Hyperkeratinization Research Articles

Novel Strategies in the Treatment of Acne: A Review

Skin break out and eruptions is a typical incendiary issue among people of all age groups, but most common in adolescents. Skin break out development is reliant upon mechanisms, including follicular hyper keratinization, excess sebum secretion, colonization of pathogenic bacteria like Propionibacterium acnes and an incendiary course. Treatment strategies predominantly include the use of antibiotics. The use of antibiotics for the treatment of acne is associated with certain side effects like imbalance of skin and gut microbiome and multidrug resistance. This article explains the use of probiotics as a promising tool for the treatment of acne rather than antibiotics. Likewise talk about the favorable conditions and extra advantages offered by probiotics for stability enhancement of topical formulations. This review focuses on the use of bacteriocins in antiacne formulations, use of natural surfactant having additional antiacne properties and bacteriocins having anti-microbial and preservative action. Recent advancements in this field along with the patents are also enlisted

A Comparative Formulation Development and Evaluation of Tazarotene Ethosomal and Transfersomal Gel for Effective Management of Acne

Acne vulgaris is the most prevalent disorder in the period before puberty when increased adrenal androgen level causes enlargement of the sebaceous glands and it increased the production of sebum on the face, chest, and back. This disease is caused due to interaction between many causative agents or pathogenic components which lead to formation of the acne and those are seborrhea, follicular hyper keratinization, microbial formation of pilosebaceous unit by Propionibacterium acne and arrival of inflammatory mediators. Tazarotene is a well-known retinoid related to vitamin A that belongs to an acetylenic class of retinoid, used in the management of acne. Oral administration of Tazarotene causes changes in bone morphology after prolonged exposure to high doses, which also exhibit teratogenicity but this does not occur with topical delivery. Ethosomes are non-invasive delivery carriers enabling drugs to reach to the bottom of the skin layers and/or the system and transfersomes are the self-adaptable ultra-deformable flexible elastic bilayer vesicles composed of phospholipids able to penetrate through the pores of skin even smaller than its size. Present research aims the comparative evaluation of ethosomal and transfersomal gels loaded with Tazarotene in the treatment of acne. In the present study, ethosomes and transfersomes were formulated by the cold method and hand-shaking method, respectively, followed by loading of Tazarotene and development into gel formulation. The formulated gel samples were evaluated for in vitro release study, in vitro permeation study, in vitro anti-acne study, in vivo percutaneous permeation study by CLSM, and in vivo anti-acne study. The results proved that both the formulated ethosomal and transfersomal gels have better permeation through the skin but ethosomal gel showed better release in comparison to transfersomal gel, also final gels exhibited the anti-acne potentiality.

The influence of retinol concentration in liquid crystal formula on epidermal growth factor, interleukin-6 and transglutaminase-1 mRNA expression in the epidermis.

Topical retinol application effectively reduces the effects of photoaging and improves skin condition, e.g. influences the process of keratinization of the epidermis, which improves stratum corneum structure and reduces transepidermal water loss. However, cosmetics use lower concentrations of retinol, which has been associated with emerging hypersensitivity reactions as well as redness and irritation of the skin. The question arises whether the vehicle used in the cosmetic may be important in stimulating the inflammatory reaction in the skin and if the concentration of retinol used could significantly affects the growth of epidermal cells. The aim of this study was to evaluate the effects of different concentrations of liquid crystal retinol (0.15%, 0.3% and 0.5%) on the clinical and histological characteristics of a reconstructed epidermis skin model. It also compares the effectiveness of 0.3% retinol formula in liquid crystal to that in lipid. The study used reconstructed human epidermis tissue containing normal human keratinocytes. Four original formulas containing retinol were tested: 0.15%, 0.3% and 0.5% with a liquid crystal base, and 0.3% with a lipid base. Interleukin 6 (IL-6), transglutaminase-1 (TGM1), and epidermal growth factor (EGF) mRNA expression was measured expression of the skin-equivalent tissue for 10 days of exposure. Histopathological analysis and mRNA quantification were performed. Gene expression was analyzed by total mRNA extraction. All liquid crystal formulas induced higher EGF mRNA expression than lipid base formula. IL-6 expression did not differ significantly from the DPBS reference values. Interestingly, TGM1 expression was found to increase together with increasing retinol concentration (0.15%, 0.3%, 0.5%). Histological examination revealed changes in epidermal structure, mainly hyperkeratinization of the stratum corneum. Our results support the hypothesis liquid crystal formula might be regarded as more beneficial since it inducess less pro-inflammatory action manifested by lowered expression IL-6. In addition, EGF expression was found to correlate significantly with the retinol concentration of the liquid crystal formula: 0.5% > 0.3% > 0.15% (P < 0.05). Lower concentrations may increase TGM1 expression, thus enhancing the formation of a protective layer of cornified envelope.

Histomorphometric Effects of Smokeless Tobacco on Submandibular Gland in Albino Rat

Background: Use of the smokeless tobacco is a major public health problem. Oral mucosal hyper keratinization occurs due to smokeless form of tobacco. Objective: To determine the Submandibular Gland injuries induced by smokeless tobacco in Albino Rat. Study Design: Experimental study. Settings: Department of Oral biology, Liaquat University of Medical & Health Sciences, Jamshoro-Pakistan. Duration: From November 1, 2015 to April 30, 2016. Methodology: Aalbano healthy rats were used to observe smokeless tobacco effects on submandibular glands. After initial weight record, rats were placed in three groups (A, B, C); Group-A (control group), group-B and group-C were fed with tobacco; non-smokeless, smokeless 5%, and smokeless 10%, respectively. During experiment, weight gain was recorded weekly and sub-mandibular gland weight was measured at the end of the trial. T-test was applied to analyze the data. H & E stain and reticulin stain were used to observed structural integrity of submandibular gland. All the data was recorded in the self-made proforma. Results: Overall body weight and submandibular weight were decreased in B and C groups as compared to control group. In group A, seromucinous acini was seen in parenchymal tissue, cuboidal epithelium showed duct line and red blood cells distended vessels. Stromal changes, narrow duct lumen and reasonable damage in parenchymal tissue with atrophy were detected in group B. Stromal tissues increased and atrophy of acini were observed in H and E stain during histological study. Further, as compared to control groups, in group B and C under reticulin stain and stromal tissues were enlarged with pragmatic vascular collapse. Conclusion: This study revealed abnormal histological changes in submandibular gland of albino female rats by oral use of smokeless tobacco.

3281 Management of Acute Rejection in Penile Allotransplantation

3281 Management of Acute Rejection in Penile Allotransplantation

Confocal microscopy in adult women with acne.

Acne is an inflammatory disease of the pilosebaceous follicle, affecting 41-54% of adult women, with a particular form that involves the mandible. We characterized infundibulum morphology in two groups of adult women using reflectance confocal microscopy. First, we investigated acne visually "healthy zones" on the forehead in 15 adult women with diffuse acne and compared with acne-free controls. We then compared healthy forehead and affected mandibular zone in 15 acne patients with mandibular involvement. Exposed results had a P<0.05. Seven hundred and ninety-one follicles were observed on apparently healthy skin of 15 adult women with acne, with a larger diameter, thicker (68%), and hyper keratinized (65%) follicle border, and more keratin plugs (44%) than in controls. In the second group of 15 adult women with mandibular acne, we compared 569 follicles in the mandibular zone and 475 on forehead. In the mandibular area, follicles were significantly larger, thicker (76%), more hyper keratinized (72%), with more keratin plugs (47%) and increased inflammation (23%) compared with the forehead area. In the mandibular area, 0.2% of follicles showed isolated inflammation without hyper keratinization, and 15.3% had both thickened borders with an onion-like appearance and keratin plugs associated with inflammation. Hyper keratinization was higher in healthy skin of adult women with acne compared with controls, confirming that microcomedo is crucial in the development of acne lesions. We also demonstrate that the repartition of comedones and microcomedones is inhomogeneous with a great number in the mandibular area where acne lesions are located.

The Role of Propionibacterium acnes Biofilm in Acne Vulgaris

Acne vulgaris is traditionally known as the result of excess sebum production, follicular hyper keratinization, infection with Propionibacterium acnes, and follicular inflammation. However, the role of P. acnes is gaining momentum as the primary impetus in the pathogenesis of acne vulgaris. The biofilm-forming ability of P. acnes in vitro and on indwelling medical appliances and catheters has been known for quite some time, but only in the last decade has the presence of P. acnes biofilm been observed within the pilosebaceous unit. Since that time, the genome of the microbe has been sequenced, and genes responsible for quorum sensing and biofilm formation have been confirmed. As a result of biofilm formation, the virulence of P. acnes is amplified. Biofilm-encapsulated P. acnes upregulates the production of lipases, resulting in the production of free fatty acids. Free fatty acids as well as the biofilm itself bind the Toll-like receptors TLR2 and TLR4, activating the innate immune system, culminating in a robust inflammatory response. Biofilms also appear to significantly contribute to antibiotic resistance. Acting as a physical barrier for antibiotics as well as a commune for bacteria to exchange antibiotic resistance genes, the biofilm plays an integral role as the major hurdle to treating acne vulgaris. Traditional antimicrobials have not shown much promise in disruption of the biofilm. Other approaches have been investigated utilizing a variety of novel topical compounds that act to prevent or disrupt the biofilm as a therapeutic modality. The role of biofilm in the pathogenesis of acne vulgaris has remained underappreciated, but with global antimicrobial resistance looming, further attention may be warranted

Predisposing genes in acne

Acne is a common chronic inflammatory disease affecting hair follicles and sebaceous glands with unclear pathogenesis. It is a multifactorial disease and several pathogenetic factors have been identified, including the increase of androgen and sebum excretion, follicular hyperkeratinization, infection with Propionibacterium acnes, external factors, innate immunity, genetics, etc. Latest studies have indicated that acne is a polygenic disease and there is a particularly close correlation between severe acne and heredity. Many predisposing genes have been discovered for acne, including human CYP11α gene, CYP17 gene, CYP1A1gene, androgen receptor gene, CYP21 gene, etc. Therefore, the investigation into susceptible genes for acne may be beneficial to the early diagnosis, treatment and prevention of severe acne. Key words: Acne vulgaris; Genes; Heredity