The Efficacy and Safety of Dual-Frequency Ultrasound for Improving Skin Hydration and Erythema in Patients with Rosacea and Acne

Inflammatory skin diseases, such as rosacea and acne, are major causes of facial erythema and accompanying skin barrier dysfunction. Several methods to restore the impaired skin barrier and improve facial erythema, such as medication, radiofrequency, laser, and ultrasound therapy were attempted. This study evaluated the efficacy and safety of dual-frequency ultrasound with impulse mode, for improving skin hydration and erythema in Asian subjects with rosacea and acne. Twenty-six subjects with facial erythema received an ultrasound treatment once per week, for 4 weeks, over both cheeks. The erythema index and transepidermal water loss (TEWL) were measured at each visit. Clinicians assessed the erythema improvement and patients evaluated their satisfaction level. The average decrease in TEWL and erythema index at 6 weeks was 5.37 ± 13.22 g·h−1·m−2 (p = 0.020) and 39.73 ± 44.21 (p = 0.010), respectively. The clinician’s erythema assessment and the subject satisfaction questionnaire score significantly improved at final follow-up (p < 0.001; p = 0.003, respectively). No serious adverse effects were observed during the treatment and follow-up periods. The dual-frequency ultrasound with impulse mode appears to be effective and safe for improving skin hydration and erythema in patients with rosacea and acne.

Download Full-text

Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Toxins ◽

10.3390/toxins13020120 ◽

2021 ◽

Vol 13 (2) ◽

pp. 120

Author(s):

Emanuela Martina ◽

Federico Diotallevi ◽

Giulia Radi ◽

Anna Campanati ◽

Annamaria Offidani

Keyword(s):

Systematic Review ◽

Skin Diseases ◽

Meta Analysis ◽

Published Data ◽

Efficacy And Safety ◽

Botulinum Toxins ◽

Epidermolysis Bullosa Simplex ◽

Off Label ◽

Facial Erythema ◽

Notalgia Paresthetica

Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

Download Full-text

Elegant flexible vesicular nanocarriers for the efficient skin delivery of topically applied drugs-

Current Nanoscience ◽

10.2174/1573413718666211230111538 ◽

2021 ◽

Vol 18 ◽

Author(s):

Waleed Albalawi ◽

Surur Alharbi ◽

Fahad Alanazi ◽

Hameed Alahmadi ◽

Mothib Alghamdi ◽

...

Keyword(s):

Drug Delivery ◽

Skin Diseases ◽

Fungal Infections ◽

Skin Barrier ◽

Therapeutic Outcome ◽

Health Concern ◽

Inflammatory Skin Diseases ◽

Skin Delivery ◽

Pubmed Database ◽

Vesicular Carriers

Background: Skin diseases represent a major health concern worldwide and negatively impact patients’ quality of life. Despite the availability of various efficacious drugs, their therapeutic outcome is often limited due to shortcomings related to the formidable skin barrier and unfavorable physicochemical properties of drugs. Flexible nano-vesicles have shown tremendous potential to overcome these hurdles and improve the local therapeutic effect of these drugs. Objective: This review article is aimed to shed light on flexible nano-vesicular carriers as a means to combat skin diseases. Methods: The literature was reviewed using PubMed database using various keywords such as liposomes, flexible (deformable liposomes) (transferosomes), ethosomes, transethosomes, niosomes, and spanlastics. Results: Liposomes and niosomes were found effective for the loading and release of both hydrophilic and lipophilic drugs. However, their limited skin penetration led to drug delivery to the outermost layers of skin only. This necessitates the search for innovative vesicular carriers, including liposomes, flexible (deformable liposomes), ethosomes, transethosomes, and spanlastics. These flexible nano-vesicular carriers showed enhanced drug delivery and deposition across various skin layers, which was better than their corresponding conventional vesicles. This resulted in superior drug efficacy against various skin diseases such as skin cancer, inflammatory skin diseases, superficial fungal infections, etc. Conclusion: Flexible nano-vesicular carriers have proven themselves as efficient drug delivery systems that are able to deliver their cargo into the deep skin layers and thus, improve the therapeutic outcome of various skin diseases. However, there remain some challenges that need to be addressed before these nanocarriers can be translated from the lab to clinics.

Download Full-text

Peroxisome Proliferator-Activated Receptors (PPARs) Activation as Therapeutic Targets in Skin Inflammation

Trends in Immunotherapy ◽

10.24294/ti.v4.i2.1063 ◽

2020 ◽

Vol 4 (2) ◽

pp. 9

Author(s):

Akihiro Aioi

Keyword(s):

Skin Diseases ◽

Skin Barrier ◽

Skin Inflammation ◽

Cell Types ◽

Immune Dysregulation ◽

Nuclear Hormone Receptor ◽

Peroxisome Proliferator ◽

Barrier Dysfunction ◽

Cytokine Network ◽

Peroxisome Proliferator Activated Receptors

Peroxisome proliferator-activated receptors (PPARs) are fatty acid activated transcription factors that belong to the nuclear hormone receptor family. They are initially known as transcriptional regulators of lipid and glucose metabolism, although further evidence has also been accumulated for other functions. Due to the nature of all PPAR isotypes which are expressed and exert effects by regulating the functions of cell types residing and infiltrating in the skin, PPARs represent a major research target for the understanding and treatment of many skin diseases. Atopic dermatitis (AD) is a chronic and relapsing disease characterized by skin barrier dysfunction and immune dysregulation. Skin barrier disturbance is one of the exacerbation factors of AD, due to facile penetration of molecules such as antigens. From the aspect of immune dysregulation, innate and acquired immunity including cell proliferation, cell differentiation, and cytokine network are involved in the pathogenesis. In this review, the role of PPAR in AD and the possibility of its agonist for the treatment of AD are discussed.

Download Full-text

Impact of Water Exposure and Temperature Changes on Skin Barrier Function

Journal of Clinical Medicine ◽

10.3390/jcm11020298 ◽

2022 ◽

Vol 11 (2) ◽

pp. 298

Author(s):

Manuel Herrero-Fernandez ◽

Trinidad Montero-Vilchez ◽

Pablo Diaz-Calvillo ◽

Maria Romera-Vilchez ◽

Agustin Buendia-Eisman ◽

...

Keyword(s):

Barrier Function ◽

Skin Diseases ◽

Cold Water ◽

Water Immersion ◽

Skin Barrier ◽

Hot Water ◽

Skin Barrier Function ◽

Inflammatory Skin Diseases ◽

Water Exposure ◽

The Impact

The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest® (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g·h−1·m−2), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g·h−1·m−2) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g·h−1·m−2) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 °C) of the TempTest. No significant differences were found after contact with the cold region (4 °C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands.

Download Full-text

Peroxisome proliferator-activated receptors (PPARs) activation as therapeutic targets in skin inflammation

Trends in Immunotherapy ◽

10.24294/ti.v2.i3.1063 ◽

2019 ◽

Vol 2 (4) ◽

Author(s):

Akihiro Aioi

Keyword(s):

Skin Diseases ◽

Skin Barrier ◽

Skin Inflammation ◽

Cell Types ◽

Immune Dysregulation ◽

Nuclear Hormone Receptor ◽

Peroxisome Proliferator ◽

Barrier Dysfunction ◽

Cytokine Network ◽

Peroxisome Proliferator Activated Receptors

Download Full-text

Role of Macrophages in the Pathogenesis of Atopic Dermatitis

Mediators of Inflammation ◽

10.1155/2013/942375 ◽

2013 ◽

Vol 2013 ◽

pp. 1-15 ◽

Cited By ~ 51

Author(s):

Sadaf Kasraie ◽

Thomas Werfel

Keyword(s):

Atopic Dermatitis ◽

Skin Diseases ◽

Inflammatory Diseases ◽

Skin Barrier ◽

Cellular Level ◽

Skin Barrier Function ◽

Inflammatory Skin Diseases ◽

Cutaneous Infections ◽

Inflammatory Phase ◽

New Findings

Atopic dermatitis (AD) is one of the most common and most intensively studied chronic inflammatory skin diseases. Several cofactors, such as an impaired skin barrier function, modifications of the immune system, and a complex genetic background, direct the course of AD. Within this complex network, macrophages play a pivotal role in enhanced susceptibility to cutaneous infections and act as central connecting components in the pathogenesis of AD on the cellular level. In AD, macrophages are known to accumulate in acutely and chronically inflamed skin. During the early and short inflammatory phase, macrophages exert proinflammatory functions like antigen-presenting phagocytosis and the production of inflammatory cytokines and growth factors that facilitate the resolution of inflammation. However, persistence of pro-inflammatory activity and altered function of macrophages result in the development of chronic inflammatory diseases such as AD. The exact mechanism of macrophages activation in these processes is not yet completely understood. Further studies should be performed to clarify the dysregulated mechanism of macrophages activation in AD, and this would allow us to target these cells with versatile functions for therapeutic purpose and improve and control the disease. In this paper, we highlight the new findings on dysregulated function of macrophages and the importance of these cells in the pathogenesis of AD in general and the contribution of these cells in enhanced susceptibility against microbial infections in particular.

Download Full-text

Biophysical parameters of rats’ skin after the administration of methimazole

Bulletin of the Veterinary Institute in Pulawy ◽

10.2478/bvip-2014-0049 ◽

2014 ◽

Vol 58 (2) ◽

pp. 315-319 ◽

Cited By ~ 3

Author(s):

Marcin Gołyński ◽

Marcin Szczepanik ◽

Krzysztof Lutnicki ◽

Łukasz Adamek ◽

Magdalena Gołyńska ◽

...

Keyword(s):

Oral Administration ◽

Water Loss ◽

Wistar Rats ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Skin Hydration ◽

Barrier Dysfunction ◽

Early Assessment ◽

Biophysical Parameters ◽

Ph Measurements

Abstract The paper describes the influence of oral administration of methimazole on biophysical skin parameters. Wistar rats of different sex (220-260 g) were used in the experiment. Biophysical skin parameters, such as transepidermal water loss (TEWL), corneometry, and pH were examined at seven-day intervals. Significant changes in the parameters were observed on the 7th d of methimazole administration. The changes were observed in both sex but males appeared to be less sensitive in that respect. Changes in the parameters in the females showed rapid mechanisms, which normalised transepidermal water loss and skin hydration, as well as restored skin barrier functions. TEWL, skin hydration, and skin pH measurements allow an early assessment of skin barrier dysfunction after administration of this drug.

Download Full-text

ADAM17/EGFR axis promotes transglutaminase-dependent skin barrier formation through phospholipase C γ1 and protein kinase C pathways

Scientific Reports ◽

10.1038/srep39780 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 9

Author(s):

Cristina Wolf ◽

Yawen Qian ◽

Matthew A. Brooke ◽

David P. Kelsell ◽

Claus-Werner Franzke

Keyword(s):

Protein Kinase C ◽

Protein Kinase ◽

Skin Diseases ◽

Skin Barrier ◽

Epidermal Differentiation ◽

Keratinocyte Differentiation ◽

Inflammatory Skin Diseases ◽

Cholesterol Sulfate ◽

Kinase C ◽

Barrier Formation

Abstract The vitally important skin barrier is formed by extensive cross-linking activity of transglutaminases (TGs) during terminal epidermal differentiation. We have previously shown that epidermal deficiency of a disintegrin and metalloproteinase 17 (ADAM17), the principal EGFR ligand sheddase, results in postnatal skin barrier defects in mice due to impeded TG activity. However, the mechanism by which ADAM17/EGFR signalling maintains TG activity during epidermal differentiation remains elusive. Here we demonstrate that ADAM17-dependent EGFR signalling promotes TG activity in keratinocytes committed to terminal differentiation by direct induction of TG1 expression. Restored TG1 expression of EGF-stimulated differentiated Adam17 −/− keratinocytes was strongly repressed by inhibitors for PLCγ1 or protein kinase C (PKC) pathways, while treatment with the PKC stimulator 12-O-tetradecanoylphorbol-13-acetate restored TG activity in the epidermis of keratinocyte-specific Adam17 −/− (AD17 ΔKC ) mice. Further investigations emphasized the expression of PKCη, a mediator of TGM1 transcription, to be sensitive to EGFR activation. In agreement, topical skin application of cholesterol sulfate, an activator of PKCη, significantly improved TG activity in epidermis of AD17 ΔKC mice. Our results suggest ADAM17/EGFR-driven PLCγ1 and PKC pathways as important promoters of TG1 expression during terminal keratinocyte differentiation. These findings may help to identify new therapeutic targets for inflammatory skin diseases related to epidermal barrier defects.

Download Full-text

Homemade Kefir Consumption Improves Skin Condition—A Study Conducted in Healthy and Atopic Volunteers

Foods ◽

10.3390/foods10112794 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2794

Author(s):

Emília Alves ◽

João Gregório ◽

André Rolim Baby ◽

Patrícia Rijo ◽

Luis M. Rodrigues ◽

...

Keyword(s):

Barrier Function ◽

Skin Diseases ◽

Skin Barrier ◽

Skin Condition ◽

Skin Barrier Function ◽

Fermented Foods ◽

Inflammatory Skin Diseases ◽

Health Promoting ◽

Relationship Of ◽

The Impact

Diet has a fundamental role in the homeostasis of bodily functions, including the skin, which, as an essential protective barrier, plays a crucial role in this balance. The skin and intestine appear to share a series of indirect metabolic pathways, in a dual relationship known as the “gut–skin axis”. Hence, the gut–skin axis might be receptive to modulation via dietary modification, where probiotics can be included, thus representing a potential therapeutic target in inflammatory skin diseases, such as atopic dermatitis (AD), in order to control and/or ameliorate symptoms. Kefir is one of the most ancient fermented foods, with probiotic characteristics that have been associated with a wide variety of health-promoting benefits, and it presents a microbiological diversity that makes its application as a probiotic in the gut–skin relationship of the utmost interest. However, the impact of a diet containing kefir on skin health has yet to be reported in scientific literature. This study aimed to assess the impact of the intake of homemade kefir in the skin of healthy and atopic volunteers. The intervention resulted in a boost on barrier function in both skin types verified only in the respective kefir intake groups. An improvement in the degree of severity of AD was also confirmed for the kefir intake group. Atopic individuals may benefit from kefir intake, especially in regard to their skin hydration. Finally, the effects observed on skin barrier function in this study probably culminate from the effects of all the ingredients in kefir, including the complex microbiota, its metabolites and macro- and micronutrients resulting from the fermentation. This work opens the way for more advanced research on the impact of the probiotic kefir on cutaneous health, further clarifying its mechanism of action namely via gut–skin axis.

Download Full-text

Practice pattern and use of a novel skin moisturizer containing skin barrier therapy in patients with atopic dermatitis: a cross-sectional survey among dermatologists in India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213341 ◽

2021 ◽

Vol 7 (5) ◽

pp. 663

Author(s):

Anil Abraham ◽

Anil Ganjoo ◽

Sheilly Kapoor ◽

Divya Sharma ◽

Abhay Talathi

Keyword(s):

Atopic Dermatitis ◽

Clinical Experience ◽

Skin Barrier ◽

Practice Pattern ◽

Treatment Modalities ◽

Efficacy And Safety ◽

Barrier Dysfunction ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Proven Efficacy

Background: Atopic dermatitis is considered as the most common chronic, inflammatory dermatological disorder. Skin barrier dysfunction represents an early pathology of this condition. Various factors contribute to development of such defects. Skin moisturizers remain the mainstay of therapy for AD along with other treatment modalities.Methods: Dermatologists across India were administered a questionnaire consisting of questions related to number of the patients seen with AD every week and their clinical experience regarding the use of novel skin moisturizer containing skin barrier therapy for the management of AD. The responses were analysed as number and percentages.Results: A total of 1605 patients were included in this survey. The complete responses were obtained from a total of 58 dermatologists. The majority (98%) of the dermatologists found the overall efficacy of novel skin moisturizer (Atoderm Intensive Baume) in AD patients as ‘satisfactory’. Atoderm Intensive Baume was found as efficacious in improving various parameters of AD such as skin dryness, severity of pruritus, inflammation, insomnia, itching, and urge to scratch. It was also well tolerated. It plays an important role in the repair of damaged skin barrier caused by AD.Conclusions: This survey findings indicated that novel skin moisturizer (Atoderm Intensive Baume) is a preferred formulation by dermatologists across India for the management of AD with proven efficacy and safety.

Download Full-text