Skin, hair and beyond: the impact of menopause.

The skin is an endocrine organ and a major target of hormones such as estrogens, androgens and cortisol. Besides vasomotor symptoms (VMS), skin and hair symptoms often receive less attention than other menopausal symptoms despite having a significant negative effect on quality of life. Skin and mucosal menopausal symptoms include dryness and pruritus, thinning and atrophy, wrinkles and sagging, poor wound healing and reduced vascularity, whereas skin premalignant and malignant lesions and skin aging signs are almost exclusively caused by environmental factors, especially solar radiation. Hair menopausal symptoms include reduced hair growth and density on the scalp (diffuse effluvium due to follicular rarefication and/or androgenetic alopecia of female pattern), altered hair quality and structure, and increased unwanted hair growth on facial areas. Hormone replacement therapy (HRT) is not indicated for skin and hair symptoms alone due to the risk-benefit balance, but wider potential benefits of HRT (beyond estrogen's effect on VMS, bone, breast, heart and blood vessels) to include skin, hair and mucosal benefits should be discussed with women so that they will be able to make the best possible informed decisions on how to prevent or manage their menopausal symptoms.

An automatic procedure that grades some facial skin structural signs: agreements and validation with clinical assessments made by dermatologists.

OBJECTIVE: To confirm the robustness and validity of an automatic scoring system, algorithm-based, that grades the severity of nine facial signs through "selfies" smartphones pictures taken by European Caucasian women through dermatological assessments. METHODS: 157 Caucasian women from three countries (France, Germany, Spain), of different ages (20-75 years), took one "selfie" image by the frontal camera of their smartphones whereas local dermatologists photographed them with the back camera of the same smartphone. The same nine facial signs of these subjects were initially graded by these local dermatologists, using referential Skin Aging Atlases. All 314 "selfies" images were then further automatically analyzed by the algorithm. The severity of facial signs (wrinkles, pigmentation, ptosis, skin folds etc.) were statistically compared to the assessments made by the three dermatologists, taken as ground truth. RESULTS: Highly significant coefficients of correlation (P < 0.001) were found in the three cohorts between the grades provided by the system and those from dermatologists in live. The back camera - of a better resolution than the frontal one - seems affording slightly more significant correlations. However, although significantly correlated, the signs of vascular disorders and cheek skin pores present some disparities that are likely linked to the technical diversity of smartphones or self-shootings, leading to lower coefficients of correlations. CONCLUSION: This automatic scoring system offers a promising approach in the harmonization of Dermatological assessments of skin facial signs and their changes with age or the follow up of anti-aging treatments.

OBJECTIF: De confirmer la validité et la solidité d'un système de scorage automatique qui quantifie la sévérité de neuf signes du visage à partir de photographies de type "selfies" prises par des femmes Caucasiennes Européennes d'âge différents. MÉTHODES: 157 femmes Caucasiennes de trois pays différents (France, Allemagne, Espagne), d'âges différents (20-75 ans) ont pris un « selfie¼ avec la caméra frontale de leur téléphone tandis que le dermatologue local les a photographiées à l'aide de la caméra dorsale du même appareil. Les neuf signes faciaux ciblés par le système de scorage automatique ont été préalablement évalués par trois dermatologues locaux, utilisant des Atlas référentiels du vieillissement cutané. Les 314 images obtenues furent ensuite analysées automatiquement par l'algorithme. Les sévérités des neuf signes (rides, ptose, plis, pigmentation...) ont été ensuite comparées à celles établies par les dermatologues, considérées comme références absolues. RÉSULTATS: De très significatifs coefficients de corrélation (P < 0.001) ont été trouvés dans les trois cohortes entre les scores fournis par le système et ceux issus des évaluations des dermatologues des visages durant la visite des volontaires. La caméra du dos des smartphones - de meilleure résolution que la frontale - semble fournir de légèrement meilleures significativités. Cependant, bien que significativement corrélés, les signes des désordres vasculaires et des pores cutanés des joues montrent quelques disparités, dues possiblement à la diversité technique des smartphones ou celle des prises de vue, conduisant à de plus faibles coefficients de corrélation. CONCLUSION: Ce système de quantification automatique semble offrir une approche prometteuse dans l'harmonisation des évaluations dermatologiques des signes faciaux et leurs modifications liées à l'âge et/ou le suivi de traitements à vocation antivieillissement cutané.

A skincare combined with combination of adapalene and benzoyl peroxide provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne.

INTRODUCTION: Acne in adult women is an increasing reason for dermatological consultations. OBJECTIVE: The aim of this study was to assess in adult women with mild acne the efficacy and tolerance of a daily adjunctive application of a skincare (Normaderm® , Laboratoires Vichy, France) to a fixed combination of adapalene/benzoyl peroxide daily or every other evening and a standard emollient. METHODS: Subjects were randomized to receive the fixed combination applied either every evening or every other evening and a daily application of the standard emollient and the test care or a once daily application of the fixed combination and the standard emollient alone. Clinical evaluations at Day 0, Day 45 and Day 90 included the count of acne lesions, assessment of clinical improvement and local tolerance. The quantitative lipid profile of the stratum corneum of the forehead was also determined. RESULTS: After 90 days of application, acne had improved in all 299 subjects with a statistically significant difference in favour of the test care regimens (P < 0.05). Moreover, skin quality, subject satisfaction, skin discomfort and sebum composition were in favour of these regimens. CONCLUSION: In conclusion, the tested skincare combined with a fixed adapalene and benzoyl peroxide combination provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne.

Root nonfinite and finite utterances in child language and agrammatic speech.

Root nonfinite structures are frequent in both child language and agrammatic speech. Moreover, root nonfinites seem to have quite similar properties in both types of speech. Although many accounts are available for child language this is not the case for agrammatic speech. I present data of a Dutch agrammatic patient in this paper. The properties of her root nonfinites are best accounted for by the assumption of an underspecified Tense Phrase licensed by an empty element. In her finite sentences a dummy Tense element shows up. The use of either an empty or a dummy Tense element is a way of reducing the processing load of the utterance. The speech of this patient shows a dissociation between the verbal and the nominal domain.

Lymphoepithelioma-like carcinoma of the skin: a light-microscopic and immunohistochemical study.

Cutaneous carcinoma histopathologically resembling nasopharyngeal carcinoma has been termed lymphoepithelioma-like carcinoma of the skin. We present an additional example of this rare cutaneous neoplasm that was located on the left temple of an 83-year-old woman. Serology for Epstein-Barr virus was negative, and exploration of the nasopharyngeal region disclosed no abnormalities. Histopathologically, the neoplasm consisted of a relatively well-circumscribed, dermal-hypodermal nodule composed of irregular aggregates of epithelial cells with vesicular nuclei, some of them in mitosis, and scant cytoplasm. A dense lymphocytic infiltrate was present within the neoplastic aggregates, obscuring the epithelial component, and at scanning magnification, the lesion closely resembled cutaneous lymphoma or pseudolymphoma. There was focal sebaceous differentiation. Immunohistochemistry showed positivity in the epithelial component for AE1/AE3 and AEB-903 cytokeratins and negativity for 8-18 cytokeratins. The inflammatory infiltrate was positive for leukocyte common antigen, UCHL-1, L-26, Leu-22, and OPD-4 in variable proportions. Scattered cells within this inflammatory infiltrate were also positive for S-100 protein, vimentin, HAM-56, and MAC-387. In situ hybridization investigations for the presence of Epstein-Barr virus genomic DNA yielded negative results. Lymphoepithelioma-like carcinoma of the skin is a distinct cutaneous neoplasm of unknown histogenesis, although some foci of adnexal differentiation have been found in some specimens. The possibility of cutaneous metastasis from occult nasopharyngeal carcinoma should be ruled out.

Pelvi-perineal rehabilitation for dysfunctioning erections. A clinical and anatomo-physiologic study.

We have studied penile structure in 24 cadaver specimens and 155 patients have been treated for organic impotence by physiotherapy. Special attention has been focused on the closure mechanism of the corpora cavernosa during erection. We have found that the leakage factor of the corpora cavernosa is, among other things, influenced by the ischiocavernous muscles. Based on the above, we propose a model for the anatomic and physiologic basis of interference of the ischiocavernous muscles in venous occlusion during penile erection. Moreover we suggest that patients with erectile dysfunction should undergo pelvi-perineal rehabilitation in order to strengthen and control ischiocavernous muscles.

Plate-like sebaceous hyperplasia overlying dermatofibroma.

Epidermal hyperplasia, sometimes with primitive hair follicle-like differentiation, is a characteristic finding overlying dermatofibroma. We here report plate-like sebaceous hyperplasia overlying a dermatofibroma. Such changes are interpreted as a result of inductive epithelial effect by the dermatofibroma on the overlying epidermis.