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INTRODUCTION: Dermatoporosis is a chronic cutaneous fragility syndrome, characterized by skin atrophy, purpura and pseudo-cicatrices. OBJECTIVE: To determine factors associated with dermatoporosis in a sample of subjects aged ≥ 60 years. METHODS: Observational, cross-sectional, descriptive, analytical study of subjects aged ≥ 60 years who underwent history taking, physical examination and application of a self-administered dermatoporosis diagnostic questionnaire. To determine the associated factors, a multivariate logistic regression analysis was used. RESULTS: In 315 evaluated subjects, the prevalence of dermatoporosis was 29%; 70% were females. Associated risk factors were age > 75 years (p = 0.001), prolonged sun exposure (p = 0.002), use of anticoagulants/antiplatelet medications (p = 0.004), oral steroids (p = 0.03) and chronic kidney disease (p = 0.03), as well as maternal age > 40 years at last pregnancy (p = 0.02), breastfeeding for > 7 months per pregnancy and > 18 cumulative months (p = 0.01). Age < 20 years at first pregnancy and menopause after 45 years were related to dermatoporosis absence. The correlation between self-assessment and clinical diagnosis was considerably high (0.95, p < 0.001). CONCLUSIONS: The risk factors associated with dermatoporosis were similar to those previously reported.
INTRODUCCIÓN: La dermatoporosis es un síndrome crónico de fragilidad cutánea, caracterizado por atrofia, púrpura y pseudocicatrices en piel. OBJETIVO: Determinar los factores asociados a dermatoporosis en una muestra de sujetos ≥ 60 años. MÉTODOS: Estudio observacional, transversal, descriptivo y analítico de sujetos ≥ 60 años a quienes se realizó historia clínica, exploración física y aplicación de un autocuestionario diagnóstico de dermatoporosis. Para determinar los factores asociados se realizó análisis de regresión logística multivariado. RESULTADOS: En 315 sujetos, la prevalencia de dermatoporosis fue de 29 %; 70 % fue del sexo femenino. Los factores asociados fueron edad > 75 años (p = 0.001), exposición solar prolongada (p = 0.002), ingesta de anticoagulantes/antiplaquetarios (p = 0.004), esteroides orales (p = 0.03) y enfermedad renal crónica (p = 0.03); así como, edad materna > 40 años en el último parto (p = 0.02), lactancia > 7 meses por embarazo y lactancia acumulada > 18 meses (p = 0.01). Se relacionaron con su ausencia, edad < 20 años en el primer embarazo y menopausia después de los 45 años. La correlación entre la autovaloración y el diagnóstico clínico fue muy alta (0.95, p < 0.001). . CONCLUSIONES: Los factores de riesgo asociados a dermatoporosis fueron similares a los previamente reportados.
Assuntos
Envelhecimento da Pele , Dermatopatias , Idoso , Feminino , Humanos , Masculino , Estudos Transversais , México/epidemiologia , Fatores de Risco , Pele , Dermatopatias/diagnóstico , Dermatopatias/epidemiologiaRESUMO
Resumen Introducción: La dermatoporosis es un síndrome crónico de fragilidad cutánea, caracterizado por atrofia, púrpura y pseudocicatrices en piel. Objetivo: Determinar los factores asociados a dermatoporosis en una muestra de sujetos ≥ 60 años. Métodos: Estudio observacional, transversal, descriptivo y analítico de sujetos ≥ 60 años a quienes se realizó historia clínica, exploración física y aplicación de un autocuestionario diagnóstico de dermatoporosis. Para determinar los factores asociados se realizó análisis de regresión logística multivariado. Resultados: En 315 sujetos, la prevalencia de dermatoporosis fue de 29 %; 70 % fue del sexo femenino. Los factores asociados fueron edad > 75 años (p = 0.001), exposición solar prolongada (p = 0.002), ingesta de anticoagulantes/antiplaquetarios (p = 0.004), esteroides orales (p = 0.03) y enfermedad renal crónica (p = 0.03); así como, edad materna > 40 años en el último parto (p = 0.02), lactancia > 7 meses por embarazo y lactancia acumulada > 18 meses (p = 0.01). Se relacionaron con su ausencia, edad < 20 años en el primer embarazo y menopausia después de los 45 años. La correlación entre la autovaloración y el diagnóstico clínico fue muy alta (0.95, p < 0.001). Conclusiones: Los factores de riesgo asociados a dermatoporosis fueron similares a los previamente reportados.
Abstract Introduction: Dermatoporosis is a chronic cutaneous fragility syndrome, characterized by skin atrophy, purpura and pseudo-cicatrices. Objective: To determine factors associated with dermatoporosis in a sample of subjects aged ≥ 60 years. Methods: Observational, cross-sectional, descriptive, analytical study of subjects aged ≥ 60 years who underwent history taking, physical examination and application of a self-administered dermatoporosis diagnostic questionnaire. To determine the associated factors, a multivariate logistic regression analysis was used. Results: In 315 evaluated subjects, the prevalence of dermatoporosis was 29%; 70% were females. Associated risk factors were age > 75 years (p = 0.001), prolonged sun exposure (p = 0.002), use of anticoagulants/antiplatelet medications (p = 0.004), oral steroids (p = 0.03) and chronic kidney disease (p = 0.03); as well maternal age > 40 years at last pregnancy (p = 0.02), breastfeeding for > 7 months per pregnancy and > 18 cumulative months (p = 0.01). Age < 20 years at first pregnancy and menopause after 45 years were related to dermatoporosis absence. The correlation between self-assessment and clinical diagnosis was considerably high (0.95, p < 0.001). Conclusions: The risk factors associated with dermatoporosis were similar to those previously reported.
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BACKGROUND: The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier. OBJECTIVE: To determine the cytotoxic effect of soaps on in vitro-cultured keratinocytes and to correlate it with clinical irritation. METHOD: A survey was conducted to find out the most widely used commercial soaps and their number. Subsequently, their cytotoxicity was evaluated in human keratinocyte cultures using the resazurin assay. The soaps with the highest and lowest cytotoxicity were applied to the skin of healthy volunteers to assess their effect on the skin barrier using colorimetry and transepidermal water loss (TEWL) assays. RESULTS: Of the analyzed soaps, 37 % were shown to be toxic to keratinocytes in vitro. The soap with the highest toxicity induced the highest rate of erythema and TEWL, in comparison with the least toxic soap and the vehicle used as the control solution. CONCLUSION: Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.
INTRODUCCIÓN: El jabón para el aseo cutáneo es de empleo común entre la población, sin embargo, es posible que cause daño a las células de la piel y modifique la barrera cutánea. OBJETIVO: Determinar el efecto citotóxico de los jabones en queratinocitos cultivados in vitro y correlacionarlo con la irritación clínica. MÉTODO: Se realizó una encuesta para conocer los jabones comerciales más utilizados y su cantidad; posteriormente, se evaluó su citotoxicidad en cultivos de queratinocitos humanos mediante el método de resazurina. Los jabones con mayor y menor citotoxicidad se aplicaron en piel de voluntarios sanos para evaluar su efecto en la barrera cutánea mediante ensayos de colorimetría y pérdida transepidérmica de agua. RESULTADOS: De los jabones analizados, 37 % demostró ser tóxico para los queratinocitos in vitro. El jabón con mayor toxicidad indujo el mayor índice de eritema y pérdida transepidérmica de agua, en comparación con el jabón menos tóxico y el vehículo empleado como solución control. CONCLUSIÓN: Los jabones comercializados para el aseo cutáneo pueden incluir ingredientes químicos que dañan los queratinocitos humanos y causan irritación subclínica de la barrera cutánea. Su utilización puede agravar dermatosis preexistentes, generar dermatitis xerósica o de contacto irritativa y causar atrofia y dermatoporosis.
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Irritantes/efeitos adversos , Queratinócitos/efeitos dos fármacos , Testes de Irritação da Pele , Sabões/efeitos adversos , Água Corporal , Células Cultivadas , Colorimetria , Dermatite Irritante/etiologia , Eritema/induzido quimicamente , Voluntários Saudáveis , Humanos , Concentração de Íons de Hidrogênio , Pele/efeitos dos fármacos , Sabões/químicaRESUMO
Resumen Introducción: El jabón para el aseo cutáneo es de empleo común entre la población, sin embargo, es posible que cause daño a las células de la piel y modifique la barrera cutánea. Objetivo: Determinar el efecto citotóxico de los jabones en queratinocitos cultivados in vitro y correlacionarlo con la irritación clínica. Método: Se realizó una encuesta para conocer los jabones comerciales más utilizados y su cantidad; posteriormente, se evaluó su citotoxicidad en cultivos de queratinocitos humanos mediante el método de resazurina. Los jabones con mayor y menor citotoxicidad se aplicaron en piel de voluntarios sanos para evaluar su efecto en la barrera cutánea mediante ensayos de colorimetría y pérdida transepidérmica de agua. Resultados: De los jabones analizados, 37 % demostró ser tóxico para los queratinocitos in vitro. El jabón con mayor toxicidad indujo el mayor índice de eritema y pérdida transepidérmica de agua, en comparación con el jabón menos tóxico y el vehículo empleado como solución control. Conclusión: Los jabones comercializados para el aseo cutáneo pueden incluir ingredientes químicos que dañan los queratinocitos humanos y causan irritación subclínica de la barrera cutánea. Su utilización puede agravar dermatosis preexistentes, generar dermatitis xerósica o de contacto irritativa y causar atrofia y dermatoporosis.
Abstract Introduction: The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier. Objective: To determine the cytotoxic effect of soaps on in vitro-cultured keratinocytes and to correlate it with clinical irritation. Method: A survey was conducted to find out the most widely used commercial soaps and their number. Subsequently, their cytotoxicity was evaluated in human keratinocyte cultures using the resazurin assay. The soaps with the highest and lowest cytotoxicity were applied to the skin of healthy volunteers to assess their effect on the skin barrier using colorimetry and transepidermal water loss (TEWL) assays. Results: Of the analyzed soaps, 37 % were shown to be toxic to keratinocytes in vitro. The soap with the highest toxicity induced the highest rate of erythema and TEWL, in comparison with the least toxic soap and the vehicle used as the control solution. Conclusion: Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.
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Humanos , Sabões/efeitos adversos , Queratinócitos/efeitos dos fármacos , Testes de Irritação da Pele , Irritantes/efeitos adversos , Pele/efeitos dos fármacos , Sabões/química , Água Corporal , Células Cultivadas , Dermatite Irritante/etiologia , Colorimetria , Eritema/induzido quimicamente , Voluntários Saudáveis , Concentração de Íons de HidrogênioRESUMO
BACKGROUND: Malar melasma has a chronic and recurrent character that may be related to epigenetic changes. OBJECTIVE: To recognize the expression and DNA methylation of DNA methyltransferases (DNMTs) in malar melasma and perilesional skin, as well as the changes in DNMTs after their treatment with sunscreen in combination with 4% niacinamide, 0.05% retinoic acid, or placebo. METHODS: Thirty female patients were clinically evaluated for the expression of DNMT1 and DNMT3b using real-time PCR and immunofluorescence. These initial results were compared to results after eight weeks of treatment with sunscreen in combination with niacinamide, retinoic acid, or placebo. RESULTS: The relative expression of DNMT1 was significantly elevated in melasma compared with unaffected skin in all subjects, indicating DNA hypermethylation. After treatment, it was decreased in all groups: niacinamide (7 versus 1; p<0.01), retinoic acid (7 versus 2; p<0.05), and placebo (7 versus 3; p<0.05), which correlates with clinical improvement. DNMT3b was not overexpressed in lesional skin but reduced in all groups. CONCLUSIONS: We found DNA hypermethylation in melasma lesions. Environmental factors such as solar radiation may induce cellular changes that trigger hyperpigmentation through the activation of pathways regulated by epigenetic modifications. However, limiting or decreasing DNA methylation through sunscreen, niacinamide, and retinoic acid treatments that provide photoprotection and genetic transcription can counteract this.
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Metilases de Modificação do DNA/metabolismo , Melanose/tratamento farmacológico , Melanose/enzimologia , Niacinamida/uso terapêutico , Protetores Solares/uso terapêutico , Tretinoína/uso terapêutico , 5-Metilcitosina/metabolismo , Adulto , Metilação de DNA , Metilases de Modificação do DNA/genética , Epiderme/efeitos dos fármacos , Epiderme/patologia , Feminino , Fluorescência , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Humanos , Placebos , Protetores Solares/farmacologiaRESUMO
Prostate cancer is the second most frequently diagnosed cancer worldwide and the fifth most common cause of cancer deaths among men. Cutaneous metastasis is an uncommon phenomenon in prostatic cancer, occurring in 0.06-0.3% of cases. Case Presentation. A 56-year-old man presented to our outpatient clinic with a one-month history of a 1.5 cm in diameter, solitary, asymptomatic, purple nodule located on his upper right cheek. After biopsy, prostatic cancer metastasis was diagnosed. Discussion. A literature review revealed 59 articles documenting 71 cases of this diagnosis. The review recorded epidemiological data, including age, duration, morphology, location, and outcome of patients. Conclusions. The skin is an uncommon site for metastasis of prostate cancer, and the review showed that its presence is associated with a poor prognosis (approximately 10 months from diagnosis).
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Background: The blend of hemoglobin, carotenes, and melanin defines the skin color. Constitutive pigmentation is genetically determined, facultative color is induced when skin is exposed to environment. The objective was to quantify both pigmentations in a sample of Mexican population and to analyze its relationship with sex, age, and phototype. Methods: We evaluated 259 individuals during the winter. Skin colorimetry was obtained by diffuse reflectance spectrometry, using the International Commission of Illumination coordenates. L*a*b* parameters were measured and the individual typological angle (ITA) was estimated from forehead, thorax, neck, forearms, and buttocks areas. Results: Facultative pigmentation differed from constitutive in L*, a*, and ITA° values. In men, L* and ITA° parameters were lower. Constitutive pigmentation was similar between sexes. Phototypes III, IV, and V showed differences in L*, b*, and ITA°. Facultative values such as L*, a*, ATI°, and the constitutive a* reduce as age increases. Conclusions: The cutaneous tones of a sample of population were quantified recognizing their values for white, light brown, and dark brown skin. A reference frame for research related to cutaneous pigmentation in Mexico is presented.
Antecedentes: La mezcla de melanina, hemoglobina y carotenos definen el color cutáneo. La pigmentación constitutiva está determinada genéticamente, la facultativa se induce cuando la piel se expone al ambiente. El objetivo fue cuantificar ambas pigmentaciones en una muestra de población mexicana, y analizar su relación con el género, edad y fototipo. Métodos: Se evaluaron 259 personas durante un periodo invernal. La colorimetría cutánea se obtuvo mediante espectrometría de reflectancia difusa utilizando las coordenadas de la Comisión Internacional de Iluminación. Se registraron los valores L*a*b* y se estimó el ángulo tipológico individual (ATI°) en frente, tórax, cuello, antebrazos y glúteos. Resultados: La pigmentación facultativa difirió de la constitutiva en los parámetros L*, a*, y ATIº. En hombres, los valores facultativos de L* y ATI° fueron menores. La pigmentación constitutiva fue similar entre sexos. Los fototipos III, IV y V muestran diferencias en L*, b* y ATI°. Los valores facultativos L*, a*, ATI° y el constitutivo a* se reducen al incrementarse la edad. Conclusiones: Se cuantificaron los tonos cutáneos de una muestra de población reconociéndose los valores para la piel blanca, morena clara y morena oscura. Se presenta un marco de referencia para estudios relacionados con la pigmentación cutánea en México.
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Pigmentação da Pele , Pele/química , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Espectral , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to obtain autologous dermal-epidermal skin substitutes from oral mucosa from diabetic subjects as a first step towards a possible clinical application for cases of diabetic foot. MATERIAL AND METHODS: Oral mucosa was obtained from diabetic and healthy subjects (n=20 per group). Epidermal cells were isolated and cultured using autologous fibrin to develop dermal-epidermal in vitro substitutes by the air-liquid technique with autologous human serum as a supplement media. Substitutes were immunocharacterized with collagen IV and cytokeratin 5-14 as specific markers. A Student´s t- test was performed to assess the differences between both groups. RESULTS: It was possible to isolate epidermal cells from the oral mucosa of diabetic and healthy subjects and develop autologous dermal-epidermal skin substitutes using autologous serum as a supplement. Differences in the expression of specific markers were observed and the cytokeratin 5-14 expression was lower in the diabetic substitutes, and the collagen IV expression was higher in the diabetic substitutes when compared with the healthy group, showing a significant difference. CONCLUSION: Cells from oral mucosa could be an alternative and less invasive source for skin substitutes and wound healing. A difference in collagen production of diabetic cells suggests diabetic substitutes could improve diabetic wound healing. More research is needed to determine the crosstalk between components of these skin substitutes and damaged tissues.