Skin Thickness Research Articles

Using Laser-Assisted Indocyanine Green Angiography to Assess Nipple-Areolar Complex Survival During Reduction Mammoplasty.

In reduction mammoplasty, preserving an appropriate skin flap is crucial to achieve a favorable postoperative appearance and prevent blood supply disorders in the nipple-areolar complex (NAC). Previous studies have indicated that a thinner or narrower flap is more favorable for breast shaping, but also increases the risk of blood supply disorders. Accessing the blood perfusion of the NAC and determining the critical threshold for NAC viability are essential aspects of reduction mammoplasty. The aim of this study was to utilize indocyanine green (ICG) angiography to assess NAC perfusion during reduction mammoplasty. It also sought to identify critical thresholds of various indicators affecting NAC survival and provide guidance for skin flap trimming. Thirty-eight patients who underwent reduction mammoplasty were included. Each patient received ICG angiography before and after skin flap trimming. Data on NAC perfusion, skin flap length, width, thickness, and other relevant indicators were collected. Among the patients, 5 experienced NAC blood supply disorders. Multiple linear regression analysis demonstrated that the NAC blood supply had a significant correlation with the tissue thickness at the pedicle base (P < .001) and with the length-to-width ratio across the nipple (P < .05). To optimize NAC survival and achieve favorable breast shaping, cutoff points for the thickness at the pedicle base and the length-to-width ratio across the nipple of 1.15 cm and 1.71, respectively, were established. ICG angiography provides an effective means to assess NAC blood supply and postoperative survival. The cutoff points established in this study help to predict the survival of the NAC and guide flap trimming.

An Outbreak of Sarcoptic Mange in Free-Ranging Arabian Oryx (Oryx leucoryx) in the United Arab Emirates, and Treatment with Ivermectin-Medicated Pelleted Feed.

At a visit to an unfenced desert conservation reserve in Dubai, United Arab Emirates in February 2022, severe skin disease was noted among resident Arabian oryx (Oryx leucoryx), manifesting as dark grayish to black bark-like thickened skin. Between and 45% and 60% of the oryx showed unrest and pruritus. Sarcoptes scabiei was detected at necropsy of six adult animals. Treatment with ivermectin-medicated pellets at 0.3 mg/kg estimated body weight over two periods of 7 d with a 14-d interval between treatments resulted in improved body and skin condition and hair regrowth. Although severe hyperkeratosis was still present shortly after treatment, no live Sarcoptes mites were found in parasitological examination of skin scrapings of two necropsied animals. By 4 mo post treatment the oryx had returned to normal body condition and coat condition.

Why Do People Think Individuals in Poverty Are Less Vulnerable to Harm?: Testing the Role of Intuitions About Adaptation.

People often falsely believe that individuals from low socioeconomic status (SES) backgrounds are less harmed than those from higher SES backgrounds by a wide range of negative events. We report three studies (total N = 1,625) that provide evidence that this "thick skin bias" emerges at least in part because people overgeneralize otherwise accurate intuitions about adaptation. Across studies, participants accurately intuited that people adapt to psychophysical experiences (e.g., brightness, weight, and volume) but also inaccurately intuited that people similarly adapt to life hardships that actually tend to exacerbate the harm of future negative events. Experimentally decreasing the salience of psychophysical adaptation intuitions reduced the thick skin bias, suggesting a causal link between these adaptation intuitions and the belief that people in poverty are less vulnerable to harm and underlining the importance of studying how biased beliefs about the effects of poverty may perpetuate inequality.

A brief discussion on the harvest of thinned perforator flap, detection of perforator vessels, and evaluation of flap blood supply

Repair and reconstruction surgery is not just a simple repair and reconstruction of tissue and organ defects in different parts, but also requires perfect repair that matches the defect and confuses the real. The thinning strategy of perforator flap is one of its main contents. In recent years, the concept of pure skin perforator flap and its clinical application have overturned the traditional concept that flaps must carry subdermal vascular plexus and improved our understanding of flap surgery, and it is expected to enhance the level of repair and reconstruction. This article explores the harvest of thinned perforator flaps, especially the harvest of innovative pure skin perforator flap with the thickness similar to full thickness skin, as well as the preoperative detection of perforator vessels, blood supply evaluation of perforator flaps, and their clinical applications. It proposes a "Jinshan" repair that perfectly matches the recipient area defect, and also prospects research on the perforasome and three-dimensional visualized digital anatomy of pure skin perforator flaps.

Injectable Antiswelling and High-Strength Bioactive Hydrogels with a Wet Adhesion and Rapid Gelling Process to Promote Sutureless Wound Closure and Scar-free Repair of Infectious Wounds.

Developing injectable antiswelling and high-strength bioactive hydrogels with wet tissue adhesiveness and a rapid gelling process to meet the requirements for rapid hemostasis, sutureless wound closure, and scar-free repair of infected skin wounds continues to have ongoing challenges. Herein, injectable, antibacterial, and antioxidant hydrogel adhesives based on poly(citric acid-co-polyethylene glycol)-g-dopamine and amino-terminated Pluronic F127 (APF) micelles loaded with astragaloside IV (AS) are prepared. The H2O2/horseradish peroxidase (HRP) system is used to cause cross-linking of the hydrogel network through oxidative coupling between catechol groups and chemical cross-linking between the catechol group and the amino group. The hydrogels exhibit a rapid gelling process, high mechanical strength, an antiswelling effect, good antioxidant property, H2O2 release behavior, and degradability. In addition, the hydrogels present good wet tissue adhesiveness, high bursting pressure, excellent antibacterial activity, long-term sustained release of AS, and good biocompatibility. The hydrogels perform good hemostasis on mouse liver, rat liver, and rabbit femoral vein bleeding models and achieve much better closure and healing of skin incisions than biomedical glue and surgical sutures. Furthermore, the hydrogel dressing significantly improved the scar-free repair of MRSA-infected full thickness skin defect wounds by modulating inflammation, regulating the ratio of collagen I/III, and improving the vascularization and granulation tissue formation. Thus, AS-loaded hydrogels show huge potential as multifunctional dressings for in vivo hemostasis, sutureless wound closure, and scar-free repair of infected skin wounds.

Study the involvement of Langerin in mediating epicutaneous sensitization of atopic dermatitis-like mouse model

Objective: To explore the role of Langerin in mediating epicutaneous sensitization of atopic dermatitis (AD) in mouse model. Methods: Mice were topically treated with calcipotriol (MC903) plus ovalbumin (OVA) on the ears to establish AD mouse models, and mice were divided into wild-type control group, wild-type AD group, Langerin knockout control group, and Langerin knockout AD group. Changes of lesion were daily observed. Infiltration of inflammatory cells, mRNA expression of Tslp, Il4, Il13, Il17a, and Il22, levels of serum total IgE, OVA-specific IgE (sIgE), OVA sIgG1 and OVA sIgG2a, proportion of regulatory T (Treg) cells in cervical draining lymph nodes were evaluated at the end of model preparation. Results: Skin tumidness and thickness, dermal inflammatory cells infiltration, the mRNA expression levels of Tslp, Il4, Il13, Il17a and Il22 in wild-type AD groups were higher than those in wild-type control groups, with (1.80±0.66, 1.64±0.25, 1.71±0.54, 2.41±0.23, 2.49±0.32) and (0.53±0.45, 0.85±0.29, 0.73±0.50, 0.72±0.25, 0.56±0.29), respectively (all P<0.05). In addition, the levels of serum total IgE, OVA sIgE and OVA sIgG1 in wild-type AD groups were higher than those in wild-type control groups, with [(1 216.00±572.70) ng/ml, (597.00±538.30) ng/ml, 1.59±0.09] and [(24.22±35.04) ng/ml, (20.01±41.71) ng/ml, 1.16±0.03], respectively (all P<0.05). In Langerin knockout mice, compared to wild-type mice, skin erythema, skin tumidness, epidermal thickening, inflammatory cell infiltration were more obvious; the mRNA expression levels of Tslp, Il4, Il13, Il17a and Il22 were upregulated with (8.19±6.44, 2.53±0.69, 2.82±0.73, 3.94±1.32, 3.80±1.43) (all P<0.05); the levels of serum total IgE, OVA sIgE and OVA sIgG1 were significantly increased with (2 508.00±657.10) ng/ml, (1 808.00±470.70) ng/ml, (1.73±0.09) (all P<0.05); the number of CD4+CD25+CD127-Treg cells were decreased significantly with (13.25±0.96)% and (15.31±1.47)%, respectively (P<0.05). Conclusion: Langerin is involved in mediating epicutaneous sensitization of the AD mouse model and plays a negative immunoregulatory role.

The effect of a 12-week dietary intake of food supplements containing collagen and MSM on dermis density and other skin parameters: A double-blind, placebo-controlled, randomised four-way study comparing the efficacy of three test products

Dietary supplementation with collagen has been gaining popularity as an anti-ageing remedy. The aim of this randomised, double-blind placebo-controlled four-way study was to investigate and compare the effects of 12-week daily dietary supplementation with products containing 10 g hydrolysed fish collagen (HC) or a combination of 5 g or 10 g HC with 1.5 g methylsulphonylmethane (MSM) on dermis density in healthy human subjects. The secondary objectives were to investigate the effects on a variety of other skin parameters. The study results showed improved dermis density, skin texture and reduced wrinkles for all the active products. However, products containing MSM were superior in the improvement of skin thickness and roughness, and a higher dose of HC combined with MSM was crucial for improvement in hydration. On the other hand, no significant effects of the supplementation on viscoelasticity and transepidermal water loss were determined with any of the products.

Bioengineered dermal matrix (Integra®) reduces donor site morbidity in total phallic construction with radial artery forearm free-flap.

Total phallic construction with radial artery forearm free-flap (RAFFF) is widely regarded as the gold standard approach for phalloplasty. However, donor-site morbidity remains a significant concern, which is typically managed by using a full-thickness skin graft (FTSG) on the forearm. Split thickness skin grafts (STSG) have been proposed as an alternative, along with the use of an acellular dermal matrix substitute. A retrospective comparative analysis was performed to assess the differences in operative, functional and cosmetic outcomes between FTSG (Group A) and the combination of acellular dermal matrix with STSG (Group B). A retrospective cohort study was conducted on all patients who underwent total phallic construction with RAFFF, between 2016 and 2021. Post-operative surgical and functional outcomes were evaluated using validated tools. A total of 34 patients were included in the study, with 18 patients (52.9%) in Group A and 16 patients (47.1%) in Group B. Group B demonstrated a significant advantage in terms of healing time (24 days vs. 30 days, p = 0.003) and complete graft take (93.8% vs. 27.8%, p = 0.001). Group B also had significantly shorter operative times (310 min vs. 447 min, p = 0.001) and a reduced median hospital stay (8 days vs. 10 days, p = 0.001). Satisfaction with cosmesis was significantly higher in Group B (93.8% vs. 66.7%, p = 0.048).

Degradation mechanisms of polyurethane grouting materials under quasi-static and cyclic compression loading: Density and size effects

Foamed polyurethane (PU) grouting materials are widely used for road trenchless rehabilitation. However, the density and size effects on their mechanical properties and the microscopic mechanisms under quasi-static and cyclic compression are still unclear. In this paper, the degradation mechanisms of PU grouting materials with different densities and specimen sizes were studied by quasi-static compression, cyclic compression, and macro–micro morphological characterization. As the specimen diameter increased, the compressive strength decreased and the elastic modulus increased. As the diameter-to-height ratio increased, the compressive strength increased and the elastic modulus decreased. The compressive strength/elastic modulus increased as a power function with density. When the stress levels were above the fatigue threshold, cyclic failure occurred. When the stress level reached the fatigue threshold, the loading rate, elastic strain, and loss factor were concentrated at 0.25 s−1, 0.013, and 0.023, respectively. The initial dynamic stiffness increased by 55.94 % compared to the quasi-static stiffness. The fatigue threshold tended to decrease with the increasing specimen diameter and diameter-to-height ratio. For specimens with D20H20, the density effect on the fatigue threshold was not significant. For specimens with D40H80 and D40H40, the fatigue threshold decreased with increasing density. Density and size effects were due to the combined effects of relative skin thickness, cell structure, and matrix content. Moreover, the S-N curve was established.

Respiratory failure in systemic sclerosis.

Systemic sclerosis (SSc) can lead to dyspnea and respiratory failure through multiple mechanisms, making a precise diagnosis particularly challenging, especially amid the current COVID-19 pandemic. In this report, we present a case involving a 26-year-old female who had previously undiagnosed SSc. She experienced acute respiratory failure necessitating orotracheal intubation. Following an extensive evaluation, the patient exhibited skin thickening, kidney failure, thrombocytopenia, microangiopathic anemia, and an antinuclear antibody with a nuclear fine speckled pattern at a titer of 1:320. A diagnosis of SSc complicated by scleroderma renal crisis (SRC) was established. The patient's condition improved after undergoing hemodialysis, receiving an angiotensin-converting enzyme inhibitor, and undergoing cyclophosphamide treatment. Subsequently, she demonstrated sustained improvement during a follow-up period of 20months.

Parameter variation effects on millimeter wave dosimetry based on precise skin thickness in real rats

This study presents a parametric analysis of the steady-state temperature elevation in rat skin models due to millimeter wave exposure at frequencies from 6–100 GHz. The statistical data of the thickness of skin layers, namely epidermis, dermis, dermal white adipose tissue, and panniculus carnosus, were measured for the first time using the excised tissues of real male Sprague–Dawley rats. Based on the precise structure obtained from the histological analysis of rat skin, we solve the bioheat transfer equation to investigate the effects of changes in parameters, such as body parts and thermal constants, on the absorbed power density and temperature elevation of biological tissues. Owing to the notably thin dermal white adipose tissue layer, the surface temperature elevation in the rat head and dorsal skin at 6–100 GHz is 52.6–32.3% and 83.3–58.8% of the average values of different human skin models, respectively. Our results also reveal that the surface temperature elevation of rat skin may correlate with the tissue thickness and deep blood perfusion rates.

Inhibition of Mitochondrial Translation Ameliorates Imiquimod-Induced Psoriasis-Like Skin Inflammation by Targeting Vγ4+ γδ T Cells

Psoriasis is an inflammatory skin disorder that is characterized by keratinocyte hyperproliferation in response to immune cell infiltration and cytokine secretion in the dermis. γδ T cells expressing the Vγ4 TCR chain are among the highest contributors of IL-17A, which is a major cytokine that drives a psoriasis flare, making Vγ4+ γδ T cells a suitable target to restrict psoriasis progression. In this study, we demonstrate that mitochondrial translation inhibition within Vγ4+ γδ T cells effectively reduced erythema, scaling, and skin thickening in a murine model of psoriatic disease. The antibiotic linezolid, which blocks mitochondrial translation, inhibited the production of mitochondrial-encoded protein cytochrome c oxidase in Vγ4+ γδ T cells and systemically reduced the frequencies of IL-17A+ Vγ4+ γδ T cells, effectively resolving IL-17A-dependent inflammation. Inhibiting mitochondrial translation could be a novel metabolic approach to interrupt IL-17A signaling in Vγ4+ T cells and reduce psoriasis-like skin pathophysiology.

Glycyl–tRNA Synthetase Induces Psoriasis-Like Skin by Facilitating Skin Inflammation and Vascular Endothelial Cell Angiogenesis

Psoriasis is characterized by excessive keratinocyte proliferation and immunocyte infiltration, but the underlying pathogenesis remains unclear. Aminoacyl-tRNA synthetases are universally expressed enzymes that catalyze the first step of protein synthesis. Glycyl-tRNA synthetase (GARS) is a member of the aminoacyl-tRNA synthetase family. In addition to its canonical function, we found that GARS was overexpressed in the serum and skin lesions of patients with psoriasis. Moreover, GARS was highly expressed in human skin keratinocytes, and GARS knockdown in keratinocytes suppressed cell proliferation and promoted apoptosis through NF-κB/MAPK signaling pathway. Moreover, intradermal injection of recombinant GARS protein caused skin thickening, angiogenesis, and IFN/TNF-driven skin inflammation. Intriguingly, the reported functional receptor for GARS, cadherin 6 (CDH6), was specifically expressed in vascular endothelial cells, and we found that keratinocyte-derived GARS promotes inflammation and angiogenesis of vascular endothelial cells through CDH6. In addition, intradermal injection of GARS aggravated the phenotype and angiogenesis in imiquimod-induced psoriasiform dermatitis models, whereas the psoriatic phenotype and angiogenesis were relieved after knockdown of GARS by adeno-associated virus. Taken together, the results of this study identify the critical role of GARS in the pathogenesis of psoriasis and suggest that blocking GARS may be a therapeutic approach for alleviating psoriasis.

Low-Field Magnetic Resonance Imaging Findings of the Fetlock Region of Nonracehorses

Low-field, magnetic resonance imaging (MRI) is an advanced imaging modality widely used to diagnose distal limb pathology in horses, but there are limited data regarding lesion distribution within the metacarpo/metatarsophalangeal joint (MCP/MTPJ) region in lame nonracehorses. The aim of this study was to describe the low-field MRI findings and lesion distribution in nonracehorses with MCP/MTPJ region pain. Clinical records from horses undergoing MRI of the MCP/MTPJ region between July 2016 and March 2023 were reviewed. Horses were included if pain causing lameness was localized to this region and conventional imaging failed to provide a definitive diagnosis. Eighty-four horses met the inclusion criteria. Soft tissues were affected in 76 (90.5%) horses, with suspensory ligament branch injuries being the most frequent (60.7%) soft tissue pathology identified. Osseous pathology was diagnosed in 51 horses. The subchondral bone (SCB) of the distal third metacarpal/metatarsal bone (MC3/MT3) was the osseous structure most frequently affected (40.5%), with 79.4% of these horses having lesions on the dorsal aspect of the bone. Osteoarthritis was present in 48 (57.1%) horses. The main limitations of the study were the lack of a standardized diagnostic analgesia pattern due to varying veterinary surgeon involvement, and the absence of bilateral magnetic resonance (MR) sequences in all limbs. MRI is a useful diagnostic tool to assess soft tissue structures in the MCP/MTP region, especially in horses with thick skin, which may make ultrasonographic imaging unreliable.

Investigation of an optimized hot press process design for manufacturing structural polyethersulfone foams

Semi-finished thermoplastic foam panels can be transformed into structural foams—a sandwich-like structure with high-density skins—through thermoforming. This transformation enables the production of mono material sandwich panels, which allow a significant increase in bending properties without increasing the part weight. This study describes the effect of process parameters on skin formation in thermoplastic structural foams manufactured in a two-step isochoric and isothermal hot press process. Process data recorded during foam manufacturing was analyzed and compared to foam behavior in quasi-static isothermal compression tests performed at different levels of temperature and crosshead speeds. The effect of skin-core structure on bending properties is compared to theoretical models from the established literature. It was found that a rule of linear mixture that considers the relative skin thickness allows adequate prediction of both bending modulus and strength. Preferable process design—especially combinations of tool temperature and maximum compaction speed—is described based on the comparison of measured and predicted performance.

Evaluation of balance in patients with systemic sclerosis

BackgroundThe aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data. Methods21 Systemic Sclerosis and 19 healthy were included.Berg Balance Scale (functional balance), Sensamove Sensbalance Maxiboard Software (static, dynamic balance:reaction time and travel time and proprioception), Scleroderma Health Assessment Questionnaire/Health Assessment Questionnaire (health status), Medsger's Disease Severity Scale, Modified Rodnan Skin Score were used in evaluation. FindingsComparing the groups, there was significant difference in Berg Balance Scale (p:0.036); Health Assessment Questionnaire/Scleroderma Health Assessment Questionnaire (p:0.001); Static balance-center (p:0.001), front (p:0.001), back (p:0.001), left (p:0.001), right (p:0.021); proprioception-front (p:0.025);Reaction Time-front (p:0.031) and left (p:0.010);Travel Time-front (p:0.041) and left (p:0.014) in favor of healthy group.In Systemic Sclerosis, disease severity had moderate correlation with static balance-back (r:-0.504,p:0.020).Skin thickness had low correlation with Reaction Time-front (r:-0.449,p:0.041).Age had low correlation with Travel time-front (r:0.458,p:0.037) and proprioception-left (r:0.450,p:0.041); moderate with Travel time-back (r:0.515;p:0.017) and proprioception-front (r:0.539,p:0.012). InterpretationCompared to healthy, Systemic Sclerosis had worse health status, functional balance, static/dynamic balance and proprioception.This situation is related to disease severity, skin thickness and age. Evaluations made with objective methods may have the potential to determine the extent of the problem.Clinicians can guide the treatment of patients with SSc by evaluating their static/dynamic balance and proprioception.With early treatment, additional problems that may occur due to worsening of balance and proprioception can be prevented.Proprioception and dynamic balance evaluation can be performed for older patients, static balance when disease activity is high, and dynamic balance when skin thickness score is high.

Mathematical modelling of peripheral haemodynamics of the shin in volleyball players of mesomorphic somatotype

Statistical modelling of peripheral haemodynamics indicators, which is conducted based on determining anthropometric and somatotypic features of the organism, can be considered a new way of personalising instrumental diagnostic examination. Therefore, determining the suitable rheovasographic parameters of the shin in highly skilled volleyball players of a particular somatotype is relevant. The purpose of this study was to investigate the total influence of indicators of the external structure of the body on the value of indicators reflecting the specific features of blood circulation in the shin in volleyball players of mesomorphic somatotype. A comprehensive clinical and laboratory study of the state of health and physical development of 108 volleyball players aged 16-20 years was conducted. The method of tetrapolar rheography with the use of a diagnostic computer multifunctional apparatus was used to determine the rheovasographic parameters of the shin, amplitude, time, and indicators of the ratio of amplitude and time rheovasographic parameters were evaluated. An anthropometric study of total and partial body measurements was carried out. Somatotyping was performed using the Heath-Carter method. The study selected 28 volleyball players of mesomorphic somatotype. Statistical models were created using direct stepwise multivariate regression analysis. For all amplitude and time rheovasographic parameters of the hip in volleyball players of mesomorphic somatotype, statistical models with high accuracy of description of signs were built. The 10 models included 94 anthropometric dimensions. The key determinants of shin blood circulation parameters are body circumference (most often forearm, neck, and shin circumference), chest and pelvic diameters, thickness of skin and fat folds (most often on the shin, abdomen, flank), and width of the epiphyses of long tubular bones. It was found that the indicators of external body structure within 63.84- 99.99% determine the value of indicators of regional blood circulation on the shin in volleyball players of mesomorphic somatotype. Statistical modelling makes it possible to determine the proper values of individual rheovasographic indicators on the shin depending on the anthropometric parameters of individuals of a certain gender, age, somatotype, which is especially significant for athletes of a certain sport, since their cardiovascular system indicators are greatly influenced by the specifics of sports activity

Electronic Health Record (EHR) System Development for Study on EHR Data-based Early Prediction of Diabetes Using Machine Learning Algorithms

Aims: This research work aims to develop an interoperable electronic health record (EHR) system to aid the early detection of diabetes by the use of Machine Learning (ML) algorithms. A decision support system developed using many ML algorithms results in optimizing the decision in preventive care in the health information system. Methods: The proposed system consisted of two models. The first model included interoperable EHR system development using a precise database structure. The second module comprised of data extraction from the EHR system, data cleaning, and data processing and prediction. For testing and training, about 1080 patients’ health record was considered. Among 1080, 1000 records were from the Kaggle dataset, and 80 records were demographic information from patients who visited our health center of Siddaganga organization for a regular checkup or during emergencies. The demographic information was collected from the proposed EHR system. Results: The proposed system was tested for the interoperability nature of the EHR system and accuracy in diabetic disease prediction using the proposed decision support system. The proposed EHR system development was tested for interoperability by random updations from various systems maintained in the laboratory. Each system acted like the admin system of different hospitals. The EHR system was tested for handling the load and interoperability by considering user view status, system matching with the real world, consistency in data updations, security etc. However, in the prediction phase, diabetes prediction was concentrated. The features considered were not randomly chosen; however, the features were those prescribed by a doctor who insisted that the features were sufficient for initial prediction. The reports collected from the doctors revealed several features they considered before giving the test details. The proposed system dataset was split into test and train datasets with eight proper features taken as input and one set as a target variable where the result was present. After this, the model was imported using standard “sklearn” libraries, and it fit with the required number of estimators, that is, the number of decision trees. The features included pregnancies, glucose level, blood pressure, skin thickness, insulin level, bone marrow index, diabetic pedigree function, age, weight, etc. At the outset, the research work concentrated on developing an interoperable EHR system, identifying the expectation of diabetic and non-diabetic conditions and demonstrating the accuracy of the system. Conclusion: In this study, the first aim was to design an interoperable EHR system that could help in accumulating, storing, and sharing patients' timely health records over a lifetime. The second aim was to use EHR data for early prediction of diabetes in the user. To confirm the accuracy of the system, the system was tested regarding interoperability to support early prediction through a decision support system.

FRI644 A Rare Case Of Autoimmune Polyglandular Disease Type 3, With Scleredema Adultorum Of Buschke, Type 1 Diabetes And Graves Disease

Abstract Disclosure: C. Pérez-Castañeda: None. G.A. González-Villaseñor: None. M. Mercado: None. A. Pozos-Ochoa: None. H.J. Medina: None. E. Gamez: None. M.T. Muñoz-Magallanes: None. Background: Scleredema Adultorum of Buschke is an uncommon skin disease, characterized by hardening and stiffness of the subcutaneous tissues, which typically starts at the neck; affecting the upper back causing immobilization; it may develop both in type 1 and type 2 diabetes mellitus and it is related with prolonged exposure to hyperglycemia, obesity and poor metabolic control. Treatment options include topical as well as systemic treatments and physical modalities; but therapy is often reported as unsuccessful. We present a case of scleredema of Buschke occurring in a patient with Autoimmune Polyglandular Disease Type 3 involving thyroid autoimmune disease and type one diabetes which to our knowledge it´s the first time to be described in literature. Clinical Case: A 42 year old male presented with history of a long standing type 1 diabetes and hypothyroidism after radioiodine treatment for refractory Graves´ disease. He complained of skin thickening and hardening in the nape, back and shoulder areas which has been slowly progressing over the last six years. Physical examination revealed a symmetric, painless, poorly defined non-pitting induration of the skin, with hyperpigmentation and peau d´ orange appearance, involving the back of the scalp, neck, upper back and both shoulders; at palpation there was a woody 1 hardness and thickness of the skin associated with failure of either rolling nor pinching the skin. There was a significant decreased range of motion in both shoulders. We performed an ultrasound which demonstrated an increased thickness of the dermis with a pronounced posterior acoustic shadow and presence of multiple echogenic dots. A magnetic resonance was subsequently conducted, revealing a thickening of the skin at subcutaneous tissue primarily through the interscapular region and a hyperintense band at the dermis. Biopsy specimen showed collagen bundles separated by gaps that correspond to mucopolysaccharide deposits. The patient was followed at the outpatient clinic, we initiated physiotherapy and we adjusted his diabetes treatment in order to achieve adequate control, the patient now refers a steady state on the clinical picture. Conclusion: Scleredema is a rare disease, treatment options include topical as well as systemic treatments and physical modalities; but therapy is often reported as unsuccessful, probably associated with the few cases published in the literature; so there is no standard therapeutic protocol. The course is usually unpredictable and the disease itself is refractory. This is the first case reporting the rare association of type one diabetes, Grave s disease and scleredema of Buschke. 2 Presentation: Friday, June 16, 2023

Correction to: 78 Improvement of Cell Viability in Temporary Storage of Split Thickness Skin Grafts.

Correction to: 78 Improvement of Cell Viability in Temporary Storage of Split Thickness Skin Grafts.