Skin Layer Research Articles

Essential Oils as Dermocosmetic Agents, Their Mechanism of Action and Nanolipidic Formulations for Maximized Skincare

Essential oils (EOs) are known for their diverse bioactivities, including antioxidant, anti-inflammatory, antibacterial, antifungal, antiviral, skin-barrier repairing and anticancer, and therefore, hold profound potential to be used in cosmetic and skincare products. Owing to these properties, EOs have long been utilized to address a range of dermatological issues, from acne and inflammation to aging and dryness. However, problems associated with EOs beset their practical applications, which include high volatility, oxidation, hydrophobic nature, low bioavailability, skin irritation, chemical transformation and poor stability in air and light. A prospective of nanolipidic formulations, including the nanostructured lipid carriers (NLCs) and solid lipid nanoparticles (SLNs) system for improved skin delivery of these EOs highlights the possibility of their use in topical applications, which offer several advantages such as improved bioavailability and stability, lower toxicity and higher drug content. These nanoformulations protect the EOs from environmental degradation and improve their penetration into deeper skin layers, leading to prolonged therapeutic benefits. The delivery of bioactive agents using a conventional topical preparation exhibits low penetration, frequent applications, poor adherence and prolonged therapy duration, whereas the novel delivery system exhibits improved stability of the drug, enhanced skin penetration, enhanced retention and better therapeutic efficacy. This review provides a comprehensive compendium of information on EOs, which are widely used in skincare, along with their nanolipidic formulations for maximized skincare uses. The mechanism of action of EOs as skin bioactive agents, challenges associated with their use, advances in nanolipidic formulations and their market value as cosmetic skincare products are also explored.

Constructing positively charged hollow fiber nanofiltration membranes with high performance for the treatment of wastewater containing heavy metal ions

The presence of heavy metal ions in wastewater has been identified as a significant environmental and human health concern. Positively charged hollow fiber (HF) Nanofiltration (NF) membranes show great promise and excellent potential for the removal of heavy metal ions due to Donnan exclusion effect. Nevertheless, the current limitations of positively charged HF NF membranes, including complex preparation process, low flux and poor selectivity, continue to impede their broader implementation. In this work, a high flux HF NF membrane with positively charged surface was fabricated via doping piperazine in the aqueous-phase solution of polyethyleneimine to modulate the interfacial polymerization and to adjust the structure of the subsequent polyamide skin layer. Subsequently, the surface of this nascent skin layer was modified with diethylenetriamine/ethanol solution to increase its positive charge density, and thus to improve the rejection of multivalent cations. The optimal HF NF membrane shows a pure water permeability of 160 LMH/MPa and a MgCl2 rejection of higher than 97 %. In addition, it shows a rejection of higher than 95 % for heavy metal salts such as CoCl2, MnCl2, NiCl2, CuCl2 and Cr2(SO4)3, and a rejection of more than 98 % for antibiotics such as tetracycline hydrochloride, oxytetracycline and levofloxacin. It also possesses good resistance to acid and contamination. In addition, the optimal HF NF membrane has been successfully scaled up to a module of 20 filaments and still shows excellent separation performance, suggesting its vast potential for industrial application.

Advanced multimodal ultrasound for pre-operative assessment of skin tumours: A case series.

Pre-operative assessment of non-melanoma skin cancers via advanced ultrasound techniques may potentially provide additional information to tumour margins and morphology compared to current assessment via dermoscopy or optical coherence tomography. In this case series, the findings of multimodal ultrasonography of non-melanoma skin cancer are described, with histological correlation. Consecutive patients with clinical suspicion of malignant skin lesions underwent multimodal ultrasonography, comprising B-mode, colour Doppler imaging, superb microvascular imaging, strain elastography, and shear-wave elastography, followed by surgical excision. Images were reviewed by two radiologists. There were 8 female and 3 male patients, whose age ranged from 66 to 98 years. A total of 11 malignant skin tumours (basal cell carcinoma, n = 6; squamous cell carcinoma, n = 5) were reviewed. Tumour depth measured via ultrasound assessment ranged from 1.20 to 7.00 mm (mean ± standard deviation: 4.35 ± 1.99 mm). Tumours were located within dermis (n = 1) and abutting subcutaneous layer (n = 10) sonographically. Where corresponding histological reports for tumour depth were available, ultrasound correlated well with histology. Ultrasound also correctly predicted the deepest layer of involvement for all lesions. The sonographic features observed in all malignant skin tumours (11/11:100%) are solid, hypoechoic, with abundant neovascularity on colour Doppler imaging and superb microvascular imaging, and appeared stiff on strain elastography and shear-wave elastography. In some cases, the microvascular network of intra-tumoural flow were better demonstrated on superb microvascular imaging. Multimodal ultrasound can potentially be a useful and quick adjunctive tool for the pre-operative assessment of skin cancer by delineating the tumour depth and deepest skin layer involvement, ensuring complete excision of tumour.

The nonlinear free vibration analysis-based an enhanced finite element procedure of tri-functionally graded sandwich plates with a square central cutout

The main goal of this article is to study the nonlinear free vibration of tri-functionally graded sandwich (Tr-FGSW) plates with a square central cutout using an enhanced FEM based on an improved FSDT (so-called i-FSDT). The Tr-FGSW plates include two 3D-FGM skin layers and a 2D-FGM core layer. The geometrical nonlinearity arising from mid-plane stretching is modeled using the von Kármán assumption. The governing equation is established by using Hamilton’s concept. The accuracy and efficiency of the proposed method are verified through comparative examples. Then, the effect of the geometrical dimensions, material properties, BCs, and central cutout size on the nonlinear free vibration of Tr-FGSW plates is investigated in detail. The obtained results show that increasing the volume ratio indices leads to a decrease in the frequency of Tr-FGSW plates while increasing the 2D-FGM core layer thickness as well as the central cutout size increases the frequency of Tr-FGSW plates. These results are expected to be useful for future design and manufacturing processes involving the nonlinear response of these structures.

Bacterial comparison study of prosthetic liners.

Amputee patients in low-resource settings face a heightened risk of skin infections at the skin-liner interface of their residual limb, which can develop into a variety of serious complications. Most research comparing prosthetic liners has focused on mechanical and aesthetic properties. However, the relative propensity of different liner types to host bacterial growth has yet to be explored. To address this question, we performed a bacterial comparison study across a traditional sock-EVA combination liner, an advanced Ossur Iceross silicone liner, and a novel silicone liner designed for low-resource hospitals in developing nations. We cultured Staphylococcus aureus within a novel physical model of the skin-liner interface, incorporating a replicate skin layer suspended over a self-regulating heat source. After culturing bacteria for 24 h, we collected and quantified cells in solution. Statistical analysis of the bacterial growth concentration from 9 trials revealed relative consistency of growth across the 3 liner types, suggesting that none of the liners pose heightened risks of infection, relative to the others. These results suggest that certain innovative prosthetic materials may safely be considered for fabrication of prosthetic liners in low-resource environments. The in vitro skin-liner model and test method for bacterial growth characterization introduced herein may be useful for future dermatological simulations.

Evaluation of Dutasteride-Loaded Liposomes and Transfersomes for Follicular-Targeting for Androgenic Alopecia Topical Treatment

Background/Objectives: Although androgenic alopecia is the most prevalent among non-cicatricial alopecia, it still lacks an effective and safe treatment. Dutasteride (DUT) shows promising results in hair regrowth; however, oral DUT intake causes serious sexual adverse events. Hence, we produced liposomes with different bilayer structures and evaluated the capability of such systems in increasing DUT accumulation in the hair follicles. Methods: In vitro skin penetration tests were performed with porcine ear skin, and the follicular targeting factor (Tf) was calculated as the ratio between DUT amount in HFs and DUT recovered from the sum of all skin layers. Results: While the stiffer DUT-loaded liposome was not able to target the hair follicles in 12 h (Tf = 0.15), a DUT-loaded liposome with an edge activator in its composition, i.e., transfersomes, promoted better control over DUT release and a higher Tf (0.32) (p < 0.005). Conclusions: Transfersomes present higher affinity with DUT providing a better controlled release; hence, they are a better option for DUT follicle targeting compared to liposomes. Further formulation optimizations are needed aiming to prolong such targeting effect.

Potential of Deer Placenta Extract in Hair Cell Regeneration and Its Nanoniosome-Microspicule Gel as a Transfollicular Delivery System

Background: Deer placenta extract (DPE), rich in bioactive macromolecules, promotes regenerative effects in both normal and damaged cells. However, effective delivery of these macromolecules through the skin remains a challenge. Objectives: To investigate the potential of DPE in regenerating hair cells and to develop a nanoniosome (NS) and microspicule (MS) formulation as a promising transfollicular delivery system. Methods: The bioactivity of DPE was assessed in human follicle dermal papilla (HFDP) cells, including cells damaged by chemotherapy. The NS-MS formulation was designed to deliver biomacromolecules from DPE into skin and hair follicles. Results: DPE at 2000 µg/mL exhibited no cytotoxicity and significantly enhanced proliferation in both normal and cisplatin-treated HFDP cells. The DPE-loaded NSs displayed nanovesicles with a uniform size distribution and a negative surface charge. When incorporated into the MS gel, NS-MS demonstrated a synergistic effect, significantly enhancing the transdermal and transfollicular delivery of macromolecular protein into the skin layers and hair follicles. Conclusions: DPE promoted hair cell proliferation and facilitated the recovery of hair cells damaged by chemotherapy, especially when formulated into the NS-MS system, which effectively delivered bioactive macromolecules to the target site. This suggests its potential role in promoting hair regrowth.

Methylglyoxal impairs human dermal fibroblast survival and migration by altering RAGE-hTERT mRNA expression in vitro

Fibroblasts are native residents in dermal layer of human skin which are important for dermal regeneration and essential during cutaneous wound healing by releasing inflammatory markers and actively migrate to close an open wound. Premature skin ageing due to methylglyoxal (MGO) has recently caught the attention considering its potential to accelerate the emergence of skin ageing signs, however previous studies were only focused in primary neonatal dermal fibroblast and NIH3t3 fibroblast cell line. Therefore, thorough investigation is required to study the impact of MGO on primary human dermal fibroblast isolated from adult subject (HDFa). In our experiments, short exposure of MGO was observed to induced significant reductions in cell viability at concentrations of 7.5, 10, 12.5, 15, and 17.5 mM (p < 0.005) after 3 hours of treatment. The cellular death of HDFa at 10, 12.5 and 15 mM of MGO were also marked by increased in intracellular ROS level, indicating the involvement of oxidative stress-induced death in these cells. We also observed enlarge scratch areas of cells exposed with 7.5 and 10 mM MGO compared to control after 26 hours, thereby suggesting a decline in cell migration and viability in this group. We propose the increased ROS as the consequence of AGE-RAGE activation which was marked by significant elevation of RAGE mRNA on cells exposed to 10 mM MGO. Our data also suggest the occurrence of DNA damage events via ROS-induced oxidation or mediated by decline in hTERT mRNA expression.

A brief review on declarative concepts of pharmaceutical characteristics, classification, mechanisms, preparation, formulation and evaluation studies of moisturizing cream

The pharmaceutical creams play important role on tropical applications in which moisturizers are one of the widely industrial preparations involved for to nourish, soften and moisten the skin for the clients. These are mainly effectively works on dry skin clients combating various cases such as itch, pain, stinging, tightness, tingling and many more problems. The moisturizers are products mainly aimed to raising the SC’s water surface content helps the skin smooth, hydrates and hence maintaining a normal pH of skin. They are classified as emollients, humectants, occlusives and protein rejuvenators moisturizers helps to aid skin layers and even modifies its barriers. But its ingredients needed to be considered as non-irritant, nontoxic and non-adverse effects. This review main purpose is to describe about the overall published studies being for making moisturizing creams are interest able, advantageous and all the characteristics, mechanism, preparation, formulation and evaluation within the elegant criteria fulfilled. Even have clinical details for various disorder which are already been suggested by expert as well as adjuvant therapy suggested by experts. The patterns are being studied about water-in-oil emulsion design along with its needs which are being qualified under evaluation parameters for to know about qualified moisturizing creams.

The Rochester Model for Spinal CSF Leak Repair Simulation and Scoring.

Iatrogenic spinal durotomies occur at a rate of 1% to 17%. Surgical simulation for durotomy repair is needed to provide affordable, accessible, and validated practice. This study sought to design and validate a simple 3-dimensional printed model for spinal cerebrospinal fluid (CSF) leak repair and to introduce the Rochester original objective structured assessment of technical skills (OSATS) CSF leak (ROCL) repair criteria for assessment. A spinal model was designed to mimic a lumbar laminectomy with the L3-5 lamina removed and 3-dimensional printed using Vero polymers. The model was paired with a porcine collagen "dura" that was pressurized using IV saline and overlayed with gel-molded fascial, muscle, and skin layers with an opening. Participants were provided a training model with a 1.5-cm midline durotomy, surgical microinstrument set, microscope, and 6-0 prolene suture. The 25-point ROCL repair criteria were adapted from the original OSATS principles to assess proficiency in surgical repair by 2 blinded neurosurgeons not participating in the trials. Postsimulation survey data regarding model realism were collected. Six residents and 4 attendings participated. Median operative time in minutes was 13 minutes among residents and 7 minutes among attendings. Moreover, the ROCL score was a median of 19/25 for attendings and 15/25 for residents. The suture angle was statistically more consistent among senior residents and attendings compared with junior residents. Participants agreed that the model was realistic (median 4/5), useful for improving the operative technique (median 5/5), and would increase comfort in spinal CSF leak repair procedures (median 5/5). Each reusable model had a cost of $19.99 if printed with polylactic acid and each replacement dura cost <3¢. This study presents an affordable, realistic, and educational spinal CSF leak repair model and introduces ROCL for assessment.

Exploring the effective reuse rate of materials and elements in the construction sector

In North-West European countries, the uptake of reusing construction elements following their first use in a building is still low. Although a large number of elements are technically reusable, they end up being recycled by crushing ormelting, or simply disposed of. This results in a high environmental impact and a net loss of economic value. This study aims to define a framework that can guide project managers, public and local authorities, as well as other organisations in setting, measuring, and reporting rates of material reuse in construction and renovation projects. To support this, a retrospective analysis was conducted on 32 construction and renovation projects that have incorporated reclaimed elements. To quantify the effective reuse rates, the data are categorised according to the types of work, functional layers, and type of projects. In summary, achievable reused targets can be determined for the structural layer (1–5% in mass), skin layer 5–15 % in mass), space plan layer (10–25 % in mass), and for outdoor surfaces (0–50 % in mass). Results confirm the contextual nature of reuse practices, emphasising that the achieved rates of reuse are linked to project types in specific layers, and depend on the overall quantity of materials in a project. It also underscores the importance of integrating reuse rate calculations proactively at the beginning of the project, particularly during the preparation of the bill of quantities. This can be accomplished by utilising appropriate procurement strategies, as-built documentation, monitoring material flows during works, and establishing a detailed record of reclaimed building elements.

On some features of diurnal dynamics of solonchak emissivity in summer

ABSTRACT Widely represented in many arid regions of the world, dry marshes pose a potential threat to the adjacent areas because of soil salinization caused by wind transfer (for long distances) of toxic mineral salts from the dried surface. For environmental monitoring of such soils, remote microwave sensing methods are used. In this work, we study at a 2.3 cm wavelength the summer diurnal dynamics of microwave radiation of sodic solonchak formed on the dried bottom of a hypersaline lake. It has been established that the study indicator (in the centimetre range) depends on the cumulative changes in temperature, moisture and salinity of soils. With rise in soil temperature, intensive evaporation and topsoil drying, a salt crust and the underlying layer with less moisture (accompanied by microwave radiation interference on the layered structure of solonchak) can be formed. In the experiment, a daily variation in the brightness temperature of the study object (a specific object) by 25 K occurred with change in thermodynamic temperature of the skin layer by 10 K.

Dosimetric and biological impact of activity extravasation of radiopharmaceuticals in PET imaging.

The increasing use of nuclear medicine and PET imaging has intensified scrutiny of radiotracer extravasation. To our knowledge, this topic is understudied but holds great potential for enhancing our understanding of extravasation in clinical PET imaging. This work aims to (1) quantify the absorbed doses from radiotracer extravasation in PET imaging, both locally at the site of extravasation and with the extravasation location as a source of exposure to bodily organs and (2) assess the biological ramifications within the injection site at the cellular level. A radiation dosimetry simulation was performed using a whole-body 4D Extended Cardiac-Torso (XCAT) phantom embedded in the GATE Monte Carlo platform. A 10-mCi dose of 18F-FDG was chosen to simulate a typical clinical PET scan scenario, with 10% of the activity extravasated in the antecubital fossa of the right arm of the phantom. The extravasation volume was modeled as a 5.5mL rectangle in the hypodermal layer of skin. Absorbed dose contributions were calculated for the first two half-lives, assuming biological clearance thereafter. Dose calculations were performed as absorbed doses at the organ and skin levels. Energy deposition was simulated both at the local extravasation site and in multiple organs of interest and converted to absorbed doses based on their respective masses. Each simulation was repeated ten times to estimate Monte Carlo uncertainties. Biological impacts on cells within the extravasated volume were evaluated by randomizing cells and exposing them to a uniform radiation source of 18F and 68Ga. Particle types, their energies, and direction cosines were recorded in phase space files using a separate Geant4 simulation to characterize their entry into the nucleus of the cellular volume. Subsequently, the phase space files were imported into the TOPAS-nBio simulation to assess the extent of DNA damage, including double-strand breaks (DSBs) and single-strand breaks (SSBs). Organ-level dosimetric estimations are presented for 18F and 68Ga radionuclides in various organs of interest. With 10% extravasation, the hypodermal layer of the skin received the highest absorbed dose of 1.32±0.01Gy for 18F and 0.99±0.01Gy for 68Ga. The epidermal and dermal layers received absorbed doses of 0.07±0.01Gy and 0.13±0.01Gy for 18F, and 0.14±0.01Gy and 0.29±0.01Gy for 68Ga, respectively. In the extravasated volume, 18F caused an average absorbed dose per nucleus of 0.17±0.01Gy, estimated to result in 10.58±0.50 DSBs and 268.11±12.43 SSBs per nucleus. For 68Ga, the absorbed dose per nucleus was 0.11±0.01Gy, leading to an estimated 6.49±0.34 DSBs and 161.24±8.12 SSBs per nucleus. Absorbed doses in other organs were on the order of micro-gray (µGy). The likelihood of epidermal erythema resulting from extravasation during PET imaging is low, as the simulated absorbed doses to the epidermis remain below the thresholds that trigger such effects. Moreover, the organ-level absorbed doses were found to be clinically insignificant across various simulated organs. The minimal DNA damage at the extravasation site suggests that long-term harm, such as radiation-induced carcinogenesis, is highly unlikely.

Polarimetric BSSRDF Acquisition of Dynamic Faces

Acquisition and modeling of polarized light reflection and scattering help reveal the shape, structure, and physical characteristics of an object, which is increasingly important in computer graphics. However, current polarimetric acquisition systems are limited to static and opaque objects. Human faces, on the other hand, present a particularly difficult challenge, given their complex structure and reflectance properties, the strong presence of spatially-varying subsurface scattering, and their dynamic nature. We present a new polarimetric acquisition method for dynamic human faces, which focuses on capturing spatially varying appearance and precise geometry, across a wide spectrum of skin tones and facial expressions. It includes both single and heterogeneous subsurface scattering, index of refraction, and specular roughness and intensity, among other parameters, while revealing biophysically-based components such as inner- and outer-layer hemoglobin, eumelanin and pheomelanin. Our method leverages such components' unique multispectral absorption profiles to quantify their concentrations, which in turn inform our model about the complex interactions occurring within the skin layers. To our knowledge, our work is the first to simultaneously acquire polarimetric and spectral reflectance information alongside biophysically-based skin parameters and geometry of dynamic human faces. Moreover, our polarimetric skin model integrates seamlessly into various rendering pipelines.

Enhanced antifouling PSE hollow fiber membrane via zwitterionic copolymer segregation

Blending hydrophilic additives is an effective method to improve the surface hydrophilcility and antifouling property of ultrafiltration membranes. In this study, we prepared a series of polysulfate (PSE) hollow fiber membranes (HFMs) containing a zwitterion-based copolymer, poly(4-vinylpyridine-co-methylacryloxyethyl phosphocholine), with varying monomer ratios and blending quantities. The relationship between cast solution properties and phase separation behavior was investigated, as well as the impacts of copolymer composition and amount on the separation performances and antifouling abilities of the membranes. A higher hydrophilic monomer ratio and more copolymer addition of zwitterionic copolymer would facilitate surface segregation, increasing the hydrophilicity of membrane surface and generating a dense hydration layer. This layer can resist macromolecule contaminants and promote water molecular transport. Furthermore, a more compacted skin layer improves separation ability. The optimized PSE HFMs had water fluxes around 140 L m−2 h−1, BSA rejections over 97 %, and flux recovery rates over 92 % during operation. Moreover, the membrane demonstrated ultra-low flux-sacrifice when applied to protein solutions while maintaining a high rejection rate, which indicates the distinctive and strong competitiveness of PSE/P(4VP-co-MPC) HFMs.

Conformal cooling channels with composite layers

ABSTRACT Conformal cooling channels (CCCs) are a cooling method used in injection molding. According to the literature review, CCCs can reduce cooling time by 2%–70%, with the average reduction being 30%, and they can improve warpage by 5%–90%, with the average improvement being 37%. But the present study found that previous research has ignored the effect of the solidified skin layer in CCCs. This study posits that during the design of cooling channel positions, the plastic solidified layer exhibits distinct thermal properties. Heat transfer involves conduction thermal resistance, which affects the effectiveness of heat conduction. Ignoring the solidified layer can lead to inaccurate predictions of cooling channel positions. Accordingly, this study developed a novel calculation formula for determining the cooling channel positions while considering the existence of the solidified layer, leveraging the concept of steady one-dimensional conduction in composite layers. The results of this study indicated that in the uniform-thickness scenarios, optimal cooling efficiency and quality were obtained when the thickness of the solidified layer was 0.10 mm. However, in the variable-thickness scenario, the cooling efficiency decreased by approximately 2%. Regarding quality, higher deformation control in three dimensions but poorer warpage control in the z-dimension was observed.

Comparative Study of the Effectiveness of Pulsed and Continuous 450 nm Laser Radiation on Tissue for Layered Removal of Pigmented Nevi

Benign pigmented skin lesions, including congenital giant pigmented nevi (CGPN), are pathological formations located in various skin layers and consisting of melanocyte clusters. CGPN represent a serious psychological and medical problem associated with extensive unaesthetic changes in the patient’s skin appearance. These lesions are currently treated by various methods, including laser radiation. However, such methods often render ineffective and lead to unsatisfactory clinical and aesthetic results, with the incidence of complications in the form of scarring and recurrence sometimes reaching 41%. Therefore, the problem of effective and appropriate treatment of this pathology is relevant, deserving further research. In this work, we conduct an experimental biomedical study into the effect of blue laser radiation with a wavelength (λ) of 450 nm on the tissues of laboratory animals in order to determine its prospects in the treatment of pigmented nevi, including CGPN. Blue laser radiation (λ — 450 nm) was generated by an Lasermed 10-03 device (Russian Engineering Club, LLC, Tula, Russia). An experimental biomedical in vitro research was performed on chilled samples of the liver and muscles of mini-pigs and in vivo on the pigmented skin of live laboratory rats. The dynamics of the regenerative wound process in the exposure areas was studied at different periods, i.e., immediately after exposure and following up to 90 days. A morphometric assessment of the exposure areas was carried out in terms of penetration depth and coagulation changes. The results obtained allowed determination of optimal parameters of 450 nm blue laser radiation for a precision removal of various pigmented skin formations. Laser radiation with a wavelength of 450 nm is a promising treatment approach for pigmented skin lesions, including CGPN.

Skin ultrasound for rheumatologists: Technical issues and challenges.

In several rheumatic diseases, the skin is involved and therefore it is an organ of interest which may be investigated by the rheumatologist. Ultrasound imaging has been proposed for assessing multiple skin conditions providing qualitative and quantitative information about different parameters in distinct skin layers. Our aim was to describe with a pictorial essay the main challenges that the ultrasound imaging may encounter when investigating the healthy skin in different body areas. Fourteen healthy subjects were submitted to skin ultrasound. The body areas that were investigated were decided following the 17 modified Rodnan skin score anatomical areas used in systemic sclerosis. Skin ultrasound was performed with a GE Logiq 10 with two probes (20 and 24 MHz). For an optimal quantification of the skin layers, the dermis interfaces either with the epidermis and hypodermis were investigated. The results of the ultrasound analysis are described and summarized in a pictorial essay which shows that some main factors may significantly influence the quality of the images of the skin layers. Specifically, age, scanning position, probe frequency, and the optimal positioning of some anatomical areas, in particular the hands and digits, emerged as factors that may have a relevance in influencing the quality of the imaging of the skin layers. Moreover, some technical suggestions are proposed to help optimizing and standardizing the performance of skin ultrasound assessment in healthy population. The pictorial essay we performed shows that the performance of skin ultrasound in healthy subjects still presents several issues that need to be addressed. The definition of the interface in different body areas is the first step which should be standardized before any measurement of the thickness of the skin layers is performed in rheumatic diseases.

The Application of High-Frequency Ultrasonography in Post-Therapeutic Assessment of Actinic Keratosis After Photodynamic Therapy.

Actinic keratoses (AKs) are one of the most common reasons for consultation in the elderly population. This study aimed to assess the efficacy of 5-ALA PDT in AK treatment using high-frequency ultrasonography (HFUS) to evaluate skin layer changes during therapy. In our study, we included 44 AK patients aged 53 to 89 years. All patients had lesions clinically evaluated with the Olsen and AKASI scale. HFUS imaging was performed on seemingly healthy skin and lesions before and at 4, 8, and 12 weeks of therapy. Ultrasound markers such as skin thickness, echogenicity, and pixel intensity were measured. 5-ALA was applied under occlusion for 3 h. After removing the occlusive dressing, 5-ALA was removed with a saline solution and a directed therapy with a BF-200 lamp. Full follow-ups of 56 markers of suitable quality were selected. The thickness of SLEB significantly decreased in the following weeks compared to the pre-therapy results, reaching its lowest values after 12 weeks. The average pixel intensity significantly increased in each skin layer after therapy (p < 0.01). For SLEB, there were statistically significant differences in LEP, MEP and contrast. The AKASI score before and after treatment was determined for the 39 patients who underwent follow-up at week 12. The median AKASI score was 3.2 (1.2-8.6) before treatment and 0.6 (0-2.8) after. According to the literature data, this is the first study describing the ALA-PDT treatment efficacy in different AK severities evaluated in HFUS. HFUS provides a valuable non-invasive tool for monitoring the efficacy of PDT in AK treatment, showing significant improvements in skin texture and structure.

Double-Layer Cogged Thread Lifting Technique: A Superficial- and Deep-Layer Lifting Method.

Although thread lifting is a widely performed method, the degree of initial lifting and sustainability varies based on how the threads are inserted into the skin layers. This study aimed to perform thread lifting on 43 patients to achieve maximum lifting effects using thicker threads in the deeper layers of the subcutaneous fat layer and thinner threads in the shallower layers. Immediately after the procedure, we measured the depth of the inserted threads using ultrasonography and evaluated the results based on patient satisfaction and the global aesthetic improvement scale (GAIS). At the end of the procedure, an upright position was employed to check for dimples or irregularities, and intraoral observation was also conducted. Patient satisfaction significantly increased immediately after the procedure compared to that before the procedure. High GAIS scores were maintained even after 6months, indicating high satisfaction with the procedure. Inserting threads into multiple layers was deemed more effective than inserting them into a single layer. Thread lifting on 43 patients was used to maximize lifting effects by utilizing thicker threads in deeper subcutaneous fat layers and thinner threads in shallower ones. Our procedure maintained high global aesthetic improvement scale (GAIS) scores even after 6months, indicating patient satisfaction. Multiple layers were shown to be more effective than a single layer for thread insertion. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .