Hiroshi Matsunaka

Preventive effect of chemical peeling on ultraviolet induced skin tumor formation

BACKGROUND Chemical peeling is one of the dermatological treatments available for certain cutaneous diseases and conditions or improvement of cosmetic appearance of photoaged skin. OBJECTIVES We assessed the photochemopreventive effect of several clinically used chemical peeling agents on the ultraviolet (UV)-irradiated skin of hairless mice. METHODS Chemical peeling was done using 35% glycolic acid dissolved in distilled water, 30% salicylic acid in ethanol, 10% or 35% trichloroacetic acid (TCA) in distilled water at the right back of UV-irradiated hairless mice every 2 weeks in case of glycolic acid, salicylic acid, and 10% TCA and every 4 weeks in case of 35% TCA for totally 18 weeks after the establishment of photoaged mice by irradiation with UVA+B range light three times a week for 10 weeks at a total dose of 420 J/cm(2) at UVA and 9.6 J/cm(2) at UVB. Tumor formation was assessed every week. Skin specimens were taken from treated and non-treated area for evaluation under microscopy, evaluation of P53 expression, and mRNA expression of cyclooxygenase (COX)-2. Serum level of prostaglandin E(2) was also evaluated. RESULTS All types of chemical peeling reduced tumor formation in treated mice, mostly in the treated area but also non-treated area. Peeling suppressed clonal retention of p53 positive abnormal cells and reduced mRNA expression of COX-2 in treated skin. Further, serum prostaglandin E(2) level was decreased in chemical peeling treated mice. CONCLUSIONS These results indicate that chemical peeling with glycolic acid, salicylic acid, and TCA could serve tumor prevention by removing photodamaged cells.

Chemokine receptor CXCR4 is a novel marker for the progression of cutaneous malignant melanomas.

The CXCR4/CXCL12 pathway has recently been reported to be involved in stimulating the metastasis of many different neoplasms, in which CXCR4 activates various phenomena such as chemotaxis, invasion, angiogenesis and proliferation. The purpose of this study was to analyze a possible association between the expression of chemokine receptors CXCR4, CCR6 and CCR7 with the clinicopathological features of cutaneous malignant melanoma, and to assess the usefulness of these chemokine receptors for diagnosis and prognosis. In our study, a percentage of immunoexpression of both CXCR4 and its ligands CXCL12 was associated with high clinical risk. In contrast, the patients with a low immunoexpression of CXCR4 and CXCL12 had low clinical risk. CCR6 and CCR7 immunoexpressions were also correlated with some clinical parameters, but seemed no more useful than CXCR4. These data suggest that the assessment of CXCR4 immunoexpression is a novel tool for predicting tumor aggressiveness in malignant melanomas, and in particular, a high immunoexpression percentage of CXCR4 and CXCL12 might be a sign of a poor prognosis.

EFFECT OF CHEMICAL PEELING ON PHOTOCARCINOGENESIS

Chemical peeling is one of the dermatological treatments available for certain cutaneous diseases and conditions or improvement of cosmetic appearance of photo‐aged skin. We assessed the photo‐chemopreventive effect of several clinically used chemical peeling agents on the ultraviolet‐irradiated skin of hairless mice. Chemical peeling was done using 35% glycolic acid dissolved in distilled water, 30% salicylic acid in ethanol, and 10% or 35% trichloroacetic acid in distilled water at the right back of ultraviolet‐irradiated hairless mice every 2 weeks for glycolic acid, salicylic acid and 10% trichloroacetic acid, and every 4 weeks for 35% trichloroacetic acid for a total of 18 weeks after the establishment of photo‐aged mice by irradiation with ultraviolet B range light three times a week for 14 weeks at a total dose of 6.66 J/cm2. Tumor formation was assessed every week. Skin specimens were taken from treated and non‐treated area for evaluation under microscopy, evaluation of p53 expression and mRNA expression of cyclooxygenase‐2. Serum level of prostaglandin E2 was also evaluated. All types of chemical peeling reduced tumor formation in treated mice, mostly in the treated area but also in the non‐treated area. Peeling suppressed retention of p53‐positive abnormal cells and reduced mRNA expression of cyclooxygenase‐2 in treated skin. Further, serum prostaglandin E2 level was decreased in chemical peeling treated mice. These results indicate that chemical peeling with glycolic acid, salicylic acid and trichloroacetic acid could serve tumor prevention by removing photo‐damaged cells.

Clinical Evaluation of Glycolic Acid Chemical Peeling in Patients with Acne Vulgaris: A Randomized, Double-Blind, Placebo-Controlled, Split-Face Comparative Study

BACKGROUND Glycolic acid (GA) peels are frequently performed as adjuvants to the treatment of facial acne. There have been few clinical trials reported of GA peels for acne in people with darker skin. OBJECTIVES To determine the safety and efficacy of GA peels in the treatment of moderate acne vulgaris in Asian skin. METHODS In this prospective, randomized, double‐blind, placebo‐controlled, split‐face clinical trial, 26 patients with moderate acne were treated with 40% GA (pH 2.0) on half of the face and placebo on the other half. The procedure was performed five times at 2‐week intervals. RESULTS The GA sides had statistically significant reductions in acne lesions at each time point from baseline values. There were statistically significant differences between the GA and placebo sides. The GA sides had better responses for noninflammatory lesions than for inflammatory lesions. In bioengineering measurements, sebum levels were statistically significantly reduced after the initiation of therapy on both sides at weeks 8 and 10, but there were no statistically significant differences between the two sides. CONCLUSION Forty percent GA peels significantly improved moderate acne in this study. It is effective and safe in Asians.

Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system.

Few clinical studies have examined the utility of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars and active acne in people with darker skin. This study was designed to compare the safety and efficacy of bipolar FRF therapy as a treatment for atrophic acne scars and acne vulgaris. Twenty‐three Japanese patients with atrophic acne scars and mild to severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron, Yokneam Illit, Israel). Five treatment sessions were carried out at 1‐month intervals, and the patients were followed up for 3 months after the final treatment. Assessments of scar severity and the number of acne lesions and 3‐D in vivo imaging analysis were performed. Evaluations of the treatment outcomes and their effects on the patients’ quality of life (QOL) were also carried out. We demonstrated that the improvement in scar volume was marked in the patients with mild scars and was at least moderate in 23 (57.5%) of the treated areas. With regard to the number of acne lesions, the treated areas exhibited significantly fewer lesions compared with the baseline at each time point (P < 0.05). The patients’ assessments of the treatment outcomes and their QOL indicated that both had improved significantly by the end of the study. Furthermore, significant reductions in the patients’ sebum levels, skin roughness and scar depth were observed. Bipolar FRF treatment significantly improved the atrophic acne scars and acne of Japanese patients and had minimal side‐effects.

Case report of aquagenic wrinkling of the palms associated with impaired stratum corneum function.

Dear Editor, Aquagenic wrinkling of the palms (AWP) is an uncommon disease characterized by the rapid formation of transient edematous and whitish plaques on the palms after exposure to water. AWP usually occurs in young females with family history, and thus heredity may be related. Although the pathophysiology of AWP remains unknown, aberrant sweat glands and alterations of the stratum corneum are thought to be involved. Herein, we report a case of AWP in which histological and functional studies were carried out.

Non-invasive quantification of melanin in the stratum corneum: a novel indicator of skin lesions in pigmentation diseases.

Skin melanin content is an important indicator for ascertaining the pathology of skin pigmentation diseases, but its analysis necessitates a biopsy or other means of collecting tissue, posing a considerable burden to the patient, and making it difficult to observe how a given skin site changes over time. Here, we aimed to establish a non‐invasive method for quantifying the eumelanin and pheomelanin content of the stratum corneum.

Physiological and microbiological verification of the benefit of hair washing in patients with skin conditions of the scalp

It is unclear whether hair washing is effective against scalp eruption and pruritus caused by seborrheic dermatitis or psoriasis vulgaris.

Repair of dry skin by minerals in seawater: OLIGOMARINE® as a skin moisturizer

OLIGOMARINE® is a complex of minerals obtained from seawater. In a cell culture system, OLIGOMARINE® stimulated not only the cell activation but also the collagen synthesis of fibroblasts. In addition, OLIGOMARINE® might have accelerated the keratinization as the expression of suprabasal markers, such as involucrin and transglutaminase, were promoted in cultured normal human keratinocytes. Furthermore, the water-holding properties and permeability barrier function of the stratum corneum were enhanced by using lotion containing OLIGOMARINE®. These results suggested that OLIGOMARINE® would be useful as a humectant for the prevention or improvement of dry skin.