ABSTRACT The development of a topical agent that would strengthen the nail, improve the natural barrier, and provide better drug penetration to the nail bed is needed. In this study, we examined the effects of a hydroxypropyl chitosan (HPCH)-based nail solution using a bovine hoof model. Following application of the nail solution, changes in the hardness of the hoof samples were measured using the Vickers method. Tensile and flexural strengths were tested by stretching or punching the samples, respectively. The ultrastructure was examined using scanning electron microscopy (SEM), and samples stained with periodic acid-Schiff (PAS) stain were used to determine the fungal penetration depth. The comparators included 40% urea and 70% isopropyl alcohol solutions. The HPCH nail solution increased hoof sample hardness in comparison to the untreated control sample (mean, 22.3 versus 19.4 Vickers pyramid number [HV]). Similarly, the HPCH solution increased the tensile strength (mean, 33.07 versus 28.42 MPa) and flexural strength (mean, 183.79 versus 181.20 MPa) compared to the untreated control. In contrast, the comparators had adverse effects on hardness and strength. SEM showed that the HPCH solution reduced the area of sample crumbling following abrasion compared to the untreated control (7,418 versus 17,843 pixels), and the PAS-stained images showed that the HPCH solution reduced penetration of the dermatophyte hyphae (e.g., penetration by Trichophyton mentagrophytes was <25 μm at day 9 versus 275 μm in the untreated control). Unlike chemicals normally used in cosmetic treatments, repeated application of the HPCH nail solution may help prevent the establishment of new or recurring fungal nail infection.

Background/purpose: Sensitive skin is a condition associated with reduced tolerance to environmental factors and/or the application of topical products, such as cosmetics. Its pathophysiology has not been fully elucidated and few data are available on its prevalence. The aim of this study was to investigate possible correlation between objective sensitivity and skin surface microrelief.Methods: During an epidemiological survey conducted for a campaign promoted by International Society of Plastic Dermatology in Italy, 243 adult healthy subjects of both sexes with no evident dermatological disorder but positive to the lactic acid stinging test, were submitted to cyanoacrylate stratum corneum stripping from the volar forearm for the determination of the irregularity of the skin surface microrelief (irregularity skin index (ISI)).Results: A significant correlation was found between intensity of symptoms in stingers and ISI (r(s)=-0.47; P < 0.001).Conclusion: Sensitive skin is common in the healthy population. ISI can contribute towards the identification of subjects with sensitive skin and the development of more specific skin treatments for this prevalent condition.

There is an increasing demand in general population regarding skin healthiness and improvement of aesthetical appearance, indicating that people require more information about how to treat healthy skin and to prevent skin disease. This study is the result of a campaign on healthy skin organized by the International Society of Plastic Dermatology. This campaign was at the same time an occasion to perform an epidemiological study on Italian population and was conducted during only one month (March 2004) throughout Italy. In total, 462 dermatologists all over Italy joined the project. Study protocol and diagnostic kits were provided to all adhering dermatologists. After signing an informed consent, subjects were assigned to undergo anamnesis, medical examination and stinging test with 10% lactic acid at the level of nasolabial fold. A total of 2101 duly compiled case record forms were sent back by the dermatologists. The analysis of the demographic features and lifestyle of the subjects who were attracted by the campaign allows us to draw the identikit of people interested in the maintenance of a healthy skin, i.e. mainly young women, who already lead a healthy life and took care of their skin. Sensitive skin was common in this healthy population.

Background/purpose: Sagging of the face skin is a visible and unattractive characteristic of skin ageing. This phenomenon, due to both gravitational force and age-related alterations in the mechanical properties of skin, has never been quantitatively studied. The aim of this paper was, first, to define a method and a precise procedure allowing the objective measurement of this phenomenon and, second, to study how it is related to age.Methods: We used an electronically controlled bed that allows the comparison of submental skin profiles in both the reclined and the upright positions. A parameter that characterises the sagging amplitude for an individual was defined and the reproducibility of measurement of this parameter was verified.Results: Results, obtained from 66 female volunteers, demonstrated a statistically significant positive correlation between this new parameter and age, and also between this new parameter and the elastic recovery parameter of skin, as measured by torquemeter.Conclusion: Age-related changes of the skin's mechanical properties and of the various underlying skin tissues would explain this phenomenon. This new method and procedure should allow objective evaluation of the efficacy of any treatments (cosmetic, medical or surgical) proposed for rendering the appearance of people younger.

Background/purpose: Colour measurements obtained from digitized images have been proposed as a simple and cost-effective way to evaluate skin colour and the activity of treatments. The main disadvantage of the method is the fact that it is highly dependent on ambient light: even if an accurate control of subjects' illumination is provided, readings remain not comparable among different laboratories. The purpose of this study was to develop a highly reproducible system for computerized colour image analysis of skin erythema, making it possible to compare readings from different environmental light conditions.Patients and Methods: Three hundred and forty-eight Caucasian adult healthy subjects (age range: 18-60 years) of both sexes (14% males, 86% females), were enrolled in the study by 49 dermatologists distributed all over Italy. They were recruited among patients who required aesthetic treatments involving skin erythema, like chemical peeling and laser epilation. Once the treatment was administered, clinical evaluations and pictures were taken at the level of treated areas. Visual assessment of erythema was done on the basis of conventional clinical grades (0 = absent; 1 = slight; 2 = moderate; 3 = intense). The clinicians participating in the study were asked to put a standard colour marker (red, green and blue coloured self-adhesive ring) in the photographed skin area. The difference between r, g, b values of photographed colour markers on the skin of single patients participating in the study and the r, g, b values obtained photographing the colour marker in fixed illumination conditions was used to adjust skin colour measurements. Then erythema index (E.I) on digitized images was calculated subtracting red value to green one by averaging procedure of different pixels.Results: Erythema index. average value among the groups divided according to the conventional clinical score increased progressively from score 0-2, while it decreased from score 2 to score 3. The differences in E.I. mean values among the score groups (0 vs. 1, 1 vs. 2, 2 vs. 3) were statistically significant (P < 0.05).Conclusion: We developed a method for the measurement of skin erythema using digital camera, normalized r, g, b colour co-ordinate system and computerized calculation of E.I. Clinical usefulness of our method for absent, slight and moderate erythema, was demonstrated. For intense erythema lesions we did not find a correspondence between clinical and computerized evaluation, probably due to other factors involved in skin inflammation (e.g. oedema).

BACKGROUND/AIMS:Irregularity of skin surface microtopography is difficult to evaluate in Euclidean geometry. Using a fast Fourier transform (FFT), it is possible to convert a space field into a frequency field and to obtain quantitative evaluation of this important feature of the skin. The aim of the present study was to test the applicability of a new parameter, derived from computer assisted FFT, to skin texture, in order to quantify its irregularity. This parameter has the additional advantage of being anisotropic.METHOD:The study was conducted on 50 female volunteers. Skin replicas were performed on a healthy area that was not chronically photo-exposed. A new parameter, called "irregularity skin index" (ISI), was identified from FFT. The correlation with volunteers' age was calculated.RESULTS:ISI was calculated by FFT in two different directions (referred to the x and y axis of the diagram of the FFT and named, respectively, ISIomegax and ISIomegay). The irregularity skin indexes increased with age of the subjects, showing a correlation with age of r=0.47 (ISIomegax) and r=0.51 (ISIomegay).CONCLUSION:By showing a relatively good correlation with age, ISI seems to be a promising parameter for the study of ageing skin.

Background/aims: Several studies have been conducted in order to assess, objectively and non‐invasively, atopic skin parameters. Since little is known about clinically uninvolved, perilesional and lesional skin pH in atopic children at different stages of the disease, we studied cutaneous pH in atopic and healthy children and investigated possible relationships among different sites, phases of the disease and main symptoms.Methods: Two hundred and eighty‐four children of both sexes, 143 atopic and 141 healthy children, aged 3 months to 11 years, examined in 10 different Italian dermatological centres were included in the study and subjected to clinical examinations and pH measurements.Results: Atopic children presented statistically significant higher pH values than controls, not only at the level of eczematous lesions (P=0.004) and of perilesional skin (P=0.003) but also at the level of apparently healthy skin (P=0.002). A progressive statistically significant increase in pH values was observed from healthy to perilesional to lesional skin. In acute dermatitis, children affected by moderate itching (considering itching complaints and scratching lesions) presented, at the level of lesional and perilesional skin, statistically significant higher pH values than children affected by mild itching.Conclusion: The correlation found in this study between severity of itch and skin surface alkalinity, far from demonstrating a therapeutic role of acidic substances against itching in atopic children, deserves new epidemiological studies on a large scale in order to identify new strategies of treatment of atopic skin.

The dermatologist assesses skin turgor in his patients by the simple manoeuvre of pinching the skin. The experienced finger and thumb can obtain invaluable qualitative information about mechanical functions of the skin in order to correlate them to the general clinical conditions of the patient. In fact, such functions depend on skin structure and skin structure varies in relation to a lot of factors, among which: age, sex, race, test-site, particular physiological and pathological conditions, pharmacological and/or cosmetic treatments. Raising and then releasing a fold of skin, the clinician assesses cutaneous estsensibility and plastoelasticity (that is elastic recovery and residual deformation). In an attempt at quantifying and analyzing the above mentioned mechanical parameters, we took part in the development of a pre-existing device for the objective study of skin plastoelasticity “in vivo” (1).