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Intense pulsed-light photorejuvenation.

Intense pulsed light photorejuvenation represents a novel mode of treatment of photodamaged skin. A broad-spectrum flashlamp (500-1200 nm) targets chromophores reversing pigmentation, vascular and pilosebaceous aberrations. Both cytokine mediated as well as thermally induced deep dermal remodeling may be achieved using the varied polychromatic wavelengths associated with this technology. Inflammatory dermatosis such as rosacea may also be addressed as well. A structural approach to non-ablative rejuvenation utilizing intense pulsed light is associated with high patient satisfaction and minimal adverse sequelae.

Facial Dermatoses↗

Antiviral and antioxidant activity of flavonoids and proanthocyanidins from Crataegus sinaica.

The antiviral and antioxidant activity of some fractions and of a series of flavonoids and proanthocyanidins obtained from Crataegus sinaica (Rosaceae) was evaluated. The O-glycosidic flavonoids and the oligomeric proanthocyanidins exhibited significant inhibitory activity against herpes simplex virus type 1 (HSV-1), which was shown to be due to an extracellular mechanism for procyanidin C-1. Procyanidin C-1 also had the highest antioxidant activity in both the microsomal lipid peroxidation and the hydroxyl radical scavenging assay. In addition to the previously reported phenolic compounds, the pentacyclic triterpenoid ursolic acid (1) and a tetrameric (2) and pentameric procyanidin (3) are reported for the first time.

Animals↗

[Periorbital contact eczema].

Periorbital contact eczema is most commonly the result of an allergic contact dermatitis whereas other eczematous skin diseases like atopic eczema or seborrheic eczema occur less frequently. Also, other diseases like autoimmune disorders or rosacea need to be considered. Allergic contact dermatitis is a T-cell-mediated immunological response towards ubiquitous contact allergens. Activated T-cells migrate through the vessels into the skin and produce several inflammatory mediators. Epicutaneous patch testing is an important tool for the diagnosis of contact allergy whereby the allergens are analysed in terms of their ability to induce eczematous skin reaction. Until now the short-term use of corticosteroids are is employed for the treatment of allergic contact eczema. Modern substances with an optimal therapeutic index should rather be used.

Dermatitis, Contact↗

Applications of aminolevulinic Acid-based photodynamic therapy in cosmetic facial plastic practices.

Photodynamic therapy (PDT) using aminolevulinic acid (ALA) is a promising new technique that is being studied extensively and used in a variety of cosmetic facial plastic arenas. These applications include U.S. Food and Drug Administration-approved treatment of premalignant and malignant skin conditions, as well as off-label uses for photorejuvenation, and the treatment of acne vulgaris, sebaceous gland hyperplasia, rosacea, and hirsutism. This article reviews the interplay of factors that contribute to the appearance of actinically damaged or photoaged skin, also known as dermatoheliosis. This is followed by a brief review of the mechanisms of action of ALA-based PDT and some of its cosmetic facial plastic uses.

Aminolevulinic Acid↗

The inhibitory effect of triterpenoid glycosides originating from Sanguisorba officinalis on tissue factor activity and the production of TNF-alpha.

We examined the inhibitory effects of novel triterpene glycoside compounds [ziyu-glycoside II (ZY-II) and its methyl ester (ZYM-201)], which originated from the roots of sanguisorba officinalis L. (Rosaceae), on tissue factor (TF) activity and tumor necrosis factor (TNF)-alpha production. In in vitro TF activity tests, ZY-II but not ZYM-201 strongly blocked lung TF activity with an IC50 value of 0.46 microM. By contrast, only ZYM-201 dose-dependently inhibited in vivo TF activity with an ED50 value of 1.7 mg/kg, when orally administered. Furthermore, ZYM-201 diminished both in vitro and in vivo TNF-alpha production with IC50 or ED50 values of 69.4 microM and 87.4 mg/kg, respectively. Therefore, these results suggest either that ZYM-201 may be developed as a potent inhibitor of both TF- and TNF-alpha-mediated diseases such as atherosclerosis and septic shock, or it may be a lead compound to be derivatized for further improvement of its curative efficacy.

Administration, Oral↗

Anti-complementary activity of Crataegus sinaica.

The 80% and 70% acetone extracts from fruits and leaves of Crataegus sinaica Boiss (Rosaceae) and the ethyl acetate-, butanol-, and water-fractions obtained from these initial extracts as well as the isolated compounds, quercetin (1) (1), hyperoside (quercetin 3-O-galactoside) (2) (2), rutin (quercetin 3-O-rutinoside) (3) (2), vitexin (4) (1), rhamnosylvitexin (5) (3), monoacetylrhamnosylvitexin (6) (3), epicatechin (7) (4), procyanidin B-5 (8) (4), proanthocyanidin A-2 (9) (5), procyanidin B-2 (10) (4), and procyanidin C-1 (11) (4), were tested for their influence on the classical (CP) and alternative (AP) pathways of complement-mediated hemolysis. All extracts and fractions showed a strong anti-complementary effect in a dose-dependent way which was more pronounced on the CP than on the AP. The results indicated that the pure proanthocyanidins were active on the CP. Procyanidin C-1 and proanthocyanidin A-2 were the most active on the CP and also showed activity on AP, whereas the flavonoids isolated were generally less active. However, rutin, showed a strong activity, quercetin and rhamnosylvitexin a moderate activity on the CP. This is the first report on the chemical constituents and complement-modulating activity of C. sinaica and on the occurrence of proanthocyanidin A-2 (9) in hawthorn.

Biflavonoids↗

New benzyl alcohol glycosides from Pyrus bourgaeana.

Two new aromatic glycosides, benzyl beta-D-glucopyranosyl-(1-->2)-[beta-D-apiofuranosyl-(1-->6)]-beta- D- glucopyranoside and p-[beta-D-apiofuranosyl-(1-->6)]-beta-D- glucopyranosyloxy-benzylic alcohol, have been isolated from the aerial parts of Pyrus bourgaeana (Rosaceae). The structures were elucidated by spectral analyses (including 2D-NMR spectral measurements) and chemical methods. Arbutin and four other aromatic glycosides have also been isolated and identified.

Carbohydrate Sequence↗

The metabolism of a natural product: lessons learned from cyanogenic glycosides.

The biosynthesis, compartmentation, and catabolism of cyanogenic glycosides are discussed for the cases of some selected examples. These include amygdalin (occurring widely in the Rosaceae), the aliphatic cyanogens linamarin and lotaustralin (widely occurring, especially in the Leguminosae), and dhurrin together with its epimer taxiphyllin (occurring in the genus SORGHUM). Mechanistic studies including tracer experiments are described in detail. Unusual and even unique metabolites of amino acids have been identified as intermediates in these biosynthetic processes.

Journal Article↗

The use of the CO2 laser in rhinophyma surgery: personal technique and experience, complications, and long-term results.

Rhinophyma is a slowly progressive disfiguring disorder of the nose that represents the end stage of acne rosacea. The cosmetic deformity is often the reason patients seek medical attention. Over the years, many treatment modalities, including dermabrasion, electrocautery, excision and grafting, decortication, and cryosurgery, among others, have been described to treat this condition, but none of them has proved very satisfactory. Special concern about the droplet dispersion of blood in dermabrasion has made this method less acceptable, as it poses a potential risk to health workers. We describe a technique in which this proliferative disorder can be treated, using CO2 laser excision and vaporization. This method provides a very dry surgical field, which allows the sculpting of the hypertrophic areas to be very effective, giving a very satisfactory immediate and long-term cosmetic results.

Burns↗

Recombinant allergens Pru av 1 and Pru av 4 and a newly identified lipid transfer protein in the in vitro diagnosis of cherry allergy.

BACKGROUND: In central and northern Europe food allergy to fruits of the Rosaceae family is strongly associated with birch pollinosis because of the existence of IgE cross-reactive homologous allergens in birch pollen and food. By contrast, in the Mediterranean population allergic reactions to these fruits frequently are not related to birch pollen allergy and are predominantly elicited by lipid transfer proteins (LTPs). OBJECTIVE: We sought to determine the prevalence of IgE sensitization to the recombinant cherry allergens Pru av 1 and Pru av 4 in comparison with cherry extract within a representative group of patients who were allergic to cherries recruited in Germany and to compare the relevance of IgE to cherry LTPs in Italian patients. METHODS: Recombinant Pru av 1 and rPru av 4 were available from earlier studies. The cDNA of the cherry LTPs was obtained by using a PCR-cloning strategy. The protein was expressed in Escherichia coli and purified by means of metal chelate affinity chromatography. Sera from 101 German patients with birch pollinosis and oral allergy syndrome to cherry and sera from 7 Italian patients with cherry allergy were investigated by using enzyme allergosorbent tests for IgE reactivity with cherry extract, rPru av 1, rPru av 4, and the recombinant cherry LTP. Inhibition experiments were performed to compare the IgE reactivity of natural and recombinant cherry LTPs and to investigate potential cross-reactivity with birch pollen allergens. RESULTS: The LTP from cherry comprises 91 amino acids and a 26 amino acid signal peptide. The mature cherry LTP shows high amino acid sequence identity with allergenic LTPs from peach (Pru p 3, 88%), apricot (Pru ar 3, 86%), and maize (Zea m 14, 59%) and displays no IgE cross-reactivity with birch pollen. The IgE prevalences in the German patients were as follows: LTP, 3 of 101 (3%); rPru av 1, 97 of 101 (96.0%); rPru av 4, 16 of 101 (16.2%); and cherry extract, 98 of 101 (97%). All 7 Italian patients had IgE against the cherry LTP. CONCLUSIONS: Recombinant allergens are useful tools for a more accurate in vitro IgE-based diagnosis of cherry allergy. Taken together, they mimic the allergenic activity of cherry extract, having slightly higher biologic activity. Sensitization to the cherry LTP is relevant for a minority of patients recruited in Germany, but our data indicate that it may be a major allergen in Italy.

Allergens↗

Population study of food allergy in France.

BACKGROUND: Food allergy (FA) is an important health problem for which epidemiologic studies are needed. OBJECTIVE: We performed an epidemiologic survey in France to determine the prevalence, clinical pictures, allergens, and risk factors of FA. METHODS: This study was conducted on 33,110 persons who answered a questionnaire addressed to a representative sample of the French population on a scale of 1:1000 (44,000 subjects aged </=60 years). One thousand one hundred twenty-nine persons with FA selected during phase 1 received a second questionnaire. RESULTS: The reported prevalence of FA is 3.52%: 3.24% evolutionary FA; 0.12% asymptomatic cases thanks to eviction diets; and 0.17% cured FA. The subjects were characterized by overrepresentation of city dwellers (80% vs 76%), women (63% vs 50%), and health care personnel (11% vs 4%). Fifty-seven percent (vs 17%) presented with atopic diseases (P <.01). FA was often persistent, lasting more than 7 years in 91% of the adults. The most frequent allergens were 14% Rosaceae, 9% vegetables, 8% milk, 8% crustaceans, 5% fruit cross-reacting with latex, 4% egg, 3% tree nuts, and 1% peanut. Sensitization to pollen was significantly correlated with angioedema, asthma, rhinitis, and fruit allergy (P <.01). FA was 4 times more frequent in patients with latex allergy. The main manifestations of FA were atopic dermatitis for subjects under 6 years of age, asthma for subjects between 4 and 6 years of age, and anaphylactic shock in adults over 30 years of age (P <.007). Shocks were correlated with alcohol or nonsteroidal anti-inflammatory drug intake (P <.01 and P <.04, respectively). CONCLUSION: The prevalence of FA is estimated at 3.24% (range, 3.04% to 3.44%) in France. This study emphasizes the increasing risk of FA in well-developed countries and draws attention to certain FA risk factors, such as the intake of drugs (nonsteroidal anti-inflammatory drugs, beta-blockers, and angiotensin-converting enzyme inhibitors) or alcohol, intolerance of latex gloves, and socioprofessional status.

Adolescent↗

Demonstration of polarizable crystals in fresh comedonal extracts: sebum crystallizes.

Previous studies using paraffin-embedded sections showed the presence of varying degrees of lipidic calculus (sebolith) formation in the pilosebaceous duct in acne comedonal lesions. The objective of this study was to examine the content of fresh acne comedonal extracts and pustules in polarizable crystalline material. Furthermore, to investigate if the amount of crystalline material correlates with the morphology, evolutionary stage, age and location of the comedone we performed polariscopic examination of 20 fresh acne comedonal extracts and 6 acne pustules. As controls, we used extracts from solar comedones, milia and epidermal inclusion cysts, follicular extracts from acne rosacea lesions, pustules of bacterial folliculitis and extracts from normal follicles from acne-prone individuals. The vast majority of acne comedones contained considerable amounts of polarizable crystalline material. Crystallization was more prominent in closed comedones, long-standing macrocomedones and conglobate comedones. Crystal formation was seen less commonly (p < 0.01) in solar comedones, milia and epidermal inclusion cysts. As shown in this study, crystallization of sebum is a common element of comedogenesis and may possibly contribute to comedo preservation.

Crystallization↗

Systematic cutaneous examination in hepatitis C virus infected patients.

The purpose of this study was to evaluate the frequency of skin changes among 100 patients from the Hepatogastroenterology Department of the University Hospital, Strasbourg, France who were hepatitis C virus-positive (HCV) and HIV-negative. Their clinical data were compared to those of 50 HCV-, and HIV-negative patients from the same Department, who suffered from various liver diseases. Psoriasis, rosacea, seborrheic dermatitis, cherry angiomas, spider nevus and skin cancers were noted in similar proportions in the two groups. In 15% of HCV-positive patients vs. 4% of controls, chronic pruritus was noted (p < 0.05). In 9 HCV-positive patients, pruritus was not related to itching dermatosis, and only 2 of these patients had mild cholestasis. Four cases of lichen planus vs. 0 in the control group were recorded. The virological data of patients with pruritus or lichen planus were not different than those of the rest of the group. Our findings indicate that systematic skin check-up in HCV-positive patients is valuable.

Adult↗

The bacterial flora of the skin surface following routine MAL-PDT.

Photodynamic therapy using methylated 5-aminolevulate (MAL-PDT) appears to have an effect on non-neoplastic skin diseases, for example acne vulgaris and rosacea, for which antibiotics are sometimes used, and a possible antibiotic effect of PDT has previously been suggested. It does, however, also cause local immunosuppression and post-treatment barrier defects, which may promote infection. At the same time, PDT-induced therapeutic skin damage is sometimes confused with secondary bacterial infection by non-dermatologists. The possible changes in bacterial flora associated with MAL-PDT were therefore studied in 47 patients undergoing treatment. Skin swabs were taken immediately before applying the MAL and instantly after light irradiation. Bacterial growth was identified in 18 cases. No statistically significant changes were seen, either in the specific species found or the estimated bacterial density on the skin surface. The observations do not support the notion that routine MAL-PDT affects the bacterial flora of the skin in a clinically significant manner. Therefore, the possible antibacterial effect of routine MAL-PDT is probably not the main explanation of its apparent effect on non-neoplastic skin disease.

Adult↗

Treatment of facial vascular lesions with intense pulsed light.

BACKGROUND: Various lasers, particularly the flashlamp-pulsed dye laser, have been proven to be effective in the treatment of facial vascular lesions. Nevertheless, the post-treatment side effects, such as pronounced purpura and changes in pigmentation, have been a matter of concern to patients. OBJECTIVE: To test the efficacy of an alternative treatment option that uses intense pulsed light to provide patients with a more tolerable post-treatment outcome. METHODS: A total of 200 patients were treated with an intense pulsed light source (PhotoDerm VL) using various treatment parameters. The patients were treated for facial veins (primarily telangiectasia), facial hemangiomas, rosacea and port wine stains. RESULTS: Of the 188 patients who returned for follow-up after 2 months, 174 achieved 75% to 100% clearance in one to four treatment sessions. The post-treatment side effects were minimal and well tolerated by the patients. There were no instances of scarring or other permanent side effects. CONCLUSION: The PhotoDerm VL provides a highly effective and safe alternative to the laser for treatment of facial vascular lesions. The device may achieve improved results for lesions that are resistant to laser therapy. The rate and degree of cosmetic side effects are considerably less than with laser treatment.

Adolescent↗

Anti-allergic effects of Sanguisorba officinalis on animal models of allergic reactions.

We investigated the effect of aqueous extract of Sanguisorba officinalis L.(Rosaceae) root (SOAE) on the immediate-type allergic reactions in vivo and in vitro. SOAE (0.01 to 1 g/kg) inhibited systemic allergic reaction induced by compound 48/80. When SOAE was employed in a systemic allergic reaction test, the plasma histamine levels were reduced in a dose-dependent manner. SOAE (0.001 to 1 g/kg) dose-dependently inhibited passive cutaneous anaphylaxis (PCA) activated by anti-dinitrophenyl (DNP) IgE. SOAE (0.001 to 1 mg/mL) also dose-dependently inhibited the histamine release from rat peritoneal mast cells (RPMC) activated by compound 48/80 or anti-DNP IgE. The level of cyclic AMP (cAMP) in RPMC, When SOAE was added, significantly increased compared with that of normal control. Moreover, SOAE (0.01 to 1 mg/mL) had a significant inhibitory effect on anti-DNP IgE-induced tumor necrosis factor-alpha (TNF-alpha) production. These results suggest that SOAE may be beneficial in the regulation of immediate-type allergic reaction.

Animals↗

Dermatological findings in 3 generations of a family with a high prevalence of human T cell lymphotropic virus type 1 infection in Brazil.

BACKGROUND: Dermatologic manifestations are quite common in patients with adult T cell leukemia and lymphoma and patients with myelopathy and/or tropical spastic paraparesis associated with human T cell lymphotropic virus type 1 (HTLV-1). The aim of this study was to investigate dermatological findings presented by 30 members of a Brazilian family, half of whom are infected with HTLV-1 (as confirmed by enzyme-linked immunosorbent assay and Western blot). METHODS: The subjects underwent dermatologic examination and laboratory assessment, which included the search for the HTLV-1 genome in peripheral blood mononuclear cells (PBMCs) by qualitative and semiquantitative polymerase chain reaction (PCR) and in skin samples by nested qualitative PCR and immunofluorescence assay. RESULTS: We found that cases of xerotic dermatological alterations, including 3 cases of acquired ichthyosis, were more frequent among the infected patients (7 cases vs. none among the uninfected individuals; P=.0063). Other lesions observed in this group included impetigo, scabies, epidermal nevus, herpes zoster scar, rosacea, and juvenile acne. One HTLV-1-infected individual presented with concurrently acquired ichthyosis, impetigo, scabies, dermatophytosis, and seborrheic dermatitis. The PCR performed on PBMCs and skin samples from 24 patients confirmed the serological results in all cases. Additionally, the HTLV-1 proviral load was higher in patients with >1 skin lesion. Finally, HTLV-1 could be identified in the skin by immunofluorescence assay, which, by use of PCR as the gold standard, showed a sensitivity and specificity of 61.5% and 100%, respectively. CONCLUSIONS: Altogether, these clinical and laboratory findings point to an HTLV-1 tropism toward the skin, even in HTLV-1 carriers without adult T cell leukemia/lymphoma or HTLV-1-associated myelopathy and/or tropical spastic paraparesis.

Adult↗

The micromorphology of pit membranes in tracheary elements of ericales: new records of tori or pseudo-tori?

BACKGROUND AND AIMS: Intervascular pit membranes were examined within Ericales to determine the distribution and structure of torus-like thickenings. METHODS: Forty-nine species representing 12 families of the order Ericales were investigated using light, scanning and transmission electron microscopy. They were compared with four species of Oleaceae to determine the true nature of the thickenings. KEY RESULTS: Pit membranes with torus-like thickenings were observed in seven species of Ericaceae and were found to be amorphous, plasmodesmata-associated structures with an irregular distribution. These pseudo-tori show major differences compared with true tori with respect to their distribution and ultrastructure. Genuine tori, which are strongly correlated with round pit apertures in narrow tracheary elements, were found in two species of Osmanthus (Oleaceae). CONCLUSIONS: The pseudo-tori found in some Ericaceae are considered to be similar to pit membrane thickenings previously recorded in Rosaceae. While true tori appear to be functionally significant in terms of efficiency and safety of water transport, the possible function of pseudo-tori could be associated with the role of plasmodesmata during differentiation of tracheids, fibre-tracheids or narrow vessels.

Ericaceae↗