Sole Skin Research Articles

CD34 distribution in C-fiber low threshold mechanoreceptors in the mouse dorsal root ganglion and spinal cord

CD34 is a well-known cell marker of hematopoietic stem/ progenitor cells, endothelial cells, and fibrocytes. In the peripheral nervous system, a certain type of primary sensory neuron C-fiber low threshold mechanoreceptors (C-LTMRs) are reported to express CD34 mRNA. Here, we investigated the distribution of CD34 protein among putative C-LTMRs (pC-LTMR) using pC-LTMR markers such as VGLUT3 and TH in the dorsal root ganglion (DRG) and spinal cord. CD34 was frequently observed in DRG neurons double-positive for VGLUT3 and TH and single-positive for VGLUT3 in C8 and L4 levels, however, in C4 and L1 levels most of CD34-positive DRG neurons were demonstrated to be double-positive for VGLUT3 and TH. As for the termination, CD34-positive DRG neurons terminated in the ventral part of inner lamina II (lamina IIiv). At C4 and L1 levels of the dorsal horn, CD34 was observed in the entire region of lamina IIiv, however, in C8 and L4 levels of the dorsal horn CD34 was not detected in the medial part of lamina IIiv, which receives neural inputs from DRG neurons that innervate palm or sole skin. These results indicate that CD34 is expressed in pC-LTMRs and suggest that CD34 may play a role in providing C-LTMRs with a specific sensation by maintaining neural circuits

The suppression of lower leg electromyography when walking in textured foot orthoses.

Previous research exploring the effects of tactile feedback in standing balance protocols may have generated results that misrepresent the modulatory capabilities of cutaneous afference on generating motor output responses. The neurosensory mechanism of textured foot orthoses to maximize the activation of cutaneous mechanoreceptors is through repetitive foot sole skin indentation. Thus, the purpose of this experimental protocol was to investigate muscular activity amplitude changes during the stance phase of gait, specifically when walking on level ground and when stepping onto a raised wedge, and while wearing textured foot orthoses compared to orthoses without texture. Twenty-one healthy young adults were fit to a standardized neutral running shoe and completed five level and wedged walking trials wearing both orthoses. Kinematic, kinetic and electromyography (EMG) data were recorded from eight lower limb muscles. The results of this study revealed EMG suppression of lower leg musculature during stance when walking in textured foot orthoses,and this was most pronounced when lower leg musculature is typically most active. The addition of texture in foot orthoses design, spanning the entire length of the foot sole, appears to be a clear mechanism to modulate neurosensory feedback with intent to suppress EMG of shank musculature during gait.

Normal and diabetic foot sole skin mimicking tissue phantom fulfillment for spectroscopic-based DFU diagnostics perspective

Normal and diabetic foot sole skin mimicking tissue phantom fulfillment for spectroscopic-based DFU diagnostics perspective

The Impact of Diabetes Complications on the Physical Function of Maintenance Hemodialysis Patients.

This study investigated the impact of diabetes on the physical function of patients undergoing dialysis.This study included 22 patients undergoing outpatient dialysis with continued exercise therapy during dialysis at our hospital between January 2021 and August 2021. The participants were divided into two groups based on the presence or absence of diabetes, and various parameters were compared between the groups. To compare each physical function assessment and measurement of anterior thigh muscle thickness, repeated-measures analysis of variance was conducted to test for the presence of interactions and main effects. Significant differences were observed in the absence of dyslipidemia (p < 0.01), high-density lipoprotein cholesterol level (p < 0.01), and foot sole skin perfusion pressure (p < 0.02). In terms of physical function, a main effect between the groups was observed in the five-time sit-to-stand test, and anterior thigh muscle thickness showed a main effect over time. Significant differences in the anterior thigh muscle thickness were observed between three and six months after the intervention (p < 0.05). In patients undergoing dialysis with diabetes complications, a decrease in physical activity and lack of exercise can lead to a reduction in overall physical activity levels. Additionally, impairments such as peripheral neuropathy may contribute to an accelerated decrease in skeletal muscle mass.

Capitalizing on skin in orthotics design: the effects of texture on plantar intrinsic foot muscles during locomotion.

Foot orthoses (FO) are a commonly prescribed intervention to alter foot function during walking although their effects have been primarily studied in the extrinsic muscles of the foot. Furthermore, enhancing sensory feedback under the foot sole has been recently shown to alter extrinsic muscle activity during gait; however, the effects of FOs with enhanced sensory feedback on plantar intrinsic foot muscles (PIFMs) remain unknown. Thus, the purpose of this study was to investigate the effect of FOs with and without sensory facilitation on PIFM activity during locomotion. Forty healthy adults completed a series of gait trials in non-textured and textured FOs when walking over hard and soft flooring. Outcome measures included bilateral joint kinematics and electromyography (EMG) of four PIFMs. Results of this study highlight the distinct onset and cessations of each PIFM throughout the stance phase of gait. PIFMs remained active during mid-stance when wearing FOs and textured FOs facilitated muscle activity across the stance phase of gait. Increasing cutaneous input from foot sole skin, via the addition of texture under the foot sole, appears to alter motor-neuron pool excitation of PIFMs. Future academics are encouraged to increase our understanding on which pathologies, diseases, and/or medical conditions would best benefit from textured FOs.

The topographical attenuation of cutaneous input is modulated at the ankle joint during gait.

The attenuation of sensory inputs via various methods has been demonstrated to impair balance control and alter locomotor behavior during human walking; however, the effects of attenuating foot sole sensation under distinct areas of the foot sole on lower extremity motor output remains poorly understood. Thus, the purpose of this study was to attenuate cutaneous feedback via regional hypothermia under five different areas of the foot sole and investigate the resultant modulation of kinematic and muscle activity during level walking. Electromyography from eight lower leg muscles, kinematics, and location of center of pressure was recorded from 48 healthy young adults completing walking trials with normal and reduced cutaneous sensation from bilateral foot soles. The results of this study highlight the modulatory response of the tibialis anterior in terminal stance (propulsion and toe-off) and medial gastrocnemius muscle throughout the entire stance phase of gait. The topographical organization of foot sole skin in response to the attenuation of cutaneous feedback from different areas of the foot sole significantly modified locomotor activity. Furthermore, the locomotor response to cutaneous attenuation under the same regions that we previously facilitated with tactile feedback do not oppose each other, suggesting different physiological changes to foot sole skin generate unique gait behaviors.

Differences in the microanatomy of skin of sole and palm in humans

Background: The prevalence of skin diseases has increased over the last few decades and they contribute to a significant burden on the health-care systems all across the world. In some forms of reconstructive or plastic surgery, palm skin has successfully been replaced with sole skin, removed to form a full-thickness graft that covered almost the entire palm of the hand without impairing the weight-bearing areas of the feet or encumbering the gait. In cases such as these, the skin of the palm and sole is preferred for grafts. Aims and Objectives: The study was conducted to learn the microanatomy of palm and sole. Materials and Methods: The present observational study was carried out in the Department of Anatomy, King George Medical University, Lucknow, from the period of September 2017 to August 2018. Ethical clearance was obtained from Institutional Ethics Committee (Ref. code:63/Ethics/R-Cell-18). For the present study, skin was procured from the palm and sole of six freshly embalmed human cadavers (three males and three females). The mean age of the cadavers was 67 years. Tissues were preserved in 10% of formaldehyde for 48 h, fixed, Stained in H and E, and observed under light microscope. Results: The study showed that the thickness of epidermis and ratio of epidermis to stratum corneum (Edp: sc) of the sole are greater than palm, dermoepidermal junctions were more in sole. Thickness of dermis both papillary and reticular dermis was more in sole than palm. Conclusion: The values of thickness of skin of palm and sole region provide data for plastic surgeons to plan cosmetic surgeries.

Correlation of dermatoglyphics and Class II skeletal malocclusion – Original research

Dermatoglyphics is a study of the unique pattern in the skin of fingers, palms, soles, and toes. These dermatoglyphics has played an important role in various fields like forensic medicine, genetics, and anthropology.Sir Francis Galton stated that an individual’s dermal pattern remained constant throughout their lifetime. Many studies have suggested the possible relation between dermatoglyphics and occlusion.Studies have suggested that dermatoglyphics could be used as a tool to identify the underlying skeletal malocclusion. As the dermal pattern and oral structures develop together, the genetic information in the dermal pattern could be used to assess the different types of skeletal malocclusions. Hence, the study was aimed to compare and evaluate the correlation between dermatoglyphics and class II skeletal malocclusion in horizontal and vertical growth patterns. The total of 50 samples were taken and divided into horizontal and vertical growth pattern consisting of 25 samples each. The dermatoglyphic pattern between the right and left hand and the pattern such as arches, loops, and whorls were evaluated. The data was analyzed by Kolmogorov – Smirnov and Shapiro Wilk test. There was a statistically significant association between class 2 malocclusion and the dermatoglyphic pattern.

Modeling foot sole cutaneous afferents: FootSim

While walking and maintaining balance, humans rely on cutaneous feedback from the foot sole. Electrophysiological recordings reveal how this tactile feedback is represented in neural afferent populations, but obtaining them is difficult and limited to stationary conditions. We developed the FootSim model, a realistic replication of mechanoreceptor activation in the lower limb. The model simulates neural spiking responses to arbitrary mechanical stimuli from the combined population of all four types of mechanoreceptors innervating the foot sole. It considers specific mechanics of the foot sole skin tissue, and model internal parameters are fitted using human microneurography recording dataset. FootSim can be exploited for neuroscientific insights, to understand the overall afferent activation in dynamic conditions, and for overcoming the limitation of currently available recording techniques. Furthermore, neuroengineers can use the model as a robust in silico tool for neuroprosthetic applications and for designing biomimetic stimulation patterns starting from the simulated afferent neural responses.

Papillion lefèvre Syndrome: Rarest of the Rare; But it is Still There

A rare autosomal recessives disorder, Papillon–Lefèvre syndrome (PLS) also known as palmoplantar keratoderma, anhidrosis and periodontitis was first described in 1924 by French Physician Papillon and Lefèver. The disorder is characterized by diffuse palmoplantar keratoderma and aggressive periodontitis, leading topremature loss of deciduous and permanent dentition at a very young age. Mutations in the cathepsin C gene (CTSC), located at human chromosome 11q14.1-q14.3, are the cause of PLS. A 22-year-old male boy was presentedwith all the characteristic feature of papillon-lefèvre syndrome. He had complaint of swollen and friable gums and discomfort in chewing the food along with persistent hyperkeratotic, Flaking and scaling of the skin of palms and soles. He also had early shedding of his milk teeth with family history of consanguineous marriage of parents.

Location-specific cutaneous electrical stimulation of the footsole modulates corticospinal excitability to the plantarflexors and dorsiflexors during standing.

Non‐noxious electrical stimulation to distinct locations of the foot sole evokes location‐specific cutaneous reflex responses in lower limb muscles. These reflexes occur at latencies that may enable them to be mediated via a transcortical pathway. Corticospinal excitability to the plantarflexors and dorsiflexors was measured in 16 participants using motor evoked potentials (MEPs). Spinal excitability was measured in eight of the original participants using cervicomedullary motor evoked potentials (CMEPs). Measurements were collected with and without preceding cutaneous stimulus to either the heel (HEEL) or metatarsal (MET) locations of the foot sole, and evoked potentials were elicited to coincide with the arrival of the cutaneous volley at either the motor cortex or spinal cord. Plantarflexor MEPs and CMEPs were facilitated with cutaneous stimulation to the HEEL for MEPs (soleus p = 0.04, medial gastrocnemius (MG) p = 0.017) and CMEPs (soleus p = 0.047 and MG p = 0.015), but they were unchanged following MET stimulation for MEPs or CMEPs. Dorsiflexor MEPs were unchanged with cutaneous stimulation at either location, but dorsiflexor CMEPs increased with cutaneous stimulation (p = 0.05). In general, the increase in CMEP amplitudes was larger than the increase in MEP amplitudes, indicating that an increase in spinal excitability likely explains most of the increase in corticospinal excitability. The larger change observed in the CMEP also indicates that excitability from supraspinal sources likely decreased, which could be due to a net change in the excitability of intracortical circuits. This study provides evidence that cutaneous reflexes from foot sole skin are likely influenced by a transcortical pathway.

The effect of texture under distinct regions of the foot sole on human locomotion.

Sensory feedback from the foot sole plays an important role in shaping human locomotion. While net muscle activity and kinematic changes have been correlated with electrical stimulation to five topographical regions of the foot, it remains unknown if these responses are similar with tactile stimulation. The purpose of this study was to use texture in foot orthosis design, applied to five distinct regions under the foot sole, and measure joint kinematics, location of center of pressure, and muscle activity of eight lower leg muscles during level and incline walking. Fifty-five healthy adults completed 48 walking trials in textured and non-textured foot orthoses. Study results confirm that tactile stimulation is stimulation-site and gait-phase specific in modulating lower leg muscle activity during walking. For example, texture under the lateral forefoot consistently generated a suppression of EMG and texture under the lateral midfoot always generated a facilitation. In early stance, adding texture under the medial midfoot or calcaneus facilitated extensor muscle activity and suppressed flexor muscle activity. Texture under the lateral midfoot or medial forefoot facilitated tibialis posterior activation. These results support the topographical organization of cutaneous mechanoreceptors in foot sole skin while considering how texture can be used in foot orthosis design to target lower leg muscular changes during locomotion.

Loss-of-function variants in KLF4 underlie autosomal dominant palmoplantar keratoderma

PurposePalmoplantar keratodermas (PPKs) form a group of disorders characterized by thickening of palm and sole skin. Over the past 2 decades, many types of inherited PPKs have been found to result from abnormal expression, processing, or function of adhesion proteins. MethodsWe used exome and direct sequencing to detect causative pathogenic variants. Functional analysis of these variants was conducted using reverse transcription quantitative polymerase chain reaction, immunofluorescence confocal microscopy, immunoblotting, a promoter reporter assay, and chromatin immunoprecipitation. ResultsWe identified 2 heterozygous variants (c.1226A>G and c.633_634dupGT) in KLF4 in 3 individuals from 2 different unrelated families affected by a dominant form of PPK. Immunofluorescence staining for a number of functional markers revealed reduced epidermal DSG1 expression in patients harboring heterozygous KLF4 variants. Accordingly, human keratinocytes either transfected with constructs expressing these variants or downregulated for KLF4 displayed reduced DSG1 expression, which in turn has previously been found to be associated with PPK. A chromatin immunoprecipitation assay confirmed direct binding of KLF4 to the DSG1 promoter region. The ability of mutant KLF4 to transactivate the DSG1 promoter was significantly decreased when compared with wild-type KLF4. ConclusionLoss-of-function variants in KLF4 cause a novel form of dominant PPK and show its importance in the regulation of epidermal differentiation.

Palmer Dermatoglyphics in Essential Hypertensive Patients: An Analytical Cross-sectional Study

Introduction: Dermatoglyphics deal with the study of papillary ridge patterns on the skin of fingers, palms, toes and soles. Each pattern is a unique anatomical marker, and their development is strongly affected by genetic and environmental factors. Aim: To determine whether essential hypertensive patients have significant dermatoglyphic pattern association as compared to non hypertensive participants in the study population. Materials and Methods: An analytical cross-sectional study was carried out in 228 patients (114 diagnosed essential hypertensive patients and 114 non hypertensive patients) attending the Department of Medicine at Sree Mookambika Institute of Medical Sciences, Kulasekharam, Tamil Nadu, India, of both the sexes and belonging to different age groups. Informed consent was obtained from each individual. Palmar and fingertip prints of the patients and the controls were taken on the white crystal bond paper by modified Purvis-Smith method and the following parameters were analysed: i) Fingertip pattern frequency; ii) Total and Absolute Finger Ridge Count (AFRC); iii) a-b ridge count; and iv) ‘atd’ angle. The statistical contents like arithmetic mean and standard deviation were calculated and the t-test and chi-square test were applied wherever necessary. Results: There were more loop pattern in digit 2 of left hand of female hypertensives than controls. There was increased Total Finger Ridge Counts (TFRC) in both males (134.14±19.560; p-value=0.038) and females (131.42±27.777; p-value=0.001) hypertensives and significantly higher AFRC (187.65±67.806; p-value=0.001) in female hypertensives, There was decreased ‘a-b’ ridge count in both hands of male (Right: 24.19±4.36; p-value=0.001left:24.54±3.586;p-value=0.001)andfemale(right: 23.65±3.43; p-value=0.001 left:24.16±3.321; p-value=0.001) patients and decreased ‘atd’ angle in both hands of male (right: 38.86±4.001; P=0.003 left: 38.51±4.428; p-value=0.001) and right hand of female (40.70±4.476; p-value=0.009) hypertensive patients, as compared to that of controls. Conclusion: As the parameters showed significant association, they can be used as dermatoglyphic markers for early detection of essential hypertension.

Remote Subthreshold Stimulation Enhances Skin Sensitivity in the Lower Extremity.

Foot sole skin interfaces with the ground and contributes to successful balance. In situations with reduced sensitivity in the glabrous foot skin, stochastic resonance (SR) improves skin sensitivity by adding tactile noise. Some situations, however, involve an interface comprised of hairy skin, which has higher thresholds for sensitivity. For example, in lower extremity amputation the residual limb is comprised of hairy leg skin. The main objective of this study was to determine if SR improves skin sensitivity in hairy skin, and whether a specific intensity of noise is most effective. Secondary objectives were to compare the effect between locations, ages and modalities. In 60 healthy participants a vibrotactile (test) input was delivered at the lower extremity concurrently with a second, noisy stimulus applied more proximally. The presence of a remote SR effect was tested in 15 young participants using electrotactile noise at the calf. Secondary objectives were tested in separate groups of 15 subjects and differed by substituting for one of the three variables: vibrotactile noise, heel site, and with older participants. A forced-choice protocol was used to determine detection ability of the subthreshold vibration test input with varying noise levels applied simultaneously (0, 20, 40, 60, 80, and 100% of perceptual threshold). An SR effect was identified when increased detection of the input was obtained at any level of noise versus no noise. It was found that all four test groups demonstrated evidence of SR: 33–47% of individuals showed better detection of the input with added noise. The SR effect did not appear consistently at any specific noise level for any of the groups, and none of the variables showed a superior ability to evoke SR. Interestingly, in approximately 33% of cases, threshold values fluctuated throughout testing. While this work has provided evidence that SR can enhance the perception of a vibrotactile input in hairy skin, these data suggest that the ability to repeatably show an SR effect relies on maintaining a consistent threshold.

Extraction Of Collagen From Fish Orientai Sole Brachirus orientalis Skin And Studying Of Some Chemical Charactristics And Amino Acid Composition

This study includes the extraction of acid soluble collagen (Acetic acid 0.5 M) from fish Oriental sole skin . After the removal of fat and non-collagenous proteins and dialyzed against distilled water, some the chemical properties were studied, that includes chemical composition and the percentage of yield were 12.15 % on the basis of wet weight. According to the electrophoretic patterns, the collagen consisted of two different chains (α1 and α 2), were characterized to be type I, β chain components as well as the observed was larger molecular weight , When estimating amino acid collagen observed that there is variation in the percentage of amino acid major such as glycine , proline , hydroxyproline and hydroxy lysine, When measuring the absorption spectrum of ultraviolet (UV) there was a single peak absorption at 232 nm for collagen fish skin, FTIR showed regions of amides A, B, I, II and III were 3408.57, 2934.89, 1651.73, 1540.85 and 1243.38 cm-1 respectively.

Role of Extracts Obtained from Rainbow Trout and Sole Side Streams by Accelerated Solvent Extraction and Pulsed Electric Fields on Modulating Bacterial and Anti-Inflammatory Activities

In this study, accelerated solvent extraction (ASE) and pulsed electric field (PEF) were used as innovative approaches to recover extracts from rainbow trout and sole side streams rich in high-added-value compounds. Then, after aseptic filtration, the impact of the obtained extracts on bacterial growth and anti-inflammatory potential was evaluated. Moreover, the protein content and the total antioxidant capacity of the samples were determined. The results showed that some extracts could inhibit the growth of pathogenic bacteria, including the ASE rainbow trout skin and the PEF sole viscera extracts, which showed significant antibacterial activity on Staphylococcus aureus. The PEF sole viscera extract also showed an inhibitory effect on the growth of Salmonella. In addition, some extracts promoted probiotic bacteria growth. For example, the PEF rainbow trout head and skin extracts promoted Lactobacillus casei growth, while the ASE rainbow trout head and skin extracts promoted Bifidobacterium lactis growth. In addition, some samples, such as the ASE rainbow trout viscera and the PEF sole skin extracts had interesting anti-inflammatory properties. Therefore, the use of ASE and PEF can be considered as useful strategies to recover antimicrobial, prebiotic and anti-inflammatory extracts from rainbow trout and sole side streams, although it is necessary to evaluate each specific side stream.

Mechanical Impedance of Rat Glabrous Skin and Its Relation With Skin Morphometry.

The mechanical impedance of intact and epidermis-peeled rat glabrous skin was studied at two sites (digit and sole) and at two frequencies (40 Hz and 250 Hz). The thicknesses of skin layers at the corresponding regions were measured histologically from intact- and peeled-skin samples in every subject. Compared to intact sole skin, digital rat skin has thicker layers and higher mechanical resistance, and it is less stiff. The resistance of the skin significantly decreased after epidermal peeling at both the digit and the sole. Furthermore, peeling caused the reactance to become positive due to inertial effects. As the frequency was increased from 40 to 250 Hz, the resistance and stiffness also increased for the intact skin, while the peeled skin showed less frictional (i.e., resistance) but more inertial (i.e., positive reactance) effects. We estimated the mechanical properties of epidermis and dermis with lumped-element models developed for both intact and peeled conditions. The models predicted that dermis has higher mass, lower stiffness, and lower resistance compared to epidermis, similar to the experimental impedance results obtained in the peeled condition which consisted mostly of dermis. The overall impedance was simulated more successfully at 40 Hz. When both frequencies are considered, the models produced consistent results for resistance in both conditions. The results imply that most of the model parameters should be frequency-dependent and suggest that mechanical properties of epidermis can be related to its thickness. These findings may help in designing artificial skin for neuroprosthetic limbs.

Management of Vipadika (~Plantar Psoriasis) in Ayurvedic Prospect

Plantar psoriasis accounts for 3%–4% of all psoriasis cases and produces significant functional and social disability. Plantar psoriasis is a variant of psoriasis that characteristically affects the skin of the soles with features, i.e.,; hyperkeratotic, pustular, or mixed morphologies. Many of the skin disorders in Ayurveda have been described under the heading of Kushtha (group of skin diseases) and Kshudra Kustha. Vipadika (Plantar psoriasis) is one of the diseases which has been included under the heading of Kshudra Kushtha. In classics, clinical features of Vipadika are cracks (Sphutana) either in palms or soles or in both with pain. A 42-year-old male patient visited our outpatient department with complaints of scaling and fissure of skin of bilateral soles, with bleeding from cracks for 6–8 months. Examination and history lead to a diagnosis of Vipadika (Plantar psoriasis). This case was managed with Virechana Krama (~therapeutic purgation), followed by Shaman Chikitsa (pacifying therapy) with internal administration of Guduchi Churna 2 g twice a day after meal with luke warm water, Panchvalkal Kwath once 4 ml morning empty stomach, with Panchvalkal Kwath wash in sufficient quantity, Triphala Churna Avchurnan (topical dusting of powder) and local application of Jatyadi tail along with Pathya (wholesome regime), and Apathya (unwholesome regimen) for 4 months. The effect of the therapy was assessed by the signs and symptoms before and after the treatment. The treatment modalities showed relief in patient's signs and symptoms. Hence, Ayurveda procedures and medicaments are promising in the management of Vipadika (~Plantar psoriasis).

A Case Report on Kawasaki Disease

Kawasaki disease is a vascular and self-limiting disease mainly effecting small to medium sized vessel. Mostly affecting the children of less than 5 years. Most of the patients has a genetic predisposition. Genetically susceptible individuals exposed to infectious agents/ environmental trigger may develop Kawasaki disease. Clinical presentations are fever, polymorphous rashes along the trunk, strawberry tongue, swollen lymph nodes around neck. Skin of palms and soles can be swollen and red. Lips are cracked, red and dry. A 7 year old male patient was brought to emergency department with Scarlett fever, dry lips, Thickening of palmar skin, Itching. Patient was shifted to pediatrics department and was provided with adequate treatment.&#x0D; Keywords: Kawasaki disease, Genetically susceptible, Strawberry tongue, polymorphous rashes.