Development and Validation of a Clinical Scale for the Evaluation of Forearm Skin Photoaging

Background: Despite the focus on facial photoaging ratings, there are few classifications developed for forearm skin aging assessment.Objective: To develop and validate a clinical scale for the evaluation of forearm skin aging.Methods: Three clinical dermatology faculty members selected, discussed, and appraised the main signs of forearm photoaging. The validation of the resulting scale was performed by 5 assessors who were previously trained to classify 102 photographs of forearms with different degrees of aging. Retests were performed in 15 days.Results: There was significant correlation between the selected variables and the subjective global aging scale. The developed scale showed high internal consistency (Cronbach's alpha = 0.87) and high correlation with the global photoaging scale (rho = 0.92). Inter- and intraobserver final scores showed high agreement.Conclusion: A validated clinical photoaging scale for forearms with internal consistency, reliability, and validity was developed.

Gene and protein expression of oestrogen-beta and progesterone receptors in facial melasma and adjacent healthy skin in women

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antiageing mechanisms of a standardized supercritical CO2 preparation of Black Jack (Bidens pilosa L.) in human fibroblasts and skin fragments

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Structural characterization and in vitro antioxidant activity of kojic dipalmitate loaded W/O/W multiple emulsions intended for skin disorders

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of the morphine-lidocaine-ketamine combination on cardiopulmonary function and isoflurane sparing in sheep

The aims of this study were to evaluate the isoflurane sparing and clinical effects of a constant rate infusion of morphine - lidocaine - ketamine (MLK) in healthy sheep undergoing experimental gastrointestinal surgery. Twelve adult female sheep (Texel breed) were used, weighing 36.5 +/- 8.1 kg. The sheep were anesthetized for the implantation of duodenal cannulas. The sheep were premedicated with 0.3 mg kg(-1) intramuscular (IM) morphine and 20 mu g kg(-1) intravenous (IV) detomidine. After premedication, anesthesia was induced using 5 mg kg(-1) ketamine and 0.5 mg kg(-1) diazepam IV and maintained using isoflurane in 100% oxygen. After the induction of anesthesia, the animals were allocated into two groups (each n=6); the GMLK (MLK group - 10 mg morphine, 150 mg lidocaine, 30 mg de ketamine were added in 500 mL saline) received a 10 mL kg(-1)h(-1) MLK infusion during the maintenance of anesthesia, and GCON (control group) received 10 mL kg(-1)h(-1) of 0.9% sodium chloride. The animals were mechanically ventilated. Cardiopulmonary variables and end-tidal isoflurane concentration (FE'Iso) were measured at baseline (immediately before the surgery) and 15, 30 and 45 minutes after initiation of surgery. In GMLK, there was a decrease in the FE 'Iso at 15, 30 and 45 minutes, a reduction of up to 75.6% during the surgery. The HR was lower in GMLK compared with GCON at 30 minutes, and the MAP was at during baseline in GCON compared with GMLK. The standing time was less in GMLK than in GCON. The use of intravenous MLK was demonstrated to offer great efficiency as part of a balanced anesthesia protocol in sheep, with a 75.6% reduction in the need for isoflurane, providing stability of the cardiovascular parameters and blood gases with a shortened recovery period.

Nephron-sparing surgery for treatment of reninoma: a rare renin secreting tumor causing secondary hypertension

A 25-year-old hypertensive female patient was referred to our institution. Initial workup exams demonstrated a 2.8 cm cortical lower pole tumor in the right kidney. She underwent laparoscopic partial nephrectomy without complications. Histopathologic examination revealed a rare juxtaglomerular cell tumor known as reninoma. After surgery, she recovered uneventfully and all medications were withdrawn. Case hypothesis: Secondary arterial hypertension is a matter of great interest to urologists and nephrologists. Renovascular hypertension, primary hyperadosteronism and pheocromocytoma are potential diagnosis that must not be forgotten and should be excluded. Although rare, chronic pyelonephritis and renal tumors as rennin-producing tumors, nephroblastoma, hypernephroma, and renal cell carcinoma might also induce hypertension and should be in the diagnostic list of clinicians. Promising future implications: Approximately 5% of patients with high blood pressure have specific causes and medical investigation may usually identify such patients. Furthermore, these patients can be successfully treated and cured, most times by minimally invasive techniques. This interesting case might expand knowledge of physicians and aid better diagnostic care in future medical practice.

Assessment of ALA-induced PpIX production in porcine skin pretreated with microneedles

Photodynamic therapy (PDT) is used for skin treatments of premalignant and cancer lesions and recognized as a non-invasive technique that combines tissue photosensitization and subsequent exposure to light to induce cell death. However, it is limited to the treatment of superficial lesions, mainly due to the low cream penetration. Therefore, the improvement of transdermal distribution of aminolevulinic acid (ALA) is needed. In this study, the kinetics and homogeneity of production of ALA-induced PpIX after the skin pre-treatment with microneedles rollers of 0.5, 1.0 and 1.5 mm length were investigated. An improvement in homogeneity and production of PpIX was shown in a porcine model. Widefield fluorescence imaging three hours after the topical application of ALA-cream in the combined treatment with microeedles rollers.

Anuran skin and basking behavior: the case of the treefrog Bokermannohyla alvarengai (Bokermann, 1956)

We investigated the morphology of the skin and the biochemistry of the lipids in the skin secretion of Bokermannohyla alvarengai, a montane treefrog that is known to bask regularly, motionless in full sunlight for extended periods of time. Our primary goal was to identify structural and biochemical modifications that might assist this frog species to accommodate the conflicting demands for heat exchange and water balance while basking. The modulation of heat exchange in basking B. alvarengai involves changes in skin coloration. We found that this response was supported by a prominent monolayer of large iridophores, whose light reflectance property is adjusted by the response of intervening melanophores. Mucosubstances and lipid compounds, mainly consisted of saturated fatty acids and presumably secreted from granular glands, were detected on the skin of B. alvarengai. These compounds formed an extra-epidermal layer over the animal's dorsal surface that might assist in the prevention of excessive water loss through evaporation. Additionally, we found well-developed skin folds at the ventral region of the frogs that lead to an increment of surface area. This feature combined with the extensive hypervascularization, also noticed for the skin of B. alvarengai, may play an important role in water reabsorption. The suite of structural and biochemical modifications identified for the integument of B. alvarengai seems to conjugate aspects relevant to both, heat exchange and water balance, allowing for this species to explore basking as an efficient thermoregulatory strategy. J. Morphol. 276:1172-1182, 2015. © 2015 Wiley Periodicals, Inc.

Does spinal block through tattooed skin cause histological changes in nervous tissue and meninges?: an experimental model in rabbits

Although there is no documented evidence that tattoo pigments can cause neurological complications, the implications of performing neuraxial anesthesia through tattooed skin are unknown. In this study, we aimed to assess whether spinal puncture performed through tattooed skin of rabbits determines changes over the spinal cord and meninges. In addition, we sought to evaluate the presence of ink fragments entrapped in spinal needles. Thirty-six young male adult rabbits, each weighing between 3400 and 3900 g and having a spine length between 38.5 and 39 cm, were divided by lot into 3 groups as follows: GI, spinal puncture through tattooed skin; GII, spinal puncture through tattooed skin and saline injection; and GIII, spinal puncture through skin free of tattoo and saline injection. After intravenous anesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance with a 22-gauge 2½ Quincke needle. Animals in GII and GIII received 5 μL/cm of spinal length (0.2 mL) of saline intrathecally. In GI, the needle tip was placed into the yellow ligament, and no solution was injected into the intrathecal space; after tattooed skin puncture, 1 mL of saline was injected through the needle over a histological slide to prepare a smear that was dyed by the Giemsa method to enable tissue identification if present. All animals remained in captivity for 21 days under medical observation and were killed by decapitation. The lumbosacral spinal cord portion was removed for histological analysis using hematoxylin-eosin stain. None of the animals had impaired motor function or decreased nociception during the period of clinical observation. None of the animals from the control group (GIII) showed signs of injuries to meninges. In GII, however, 4 animals presented with signs of meningeal injury. The main histological changes observed were focal areas of perivascular lymphoplasmacyte infiltration in the pia mater and arachnoid. There was no signal of injury in neural tissue in any animal of both groups. Tissue coring containing ink pigments was noted in all GI smears from the spinal needles used to puncture the tattooed skin. On the basis of the present results, intrathecal injection of saline through a needle inserted through tattooed skin is capable of producing histological changes over the meninges of rabbits. Ink fragments were entrapped inside the spinal needles, despite the presence of a stylet.

Development and in vitro skin delivery of dexamethasone acetate-loaded surfactant-based systems

Topical corticosteroids, e.g., dexamethasone acetate (DMA), are extensively used to treat cutaneous inflammatory disorders even though their use is correlated with potential local and systemic side effects. The objective of this study was to develop and test the topical delivery of DMA-loaded surfactant based systems in vitro; these studies could guarantee a suitable delivery and therapeutic efficacy, as well as minimize DMA's side effects. A phase diagram was constructed using polyoxypropylene (5) polyoxyethylene (20) cetyl alcohol as the surfactant (S), isopropyl myristate as the oil phase (O) and water (W). The systems were characterized using polarization light microscopy (PLM), as well as rheological and small angle X-ray scattering (SAXS) measurements. Depending on the concentration of the constituents, it was possible to obtain microemulsions (MEs) and liquid crystalline mesophases (lamellar and hexagonal). These types of arrangement were verified using PLM measurements. The SAXS results revealed that increasing the W/S ratio led to ME, as well as lamellar (LAM) and hexagonal (HEX) arrangements. The MEs displayed typical Newtonian behavior while the LAM and HEX phases exhibited pseudoplasticity and plasticity, respectively. The MEs displayed excellent drug solubilization that was approximately 10-fold higher than was observed with the individual components. The in vitro cutaneous permeation studies using pig ear skin and analysis of the mechanical parameters (hardness, compressibility, cohesiveness and adhesiveness) were carried out with a HEX phase and O/W emulsion. The HEX phase achieved better drug permeation and retention in the skin while its mechanical properties were suitable for skin administration. PPG-5-CETETH-20-based systems may be a promising platform delivering DMA and other topical corticosteroids through the skin.

Surfactant-based transdermal system for fluconazole skin delivery

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tuberculin Skin Testing in White-Tailed Deer (Odocoileus virginianus)

The comparative cervical skin test for antemortem diagnosis of tuberculosis was done 169 times on 116 different white-tailed deer of known Mycobacterium bovis infection status. The sensitivity and specificity were 97 and 81%, respectively. The magnitude of change in skin thickness at test sites was not significantly influenced by dosage of inoculum, dissemination of the disease process, or repeated skin testing. However, the magnitude of change in skin thickness was significantly greater in deer infected for less than 109 days than in deer infected for more than 109 days. As used in the present study, the comparative cervical skin test is a sensitive method of antemortem diagnosis of M. bovis infection in white-tailed deer.

Skin lesions on blue whales off southern Chile: Possible conservation implications?

We report on three types of skin lesions in a population of blue whales, Balaenoptera musculus, off the northwestern coast of Isla Grande de Chiloe, Chile. These lesions were: (1) cookie-cutter shark, Isistius brasilensis, bites, (2) vesicular or blister lesions, and (3) a tattoo-like skin disease. The presence of these lesions was determined by the examining photos collected in 2006 and 2007 for a blue whale photo-identification project. We examined 289 photographs of 68 individuals for lesions. The cookie-cutter shark lesions are common on these blue whales and similar to those reported from other species of cetaceans. Skin peeling or shedding was observed on some whales and is believed to be a normal condition. Based on the photographs examined to date the vesicular lesions are more common than the tattoo-like lesions. The tattoo-like skin lesions was observed just on a single whale in 2007. The blister lesions were common on whales in both 2006 and 2007. The presence of blister lesions in both years may indicate that this “disease” will be present in the population for a long time. It is unknown if these lesions contribute to mortality of blue whales frequenting Chilean waters, but the tattoo-like skin lesions if shown to be a pox virus could cause neonatal and calf mortality. Additional investigations are needed that, as a minimum, must include the histological and genetic examination of the two types of disease from live or dead whales, especially the tattoo-like skin lesions. Until this work is undertaken, it will be impossible to determine if these lesions pose a conservation risk to the blue whales off Chile.