A new ten-item questionnaire for assessing sensitive skin: the Sensitive Scale-10.

Sensitive skin is common but until now there has been no scale for measuring its severity. The Sensitive Scale is a new scale with a 14-item and a 10-item version that was tested in 11 countries in different languages on 2,966 participants. The aim of this study was to validate the pertinence of using the Sensitive Scale to measure the severity of sensitive skin. The internal consistency was high. Correlations with the dry skin type, higher age, female gender, fair phototypes and Dermatology Life Quality Index were found. Using the 10-item version appeared to be preferable because it was quicker and easier to complete, with the same internal consistency and the 4 items that were excluded were very rarely observed in patients. The mean initial scores were around 44/140 and 37/100. The use of a cream for sensitive skin showed the pertinence of the scale before and after treatment.

Defects of filaggrin-like proteins in both lesional and nonlesional atopic skin.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by a disturbed epidermal barrier. In a subset of patients, this is explained by nonsense mutations in the gene encoding filaggrin (FLG). OBJECTIVES: We sought to evaluate the respective role of FLG mutations and proinflammatory cytokines and to assess the expression of FLG, hornerin (HRNR), and FLG2, 2 FLG-like proteins, which are involved in epidermal barrier functions, in normal skin and both lesional and nonlesional skin of patients with AD. METHODS: An FLG-genotyped cohort of 73 adults with AD and 73 aged-matched control subjects was analyzed by using immunohistochemistry and immunoblotting. Normal primary human keratinocytes were differentiated in either the absence or presence of IL-4, IL-13, and IL-25. RESULTS: Compared with control subjects, FLG, HRNR, and FLG2 were detected at significantly lower levels in the skin of patients with AD, irrespective of their FLG genotype. The reduction was greater in lesional compared with nonlesional skin. In addition, the proFLG/FLG ratio was found to be higher in the skin of wild-type patients than in control subjects. Cytokine treatment of keratinocytes induced a dramatic reduction in FLG, FLG2, and HRNR expression both at the mRNA and protein levels. CONCLUSION: The stratum corneum of lesional but also clinically unaffected skin of adults with AD is abnormal, with reduced expression of FLG and FLG-like proteins. In addition to nonsense mutations, proinflammatory cytokines and some defects in the proFLG processing can contribute to the FLG downregulation. Our study suggests that skin inflammation reduces the expression of FLG-like proteins, contributing to the AD-related epidermal barrier dysfunction.

Hornerin is a component of the epidermal cornified cell envelopes.

A single-nucleotide polymorphism within the gene encoding hornerin (HRNR) has recently been linked with atopic dermatitis (AD) susceptibility. HRNR shares features with filaggrin, a key protein for keratinocyte differentiation, but conflicting reports have been published concerning its expression in the epidermis, and its role is still unknown. To analyze HRNR expression and function in the epidermis, anti-HRNR antibodies were produced and used in Western blot analysis and immunohistochemical, confocal, and immunoelectron microscopy analyses of human skin and of cornified cell envelopes purified from plantar stratum corneum. We also tested whether HRNR was a substrate of transglutaminases. In the epidermis, HRNR was detected at the periphery of keratohyalin granules in the upper granular layer and at the corneocyte periphery in the whole cornified layer. Detected in Western blot analysis as numerous bands, HRNR was relatively insoluble and only extracted from epidermis with urea and/or reducing agents. The presence of HRNR in the purified envelopes was confirmed by immunoelectron microscopy and by Western blot analysis after V8-protease digestion. HRNR was shown to be a substrate of transglutaminase 3. These data demonstrate that HRNR is a component of cornified cell envelopes of human epidermis. Its reduced expression in AD may contribute to the epidermal barrier defect observed in the disease.

An Emollient Containing Aquaphilus dolomiae Extract is Effective in the Management of Xerosis and Pruritus: An International, Real-World Study.

INTRODUCTION: Xerosis and pruritus are common manifestations of numerous dermatologic and systemic diseases. We evaluated the effectiveness of an emollient containing an Aquaphilus dolomiae extract (ADE-G1) for the management of pruritus and xerosis in patients of all age with a range of dermatologic and systemic diseases. METHODS: This open-label, real-world study involved 5910 patients from 33 European, South American, Asian, and North and South African countries, who applied the product for 7 days twice daily to the face and body after the skin had been cleansed and dried. The physician assessed xerosis severity and patients assessed pruritus severity, the duration of itch, sleep quality, and the impact of their skin disease on their quality of life, using scales derived from the SCORing Atopic Dermatitis (SCORAD) index and questionnaires, at inclusion and after 7 days of use. RESULTS: The 7-day care regimen resulted in 56% and 60% reductions in xerosis and pruritus severity, respectively, regardless of the underlying pathology (p < 0.0001), with the largest decreases observed for patients with ichthyosis for xerosis and for patients post scabies treatment for pruritus. The mean sleep disturbance and mean total Dermatology Life Quality Index (DLQI) scores were also reduced by 58% and 60% (p < 0.0001), respectively. The emollient was effective whether the product was used alone or in combination with topical or systemic treatments and was well tolerated. CONCLUSION: Our study shows that the 7-day regimen with the emollient was a universally effective treatment for pruritus and xerosis, regardless of the underlying pathology.

Tolerance of oat-based topical products in cereal-sensitized adults with atopic dermatitis.

BACKGROUND: Few data suggest oat-based cosmetics may cause allergic reactions in atopic subjects, especially when sensitized to cereals. OBJECTIVES: To evaluate the risk of immediate and delayed allergic reactions to repeated and maximized applications (RMA) of oat-containing cosmetics and oat extracts and their tolerance in cereal-sensitized atopic adults. METHODS: Open-label pilot study in 12 cereal-sensitized atopic adults over 45 days. Open tests and RMA were performed with Rhealba oat-containing cosmetics at day 0 (D0) and D10, and from D10 to D31. Patch and prick tests were performed at D7 and D42 with wheat and Rhealba oat extracts and the study cream. RESULTS: The RMA of oat-based cosmetics in cereal-sensitized atopic adults did not induce any immediate or delayed allergic reaction and was well tolerated. No immediate or delayed positive skin test to oat extracts was observed. CONCLUSION: Sensitization to cereals does not increase the risk of allergic reactions to oat-containing cosmetics.

Profile of patients with mild-to-moderate acne in Europe: a survey.

Although acne is almost universal in teenagers, few large cohort studies have investigated the profile of acne patients. To identify the profile of European patients with mild-to-moderate acne. an epidemiological study was performed using inclusion data from a prospective, international, observational phase IV study conducted in patients prescribed an anti-acne cream containing retinaldehyde, glycolic acid, modified rhamnose and Avene Thermal Spring Water. A total of 2926 patients (73.1% female) with mild to moderate acne (mean Global Evaluation of Acne score of 2.55 ± 0.7), aged 22.5 ± 8.0 years, were included in France, Switzerland, Italy and Portugal. A family history of acne was present in 62.9% of patients and mean age at acne onset was 16.0 ± 4.9 years. In total, 69.6% of patients had moderate to severe hyperseborrhoea, 35.6% acne lesions on both face and trunk, 23.6% facial pigmentation and 46% scars. The extent of acne was significantly associated with sex, age at acne onset, history of acne and presence of scars. In women, acne onset was delayed (p<0.0001) and a family history of acne and extension to the trunk were less common than in men (p = 0.0118, and p<0.0001), as were scars (p = 0.0042). In subjects with a family history of acne, the frequency in men was higher (p = 0.0118), acne onset was earlier (p<0.0001) and extension to the trunk and presence of scars were more common (both p<0.0001). Further epidemiological studies would help define specific risk factors for acne occurrence or progression, which may be modified.