Histometric and histochemical analysis of the effect of trichloroacetic acid concentration in the chemical reconstruction of skin scars method.

BACKGROUND: Atrophic scars can be induced by various causes, including severely inflamed acne, chicken pox, and trauma. Many treatment modalities are used for reconstructing and improving the appearance of scars with various treatment results. OBJECTIVE: A recent report shows the clinical efficacy of the chemical reconstruction of skin scars (CROSS) method, which consists of the focal application of trichloroacetic acid (TCA) in a higher concentration. Histometric analysis of the CROSS method, however, has not yet been established. METHODS: In this study, five hairless mice were used to evaluate the effect of the CROSS method and to analyze the difference between the CROSS method and simple TCA application. RESULTS: Similar histologic changes were observed in the two methods, including epidermal and dermal rejuvenation with new collagen deposition. These changes, however, were more prominent in the CROSS method-treated areas, particularly when 100% TCA was used. CONCLUSION: The results of this study suggest that treatment of atrophic scars using the CROSS method is more effective than simple application of TCA in activating fibroblasts in the dermis and increasing the amount of collagen.

The effectiveness of hand acupuncture and moxibustion in decreasing pain and "coldness" in Korea women who have had hysterectomy: a pilot study.

This pilot study compared the relative effectiveness of hand acupuncture and moxibustion in relieving pain and decreasing "coldness" in certain body parts experienced by subjects who have undergone a hysterectomy. The study participants were 10 women between 40 and 65 years, whose hysterectomies had been performed within 5 years before the study. The 10 subjects were divided randomly into two independent experimental groups, with one group being treated with hand moxibustion, whereas the other group received hand acupuncture therapy. The visual analogue scale evaluation tool was used to measure the pain and digital infrared thermographic imaging to measure "coldness" and blood circulation. When measuring the degree of pain, it was noted that pain scores decreased conspicuously over time. The responses of the two groups did not differ significantly, but moxibustion therapy was found to increase the temperature of internal parts of the body (i.e., abdominal and waist areas), whereas acupuncture affected the peripheral parts of the body.

Focal trichloroacetic acid peel method for benign pigmented lesions in dark-skinned patients.

BACKGROUND: Benign pigmented lesions, including seborrheic keratosis, solar lentigines, melasma, and freckles, are common disorders, and various treatment modalities have been tried. We suggest a technique consisting of focal trichloroacetic acid (TCA) peel applied by pressing firmly onto the focal lesions. OBJECTIVE: To evaluate the clinical effects of focal TCA peel on pigmented lesions in dark-skinned patients. METHODS: An analysis was conducted of 106 patients with benign pigmented lesions who were treated using focal TCA peel. Seborrheic keratosis was treated with 65% focal TCA peel, solar lentigines, and freckles with 50% to 65% focal TCA peel, and melasmas with 10% to 50% focal TCA peel. Patients had Fitzpatrick skin types IV-V. RESULTS: Patient treatment data indicated that 19 of 23 (83%) patients with seborrheic keratosis, 42 of 49 (86%) patients with solar lentigines, 8 of 14 (58%) patients with freckles, and 11 of 20 (55%) patients with melasma experienced a good clinical response. Good satisfaction rates in the seborrheic keratosis, solar lentigines, freckles, and melasma groups were recorded. No significant complications were observed. CONCLUSION: The focal TCA peel method presented in this study is a safe and effective modality for the treatment of benign pigmented lesions with no significant complications.

Receptors for Treponema pallidum attachment to the surface and matrix proteins of cultured human dermal microvascular endothelial cells.

Pathogenicity of Treponema pallidum may depend upon the binding of Treponema pallidum to matrix proteins, especially to fibronectin. Infectious organism or cell to matrix interactions are mediated by a family of adhesion molecule receptors known as integrins. Once in the host, the pathogenic Treponema pallidumdum adheres to the vascular endothelium and readily penetrates surrounding tissues. Fibronectin plays an important role in the mediation of the attachment of Treponema pallidum to host cells, including endothelial cells. We found that the binding of Treponema pallidum to human dermal microvascular endothelial cells and to a glass surface coated with fibronectin is inhibited by the presence of arginine-glycine- aspartic acid (RGD), and analysis of the surface receptor revealed an antigenic similarity to an integrin molecule, namely alpha5. This ability to adhere to host endothelium and fibronectin is quite unique to T. pallidum among the treponemes, and may be a key pathogenic factor.

Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method.

BACKGROUND: Acne scarring is a common complication of acne and yet no appropriate and effective single treatment modality has been developed. We suggest a technique consisting of the focal application of higher trichloroacetic acid (TCA) concentrations by pressing hard on the entire depressed area of atrophic acne scars. This technique is called chemical reconstruction of skin scars (CROSS) by the authors. OBJECTIVE: To evaluate the clinical effects of CROSS on atrophic acne scars in dark-complexioned patients. METHODS: An analysis was conducted of 65 patients with atrophic acne scars who were treated with CROSS in our hospitals between July 1996 and July 2001. Thirty-three patients were treated with 65% TCA CROSS and 32 patients were treated with 100% TCA CROSS. All patients had Fitzpatrick skin types IV-V. RESULTS: Patient treatment data indicated that 27 of 33 patients (82%) (the 65% TCA group) and 30 of 32 patients (94%) (the 100% TCA group) experienced a good clinical response. All patients in the 100% TCA group who received five or six courses of treatment showed excellent results. Good satisfaction rates in the 65% and 100% TCA groups were recorded. There were no cases of significant complication. CONCLUSION: CROSS is a safe and very effective single modality for the treatment of atrophic acne scars with no significant complications.

Treponema pallidum induces up-regulation of interstitial collagenase in human dermal fibroblasts.

In this study we investigated the capability of Treponema pallidum to stimulate human dermal fibroblasts to produce interstitial collagenase (MMP-1), which is needed to degrade type I collagen, the most abundant component of the human dermis. When T. pallidum was added to human dermal fibroblast culture, both the amount of secreted MMP-1 and its mRNA levels were increased. Our results show that T. pallidum can stimulate host human fibroblasts to increase the synthesis of MMP-1, which may act as a virulence factor of the organism.