RESUMEN
BACKGROUND: Microneedling is a technique of repeated puncturing or drilling of the skin to induce repair and collagen induction. There are many reported important factors determining the efficacy of microneedling treatment. The extent of injury needed to produce the desired effect in each condition is one of these important factors. OBJECTIVES: We designed the present split-face comparative study to evaluate the use and effectiveness of two different depths of penetration of Dermapen needles in the management of atrophic postacne scars. PATIENTS AND METHODS: The present study involved 14 subjects with atrophic postacne scars. In each patient, both sides of the face were treated with six sessions of microneedling, using Dermapen at 2-week intervals. A split-face study design was performed. The right (Rt) side of the face was treated with Dermapen using 2.5 mm needle length, while the left (Lt) side was treated using 1.5 mm needle length. RESULTS: There was a significantly better percentage of improvement of acne scars on the Rt side of the face compared to the Lt side (P = 0.02) after six sessions. Both sides of the face showed improvement of collagen bundles and elastic fibers characteristics after six sessions. CONCLUSIONS: The use of 2.5 mm depth proved to be more effective both clinically and histologically in the management of atrophic postacne scars.
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Acné Vulgar , Atrofia , Cicatriz , Agujas , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Acné Vulgar/complicaciones , Acné Vulgar/terapia , Atrofia/terapia , Cicatriz/etiología , Cicatriz/terapia , Cicatriz/patología , Cicatriz/diagnóstico , Colágeno , Técnicas Cosméticas/instrumentación , Tejido Elástico/patología , Cara , Inducción Percutánea del Colágeno/instrumentación , Inducción Percutánea del Colágeno/métodos , Resultado del TratamientoRESUMEN
The increase in the production of melanin level inside the skin prompts a patient-inconvenient skin color disorder namely; melasma. This arouses the need to develop efficacious treatment modalities, among which are topical nano-delivery systems. This study aimed to formulate functionalized chitosan nanoparticles (CSNPs) in gel form for enhanced topical delivery of alpha-arbutin as a skin whitening agent to treat melasma. Ionic gelation method was employed to prepare α-arbutin-CSNPs utilizing a 24 full factorial design followed by In vitro, Ex vivo and clinical evaluation of the nano-dispersions and their gel forms. Results revealed that the obtained CSNPs were in the nanometer range with positive zeta potential, high entrapment efficiency, good stability characteristics and exhibited sustained release of α-arbutin over 24 h. Ex vivo deposition of CSNPs proved their superiority in accumulating the drug in deep skin layers with no transdermal delivery. DSC and FTIR studies revealed the successful amorphization of α-arbutin into the nanoparticulate system with no interaction between the drug and the carrier system. The comparative split-face clinical study revealed that α-arbutin loaded CSNPs hydrogels showed better therapeutic efficacy compared to the free drug hydrogel in melasma patients, as displayed by the decrease in: modified melasma area and severity index (mMASI) scores, epidermal melanin particle size surface area (MPSA) and the number of epidermal monoclonal mouse anti-melanoma antigen recognized by T cells-1 (MART-1) positive cells which proved that the aforementioned system is a promising modality for melasma treatment.
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Quitosano , Melanosis , Nanopartículas , Preparaciones para Aclaramiento de la Piel , Animales , Arbutina , Humanos , Hidrogeles , Melaninas/uso terapéutico , Melanosis/tratamiento farmacológico , Ratones , Preparaciones para Aclaramiento de la Piel/uso terapéuticoRESUMEN
PURPOSE: This manuscript aimed at encapsulating an antifungal terconazole (TCZ) into innovative novasomes for improving its penetration into the skin and clinically modulating its therapeutic efficacy. METHODS: Novasomes containing free fatty acid (FFA) as a penetration enhancer were formulated using ethanol injection technique based on 24 full factorial design to explore the impact of various formulation variables on novasomes characteristics regarding entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). The optimum formulation was chosen using Design-Expert® software and utilized for further explorations. RESULTS: The chosen formulation (N15; including 100 mg lipid components and Span 80 to oleic acid in a ratio of 2:1 (w/w)) exhibited an EE% = 99.45 ± 0.78%, PS = 623.00 ± 2.97 nm, PDI = 0.40 ± 0.04, and ZP = -73.85 ± 0.64 mV. N15 showed spherical vesicles with a higher deformability index (DI) (9.62 ± 0.15 g) compared to traditional niosomal formulation (0.92 ± 0.12 g). Further, N15 showed superior inhibition of Candida albicans growth relative to TCZ suspension using XTT (2,3-bis-(2-methyloxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) reduction assay. Moreover, in vivo skin deposition tests revealed a superior TCZ deposition inside the skin from N15 in comparison to traditional niosomal formulation and TCZ suspension. Furthermore, histopathological examination for rats assured the safety of N15 for topical use. A clinical study conducted on infants suffering from napkin candidiasis proved the superiority of N15 to placebo in providing a complete cure of such fungal infections. CONCLUSION: Concisely, the obtained outcomes confirmed the pronounced efficacy of N15 to successfully treat skin fungal infections.
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Portadores de Fármacos/química , Sistemas de Liberación de Medicamentos , Triazoles/administración & dosificación , Administración Tópica , Animales , Antifúngicos/administración & dosificación , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Candida albicans/efectos de los fármacos , Candidiasis/tratamiento farmacológico , Candidiasis/microbiología , Análisis Factorial , Humanos , Lactante , Liposomas , Masculino , Pruebas de Sensibilidad Microbiana , Tamaño de la Partícula , Ratas , Ratas Wistar , Piel/efectos de los fármacos , Piel/microbiología , Piel/patología , Absorción Cutánea/efectos de los fármacos , Electricidad Estática , Suspensiones , Triazoles/farmacología , Triazoles/uso terapéuticoRESUMEN
BACKGROUND: The use of stem cells derived growth factors is representing a novel treatment modality in facial rejuvenation. Nowadays, skin needling is considered a very famous treatment of skin aging. However, the addition of such derived products, augments its therapeutic efficacy in the management and delay of skin aging. OBJECTIVE: Comparing the effect of amniotic fluid mesenchymal stem cell derived conditioned media (AF-MSC-CM) combined with skin needling versus the needling alone in the management of facial aging. METHODS: Both sides of the face of ten volunteers, suffering from facial aging, were treated with five sessions of skin needling, 2 weeks apart. After skin microneedling, AF-MSC-CM was added topically to the right side only. Clinical, histological, and morphometrical assessment of the treated skin was done at 1 month after the last session. RESULTS: The percentage of improvement of aged skin increased significantly on the combined treated side (AF-MSC-CM and dermaroller [DR]), when compared with the other side (DR only) (P < .001). Remodeling of the dermal structures was observed mainly on the combined side. Meanwhile, histometry of the epidermis revealed a significant increase in the epidermal thickness on both treated sides. CONCLUSION: AF-MSC-CM combined with skin needling was more efficient in managing facial aging than skin needling alone.
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Rejuvenecimiento , Envejecimiento de la Piel , Anciano , Medios de Cultivo Condicionados , Epidermis , Humanos , PielRESUMEN
The full exploration of the 'nutraceuticals' therapeutic potential in cosmetics has been hindered by their poor stratum corneum permeation. Therefore, the aim of the present study was to formulate a nutraceutical; quercetin, in novel vitamin C based nanovesicles (aspasomes), and to explore their beneficial effects in the treatment of acne. Aspasomes were characterized for their particle size, zeta potential, entrapment efficiency (EE%), 3-months storage stability, skin deposition/permeation, antioxidant potential, and morphology. Aspasomes antibacterial efficacy on Propionibacterium acnes using the zone of inhibition assay was also tested, whilst their safety on skin fibroblastic cells was assessed in vitro using 3T3 CCL92 cell lines. An exploratory clinical trial was conducted in acne patients, and the percentage reduction of inflammatory, non-inflammatory and total acne lesions was taken as the evaluation criterion. Results revealed that quercetin-loaded aspasomes displayed a desirable nanometer size (125-184 nm), negative charge with good storage stability, and high skin deposition reaching 40%. Aspasomes managed to preserve the antioxidant activity of quercetin, and exhibited a significantly higher antibacterial effect (15 ± 1.53 mm) against Propionibacterium acnes than quercetin alone (8.25 ± 2.08 mm), and were safe on skin fibroblastic cells. Upon clinical examination in 20 acne patients (14 females, 6 males), quercetin aspasomes exhibited reduction percentages of 77.9%, 11.8% and 55.3% for inflammatory lesions, comedones and total lesions respectively. This opens vast applications of the presented formulation in the treatment of other oxidative skin diseases, and delineates the nutraceuticals and nanoformulations prepared from natural materials as promising dermatological treatment modes.
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Acné Vulgar/tratamiento farmacológico , Cosmecéuticos , Suplementos Dietéticos , Quercetina/administración & dosificación , Células 3T3 , Acné Vulgar/patología , Adolescente , Adulto , Animales , Antibacterianos/administración & dosificación , Antibacterianos/química , Antibacterianos/farmacología , Antioxidantes/administración & dosificación , Antioxidantes/química , Antioxidantes/farmacología , Ácido Ascórbico/química , Femenino , Fibroblastos/efectos de los fármacos , Humanos , Masculino , Ratones , Tamaño de la Partícula , Propionibacterium acnes/efectos de los fármacos , Quercetina/química , Quercetina/farmacología , Ratas , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Postacne scars are still a challenge in its management. Microneedling is a popular minimally invasive technique in treatment of such scars. However, the addition of topical stem cell products after microneedling is considered a new treatment regimen for these scars. OBJECTIVE: To compare efficacy of amniotic fluid-derived mesenchymal stem cell-conditioned media (AF-MSC-CM) and microneedling vs microneedling alone in management of atrophic acne scars. METHODS: Ten cases with atrophic postacne scars received five sessions of microneedling, with 2-week interval on both sides of the face. Then, AF-MSC-CM was topically applied to right side of the face after microneedling. Clinical examination with histopathological and computerized histometric analysis was done 1 month after the sessions. RESULTS: There was significant increase in the improvement percentage of acne scars on right side (dermaroller and AF-MSC-CM) vs left side of face (dermaroller; P < 0.001). Histologically, improvement of character of collagen and elastic fibers was noticed, especially on right side. Meanwhile, significant increase in epidermal thickness on both sides of face was detected. CONCLUSION: Amniotic fluid-derived mesenchymal stem cell-conditioned media combined with microneedling is more effective in management of atrophic postacne scars than microneedling alone.
RESUMEN
BACKGROUND: The present work aims to formulate nanostructured lipid carriers (NLCs) exhibiting high skin deposition and high inherent antioxidant potential to repurpose the use of melatonin hormone and some antioxidant oils in the treatment of androgenic alopecia (AGA). RESEARCH DESIGN AND METHODS: NLCs were characterized for their size, charge, drug entrapment, anti-oxidant potential, physical stability, in vitro release, surface morphology, and ex-vivo skin deposition. Their merits were clinically tested on patients suffering from AGA by calculating the degree of improvement, conduction of hair pull test, histometric assessment, and dermoscopic evaluation. RESULTS: Results revealed that melatonin NLCs showed nanometer size, negatively charged surface, high entrapment efficiency, and high anti-oxidant potential, in addition to sustained release for 6 h. Furthermore, NLCs displayed good storage stability and they were able to increase the skin deposition of melatonin 4.5-folds in stratum corneum, 7-folds in epidermis, and 6.8-folds in the dermis compared to melatonin solution. Melatonin NLCs displayed more clinically desirable results compared to the melatonin solution in AGA patients, manifested by increased hair density and thickness and decreased hair loss. CONCLUSIONS: The aforementioned system was shown to be a very promising treatment modality for AGA, which is worthy of futuristic experimentation.
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Alopecia/tratamiento farmacológico , Antioxidantes/administración & dosificación , Cosmecéuticos/administración & dosificación , Melatonina/administración & dosificación , Portadores de Fármacos/química , Reposicionamiento de Medicamentos , Humanos , Lípidos/química , Nanoestructuras , Tamaño de la Partícula , Aceites de Plantas/administración & dosificaciónRESUMEN
The present study aimed to develop vitamin C based nanovesicles (aspasomes) loaded with the antioxidant melatonin, as a novel cosmeceutical to be used for clinical treatment of androgenic alopecia (AGA). Aspasomes were assessed regarding their particle size, charge, drug entrapment, anti-oxidant potential, physical stability, in vitro release, surface morphology, and ex-vivo skin deposition. Clinically, melatonin aspasomes were tested on AGA patients, and assessed by evaluating the degree of improvement through conduction of hair pull test, histometric analysis and dermoscopic evaluation. Results revealed that melatonin aspasomes showed favorable pharmaceutical properties in addition to clinically promising results compared to melatonin solution, manifested by increased hair thickness, density and decreased hair loss, with photographic improvement in most patients. Therefore, melatonin vitamin C-based aspasomes were clinically auspicious in the treatment of AGA, hence, paving the way for their further exploration in other oxidative-dependent dermatological diseases.
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Alopecia/tratamiento farmacológico , Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Portadores de Fármacos/administración & dosificación , Melatonina/administración & dosificación , Vitaminas/administración & dosificación , Adolescente , Adulto , Animales , Antioxidantes/química , Ácido Ascórbico/química , Portadores de Fármacos/química , Liberación de Fármacos , Humanos , Masculino , Melatonina/química , Persona de Mediana Edad , Ratas , Piel/metabolismo , Resultado del Tratamiento , Vitaminas/química , Adulto JovenRESUMEN
BACKGROUND: Acne scarring has been a challenge to treat. Microneedling gained popularity in treatment of such scars. Meanwhile, carboxytherapy (CXT) is considered a novel treatment modality for acne scars. OBJECTIVE: To evaluate efficacy of CXT versus microneedling in treatment of acne scars. METHODS AND MATERIALS: Thirty-two patients with atrophic acne scars received 6 sessions of microneedling and CXT on right and left sides of face, respectively. Clinical evaluation with histopathological and computerized morphometric analysis was performed at 2 months after treatment. RESULTS: After either microneedling or CXT, there was significant decrease of total acne scars and its 3 types separately (icepicks, boxcar, and rolling) (p ≤ .001). Comparing both sides of face, there was no significant difference regarding grading response and reduction percentage of total scars and its types (p > .05). Histopathologically, there was an improvement of character and organization of collagen and elastic fibers in addition to significant increase in epidermal thickness on both sides of face, with no significant difference between them (p > .05). CONCLUSION: Both CXT and microneedling are equally effective, tolerable, safe, and noninvasive treatment modalities of atrophic acne scars. Similar histopathological changes were observed after both modalities, helping in better understanding their action.
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Acné Vulgar/complicaciones , Dióxido de Carbono/uso terapéutico , Cicatriz/patología , Cicatriz/terapia , Técnicas Cosméticas , Agujas , Adolescente , Adulto , Atrofia , Cicatriz/etiología , Estudios de Cohortes , Femenino , Humanos , Inyecciones Intradérmicas , Masculino , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUNDS: Treatment of mixed melasma remains challenging. Promising results have been achieved with low-fluence 1064-nm Q-switched Nd-YAG laser; however, multiple sessions are necessary with occurrence of complications especially in dark skin types. So, combination methods may be recommended. AIMS: To compare efficacy of Q-switched Nd-YAG laser alone or with modified Jessner's peel in mixed melasma in dark skin. PATIENTS/METHODS: Nineteen patients with mixed melasma received 6 sessions of laser on left side of face and alternating laser and modified Jessner on right side. Evaluation was carried out clinically through modified melasma area and severity index at 1 month after last session. Using histopathological, immunohistochemical, and computerized morphometric analysis, objective evaluation of melanin particle surface area and MART-1-positive cells was performed for pre- and post-treated skin biopsies. RESULTS: There was significant clinical improvement on both sides of face (P < .001), without significant difference (P > .05). At the sixth laser session on left side of face, ill-defined mottled hypopigmentation was observed in 21.05% of patients. Histopathologically, melanin particle surface area and number of MART-1-positive cells (total, epidermal, and dermal) were significantly decreased after two treatment modalities (P < .001), without significant difference in their reduction percentage between both sides of face (P > .05). CONCLUSION: Low-fluence Q-switched Nd-YAG laser alone and with modified Jessner's peel are equally effective regimens for mixed melasma clinically, histopathologically, and immunohistochemically. However, combined method is preferred, especially in dark skin, for obtaining better cosmetic result with fewer side effects of multiple laser sessions and decreasing cost rate of laser.
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Quimioexfoliación/métodos , Láseres de Estado Sólido/uso terapéutico , Melanosis/patología , Melanosis/terapia , Adulto , Biopsia , Terapia Combinada , Femenino , Humanos , Hipopigmentación/etiología , Láseres de Estado Sólido/efectos adversos , Antígeno MART-1/metabolismo , Melanosis/metabolismo , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Piel/patología , Pigmentación de la Piel , Resultado del TratamientoRESUMEN
Intense pulsed light (IPL) has been used for years in hair reduction; however, no previous studies discussed quantitative histological and immunohistochemical changes of hair follicles after IPL. Accordingly, this study aims to objectively quantify histological and immunohistochemical changes of hair follicles after IPL hair reduction. Right axillae of 21 volunteers were subjected to 6 IPL sessions using Quanta system IPL and evaluated at 1 week and 1 month after last session (i.e., 3 and 4 months from the start of treatment, respectively) in comparison to baseline and left control axillae. Using hair count, histological and immunohistochemical assessment of vertical and serial transverse sections coupled with computerized morphometric analysis, determination of hair reduction percentage, measurement of hair shaft (HS) diameter, calculation of percentage of hair follicle types and quantitative evaluation of PCNA, Ki67 and P53 markers were performed. After IPL, there was significant decrease of hair count, HS diameter, percentage of terminal anagen follicles, terminal/vellus (T/V) ratio, anagen/telogen (A/T) ratio and expression of PCNA and Ki67; however, significant increase of percentage of terminal telogen and total vellus follicles with vellus-like type and P53 expression was identified. So, reduction of hair number and thickness occurred after IPL by induction of telogenesis and miniaturization through decreased hair follicle proliferation and increase in DNA damage that could favor apoptosis.
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Folículo Piloso/fisiopatología , Remoción del Cabello/métodos , Antígeno Ki-67/metabolismo , Fototerapia/métodos , Antígeno Nuclear de Célula en Proliferación/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Adolescente , Adulto , Femenino , Humanos , Luz , Adulto JovenRESUMEN
Nanotechnology and material surface modification have provided a functional platform for the advancement of several medical fields such as dermatology. Furthermore, the smart choice of preparation material was proven to confer unique properties to the developed nanosystems. In this context, we focused on the sphingolipid "ceramide", whose deficiency was found to negatively affect psoriasis. Ceramide was doped into surfactant based vesicular phospholipid systems to create tubulated vesicles "cerosomes" loaded with a model anti-psoriatic drug "tazarotene", and their properties were tested as compared to ceramide free vesicles. Cerosomes were characterized for their drug entrapment, viscosity, in vitro drug release, morphology, ex vivo drug skin deposition, thermal behavior, and were clinically tested on psoriatic patients. The factorial design study revealed that the surfactant type, the ceramide: surfactant ratio, and the presence of ethanol in the hydration buffer affected the entrapment efficiency and the viscosity of the vesicles. Ceramide increased the entrapment of tazarotene, decreased its release while enhancing its deposition within the skin, correlating with better clinical therapeutic outcome compared to the topical marketed product. Ceramide was also able to cause significant membrane tubulation in the vesicles, causing them to deviate from the conventional spherical morphology. As a conclusion, cerosomes present a new functional treatment modality for psoriasis which is worthy of future experimentation.
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Ceramidas/química , Fármacos Dermatológicos/química , Fármacos Dermatológicos/uso terapéutico , Ácidos Nicotínicos/química , Ácidos Nicotínicos/farmacología , Fosfolípidos/química , Psoriasis/tratamiento farmacológico , Administración Cutánea , Química Farmacéutica/métodos , Portadores de Fármacos/química , Humanos , Masculino , Nanotecnología/métodos , Tamaño de la Partícula , Piel/efectos de los fármacos , Piel/metabolismo , Absorción Cutánea , Tensoactivos/químicaRESUMEN
BACKGROUND: Nanotechnology has provided substantial benefits in drug delivery, especially in the treatment of dermatological diseases. Psoriasis is a chronic inflammatory skin disease in which topical delivery of antipsoriatic agents is considered the first line treatment. OBJECTIVE: To investigate whether the encapsulation of the synthetic retinoid tazarotene in a nanocarrier based on jojoba oil would decrease its irritation potential and clinically improve its therapeutic outcome in psoriatic patients. METHOD: A microemulsion system based on jojoba wax and labrasol/plurol isostearique was prepared and characterized. RESULTS: The selected formula displayed spherical morphology, particle size of 15.49±2.41 nm, polydispersity index of 0.20 ±0.08, negative charge and low viscosity. The microemulsion provided two folds increase in skin deposition of tazarotene, correlating with higher reduction in psoriatic patients PASI scores after treatment (68% reduction in PASI scores versus 8.96% reduction with the marketed gel). No irritation was encountered in patients using microemulsion, with redness and inflammation reported with the marketed gel-treated patients. CONCLUSION: Jojoba oil microemulsion proved to be advantageous in reducing the irritancy of tazarotene, enhancing its skin deposition and achieving better therapeutic outcome in psoriatic patients.
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Fármacos Dermatológicos/administración & dosificación , Portadores de Fármacos/química , Psoriasis/tratamiento farmacológico , Retinoides/administración & dosificación , Ceras/química , Adulto , Anciano , Animales , Femenino , Humanos , Masculino , Ratones , Persona de Mediana Edad , Nanopartículas , Resultado del Tratamiento , Adulto JovenRESUMEN
Intense pulsed light (IPL) has been used for years in treatment of acne vulgaris. However, quantitative evaluation of histopathological changes after its use as a sole therapy was poorly investigated. Accordingly, this study aims to objectively evaluate inflammatory infiltrate and sebaceous glands in acne vulgaris after IPL. Twenty-four patients of acne were treated with six IPL sessions. Clinical evaluation was done at 2 weeks after last session by counting acne lesions. Patient satisfaction using Cardiff Acne Disability Index (CADI) was recorded at baseline, 2 weeks and 3 months after IPL. Using histopathological and computerized morphometric analysis, quantitative evaluation of inflammatory infiltrate and measurement of surface area of sebaceous glands were performed for skin biopsies at baseline and 2 weeks after last session. After IPL, there was significant reduction of all acne lesions especially inflammatory variety with significant decrease of CADI score at 2 weeks and 3 months after IPL (p < .05). Microscopically, there was significant decrease in density of inflammatory infiltrate and surface area of sebaceous glands (p < .05). So, IPL is fairly effective therapy in acne vulgaris especially inflammatory variety. The results suggest that IPL could improve acne lesions through targeting both inflammation and sebaceous glands.
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Acné Vulgar/terapia , Dermatitis/terapia , Tratamiento de Luz Pulsada Intensa , Glándulas Sebáceas/patología , Acné Vulgar/diagnóstico , Acné Vulgar/patología , Adolescente , Adulto , Biopsia , Dermatitis/diagnóstico , Dermatitis/patología , Femenino , Humanos , Masculino , Satisfacción del Paciente , Fotograbar , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
AIM: To study whether the formulation of an antifungal drug in nanovesicular form containing skin penetration enhancer would clinically modulate its therapeutic effectiveness. MATERIALS & METHODS: Nanovesicles containing different skin penetration enhancers 'PEVs' were prepared and loaded with sertaconazole. Penetration-enhancer vesicles were characterized for entrapment efficiency, particle size, zeta potential, elasticity, viscosity, morphology and ex vivo skin deposition. Selected formulae were preliminary tested for clinical efficacy on patients suffering from tinea corporis and tinea versicolor. RESULTS & CONCLUSION: The nanosize of the vesicles, their content of penetration enhancer and their deformable nature are three cornerstones positively influencing the therapeutic outcome of topical antifungal therapy, and hence, can be considered a promising treatment modality for skin fungal diseases.
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Antifúngicos/administración & dosificación , Dermatomicosis/tratamiento farmacológico , Imidazoles/administración & dosificación , Nanocápsulas/química , Vehículos Farmacéuticos/química , Piel/microbiología , Piel/patología , Tiofenos/administración & dosificación , Adolescente , Adulto , Animales , Antifúngicos/farmacocinética , Antifúngicos/uso terapéutico , Niño , Dermatomicosis/metabolismo , Dermatomicosis/patología , Femenino , Humanos , Imidazoles/farmacocinética , Imidazoles/uso terapéutico , Masculino , Ratones , Tamaño de la Partícula , Piel/metabolismo , Absorción Cutánea , Tiofenos/farmacocinética , Tiofenos/uso terapéutico , Viscosidad , Adulto JovenRESUMEN
Botulinum toxin (BTX)-A has been used for years in the reduction of facial wrinkles; however, histological and immunohistochemical changes after its use were not previously investigated. To evaluate histological and immunohistochemical changes after BTX-A injection for facial wrinkles, sixteen volunteers, with wrinkles on the upper third of the face, were subjected to single injection of BTX-A. Skin biopsy specimens were obtained from peri-orbital wrinkle site (crow's feet area) before and after 3 months of BTX-A injection. Using histological and immunohistochemical evaluation coupled with computerized morphometric analysis, measurement of epidermal thickness, wrinkle depth and width as well as quantitative evaluation of collagen types I and III and elastin was performed for skin biopsies. After BTX-A injections, there were significant increase in wrinkle width and granular layer thickness (P < 0.001), while the other histometrical measures as well as the immunohistochemical expression of collagen types I and III and elastin showed no significant difference (P > 0.05). However, collagen fibers showed better organization and orientation after BTX-A injection. The histological changes observed after BTX-A injection for facial wrinkles may help in better understanding of its mechanism of action.
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Toxinas Botulínicas Tipo A/administración & dosificación , Fármacos Neuromusculares/administración & dosificación , Envejecimiento de la Piel/efectos de los fármacos , Piel/metabolismo , Piel/patología , Adulto , Biopsia , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Elastina/metabolismo , Epidermis/metabolismo , Epidermis/patología , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Envejecimiento de la Piel/patología , Envejecimiento de la Piel/fisiologíaRESUMEN
BACKGROUND: Wrinkles are associated with cutaneous aging especially on sun-exposed skin. Despite they are considered a major topic in cosmetic dermatology, very few reports have studied the specific histological and immunohistochemical changes characteristic for wrinkles. AIM: The study aims to evaluate the histological and immunohistochemical changes of static forehead wrinkles in relation to surrounding photoaged skin. METHODS: Biopsy specimens were obtained from the forehead wrinkles of 20 volunteers of Glogau's class III-IV wrinkles. Using histological and immunostaining methods coupled with computerized morphometric analysis, measurement of epidermal thickness and quantitative evaluation of total elastin and tropoelastin as well as collagen types I, III, and VII were performed for skin biopsies. RESULTS: In the wrinkle site, there was statistically significant lower epidermal thickness (P = 0.001), elastin (P < 0.001), tropoelastin (P < 0.001), and collagen VII (P < 0.001) than the surrounding photoaged skin. Meanwhile, there was no significant difference between the wrinkle site and adjacent photoaged skin regarding collagen type I (P = 0.07) or III (P = 0.07). CONCLUSION: This study detected some histological and immunohistochemical differences in the wrinkle site when compared to adjacent photoaged skin. This may help in understanding the pathophysiology of facial wrinkling as well as its ideal way of management.
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Frente/patología , Envejecimiento de la Piel/patología , Biopsia con Aguja , Colágeno/metabolismo , Dermis/metabolismo , Dermis/patología , Elastina/metabolismo , Epidermis/metabolismo , Epidermis/patología , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Envejecimiento de la Piel/fisiología , Tropoelastina/metabolismoRESUMEN
OBJECTIVES: Cutaneous schistosomal granuloma (CSG) is a rare dermatological disease, the clinical and histopathological features of which are well defined. Although a panoramic picture of its immunopathogenesis in humans is not yet available, it is believed to be induced by T helper 1 (Th1), Th2, or Th17 cytokines in animals. This study evaluated the expression of different types of Th cytokines, including Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4), and Th17 cytokine IL-17, in human CSG. METHODS: This study included nine patients with CSG. Dermatological examinations were conducted in all subjects. Skin biopsy specimens were stained with hematoxylin and eosin (H&E). Immunohistochemical examination was performed using three monoclonal anti-human antibodies against IFN-γ, IL-4, and IL-17 to evaluate Th1, Th2, and Th17 cytokines, respectively. RESULTS: The most common site of CSG manifestation was the paraumbilical area, which was affected in 66.7% of patients. All lesional skin biopsy specimens revealed multiple dermal granulomas surrounding schistosomal eggs. Positive immunoreactivity for IFN-γ, IL-4, and IL-17 was present in dermal inflammatory infiltrate in 88.9, 11.1, and 88.9% of subjects, respectively. There were statistically significant negative correlations between the duration of disease and both IFN-γ and IL-17 (P ≤ 0.05), and a statistically significant positive correlation between IFN-γ and IL-17 (P ≤ 0.05). CONCLUSIONS: This study suggests that CSG is formed by the action of both Th1 (IFN-γ) and Th17 (IL-17) cytokines, which have been shown to be directed against the schistosomal egg to induce a cell-mediated immune response.
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Granuloma/inmunología , Interferón gamma/análisis , Interleucina-17/análisis , Interleucina-4/análisis , Esquistosomiasis/complicaciones , Enfermedades Cutáneas Parasitarias/inmunología , Piel/inmunología , Adolescente , Animales , Niño , Femenino , Granuloma/parasitología , Granuloma/patología , Humanos , Inmunohistoquímica , Masculino , Óvulo/inmunología , Estudios Retrospectivos , Schistosoma/inmunología , Piel/patología , Enfermedades Cutáneas Parasitarias/patologíaRESUMEN
Both vitiligo and alopecia areata (AA) are associated together, associated with other autoimmune diseases, and autoimmunity is one of the important theories in their etiology. Nail changes are a known association with AA, thus we hypothesized that nail changes can be found in vitiligo patients. On revising the literature, only two types of nail changes were described in association with vitiligo. Our aim was to study the frequency and types of nail changes among vitiligo patients in comparison with normal healthy volunteers. This multi-centric study was carried on 91 patients with vitiligo, as well as 91 normal healthy control subjects who were age- and sex-matched. Nails were examined for changes in nail plates as regards striations, texture, curvature, dystrophy, and pigmentation. The presence or absence of the thumb lunula was also reported. Nail changes were observed in 62 patients (68.1%) and 46 (50.5%) control subjects with a statistically significant difference (P = 0.016). Longitudinal ridging and absent lunula were significantly higher in patients than in the controls (P = 0.001 and 0.037, respectively). Other reported nail abnormalities in the current study included punctate leukonychia, pitting, flag sign, and Terry's nails. Awareness of this association will widen the clinician's perspective to carefully examine the nail changes in vitiligo patients and conversely examine patients with nail changes for vitiligo.
Asunto(s)
Uñas Malformadas/etiología , Vitíligo/complicaciones , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Egipto/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Uñas Malformadas/diagnóstico , Uñas Malformadas/epidemiología , Uñas Malformadas/inmunología , Vitíligo/diagnóstico , Vitíligo/epidemiología , Vitíligo/inmunologíaRESUMEN
BACKGROUND: The histopathologic changes characteristic of psoriasis might be related to suppressed apoptosis. One of the actions of psoralen ultraviolet A (PUVA) in psoriasis could be exerted through induction of apoptosis of keratinocytes and lymphocytes; however, its exact molecular mechanism is still confusing. AIM: In this study, we evaluated the expression of pro-apoptotic (P53, Fas and Bax) and anti-apoptotic (Bcl-2) proteins correlating it with apoptotic index (AI) and epidermal thickness in psoriatic skin before and after PUVA therapy. METHODS: Lesional and non-lesional skin biopsy specimens were obtained from 10 patients with generalized plaque psoriasis before and after 8 weeks of PUVA therapy. Histometric measurements of epidermal thickness as well as P53, Fas, Bax and Bcl-2 expressions were evaluated using immunoperoxidase technique and apoptotic cells were detected by terminal deoxynucleotide transferase (TdT) mediated deoxyuridine triphosphate nick end labeling (TUNEL) method. RESULTS: After PUVA therapy, the epidermal thickness of psoriatic skin was significantly decreased (P < 0.001) and keratinocytes of psoriatic skin showed significant increased expression of P53 (P < 0.001), Fas (P < 0.001) and Bcl-2 (P < 0.001) with no significant change in Bax expression (P > 0.05). Apart from significant decrease of Bcl-2 expression (P = 0.01), no significant difference in all previous markers were encountered in lymphocytes (P53, Fas and Bax; P > 0.05) after PUVA therapy. The AI was significantly increased (P = 0.008) after PUVA therapy especially in lymphocytes (P = 0.002). CONCLUSION: The present study suggests that one of the actions of PUVA therapy in psoriasis might be exerted through induction of apoptosis especially of lymphocytes by suppression of Bcl-2 expression and of keratinocytes through P53 and Fas pathways leading to healing of psoriasis.