Effect of haemodialysis on acoustic shear wave propagation in the skin.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2004), 209(2), 95-100

BACKGROUND: Diverse skin alterations may develop in patients under chronic haemodialysis. Among them, signs of premature photo-ageing have been described. AIM: To assess alterations in the physical ... [more ▼]

BACKGROUND: Diverse skin alterations may develop in patients under chronic haemodialysis. Among them, signs of premature photo-ageing have been described. AIM: To assess alterations in the physical properties of skin consistent with ageing effects and with cutaneous fluid exchanges during haemodialysis sessions. METHODS: In the first part of the study, 45 haemodialysed patients were compared to 45 age-, sex- and body-mass-index-matched healthy subjects. In the second part of the study, skin of 30 haemodialysed patients was assessed immediately before and after a haemodialysis session. The speed of ultrasound shear wave propagation was measured in each subject. Series of 16 multidirectional resonance running time measurements (RRTM) were performed on the forehead and/or the volar forearm. They were averaged for each subject. The corresponding intra-individual coefficients of variation were calculated as an estimate of the skin mechanical anisotropy. RESULTS: In both haemodialysed patients and their matched controls, RRTM values were significantly higher on the forearms than on the forehead. By contrast, no significant difference was found in RRTM values that could be ascribed to chronic haemodialysis. However, RRTM values were significantly increased as an immediate and probably transient effect of haemodialysis sessions. In healthy subjects, ageing was associated with increased RRTM values. CONCLUSION: Chronic haemodialysis does not appear to influence significantly the functional expression of the dermal ageing process. Subtle fluid movements occurring in the skin during haemodialysis sessions can be assessed by measuring non-invasively the speed of ultrasound shear wave propagation in the skin. [less ▲]

Ultraviolet light-enhanced visualization of cutaneous signs of carotene and vitamin A dietary deficiency.

in Acta Clinica Belgica (2004), 59(2), 97-101

Dietary deficiencies are multiple and some of them may induce specific changes in the skin biology and structure. Vitamin A deficiency is well identified as a cause of xerosis and follicular keratosis ... [more ▼]

Dietary deficiencies are multiple and some of them may induce specific changes in the skin biology and structure. Vitamin A deficiency is well identified as a cause of xerosis and follicular keratosis. Skin of the forehead and balding scalp was examined in 3 homeless alcoholic men who suffered from altered liver functions and denutrition including carotene and vitamin A deficiencies. The ultraviolet light-enhanced visualization (ULEV) method was used with a computer-assisted video camera equipped with an internal ultraviolet-emitting unit. Twenty healthy age- and phototype-matched men served as controls. Subclinical alterations of the stratum corneum and tiny follicular horny spikes at the skin surface were disclosed by ULEV. They were consistent with discrete flakiness on the forearms. By contrast, skin of the face and scalp showed follicular horny impactions corresponding to kerosis without any evidence for interfollicular xerosis. The skin condition was markedly improved after a 10-week dietary normalization. It is concluded that the ULEV method reveals some of the mildest and subclinical skin changes secondary to carotene and vitamin A deficiency. It could tentatively be used as a cheap and non-invasive aid in clinical screening programs among populations at risk. [less ▲]

EEMCO guidance for the assessment of hair shedding and alopecia.

in Skin Pharmacology & Physiology (2004), 17(2), 98-110

Knowledge of the hair follicle anatomy and the dynamics of hair cycling is substantial. Recognizing the anagen, catagen and telogen phases as well as teloptosis and the hair eclipse phenomenon clearly ... [more ▼]

Knowledge of the hair follicle anatomy and the dynamics of hair cycling is substantial. Recognizing the anagen, catagen and telogen phases as well as teloptosis and the hair eclipse phenomenon clearly characterizes the typical hair chronobiology. Physiological modulators include hormones, neuromediators, miscellaneous biomolecules, seasons, micro-inflammation and ageing. For individuals who present with the complaint of increased hair shedding or alopecia, a host of evaluation techniques are available in addition to history, physical examination and laboratory assessment. Various clinical hair techniques can help in assessing the efficacy of drugs and cosmetics on hair growth. The methods are quite similar to those used to establish a definite diagnosis in dermatological practice. Great strides have been made during the recent decades in the methodology of hair growth trials in dermatology and cosmetology. Clinical evaluations benefit from a few additional specific techniques that enhance the perception of hair (re-) growth, shedding and alopecia. These assessments include the determination of hair patterning and density that may be helped by the 'black-and-white felt' examination. Daily hair counts, the 'hair pull test' and the 'hair feathering test' are also available. Instrumental methods provide reliable quantitative information that is useful if there are adequate controls. Some photographic methods, the trichogram, hair weighing and variants of the hair growth window technique including the phototrichogram, videotrichogram and tractio-phototrichogram provide insight into the complexities of hair cycling and shedding. Skin biopsy is indicated for diagnostic purposes, especially when the hair loss is accompanied by scarring. [less ▲]

Itraconazole corneofungimetry bioassay on Malassezia species.

in Mycoses (2004), 47(9-10), 418-21

Yeasts of the genus Malassezia are part of the normal skin biocenosis and are involved in a series of distinct skin disorders and specific dermatomycoses in man and animals. Several species are currently ... [more ▼]

Yeasts of the genus Malassezia are part of the normal skin biocenosis and are involved in a series of distinct skin disorders and specific dermatomycoses in man and animals. Several species are currently distinguished. Their relative in vitro susceptibility to antifungals appears different according to the species and to the nature and route of administration of the drug. Corneofungimetry is an ex vivo bioassay allowing to test the fungal response on human stratum corneum following oral intake of a given antifungal by volunteers. Two series of cyanoacrylate skin surface strippings (CSSS) were harvested from the volar forearm of 30 volunteers before and after a 2-week treatment with itraconazole 200 mg daily. They were coated by olive oil and inoculated with suspensions of seven different Malassezia spp. After a 1-week culture on CSSS, the amount of viable yeasts was assessed using neutral red staining assisted by computerized image analysis. Growth of the seven species was not similar on the CSSS from untreated stratum corneum. The ranking order from the most proliferative to the least was M. restricta, M. sympodialis, M. globosa, M. furfur, M. obtusa, M. slooffiae and M. pachydermatis. Their growth was abated to almost the same level after itraconazole treatment. It is concluded that in vivo treatment with itraconazole is highly active against all Malassezia spp. colonizing the human stratum corneum. [less ▲]

Reactions paroxystiques du cuir chevelu.

in Revue Médicale de Liège (2004), 59(4), 180-5

The scalp is a unique site of the human body that may exhibit some particular physiopathological reactions. A few manifestations are paroxysmal. The main ones are the acute pruritus of pediculosis, and ... [more ▼]

The scalp is a unique site of the human body that may exhibit some particular physiopathological reactions. A few manifestations are paroxysmal. The main ones are the acute pruritus of pediculosis, and the pruritus at onset of dandruff or seborrhoeic dermatitis. One must add the telogen effuvium after solar exposure or during the post-partum, and the anagen dystrophic alopecia following chemotherapy. Other paroxysmal events include acute canitia and alopecia areata. [less ▲]

Histometric assessment of psoriatic plaques treated by vitamin D3 derivatives.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 366-9

BACKGROUND: Psoriasis is an immunogenetic disorder. Factor XIIIa+ dermal dendrocytes (DD) are part of the pathobiological changes in the plaque type of the disease. OBJECTIVE: The present study aimed at ... [more ▼]

BACKGROUND: Psoriasis is an immunogenetic disorder. Factor XIIIa+ dermal dendrocytes (DD) are part of the pathobiological changes in the plaque type of the disease. OBJECTIVE: The present study aimed at comparing the effect of 3 vitamin D(3) derivatives on the epidermis, microvasculature and DD in psoriasis. METHOD: Twenty men suffering from chronic plaques of psoriasis on the trunk were enrolled in this study. They applied twice a day for 3 weeks calcipotriol, tacalcitol and calcitriol, each to one plaque. Another similar lesion received petrolatum as a placebo treatment. Skin biopsies were taken at entry and at completion of the 3-week treatment phase. Immunohistochemistry was performed using the lectin of Ulex europaeus and an antibody to factor XIIIa. Computerized image analysis served to measure the stratum Malpighii area, the microvasculature area and the DD numerical density in the papillary dermis. RESULTS: At entry in the study, the 4 test sites were indistinguishable with regard to the stratum Malpighii area, the papillary microvasculature area and the papillary DD density. The 3 histometric parameters appeared correlated with each other. At completion of the 3-week treatment phase, the 3 vitamin D derivatives had decreased the size of the stratum Malpighii. In addition, calcitriol had also reduced the DD density in the papillary dermis. No other significant changes were yielded. CONCLUSION: As assessed by histometry, the psoriatic epidermis responded to a short treatment using the 3 vitamin D derivatives. The better result compared to the control site was achieved by calcitriol. DD appeared to be most controlled by the same drug. The microvasculature did not appear to be decreased at the 3-week time point in treatment. [less ▲]

Le médicament du mois Le voriconazole (Vfend).

in Revue Médicale de Liège (2003), 58(5), 351-5

Invasive fungal infections are a rare but important cause of morbidity and mortality among patients with severely compromised host defenses. Despite considerable advances in antifungal therapies over the ... [more ▼]

Invasive fungal infections are a rare but important cause of morbidity and mortality among patients with severely compromised host defenses. Despite considerable advances in antifungal therapies over the past years, invasive mycoses remain a stubborn and dramatic problem. Voriconazole is a new triazole antifungal agent which confers a relative survival benefit in fluconazole-resistant invasive candidiasis, and in invasive aspergillosis, fusariosis and Scedosporium infections as well. [less ▲]

Le pimecrolimus topique (Elidel).

in Revue Médicale de Liège (2003), 58(3), 168-71

Pimecrolimus inhibits some specific steps of the Th1 and Th2 immune reactions. It belongs to the class of ascomycin macrolactams. The topical drug formulation targets cutaneous inflammation, more ... [more ▼]

Pimecrolimus inhibits some specific steps of the Th1 and Th2 immune reactions. It belongs to the class of ascomycin macrolactams. The topical drug formulation targets cutaneous inflammation, more particularly lymphocytes and mast cells without impairing systemic immunosurveillance. Topical applications are indicated for treating atopic dermatitis. In this indication, it represents an alternative or an adjuvant drug to topical corticosteroids. The treatment of other dermatoses could also benefit from pimecrolimus. [less ▲]

Deciphering the impaired cytokine cascades in chronic leg ulcers (review).

in International Journal of Molecular Medicine (2003), 11(4), 411-8

Chronic leg ulcers are typically wounds that do not heal at a normal rate. Impaired healing appears to be due to primary microvascular changes and it is aggravated by ongoing bacteria-driven vasculitis ... [more ▼]

Chronic leg ulcers are typically wounds that do not heal at a normal rate. Impaired healing appears to be due to primary microvascular changes and it is aggravated by ongoing bacteria-driven vasculitis. The various cytokines identified in experimental wounds are also present in leg ulcers. VEGF is strongly implicated as a promoter of blood vessel growth in patients with venous disease. In addition, there is good evidence of increased expression of bFGF, TGF-beta1, and PDGF in lipodermatosclerosis. All of these growth factors are involved in wound healing. Upregulated TGF-beta1 is probably one of the main causes of the fibrosis observed in lipodermatosclerosis. In leg ulcers, cytokines appear to be trapped in the perivascular fibrinoid deposits. It is not the nature and amount of cytokines that are inadequate in leg ulcers, but rather their spatial distribution. Dermal dendrocytes (DD) are resident factor XIIIa-enriched macrophages. They likely play a role in tissue repair when boosted adequately. New therapies aiming at helping the release of cytokines by DD apparently promote and improve the healing phase. [less ▲]

Incidental control of rosacea by somatostatin.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(3), 249-51

BACKGROUND: The precise pathomechanism of rosacea remains elusive. The disease commonly requires long-term treatments using topical or oral therapies. OBJECTIVE: This report presents incidental findings ... [more ▼]

BACKGROUND: The precise pathomechanism of rosacea remains elusive. The disease commonly requires long-term treatments using topical or oral therapies. OBJECTIVE: This report presents incidental findings about the possible modulatory role of somatostatin in the outcome of rosacea. METHOD: Four patients presenting long-standing recalcitrant facial rosacea were treated with octreotide for diabetic retinopathy. RESULTS: Rosacea improved rapidly and even cleared without any recurrence in 3 of the patients. CONCLUSION: The beneficial effect might be attributed to inhibitory actions on the sebaceous gland, the neovascularization and/or on the inflammatory process. [less ▲]