Transepidermal Water Loss Values Research Articles

Skin Barrier Function Defect - A Marker of Recalcitrant Tinea Infections.

Context:Recently, there has been an increase in the number of chronic, recurrent, and recalcitrant dermatophytosis. Many factors implicated are barrier defects, aberrant host immune response, application of steroids or other irrational combination creams, transmission within family, occlusive clothing, poor hygienic conditions, poor compliance, drug resistance and virulence of the infecting strain. Transepidermal water loss (TEWL) is an important index in accessing the barrier function of skin.Aim:To ascertain the role of TEWL from the lesional skin and its effect on the cure rate and relapse in patients of tinea cruris.Materials and Method:A hospital based prospective comparative study was conducted for 1 year. A total of 200 patients of tinea cruris diagnosed clinically and by KOH examination, were included in the study. TEWL was calculated using Tewameter TM300 open chamber probe of Courage and Khazaka, Cologne, Germany. Patients were classified according to the TEWL values into Group A (patients with abnormal TEWL) and Group B (normal TEWL). Both groups were given oral itraconazole and antihistamines for 4 weeks. The cure rates and recurrence rates of both the groups were analyzed and compared.Results:In the Group A, i.e., patients of tinea cruris with abnormal TEWL, only 28% of the patients showed clinical improvement at the end of 1 month. Out of those cured, 78.57% of the cases showed recurrence after 2 months of completion of therapy. In Group B, i.e., patients of tinea cruris with normal TEWL, 69% (n = 69) of the patients showed clinical improvement at the end of 1 month. Out of those cured, only 21.74% of the cases (n = 15) showed recurrence.Conclusion:The cases of tinea cruris with abnormal TEWL show significant decrease in cure rates and significant relapse rates among those initially cured.

Study on the Repairing Effect of Cosmetics Containing <i>Artemisia annua</i> on Sensitive Skin

In view of the increasing sensitivity of consumer skin in recent years, cosmetics containing Artemisia annua extract was tested to evaluate its effectiveness in repairing sensitive skin. Through the experiment of xylene-induced ear swelling in mice, it was found that the inhibition rates of ear swelling in mice induced by xylene in three groups of cosmetics containing Artemisia annua extract reached 60.40%, 73.36% and 74.01%, respectively, close to the positive drug group. Twenty-five sensitive skin volunteers were selected for human clinical trial, and the skin TEWL value, cuticle hydration degree and skin heme (ultra-high concentration) were tested. The results showed that using cosmetics containing Artemisia annua extract for four weeks could effectively increase the hydration degree of cheek cuticle by 63.90% and reduce transepidermal waterloss (TEWL) by 21.51%. The skin heme (ultra-high concentration) decreased by 69.14% and the affected area decreased by 77.47%. The results show that the cosmetics containing Artemisia annua extract can inhibit inflammation, repair skin barrier, improve damaged skin, and reduce redness and other sensitive skin symptoms.

Short-term skin problems in infants aged 0\u20133\xa0months affect food allergies or atopic dermatitis until 2\xa0years of age, among infants of the general population

BackgroundThis study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years.MethodsThis study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression.ResultsOf 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years.ConclusionsAfter adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases.Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)

Barrier Capability of Skin Lipid Models: Effect of Ceramides and Free Fatty Acid Composition.

The skin is an effective barrier that prevents the influx of harmful substances from the environment and the efflux of body fluid. This barrier function is ascribed to the intercellular lipids present in the outermost layer of the skin referred to as the stratum corneum (SC). These lipids are composed mainly of ceramides (CERs), cholesterol, and free fatty acids (FFAs). Alterations in the SC lipid composition and barrier function impairment occur in several skin diseases including atopic dermatitis (AD). As the etiology of AD is multifactorial, establishing the relationship between the changes in SC lipid composition and barrier function impairment in the patients remains a challenge. Here, we employed model membrane systems to investigate the contribution of various anomalies in the SC CER and FFA composition observed in AD patients' skin to the barrier dysfunction. Using ethyl-p-aminobenzoate permeation and transepidermal water loss values as markers for barrier function, we determined that the alterations in SC lipid composition contribute to the impaired barrier function in AD patients. By the use of biophysical techniques, we established that the largest reduction in barrier capability was observed in the model with an increased fraction of short-chain FFAs, evident by the decrease in chain packing density. Modulations in the CER subclass composition impacted the lamellar organization while having a smaller effect on the barrier function. These findings provide evidence that AD therapies normalizing the FFA composition are at least as important as normalizing CER composition.

Traffic-derived air pollution compromises skin barrier function and stratum corneum redox status: A population study.

Since air pollution is only one of many environmental stressors that can affect skin, it has been challenging to identify skin appearance or functional features profoundly affected by chronic exposure to traffic-derived air pollution. The current population study focused on taxi drivers working in urban and rural areas in order to take advantage of difference in occupational exposure. The skin conditions of 100 middle-aged male taxi drivers from urban Shanghai and 66 from rural Chongming were measured with facial tape strips were collected for biomarker analyses. Trans-epidermal water loss (TEWL) values before and after tape stripping were considerably higher in urban taxi drivers from Shanghai. Contrary to previous studies, there was no apparent detrimental effect on skin wrinkle or pigmentation from traffic pollution, which might be attributed to the higher than general public level of photo-exposure in this population. At the same time, pollution exposure especially the heavy traffic pollution exposure was found to associate with lower stratum corneum trypsin-like enzyme activity (SCTE), reduced catalase activity and total antioxidant capacity (TAOC) in tape strips. The evidence suggests that traffic-derived air pollution could deteriorate skin's physical and antioxidant barrier, whereas factors like photo-exposure can be overwhelming against appearance aging. Therefore, in addition to photoprotection, skin barrier care should be considered for people with high air pollution exposure.

Assessment of Skin Properties in Chronic Lymphedema: Measurement of Skin Stiffness, Percentage Water Content, and Transepidermal Water Loss.

Background: Lymphedema (LE) is a chronic progressive protein-rich edema of the soft tissues. Measurement of extracellular fluid of the affected limbs is widely used in detecting LE; however, quantification of the skin alterations and early tissue changes in LE lacks approaches. Methods and Results: Ninety-one patients with LE were assessed. Measurement of transepidermal water loss (TEWL), skin stiffness (SF), and percentage water content (PWC) was assessed on five predetermined skin sites. The value of TEWL, SF, and PWC increased significantly in lymphedematous skin compare with controls, indicating damaged function and texture of the affected skin. Both PWC ratio and SF ratio strongly correlated with LE stage. High correlations were found among instruments assessing tissue fluid. Conclusions: Assessment of the skin parameters has contributed new information about the functional and structural alterations in chronic lymphedematous skin. Quantification of skin properties changes could be a valuable supplement to diagnosis and evaluation of chronic LE.

Skin sensitivity evaluation: What could impact the assessment results?

For the evaluation results of skin sensitivity, such as clinical parameters, stinging test records and biophysical assessments dates might be impacted by many factors, the influence factors need to be further explored, and the skin sensitivity evaluation process and methodology needed distinction and normalization. In this study, we investigated the changes of sensitive skin indexes and lactic acid stinging test results in different seasons, facial regions, skin photo-type, and living habits. Twenty-four healthy subjects had completed this study. Lactic acid stinging test was performed in different seasons. Transepidermal water loss (TEWL), skin hydration, sebum secretion, and pH were measured in an environment-controlled room. Correlations between stinging responses, skin biophysical parameters, and sensitive skin inducements in different seasons were statistically analyzed. Skin TEWL, hydration, sebum secretion, and pH values on different facial parts were various. Two-way correlation analysis between the results of lactic acid stinging test in different seasons and the sensitivity factors showed differences between summer, autumn, and winter. The mean scores of lactic acid stinging test increased in autumn. Linear regression analysis of skin sensitivity factors in type III and type IV photobiology skin found that the frequency of sleeping time and eating spicy food in the past of week could infect the sensitive skin evaluation dates statistically (P<.05). Skin sensitivity assessment results were impacted by seasonal transformation, living habits and customs, and facial regions. These indicted that we should consider above interfering factors when evaluated the skin sensitivity for getting more precise dates.

The Significance of Trans-Epidermal Water Loss After Microneedling and Microneedling-Radiofrequency Procedures: Histological and IRB-Approved Safety Study.

BackgroundMicroneedling (MN) and microneedling-radiofrequency (MN-RF) result in skin rejuvenation and skin exposure to pathogens.ObjectivesThe aim was to determine histopathological changes of needle-depth injuries in preauricular skin and measure time-dependent repair of transepidermal water loss (TEWL) in subjects.MethodsMN and MN-RF procedures were performed at 0.5- and 1.5-mm needle depths on preauricular skin strips from a facelift patient. In 10 subjects, MN and MN-RF procedures were performed at 0.5-mm needle lengths on 6 marked opposing face and body sites. MN and MN-RF at 1.5-mm needle lengths were also carried out on each subject’s midface skin lateral to the nasolabial fold. TEWL measurements were recorded with a calibrated DermaLab Cortex device (Hadsund, Denmark).ResultsHistological examination confirmed that the penetration depths of microchannels closely approximated the 0.5- or 1.5-mm needle lengths. In addition, MN-RF exhibited zones of coagulation injury at the distal end of the channel. After MN or MN-RF at 0.5-mm needle length, TEWL values were greatest immediately after needling to scalp, midface, neck, chest, arm, and thigh sites and remained slightly higher than baseline throughout the 48-h evaluation period. TEWL measurements after MN or MN-RF at 1.5-mm needle length resulted in the highest- and longest-lasting values throughout the 2-day observation period.ConclusionsMN and MN-RF devices are novel devices that require further investigation into optimal treatment parameters and protocols, patient selection, and protection against intrusion of external pathogens and reactive cosmeceutical ingredients with barrier repair.Level of Evidence: 2

Relationship between subjective facial skin types and skin microbiota in 31 healthy female undergraduates aged 20-25 years in Beijing

Objective To analyze the composition of bacteria and fungi on the facial skin of healthy women aged 20-25 years in Beijing by using high-throughput sequencing technology, and to compare the composition and diversity of microbes among 4 kinds of subjective skin types. Methods Totally, 31 female undergraduates were enrolled from Beijing Technology and Business University, and classified into 4 groups, including dry skin group (n=6) , neutral skin group (n=8) , mixed skin group (n=9) and oily skin group (n=8) , according to their subjective feeling of facial skin greasiness and dryness. On 24th December 2017, the facial skin water content, transepidermal water loss (TEWL) , sebum content and pH value were determined for these undergraduates, and these physiological parameters of the skin were compared among the 4 kinds of subjective skin types. Skin samples were collected with swabs from the cheeks of these subjects. After DNA extraction and PCR amplification, the bacterial 16S rRNA regions V1-V2 and fungal internal transcribed spacer regions 1 and 2 (ITS-1-ITS-2) were sequenced separately, and sequences were grouped by OUT cluster analysis at 97% sequence similarity followed by classification and annotation of species. One-way analysis of variance was used for intergroup comparison, and least significant difference (LSD) -t test for multiple comparison. Results The sebum content and bacterial diversity of the facial skin both significantly differed among the 4 kinds of subjective skin types. The skin sebum content in the dry skin group, neutral skin group, mixed skin group and oily skin was 5.50 ± 4.60 μg/cm2, 7.69 ± 5.26 μg/cm2, 10.56 ± 5.42 μg/cm2, 22.81 ± 8.53 μg/cm2 respectively (F=11.685, P 0.05) . The fungi on the facial skin of these subjects mainly consisted of Ascomycota and Basidiomycota, and no significant difference in their relative abundance was observed among the 4 groups (both P > 0.05) . Moreover, there was no significant difference in the composition of fungal genera at relative abundance > 1% among the 4 groups (all P > 0.05) . Conclusion The physiological parameters and bacterial diversity of the cheek skin differed among young women of different subjective skin types, while there was no difference in the fungal diversity or richness, suggesting that the colonization of skin bacteria is associated with subjective skin types. Key words: Skin; Microbial consortia; Bacteria; Fungi; Subjective skin types; High-throughput sequencing

Simultaneous Measurements of Structure and Water Permeability in an Isolated Human Skin Stratum Corneum Sheet

Stratum corneum (SC), the outermost layer of human skin, acts as an intelligent physicochemical interface between the inside and the outside of our body. To make clear the relationship between structure and physical barrier properties of SC, we developed a method that enables us to simultaneously acquire X-ray diffraction (XD) patterns and transepidermal water loss (TEWL) values using a spread SC sheet isolated from human skin. The synchrotron X-ray was incident on the SC sheet surface at an angle of 45° to avoid interference between the two kinds of measurements. Detailed comparison between XD and TEWL data suggested that the thermal behavior of water permeability is closely related to the thermal expansion of the lattice spacings of the hexagonal phases above 40 °C and to the existence ratio of the orthorhombic phase below 40 °C. Thus, the new method we developed can give useful information on the mechanism of water permeation in SC without ambiguity caused by separate measurements of structure and water permeability with different samples.

Crosstalk among adipose tissue, vitamin D level, and biomechanical properties of hypertrophic burn scars

PurposeThis cross-sectional study aimed to investigate whether adipose tissue loss and reduced vitamin D levels following severe burn injury are associated with pathologic scar formation and biomechanical scar properties. MethodsA total of 492 male subjects with hypertrophic burn scars were enrolled from January 2014 to July 2018 and analyzed. Body fat content was measured using dual-energy X-ray absorptiometry. Values of melanin, erythema, and trans-epidermal water loss (TEWL) and the distensibility and elasticity of hypertrophic scars were examined using pigment- and TEWL-measuring devices and a suction skin elasticity meter. ResultsBurn patients with higher fat percentage tended to have higher 25(OH) vitamin D levels (P < 0.001). As body fat percentage increased, hypertrophic scars showed higher mean value of Uf (distensibility, P < 0.001) and lower mean value of Uv/Ue (viscoelasticity or interstitial fluid shifting, P < 0.001). Burn patients with higher 25(OH) vitamin D levels tended to have higher mean values of Uf (P < 0.001) and Ua/Uf (gross elasticity, P = 0.013) and lower mean value of Uv/Ue (P = 0.008). ConclusionAdipose tissue loss and decreased 25(OH) vitamin D levels following burn injury were related to scar rigidity and slow interstitial fluid shifting in hypertrophic scars.

Optimasi Formula Sediaan Krim Sunflower (Helianthus annuus L.) Oil

Minyak biji bunga matahari (sunflower oil) banyak digunakan dalam krim pelembab untuk menjaga kehalusan dan kelembapan kulit. Penggunaan emulgator yang tepat dapat membantu terbentuknya sediaan krim yang stabil. Penelitian ini bertujuan untuk mencari komposisi optimum antara Tween 80 dan Span 80 yang menghasilkan sediaan krim dengan sifat fisik dan stabilitas fisik yang baik ditinjau dari viskositas, daya sebar, dan pergeseran viskositas setelah 30 hari. Kemampuan krim dalam mempertahankan kelembapan kulit diuji dengan metode Transepidermal Water Loss (TEWL). Rancangan penelitian menggunakan Simplex Lattice Design 2 faktor 2 level. Hasil penelitian menunjukkan bahwa dari formula yang diuji, terdapat 3 formula yang memenuhi persyaratan untuk respon yang diuji, yaitu pada kombinasi Tween 80:Span 80 (6:4)%, (7;3)% dan (8:2)%. Viskositas yang diperoleh berada dalam kisaran 143,3-153,3 dPas, daya sebar antara 5,0-5,3 cm, dan pergeseran viskositas antara 4,3-6,8%. Uji TEWL dilakukan terhadap formula optimum yang diperoleh, dan penurunan TEWL yang diperoleh berkisar antara 17,9-38,0%. Berdasarkan data yang diperoleh, dapat disimpulkan bahwa sunflower oil dapat diformulasikan dalam sediaan krim menggunakan kombinasi Tween 80 dan Span 80 pada konsentrasi (6:4)%, (7;3)% dan (8:2)% yang memenuhi persyaratan viskositas, daya sebar, dan pergeseran viskositas selama waktu penyimpanan 30 hari, dan terbukti mampu mempertahankan kelembapan kulit.

Preliminary Comparison of the Efficacy and Safety of Needle-Embedding Therapy with Acupuncture for Atopic Dermatitis Patients

Objectives Among Traditional Korean Medicine approaches, needle-embedding therapy is used in various fields and consistently studied; however, there have been no clinical studies of the treatment of adult atopic dermatitis (AD) with needle-embedding therapy. Thus, there is a need to investigate the effects of needle-embedding therapy for treatment of AD. This study was performed to identify possible effects of needle-embedding therapy at Quchi acupoint (LI11) on AD and to compare these effects with those of acupuncture therapy. Methods A total of 14 participants were enrolled in this study. Participants received acupuncture or needle-embedding treatments for 4 weeks and then were followed for an additional 2 weeks because of safety assessment. The participants were divided into 2 groups: the acupuncture group, receiving treatment at Quchi acupoint (LI11) 3 times per week, and the needle-embedding group, receiving treatment at Quchi acupoint (LI11) once per week. The groups were compared on the basis of the SCORing Atopic Dermatitis (SCORAD) index, Transepidermal Water Loss (TEWL), skin hydration, and Dermatology Life Quality Index (DLQI) at baseline and 1 week after treatment was completed (5th week). Results The SCORAD index, TEWL, Skin hydration, and DLQI at 1 week after treatment were significantly improved in both groups (p<0.05). However, there were no significant differences between the acupuncture and needle-embedding groups in any of the main evaluation indices (p>0.05). The study participants received a total of 84 acupuncture treatments or 28 needle-embedding treatments. No adverse events occurred during the study period. Conclusions Based on changes in the SCORAD index, TEWL, skin hydration, and DLQI value, we found that both needle-embedding and acupuncture treatments at the Quchi acupoint (LI11) were effective in decreasing the symptoms of AD and exhibited similar therapeutic effects, which suggests that needle-embedding treatment may be more clinically convenient than acupuncture, with longer effects and fewer treatments.

The Association Between Postburn Vitamin D Deficiency and the Biomechanical Properties of Hypertrophic Scars.

Fibroblasts, keratinocytes, mast cells, and other cells participate in hypertrophic scar formation and express the vitamin D receptor. We investigated the association between vitamin D deficiency and the biomechanical properties of hypertrophic burn scars. This cross-sectional study analyzed 486 participants enrolled from May 1, 2013 to April 30, 2017. When complete wound healing was agreed with by the two opinions, blood sampling and scar evaluation were performed. The values of melanin and erythema, trans-epidermal water loss (TEWL), and scar distensibility and elasticity were measured using pigment- and TEWL-measuring devices and a suction skin elasticity meter. 25(OH) vitamin D deficiency was defined as plasma level of <20 ng/ml. The vitamin D-deficient patients had significantly higher mean values of scar melanin and TEWL (P = .032, P = .007), whereas scar erythema level was similar. They also showed significantly lower values of Uf (final distensibility; P < .001), Ua/Uf (gross elasticity; P < .001) and Ur/Uf (biological elasticity; P = .014), and higher value of Uv/Ue (viscoelasticity or potency against interstitial fluid shift; P = .016). In multiple linear regression analysis, Uf, Ua/Uf, Uv/Ue, and Ur/Uf were significantly affected by 25(OH)-vitamin D level in deficient patients (Uf, P = .017; Ua/Uf, P = .045; Uv/Ue, P = .024; Ur/Uf, P = .021). Our results demonstrated that vitamin D deficiency was significantly related to increased pigmentation, decreased skin barrier function, low scar distensibility and elasticity, and slow interstitial fluid movement in burn patients.

Transepidermal water loss and skin hydration in healthy cats and cats with non-flea non-food hypersensitivity dermatitis (NFNFHD).

Allergic skin diseases in cats are amongst the most prevalent dermatological conditions in this species. The objectives of this study were to evaluate different types of skin barrier measurements in healthy cats and cats with non-flea non-food hypersensitivity dermatitis (NFNFHD). 24 clinically healthy and 19 NFNFHD cats were included in this clinical trial. In each animal, the transepidermal water loss (TEWL) and skin hydration (SH) were assessed on six clipped body sites by VapoMeter SWL 4605 and Corneometer ®CM 825, respectively. Results of TEWL measurement were , significantly higher in one of the six examined body sites, namely on the lumbar area (p=0.0049). Furthermore, a statistically significant difference was found between the average TEWL values (p=0.019). Statistically notable differences were measured at least in one certain body site for SH: in the groin (p=0.02), where the values in the affected cats were lower than in the healthy individuals. These results may suggest that in NFNFHD cats transepidermal water loss is higher than in healthy cats. Skin hydration is, at least, in certain body sites, lower in atopic feline patients than in healthy individuals.

Longitudinal progress of transepidermal water loss, color, and sensory elements in split-thickness skin graft donor sites in East Asians.

There is little research available that describes the natural progression of split-thickness skin graft (STSG) donor site wounds after re-epithelialization. The purpose of this study was to evaluate the longitudinal clinical progress of transepidermal water loss (TEWL), color, and sensory elements in STSG donor sites in East Asians. Eighteen patients participated in this study. The TEWL, color, pressure threshold, and static two-point discrimination were evaluated from the center and upper lateral corner of the wounds and adjacent normal skin preoperatively and at 1, 2, 7, and 12months postoperatively. The age was negatively correlated with preoperative values of TEWL (r=-0.49, P=0.039). The elevated TEWL level from the STSG donor sites did not return to normal until 12months after surgery. In the measurement of skin color, the elevated L* value normalized after 12months following surgery, while the elevated a* and b* values persisted. In the sensory testing, there were no significant changes during the observation period except at 2months postoperatively, representing a significant increase of pressure threshold in the periphery. In East Asians, elevated skin lightness level in STSG donor sites returned to normal at 12months postoperatively, while the elevated TEWL and skin redness levels were improved but were not normalized at 12months after surgery.

Cosmetic benefit of a biomimetic lamellar cream formulation on barrier function or the appearance of fine lines and wrinkles in randomized proof-of-concept clinical studies.

ObjectiveTwo studies were designed to evaluate the potential cosmetic benefit of a biomimetic, niacinamide‐containing moisturizing cream for the first time in humans.MethodsIn both studies, healthy women were randomized to use two treatments, one for the left side of the body and one for the right, from three options: the test cream, a positive control or no treatment (use of standard cleanser only). Treatments were applied twice daily for 4 weeks to the face and forearms (Study 1) or the face only (Study 2). Instrumental and clinical skin assessments were performed by trained technicians. Study 1 involved tape stripping and a 5‐day no‐treatment (‘regression’) period at the end of the 4 weeks. Independent lay graders were asked to grade the skin texture of subjects in Study 2 from high‐resolution photographs.ResultsIn Study 1 (n = 66), the test cream significantly decreased the transepidermal water loss (TEWL) values on the forearm, and in the cheek area of the face, relative to baseline and compared to no treatment, and increased skin Corneometer values. The improvements were partially retained during a subsequent 5‐day period of no treatment. Increases in TEWL values on skin subjected to tape stripping were significantly lower after 4 weeks of using the test cream compared to no treatment. In Study 2 (n = 72 subjects with visible signs of ageing), there was a favourable trend in the change from baseline of a skin roughness parameter, Ra, for the test cream compared to no treatment. There were statistically significant improvements in the Fitzpatrick wrinkle score compared to no treatment, decreases in TEWL and increased Corneometer values and Cutometer values (R5 elasticity parameter). Grading of high‐resolution images failed to detect the improvements in skin texture (defined as pores, smoothness and unevenness) for the test cream vs. no treatment. No treatment‐related serious or severe adverse events were reported.ConclusionTwice daily application of the test cream over 4 weeks had beneficial effects on skin barrier function, moisturization, wrinkle dimensions and elasticity compared to no treatment. These studies provide proof‐of‐concept evidence and highlight the cosmetic benefit of the biomimetic lamellar cream formulation. Study registration: NCT03216265, NCT03180645.

Effects of Silk Fibroin Moisturizing Cream on Acetone/Ether-Induced Dry Skin Pruritus in Mice

Objectives: The morbidity of dry and itchy skin was high during a person’s lifetime and it had a significant negative impact. This study aimed to investigate the positive effect of silk fibroin moisturizing cream on dry skin pruritus induced by acetone/ether-water (AEW) method in mice. Method: We established a dry skin model in mice with AEW treatment, and the control group was treated with ultrapure water. The mice in AEW model group were locally administrated with silk fibroin moisturizing cream (SilkArmor)®. The transepidermal water loss (TEWL), scratching behavior, condition of skin erythema, skin histology (by hematoxylin-eosin staining) and the results of electron microscopy were measured to evaluate the positive effect of SilkArmor on dry and itchy skin in mice. Results: The TEWL value, spontaneous scratching behavior and erythema score were significantly increased after AEW modeling compared with the control group. There was no significant difference in the TEWL value, scratching behavior and erythema score between the SilkArmor group and the control group (P > 0.05). Compared with the AEW group, the value of TEWL, scratching behavior and the erythema score of mice in the AEW + SilkArmor group were improved, with statistically significant differences (P < 0.05). Skin histopathology and electron microscopy also showed that SilkArmor had certain improvement and repairment on AEW-induced skin pathological changes. Conclusions: A dry skin model was successfully established in this experiment, showing that SilkArmor brought an obvious alleviation to AEW-induced dry and itchy skin in mice.

Skin physiology and safety of microfocused ultrasound with visualization for improving skin laxity.

PurposeThe efficacy of microfocused ultrasound with visualization (MFU-V; Ultherapy®) has been demonstrated in clinical studies and daily practice. However, data addressing skin physiology after MFU-V treatment are lacking. This observational evaluation was aimed to assess skin physiology before and after MFU-V treatment using noninvasive biophysical measurements.Patients and methodsTwenty-two female patients with moderate-to-severe skin sagging at the jawline and submental region on the Merz Aesthetics Scale obtained a single MFU-V treatment according to protocol. Skin function measurements focused on short-term effects up to 3 days and long-term effects up to 24 weeks after treatment. Skin temperature, transepidermal water loss, skin hydration, erythema, elasticity, and skin thickness and density were evaluated under standardized conditions. Pain was assessed using a validated numeric visual analog scale.ResultsSkin temperature remained in a physiologic range and no significant increase was noted at day 3 after MFU-V treatment. Transepidermal water loss, hydration, and erythema values were fairly stable and showed no significant differences at short- and long-term measurements vs baseline. At week 4 after a single MFU-V treatment, gross and net elasticity values were significantly decreased (P=0.003 and P=0.0001, respectively), followed by significantly increased values at week 12 (P=0.015, P=0.046) and week 24 (P=0.001, P=0.049). Edema due to MFU-V treatment resolved without sequelae. For all patients, pain diminished shortly after treatment. No adverse events occurred during the 24-week follow-up period.ConclusionsMFU-V treatment is well tolerated and it does not alter the epidermal barrier function or physiology of skin. Significant increase in the elasticity of skin was observed at 12 and 24 weeks after a single treatment, which reflects improvement in dermal tissue function. These short- and long-term effects are congruous with the mode of action of MFU-V due to a proven intrinsic tissue remodeling process.

Phenotypes of atopic dermatitis identified by cluster analysis in early childhood.

Atopic dermatitis is a chronic, relapsing, inflammatory skin disease that usually appears in early childhood and develops into a heterogeneous disease during childhood. The clinical course and treatment for atopic dermatitis can differ according to its phenotype and/or endotype. This study aimed to identify clinical phenotypes of atopic dermatitis in early childhood. Data were obtained from 572 children under 3 years of age with atopic dermatitis. Cluster analysis applied to 11 variables, and we identified four clusters of atopic dermatitis. Children in cluster A (n = 141) had early-onset atopic dermatitis with high blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to food allergens. Children in cluster B (n = 218) had early-onset atopic dermatitis with low blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to both food and inhalant allergens. Children in cluster C (n = 53) had early-onset atopic dermatitis with high C-reactive protein levels and white blood cell counts. Children in cluster D (n = 160) had middle-onset atopic dermatitis with high serum total immunoglobulin E and rates of sensitization to inhalant allergens. Cluster A had the highest Scoring for Atopic Dermatitis and transepidermal water loss values. Age at onset, age at diagnosis, white blood cell count, eosinophil count, C-reactive protein and serum total immunoglobulin E level were the strongest predictors of cluster assignment. Analysis of these six variables alone resulted in correct classification of 95.5% of the subjects. These results support the heterogeneity of atopic dermatitis, even in early childhood.