Impact of Water Exposure and Temperature Changes on Skin Barrier Function

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.

Crosstalk between keratinocytes and immune cells in inflammatory skin diseases

Cutaneous homeostasis is maintained by dynamic cellular communications between different cell types in the skin through interactions with various mediators, including cytokines, chemokines and antimicrobial peptides/proteins (AMPs). Keratinocytes, as the major cell type of the epidermis, not only form a passive physical barrier, but also actively participate in the pathogenesis of many, if not all, inflammatory skin diseases. Keratinocytes highly interact with immune cells to shape, amplify or regulate inflammatory responses, thus triggering and/or sustaining these inflammatory skin diseases. In this review, crosstalk between keratinocytes and immune cells is summarized, and its contributions to two major inflammatory skin disorders including psoriasis and atopic dermatitis are highlighted.

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

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.

SERUM LIPID LEVELS IN PATIENTS WITH LICHEN PLANUS: مستويات شحوم الدم عند مرضى الحزاز المسطح

Background: Lichen planus (LP) is a chronic inflammatory disease, involving the skin, mucous membranes, hair, and nails. Cardiovascular risk factors have been assessed with some chronic inflammatory skin diseases such as alopecia and psoriasis. Recently, some studies found that lichen planus (LP) was associated with dyslipidemia. So we did this study to find this association in our patients. Objective: To evaluate lipid levels in patients with L.P and compare it with controls. Materials and Methods: This case- control study included 160 participators (80 with L.P. and 80 controls) admitted to dermatology clinic at Tishreen University Hospital, Lattakia, Syria, from 2020- 2021. Results: Cholesterol, triglyceride and Low- density lipoprotein (LDL) levels in patients were significantly higher than the control group; it was only regarding high- density lipoprotein (HDL) levels that no significant difference was observed between the two groups. Triglyceride levels were significantly higher and HDL levels were lower in patients with diffused disease. There was a recognizable correlation between elevated levels of LDL and cholesterol with disease duration. Conclusion: In this study, a disrupted lipid profile was observed in LP patients, which can be associated with disease severity. This study proposes measuring lipid serum levels prior to commencing the treatment in all known cases of lichen planus, so as to preclude cardiovascular diseases if there is a problem with the lipid profile.

Role of Aryl Hydrocarbon Receptor Activation in Inflammatory Chronic Skin Diseases

Aryl Hydrocarbon Receptor (AhR) is an evolutionary transcription factor which acts as a crucial sensor of different exogenous and endogenous molecules Recent data indicate that AhR is implicated in several physiological processes such as cell physiology, host defense, proliferation and differentiation of immune cells, and detoxification. Moreover, AhR involvement has been reported in the development and maintenance of several pathological conditions. In recent years, an increasing number of studies have accumulated highlighting the regulatory role of AhR in the physiology of the skin. However, there is evidence of both beneficial and harmful effects of AHR signaling. At present, most of the evidence concerns inflammatory skin diseases, in particular atopic dermatitis, psoriasis, acne, and hidradenitis suppurativa. This review examines the role of AhR in skin homeostasis and the therapeutic implication of its pharmacological modulation in these cutaneous inflammatory diseases.