Post-Treatment of Micro-Needling with a Dexpanthenol-Containing Ointment Accelerates Epidermal Wound Healing in Human 3D Skin Models.

Purpose: In vitro study on the molecular effects of post-treatment after micro-needling applications with a dexpanthenol-containing ointment (DCO) using 3D skin models. Patients and Methods: In this in vitro study, full-thickness human 3D skin models were treated with a micro-needling device according to its clinical application. For post-treatment, some of the models were additionally treated with a dexpanthenol-containing ointment (DCO). Histological samples were taken at 0, 24 and 48 hours. Gene expression analysis was performed after 24 hours. Results: Histological examination showed that DCO post-treated 3D skin models revealed a completed wound closure 24 hours after the micro-needling procedure. In contrast, DCO-untreated models still clearly exhibited the micro-needling lesions after the same period of time. After 48 hours, all models revealed a completed wound healing. In skin models that received micro-needling but no post-treatment with DCO, microarray analysis identified an upregulation of proinflammatory cytokines and chemokines and a downregulation of skin barrier and differentiation markers. In contrast, post-treatment with DCO leads to accelerated wound healing without affecting the initial inflammatory response caused by micro-needling, which leads to the subsequent collagen expression. This data was supported by qRT-PCR analyses. Conclusion: Post-treatment with DCO accelerates epidermal wound healing after micro-needling of 3D skin models without impairing the immunostimulatory properties of micro-needling. These findings can help to optimise the aftercare routine after micro-needling procedures and to shorten the downtime for the patient after treatment.

Infections with Herpes simplex and Varicella zoster virus.

Human herpes viruses belong to the DNA viruses and are among the most common viral pathogens. Currently, eight human herpes viruses have been characterized. Primary infection is typically followed by virus latency. Viral reactivations are more often symptomatic than primary infections and lead more often to medical consultation. In daily practice, infections with herpes simplex virus (HSV) and varicella zoster virus (VZV) are the most common. If HSV primary infections become clinically manifest, they are often accompanied by systemic symptoms whereas manifest HSV reactivations are usually harmless, self-limiting and present as grouped vesicles on an erythematous base (herpetiform). Primary VZV infection leads to the clinical picture of varicella (chickenpox). VZV reactivation manifests clinically as shingles and can be accompanied by severe acute neuralgiform pain. In immunosuppression, complicated (necrotizing, ulcerative, hemorrhagic, generalized) manifestations may occur. The diagnosis is usually made clinically. Therapeutic options include topical agents and systemic antivirals. Adequate therapeutic management includes the recognition and treatment of complications such as the possible involvement of other organ systems and pain. Infection during pregnancy may result in transmission to the unborn child.

Infektionen mit Herpes-simplex- und Varizella-zoster-Virus.

Humane Herpesviren gehören zu den DNA-Viren und zählen zu den häufigsten Erregern viraler Infektionen beim Menschen. Nach der Primärinfektion mit einem dieser Viren kommt es typischerweise zur Latenz mit dem Potenzial späterer Reaktivierungen, die häufiger symptomatisch sind und zum Arztbesuch führen als die Primärinfektion. In der täglichen Praxis sind Infektionen mit dem Herpes-simplex-Virus (HSV) und dem Varizella-zoster-Virus (VZV) am häufigsten vertreten. Sofern HSV-Primärinfektionen klinisch manifest werden, gehen sie häufig mit Allgemeinsymptomen einher. HSV-Reaktivierungen verlaufen meist harmlos und selbstlimitierend und präsentieren sich als gruppierte Bläschen auf erythematösen Grund (herpetiform). Die VZV-Primärinfektion führt zum klinischen Bild der Varizellen (Windpocken). Bei Immunsuppression kann es zu komplizierten (nekrotisierenden, ulzerierenden, hämorrhagischen, generalisierten) Verläufen kommen. Die VZV-Reaktivierung manifestiert sich klinisch als Herpes zoster (Gürtelrose) und kann mit starken akuten Schmerzen einhergehen. Die Diagnosestellung erfolgt meist klinisch. Therapeutisch stehen Topika und systemische Virostatika zur Verfügung. Das adäquate therapeutische Management umfasst das Erkennen und Behandeln von Komplikationen wie der möglichen Beteiligung weiterer Organsysteme und Schmerzen. Eine Infektion in der Schwangerschaft kann zur Übertragung auf das ungeborene Kind führen.

Pain drawing as a screening tool for anxiety, depression and reduced health-related quality of life in back pain patients: A cohort study.

BACKGROUND: Back pain patients are more likely to suffer from depression, anxiety and reduced quality of life. Pain drawing is a simple, frequently used anamnesis tool that facilitates communication between physicians and patients. This study analysed pain drawings to examine whether pain drawing is suitable as a screening tool for signs of anxiety, depression or reduced quality of life, as the detection of these symptoms is essential for successful treatment. METHODS: Pain drawings of 219 patients with lower back pain were evaluated retrospectively. Pain drawings are a schematic drawing of a human being. Six variables of the pain drawing were analysed. Subscales of the Hospital Anxiety and Depression Scale (HADS) and the Mental Component Summary (MCS) of the Short Form 12 (SF-12) were used to measure anxiety, depression and quality of life, respectively. Descriptive statistics, uni- and multivariate linear regression analyses and analysis of variance were performed. Logistic regression analyses were conducted for suitable variables. RESULTS: We revealed significant positive correlations between the variables "filled body surface" and "number of pain sites" and the anxiety (HADS-A) and depression subscales (HADS-D) of the HADS (p<0.01). The same predictors had significant negative correlations with the MCS (p<0.01). However, the sensitivity and specificity of the variable "number of pain sites" were too low compared to those for existing screening tests to consider it as a screening tool for anxiety, depression and quality of life (HADS-A: sensitivity: 45.2%, specificity: 83.3%; HADS-D: sensitivity: 61.1%, specificity: 51%; MCS: sensitivity: 21.2%, specificity: 85.7%). CONCLUSIONS: There were significant correlations between the amount of filled body surface and the number of pain sites in the pain drawing and anxiety, depression and quality of life. Although useful in routine clinical practice, pain drawing cannot be used as a screening tool based on our results.