Hiromi Kanto

Use of Cutometer area parameters in evaluating age-related changes in the skin elasticity of the cheek.

The decrease of skin elasticity on the cheek is a major concern to woman. The Cutometer® has been widely used to evaluate skin elasticity and its change with aging. Cutometer parameters derived from one suction have been traditionally used to evaluate skin elasticity, and few reports describe the use of multiple suctions to obtain parameters to assess the skin elasticity of the cheek. To find the most suitable Cutometer parameter that reflects age‐related changes in the elasticity of cheek skin using multiple suctions.

Adverse skin reactions due to pegylated interferon alpha 2b plus ribavirin combination therapy in a patient with chronic hepatitis C virus.

Pegylated interferon (IFN)‐α‐2b with ribavirin has recently replaced “standard” IFN‐α for the treatment of chronic hepatitis C. The most common side‐effect of pegylated IFN‐α‐2b plus ribavirin combination therapy is localized inflammatory skin lesions at the site of injection. A 66‐year‐old female treated with once‐weekly pegylated IFN‐α‐2b plus ribavirin for active chronic hepatitis C developed inflammatory skin lesions 2 months after starting antiviral treatment. The type of skin reactions observed were vesicle erythematous eruptions at the injection sites, and pruritic papular erythematous eruptions located on the face, neck, distal limbs, dorsa of the hands, trunk and buttocks away from the injection sites. Histological examination was performed on the pruritic papular erythematous eruption located on the left forearm, away from the injection sites. It showed epidermal spongiosis, a spongiotic microvesicle, and perivascular infiltration of the upper dermis with lymphocytes. The treatment was interrupted subsequently and the patient was rechallenged with pegylated IFN‐α‐2b plus ribavirin combination therapy, oral prednisolone with olopatadine hydrochloride and topical 0.1% diflucortolone valerate, which led to a significant improvement of skin lesions. Erythema with infiltration can occur at the injection sites of pegylated IFN‐α‐2b. However, the occurrence of vesicle erythematous eruptions away from the injection sites and autosensitization dermatitis apart from injection sites have not yet been frequently reported.

Melanin and facial skin fluorescence as markers of yellowish discoloration with aging

Background: Although one clinical sign of aging and/or photoaging is a yellowish discoloration of the facial skin, little is known about the cause of this change. In addition to the increase in the epidermal melanin content, it has been suggested that advanced glycation end products (AGEs), which are known to accumulate in photoaged skin, may affect this discoloration.

Relevance of the directionality of skin elasticity to aging and sagging of the face

Background: Forces acting in facial skin have been suggested to show directionality. Non‐invasive methods of measuring this directionality may thus provide information related to aging processes. The Reviscometer® RVM600 device is capable of measuring directionality of forces on the skin. This device has not been used previously in a published study to evaluate changes in directionality of forces on facial skin with aging.

Effects of vitamin C on dark circles of the lower eyelids: quantitative evaluation using image analysis and echogram

Background/aims: The pathogenesis of dark circles of the lower eyelid (DCLE) has been considered to involve stasis and hyperpigmentation of the eyelids. We have already reported that dermal thickness of lower eyelid skin may represent another factor that affects the appearance of DCLE. The aim of this study was to evaluate the efficacy of vitamin C, which is known to increase collagen, on DCLE through a clinical trial.

Pyoderma gangrenosum of the skin and respiratory tract in a 5-year-old girl

Pyoderma gangrenosum (PG) is a rare ulcerative, chronic, cutaneous inflammatory disorder of unknown aetiology. The condition manifests at all ages and may arise almost anywhere in the body, although infants and children account for only 3%–4 % of the total incidence [2]. PG does not usually affect the respiratory tract. A previously healthy Japanese girl developed a barking cough, biphasic stridor and remittent fever, initially diagnosed as laryngotracheobronchitis, but antibiotics and inhalation of dexamethasone and epinephrine had no effect. Nine days later, a small painful skin nodule developed on the lateral surface of her right leg, progressing rapidly to an ulcerative lesion. After 28 days of unsuccessful treatment, she was referred to our hospital. A physical examination revealed a 5·7 cm ulcer on the skin of her right leg and an aphthoid lesion on the soft palate. The skin needle reaction was positive. Crackles and rhonchi were audible in the chest. Blood examination revealed elevated level of inflammatory reactants. Repeated cultures from the skin, pharynx and arterial blood were negative. Biopsies of the skin lesion suggested chronic non-specific inflammation and a diagnosis of PG was made. A chest radiograph showed a diffuse bilateral hazy shadow and an indistinct

Quantitative evaluation of patch test reactions: a comparison between visual grading and erythema index image analysis

Background/aims: The interpretation of patch test reactions may vary between examiners. As test results are graded, an issue also arises when differing degrees of erythema are placed in the same grade. The purpose of this study was to quantitatively evaluate the degree of erythema in patch tests using image analysis and to study the usefulness of this method by comparing it with visual grading.

Optimal patch application time in the evaluation of skin irritation

We investigated the optimum application for evaluating skin irritation response by using samples of irritants commonly used as additives in cosmetics and other common household products. We studied 47 volunteers (16 men and 31 women). We selected three types of surfactant, one moisturizer, one anti‐infective agent and one oil solution. Using Finn chambers on Scanpor tape, we performed the patch test. A total of 0.015 mL of each sample was applied to the Finn chamber. For liquids, circular filter paper was soaked in 0.015 mL of the sample. Samples were placed on the upper back of participants, and closed for 4, 24 or 48 h. A patch application time of 24 h is sufficient to detect primary skin irritation from irritants in cosmetics and other common household products. In addition, we found that skin irritation reactions were strongest at 24 h after patch removal and that the reaction tended to be weaker at 48 h after patch removal. Patch testing to evaluate irritants should be performed by means of a 24‐h patch test with a follow‐up reading at 24 h after patch removal. An application time of 24 h places less of a burden on patients than a 48‐h patch test.

A case of allergic contact dermatitis to polyglyceryl laurate

An 80-year-old woman experienced recurring pruritic erythema on her face for 3 months. She was treated with steroid ointment, but her condition gradually became worse, and she therefore visited our hospital on 10 February 2005. We suspected contact dermatitis. Using Finn Chamber (Epitest Ltd Oy, Tuusula, Finland) and Scanpor tape (Alpharma AS, Norgesplaster Facility, Vennesla, Norway), we performed 48-hr closed patch testing with the cosmetics that she had been using. Readings were made at 1 hr and 1 D after removal according to International Contact Dermatitis Research Group (ICDRG) recommendations. She showed a positive reaction (þþ) to the essential gel (as is). Further patch testing was performed with all ingredients of the essential gel. She exhibited a positive reaction (þ) to polyglyceryl-10 laurate 0.5%aq., and this positive reaction remained positive after 7 days. A 3rd patch test was performed with polyglyceryl-10 laurate (1%, 0.5%, 0.1%, and 0.05%aq.), and she exhibited positive reactions (þ) to all concentrations tested. After 6 months, a 4th patch test was performed using polyglyceryl laurate produced by several manufacturers, as we did not know which manufacturer produced the polyglyceryl-10 laurate in the essential gel the patient had been using. She showed positive reactions (þ) to polyglyceryl-10 laurate from manufacturer A, manufacturer B (1%, 0.5%, 0.05%, and 0.01%aq.) and polyglyceryl-10 laurate from manufacturer C (1% and 0.5%aq.). We then performed patch testing with polyglyceryl-4 laurate and polyglyceryl-6 laurate from manufacturer C (1% and 0.5%aq.), and she exhibited positive reactions (þ) to both as well. She exhibited negative reactions to polyglyceryl-10 myristate, polyglyceryl-10 isostearate, polyglyceryl-10 stearate, and polyglyceryl-10 oleate (1%, 0.5%, 0.05%, and 0.01%aq). The 7 control materials tested gave negative reactions. The dermatitis cleared after the patient ceased using the essential gel. We thus concluded that our patient had developed allergic contact dermatitis against the polyglyceryl laurate present in the essential gel.

A multi-institutional joint study of contact dermatitis related to hair colouring and perming agents in Japan

In Japan, allergic contact dermatitis caused by hair colouring agents is a considerable problem for those occupationally exposed and also for consumers. Over the last 20 years, p‐phenylenediamine (PPD) has been a common allergen, with ∼7% positive patch test reactions.