Skin assessment in congenital untreated isolated GH deficiency.

PURPOSE: The separation between the inside and outside through the skin was fundamental for the evolution of prevertebrates, which grow through extrapituitary circuits, to vertebrates, which grow through the somatotrophic axis, namely pituitary growth hormone (GH). and circulating IGF1.Individuals with untreated isolated growth hormone (GH) deficiency (IGHD) due to a mutation in the GH-releasing hormone receptor (GHRH) gene, residing in Itabaianinha, Brazil, are vulnerable to skin cancer and have reduced sweating. However other aspects of their skin physiology are still unknown. Our objectives were to evaluate the number of skin cancers, skin aging, and functional aspects of the skin in this IGHD cohort. METHODS: Twenty-six IGHD individuals and 26 controls matched by age, sex, ethnicity, and occupation were submitted to a biochemical, dermatological and a functional skin assessment by the Multi Probe Adapter Cutometer® MPA 580. RESULTS: There was no difference in the number of skin cancers and in the degrees of photodamage between the groups. The melanin content in the forearm was similar between the groups but was lower in the buttocks (p = 0.005), as well as skin resistance (p < 0.0001) and elasticity (p = 0.003), lower in the IGHD. There was no difference in hydration and sebum content between the two groups. CONCLUSION: IGHD is apparently associated with a neutral profile in terms of skin cancer and photodamage, with similar melanin on the forearm and lower buttocks, lower skin resistance and elasticity, with hydration and sebum similar to controls.

Depiction of ethnic facial aging by forensic artists and preliminary assessment of the applicability of facial averages.

Many characteristics of facial aging are common to all. The age of their onset and which characteristics tend to predominate varies among individuals depending on many factors including their genetic makeup, life experiences, environment in which they live, and the regional, ethnic, or socially perceived group to which they belong. Forensic artists are often asked to provide sketches, 2D or 3D digital renderings, or sculptures representative of how an individual may appear at an older age based on a provided photograph, victim or witness description, and/or cranial remains. The challenge escalates when the subject is a member of a regional, ethnic, or other socially perceived group to which the artist has had little or no exposure. We describe aspects of adult facial aging that are of particular relevance to the forensic artist, applicable software tools, and pertinent facial databases, especially those emphasizing non-white populations. We demonstrate that facial averaging offers two key advantages to the artistic portrayal of facial aging: first, the technique requires relatively small reference databases from groups that may present logistical challenges to collect and second, that a facial average provides a useful representation of the gestalt of the age and ethnicity cohort to which a subject belongs. The artist may use an average along with other available information such as photo reference books, eyewitness descriptions, photos of immediate family members, and cranial structure to guide production of a facial composite drawing, digital age progression, or sculpture of the subject in question.

Minimally Invasive Facial Cosmetic Procedures for the Millennial Aesthetic Patient.

Millennials, defined as the generation of individuals born between 1981 and 1996, have emerged as one of the leading patient demographics seeking minimally invasive cosmetic procedures. Worldwide, millennials are more likely to consider preventative treatments compared to any other age-group. The three most popular minimally invasive facial procedures in this demographic include botulinum toxin, dermal fillers (eg, hyaluronic acid, calcium hydroxylapatite, facial fat-fillers), and microdermabrasion. Given their impact on the expanding aesthetic medicine market and their favorable disposition towards cosmetic procedures, it is necessary for dermatologists and cosmetic providers to understand their motivations and perspectives. While some research studies have elicited the opinions of millennials on social issues, education, and technology, there is a paucity of literature on millennials' impressions, opinions, and perceptions of aesthetic procedures. As a generation that has been reshaping the culture of healthcare delivery and encouraging the innovation of products and procedures with their unique values and perspectives, accounting for their beliefs and fostering a better understanding of their experiences will promote an elevation in the quality of their care.

3D surface texture analysis of high-resolution normal fields for facial skin condition assessment.

BACKGROUND: This paper investigates the use of a light stage to capture high-resolution, 3D facial surface textures and proposes novel methods to use the data for skin condition assessment. MATERIALS AND METHODS: We introduce new methods for analysing 3D surface texture using high-resolution normal fields and apply these to the detection and assessment of skin conditions in human faces, specifically wrinkles, pores and acne. The use of high-resolution normal maps as input to our texture measures enables us to investigate the 3D nature of texture, while retaining aspects of some well-known 2D texture measures. The main contributions are as follows: the introduction of three novel methods for extracting texture descriptors from high-resolution surface orientation fields; a comparative study of 2D and 3D skin texture analysis techniques; and an extensive data set of high-resolution 3D facial scans presenting various skin conditions, with human ratings as "ground truth." RESULTS: Our results demonstrate an improvement on state-of-the-art methods for the analysis of pores and comparable results to the state of the art for wrinkles and acne using a considerably more compact model. CONCLUSIONS: The use of high-resolution normal maps, captured by a light stage, and the methods described, represent an important new set of tools in the analysis of skin texture.

Efficacy of dermal redensification in chronoaged face: Quantitative volumetric assessment.

BACKGROUND: Mesotherapy for chronoaged skin shows heterogeneous results. OBJECTIVES: The aim of the study was to assess the efficacy of dermal redensification on the face and neck. METHODS: Patients with mild-moderate-severe chronoaging of face and neck were included and, every 14 days, treated with four sessions of dermal redensification, consisting of 1 mL of hyaluronic acid (15 mg/mL) plus a dermo-restructuring complex. Skin improvements were analyzed at 8 weeks for amelioration by Wrinkle Severity Rating Scale and quantification of superficial wrinkles and texture by high-resolution 3D camera. All patients underwent a self-assessment questionnaire and Global Aesthetic Improvement Scale. RESULTS: Thirty-six patients were enrolled (median age 55 [42-67] years). Eight weeks after treatment all patients reported a significant improvement, being Global Aesthetic Improvement Scale ≥2 in 69% of the subjects. Patients' perception of improvement of their skin quality was highly satisfactory in all items explored on the self-assessment questionnaire relating to radiance, elasticity, texture, and smoothness. Subjects with fine and moderate/deep wrinkles had an improvement >25% and 50%, respectively. Quantification of wrinkles with filters for superficial plane (1 mm) showed a statistically significant median decrease, both in width (1.53 [1.41-1.72] mm vs 1.27 [1.12-1.34] P < 0.001) and depth (0.46 [0.27-0.61] vs 0.12 [0.6-0.18] P < 0.001). Indentation decreased by a median of 20%. CONCLUSIONS: The synergic effects of hyaluronic acid and dermo-restructuring complex show an objective amelioration of skin texture, wrinkles, and self-evaluation of skin appearance.

Development of a Global Subjective Skin Aging Assessment score from the perspective of dermatologists.

OBJECTIVE: Several skin aging assessment scales exist but no standard scale is widely used. Dermatologists may be the most appropriate persons for skin assessment but their perceptions regarding the signs of skin aging are unexplored. To develop a simple global skin aging assessment score from the perspective of dermatologists, an online questionnaire, the Thai Dermatologist Survey of Skin Aging Assessment, was conducted from October to December, 2016. Twenty-nine signs with published evidence of their relevancy to skin aging were included. Certified dermatologists were asked to score each sign using a 5-point Likert scale. Descriptive statistics and exploratory factor analysis (EFA) were used for data analysis. RESULTS: Of 213 randomly selected dermatologists, 145 responded to the survey. EFA revealed 3 important factors related to skin aging: Factor 1 comprised 8 signs related to atrophy (deep/superficial wrinkles, eye bags, lax appearance, etc.); Factor 2 comprised 7 signs related to discoloration (freckles, lentigines, melasma, etc.); and Factor 3 comprised 3 malignant skin lesions. The Global Subjective Skin Aging Assessment (GS2A2) score is a simple numerical score that can be used to evaluate the anti-aging effects of a cosmetic product or dermatologic intervention. This score should be tested further for validity and reliability.

Method using in vivo quantitative spectroscopy to guide design and optimization of low-cost, compact clinical imaging devices: emulation and evaluation of multispectral imaging systems.

With recent proliferation in compact and/or low-cost clinical multispectral imaging approaches and commercially available components, questions remain whether they adequately capture the requisite spectral content of their applications. We present a method to emulate the spectral range and resolution of a variety of multispectral imagers, based on in-vivo data acquired from spatial frequency domain spectroscopy (SFDS). This approach simulates spectral responses over 400 to 1100 nm. Comparing emulated data with full SFDS spectra of in-vivo tissue affords the opportunity to evaluate whether the sparse spectral content of these imagers can (1) account for all sources of optical contrast present (completeness) and (2) robustly separate and quantify sources of optical contrast (crosstalk). We validate the approach over a range of tissue-simulating phantoms, comparing the SFDS-based emulated spectra against measurements from an independently characterized multispectral imager. Emulated results match the imager across all phantoms (<3 % absorption, <1 % reduced scattering). In-vivo test cases (burn wounds and photoaging) illustrate how SFDS can be used to evaluate different multispectral imagers. This approach provides an in-vivo measurement method to evaluate the performance of multispectral imagers specific to their targeted clinical applications and can assist in the design and optimization of new spectral imaging devices.

Assessment of efficacy and safety of a fractionated bipolar radiofrequency device for the treatment of lower face wrinkles and laxity.

Skin aging, as a natural course, is a gradual process. It can be classified as either intrinsic or photo-aging. In recent years, as the attention to lower face wrinkles and laxity has raised significantly, the demands to facial rejuvenation also increased, along with a variety of technologies coming into being. Fractional bipolar RF as a novel means of rejuvenation has been used in clinical practice, but questions remain in terms of its efficacy and safety. Considering a large population in our country and huge demands for skin tightening, we did this research to evaluate the efficacy and safety of fractional bipolar radiofrequency.

Objective estimation of patient age through a new composite scale for facial aging assessment: The face - Objective assessment scale.

Most patients requesting aesthetic rejuvenation treatment expect to look healthier and younger. Some scales for ageing assessment have been proposed, but none is focused on patient age prediction. The aim of this study was to develop and validate a new facial rating scale assessing facial ageing sign severity. One thousand Caucasian patients were included and assessed. The Rasch model was used as part of the validation process. A score was attributed to each patient, based on the scales we developed. The correlation between the real age and scores obtained, the inter-rater reliability and test-retest reliability were analysed. The objective was to develop a tool enabling the assigning of a patient to a specific age range based on the calculated score. All scales exceeded criteria for acceptability, reliability and validity. The real age strongly correlated with the total facial score in both sex groups. The test-retest reliability confirmed this strong correlation. We developed a facial ageing scale which could be a useful tool to assess patients before and after rejuvenation treatment and an important new metrics to be used in facial rejuvenation and regenerative clinical research.

Assessment of a Comprehensive Anti-Aging Neck Cream.

INTRODUCTION: With many effective anti-aging solutions for the face, consumer focus is now turning to other parts of the body including the delicate skin on the neck. This study investigates the effect of a new neck cream on the appearance of texture, fine lines and wrinkles, laxity, and hydration. METHODS: 85 adult females ages 35-65 with Fitzpatrick skin types I through IV applied the test neck cream twice daily for a 3-month study period. Screening was conducted at Baseline, 2, 30, 60, and 90 days via a virtual trial. Subjects rated satisfaction in each of 4 anti-aging categories including hydration, texture, appearance of wrinkles, and appearance of laxity as well as three product attributes including application, feel, and smell. RESULTS: Improvement was statistically significant for all measured categories (hydration, texture, appearance of wrinkles, and appearance of laxity) with 94% of study subjects noting improvement in one or more of the measured categories. Further, the quantity of "Satisfied" and "Highly Satisfied" assessments increased 8-fold from baseline with a 94x increase in the quantity of "Highly Satisfied" assessments. DISCUSSION: The results demonstrate the product's rapid and continuing ability to improve the self-perceived signs of aging in the neck area including improvement in skin texture on the neck and a reduction in the appearance of wrinkles and laxity along the jawline. Future studies are recommended to determine the primary action mechanisms and to assess the degree of improvement by blinded physician assessment.