Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Dermis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed2005

[Reconstructive surgery using an artificial dermis (Integra): results with 19 grafts].

BACKGROUND: Integra was initially developed for covering of acute burn wounds. The artificial dermis is a bilayered dermal substitute, the upper layer is a thin silicone layer, which acts as temporary epidermis, the under layer is a collagen network, which functions as the dermis. In the meantime, Integra is applicated in reconstructive surgery. PATIENTS AND METHODS: We present a series of 12 patients who underwent reconstructive surgery with Integra grafting for a total of 19 operational sites. The average area grafted per procedure was 210 cm(2) (15-1 200 cm(2)). The operation sites were located at the extremities, trunk and head-neck. The split thickness skin graft was performed, on average, after 20 days (16-29 days). The patients were admitted for 41 days on average (24 days-3 months). The follow-up was after 17 months (9-30 months). RESULTS: Early complications included seroma, loss of Intregra, and infection. Late complications were instable scars. In five cases, we found slight hypertrophe scars in borderline between healthy skin and covering with Integra. CONCLUSION: The advantages of using Integra in reconstructive surgery are its immediate availability and the availability in large quantities. Disadvantages are the necessity of two operations, risks of infection, the high price and time-consuming dressing changes. Defect covering with Integra should be used in special cases.

Adult↗
PubMed1998

Feasibility of measuring lipophilic or protein-bound drugs in the dermis by in vivo microdialysis after topical or systemic drug administration.

Our aim was to assess the microdialysis technique for determining in vivo drug levels of a lipophilic and a protein-bound model drug in the dermis. Forearm skin of healthy volunteers received topical 2% fusidic acid or 0.1% betamethasone-17-valerate formulations twice daily as occluded treatment on irritative dermatitis. Microdialysis sampling in the dermis after 48 h was without measurable drug. Hairless rats received maximized treatment with occluded applications of 10% fusidic acid or 4% betamethasone-17-valerate in ethanol for 72 h followed by microdialysis. Mean levels of betamethasone-17-valerate were 11-45 ng/ml; fusidic acid was not measurable. Systemic administration in clinical doses to rats was without measurable drug levels; increasing doses to 312 mg/kg of fusidic acid and 158 mg/kg of betamethasone-17-valerate yielded betamethasone-17-valerate levels of 25-44 ng/ml and fusidic acid levels of 10-90 ng/ml. This study demonstrates the challenges arising when using microdialysis for measuring in vivo-drug levels. For the drugs chosen it was necessary to administer very high systemic doses or apply a high topical drug concentration to obtain measurable drug levels in the dialysates. Drug levels were in the nanomolar range and demonstrated reproducible and dynamic monitoring of in vivo drug levels in the skin. Using microdialysis for sampling highly protein-bound or lipophilic drugs in the skin requires very sensitive analytical methods, and the sensitivity of the analysis is likely to be the limiting factor.

Administration, Oral↗
PubMed1994

Versican is expressed in the proliferating zone in the epidermis and in association with the elastic network of the dermis.

The expression of the large chondroitin sulfate proteoglycan versican was studied in human adult skin. For this purpose, bacterial fusion proteins containing unique portions of the versican core protein were prepared. Polyclonal antibodies against the fusion proteins specifically reacted with versican from a proteoglycan fraction of MG63 osteosarcoma cells. In immunohistochemical experiments, the affinity-purified antibodies localized versican in the stratum basale of the epidermis, as well as in the papillary and reticular layers of the dermis. An apparent codistribution of versican with the various fiber forms of the elastic network of the dermis suggested an association of versican with microfibrils. Both dermal fibroblasts and keratinocytes expressed versican in culture during active cell proliferation. In line with the observation that versican is absent in the suprabasal layers of the epidermis where keratinocytes terminally differentiate, culture conditions promoting keratinocyte differentiation induced a down-regulation of versican synthesis. In Northern blots versican mRNA could be detected in extracts from proliferating keratinocytes and dermal fibroblasts. Comparison of RNA preparations from semi-confluent and confluent fibroblast cultures demonstrated decreasing amounts of versican mRNA at higher cell densities. This inverse correlation of versican expression and cell density was confirmed by indirect immunofluorescence staining of cultured fibroblasts and keratinocytes. The localization of versican in the basal zone of the epidermis as well as the density dependence of versican in cell cultures suggest a general function of versican in cell proliferation processes that may not solely be confined to the skin.

Adult↗
PubMed1980

Globular deposits of immunoglobulins and complement in the papillary dermis. Clinical significance.

Globular deposits of immunoglobulins in the papillary dermis have been reported to occur in certain dermatoses, particularly in lichen planus. The clinical correlation of these deposits in 52 skin biopsy specimens reviewed by light and fluorescent microscopy was studied. These cases included five of lichen planus, 24 of lupus erythematosus or related diseases, four of dermatitis herpetiformis, three of drug eruption; two each of bullous pemphigoid, erythema nodosum, porphyria cutanea tarda; one each of vitiligo, pyoderma gangrenosum, neurodermatitis, erythema multiforme, granuloma annulare, vasculitis, epidermolysis bullosa simplex, Rothmund-Thompson syndrome, and four of unspecified dermatoses. Using an arbitrary scale of 1-4 based on the frequency of deposits, 3+ and 4+ deposits were identified in all five cases of lichen planus, as well as in six cases of lupus erythematosus, one of drug eruption, one of bullous pemphigoid, one of erythema nodosum, the vitiligo, vasculitis, and Rothmund-Thompson syndrome cases, and two cases of unspecified dermatoses; other cases showed only 1+ and 2+ deposits. In all five cases of lichen planus, the deposits contained IgM and C3, and in addition, IgA was present in four, IgG and fibrinogen in three. Among non-lichen planus cases, C3 was detected in 11 of 49, and fibrinogen in only four of 49. These findings indicate that globular deposits of Ig in the dermis, though suggestive, are not pathognomonic of lichen planus.

Biopsy↗
PubMed2004

Use of artificial dermis and recombinant basic fibroblast growth factor for creating a neovagina in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome.

Vaginal agenesis is an uncommon, but not rare, condition. Although there are many methods for creating a neovagina, the optimal treatment is unknown. An 18-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome received vaginoplasty with a modified Wharton procedure using an artificial dermis (atelocollagen sponge). From 10 days after the operation, the patient was administered human recombinant basic fibroblast growth factor (bFGF) spray to accelerate epithelialization on the neovagina. At 50 days after the operation, we confirmed histological squamous epithelialization of the vaginal epithelium. At 12 months after the operation, the neovagina was at least 3.5 cm in width and approximately 8 cm in length. In this case, use of artificial dermis and recombinant bFGF to create a neovagina was an easy, less invasive and useful method.

Abnormalities, Multiple↗
PubMed1987

Microanatomy of the dermis in relation to relaxed skin tension lines and Langer's lines.

The microanatomy of the dermis was studied by optical and scanning electron microscopy in order to visualize the relationship between orientation of fibers and skin tension lines. In the reticular dermis of the normal adult human, skin tension lines have an anatomical counterpart consisting of a preferential parallel orientation and a straightening of thin collagen bundles and elastic fibers. This was observed only when mechanical tensions normally present in the skin were preserved during the processing of the samples, but was not observed in those that had retracted during biopsy. A comparative study of the fetal skin of calves, where relaxed skin tension lines were absent, offered further evidence that the presence of tension lines in the skin depends on the interrelationship between elastic fibers and collagen fibers, as well as on the anchorage of collagen bundles one upon another.

Adult↗
PubMed1993

Structure of the dermis in type VIIC Ehlers-Danlos syndrome.

This report is the first to study histological, immunopathological, ultrastructural, and morphometric aspects of the abnormal structure of the dermis in Ehlers-Danlos syndrome, type VIIc. This disease, resulting from a defect in procollagen peptidase, resembles dermatosparaxis in animals. Dermal cells were abnormal in many aspects, including their large number, their strong argent affinity, and the occasional presence of oligocilia. Factor XIIIa-positive dendrocytes were, however, few in number. The stroma had many tears resulting from the absence of collagen bundles replaced by a loose meshwork of cauliflower fibrils. The mean collagen area, measured from fibrils, was similar to normal, and the individual values of this parameter were inversely related to the form factor that quantifies irregularity in fibril shape. Basement membranes were also defective, with an apparent paucity or focal absence of type IV collagen and laminin. The biology responsible for these many alterations in dermal structure is complex and not yet understood. The many morphological changes seen in Ehlers-Danlos syndrome, type VIIc, underscore the complexity of cell-matrix interactions in establishing a normal dermis.

Animals↗
PubMed1999

Application of artificial dermis prior to full-thickness skin grafting for resurfacing the nose.

Two patients with nasal skin defects resulting from excision of rhinophyma and multiple angiofibromas were treated with artificial dermis followed by full-thickness skin grafts taken from the postauricular region. The secondary skin grafts took completely in both patients, and the postoperative results were excellent. Although a two-stage operation is required, application of artificial dermis prior to full-thickness skin grafting is a reliable method for resurfacing the nose.

Adult↗
PubMed1988

Fate of primary orbital dermis-fat grafts in guinea pigs.

A year-long study was undertaken to serially evaluate the tissue changes occurring in dermis-fat graft (DFG) after orbital implantation in nine guinea pigs. Methods used to evaluate the DFGs were histology, magnetic resonance imaging, morphometric analysis, and clinical observations. The histology of a 1-year-old failed human dermis-fat graft has been included for completeness. The study reveals that clinically successful DFGs have a fibrous capsule surrounding the DFG. Minimal revascularization was present. The grafts appear to undergo continual histological changes for approximately 9 months before a steady-state condition ensues. Of interest are changes in the deep-orbital fat posterior to the DFG.

Adipose Tissue↗
PubMed1989

Dermis fat graft in eviscerated sockets.

Following evisceration, three patients who experienced extrusion of synthetic orbital implant underwent socket reconstruction using an autogenous dermis fat graft. An incision into the fundus of the existing sclera was necessary to provide for an adequate vascular bed for a composite fat graft, although the anterior ring of existing sclera with extraocular muscle attachments was not disturbed. Conjunctival reepithelialization of the dermal surface and enhancement of orbital volume occurred in each case. Furthermore, the autogenous fat graft retained the original excellent globe motility that was present before the socket reconstruction. After an average follow-up of 18 months, the volume restoration, integrity of conjunctival epithelium and fornices, and the graft viability have remained unchanged. As with alloplastic orbital implant extrusions in enucleated sockets, autogeneous dermis fat grafts can be useful in managing extrusions in previously eviscerated sockets.

Adipose Tissue↗
PubMed1998

Unilateral dermis-fat graft implantation in the pediatric orbit.

The purpose of this study was to evaluate the role of the dermis-fat graft (DFG) as an orbital implant in the pediatric age group. A retrospective study was made of a series of 16 patients who had undergone unilateral orbital implantation of a DFG. The ages of the patients at the time of surgery ranged from 2 months to 17 years, with followup ranging from 2 to 15 years. Growth of the graft was clinically apparent in the younger children. Increasing proptosis required surgical debulking of the graft in six of eight children who were 4 years old or younger at the time of DFG implantation. None of the eight children who were 9 years or older at the time of DFG implantation required surgical debulking. Indeed, five of the older patients demonstrated some degree of graft atrophy. Dermis-fat grafts placed in the orbits of young children appear to grow after implantation. This growth of the implant may help stimulate orbital growth, potentially leading to more symmetry between the involved and uninvolved sides.

Adipose Tissue↗
PubMed1983

The application of dermis grafts in deformities of the nose.

Dermis grafts were used by themselves or in conjunction with a more rigid material such as cartilage or bone in a series of 220 patients during a period of 18 years. Of these, 182 patients were seen between 6 months and 2 years after operation. The significant problem during the earlier postoperative period was a transient swelling of the recipient site, which was seen in 150 of the 182 patients (82 percent) and which lasted for up to 6 months. It resolved spontaneously in all cases without active treatment in between 3 and 6 months. In the late postoperative period a significant permanent decrease in graft volume with a return to the previous deformity occurred in 9 of 182 patients (5 percent). This paper illustrates the versatility of dermis grafts in dealing with a variety of iatrogenic and accidental traumatic deformities of the nose.

Edema↗
PubMed2000

Orbital dermis-fat graft using periumbilical tissue.

Dermis-fat grafts are currently used in orbital reconstruction in a variety of procedures. The most frequent harvesting site is the gluteal area. However, we encountered some patients with anophthalmic socket who wished to avoid a visible scar on the buttock. In this article, we describe the effort to offer the patient an alternative donor site. Of the last 36 patients with anophthalmic socket who needed a dermal fat implant, 11 wished to avoid a visible scar on the buttock. To satisfy their requests we have endeavored to harvest the dermis graft from the periumbilical area. The rate of absorption, the motility, and the satisfaction of the patients were used as outcome measures and were analyzed carefully. Of 11 patients, 4 were women and 7 were men. The ages of these patients ranged from 24 to 56. The maximum follow-up was 137 months and the minimum 22 months, with a mean follow-up of 79 months. Some degree of absorption of the graft developed in one patient who had a severe absorption and required further operation. Of 11 cases, there were 7 with excellent motility, 3 with good motility, and 1 not evaluated. The motility was measured with the final prosthesis. The results for all patients were satisfactory. The periumbilical area has sufficient concentration of subdermal fat, and it is a relatively hair-free region as the lateral quadrant of the buttock. This area is a suitable alternative donor site of dermal fat implant for anophthalmic socket, especially in young women.

Adipose Tissue↗
PubMed1999

In vivo high-frequency ultrasonic characterization of human dermis.

The aim of this study is in vivo skin tissue characterization of young and old human cutaneous tissues by estimating the slope of the attenuation coefficient. The method used is the centroid algorithm with a second-order autoregressive model to perform the spectral analysis. Backscattered signals are acquired with a 40-MHz transducer fixed on a three-dimensional robot. Diffraction phenomena are eliminated via an axial translation of the transducer that allows the acquisition of the signal in the focal zone. The slope of the attenuation coefficient is estimated on phantoms of known attenuation, in order to validate the method. Preliminary measurements of the slope of the attenuation coefficient are subsequently performed in the echographic mode on abdominal human skin samples in vitro at 40 MHz. After assessing the reproducibility of the measurement of the attenuation coefficient slope in human dermis at 40-MHz in vivo, this is carried out on the volar face of the forearm of 150 healthy subjects aged 14-85 yr. The values measured range from 0.7 to 3.6 dB/cm.MHz. The main result of this study is the decrease with advancing age of the attenuation coefficient slope, which may reflect structural modifications of human dermis with age.

Adolescent↗
PubMed1985

Inhibition of collagen production in scleroderma fibroblast cultures by a connective tissue glycoprotein extracted from normal dermis.

It was shown in a previous paper that a connective tissue glycoprotein (CTGP) extracted from normal rabbit dermis was able to inhibit total protein and collagen syntheses by normal dermis fibroblast cultures. In the present study, the effects of CTGP on scleroderma fibroblasts were investigated. [14C]Proline incorporation into total proteins of the supernatant was not significantly different from that found in controls. By contrast, the amount of collagen, expressed as percentage of total secreted protein, was far higher in scleroderma cultures than in normal ones (14.4% +/- 6.0% vs 4.6% +/- 0.9%). Addition of CTGP to the medium induced a concentration-dependent inhibition of [14C]proline incorporation into proteins from both control and scleroderma cells. In control cultures, no significant decrease of the percentage of collagen was observed, but over 60 micrograms/ml, both cytotoxic effects and inhibition of protein synthesis occurred. In scleroderma cultures, the inhibition was twice as effective on collagen as on noncollagen protein synthesis. The inhibition of collagen secretion was not related either to changes in collagen hydroxylation or to the intracellular catabolism of newly synthesized procollagen.

Animals↗
PubMed1997

Mutations in the COL3A1 gene result in the Ehlers-Danlos syndrome type IV and alterations in the size and distribution of the major collagen fibrils of the dermis.

Ehlers-Danlos syndrome type IV (EDS type IV) results from heterozygosity for mutations in the COL3A1 gene that encodes the chains of type III procollagen. By using light, transmission, and scanning electron microscopy, we examined skin biopsies from 22 individuals with EDS type IV in whom the COL3A1 mutations had been identified. The most striking changes in EDS type IV were correlated with point mutations that substituted a residue for a glycine near the carboxyl-terminal end of the triple-helical domain of pro alpha1(III). In three cases with the mutation G1012R, G1018V, or G1021E, cells in the dermis had extremely dilated rough endoplasmic reticulum (RER), the dermis was thin, and there was a reduced proportion of collagen although the proportion of elastic fibers appeared increased. In these tissues, collagen fibrils were small (65-80 nm) compared to normal (95-110 nm). Fibrils 80-90 nm in diameter and moderately dilated RER were found with mutations G769R, G373R, and G061E and with exon-skipping mutations of exons 34 and 45. With mutations G034R and G016C and exon-skipping mutations that deleted the sequences of exons 7, 8, 14, 18, 24, and 27, fibrils were more variable in size (85-120 nm). The composite collagen fibrils characteristic of EDS types I and II were not found in EDS type IV. These findings indicate that mutations in the COL3A1 gene have effects on secretion, fibrillogenesis, and skin architecture that reflect the position and nature of the mutation.

Adult↗
PubMed1994

Distinction of class II MHC+ Langerhans cell-like interstitial dendritic antigen-presenting cells in murine dermis from dermal macrophages.

Dermal cells are capable of initiating contact-hypersensitivity responses but the precise identification of the antigen-presenting cell within murine dermis is lacking. Class II major histocompatibility complex (MHC)+ cells with dendritic shape and lacking endothelial factor VIII but expressing the dendritic antigen-presenting cell marker NLDC-145 were observed in the perivascular and interstitial dermis of BALB/c and C3H/HeN skin. The heterogeneous class II MHC+ cells could be divided into two subsets: each was class II MHC+ CD45+ (bone marrow derived) GR-1- (non-neutrophil/macrophage) CD3- (non T), but one subset was CD11b+ (beta 2 integrin) and the other was CD11b-. Ultrastructural examination of class II MHC+ cells revealed the presence of a Langerhans cell-like/indeterminant cell subset with indented nuclei, dendritic morphology, active cytoplasm, and dense intermediate filaments. Phagolysomes and Birbeck granules were not observed in such cells, indicating these were distinct from dermal macrophages and from classical epidermal Langerhans cells, respectively. Cells with a monocyte/macrophage ultrastructural appearance were also noted, likely representing the class II MHC subset expressing CD11b and Ly6c (monocyte/endothelial antigen). Dermal cells in suspension were capable of processing and presenting large protein antigens to antigen-specific T-cell hybridomas; dermal cells also induced the syngeneic mixed lymphocyte reaction. The dermal antigen-presentation activities were totally abrogated by removal of class II MHC+ cells, but not by removal of CD11b+ cells or Ly6c+ cells, indicating that potent antigen-presenting cell activity was restricted to the class II MHC+ CD11b- Ly6c- subset (Langerhans cell-like/indeterminant cells). In conclusion, within a complex array of dermal leukocytes a murine dermal class II MHC+ cell population expressing a Langerhans cell-like/dendritic antigen-presenting cell phenotype and exhibiting potent antigen processing and presenting activity can be identified. The positioning of potent interstitial dendritic antigen-presenting cells at the interface of the vasculature with the dermal interstitium provides rapid access to an antigen-presenting cell as T cells first egress into the skin.

Animals↗
PubMed1981

Ultrastructure of the human dermal microcirculation. III. The vessels in the mid- and lower dermis and subcutaneous fat.

This paper describes the ultrastructure of the microcirculatory vessels in the mid- and lower dermis and subcutaneous fat. Reconstruction of vessel walls, tracing out the courses of individual vessels, and survey examination of vessels were carried out by various combinations of routine and serial, ultrathin, and 1-micron sections. Intracellular myofilamentous bundles associated with extracellular filaments were a characteristic feature of the endothelial cells in arterioles possessing an internal elastic lamina, but were only rarely seen in endothelial cells of venules. The ultrastructural features of these bundles and filaments suggested both contractile and anchoring functions. The elastic lamina of the arterioles was shown to be composed of individual elastic fibers oriented in the long axis of the blood vessel under the endothelium, rather than being a continuous sheet as in larger arteries and arterioles. The capillaries in the fat had walls of normal thickness (0.1-0.3 micron) similar to capillaries in other organs, in contrast to the dermal capillaries whose walls are 2-3 micron thick. The arterioles, capillaries, and venules in the fat were frequently devoid of veil cells in contrast to those in the dermis. Venous capillaries with bridged fenestrations were found in close proximity to eccrine sweat glands and hair bulbs in the forearm, trunk, and buttock skin.

Abdomen↗