Effects Of Skin Disease Research Articles

Probiotic-Derived P8 Protein: Promoting Proliferation and Migration in Stem Cells and Keratinocytes.

Probiotics exert various effects on the body and provide different health benefits. Previous reports have demonstrated that the P8 protein (P8), isolated from Lactobacillus rhamnosus, has anticancer properties. However, its efficacy in stem cells and normal cells has not been reported. In this study, the effect of P8 on cell proliferation and wound healing was evaluated, investigating its underlying mechanism. Based on scratch assay results, we demonstrated that P8 treatment significantly increases wound healing by activating the cell cycle and promoting stem cell stemness. Cellular mechanisms were further investigated by culturing stem cells in a medium containing Lactobacillus-derived P8 protein, revealing its promotion of cell proliferation and migration. Also, it is found that P8 enhances the expression of stemness markers, such as OCT4 and SOX2, along with activation of the mitogen-activated protein kinase (MAPK) signaling and Hippo pathways. These results indicate that P8 can promote cell growth by increasing stem cell proliferation, migration, and stemness in a manner associated with MAPK and Hippo signaling, which could contribute to the increased wound healing after P8 treatment. Furthermore, P8 could promote wound healing in keratinocytes by activating the MAPK signaling pathways. These results suggest that P8 might be a promising candidate to enhance stem cell culture efficiency by activating cell proliferation, and enhance therapeutic effects in skin diseases.

Therapeutic effects of candesartan in inflammatory skin disorders by suppressing Th17 differentiation

As angiotensin II is associated with inflammation, type I angiotensin II receptor blockers (ARBs) exibit anti-inflammatory effects in patients with hypertension as well as inflammatory disease animal models including arthritis models. The present study aimed to investigate whether ARBs exert anti-inflammatory effects in vivo in skin disorders. We tested effects of ARBs on 1-chloro-2,4-dinitrobenzene(CDNB)-induced atopic dermatitis-like and imiquimod-induced psoriasis-like skin models. CDNB-induced atopic dermatitis-like skin lesions were suppressed by administration of candesartan or telmisartan. The suppressive effect of telmisartan was blocked by the presence of GW9662, a selective PPARγ inhibitor, but not that of candesartan. Both ARBs suppressed increases in pro-inflammatory cytokine (IL-4, IL-13, IFN-γ, and IL-17A) levels, and GW9662 inhibited telmisartan-induced suppression but not candesartan. Candesartan significantly inhibited in vitro differentiation of naïve T cells into Th17 cells to a greater extent than telmisartan. In the imiquimod-induced psoriasis model, whose primary etiology is activation of IL-23/IL-17 axis, candesartan significantly suppressed psoriasis-like skin lesions and Th17 cell populations in both lymph nodes and spleens to a greater extent than telmisartan. Overall, certain ARBs may have anti-inflammatory effects in skin diseases. Candesartan may have therapeutic implications in inflammatory skin disorders by suppressing Th17 differentiation, while telmisartan might have therapeutic potential by activating PPARγ.

31085 Bimekizumab early treatment response translates into cumulative benefits in health-related quality of life in patients with moderate to severe plaque psoriasis: Pooled results from three multicenter, randomized, double-blinded phase 3 trials

Introduction: Speed of clinical response is an important treatment goal for patients with plaque psoriasis. We examined how early clinical response translated into cumulative health-related quality of life (HRQoL) benefits in patients with moderate to severe plaque psoriasis treated with bimekizumab (BKZ) over 1 year. Methods: Data were pooled for patients randomized to BKZ 320 mg every 4 weeks (wks)(Q4W) in BE SURE, BE READY, and BE RADIANT. Through Wks16–48, data were combined for both BKZ maintenance doses (BKZ 320 mg Q4W and Q8W). The proportions of patients achieving DLQI0/1 (no effect of skin disease on patient’s life) are reported at Wk4 by PASI90 status; cumulative HRQoL benefits through 48 wks were estimated using total area under the curve (AUC0–48) for patients achieving DLQI0/1 by Wk4 PASI90 status. Missing data were imputed as nonresponse (NRI). Results: At Wk4, 352/880 (40.0%) patients achieved PASI90. 57.4% of Wk4 PASI90 responders achieved DLQI0/1, compared with 40.5% of Wk4 PASI90 nonresponders. Total AUC0–48 for achievement of DLQI0/1 was greater in Wk4 PASI90 responders vs Wk4 PASI90 nonresponders: 3664 vs 3263. Patients who achieved PASI90 at Wk4 achieved DLQI0/1 for a greater number of days throughout the 48-wk trial compared with patients who did not achieve PASI90 at Wk4: 256 vs 228 days. Conclusions: BKZ demonstrated fast skin clearance. Early treatment response on BKZ translated into cumulative benefits in HRQoL: Wk4 PASI90 responders achieved DLQI0/1 for a greater number of days during the 48-wk trial than Wk4 PASI90 nonresponders.

Mucopolysaccharide polysulfate promotes microvascular stabilization and barrier integrity of dermal microvascular endothelial cells via activation of the angiopoietin-1/Tie2 pathway

BackgroundMucopolysaccharide polysulfate (MPS) is a heparinoid and MPS-containing formulations are widely used as moisturizers for dry skin and to treat peripheral vascular insufficiency. Although MPS has therapeutic effects in skin diseases with microvascular abnormalities, the effects of MPS on microvascular function remain incompletely understood. ObjectiveThe aim of this study was to evaluate the functional activities of MPS on human pericytes (HPC) and human dermal microvascular endothelial cells (HDMEC) in vitro, and on microvascular permeability of the skin. MethodsThe protein expression of angiopoietin (Ang)-1 in HPC, and platelet-derived growth factor-BB (PDGF-BB) and phosphorylated tyrosine-protein kinase receptor 2 (Tie2) in HDMEC were measured in the presence or absence of MPS. The vascular barrier was evaluated by the expressions of claudin-5 and vascular endothelial (VE)-cadherin, and transendothelial electrical resistance (TEER). ResultsIn HPC, MPS dose-dependently enhanced Ang-1 secretion, which activated Tie2 in HDMEC. In HDMEC, MPS significantly increased the production of PDGF-BB, which is important for the recruitment of HPC to the vascular endothelium, and significantly increased the phosphorylation of Tie2, which results in the activation of the Ang-1/Tie2 signaling . MPS significantly increased the expression of tight junction protein claudin-5 and TEER in the HDMEC. Moreover, the intradermal injection of MPS prevented vascular endothelial growth factor-induced increase in vascular permeability in mouse skin. ConclusionWe found that MPS promoted microvascular stabilization and barrier integrity in HDMEC via Ang-1/Tie2 activation. These results suggest that MPS might improve microvascular abnormalities in various diseases accompanied by disturbances in Ang-1/Tie2 signaling.

Prevalence of skin disease among adolescent girls and their impact on quality of life

Introduction: Skin diseases can adversely affect the quality of life of an individual. Adolescence is acritical time in biophysical development and adverse skin conditions during this period can alter thegrowth in self-confidence and self-esteem and social engagement. Purpose: The present study wasdesigned to assess the burden, the pattern of skin diseases and their impact on their quality of life inadolescent students. Materials and Methods: A total of 23 schools having 3581 students between10-16 years of age were visited, out of which 3367 students were covered and screened. Skincharacteristics such as the severity of skin disease were recorded by the attended physician. Adermatology life quality index (DLQI) questionnaire was used to assess the effect of skin diseases ontheir quality of life. Results: Among the total cases 2,783 (82%) had skin diseases, of the651(19%) had two or more 2 skin diseases. Prevalence of infectious skin diseases was more in (10-12) young age groups 78.5% as compared to (13-16) later age groups of 55.2% (p<0.01).Pediculosis (52%) has a high point of prevalence, followed by scabies (25%), Pityriasis alba (6.6%),Seborrheic dermatitis (5%), Pyoderma (3.3%), Acne (2.6%) and Tinea (2%). Pediculosis andscabies together constitute 77% of all skin diseases. Conclusion: Good hygiene practices likeregular bathing, regular head wash, and hand wash should be taught to children. Hence training ofschool teachers and PHC doctors regarding the management of common skin diseases and Healtheducation to parents or guardians of children about Hygienic measures, sexual behaviour and needof seeking medical advice.

Prevalence of skin disease among adolescent girls and their impact on quality of life

Introduction: Skin diseases can adversely affect the quality of life of an individual. Adolescence is acritical time in biophysical development and adverse skin conditions during this period can alter thegrowth in self-confidence and self-esteem and social engagement. Purpose: The present study wasdesigned to assess the burden, the pattern of skin diseases and their impact on their quality of life inadolescent students. Materials and Methods: A total of 23 schools having 3581 students between10-16 years of age were visited, out of which 3367 students were covered and screened. Skincharacteristics such as the severity of skin disease were recorded by the attended physician. Adermatology life quality index (DLQI) questionnaire was used to assess the effect of skin diseases ontheir quality of life. Results: Among the total cases 2,783 (82%) had skin diseases, of the651(19%) had two or more 2 skin diseases. Prevalence of infectious skin diseases was more in (10-12) young age groups 78.5% as compared to (13-16) later age groups of 55.2% (p<0.01).Pediculosis (52%) has a high point of prevalence, followed by scabies (25%), Pityriasis alba (6.6%),Seborrheic dermatitis (5%), Pyoderma (3.3%), Acne (2.6%) and Tinea (2%). Pediculosis andscabies together constitute 77% of all skin diseases. Conclusion: Good hygiene practices likeregular bathing, regular head wash, and hand wash should be taught to children. Hence training ofschool teachers and PHC doctors regarding the management of common skin diseases and Healtheducation to parents or guardians of children about Hygienic measures, sexual behaviour and needof seeking medical advice.

Prevalence and Characterization of Fatigue in Patients with Skin Diseases.

The aim of this study was to examine the prevalence and nature of fatigue in patients with skin diseases by comparison with controls, using a survey of a large representative sample of the French population (n = 2,502). Of the respondents, 659 reported having a skin disease and 1,843 did not. Quality of life was decreased in people with skin diseases compared with controls, while levels of stress and sleep deprivation were higher in people with skin diseases. Level of fatigue was higher in people with skin diseases than in controls. The relative risk of fatigue was 4.71 (3.44– 5.98, p < 0.001). Mediation analysis, adjusted according to sex, age and each skin disease, showed that the effects of skin diseases on fatigue were more commonly direct than indirect. To our knowledge, this is the first study to demonstrate that patients with skin diseases experience fatigue more frequently and more intensely. Hence, fatigue should be used as a new patient-related outcome in clinical trials.

The stigma of skin disease.

The effects of skin disease on stigmatization are important but understudied in the pediatric population. Given the highly visible nature of dermatologic conditions, stigmatization is a common problem that requires significant attention in patients with skin diseases. In this review, we examine the recent literature addressing stigmatization of patients suffering from common dermatologic diseases with the goal to increase clinician awareness of these issues and identify new avenues for future research. A number of studies have examined the impact of skin disease on psychosocial well being and quality of life. Although some skin diseases are often overlooked medically and considered to be primarily cosmetic issues, the long-term consequences of skin diseases on psychosocial health, especially in pediatric patients, can be profound. The precipitating factors for stigma vary widely depending on age, sex, and culture. In order to effectively reduce the impact of pediatric skin diseases on psychosocial health, physicians should be able to identify specific characteristics that may increase risks for stigmatization in chidlren. Carefully monitoring psychosocial development in pediatric patients with dermatological conditions in addition to proactively guiding patients and families to appropriate resources can benefit the child's development and overall long-term well being.

Provitamin supramolecular polymer micelle with pH responsiveness to control release, bioavailability enhancement and potentiation of cytotoxic efficacy.

Encapsulation techniques to generate core/shell systems provide a method that improves physicochemical properties, which are very important in biological applications. β-carotene is a common carotenoid that has shown preventive effects in skin diseases and vitamin A deficiency but this compound has limited water solubility and bioavailability, which hinder its broad application. The use of polyrotaxane compounds formed from cyclodextrins has allowed supramolecular polymer micelles (SMPMs) to be synthesized to encapsulate β-carotene. The polymeric compound Pluronic F127® was also used to create core/shell nanoparticles (NPs) that contain β-carotene. Bioactive compound encapsulation was fully confirmed by nuclear magnetic resonance spectroscopy and by scanning and transmission electron microscopy. The method based on cyclodextrin and lecithin allow to release slowly when the systems were exposed to an aqueous medium by pH control, with an increase of 16 times of bioavailability comparing with free carotenoid. This allowed to potentiate the cytotoxic activity on a melanoma cell line by enhancing the water solubility to more than 28 mg/L, and present promising applications of SMPMs to provitamins.

Evidence of curcumin and curcumin analogue effects in skin diseases: A narrative review.

Curcumin, a natural polyphenolic and yellow pigment obtained from the spice turmeric, has strong antioxidative, anti-inflammatory, and antibacterial properties. Due to these properties, curcumin has been used as a remedy for the prevention and treatment of skin aging and disorders such as psoriasis, infection, acne, skin inflammation, and skin cancer. Curcumin has protective effects against skin damage caused by chronic ultraviolet B radiation. One of the challenges in maximizing the therapeutic potential of curcumin is its low bioavailability, limited aqueous solubility, and chemical instability. In this regard, the present review is focused on recent studies concerning the use of curcumin for the treatment of skin diseases, as well as offering new and efficient strategies to optimize its pharmacokinetic profile and increase its bioavailability.

567 Optimal ultraviolet wavelength to induce natural regulatory T cells

Narrowband ultraviolet B (NB-UVB) phototherapy (311-nm) is widely used to treat refractory skin disorders, such as psoriasis and atopic dermatitis. Recent studies reported that the mechanisms underlying the effects of phototherapy include inhibition of cell proliferation in keratinocytes, induction of apoptosis in pathogenetically relevant cells, and expansion of regulatory T (Treg) cells. Treg cells suppress inflammatory skin disorders. Although broadband UVB (290-320 nm) induces Treg cells, the optimal UV wavelength for inducing Treg is not known. Here we investigated which wavelength effectively induces Treg cells in a mouse model. Shaved C57BL6J mice were irradiated with several UV wavelengths (290 nm, 300 nm, 310 nm, and 320 nm) using a monochromator. After a single dose of 100 mJ/cm2 UV exposure, the lymph nodes and spleen were collected and analyzed with a flow cytometer. After 300 nm and 310 nm UV exposure, CD4+CD25+Foxp3+neuropilin-1+ (Natural Treg: nTreg) cells were increased by 3% to 4% in lymph nodes compared with those in sham irradiated mice (300 nm: from 9.17% to 13.5%. 310 nm: from 7.37% to 10.3%). The optimal UV wavelength range for inducing nTreg was 300 nm to 310 nm. This finding suggests that NB-UVB therapy effectively induces nTreg cells and mediates therapeutic effects in skin diseases.

Effects of Topical N-Acetylcysteine on Skin Hydration/Transepidermal Water Loss in Healthy Volunteers and Atopic Dermatitis Patients.

Dear Editor: Atopic dermatitis (AD) is a relapsing chronic inflammatory pruritic skin disorder that has been partially attributed to skin barrier dysfunction. Skin barrier function was previously estimated by measuring skin hydration and transepidermal water loss (TEWL), and low levels of skin hydration along with high levels of TEWL were reported in AD patients1,2. N-acetylcysteine (NAC) is a thiol derivative that stimulates the synthesis of glutathione, an internal antioxidant. NAC has been clinically used as a mucolytic agent as well as an antidote for acetaminophen toxicity. NAC was previously reported to be useful in the treatment of skin diseases including toxic epidermal necrolysis and lamellar ichthyosis3,4. NAC may exert beneficial effects in skin diseases by: (1) reacting with oxidative intermediates and replenishing intracellular cysteine levels; (2) inhibiting the production of proinflammatory cytokines and factors; and (3) regulating epidermal proliferation. In the present study, we assessed the clinical effects of topical NAC on skin hydration and TEWL in healthy volunteers and AD patients. We enrolled 10 healthy volunteers (6 males and 4 females, age range: 28 to 76 years) and 11 AD patients (6 males and 5 females, age range: 31 to 73 years). AD patients had been receiving topical treatments including corticosteroids and tacrolimus ointment. Patients were not receiving cyclosporine or methotrexate. Patients with severe co-existing conditions as well as those with a heavy smoking status and/or high alcohol consumption were excluded. Informed consent was obtained from all patients. This study was approved by the Ethics Committee of the Faculty of Medicine, Kagawa University (No. 20-14). A NAC solution (20 w/v%; Senju Pharmaceutical Co., Ltd., Osaka, Japan) or its control vehicle was applied to the forearm skin twice a day for 4 weeks. Forearm skin hydration and TEWL were measured before and after the topical NAC application. Skin hydration and TEWL were measured using a Corneometer and Tewameter (Courage+Khazaka Electronic GmbH, Cologne, Germany). The topical application of NAC for 4 weeks increased skin hydration in 9/10 healthy volunteers (Fig. 1A, increase from 36.2±9.9 to 48.8±15.7 arbitrary units, p=0.001) and decreased TEWL in 8/10 healthy volunteers (Fig. 1B, decrease from 13.5±8.9 to 10.1±6.1 g/hm2, p= 0.0341). Topical application of the control vehicle for 4 weeks decreased skin hydration in 8/11 AD patients (Fig. 1C, decrease from 39.3±15.1 to 33.3±11.6 arbitrary units, p=0.0409). The topical application of NAC increased skin hydration in 9/11 AD patients (Fig. 1C, increase from 35.6±12.0 to 44.7±13.9 arbitrary units, p=0.0262) and decreased TEWL in 9 AD patients (Fig. 1D, decrease from 18.1±15.1 to 10.8±11.2 g/hm2, p=0.0409). Fig. 1 (A, B) Effects of the topical application of N-acetylcysteine (NAC) (for 4 weeks) on skin hydration and transepidermal water loss (TEWL) in healthy volunteers. (C, D) Effects of the topical application of NAC on skin hydration and TEWL in atopic dermatitis ... In a mouse model of AD, NAC was reported to restore the expression of some cell adhesion molecules that contribute to skin barrier formation by reducing oxidative stress5. Therefore, the topical application of NAC may increase skin hydration and decrease TEWL by strengthening the function of this barrier. Lamellar ichthyosis exhibits abnormal keratinization due to TGM1 gene mutations and a differential pattern of filaggrin expression, which implies that the success of NAC treatment in lamellar ichthyosis may be attributed to NAC-induced amelioration of abnormal keratinization and improvements in skin barrier function. Our results also support the possibility of skin barrier function restoration by NAC. Although AD patients generally have low levels of skin hydration and high levels of TEWL1,2, we could not obtain consistent results. Some AD patients have been shown to have normal skin barrier function6, and these values can be affected by various factors such as seasonality, exercise, and lifestyle. Thus, future studies involving a larger number of patients and excluding skin barrier-deteriorating factors are required to accurately assess the effects of NAC on AD.

Stressing the Steroids in Skin: Paradox or Fine-Tuning?

The skin has recently been found to be an extra-adrenal site for glucocorticoid (GC) synthesis that likely acts to modulate local inflammation. Psychological, physiological, and physical stress, both acute and chronic, triggers immune-protective or -damaging responses, including increases in systemic GC levels, which, according to Lin et al. (this issue), may be beneficial in inflammatory skin disease. However, little is known about the interplay between local and systemic production of GCs and the effect of stress (local or systemic) in regulating tissue-specific GC synthesis, its impact on skin homeostasis, and its effect of skin disease.

The effects of skin disease on the penetration kinetics of hydrocortisone through canine skinin vitro

This study investigated the effects of allergic skin disease on the penetration kinetics of hydrocortisone through canine skin in vitro. Full-thickness lesional and nonlesional (normal) skin was removed from the dorsal lumbosacral and dorsocaudal thoracic regions, respectively, of five canine cadavers. The dogs were suspected of having flea allergy dermatitis based on their distribution and types of skin lesions. Nonlesional skin was confirmed to be histologically normal, and the histopathology of the lesional skin was consistent with allergic dermatitis. Excised skin was clipped, mounted in Franz-type diffusion cells, and the transdermal penetration of a saturated, radiolabelled hydrocortisone solution was measured over 30 h. When the penetration data for all five dogs were pooled, a restricted (or residual) maximal likelihood mixed model predicted that the permeability coefficient and pseudosteady-state flux of hydrocortisone was more than twice as great (95% confidence interval 1.55-2.71 times as great; P < 0.0001) through lesional compared with nonlesional skin. There was no significant difference in the lag time for hydrocortisone penetration through lesional compared with nonlesional skin of the dogs. This study has confirmed that the transdermal penetration of hydrocortisone may be altered, typically increased twofold, but could be as high as 10-fold, through lesional compared with nonlesional skin of dogs with suspected flea allergy dermatitis. This is likely to be affected by variables such as disease severity, concurrent infections and interindividual differences in skin characteristics.

Effects of Skin Disease on Quality of Life

Skin diseases such as acne, psoriasis, and eczema are associated with a significant impairment in the quality of the patient's daily life. Several

Sex and the skin: A qualitative study of patients with acne, psoriasis and atopic eczema

Quantitative questionnaire-based research has suggested a considerable effect of skin disease on the sexual life of sufferers. In this study, we explored the effects of acne, psoriasis and atopic eczema upon sexual functioning and sexual relationships in the context of a wider exploration of the psychological sequelae of these diseases. We employed a qualitative methodology employing in-depth semi-structured interviews and involving thematic analysis and constant comparison. Participants were patients with currently active acne, psoriasis or atopic eczema. Purposive sampling aimed to obtain a sample reflecting a wide range of participant characteristics including skin disease severity, age, sex, and care by general practitioner or dermatologist. Sixty-two semi-structured interviews were conducted. Acne had adverse effects on participants' self-perceived sexual attractiveness and self-confidence, as did psoriasis and eczema. But psoriasis and eczema also had marked effects on sexual well-being and on capacity for intimacy. These were related to issues of self-esteem and sexual self-image and were often pervasive, resulting in marked behavioural avoidance of intimate situations and continuing effects on sexual well-being even in long-established sexual relationships. Effects of psoriasis and eczema on sexual well-being and sexual relationships were mediated more by appearance and texture of non-genital skin than by involvement of genital skin. We conclude that, while recognising the distressing effects of acne on self-perceived sexual attractiveness, clinicians should be especially aware of the capacity of psoriasis and eczema to profoundly affect patients' psychological and sexual well-being.

Pregnancy and Pregnancy Outcome among Women with Inflammatory Skin Diseases

Background/Aims: The effect of inflammatory skin diseases on pregnancy has been incompletely characterized. We sought to estimate the incidence of pregnancy and pregnancy outcomes among women with inflammatory skin diseases. Methods: Cohort study of women with atopic dermatitis (AD), psoriasis, other inflammatory skin diseases, and comparison group, followed for pregnancies and pregnancy outcomes. Results: There were 3,131 pregnancies among 64,773 woman-years (4.8/100) in women with skin diseases, and 2,592 pregnancies among 59,826 woman-years (4.3/100) in the comparison group. The age-standardized incidence of pregnancy was similar to the comparison group [rate ratio (RR) = 1.2, 95% confidence interval (CI) 1.0–1.4 for AD, RR = 1.1, 95% CI 1.0–1.2 for psoriasis, and RR = 1.1, 95% CI 1.0–1.1 for other]. Spontaneous abortion was also similar to the comparison group (RR = 1.2 for AD, 95% CI 1.0–1.4, RR = 1.1, 95% CI 1.0–1.2 for psoriasis, and RR = 1.1, 95% CI 1.0–1.1 for other). Conclusions: Our results suggest little effect of skin disease on incidence or outcome of pregnancy.

Skin disease disability: measuring its magnitude.

Skin diseases cause considerable discomfort, but usually do not affect patients' lifespan. However the effects of skin disease on patients' lives can be profound, as all aspects of life can be interfered with. Methods to measure these effects on life quality are needed for clinical, research, audit and political reasons. General health questionnaires such as the Sickness Impact Profile or the Short Form 36 can be used to compare the impact of skin disease to the impact of diseases of other systems. Disease specific questionnaires such as the Psoriasis Disability Index, dermatology specific measures such as the Dermatology Life Quality Index (DLQI), and utility measures can all be used in dermatology and have their different specific indications. The use of the DLQI has quantified the major impact that inflammatory skin disease has on patients and has been used to demonstrate the improvement resulting from systemic therapy and from inpatient management. A version for use in children has also been described. The information gained from this work can be used to demonstrate the importance of adequately managing skin disease in the community and can help to guide resource allocation.

Studies on human skin lymph containing Langerhans cells from sodium lauryl sulphate contact dermatitis.

Immunologic processes in diseased human skin have been extensively investigated, but little is known about the effect of skin diseases on human afferent skin lymph. Starting in the papillary dermis, the skin lymphatics drain the adjacent tissue in a one-way flow toward the regional lymph nodes. The composition of the afferent lymph, therefore, reflects the immunologic inflammatory processes in the drained tissue. To obtain afferent lymph to investigate its content, we inserted a cannula, by means of microsurgery, into a superficial peripheral lymph vessel draining a defined skin area. By manipulating the drained skin area and subsequent examination of the lymph we established an in vivo system for investigating the kinetics of lymph changes during the course of skin reactions. In lymph derived from a mild sodium lauryl sulphate (SLS)--induced contact dermatitis we could demonstrate an increase of both flow and cells. In particular, the number of Langerhans cells (LC) increased enormously during the course of the skin reaction. It, therefore, seems that a large increase in the migration of LC from the skin to the regional lymph nodes is a major feature of SLS-induced contact dermatitis, suggesting that LC may play a major role in the irritant contact dermatitis reaction.

Effect of skin diseases on attitudes and interpersonal behavior

Our observations of psychosomatic dermatology, formed in liaison consultation within the Unit of Psychosomatics of the University of Florence Department of Dermatology, have led us to certain considerations along lines suggested to us by social psychology, a discipline that tends to consider all human phenomena from a viewpoint which is at the same time psychological and sociologic, rejecting the prejudice which relegates the psychologic to the sphere of the individual and the social to that of the collective. Social psychology was recognized as a separate discipline at the beginning of the century when, in 1908, two treatises that appeared within a few months of each other—one by an American, Ross, 1 the other by an Englishman, McDougall 2—were the first to use the title “Social Psychology.” With these began the period of scientific elaboration of social psychology. In 1924, another text, by Allport, 3 was the beginning of systematic experimental elaboration of social psychology. Freud 4 confirmed, in 1921, that the contraposition of individual and social psychology is really meaningless, since man is always, with rare exceptions, in relationship with others; therefore, individual psychology is also social psychology.