Potential application of PS-OCT in the safety assessment of non-steroidal topical creams for atopic dermatitis treatment.

Crisaborole 2% ointment is a non-steroidal treatment for mild-moderate atopic dermatitis (AD) and may produce fewer adverse effects than topical corticosteroids (TCS). We used PS-OCT to quantify dermal collagen at baseline and after 29 days of treatment with crisaborole and betamethasone valerate (BMV), in 32 subjects. PS-OCT detected a mean increase 1 × 10-6, 95% CI (6.3, 1.37) × 10-6 in dermal birefringence following TCS use (p < 0.0001, ad-hoc, not powered), whereas a change of -4 × 10-6, 95% CI (-32, 24) × 10-6 was detected for crisaborole (p = 0.77, ad-hoc, not powered). These results could suggest a differential effect on dermal collagen between the two compounds. PS-OCT may thus find an important role in safety assessment of novel AD treatment' and larger trials are warranted.

Effect of seasonal change on the biomechanical and physical properties of the human skin.

In this study, the effect of one cycle of winter to summer seasonal transition on the mechanical and physical properties of skin was investigated in vivo. Fourteen healthy skin volunteers aged between 22 and 42 years were studied at the volar lower and upper arms. The findings indicate a 22.15% and 34.29% decrease in trans-epidermal water loss (TEWL) and the average epidermal roughness (AER), respectively. Also, improved skin properties were observed such as a 25.48% rise in average epidermal hydration (AEH), 22.59% in skin thickness, 38.64% and 21.92% in melanin and redness, respectively, as well as an 8.25% rise in its firmness and 23.14% in elasticity when strained with uniaxial deformations. An inverse correlation was established between TEWL and AEH with a linear relationship between stratum corneum roughness versus TEWL as well as thickness and hydration. Also, the skin firmness exhibited a direct proportionality with TEWL and an inverse correlation with skin hydration where these relationships were stronger in summer than in winter. Furthermore, time-dependent results demonstrated three-staged elastic, viscoelastic and creep deformations with high, moderate and low strain rates respectively at both anatomical locations. The winter season displayed lower skin firmness and elasticity of 0.37 mm and 0.04 mm compared to 0.40 mm and 0.06 mm in summer accordingly. Anatomically, the two arm regions displayed different results with the upper arm having more consistent results than the lower arm. These results will find relevance in sensor skins and exoskeletons in Medicare, robotic and military technologies as well as innovations in cosmetics and dermatology.

Atopic dermatitis epidemiology and unmet need in the United Kingdom.

Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin condition associated with a significant health-related and socioeconomic burden, and is characterized by intense itch, disruption of the skin barrier, and upregulation of type 2-mediated immune responses. The United Kingdom (UK) has a high prevalence of AD, affecting 11-20% of children and 5-10% of adults. Approximately 2% of all cases of childhood AD in the UK are severe. Despite this, most AD treatments are performed at home, with little contact with healthcare providers or services. Here, we discuss the course of AD, treatment practices, and unmet need in the UK. Although the underlying etiology of the disease is still emerging, AD is currently attributed to skin barrier dysfunction and altered inflammatory responses. Management of AD focuses on avoiding triggers, improving skin hydration, managing exacerbating factors, and reducing inflammation through topical and systemic immunosuppressants. However, there is a significant unmet need to improve the overall management of AD and help patients gain control of their disease through safe and effective treatments. Approaches that target individual inflammatory pathways (e.g. dupilumab, anti-interleukin (IL)-4 receptor α) are emerging and likely to provide further therapeutic opportunities for patient benefit.

Sub-clinical assessment of atopic dermatitis severity using angiographic optical coherence tomography.

Measurement of sub-clinical atopic dermatitis (AD) is important for determining how long therapies should be continued after clinical clearance of visible AD lesions. An important biomarker of sub-clinical AD is epidermal hypertrophy, the structural measures of which often make optical coherence tomography (OCT) challenging due to the lack of a clearly delineated dermal-epidermal junction in AD patients. Alternatively, angiographic OCT measurements of vascular depth and morphology may represent a robust biomarker for quantifying the severity of clinical and sub-clinical AD. To investigate this, angiographic data sets were acquired from 32 patients with a range of AD severities. Deeper vascular layers within skin were found to correlate with increasing clinical severity. Furthermore, for AD patients exhibiting no clinical symptoms, the superficial plexus depth was found to be significantly deeper than healthy patients at both the elbow (p = 0.04) and knee (p<0.001), suggesting that sub-clinical changes in severity can be detected. Furthermore, the morphology of vessels appeared altered in patients with severe AD, with significantly different vessel diameter, length, density and fractal dimension. These metrics provide valuable insight into the sub-clinical severity of the condition, allowing the effects of treatments to be monitored past the point of clinical remission.