Dermal Density Research Articles

질려자 추출물의 피부 볼륨 증진 및 주름개선 효과

Aging of the face is mainly related to the features that are sagging or loss of elasticity of the skin by reducing the volume around the eyes or cheek. Intrinsic aging can be seen to cause thinner dermis, reduction of extracellular matrix and subcutaneous fat. This study was carried out to investigate the skin volume augmentation and anti-wrinkle effects of Tribulus terrestris fruit extract. Skin anti-aging effect of Tribulus terrestris fruit extract was evaluated by using lipid accumulation, expressin of type I procollagen and elastin in preadipocytes and human dermal fibroblasts. Tribulus terrestris fruit extract augmented preadipocytes differentiation about 56% at 100 μg/mL. The type I procollagen and elastin were increased about 35% and 25% by treatment 20% Tribulus terrestris fruit extract, respectively. The clinical study also showed that skin sagging, skin elasticity, and dermal density improved without adverse effect following 4 week application of cream containing 2% Tribulus terrestris fruit extract. We suggest that Tribulus terrestris fruit extract can have the good possibility as skin volume augmenting, skin elasticity and wrinkle improving agent.

A novel imaging technique for skin dermal viscoelasticity and its correlation with dermal density

Human skin consists of three distinct layers’ epidermis, dermis and hypodermis. In the dermis layer, collagen is responsible for the tensile strength, and elastic fibers are interwoven among collagen bundles providing elasticity. For measuring skin viscoelasticity, there have been studies focusing on the epidermis layer. However, the viscoelastic properties are mainly associated with the fiber matrix of dermis layer. Therefore, we measured the viscoelasticity of dermis layer and investigated the correlation with dermal density in this study. In addition, we developed the novel facial images representing the distribution of dermal viscoelasticity. Twenty healthy subjects, aged between 20 and 40 years, participated in the study. Skin Fibrometer® and Skin scanner DUB® were used for the evaluation. As a result, there were significant positive correlations between viscoelasticity parameter of Skin Fibrometer® and dermal density, thickness parameters of Skin scanner DUB® (p < 0.01). As the viscoelasticity of skin increased, the density and thickness of dermis layer both increased. Furthermore, the results of dermal viscoelasticity were represented by visual images not only by numerical values using newly developed analyzing program. For the visualization, 25 areas of each subject's face were evaluated, and the facial images were taken by VISIA-CR®. The visualizing program was developed based on IDW (Inverse Distance Weighting) interpolation principle, which is a deterministic method for interpolation with a known scattered set of measuring points. Conclusively, the correlative relation between parameters of dermis layer was investigated, and the facial images representing the dermal viscoelasticity were newly developed in this study.

Short-term effects of vacuum massage on epidermal and dermal thickness and density in burn scars: an experimental study.

BackgroundVacuum massage is a non-invasive mechanical massage technique invented to treat burns and scars. To date, no effects of vacuum massage on thickness and density of human scar tissue have been reported. The process in which external stimuli are converted into biochemical responses in the cell is known as mechanotransduction. In the skin endothelial cells, fibroblasts and myofibroblasts embedded in the extracellular matrix (ECM) sense mechanical stimuli (created by vacuum massage) and may promote intracellular processes leading to matrix remodelling. Since mechanotransduction could be a plausible working mechanism for vacuum massage as an anti-scarring therapy, this study aims to investigate the short-term effects of vacuum massage on thickness and density of epidermis and dermis in burn scars in order to find proof of ECM remodelling.MethodsA one group experimental study was performed. Patients with burn scars on upper extremities, lower extremities, and trunk were recruited for participation in this study. The DUB®cutis 22 MHz ultrasound scanner was used to assess thickness and density of the epidermal and dermal skin layers. After baseline measurements, vacuum massage was performed according to a pre-defined protocol. Measurements were carried out at 5 min, 30 min, 1 h, and 2 h post-intervention.ResultsThirteen scar sites from 9 different patients were investigated. In 8 out of the 13 scar sites, a disruption of the epidermis was noticed after the vacuum massage. Five minutes after the intervention, epidermal density decreased statistically significantly (p = .022) and dermal thickness increased (p = .018). Both changes lasted for more than 1 h, but after 2 h, the changes were no longer statistically significant. Dermal density decreased significantly (p = .048) immediately after the intervention, and this decrease was still present after 2 h (p = .011).ConclusionsPreliminary results show that the disruption of the epidermis may indicate that vacuum massage could be able to actually breach the skin barrier. The statistically significant changes in the dermal layers could suggest an increased ECM production after vacuum massage.

Instrumental evaluation of anti-aging effects of cosmetic formulations containing palmitoyl peptides, Silybum marianum seed oil, vitamin E and other functional ingredients on aged human skin.

Anti-aging cosmetics are widely used for improving signs of aged skin such as skin wrinkles, decreased elasticity, low dermal density and yellow skin tone. The present study evaluated the effects of cosmetic formulations, eye cream and facial cream, containing palmitoyl peptides, Silybum marianum (S. marianum) seed oil, vitamin E and other functional ingredients on the improvement of facial wrinkles, elasticity, dermal density and skin tone after 4 weeks period of application on aged human skin. Healthy volunteers (n=20) with aged skin were recruited to apply the test materials facially twice per day for 4 weeks. Skin wrinkles, elasticity, dermal density and skin tone were measured instrumentally for assessing the improvement of skin aging. All the measurements were conducted prior to the application of test materials and at 2 and 4 weeks of treatment. Crow's feet wrinkles were decreased 5.97% after 2 weeks of test material application and 14.07% after 4 weeks of application in comparison of pre-application. Skin elasticity was increased 6.81% after 2 weeks and 8.79% after 4 weeks. Dermal density was increased 16.74% after 2 weeks and 27.63% after 4 weeks. With the L* value indicating skin brightness and the a* value indicating erythema (redness), the results showed that brightness was increased 1.70% after 2 weeks and 2.14% after 4 weeks, and erythema was decreased 10.45% after 2 weeks and 22.39% after 4 weeks. Hence, the test materials appear to exert some degree of anti-aging effects on aged human skin. There were no abnormal skin responses from the participants during the trial period. We conclude that the facial and eye cream containing palmitoyl peptides and S. marianum seed oil, vitamin E and other ingredients have effects on the improvement of facial wrinkles, elasticity, dermal density and skin tone.

Apigenin inhibits UVA-induced cytotoxicity invitro and prevents signs of skin aging invivo.

Apigenin(4',5,7-trihydroxyflavone) is a flavone that has been reported to have anti-inflammatory, antioxidant and anti-carcinogenic properties. In this study, we investigated the protective effects of apigenin on skin and found that, in experiments using cells, apigenin restored the viability of normal human dermal fibroblasts(nHDFs), which had been decreased by exposure to ultraviolet(UV) radiation in the UVA range. Using a senescence-associated(SA)-β-gal assay, we also demonstrate that apigenin protects against the UVA-induced senescence of nHDFs. Furthermore, we found that apigenin decreased the expression of the collagenase, matrix metalloproteinase(MMP)-1, in UVA-irradiated nHDFs. UVA, which has been previously identified as a photoaging-inducing factor, has been shown to induce MMP-1 expression. The elevated expression of MMP-1 impairs the collagen matrix, leading to the loss of elasticity and skin dryness. Therefore, we examined the clinical efficacy of apigenin on aged skin, using an apigenin‑containing cream for clinical application. Specifically, we measured dermal density, skin elasticity and the length of fine wrinkles in subjects treated with apigenin cream or the control cream without apigenin. Additionally, we investigated the effects of the apigenin-containing cream on skin texture, moisture and transepidermal water loss(TEWL). From these experiments, we found that the apigenin‑containing cream increased dermal density and elasticity, and reduced fine wrinkle length. It also improved skin evenness, moisture content and TEWL. These results clearly demonstrate the biological effects of apigenin, demonstrating both its cellular and clinical efficacy, and suggest that this compound holds promise as an anti-aging cosmetic ingredient.

Biological effects of rutin on skin aging.

Rutin, a quercetin glycoside is a member of the bioflavonoid family which is known to possess antioxidant properties. In the present study, we aimed to confirm the anti‑aging effects of rutin on human dermal fibroblasts(HDFs) and human skin. We examined the effects of rutin using a cell viability assay, senescence-associated-β-galactosidase assay, reverse transcription-quantitative polymerase chain reaction, and by measuring reactive oxygen species(ROS) scavenging activityinvitro. To examine the effects of rutin invivo, rutin‑containing cream was applied to human skin. A double-blind clinical study was conducted in 40 subjects aged between 30-50 years and divided into control and experimental groups. The test material was applied for 4weeks. After 2 and 4weeks, dermal density, skin elasticity, the length and area of crow's feet, and number of under-eye wrinkles following the application of either the control or the rutin-containing cream were analyzed. Rutin increased the mRNA expression of collagen, typeI, alpha1(COL1A1) and decreased the mRNA expression of matrix metallopeptidase1(MMP1) in HDFs. We verified that ROS scavenging activity was stimulated by rutin in a dose‑dependent manner and we identified that rutin exerted protective effects under conditions of oxidative stress. Furthermore, rutin increased skin elasticity and decreased the length, area and number of wrinkles. The consequences of human aging are primarily visible on the skin, such as increased wrinkling, sagging and decreased elasticity. Overall, this study demonstrated the biological effects of rutin on ROS-induced skin aging.

A placebo-controlled, double-blind clinical trial to evaluate the efficacy of Imedeen(®) Time Perfection(®) for improving the appearance of photodamaged skin.

ObjectiveTo assess the efficacy of Imedeen Time Perfection for improving the appearance and condition of photoaged skin in healthy women.MethodsThis randomized, double-blind, placebo-controlled clinical trial enrolled healthy women, 35–60 years of age, with Fitzpatrick I–III and Glogau II–III skin types and mild-to-moderate facial fine lines/wrinkles. The eligible subjects were randomized to receive two tablets daily of either Imedeen Time Perfection (Imedeen) or a matching placebo for 12 weeks. Efficacy assessments included investigator rating of 16 photoaging parameters (ie, global facial appearance and 15 individual facial parameters and the average of all parameters), instrumentation (ie, ultrasound dermal density, moisture level of the stratum corneum, transepidermal water loss, cutometry), and subjects’ self-assessment. Differences in the mean change from baseline to week 12 values on these outcomes were compared between Imedeen and placebo using analysis of variance or a paired t-test.ResultsSeventy-four subjects with primarily Fitzpatrick skin type III (78%–79%) and Glogau type III (53%–58%) completed the study (Imedeen: n=36; placebo: n=38). The mean difference in change from baseline to week 12 for global facial assessment significantly favored Imedeen over placebo (−0.52; P=0.0017). Additionally, the mean differences in the average of all facial photoaging parameters (−0.29), mottled hyperpigmentation (−0.25), tactile laxity (−0.24), dullness (−0.47), and tactile roughness (−0.62) significantly favored Imedeen over placebo (P≤0.05). Significantly greater increases in ultrasound dermal density (+11% vs +1%; P≤0.05) and stratum corneum moisturization (+30% vs +6%; P≤0.05) were also observed for Imedeen than for placebo. There were no significant differences on other instrumental outcomes.ConclusionThe results of this study suggest that Imedeen Time Perfection can positively affect the appearance of photoaged skin, moisturization, and skin density over 12 weeks of treatment.

Effects of hair removal alexandrite laser on biometric parameters of the skin.

The effects of alexandrite laser (AL) on skin parameters such as melanin content, skin layer depth, elasticity, and density have not been investigated through biometric methods. We aim to assess the effect of AL on the skin parameters through biometric devices to determine whether it has positive effects on treated region. In this pretest-posttest study, we recruited patients who attended Laser Clinic of Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran, from January through December 2014. Patients had to be free of any dermatologic conditions and lesion at the site of treatment or any contraindication to laser therapy. Baseline measurements were performed and patients received four sessions of AL therapy (spot size, 12 mm; fluence, 12 J/cm(2); and pulse width, 5 Hz) with 4-week intervals. Four weeks after the last treatment session, the same parameters were assessed that included skin color, transepidermal water loss (TEWL), dermis and epidermis density and depth (through skin ultrasonography), melanin content, erythema intensity, and skin elasticity. Biometric parameters of 33 patients (27 females [81.8%]), with mean (SD) age of 35.7 (9.5) years were evaluated. The mean percent changes of skin parameters were as follows: skin color, 5.88% through Visioface and by 56.8% through Colorimeter devices (became lighter); melanin content, -15.95%; TEWL, -2.96%; elasticity, +14.88%; dermis depth -19.01%; and dermis density, +1580.11% (P < 0.001 for changes in each parameter). AL could decrease melanin content of the skin and make the skin thinner while it could increase elasticity and density of epidermis and dermis, which might indicate increased collagen content of skin.

Rejuvenation of facial skin and improvement in the dermal architecture by transplantation of autologous stromal vascular fraction: a clinical study.

Introduction: The rejuvenation characteristics of fat tissue grafting has been established for many years. Recently it has been shown that stromal vascular fraction (SVF) of fat tissue contributes to its rejuvenation properties. As the SVF is a minimal processed cell population (based on FDA guidance), therefore it is a suitable cell therapy for skin rejuvenation. This clinical trial was aimed to evaluate the ultrastructural improvement of aging skin in the facial nasolabial region after transplantation of autologous SVF. Methods: Our study was conducted in 16 patients aged between 38 and 56 years old that were interested in face lifting at first. All of the cases underwent the lipoaspiration procedure from the abdomen for sampling of fat tissue. Quickly, the SVF was harvested from 100 mL of harvested fat tissue and then transplanted at dose of 2.0×107 nucleated cells in each nasolabial fold. The changes in the skin were evaluated using Visioface scanner, skin-scanner DUB, Visioline, and Cutometer with multi probe adopter. Results: By administration of autologous SVF, the elasticity and density of skin were improved significantly. There were no changes in the epidermis density in scanner results, but we noticed a significant increase in the dermis density and also its thickness with enrichment in the vascular bed of the hypodermis. The score of Visioface scanner showed slight changes in wrinkle scores. The endothelial cells and mesenchymal progenitors from the SVF were found to chang the architecture of the skin slightly, but there was not obvious phenotypic changes in the nasolabial grooves. Conclusion: The current clinical trial showed the modification of dermis region and its microvascular bed, but no changes in the density of the epidermis. Our data represent the rejuvenation process of facial skin by improving the dermal architecture.

Dietary Supplementation with Specific Collagen Peptides Has a Body Mass Index-Dependent Beneficial Effect on Cellulite Morphology.

In this double-blind, placebo-controlled clinical study, we investigated the efficacy of specific bioactive collagen peptides (BCP) on the cellulite treatment of normal and overweight women. In total, 105 women aged 24–50 years with moderate cellulite were randomized to orally receive a daily dosage of 2.5 g BCP or a placebo over 6 months. The degree of cellulite was evaluated before starting the treatment and after 3 and 6 months of intake. In addition, skin waviness, dermal density, and the length of subcutaneous borderline were assessed. BCP treatment led to a statistically significant decrease in the degree of cellulite and a reduced skin waviness on thighs (P < 0.05) in normal weight women. Moreover, dermal density was significantly improved (P < 0.05) compared to placebo. The subcutaneous borderline showed a significant shortening after BCP intake compared to the beginning of the study, indicating cellulite improvement, but the data failed to reach statistical significance compared to placebo. The efficacy of BCP treatment was also confirmed in overweight women, although the impact was less pronounced in comparison with women of normal body weight. The results of the study demonstrated that a regular ingestion of BCP over a period of 6 months led to a clear improvement of the skin appearance in women suffering from moderate cellulite. Based on the current data, it can be concluded that a long-term therapy with orally administered BCP leads to an improvement of cellulite and has a positive impact on skin health.

Advancing methods for characterizing structure and functions of small nerve fibres in neuropathic conditions

In this issue of Scandinavian Journal of Pain Pall Karlsson and o-workers publish a study of the sensitivity and specificity of arious methods for the diagnosis of small fibre impairment in atients with painful distal sensory polyneuropathies compared ith healthy subjects [1]. In more detail, they have compared esults of quantitative sensory testing (QST) (including temperture thresholds), response on pain and local vasodilatation by opical application of capsaicin, and various morphological varibles of skin biopsies, such as intraepidermal nerve fibre density IENFD) and new measures such as small fibre axonal swellings nd the epidermal and dermal nerve length density (eNFLD and NFDL).

Biorevitalizing effect of a novel facial serum containing apple stem cell extract, pro-collagen lipopeptide, creatine, and urea on skin aging signs.

Epithelial regeneration in skin is achieved by the constant turnover and differentiation of keratinocytes. Epidermal and dermal stem cells compartments are fundamental for the continuous renewal of the skin. Adult stem cells are the unique source for skin tissue renewal. Plants have stem cells and plant derived stem cell extracts are now used in topical products for their potential anti-ageing and anti-wrinkle effects. A new dermocosmetic product containing apple stem cell extract, urea, creatine and palmitoyl tripeptide-38 (Ureadin Fusion Serum Lift Antiarrugas, ISDIN S.A), has been recently developed to target different aspects involved in skin aging. To assess in vitro the effects of this new serum on the metabolic functions of human senescent fibroblasts and in vivo the anti-aging effects by clinical and instrumental evaluation. We evaluated the effects of the serum on the mitochondrial ROS (reactive oxygen species) production in human senescent cultured fibroblasts measured at 0.1% and 1% using the Mitoread AntiOx mtROS method. In addition we evaluated the anti-ageing in vivo effect of this new serum applied on the face twice daily for 28 consecutive days and assessed by clinical and instrumental evaluation in 32 women with sensitive skin bearing wrinkles on crow's feet. The tested serum both at 0.1% and 1% induces a significant increase in 02 consumption, cellular ATP level and a reduction in extra-cellular lactate concentration. The product reduces also significantly the mitochondrial ROS production. The clinical study shows a relevant anti-wrinkle effect in 71% of the treated women with visible effects in 68% of the subjects as soon as 7 days of treatment. A significant increase in dermal density and skin elasticity was also observed. The use of this novel anti-aging serum demonstrated a significant improvement of aging skin signs with first visible results achieved after one week of use. The product seemed to optimize the metabolic functions in human senescent cultured fibroblast restoring a more efficient cell metabolism therefore contributing to the anti-aging properties of the product.

The Antiaging Properties of Andrographis paniculata by Activation Epidermal Cell Stemness.

Andrographis paniculata (A. paniculata, Chuanxinlian), a medicinal herb with an extremely bitter taste that is native to China and other parts of Southeast Asia, possesses immense therapeutic value; however, its therapeutic properties have rarely been applied in the field of skin care. In this study, we investigated the effect of an A. paniculata extract (APE) on human epidermal stem cells (EpSCs), and confirmed its anti-aging effect through in vitro, ex vivo, and in vivo study. An MTT assay was used to determine cell proliferation. A flow cytometric analysis, with propidium iodide, was used to evaluate the cell cycle. The expression of integrin β1 (CD29), the stem cell marker, was detected with antibodies, using flow cytometry in vitro, and immunohistochemical assays in ex vivo. Type 1 collagen and VEGF (vascular endothelial growth factor) were measured using an enzyme-linked immunosorbent assay (ELISA). During the clinical study, skin hydration, elasticity, wrinkling, sagging, and dermal density were evaluated before treatment and at four and eight weeks after the treatment with the test product (containing the APE) on the face. The proliferation of the EpSCs, treated with the APE, increased significantly. In the cell cycle analysis, the APE increased the G2/M and S stages in a dose-dependent manner. The expression of integrin β1, which is related to epidermal progenitor cell expansion, was up-regulated in the APE-treated EpSCs and skin explants. In addition, the production of VEGF in the EpSCs increased significantly in response to the APE treatment. Consistent with these results, the VEGF and APE-treated EpSCs conditioned medium enhanced the Type 1 collagen production in normal human fibroblasts (NHFs). In the clinical study, the APE improved skin hydration, dermal density, wrinkling, and sagging significantly. Our findings revealed that the APE promotes a proliferation of EpSCs, through the up-regulation of the integrin β1 and VEGF expression. The VEGF might affect the collagen synthesis of NHF as a paracrine factor. Clinical studies further suggested that treatment with formulations containing APE confers anti-aging benefits. Based on these results, we suggest that APE may be introduced as a possible anti-aging agent.

Effects of position and operator on high-frequency ultrasound scan quality

High-frequency ultrasound may evaluate those at risk for pressure ulcers. Images may be obtained by clinicians with limited training. The prone position is recommended for obtaining sacral scans but may not be feasible in the critically ill. This study investigated image quality using multiple operators and a variety of patient positions. Sacral scans were performed in three randomised positions in 50 volunteers by three different investigators using a 20 MHz ultrasound system. General linear models and ANOVA random effects models were used to examine the effects of operator and position on image quality rating, and measures of dermal thickness and dermal density. The best scan for each position and operator was used for analysis (n=447 images). Image rating varied by operator (p=0.0004), although mean ratings were 3.5 or above for all operators. Dermal thickness was less for the prone position than in 90° or 60° side-lying positions (p=0.0137, p=0.0003). Dermal density was lower for the prone position than for the 90° or 60° positions (p<0.0001 for both). These data show that overall scan quality was acceptable in all positions with all operators. However, differences were found between side-lying positions and the prone for dermal thickness and dermal density measures.

Biophysical Characteristics of Melasma Skin Comparing with the Perilesional Normal Skin and its Relation to the Melasma Subtype

Background: Melasma is a common disorder of hyperpigmentation affecting millions of people worldwide. All the exact pathways to understand the complete pathogenesis of melasma is unknown. Aims: To determine the biophysical characteristics of melasma skin compared to the normal surrounding skin. Methods: Thirty-six patients with melasma were recruited in this case-control study. The subtype of melasma (epidermal, dermal, or mixed) was determined by Wood lamp examination. The melanin index, erythema index, stratum corneum (SC), hydration, sebum content, transepidermal water loss (TEWL), temperature, friction index, and pH of lesional and perilesional normal skin of patients were measured in standardized temperature and humidity conditions. The epidermal and dermal thickness and dermal echo-density were determined on the same locations. The measurements were compared between lesional and perilesional normal skin using dependent t-test and among three subtypes of melasma using one-way ANOVA. P values of <0.05 were considered statistically significant. Results: Melanin index, erythema index, SC hydration, pH, thickness of dermis and epidermis were significantly higher and the temperature was significantly lower in lesional skin compared with surrounding normal skin. No significant differences were found in TEWL, friction index, sebum content and density of dermis. Melasma subtype, age, skintype, location and duration of melasma had no significant effect on any of these variables. Conclusions: Melasma skin is characterized by certain changes in biophysical factors of epidermis and dermis. The relation of these changes with the hyper-activity of melanocytes and melanin overproduction should be determined in future studies. Keywords: Melasma; Melanin; Skin; Biophysical characteristics

Influence of a nutritional supplement containing collagen peptides on the properties of the dermis

The loss of dermal density and thickness, characterized by sagging and thinning skin, may be related to various conditions such as aging (both intrinsic and extrinsic) as well as abrupt changes in body mass – such as pregnancy or increased weight – and the resulting rupture of collagen fibers. Some nutrients can positively affect the dermal metabolism, thus improving its functional properties. Objective: To evaluate clinically and through ultrasound the effect of a nutritional supplement on the thickness of the dermis and on its functional properties. Methods: Twenty-eight female patients between the ages of 35 and 65 years, with facial sagging complaints, used the supplement for 90 days, having been evaluated subjectively and through ultrasound for clinical safety and efficacy. Results: The studied nutritional supplement provided a significant increase in dermal thickness after 30 days of use, in the areas evaluated. There was significant improvement in the firmness, elasticity, hydration and overall appearance of the skin. No adverse reaction related to the product was observed during the study period. Conclusions: The nutritional supplement was effective in improving the conditions of the dermis, increasing its thickness and clinical parameters of firmness, elasticity, and hydration, and has been proven safe and well-tolerated when used as instructed

Cellulite: poor correlation between instrumental methods and photograph evaluation for severity classification.

Cellulite refers to skin relief alterations in women's thighs and buttocks, causing dissatisfaction and search for treatment. Its physiopathology is complex and not completely understood. Many therapeutic options have been reported with no scientific evidence about benefits. The majority of the studies are not controlled nor randomized; most efficacy endpoints are subjective, like not well-standardized photographs and investigator opinion. Objective measures could improve severity assessment. Our purpose was to correlate non-invasive instrumental measures and standardized clinical evaluation. Twenty six women presenting cellulite on buttocks, aged from 25 to 41, were evaluated by: body mass index; standardized photography analysis (10-point severity and 5-point photonumeric scales) by five dermatologists; cutometry and high-frequency ultrasonography (dermal density and dermis/hypodermis interface length). Quality of life impact was assessed. Correlations between clinical and instrumental parameters were performed. Good agreement among dermatologists and main investigator perceptions was detected. Positive correlations: body mass index and clinical scores; ultrasonographic measures. Negative correlation: cutometry and clinical scores. Quality of life score was correlated to dermal collagen density. Cellulite caused impact in quality of life. Poor correlation between objective measures and clinical evaluation was detected. Cellulite severity assessment is a challenge, and objective parameters should be optimized for clinical trials.

Контроль эффективности лечения целлюлита при помощи высокочастотной ультразвуковой визуализации высокого разрешения

To describe ultrasonographic image of human skin with cellulite, the authors used high-frequency ultrasound visualization of the skin with a frequency of 22 MHz using a system DUB (tpm GmbH Germany). The skin on the thigh in 15 patients with cellulite and in 10 patients in the control group was examined. The differences in thickness and acoustic density of dermis and subcutaneous tissue between the group of patients with cellulite and in control were described. Objective data of high frequency ultrasound allow to quantify morphological and functional parameters of the skin in the dynamics and results of cellulite correction.

Dermal matrix affects translucency of incident light on the skin.

The age-dependent changes in the optical reflection characteristics have been studied about skin hydration, melanin index, or skin color. However, the age-dependent changes in the optical reflection have little attention on inner skin structures. To control the factors affecting the optical reflection except for dermal matrix, subjects were selected as our guideline and we evaluated the optical reflection of subsurface on skin layers of two age groups. Young and old healthy volunteers were recruited after signing a written informed consent form. Facial skin was measured by means of noninvasive measurements: skin hydration, color, epidermis and dermis thickness, dermal density, subsurface reflectance, and transmittance. Compared to young group, old group showed that dermal density and thickness was decreased significantly although epidermis thickness was not changed. In conclusion, dermal density is one of the major factors which affects the subsurface reflectance in skin.

UV-A1 Phototherapy vs Clobetasol Propionate, 0.05%, in the Treatment of Vulvar Lichen Sclerosus

Topical corticosteroids are the current first-line therapy for vulvar lichen sclerosus (VLS). UV-A1 phototherapy may be a promising alternative treatment option, but controlled studies are lacking. To compare the efficacy of high-potent topical corticosteroids with UV-A1 phototherapy in the treatment of VLS. A 2-arm randomized clinical trial was conducted at a university hospital dermatology department according to the intention-to-treat principle with last observation carried forward. The study population comprised 30 female patients with VLS. Treatment of VLS with clobetasol propionate, 0.05%, ointment applied once daily for 3 months or medium-dose UV-A1 (50 J/cm²) home-based phototherapy, performed 4 times weekly for 3 months. Mean relative reduction of the total clinician's score (TCS) was considered the primary outcome measure. Secondary outcome measures included the reduction of pruritus and burning and/or pain according to a visual analog scale (VAS), a health-related quality of life score (Skindex-29), 20-MHz ultrasonography, and histopathological analysis before and after 3 months of therapy. Fifteen patients were randomized in each treatment arm, and 2 patients dropped out in both treatment arms. After therapy, both therapies resulted in a significant decrease in mean TCS (51.4% [95% CI, 39.7% to 63.0%] for clobetasol ointment [P < .001] and 35.6% [95% CI, 18.2% to 53.1%] for UV-A1 phototherapy [P = .006]). No significant difference was found between both treatments (P > .05). The Skindex-29 (mean difference [MD], 29.6 [95% CI, 7.9 to 51.2] [P = .009]) and the VAS score for pruritus (MD, 4.6 [95% CI, 1.5 to 7.7] [P = .005]) and burning and/or pain (MD, 4.2 [95% CI, 1.9 to 6.6] [P = .001]) significantly decreased after clobetasol treatment. After UV-A1 phototherapy, the VAS score for burning and/or pain (MD, 3.2 [95% CI, 0.7 to 5.7] [P = .01]) was also significantly reduced; however, there was no significant reduction in pruritus (MD, 2.1 [95% CI, 0.5 to 3.7] [P = .16]) and in the Skindex-29 score (MD, 4.9 [95% CI, -12.6 to 22.4] [P > .99]). A significant reduction of the corium thickness and a significant increase in dermal density in 20-MHz ultrasonography as well as significant histopathological reduction of the inflammatory infiltrate was observed after clobetasol treatment but not after UV-A1 phototherapy. Although resulting in a significant clinical improvement, UV-A1 phototherapy was inferior to the current gold standard treatment with topical high-potent corticosteroids with respect to practicability, relief of itch, and improvement in quality of life. UV-A1 phototherapy may be considered a potential second-line treatment for VLS. clinicaltrials.gov Identifier: NCT01400022.