgically excised. Since the last 6 months, she had a recurrence of the similar lesions so this time we chose MNRF every 40 days to treat this case which was combined with topical sirolimus 0.01% during and after the procedure. Discussion: MNRF helps in neoelastogenesis and neocollagenosis, which leads to dermal thickening. It also acts as a drug delivery system by creating dermal channels. Sirolimus with its antilymphangiogenic properties helps prevent recurrence.

The initial steps toward the formation of somatic tissue banks and cell cultures derived from captive Antillean manatee (Trichechus manatus manatus) skin biopsies.

The declining population of the Antillean manatee caused by ecosystem degradation and rising pollution has prompted interest in developing conservation strategies for this species. Given this scenario, somatic tissue banks are important tools for acquiring knowledge about the species, as well as for obtaining somatic cells for biotechnological and ecotoxicological applications. Therefore, we aimed to assess the effects of slow freezing (SF) and solid-surface vitrification (SSV) of the dermis of captive Antillean manatees on the histology and ultrastructure of the tissue and cell viability in culture. While the SSV did not change the dermis thickness, the SF maintained the tissue proliferative potential, assessed by the nucleolar organizer region area, similar to noncryopreserved tissues. Moreover, both techniques reduced the number of fibroblasts and increased the percentage of collagen fibers. Nevertheless, only tissues cryopreserved with SF and noncryopreserved tissues were able to produce cells after in vitro culture. Although SF did not alter cell viability and proliferative activity, cells derived from cryopreserved tissues showed decreased metabolism, altered apoptosis, increased levels of reactive oxygen species, and mitochondrial membrane potential compared to cells from noncryopreserved tissues. In summary, we demonstrated for the first time that Antillean manatee somatic tissues can be cryopreserved by SF, and cells can be obtained after in vitro culture. Improvements in cryopreservation conditions, especially vitrification, of somatic samples are needed to increase the quality of somatic tissue banks in this species.