Max Gloor

On the Resident Aerobic Bacterial Skin Flora in Unaffected Skin of Patients with Atopic Dermatitis and in Healthy Controls

In 14 patients with atopic dermatitis the superficial bacteria from unaffected skin were extracted with the scrub method, aerobically cultured, and analysis qualitatively and quantitatively. For comparison, 12 healthy subjects served as control group. Staphylococcus aureus, as well as coagulase-negative staphylococci were significantly increased in patients with atopic dermatitis. It is assumed that special characteristics of the horny layer in atopic dermatitis favor the growth of aerobic bacteria. The qualitative biotyping and phage typing gave no support to the claim that special bacteria dominate the microbial flora of the skin of patients with atopic dermatitis.

Comparative Investigations on the Water Content of the Stratum corneum Using Different Methods of Measurement

Measurements of the water content of the stratum corneum were made on the flexor side of the forearm in healthy male volunteers using direct current resistance and alternating current (1.5 and 15 kHz) electric impedance measurements, capacity measurements and measurements of transepidermal water loss. In addition, infrared-spectroscopic investigations were made using a Frustrated Multiple Internal Reflection device on unstripped skin, then on the same skin area after five and ten strippings with adhesive tape. The tests showed (except for the measurements of transepidermal water loss) all of the aforementioned test methods led to relevant measurement values. While the direct current electrical resistance measurement yielded data on the water content of the most superficial layer of the stratum corneum, it was found that the capacitor measurements gave results from the deep layers of the stratum corneum. With the alternating current impedance measurement method, both superficial and deep layers of the stratum corneum were taken into account. Comparative measurements of direct current resistance and infrared absorption after occlusion treatment revealed that under certain circumstances using both methods can lead to contradictory results.

On the use of infrared spectroscopy for the in vivo measurement of the water content of the horny layer after application of dermatologic ointments.

SummaryInfrared-spectroscopic investigations of the water content of the stratum corneum after application of emulsions and wash solutions are reported. As a methodologic variation infrared spectroscopy is applied after stripping the skin to determine the hydration of various depths of the stratum corneum by ointments. Using soap as an example, a method of correcting the overlap effects between the ointment and skin spectrums is presented which expands the application possibilities of infrared spectroscopy. An o/w emulsion with plenty of water and a w/o emulsion containing less water produce to almost the same degree a hydration of the deeper layers of the stratum corneum which lasts for at least 40 min. The report in the literature that soap solutions produce a stronger hydration of the stratum corneum than surfactant solutions is not supported.ZusammenfassungEs wird über infrarotspektroskopische Analysen des Wassergehaltes der Hornschicht nach Applikation von Emulsionen und Waschlösungen berichtet. Als methodische Variation wird die Infrarotspektroskopie nach Strippen der Haut angegeben, die die Messung des Wassergehaltes in verschiedenen Tiefen der Hornschicht ermöglicht. Am Beispiel der Seife wird gezeigt, daß Überlagerungseffekte der Spektren der Haut und des verabreichten Externums korrigiert werden können. Dadurch werden die Möglichkeiten zur Anwendung der Methode deutlich erweitert. Eine wasserreiche O/W-Emulsion bewirkt nahezu die gleiche Hydration der Hornschicht wie eine wasserarme W/O-Emulsion. Der Hydrationseffekt erstreckt sich auch auf tiefere Hornschichtbereiche und hält mindestens 40 min an. Nicht bestätigt werden konnte die Literaturangabe, daß Seife eine stärkere Aufquellung der Hornschicht bewirkte als Syndets.

Opposing Effects of Glycerol on the Protective Function of the Horny Layer against Irritants and on the Penetration of Hexyl Nicotinate

Background: It is known that glycerol in an oil-in-water emulsion has a protective effect against irritating substances. Objective: To answer the question: is the protection effect of glycerol based on a regenerative process? Methods: Upon irritation by either tape stripping or acetone treatment, we applied glycerol to the skin surface under an occlusive dressing to create transepidermal water movement. As a control we used water under the occlusive dressing on the contralateral forearm. After 5 h we compared the barrier function using biological tests. Results: A significant improvement of the protective barrier function was observed in the glycerol-treated areas, as shown by the alkali resistance and by the irritant effect of dimethyl sulfoxide (DMSO) as well as sodium lauryl sulfate. Surprisingly, at the same time penetration of hexyl nicotinate improved on the glycerol-treated areas. A direct physicochemical protection effect on the surface of the skin was ruled out in additional studies using NaOH and DMSO. Conclusions: Under the given conditions glycerol leads to a more rapid reconstitution of the protective skin barrier and initiates a regenerative skin protection. In contrast to that, it is acting as a penetration enhancer.

Cleansing, dehydrating, barrier-damaging and irritating hyperaemising effect of four detergent brands: comparative studies using standardised washing models.

Background and problem: It is well known that the damaging effect of surfactants on the stratum corneum varies according to the surfactant used. The present investigations aim to compare four standard commercial cleansing solutions (Esemptan® Cleansing Lotion, Stephalen® Shower Gel, Manipur® Antimicrobial Cleansing Solution and Tork® Mevon 55TM Liquid Soap) with respect to their cleansing and skin barrier‐damaging effects.

Influence of a pretreatment with emulsions on the dehydration of the skin by surfactants.

Improving the water content of the horny layer of the skin is of great importance in dermatology (atopic dermatitis, ichthyosis etc.) and in cosmetics (to soften the skin surface [l]). It is believed that emulsion bases lead to hydration of the stratum corneum [2]. The hydration is believed to last a few minutes if an o/w-emulsion is used [3] and a few hours in the case of w/o-emulsions [4]. The present study addresses whether the hydrating effect really does last for such a short time. Literature also proposes an increase in water content by using urea, which is a component of many dermatological skin-care ointments [3,5-8]. The cosmetic industry mostly prefers glycerol of which a hydrating effect is also assumed [9], although it is not well documented. Our study compares in a quantitative way the hydrating effect of urea and glycerol applied in different types of emulsions. In practice the dehydration caused by surfactants is a major problem for people with ‘dry’ skin. As far as we know there are no adequate studies about the influence of skin-care products with or without moisturizers like urea or glycerol. The purpose of our study was to compare the protective effect of w/oand o/w-emulsions with and without urea or glycerol against exsiccation caused by surfactants.

Sebaceous glands in uninvolved skin of patients suffering from atopic dermatitis

I t is genera l ly k n o w n t h a t m a n y pa t i en t s w i th a t o p i c de rma t i t i s h a v e dry scal ing o f the skin. Th i s m a y be pa r t l y due to a cha rac te r i s t i c s t ruc tu re o f the h o r n y layer a n d a d i s o r d e r o f swea t g l and secre t ion. A decrease in the s ebaceous g l and sec re t ion m a y also h a v e an i m p o r t a n t b e a r i n g on the typica l d ryness o f the skin in a t o p i c dermat i t i s . S ince ne i the r ce l l -k ine t ic n o r h i s to log ica l i nves t iga t ions o f the s ebaceous g lands o f n o n a f f e c t e d skin o f adu l t pa t i en t s w i th a top i c de rma t i t i s have b e e n r e p o r t e d , the p u r p o s e o f this s tudy was to u n d e r t a k e such inves t iga t ions .

Infrared-spectroscopic determination of the water content of the horny layer in healthy subjects and in patients suffering from atopic dermatitis.

SummaryInfrared spectroscopic measurements of hydration of the stratum corneum before and after stripping the skin five and ten times with scotch tape are reported. Investigations on 64 healthy persons show that for individuals over 45 and under 15 years of age the range of the measurement values is strikingly larger than for persons in the age group 15–45 years of age. A small, but not significant reduction in the measurement values is found in females as compared to males. A comparison of the clinically unaffected skin of atopic dermatitis patients with the skin of normal persons points to an increase in the hydration of the stratum corneum of atopic dermatitis patients, which is especially evident in patients who show clinical evidence of “dry” and rough skin.ZusammenfassungEs wird über infrarotspektroskopische Messungen der Hornschichtfeuchtigkeit vor und nach fünf bzw. zehnmaligen Tesafilmabrissen berichtet. Untersuchungen an 64 gesunden Probanden lassen erkennen, daß bei Personen über 45 und unter 15 Jahren die Streuung der Meßwerte erheblich größer ist als in den dazwischenliegenden Altersstufen. Bei den weiblichen Versuchspersonen ist eine geringe, nicht signifikante Reduktion der Meßwerte im Vergleich zu den männlichen Personen erkennbar. Beim Vergleich der klinisch nicht erkrankten Haut von Neurodermitikern und der Haut von Gesunden ergibt sich ein Hinweis auf eine Erhöhung des Wassergehaltes der Hornschicht bei den Neurodermitikern, die besonders die Neurodermitiker betrifft, die klinisch eine “trockene” und rauhe Haut aufweisen.

Qualitative and quantitative investigations on the resident bacterial skin flora in healthy persons and in the non-affected skin of patients with seborrheic Eczema.

SummaryThe composition of the aerobic and anaerobic bacterial skin flora was investigated quantitatively and qualitatively in 25 patients with seborrheic eczema (SE) and in 35 healthy persons. In SE patients, the geometric mean count for propionibacteria in the pilosebaceous ducts of the forehead was reduced to a statistically significant extent in comparison with the control group. There was the same tendency with regard to the geometric mean count of the superficial anaerobic bacterial flora of the back, whereas the geometric mean counts of the coagulase-negative staphylococci were the same in the two groups. These results may explain earlier findings of a reduction of free fatty acids in the surface lipids in SE patients. According to the results of differentiation in 295 propionibacteria and 157 micrococcaceae, 7 biotypes and 10 phage types of propionibacteria which were so far unknown could be demonstrated. Significant differences between the groups with regard to the frequency of different biotypes, serotypes, and phage types could be demonstrated neither in propionibacteria nor in coagulase-negative staphylococci. The results of typing, however, showed that patients with SE displayed much more frequently several different propionibacterial species and types as well as several different micrococcal species and types than persons with healthy skin.ZusammenfassungDie Zusammensetzung der aerob und anaerob züchtbaren bakteriellen Hautflora wurde bei 25 Patienten mit seborrhoischem Ekzem (SE) und 35 gesunden Vergleichspersonen quantitativ und qualitativ untersucht. Bei SE-Patienten waren im Talgdrüseninfundibulum der Stirn die Keimzahlen für Propionibakterien statistisch signifikant gegenüber der Vergleichsgruppe reduziert. Tendenziell das gleiche Bild ergab sich für die Keimzahlen der superfiziellen, anaerob züchtbaren Bakterienflora des Rückens, während die Keimzahlen der plasmakoagulase-negativen Staphylokokken dort bei beiden Kollektiven gleich waren. Diese Ergebnisse können frühere Befunde einer Reduktion der freien Fettsäuren in den Hautoberflächenlipiden bei SE-Patienten erklären. Nach den Differenzierungsergebnissen bei 295 Propionibakterien und 157 Micrococcaceae konnten 7 bisher nicht bekannte Biotypen und 10 neue Phagtypen der Propionibakterien nachgewiesen werden. Signifikante Unterschiede zwischen den Kollektiven bezüglich der Häufigkeiten von verschiedenen Bio-, Sero- und Phagtypen ließen sich weder bei Propionibakterien noch bei den plasmakoagulase-negativen Staphylokokken nachweisen. Die Typisierungsergebnisse zeigten jedoch, daß Patienten mit SE deutlich häufiger sowohl mehrere unterschiedliche Propionibakterien-Spezies und-Typen als auch mehrere unterschiedliche Micrococcaceae-Spezies und-Typen aufweisen als hautgesunde Personen.

Influence of cyproterone acetate and estradiol on cell kinetics in the sebaceous gland of the golden hamster ear

SummaryThe cell kinetics of the sebaceous gland of the hamster ear were analysed in untreated animals, in animals treated with cyproterone acetate, and in animals treated with estradiol. Both active substances lead to a reduction in the size of the sebaceous gland (measurement with the integration plate), to a reduction of mitoses (colcemide method), to a reduction in the 3H-thymidine labelling index, to a prolongation of the S-phase (double labelling technique with 3H-thymidine which remain in contact with the basal lamina of the sebaceous gland 6 days after application of the isotope. The results indicate that, like cyproterone acetate, estradiol reduces the effect of androgens on cell kinetics in the sebaceous gland under the test conditions chosen, even if in an entirely different way.ZusammenfassungDie Zellkinetik der Talgdrüse des Hamsterohres wurde bei unbehandelten Tieren, bei mit Cyproteronacetat behandelten und bei mit Östradiol behandelten Tieren analysiert. Beide Wirkstoffe führen zu einer Verkleinerung der Talgdrüsen (Messung mit der Integrationsplatte), zu einer Reduktion der Mitosen (Colcemidmethode), zu einer Reduktion des 3H-Thymidin-Labelling-Index, zu einer Verlängerung der S-Phase (Doppelmarkierungsmethode mit 3H-Thymidin und 14C-Thymidin in vivo) und zu einer Verminderung der markierten Zellen, die 6 Tage nach Isotopenapplikation noch Kontakt mit der Basallamina der Talgdrüse haben. Die Ergebnisse lassen annehmen, daß Östradiol ähnlich wie Cyproteronacetat — wenn auch auf eine völlig andere Weise — die Wirkung der Androgene auf die Zellkinetik der Talgdrüse behindert.