Dorsum Of Hand Research Articles

Photobiomodulation in the treatment of palmar–plantar erythrodysesthesia: a randomised controlled clinical study protocol

IntroductionHand–foot syndrome, also known as palmar–plantar erythrodysesthesia (PPE), is a complication caused by chemotherapy. Clinically, it manifests as erythema and oedema on the palms of the hands and feet, dry...

359 Low-Intensity Focused Ultrasound to Human Dorsal Anterior Cingulate Cortex and Insula Attenuates Measures of Central Sensitization

INTRODUCTION: Central sensitization is the abnormal amplified response to pain and is associated with chronic pain. Increased insula and dorsal anterior cingulate cortex (dACC) activity is associated with central sensitization. Low-intensity focused ultrasound (LIFU) is a novel form of non-invasive neuromodulation that can precisely target the anterior insula (AI), posterior insula (PI) and dACC. METHODS: N = 18 healthy participants underwent conditioned pain modulation (CPM) and temporal summation of pain (TSP) tasks before and after 10 minutes of LIFU or sham stimulations. For CPM, the conditioning stimulus (CS) was a cold pressor test to the left hand and the test stimulus (TS) was a brief transient heat stimulus to the dorsum of the right hand. For TSP, 10 transient heat stimuli (>0.33 Hz) were administered to the dorsum of the right hand. The primary outcome measure for both tasks was perceived pain ratings (0-9). Electrodermal response and electrocardiogram was collected to evaluate the effect of LIFU on autonomic reactivity. RESULTS: LIFU to PI increased CPM 0.5 ± 0.181 compared to sham (p = 0.024). LIFU to PI also significantly reduced perceived pain during the TSP task compared to sham (p < 0.001). We also found a significant difference between dACC and sham conditions during TSP by -0.55 ± 0.05 (p < 0.001). LIFU to the AI increases frequency domain measures of heart-rate variability. CONCLUSIONS: LIFU to the insula and dACC affects pain processing in measures of central sensitization. This demonstrates the neuromodulation abilities of LIFU and is a promising tool to develop noninvasive clinical therapies for chronic pain conditions.

Neutrophilic Dermatosis of the Dorsal Hands

Neutrophilic dermatosis of the dorsal hands (NDDH) is a localized variant of Sweet syndrome, a neutrophilic dermatosis commonly associated with underlying malignancy or systemic inflammatory disorders. NDDH can be mistaken for infection due to its rarity, clinical appearance, and common association with elevated inflammatory markers. A high index of suspicion for this diagnosis should be maintained with symmetrical hand lesions, as approximately 78% of patients with NDDH have bilateral disease. Patients respond rapidly to the initiation of systemic steroids; however, like with generalized cutaneous Sweet syndrome, diagnosis should prompt further work-up for underlying disease.

Venous blood gases in the assessment of respiratory failure in patients undergoing sleep studies: a randomized study.

Venous blood gases (VBGs) are not consistently considered suitable surrogates for arterial blood gases (ABGs) in assessing acute respiratory failure due to variable measurement error. The physiological stability of patients with chronic ventilatory failure may lead to improved agreement in this setting. Adults requiring ABGs for sleep or ventilation titration studies had VBGs drawn before or after each ABG, in a randomized order. Veno-arterial correlation and agreement were examined for carbon dioxide tension (PCO2), pH, oxygen tension (PO2), and oxygen saturation (SO2). We analyzed 115 VBG-ABG pairs from 61 patients. Arterial and venous measures were correlated (P < .05) for PCO2 (r = .84) and pH (r = .72), but not for PO2 or SO2. Adjusted mean veno-arterial differences (95% limits of agreement) were +5.0 mmHg (-4.4 to +14.4) for PCO2; -0.02 (-0.09 to +0.04) for pH; -34.3 mmHg (-78.5 to +10.0) for PO2; and -23.9% (-61.3 to +13.5) for SO2. VBGs obtained from the dorsal hand demonstrated a lower mean PCO2 veno-arterial difference (P < .01). A venous PCO2 threshold of ≥ 45.8 mmHg was > 95% sensitive for arterial hypercapnia, so measurements below this can exclude the diagnosis without an ABG. A venous PCO2 threshold of ≥ 53.7 mmHg was > 95% specific for arterial hypercapnia, so such readings can be assumed diagnostic. The area under the receiver operating characteristic curve of 0.91 indicated high discriminatory capacity. A venous PCO2 < 45.8 mmHg or ≥ 53.7 mmHg would exclude or diagnose hypercapnia, respectively, in patients referred for sleep studies, but VBGs are poor surrogates for ABGs where precision is important. Registry: Australian New Zealand Clinical Trials Register; Name: A comparison of arterial and blood gas analyses in sleep studies; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372717; Identifier: ACTRN12617000562370. Lindstrom SJ, McDonald CF, Howard ME, etal. Venous blood gases in the assessment of respiratory failure in patients undergoing sleep studies: a randomized study. J Clin Sleep Med. 2024;20(8):1259-1266.

CHALLENGING THE INTERPRETATION OF THE VERSE ON HIJAB BY M. QURAISH SHIHAB: A CRITICAL ANALYSIS REVIEW

There is a variety of interpretations regarding the verse on the hijab in the Qur'an. Some commentaries demonstrate strong arguments, while others appear to be subjective and ambiguous. This article examines the thoughts of Quraish Shihab on the hijab verse and critically analyzes them. The research falls under the category of library research, utilizing a descriptive analysis method to explain research findings based on the study's focus with a critical analysis to produce objective results. The approach employed is content analysis. The primary sources for this research are the Tafsir Al-Mishbah and Jilbab Pakaian Wanita Muslimah. The research findings indicate: First, Quraish Shihab argues that wearing the hijab is not obligatory but merely a recommendation and is applicable only in the time of Prophet Muhammad. Scholars also do not agree on the limits of women's modesty, and the rules of the hijab are considered part of Arab cultural traditions, not applicable to other nations that do not wear the hijab. Second, Quraish Shihab's interpretation of the hijab verse lacks strong arguments in the context of Islamic studies. The wording of the command in the hijab verse is still regarded as an obligation and cannot be transformed into a recommendation due to the lack of supporting evidence. Scholars have unanimously agreed on the limits of women's modesty, from the top of the head to the tips of the toes, excluding the face and the palms of the hands. The law of the hijab remains in effect until the end of time, even though it was revealed under specific conditions and in specific regions, as Islam is considered a universal religion.

Calcium Hydroxylapatite (CaHA) and Aesthetic Outcomes: A Systematic Review of Controlled Clinical Trials.

Background: This study aimed to systematically review and summarize the available controlled clinical trials on the effectiveness of calcium hydroxylapatite (CaHA) in terms of aesthetic outcomes, skin-aging-related outcomes, and patient/investigator satisfaction. Methods: We included controlled clinical trials involving at least 10 human adults that examined the effects of CaHA on aesthetic and skin-aging-related outcomes and satisfaction. Due to the high heterogeneity among the included studies, only a qualitative analysis is provided. Results: Out of 2935 relevant references, 13 studies were included, of which 8 studies focused on facial areas and 5 on dorsum of hand. CaHA injection was associated with enhancements in global aesthetic improvement scale, whether applied in facial regions or on the dorsum of hands. The findings suggested high patients' satisfaction following CaHA when applied to facial areas. Studies highlighted improvements in hand grading scales and a reduction in facial wrinkles. Conclusions: Current evidence suggests that CaHA injections improve aesthetic results, including facial areas, such as nasolabial folds and jawline, and hands, with high levels of satisfaction. Considering the methodological limitations and heterogeneous comparisons groups, additional controlled clinical trials would contribute to a better understanding of the applications and advantages offered by CaHA.

Multimodal biometric user authentication using improved decentralized fuzzy vault scheme based on Blockchain network

Biometric security has emerged as a major concern in the field of Biometric Systems. The existing centralized Biometric Cryptosystems approach still suffers from privacy issues and network-based attacks. In particular, the Biometric Cryptosystems are susceptible to Attack via Record Multiplicity, brute force and collusion attacks. To address these issues, this paper proposes a multimodal biometric user authentication scheme using a decentralized fuzzy vault based on Blockchain technology. In this scheme, the facial biometric images and dorsal hand images together form the multimodal biometric. The proposed security framework is implemented in two phases. In the first phase, multimodal biometric user authentication using an improved fuzzy vault scheme is implemented. In the second phase, a privacy preservation technique using a decentralized fuzzy vault biometric system based on the Blockchain network is implemented. The performance of the proposed framework is verified on the biometric datasets consisting of both genuine and imposter users, and a comparative analysis with the existing state-of-the-art approaches is also presented. The Detection Error Trade-off (DET) curve and the Receiver Operating Characteristic (ROC) curve, obtained for verifying the efficacy of the proposed framework, are also presented. The proposed framework yielded an accuracy of 99.8% and an Equal Error Rate of 0.08. Furthermore, to validate the biometric template protection, the security analysis of the proposed scheme based on irreversibility, unlinkability, and revocability criteria is described. The proposed framework achieves significant improvement in terms of a low False Acceptance Rate (0.08), and a high True Acceptance Rate (0.96).

Predicting human chronological age via AI analysis of dorsal hand versus facial images: A study in a cohort of Indian females.

Predicting a person's chronological age (CA) from visible skin features using artificial intelligence (AI) is now commonplace. Often, convolutional neural network (CNN) models are built using images of the face as biometric data. However, hands hold telltale signs of a person's age. To determine the utility of using only hand images in predicting CA, we developed two deep CNNs based on 1) dorsal hand images (H) and 2) frontal face images (F). Subjects (n = 1454) were Indian women, 20-80 years, across three geographic cohorts (Mumbai, New Delhi and Bangalore) and having a broad variation in skin tones. Images were randomised: 70% of F and 70% of H were used to train CNNs. The remaining 30% of F and H were retained for validation. CNN validation showed mean absolute error for predicting CA using F and H of 4.1 and 4.7 years, respectively. In both cases correlations of predicted and actual age were statistically significant (r(F) = 0.93, r(H) = 0.90). The CNNs for F and H were validated for dark and light skin tones. Finally, by blurring or accentuating visible features on specific regions of the hand and face, we identified those features that contributed to the CNN models. For the face, areas of the inner eye corner and around the mouth were most important for age prediction. For the hands, knuckle texture was a key driver for age prediction. Collectively, for AI estimates of CA, CNNs based solely on hand images are a viable alternative and comparable to CNNs based on facial images.

A Case of a 50-Year-Old Female with Dermatomyositis Secondary to a Paraneoplasm (Infiltrating Ductal Carcinoma, Grade 2)

Introduction: Dermatomyositis is an autoimmune disorder with an incidence of 5 to 10 per 1 million per year. 10 to 20% of patients with adult-onset Dermatomyositis have an underlying malignancy. There are currently no specific cutaneous markers for Paraneoplastic Dermatomyositis. This case highlights a patient with uncommon features of paraneoplasm after breast malignancy. Case Report: A 50-year-old female with Infiltrating Ductal Carcinoma, presented with patches on the face, neck, chest, upper back, outer arms, dorsal hands, thighs, hair loss and weakness. Histopathology revealed widened basal layer vacuolization with widened spaces between collagen bundles filled with mucin deposition, and pigment incontinence in the papillary dermis. Direct immunofluorescence showed granular deposits of IgG, C3, IgM and IgA in the basement membrane zone, which are consistent with Dermatomyositis. The patient was prescribed with Clobetasol ointment mixed equally with petrolatum on the body and Mometasone cream on the face. She was subsequently started on Prednisone at 0.5 mkd with eventual tapering, Omeprazole, and Calcium + Vitamin D tablet daily. Hydroxychloroquine 200 mg/tab daily was added. Referral to Rheumatology for co-management and Surgery for management of the breast mass was also done. Conclusion: This case emphasizes the rare occurrence of a Paraneoplastic Dermatomyositis following a diagnosis of breast malignancy. A careful review upon diagnosis may detect occult malignancies especially in patients who present primarily with cutaneous Dermatomyositis. Clinicopathologic correlation and a multi-disciplinary approach, with Surgery, Oncology, Rheumatology and Dermatopathology are needed to identify the underlying cause and facilitate successful treatment of a neoplasm followed by improvement of Dermatomyositis.

Longitudinal analysis of the skin microbiome in association with hand eczema, hand hygiene practices and moisturizer use.

The skin microbiota maintains a physical and immunological barrier to the environment. Little is known about how the microbiome changes over time or the effect of hand hygiene practices and moisturizer use. To assess sex-specific changes in skin bacteria over time, and how the microbiome is related to self-reported hand eczema, hand hygiene practices and use of moisturizers. Swab samples from the dorsal hand were collected at baseline and 6.5 years later during the COVID-19 pandemic, in 168 participants from the RHINESSA study in Bergen, Norway. The skin samples were analysed by 16S rRNA amplicon sequencing. The alpha diversity of the hand microbiome increased from baseline to follow-up, and beta diversity differed by sex at both time points. The relative abundance increased for several bacteria from baseline to follow-up, with sex-specific differences. Current hand eczema and aggravating hand eczema during the COVID-19 pandemic were associated with an increase in Staphylococcus. High hand washing frequency at home was associated with lower alpha diversity and with higher abundance of Staphylococcus, Corynebacterium, Finegoldia, and Pseudomonas and lower abundance of Propionibacterium and Pelomonas. The alpha diversity increased with increasing time passing between hand washing and sampling, whereas more frequent moisturizer use was associated with significantly lower alpha diversity, and a change in abundance for some bacteria, such as more Pseudomonas. This longitudinal study revealed an overall increase in skin microbial diversity over a 6-year period, which was unexpected since follow-up was performed during the COVID-19 pandemic when vigorous hand hygienic practices were introduced. Sex-specific differences were identified at both time points. Individuals with hand eczema seem to develop a more dysbiotic skin bacterial community over time. Hand washing and use of moisturizers, with typically gender-specific habitual patterns, may lead to change in bacterial composition.

Management of Patients with Oral Lesions Associated Systemic Lupus Erythematous (SLE) Nephritis: A Case Report

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease involving multi-organ such as mucocutaneous, musculoskeletal, and blood vessels with varied extraoral and intraoral clinical manifestations that require treatment from many medical specialists including dentists. The purpose of writing a case report is to describe how to manage oral lesions in patients with SLE Nephritis.&#x0D; Case report: A female 17 years old patient was referred to the oral medicine department of Dr. Hasan Sadikin General Hospital from the pediatrics department and was diagnosed with SLE nephritis due to complaints of ulcers on almost the entire oral mucosa. Extraoral examination revealed a moon face, malar rash, and erythematous rash on the palms of the hands. Intraoral examination revealed multiple ulcers, on labial mucosa, buccal mucosa, lateral right of the tongue, palate, and white plaque on the dorsum of the tongue. The therapy provided was non-pharmacological and pharmacological. Non-pharmacological therapies include oral hygiene instruction and communication, information, education. Pharmacological therapy is a solution containing sucralfate and prednisone which is gargled for one minute, then followed by nystatin oral suspension drug that discards after one minute, then followed by chlorhexidine digluconate 0,12% mouthwash, gargle for one minute, as an antiseptic (each drug is applied in 0,5 – 1 hours). The patient has received a systemic corticosteroid drug (methylprednisolone), but the treatment of oral lesions requires additional topical corticosteroids to accelerate the healing process because of its direct effect on the mucosa.&#x0D; Conclusion: The management of oral lesions using topical corticosteroids in patients with SLE nephritis can help accelerate the healing process.&#x0D; Keywords: Management, Oral Lesions, SLE nephritis

Self-reported clinical features and treatment effectiveness of Papillon-Lefèvre syndrome patients from five Latin American countries: A cross-sectional online survey study.

Most studies about Papillon-Lefèvre syndrome (PLS) are limited to case reports and patients of the same nationality. This study aimed to determine the self-reported prevalence of signs, symptoms and treatment effectiveness in PLS patients from five Latin American countries. An online survey was conducted among adult and paediatric patients from Mexico, Argentina, Colombia and Brazil. Data were collected using multiple-choice, open-ended and image-chooser questions on demographics, signs and symptoms, perceived treatment effectiveness and quality of life. Seventeen patients (10 males and 7 females) aged 4-47 years were surveyed. All had palmoplantar hyperkeratosis. Other affected sites were the feet and hand dorsum (82.35%), Achilles tendon (88.24%), forearms (58.82%), legs (29.41%) and glutes (23.53%). They frequently presented hyperhidrosis and nail pitting. Four had a history of delayed umbilical cord separation. All used topical treatments, with moderate effectiveness; half used oral retinoids, perceived as highly effective. Most reported decreased quality of life and walking difficulties. The study's results align with prior research on PLS, but reveal new insights, including the impact on patients' quality of life and a history of delayed umbilical cord separation. These findings warrant consideration in future research and patient care.

Change in Religious Understanding and Language Shift of the Recitations of the Quran and Hadith in the Perspective of Islamic Jurisprudence

This writing aims to analyze the occurrence of changes in the understanding of the community and the shift in language of some recitations of the Quran and Hadith from the perspective of Islamic jurisprudence (fiqh). Understanding religion cannot be separated from the issue of language shift because the fundamental sources of Islamic teachings are the Quran and Hadith, both of which are in Arabic. The translation of verses from the Quran and Hadith into the Indonesian language is not without uncertainties. For example, the change in understanding of the word "telapak tangan" (palm of the hand) as a translation of the Arabic term "kaff," which excludes the back part of the palm, leading to difficulties in practice. This study is a literature review, and data collection and analysis were conducted using this method. Changes in the community's understanding of these words can be observed in the everyday practices of the community (observation). The results of the study indicate that one of the changes in the community's understanding is the shift from the term "kaff" to "telapak tangan." Its influence can be seen in the understanding and application of the boundaries of the female aurah (parts to be covered) and the attire during ihram. Based on Hadith, most people consider the boundaries of a woman's aurah to be everything except the face and both palms. In fiqh, it is mentioned that a woman in ihram is prohibited from covering her face and both palms. This understanding and practice differ from what is intended in the Hadith and fiqh texts.

Nature’s therapeutic power: a study on the psychophysiological effects of touching ornamental grass in Chinese women

The health of city residents is at risk due to the high rate of urbanization and the extensive use of electronics. In the context of urbanization, individuals have become increasingly disconnected from nature, resulting in elevated stress levels among adults. The goal of this study was to investigate the physical and psychological benefits of spending time in nature. The benefits of touching real grass and artificial turf (the control activity) outdoors with the palm of the hand for five minutes were measured. Blood pressure and electroencephalography (EEG) as well as State-trait Anxiety Inventory (STAI) scores, and the semantic differential scale (SDM) were used to investigate psychophysiological responses. Touching real grass was associated with significant changes in brainwave rhythms and a reduction in both systolic and diastolic blood pressure compared to touching artificial turf. In addition, SDM scores revealed that touching real grass increased relaxation, comfort, and a sense of naturalness while decreasing anxiety levels. Compared to the control group, the experimental group had higher mean scores in both meditation and attentiveness. Our findings indicate that contact with real grass may reduce physiological and psychological stress in adults.

Mechatronic Hand Exoskeleton for Rehabilitation after Stroke

The article presents the results of the development of a prototype of a functional layout of a soft exoskeleton of the hand, which is part of a robotic complex for restoring the function of the upper limb of patients after a stroke. The use of the layout will allow for therapy based on a mixed approach, which implements both assistance in carrying out independent movements of the patient’s hand, and their full implementation using data on its movement recorded during rehabilitation procedures. The authors of the manuscript present a comparative and quantitative analysis of two options for laying a cable system that drives the patient’s hand and fingers. To determine the best option for laying cables, a parametric study of the amount of work performed and the bending time of one finger was carried out, depending on the options for laying with and without taking into account the load. In the first variant, the cables were laid with small stitches of the order of one centimeter along the lower surface of the finger. In the second variant, the cable passed through the glove in places of natural attachment of tendons to bones. Testing was carried out on the index finger of a relaxed healthy person. At the initial moment of time, the hand occupied a position along the body, the fingers were completely unclenched, while a load was fixed on the distal phalanx. The flexion time of the finger was determined by a touch sensor attached to the palm of the hand. The results of experimental studies showed that cables with a minimum number of attachment points to the base of the exoskeleton in places of natural attachment of tendons to the bone give maximum effort and ensure the achievement of the largest range of possible positions of the phalanges of the fingers. The results of studies of the developed efforts on the part of the device on the fingers of a healthy person are also presented, which allow us to conclude that it can be used for rehabilitation purposes.

“All the world at the palm of the hand”: imagining history through the life of an early Afghan saint

AbstractIn this article I explore hagiographical narratives about Khwāja Yaḥyā Kabīr (d. 1430), among the earliest of the Sufi masters to be identified as Afghan. The social memory of Yaḥyā Kabīr's life exemplifies the function of hagiography as a key arena for the production of historical knowledge, generating a vivid and specific imaginary of the past for devotees. My goal here is to present a reading of the hagiography, but first I will situate it within the discursive nexus of Persian historical writing, which often essentialized Afghans as innately barbarous while peripheralizing Afghan homelands (identified with the Sulaiman Mountains). Yaḥyā Kabīr's hagiography is both reflective of Indo-Afghan anxieties about social hierarchies and a device by which marginalizing traditions could be subverted through a highly textured portrayal of the past. As such, it exemplifies how saints’ lives can index not only the hierarchies of imperial life, but also the techniques by which to escape them.

Epidermodysplasia verruciformis arising in a female with systemic lupus erythematosus: a rare case from Syria

Introduction and importance: Epidermodysplasia verruciformis is a rare autosomal recessive genodermatosis. Clinical manifestations might be helpful in the diagnosis of this disease. However, the final diagnosis is made after a genetic and histological study. Acquired epidermodysplasia verruciformis is a form of epidermodysplasia verruciformis described in patients with compromised cell-mediated immunity. Case presentation: A 42-year-old female with a history of a pain and itch on the soles and palms started a year ago. There were multiple flat papules on the dorsal hands, scarring alopecia, malar rash, oral ulcers, Raynaud phenomenon, and palpable purpura. A histological examination confirmed the diagnosis of epidermodysplasia verruciformis. Clinical discussion: Epidermodysplasia verruciformis is an uncommon disease that affects the immune system. The coexistence of systemic lupus erythematosus and epidermodysplasia verruciformis is rarely reported in the medical literature. This paper reports a rare case in which these two diseases have coexisted. Conclusion: This publication aims to document this rare case and highlight the ideal criteria in diagnosing and treating epidermodysplasia verruciformis.

ATYPICAL MYCOBACTERIAL INFECTION

We describe a 47-year-old healthy man who, after an injury to the third finger of the right hand, developed a reddened papule that did not disappear. Over a period of three months, edema developed on the finger and dorsum of the right hand, followed by several variegated nodules along the 3rd finger, dorsum of the right hand, and right forearm. There are no subjective complaints. The patient has an aquarium at home, and the complaints coincide with a period of growth of the fish in it. The diagnosis of Mycobacterium marinum infection is made on the basis of history, clinical picture, histology and molecular genetic testing for mycobacteria. Treatment with numerous antibacterial agents was carried out, and the long-term (9 months) therapy with clarithromycin, rifampicin and ethambutol, appointed after the diagnostic clarification, led to the cure of the infection. A brief review of the literature on the issue is made.

Investigation of the limiting factors of shoulder joint complex motion in college baseball players: motion analysis of the humeral head and rotator cuff using ultrasound

BackgroundThe relationship between lower mobility, as measured by the elbow forward translation motion (T-motion) test, a new indicator of shoulder joint complex movement that measures elbow position when both dorsal hands are placed on the iliac crest while in a sitting position, and the parameters calculated by ultrasonography is unknown. The purpose of this study was to investigate the limiting factors of T-motion through motion analysis of the humeral head and rotator cuff muscles using ultrasonography in college baseball players. MethodsThirteen college baseball players participated in this cross-sectional study. The shortest distance from the posterior edge of the glenoid to the humeral head was measured in the static and T-motion positions, and the difference was calculated as the humeral head translation. The velocity of the infraspinatus was calculated during shoulder internal/external rotation using the particle image velocimetry method. These parameters were compared between the throwing and nonthrowing sides to examine the limiting factors of T-motion. ResultsThis study indicated moderate-to-good reliability for the parameters calculated by ultrasonography. The mean anterior translation distance was significantly greater on the throwing side than on the nonthrowing side (r=0.56, p=.015). The mean velocity of infraspinatus during internal rotation was significantly lower on the throwing side than on the nonthrowing side (r=0.51, p=.028). ConclusionIncreased anterior translation of the humeral head and decreased the velocity of infraspinatus are likely correlated with reduced T-motion mobility in college baseball players. These methods showed potential for physical therapy assessment and intervention to prevent shoulder dysfunction.

Natural moisturising factor constituents in South African nursing students.

The majority of South African healthcare workers are Black Africans with dark-pigmented skin. Studies on how the markers of skin barrier function and natural moisturising factor (NMF) compare between dark and light-pigmented skin are limited. Quantifying NMF in a nursing student population during their practical training at university may provide valuable insight into their potential susceptibility to skin conditions associated with low NMF. The objectives of this study were to quantify and compare NMF content of Black African, Mixed Race and White nursing students from their dominant dorsal hand. Forty-nine White, 32 Black African and 5 Mixed Race nursing students participated in this study. Tape strip samples were collected from the participants' dominant dorsal hand and NMF content was measured, including histidine (HIS), pyrrolidone carboxylic acid (PCA), trans-urocanic acid (t-UCA) and cis-urocanic acid (c-UCA), as well as cytokines interleukin-1 alpha (IL-1α) and interleukin-1 receptor antagonist (IL-1RA). No statistically significant differences in PCA, t-UCA, c-UCA, IL-1α or IL-1RA were found between Black African and White nursing students. HIS was significantly (p = 0.001) higher in White nursing students when compared to Black African students. The ratio of tot-UCA/HIS was significantly higher in Black Africans (p = 0.0002) when compared to White nursing students. No significant differences were established in NMF content between White and Black African nursing students, other than HIS which was significantly higher in White students than in Black African students. Different HIS levels between the racial groups suggest variation in histidase activity which may be related to skin pH and pigmentation. This finding may suggest that nursing students at the beginning of their careers may have similar susceptibility to skin diseases related to NMF.