Skin Thickness Research Articles

First Report of Fusarium pernambucanum Causing Fruit Rot of Melon in China.

In May of 2020, November of 2021 and May of 2022, a preharvest fruit rot with white mycelia was observed inside and outside of the fruits of thick skin muskmelon (Cucumis melo L.) growing in about ten greenhouses (each greenhouse had about 320 muskmelons) with disease incidence of 70% in Ningbo, Zhejiang Province of China. In order to identify the causal agent, plant tissues from the margin of the symptomatic tissue were sterilized for 1 min with 1% sodium hypochlorite (NaClO), 2 min with 75% ethyl alcohol, rinsed in sterile distilled water three times (Zhou et al 2019), and then placed on potato dextrose agar (PDA) plates containing streptomycin sulfate (100 μg/mL) at 25℃ for 4 days. Only Fusarium colonies were isolated from all the plant tissues. The growing hyphae were transferred to new PDA plates using the hyphal tip method, putative Fusarium colonies were purified by single-sporing. Six fungal isolates (Fi-1~6) were obtained. The average radial mycelial growth rate of Fusarium isolate Fi-3 was 4.6 mm/day at 25℃ in the dark on PDA, and like other five isolates. The colonies are abnormal, producing lots of aerial hyphae, each isolate was white to light orange. Isolate Fi-3 produced macroconidia with 4 to 6 septa, tapered with pronounced dorsiventral curvature and measured 21 to 30 μm long 4 to 5 μm wide on Spezieller Nährstoffarmer Agar (SNA) medium at 25℃ for 10 days (Leslie and Summerell 2006), but polyphialides and chlamydospores were still not available for 30 days. The pathogen species was further identified by translation elongation factor-1 alpha (EF-1α) sequencing. The EF-1α of six isolates were sequenced, and their EF-1α sequences were 100% identical to each other, and the sequence of strain Fi-3 was deposited in GenBank with accession no. OL782040 and was also compared with sequences in the FUSARIUM-ID database (Geiser et al. 2004), which indicated that it was 100% identical to those of F. pernambucanum strain NRRL 32864 (GenBank accession GQ505613), F. pernambucanum strain LC7040 (GenBank accession MK289626), and F. pernambucanum strain LC12149 (GenBank accession MK289588) within the Fusarium incarnatum - F. equiseti species complex 17 (FIESC17). Two phylogenetic trees were established based on the TEF1-α sequences of Fi-1~6 and other Fusarium spp., Fi-1~6 was clustered with the sequences of F. pernambucanum within the FIESC17. Thus, both morphological and molecular criteria supported identification of the strain as F. pernambucanum. A pathogenicity test was conducted to verify Koch's postulates, mycelium agar plugs (6 mm in diameter) were removed from the colony margin of a 3-day-old culture of strain Fi-3, healthy melon fruits were surface-sterilized with 70% ethanol and rinsed twice with sterile-distilled water. Then, the melons were wounded using a sterile inoculating needle to stab and inoculated by a mycelium agar plug of strain Fi-3 on the wound sites. 5 fruits were inoculated in each treatment, and a mycelium-free PDA plug was used as a negative control, repeated 3 times, at 25℃ with high relative humidity for 10 days. The results show disease symptoms similar to those naturally infected fruits on all inoculated melon fruits. The fungus re-isolated from the diseased fruits, showed the same colony morphology as the original isolate. Koch's postulates were repeated three times with the same results. Strain Fi-3 inoculated fruits without wounding remained healthy. To our knowledge, this is the first report of fruit rot of melon caused by F. pernambucanum in China.

Medial and Lateral Burns With Concomitant Infection After Genicular Nerve Radiofrequency Ablation: A Case Report

BACKGROUND: Knee osteoarthritis management might include medication, intraarticular injections, physical therapy, and surgical intervention. Genicular nerve radiofrequency ablation (RFA) is an effective therapy for patients who do not receive benefit from conservative medical management and are not surgical candidates (secondary to medical comorbidity, patient preference, and other factors). Genicular nerve RFA is generally safe and has a low complication rate. However, there have been case reports of minor and major complications after RFA. We report a case of burns after genicular nerve RFA. CASE REPORT: A 49-year-old man (92 kg; body mass index [kg/m2] 28.3), with a history of coronary artery disease and chronic tobacco use, presented with 20 years of chronic knee pain. He previously had short-term relief with an intraarticular steroid knee injection. He was found to be a suitable candidate for genicular nerve RFA and underwent the procedure successfully without any immediate complications. His pain decreased from 9/10 before the procedure to 5/10 after his RFA. On postprocedure day 33, a 1 cm circular lesion with drainage was noted on the medial aspect of his knee. A lateral lesion was discovered at a subsequent follow-up appointment. He was treated with antibiotics, chlorhexidine cleansing, and dressing changes which resolved the lesions without any long-term sequelae. CONCLUSION: Our case represents an instance of full thickness skin burns with concomitant infection post genicular RFA, uniquely in both the medial and lateral sites. Our patient’s risk factors of low body mass index, smoking, and vascular disease may have led to a delayed healing response. In addition, needle depth may also have contributed to his injury. Ensuring adequate needle depth and patient selection can minimize these complications. KEY WORDS: Radiofrequency ablation, knee pain, osteoarthritis, chronic pain, genicular nerve, RFA, adverse event, complication

The Assessment of the Long-Term Impact of Radiotherapy on Biophysical Skin Properties in Patients after Head and Neck Cancer.

Background and Objectives: Chronic radiotherapy-induced skin injury (cRISI) is an irreversible and progressive condition that can significantly impact a patient's quality of life. Despite the limited literature available on the assessment of the epidermal barrier in cRISI, there is a consensus that appropriate skincare, including the use of emollients, is the primary therapeutic approach for this group of patients. The aim of this study was to evaluate the biophysical properties of the skin during the late period (at least 90 days) following radiation therapy (RT) for head and neck cancer. Materials and Methods: This was a single-center prospective non-randomized study. It involved the analysis of 16 adult patients with head and neck cancer who underwent RT at the Greater Poland Cancer Center, along with 15 healthy volunteers. The study and control groups were matched for gender and age (p = 0.51). Clinical assessment, based on the LENT-SOMA scale, was conducted for all patients. Evaluation of the skin's biophysical properties included: an analysis of transepidermal water loss (TEWL), stratum corneum hydration (SCH), and skin visualization using high-frequency ultrasonography (HF-USG). Results: A significantly higher TEWL was observed in the irradiated area compared to the control area in the study group (p = 0.004). However, there was no statistically significant difference in SCH (p = 0.073). Additionally, no significant difference was observed in the values of TEWL and SCH in the irradiated area between the group of patients with and without clinically obvious RISI (p = 0.192 and p = 0.415, respectively). The skin thickness of the irradiated area, assessed by HF-USG, did not differ significantly from the skin thickness of the control area (p = 0.638). Furthermore, no difference in skin thickness was observed in patients with clinical features of cRISI in the irradiated and control areas (p = 0.345). The mean time after RT was 6.1 years. Conclusions: This study marks the first demonstration of epidermal barrier damage in patients in the long term following RT for head and neck cancer. The impairment of the epidermal barrier was observed independently of evident cRISI features. This observation underscores the necessity to recommend appropriate skin care, including the use of emollients, for all patients following RT. We also suggest that HF-USG examination is generally inconclusive in determining the degree of skin damage in the late period after RT.

Test and numerical analysis for water entry of elastic cabin from amphibious aircraft

Water-entry performance of amphibious aircraft is one of the main factors affecting the structural design. However, it is analyzed by rigid models in general, which is difficult to reflect the elastic characteristics of the structure. And it is difficult to obtain sufficient guidance for structural design from rigid-body analysis. In this study, water-entry model of an elastic cabin from amphibious aircraft was developed using the Arbitrary Lagrangian-Eulerian (ALE) method and validated by a designed 1:1 cabin water-entry test. Analysis under various conditions revealed the cabin's dynamic response in three steps: (1) the keel of the cabin section touches the water, (2) the bottom skin is wetted, and (3) the bottom skin is submerged. This study also compares the rigid-surface crashes and water-entry impacts of the cabin from the point of view of load and energy analysis. The results show that rigid-surface crash mainly affects bulkhead and keel, whereas water-entry energy is mainly absorbed by the skin, connectors, and stringers. Additionally, varying skin thicknesses showed a negative correlation with back surface deformation. The methodologies and conclusions presented in this study can offer valuable references for researchers in the field of water entry.

NovoSorb® Biodegradable Temporizing Matrix: a novel approach for treatment of extremity avulsion injuries in children

PurposeIn pediatric population, large soft tissue defects occur in avulsion injuries. In addition to the challenges of primary surgical therapy, elasticity, appearance and function of the scar in children are of crucial importance, especially in the context of body growth. So far various flaps, plasties, skin grafts and dermal substitutes have become established, although infections and skin shrinkage remain challenging. In 2020, a new skin substitute material—NovoSorb® Biodegradable Temporizing Matrix (BTM)—was introduced in Europe for temporary wound closure and tissue regeneration. The aim of this study was to evaluate the value of BTM in pediatric patients.MethodsThe study included all children treated with BTM after traumatic soft tissue defects following limb avulsion injuries between June 2021 and June 2023 at a university hospital.Results7 patients with limb avulsion injuries were treated with BTM, 4 boys, 3 girls. Mean age was 6.5 years (2–11 years) at the time of BTM placement. 4/7 had concomitant fractures. BTM was used successfully in all cases, infection did not occur, skin shrinkage was seen in one case. Split thickness skin graft (STSG) after BTM application was performed in average after 33 days (26 to 39 days). Limitations of this study were highlighted.ConclusionBTM is a promising alternative for reconstruction of complex trauma extremity wounds in children following avulsion injuries, even in cases of concomitant bone injuries. Interpretation may be limited by sample size.

Amino Acids Oral Treatment for the Amelioration of Skin, Hair, and Nails Conditions: An Open-Label Study

This study aimed at investigating the effect of a food supplement in ameliorating the skin, hair, and nails conditions. An open-label study on 21 women with mild-to-moderate aging all over the face (including wrinkles/fine lines, loss of skin firmness/elasticity, and normal to dry skin), acute telogen effluvium, and brittle/fragile nails was conducted. Skin (moisturization, elasticity, profilometry, and skin thickness), hair (pull test and phototricogram), and nails (clinical analysis of nail plate status) parameters were measured at baseline, and after 28 and 84 days of intake. The clinical analysis carried out by a board-certified dermatologist and the self-evaluation integrated the instrumental measurements. After 28 (D28) and 84 (D84) days of product intake the skin moisturization (superficial moisturization: +6.0% at D28 and +9.2% at D84; deep moisturization: +4.2% at D28 and +7.6 at D84), elasticity (R0 parameter: -11.5% at D28 and -19.3% at D84; R2 parameter: +7.8% at D28 and +11.9 at D84), profilometry (wrinkle depth: -9.5% at D28 and -14.5% at D84; skin smoothness: -4.9% at D28 and -7.7% at D84) and thickness (+0.11 mm at D28 and +0.24 mm at D84) were improved. At D84 the density of telogen hair was reduced by 9.5%; while at day 28 pull test was not indicative for telogen effluvium. The nail status was improved in most of the enrolled subjects. The instrumental measured effects were perceived by both the dermatologist and the enrolled subjects. Our results highlight the test product efficacy in improving the skin, hair, and nails conditions.

A chromosome-level genome of Chenghua pig provides new insights into the domestication and local adaptation of pigs

As a country with abundant genetic resources of pigs, the domestication history of pigs in China and the adaptive evolution of Chinese pig breeds at different latitudes have rarely been elucidated at the genome-wide level. To fill this gap, we first assembled a high-quality chromosome-level genome of the Chenghua pig and used it as a benchmark to analyse the genomes of 272 samples from three genera of three continents. The divergence of the three species belonging to three genera, Phacochoerus africanus, Potamochoerus porcus, and Sus scrofa, was assessed. The introgression of pig breeds redefined that the migration routes were basically from southern China to central and southwestern China, then spread to eastern China, arrived in northern China, and finally reached Europe. The domestication of pigs in China occurred ∼12,000 years ago, earlier than the available Chinese archaeological domestication evidence. In addition, FBN1 and NR6A1 were identified in our study as candidate genes related to extreme skin thickness differences in Eurasian pig breeds and adaptive evolution at different latitudes in Chinese pig breeds, respectively. Our study provides a new resource for the pig genomic pool and refines our understanding of pig genetic diversity, domestication, migration, and adaptive evolution at different latitudes.

Artificial Fingertip with Embedded Fiber-Shaped Sensing Arrays for High Resolution Tactile Sensing.

Replication of the human sense of touch would be highly advantageous for robots or prostheses as it would allow an agile and dexterous interaction with the environment. The article presents an approach for the integration of a micro-electromechanical system sensing skin with 144 tactile sensors on a soft, human-sized artificial fingertip. The sensing technology consists of thin, 1D sensing strips which are wrapped around the soft and curved fingertip. The sensing strips include 0.5 mm diameter capacitive sensors which measure touch, vibrations, and strain at a resolution of 1 sensor/mm2. The method allows to leverage the advantages of sensing skins over other tactile sensing technologies while showing a solution to integrate such skins on a soft three-dimensional body. The adaptable sensing characteristics are dominated by the thickness of a spray coated silicone layer, encapsulating the sensors in a sturdy material. We characterized the static and dynamic sensing capabilities of the encapsulated taxels up to skin thicknesses of 600 μm. Taxels with 600 μm skin layers have a sensitivity of 6 fF/mN, corresponding to an ∼5 times higher sensitivity than a human finger if combined with the developed electronics. They can detect vibrations in the full tested range of 0-600 Hz. The softness of a human finger was measured to build an artificial sensing finger of similar conformity. Miniaturized readout electronics allow the readout of the full finger with 220 Hz, which enables the observation of touch and slipping events on the artificial finger, as well as the estimation of the contact force. Slipping events can be observed as vibrations registered by single sensors, whereas the contact force can be extracted by averaging sensor array readouts. We verified the sturdiness of the sensing technology by testing single coated sensors on a chip, as well as the completely integrated sensing fingertip by applying 15 N for 10,000 times. Qualitative datasets show the response of the fingertip to the touch of various objects. The focus of this article is the development of the sensing hardware and the basic characterization of the sensing performance.

P139 Self-assessment of scleroderma skin: validation of the PASTUL questionnaire

Abstract Background/Aims The PASTUL (Patient self-Assessment of Skin Thickness in Upper Limb) questionnaire was developed during the COVID pandemic to allow self-assessment of skin remotely in systemic sclerosis (SSc). The aim of this study was to validate PASTUL, evaluate responsiveness and assess impact of skin on quality of life. Methods SSc patients were included in four centres. The PASTUL questionnaire specifies a grading of skin (normal, mild, moderate, severe thickness (0-3)) at eight sites corresponding to the modified Rodnan Skin Score (mRSS) with maximum score assigned to each site. Validity was assessed by comparing PASTUL scores with mRSS assessed by trained rheumatologists. Health Related Quality of Life (EQ5D5L and SSc HRQoL) and Scleroderma Skin Patient reported Outcome (SSPRO) were collected for construct validity, using Pearson’s correlation coefficient (0-0.19 = negligible, 0.2-0.39 = weak, 0.4-0.59 = moderate, 0.6-0.79 = strong, 0.8-1.0 = very strong). Test-retest reliability was estimated using intraclass correlation coefficient (ICC). Patients were followed for six months. Results 149 patients were included, mean age 56.6 years (SD 13.2), 79.7% female, 78 (56.1%) had limited cutaneous SSc (lcSSc) and 61 (43.9%) diffuse cutaneous SSc (dcSSc). Mean disease duration was 12.8 years (SD 9.2), mean mRSS was 9.2 (SD 6.2). At baseline and six months follow-up, PASTUL and mRSS were strongly correlated (r = 0.63 and r = 0.78, p < 0.001, respectively). Test-retest reliability, assessed in 75 patients, was very good (ICC of 0.83, 95% CI 0.74-0.89, p < 0.001). Mean PASTUL scores were 9.3 (SD 6.2) at baseline and 8.5 (SD 6.6) at six months follow-up. In patients with >2 points increase in mRSS, change in PASTUL was significant (p = 0.042). The standardized response mean (SRM) of mRSS and PASTUL in patients with clinically significant change in HRQoL (>0.082) was 0.29 and 0.24, respectively. Correlation between PASTUL and mRSS was moderate in lcSSc and strong in dcSSc (r = 0.54 p < 0.001, and 0.63 p < 0.001, respectively). In patients with disease duration < 4 years, PASTUL was very strongly correlated with mRSS (r = 0.84, p < 0.001), and strongly correlated with HRQoL (EuroQoL, r= -0.67, p = 0.004). SSPRO scores were not correlated with mRSS or PASTUL, but were moderatedly associated with SSc HRQoL scores (r = 0.425, p < 0.001). Conclusion Our preliminary results show that PASTUL is a valid and feasible outcome tool that adds a self-reported measure of skin severity to impact assessments like SSPRO. HRQoL was associated with skin thickening in patients with early disease. SRM was low and needs further assessment in a larger group. Disclosure J. Spierings: None. V.H. Ong: None. P.M.J. Welsing: None. M. Hughes: None. J.D. Pauling: None. F. Del Galdo: None. A.L. Herrick: None. C.P. Denton: None.

P148 CCN3-derived peptides as anti-fibrotic therapies for systemic sclerosis

Abstract Background/Aims Effective therapy for skin fibrosis in scleroderma (systemic sclerosis: SSc) remains an unmet clinical challenge. Persistently activated M2 macrophages are believed to stimulate myofibroblasts in the disease microenvironment creating a pro-fibrotic niche in the skin. Expression of the anti-fibrotic matricellular protein CCN3 is reduced in animal models of fibrosis. We have identified a small peptide based on an amino acid sequence in CCN3, BLR-200, which mimics the anti-fibrotic activity of CCN3, and propose that BLR-200 could be used to treat patients in whom lack of CCN3 activity is permissive for fibrosis. However, whether there is lack of CCN3 activity in SSc and whether BLR-200 has effective anti-fibrotic activity in SSc are unknown. Methods We used ELISAs (R&D Systems) to detect CCN3 and the M2 macrophage marker CD206 in the serum of scleroderma patients with early stage diffuse subset disease (within two years of disease onset), those with late-stage diffuse subset disease (over five years duration) as well as healthy controls (all n = 20). The bleomycin-induced mouse model of skin scleroderma, in which bleomycin is injected subcutaneously every day for 21 days, was used to assess the antifibrotic ability of BLR200 in vivo. Results In scleroderma serum, CCN3 was significantly reduced, relative to matched healthy controls and patients with inactive disease, in early onset scleroderma patients with active disease that show elevated CD206 levels (p < 0.01). In the mouse model of human SSc, compared to injection with a scrambled control peptide and relative to control mice treated with phosphate buffered saline, injection with BLR-200 prevented bleomycin-induced changes in collagen deposition, myofibroblast differentiation and skin thickness as measured by Trichrome stain, indirect immunofluorescence analysis with an anti-a-smooth muscle actin antibody, and morphometric analysis, respectively (N = 8 mice per group, p < 0.05). Similarly, RNA sequencing and real-time polymerase chain reaction analysis revealed that BLR-200 significantly impaired the ability of bleomycin to induce expression of fibrogenic genes such as: integrin alpha 11, CCN2, CCN1, Smad3, wnt4, YAP1 and tenascin-C (all N = 5, p < 0.05). Spatial transcriptomics analysis revealed that BLR-200 impaired bleomycin-induced alterations in skin cell populations, including the activation and expansion of epithelial and reticular fibroblast niches and the induction of Wnt, hippo, focal adhesion and actin cytoskeleton gene expression cluster, all of which are known to be activators of fibrosis and myofibroblast activation and persistence. Conclusion CCN3 expression is reduced in serum of scleroderma patients with active skin disease that show M2 macrophage activation as visualized by elevated CD206 levels. Since BLR-200 has antifibrotic activity in the bleomycin model of skin scleroderma, our data are consistent with the hypothesis that BLR-200 could be used to block fibrosis progression in early onset diffuse scleroderma patients who possess both low CCN3 and high CD206 in serum. Disclosure J. Nguyen: None. K. Zestranjyan: None. S. Xu: None. B.L. Riser: Corporate appointments; CEO of BLR Bio. R.J. Stratton: None. A. Leask: None.

Superb microvascular imaging for evaluating the activity of juvenile localised scleroderma: a preliminary study

ObjectivesTo investigate microvascular changes in juvenile localised scleroderma (JLS) lesions using superb microvascular imaging (SMI) and assess SMI’s utility in evaluating disease activity.MethodsThis prospective study enroled 16 children (7 males) with pathologically diagnosed JLS between January 2021 and June 2023. Lesions were assessed using Localised Scleroderma Cutaneous Assessment Tools, including the localised scleroderma skin activity index (LoSAI) and localised scleroderma skin damage index (LoSDI). Lesions with LoSAI scores > 0 were classified as active. The thickness and blood flow of the lesions and healthy skin layers of the contralateral site were evaluated using ultrasound. SMI was used to detect microvascular blood flow in the lesions and healthy skin, and the vascular index (VI) was calculated. The difference in VI between active lesions and healthy skin was correlated with LoSAI and total scores.ResultsOf 46 lesions, 23 were active and 23 inactive. The skin thickness of the lesion was 0.094 ± 0.024 cm, and that of the healthy site was 0.108 ± 0.026 cm (p < 0.001). The VI of the active lesions and healthy skin were 7.60 (3.60, 12.80)% and 1.10 (0.50, 2.10)%, respectively (p < 0.001). The VI of the inactive lesions and the healthy skin were 0.85 (0.00, 2.20)% and 1.60 (1.00, 3.10)%, respectively (p = 0.011). VI differences between active lesions and healthy skin positively correlated with the LoSAI clinical score (r = 0.625, p = 0.001) and total score (r = 0.842, p < 0.001).ConclusionSMI can quantitatively detect microvascular blood flow changes in JLS skin, indicating lesion activity and severity.Clinical relevance statementSMI is a convenient, non-invasive, technique for detecting active JLS lesions and can provide valuable information to guide treatment options.Key PointsCurrent grading systems of juvenile localised scleroderma rely on subjective clinical information.Superb Microvascular Imaging identified that vascular indexes between active lesions and healthy skin positively correlated with clinical scores.Superb Microvascular Imaging effectively assesses microvascular blood flow, aiding juvenile localised scleroderma lesion activity evaluation.

Ayurvedic Management of Refractory Atopic Dermatitis - Case Report

The term 'eczema' refers to inflammation of the skin and makes the skin irritated. Most common type is atopic dermatitis or atopic eczema. Vicharchika (skin disease with excessive exudation) in ayurveda can be compared to atopic dermatitis (AD). It manifests as erythema, vesiculation and oozing in the acute stage, scaling, and crusting in the subacute stage and lichenification (hyperpigmentation, accentuation of skin markings and thickening of the skin) in the chronic stage. The current condition known as atopic dermatitis leads to eager, aroused skin. Most often, it takes the form of patches on the face, neck, trunk, or extremities. This article presents a case study of a child who is having signs and symptoms of vicharchika. According to ayurvedic etiopathogenesis (samprapti) patient was diagnosed with vicharchika and is treated accordingly by internal and external therapies. Assessment was conducted using subjective as well as objective criteria. Oral ayurvedic medications along with udvartanachurna for local applications as part of the treatment was given. This case was successfully treated using the chikitsasiddhanta of vicharchika. After treatment, there was noticeable improvement in both signs and symptoms. The course of treatment revealed no complications. The study's goals and objectives were to assess the efficacy of simple ayurvedic formulations for the treatment. This single case report highlights thatthis ayurvedic intervention generated beneficial results and raised the quality of life of the patient.

Fascia Iliaca Catheters for Donor Site Pain After Split-Thickness Skin Grafting for Acute Burn Injury: A Retrospective Review.

The management of acute burn pain poses significant challenges. Regional techniques have become increasingly popular in perioperative burn pain management. Continuous nerve block catheters are particularly useful for split-thickness skin grafts where donor site pain can exceed that of the burn-injured site. Donor skin is frequently harvested from the anterolateral thigh. The fascia iliaca (FI) compartment block provides blockade of both the lateral femoral cutaneous nerve and the femoral nerve, and thus, it is a useful modality for burn donor pain. Our institution initiated a protocol in which continuous FI catheters were placed in patients undergoing split-thickness skin grafting of the anterolateral thigh. This retrospective review seeks to assess the impact of this modality on postoperative pain scores and opioid requirements. Oral morphine equivalent (OME) administration was significantly lower in the FI group than the control group, starting with POD 0, which is the day of the FI catheter insertion (188 vs 327 mg, P < .001). Over the next 4 postoperative days (PODs), OME administration remained lower in the FI group compared to control patients, although not statistically significant on PODs 3-4. There was a significant difference in OME administered between the FI group and the control group on POD 5 (159.5 vs 209.2 mg, P < .05). Our retrospective study evaluating the role of FI catheters in burn patients undergoing split-thickness skin grafting surgery showed significantly lower opioid consumption on PODs 1-5 compared to patients without an FI catheter.

Ultrasound Assessment of Psoriatic Arthritis Patients With Clinically Normal Nails and Evaluation of its Correlation With the Disease Activity: A Case-Control Study.

Nail unit is one of the targets of ultrasound (US) assessment. We aimed to compare ultrasound parameters of clinically normal nail unit in psoriatic arthritis (PsA) patients with healthy controls (HC) and evaluate their correlations with disease activity. This was a cross-sectional study including patients with PsA and matched HC. Tender (TJC) and swollen joint count (SJC), Psoriasis Area and Severity Index (PASI), and Disease Activity in Psoriatic Arthritis (DAPSA) were collected in PsA patients. Patients underwent US assessment of fingernails with a study of morphological changes and measurement of the thickness of nail bed (NBT), nail plate (NPT), and adjacent skin (ST). Correlation between nail unit parameters and disease activity was studied. We evaluated 22 PsA patients (219 nails) and 21 HC (210 nails). Mean DAPSA was 21.56 ± 14.36 and mean PASI was 2.19 ± 3.8. PsA patients had more US morphological changes than HC (16.89 vs 3.33%, P = .03). NPT comparison between identical fingernails of PsA and HC did not reveal significant difference. However, NBT was significantly higher in HC (1.77 vs 2.07 mm, P = .027) as well as ST (2.26 vs 2.59 mm, P = .003). TJC and ST were positively correlated (r = .46, P = .03). No correlation was noted between disease activity scores and NPT, NBT, or ST in PsA patients. In biologic parameters, ESR was negatively correlated with ST (r = -.41, P = .05). Nail bed and adjacent skin US morphological changes were contributive to distinguish psoriatic from healthy nails. Adjacent skin thicknessmeasurement was positively correlated with TJC and ESR, suggesting that it could be used as an indicator of disease activity in PsA.

Comparison of Different Suture Techniques on Nasal Soft Tissue Envelope to Prevent Supratip Deformity: A Histologic Study

BackgroundStudies have described various surgical maneuvers in rhinoplasty to limit thickening from excessive scarring in the supratip region. This study aimed to compare the effectiveness of three maneuvers—a simple suture, a U suture, and bolster dressing—used to avoid supratip deformity in a rabbit model.MethodsThirty-two male New Zealand white rabbits were included. The animals were divided into four groups, and dissection was performed in the supra-perichondrial plane up to the supratip region through an open rhinoplasty incision. After dissection, the following approaches were applied to the supratip region: Group 1, simple approximation suture; Group 2, U suture; Group 3, bolster dressing; and Group 4 (control group), no suture. All animals were sacrificed after 12 weeks. Histological analysis was performed.ResultsIn Group 4, scar thickness was significantly greater than in the other groups (p < 0.05). Group 3 had greater scar thickness than Group 2 (p < 0.05). The ratio of scar thickness to skin thickness was higher in Group 4 compared with the other groups (p < 0.05). Finally, there was no difference in the ratio of scar thickness to skin thickness between Groups 1, 2, and 3 (p > 0.05).ConclusionsIn this study, it was concluded that surgical methods using sutures in the supratip region reduced scar thickness in a rabbit model, and these surgical methods had similar levels of effectiveness.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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.

Enhancement of skin rejuvenation and hair growth through novel near-infrared light emitting diode (nNIR) lighting: in vitro and in vivo study

The study aimed to explore the impact of a novel near-infrared LED (nNIR) with an extended spectrum on skin enhancement and hair growth. Various LED sources, including White and nNIRs, were compared across multiple parameters: cytotoxicity, adenosine triphosphate (ATP) synthesis, reactive oxygen species (ROS) reduction, skin thickness, collagen synthesis, collagenase expression, and hair follicle growth. Experiments were conducted on human skin cells and animal models. Cytotoxicity, ATP synthesis, and ROS reduction were evaluated in human skin cells exposed to nNIRs and Whites. LED irradiation effects were also studied on a UV-induced photoaging mouse model, analyzing skin thickness, collagen synthesis, and collagenase expression. Hair growth promotion was examined as well. Results revealed both White and nNIR were non-cytotoxic to human skin cells. nNIR enhanced ATP and collagen synthesis while reducing ROS levels, outperforming the commonly used 2chip LEDs. In the UV-induced photoaging mouse model, nNIR irradiation led to reduced skin thickness, increased collagen synthesis, and lowered collagenase expression. Additionally, nNIR irradiation stimulated hair growth, augmented skin thickness, and increased hair follicle count. In conclusion, the study highlighted positive effects of White and nNIR irradiation on skin and hair growth. However, nNIR exhibited superior outcomes compared to White. Its advancements in ATP content, collagen synthesis, collagenase inhibition, and hair growth promotion imply increased ATP synthesis activity. These findings underscore nNIR therapy’s potential as an innovative and effective approach for enhancing skin and promoting hair growth.

789 Six Year Experience with Autologous Skin Cell Suspension for Burn Wounds

Abstract Introduction Autologous skin cell suspensions (ASCS) minimize the donor site required for addressing partial and full thickness burns. ASCS is currently FDA approved for use in combination with meshed split thickness skin grafts (STSGs) for full-thickness thermal burns in pediatric and adult patients. Besides the initial clinical trials of ASCS and STSG use for burn wounds, there are minimal studies reporting outcomes of their use. Here, we present our experience using ASCS in the past six years. We hypothesized that ASCS and STSG would result in a low reoperation and infection rate. Methods Retrospective review of patients seen at an American Burn Association verified burn center between 2017 and 2023 identified 15 patients treated with ASCS overlying STSG. Data collected included patient demographics, burn characteristics, surface area of ASCS usage, and patient outcomes. The primary outcome of interest was the requirement for reoperation following ASCS use. Secondary outcomes included hospital length of stay (LOS), ICU LOS, infection, and the necessity for scar revision via surgery or laser treatment. Data was analyzed using descriptive statistics with categorical variables presented as frequencies and percentages and continuous variables reported as medians and ranges. Results The median age of patients treated with ASCS was 36 years (13-67 years). The median BMI was 27.4 (17.7-35.4) and median total body surface area (TBSA) affected by burn was 18% (5.75-69.5%). Six patients (40%) had full thickness in addition to partial thickness burns. Most burns, 11 (73%) were the result of flames, although there were three grease burns and one friction burn. The median time to ASCS application was 10 days (1-39 days) and the median number of ASCS application sites was 2 (1-6). Most ASCS sites were on the upper or lower extremities or the torso; however, two patients had ASCS applied to their feet while another patient had it applied to their genitalia. Median ASCS surface area was 2,464 cm2 (289-20,000 cm2). Median LOS was 23 days (8-125 days) and median ICU LOS was 3 days (0-94 days). Four patients (26.7%) required reoperation on sites of ASCS application with the median time to reoperation being 40.5 days (28-66 days). Three patients (20%) required scar contracture surgery and three (20%) received laser treatments. There were no cutaneous infections in our cohort. Conclusions ASCS was effectively used to treat both partial thickness and full thickness burns and burns due to flame, grease, and friction. There did not seem to be any relationship between the necessity for reoperation after ASCS and the burn depth, etiology, surface area, or location. Applicability of Research to Practice Clinicians can look to our study for potential outcomes when using ASCS with STSG in a variety of situations.

Type I Diabetes Mellitus Suppresses Experimental Skin Carcinogenesis.

This study explores the previously uncharted territory of the effects of ultraviolet (UV) radiation on diabetic skin, compared to its well-documented impact on normal skin, particularly focusing on carcinogenesis and aging. Employing hairless SKH-hr2, Type 1 and 2 diabetic, and nondiabetic male mice, the research subjected these to UV radiation thrice weekly for eight months. The investigation included comprehensive assessments of photoaging and photocarcinogenesis in diabetic versus normal skin, measuring factors such as hydration, trans-epidermal water loss, elasticity, skin thickness, melanin, sebum content, stratum corneum exfoliation and body weight, alongside photo documentation. Additionally, oxidative stress and the presence of hydrophilic antioxidants (uric acid and glutathione) in the stratum corneum were evaluated. Histopathological examination post-sacrifice provided insights into the morphological changes. Findings reveal that under UV exposure, Type 1 diabetic skin showed heightened dehydration, thinning, and signs of accelerated aging. Remarkably, Type 1 diabetic mice did not develop squamous cell carcinoma or pigmented nevi, contrary to normal and Type 2 diabetic skin. This unexpected resistance to UV-induced skin cancers in Type 1 diabetic skin prompts a crucial need for further research to uncover the underlying mechanisms providing this resistance.

Marijuana Use in Aesthetic Surgery Patients: A Retrospective Review of 441 Cases

Abstract Goals/Purpose Marijuana use is increasing in Canada following its legalization in 2018. 27% of Canadians were reported to have consumed marijuana in 2022. Marijuana use in surgical patients is a topic that has had exponential growth in the literature recently. The drug has many therapeutic effects such as analgesia, muscle relaxation, sedation and mood improvement. However, it is also associated with deleterious cardiovascular, respiratory and coagulopathic effects that can significantly impact the care of surgical patients in the peri-operative period. Literature from other surgical specialities has shown similar recovery and ultimate surgical outcome between marijuana users and non-marijuana users despite increased pain and poorer quality of life associated with marijuana use. There is a paucity of information about the effects of marijuana on aesthetic plastic surgery outcomes. The prevalence of marijuana use in aesthetic plastic surgery patients is currently unknown and there is a need for more evidence to develop clinical practice guidelines regarding the use of marijuana in the perioperative period. The purpose of this study is to describe the effects of marijuana consumption on aesthetic plastic surgery outcomes. Methods/Technique A single-center retrospective review was completed including all patients who underwent abdominoplasty, mastopexy and/or other body contouring surgery (such as brachioplasty, thigh lift or lower body lift) between January 2021 and August 2023. Other procedures such as liposuction, fat grafting, implant insertion or removal were also reviewed if they took place during the same general anesthetic. Marijuana use was defined as use within 4 weeks pre- and/or post-operatively. Data collection included patient demographics, body mass index (BMI), marijuana use, smoking status, comorbidities, surgical procedure(s) performed, operative time, resection weight and/or liposuction volume (if applicable), complications and follow up. Results/Complications A total of 1000 procedures in 441 patients were reviewed during the 32-month study period. Average patient age was 43 years old and average patient BMI was 27.3 kg/m2. 20.4% of patients were marijuana users. The average number of procedures completed per patient was 2.3 and average operative time was 167 minutes (2 hours and 47 minutes). 79% of cases involved more than one surgical procedure. 63% of the 441 cases involved an abdominoplasty, 49% involved a mastopexy, 5% involved a brachioplasty and 4% involved a thigh lift procedure. 33% of cases included breast implants and 47% liposuction. Average follow up time was 5.2 months. Overall surgical complications consisted of a 5% superficial infection rate, 1% deep infection rate, 9% seroma rate, 1% hematoma and lymphocele rates, 3% rate of wound dehiscence requiring surgical intervention and 11% rate of superficial delayed wound healing. There were no cases of nipple necrosis or full thickness skin necrosis. A comparison of patient demographics between marijuana and non-marijuana user groups revealed that marijuana users were significantly younger than non-marijuana users (average age 39 and 44 years old respectively). Surgical data, outcomes and complications were not found to be significantly different between the 2 groups for all variables. Conclusion Marijuana consumption in the perioperative period does not appear to affect aesthetic surgery outcomes such as post-operative infections, seroma, lymphocele, wound dehiscence, or fat necrosis based on the results of this study. There is a need for prospective work on this topic to produce better quality evidence and ultimately to create evidence-based guidelines on the perioperative use of marijuana for aesthetic surgery patients.

In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement.

Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.