Skin Thickness Research Articles

Ionic Liquid-Mediated Transdermal Delivery of Organogel Containing Cyclosporine A for the Effective Treatment of Psoriasis.

The dermal delivery of peptide therapeutics that are of high molecular weight is a challenge. Cyclosporine A (CsA) is a cyclic undecapeptide with poor aqueous solubility and high molecular weight (1202 Da) indicated for psoriasis. The objective of the study was to evaluate the effect of ionic liquids mixed with the Pluronic F127 matrix in skin permeation of CsA and its efficacy in psoriasis treatment. Choline and geranic acid (CAGE) ionic liquids in a 1:2 molar ratio were mixed with Pluronic F127 (22.7%) and PEG 400 (45%) to prepare an organogel formulation. The CsA-loaded CAGE (CsA-CAGE) and CAGE-Pluronic F127 gels (CsA-CAGE-P gel) were characterized for physical and rheological characteristics. The skin transport studies showed that free CsA did not permeate across the excised porcine skin after 48 h. The amount of CsA permeated across the oleic acid (0.25% v/v) and palmitic acid (0.25% w/v) cotreated skin was found to be 244 ± 4 and 1236 ± 17 μg/cm2, respectively. The application of CsA-CAGE and CsA-CAGE-P gel enhanced CsA flux by 110- and 135-fold, respectively, compared with the control. The thermal analysis and biophysical studies changed the barrier property of the skin significantly (p < 0.05) after incubation with CAGE and CAGE-P gel. The pharmacokinetic studies in the rat model showed that topical application of CsA-CAGE-P gel provided 2.6- and 1.9-fold greater C max and AUC0-t, respectively, compared to the control group. In vitro-in vivo level A correlations were established with R 2 values of 0.991 and 0.992 for both linear and polynomial equations for the CsA-CAGE-P gel formulation using the Wagner-Nelson method. The topical application of CsA-CAGE-P gel (10 mg/kg) on an imiquimod-induced plaque psoriatic model reduced the area of the psoriasis and severity index (PASI) score significantly for erythema and scaling, reversing the changes to skin thickness, blood flow rate, and transepidermal water loss. Together, CAGE-Pluronic F127 organogel was developed as an effective topical formulation for the local and systemic delivery of CsA for the treatment of psoriasis.

Knowledge-based model generation for aircraft cabin noise prediction from pre-design data

The climate targets set out in the “European Green Deal” call for the consideration and implementation of climate-friendly propulsion concepts and sustainable fuels in future aircraft configurations. This puts the use of very efficient propeller engines into the focus of aircraft design. However, these pose major challenges, especially to cabin acoustics, due to high, tonal sound pressure levels on the fuselage. The design of noise control measures requires the competence to predict the resulting interior noise as early as possible in the design process of the vehicle. This requires a high level of geometric and structural detail regarding the fuselage structure and cabin components. With increasing frequency range, the necessary structural details also increase, which have to be resolved in the simulation models due to the associated decreasing structural wavelength. Especially in the context of aircraft pre-design, there is usually not enough information available for a detailed vibro-acoustic modeling of the fuselage and cabin components, which allows a meaningful prediction of the vibrations and thus the cabin noise. Therefore, the knowledge-based tool Fuselage Geometry Assembler (FUGA) is developed for the targeted enrichment of preliminary design data with knowledge for detailed numerical analyses. This paper describes the knowledge-based geometry and model generation in FUGA, which can consider the necessary (increasing) level of detail for the vibro-acoustic prediction already in the preliminary design. For this purpose, aircraft data sets in the preliminary design data format Common Parametric Aircraft Configuration Schema (CPACS) form the modeling basis. Originating from the aircraft preliminary design, these initially describe the outer shell of the vehicle and are extended by detailed structural information that defines the geometric boundary conditions for component placement in cabin design. For the cabin components, the open-source geometry kernel Open Cascade Technology (OCCT) is used to provide geometries at the level of detail required for subsequent analyses. The geometry models are then discretized in open source (e.g. Gmsh) or commercial meshers and further used for numerical analysis. Finally, the prediction of cabin noise is demonstrated as a Proof of Concept using the example of a short-haul propeller-driven aircraft and the feasibility of the proposed method is indicated by investigating the sensitivity of resulting simulation models to the fuselage skin thickness.

Effect of Honeycomb Geometrical Parameters on Equivalent Radiated Power and Frequency Response of Motor Casing and Gearbox Surface of a Powertrain

ABSTRACTThe powertrain, as a central source of noise and vibration, is crucial in determining the overall NVH (noise, vibration and harshness) performance of vehicles, necessitating the optimisation of its structural components for improved durability and passenger comfort. This paper investigates the influence of key geometrical parameters—cell thickness, skin thickness and cell length—on the complex frequency modes of honeycomb and square sandwich structures using the Altair OptiStruct solver 2022 and fast Fourier transform analyser. The driven and non‐driven ends of a motor casing and a gearbox, represented by honeycomb structures and ribs, were subjected to an evaluation of equivalent radiated power (ERP). The results show that the square structure performs better at higher skin thickness when resisting severe lateral stresses than the honeycomb while being less stiff at higher cell thickness. Notably, smaller cell length had a substantial impact on the modes of the honeycomb structure, whereas larger cell length had an impact on the square structure. Response surface methodology was used to optimise the modal frequencies of both square and honeycomb panels simultaneously. An ideal cell length of 5.88 mm, skin thickness of 1.303 mm and cell thickness of 0.381 mm were found for the honeycomb construction, yielding a composite desirability of 0.981. On the other hand, with a cell length of 5.045 mm, skin thickness of 1.484 mm and cell thickness of 0.331 mm, the square structure achieved a composite desirability of 0.989. It is interesting to note that the driven end casing of the motor casing made more noise with the addition of ribs than the non‐driven end and gearbox. But compared to the original powertrain model, adding a honeycomb structure resulted in a noise reduction of about 10%.

Damping optimization of a fully viscoelastic structure with enforced mass reduction

Current damping methods employed in industry, such as Constrained Layer Damping (CLD), all require the introduction of additional mass and a secondary material to the structure. In transportation industries, this weight addition is often correlated with an increase in operational costs. Additionally, in applications with large temperature changes, such as in space, the secondary material introduces an additional source of stress during thermal expansion and contraction. This work presents a methodology to significantly improve the damping performance of a fully viscoelastic, single material structure while also enforcing a mass reduction. The work expands upon the modal strain energy (MSE) method to calculate the damping performance of a fully viscoelastic structure and develops a novel weighting scheme to make the optimization more robust. The methodology is then implemented on a technology demonstration thermoplastic lunar rover. This implementation demonstrates the ability to optimize a fully viscoelastic structure to significantly improve the damping performance while also achieving a large decrease in mass. The implementation also demonstrates the robustness of the weighting scheme as it allows the natural frequencies to shift between iterations. The skin thickness of the rover’s base panel was optimized. After optimization, the base panel of the rover achieved a 20% damping improvement for Mode 1 with a 9% mass reduction. The skin thickness of the full rover was optimized and achieved a 15% damping improvement for Mode 2 with an 11% mass reduction.

Enoximone alleviates atopic dermatitis-like skin inflammation via inhibition of type 2 T helper cell development

Atopic dermatitis (AD) is an inflammatory skin disease that affects approximately 15–20 % of the children and 1–3 % of the adults worldwide. Corticosteroids and calcineurin inhibitors are used in AD therapy; however, they cause various side effects. Current studies focus on novel therapeutic targets such as phosphodiesterases (PDEs) to mitigate AD. However, the relationship between PDE3 inhibitors and AD has not yet been reported. This study aimed to investigate the therapeutic effects and pharmaceutical mechanisms of enoximone (Enox), a PDE3 inhibitor. Mice were stimulated with 2,4-dinitrochlorobenzene (DNCB) to induce AD-like skin inflammation and were topically treated with Enox for 2 weeks. Treatment with Enox reduced the dermatitis score, skin water loss, IgE production, and expression of cytokines and chemokines that were elevated by DNCB. Histologically, Enox treatment reduced the skin thickness and the infiltration of various inflammatory cells, including macrophages, mast cells, eosinophils, and type 2 T helper (Th2) cells. HuT78, a human T cell line, was used to investigate the differentiation of T cells into Th2 cells. Enox treatment decreased the expression of Th2 cytokines and GATA3, a Th2 cell marker in HuT78, and suppressed signaling pathways that play a crucial role in Th2 cell differentiation. Collectively, the results demonstrate that Enox alleviates AD-like skin inflammation by inhibiting T-cell development. Thus, Enox may be a therapeutic candidate for the treatment of AD.

Composite skin substitutes, 3D skin bioprinting and the “BioMask” concept in regenerating skin defects - review

The treatment of skin trauma, especially facial skin trauma, is a major challenge due to its complex structure, the presence of appendages, color, texture, and the large area to be reconstructed in extensive trauma. “The gold standard” for treating trauma is autologous intermediate thickness skin grafting. An alternative solution is the usage of bioengineered skin substitutes. Tissue engineering is intended to provide patients with better treatment options and more effective pain reduction. Unique skin lesions are those related to the face. To fulfill the need to improve the results of facial skin reconstruction, the “Biomask” concept was introduced for the treatment of facial wounds. The purpose of this review is to analyze composite dermal-epidermal substitutes already on the market for clinical use, as well as briefly discussing materials in the testing phase, focusing on 3D skin bioprinting and facial trauma regeneration using “BioMask”. PubMed and Google Scholar databases were searched for relevant sources. Search terms included “skin substitutes”, “synthetic skin substitutes”, “bioengineered skin”, “composite skin substitutes” and additionally each analyzed unit of composite skin substitutes was searched. Bioengineered skin substitutes effectively fulfill the role of dressings during the reconstruction of skin injuries. The development of 3D skin bioprinting is enabling the increasing and effective use of these materials. The high requirements in the treatment of facial skin injuries are the trigger for the development of new materials such as "BioMask". The synergy of new technologies makes it possible to create improved methods of wound dressing and reconstruction of skin defects.

Evaluation of Axillae Skin Thickness by High-Frequency Ultrasound.

High-frequency ultrasound has been utilized in dermatology to visualize superficial cutaneous structures. Axillae are often target of treatments for hair removal, for spot clearing, and for skin conditions such as hyperhidrosis, bromhidrosis, and hidradenitis. Detailed knowledge of armpit thickness can help improve existing therapies and increase their effectiveness. To describe the mean skin thickness of axillae, by further investigating possible correlations with variations in age, sex, and body mass index (BMI). Axillae were divided into 5 quadrants, 1 central and 4 peripherals. Skin has been assessed by ultrasonography, measuring the distance from epidermis surface to dermal depth, in millimeters, for each of the regions. Thirty healthy patients participated, most of them were female (n = 22; 73%), mean age 50 years (26-70 years). Most patients have maximum thickness in the center of axillae (87%). Average skin thickness in the central region was 3.1 ± 0.4 mm. There was significant difference between axillary thickness in central and peripheral regions (p < .05). On the periphery, the mean thickness was smaller (1.8 mm) without significant variation between the squares. There was no significant variation of skin thickness by sex, age, and BMI. This study shows a difference between thickness of axillae in the central region and in its periphery.

IL-21 drives skin and lung inflammation and fibrosis in a model for systemic sclerosis

BackgroundSystemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy, abnormal inflammation, and fibrosis of the skin and internal organs, notably the skin and lungs, significantly impairing quality of life. There is currently no cure for SSc, and its etiology remains largely unknown, presenting a primary barrier to effective treatment. We investigated the role of interleukin-21 (IL-21) in the pathogenesis of SSc. MethodsWe assessed the expression levels of fibrosis-related genes in human dermal fibroblasts exposed to IL-21 and TGF beta. We also induced SSc in wild-type C57BL/6 mice and IL-21 knockout (KO) mice with a C57BL/6 background using bleomycin (Bleomycin). Histological analyses were conducted on skin and lung tissues from these mice. The distribution and expression levels of fibrosis-related proteins in the tissues were examined via immunohistochemistry and quantitative real-time PCR. Furthermore, we measured the frequency of Th1, Th2, and Th17 cells among splenocytes through flow cytometry. ResultsIL-21 activation led to STAT3 phosphorylation more than TGF beta in dermal fibroblasts. In IL-21 KO mice with BLM-induced SSc, skin thickness and lung fibrosis were reduced. The absence of IL-21 in these mice resulted in suppressed expression of fibrosis-related genes, including Col1a1, Col1a2, Col3a1, CTGF, α-SMA, STAT3, and TGFβ, in the skin and lungs. It also led to a decreased frequency of Th1, Th2, and Th17 cells, as well as a lower Th17/Treg ratio among splenocytes, factors known to contribute to the development of SSc. ConclusionsIL-21 contributes to the development of SSc by promoting the expression of fibrosis-related genes and modulating the levels of CD4+ T cells.

Comparative Trial Evaluating a High- Versus Low-Integration Hyaluronic Acid Filler for Contouring the Jawline.

Contour deficits of the jawline are an area of concern for many aesthetic patients. While the use of hyaluronic acid (HA) for jawline enhancement has been described previously, comparative investigations of HA fillers manufactured with different technologies are limited. Therefore, the aim of the current investigation was to evaluate the safety and efficacy of Restylane Lyft (HA-L) and Restylane Defyne (HA-D) for contouring of the jawline. This prospective clinical trial enrolled forty (40) participants. Twenty (20) participants with thin skin were treated with HA-D, and twenty (20) participants with thick skin were treated with HA-L. Visits occurred at Screening/Baseline (treatment), Week 2 (touch-up), and Months 1, 3, and 6. At each visit, a blinded evaluator rated 3-dimensional participant imagery according to the Jawline Volume Loss Scale and participants completed the Jawline Subject Satisfaction Scale. Frequency of treatment-emergent adverse events was collected via participant diaries, and product integration characteristics were evaluated via ultrasound. Chi-square tests of independence revealed statistically significant improvements in severities of jawline volume loss, which were maximal at Month 1 (100%) and maintained until Month 6 (82.05%). At Month 1, 92.10% of participants reported being satisfied with overall treatment effects. Adverse events were expected per the product monographs and did not vary per group. On ultrasound, HA-L displayed targeted product integration and HA-D displayed diffuse product integration. Results support the use of HA-L and HA-D for the contouring of the jawline with each product capable of providing distinct advantages depending on patient attributes (e.g., skin thickness, underlying bone structure, desired outcomes). Evidence obtained from well-designed cohort or case-control analytic studies. 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 .

The Neo-Pitanguy Ligament: A Three-Flap Technique For Skin Tensioning.

Creating a stable, long-lasting supratip break continues to be a challenge, particularly in patients with moderate to severe skin thickness. Multiple techniques have been previously described to address this, including Pitanguy's ligament preservation, re-suturing, and cartilage frame alterations to increase the tip-to-septal angle differential. Each have noteworthy limitations. The senior author developed a novel technique which utilizes the native Pitanguy ligament augmented by two bilateral, medially-based superficial musculo-aponeurotic system (SMAS)/soft tissue flaps. This reduces supratip dead space, prevents tissue glide while controlling supratip/tip shape and position. Twenty-six (n=26) primary rhinoplasties in which the supratip and tip skin sleeve was of appropriate thickness were selected and followed for 1-year post operatively. The tri-laminar neo-Pitanguy ligament (NPL) technique was employed in all patients. Every patient maintained a varied degree of supratip break at an average follow up time of 14 months (range: 12-16 months). There was one revision requiring local anesthesia. No patients requested or were indicated for a return to the operating room. No cases of post-operative pollybeak deformity were observed. The power of this novel supratip control technique is multidimensional. It allows the surgeon to precisely control the location of supratip break, creating a broad based, diamond-shaped supratip depression. Tri-lamination with the use of the two SMAS/soft tissue flaps provides added strength, control, and long-term stability compared to simple suturing. Soft tissue tensioning above, around, and below the new tip complex prevents dorsal skin tissue glide and further secures the infratip/columella in appropriate position.

Effect of breed, obturator type and surgical experience on tenoscopic portal creation into the digital flexor tendon sheath in horses.

To determine the influence of breed (cob [CB] and non-cob [NC]), obturator type and surgical experience on the number of attempts, time taken and iatrogenic damage (ID) created when entering the digital flexor tendon sheath (DFTS) tenoscopically. Prospective experimental cadaveric study. A total of 104 cadaver limbs. An equal number of randomly selected CB and NC limbs were operated using a conical obturator (OB) or a switching stick (SS) by one boarded (BS) and one resident surgeon (RS). Skin measurements, number of attempts and time taken to enter the DFTS were recorded. The DFTS was endoscopically examined and then dissected to record ID and cumulative ID calculated. Mean CB skin thickness (8.4 mm) was nearly twice that of NC limbs (4.5 mm) (p < .001). Mean DFTS entry took longer in CB limbs (133 s) compared to NC limbs (112 s) (p = .02). BS mean entry time in CB limbs was 115 s compared to 46 s in NC limbs (p < .001). Cumulative ID was greater in CB limbs (25 of 52 limbs with ID) compared to NC limbs (14 of 52 limbs with ID) (p = .04). No difference was noted between obturators. Surgical experience reduced attempts and time entering the DFTS. Surgeons take longer to enter DFTS in CB limbs and more cumulative ID is created, regardless of obturator type used. Skin thickness is a major determinant of time taken to enter the DFTS and increases the risk of ID. Awareness of the challenges in CB limbs is important.

Integrated Scale-Adaptive Adjustment Factor-Enhanced BlendMask Method for Pineapple Processing System

This study addresses the challenge of efficiently peeling pineapples, which have a distinct elliptical form, thick skin, and small eyes that are difficult to detect with conventional automated methods. This results in significant flesh waste. To improve the process, we developed an integrated system combining an enhanced BlendMask method, termed SAAF-BlendMask, and a Pose Correction Planning (PCP) method. SAAF-BlendMask improves the detection of small pineapple eyes, while PCP ensures accurate posture adjustment for precise path planning. The system uses 3D vision and deep learning technologies, achieving an average precision (AP) of 73.04% and a small object precision (APs) of 62.54% in eye detection, with a path planning success rate reaching 99%. The fully automated electromechanical system was tested on 110 real pineapples, demonstrating a reduction in flesh waste by 11.7% compared to traditional methods. This study highlights the potential of advanced machine vision and robotics in enhancing the efficiency and precision of food processing.

WP3.2 - Craniectomy With Soft Tissue Reconstruction for Locally Advanced Non-Melanoma Skin Cancer of Scalp with Calvarial Invasion: the Nottingham experience

Abstract Introduction Locally advanced non-melanoma skin cancer (NMSC) involving the periosteum or calvarium remain clinically challenging for patients unfit for immunotherapy due to medical comorbidities and/or frailty. This case series aims to explore outcomes for patients that underwent craniectomy and soft tissue reconstruction. Method Patients underwent craniectomy and soft tissue reconstruction for invasive NMSC with calvarium or periosteal invasion from 2016 to 2022 were included. Data including demographics, operative details, and clinical outcomes were sourced from Nottingham University Hospitals digital health record and the histopathology electronic database. Result 8 patients (Age: 78.4, 3F 5M) with significant comorbidities and varying degrees of periosteal or bone invasion fulfilled the inclusion criteria. These included four squamous cell carcinoma, two basal cell carcinoma and two pleomorphic dermal sarcomas. Five patients had a history of prior incomplete deep margin excision. The median soft tissue defect, tumour and bone defect size was 51.83cm2, 34.63cm2 and 42.25cm2 respectively. Intraoperative complications included one dural tear. Four patients underwent local flap reconstruction and with split thickness skin grafting, four patients underwent free flap reconstruction. Adjuvant radiotherapy was administered to three. Complications comprised partial graft loss in two and complete graft loss in one. There was partial flap loss in one case. One patient required subsequent parotidectomy due to regional progression before achieving disease control. All patients achieved lasting locoregional disease control (average follow up 29.7 months). Conclusion Craniectomy with soft tissue reconstruction is a safe and effective treatment option in advanced NMSC of the scalp in patients unsuitable for immunotherapy due to frailty or medical co-morbidity.

Diagnosis and features of the treatment algorithm of non-lactational chronic mastitis on the example of a clinical case

Inflammatory processes in the mammary gland (MG) do not lose their relevance, the frequency of occurrence reaches 16% among all diseases of the MG. Non-lactational mastitis (NM) – inflammation in the MG outside the period of pregnancy and lactation – stands out among them [1]. With untimely and non-radical treatment of acute forms, there is a transition to chronic, with the formation of bacterial biofilm in the focus of inflammation and thick scar capsule after repeated surgical interventions, which is due to a vicious circle. The clinical picture of non-lactational chronic mastitis in most cases resembles a diffuse (mastitis-like, edematous-infiltrative) form of breast cancer (BC), which determines the differential-diagnostic difficulties in referring to a doctor both at initial treatment and at recurrence. This problem is faced by doctors of different specialties: oncologists, surgeons, gynecologists, therapists, specialists in radiation and radiological diagnostics [2, 3]. Radiation diagnostics is always the «gold standard» in the diagnosis of breast diseases, but has a number of disadvantages in the inflammatory process in the breast, and, in some cases, it is worth prioritizing the ultrasound method of investigation [4]. Through the combined interpretation of clinical data and ultrasound (USG) findings, the following parameters should be evaluated: skin thickness, pre-mammary fatty tissue, structure of glandular parenchyma of the MJ, presence and boundaries of inflammatory infiltrate/infiltrates in the MJ tissue; formation of «rarefaction» zones, microabscesses and/or already formed «draining» abscess cavities, assess the content of fluid cavities (homogeneity/homogeneity), the presence of pyogenic capsule, as well as the boundaries of inflammation/abscessing with unchanged breast tissue, taking into account possible «microfoci» outside the main mass of changes (like «satellites», «fluid spurs»). It is important to analyze the state of the ductal system of the breast (ductal diameter dilation, intraluminal content) and possible connection of ducts with abscessed areas, which may be a predictor of further spread of the process, recurrence or chronicization of the disease. Inflammation on the background of subacute and chronic process can lead to the development of fistulas [5]. However, there is not always the classic ultrasound picture of a purulent focus in the breast [6–9].

Comparative analysis of one-step and two-step full thickness skin grafting and secondary intention healing for skin defects after surgical management of plantar malignant melanoma.

Plantar malignant melanoma is largely managed surgically, particularly in its early stages. However, the plantar region has a lower survival rate of skin grafts than other regions. Furthermore, complete wound healing occurs over a long period of time, postoperatively. Thus, in this study, we retrospectively analyzed the use of skin grafts to reconstruct skin defects, as postoperative complications of plantar malignant melanoma. Forty-nine patients, (23 males, 26 females; mean age 70.4-years) underwent excisional surgery for plantar malignant melanoma at our hospital, between March 2018 and December 2022. The time from initial surgery to wound healing was analyzed, using a multivariate Cox proportional hazards model, to identify related factors. We excluded cases with lesions in non-weight-bearing areas and cases with segmental layer grafts, based on multivariate analysis, to eliminate bias when comparing a one-step resection and reconstruction technique to resection followed by waiting for granulation to occur before reconstruction. Patients were categorized into three cohorts. The first and second cohorts had undergone one-step and two-step skin grafting, respectively. Patients in the third cohort underwent secondary intention healing without skin grafting. The results revealed that the factors associated with wound-healing time included a defect size of >1800 mm2, in addition to two-step and split-thickness skin grafting. Therefore, Kaplan-Meier curves were constructed across the three cohorts, based on the data of 37 patients. Nine cases of non-weight-bearing areas and three cases of split-thickness skin grafts were excluded from the original total of 49 patients. The median times from the initial surgery to wound healing were 14.6, 12.0, and 21.9 weeks for the one- and two-step skin grafting and secondary intention healing cohorts, respectively. A statistically significant difference in the treatment time between the skin grafting and secondary intention healing cohorts was observed (p < 0.001) Moreover, a statistically significant difference in the treatment time between the one- and two-step skin grafting cohorts was noted (p = 0.046). Thus, two-step skin grafting after surgical treatment for plantar malignant melanoma may shorten the overall treatment duration by allowing granulation to occur.

Effectiveness of negative pressure wound therapy as a fixator in split thickness skin graft applied diabetic patients: evaluation of 25 cases

Objective: Microangiopathies expose diabetic patients to lower extremity wounds at certain stages of their lives. Split-thickness skin grafting (STSG) has an important place in the surgical treatment of such wounds. The aim of the present study is to evaluate the effects of negative pressure wound therapy (NPWT) on STSG survival. Methods: A total of 25 diabetic patients (M = 20, F = 5) with acute or chronic lower extremity open wounds were included in the study. All patients underwent wound debridement under regional anesthesia. STSG was applied after wound debridement. NPWT was applied to STSG to increase graft survival. Results: The hospitalization times of the patients ranged from 1 to 2 weeks. The mean follow-up period of the patients was 6 months. All wounds healed on the 14th postoperative day. There was no recurrence in the 6-month follow-up period. Conclusion: We objectively demonstrated the positive effects of NPWT application on STSG and graft survival.

Coleus forskohlii shows anti-psoriatic activity in imiquimod-induced psoriasis rats

Objective: To evaluate anti-psoriatic activity of Coleus forskohlii in rats with imiquimod-induced psoriasis. Methods: Imiquimod was used to induce psoriasis in rats. Body weight, skin thickness, erythema, scaling, spleen weight, and histological alternations were measured to assess the effect of Coleus forskohlii. Furthermore, an emulgel formulation containing Coleus forskohlii 10% was prepared and characterized along with its ex vivo permeation studies. Results: The emulgel formulation containing Coleus forskohlii 10% had a pH of 5.40±0.36, with optimum spreadability of (31.67±2.08) g/(cms) and viscosity of (15 966.67±1 274.10) cps, and enhanced both the rate and the extent of drug permeation through psoriatic skin. In an ex vivo study, the quantity of drug permeated (19.18%), deposited (52.38%), and drug remaining in the donor compartments (28.31%) was satisfactory. Coleus forskohlii significantly alleviated imiquimod-induced psoriasis by increasing glutathione and superoxide dismutase activity, decreasing malondialdehyde and nitric oxide levels, and alleviating histological alternations in rat skin. Conclusions: Coleus forskohlii can alleviate imiquimod-induced psoriasis, which may be used as a therapeutic candidate for the treatment of psoriasis.

Fournier's Gangrene reconstruction in black patients using SCIP flap and split thickness skin graft: 2 case reports and a literature review

Fournier's gangrene is a potentially life-threatening infectious disease involving the perineum and genitals. Aggressive surgical and medical management is often required, leaving the patient with large integumentary defects. The multiplicity of reconstructive options reported highlights the lack of consensus on the best covering option. Functional and aesthetic considerations are in play, and the literature is scarce on male black patients. We report here two cases of dark-skinned patients presenting with scrotal and penile integumentary defects that were respectively reconstructed with a superficial circumflex iliac artery propeller perforator flap and a split-thickness meshed skin graft and discuss the available literature on the topic.

Ultrasound-based histological differences in thickness between puffy eyelids and normal eyelids in Asian monolid women

BackgroundUpper eyelid tissue swelling is a common characteristic among Asian monolid individuals and is associated with a high incidence of complications following eyelid surgery. Currently, there is no precise definition for upper eyelid tissue swelling, necessitating further research to elucidate the specific causes contributing to upper eyelid puffiness. MethodBetween June 2023 and February 2024, we recruited 84 Asian monolid women categorized into groups based on the severity of upper eyelid tissue swelling: the puffy eyelid group and the normal eyelid group. High-frequency ultrasound was employed to capture images of the upper eyelids and measure the thickness of various tissue layers. This study aims to conduct a comparative analysis to identify the factors contributing to upper eyelid fullness, focusing on elucidating the underlying causes of this condition. ResultAll volunteers underwent bilateral upper eyelid ultrasound imaging. Significant differences were observed in the thickness of subcutaneous fat, pre-tarsal fat, retro-orbicularis oculi fat（ROOF）, and composite fat(ROOF and pre-aponeurotic fat) layer between the puffy eyelid group and the normal eyelid group. However, no significant differences were found in skin thickness or orbicularis oculi muscle thickness. Additionally, no significant differences were observed in the thickness of various layers of the upper eyelid tissue between the left and right eyes in all participants. ConclusionThickening of the upper eyelid fat layer is a primary cause of upper eyelid puffiness. In upper blepharoplasty, targeted removal of pre-aponeurotic fat, ROOF, and pre-tarsal fat can achieve precise reduction to correct upper eyelid puffiness effectively.

Biomarkers reflecting the pathogenesis, clinical manifestations, and guide therapeutic approach in systemic sclerosis: a narrative review.

Systemic sclerosis (SSc) is a progressive autoimmune disorder that mainly affects the skin. There are other clinical manifestations as renal, pulmonary, cardiovascular, and gastrointestinal tract involvements. Based on the skin involvement there are two subtypes of SSc, as limited cutaneous SSc (lSSc) which involves the acral part of the body and diffuse cutaneous SSc (dSSc) resulting in significant skin thickening of the body. Despite of the extensive research the pathomechanism is not fully clarified, how Ssc develops, moreover identifying biomarkers to predict the clinical outcome and prognosis still remains challenging. Circulating biomarkers can be crucial to define the diagnosis, to predict the prognosis and monitor the clinical course. However, only some patients are responsive to the therapy in SSc, and there is a need to reach the ideal therapy for any individual to prevent or slow down the progression in early stages of the disease. In this narrative review, our purpose was to summarize the potential biomarkers in Ssc, describe their role in the diagnosis, pathomechanism, clinical course, organ manifestations, as well as the response to the therapy. Biomarkers assessment aids in the evaluation of disease progression, and disease outcome.