Claudio Castillo-Martínez

Noninvasive detection of filaggrin gene mutations using Raman spectroscopy

Knowledge of the existence of filaggrin (FLG) gene mutations might be helpful for a subclassification of patients with atopic dermatitis (AD) which can be used to introduce individualized treatments. In this work the filaggrin content in the skin is assessed using Raman spectroscopy and the results are compared to FLG genotyping of Mexican-mestizo patients. Results showed that the 2282del4 and R501X mutations present in the European population but absent in people of Asian or African descent are also present in the Mexican-mestizo population. The results also showed that patients with filaggrin gene mutations presented lower filaggrin concentrations measured using the vector correlation of their skin Raman spectra and a fixed spectrum of pure human recombinant filaggrin, these results indicate that Raman spectroscopy may be used as a noninvasive tool to detect FLG gene mutations.

The sticky platelet syndrome

Abstract The sticky platelets syndrome (SPS) is a procoagulant condition based on either arterial, venous, or capillary thrombi caused by hyperesponsive and hyperaggregable platelets. This is a frequent disease, which often remains clinically inapparent, until stressful events or combination with other factors increase the risk of developing SPS. The condition is due to a congenital platelet defect with autosomal dominant characteristics, leading to the increased platelet aggregability when they are challenged with epinephrine and adenosine diphosphate. Nowadays classification of this disorder is based on platelet reactivity to both ADP and epinephrine (SPS type 1), epinephrine alone (SPS type 2), and ADP alone (SPS type 3). The diagnoses of the syndrome depend on the functional aggregometer assay. This condition should be taken into account whenever a patient with thrombophilia is considered.

Use of Raman spectroscopy in the analysis of nickel allergy

Abstract. Raman spectra of the skin of subjects with nickel allergy are analyzed and compared to the spectra of healthy subjects to detect possible biochemical differences in the structure of the skin that could help diagnose metal allergies in a noninvasive manner. Results show differences between the two groups of Raman spectra. These spectral differences can be classified using principal component analysis. Based on these findings, a novel computational technique to make a fast evaluation and classification of the Raman spectra of the skin is presented and proposed as a noninvasive technique for the detection of nickel allergy.

Noninvasive estimation of chronological and photoinduced skin damage using Raman spectroscopy and principal component analysis.

Skin aging can be attributed to endogenous and exogenous factors which modify the hydration and protein structure of the skin which can be measured using Raman spectroscopy.

Use of digital infrared imaging in the assessment of childhood psoriasis.

a chronic autoimmune diseasethat occurs when the immune system sendsout faulty signals that speed up the growthcycle of skin cells. It is well recognized that pso-riasis may have a markedly deleterious effecton the patient’s quality of life, with the physi-cal, social and psychological impact comparableto that seen in heart disease, diabetes mellitusand cancer (1). Psoriasis can affect children,approximately one-third of psoriasis patientsreport being diagnosed before being 20 yearsold (2). Self-esteem and behavior can be affectedby the disease and bullying has also been notedin clinical research (3).A wide variety of scoring systems have beenproposed to assess the severity of psoriasis;however, despite the importance of the evalua-tion of psoriasis there is a lack of consensus onthe most appropriate scoring system (4).The PASI (Psoriasis Area Severity Index)score is the most extensively studied clinicalseverity score for psoriasis and the most thor-oughly validated (4).In childhood and adolescence, the presence ofpsoriasis is associated with weight fluctuationsand an increased BMI, with poor cardiovascularprognosis (5). For this reason, it is difficult toassess the PASI, because the body surface area inchildhood and adolescence has larger variationsin short periods of time than the average adult.In this letter, thermal digital infrared imagingwas used to assess the progress and outcome ofan obese 9-year-old boy with psoriasis to objec-tively evaluate the affected area in a subjectwith significant surface area variations.The patient was a 9-year-old boy, obese(height 1.40 m, and weight 42.5 kg, both overthe 90th percentile), with a history of 4 yearswith a diagnosis of psoriasis and vitiligo treatedwith topical betamethasone as initial therapy,3 years after initial diagnosis a clinical worsen-ing of psoriatic lesions was observed and meth-otrexate was added to the treatment at a12.5 mg/week dose. No significant improve-ment was observed with treatment and thepatient maintained a PASI around 12.6 ± 2 for6 months. After a routine lab work was per-formed on the patient an infectious pyelonephri-tis was found, for that reason the methotrexatewas suspended and 50 mg of acitretin per daywas initiated and the psoriatic lesions weremonitored using digital infrared thermal imag-ing to evaluate the intensity of the lesions as thePASI alone gave significant variations due to thebody mass fluctuations observed on the patientduring the duration of treatment.Infrared imaging was performed using aFLIR T400 infrared camera (FLIR Systems, Wil-sonville, OR, USA) which has a 320 9 240 FocalPlane Array of uncooled microbolometers witha spectral range of 7.5–13 lm and a thermalsensitivity of 50 mK at 30°C.The thermographic analysis was performedusing FLIR QuickReport v1.2 (FLIR Systems,Wilsonville, OR, USA) which includes a tool toobtain maximum, minimum, and average tem-perature of a user-defined area.Before treatment the patient presented scat-tered lesions mostly around the right part ofthe chest and on the abdominal area (Fig. 1a),

Raman spectroscopy analysis of the skin of patients with melasma before standard treatment with topical corticosteroids, retinoic acid, and hydroquinone mixture

Melasma is an abnormal acquired hyperpigmentation of the face of unknown origin, it is considered a single disease and very little has been found regarding its pathogenesis. It is usually assumed that melasma is due to excessive melanin production, but previous work using Raman spectroscopy showed degraded molecules of melanin in some melasma subjects, which may help to explain the success or failure of the standard therapy.

Livedoid vasculopathy (LV) associated with sticky platelets syndrome type 3 (SPS type 3) and enhanced activity of plasminogen activator inhibitor (PAI-1) anomalies.

We report the case of a 12-year-old girl Mexican mestizo, who had for the past six months a red linear pattern with several painful ulcerations in both extremities and subsequent white porcelain-like atrophy of the skin (Fig. 1a). A clinical diagnosis of atrophy blanche was made, and on histology grounds thrombosis of dermal arterioles, with only scattered mononuclear cells near the affected arterioles. The absence of polymorphonuclear cells, as well as the lack of leukocytoclasia in the blood vessels, was noteworthy (Fig. 2). Routine laboratory work was unremarkable, and a thrombophilia profile was performed (Table 1). Two anomalies were found, leading to permanent anti-aggregation therapy with acetylsalicylic acid (81 mg) daily, obtaining a full recovery after four months (Fig. 1b). There was no family history of thrombotic events. Discussion

Noninvasive detection of collagen regeneration after an isotretinoin treatment and ablative laser surgery in patients with acne scars by Raman spectroscopy

Background: To the date, oral isotretinoin is the most effective treatment for acne scars, and by combining their use with an ablative surgery results in improving the effects of the skin restoration. However, it is highly recommended by dermatologists, to wait for a period of 6 months between the isotretinoin treatment and the laser surgery, and that relative high period of time can lead to negative effects like anxiety or psychological distress in the patients. Our objective is to demonstrate that combining an ablative laser surgery and an isotretinoin treatment at therapeutic doses improves the acne wound healing in a considerably short period of time in comparison with previous studies. Additionally, it is of our interest to evaluate the wound healing due the collagen regeneration by the use of Raman spectroscopy, recently used as a non-invasive medical tool for skin diseases. Method: The study was performed in 9 patients who underwent on an oral isotretinoin treatment due to the presence of acne scars on the face. All patients received one single treatment with a CO2 Ablative Fractional Laser (AFL) on four zones of the face within a range of four weeks after isotretinoin treatment. Additionally, an untreated measurement in the elbow side of the arm acted as a control. Both treatments, the isotretinoin and the ablative surgery, were performed by the same dermatologist. The patients were evaluated by means of Raman spectroscopy before and after the treatment and for the data processing, two different statistical approaches were applied to the Raman spectra with the objective to assess the presence of a specific collagen type. Results: The patients showed normal wound healing post AFL treatments and it was shown that with a therapeutic dose of oral isotretinoin and with one single laser surgery in a relative short period of time, a collagen regeneration was observed. Conclusion: When combined AFL surgery and isotretinoin treatment at therapeutic doses, a regeneration of a type of collagen is observed, which is quantified non-invasively by Raman spectroscopy.

Solar exposure of head and cleavage of the Mexican population and its effect on the clinical assessment of skin phototype

BACKGROUND: The amount of UV rays that reach the ground as well as the UVA/UVB ratio depend on several factors such as latitude, season, cloud coverage and time of day, both UVA and UVB radiation are responsible of a great variety of skin disorders such as actinic keratoses, non-melanoma skin cancer and melanoma. METHODS: In this work the solar radiation of face and chest is calculated for 80 Mexican-mestizo volunteers using their melanin concentration relative to a non-photoexposed area which were obtained using diffuse reflectance spectrophotometry. RESULTS: The results show that the points of highest solar exposure are cheeks and cleavage, the points with lowest solar exposure are the chin and lower chest. It was also observed that the amount of solar exposure influenced the clinical assessment of skin phototype. CONCLUSION: The results support the concept that proper education on solar preventive measures mainly on the head and cleavage is fundamental to reduce the incidence of photaging and skin cancer, and that diffuse reflectance spectrophotometry can be used to reduce the effect of chronic sun exposure in the determination of the skin phototype.

Diffuse neonatal hemangiomatosis: a case report.

Diffuse neonatal hemangiomatosis (DNH) is a rare, frequently fatal disease of unknown etiology. The appearance of DNH is characterized by multiple hemangiomas, which are generalized lesions that can begin as nodular masses or as flat, ill-defined, telangiectatic macules that are often mistaken for bruises. DNH can develop in any location throughout the skin, sometimes affecting internal organs, i.e. gastrointestinal tract. Serious complications may follow a disseminated intravascular coagulation in which platelets and clotting factors are locally consumed within the hemangioma, and this may be associated with the rapid growth of the hemangiomas. Mortality rates usually go from 60% to 90% within the first three thinsp;months of life.