A randomized half-body, double blind, controlled trial on the effects of a pH-modified moisturizer vs. standard moisturizer in mild to moderate atopic dermatitis,

Abstract Background: Higher skin pH in atopic dermatitis contributes to impaired epidermal barrier. A moisturizer compatible with physiological pH could improve atopic dermatitis. Objective: To determine the effect of a physiologically compatible pH moisturizer in atopic dermatitis. Methods: A randomized half body, double blind, controlled trial involving patients with stable atopic dermatitis was performed. pH-modified moisturizer and standard moisturizer were applied to half body for 6 weeks. Results: A total of 6 (16.7%) males and 30 (83.3%) females participated. Skin pH reductions from week 0, week 2 and 6 were significant at the forearms (5.315 [0.98] to 4.85 [0.54] to 5.04 [0.78], p = 0.02) and abdomen (5.25 [1.01], 4.82 [0.64], 5.01 [0.59], p = 0.00) but not at the shins (5.01 [0.80], 4.76 [0.49], 4.85 [0.79], p = 0.09) with pH-modified moisturizer. Transepidermal water loss (TEWL) at the forearms decreased (4.60 [2.55] to 3.70 [3.10] to 3.00 [3.55], p = 0.00), abdomen (3.90 [2.90] to 2.40 [3.45] to 2.70 [2.25], p = 0.046). SCORAD improved from 14.1 ± 12.75 to 10.5 ± 13.25 to 7 ± 12.25, p = 0.00. In standard moisturizer group, pH reductions were significant at the forearms (5.29 [0.94] to 4.84 [0.55] to 5.02 [0.70], p = 0.00) and abdomen (5.25 [1.09], 4.91 [0.63], 5.12 [0.66], p = 0.00). TEWL at the forearm were (4.80 [2.95], 4.10 [2.15], 4.60 [3.40], p = 0.67), shins (3.80 [1.40], 3.50 [2.35], 4.00 [2.50], p = 0.91) and abdomen (3.70 [2.45], 4.10 [3.60], 3.40 [2.95], p = 0.80). SCORAD improved from 14.2 ± 9.1 to 10.9 ± 10.65 to 10.5 ± 11, p = 0.00. Reduction in pH was observed with both moisturizers while TEWL significantly improved with pH-modified moisturizer. pH-modified moisturizer resulted in greater pH, TEWL and SCORAD improvements however the differences were not significant from standard moisturizer. Study limitation: Skin hydration was not evaluated. Conclusion: Moisturization is beneficial for atopic dermatitis; use of physiologically compatible pH moisturizer is promising.

The pH of the main Brazilian commercial moisturizers and liquid soaps: considerations on the repair of the skin barrier

Abstract: The pH of the skin is slightly acidic (4.6 to 5.8) which is important for appropriate antibacterial, antifungal, constitution of barrier function, as well as structuring and maturation of the stratum corneum. This study aimed to evaluate the pH of the main commercial moisturizers and liquid soaps in Brazil. Thus, pH of the products was quantified by pH meter in three measurements. A total of 38 moisturizers and six commercial liquid soaps were evaluated. Mean pH of 63% and 50% of the moisturizing and liquid soaps presented results above 5.5, disfavoring repair, function, and synthesis of dermal barrier.

pH, Temperature, Hydration of the Stratum Corneum of the Dorsal Hand and the Cord Area, and Acid Mantle Formation during Early Days of life in High-risk Newborns

PURPOSE: The study was done to explore variations in physiologic parameters of the stratum corneum (SC) of the dorsal hand and cord area during early days of life in high-risk newborns. METHODS: In this longitudinal study, a total of 77 high-risk newborns were assessed for pH, temperature and hydration of the SC of the dorsal hand and the cord area on the 1st, 2nd, 3rd, 5th and 7th days of life. RESULTS: Results showed that an acid mantle (AM) was formed in 57.1% for dorsal hand and 35.1% for cord area, implying significant delay regardless of decrease in pH (F=103.60, p<.001), and hydration (F=4.00, p=.003) across days in both areas. Peripheral hypothermia with low hydration level was also observed in both areas. There was a positive relation between hydration and temperature (.14

Clinical use of a ceramide-based moisturizer for treating dogs with atopic dermatitis

In humans, skin barrier dysfunction is thought to be responsible for enhanced penetration of allergens. Similar to conditions seen in humans, canine atopic dermatitis (CAD) is characterized by derangement of corneocytes and disorganization of intercellular lipids in the stratum corenum (SC) with decreased ceramide levels. This study was designed to evaluate the effects of a moisturizer containing ceramide on dogs with CAD. Dogs (n = 20, 3~8 years old) with mild to moderate clinical signs were recruited and applied a moisturizer containing ceramide for 4 weeks. Transepidermal water loss (TEWL), skin hydration, pruritus index for canine atopic dermatitis (PICAD) scores, and canine atopic dermatitis extent and severity index (CADESI) scores of all dogs were evaluated. Skin samples from five dogs were also examined with transmission electron microscopy (TEM) using ruthenium tetroxide. TEWL, PICAD, and CADESI values decreased (p < 0.05) and skin hydration increased dramatically over time (p < 0.05). Electron micrographs showed that the skin barrier of all five dogs was partially restored (p < 0.05). In conclusion, these results demonstrated that moisturizer containing ceramide was effective for treating skin barrier dysfunction and CAD symptoms.

Coma blisters after poisoning caused by central nervous system depressants: case report including histopathological findings / Bolhas do coma pós-intoxicação por depressores do sistema nervoso central: relato de caso incluindo achados histopatológicos

Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed "coma blisters" at six distinct anatomic sites after confirmed (laboratory) phenobarbital poisoning, associated with other central nervous system depressants (clonazepam, promethazine, oxcarbazepine and quetiapine), is presented. A biopsy from the left thumb blister taken on day 4 revealed focal necrosis of the epidermis and necrosis of sweat gland epithelial cells; direct immunofluorescence was strongly positive for IgG in superficial blood vessel walls but negative for IgM, IgA, C3 and C1q. The patient was discharged on day 21 with no sequelae.

Formação de bolhas e necrose de glândula sudoríparas écrinas é uma manifestação cutânea associada com estados de diminuição da consciência, mais frequentemente relatada após superdosagens de depressores do sistema nervoso central, particularmente fenobabital. Relatamos o caso de uma paciente de 45 anos que desenvolveu "bolhas do coma" após tentativa de suicídio por fenobarbital (confirmada laboratorialmente), associada a outros depressores do sistema nervoso central (clonazepam, prometazina, oxcarbazepina e quetiapina). Biópsia da bolha do 1o quirodáctilo esquerdo no 4o dia de internação revelou necrose focal da epiderme e necrose de células epiteliais de glândula sudorípara; a imunofluorescência direta foi fortemente positiva para IgG na parede superficial dos vasos sanguíneos, mas negativa para IgM, IgA, C3 e C1q. A paciente teve alta no 21o dia, sem seqüelas.

role of vitamin 'C' on the thickness of the epidermis after x-irradiation of the guinea pigs a morphological study under light microscope

To study the role of vitamin 'C' on X-irradiated epidermis of Guinea pigs under light microscope. A prospective experimental study. This study was conducted at the Department of Anatomy, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi 2008 to 2009. Twenty seven animals were taken and were divided in to three groups. Each group was further subdivided into three subgroups containing three animals each according to the time of sacrifice i.e. 48 hours, 15[th] day and 45[th] day respectively. A single whole body x-irradiation in a dose of 5 Gy was given. Group C animals were also given injection of vitamin-C intraperitoneally in the dose of 1mg/G/day. Animals were sacrificed under ether anaesthesia after completion of their respective periods. Tissues were processed and 4-5 micron thick paraffin embedded sections were cut and stained with Hematoxylin and eosin. Decrease in epidermal thickness was observed in Group B1 animals. Which is highly significant [P <0.001] when compared to control. Results of animals of Group B2, and B3 were non significant [P>0.05] when compared to control. Non significant results were obtained when Group C was compared to control group. X-irradiation damages the epidermis and vitamin 'C' minimizes the damaging effects

Comparison of skin permeability of drugs in mice and human cadaver skin.

In vitro percutaneous absorption of four antihypertensive drugs were carried out across the mice and human cavader skin in order to compare their skin permeability. An interesting trend was noticed in these experiments. Poorly water soluble drug prazosin hydrochloride showed 13 times enhanced flux in the mice skin whereas the steady-state flux of the water soluble drug propranolol hydrochloride was almost same in both human cadaver and mice skin. The permeation rate of prazosin hydrochloride and propranolol hydrochloride through the human cadaver skin fluctuated widely over time, but in mice skin, distinct trends were noticed. The study indicates that the overall permeation rate in mice skin is higher than that in the cadaver skin and the meeting of the target-flux in mice skin does not guarantee its good permeability in human skin.

Efectos del etanol sobre la epidermis de fetos de rata: estudio morfológico y morfométrico / Ethanol effects on the epidermis of rat fetuses: morphologic and morphometric study

Fueron estudiados los efectos de la intoxicación prenatal con etanol sobre la histología y los parámetros morfométricos de la epidermis de la región occipitofrontal de la bóveda del cráneo fetal. Una solución de etanol al 25 por ciento, administrada intraperitonealmente en dosis de 0,03 mllg de peso corporal, en los días 9, 10 y 11 de embarazo, en ratas Wistar, causó retardo en el crecimiento intrauterino de fetos y placentas. Fue demostrado que la epidermis de la bóveda del cráneo es más delgada en los fetos del grupo intoxicado. Los resultados del análisis morfométrico sugieren que el etanol causa retardo de crecimiento (hipoplasia) en las células epidérmicas de la bóveda craneal en los fetos de ratas intoxicadas con etanol

Adult gerbil epidermal cells resistant to terminal differentiation associated with initiation of carcinogenesis

In order to identify the cellular basis of the gerbil skin unresponsiveness to two-stage carcinogenesis, it was studied the effect of an initiating dose of carcinogen on the biological behaviour of gerbil skin. Treatment of adult gerbil epidermal cells either in vivo or in vitro with 3-methylcholanthrene yielded cells which were resistant to terminal differentiation induced by calcium. These results support the concept derived from the mouse model system of skin carcinogenesis in which initiation is associated with an altered program of epidermal differentiation. The results also suggest that relative resistance of gerbil skin to two-stage carcinogenesis is related to promotion stage

Benzoyl peroxide modulates gene expression by epigenetic mechanism in mouse epidermal JB6 cells.

The mechanism by which an oxidant tumor promoter benzoyl peroxide (BP) influences signal transduction, was studied in promotion insensitive (P-), promotion sensitive (P+) and transformed (Tx) mouse epidermal JB6 cells. The basal levels of antioxidant enzymes CuZn-superoxide dismutase and catalase were higher in P+ and Tx JB6 cells. BP decreased the activities of these enzymes transiently in P+ and Tx cells, but induced them in P- JB6 cells. BP increased poly ADPR polymerase activity accompanied by a drop in NAD+ levels more significantly in P- JB6 cells, but did not affect PKC activity. It induced c-jun and c-fos gene expression in JB6 variants but to different extents, suggesting that it mediates its effects via genetic- epigenetic mechanism(s).

Effects of tretinoin pretreatment on TCA chemical peel in guinea pig skin

This study was done to characterize the structural changes in the tretinoin pretreatment on trichloroacetic acid(TCA) chemical peel. In guinea pigs, the right halves pretreated with tretinoin and the left halves treated nothing were compared in their structural changes after TCA chemical peel. Epidermal thickness in the tretinoin pretreated group was almost the same in the first and second week. But epidermis of the TCA group increased continuously. In the first week, mitotic figures in the epidermis were more increased in the TCA group, but those in hair follicles were more increased in the tretinoin pretreated group. In the second week, mitotic figures in the epidermis were almost same in both group, but in hair follicles of the tretinoin pretreated group, mitotic figures were much more increased. In alcian blue staining, glycosaminoglycan was stained much more strongly in dermis of the TCA group in first week, but was more strongly stained in the tretinoin pretreated group in second week. On electron microscopic findings, the fibroblasts in upper dermis were larger and had plentier cytoplasm with more organelles in the tretinoin pretreated group. Conclusively, tretinoin pretreatment on TCA chemical peel sustained the effects of TCA longer and showed synergistic effects of TCA and induced enhanced wound healing.

Alguns aspectos ultra-estruturais do processo de reparaçäo da pele de ratos sob açäo da dactinomicina. I. Epiderme / Ultrastructural aspects of the process of rats skin repair under dactinomycin action. I. Epidermis

Os autores estudaram a nível ultra-estrutural, a resposta da epiderme na reparaçao de feridas cutâneas sob efeito de dactinomicina. Foram observadas alteraçoes celulares envolvendo a organizaçao citoplasmática e nuclear.