skin-care-3.matches: skin care
Facial resurfacing in patients with Fitzpatrick skin type IV.

Sriprachya-anunt S, Marchell NL, Fitzpatrick RE, Goldman MP, Rostan EF.

Pornkasem Skin and Laser Center, Bangkok, Thailand.

BACKGROUND AND OBJECTIVES: Though post-inflammatory hyperpigmentation (PIH) is probably the most common complication of laser resurfacing and appears to correlate directly with the intensity of the patient's natural pigmentation, there is very little data that specifically addresses the risks of dyspigmentation in more darkly pigmented patients (Fitzpatrick skin types IV and above). The objective of this study was to evaluate the long-term dyspigmentation of patients with skin type IV having radial laser resurfacing. STUDY DESIGN/MATERIALS AND METHODS: A retrospective review of the clinical efficacy, incidence of dyspigmentation and other adverse effects, as well as the pre/post-operative protocol of 22 patients with Fitzpatrick skin type IV who were a minimum of 1 year post-operative following facial laser resurfacing. RESULTS: The average patient achieved greater than 50% improvement, indicating adequate treatment being delivered. PIH occurred in 68% of patients, starting 1 month post-operative and lasting 3.8 months. There was no correlation to pre-treatment or type of laser used as far as incidence of PIH. True hypopigmentation was not seen in this group of 22 patients. CONCLUSIONS: PIH is the most common complication of facial resurfacing in patients with skin type IV. It is not preventable by choice of laser or skin care regimen pre-operative, but appears to respond to appropriate treatment once it has developed. Copyright 2002 Wiley-Liss, Inc.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11870786&dopt=Abstract skin, skin care, skin care medicine skin-care-1.matches: skin care
Nanoemulsions: a new vehicle for skincare products.

Sonneville-Aubrun O, Simonnet JT, L'Alloret F.

Cenal d Chevilly, 94152 Chevilly-Larue, France. oaubrun rd.loreal.com

Nanoemulsions consist in very fine oil-in-water dispersions, having droplet diameter smaller than 100 nm. Compared to microemulsions, they are in a metastable state, and their structure depends on the history of the system. In the present work, nanoemulsions were prepared with a high shear device, which is less constraining than spontaneous emulsification procedures. Nanoemulsions are very fragile systems by nature. As they are transparent, the slightest sign of destabilisation appears visually. Two major sources of unstability were identified and extensively studied: Ostwald ripening and depletion induced floculation following the addition of thickening polymers. The control of these two mechanisms allowed the industrial production of a large variety of cosmetic products, from water-like fluids, to ringing gels obtained by increasing the oil phase content or by adding polymers. The nanoemulsions are easily valued in skin care due to their good sensorial properties (rapid penetration, merging textures) and their biophysical properties (especially their hydrating power).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15072937&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Cataract and retinal detachment in patients with severe atopic dermatitis who were withdrawn from the use of topical corticosteroid.

Taniguchi H, Ohki O, Yokozeki H, Katayama I, Tanaka A, Kiyosawa M, Nishioka K.

Department of Dermatology, Tokyo Medical and Dental University School of Medicine, Japan.

Many patients with severe atopic dermatitis (AD) in Japan are afflicted with persistent erythema of the face (atopic red face) that is not only resistant to topical corticosteroid, but often becomes worse with its use. During a three-year period (1991-1993), we treated 79 inpatients with severe AD by a combination of careful daily skin care, use of emollients, and exclusion of exacerbating factors. Occular complications before and after treatment were examined in these cases. After withdrawal of topical corticosteroid, almost all of the patients showed a temporary worsening of their skin condition. Immediately thereafter, their occular symptoms did not change. Cataract was found in 20 cases (25.3%), and retinal detachment in 9 (11.4%). After 2 months, 11 cases of cataract and 5 cases of retinal detachment in the peripheral retina were observed. However, these incidences were similar to the numbers reported in Japan during conventional treatment with topical corticosteroid. The development of cataract or retinal detachment had no relationship to serum IgE levels, personal history of respiratory atopy, the duration of topical corticosteroid use on the face, or treatment with systemic corticosteroid. Our observations suggest that patients who habitually tap or rub their faces strongly tend to develop cataract or retinal detachment at a statistically significant higher frequency. Patients with AD should have ophthalmologic examinations every one to two months for at least one year after a facial oozing attack or withdrawal of corticosteroid.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10554432&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Neck rejuvenation by combining Jessner/TCA peel, dermasanding, and CO2 laser resurfacing.

Fulton JE, Rahimi AD, Helton P, Dahlberg K.

Fulton Skin Institute, Newport Beach, California, USA.

BACKGROUND: One of the greatest challenges facing facial cosmetic surgeons today is the simultaneous rejuvenation of the neck and face. Laser resurfacing of the face using the carbon dioxide (CO2) laser or the erbium:yttrium-aluminum-garnet (Er:YAG) laser has enjoyed widespread popularity, but the neck and chest are often avoided. It would be quite helpful to rejuvenate the neck at the same time the face is being resurfaced. This would diminish lines of demarcation and help reduce the signs of aging of the neck. There would be a better match between the new skin of the neck and face. OBJECTIVE: To develop a safe and effective method to rejuvenate the neck. METHOD: A step-by-step skin care program was instituted. The patients preconditioned their face and neck skin with vitamin A/glycolic skin conditioning lotions for 6-8 weeks prior to surgery. Following this the chest and neck area was treated with the Jessner-trichloroacetic acid (TCA) peel. Then the middle section of the neck was sanded with 150 grit sandscreen. Finally, the central area was resurfaced with the UltraPulse CO2 laser using reduced power settings. Usually two passes was adequate to shrink the skin of this central section of the neck. A petrolatum-based ointment was applied during the initial 7-day postoperative period. After reepithelialization a sunscreen-moisturizer was used during the day and hydrocortisone moisturizer was applied at night. RESULTS: The neck skin was able to tolerate this step-by-step skin rejuvenation. The blending from the decollete area to the hairline produced a rejuvenation without a line of demarcation. There were no examples of scarring in the 12 cases that were evaluated for 6 months. Two cases developed persistent erythema that responded to silicone gel sheeting. Although no patients complained of hypopigmentation, a decrease in pigment was found using special UV photography. CONCLUSION: It is possible with this gradient, step-by-step method to produce a rejuvenation of the neck. An improved texture of the neck developed without visible scarring.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10594574&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
'Eczema school' to improve compliance in an occupational dermatology clinic.

Kalimo K, Kautiainen H, Niskanen T, Niemi L.

Department of Dermatology, Turku University Central Hospital, Finland.

From the beginning of 1990 a trained nurse has been employed at our Department of Dermatology to give information about skin care, allergen avoidance and skin protection to the patients. To find out the possible benefit obtained by this patient education, a questionnaire was sent out to 540 patients who had been diagnosed with an occupational skin disease established at the Department of Dermatology between 1985 and 1992. It is evident that direct comparison in this kind of longitudinal follow-up must be carried out with great criticism, since changes in patients' work exposure and socioeconomical situation during the follow-up time will also affect the prognosis. In this study, 424 patients returned the questionnaire, 252 who had been examined before 1990 and 172 later. According to the answers, it appeared that during the last 12 months, the majority (65%) had suffered from dermatitis, 13% from constant and 52% from periodic symptoms. However, when the diagnosis had been irritant contact dermatitis without allergens found, the prognosis was significantly better (p<0.008) among those who had received "extra education" and none had persistent dermatitis. Patients with contact allergy to metals or synthetic resins had also managed better, as compared to those who had received traditional treatment (p<0.002, p<0.003). Other factors such as personal motivation and possibilities for work reorganization were also important for the prognosis. 60% of patients were not initially aware of the decision given by the insurance companies, although 94% of their skin diseases had been accepted as occupational dermatoses. Generally, the patients were satisfied with the extra information given by the nurse.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10617211&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Polymorphous light eruption: A clinical, photobiologic, and follow-up study of 110 patients.

Boonstra HE, van Weelden H, Toonstra J, van Vloten WA.

Department of Dermatology, University Hospital Utrecht, The Netherlands.

BACKGROUND: Polymorphous light eruption is a common chronic idiopathic photodermatosis. The action spectrum and therapy are under debate. OBJECTIVE: The aim of the study was to analyze the clinical aspects of this dermatosis, the photodiagnostic tests, and the results of therapy in an academic center. METHODS: To obtain a reasonable follow-up period, we examined all available data of the patients who underwent diagnostic phototests in the period 1985 through 1991. Our procedure of phototesting included determination of minimal erythema doses, photoprovocation tests, and photopatch tests. The evaluation of the effect of the therapy was based on the patients' experiences, time spent outdoors, and amount of sun exposure. RESULTS: Our collection included data on 35 men and 75 women. The age at onset differed significantly between men and women (averages 46 and 28 years, respectively; P <.01). The minimal erythema doses for UVB were lowered in 43% of the men and in 4% of the women (P <.01); the minimal erythema doses for UVA were lowered in 37% of the men and in 11% of the women (P <.01). The photoprovocation tests showed a pathologic reaction to both UVB and UVA in 88% of the men and in 52% of the women (P <.01). In the remaining patients we found pathologic reactions to UVB alone (for men 9%, for women 24%; P >.05) or UVA alone (for men 3%, for women 24%; P <.01). The abnormal reactions to visible light were almost exclusively observed in those patients who reacted pathologically to both UVB and UVA (43% of the male patients, 11% of the female patients; P <.01). The photopatch tests showed a large number of positive test results, mainly to skin care products or sunscreens (75% of all patients). The 70 most sensitive patients (64%) were treated with prophylactic UVB therapy 2 or 3 times a week at home or initially in the outpatient department. This treatment was normally done from February to June, but in severe cases throughout the whole year. CONCLUSION: Phototests revealed abnormal reactions to UVB as well as UVA and to some extent also to visible light. Prophylactic UVB therapy is a successful treatment for polymorphous light eruption.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10642673&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Skin care management practices for premature infants.

Baker SF, Smith BJ, Donohue PK, Gleason CA.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

OBJECTIVE: To describe current skin care practices for preterm infants in neonatal intensive care units in the United States. We hypothesized that there would be little consensus among facilities. STUDY DESIGN: Neonatal intensive care units (n = 823) listed in the 1996 United States Neonatologists Directory (American Academy of Pediatrics, Section on Perinatal Pediatrics) were sent a 28-question survey dealing with many aspects of neonatal skin care along with descriptive data about their neonatal intensive care unit. Descriptive data analysis was performed. RESULTS: A total of 305 surveys were returned (37% return rate); of these, 241 of the respondents reported admitting infants weighing < or = 1000 gm. Some neonatal skin care practices showed wide consensus (> 70%) (e.g., scrub procedure for staff; use of a skin barrier under tapes/adhesives), whereas other practices showed little consensus (< 30%) (e.g., routine surveillance cultures; use of Aquaphor). CONCLUSION: Consensus on skin care practices was not found among neonatal intensive care units. Data from this survey can be used to develop studies to examine whether certain skin care management practices can improve neonatal outcomes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10685272&dopt=Abstract skin, skin care, skin care medicine