Hand coverage by alcohol-based handrub varies: Volume and hand size matter.

PubMed

Zingg, Walter; Haidegger, Tamas; Pittet, Didier

2016-12-01

Visitors of an infection prevention and control conference performed hand hygiene with 1, 2, or 3 mL ultraviolet light-traced alcohol-based handrub. Coverage of palms, dorsums, and fingertips were measured by digital images. Palms of all hand sizes were sufficiently covered when 2 mL was applied, dorsums of medium and large hands were never sufficiently covered. Palmar fingertips were sufficiently covered when 2  or 3 mL was applied, and dorsal fingertips were never sufficiently covered. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Hand hygiene and skin health.

PubMed

Kownatzki, E

2003-12-01

The high rate of hand problems associated with the hand hygiene of medical professions is due to a combination of damaging factors: (1) the removal of barrier lipids by detergent cleaning and alcohol antisepsis followed by a loss of moisturizers and stratum corneum water and (2) the overhydration of the stratum corneum by sweat trapped within gloves. Together the facilitate the invasion of irritants and allergens which elicit inflammatory responses in the dermis. Among the lipids and water-soluble substances removed are natural antibacterials. Their loss leads to increased growth of transient and pathogenic micro-organisms which jeapordizes the very intention of skin hygiene. The kinetics of damage and its repair, and epidemiological evidence suggest that modern synthetic detergents as used in foaming liquid cleansers are the major offender. Conversely, the replacement of detergents with non-detergent emulsion cleansers has been shown to be effective in reducing the prevalence of hand problems among hospital staff. Presently recommended hand antisepsis reduces the risks to patients, but puts the burden on the health care provider. Rather than fighting micro-organisms at the expense of the skin's health, the skin and its own defences should be considered a collaborator in combating infectious diseases.

Increased transcutaneous oxygen tension in the skin dorsum over the foot in patients with diabetic foot disease in response to the topical use of an emulsion of hyperoxygenated Fatty acids.

PubMed

Lázaro-Martínez, J L; Sánchez-Ríos, J P; García-Morales, E; Cecilia-Matilla, A; Segovia-Gómez, T

2009-12-01

The aim of this study was to examine changes in the skin over the feet of patients with diabetic foot syndrome after local application of a product containing hyperoxygenated fatty acids (HOFAs) by measuring transcutaneous oxygen. In 64 patients, transcutaneous oxygen pressure (TcPo(2)) was measured on days 0, 7, 30, 60, and 90 of the study. Foot skin dryness, shedding, and skin color were also assessed using a clinical score. The patients were grouped on the basis of initial levels of transcutaneous oxygen; group 1 comprised patients with TcPo( 2) >30 mm Hg and group 2 comprised patients with TcPo(2) <30 mm Hg on the skin over the dorsum of the feet. Increases in local oxygenation values were observed at a local level in group 2 patients after 30 days of treatment. Skin trophism showed clinical improvement in all patients and these observations may be attributed to improved local microcirculation.

Beyond the Bottom of the Foot: Topographic Organization of the Foot Dorsum in Walking.

PubMed

Klarner, Taryn; Pearcey, Gregory E P; Sun, Yao; Barss, Trevor S; Kaupp, Chelsea; Munro, Bridget; Frank, Nick; Zehr, E Paul

2017-12-01

Sensory feedback from the foot dorsum during walking has only been studied globally by whole nerve stimulation. Stimulating the main nerve innervating the dorsal surface produces a functional stumble corrective response that is phase-dependently modulated. We speculated that effects evoked by activation of discrete skin regions on the foot dorsum would be topographically organized, as with the foot sole. Nonnoxious electrical stimulation was delivered to five discrete locations on the dorsal surface of the foot during treadmill walking. Muscle activity from muscles acting at the ankle, knee, hip, and shoulder were recorded along with ankle, knee, and hip kinematics and kinetic information from forces under the foot. All data were sorted on the basis of stimulus occurrence in 12 step cycle phases, before being averaged together within a phase for subsequent analysis. Results reveal dynamic changes in reflex amplitudes and kinematics that are site specific and phase dependent. Most responses from discrete sites on the foot dorsum were seen in the swing phase suggesting function to conform foot trajectory to maintain stability of the moving limb. In general, responses from lateral stimulation differed from medial stimulation, and effects were largest from stimulation at the distal end of the foot at the metatarsals; that is, in anatomical locations where actual impact with an object in the environment is most likely during swing. Responses to stimulation extend to include muscles at the hip and shoulder. We reveal that afferent feedback from specific cutaneous locations on the foot dorsum influences stance and swing phase corrective responses. This emphasizes the critical importance of feedback from the entire foot surface in locomotor control and has application for rehabilitation after neurological injury and in footwear development.

Primary tumor sites in relation to ultraviolet radiation exposure and skin visibility correlate with survival in cutaneous melanoma.

PubMed

Gordon, Daniela; Hansson, Johan; Eloranta, Sandra; Gordon, Max; Gillgren, Peter; Smedby, Karin E

2017-10-01

The prognostic value of detailed anatomic site and ultraviolet radiation (UVR) exposure patterns has not been fully determined in cutaneous melanoma. Thus, we reviewed medical records for detailed site in a population-based retrospective Swedish patient cohort diagnosed with primary invasive melanoma 1976-2003 (n = 5,973). We followed the patients from date of diagnosis until death, emigration or December 31 st 2013, and evaluated melanoma-specific survival by subsite in a multivariable regression model adjusting for established prognostic factors. We found that melanoma on chronic UVR exposure sites (face, dorsum of hands; adjusted HR 0.6; CI 0.4-0.7) and moderately intermittent UVR sites (lateral arms, lower legs, dorsum of feet; HR 0.7; CI 0.6-0.8) were associated with a favorable prognosis compared with highly intermittent sites (chest, back, neck, shoulders and thighs). Further, melanoma on poorly visible skin sites upon self-examination (scalp, retroauricular area, back, posterior upper arms and thighs, buttocks, pubic area; HR 1.3; CI 1.1-1.5) had a worse prognosis than those on easily visible sites (face, chest, abdomen, anterior upper arms and thighs, lower arms and legs, dorsum of hands and feet, palms). In conclusion, highly intermittent UVR exposure sites and poor skin visibility presumably correlate with reduced melanoma survival, independent of established tumor characteristics. A limitation of the study was the lack of information on actual individual UVR exposure. © 2017 UICC.

Skin hamartoma on the hand of a newborn infant.

PubMed

Kaga, Akimune; Itabashi, Chieko; Kanda, Susumu; Suzuki, Yutaka; Tanabu, Muneyuki; Kure, Shigeo

2013-06-01

Skin hamartoma is an extremely rare disease on the hand in newborn infants. Reported herein is the case of a newborn infant who presented with a skin hamartoma on the hand. The patient was a girl born at 37 weeks of gestational age. The mass was seen on her proximal left thumb at birth. The mass had a spherical diameter of 4 cm and was pedunculated. One the day after birth, the stalk on the mass was ligated in the neonatal intensive care unit. The mass was diagnosed as skin hamartoma on histopathology. At 1 year of age, the child had good hand function, and no recurrence of the neoplasia was evident. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Microsurgery in 46 cases with total hand degloving injury.

PubMed

Ju, Jihui; Li, Jianning; Hou, Ruixing

2015-10-01

To summarize the characteristics of total hand degloving injury and investigate the curative effect of microsurgery. A total of 46 patients with total hand degloving injury were enrolled in this study. The injury classification and treatment methods were as follows: Type I (11 cases), treated by replantation of the gloved skin; Type II (6 cases), treated by reconstruction using thumb wrap-around flap and second toe; Type III (4 cases), treated by reconstruction using bilateral second toe with dorsal foot flap; Type IV (9 cases), treated by replantation in situ or reconstruction; Type V (16 cases), treated by replantation or abdominal flap reconstruction. Of the patients who received Type I treatment, five completely survived, whereas eight had finger necrosis. In Type II, both the reconstructed fingers and hand flaps survived. For four patients who received Type III treatment, eight reconstructed fingers survived. In Type IV, two patients with reconstructed fingers survived, whereas the six with replantation in situ had necrosis of the partial palmar or hand dorsum skin. In Type V, nine patients with reconstructed fingers survived, and five cases with abdominal skin flap reconstruction and one case with anterolateral femoral flap survived. The restoration of hand appearance and function was the best in patients who received replantation. For reconstruction cases, however, the hand function was recovered to the basic self-care level. In cases with abdominal flap reconstruction, the hand function showed poor recovery. Total hand degloving injury can be classified into different types according to the injury degree. The appropriate microsurgical treatment based on these types can produce better curative effect. Copyright © 2015. Published by Elsevier Taiwan.

Hand motion segmentation against skin colour background in breast awareness applications.

PubMed

Hu, Yuqin; Naguib, Raouf N G; Todman, Alison G; Amin, Saad A; Al-Omishy, Hassanein; Oikonomou, Andreas; Tucker, Nick

2004-01-01

Skin colour modelling and classification play significant roles in face and hand detection, recognition and tracking. A hand is an essential tool used in breast self-examination, which needs to be detected and analysed during the process of breast palpation. However, the background of a woman's moving hand is her breast that has the same or similar colour as the hand. Additionally, colour images recorded by a web camera are strongly affected by the lighting or brightness conditions. Hence, it is a challenging task to segment and track the hand against the breast without utilising any artificial markers, such as coloured nail polish. In this paper, a two-dimensional Gaussian skin colour model is employed in a particular way to identify a breast but not a hand. First, an input image is transformed to YCbCr colour space, which is less sensitive to the lighting conditions and more tolerant of skin tone. The breast, thus detected by the Gaussian skin model, is used as the baseline or framework for the hand motion. Secondly, motion cues are used to segment the hand motion against the detected baseline. Desired segmentation results have been achieved and the robustness of this algorithm is demonstrated in this paper.

Skin microvascular flow during hypobaric exposure with and without a mechanical counter-pressure space suit glove

NASA Technical Reports Server (NTRS)

Tanaka, Kunihiko; Waldie, James; Steinbach, Gregory C.; Webb, Paul; Tourbier, Dietmar; Knudsen, Jeffrey; Jarvis, Christine W.; Hargens, Alan R.

2002-01-01

INTRODUCTION: Current space suits are rigid, gas-pressurized shells that protect astronauts from the vacuum of space. A tight elastic garment or mechanical-counter-pressure (MCP) suit generates pressure by compression and may have several advantages over current space suit technology. In this study, we investigated local microcirculatory effects produced with and without a prototype MCP glove. METHODS: The right hand of eight normal volunteers was studied at normal ambient pressure and during exposure to -50, -100 and -150 mm Hg with and without the MCP glove. Measurements included the pressure against the hand, skin microvascular flow, temperature on the dorsum of the hand, and middle finger girth. RESULTS: Without the glove, skin microvascular flow and finger girth significantly increased with negative pressure, and the skin temperature decreased compared with the control condition. The MCP glove generated approximately 200 mm Hg at the skin surface; all measured values remained at control levels during exposure to negative pressure. DISCUSSION: Without the glove, skin microvascular flow and finger girth increased with negative pressure, probably due to a blood shift toward the hand. The elastic compression of the material of the MCP glove generated pressure on the hand similar to that in current gas-pressurized space suit gloves. The MCP glove prevented the apparent blood shift and thus maintained baseline values of the measured variables despite exposure of the hand to negative pressure.

Automatic measurement of skin textures of the dorsal hand in evaluating skin aging.

PubMed

Gao, Qian; Yu, Jiaming; Wang, Fang; Ge, Tiantian; Hu, Liwen; Liu, Yang

2013-05-01

Changes in skin textures have been used to evaluate skin aging in many studies. In our previous study, we built some skin texture parameters, which can be used to evaluate skin aging of human dorsal hand. However, it will take too much time and need to work arduously to get the information from digital skin image by manual work. So, we want to build a simple and effective method to automatically count some of those skin texture parameters by using digital image-processing technology. A total of 100 subjects aged 30 years and above were involved. Sun exposure history and demographic information were collected by using a questionnaire. The skin image of subjects' dorsal hand was obtained by using a portable skin detector. The number of grids, which is one of skin texture parameters built in our previous study, was measured manually and automatically. Automated image analysis program was developed by using Matlab 7.1 software. The number of grids counted automatically (NGA) was significantly correlated with the number of grids counted manually (NGM) (r = 0.9287, P < 0.0001). And in each age group, there were no significant differences between NGA and NGM. The NGA was negatively correlated with age and lifetime sun exposure, and decreased with increasing Beagley-Gibson score from 3 to 6. In addition, even after adjusting for NGA, the standard deviation of grid areas for each image was positively correlated with age, sun exposure, and Bealey-Gibson score. The method introduced in present study can be used to measure some skin aging parameters automatically and objectively. And it will save much time, reduce labor, and avoid measurement errors of deferent investigators when evaluating a great deal of skin images in a short time. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

The Effects of Industrial Protective Gloves and Hand Skin Temperatures on Hand Grip Strength and Discomfort Rating

PubMed Central

2017-01-01

Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation) of 30.44 (5.35) years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI), hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C) and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove). The data were analyzed using the Shapiro–Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA) of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C) had a significant influence on grip when compared to medium (25 °C) and high (45 °C) hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves. PMID:29207573

Hand and finger dexterity as a function of skin temperature, EMG, and ambient condition.

PubMed

Chen, Wen-Lin; Shih, Yuh-Chuan; Chi, Chia-Fen

2010-06-01

This article examines the changes in skin temperature (finger, hand, forearm), manual performance (hand dexterity and strength), and forearm surface electromyograph (EMG) through 40-min, 11 degrees C water cooling followed by 15-min, 34 degrees C water rewarming; additionally, it explores the relationship between dexterity and the factors of skin temperature, EMG, and ambient condition. Hand exposure in cold conditions is unavoidable and significantly affects manual performance. Two tasks requiring gross and fine dexterity were designed, namely, nut loosening and pin insertion, respectively. The nested-factorial design includes factors of gender, participant (nested within gender), immersion duration, muscle type (for EMG), and location (for skin temperature). The responses are changes in dexterity, skin temperature, normalized amplitude of EMG, and grip strength. Finally, factor analysis and stepwise regression are used to explore factors affecting hand and finger dexterity. Dexterity, EMG, and skin temperature fell with prolonged cooling, but the EMG of the flexor digitorum superficialis remained almost unchanged during the nut loosening task. All responses but the forearm skin temperature recovered to the baseline level at the end of rewarming. The three factors extracted by factor analysis are termed skin temperature, ambient condition, and EMG. They explain approximately two thirds of the variation of the linear models for both dexterities, and the factor of skin temperature is the most influential. Sustained cooling and warming significantly decreases and increases finger, hand, and forearm skin temperature. Dexterity, strength, and EMG are positively correlated to skin temperature. Therefore, keeping the finger, hand, and forearm warm is important to maintaining hand performance. The findings could be helpful to building safety guidelines for working in cold environments.

Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age.

PubMed

Kingma, B R M; Frijns, A J H; Saris, W H M; van Steenhoven, A A; van Marken Lichtenbelt, W D

2010-07-01

During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have been studied. Here, we tested the hypotheses that at hand sites (a) elderly show equal vasoconstriction due to local cooling and (b) elderly show reduced response to noradrenergic stimuli. Skin perfusion and mean arterial pressure were measured in 16 young adults (Y: 18-28 years) and 16 elderly (E: 68-78 years). To study the effect of local vasoconstriction mechanisms local sympathetic nerve terminals were blocked by bretylium (BR). Baseline local skin temperature was clamped at 33 degrees C. Next, local temperature was reduced to 24 degrees C. After 15 min of local cooling, noradrenaline (NA) was administered to study the effect of neural vasoconstriction mechanisms. No significant age effect was observed in vasoconstriction due to local cooling at BR sites. After NA, vasoconstriction at the forearm showed a significant age effect; however, no significant age effect was found at the hand sites. [Change in CVC (% from baseline): Forearm Y: -76 +/- 3 vs. E: -60 +/- 5 (P < 0.01), dorsal hand Y: -74 +/- 4 vs. E: -72 +/- 4 (n.s.), ventral hand Y: -80 +/- 7 vs. E: -70 +/- 11 (n.s.)]. In conclusion, in contrast to results from the ventral forearm, elderly did not show a blunted response to local cooling and noradrenaline at hand skin sites. This indicates that at hand skin the noradrenergic mechanism of vasoconstriction is maintained with age.

Erbium:YAG laser contouring of the nasal dorsum: a preliminary investigation

NASA Astrophysics Data System (ADS)

Truong, Mai T.; Majaron, Boris; Pandoh, Nidhi S.; Wong, Brian J.

2001-05-01

In conventional aesthetic rhinoplasty operations, manual or powered rasps are used to reduce the osseo-cartilagenous nasal dorsum. This tactile method requires palpation of the instrument and the dorsum during surgery to estimate the degree of volume reduction, and often requires forceful manipulation of the dorsum which may illicit pain during surgery and contribute to post-operative edema and echymosis. In this preliminary study, we investigated the use of the Erbium:YAG laser ((lambda) equals294 micrometers ) to reduce bone and cartilage using ex-vivo porcine nasal dorsum and human cadaveric tissues. The short pulsed length and high absorption of this laser in biologic tissues results in minimization of thermal injury which are ideal for non- contact optical contouring of osseous and cartilagenous tissues in the face. Two Erbium:YAG lasers were used to ablate fresh porcine nasal bone and compared for their use. One Erbium:YAG laser, the Fidelis Laser, Fontana Medical Lasers, Ljubljana, Slovenija with variable pulse repetition rates (2 to 50 Hz), pulse energy (80 to 1000 mJ), and pulse duration (100, 300, 750 and 1000 microsecond(s) ) was used and compared to the Ultrafine Erbium:YAG laser, Coherent Inc., Santa Clara California, with variable pulse repetition rate (2 to 10 Hz), pulse energy (2-16 J/cm2), and spot diameter (2-6 mm). Only laser parameters approximating the conditions for thermal confinement were evaluated.

Efficacy of fermented green tea on peripheral skin temperature: a randomized and placebo-controlled clinical study.

PubMed

Lee, Eunyoung; Lee, Bum-Jin; Ha, Jaehyoun; Shin, Hyun-Jung; Chung, Jin-Oh

2016-09-01

This study was aimed at assessing the therapeutic efficacy of green tea on peripheral skin for cold hypersensitive subjects, who had the feeling of cold hands and feet at cold temperatures, one of the most common complaints in Asian women. This randomized and placebo-controlled clinical study included 60 female Korean subjects who had the feeling of cold hands and feet at cold temperatures. The subjects were randomly assigned into two groups to receive fermented green tea or a placebo (hot water). The skin temperature of the hands and feet was measured using digital infrared thermography at the baseline and at 15, 30, 45, and 60 min after the oral administration of the tea or placebo. The skin temperature of the hands and feet of the fermented green tea-administered group was significantly higher than that of the placebo-administered group. The temperature difference between the finger and the dorsum of the hand was significantly lower in the fermented green tea-administered group than that in the placebo group. Fermented green tea is helpful for cold hypersensitivity. This is the first clinical study to evaluate the efficacy of fermented green tea on peripheral skin in subjects having the feeling of cold hands and feet at cold temperatures by infrared thermography. However, further studies are necessary to evaluate the long-term effects of the fermented green tea for cold hypersensitivity and to elucidate the underlying physiological mechanism. © 2015 Wiley Periodicals, Inc.

Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age

PubMed Central

Frijns, A. J. H.; Saris, W. H. M.; van Steenhoven, A. A.; van Marken Lichtenbelt, W. D.

2010-01-01

During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have been studied. Here, we tested the hypotheses that at hand sites (a) elderly show equal vasoconstriction due to local cooling and (b) elderly show reduced response to noradrenergic stimuli. Skin perfusion and mean arterial pressure were measured in 16 young adults (Y: 18–28 years) and 16 elderly (E: 68–78 years). To study the effect of local vasoconstriction mechanisms local sympathetic nerve terminals were blocked by bretylium (BR). Baseline local skin temperature was clamped at 33°C. Next, local temperature was reduced to 24°C. After 15 min of local cooling, noradrenalin (NA) was administered to study the effect of neural vasoconstriction mechanisms. No significant age effect was observed in vasoconstriction due to local cooling at BR sites. After NA, vasoconstriction at the forearm showed a significant age effect; however, no significant age effect was found at the hand sites. [Change in CVC (% from baseline): Forearm Y: −76 ± 3 vs. E: −60 ± 5 (P < 0.01), dorsal hand Y: −74 ± 4 vs. E: −72 ± 4 (n.s.), ventral hand Y: −80 ± 7 vs. E: −70 ± 11 (n.s.)]. In conclusion, in contrast to results from the ventral forearm, elderly did not show a blunted response to local cooling and noradrenalin at hand skin sites. This indicates that at hand skin the noradrenergic mechanism of vasoconstriction is maintained with age. PMID:20300768

Reverse radial artery flap for soft tissue defects of hand in pediatric age group.

PubMed

Cheema, Saeed Ashraf; Talaat, Nabeela

2009-01-01

To highlight the usefulness of reverse radial artery flap in covering various soft tissue defects of hand in paediatric age group. A total of 16 reverse radial artery flaps were utilized in a period of three years to cover various soft tissue defects of hand for paediatric age group patients. The age ranged from 5-18 years. The two common causes of soft tissue defects in this series were mechanical trauma and fireworks trauma with five cases in each group. Three of the cases were burn victims and other two presented with earth quake injuries. One patient had wound because of road traffic accident. Soft tissue defects of palm were covered with this flap in eight cases while in three cases it was wrapped around the thumb. First web space defects were covered with this flap in two cases. Two cases required coverage of amputation stump at transmetacarpal level and yet another required a big flap to cover the soft tissue defects at palm, dorsum and thumb. Donor site was covered with split skin graft in all cases but one, which was closed primarily. We had partial loss of flap in one case. Grafted donor sites healed uneventfully and were quite acceptable to the patients in due course of time. Reverse radial artery flap has a quite long arc of rotation which brings it great ease to cover the soft tissue defects of various areas of hand like palm, dorsum, first web space and thumb.

Hand hygiene using a new hand-cleansing formulation without sanitizers: Effect on Staphylococcus aureus removal and recovery of properties against skin damage.

PubMed

Asaoka, Kentaro; Endo, Shiro; Suzuki, Yuki; Komuro, Satoru; Nemoto, Tadanobu; Kaku, Mitsuo

2016-08-01

Staphylococcus aureus is known to form a biofilm and colonize on damaged skin of the hands. We investigated changes in the quantity of S aureus on the hands and changes in skin damage when using a hand-cleansing formulation with potassium oleate but without a sanitizer (formulation A), which is highly effective in removing S aureus biofilm and causes minimal skin damage. The participants (14 medical staff members) used 2 types of hand-cleansing formulations (formulations A and B), each for 4 weeks. S aureus of the hands was cultured from swab samples on agar plates. Surface of hands was measured using an ultraviolet light microscope. The quantity of S aureus after using formulation A for 4 weeks was 10(1.08 ± 0.05) CFU/mL, a statistically significant decrease from the quantity of S aureus (10(1.59 ± 0.19) CFU/mL) just before use (P = .029). Also, dryness of hand surfaces decreased. With formulation B, the quantity of S aureus did not significantly change from before to after use (P > .05). This presumably occurs because formulation A gently removes S aureus biofilm. Formulation A removed S aureus from the hands of participants, and skin damage on the hands improved. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Skin texture parameters of the dorsal hand in evaluating skin aging in China.

PubMed

Gao, Qian; Hu, Li-Wen; Wang, Yang; Xu, Wen-Ying; Ouyang, Nan-Ning; Dong, Guo-Qing; Shi, Song-Tian; Liu, Yang

2011-11-01

There are various non-invasive methods in skin morphology for assessing skin aging. The use of digital photography will make it easier and more convenient. In this study, we explored some skin texture parameters for evaluating skin aging using digital image processing. Two hundred and twenty-eight subjects who lived in Sanya, China, were involved. Individual sun exposure history and other factors influencing skin aging were collected by a questionnaire. Meanwhile, we took photos of their dorsal hands. Skin images were graded according to the Beagley-Gibson system. These skin images were also processed using image analysis software. Five skin texture parameters, Angle Num., Angle Max., Angle Diff., Distance and Grids, were produced in reference to the Beagley-Gibson system. All texture parameters were significantly associated with the Beagley-Gibson score. Among the parameters, the distance between primary lines (Distance) and the value of angle formed by intersection textures (Angle Max., Angle Diff.) were positively associated with the Beagley-Gibson score. However, there was a negative correlation between the number of grids (Grids), the number of angle (Angle Num.) and the Beagley-Gibson score. These texture parameters were also correlated with factors influencing skin aging such as sun exposure, age, smoking, drinking and body mass index. In multivariate analysis, Grids and Distance were mainly affected by age. But Angle Max. and Angle Diff. were mainly affected by sun exposure. It seemed that the skin surface morphologic parameters presented in our study reflect skin aging changes to some extent and could be used to describe skin aging using digital image processing. © 2011 John Wiley & Sons A/S.

Warm hands, cold heart: progressive whole-body cooling increases warm thermosensitivity of human hands and feet in a dose-dependent fashion.

PubMed

Filingeri, Davide; Morris, Nathan B; Jay, Ollie

2017-01-01

What is the central question of this study? Investigations on inhibitory/facilitatory modulation of vision, touch and pain show that conditioning stimuli outside the receptive field of testing stimuli modulate the central processing of visual, touch and painful stimuli. We asked whether contextual modulation also exists in human temperature integration. What is the main finding and its importance? Progressive decreases in whole-body mean skin temperature (the conditioning stimulus) significantly increased local thermosensitivity to skin warming but not cooling (the testing stimuli) in a dose-dependent fashion. In resembling the central mechanisms underlying endogenous analgesia, our findings point to the existence of an endogenous thermosensory system in humans that could modulate local skin thermal sensitivity to facilitate thermal behaviour. Although inhibitory/facilitatory central modulation of vision and pain has been investigated, contextual modulation of skin temperature integration has not been explored. Hence, we tested whether progressive decreases in whole-body mean skin temperature (T sk ; a large conditioning stimulus) alter the magnitude estimation of local warming and cooling stimuli applied to hairy and glabrous skin. On four separate occasions, eight men (27 ± 5 years old) underwent a 30 min whole-body cooling protocol (water-perfused suit; temperature, 5°C), during which a quantitative thermosensory test, consisting of reporting the perceived magnitude of warming and cooling stimuli (±8°C from 30°C baseline) applied to the hand (palm/dorsum) and foot (sole/dorsum), was performed before cooling and every 10 min thereafter. The cooling protocol resulted in large progressive reductions in T sk [10 min, -3.36°C (95% confidence interval -2.62 to -4.10); 20 min, -5.21°C (-4.47 to -5.95); and 30 min, -6.32°C (-5.58 to -7.05); P < 0.001], with minimal changes (∼0.08°C) in rectal temperature. While thermosensitivity to local skin cooling

[Development of alternative to animal experiment in evaluation of skin irritation caused by alcohol-based hand rubs].

PubMed

Yamamoto, Nobuyuki; Miyamoto, Koji; Katoh, Masakazu

2010-08-01

Alcohol-based hand rubs are widely used for infection control in clinical practice. However, it is known that frequent use of the alcohol-based hand rubs may cause skin irritation. To predict the skin irritation in human, animal experiments are quite useful. Especially, the Draize Test using rabbits is suitable for this purpose because their skin is highly sensitive. On the other hand, the development of alternative to animal experiments is important not only from the viewpoint of ethical aspects but also from the efficient research and development. Reconstructed human epidermis (RhE) was developed as a human skin equivalent model in vitro, and has been applied to the evaluation of skin irritation. But the RhE has not been utilized for the evaluation of alcohol-based hand rubs because of the high skin permeability and cytotoxicity of alcohols. The aim of this study was to develop a new method using the RhE in evaluation of skin irritation caused by alcohol-based hand rubs. The authors propose an experimental technique named "Skin model blowing method (SMBM)" consisting of the sequential procedure as follows; applying small amount of testing sample on RhE, blow-dry, post incubation, and cell viability measurement. According to the SMBM, the skin irritation caused by alcohol-based hand rubs could be evaluated under the similar condition of their actual use. It was found that a high correlation existed between the cell viability obtained from SMBM and the skin irritation index in rabbit which had been reported previously.

Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing".

PubMed

Çağıcı, Can Alper

2017-11-16

Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Photographic analyses using skin detail of the hand: a methodology and evaluation.

PubMed

Malone, Christina A

2015-03-01

Skin features have been employed by law enforcement agencies for suspect and victim identification. Comparisons of hand have arisen in casework where images have been submitted where a face was not present but a hand was visible. This research utilizes a collection of 128 hands from employees of the U.S. Army Criminal Investigation Laboratory to examine the frequency and distribution of skin detail on the dorsal surface of the hand. To assess the location of features, the hand was segmented into 14 regions using readily discernible anatomical landmarks. Overall, 2618 pigmented lesions and 92 scars or injuries were documented. When comparing the regions with one another, Regions 1-10 had fewer pigmented lesions than Regions 11-14. There was no pattern to the distribution of scars throughout the regions. The findings presented a foundation for one possible method that may differentiate hands based on the frequency and distribution of such features. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Effects of pressure, cold and gloves on hand skin temperature and manual performance of divers.

PubMed

Zander, Joanna; Morrison, James

2008-09-01

Cold water immersion and protective gloves are associated with decreased manual performance. Although neoprene gloves slow hand cooling, there is little information on whether they provide sufficient protection when diving in cold water. Nine divers wearing three-fingered neoprene gloves and dry suits were immersed in water at 25 and 4 degrees C, at depths of 0.4 msw (101 kPa altitude adjusted) and 40 msw (497 kPa) in a hyperbaric chamber. Skin temperatures were measured at the fingers, hand, forearm, chest and head. Grip strength, tactile sensitivity and manual dexterity were measured at three time intervals. There was an exponential decay in finger and back of hand skin temperatures with exposure time in 4 degrees C water. Finger and back of hand skin temperatures were lower at 40 msw than at 0.4 msw (P < 0.05). There was no effect of pressure or temperature on grip strength. Tactile sensitivity decreased linearly with finger skin temperature at both pressures. Manual dexterity was not affected by finger skin temperature at 0.4 msw, but decreased with fall in finger skin temperature at 40 msw. Results show that neoprene gloves do not provide adequate thermal protection in 4 degrees C water and that impairment of manual performance is dependent on the type of task, depth and exposure time.

Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand.

PubMed

Weeks, Dexter; Kasdan, Morton L; Wilhelmi, Bradon J

2016-01-01

The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.

Resurfacing glabrous skin defects in the hand: the thenar base donor site.

PubMed

Milner, Chris S; Thirkannad, Sunil M

2014-06-01

Defects of the glabrous skin surfaces of the palm and fingers result from numerous causes including larger fingertip injuries, unhealed burns, and after surgery for diverse pathologies. The qualities of glabrous skin are specifically tailored to the functional requirements of high-shear strength and robustness. Despite these unique properties, graft reconstruction of defects in the glabrous regions of the hand is frequently achieved with skin from nonglabrous donor sites such as the medial forearm. Nonglabrous skin has a poor color and texture match for such applications and is frequently associated with tender and unsightly donor scars. We describe our experiences of harvesting full-thickness grafts from the glabrous skin centered over the proximal flexion crease at the level of the metacarpophalangeal joint of the thumb. We have utilized this site to harvest skin grafts of up to 2 cm in width for the resurfacing of small-sized to medium-sized defects on the palmar surfaces of the hands and fingers in 28 patients under both traumatic and elective circumstances. The skin has an excellent type-match to the defect and is quick and easy to harvest due to its adjacent location to the defect. The donor scar matures quickly, and as it lies along the thumb base crease, it runs along one of the least used contact surfaces, thereby limiting the potential discomfort associated with FTSG harvest sites from other areas. Patient satisfaction with the procedure has been high, and it represents a useful alternative to traditional nonglabrous skin graft donor sites for small-sized to medium-sized defects.

Practice of skin protection and skin care among German surgeons and influence on the efficacy of surgical hand disinfection and surgical glove perforation

PubMed Central

2014-01-01

Background Surgical hand rub and healthy skin are basic requirements to prevent surgical site infections. Nevertheless, there is little knowledge about the current practice of skin protection and/or skin care products (SP/SC) using among surgeons as well as a lack of data pertaining to the influence of SP/SC on the antimicrobial efficacy of surgical hand rub. Methods A 10 weeks-survey among German surgeons as well as an experimental crossover study involving 26 participants were conducted. The immediate and sustainable efficacy (IE/SE) of surgical hand rub and participants’ hand moisture were measured after an 8-day usage of SP/SC, as well as the influence on micro-perforations on surgical gloves. Results The questionnaire was available to 16,000 German surgeons. Thereof, 1,771 surgeons accessed the questionnaire, representing a total participation rate of 11%. As 19% (n = 338) of questionnaires were incomplete, a total of 1,433 completed questionnaires were available for further analysis. More than 75% of the participants stated not to use any SP/SC, yet, almost 50% suffered from skin irritation or discomfort. Only 5% used SP/SC at the beginning of their shift. 10% refused to use SP/SC because of concerns that SP/SC may reduce the antimicrobial efficacy of surgical hand rub. After usage of SP/SC over 8-days, skin moisture was significantly higher (P < 0.001), whereas no significant influence on the antimicrobial efficacy of surgical hand rub was observed (IE: P = 0.135; SP: P = 0.681). Micro-perforations were detected in 8/52 surgical gloves (15%), with no statistical significant difference between SP/SC users (n = 2/26; 8%) and non-users (n = 6/26; 23%; P = 0.249). Conclusions Following the results of this largest questionnaire base survey among German surgeons on skin care, there is a need to educate and inform surgeons on the correct application and the concept of SP/SC strategies. In the present study, the combination of selected

Conducted healing to treat large skin wounds.

PubMed

Salgado, M I; Petroianu, A; Alberti, L R; Burgarelli, G L; Barbosa, A J A

2013-01-01

Improvement of the healing process to provide better aesthetical and functional results continues to be a surgical challenge. This study compared the treatment of skin wounds by means of conducted healing (an original method of treatment by secondary healing) and by the use of autogenous skin grafts. Two skin segments, one on each side of the dorsum,were removed from 17 rabbits. The side that served as a graft donor site was left open as to undergo conducted healing (A)and was submitted only to debridement and local care with dressings. The skin removed from the side mentioned above was implanted as a graft (B) to cover the wound on the other side. Thus, each animal received the two types of treatment on its dorsum (A and B). The rabbits were divided into two groups according to the size of the wounds: Group 1 - A and B (4 cm2)and Group 2 - A and B (25 cm2). The healing time was 19 days for Group 1 and 35 days for Group 2. The final macro- and microscopic aspects of the healing process were analysed comparatively among all subgroups. The presence of inflammatory cells, epidermal cysts and of giant cells was evaluated. No macro- or microscopic differences were observed while comparing the wounds that underwent conducted healing and those in which grafting was employed, although the wounds submitted to conducted healing healed more rapidly. Conducted wound healing was effective for the treatment of skin wounds. Celsius.

The Hand-Foot Skin Reaction and Quality of Life Questionnaire: An Assessment Tool for Oncology.

PubMed

Anderson, Roger T; Keating, Karen N; Doll, Helen A; Camacho, Fabian

2015-07-01

Skin toxicity (hand-foot syndrome/hand-foot skin reaction, HFS/R) related to antineoplastic therapy is a significant issue in oncology practice, with potentially large impacts on health-related quality of life (HRQL). A patient-reported questionnaire, the hand-foot skin reaction and quality of life (HF-QoL) questionnaire was developed to measure the HFS/R symptoms associated with cancer therapeutic agents and their effect on daily activities. The validity and reliability of the HF-QoL questionnaire was tested in a randomized trial of capecitabine with sorafenib/placebo in 223 patients with locally advanced/metastatic breast cancer. Other measures completed included patient ratings of condition severity, the Functional Assessment of Cancer Therapy-Breast cancer (FACT-B), and the clinician-rated National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, hand-foot skin reaction grade. The psychometric properties of the HF-QoL tested included structural validity, internal consistency, construct validity, discriminant validity, and responsiveness. Finally, the minimal clinically important difference (MCID) was estimated. The HF-QoL instrument comprises a 20-item symptom scale and an 18-item daily activity scale. Each scale demonstrated excellent measurement properties and discriminated between NCI-CTCAE grade and patient-rated condition severity with large effect sizes. The daily activity scale had excellent internal consistency and correlated with the FACT-B and HF-QoL symptom scores. Both HF-QoL scale scores increased linearly with increasing patient-rated condition severity. The MCIDs were estimated as 5 units for daily activities and 8 units for symptoms mean scores. The HF-QoL was sensitive to symptoms and HRQL issues associated with HFS/R among participants treated with capecitabine with and without sorafenib. The HF-QoL appears suitable for assessing the HRQL impairment associated with HFS/R to cancer therapies. Skin

A mild hand cleanser, alkyl ether sulphate supplemented with alkyl ether carboxylic acid and alkyl glucoside, improves eczema on the hand and prevents the growth of Staphylococcus aureus on the skin surface.

PubMed

Fukui, S; Morikawa, T; Hirahara, M; Terada, Y; Shimizu, M; Takeuchi, K; Takagi, Y

2016-12-01

Washing the hands using cleansers with antiseptic materials is the most popular method for hand hygiene and helps maintain health by preventing food poisoning and bacterial infections. However, repeated hand washing tends to induce eczema of the hand, such as dryness, cracking and erythema. Moreover, eczema on the hand leads to increased levels in Staphylococcus aureus (S. aureus) on the skin surface in contrast to expectations. Thus, mild hand cleansers which induce less eczema even with repeated washings are desired. Here, we evaluated the efficacy of a hand cleanser formulated with alkyl ether sulphate (AES), alkyl ether carboxylic acid (AEC) and alkyl glucoside (AG) that contains isopropyl methylphenol (IPMP) on skin symptoms and S. aureus levels. Eczema of the hand and the presence of S. aureus on the skin surface were analysed prior to and following 4 weeks of usage of the hand cleanser. A soap-based hand cleanser with IPMP was used as a reference cleanser. Eczema and cutaneous conditions were evaluated by visual grading, transepidermal water loss (TEWL), stratum corneum moisture-retention ability (MRA) and skin surface pH. The repeated use of the soap-based hand cleanser significantly worsened the hand dryness, scaling and cracks on the tips of the fingers and significantly increased the TEWL and decreased the MRA. In contrast, usage of the test cleanser only induced a significant increase in skin dryness but did not induce skin scaling or cracking and did not increase TEWL or decrease the MRA. Corresponding to these changes in skin symptoms, the presence of S. aureus increased the following use of the reference cleanser but not the test cleanser. There was no significant difference in skin surface pH between the two cleansers. Moreover, the increase in S. aureus was significantly correlated to the worsening of skin dryness and scaling. These results suggest that not only antimicrobial activity but also the mildness, which minimizes cutaneous effects

Efficacy of a Hand Regimen in Skin Barrier Protection in Individuals With Occupational Irritant Contact Dermatitis.

PubMed

Jordan, Laura

2016-11-01

Occupational irritant contact dermatitis (OICD) is a dif cult and hard to manage condition. It occurs more frequently in certain occupations where contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing heightens the risk. Treatment for OICD includes patient education in addition to physical, topical, and systemic therapies. To review the pathogenesis and treatment options for OICD and evaluate the ef cacy of a selective skin-care regimen involv- ing a hand protectant cream alone as well as combined with a repair cream and speci c cleanser. A single-center open study was performed comprising 42 healthy male and female adult volunteers prone to occupational irritant contact dermatitis due to frequent wet work or contact with detergents. Between day 0 and day 7, subjects applied a hand protectant cream as needed on both hands (at least twice daily). On days 7 to 14, subjects applied a hand protectant cream and cleanser as needed on both hands (at least twice daily) as well as a repair cream each evening. A diary log was given to each volunteer for application control and for a subjective evaluation of daily tolerability. In these subjects prone to occupational irritant contact dermatitis, the hand protectant cream applied during the initial 7-day period was effective in restoring the damaged skin barrier and improving the stratum corneum hydration. A regimen that combined the hand protectant and repair creams with a speci c cleanser during a further 7-day period allowed contin- ued improvement of skin hydration and additional clinical bene ts while respecting the skin barrier function. The results of this study support the use of a 3-step approach for patients who are at risk of repeated exposure to external irritants. J Drugs Dermatol. 2016;15(suppl 11):s81-85..

A Possible Landing Site in Aram Dorsum for the ExoMars Rover

NASA Image and Video Library

2014-08-27

This image captured by NASA Mars Reconnaissance Orbiter is of an area called Aram Dorsum also known by its old name, Oxia Palus that has been suggested for the 2018/2020 ExoMars Rover because it contains an ancient, exhumed alluvial system.

Molecular identification of bacteria on the tongue dorsum of subjects with and without halitosis.

PubMed

Riggio, M P; Lennon, A; Rolph, H J; Hodge, P J; Donaldson, A; Maxwell, A J; Bagg, J

2008-04-01

Compare the microbial profiles on the tongue dorsum in patients with halitosis and control subjects in a UK population using culture-independent techniques. Halitosis patients were screened according to our recently developed recruitment protocol. Scrapings from the tongue dorsum were obtained for 12 control subjects and 20 halitosis patients. Bacteria were identified by PCR amplification, cloning and sequencing of 16S rRNA genes. The predominant species found in the control samples were Lysobacter-type species, Streptococcus salivarius, Veillonella dispar, unidentified oral bacterium, Actinomyces odontolyticus, Atopobium parvulum and Veillonella atypica. In the halitosis samples, Lysobacter-type species, S. salivarius, Prevotella melaninogenica, unidentified oral bacterium, Prevotella veroralis and Prevotella pallens were the most commonly found species. For the control samples, 13-16 (4.7-5.8%) of 276 clones represented uncultured species, whereas in the halitosis samples, this proportion increased to 6.5-9.6% (36-53 of 553 clones). In the control samples, 22 (8.0%) of 276 clones represented potentially novel phylotypes, and in the halitosis samples, this figure was 39 (7.1%) of 553 clones. The microflora associated with the tongue dorsum is complex in both the control and halitosis groups, but several key species predominate in both groups.

Pituitary stalk compression by the dorsum sellae: possible cause for late childhood onset growth disorders.

PubMed

Taoka, Toshiaki; Iwasaki, Satoru; Okamoto, Shingo; Sakamoto, Masahiko; Nakagawa, Hiroyuki; Otake, Shoichiro; Fujioka, Masayuki; Hirohashi, Shinji; Kichikawa, Kimihiko

2006-06-01

The purpose of this study was to evaluate the relationship between pituitary stalk compression by the dorsum sellae and clinical or laboratory findings in short stature children. We retrospectively reviewed magnetic resonance images of the pituitary gland and pituitary stalk for 34 short stature children with growth hormone (GH) deficiency and 24 age-matched control cases. We evaluated the degree of pituitary stalk compression caused by the dorsum sellae. Body height, GH level, pituitary height and onset age of the short stature were statistically compared between cases of pituitary stalk compression with associated stalk deformity and cases without compression. Compression of the pituitary stalk with associated stalk deformity was seen in nine cases within the short stature group. There were no cases observed in the control group. There were no significant differences found for body height, GH level and pituitary height between the cases of pituitary stalk compression with associated stalk deformity and cases without compression. However, a significant difference was seen in the onset age between cases with and without stalk compression. Pituitary stalk compression with stalk deformity caused by the dorsum sellae was significantly correlated with late childhood onset of short stature.

A Possible Landing Site for the ExoMars Rover in Aram Dorsum

NASA Image and Video Library

2015-07-29

This image from NASA Mars Reconnaissance Orbiter is part of a proposed landing site in Aram Dorsum for the ExoMars Rover, planned for launch in 2018. Upper layers of light toned sediments have been eroded, leaving a lower surface which appears dark. The retreating sediment scarp slopes would be an important target for the rover if it ends up going to Aram Dorsum. The retreating scarps will be relatively recent compared to the ancient age of the terrain. That means that organic compounds-which is what ExoMars is designed to drill to 2 meters depth and analyze-will not have been exposed to the full effects of solar and galactic radiation for their entire history. Such radiation can break down organic compounds. Prior to this later erosion, the rocks formed in the ancient, Noachian era as alluvial deposits of fine grained sediment. http://photojournal.jpl.nasa.gov/catalog/PIA19859

Close range gun shot injuries of the hand with the "mole gun".

PubMed

Keskin, Mustafa; Beydes, Tolga; Tosun, Zekeriya; Savaci, Nedim

2009-07-01

A mole gun is a handmade weapon used as a trap to kill moles by farmers. Their action is based on a simple hammer mechanism: when the moles put their head through the metal ring to get hold of the food, they trigger the mechanism. The hammer strikes the primer, which ignites the gunpowder, propelling the pellets from the barrel. The purpose of this study was to report our experiences in a group of patients who accidentally suffered injuries by mole guns to the hand. Since 2000, 20 patients had attended the clinic with mole gun shot injuries to the hand. The mean age of patients was 38 years. Thirteen cases involved skin defects over the dorsum of the hand associated with extensor tendon and bone injuries. The skin defect was covered with posterior interosseous artery (PIA) flap in 12 cases. In one case, the PIA pedicle was found to be injured so radial forearm flap was used. The main intervention time for these cases was 6.2 days. All flaps except two PIA flap survived uneventfully. One flap was completely lost while other survived with distal necrosis. In remaining seven cases the thumb was the main injured part; it had complete disruption of its arterial supply and was managed with amputation with or without matarcarpal removal. These cases were managed immediately. The risk of injury to the PIA by pellets is low in such close range shots to the hand and PIA flap could be used to cover the defects. In such cases, initial debridement should be minimal and the soft tissue, tendon, and bone injury can be managed in the same stage during the first week of injury.

Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger.

PubMed

Calafat, V; Strugarek, C; Montoya-Faivre, D; Dap, F; Dautel, G

2018-04-04

Skin envelope degloving of fingers are rare injuries that require rapid care and surgical treatment. Mostly caused by ring finger injuries, these traumas include bone, tendon and neurovascular pedicle damage. The authors present an unusual case of finger degloving limited exclusively to the skin envelope, without skeletal, tendinous or vascular lesion. This rare case of skin envelope degloving rendered microsurgical revascularization impossible. The authors report the results at 12 months following salvage reconstruction combining a partial second toe pulp free flap for the volar side and a dermal substitute with a thin skin graft for the dorsum. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Determinants of hand dermatitis, urticaria and loss of skin barrier function in professional cleaners in New Zealand.

PubMed

Douwes, Jeroen; Slater, Tania; Shanthakumar, Mathangi; McLean, Dave; Firestone, Ridvan Tua; Judd, Lissa; Pearce, Neil

2017-04-01

This study assessed the risk of dermatitis, urticaria and loss of skin barrier function in 425 cleaners and 281 reference workers (retail workers and bus drivers). Symptoms, atopy and skin barrier function were assessed by questionnaire, skin prick tests, and measurement of transepidermal water loss. Cleaners had an increased risk of current (past 3 months) hand/arm dermatitis (14.8% vs. 10.0%; OR = 1.9, p < 0.05) and urticaria (11% vs. 5.3%; OR = 2.4, p < 0.05) and were more likely to have dermatitis as adults (17.6% vs. 11.4%; OR = 1.8, p < 0.05). The risk of atopy was not increased, but associations with symptoms were more pronounced in atopics. Transepidermal water loss was significantly higher in cleaners. Wet-work was a significant risk factor for dermatitis and hand washing and drying significantly reduced the risk of urticaria. In conclusion, cleaners have an increased risk of hand/arm dermatitis, urticaria and loss of skin barrier function.

Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial.

PubMed

Ibler, Kristina Sophie; Jemec, Gregor B E; Diepgen, Thomas L; Gluud, Christian; Lindschou Hansen, Jane; Winkel, Per; Thomsen, Simon Francis; Agner, Tove

2012-12-12

To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Randomised, observer blinded parallel group superiority clinical trial. Three hospitals in Denmark. 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Education in skin care and individual counselling based on patch and prick testing and assessment of work and domestic related exposures. The control was treatment as usual. The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index. The secondary outcomes were scores on the dermatology life quality index, self evaluated severity of hand eczema, skin protective behaviours, and knowledge of hand eczema from onset to follow-up. Follow-up data were available for 247 of 255 participants (97%). At follow-up, the mean score on the hand eczema severity index was significantly lower (improved) in the intervention group than control group: difference of means, unadjusted -3.56 (95% confidence interval -4.92 to -2.14); adjusted -3.47 (-4.80 to -2.14), both P<0.001 for difference. The mean score on the dermatology life quality index was also significantly lower (improved) in the intervention group at follow-up: difference of means: unadjusted -0.78, non-parametric test P=0.003; adjusted -0.92, -1.48 to -0.37). Self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves were also statistically significantly better in the intervention group, whereas this was not the case for knowledge of hand eczema. A secondary prevention programme for hand eczema improved severity and quality of life and had a positive effect on self evaluated severity and skin protective

[The combined use of capillaroscopy and skin thermometry in health surveillance of workers exposed to hand-arm vibration].

PubMed

Riolfi, A; Perbellini, L

2010-01-01

The use of nailfold capillaroscopy combined with skin thermometry in the study of microcirculation of the hands in workers exposed to hand-arm vibration is assessed. Fifty-eight subjects were studied; 40 asymptomatic forestry workers exposed to hand-arm vibration, 13 forestry workers exposed to hand-arm vibration with Raynaud-like symptoms confirmed by skin thermometry; 5 controls. Reduction of capillary density was observed in workers exposed to vibrating tools with respect to controls. Tortuosity of capillary loops was significantly more frequent in subjects exposed to vibrating tools than in controls. No statistically significant difference in capillary vessels of the hands was found between asymptomatic exposed subjects and workers affected by Raynaud-like symptoms. In our sample nailfold capillaroscopy shows good sensibilty and specificity in detecting capillary modifications secondary to exposure to hand-vibration. Weaker evidence is instead given in order to actual disturbances of hands circulation in chronic exposure to vibrating tools.

Skin changes in streptozotocin-induced diabetic rats.

PubMed

Andrade, Thiago Antônio Moretti; Masson-Meyers, Daniela Santos; Caetano, Guilherme Ferreira; Terra, Vânia Aparecida; Ovidio, Paula Payão; Jordão-Júnior, Alceu Afonso; Frade, Marco Andrey Cipriani

2017-09-02

Diabetes can cause serious health complications, which can affect every organ of the body, including the skin. The molecular etiology has not yet been clarified for all diabetic skin conditions. Thus, this study aimed to investigate the changes of diabetes in skin compared to non-diabetic skin in rats. Fifteen days after establishing the diabetic status, skin samples from the dorsum-cervical region were harvested for subsequent analysis of alterations caused by diabetes. Our results demonstrate that diabetes stimulated higher inflammation and oxidative stress in skin, but antioxidant defense levels were lower compared to the non-diabetic group (p < 0.05). This could have been related to a decreased number of blood vessels and low expression of VEGF, eNOS and TGF-β1. Finally, insulin signaling proteins IRS, Akt, Shc and ERK showed a low expression in the diabetic group. Thus, our study shows that the pathology of diabetes induced immunohistopathological and biochemical skin changes compared to non-diabetic skin in rats. Copyright © 2017 Elsevier Inc. All rights reserved.

Routine closure of the donor site with a second dorsal metacarpal artery flap to avoid the use of a skin graft after harvest of a first dorsal metacarpal artery flap.

PubMed

Chi, Zhenglin; Lin, Damu; Chen, Yiheng; Xue, Jixin; Li, Shi; Chu, Tinggang; Li, Zhijie

2018-06-01

Closure of the donor site on the index finger after raising a first dorsal metacarpal artery (DMA) flap harvest is challenging. The conventional choice is to use a full-thickness skin graft. However, this procedure is associated with several complications and a second donor site to harvest the skin graft is inevitable. The aim of this study was to design a modified incision to allow harvest of a first DMA flap without skin graft. From 2015 to 2016, 18 patients with a soft tissue defect of the thumb had reconstruction of the defect using a first DMA flap. A modified incision was used and a relaying perforator flap pedicled on the second DMA was raised through the same incision to cover the donor site. Patient satisfaction, appearance of the injured hand, and the active range of motion (ROM) were assessed. The sensitivity was evaluated by the 2-point discrimination (2-PD) test. All flaps survived completely without complications. Good coverage was obtained with only one linear scar in the dorsum of the hand and no skin grafts. All patients recovered full range of movement in their fingers and regained sensitivity of the flaps. All patients were satisfied with their hand function according to the Michigan Hand Outcomes Questionnaire (MHQ). The mean cosmetic score for the appearance of the injured hand was 8.2 out of 10. Using our modified incision, it was possible to harvest a second DMA flap at the same time as a first DMA flap allowing simultaneous coverage of the donor defect on the index finger. This prevented the need for a skin graft with all of the associated disadvantages. Copyright © 2018. Published by Elsevier Ltd.

Skin physiology in men and women: in vivo evaluation of 300 people including TEWL, SC hydration, sebum content and skin surface pH.

PubMed

Luebberding, S; Krueger, N; Kerscher, M

2013-10-01

Evidence is given that differences in skin physiological properties exist between men and women. However, despite an assessable number of available publications, the results are still inconsistent. Therefore, the aim of this clinical study is the first systematic assessment of gender-related differences in skin physiology in men and women, with a special focus on changes over lifetime. A total of 300 healthy male and female subjects (20-74 years) were selected following strict criteria including age, sun behaviour or smoking habits. TEWL, hydration level, sebum production and pH value were measured with worldwide-acknowledged biophysical measuring methods at forehead, cheek, neck, volar forearm and dorsum of hand. Until the age of 50 men's TEWL is significantly lower than the water loss of women of the same age, regardless of the location. With ageing gender-related differences in TEWL assimilate. Young men show higher SC hydration in comparison with women. But, whereas SC hydration is stable or even increasing in women over lifetime, the skin hydration in men is progressively decreasing, beginning at the age of 40. Sebum production in male skin is always higher and stays stable with increasing age, whereas sebum production in women progressively decreases over lifetime. Across all localizations and age groups, the pH value in men is below 5, the pH value of female subjects is, aside from limited expectations, higher than 5. Skin physiological distinctions between the sexes exist and are particularly remarkable with regard to sebum production and pH value. © 2013 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Ultra-weak photon emission of hands in aging prediction.

PubMed

Zhao, Xin; van Wijk, Eduard; Yan, Yu; van Wijk, Roeland; Yang, Huanming; Zhang, Yan; Wang, Jian

2016-09-01

Aging has been one of the several topics intensely investigated during recent decades. More scientists have been scrutinizing mechanisms behind the human aging process. Ultra-weak photon emission is known as one type of spontaneous photon emission that can be detected with a highly sensitive single photon counting photomultiplier tube (PMT) from the surface of human bodies. It may reflect the body's oxidative damage. Our aim was to examine whether ultra-weak photon emission from a human hand is able to predict one's chronological age. Sixty subjects were recruited and grouped by age. We examined four areas of each hand: palm side of fingers, palm side of hand, dorsum side of fingers, and dorsum side of hand. Left and right hand were measured synchronously with two independent PMTs. Mean strength and Fano factor values of photon counts were utilized to compare the UPE patterns of males and females of different age groups. Subsequently, we utilized UPE data from the most sensitive PMT to develop an age prediction model. We randomly picked 49 subjects to construct the model, whereas the remaining 11 subjects were utilized for validation. The results demonstrated that the model was a good regression compared to the observed values (Pearson's r=0.6, adjusted R square=0.4, p=9.4E-7, accuracy=49/60). Further analysis revealed that the average difference between the chronological age and predicted age was only 7.6±0.8years. It was concluded that this fast and non-invasive photon technology is sufficiently promising to be developed for the estimation of biological aging. Copyright © 2016 Elsevier B.V. All rights reserved.

Isolation of bacterial skin flora of healthy sheep, with comparison between frequent and minimal human handling.

PubMed

Haarstad, Amy C; Eisenschenk, Melissa C; Heinrich, Nicole A; Weese, J Scott; McKeever, Patrick J

2014-06-01

Few data are available regarding skin bacterial flora of healthy sheep and meticillin-resistant Staphylococcus carriage. To compare skin, ear and mucosal bacterial populations between minimally and frequently handled sheep; to determine whether the frequency of meticillin-resistant Staphylococcus aureus varied between groups. One hundred and three healthy feedlot and show sheep from eight farms. Swabs were collected from the dorsum, right ear and right nostril of each sheep. Two groups from each farm were evaluated, except from one farm, which had only one group. Bacterial isolates were identified to the genus or species level using phenotypic analysis or matrix-associated laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing and spa typing were performed on isolates of S. aureus. Sixteen bacterial genera were identified and 11 staphylococcal species, including S. aureus. The skin and mucosal bacterial flora were compared between the groups. The only statistically significant difference in bacteria was Streptococcus spp. on the dorsum (P = 0.0088), with carriage being more common in frequently handled sheep. Antimicrobial susceptibility testing did not find meticillin-resistant S. aureus. There was no significant difference in S. aureus carriage in the ear (P = 0.33), nostril (P = 0.43) or dorsum (P = 0.053) between frequently and minimally handled sheep. The S. aureus isolates belonged to six different spa types. Three were of the ST398 lineage. Sheep are a potential source of livestock-associated meticillin-sensitive Staphylococcus aureus ST398. © 2014 ESVD and ACVD.

Skin color analysis using a spectrophotometer in Asians.

PubMed

Yun, In Sik; Lee, Won Jai; Rah, Dong Kyun; Kim, Yong Oock; Park, Be-young Yun

2010-08-01

To objectively describe skin color, the Commission International d'Eclairage (CIE) L*a*b* color coordinates and melanin and erythema indexes are used. However, it was difficult to understand the relationship among these parameters and to convert them into each other. We introduced a new technique to measure L*a*b* color coordinates and the melanin and erythema indexes at the same time. We analyzed the skin color of normal Asians using this method. The skin color of the forehead, cheek, upper inner arm, dorsum of hand, and anterior chest of 148 volunteers was measured using a spectrophotometer. Using a computer analysis program, L*a*b* values and the melanin and erythema indexes were presented at the same time. The averages of these data were shown according to gender, age, body parts, and correlations among the melanin and erythema indexes and L*a*b* color coordinates, and then they were analyzed. The averages of the melanin and erythema indexes of 148 participants were 1.10 +/- 0.29 and 1.29 +/- 0.38, respectively. The averages of the L*, a*, and b* values were 64.15 +/- 4.86, 8.96 +/- 2.65, and 18.34 +/- 2.39, respectively. The melanin and erythema indexes were higher in males than in females. While the correlation of the melanin index with the L* value was negative, it was positively correlated with the a* and b* values. While the erythema index showed a weak correlation with the b* value, its correlation was negative with the L* value and positive with the a* value. Our method of skin color measurement is useful. We consider the data of this study valuable basic data for the evaluation of colors of pigmental skin diseases and scars in the future.

Further development of LLNA:DAE method as stand-alone skin-sensitization testing method and applied for evaluation of relative skin-sensitizing potency between chemicals.

PubMed

Yamashita, Kunihiko; Shinoda, Shinsuke; Hagiwara, Saori; Itagaki, Hiroshi

2015-04-01

To date, there has been no well-established local lymph node assay (LLNA) that includes an elicitation phase. Therefore, we developed a modified local lymph node assay with an elicitation phase (LLNA:DAE) to discriminate true skin sensitizers from chemicals that gave borderline positive results and previously reported this assay. To develop the LLNA:DAE method as a useful stand-alone testing method, we investigated the complete procedure for the LLNA:DAE method using hexyl cinnamic aldehyde (HCA), isoeugenol, and 2,4-dinitrochlorobenzene (DNCB) as test compounds. We defined the LLNA:DAE procedure as follows: in the dose-finding test, four concentrations of chemical applied to dorsum of the right ear on days 1, 2, and 3 and dorsum of both ears on day 10. Ear thickness and skin irritation score were measured on days 1, 3, 5, 10, and 12. Local lymph nodes were excised and weighed on day 12. The test dose for the primary LLNA:DAE study was selected as the dose that gave the highest left ear lymph node weight in the dose-finding study, or the lowest dose that produced a left ear lymph node of over 4 mg. This procedure was validated using nine different chemicals. Furthermore, qualitative relationship was observed between the degree of elicitation response in the left ear lymph node and the skin sensitizing potency of 32 chemicals tested in this study and the previous study. These results indicated that LLNA:DAE method was as first LLNA method that was able to evaluate the skin sensitizing potential and potency in elicitation response.

Analysis of relative displacement between the HX wearable robotic exoskeleton and the user's hand.

PubMed

Cempini, Marco; Marzegan, Alberto; Rabuffetti, Marco; Cortese, Mario; Vitiello, Nicola; Ferrarin, Maurizio

2014-10-18

Advances in technology are allowing for the production of several viable wearable robotic devices to assist with activities of daily living and with rehabilitation. One of the most pressing limitations to user satisfaction is the lack of consistency in motion between the user and the robotic device. The displacement between the robot and the body segment may not correspond because of differences in skin and tissue compliance, mechanical backlash, and/or incorrect fit. This report presents the results of an analysis of relative displacement between the user's hand and a wearable exoskeleton, the HX. HX has been designed to maximize comfort, wearability and user safety, exploiting chains with multiple degrees-of-freedom with a modular architecture. These appealing features may introduce several uncertainties in the kinematic performances, especially when considering the anthropometry, morphology and degree of mobility of the human hand. The small relative displacements between the hand and the exoskeleton were measured with a video-based motion capture system, while the user executed several different grips in different exoskeleton modes. The analysis furnished quantitative results about the device performance, differentiated among device modules and test conditions. In general, the global relative displacement for the distal part of the device was in the range 0.5-1.5 mm, while within 3 mm (worse but still acceptable) for displacements nearest to the hand dorsum. Conclusions over the HX design principles have been drawn, as well as guidelines for future developments.

Post-metamorphic development of skin glands in a true toad: Parotoids versus dorsal skin.

PubMed

Regueira, Eleonora; Dávila, Camila; Sassone, Alina G; O'Donohoe, María E Ailín; Hermida, Gladys N

2017-05-01

Chemical defenses in amphibians are a common antipredatory and antimicrobial strategy related to the presence of dermal glands that synthesize and store toxic or unpalatable substances. Glands are either distributed throughout the skin or aggregated in multiglandular structures, being the parotoids the most ubiquitous macrogland in toads of Bufonidae. Even though dermal glands begin to develop during late-larval stages, many species, including Rhinella arenarum, have immature glands by the end of metamorphosis, and their post-metamorphic growth is unknown. Herein, we compared the post-metamorphic development of parotoids and dorsal glands by histological and allometric studies in a size series of R. arenarum. Histological and histochemical studies to detect proteins, acidic glycoconjugates, and catecholamines, showed that both, parotoids and dorsal glands, acquire characteristics of adults in individuals larger than 50 mm; that is, a moment in which the cryptic coloration disappears. Parotoid height increased allometrically as a function of body size, whereas the size of small dorsal glands decreased with body size. The number of glands in the dorsum was not linearly related to body size, appearing to be an individual characteristic. Only adult specimens had intraepithelial granular glands in the duct of the largest glands of the parotoids. Since toxic secretions accumulate in the central glands of parotoids, allometric growth of parotoids may translate into greater protection from predators in the largest animals. Conversely, large glands in the dorsum, which produce a proteinaceous secretion of unknown function, grow isometrically to body size. Some characteristics, like intraepithelial glands in the ducts and basophilic glands in the dorsum, are limited to adults. © 2017 Wiley Periodicals, Inc.

The Effects of Surgical Hand Scrubbing Protocols on Skin Integrity and Surgical Site Infection Rates: A Systematic Review.

PubMed

Liu, Liang Qin; Mehigan, Sinead

2016-05-01

This systematic review aimed to critically appraise and synthesize updated evidence regarding the effect of surgical-scrub techniques on skin integrity and the incidence of surgical site infections. Databases searched include the Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Embase, and Cochrane Central. Our review was limited to eight peer-reviewed, randomized controlled trials and two nonrandomized controlled trials published in English from 1990 to 2015. Comparison models included traditional hand scrubbing with chlorhexidine gluconate or povidone-iodine against alcohol-based hand rubbing, scrubbing with a brush versus without a brush, and detergent-based antiseptics alone versus antiseptics incorporating alcohol solutions. Evidence showed that hand rubbing techniques are as effective as traditional scrubbing and seem to be better tolerated. Hand rubbing appears to cause less skin damage than traditional scrub protocols, and scrub personnel tolerated brushless techniques better than scrubbing using a brush. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Moisturizing alcohol hand gels for surgical hand preparation.

PubMed

Jones, R D; Jampani, H; Mulberry, G; Rizer, R L

2000-03-01

With the use of novel formulary technology, unique moisturizing hand gels have been developed that offer significant advantages in perioperative and other health care settings. These advantages include the time-saving capabilities of a waterless formulation, the persistence and effectiveness of a surgical scrub, and the moisturization and protective properties of a lotion. Extensive laboratory and clinical studies, involving in vivo antimicrobial activity against resident and transient flora, skin moisturization on normal and dry skin, and compatibility with latex gloves, have supported these advantages. Nondrying alcohol hand gels can be used for antiseptic hand washing, hand scrubs between procedures (i.e., reentry scrubs), brushless surgical scrubs, moisturizers, and glove-donning aids.

Evaluation of an alcohol-based surgical hand disinfectant containing a synergistic combination of farnesol and benzethonium chloride for immediate and persistent activity against resident hand flora of volunteers and with a novel in vitro pig skin model.

PubMed

Shintre, Milind S; Gaonkar, Trupti A; Modak, Shanta M

2007-02-01

To evaluate the immediate, persistent and sustained in vivo activity of an alcohol-based surgical hand disinfectant, consisting of a zinc gel and a preservative system containing a synergistic combination of farnesol and benzethonium chloride (ZBF disinfectant), and to develop a pig skin model for in vitro evaluation of the immediate and persistent efficacy of alcohol-based surgical hand disinfectants against resident hand flora. The in vivo immediate, persistent, and sustained activity of ZBF disinfectant was evaluated using human volunteers and the "glove-juice" method described in the US Food and Drug Administration's Tentative Final Monograph (FDA-TFM) for Healthcare Antiseptic Products. A novel in vitro pig skin model was developed to compare the immediate and persistent activity of alcohol-based surgical hand disinfectants against resident flora using Staphylococcus epidermidis as the test organism. Four alcohol-based surgical hand disinfectants were evaluated using this model. The results for the ZBF disinfectant exceed the FDA-TFM criteria for immediate, persistent, and sustained activity required for surgical hand disinfectants. The reduction factors for the 4 hand disinfectants obtained using the pig skin model show good agreement with the log(10) reductions in concentrations of hand flora obtained using human volunteers to test for immediate and persistent activity. The ZBF disinfectant we evaluated met the FDA-TFM criteria for surgical hand disinfectants. The immediate and persistent efficacy of the surgical hand disinfectants evaluated with the novel pig skin model described in this study shows good agreement with the results obtained in vivo.

A Study of Hand Back Skin Texture Patterns for Personal Identification and Gender Classification

PubMed Central

Xie, Jin; Zhang, Lei; You, Jane; Zhang, David; Qu, Xiaofeng

2012-01-01

Human hand back skin texture (HBST) is often consistent for a person and distinctive from person to person. In this paper, we study the HBST pattern recognition problem with applications to personal identification and gender classification. A specially designed system is developed to capture HBST images, and an HBST image database was established, which consists of 1,920 images from 80 persons (160 hands). An efficient texton learning based method is then presented to classify the HBST patterns. First, textons are learned in the space of filter bank responses from a set of training images using the l1 -minimization based sparse representation (SR) technique. Then, under the SR framework, we represent the feature vector at each pixel over the learned dictionary to construct a representation coefficient histogram. Finally, the coefficient histogram is used as skin texture feature for classification. Experiments on personal identification and gender classification are performed by using the established HBST database. The results show that HBST can be used to assist human identification and gender classification. PMID:23012512

[The morphological features of skin wounds inflicted by joinery hand saws designed for different types of sawing].

PubMed

Sarkisian, B A; Azarov, P A

2014-01-01

The objective of the present work was to study the morphological features of skin wounds inflicted by joinery hand saws designed for longitudinal, transverse, and mixed sawing. A total of 60 injuries to the thigh skin inflicted by the recurring and reciprocating saw movements were simulated. The hand saws had 5 mm high "sharp" and "blunt"-tipped teeth. The analysis of the morphological features of the wounds revealed differences in their length and depth, shape of edge cuts and defects, and the relief of the walls depending on the sawtooth sharpness and the mode of sawing. It is concluded that morphological features of the wounds may be used to determine the type of the saw, the sharpness of its teeth, the direction and frequency of its movements.

Occurrence and distribution of Malassezia species on skin and external ear canal of horses.

PubMed

Shokri, Hojjatollah

2016-01-01

The aim of this study was to investigate the prevalence of Malassezia species from the body skin and external ear canal of healthy horses. The samples were obtained by scraping the skin surface from the nose, groin and dorsum and swabbing from the external ear canal of 163 animals, and then incubated on sabouraud dextrose agar and modified Dixon agar. Malassezia species were isolated from 34.9% of horses. The percentages of Malassezia species were 64.3% for Arab, 35.7% for Persian, 35.4% for Thoroughbred and 27.1% for Turkmen breeds. The greatest abundance of Malassezia species was found in the external ear canal (47.7%, representing significant difference with other sites), followed by nose (26.3%), groin (15.8%) and dorsum (10.5%) (P < 0.05). A total of 57 strains from six Malassezia species were detected with a frequency rate as follows: M. pachydermatis (33.3%), M. globosa (26.3%), M. sympodialis (14.1%), M. restricta (10.5%), M. obtusa (8.8%) and M. furfur (7%). The most common age-group affected was 1-3 years (59.4%). This study confirmed that cutaneous Malassezia microbiota in healthy horses varies by body site and age but not by breed and gender, representing M. pachydermatis as the most prevalent species on horse skin. © 2015 Blackwell Verlag GmbH.

[Retrospective, descriptive, observational study of treatment of multiple actinic keratoses with topical methyl aminolevulinate and red light: results in clinical practice and correlation with fluorescence imaging].

PubMed

Fernández-Guarino, M; Harto, A; Sánchez-Ronco, M; Pérez-García, B; Marquet, A; Jaén, P

2008-12-01

Actinic keratosis (AK) is one of the most common skin diseases seen in clinical practice. In the last 5 years, several studies assessing the efficacy of photodynamic therapy in the treatment of multiple AKs have been published. We aimed to assess the clinical outcomes of photodynamic therapy in patients with multiple AKs and the correlation of those outcomes with fluorescence imaging. In this retrospective, descriptive, observational study of 57 patients treated in our hospital with photodynamic therapy for multiple AKs, we recorded age, sex, and lesion site (face, scalp, and dorsum of the hands). All patients were treated in the same way: methyl aminolevulinic acid (Metvix) was applied for 3 hours and the skin then irradiated with red light at 630 nm, 37 J/cm(2), for 7.5 minutes (Aktilite). The response, remission duration, tolerance, number of sessions, and fluorescence images were recorded by site. The chi(2) test was used to assess between-site differences and the correlation between fluorescence imaging and clinical response. The greatest improvements were obtained for facial lesions; these required fewer sessions and remission lasted longer than lesions at other sites. The treatment was best tolerated on the dorsum of the hands. The fluorescence area and the reduction in intensity on applying treatment were found to be strongly and significantly correlated with the extent of clinical response. Overall, the outcomes of treatment of multiple AKs with photodynamic therapy are better for the face than for the scalp and dorsum of the hands. Fluorescence imaging may be an effective tool for predicting response to treatment.

Reliability of infrared thermometric measurements of skin temperature in the hand.

PubMed

Packham, Tara L; Fok, Diana; Frederiksen, Karen; Thabane, Lehana; Buckley, Norman

2012-01-01

Clinical measurement study. Skin temperature asymmetries (STAs) are used in the diagnosis of complex regional pain syndrome (CRPS), but little evidence exists for reliability of the equipment and methods. This study examined the reliability of an inexpensive infrared (IR) thermometer and measurement points in the hand for the study of STA. ST was measured three times at five points on both hands with an IR thermometer by two raters in 20 volunteers (12 normals and 8 CRPS). ST measurement results using IR thermometers support inter-rater reliability: intraclass correlation coefficient (ICC) estimate for single measures 0.80; all ST measurement points were also highly reliable (ICC single measures, 0.83-0.91). The equipment demonstrated excellent reliability, with little difference in the reliability of the five measurement sites. These preliminary findings support their use in future CRPS research. Not applicable. Copyright © 2012 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Assessing the influence of antivibration glove on digital vascular responses to acute hand-arm vibration.

PubMed

Mahbub, Md H; Yokoyama, Kenjiro; Laskar, Md S; Inoue, Masaiwa; Takahashi, Yukio; Yamamoto, Shinji; Harada, Noriaki

2007-05-01

This study was designed to assess the influence of an antivibration glove on digital vascular responses in healthy subjects exposed to short-term grasping of a vibrating handle. To measure finger blood flow (FBF) and finger skin temperature (FST) once at the end of every min, a blood flowmeter sensor was attached to the dorsum and a thermistor sensor was attached to the medial surface of the subject's middle phalanx of the third finger of the right hand. After 5 min of baseline measurements without or with an antivibration glove meeting ISO standard 10819, worn on the right hand, subjects gripped a vibrating handle with the same hand for a period of 5 min. Vibration was generated at two frequencies of 31.5 Hz and 250 Hz with a frequency weighted rms acceleration of 5.5 m/s(2). FBF and FST continued to be recorded for a further 5 min after release of the vibrating handle. Statistical analysis showed no significant change after vibration exposure in either FST or FBF at 250 Hz, compared to baseline (control) measurements while using the antivibration glove. At 31.5 Hz, FBF data exhibited a significant difference between before and after grasping of vibrating handle, which was less under the condition of wearing the antivibration glove than under the condition of bare hand. The results provide evidence that the antivibration glove considerably influenced finger vascular changes in healthy subjects induced by vibration exposure, especially against high frequency vibration. Further studies are required to assess finger vascular responses to hand-transmitted vibration with antivibration gloves of different manufacturers.

[DORSALIS PEDIS FLAP SERIES-PARALLEL BIG TOE NAIL COMPOSITE TISSUE FLAP TO REPAIR HAND SKIN OF DEGLOVING INJURY WITH THUMB DEFECT].

PubMed

Shi, Pengju; Zhang, Wenlong; Zhao, Gang; Li, Zhigang; Zhao, Shaoping; Zhang, Tieshan

2015-07-01

To investigate the effectiveness of dorsalis pedis flap series-parallel big toe nail composite tissue flap in the repairment of hand skin of degloving injury with tumb defect. Between March 2009 and June 2013, 8 cases of hand degloving injury with thumb defect caused by machine twisting were treated. There were 7 males and 1 female with the mean age of 36 years (range, 26-48 years). Injury located at the left hand in 3 cases and at the right hand in 5 cases. The time from injury to hospitalization was 1.5-4.0 hours (mean, 2.5 hours). The defect area was 8 cm x 6 cm to 15 cm x 1 cm. The thumb defect was rated as degree I in 5 cases and as degree II in 3 cases. The contralateral dorsal skin flap (9 cm x 7 cm to 10 cm x 8 cm) combined with ipsilateral big toe nail composite tissue flap (2.5 cm x 1.8 cm to 3.0 cm x 2.0 cm) was used, including 3 parallel anastomosis flaps and 5 series anastomosis flaps. The donor site of the dorsal flap was repaired with thick skin grafts, the stumps wound was covered with tongue flap at the shank side of big toe. Vascular crisis occurred in 1 big toe nail composite tissue flap, margin necrosis occurred in 2 dorsalis pedis flap; the other flaps survived, and primary healing of wound was obtained. The grafted skin at dorsal donor site all survived, skin of hallux toe stump had no necrosis. Eight cases were followed up 4-20 months (mean, 15.5 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months (mean, 5 months). At 4 months after operation, the two-point discrimination of the thumb pulp was 8-10 mm (mean, 9 mm), and the two-point discrimination of dorsal skin flap was 7-9 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the results were excellent in 4 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function. Dorsalis pedis flap series-parallel big toe nail composite tissue flap is an ideal

Sulfur mustard-induced poikiloderma: a case report.

PubMed

Emadi, Seyed Naser; Kaffashi, Mohammad; Poursaleh, Zohreh; Akhavan-Moghaddam, Jamal; Soroush, Mohammad Reza; Emadi, Seyed Emad; Taghavi, Nez'hat-o-Sadat

2011-06-01

Sulfur mustard (SM) is a potent chemical warfare agent that was widely used during the First World War and the Iran-Iraq conflict. This vesicant agent causes several acute and chronic effects on the skin, eye, and respiratory system. We report the case of a 41-year-old man who was injured with SM in Iraq chemical attack in 1988. After exposure, he developed severe skin blisters on his upper trunk, dorsum of hands, and genitalia. Based on several clinical observations, such as atrophy, pigmentation, and vascular changes on genitalia with relevant findings in histopathological studies, persistent pigmentation, and damaged skin appendix in hand lesions, a diagnosis of "SM-induced poikiloderma" was postulated. The absence of any complication on the palmar aspect of hands is another remarkable finding in presented case, which suggests a plausible role of the palms as a vector for transporting SM to other sites of the skin.

Correlations between skin blood perfusion values and nailfold capillaroscopy scores in systemic sclerosis patients.

PubMed

Ruaro, B; Sulli, A; Pizzorni, C; Paolino, S; Smith, V; Cutolo, M

2016-05-01

To correlate blood perfusion (BP) values assessed by laser speckle contrast analysis (LASCA) in selected skin areas of hands and face with nailfold capillary damage scores in systemic sclerosis (SSc) patients. Seventy SSc patients (mean SSc duration 6 ± 5 years) and 70 volunteer healthy subjects were enrolled after informed consent. LASCA was performed at different areas of the face (forehead, tip of nose, zygomas and perioral region) and at dorsal and volar regions of hands. Microvascular damage was assessed and scored by nailfold videocapillaroscopy (NVC) and the microangiopathy evolution score (MES) was calculated. SSc patients showed a significantly lower BP than healthy subjects at fingertips, periungual areas and palm of hands (p<0.0001), but not at the level of face and dorsum of hands. A gradual decrease of BP at fingertips, periungual and palm areas, was found in SSc patients with progressive severity of NVC patterns of microangiopathy ("early", "active", or "late") (p<0.01). A negative correlation was observed between MES and BP values, as well as between loss of capillaries and BP, at the same areas (p<0.001 and p<0.01, respectively). Patients with diffuse cutaneous SSc (dcSSc) showed lower BP than those with limited cutaneous SSc (p<0.04). LASCA detects a significant reduction of BP only in those areas usually affected by Raynaud's phenomenon (fingertips, periungual and palm areas), especially in dcSSc patients, and BP values significantly correlate with the nailfold capillaroscopy scores of microangiopathy. Copyright © 2016. Published by Elsevier Inc.

Guideline Implementation: Hand Hygiene.

PubMed

Goldberg, Judith L

2017-02-01

Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Spatially defined modulation of skin temperature and hand ownership of both hands in patients with unilateral complex regional pain syndrome.

PubMed

Moseley, G Lorimer; Gallace, Alberto; Iannetti, Gian Domenico

2012-12-01

Numerous clinical conditions, including complex regional pain syndrome, are characterized by autonomic dysfunctions (e.g. altered thermoregulation, sometimes confined to a single limb), and disrupted cortical representation of the body and the surrounding space. The presence, in patients with complex regional pain syndrome, of a disruption in spatial perception, bodily ownership and thermoregulation led us to hypothesize that impaired spatial perception might result in a spatial-dependent modulation of thermoregulation and bodily ownership over the affected limb. In five experiments involving a total of 23 patients with complex regional pain syndrome of one arm and 10 healthy control subjects, we measured skin temperature of the hand with infrared thermal imaging, before and after experimental periods of either 9 or 10 min each, during which the hand was held on one or the other side of the body midline. Tactile processing was assessed by temporal order judgements of pairs of vibrotactile stimuli, delivered one to each hand. Pain and sense of ownership over the hand were assessed by self-report scales. Across experiments, when kept on its usual side of the body midline, the affected hand was 0.5 ± 0.3°C cooler than the healthy hand (P < 0.02 for all, a common finding in cold-type complex regional pain syndrome), and tactile stimuli delivered to the healthy hand were prioritized over those delivered to the affected hand. Simply crossing both hands over the midline resulted in (i) warming of the affected hand (the affected hand became 0.4 ± 0.3°C warmer than when it was in the uncrossed position; P = 0.01); (ii) cooling of the healthy hand (by 0.3 ± 0.3°C; P = 0.02); and (iii) reversal of the prioritization of tactile processing. When only the affected hand was crossed over the midline, it became warmer (by 0.5 ± 0.3°C; P = 0.01). When only the healthy hand was crossed over the midline, it became cooler (by 0.3 ± 0.3°C; P = 0.01). The temperature change of

The treatment of deep dermal hand burns: How do we achieve better results? Should we use allogeneic keratinocytes or skin grafts?

PubMed

Haslik, W; Kamolz, L-P; Lumenta, D B; Hladik, M; Beck, H; Frey, M

2010-05-01

The treatment of deep dermal burns has a broad spectrum and has been subject to discussion over the past years. The treatment of hand burns is challenging due to the high requirements to aesthetic and functional outcome. 27 patients, 7 women and 20 men with deep dermal hand burns with a mean age of 41.3+/-16.5 and a mean TBSA of 15%+/-19.6% were treated either with allogeneic cryopreserved keratinocytes or with split skin grafts. Long-term follow-up revealed no statistical significant differences between the two groups concerning Vancouver Scar Scale as well as hand function judged by the DASH score; however there was a tendency to higher VSS scores and impaired aesthetic results in the keratinocyte group. Allogeneic keratinocytes are a suitable armentarium for the treatment of deep dermal hand burns; and, if used correctly, they can produce a timely healing comparable to split-thickness skin grafts. Limited availability, high costs as well as the need for special skills are key factors, which render application of this technique outside specialist burn centres virtually impossible. In our opinion, the cultivation and use of keratinocytes should be reserved to these centres in order to facilitate a sensible application for a full range of indications. We recommend usage of allogeneic keratinocytes for deep dermal hand burns only in severely burned patients with a lack of donor sites. Patients with unrestricted availability of donor sites seem to profit from the application of split-thickness skin grafts according to our results. Copyright 2009 Elsevier Ltd and ISBI. All rights reserved.

Regorafenib-associated hand-foot skin reaction: practical advice on diagnosis, prevention, and management.

PubMed

McLellan, B; Ciardiello, F; Lacouture, M E; Segaert, S; Van Cutsem, E

2015-10-01

Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand-foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand-foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and tried-and-tested empirical

Evaluation of the effect of LED radiation in the repair of skin wounds on the dorsum of rats with iron deficiency anemia

NASA Astrophysics Data System (ADS)

de Oliveira, Susana Carla Pires Sampaio; de Carvalho Monteiro, Juliana Santos; dos Santos Aciole, Gilberth Tadeu; DeCastro, Isabele Cardoso V.; Menezes, Diego Silva; de Fátima Lima Ferreira, Maria; dos Santos, Jean Nunes; Zanin, Fátima; Barbosa Pinheiro, Antônio Luiz

2010-05-01

Iron deficiency anemia causes reduction on the level of hemoglobin and of the number of RBC and affects around 35% of the human population. Laser and LED therapies have been successfully used on wound healing studies. The aim of the present study was to assess histologically the effect of LED Phototherapy on the healing of cutaneous wounds on anemic rats. Fifty one 21 days old male wistar rats weighting around 50 g were kept under iron free die (Sem ferro-AIN93-G) during 15 days in order to induce anemia. Non treated animals acted as controls. A standartized cutaneous wound was created on the dorsum of each animal whom were distributed into four groups: Group I—Anemia+LED, Group II—Non anemic+LED, Group III—Anemia+no treatment, Group IV—No anemic+no-treatment. Irradiation started immediately after surgery and repeated at 48 h intervals during 21 days. Animal death occurred after 7, 14 and 21 days after wounding. The results of the histologic analysis showed that LED Phototherapy stimulated fibroblastic proliferation. It is concluded that LED irradiation improves wound healing on iron deficient anemic animals.

Scabies in a bilateral hand allograft recipient: An additional mimicker of acute skin rejection in vascularized composite allotransplantation.

PubMed

Kanitakis, Jean; Morelon, Emmanuel

2017-06-01

Vascularized composite tissue allografts include skin, which frequently undergoes, in the early post-graft period, acute rejections. The diagnosis of acute rejection may be difficult as it can be mimicked by several dermatoses. We present a bilateral hand allograft recipient who developed, 16.5 years post-graft, cutaneous lesions raising suspicion about rejection. Physical examination and skin biopsy were diagnostic of scabies. This ectoparasitosis should be added in the list of dermatoses that can mimic allograft rejection in vascular composite allografts. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Normative-Speaker Validation Study of Two Indices Developed to Quantify Tongue Dorsum Activity from Midsagittal Tongue Shapes

ERIC Educational Resources Information Center

Zharkova, Natalia

2013-01-01

This study reported adult scores on two measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging. One of the measures quantified the extent of tongue dorsum excursion, and the other measure represented the place of maximal excursion. Data from six adult speakers of Scottish Standard English without speech disorders…

The effect of compressed air massage on skin blood flow and temperature.

PubMed

Mars, Maurice; Maharaj, Sunil S; Tufts, Mark

2005-01-01

Compressed air massage is a new treatment modality that uses air under pressure to massage skin and muscle. It is claimed to improve skin blood flow but this has not been verified. Several pilot studies were undertaken to determine the effects of compressed air massage on skin blood flow and temperature. Skin blood flow (SBF), measured using laser Doppler fluxmetry and skin temperature was recorded under several different situations: (i) treatment, at 1 Bar pressure using a single-hole (5-mm) applicator head, for 1 min at each of several sites on the right and left lower legs, with SBF measured on the dorsum of the left foot; (ii) at the same treatment pressure, SBF was measured over the left tibialis anterior when treatment was performed at different distances from the probe; (iii) SBF and skin temperature of the lower leg were measured with treatment at 0 or 1 Bar for 45 min, using two different applicator heads; (iv) SBF was measured on the dorsum of the foot of 10 subjects with treatment for 1 min at 0, 0.5, 1, 1.5 and 2 Bar using three different applicator heads. (i) SBF of the left foot was not altered by treatment of the right leg or chest, but was significantly increased during treatment of the left sole and first web, p < 0.0001. (ii) SBF over the tibialis anterior was increased when treatment was 5 cm from the probe, p < 0.0001, but not when 10 cm away. iii) SBF was significantly elevated throughout the 45-min treatments at 1 Bar and returned to normal within 1 min of stopping treatment. Skin temperature fell by 6.8 degrees C and 4.3 degrees C after 45-min treatments at 1 Bar, and slight rewarming occurred within 15 min. At 0 Bar, no change in SBF or temperature was noted. (iv) A near-linear increase in SBF was noted with increasing treatment pressure for two of the three applicator heads. Compressed air massage causes an immediate increase in SBF, and an immediate fall in SBF when treatment is stopped. The effect appears to be locally and not centrally

Effectiveness of skin protection measures in prevention of occupational hand eczema: results of a prospective randomized controlled trial over a follow-up period of 1 year.

PubMed

Kütting, B; Baumeister, T; Weistenhöfer, W; Pfahlberg, A; Uter, W; Drexler, H

2010-02-01

We recently found a very low adherence to a generally recommended skin protection regimen in a sample of 1355 metalworkers. The present study assessed the effectiveness of skin protection as presently recommended, especially the differential contribution of skin care and skin protection, to the prevention of occupational hand eczema. Methods Of 1355 metalworkers screened, 1020 male volunteers, all fit for work, were recruited for a prospective intervention study with four arms (skin care, skin protection, both combined, and control group, i.e. no recommendation). The study was performed from winter 2006/2007 to spring 2008, following each subject for up for 12 months. Both hands were examined using a quantitative skin score, and a standardized personal interview was performed three times. The change of the objective skin score from baseline to 12 months was used as primary outcome measure. After 12 months 800 subjects were included (78.4% of those recruited). The compliance to follow the randomized measure depended on the recommended measure and ranged from 73.7% to 88.7%. While in the control group a significant deterioration was found, the largest and significant improvement was noted in the group following the generally recommended skin protection programme (skin care + skin protection) followed by skin protection alone as second best. The generally recommended skin protection regimen seems to provide effective prevention of occupational skin disease. Therefore, the compliance to follow the skin protection regimen, especially the use of skin protection, should be enhanced.

Effects of a warm hand bath on the blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort in healthy women: An experimental cross-over trial.

PubMed

Kudo, Yukiko; Sasaki, Makiko; Kikuchi, Yukiko; Sugiyama, Reiko; Hasebe, Makiko; Ishii, Noriko

2018-06-19

The present study was conducted in order to clarify the effects of a warm hand bath at 40°C for 10 min on the blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort in healthy women. The study's participants were 40 healthy adult women who were randomly assigned to either a structured hand bath first and no hand bath second (Group A) or to no hand bath first and a hand bath second (Group B). The blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort then were recorded in all the participants. A repeated-measures ANOVA revealed no significant difference in the blood flow in the right shoulder or deep body temperature between groups. The skin temperature of the hands, forearms, and arms was significantly increased, but not of the face and upper back. The skin temperature of the forearms was maintained at 0.5°C-1°C higher for 30 min in the hand bath group, compared with the no hand bath group. The hand bath group had a significantly higher heart rate while bathing and a significantly lower parasympathetic nerve activity level during bathing. No significant difference was seen in the sympathetic activity level between groups. The hand bath group had a significantly higher subjective comfort level. Hand baths can improve the level of subjective comfort and increase the heart rate and might affect autonomic nervous activity. The skin temperature of the forearms was maintained for 30 min in the hand bath group. © 2018 Japan Academy of Nursing Science.

Melorheostosis of the hand with complicating bony spur formation and bursal inflammation: diagnosis and treatment.

PubMed

Ameen, S; Nagy, L; Gerich, U; Anderson, S E

2002-08-01

A 37-year old woman presented with intolerable pain associated with a slowly growing mass on the dorsum of the right hand. The radiographs were characteristic of melorheostosis involving the third and fourth metacarpals, with a cortical bony projection extending from the base of the third metacarpal eroding slightly into the fourth metacarpal, associated with bursal formation. Magnetic resonance imaging (MRI) demonstrated an inflamed bursal collection adjacent to the spur. This region corresponded to the patient's severe clinical, focal pain. To our knowledge, this is the first case report in which melorheostosis of the hand has been associated with bony spur formation and complicated by an inflamed bursa.

Myxoinflammatory fibroblastic sarcoma of the nose: First reported case at an unusual location (nasal dorsum), with a review of the literature.

PubMed

Numminen, Jura; Bizaki, Argyro; Kujansivu, Jarno; Huovinen, Sanna; Rautiainen, Markus

2016-03-01

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, low-grade, malignant, soft-tissue tumor that typically affects the distal extremities of middle-aged patients. In most cases, it presents as a painless, slowly growing mass within the subcutaneous tissue. It is associated with a low rate of metastasis but a high rate of local recurrence. In addition to the distal extremities, MIFS has been reported in the thigh, arm, forearm, groin, upper back, neck, and temporal area. As far as we know, no case has been previously reported in the nasal area. We report for the first time a case of MIFS presenting on the dorsum of the nose. The painless, 3.0-cm tumor was initially mistaken for reticular erythematous mucinosis, a benign skin condition that occurs when fibroblasts produce abnormally large amounts of mucopolysaccharides. The tumor was surgically removed in its entirety with surgical margins of 3 to 5 mm. During 4 years of follow-up, no clinical or radiologic evidence of a recurrence or metastasis was seen. We discuss the imaging and histologic features of MIFS, as well as its clinical management and follow-up, and we review related reports in the literature.

Ultra-weak photon emission as a non-invasive tool for monitoring of oxidative processes in the epidermal cells of human skin: comparative study on the dorsal and the palm side of the hand.

PubMed

Rastogi, Anshu; Pospísil, Pavel

2010-08-01

All living organisms emit spontaneous ultra-weak photon emission as a result of cellular metabolic processes. Exposure of living organisms to exogenous factors results in oxidative processes and enhancement in ultra-weak photon emission. Here, hydrogen peroxide (H(2)O(2)), as a strongly oxidizing molecule, was used to induce oxidative processes and enhance ultra-weak photon emission in human hand skin. The presented work intends to compare both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the dorsal and the palm side of the hand. A highly sensitive photomultiplier tube and a charge-coupled device camera were used to detect ultra-weak photon emission from human hand skin. Spontaneous ultra-weak photon emission from the epidermal cells on the dorsal side of the hand was 4 counts/s. Topical application of 500 mM H(2)O(2) to the dorsal side of the hand caused enhancement in ultra-weak photon emission to 40 counts/s. Interestingly, both spontaneous and peroxide-induced ultra-weak photon emission from the epidermal cells on the palm side of the hand were observed to increase twice their values, i.e. 8 and 80 counts/s, respectively. Similarly, the two-dimensional image of ultra-weak photon emission observed after topical application of H(2)O(2) to human skin reveals that photon emission from the palm side exceeds the photon emission from the dorsal side of the hand. The results presented indicate that the ultra-weak photon emission originating from the epidermal cells on the dorsal and the palm side of the hand is related to the histological structure of the human hand skin. Ultra-weak photon emission is shown as a non-destructive technique for monitoring of oxidative processes in the epidermal cells of the human hand skin and as a diagnostic tool for skin diseases.

Mind the Gap: The Effects of Temporal and Spatial Separation in Localization of Dual Touches on the Hand.

PubMed

Sadibolova, Renata; Tamè, Luigi; Walsh, Eamonn; Longo, Matthew R

2018-01-01

In this study, we aimed to relate the findings from two predominantly separate streams of literature, one reporting on the localization of single touches on the skin, and the other on the distance perception of dual touches. Participants were touched with two points, delivered either simultaneously or separated by a short delay to various locations on their left hand dorsum. They then indicated on a size-matched hand silhouette the perceived locations of tactile stimuli. We quantified the deviations between the actual stimulus grid and the corresponding perceptual map which was constructed from the perceived tactile locations, and we calculated the precision of tactile localization (i.e., the variability across localization attempts). The evidence showed that the dual touches, akin to single touch stimulations, were mislocalized distally and that their variable localization error was reduced near joints, particularly near knuckles. However, contrary to single-touch localization literature, we observed for the dual touches to be mislocalized towards the ulnar side of the hand, particularly when they were presented sequentially. Further, the touches presented in a sequential order were slightly "repelled" from each other and their perceived distance increased, while the simultaneous tactile pairs were localized closer to each other and their distance was compressed. Whereas the sequential touches may have been localized with reference to the body, the compression of tactile perceptual space for simultaneous touches was related in the previous literature to signal summation and inhibition and the low-level factors, including the innervation density and properties of receptive fields (RFs) of somatosensory neurons.

Body Context and Posture Affect Mental Imagery of Hands

PubMed Central

Ionta, Silvio; Perruchoud, David; Draganski, Bogdan; Blanke, Olaf

2012-01-01

Different visual stimuli have been shown to recruit different mental imagery strategies. However the role of specific visual stimuli properties related to body context and posture in mental imagery is still under debate. Aiming to dissociate the behavioural correlates of mental processing of visual stimuli characterized by different body context, in the present study we investigated whether the mental rotation of stimuli showing either hands as attached to a body (hands-on-body) or not (hands-only), would be based on different mechanisms. We further examined the effects of postural changes on the mental rotation of both stimuli. Thirty healthy volunteers verbally judged the laterality of rotated hands-only and hands-on-body stimuli presented from the dorsum- or the palm-view, while positioning their hands on their knees (front postural condition) or behind their back (back postural condition). Mental rotation of hands-only, but not of hands-on-body, was modulated by the stimulus view and orientation. Additionally, only the hands-only stimuli were mentally rotated at different speeds according to the postural conditions. This indicates that different stimulus-related mechanisms are recruited in mental rotation by changing the bodily context in which a particular body part is presented. The present data suggest that, with respect to hands-only, mental rotation of hands-on-body is less dependent on biomechanical constraints and proprioceptive input. We interpret our results as evidence for preferential processing of visual- rather than kinesthetic-based mechanisms during mental transformation of hands-on-body and hands-only, respectively. PMID:22479618

The 'holi' dermatoses: annual spate of skin diseases following the spring festival in India.

PubMed

Ghosh, Sudip Kumar; Bandyopadhyay, Debabrata; Chatterjee, Gobinda; Saha, Debabrata

2009-07-01

'Holi' is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration. To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi. Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India. Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%), followed by burning sensation, pain, oozing, and scaling. Eleven patients' symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1%) followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9%) patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia). Secondary pyoderma occurred in 3 (7.1%). Face was the commonest site affected (24, 57.1%), followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7%) patients. Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions.

Efficacy of a protocol including heparin ointment for treatment of multikinase inhibitor-induced hand-foot skin reactions.

PubMed

Li, Jian-ri; Yang, Chi-rei; Cheng, Chen-li; Ho, Hao-chung; Chiu, Kun-yuan; Su, Chung-Kuang; Chen, Wen-Ming; Wang, Shian-Shiang; Chen, Chuan-Shu; Yang, Cheng-Kuang; Ou, Yen-chuan

2013-03-01

The purpose of this study is to evaluate the efficacy of a protocol including topical heparin therapy for hand-foot skin reactions (HFSR) during multikinase (MKI) treatment. We prospectively collected 26 patients who had HFSRs during treatment with the MKIs, sunitinib, sorafenib, or axitinib. The age distribution ranged from 46 to 87 years, with a mean of 66 years. The distribution of HFSR severity was 12 patients with grade 1, 12 with grade 2, and 2 with grade 3. A heparin-containing topical ointment treatment, combined with hand-foot shock absorbers and skin moisturizers, was used at the lesion sites. Changes in the grade of HFSR, MKI dosage, and interruptions of MKI therapy were recorded. The results showed that 66.7% of grade 1 patients were cured of disease, 83.3% of grade 2 patients had improved symptoms, and both grade 3 patients (100%) had improved symptoms and were downgraded to grade 2. Four (15.4%) patients required reduction of MKI dosage, but there were no treatment interruptions or dropouts. Our protocol is beneficial in promoting resolution of HFSRs induced by MKIs. Further validation in large control studies should be investigated.

In vivo skin effects of a dimethylaminoethanol (DMAE) based formulation.

PubMed

Tadini, K A; Campos, P M B G Maia

2009-12-01

Dimethylaminoethanol (DMAE) has been used in anti-aging formulations but few scientifically based data address its efficacy. The aim of this study was to evaluate the effects of DMAE-based formulations on hairless mice and human skin. Formulations containing with or without DMAE were applied to the dorsum of hairless mice. Histopathological and histometric evaluations were carried out after seven days. Formulations were also applied to the ventral forearm and the lateral periocular area of human volunteers. Stratum corneum water content and skin mechanical properties were analyzed using Corneometer and Cutometer, before and after a single and repeated application. Histometric evaluations showed that formulations with or without DMAE increased the viable epidermis thickness, but only the DMAE-supplemented formulation led to increased dermal thickness. DMAE also induced increase in collagen fiber thickness, which was observed in the histopathological study. After the single and the 8-week period application on human skin, formulations with and without DMAE enhanced the stratum corneum water content in the forearm skin. Mechanical properties were not significantly modified. So, we can suggest that DMAE action is related to its effects on the dermis as observed in the histopathological and histometric studies and showed hydration effects on skin.

Evaluation of the effectiveness of thoracic sympathectomy in the treatment of primary hyperhidrosis of hands and armpits using the measurement of skin resistance

PubMed Central

Jabłoński, Sławomir; Rzepkowska-Misiak, Beata; Piskorz, Łukasz; Brocki, Marian; Wcisło, Szymon; Smigielski, Jacek; Kordiak, Jacek

2012-01-01

Introduction Hyperhidrosis is excessive sweating beyond the needs of thermoregulation. It is disease which mostly affects young people, often carrying a considerable amount of socio-economic implications. Thoracic sympathectomy is now considered to be the "gold standard" in the treatment of idiopathic hyperhidrosis of hands and armpits. Aim Assessment of early effectiveness of thoracic sympathectomy using skin resistance measurements performed before surgery and in the postoperative period. Material and methods A group of 20 patients with idiopathic excessive sweating of hands and the armpit was enrolled in the study. Patients underwent two-stage thoracic sympathectomy with resection of Th2-Th4 ganglions. The skin resistance measurements were made at six previously designated points on the day of surgery and the first day after the operation. Results In all operated patients we obtained complete remission of symptoms on the first day after the surgery. Inhibition of sweating was confirmed using the standard starch iodine (Minor) test. At all measurement points we obtained a statistically significant increase of skin resistance, assuming p < 0.05. To check whether there is a statistically significant difference in the results before and after surgery we used sequence pairs Wilcoxon test. Conclusions Thoracic sympathectomy is an effective curative treatment for primary hyperhidrosis of hands and armpits. Statistically significant increase of skin resistance in all cases is a good method of assessing the effectiveness of the above surgery in the early postoperative period. PMID:23256019

THE ‘HOLI’ DERMATOSES: ANNUAL SPATE OF SKIN DISEASES FOLLOWING THE SPRING FESTIVAL IN INDIA

PubMed Central

Ghosh, Sudip Kumar; Bandyopadhyay, Debabrata; Chatterjee, Gobinda; Saha, Debabrata

2009-01-01

Background: ‘Holi’ is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration. Aims: To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi. Methods: Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India. Results: Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%), followed by burning sensation, pain, oozing, and scaling. Eleven patients’ symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1%) followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9%) patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia). Secondary pyoderma occurred in 3 (7.1%). Face was the commonest site affected (24, 57.1%), followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7%) patients. Conclusion: Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions. PMID:20161854

Impact of systemic alitretinoin treatment on skin barrier gene and protein expression in patients with chronic hand eczema.

PubMed

Kumari, V; Timm, K; Kühl, A A; Heine, G; Worm, M

2016-12-01

Chronic hand eczema (CHE) is a common inflammatory skin disease that affects approximately 10% of the population. Systemic alitretinoin has been shown to be effective in patients with CHE who are refractory to topical corticosteroids. To analyse the impact of alitretinoin on the skin barrier genes and protein expression in the skin lesions of patients with CHE. Fifteen patients with CHE were treated with 30 mg daily of alitretinoin for up to 27 weeks. Disease severity was assessed using a clinical score. Skin biopsies from all the patients were evaluated before and after therapy for the expression of Ki-67, various skin barrier genes and thymic stromal lymphopoietin (TSLP) by real-time quantitative polymerase chain reaction and immunohistochemistry. After alitretinoin application, an improvement in the clinical severity of CHE was observed in the majority of patients. Analysis of skin biopsies before treatment showed a significant increase in Ki-67-positive cells in the suprabasal layer and a dysregulated expression of various skin barrier genes, such as claudin 1, loricrin, filaggrin and cytokeratin 10, which were normalized after treatment. TSLP was significantly upregulated in patients with CHE and also normalized after alitretinoin treatment and negatively correlated with filaggrin. Our data indicate that the expression of barrier genes and proteins was normalized following treatment with alitretinoin in patients with CHE. The change in expression levels of these genes correlated with the clinical efficacy, suggesting that alitretinoin exhibits a disease-modifying activity. TSLP is upregulated in CHE and seems to counteract filaggrin expression in the skin. © 2016 British Association of Dermatologists.

The Marble-Hand Illusion

PubMed Central

Senna, Irene; Maravita, Angelo; Bolognini, Nadia; Parise, Cesare V.

2014-01-01

Our body is made of flesh and bones. We know it, and in our daily lives all the senses constantly provide converging information about this simple, factual truth. But is this always the case? Here we report a surprising bodily illusion demonstrating that humans rapidly update their assumptions about the material qualities of their body, based on their recent multisensory perceptual experience. To induce a misperception of the material properties of the hand, we repeatedly gently hit participants' hand with a small hammer, while progressively replacing the natural sound of the hammer against the skin with the sound of a hammer hitting a piece of marble. After five minutes, the hand started feeling stiffer, heavier, harder, less sensitive, unnatural, and showed enhanced Galvanic skin response (GSR) to threatening stimuli. Notably, such a change in skin conductivity positively correlated with changes in perceived hand stiffness. Conversely, when hammer hits and impact sounds were temporally uncorrelated, participants did not spontaneously report any changes in the perceived properties of the hand, nor did they show any modulation in GSR. In two further experiments, we ruled out that mere audio-tactile synchrony is the causal factor triggering the illusion, further demonstrating the key role of material information conveyed by impact sounds in modulating the perceived material properties of the hand. This novel bodily illusion, the ‘Marble-Hand Illusion', demonstrates that the perceived material of our body, surely the most stable attribute of our bodily self, can be quickly updated through multisensory integration. PMID:24621793

Thermography-based blood flow imaging in human skin of the hands and feet: a spectral filtering approach.

PubMed

Sagaidachnyi, A A; Fomin, A V; Usanov, D A; Skripal, A V

2017-02-01

The determination of the relationship between skin blood flow and skin temperature dynamics is the main problem in thermography-based blood flow imaging. Oscillations in skin blood flow are the source of thermal waves propagating from micro-vessels toward the skin's surface, as assumed in this study. This hypothesis allows us to use equations for the attenuation and dispersion of thermal waves for converting the temperature signal into the blood flow signal, and vice versa. We developed a spectral filtering approach (SFA), which is a new technique for thermography-based blood flow imaging. In contrast to other processing techniques, the SFA implies calculations in the spectral domain rather than in the time domain. Therefore, it eliminates the need to solve differential equations. The developed technique was verified within 0.005-0.1 Hz, including the endothelial, neurogenic and myogenic frequency bands of blood flow oscillations. The algorithm for an inverse conversion of the blood flow signal into the skin temperature signal is addressed. The examples of blood flow imaging of hands during cuff occlusion and feet during heating of the back are illustrated. The processing of infrared (IR) thermograms using the SFA allowed us to restore the blood flow signals and achieve correlations of about 0.8 with a waveform of a photoplethysmographic signal. The prospective applications of the thermography-based blood flow imaging technique include non-contact monitoring of the blood supply during engraftment of skin flaps and burns healing, as well the use of contact temperature sensors to monitor low-frequency oscillations of peripheral blood flow.

Sunscreen Use on the Dorsal Hands at the Beach

PubMed Central

Warren, Donald B.; Riahi, Ryan R.; Hobbs, Jason B.; Wagner, Richard F.

2013-01-01

Background. Since skin of the dorsal hands is a known site for the development of cutaneous squamous cell carcinoma, an epidemiologic investigation was needed to determine if beachgoers apply sunscreen to the dorsal aspect of their hands as frequently as they apply it to other skin sites. Aim. The aim of the current study was to compare the use of sunscreen on the dorsal hands to other areas of the body during subtropical late spring and summer sunlight exposure at the beach. Materials and Methods. A cross-sectional survey from a convenience sample of beachgoers was designed to evaluate respondent understanding and protective measures concerning skin cancer on the dorsal hands in an environment with high natural UVR exposure. Results. A total of 214 surveys were completed and analyzed. Less than half of subjects (105, 49%) applied sunscreen to their dorsal hands. Women applied sunscreen to the dorsal hands more than men (55% women versus 40% men, P = 0.04). Higher Fitzpatrick Skin Type respondents were less likely to protect their dorsal hands from ultraviolet radiation (P = 0.001). Conclusions. More public education focused on dorsal hand protection from ultraviolet radiation damage is necessary to reduce the risk for squamous cell carcinomas of the hands. PMID:23840956

Is there a real danger of concealing gunshot residue (GSR) particles by skin debris using the tape-lift method for sampling GSR from hands?

PubMed

Zeichner, A

2001-11-01

Experiments were carried out to assess the danger of concealing GSR particles by skin debris using the tape-lift method for sampling GSR from hands. Thirty discrete spherical particles (from GSR and from the debris of oxygen cutting of steel) sized from 8 to 30 microns were mounted on a double-side adhesive coated stubs in known locations using a stereomicroscope. These stubs were then used for dabbing hands 50 times. Some of the particles or parts thereof were covered by skin flakes, however, all particles could be detected using the backscattered electron image (BEI) in the scanning electron microscope (SEM). Also, all could be identified by the energy dispersive X-ray spectroscopy (EDX).

Bimodal Biometric Verification Using the Fusion of Palmprint and Infrared Palm-Dorsum Vein Images

PubMed Central

Lin, Chih-Lung; Wang, Shih-Hung; Cheng, Hsu-Yung; Fan, Kuo-Chin; Hsu, Wei-Lieh; Lai, Chin-Rong

2015-01-01

In this paper, we present a reliable and robust biometric verification method based on bimodal physiological characteristics of palms, including the palmprint and palm-dorsum vein patterns. The proposed method consists of five steps: (1) automatically aligning and cropping the same region of interest from different palm or palm-dorsum images; (2) applying the digital wavelet transform and inverse wavelet transform to fuse palmprint and vein pattern images; (3) extracting the line-like features (LLFs) from the fused image; (4) obtaining multiresolution representations of the LLFs by using a multiresolution filter; and (5) using a support vector machine to verify the multiresolution representations of the LLFs. The proposed method possesses four advantages: first, both modal images are captured in peg-free scenarios to improve the user-friendliness of the verification device. Second, palmprint and vein pattern images are captured using a low-resolution digital scanner and infrared (IR) camera. The use of low-resolution images results in a smaller database. In addition, the vein pattern images are captured through the invisible IR spectrum, which improves antispoofing. Third, since the physiological characteristics of palmprint and vein pattern images are different, a hybrid fusing rule can be introduced to fuse the decomposition coefficients of different bands. The proposed method fuses decomposition coefficients at different decomposed levels, with different image sizes, captured from different sensor devices. Finally, the proposed method operates automatically and hence no parameters need to be set manually. Three thousand palmprint images and 3000 vein pattern images were collected from 100 volunteers to verify the validity of the proposed method. The results show a false rejection rate of 1.20% and a false acceptance rate of 1.56%. It demonstrates the validity and excellent performance of our proposed method comparing to other methods. PMID:26703596

Bimodal Biometric Verification Using the Fusion of Palmprint and Infrared Palm-Dorsum Vein Images.

PubMed

Lin, Chih-Lung; Wang, Shih-Hung; Cheng, Hsu-Yung; Fan, Kuo-Chin; Hsu, Wei-Lieh; Lai, Chin-Rong

2015-12-12

In this paper, we present a reliable and robust biometric verification method based on bimodal physiological characteristics of palms, including the palmprint and palm-dorsum vein patterns. The proposed method consists of five steps: (1) automatically aligning and cropping the same region of interest from different palm or palm-dorsum images; (2) applying the digital wavelet transform and inverse wavelet transform to fuse palmprint and vein pattern images; (3) extracting the line-like features (LLFs) from the fused image; (4) obtaining multiresolution representations of the LLFs by using a multiresolution filter; and (5) using a support vector machine to verify the multiresolution representations of the LLFs. The proposed method possesses four advantages: first, both modal images are captured in peg-free scenarios to improve the user-friendliness of the verification device. Second, palmprint and vein pattern images are captured using a low-resolution digital scanner and infrared (IR) camera. The use of low-resolution images results in a smaller database. In addition, the vein pattern images are captured through the invisible IR spectrum, which improves antispoofing. Third, since the physiological characteristics of palmprint and vein pattern images are different, a hybrid fusing rule can be introduced to fuse the decomposition coefficients of different bands. The proposed method fuses decomposition coefficients at different decomposed levels, with different image sizes, captured from different sensor devices. Finally, the proposed method operates automatically and hence no parameters need to be set manually. Three thousand palmprint images and 3000 vein pattern images were collected from 100 volunteers to verify the validity of the proposed method. The results show a false rejection rate of 1.20% and a false acceptance rate of 1.56%. It demonstrates the validity and excellent performance of our proposed method comparing to other methods.

Comparative efficacy of a simplified handwashing program for improvement in hand hygiene and reduction of school absenteeism among children with intellectual disability.

PubMed

Lee, Regina L T; Leung, Cynthia; Tong, Wah Kun; Chen, Hong; Lee, Paul H

2015-09-01

Infectious diseases are common among schoolchildren as a result of their poor hand hygiene, especially in those who have developmental disabilities. A quasi-experimental study using a pre- to post-test design with a control group was used to test the feasibility and sustainability of simplified 5-step handwashing techniques to measure the hand hygiene outcome for students with mild intellectual disability. Sickness-related school absenteeism was compared. The intervention group experienced a significant increase in the rating of their handwashing quality in both hands from pre- to post-test: left dorsum (+1.05, P < .001); right dorsum (+1.00, P < .001); left palm (+0.98, P < .001); and right palm (+1.09, P < .001). The pre- to post-test difference in the intervention group (+1.03, P < .001) was significantly greater than the difference in the control group (+0.34, P = .001). There were no differences between the post-test and the sustainability assessment in the intervention group. The intervention school experienced a significantly lower absenteeism rate (0.0167) than the control group in the same year (0.028, P = .04).Students in this study showed better performance in simplified handwashing techniques and experienced lower absenteeism than those using usual practice in special education school settings. The simplified 5-step hand hygiene technique has been proven effective in reducing the spread of infectious diseases. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Laser-assisted skin closure at 1.32 microns: the use of a software-driven medical laser system

NASA Astrophysics Data System (ADS)

Dew, Douglas K.; Hsu, Tung M.; Hsu, Long S.; Halpern, Steven J.; Michaels, Charles E.

1991-06-01

This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal approximated wound edges in pig skin. The medical laser system used was the DLS Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG laser in a large animal model. Effectiveness was judged on the basis of wound dehiscence, infection, unusual healing result and consistency of results. Comparative cosmetic result was also evaluated. In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness wounds. The pig model was chosen for its many integumentary similarities to man. Controls included scalpel-induced wounds closed using suture, staple and some with norepair. After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75- 100 pounds) each was clipped with animal hair clippers from the shoulder area to the hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or abrasions of the skin. The dorsum was divided into four rows of four parallel incisions made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the dorsum of the pigs and then closed either with one loosely approximating Prolene" suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs. Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart along the 9 cm incision. The no-repair incisions were grossly approximated using a single 2-0 Prolene full thickness, simple, interrupted suture located at the

Back to basics: hand hygiene and surgical hand antisepsis.

PubMed

Spruce, Lisa

2013-11-01

Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Extensor Tendon Injuries and Repairs in the Hand

PubMed Central

Kontor, J. A.

1982-01-01

Due to their superficial course, the extensor tendons are frequently lacerated over the dorsum of the hand and fingers. Excellent functional results are obtained in repairs of simple tendon lacerations. ‘Open’ mallet lacerations over the distal IP joint or involving the central extensor slip over the proximal IP joint require more precise suturing methods. More proximal extensor tendon divisions near the wrist involve dissection of the retracted finger extensors or long thumb extensor in the distal forearm and more formal tendon repairs, including a possible tendon transfer to the thumb. ‘Closed injuries’, with varying degrees of extensor tendon disruption, occur at three main sites. The mallet injury at the DIP joint and the boutonnière deformity over the PIP joint are sometimes recognized late, but respond to conservative splinting for a minimum of four weeks with guarded motion avoiding secondary stiffening of the remaining small joints of the hand. Surgery of closed injuries most frequently involves the intra-articular traction fracture type of mallet deformities in which the DIP joint has taken the brunt of the injury. PMID:21286174

Methods for evaluating changes in skin condition due to the effects of antimicrobial hand cleansers: two studies comparing a new waterless chlorhexidine gluconate/ethanol-emollient antiseptic preparation with a conventional water-applied product.

PubMed

Grove, G L; Zerweck, C R; Heilman, J M; Pyrek, J D

2001-12-01

Hand-cleansing products that are milder to the skin of health care personnel are being developed, but the available methodologies to appropriately evaluate these products and quantify differences are not generally being applied in well-controlled studies. Two randomized, blinded, bilateral comparison studies evaluated skin condition during use of 2 antiseptic hand preparation products: a new 1% chlorhexidine gluconate (CHG)/61% wt/wt ethanol antiseptic hand preparation in a unique emollient system for waterless/brushless application and a conventional 4% CHG antimicrobial product that is applied with water and a scrub brush. Trained technicians applied treatments 6 times (for a surgical scrub study) or 24 times (for a personnel handwash study) daily to the hands of healthy volunteers during 5 days of controlled washing. An expert grader evaluated skin for dryness, erythema, and roughness. Subjects completed a self-assessment questionnaire on skin condition. Transepidermal water loss was measured by an evaporimeter, and the skin surface hydration level was measured by an electrical conductance meter. Fifty-eight subjects were enrolled in the 2 studies and received both treatments. In general, skin treated with the waterless CHG/ethanol product scored significantly (P <.004) better on evaluations of visual dryness and erythema and showed greater improvement in the level of hydration (P <.003). In the health care personnel handwash study, transepidermal water loss was less than that for skin treated with the conventional CHG product (P <.002). Subject assessments showed similar results (total score, P <.007). All 3 approaches of expert grader evaluation, subject assessment, and instrumentation were in concordance, demonstrating that the waterless CHG/ethanol product was gentler to skin than the conventional CHG product.

Hand burns surface area: A rule of thumb.

PubMed

Dargan, Dallan; Mandal, Anirban; Shokrollahi, Kayvan

2018-08-01

Rapid estimation of acute hand burns is important for communication, standardisation of assessment, rehabilitation and research. Use of an individual's own thumbprint area as a fraction of their total hand surface area was evaluated to assess potential utility in hand burn evaluation. Ten health professionals used an ink-covered dominant thumb pulp to cover the surfaces of their own non-dominant hand using the contralateral thumb. Thumbprints were assessed on the web spaces, sides of digits and dorsum and palm beyond the distal wrist crease. Hand surface area was estimated using the Banerjee and Sen method, and thumbprint ellipse area calculated to assess correlation. Mean estimated total hand surface area was 390.0cm 2 ±SD 51.5 (328.3-469.0), mean thumbprint ellipse area was 5.5cm 2 ±SD 1.3 (3.7-8.4), and mean estimated print number was 73.5±SD 11.0 (range 53.1-87.8, 95% CI 6.8). The mean observed number of thumbprints on one hand was 80.1±SD 5.9 (range 70.0-88.0, 95% CI 3.7), χ 2 =0.009. The combined mean of digital prints was 42, comprising a mean of two prints each on volar, dorsal, radial and ulnar digit surfaces, except volar middle and ring (3 prints each). Palmar prints were 15 (11-19), dorsal 15 (11-19), ulnar palm border 3, first web space 2, and second, third and fourth web spaces one each. Using the surface of the palm alone, excluding digits, as 0.5% of total body surface area, the area of one thumbprint was approximated as 1/30th of 1%. We have demonstrated how thumbprint area serves as a simple method for evaluating hand burn surface area. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema.

PubMed

Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane Lindschou; Gluud, Christian

2010-08-31

Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. The trial is registered in ClinicalTrials.Gov, NCT01012453.

Dry skin - self-care

MedlinePlus

... or showers frequently Washing your hands often Some soaps and detergents Skin conditions, such as eczema and ... apply your moisturizer. Avoid skin care products and soaps that contain alcohol, fragrances, dyes, or other chemicals. ...

Hyperbaric gaseous cryotherapy: effects on skin temperature and systemic vasoconstriction.

PubMed

Mourot, Laurent; Cluzeau, Christian; Regnard, Jacques

2007-10-01

To compare skin-surface cooling caused by the application of an ice bag (15min) and the projection of carbon dioxide microcristals (2min) under high pressure (75 bar) and low temperature (-78 degrees C), a modality called hyperbaric gaseous cryotherapy. Randomized controlled trial with repeated measure. Laboratory experiment. Twelve healthy male subjects (mean +/- standard deviation, 22.9+/-1.8y). Ice bag and hyperbaric gaseous cryotherapy were randomly applied on the skin of the nondominant hand. Skin temperature of the cooled (dorsal and palmar sides) and contralateral (dorsal side) hands were continuously measured with thermistor surface-contact probes before, during, and after (30min) cooling. Hyperbaric gaseous cryotherapy projection induced a large decrease (P<.05) of the dorsal skin temperature of the cooled hand (from 32.5 degrees +/-0.5 degrees C to 7.3 degrees +/-0.8 degrees C) and a significant decrease of the skin temperature of the palmar side and of the contralateral hand. The skin temperature of the dorsal side of the cooled hand was decreased with an ice bag (from 32.5 degrees +/-0.6 degrees C to 13.9 degrees +/-0.7 degrees C, P<.05). However, the lowest temperature was significantly higher than during hyperbaric gaseous cryotherapy, and no significant changes in the other skin temperatures were observed. Rewarming was equal after the 2 modalities, highlighting a more rapid increase of the skin temperature after hyperbaric gaseous cryotherapy. Hyperbaric gaseous cryotherapy projection decreased the skin temperature of the cooled and contralateral hand, suggesting a systemic skin vasoconstriction response. On the other hand, the vascular responses triggered by ice pack cooling appeared limited and localized to the cooled area.

Assessment of two hand hygiene regimens for intensive care unit personnel.

PubMed

Larson, E L; Aiello, A E; Bastyr, J; Lyle, C; Stahl, J; Cronquist, A; Lai, L; Della-Latta, P

2001-05-01

To compare skin condition and skin microbiology among intensive care unit personnel using one of two randomly assigned hand hygiene regimens: a 2% chlorhexidine gluconate (CHG)-containing traditional antiseptic wash and a waterless handrub containing 61% ethanol with emollients (ALC). Prospective, randomized clinical trial. Two critical care units (medical and surgical) in a large, metropolitan academic health center in Manhattan. Fifty staff members (physicians, nurses, housekeepers, respiratory therapists) working full time in the intensive care unit. One of two hand hygiene regimens randomly assigned for four consecutive weeks. The two outcomes were skin condition (measured by two tools: Hand Skin Assessment form and Visual Skin Scaling form) and skin microbiology. Samples were obtained at baseline, on day 1, and at the end of wks 2 and 4. Participants in the ALC group had significant improvements in the Hand Skin Assessment scores at wk 4 (p = 0.04) and in Visual Skin Scaling scores at wks 3 (p = 0.01) and 4 (p = 0.0005). There were no significant differences in numbers of colony-forming units between participants in the CHG or ALC group at any time period. The ALC regimen required significantly less time than the CHG regimen (mean: 12.7 secs and 21.1 secs, respectively; p = 0.000) and resulted in a 50% reduction in material costs. Changes in hand hygiene practices in acute care settings from the traditional antiseptic wash to use of plain, mild soap and an alcohol-based product should be considered. Further research is needed to examine the association between use of antiseptic products for hand hygiene of staff and reductions in nosocomial infection rates among patients.

Skin Cancer of the Hand and Upper Extremity

MedlinePlus

... the Hand. Find a hand surgeon near you. Videos Figures Figure 1 - Squamous cell carcinoma with small ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Role of linoleic acid in arsenical palmar keratosis.

PubMed

Ahmed, Tarafder S; Misbahuddin, Mir

2016-03-01

Chronic arsenic exposure can lead to palmoplantar keratosis. In the stratum corneum of skin, linoleic acid is of the utmost importance to the inflammation, keratinization, and regeneration processes. The aims of this study were: (i) to present quantitative information on the linoleic acid fraction of intercorneocyte lipids, and (ii) to elucidate the role of linoleic acid in the pathophysiology of arsenical keratosis. Lipid extracts were collected from keratotic lesions in seven patients, seven arsenic-exposed subjects, and seven non-exposed control subjects. Linoleic acid levels of the specimens were estimated by reverse-phase high-performance liquid chromatography (RP-HPLC). There was a significant (P < 0.001) increase in mean ± standard error (SE) linoleic acid levels in arsenical keratosis patients (palm: 25.66 ± 4.95 μg/cm(2); dorsum: 28.25 ± 6.20 μg/cm(2)) compared with arsenic-exposed (palm: 2.75 ± 0.85 μg/cm(2); dorsum: 1.96 ± 0.64 μg/cm(2)) and non-exposed (palm: 1.52 ± 0.61 μg/cm(2); dorsum: 1.28 ± 0.39 μg/cm(2)) control subjects. There was no significant difference (P = 0.556) in linoleic acid concentration in the non-affected skin of the dorsum of the hand (28.25 ± 6.20 μg/cm(2)) compared with that in the palmar sites (25.66 ± 4.95 μg/cm(2)) in the patient group. The change in linoleic acid levels in the arsenic-exposed control group did not differ from that in non-exposed controls (P = 1.000). Linoleic acid concentration is elevated in arsenical keratosis; this finding warrants further investigation to ascertain whether linoleic acid plays a direct role in the pathophysiology of arsenical keratosis. © 2015 The International Society of Dermatology.

Reconstruction of internal nasal valve, septum, dorsum, and anterior structures of the nose in a single procedure with a molded bone graft: the sail graft.

PubMed

Guneren, Ethem; Ciftci, Mehmet; Karaaltin, Mehmet Veli; Yildiz, Kemalettin

2012-05-01

Excessive surgical removal or traumatic loss of the tissues supporting the nasal roof can result in the "saddle nose" deformity. It involves both cartilage and bone deficiencies. Two main resources are used to reconstruct this difficult deformity: autogenous bone and cartilage grafts and alloplastic materials. This study presents the reconstruction of the dorsum, septum, internal nasal valve, and anterior structures and the tip of the nose using a block of molded autogenous bone graft. We called it the "sail graft," because it looks like a sail from a lateral view. The mast of the sail is oriented in a superior-to-inferior direction, beginning in the frontonasal region to the tip of the nose to form a straight, well-rounded dorsum. The longest postoperative follow-up of 13 cases is now 10 years; the median follow-up is 2 years. The results have been satisfactory.

The first step in infection control is hand hygiene.

PubMed

Canham, Leslie

2011-01-01

A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes

The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients--a randomized clinical trial.

PubMed

Ademovski, Seida Erovic; Persson, G Rutger; Winkel, Edwin; Tangerman, Albert; Lingström, Peter; Renvert, Stefan

2013-03-01

This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue. A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization. No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21 with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone. VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied. Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

[Prevention of hand dermatoses in small catering enterprises].

PubMed

Kurpiewska, Joanna; Liwkowicz, Jolanta; Padlewska, Kamila

2013-01-01

Work in catering and food processing is mostly performed by hands. Mechanical, thermal and chemical agents, as well as damp working conditions and frequent hand washing aggravate skin irritation. The aim of the study was to test the efficacy of hydrophobic skin protection measure at these workplaces. We recommended the prevention of contact skin disorders by using hydrophobic skin protection measure. The study was conducted in a group of 20 food service sector workers, They were interviewed about skin problems and skin protection measures. Tolb assess the effect of the protective preparation on the skin dermatological test procedures, corneometry and sebumetry, were applied, as well as the level of transepidermal water loss (TEWL) was measured. The same survey was performed in the control group composed of 10 workers who used and 10 who did not use barrier preparation. The respondents declared dryness, roughness, peeling, burning, redness, erythema of the skin. All who had applied barrier cream observed a significant improvement of the skin hydration increased by about 30%, and lubrication of the skin - by 11 times on average. Also the level of TEWL decreased by about 25%. The improvement of skin conditions and reduction of skin disorders were observed confirming the effectiveness of the protection of the skin from exposure to harmful factors. Knowledge about prevention of skin diseases should be promoted among employees of catering enterprises.

Dupuytren Disease Infiltrating a Full-Thickness Skin Graft.

PubMed

Wade, Ryckie George; Igali, Laszlo; Figus, Andrea

2016-08-01

Although the role of the skin in the development and propagation of Dupuytren disease remains unclear, dermofasciectomy and full-thickness skin grafting (FTSG) appears to delay recurrence. In 2011, a 71-year-old, left-handed man presented with recurrent Dupuytren disease in the dominant hand. In 1991, he originally underwent a primary dermofasciectomy and FTSG for Dupuytren disease involving the palmar skin. Twenty years later, the left middle finger was drawn into flexion by a recurrent cord, and the old graft and adjacent palmar skin were clinically involved by fibromatosis. We performed a revision dermofasciectomy and FTSG. Microscopic analysis of the excised graft demonstrated dense infiltration of the entire skin graft by Dupuytren disease, with areas of active and burnt-out fibromatosis distinct from hypertrophic scarring. This report of Dupuytren fibromatosis infiltrating a skin graft raises questions about the pathophysiology of Dupuytren disease. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Inefficacy of alcohol-based hand rub on mites in a patient with hyperkeratotic scabies.

PubMed

Cinotti, E; Perrot, J L; Labeille, B; Maguet, H; Couzan, C; Flori, P; Cambazard, F

2015-03-01

The World Health Organization is strongly promoting alcohol-based hand rubs to interrupt transmission of pathogens within the healthcare environment, and in some hospitals they are being recommended in cases of scabies. However, there are no studies that demonstrate the efficacy of such hand rubs against scabies. To evaluate the viability of Sarcoptes scabiei after the application of various topical antiseptics used for hand hygiene, and the effect of hand washing on the number of parasites present on the skin surface of a patient with scabies. We applied three different topical antiseptics (two alcohol-based and one povidone-iodine-based) to the skin of one hand that was affected by scabies, and took a skin scraping of each area to evaluate the viability of the mites over time. A skin scraping of a control area without antiseptic application was also taken. We also tested the antiseptics directly on the mites. Statistical comparison between the percentages of vital mites in the different samples was assessed using the χ(2) test. We also captured a dermoscopic image of the other hand before and after hand washing to count the number of parasites on the skin surface. Topical antiseptics did not reduce the number of living mites compared with control skin, and hand washing did not reduce the number of parasites on the skin surface. Application of topical antiseptics does not reduce the viability of S. scabiei, and is therefore unable to prevent the transmission of scabies. The usefulness of hand washing in preventing transmission of scabies to new subjects remains to be investigated. © 2014 British Association of Dermatologists.

Left-right asymmetry of biophoton emission from hemiparesis patients.

PubMed

Jung, Hyun-Hee; Woo, Won-Myung; Yang, Joon-Mo; Choi, Chunho; Lee, Jonghan; Yoon, Gilwon; Yang, Jong S; Lee, Sungmuk; Soh, Kwang-Sup

2003-05-01

Left-right biophoton asymmetry from the palm and the dorsum of hands from 7 Korean hemiparesis patients were studied. There is a strong tendency that the left-hemiparesis patients emit more biophotons from the right than the left hands, while the right-hemiparesis patient emits more from the left hand. Acupuncture treatment reduces dramatically the left-right asymmetry of biophoton emission rates. However there is no systematic difference for the patients in the emission rates from the palm and the dorsum of hands.

Skin glands, poison and mimicry in dendrobatid and leptodactylid amphibians.

PubMed

Prates, Ivan; Antoniazzi, Marta M; Sciani, Juliana M; Pimenta, Daniel C; Toledo, Luís Felipe; Haddad, Célio F B; Jared, Carlos

2012-03-01

In amphibians, secretions of toxins from specialized skin poison glands play a central role in defense against predators. The production of toxic secretions is often associated with conspicuous color patterns that warn potential predators, as it is the case of many dendrobatid frogs, including Ameerega picta. This species resembles the presumably nontoxic Leptodactylus lineatus. This study tests for mimicry by studying the morphology and distribution of skin glands, components of skin secretion, and defensive behavior. Dorsal skin was studied histologically and histochemically, and skin secretions were submitted to sodium dodecyl sulfate polyacrylamide gel electrophoresis, reversed phase high performance liquid chromatography and assays for proteolytic activity. We found that poison glands in A. picta are filled with nonprotein granules that are rich in carbohydrates, while L. lineatus glands present protein granules. Accordingly, great amounts of proteins, at least some of them enzymes, were found in the poison of L. lineatus but not in that of A. picta. Both species differ greatly on profiles of gland distribution: In L. lineatus, poison glands are organized in clusters whose position coincides with colored elements of the dorsum. These regions are evidenced through a set of displays, suggesting that poison location is announced to predators through skin colors. In contrast, A. picta presents lower densities of glands, distributed homogeneously. This simpler profile suggests a rather qualitative than quantitative investment in chemical defense, in agreement with the high toxicity attributed to dendrobatids in general. Our data suggest that both species are toxic or unpalatable and transmit common warning signals to predators, which represents a case of Müllerian mimicry. Copyright © 2011 Wiley Periodicals, Inc.

Managing Occupational Irritant Contact Dermatitis Using a Two-Step Skincare Regimen Designed to Prevent Skin Damage and Support Skin Recovery.

PubMed

von Grote, Erika C; Palaniswarmy, Kiruthi; Meckfessel, Matthew H

2016-12-01

Occupational irritant contact dermatitis (ICD) affecting the hands is a common and difficult-to-manage condition. Occupations that necessitate contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing elevate the risk of ICD. Management strategies that do not adequately prevent accumulated damage and repair skin, can develop into chronic dermatoses which negatively impact work productivity and quality of life. A 2-step skin-care regimen (Excipial Daily Protection Hand Cream (EP) and Excipial Rapid Repair Hand Cream (ER), Galderma Laboratories, L.P.) has been developed as a daily-use management strategy to protect and repair vulnerable hands. The protective barrier cream is formulated with aluminum chlorohydrate and designed for pre-exposure application to enhance the skin's natural protective barrier and minimize excessive moisture while wearing protective gloves. The repair cream, a lipid-rich formulation, is intended for post-exposure application to rehydrate and facilitate the skin's natural healing process. The results of 3 clinical studies highlighted in this review demonstrate how the use of a 2-step skin-care regimen offers a greater protective effect against ICD than the use of barrier cream alone, and also how the formulation of the barrier cream used in these studies helps minimize the occlusion effect caused by gloves and does not interfere with the antibacterial efficacy of an alcohol-based hand sanitizer. This 2-step skin-care regimen is effectively designed to manage and minimize the risk of ICD development in a variety of patients and provides clinicians an additional tool for helping patients manage ICD. J Drugs Dermatol. 2016;15(12):1504-1510.

The effectiveness of a skin care program for the prevention of contact dermatitis in health care workers (the Healthy Hands Project): study protocol for a cluster randomized controlled trial.

PubMed

Soltanipoor, Maryam; Kezic, Sanja; Sluiter, Judith K; Rustemeyer, Thomas

2017-02-28

Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to 'wet work'. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed. This is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months. The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as 'care as usual'). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome. This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers TRIAL REGISTRATION: Netherlands Trial Register (NTR), identification number NTR5564

Custom-made silicone hand prosthesis: A case study.

PubMed

Nayak, S; Lenka, P K; Equebal, A; Biswas, A

2016-09-01

Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.

Release of hand burn contracture: comparing the ALT perforator flap with the gracilis free flap with split skin graft.

PubMed

Misani, M; Zirak, C; Hau, Lê Thua Trung; De Mey, A; Boeckx, W

2013-08-01

The use of microsurgery in the management of burn sequelae is not a new idea. According to the properties of various types of free flaps different goals can be achieved or various additional procedures have to be combined. We report the comparison of two different free flaps on a single patient for reconstruction of both upper extremities for burn sequelae. A 1-year-old child sustained severe burns on both hands, arms and thorax and was initially only treated conservatively. This resulted in severe contractures. At the age of 4-years a free gracilis flap was selected for reconstruction of his left hand and a free anterolateral thigh flap for the right hand. We noticed a better functional and esthetic result for the gracilis flap associated with a shorter operative time and a minor donor site morbidity. The intraoperative technique and time, postoperative complications, functional and esthetic results and donor site morbidities were studied in the two types of flaps chosen. A review of literature was also performed. Our experience reported a better success of the gracilis muscle flap covered with a split skin graft compared to the anterolateral thigh flap in the reconstruction of hand function after severe burn sequelae. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Preoperative Disinfection of Surgeons' Hands: Use of Alcoholic Solutions and Effects of Gloves on Skin Flora

PubMed Central

Lowbury, E. J. L.; Lilly, H. A.; Ayliffe, G. A. J.

1974-01-01

A single application of about 10 ml of 95% alcoholic chlorhexidine (0·5%) or tetrabrom-o-methyl phenol (0·1%) rubbed on to the hands until they were dry led to mean reduction in viable bacterial counts from standard handwashings of 97·9 ± 1·09% and 91·8 ± 4·63% respectively. After six of such treatments, three on each of two successive days, the mean reductions in relation to viable counts before the first treatment were 99·7 ± 0·09% for alcoholic chlorhexidine and 99·5 ± 0·17% for tetrabrom-o-methyl phenol. These reductions were greater than those obtained with 4% chlorhexidine detergent solution— 87·1 ± 3·5% and 98·2 ± 1·6%, and with 95% or 70% ethyl alcohol and with aqueous 0·5% chlorhexidine. Preoperative washing of the surgeon's hands with alcoholic chlorhexidine used without addition of water is more effective and less expensive than handwashing with antiseptic detergent preparations and running water. The viable counts of washings from hands treated with various antiseptics, including ethyl alcohol, were lower in relation to the pretreatment levels when gloves had been worn for three hours than when samples for counts were taken immediately after the antiseptic treatment. No such difference was found in samplings from hands washed with unmedicated soap. Tests for residual action of antiseptics on the skin showed a greater effect with alcoholic chlorhexidine than with tetrabrom-o-methyl phenol, though both showed greater residual activity than an Irgasan DP 300 detergent preparation. No residual action was shown after 70% ethyl alcohol. PMID:4609555

Hand Eczema

PubMed Central

Agarwal, Uma Shankar; Besarwal, Raj Kumar; Gupta, Rahul; Agarwal, Puneet; Napalia, Sheetal

2014-01-01

Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients. PMID:24891648

Single treatment with ethanol hand rub is ineffective against human rhinovirus--hand washing with soap and water removes the virus efficiently.

PubMed

Savolainen-Kopra, Carita; Korpela, Terttu; Simonen-Tikka, Marja-Leena; Amiryousefi, Ali; Ziegler, Thedi; Roivainen, Merja; Hovi, Tapani

2012-03-01

Ethanol-containing hand rubs are used frequently as a substitute for hand washing with water and soap. However, not all viruses are inactivated by a short term rubbing with alcohol. The capacity of a single round of instructed and controlled hand cleaning with water and soap or ethanol-containing hand rub, respectively, was tested for removal of human rhinovirus administered onto the skin of healthy volunteers on the back of the hands. Hand washing with soap and water appeared to be much more efficient for removing rhinoviruses from skin than rubbing hands with an ethanol-containing disinfectant. After washing with soap and water the virus was detected in 3/9 (33.3%) test persons from the left hand and 1/9 (11.1%) cases from the right hand, whereas the virus was detected invariably by real-time RT-PCR from both hands after cleaning with alcohol hand rub (P-value <0.01). Both substances evaluated clinically were also tested in vitro for virucidal efficacy against Human rhinovirus2 (HRV2) using a standardized assay. Both tested substances were poor within the contact time used in the hand-cleaning test. In conclusion, thorough and conventional hand washing with water and soap can clean efficiently hands contaminated with the virus responsible for an extensive share of common cold episodes. Copyright © 2012 Wiley Periodicals, Inc.

Autologous bone marrow stem cell transplantation for the treatment of postoperative hand infection with a skin defect in diabetes mellitus: A case report.

PubMed

Liu, Yihong; Liu, Yuchen; Wang, Pujie; Tian, Haoming; Ai, Jianzhong; Liu, Yangbo; Zhou, Yi; Liu, Zhongwen; Guo, Wenjun; Yang, Shenke

2014-06-01

Among stem cells, autologous mesenchymal stem cells (MSCs) are ideal for transplantation by virtue of limited rejection reactions and marked proliferative ability. This study presents a novel method by which MSCs were harvested from the bone marrow of a patient who presented with severe post-traumatic infection and a non-healing skin defect in the hand, secondary to uncontrolled diabetes mellitus (DM). An autologous MSC suspension was injected into the persistent skin defect after stabilizing the blood glucose level and appropriate infection control. During the course of a regular 18-month postoperative follow-up, the patient exhibited immediate recovery with no transplant-associated complications, as well as no evidence of tumorigenicity. Thus, transplantation of autologous MSCs may play a role in the clinical application of stem cells, particularly for treatment of skin defects following surgery in cases of DM and for those caused by various other traumas.

EEG frequency tagging using ultra-slow periodic heat stimulation of the skin reveals cortical activity specifically related to C fiber thermonociceptors

PubMed Central

Colon, Elisabeth; Liberati, Giulia; Mouraux, André

2017-01-01

The recording of event-related brain potentials triggered by a transient heat stimulus is used extensively to study nociception and diagnose lesions or dysfunctions of the nociceptive system in humans. However, these responses are related exclusively to the activation of a specific subclass of nociceptive afferents: quickly-adapting thermonociceptors. In fact, except if the activation of Aδ fibers is avoided or if A fibers are blocked, these responses specifically reflect activity triggered by the activation of Type 2 quickly-adapting A fiber mechano-heat nociceptors (AMH-2). Here, we propose a novel method to isolate, in the human electroencephalogram (EEG), cortical activity related to the sustained periodic activation of heat-sensitive thermonociceptors, using very slow (0.2 Hz) and long-lasting (75 s) sinusoidal heat stimulation of the skin between baseline and 50°C. In a first experiment, we show that when such long-lasting thermal stimuli are applied to the hand dorsum of healthy volunteers, the slow rises and decreases of skin temperature elicit a consistent periodic EEG response at 0.2 Hz and its harmonics, as well as a periodic modulation of the magnitude of theta, alpha and beta band EEG oscillations. In a second experiment, we demonstrate using an A fiber block that these EEG responses are predominantly conveyed by unmyelinated C fiber nociceptors. The proposed approach constitutes a novel mean to study C fiber function in humans, and to explore the cortical processing of tonic heat pain in physiological and pathological conditions. PMID:27871921

Morphological Changes in Skin Glands During Development in Rhinella Arenarum (Anura: Bufonidae).

PubMed

Regueira, Eleonora; Dávila, Camila; Hermida, Gladys N

2016-01-01

Avoiding predation is critical to survival of animals; chemical defenses represent a common strategy among amphibians. In this study, we examined histologically the morphology of skin glands and types of secretions related to chemical skin defense during ontogeny of Rhinella arenarum. Prior to metamorphic climax the epidermis contains typical bufonid giant cells producing a mucous substance supposedly involved in triggering a flight reaction of the tadpole school. An apical layer of alcianophilic mucus covers the epidermis, which could produce the unpleasant taste of bufonid tadpoles. Giant cells disappear by onset of metamorphic climax, when multicellular glands start developing, but the apical mucous layer remains. By the end of climax, neither the granular glands of the dorsum nor the parotoid regions are completely developed. Conversely, by the end of metamorphosis the mucous glands are partially developed and secrete mucus. Adults have at least three types of granular glands, which we designate type A (acidophilic), type B (basophilic) and ventral (mucous). Polymorphic granular glands distribute differently in the body: dorsal granular glands between warts and in the periphery of parotoids contain protein; granular glands of big warts and in the central region of parotoids contain catecholamines, lipids, and glycoconjugates, whereas ventral granular glands produce acidic glycoconjugates. Mucous glands produce both mucus and proteins. Results suggest that in early juveniles the chemical skin defense mechanisms are not functional. Topographical differences in adult skin secretions suggest that granular glands from the big warts in the skin produce similar toxins to the parotoid glands. © 2015 Wiley Periodicals, Inc.

The influence of cooling forearm/hand and gender on estimation of handgrip strength.

PubMed

Cheng, Chih-Chan; Shih, Yuh-Chuan; Tsai, Yue-Jin; Chi, Chia-Fen

2014-01-01

Handgrip strength is essential in manual operations and activities of daily life, but the influence of forearm/hand skin temperature on estimation of handgrip strength is not well documented. Therefore, the present study intended to investigate the effect of local cooling of the forearm/hand on estimation of handgrip strength at various target force levels (TFLs, in percentage of MVC) for both genders. A cold pressor test was used to lower and maintain the hand skin temperature at 14°C for comparison with the uncooled condition. A total of 10 male and 10 female participants were recruited. The results indicated that females had greater absolute estimation deviations. In addition, both genders had greater absolute deviations in the middle range of TFLs. Cooling caused an underestimation of grip strength. Furthermore, a power function is recommended for establishing the relationship between actual and estimated handgrip force. Statement of relevance: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Practitioner Summary: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the

Phaeohyphomycosis caused by Exophiala jeanselmei in a patient with polymyalgia rheumatica.

PubMed

Arakaki, Osao; Asato, Yutaka; Yagi, Nobutake; Taira, Kiyohito; Yamamoto, Yu-Ichi; Nonaka, Kimiko; Hosokawa, Atsushi; Kayo, Susumu; Hagiwara, Keisuke; Uezato, Hiroshi

2010-04-01

An 87-year-old man, a gardener in Okinawa, first noticed a tumor on the dorsum of his right hand in November 2005. He had been taking prednisolone for the treatment of polymyalgia rheumatica since 2000. A nearby dermatologist incised the tumor for pus drainage in February 2006. In April of the same year, the dome-like tumor reappeared. The same treatment was repeated. Because the culture of the pus revealed fungi at that time, terbinafine hydrochloride and minocycline were administrated under the diagnosis of a deep fungal infection. After a short remission, the tumor recurred in November of the same year and in May and August of 2007 regardless of the repeated incision and pus drainage. He was referred to our hospital on 27 September 2007. His first physical examination at our outpatient office showed a skin-colored, well-demarcated, multilocular, cystic subcutaneous tumor on the dorsum of his right hand. Histopathological examination revealed a pseudocyst with fibrous walls of connective tissue. Continuous, bead-like hyphae, positive with periodic acid-Schiff stain and Grocott stain, were found within the pseudocyst. Morphological and molecular biological examinations of the separately cultured specimens identified the causative agent as Exophiala jeanselmei. The entire cyst was removed under local anesthesia, and an artificial dermis made of silicon membrane was applied to the wound. Skin graft was performed in November after confirming no recurrence of the fungal infection. Terbinafine hydrochloride 125 mg/day has continued. No recurrence has been observed up to now.

Skin health and safety at work in Croatian hairdressing apprentices.

PubMed

Samardžić, Tea; Varnai, Veda Marija; Bakotić, Marija; Babić, Željka; Brans, Richard; Cvijetić Avdagić, Selma; Štampar Šmaguc, Darinka; Kovačević, Iva; Macan, Jelena

2016-07-01

The risk of developing occupational skin disease (OSD) is high in hairdressers, but may differ between countries. To evaluate safety at work measures, and the prevalence and severity of skin symptoms and their impact on quality of life (QoL), among Croatian hairdressing apprentices. Data on self-reported skin symptoms, safety measures and QoL were collected for 101 final-year apprentices. The presence and severity of skin lesions were assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Transepidermal water loss (TEWL) was measured on the forearm and hand. Ninety-one percent of apprentices reported wearing gloves while dyeing hair, 45% while rinsing hair dyes, and 4% while washing hair. A history of skin symptoms was found in 35% of apprentices, and a history of dry hands in 37%. Skin changes were clinically observed in 40% of apprentices, most frequently erythema, infiltration, and desquamation. The OHSI score ranged from 0 to 6. Only washing hands >20 times per day was positively associated with TEWL. A history of skin symptoms negatively correlated with self-esteem, and social and mental functioning, and positively with anxiety and depression. The results indicate the need for the continuation of efforts to establish effective primary preventive programmes for OSDs at national and EU levels. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bullous phytophotodermatitis associated with high natural concentrations of furanocoumarins in limes.

PubMed

Wagner, Annette M; Wu, Jashin J; Hansen, Ronald C; Nigg, Herbert N; Beiere, Ross C

2002-03-01

Phytophotodermatitis is a phototoxic reaction, occurring in skin exposed to sunlight after contact with plants containing furanocoumarins. Typical reactions are mild, showing erythema with post-inflammatory hyperpigmentation. A 6-year-old boy presented with marked, symmetric, painful erythema and edema of both hands that rapidly developed into dramatic bullae covering the entire dorsum of the hands. The history revealed that the hands had been bathed in lime juice for a prolonged period in the preparation of limeade. This report documents an unusual bullous presentation of phytophotodermatitis resulting from contact with furanocoumarins in local limes. This study was conducted to identify and measure the inciting substances from the rind and pulp of the limes. Psoralen, xanthotoxin, bergapten, and isopimpinellin content were measured by gas chromatography and high-pressure liquid chromatography The rind contained 6- to 182-fold concentrations of all furanocoumarins measured when compared with pulp. Bergapten was the most abundant substance in the rind. Hydration of the skin during the preparation of limeade combined with increased levels of bergapten in local limes to produce a dramatic bullous reaction. We encourage clinicians to consider the possibility of phytophotodermatitis in severe bullous skin reactions. Copyright 2002, Elsevier Science (USA). All rights reserved.

Effect of ambient temperature on the thermal profile of the human forearm, hand, and fingers

NASA Technical Reports Server (NTRS)

Montgomery, L. D.; Williams, B. A.

1976-01-01

Forearm, hand, and finger skin temperatures were measured on the right and left sides of seven resting men. The purpose was to determine the bilateral symmetry of these segmental temperature profiles at ambient temperatures from 10 to 45 C. Thermistors placed on the right and left forearms, hands, and index fingers were used to monitor the subjects until equilibration was reached at each ambient temperature. Additionally, thermal profiles of both hands were measured with copper-constantan thermocouples. During one experimental condition (23 C ambient), rectal, ear canal, and 24 skin temperatures were measured on each subject. Average body and average skin temperatures are given for each subject at the 23 C ambient condition. Detailed thermal profiles are also presented for the dorsal, ventral, and circumferential left forearm, hand, and finger skin temperatures at 23 C ambient. No significant differences were found between the mean skin temperatures of the right and left contralateral segments at any of the selected ambient temperatures.

Immunohistochemical analysis of the distribution of desmoglein 1 and 2 in the skin of dogs and cats.

PubMed

Miragliotta, Vincenzo; Coli, Alessandra; Ricciardi, Maria P; Podestà, Adriano; Abramo, Francesca

2005-11-01

To compare the distribution of desmoglein (Dsg) 1 and 2 in skin specimens obtained from dogs and cats to provide information about the possible role of the density of Dsg 1 and 2 in the localization of lesions attributable to pemphigus foliaceus in these 2 species. Skin biopsy specimens obtained from 4 dogs and 4 cats. Biopsy specimens were collected from the muzzle, bridge of the nose, ear, dorsum, abdomen, area adjacent to the teats, and footpads of each animal. Immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded skin samples by use of a biotinylated mouse monoclonal anti-Dsg 1 and 2 antibody raised against bovine muzzle. Color development was performed by use of the streptavidin-biotin-peroxidase method with a chromogenic substrate. Immunohistochemical staining yielded a positive reaction in skin samples obtained from all anatomic sites. The intensity and distribution of staining were related to the number of layers of the stratum spinosum. No differences were detected between samples obtained from dogs and cats. No differences in intensity of Dsg 1 and 2 antigen were observed in the stratum spinosum between skin samples obtained from dogs and cats. Analysis of this result suggests that factors other than the distribution of Dsg may be responsible for the differences in localization of primary clinical lesions in dogs and cats with pemphigus foliaceus.

Rice cooker steam hand burn in the pediatric patient.

PubMed

Roh, T S; Kim, Y S; Burm, J S; Chung, C H; Kim, J B; Oh, S J

2000-07-01

Burn injuries often lead to significant cosmetic and functional deformity. In the Orient, household electric rice cookers have caused a significant number of steam burns to infant hands. The clinical course and treatment outcome of these burns have been studied retrospectively in a review of the medical records of 79 pediatric patients treated for acute hand steam burns and of 38 other patients who underwent correction for postburn contracture. Electric rice cookers caused all of the acute pediatric steam burns treated at our institute. Of the 81 hands treated between 1995 and 1998, 38.3 percent healed with conservative treatment and 61.7 percent required skin grafting. The volar aspects of the index and middle fingers were those most frequently involved. Eighteen of 36 hands (50 percent) grafted with split-thickness skin developed late contractures requiring additional procedures. Among the 38 patients who underwent correction for postburn deformity, initial treatment was split-thickness grafting for 60.5 percent, full-thickness skin grafting for 7.9 percent, and spontaneous healing for 31.6 percent. Awareness among medical personnel and continued public education should be promoted to help prevent this unique type of pediatric steam burn from occurring.

Efficacy of enzymatic debridement of deeply burned hands.

PubMed

Krieger, Yuval; Bogdanov-Berezovsky, Alexander; Gurfinkel, Reuven; Silberstein, Eldad; Sagi, Amiram; Rosenberg, Lior

2012-02-01

The burned hand is a common and difficult to care-for entity in the field of burns. Due to the anatomy of the hand (important and delicate structures crowded in a small limited space without sub-dermal soft tissue), surgical debridement of the burned tissue is technically difficult and may cause considerable complications and, therefore, should be performed judiciously. Selective enzymatic debridement of the burn wound can preserve the spontaneous epithelialisation potential and reduce the added injury to the traumatised tissue added by a surgical debridement. The aim of the study was to assess the implication of a selective enzymatic compound (Debrase(®) - Ds) in the special field of deep hand burns, by comparing the actual burn area that required surgical coverage after enzymatic debridement to the burn area clinically judged to require skin grafting prior to debridement. This was a retrospective data collection and analysis from 154 complete files of prospective, open-label study in 275 hospitalised, Ds-treated burn patients. A total of 69 hand burns diagnosed as 'deep' was analysed; 36% of the wounds required surgical intervention after enzymatic debridement; 28.6% of the total burned area estimated initially as deep was covered by skin graft (statistically significant p<0.001). Debridement of deep-hand burns with a selective enzymatic agent decreased the perceived full-thickness wound area and skin-graft use. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Proliferation of protease-enriched mast cells in sarcoptic skin lesions of raccoon dogs.

PubMed

Noviana, D; W Harjanti, D; Otsuka, Y; Horii, Y

2004-07-01

Skin sites, tongue, lung, liver, jejunum and rectum from two raccoon dogs with Sarcoptes scabiei infestation and five normal (control) raccoon dogs were examined in terms of the distribution, proteoglycan properties and protease activity of mast cells. Infestation with S. scabiei caused a significant increase in the number of dermal mast cells. While the number of mast cells (average +/- standard deviation) in specimens of skin from the dorsum, dorsal neck, dorsal hind foot and dorsal fore foot was 40.0 +/- 19.8/mm2 in control animals, it was 236.1 +/- 58.9/mm2 in the skin of mange-infested animals. Histochemical analysis revealed the glycosaminoglycan, heparin, within the mast cells of all organs examined in both control and affected animals. Enzyme-histochemical detection of serine proteases demonstrated an increase in mast-cell-specific protease activity (i.e., chymase and tryptase) in the skin of infested animals. The percentage of mast cells demonstrating chymase activity was 53.0 +/- 27.4% in control animals and 73.8 +/- 19.4% in mite-infested animals. The corresponding results for tryptase activity were 53.5 +/- 25.2% and 89.4 +/- 9.8%. Increases in mast cell chymase or tryptase activity, or both, were also observed within other organs of the infected animals, but the total number of mast cells found at such sites (with the exception of liver and ventrolateral pinna) did not differ from those of control animals. Copyright 2004 Elsevier Ltd.

Illusory sense of human touch from a warm and soft artificial hand.

PubMed

Cabibihan, John-John; Joshi, Deepak; Srinivasa, Yeshwin Mysore; Chan, Mark Aaron; Muruganantham, Arrchana

2015-05-01

To touch and be touched are vital to human development, well-being, and relationships. However, to those who have lost their arms and hands due to accident or war, touching becomes a serious concern that often leads to psychosocial issues and social stigma. In this paper, we demonstrate that the touch from a warm and soft rubber hand can be perceived by another person as if the touch were coming from a human hand. We describe a three-step process toward this goal. First, we made participants select artificial skin samples according to their preferred warmth and softness characteristics. At room temperature, the preferred warmth was found to be 28.4 °C at the skin surface of a soft silicone rubber material that has a Shore durometer value of 30 at the OO scale. Second, we developed a process to create a rubber hand replica of a human hand. To compare the skin softness of a human hand and artificial hands, a robotic indenter was employed to produce a softness map by recording the displacement data when constant indentation force of 1 N was applied to 780 data points on the palmar side of the hand. Results showed that an artificial hand with skeletal structure is as soft as a human hand. Lastly, the participants' arms were touched with human and artificial hands, but they were prevented from seeing the hand that touched them. Receiver operating characteristic curve analysis suggests that a warm and soft artificial hand can create an illusion that the touch is from a human hand. These findings open the possibilities for prosthetic and robotic hands that are life-like and are more socially acceptable.

Thermal injury to the hand: review of the literature

PubMed Central

Abu-Sittah, G.S.; El Khatib, A.M.; Dibo, S.A.

2011-01-01

Summary This paper is a comprehensive review of hand burn injuries. The different classifications of thermal burns, out- and inpatient care, indications for escharotomies as well as surgical management, skin substitutes, and paediatric hand burns are thoroughly reviewed. PMID:22639560

Sensitive skin and stratum corneum reactivity to household cleaning products.

PubMed

Goffin, V; Piérard-Franchimont, C; Piérard, G E

1996-02-01

Products intended for individuals with sensitive skin are being increasingly developed by formulators of household cleaning products. However, there is currently no consensus about the definition and recognition of the biological basis of sensitive skin. We sought to determine the relation between the nature of environmental threat perceived as aggressive by panelists, and the stratum corneum reactivity to household cleaning products as measured by the corneosurfametry test. Results indicate substantial differences in irritancy potential between proprietary products. Corneosurfametry data show significant differences in stratum corneum reactivity between, on the one hand, individuals with either non-sensitive skin or skin sensitive to climate/fabrics, and, on the other hand, individuals with detergent-sensitive skin. It is concluded that sensitive skin is not one single condition. Sound information in rating detergent-sensitive skin may be gained by corneosurfametry.

A hand tracking algorithm with particle filter and improved GVF snake model

NASA Astrophysics Data System (ADS)

Sun, Yi-qi; Wu, Ai-guo; Dong, Na; Shao, Yi-zhe

2017-07-01

To solve the problem that the accurate information of hand cannot be obtained by particle filter, a hand tracking algorithm based on particle filter combined with skin-color adaptive gradient vector flow (GVF) snake model is proposed. Adaptive GVF and skin color adaptive external guidance force are introduced to the traditional GVF snake model, guiding the curve to quickly converge to the deep concave region of hand contour and obtaining the complex hand contour accurately. This algorithm realizes a real-time correction of the particle filter parameters, avoiding the particle drift phenomenon. Experimental results show that the proposed algorithm can reduce the root mean square error of the hand tracking by 53%, and improve the accuracy of hand tracking in the case of complex and moving background, even with a large range of occlusion.

The effect of prazosin on skin microcirculation as assessed by laser Doppler flowmetry.

PubMed Central

Khan, F; Struthers, A D; Spence, V A

1988-01-01

1. Laser Doppler flowmetry was used in six normal volunteers to record changes in fingertip skin blood flow after the administration of prazosin to block postsynaptic alpha 1-adrenoceptors. 2. Prazosin (0.5 mg orally) did not alter systolic or diastolic blood pressure or heart rate. 3. Prazosin did significantly increase basal skin blood flow 2 h after its administration but this effect was no longer evident after contralateral hand warming. Prazosin markedly reduced the skin vasoconstrictor response to deep inspiration and to contralateral hand cooling. 4. This study suggests that postsynaptic alpha 1-adrenoceptors are involved in maintaining skin vasoconstrictor tone at rest and are also involved in the rapid skin vasoconstriction seen in response to a deep inspiration and to contralateral hand cooling. PMID:2846022

Effects of a Fibrin Sealant on Skin Graft Tissue Adhesion in a Rodent Model.

PubMed

Balceniuk, Mark D; Wingate, Nicholas A; Krein, Howard; Curry, Joseph; Cognetti, David; Heffelfiner, Ryan; Luginbuhl, Adam

2016-07-01

To establish a rodent model for skin grafting with fibrin glue and examine the effects of fibrin glue on the adhesive strength of skin grafts without bolsters. Animal cohort. Academic hospital laboratory. Three skin grafts were created using a pneumatic microtome on the dorsum of 12 rats. Rats were evenly divided into experimental (n = 6) and control (n = 6) groups. The experimental group received a thin layer of fibrin glue between the graft and wound bed, and the control group was secured with standard bolsters. Adherence strength of the skin graft was tested by measurement of force required to sheer the graft from the recipient wound. Adhesion strength measurements were taken on postoperative days (PODs) 1, 2, and 3. The experimental group required an average force of 719 g on POD1, 895 g on POD2, and 676 g on POD3, while the average force in the control group was 161 g on POD1, 257 g on POD2, and 267 g on POD3. On each of the 3 PODs, there was a significant difference in adherence strength between the experimental and control groups (P = .036, P = .029, P = .024). There is a significant difference in the adhesion strength of skin grafts to the wound bed in the early postoperative period of the 2 groups. In areas of high mobility, using the fibrin sealant can keep the graft immobile during the critical phases of early healing. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Demodicosis in red-handed tamarins (Saguinus midas).

PubMed

James, S B; Raphael, B L

2000-06-01

Two nonrelated but paired red-handed tamarins (Saguinus midas) presented with diffuse, multifocal, raised, nonpruritic, hyperkeratotic lesions on the appendages and face. Skin biopsies identified acarids and skin scrapings confirmed demodex-like mites. The animals were treated with ivermectin, at the endoparasite dose, which initially resulted in resolution of clinical signs; however, signs recurred after numerous treatments. After four treatments with amitraz dips, demodicosis lesions resolved.

[APPLICATION OF DIGITAL TECHNOLOGY IN ANTEROLATERAL THIGH FLAP FOR REPAIRING WOUNDS OF HAND AND FOOT].

PubMed

Duan, Jiazhang; He, Xiaoqing; Xu, Yongqing; Fan, Xinyu; Luo, Haotian; Wang, Teng; Dong, Kaixuan; Yu, Kaifu

2015-07-01

To investigate the effectiveness of digital technology in repairing wounds of the hand and foot with anterolateral thigh flap. Between September 2013 and September 2014, 16 cases of wounds of the hand and foot were treated with the anterolateral thigh flap. There were 10 males and 6 females, with an average age of 31 years (range, 20-52 years). The causes included traffic accident injury in 8 cases, crushing injury by machine in 6 cases, burning injury in 1 case, and animal biting injury in 1 case. The locations of soft tissue defect were the dorsum of the foot in 5 cases, the ankle in 4 cases, the planta pedis in 1 case, and the hand and forearm in 6 cases. The time was 2 hours to 45 days from injury to hospitalization (mean, 14.3 days). All defects were associated with exposure of bone and tendon. The size of wound was from 9.0 cmx4.0 cm to 29.0 cmx8.5 cm. CT angiography (CTA) was performed before operation, and the appropriate perforator as well as the donor site was selected. Then the Mimics l5.0 software was used to reconstruct the data of CTA so as to locate the main perforators, design the three-dimensional models of the anterolateral thigh flap, and simulate operation. The flap was obtained according to preoperative plan during operation. The size of flaps varied from 11 cm x 5 cm to 31 cm x 10 cm. The donor sites were sutured directly in 14 cases and were repaired by free skin graft in 2 cases. The lateral femoral circumflex artery identified by Mimics l5.0 software before operation, as well as the starting position of its descending branch, the blood vessel diameter at start site, vascular distribution, the maximum cutting length of the vascular pedicle were consistent with the actual observation during operation. All flaps were harvested and were used to repair defect smoothly. Vascular crisis occurred in 1 flap after operation, and the other flaps survived successfully. The wounds and the incisions obtained healing by first intention, and grafted skin

Hand and goods judgment algorithm based on depth information

NASA Astrophysics Data System (ADS)

Li, Mingzhu; Zhang, Jinsong; Yan, Dan; Wang, Qin; Zhang, Ruiqi; Han, Jing

2016-03-01

A tablet computer with a depth camera and a color camera is loaded on a traditional shopping cart. The inside information of the shopping cart is obtained by two cameras. In the shopping cart monitoring field, it is very important for us to determine whether the customer with goods in or out of the shopping cart. This paper establishes a basic framework for judging empty hand, it includes the hand extraction process based on the depth information, process of skin color model building based on WPCA (Weighted Principal Component Analysis), an algorithm for judging handheld products based on motion and skin color information, statistical process. Through this framework, the first step can ensure the integrity of the hand information, and effectively avoids the influence of sleeve and other debris, the second step can accurately extract skin color and eliminate the similar color interference, light has little effect on its results, it has the advantages of fast computation speed and high efficiency, and the third step has the advantage of greatly reducing the noise interference and improving the accuracy.

Electronic Cigarettes Are as Toxic to Skin Flap Survival as Tobacco Cigarettes.

PubMed

Rau, Aline Sabrina; Reinikovaite, Viktorija; Schmidt, Eric P; Taraseviciene-Stewart, Laima; Deleyiannis, Frederic White-Brown

2017-07-01

Electronic cigarettes (e-cigarettes) have become increasingly popular. However, information about the health risks associated with e-cigarette use is sparse. Currently, no published studies examine the effects of chronic e-cigarette exposure on microcirculation or perfusion. Using a rat skin flap model, we examined the toxic microcirculatory effects e-cigarettes may have in comparison with tobacco cigarettes. Fifty-eight rats were randomized to either exposure to room air, tobacco cigarette smoke, medium-nicotine content (1.2%) e-cigarette vapor, or a high-nicotine content (2.4%) e-cigarette vapor. After 4 weeks of exposure, a random pattern, 3 × 9 cm skin flap was elevated on the dorsum of the rats. At 5 weeks, flap survival was evaluated quantitatively, and the rats were euthanized. Plasma was collected for nicotine and cotinine analysis, and flap tissues were harvested for histopathological analysis. Evaluation of the dorsal skin flaps demonstrated significantly increased necrosis in the vapor and tobacco groups. The average necrosis within the groups was as follows: control 19.23%, high-dose vapor 28.61%, medium-dose vapor 35.93%, and tobacco cigarette 30.15%. Although the e-cigarette and tobacco cigarette groups did not differ significantly, each individual group had significantly more necrosis than the control group (P<0.05). These results were corroborated with histopathological analysis of hypoxic tissue. Both the medium-content and high-nicotine content e-cigarette exposure groups had similar amounts of flap necrosis and hypoxia when compared with the tobacco cigarette exposure group. Nicotine-containing e-cigarette vapor is similarly toxic to skin flap survival as tobacco cigarettes.

[The role of psychological factors and psychiatric disorders in skin diseases].

PubMed

Kieć-Swierczyńska, Marta; Dudek, Bohdan; Krecisz, Beata; Swierczyńska-Machura, Dominika; Dudek, Wojciech; Garnczarek, Adrianna; Turczyn, Katarzyna

2006-01-01

In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), on the other hand psychological disorders can result in some skin diseases (psoriasis, atopic dermatitis). In the majority of cases the quality of life is poorly estimated by patients with skin problems. Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders: 1) psychophysiologic disorders caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema); 2) primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania); and 3) secondary psychiatric disorders caused by disfiguring skin (ichthyosis, acne conglobata, vitiligo), which can lead to states of fear, depression or suicidal thoughts.

Hand-arm Vibration Effects on Performance, Tactile Acuity, and Temperature of Hand

PubMed Central

Forouharmajd, Farhad; Yadegari, Mehrdad; Ahmadvand, Masoumeh; Forouharmajd, Farshad; Pourabdian, Siamak

2017-01-01

Effects of vibration appear as mechanical and psychological disorders, including stress reactions, cognitive and movement disorders, problem in concentration and paying attention to the assigned duties. The common signs and symptoms of hand-arm vibration (HAV) in the fingers and hands may appear as pins and needles feeling, tingling, numbness, and also the loss of finger sensation and dexterity. Laboratory Virtual Instrument Engineering Workbench programming software designed for occupational vibrations measurement was used to calculate HAV acceleration. Hole steadiness test is designed to measure involuntary movement of people. V-Pieron test is designed for one of the other aspects of the psycho motor phenomena of steadiness by moving the stylus across a V-form ruler. The two points test was an experiment of touch acuity, which used a caliper by placing the two styli very close on the pad of finger knuckles. The temperature of finger skin is also measured simultaneous to the above tests. Wilcoxon test indicated that a significant decrement in hand steadiness occurred after gripping a vibrating handle for 2 min (P ≤ 0.003). Wilcoxon test also represented a significant change in errors after gripping a grinder vibratory handle (P ≤ 0.003). The differences at all of the knuckles were significant with a confidence interval percentage of 99%. There was a significant reduction in finger skin temperature before and after exposure to vibration (mean = 0.45°C, based on paired sample test). The obtained results considerably demonstrated the relation between hand performance and vibrations due to gripping a grinder. It can be concluded that an injury or accident may happen after exposure to vibrations for the fine duties, in fast actions. PMID:29204383

Hand-arm Vibration Effects on Performance, Tactile Acuity, and Temperature of Hand.

PubMed

Forouharmajd, Farhad; Yadegari, Mehrdad; Ahmadvand, Masoumeh; Forouharmajd, Farshad; Pourabdian, Siamak

2017-01-01

Effects of vibration appear as mechanical and psychological disorders, including stress reactions, cognitive and movement disorders, problem in concentration and paying attention to the assigned duties. The common signs and symptoms of hand-arm vibration (HAV) in the fingers and hands may appear as pins and needles feeling, tingling, numbness, and also the loss of finger sensation and dexterity. Laboratory Virtual Instrument Engineering Workbench programming software designed for occupational vibrations measurement was used to calculate HAV acceleration. Hole steadiness test is designed to measure involuntary movement of people. V-Pieron test is designed for one of the other aspects of the psycho motor phenomena of steadiness by moving the stylus across a V-form ruler. The two points test was an experiment of touch acuity, which used a caliper by placing the two styli very close on the pad of finger knuckles. The temperature of finger skin is also measured simultaneous to the above tests. Wilcoxon test indicated that a significant decrement in hand steadiness occurred after gripping a vibrating handle for 2 min ( P ≤ 0.003). Wilcoxon test also represented a significant change in errors after gripping a grinder vibratory handle ( P ≤ 0.003). The differences at all of the knuckles were significant with a confidence interval percentage of 99%. There was a significant reduction in finger skin temperature before and after exposure to vibration (mean = 0.45°C, based on paired sample test). The obtained results considerably demonstrated the relation between hand performance and vibrations due to gripping a grinder. It can be concluded that an injury or accident may happen after exposure to vibrations for the fine duties, in fast actions.

Skin lesion removal-aftercare

MedlinePlus

... skin cleansers, alcohol, peroxide, iodine, or soap with antibacterial chemicals. These can damage the wound tissue and ... the wound from re-opening by keeping strenuous activity to a minimum. Make sure your hands are ...

Finger tips detection for two handed gesture recognition

NASA Astrophysics Data System (ADS)

Bhuyan, M. K.; Kar, Mithun Kumar; Neog, Debanga Raj

2011-10-01

In this paper, a novel algorithm is proposed for fingertips detection in view of two-handed static hand pose recognition. In our method, finger tips of both hands are detected after detecting hand regions by skin color-based segmentation. At first, the face is removed in the image by using Haar classifier and subsequently, the regions corresponding to the gesturing hands are isolated by a region labeling technique. Next, the key geometric features characterizing gesturing hands are extracted for two hands. Finally, for all possible/allowable finger movements, a probabilistic model is developed for pose recognition. Proposed method can be employed in a variety of applications like sign language recognition and human-robot-interactions etc.

Characterization of Skin Friction Coefficient, and Relationship to Stratum Corneum Hydration in a Normal Chinese Population

PubMed Central

Zhu, Y.H.; Song, S.P.; Luo, W.; Elias, P.M.; Man, M.Q.

2011-01-01

Background and Objectives Studies have demonstrated that some cutaneous biophysical properties vary with age, gender and body sites. However, the characteristics of the skin friction coefficient in different genders and age groups have not yet been well established. In the present study, we assess the skin friction coefficient in a larger Chinese population. Methods A total of 633 subjects (300 males and 333 females) aged 0.15–79 years were enrolled. A Frictiometer® FR 770 and Corneometer® CM 825 (C&K MPA 5) were used to measure the skin friction coefficient and stratum corneum hydration, respectively, on the dorsal surface of the hand, the forehead and the canthus. Results In the females, the maximum skin friction coefficients on both the canthus and the dorsal hand skin were observed around the age of 40 years. In the males, the skin friction coefficient on the dorsal hand skin gradually increased from 0 to 40 years of age, and changed little afterward. Skin friction coefficients on some body sites were higher in females than in age-matched males in some age groups. On the canthus and the dorsal hand skin of females, a positive correlation was found between skin friction coefficient and stratum corneum hydration (p < 0.001 and p < 0.0001, respectively). In contrast, in males, the skin friction coefficient was positively correlated with stratum corneum hydration on the forehead and the dorsal hand skin (p < 0.05 and p < 0.0001, respectively). Conclusion The skin friction coefficient varies with age, gender and body site, and positively correlates with stratum corneum hydration on some body sites. PMID:21088455

Characterization of skin friction coefficient, and relationship to stratum corneum hydration in a normal Chinese population.

PubMed

Zhu, Y H; Song, S P; Luo, W; Elias, P M; Man, M Q

2011-01-01

Studies have demonstrated that some cutaneous biophysical properties vary with age, gender and body sites. However, the characteristics of the skin friction coefficient in different genders and age groups have not yet been well established. In the present study, we assess the skin friction coefficient in a larger Chinese population. A total of 633 subjects (300 males and 333 females) aged 0.15-79 years were enrolled. A Frictiometer FR 770 and Corneometer CM 825 (C&K MPA 5) were used to measure the skin friction coefficient and stratum corneum hydration, respectively, on the dorsal surface of the hand, the forehead and the canthus. In the females, the maximum skin friction coefficients on both the canthus and the dorsal hand skin were observed around the age of 40 years. In the males, the skin friction coefficient on the dorsal hand skin gradually increased from 0 to 40 years of age, and changed little afterward. Skin friction coefficients on some body sites were higher in females than in age-matched males in some age groups. On the canthus and the dorsal hand skin of females, a positive correlation was found between skin friction coefficient and stratum corneum hydration (p < 0.001 and p < 0.0001, respectively). In contrast, in males, the skin friction coefficient was positively correlated with stratum corneum hydration on the forehead and the dorsal hand skin (p < 0.05 and p < 0.0001, respectively). The skin friction coefficient varies with age, gender and body site, and positively correlates with stratum corneum hydration on some body sites. Copyright © 2010 S. Karger AG, Basel.

Thermal comfort zone of the hands, feet and head in males and females.

PubMed

Ciuha, Urša; Mekjavic, Igor B

2017-10-01

The present study compared the thermal comfort zones (TCZ) of the hands, feet and head in eight male and eight female participants, assessed with water-perfused segments (WPS). On separate occasions, and separated by a minimum of one day, participants were requested to regulate the temperature of three distal skin regions (hands, feet and head) within their TCZ. On each occasion they donned a specific water-perfused segment (WPS), either gloves, socks or hood for assessing the TCZ of the hands, feet and head, respectively. In the absence of regulation, the temperature of the water perfusing the WPS changed in a saw-tooth manner from 10 to 50°C; by depressing a switch and reversing the direction of the temperature at the limits of the TCZ, each participant defined the TCZ for each skin region investigated. The range of regulated temperatures (upper and lower limits of the TCZ) did not differ between studied skin regions or between genders. Participants however maintained higher head (35.7±0.4°C; p˂0.001) skin temperature (Tsk) compared to hands (34.5±0.8°C) and feet (33.8±1.1°C). When exposed to normothermic conditions, distal skin regions do not differ in ranges of temperatures, perceived as thermally comfortable. Copyright © 2017. Published by Elsevier Inc.

A new feature extraction method for signal classification applied to cord dorsum potentials detection

PubMed Central

Vidaurre, D.; Rodríguez, E. E.; Bielza, C.; Larrañaga, P.; Rudomin, P.

2012-01-01

In the spinal cord of the anesthetized cat, spontaneous cord dorsum potentials (CDPs) appear synchronously along the lumbo-sacral segments. These CDPs have different shapes and magnitudes. Previous work has indicated that some CDPs appear to be specially associated with the activation of spinal pathways that lead to primary afferent depolarization and presynaptic inhibition. Visual detection and classification of these CDPs provides relevant information on the functional organization of the neural networks involved in the control of sensory information and allows the characterization of the changes produced by acute nerve and spinal lesions. We now present a novel feature extraction approach for signal classification, applied to CDP detection. The method is based on an intuitive procedure. We first remove by convolution the noise from the CDPs recorded in each given spinal segment. Then, we assign a coefficient for each main local maximum of the signal using its amplitude and distance to the most important maximum of the signal. These coefficients will be the input for the subsequent classification algorithm. In particular, we employ gradient boosting classification trees. This combination of approaches allows a faster and more accurate discrimination of CDPs than is obtained by other methods. PMID:22929924

A new feature extraction method for signal classification applied to cord dorsum potential detection.

PubMed

Vidaurre, D; Rodríguez, E E; Bielza, C; Larrañaga, P; Rudomin, P

2012-10-01

In the spinal cord of the anesthetized cat, spontaneous cord dorsum potentials (CDPs) appear synchronously along the lumbo-sacral segments. These CDPs have different shapes and magnitudes. Previous work has indicated that some CDPs appear to be specially associated with the activation of spinal pathways that lead to primary afferent depolarization and presynaptic inhibition. Visual detection and classification of these CDPs provides relevant information on the functional organization of the neural networks involved in the control of sensory information and allows the characterization of the changes produced by acute nerve and spinal lesions. We now present a novel feature extraction approach for signal classification, applied to CDP detection. The method is based on an intuitive procedure. We first remove by convolution the noise from the CDPs recorded in each given spinal segment. Then, we assign a coefficient for each main local maximum of the signal using its amplitude and distance to the most important maximum of the signal. These coefficients will be the input for the subsequent classification algorithm. In particular, we employ gradient boosting classification trees. This combination of approaches allows a faster and more accurate discrimination of CDPs than is obtained by other methods.

Comparison of Standard Culture-Based Method to Culture-Independent Method for Evaluation of Hygiene Effects on the Hand Microbiome.

PubMed

Zapka, C; Leff, J; Henley, J; Tittl, J; De Nardo, E; Butler, M; Griggs, R; Fierer, N; Edmonds-Wilson, S

2017-03-28

Hands play a critical role in the transmission of microbiota on one's own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples ( P < 0.001); we were unable to detect changes with glove-based samples. Bacterial cell counts significantly decreased with use of the ABHS ( P < 0.05) and ethanol control ( P < 0.05). Skin hydration at baseline correlated with bacterial abundances, bacterial community composition, pH, and redness across subjects. The importance of the method choice was substantial. These findings are important to ensure improvement of hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. IMPORTANCE The hand microbiome is a critical area of research for diverse fields, such as public health and forensics. The suitability of culture-independent methods for assessing effects of hygiene products on microbiota has not been demonstrated. This is the

Impairment of Skin Capillary Recruitment Precedes Chronic Complications in Patients with Type 1 Diabetes

PubMed Central

Tibirica, Eduardo; Rodrigues, Elba; Cobas, Roberta; Gomes, Marilia B.

2007-01-01

Microvascular function in patients with type 1 diabetes without chronic complications was assessed using skin capillary recruitment during post-occlusive reactive hyperemia (PORH). Structural (maximal) capillary density was evaluated during venous occlusion. The study included 48 consecutive outpatients aged 26.3 ± 10.8 years with type 1 diabetes (duration of 9.5 years) without chronic complications and 34 control subjects. Intravital capillary video-microscopy was used in the dynamic study of skin capillaries in the dorsum of the fingers and toes. Capillary recruitment during PORH (% increase in mean capillary density, MCD) was significantly higher in the controls than the patients in both the fingers (p < 0.001) and toes (p < 0.001). During venous occlusion, MCD increase was also higher in the controls than the patients in both the fingers (p < 0.05) and toes (p < 0.0001). In patients, no difference was found between MCD at baseline and after venous occlusion in the fingers but a decrease was observed in the toes (p < 0.001). It is concluded that skin capillary function is significantly impaired in both fingers and toes of patients with type 1 diabetes without chronic complications. Moreover, capillary density during venous occlusion did not increase in either extremity in the patients, suggesting that their capillaries at rest are already maximally recruited. PMID:17823692

Full-thickness skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin: bilayered versus single-layered substitute.

PubMed

Idrus, Ruszymah Bt Hj; Rameli, Mohd Adha bin P; Low, Kiat Cheong; Law, Jia Xian; Chua, Kien Hui; Latiff, Mazlyzam Bin Abdul; Saim, Aminuddin Bin

2014-04-01

Split-skin grafting (SSG) is the gold standard treatment for full-thickness skin defects. For certain patients, however, an extensive skin lesion resulted in inadequacies of the donor site. Tissue engineering offers an alternative approach by using a very small portion of an individual's skin to harvest cells for propagation and biomaterials to support the cells for implantation. The objective of this study was to determine the effectiveness of autologous bilayered tissue-engineered skin (BTES) and single-layer tissue-engineered skin composed of only keratinocytes (SLTES-K) or fibroblasts (SLTES-F) as alternatives for full-thickness wound healing in a sheep model. Full-thickness skin biopsies were harvested from adult sheep. Isolated fibroblasts were cultured using medium Ham's F12: Dulbecco modified Eagle medium supplemented with 10% fetal bovine serum, whereas the keratinocytes were cultured using Define Keratinocytes Serum Free Medium. The BTES, SLTES-K, and SLTES-F were constructed using autologous fibrin as a biomaterial. Eight full-thickness wounds were created on the dorsum of the body of the sheep. On 4 wounds, polyvinyl chloride rings were used as chambers to prevent cell migration at the edge. The wounds were observed at days 7, 14, and 21. After 3 weeks of implantation, the sheep were euthanized and the skins were harvested. The excised tissues were fixed in formalin for histological examination via hematoxylin-eosin, Masson trichrome, and elastin van Gieson staining. The results showed that BTES, SLTES-K, and SLTES-F promote wound healing in nonchambered and chambered wounds, and BTES demonstrated the best healing potential. In conclusion, BTES proved to be an effective tissue-engineered construct that can promote the healing of full-thickness skin lesions. With the support of further clinical trials, this procedure could be an alternative to SSG for patients with partial- and full-thickness burns.

[Necrotizing fasciitis of the hand and forearm : Acute surgical treatment and defect reconstruction with MatriDerm® and split-thickness skin graft].

PubMed

Niedermueller, B; Singer, G; Pickl, P; Jesacher, M

2018-03-01

This case report describes a 55-year-old male patient with type II necrotizing fasciitis (NF) of the hand and forearm. The rapid progression of the tissue infection could be successfully stopped with radical surgical débridement and antibiotic therapy. For the reconstruction of the extensive loss of soft tissue a combination of split-thickness skin graft (STSG) and the synthetic dermal substitute MatriDerm® was used. In cases of NF, MatriDerm® and STSG provide a rapidly available and simple alternative to other reconstruction techniques.

Use of a machine learning algorithm to classify expertise: analysis of hand motion patterns during a simulated surgical task.

PubMed

Watson, Robert A

2014-08-01

To test the hypothesis that machine learning algorithms increase the predictive power to classify surgical expertise using surgeons' hand motion patterns. In 2012 at the University of North Carolina at Chapel Hill, 14 surgical attendings and 10 first- and second-year surgical residents each performed two bench model venous anastomoses. During the simulated tasks, the participants wore an inertial measurement unit on the dorsum of their dominant (right) hand to capture their hand motion patterns. The pattern from each bench model task performed was preprocessed into a symbolic time series and labeled as expert (attending) or novice (resident). The labeled hand motion patterns were processed and used to train a Support Vector Machine (SVM) classification algorithm. The trained algorithm was then tested for discriminative/predictive power against unlabeled (blinded) hand motion patterns from tasks not used in the training. The Lempel-Ziv (LZ) complexity metric was also measured from each hand motion pattern, with an optimal threshold calculated to separately classify the patterns. The LZ metric classified unlabeled (blinded) hand motion patterns into expert and novice groups with an accuracy of 70% (sensitivity 64%, specificity 80%). The SVM algorithm had an accuracy of 83% (sensitivity 86%, specificity 80%). The results confirmed the hypothesis. The SVM algorithm increased the predictive power to classify blinded surgical hand motion patterns into expert versus novice groups. With further development, the system used in this study could become a viable tool for low-cost, objective assessment of procedural proficiency in a competency-based curriculum.

Repellent activity screening of 11 kinds of essential oils against Aedes albopictus Skuse: microcapsule preparation of Herba Schizonepetae oil and repellent bioassay on hand skin.

PubMed

Wu, H; Fu, C C; Yu, D D; Feng, J T; Zhang, X; Ma, Z Q

2013-08-01

The main ingredient of most repellents on the market is DEET, an effective compound that has the disadvantages of toxic reactions as well as damaging effects on plastic and synthetic fabric. DEET alternatives are urgently needed. The repellent activities of 11 kinds of essential oils were tested against Aedes albopictus Skuse by a Y-tube olfactometer. Using essential oils with high repellent activity as core material and gelatin and gum arabic as wall materials, we prepared microcapsules of essential oils and optimized the preparation process. The microcapsule formulation was then subjected to repellent bioassay on hand skin. when the dosage of essential oils was 5 µL, the cinnamon oil repellent rate was 87.5% within 10 min and the Herba Schizonepetae oil (HSO) repellent rate was 98.0% within 3 min. Up to 1.5% (w/v) gelatin and 1.5% (w/v) gum arabic (as wall materials), and HSO (as core material) were used to form microcapsules with a 1:1 ratio of core material to wall material. The ointment preparations effectively protected hand skin exposed to a high-density A. albopictus Skuse rearing cage for 4-5 h. The HSO microcapsule repellent has broad application and development prospects.

The influence of gender and age on the thickness and echo-density of skin.

PubMed

Firooz, A; Rajabi-Estarabadi, A; Zartab, H; Pazhohi, N; Fanian, F; Janani, L

2017-02-01

The more recent use of ultrasound scanning allows a direct measurement on unmodified skin, and is considered to be a reliable method for in vivo measurement of epidermal and dermal thickness. The objective of this study was to assess the influence of gender and age on the thickness and echo-density of skin measured by high frequency ultrasonography (HFUS). This study was carried out on 30 healthy volunteers (17 female, 13 male) with age range of 24-61 years old. The thickness and echo-density of dermis as well as epidermal entrance echo thickness in five anatomic sites (cheek, neck, palm, dorsal foot, and sole) were measured using two different types of B mode HFUS, 22 and 50 MHz frequencies. The epidermal entrance echo thickness and thickness of dermis in males were higher than females, which was statistically significant on neck and dorsum of foot. The echo-density of dermis was higher in females on all sites, but was only statistically significant on neck. The epidermal entrance echo thickness and thickness of dermis in young age group was statistically higher than old group on sole and dorsal of the foot respectively. Overall, the skin thickness decreased with age. High frequency ultrasonography method provides a simple non-invasive method for evaluating the skin thickness and echo-density. Gender and age have significant effect on these parameters. Differences in study method, population, and body site likely account for different results previously reported. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting

PubMed Central

Babeluk, Rita; Jutz, Sabrina; Mertlitz, Sarah; Matiasek, Johannes; Klaus, Christoph

2014-01-01

Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid), desderman pure gel (odorless, gel) and Lavit (perfumed, spray). Sterillium and desderman are EN1500 (hygienic hand rub) certified products (available in pharmacy) and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group. PMID:25379773

Topical application of nitrosonifedipine, a novel radical scavenger, ameliorates ischemic skin flap necrosis in a mouse model.

PubMed

Fukunaga, Yutaka; Izawa-Ishizawa, Yuki; Horinouchi, Yuya; Sairyo, Eriko; Ikeda, Yasumasa; Ishizawa, Keisuke; Tsuchiya, Koichiro; Abe, Yoshiro; Hashimoto, Ichiro; Tamaki, Toshiaki

2017-04-01

Ischemic skin flap necrosis can occur in random pattern flaps. An excess amount of reactive oxygen species is generated and causes necrosis in the ischemic tissue. Nitrosonifedipine (NO-NIF) has been demonstrated to possess potent radical scavenging ability. However, there has been no study on the effects of NO-NIF on ischemic skin flap necrosis. Therefore, they evaluated the potential of NO-NIF in ameliorating ischemic skin flap necrosis in a mouse model. A random pattern skin flap (1.0 × 3.0 cm) was elevated on the dorsum of C57BL/6 mice. NO-NIF was administered by topical injection immediately after surgery and every 24 hours thereafter. Flap survival was evaluated on postoperative day 7. Tissue samples from the skin flaps were harvested on postoperative days 1 and 3 to analyze oxidative stress, apoptosis and endothelial dysfunction. The viable area of the flap in the NO-NIF group was significantly increased (78.30 ± 7.041%) compared with that of the control group (47.77 ± 6.549%, p < 0.01). NO-NIF reduced oxidative stress, apoptosis and endothelial dysfunction, which were evidenced by the decrease of malondialdehyde, p22phox protein expression, number of apoptotic cells, phosphorylated p38 MAPK protein expression, and vascular cell adhesion molecule-1 protein expression while endothelial nitric oxide synthase protein expression was increased. In conclusion, they demonstrated that NO-NIF ameliorated ischemic skin flap necrosis by reducing oxidative stress, apoptosis, and endothelial dysfunction. NO-NIF is considered to be a candidate for the treatment of ischemic flap necrosis. © 2017 by the Wound Healing Society.

Human skin volatiles: a review.

PubMed

Dormont, Laurent; Bessière, Jean-Marie; Cohuet, Anna

2013-05-01

Odors emitted by human skin are of great interest to biologists in many fields; applications range from forensic studies to diagnostic tools, the design of perfumes and deodorants, and the ecology of blood-sucking insect vectors of human disease. Numerous studies have investigated the chemical composition of skin odors, and various sampling methods have been used for this purpose. The literature shows that the chemical profile of skin volatiles varies greatly among studies, and the use of different sampling procedures is probably responsible for some of these variations. To our knowledge, this is the first review focused on human skin volatile compounds. We detail the different sampling techniques, each with its own set of advantages and disadvantages, which have been used for the collection of skin odors from different parts of the human body. We present the main skin volatile compounds found in these studies, with particular emphasis on the most frequently studied body regions, axillae, hands, and feet. We propose future directions for promising experimental studies on odors from human skin, particularly in relation to the chemical ecology of blood-sucking insects.

The effect of skin moisture on the density distribution of OH and O close to the skin surface

NASA Astrophysics Data System (ADS)

Wu, F.; Li, J.; Liu, F.; Zhou, X.; Lu, X.

2018-03-01

OH radicals and O atoms are believed to be two of the most important reactive species in various biomedical applications of atmospheric pressure plasma jets. In this study, the effect of the skin moisture on the density distribution of OH and O close to the surface of the ex vivo pig skin is investigated by using laser-induced fluorescence technology. The skin moistures used in this study are 20%, 40%, 60%, and 80%, respectively. The experiment results indicate that, at a gas flow rate of 0.5 L/min, when the skin moisture is increased, the OH density close to the skin surface increases, while the O density decreases. On the other hand, when the gas flow rate is increased to 1 L/min, the OH density close to the skin surface is less sensitive with the moisture of the skin surface. Besides, when the skin moisture is 80%, the OH density increases with the increase in the concentration of H2O in the working gas and it reaches its maximum 7.9 × 1013 cm-3 when the concentration of H2O in the working gas is about 500 ppm. The OH density starts to decrease while the H2O concentration in the working gas keeps increasing. On the order hand, the O density shows a maximum 7.4 × 1014 cm-3 when the gas flow rate is 0.5 L/min with no O2 added and the skin moisture is 20%. But, when the gas flow rate is increased to about 1 to 2 L/min, the O density achieves its maximum when 0.5% of O2 is added to the working gas. The possible reasons for these observations are discussed.

[RS3PE-syndrome].

PubMed

Segerer, S; Dietz-Laukemann, P; Schattenkirchner, M

1999-02-01

The RS3PE syndrome (Remitting Seronegative Symmetrical Synovitis with Pitting Edema) is a manifestation of rheumatoid arthritis in the elderly with a good prognosis. It usually presents as an acute, symmetric polysynovitis with edema of the dorsum of the hands and feet. Anti-inflammatory treatment with corticosteroids leads to prompt improvement. We describe the case of an 81 year old man with a primarily unilateral manifestation involving the right hand. A thrombosis of the axillary vein was suspected. Within a few days he developed a pitting edema of the dorsum of the other hand. Movement of both shoulders and wrists was painful. Low-dose corticosteroid therapy resulted in a rapid improvement of the edema and the inflammatory symptoms.

Influences on use of hand moisturizers in nurses.

PubMed

Burke, K M; Wright, A J; Parsons, V; Madan, I

2018-05-07

Nurses are at high risk of hand dermatitis. Regular hand moisturizing can prevent dermatitis, but nurses' use of hand moisturizers is suboptimal. To establish (i) what beliefs about hand dermatitis and hand moisturizer use are associated with hand moisturizer use by nurses at home and at work and (ii) if hand moisturizer use behaviours in nurses are associated with the prevalence of hand dermatitis. We used a questionnaire to investigate nurses' knowledge, beliefs and behaviours regarding hand dermatitis and use of hand moisturizers. The response rate was 55/65 (85%). Forty-two (76%) participants agreed that applying hand moisturizers reduced the risk of dermatitis, and 53 (96%) agreed that dermatitis increased the risk of skin carrying pathogenic organisms. Frequent moisturizer application was associated with beliefs that it was part of the nurse's role to apply hand creams, a belief that they had had training in the use of moisturizers and believing that patients approved of them moisturizing their hands. Hand moisturizer use by nurses can be improved by enhancing their beliefs that it is part of their professional role to apply hand cream regularly.

Dermal Fibroblasts from Different Layers of Pig Skin Exhibit Different Profibrotic and Morphological Characteristics.

PubMed

Zuo, Yanhai; Yu, Xiaoping; Lu, Shuliang

2016-11-01

In vitro studies of human dermal fibroblast (DF) heterogeneity have long been reported, yet in vivo studies and related research on animals are rare. The objectives of the study were to determine whether the DFs of pigs exhibit heterogeneity and to identify an animal model for the in vivo study of DF heterogeneity. The skin of three female red Duroc pigs (FRDPs) was separated into six layers, and the second and fifth layers (i.e., the superficial and deep dermis) were used in the establishment of wound models and cell cultures. To create the wound models, 54 tongue-shaped flaps were created on one side of the dorsum, and the underlying dermis was then fully replaced with the superficial or deep dermis (the superficial and deep groups, respectively). Skin samples were harvested at postoperative weeks 1, 2, and 3 for measurements of the normal and wounded skin thicknesses. Cells cultured from the superficial and deep dermis (i.e., superficial and deep DFs) were subjected to quantitative estimation of collagen and electron microscopy. The wounded skin thickness in the deep group was significantly greater than that in the superficial group. In contrast with the long deep DFs, the superficial DFs were short and exhibited microvilli-like cell surface projections. Compared with the superficial DFs, the deep DFs exhibited a greater density of rough endoplasmic reticulum and produced significantly more collagen. Similar to humans, FRDPs exhibit DF heterogeneity and should thus be a good animal model for in vivo studies of DF heterogeneity. Anat Rec, 299:1585-1599, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Effectiveness of hand washing on the removal of iron oxide nanoparticles from human skin ex vivo.

PubMed

Lewinski, Nastassja A; Berthet, Aurélie; Maurizi, Lionel; Eisenbeis, Antoine; Hopf, Nancy B

2017-08-01

In this study, the effectiveness of washing with soap and water in removing nanoparticles from exposed skin was investigated. Dry, nanoscale hematite (α-Fe 2 O 3 ) or maghemite (γ-Fe 2 O 3 ) powder, with primary particle diameters between 20-30 nm, were applied to two samples each of fresh and frozen ex vivo human skin in two independent experiments. The permeation of nanoparticles through skin, and the removal of nanoparticles after washing with soap and water were investigated. Bare iron oxide nanoparticles remained primarily on the surface of the skin, without penetrating beyond the stratum corneum. Skin exposed to iron oxide nanoparticles for 1 and 20 hr resulted in removal of 85% and 90%, respectively, of the original dose after washing. In the event of dermal exposure to chemicals, removal is essential to avoid potential local irritation or permeation across skin. Although manufactured at an industrial scale and used extensively in laboratory experiments, limited data are available on the removal of engineered nanoparticles after skin contact. Our finding raises questions about the potential consequences of nanoparticles remaining on the skin and whether alternative washing methods should be proposed. Further studies on skin decontamination beyond use of soap and water are needed to improve the understanding of the potential health consequences of dermal exposure to nanoparticles.

Glove Use and Glove Education in Workers with Hand Dermatitis.

PubMed

Rowley, Kyle; Ajami, Daana; Gervais, Denise; Mooney, Lindsay; Belote, Amy; Kudla, Irena; Switzer-McIntyre, Sharon; Holness, D Linn

2016-01-01

Occupational skin diseases are common. The occurrence of occupational skin diseases represents a failure of primary prevention strategies that may include the use of personal protective equipment, most commonly gloves. The objective of this study was to describe current glove use and education practices related to gloves in workers being assessed for possible work-related hand dermatitis. Participants included consecutive patients being assessed for possible work-related hand dermatitis. A self-administered questionnaire obtained information on demographics, workplace characteristics and exposures, glove use, and education regarding gloves. Ninety percent of the 105 participants reported using gloves. Only 44% had received training related to glove use in the workplace. Major gaps in training content included skin care when using gloves, warning signs of skin problems, and glove size. If the worker indicated no glove training received, the majority reported they would have used gloves if such training was provided. Although the majority of workers being assessed wore gloves, the minority had received training related to glove use. Particular gaps in training content were identified. Those who had not received training noted they would likely have used gloves if training had been provided.

Return to Work for Nurses With Hand Dermatitis.

PubMed

Chen, Jennifer; Gomez, Pilar; Kudla, Irena; DeKoven, Joel; Holness, D Linn; Skotnicki, Sandra

2016-01-01

Occupational skin disease is common in healthcare workers. If the healthcare worker develops moderate to severe dermatitis, return to work (RTW) may be challenging. The study objectives were to review the impact of an RTW program on the work status of nurses with occupational hand dermatitis and to identify successful intervention methods and strategies. Nurses who received RTW services at a tertiary occupational medicine clinic were identified, and information related to their diagnosis and RTW was abstracted from their charts. Eighteen nurses with irritant hand dermatitis who received RTW services were identified. Twelve nurses (67%) were performing administrative duties because of their skin condition when admitted to the RTW program, and others were performing patient care with modifications. A graduated RTW trial was commonly implemented with optimized skin care management and monitoring by physicians and the RTW coordinator. Upon discharge, 14 nurses (78%) had returned to their nursing roles with direct patient care, 3 (17%) were working as nurses in non-patient care roles, and 1 (6%) was on permanent disability. A graduated RTW trial to reduce cumulative irritant exposure is a crucial strategy to facilitate nurses' transition back to work and to maintain direct patient care nursing roles.

Skin anti-aging strategies

PubMed Central

Ganceviciene, Ruta; Liakou, Aikaterini I.; Theodoridis, Athanasios; Makrantonaki, Evgenia; Zouboulis, Christos C.

2012-01-01

Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors. Because of the fact that skin health and beauty is considered one of the principal factors representing overall “well-being” and the perception of “health” in humans, several anti-aging strategies have been developed during the last years. It is the intention of this article to review the most important anti-aging strategies that dermatologists have nowadays in hand, including including preventive measurements, cosmetological strategies, topical and systemic therapeutic agents and invasive procedures. PMID:23467476

Do 'chlorine covers' exert a sustained bactericidal effect on the bacterial hand flora?

PubMed

Koller, W; Rotter, M L; Gottardi, W

1995-11-01

Treatment of skin with chlorine generates 'chlorine covers' which, in a previous study, exerted significant sustained bactericidal effects against transient skin flora on the upper arm and forearm. In this investigation, this effect was studied on both the transient and resident flora of the hands using test models for the evaluation of hand disinfectants as agreed upon in Austria and Germany. Chlorine covers were generated by bathing hands in a solution of 2% sodium tosylchloramide for 1 min. Subsequently, this cover was destroyed on one, randomly selected, hand by bathing it in a solution of 0.5% sodium thiosulphate for 15 s. The amount of chlorine on the fingertips of chlorinated hands was 2.2 +/- 0.4 micrograms/cm2; that on subsequently dechlorinated hands was 0.2 +/- 0.1 microgram/cm2. In experiments with artificially contaminated hands (Escherichia coli), the kinetics of bacterial die-off were the same on both hands. Also, in experiments with resident flora, the kinetics of bacterial die-off did not suggest bacterial reductions that increase with the duration of contact with the chlorine cover. It was concluded that with the test models used, a significant sustained antimicrobial effect of the chlorine cover could not be demonstrated on hands.

[Hand eczema. The clinical classification of the roles of exogenous and endogenous factors in each type].

PubMed

Tamiya, Y

1994-08-01

Hand eczema is one of the most common dermatological disorders. Although it is a general term referring to eczematous dermatitis of the hands, it actually covers a wide range of diseases. The classification of hand eczema is controversial even now, as definitions of individual diseases have not yet been established. It is well-known that exogenous factors, such as chemicals or water, are associated with the occurrence of hand eczema. In this study, we focused on endogenous factors, especially personal or family history of atopy as a causative factor in hand eczema. According to exogenous and endogenous factors, we classified hand eczema into three types: atopic dermatitis, contact dermatitis and dysidrosis. This classification is useful because it makes the definition of each disease clear. Skin-humidity and sebum measurement are simple and rapid methods of determining personal atopy, skin condition and the effect of treatment on hand eczema patients.

Design and preliminary testing of a novel skin expander for total ear reconstruction in a rabbit model.

PubMed

Xiong, Wu; Yan, Yu; Hu, Feng; Liu, Can; Wang, Shaohua; Chen, Jia; Wang, Xueqi; Zhou, Jianda

2016-01-01

Ear reconstruction is one of the most complicated and challenging techniques in plastic surgery because of the histologic and anatomic properties of the ear. Success depends on fitting the auriform cartilage scaffold into the overlying skin, but current approaches can just give results that are not lifelike and can lead to complications. A novel double-capsule, double-valve plastic ear expander was designed and implanted subcutaneously on either side of the dorsum of six New Zealand white rabbits (two expanders per rabbit). The outer capsule was expanded by injecting approximately 120 mL of physiological saline, then withdrawing the liquid on two occasions. Next, the ear-shaped inner capsule was filled with high-hardness plaster, and the external capsule was emptied such that the expanded skin flap and external capsule responded to the negative pressure and closed over the ear-shaped inner capsule. As a result, the skin flap adopted an ear shape. The ear expander was left in place for 4 wk, removed with the help of a mini-incision, and stripped of its fibrous capsule. To simulate human ear reconstruction, the expander was replaced with an auriform silicone prosthesis, and the effects of auricular reconstruction were observed dynamically. All 12 skin flaps maintained abundant blood supply, created a clear outline of the ear framework, and produced a lifelike result. No complications were observed during the 4-wk observation period. The expanded skin flaps described here can mold to the desired contours and appear lifelike, as well as maintain abundant blood supply. This may provide a simpler approach to total ear reconstruction that reduces risk of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

The Hygienic Efficacy of Different Hand-Drying Methods: A Review of the Evidence

PubMed Central

Huang, Cunrui; Ma, Wenjun; Stack, Susan

2012-01-01

The transmission of bacteria is more likely to occur from wet skin than from dry skin; therefore, the proper drying of hands after washing should be an integral part of the hand hygiene process in health care. This article systematically reviews the research on the hygienic efficacy of different hand-drying methods. A literature search was conducted in April 2011 using the electronic databases PubMed, Scopus, and Web of Science. Search terms used were hand dryer and hand drying. The search was limited to articles published in English from January 1970 through March 2011. Twelve studies were included in the review. Hand-drying effectiveness includes the speed of drying, degree of dryness, effective removal of bacteria, and prevention of cross-contamination. This review found little agreement regarding the relative effectiveness of electric air dryers. However, most studies suggest that paper towels can dry hands efficiently, remove bacteria effectively, and cause less contamination of the washroom environment. From a hygiene viewpoint, paper towels are superior to electric air dryers. Paper towels should be recommended in locations where hygiene is paramount, such as hospitals and clinics. PMID:22656243

Hand hygiene for the prevention of nosocomial infections.

PubMed

Kampf, Günter; Löffler, Harald; Gastmeier, Petra

2009-10-01

The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

Improving hand sensibility in vibration induced neuropathy: A case-series.

PubMed

Rosén, Birgitta; Björkman, Anders; Lundborg, Göran

2011-04-27

We report a long-term series of nine workers suffering from vibration-induced neuropathy, after many years of exposure to hand-held vibrating tools at high or low frequency. They were treated with temporary selective cutaneous anaesthesia (EMLA® cream) of the forearm repeatedly for a period up to one year (in two cases four years). The aim was to improve their capacity to perceive touch and thereby improve hand function and diminish disability. The treatment principle is based on current concepts of brain plasticity, where a deafferentation of a skin area results in improved sensory function in adjacent skin areas. All participants had sensory hand problems in terms of numbness (median touch thresholds > 70 mg) and impaired hand function influencing ADL (mean DASH score 22).After an initial identical self-administered treatment period of 8 weeks (12-15 treatments with increasing intervals) they did one treatment every 2-3 month. After one year sensibility (touch thresholds and tactile discrimination) as well as hand function (mean DASH score 13) were improved in a majority of the cases. Seven of the participants choose to continue the treatment after the first year and two of them have continued at a regular basis for up to four years. A surprising, secondary finding was diminishing nocturnal numbness of the hand and arm in eight of the nine subjects from "frequently" to "hardly ever or never". Our observations open new perspectives for treatment of impaired sensibility and hand function in a group of patients with vibration induced hand problems where we have no treatment to offer today.

Using Copper to Improve the Well-Being of the Skin

PubMed Central

Borkow, Gadi

2014-01-01

Copper has two key properties that are being exploited in consumer and medical device products in the last decade. On the one hand, copper has potent biocidal properties. On the other hand, copper is involved in numerous physiological and metabolic processes critical for the appropriate functioning of almost all tissues in the human body. In the skin, copper is involved in the synthesis and stabilization of extracellular matrix skin proteins and angiogenesis. This manuscript reviews clinical studies that show that the use of textile consumer and medical device products, embedded with microscopic copper oxide particles, improve the well-being of the skin. These include studies showing a) cure of athlete’s foot infections and improvement in skin elasticity, especially important for individuals suffering from diabetes; b) reduction of facial fine line and wrinkles; and c) enhancement of wound healing; by copper oxide embedded socks, pillowcases and wound dressings, respectively. The manuscript also reviews and discusses the mechanisms by which the presence of copper in these products improves skin well-being. PMID:26361585

Correction of severe postburn claw hand.

PubMed

Davami, Babak; Pourkhameneh, Golnar

2011-12-01

Burn scar contractures are perhaps the most frequent and most frustrating sequelae of thermal injuries to the hand. Unfortunately, stiffness occurs in the burned hand quickly. A week of neglect in the burned hand can lead to digital malpositioning and distortion that may be difficult to correct. The dorsal contracture is the most common of all the complications of the burned hand. It is the result of damage to the thin dorsal skin and scant subcutaneous tissue, which offers little protection to the deeper structures. Consequently, these injuries are deep resulting in a spectrum of deformities that has remained the bane of reconstructive surgery. Flap coverage will be required in the event of exposure of joints and tendons with absent paratenons. Multiple different flap types are available to treat complex severe postburn hand contractures. In our center, which is the largest regional burn center in northwest Iran, we have considerable experience in the treatment of thermal hand injuries. Between 2005 and 2010, we treated 53 consecutive patients with 65 severe postburn hand deformities. There were 35 men and 18 women with a mean age of 35±3 years. Flame injury was the inciting traumatic event in each patient. The severity of original injury and inadequate early treatment resulted in all of the fingers developing a severe extension contracture with scarred and adherent extensor tendons and subluxed metacarpophalangeal joints. In 36 cases, the injury was in the patients' dominant hand. We first incised the dorsal aspect of the contracted hands where there was maximum tension, then tenolysed the extensor tendons and released the volar capsules, collateral ligaments, and volar plate in all cases. In 30 cases, we also tenolysed the flexor tendons. We reduced the subluxed metacarpophalangeal joints and fixed them with Kirschner wires in 70 to 90 degrees flexion. Then, we planned and performed axial groin flaps to reconstruct the defects in all of them. In all of these

Experiencing ownership over a dark-skinned body reduces implicit racial bias.

PubMed

Maister, Lara; Sebanz, Natalie; Knoblich, Günther; Tsakiris, Manos

2013-08-01

Previous studies have investigated how existing social attitudes towards other races affect the way we 'share' their bodily experiences, for example in empathy for pain, and sensorimotor mapping. Here, we ask whether it is possible to alter implicit racial attitudes by experimentally increasing self-other bodily overlap. Employing a bodily illusion known as the 'Rubber Hand Illusion', we delivered multisensory stimulation to light-skinned Caucasian participants to induce the feeling that a dark-skinned hand belonged to them. We then measured whether this could change their implicit racial biases against people with dark skin. Across two experiments, the more intense the participants' illusion of ownership over the dark-skinned rubber hand, the more positive their implicit racial attitudes became. Importantly, it was not the pattern of multisensory stimulation per se, but rather, it was the change in the subjective experience of body ownership that altered implicit attitudes. These findings suggest that inducing an overlap between the bodies of self and other through illusory ownership is an effective way to change and reduce negative implicit attitudes towards outgroups. Copyright © 2013 Elsevier B.V. All rights reserved.

Paracoccidioidomycosis mimicking squamous cell carcinoma on the dorsum of the tongue and review of published literature.

PubMed

Pedreira, Renato do Prado Gomes; Guimarães, Eduardo Pereira; de Carli, Marina Lara; Magalhães, Evandro Monteiro de Sá; Pereira, Alessandro Antônio Costa; Hanemann, João Adolfo Costa

2014-06-01

Paracoccidioidomycosis is a disease that is endemic to southern and southeastern Brazil, caused by the fungus Paracoccidioides brasiliensis. The most common clinical oral manifestation is the presence of multiple granulomatous ulcers with hemorrhagic dots, located mainly on the lips, palate, and buccal mucosa. However, the disease can manifest atypically as a single ulcer, mimicking oral squamous cell carcinoma (SCC) or tuberculosis. A 65-year-old male patient presented with a complaint of a single ulcerated lesion on the dorsum of the tongue; the lesion had evolved over 6 months. The diagnostic hypotheses were SCC and oral manifestation of tuberculosis. An incisional biopsy was performed, and histopathological analysis of the specimen revealed pseudoepitheliomatous hyperplasia, a granulomatous structure of epithelioid histiocytes, multinucleated giant cells, and lymphocytes in the connective tissue. Grocott staining confirmed the presence of the fungus in the lesion, and a diagnosis was made of paracoccidioidomycosis. The patient was treated with 200 mg/day of itraconazole for 12 months and now shows no signs or symptoms of recurrence of the disease. Correct diagnosis is essential for a successful therapeutic approach and resolution of the lesion.

[Pedicled vascularized bone grafts from the dorsum of the distal radius for treatment of scaphoid nonunions].

PubMed

Sauerbier, Michael; Bishop, Allen T; Ofer, Nina

2009-11-01

Bony healing and reconstruction of the scaphoid with use of a reverse-flow pedicle vascularized bone graft from the dorsal aspect of the distal radius. Revitalization of the proximal fragment in case of avascular necrosis. Scaphoid nonunion, especially of the proximal pole. Nonunion after failed attempts of autogenous nonvascularized bone grafting. Avascular necrosis of the scaphoid (Preiser's disease). Avascular osteonecrosis of other carpal bones (i.e., Kienböck's disease stage II and IIIa). However, these will not be addressed in this paper. Advance carpal collapse (SNAC [scaphoid nonunion advanced collapse] wrist stage II and III). Avascular necrosis with broken proximal pole of the scaphoid. Malformation, disease or previous injury of the vascular system. Reconstruction of the scaphoid by interposition of a vascularized bone graft from the dorsum of the distal radius, where several vascularized bone grafts can be harvested, and fixation by a scaphoid screw. Management Immobilization for 6 weeks in a forearm cast including the first phalanx of the thumb. 48 scaphoid nonunions were treated with 1,2-ICSRA-based (intercompartmental supraretinacular artery) vascularized bone grafts: 34 scaphoid nonunions went on to union at an average of 15.6 weeks after surgery.

Severe Tissue Trauma Triggers the Autoimmune State Systemic Lupus Erythematosus in the MRL/++ Lupus-Prone Mouse

DTIC Science & Technology

2009-01-01

to a trans- planted ’self skin (isograft). We transplanted synge- neic naive skin onto the dorsum of MRL/++ mice 30-40 days post-bum injury. Graft...through molecular mimicry . Nat Med 2005; 11: 85-89. Cooper GS, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS. Risk factors for development of

Locomotor Hand Postures, Carpal Kinematics During Wrist Extension, and Associated Morphology in Anthropoid Primates.

PubMed

Orr, Caley M

2017-02-01

The biomechanics of wrist extension (or dorsiflexion) are important for understanding functional adaptation of the primate hand because extension mobility varies with habitual locomotor hand posture and facilitates certain manipulative tasks. Here, intercarpal kinematics are employed to investigate mechanisms underlying wrist extension in a sample of anthropoids representing various arboreal and terrestrial locomotor modes. Carpal kinematics are studied using computed-tomography of cadaveric forelimbs, and these data are combined with a morphometric analysis of biomechanically-informative anatomical features. The results indicate that stiff-wristed knuckle-walking chimpanzees and digitigrade baboons are characterized by low ranges of motion (ROMs) at the radiocarpal and midcarpal complexes. Palmigrade-capable monkeys have high extension ROMs at both the radiocarpus and midcarpus, while palmigrade-capable orangutans achieve wrist extension through moderate radiocarpal ROMs and high midcarpal ROMs. Morphometrics demonstrate that a more projecting dorsal ridge of the distal radius corresponds with low-to-moderate radioscaphoid mobility in the apes, but that baboons resemble palmigrade-capable monkeys in this metric. Thus, the dorsal ridge of the radius alone is not a good indicator of wrist mobility and hand posture. However, the extent of the lunate's articular arc on the dorsum of the capitate head is correlated with midcarpal mobility across taxa. These findings suggest that although a precise relationship between wrist extension ROM and morphology is difficult to define, the presence of a pronounced dorsal ridge combined with an abbreviated dorsal capitate articular arc reflects limited overall dorsiflexion with attendant constraints on the adoption of palmigrade hand postures. Anat Rec, 300:382-401, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Biomechanical Testing and Histologic Examination of Intradermal Skin Closure in Dogs Using Barbed Suture Device and Non-Barbed Monofilament Suture.

PubMed

Law, Andy Y; Butler, James R; Patnaik, Sourav S; Cooley, James A; Elder, Steven H

2017-01-01

To compare the biomechanical strength and histologic features of 3-0 Glycomer™ 631 barbed suture (V-LOC™ 90 Absorbable Wound Closure Device, Covidien, Mansfield, MA) to non-barbed 3-0 Glycomer™ 631 suture (Biosyn™, Covidien) for intradermal skin wound closure in the dog. Randomized, factorial, in vivo. Eighteen purpose-bred, mature male, and female hound dogs. Eighteen adult hound dogs were randomly assigned to 1 of 3 groups designated by postoperative day of assessment. Six skin incisions were made along the dorsum in the thoracolumbar region of each dog with an equal number (n=3) randomly assigned to closure with barbed or non-barbed suture. Six dogs were euthanatized on postoperative days 3, 10, and 14, respectively. Two additional incisions were made on each dog after euthanasia for baseline data (Day 0). The skin incision specimens were harvested for biomechanical testing and histologic evaluation. Non-barbed closure had significantly higher maximum load at failure (P<.001) and stiffness (P<.001) than barbed closure regardless of day. The average tissue reaction score was significantly higher for barbed closure (P=.008), regardless of day. Suturing time for barbed closures was significantly shorter. There was no significant difference in frequency of complications between closures. Barbed Glycomer™ 631 closures had a significantly lower maximum load at failure and stiffness, and higher average tissue reaction scores, but showed no difference in short term outcome for intradermal closure of dorsally located skin incisions in dogs. © 2016 The American College of Veterinary Surgeons.

Contamination of stethoscopes and physicians' hands after a physical examination.

PubMed

Longtin, Yves; Schneider, Alexis; Tschopp, Clément; Renzi, Gesuèle; Gayet-Ageron, Angèle; Schrenzel, Jacques; Pittet, Didier

2014-03-01

To compare the contamination level of physicians' hands and stethoscopes and to explore the risk of cross-transmission of microorganisms through the use of stethoscopes. We conducted a structured prospective study between January 1, 2009, and May 31, 2009, involving 83 inpatients at a Swiss university teaching hospital. After a standardized physical examination, 4 regions of the physician's gloved or ungloved dominant hand and 2 sections of the stethoscopes were pressed onto selective and nonselective media; 489 surfaces were sampled. Total aerobic colony counts (ACCs) and total methicillin-resistant Staphylococcus aureus (MRSA) colony-forming unit (CFU) counts were assessed. Median total ACCs (interquartile range) for fingertips, thenar eminence, hypothenar eminence, hand dorsum, stethoscope diaphragm, and tube were 467, 37, 34, 8, 89, and 18, respectively. The contamination level of the diaphragm was lower than the contamination level of the fingertips (P<.001) but higher than the contamination level of the thenar eminence (P=.004). The MRSA contamination level of the diaphragm was higher than the MRSA contamination level of the thenar eminence (7 CFUs/25 cm(2) vs 4 CFUs/25 cm(2); P=.004). The correlation analysis for both total ACCs and MRSA CFU counts revealed that the contamination level of the diaphragm was associated with the contamination level of the fingertips (Spearman's rank correlation coefficient, ρ=0.80; P<.001 and ρ=0.76; P<.001, respectively). Similarly, the contamination level of the stethoscope tube increased with the increase in the contamination level of the fingertips for both total ACCs and MRSA CFU counts (ρ=0.56; P<.001 and ρ=.59; P<.001, respectively). These results suggest that the contamination level of the stethoscope is substantial after a single physical examination and comparable to the contamination of parts of the physician's dominant hand. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by

Vitamin D production after UVB exposure - a comparison of exposed skin regions.

PubMed

Osmancevic, Amra; Sandström, Katarina; Gillstedt, Martin; Landin-Wilhelmsen, Kerstin; Larkö, Olle; Wennberg Larkö, Ann-Marie; F Holick, Michael; Krogstad, Anne-Lene

2015-02-01

Cholecalciferol is an essential steroid produced in the skin by solar ultraviolet B radiation (UVB 290-315nm). Skin production of cholecalciferol depends on factors affecting UVB flux, age and exposed skin area. Serum cholecalciferol and 25-hydroxyvitamin D3 [25(OH)D3] concentrations were measured after UVB irradiation of 3 different skin areas to compare the skin capacity to produce vitamin D in different anatomic sites in the same individuals. Ten voluntary Caucasians (skin photo type II & III, aged 48±12years (±SD)) were exposed to broadband UVB (280-320nm) between February and April. Hands and face, upper body and whole body were exposed to a suberythemic dose of UVB (median 101mJ/cm(2) (min 66, max 143)) (for 3 subsequent days 24h apart with a wash out period of about 3weeks (median 18days (min 11, max 25)) between the exposures of respective area. Serum concentrations of cholecalciferol and 25(OH)D3, were measured immediately before the first and 24h after the last dose of radiation. There was a significantly higher increase in serum cholecalciferol after UVB exposure of the two larger skin areas compared to face and hands, but no difference in increase was found between upper body and whole body exposures. Exposure of a larger skin area was superior to small areas and gave greater increase in both serum cholecalciferol and serum 25(OH)D3 concentrations. However, exposure of face and hands, i.e. only 5% of the body surface area, was capable of increasing serum concentrations of 25(OH)D3. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparative assessment of local tolerance of alcohols commonly used in alcohol-based hand rubs for hand hygiene.

PubMed

Manche, Monique; Foligné, Benoît; Sauty, Mathieu; Platel, Anne; Vercauteren, Eric; Rauwel, Gaétan; Catoire, Sophie; Ficheux, Hervé; Criquelion, Jacques; Nesslany, Fabrice

2017-10-01

Hand hygiene plays a key role in nosocomial infection prevention. To achieve users' adherence, products' dermal tolerance is essential. We aimed at making a comparative assessment of skin irritation and phototoxicity of the 3 alcohols commonly used in alcohol-based hand rubs (Ethanol, Propan-2-ol, Propan-1-ol) at 60, 70, 80 or 85% w/w in water or with co-formulates (hydrating, emollient and skin protective agents). In vitro validated OECD methods 439 and 432 were used. For irritation, EpiSkin™ Small Model was the chosen Reconstructed Human Epidermis (RhE). For phototoxicity, co-formulates alone or in mixture with and without alcohol were tested using BALB/c 3T3 cell cultures. Whilst Ethanol and Propan-2-ol could not be differentiated and displayed good skin tolerance profiles, Propan-1-ol based products lead to significant viability impairments of RhE at 60, 70 or 80% and at 60% in the presence of co-formulates. However, these results could not be reproduced in another RhE model. Taking also into account bibliographic data on Propan-1-ol, this suggests that our results are probably related to a lack of specificity of the used RhE. Therefore, it can be relevant in case of significant results to use two different RhE models before performing any classification and/or performing any complementary tests. Copyright © 2017 Elsevier Ltd. All rights reserved.

Arm, Leg, and Foot Skin Water in Persons With Diabetes Mellitus (DM) in Relation to HbA1c Assessed by Tissue Dielectric Constant (TDC) Technology Measured at 300 MHz.

PubMed

Mayrovitz, Harvey N; Volosko, Irina; Sarkar, Bansari; Pandya, Naushira

2017-05-01

DM is associated with structural skin changes. However, few studies have investigated changes in dermal water and specifically its relationship to glucose control as measured by HbA1c. Our goal was to test the hypothesis that skin water, assessed by its tissue dielectric constant (TDC), is inversely related to HbA1c. Water content of 3 skin sites (forearm, lower leg, and foot dorsum) of 50 persons with DM was estimated by measuring TDC at 300 MHz. TDC is the ratio of tissue dielectric constant to vacuum and depends on free and bound water in the measured volume. TDC was measured in triplicate to 4 depths, 0.5. 1.5, 2.5, and 5.0 mm to include different skin components. At each site increased measurement depth showed (1) a significant decrease in absolute TDC values and (2) a significant increase in foot-to-arm TDC ratios. TDC values at forearm were shown to be greater than at either leg or foot. However, testing of these 50 patients at 3 sites and 4 skin depths did not show any significant relationship between TDC and HbA1c or fasting glucose. The data indicate no relationship between TDC values, as indices for skin water, and HbA1c or fasting glucose. This implies that skin TDC values to assess skin property features and changes in persons with DM are not sensitive to recent glucose control. Furthermore, the results introduce a newly applied TDC technology useful to assess skin properties of persons with DM.

Military Return to Duty and Civilian Return to Work Factors Following Burns With Focus on the Hand and Literature Review

DTIC Science & Technology

2008-10-01

the three parameters of skin graft - ing, treatment time and presence of a face burn where all reports agree as to the influence of each one of these...cluding the presence of hand burns. Of the studies that agree on factor influence, five document that skin grafting had a significant effect on...stepwise multiple regression analysis, Helm et al determined TBSA to be the stron- gest predictor of RTW followed equally by skin graft - ing and hand burn

Improving hand sensibility in vibration induced neuropathy: A case-series

PubMed Central

2011-01-01

Objectives We report a long-term series of nine workers suffering from vibration-induced neuropathy, after many years of exposure to hand-held vibrating tools at high or low frequency. They were treated with temporary selective cutaneous anaesthesia (EMLA® cream) of the forearm repeatedly for a period up to one year (in two cases four years). The aim was to improve their capacity to perceive touch and thereby improve hand function and diminish disability. The treatment principle is based on current concepts of brain plasticity, where a deafferentation of a skin area results in improved sensory function in adjacent skin areas. Methods All participants had sensory hand problems in terms of numbness (median touch thresholds > 70 mg) and impaired hand function influencing ADL (mean DASH score 22). After an initial identical self-administered treatment period of 8 weeks (12-15 treatments with increasing intervals) they did one treatment every 2-3 month. Results After one year sensibility (touch thresholds and tactile discrimination) as well as hand function (mean DASH score 13) were improved in a majority of the cases. Seven of the participants choose to continue the treatment after the first year and two of them have continued at a regular basis for up to four years. A surprising, secondary finding was diminishing nocturnal numbness of the hand and arm in eight of the nine subjects from "frequently" to "hardly ever or never". Conclusions Our observations open new perspectives for treatment of impaired sensibility and hand function in a group of patients with vibration induced hand problems where we have no treatment to offer today. PMID:21524297

Comparison of native porcine skin and a dermal substitute using tensiometry and digital image speckle correlation.

PubMed

Fritz, Jason R; Phillips, Brett T; Conkling, Nicole; Fourman, Mitchell; Melendez, Mark M; Bhatnagar, Divya; Simon, Marcia; Rafailovich, Miriam; Dagum, Alexander B

2012-10-01

Dermal substitutes are currently used in plastic surgery to cover various soft tissue defects caused by trauma, burns, or ablative cancer surgery. Little information is available on the biomechanical properties of these dermal substitutes after adequate incorporation as compared to normal skin. Determining parameters such as tensile strength in these skin substitutes will help us further understand their wound healing properties and potential in developing artificial tissue constructs. We hypothesize that a dermal substitute has a lower stress-strain curve and altered stress-induced deformation quantified with tensiometry and digital image speckle correlation (DISC) analysis. Two separate 5×10-cm full-thickness wounds were created on the dorsum of 3 female swine. Fibrin glue was applied before either a full-thickness skin graft (FTSG) or application of artificial dermal matrix. On day 42, cultured autologous keratinocytes were applied as a cell sheet to the wound covered with Integra. On day 56, the wounds were fully excised and fresh tissue specimens, including normal skin, were stored in a physiological solution and prepared for analysis. Rectangular samples were excised from the center of each specimen measuring 4×4×30 mm. Using a tensiometer and DISC analysis, we evaluated the tensile strength of 3 different groups of skin, namely, normal, FTSG, and Integra. There is a significant difference between the Integra specimen when compared to normal skin and FTSG. We found a minimal difference in the stress-strain curves of the latter two. Integra alone shows plastic deformation with continued stretching before ultimate midline fracture. There is significant change between the Young's moduli of the normal skin and the Integra, whereas there is little difference between the FTSG and the normal skin; DISC confirms this analysis. The normal skin and FTSG show a convergence of vectors to a linear plane, whereas Integra shows very little organization. Using 2 different

Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure.

PubMed

Susitaival, P; Flyvholm, M-A; Meding, B; Kanerva, L; Lindberg, M; Svensson, A; Olafsson, J H

2003-08-01

Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool - Nordic Occupational Skin Questionnaire (NOSQ-2002) - for surveys on work-related skin disease and exposures to environmental factors. The 2 NOSQ-2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ-2002/SHORT is a ready-to-use 4-page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ-2002/SHORT) are included in the long version, NOSQ-2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ-2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ-2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ-2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries.

Hydrogel-forming microneedles increase in volume during swelling in skin, but skin barrier function recovery is unaffected

PubMed Central

Donnelly, Ryan F.; Mooney, Karen; McCrudden, Maelíosa T.C.; Vicente-Pérez, Eva M.; Belaid, Luc; González-Vázquez, Patricia; McElnay, James C.; Woolfson, A. David

2014-01-01

We describe, for the first time, quantification of in-skin swelling and fluid uptake by hydrogel-forming microneedle arrays (MN) and skin barrier recovery in human volunteers. Such MN, prepared from aqueous blends of hydrolysed poly(methylvinylether/maleicanhydride) (15% w/w) and the crosslinker poly(ethyleneglycol) 10,000 daltons (7.5% w/w), were inserted into the skin of human volunteers (n = 15) to depths of approximately 300 μm by gentle hand pressure. The MN swelled in skin, taking up skin interstitial fluid, such that their mass had increased by approximately 30% after 6 hours in skin. Importantly, however, skin barrier function recovered within 24 hours post microneedle removal, regardless of how long the MN had been in skin or how much their volume had increased with swelling. Further research on closure of MN-induced micropores is required, since transepidermal water loss measurements suggested micropore closure, while optical coherence tomography indicated that MN-induced micropores had not closed over, even 24 hours after MN had been removed. There were no complaints of skin reactions, adverse events or strong views against MN use by any of the volunteers. Only some minor erythema was noted after patch removal, although this always resolved within 48 hours and no adverse events were present on follow-up. PMID:24633895

Occupational skin problems in construction workers.

PubMed

Shah, Kartik R; Tiwari, Rajnarayan R

2010-10-01

Construction workers handle cement which has constituents to produce both irritant contact dermatitis and corrosive effects (from alkaline ingredients, such as lime) and sensitization, leading to allergic contact dermatitis (from ingredients, such as chromium). The present study has been carried out among unorganized construction workers to find the prevalence of skin problems. The present cross-sectional study was conducted in 92 construction workers of Ahmedabad and Vadodara. All the workers were subjected to clinical examination after collection of information regarding demographic characteristics, occupational characteristics and clinical history on a predesigned proforma. Of them, 47.8% had morbid skin conditions. Frictional callosities in palm were observed in 18 (19.6%) subjects while 4 (4.3%) subjects had contact dermatitis. Other conditions included dry, fissured and scaly skin, infectious skin lesion, tinea cruris, lesion and ulcers on hands and/or soles. The skin conditions were common in the age group of 20-25 years, males, those having ≥1 year exposure and those working for longer hours. Half of the workers not using personal protective equipment had reported skin-related symptoms.

Fasciocutaneous Propeller Flap Based on Perforating Branch of Ulnar Artery for Soft Tissue Reconstruction of the Hand and Wrist.

PubMed

Jang, Hyo Seok; Lee, Young Ho; Kim, Min Bom; Chung, Joo Young; Seok, Hyun Sik; Baek, Goo Hyun

2018-03-01

A skin defect of the hand and wrist is a common manifestation in industrial crushing injuries, traffic accidents or after excision of tumors. We reconstructed a skin defect in the ulnar aspect of the hand and wrist with a perforator-based propeller flap from the ulnar artery. The aims of our study are to evaluate the utility and effectiveness of this flap and to discuss the advantages and disadvantages of the flap in hand and wrist reconstruction with a review of the literature. Between April 2011 and November 2016, five cases of skin defect were reconstructed with a perforator-based propeller flap from the ulnar artery. There were four males and one female. The age of patients ranged from 36 to 73 years. Skin defect sites were on the dorso-ulnar side of the hand in three cases and palmar-ulnar side of the wrist in two cases. The size of the skin defect ranged from 4 × 3 cm to 8 × 5 cm. We evaluated the viability of the flap, postoperative complication and patient's satisfaction. There was no failure of flap in all cases. The size of the flap ranged from 4 × 4 cm to 12 × 4 cm. One patient, who had a burn scar contracture, presented with limited active and passive motion of the wrist after the operation. The other patients had no complications postoperatively. Cosmetic results of the surgery were excellent in one patient, good in three patients, and fair in one patient. The fasciocutaneous propeller flap based on a perforating branch of the ulnar artery is a reliable treatment option for the ulnar side skin defect of the hand and wrist.

Study on Surgical Management of Post Burn Hand Deformities

PubMed Central

Ahmed, Firdos; Jash, Prabir Kumar; Gupta, Madhumita; Suba, Santanu

2015-01-01

Context Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. Aim The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome. Settings and Design It’s a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department. Materials and Methods Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months. Results Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties and 23% with flap coverage. Split thickness skin grafts (STSG) and full thickness graft (FTSG) reconstructed cases had good recovery of joint mobility in 43% and 75% of cases respectively. Reconstructive procedures were aesthetically acceptable to the patients in 63%, 75% and 94% of STSG, FTSG and Z plasty cases respectively. Recurrence was seen in 17% of STSG done cases. Conclusion Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases. PMID:26435994

Safety, effectiveness and comparability of professional skin cleansers.

PubMed

Terhaer, Flora K; Bock, Meike; Fartasch, Manigé; Gabard, Bernard; Elsner, Peter; Kleesz, Peter; Landeck, Lilla; Pohrt, Ute; Seyfarth, Florian; Schliemann, Sibylle; Diepgen, Thomas L; Zagrodnik, Fred; John, Swen Malte

2010-10-01

There are no widely-accepted methodical specifications with which to objectify cleansing effectiveness and skin compatibility of occuptional skin cleansing products in Europe. Therefore the German Social Insurance Agency (DGUV) initiated a study with the goal to evaluate such products in view of the potency and the safety of hand cleansers. A market analysis was a part of the project. The product descriptions and safety data sheets of 120 products (5-20/manufacturer) of 11 manufacturers were evaluated between 02/2008 and 04/2008. The manufacturers used mainly ingredients of low irritancy. The declaration of the applied ingredients was in the majority of the cases correctly labeled according to the INCI Declaration. Although there was documentation of skin tolerability for most products, the manufacturers used widely differing tests of skin compatibility. Evidences for cleansing effectiveness were not declared or have not been provided. One manufacturer even promised medical effects of its products. There was no uniform general classification of products making it difficult to identify characteristics of cleansers and choose between them. Presently, there are no commonly accepted criteria to classify products in view of cleansing effectiveness und skin compatibility. Generally accepted criteria and test methods are needed for the evaluation of hand cleansers in order to provide the possibility of transparency and comparability. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Surgical Management of the Thick-Skinned Nose.

PubMed

Davis, Richard E; Hrisomalos, Emily N

2018-02-01

When executed properly, open structure rhinoplasty can dramatically improve the consistency, durability, and quality of the cosmetic surgical outcome. Moreover, in expert hands, dramatic transformations in skeletal architecture can be accomplished with minimal risk and unparalleled control, all while preserving nasal airway function. While skeletal enhancements have become increasingly more controlled and precise, the outer skin-soft tissue envelope (SSTE) often presents a formidable obstacle to a satisfactory cosmetic result. In noses with unusually thick skin, excessive skin volume and characteristically hostile healing responses frequently combine to obscure or sometimes even negate cosmetic skeletal modifications and taint the surgical outcome. For this challenging patient subgroup, care must be taken to optimize the SSTE using a graduated treatment strategy directed at minimizing skin thickness and controlling unfavorable healing responses. When appropriate efforts are implemented to manage thick nasal skin, cosmetic outcomes are often substantially improved, sometimes even negating the ill-effects of thick skin altogether. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Kaiser Permanente National Hand Hygiene Program

PubMed Central

Barnes, Sue; Barron, Dana; Becker, Linda; Canola, Teresa; Salemi, Charles

2004-01-01

Objective: Hand hygiene has historically been identified as an important intervention for preventing infection acquired in health care settings. Recently, the advent of waterless, alcohol-based skin degermer and elimination of artificial nails have been recognized as other important interventions for preventing infection. Supplied with this information, the National Infection Control Peer Group convened a KP Hand Hygiene Work Group, which, in August 2001, launched a National Hand Hygiene Program initiative titled “Infection Control: It’s In Our Hands” to increase compliance with hand hygiene throughout the Kaiser Permanente (KP) organization. Design: The infection control initiative was designed to include employee and physician education as well as to implement standard hand hygiene products (eg, alcohol degermers), eliminate use of artificial nails, and monitor outcomes. Results: From 2001 through September 2003, the National KP Hand Hygiene Work Group coordinated implementation of the Hand Hygiene initiative throughout the KP organization. To date, outcome monitoring has shown a 26% increase in compliance with hand hygiene as well as a decrease in the number of bloodstream infections and methycillin-resistant Staphylococcus aureus (MRSA) infections. As of May 2003, use of artificial nails had been reduced by 97% nationwide. Conclusions: Endorsement of this Hand Hygiene Program initiative by KP leadership has led to implementation of the initiative at all medical centers throughout the KP organization. Outcome indicators to date suggest that the initiative has been successful; final outcome monitoring will be completed in December 2003. PMID:26704605

The Microbiota of the Human Skin.

PubMed

Egert, Markus; Simmering, Rainer

2016-01-01

The aim of this chapter is to sum up important progress in the field of human skin microbiota research that was achieved over the last years.The human skin is one of the largest and most versatile organs of the human body. Owing to its function as a protective interface between the largely sterile interior of the human body and the highly microbially contaminated outer environment, it is densely colonized with a diverse and active microbiota. This skin microbiota is of high importance for human health and well-being. It is implicated in several severe skin diseases and plays a major role in wound infections. Many less severe, but negatively perceived cosmetic skin phenomena are linked with skin microbes, too. In addition, skin microorganisms, in particular on the human hands, are crucial for the field of hygiene research. Notably, apart from being only a potential source of disease and contamination, the skin microbiota also contributes to the protective functions of the human skin in many ways. Finally, the analysis of structure and function of the human skin microbiota is interesting from a basic, evolutionary perspective on human microbe interactions.Key questions in the field of skin microbiota research deal with (a) a deeper understanding of the structure (species inventory) and function (physiology) of the healthy human skin microbiota in space and time, (b) the distinction of resident and transient skin microbiota members, (c) the distinction of beneficial skin microorganisms from microorganisms or communities with an adverse or sickening effect on their hosts, (d) factors shaping the skin microbiota and its functional role in health and disease, (e) strategies to manipulate the skin microbiota for therapeutic reasons.

Markovian Analysis of the Sequential Behavior of the Spontaneous Spinal Cord Dorsum Potentials Induced by Acute Nociceptive Stimulation in the Anesthetized Cat.

PubMed

Martin, Mario; Béjar, Javier; Esposito, Gennaro; Chávez, Diógenes; Contreras-Hernández, Enrique; Glusman, Silvio; Cortés, Ulises; Rudomín, Pablo

2017-01-01

In a previous study we developed a Machine Learning procedure for the automatic identification and classification of spontaneous cord dorsum potentials ( CDPs ). This study further supported the proposal that in the anesthetized cat, the spontaneous CDPs recorded from different lumbar spinal segments are generated by a distributed network of dorsal horn neurons with structured (non-random) patterns of functional connectivity and that these configurations can be changed to other non-random and stable configurations after the noceptive stimulation produced by the intradermic injection of capsaicin in the anesthetized cat. Here we present a study showing that the sequence of identified forms of the spontaneous CDPs follows a Markov chain of at least order one. That is, the system has memory in the sense that the spontaneous activation of dorsal horn neuronal ensembles producing the CDPs is not independent of the most recent activity. We used this markovian property to build a procedure to identify portions of signals as belonging to a specific functional state of connectivity among the neuronal networks involved in the generation of the CDPs . We have tested this procedure during acute nociceptive stimulation produced by the intradermic injection of capsaicin in intact as well as spinalized preparations. Altogether, our results indicate that CDP sequences cannot be generated by a renewal stochastic process. Moreover, it is possible to describe some functional features of activity in the cord dorsum by modeling the CDP sequences as generated by a Markov order one stochastic process. Finally, these Markov models make possible to determine the functional state which produced a CDP sequence. The proposed identification procedures appear to be useful for the analysis of the sequential behavior of the ongoing CDPs recorded from different spinal segments in response to a variety of experimental procedures including the changes produced by acute nociceptive stimulation. They

Comparison of tissue viability imaging and colorimetry: skin blanching.

PubMed

Zhai, Hongbo; Chan, Heidi P; Farahmand, Sara; Nilsson, Gert E; Maibach, Howard I

2009-02-01

Operator-independent assessment of skin blanching is important in the development and evaluation of topically applied steroids. Spectroscopic instruments based on hand-held probes, however, include elements of operator dependence such as difference in applied pressure and probe misalignment, while laser Doppler-based methods are better suited for demonstration of skin vasodilatation than for vasoconstriction. To demonstrate the potential of the emerging technology of Tissue Viability Imaging (TiVi) in the objective and operator-independent assessment of skin blanching. The WheelsBridge TiVi600 Tissue Viability Imager was used for quantification of human skin blanching with the Minolta chromameter CR 200 as an independent colorimeter reference method. Desoximetasone gel 0.05% was applied topically on the volar side of the forearm under occlusion for 6 h in four healthy adults. In a separate study, the induction of blanching in the occlusion phase was mapped using a transparent occlusion cover. The relative uncertainty in the blanching estimate produced by the Tissue Viability Imager was about 5% and similar to that of the chromameter operated by a single user and taking the a(*) parameter as a measure of blanching. Estimation of skin blanching could also be performed in the presence of a transient paradoxical erythema, using the integrated TiVi software. The successive induction of skin blanching during the occlusion phase could readily be mapped by the Tissue Viability Imager. TiVi seems to be suitable for operator-independent and remote mapping of human skin blanching, eliminating the main disadvantages of methods based on hand-held probes.

Technical note: comparing von Luschan skin color tiles and modern spectrophotometry for measuring human skin pigmentation.

PubMed

Swiatoniowski, Anna K; Quillen, Ellen E; Shriver, Mark D; Jablonski, Nina G

2013-06-01

Prior to the introduction of reflectance spectrophotometry into anthropological field research during the 1950s, human skin color was most commonly classified by visual skin color matching using the von Luschan tiles, a set of 36 standardized, opaque glass tiles arranged in a chromatic scale. Our goal was to establish a conversion formula between the tile-based color matching method and modern reflectance spectrophotometry to make historical and contemporary data comparable. Skin pigmentation measurements were taken on the forehead, inner upper arms, and backs of the hands using both the tiles and a spectrophotometer on 246 participants showing a broad range of skin pigmentation. From these data, a second-order polynomial conversion formula was derived by jackknife analysis to estimate melanin index (M-index) based on tile values. This conversion formula provides a means for comparing modern data to von Luschan tile measurements recorded in historical reports. This is particularly important for populations now extinct, extirpated, or admixed for which tile-based measures of skin pigmentation are the only data available. Copyright © 2013 Wiley Periodicals, Inc.

Experimental skin deposition of chromium on the hands following handling of samples of leather and metal.

PubMed

Bregnbak, David; Thyssen, Jacob P; Jellesen, Morten S; Zachariae, Claus; Johansen, Jeanne D

2016-08-01

Chromium is an important skin sensitizer. Exposure to it has been regulated in cement, and recently in leather. Studies on the deposition of chromium ions on the skin as a result of handling different chromium-containing materials are sparse, but could improve the risk assessment of contact sensitization and allergic contact dermatitis caused by chromium. To determine whether the handling of chromium-containing samples of leather and metal results in the deposition of chromium onto the skin. Five healthy volunteers participated. For 30 min, they handled samples of leather and metal known to contain and release chromium. Skin deposition of chromium was assessed with the acid wipe sampling technique. Acid wipe sampling of the participants' fingers showed chromium deposition on the skin in all participants who had been exposed to leather (range 0.01-0.20 µg/cm(2) ) and in 3 of 5 participants after they had manually handled metal discs (range 0.02-0.04 µg/cm(2) ). We found that samples of leather and metal had the ability to deposit chromium on the skin at significant levels, in spite of a short duration of exposure. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hand sanitizer dispensers and associated hospital-acquired infections: friend or fomite?

PubMed

Eiref, Simon D; Leitman, I Michael; Riley, William

2012-06-01

Waterless alcohol-based hand sanitizers are an increasingly popular method of hand hygiene and help prevent hospital-acquired infection (HAI). Whether hand sanitizer dispensers (HSDs) may themselves harbor pathogens or act as fomites has not been reported. All HSDs in the surgical intensive care unit of an urban teaching hospital were cultured at three sites: The dispenser lever, the rear underside, and the area surrounding the dispensing nozzle. All HSDs yielded one or more bacterial species, including commensal skin flora and enteric gram-negative bacilli. Colonization was greatest on the lever, where there is direct hand contact. Hand sanitizer dispensers can become contaminated with pathogens that cause HAI and thus are potential fomites.

Scar Management of the Burned Hand

PubMed Central

Sorkin, Michael; Cholok, David; Levi, Benjamin

2017-01-01

Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars. PMID:28363297

Apparatus and method for skin packaging articles

NASA Technical Reports Server (NTRS)

Madsen, B.; Pozsony, E. R.; Collin, E. E. (Inventor)

1973-01-01

A system for skin packaging articles including a loading zone for positioning articles to be packaged upon a substrate, a thermoplastic film heating and vacuum operated skin packaging zone for covering the articles with film laminated to the substrate and a slitting zone for separating and trimming the individual skin packaged articles. The articles are passed to the successive zones. The loading zone may be adapted for conveyorized instead of hand loading. In some cases, where only transverse cutting of the film web is necessary, it may be desirable to eliminate the slitting zone and remove the skin packaged article or articles directly from the packaging zone. A conveniently located operating panel contains controls for effecting automatic, semiautomatic or manual operation of the entire system of any portions in any manner desired.

The use of a measure of acute irritation to predict the outcome of repeated usage of hand soap products.

PubMed

Williams, C; Wilkinson, M; McShane, P; Pennington, D; Fernandez, C; Pierce, S

2011-06-01

Healthcare-associated infection is an important worldwide problem that could be reduced by better hand hygiene practice. However, an increasing number of healthcare workers are experiencing irritant contact dermatitis of the hands as a result of repeated hand washing. This may lead to a reduced level of compliance with regard to hand hygiene. To assess whether a measure of acute irritation by hand soaps could predict the effects of repeated usage over a 2-week period. In a double-blind, randomized comparison study, the comparative irritation potential of four different hand soaps was assessed over a 24-h treatment period. The effect of repeated hand washing with the hand soap products over a 2-week period in healthy adult volunteers on skin barrier function was then determined by assessment of transepidermal water loss (TEWL), epidermal hydration and a visual assessment using the Hand Eczema Severity Index (HECSI) at days 0, 7 and 14. A total of 121 subjects from the 123 recruited completed phase 1 of the study. All four products were seen to be significantly different from each other in terms of the irritant reaction observed and all products resulted in a significantly higher irritation compared with the no-treatment control. Seventy-nine of the initial 121 subjects were then enrolled into the repeated usage study. A statistically significant worsening of the clinical condition of the skin as measured by HECSI was seen from baseline to day 14 in those subjects repeatedly washing their hands with two of the four soap products (products C and D) with P-values of 0·02 and 0·01, respectively. Subclinical assessment of the skin barrier function by measuring epidermal hydration was significantly increased from baseline to day 7 after repeated hand washing with products A, B and D but overall no significant change was seen in all four products tested by day 14. A statistically significant increase in TEWL at day 14 was seen for product A (P = 0·02) indicating a

[Features of skin graft in pediatric plastic surgery].

PubMed

Depoortère, C; François, C; Belkhou, A; Duquennoy-Martinot, V; Guerreschi, P

2016-10-01

Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc. Specific skin graft techniques in children are developed: donor sites, sampling technique and procedure, early postoperative care. Especially in children, the scalp is a perfect site for split skin graft and technique is actively developed. Refinements and special cases are discussed: use of dermal matrices, allografts, xenografts, negative pressure therapy, prior skin expansion of the donor site. Results of skin graft in children are exposed: taking of graft, growth and shrinkage, pigmentation. Skin graft sometimes allows to stay the complex movement and get the best final benefit, permanent or at least temporary, in a growing being. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Signatures of human skin in the millimetre wave band (80-100) GHz

NASA Astrophysics Data System (ADS)

Owda, Amani Y.; Rezgui, Nacer-Ddine; Salmon, Neil A.

2017-10-01

With the performance of millimeter wave security screening imagers improving (reduced speckle, greater sensitivity, and better spatial resolution) attention is turning to identification of anomalies which appear on the human body. Key to this identification is the understanding of how the emissive and reflective properties vary over the human body and between different categories of people, defined by age and gender for example. As the interaction of millimetre waves with the human body is only a fraction of a millimetre into the skin, precise measurement of the emission and reflection of this radiation will allow comparisons with the norm for that region of the body and person category. On an automated basis at security screening portals, this will increase detection probabilities and reduce false alarm rates, ensuring high throughputs at entrances to future airport departure lounges and transport networks. A technique to measure the human skin emissivity in vivo over the frequency band 80 GHz to 100 GHz is described. The emissivities of the skin of a sample of 60 healthy participants (36 males and 24 females) measured using a 90 GHz calibrated radiometer was found to range from 0.17+/-0.002 to 0.68+/-0.002. The radiometric measurements were made at four locations on the arm, namely: palm of hand, back of hand, dorsal surface of the forearm, and volar side of the forearm, where the water content and the skin thickness are known to be different. These measurements show significant variation in emissivity from person to person and, more importantly, significant variation at different locations on the arms of individuals. Males were found to have an emissivity 0.03 higher than those of females. The emissivity of the back of the hand, where the skin is thinner and the blood vessels are closer to the skin surface, was found to be lower by 0.0681 than the emissivity of the palm of the hand, where the skin is thicker. The measurements also show that the emissivity of the

Novel Strategies for Enhanced Removal of Persistent Bacillus anthracis Surrogates and Clostridium difficile Spores from Skin

PubMed Central

Nerandzic, Michelle M.; Rackaityte, Elze; Jury, Lucy A.; Eckart, Kevin; Donskey, Curtis J.

2013-01-01

Background Removing spores of Clostridium difficile and Bacillus anthracis from skin is challenging because they are resistant to commonly used antimicrobials and soap and water washing provides only modest efficacy. We hypothesized that hygiene interventions incorporating a sporicidal electrochemically generated hypochlorous acid solution (Vashe®) would reduce the burden of spores on skin. Methods Hands of volunteers were inoculated with non-toxigenic C. difficile spores or B. anthracis spore surrogates to assess the effectiveness of Vashe solution for reducing spores on skin. Reduction in spores was compared for Vashe hygiene interventions versus soap and water (control). To determine the effectiveness of Vashe solution for removal of C. difficile spores from the skin of patients with C. difficile infection (CDI), reductions in levels of spores on skin were compared for soap and water versus Vashe bed baths. Results Spore removal from hands was enhanced with Vashe soak (>2.5 log10 reduction) versus soap and water wash or soak (~2.0 log10 reduction; P <0.05) and Vashe wipes versus alcohol wipes (P <0.01). A combined approach of soap and water wash followed by soaking in Vashe removed >3.5 log10 spores from hands (P <0.01 compared to washing or soaking alone). Bed baths using soap and water (N =26 patients) did not reduce the percentage of positive skin cultures for CDI patients (64% before versus 57% after bathing; P =0.5), whereas bathing with Vashe solution (N =21 patients) significantly reduced skin contamination (54% before versus 8% after bathing; P =0.0001). Vashe was well-tolerated with no evidence of adverse effects on skin. Conclusions Vashe was safe and effective for reducing the burden of B. anthracis surrogates and C. difficile spores on hands. Bed baths with Vashe were effective for reducing C. difficile on skin. These findings suggest a novel strategy to reduce the burden of spores on skin. PMID:23844234

A hand-held EPR scanner for transcutaneous oximetry

NASA Astrophysics Data System (ADS)

Wolfson, Helen; Ahmad, Rizwan; Twig, Ygal; Blank, Aharon; Kuppusamy, Periannan

2015-03-01

Cutaneous (skin) oxygenation is an important prognostic factor for the treatment of chronic wounds, skin cancer, diabetes side effects, and limb amputation. Currently, there are no reliable methods for measuring this parameter. Oximetry, using electron paramagnetic resonance (EPR) spectroscopy, is emerging as a potential tool for clinical oximetry, including cutaneous applications. The problem with EPR oximetry, however, is that the conventional EPR design requires the use of a large magnet that can generate homogeneous field across the sample, making it unattractive for clinical practice. We present a novel approach that makes use of a miniature permanent magnet, combined with a small microwave resonator, to enable the acquisition of EPR signals from paramagnetic species placed on the skin. The instrumentation consists of a hand-held, modular, cylindrical probehead with overall dimensions of 36-mm diameter and 24-mm height, with 150-g weight. The probehead includes a Halbach array of 16 pieces (4×4×8 mm3) of Sm-Co permanent magnet and a loop-gap resonator (2.24 GHz). Preliminary measurements using a Hahn-echo pulse sequence (800 echos in 20 ms) showed a signalto- noise ratio of ~70 compared to ~435 in a homogenous magnet under identical settings. Further work is in progress to improve the performance of the probehead and to optimize the hand-held system for clinical use

A Review of the Quantification and Classification of Pigmented Skin Lesions: From Dedicated to Hand-Held Devices.

PubMed

Filho, Mercedes; Ma, Zhen; Tavares, João Manuel R S

2015-11-01

In recent years, the incidence of skin cancer cases has risen, worldwide, mainly due to the prolonged exposure to harmful ultraviolet radiation. Concurrently, the computer-assisted medical diagnosis of skin cancer has undergone major advances, through an improvement in the instrument and detection technology, and the development of algorithms to process the information. Moreover, because there has been an increased need to store medical data, for monitoring, comparative and assisted-learning purposes, algorithms for data processing and storage have also become more efficient in handling the increase of data. In addition, the potential use of common mobile devices to register high-resolution images of skin lesions has also fueled the need to create real-time processing algorithms that may provide a likelihood for the development of malignancy. This last possibility allows even non-specialists to monitor and follow-up suspected skin cancer cases. In this review, we present the major steps in the pre-processing, processing and post-processing of skin lesion images, with a particular emphasis on the quantification and classification of pigmented skin lesions. We further review and outline the future challenges for the creation of minimum-feature, automated and real-time algorithms for the detection of skin cancer from images acquired via common mobile devices.

The regeneration of thermal wound on mice skin (Mus Musculus) after Q-Switch Nd: YAG laser irradiation for cancer therapy candidate

NASA Astrophysics Data System (ADS)

Apsari, R.; Nahdliyatun, E.; Winarni, D.

2017-09-01

The aims of this study are to investigate the regeneration of mice skin tissue (Mus Musculus) irradiated by Q-Switch Nd: YAG laser and morphological change due to Q-Switch Nd: YAG laser irradiation compared to conventional heating (hairdryer). The 2-3 month of twenty-seven mice were used for experimental animals. Mice were incised in the dorsum by the damage effect of laser energy dose (therapeutic dose) of 29.5 J/cm2 with 10 seconds of exposure time, 10 Hz of repetition rate, and 100 pulses of the given single pulse energy. The mice skin tissue was injuried by hairdryer to get burned effect. Mice were divided into three groups, Group I (control) were not treated by anything, Group II were treated by Q-Switch Nd: YAG laser irradiation and sacrificed on (0, 1, 3, 5) days, and Group III were treated by hairdryer then sacrificed on (0, 1, 3, 5) days. Pathology examination showed that the energy of 29,5 J/cm2 dose produced the hole effect (ablation) through the hypodermic layer caused by optical breakdown and collagen coagulation. Thus, the 60 °C temperature of burn showed coagulation necrosis because piknosis discovered in the injured area. The regeneration process showed that the mice skin tissue's ability to regenerate was irradiated by fast laser because of the focus of Q-Switch Nd: YAG laser. It was showed by the scab releases on third day and completely reepithelialization formation on the fifth day. The collagen fibers distribution was same as normal skin tissue on day 5 and so did angiogenesis. Therefore, Q-Switch Nd: YAG laser can be applied for problems of dermatology medical therapies, especially melasma, nevus of ota and tatto therapy. For skin cancer therapy application, energy dose of unregenerated skin tissue is chosen because the death expected effect is permanent.

Skin Ageing: Natural Weapons and Strategies

PubMed Central

Binic, Ivana; Lazarevic, Viktor; Ljubenovic, Milanka; Mojsa, Jelena; Sokolovic, Dusan

2013-01-01

The fact that the skin is the most visible organ makes us aware of the ageing process every minute. The use of plant extracts and herbs has its origins in ancient times. Chronological and photo-ageing can be easily distinguished clinically, but they share important molecular features. We tried to gather the most interesting evidence based on facts about plants and plant extracts used in antiaging products. Our main idea was to emphasize action mechanisms of these plant/herbal products, that is, their “strategies” in fighting skin ageing. Some of the plant extracts have the ability to scavenge free radicals, to protect the skin matrix through the inhibition of enzymatic degradation, or to promote collagen synthesis in the skin. There are some plants that can affect skin elasticity and tightness. Certainly, there is a place for herbal principles in antiaging cosmetics. On the other hand, there is a constant need for more evaluation and more clinical studies in vivo with emphasis on the ingredient concentration of the plant/herbal products, its formulation, safety, and duration of the antiaging effect. PMID:23431351

The effects of cold immersion and hand protection on grip strength.

PubMed

Vincent, M J; Tipton, M J

1988-08-01

The maximal voluntary grip strength (MVGS) of male volunteers was examined following a series of five intermittent 2 min cold water (5 degrees C) immersions of the unprotected hand or forearm. MVGS changes due to wearing a protective glove were also investigated. The surface electrical activity over the hand flexor muscles was recorded, as was the skin temperature of the hand and forearm. MVGS decreased significantly (p less than 0.01) following hand immersions (16%) and forearm immersion (13%). The majority of these reductions occurred during the first 2-min period of immersion. The effect of wearing a glove after unprotected hand cooling also produced significant (p less than 0.01) MVGS reductions which averaged 14%. These reductions were in addition to those caused by hand cooling. We conclude that both hand and forearm protection are important for the maintenance of hand-grip strength following cold water immersion.

A survey of occupational skin disease in UK health care workers.

PubMed

Campion, K M

2015-01-01

Occupational skin disease is a common problem among health care workers (HCWs). The prevalence of occupational skin disease in HCWs has been reported in several international studies, but not in the UK. To estimate the prevalence of occupational skin disease in a population of UK HCWs and to explore possible causative factors. Clinical and non-clinical HCWs attending for an influenza vaccine during October and November 2013 were invited to complete a brief skin questionnaire. Data from staff who stated their skin had suffered as a result of work were compared with data from staff who did not, to explore differences in potential causative factors. A total of 2762 questionnaires were analysed. The estimated prevalence of occupational skin disease was 20% for clinical and 7% for non-clinical staff. In total, 424 clinical staff stated their skin had been made worse by work. There were statistically significant differences between clinical staff with and without reported skin symptoms regarding a history of eczema, frequent hand washing and moisturizer use but no statistically significant difference in the relative proportions of soap and alcohol hand gel use. Non-clinical staff reported significantly more use of soap relative to alcohol gel than clinical staff. This study demonstrated the prevalence of occupational skin disease in a population of UK HCWs. More work is indicated to explore if the ratio of soap and alcohol gel reported in this study are typical and whether this has any impact on the development of occupational skin disease. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An examination of the vibration transmissibility of the hand-arm system in three orthogonal directions.

PubMed

Welcome, Daniel E; Dong, Ren G; Xu, Xueyan S; Warren, Christopher; McDowell, Thomas W; Wu, John Z

2015-02-01

The objective of this study is to enhance the understanding of the vibration transmission in the hand-arm system in three orthogonal directions ( X, Y , and Z ). For the first time, the transmitted vibrations distributed on the entire hand-arm system exposed in the three orthogonal directions via a 3-D vibration test system were measured using a 3-D laser vibrometer. Seven adult male subjects participated in the experiment. This study confirms that the vibration transmissibility generally decreased with the increase in distance from the hand and it varied with the vibration direction. Specifically, to the upper arm and shoulder, only moderate vibration transmission was measured in the test frequency range (16 to 500 Hz), and virtually no transmission was measured in the frequency range higher than 50 Hz. The resonance vibration on the forearm was primarily in the range of 16-30 Hz with the peak amplitude of approximately 1.5 times of the input vibration amplitude. The major resonance on the dorsal surfaces of the hand and wrist occurred at around 30-40 Hz and, in the Y direction, with peak amplitude of more than 2.5 times of the input amplitude. At higher than 50 Hz, vibration transmission was effectively limited to the hand and fingers. A major finger resonance was observed at around 100 Hz in the X and Y directions and around 200 Hz in the Z direction. In the fingers, the resonance magnitude in the Z direction was generally the lowest, and the resonance magnitude in the Y direction was generally the highest with the resonance amplitude of 3 times the input vibration, which was similar to the transmissibility at the wrist and hand dorsum. The implications of the results are discussed. Prolonged, intensive exposure to hand-transmitted vibration could result in hand-arm vibration syndrome. While the syndrome's precise mechanisms remain unclear, the characterization of the vibration transmissibility of the system in the three orthogonal dimensions performed in this

An examination of the vibration transmissibility of the hand-arm system in three orthogonal directions

PubMed Central

Welcome, Daniel E.; Dong, Ren G.; Xu, Xueyan S.; Warren, Christopher; McDowell, Thomas W.; Wu, John Z.

2015-01-01

The objective of this study is to enhance the understanding of the vibration transmission in the hand-arm system in three orthogonal directions (X, Y, and Z). For the first time, the transmitted vibrations distributed on the entire hand-arm system exposed in the three orthogonal directions via a 3-D vibration test system were measured using a 3-D laser vibrometer. Seven adult male subjects participated in the experiment. This study confirms that the vibration transmissibility generally decreased with the increase in distance from the hand and it varied with the vibration direction. Specifically, to the upper arm and shoulder, only moderate vibration transmission was measured in the test frequency range (16 to 500 Hz), and virtually no transmission was measured in the frequency range higher than 50 Hz. The resonance vibration on the forearm was primarily in the range of 16–30 Hz with the peak amplitude of approximately 1.5 times of the input vibration amplitude. The major resonance on the dorsal surfaces of the hand and wrist occurred at around 30–40 Hz and, in the Y direction, with peak amplitude of more than 2.5 times of the input amplitude. At higher than 50 Hz, vibration transmission was effectively limited to the hand and fingers. A major finger resonance was observed at around 100 Hz in the X and Y directions and around 200 Hz in the Z direction. In the fingers, the resonance magnitude in the Z direction was generally the lowest, and the resonance magnitude in the Y direction was generally the highest with the resonance amplitude of 3 times the input vibration, which was similar to the transmissibility at the wrist and hand dorsum. The implications of the results are discussed. Relevance to industry Prolonged, intensive exposure to hand-transmitted vibration could result in hand-arm vibration syndrome. While the syndrome's precise mechanisms remain unclear, the characterization of the vibration transmissibility of the system in the three orthogonal

The Cutaneous Microbiome and Aspects of Skin Antimicrobial Defense System Resist Acute Treatment with Topical Skin Cleansers.

PubMed

Two, Aimee M; Nakatsuji, Teruaki; Kotol, Paul F; Arvanitidou, Evangelia; Du-Thumm, Laurence; Hata, Tissa R; Gallo, Richard L

2016-10-01

The human skin microbiome has been suggested to play an essential role in maintaining health by contributing to innate defense of the skin. These observations have inspired speculation that the use of common skin washing techniques may be detrimental to the epidermal antibacterial defense system by altering the microbiome. In this study, several common skin cleansers were used to wash human forearms and the short-term effect on the abundance of the antimicrobial peptide LL-37 and the abundance and diversity of bacterial DNA was measured. Despite small but significant decreases in the amount of LL-37 on the skin surface shortly after washing, no significant change in the bacterial community was detected. Furthermore, Group A Streptococcus did not survive better on the skin after washing. In contrast, the addition of antimicrobial compounds such as benzalkonium chloride or triclocarban to soap before washing decreased the growth of Group A Streptococcus applied after rinse. These results support prior studies that hand washing techniques in the health care setting are beneficial and should be continued. Additional research is necessary to better understand the effects of chronic washing and the potential impact of skin care products on the development of dysbiosis in some individuals. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Skin reactions amongst Greek endodontists: a national questionnaire survey.

PubMed

Zarra, T; Lambrianidis, T

2015-04-01

To investigate amongst Greek endodontists in the past 5 years the prevalence, aetiologic factors, severity and treatment for skin reactions. One hundred and 47 endodontists met the inclusion criteria and were invited to participate in the survey. Participants were asked for personal/professional data, prevalence, aetiologic factors, symptoms, severity and treatment for skin reactions in the past 5 years. The type of gloves used and frequency of hand washing as well as information on history of atopy and eczema were also recorded. Data were analysed using chi-square test and independent samples t-test. The level of significance was set at P = 0.05. The response rate was 84%. Skin reactions were reported by 32.5% of participants. Hands were the body part most frequently affected (66% of cases); glove powder accounted for 73% of skin reactions. Medical care was sought by 28.2% of the affected participants. Endodontists with a history of atopy (P < 0.001) and dermal eczema (P < 0.001) as well as females (P = 0.023) were more likely to report skin reactions. Replacement of powdered latex gloves with powder-free or vinyl/nitrile gloves, avoidance of potential allergens and use of pharmaceutical ointments were adopted by 48.7%, 23.1% and 2.6% of the affected endodontists, respectively, to manage skin reactions. Approximately one-third of participants reported skin reactions. History of atopy and dermal eczema as well as gender was significantly associated with such reactions. The use of powder-free latex gloves instead of powdered ones was the measure most frequently adopted to manage reactions. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Evaluation of Patients' Satisfaction and Functional Outcome of Dorsal Hand Unit Reconstruction in Burn Patients in Shiraz, Southern Iran.

PubMed

Mohammadi, Ali Akbar; Foroutan, Ali; Mohammadi, Soheil; Zardosht, Mitra

2018-06-13

The aim of this study was to assess patients' satisfaction and functional outcome of dorsal hand unit reconstruction in burn patients in Shiraz, southern Iran.From September 2013 to February 2017, 11 patients (15 hands) with hand aesthetic complaint who were unhappy with their hand appearance were included for dorsal hand unit reconstruction. Under general anesthesia and tourniquet control, the burned tissue on dorsal surface of the hands was excised and a thick partial thickness skin graft was used for coverage, whereas the fingers were fixed by sutures to the palm. After 1 year, the five-points scale was used for evaluation of patients' satisfaction regarding the five major activities considered for hand function before and after operation. The mean age of the patients was 25.8 ± 5.17 years. The skin grafts were well taken. Six (40%) and eight patients (53%) reported the result of operation as completely satisfied and satisfied, respectively. Dorsal hand unit reconstruction in patients with dorsal hand contracture and significant dorsal scar was shown to simultaneously improve the function and aesthetic outcome of the surgery.

[Functional food and bioavailability in the target organ skin].

PubMed

Darwin, M; Schanzer, S; Teichmann, A; Blume-Peytavi, U; Sterry, W; Lademann, J

2006-04-01

Reactive free radicals can be produced in the skin by the action of environmental factors, such as sun radiation and toxins. These radicals can damage the DNA, proteins and lipids of the living cells. The consequences can be skin aging, immune suppression and even skin cancer. Humans have developed a protective mechanism against the action of free radicals in the form of antioxidant substances. Several of these antioxidants cannot be produced by humans and have to be acquired via food, such as carotenoids. Optical, non-invasive methods, like resonance Raman spectroscopy, allow a qualitative and quantitative online detection of the kinetics of antioxidants such as carotenoids in the skin. By employing this method it has been shown that the uptake of carotenoids in food can lead to an accumulation in the skin. On the other hand, stress, illness and UV-radiation can reduce the concentration of antioxidant substances in the skin. A high concentration of antioxidant substances is protective and associated with a reduction in skin wrinkling.

Hand dermatitis/eczema: current management strategy.

PubMed

Sehgal, Virendra N; Srivastava, Govind; Aggarwal, Ashok K; Sharma, Alpna D

2010-07-01

Ever since its inception a couple of centuries ago, hand dermatitis/eczema has been in the reckoning. Idiosyncrasies continued to loom large thereafter, till it acquired its appropriate position. Dermatitis/eczema are synonymous, often used to indicate a polymorphic pattern of the inflammation of the skin, characterized by pruritus, erythema and vesiculation. A spectrum delineated into acute sub-acute and chronic dermatitis of the hands. Pompholyx, recurrent focal palmer peeling, ring, wear and tear and fingertip eczema, apron, discoid eczema, chronic acral dermatitis, gut and patchy papulosquamous eczema are its clinical variants. Occupational dermatitis/eczema may be contributory. Etiological definitions are clinched by detailed history of exogenous and endogenous factors. However, scientific confirmation of the entity is through patch testing by using available antigens.

The influence of daily dish-washing with synthetic detergent on human skin.

PubMed

Klein, G; Grubauer, G; Fritsch, P

1992-08-01

The effects of regular dish-washing on the stratum corneum barrier function, as determined by transepidermal water loss (TEWL), and objective and subjective skin parameters, were investigated in a 'use test' performed by 18 healthy volunteers. Hands were soaked in a 0.05% solution of a commercial dish-washing product (three times/day, for 15 min, at 37 degrees C) over a period of 3 weeks; one hand was unprotected and the other was protected with a commercial rubber glove. TEWL increased in 13/18 volunteers by more than 25% above baseline on exposed hands within the first 2 weeks of the study. Objective skin signs (erythema, scaling, fissures) and subjective symptoms (itching, dryness, smarting) occurred almost exclusively in subjects with substantial TEWL increases and were most prominent 1-2 weeks following peak TEWL values. There was a highly significant correlation between cumulative relative symptom scores and TEWL changes. TEWL increase and symptom scores were not correlated with a history of inhalant allergy and/or elevated serum IgE levels. Three volunteers, who had shown the highest increase of TEWL values and the most intense clinical reactions to the detergent were subjected to a control experiment in which one hand was soaked in warm tap-water following the same experimental protocol. No significant effects on TEWL values or skin symptoms were observed. We conclude that regular exposure to low concentrations of detergents as used for dish-washing is capable of inducing skin lesions in a substantial proportion of individuals.

Air pulse deformation measurement: a preliminary method for noninvasive vocal fold pliability analysis.

PubMed

Larsson, Hans; Lindestad, P Å; Hertegård, S

2011-01-01

A new method, air pulse pliability measurement, is presented, with which the pliability and elasticity of the vocal folds was measured in vitro and in vivo using air pulses. The size of the mucosal movements induced by air pulse stimulation was measured with a laser-based technique. The air pulses fed via a 2-mm tubing, introduced through the working channel of a flexible endoscope. Both in vitro and in vivo tests were performed. Nine normal, vocally healthy subjects were examined by air pulse stimulations of the vocal folds, of the skin (cheek and dorsum of the hand) and of the inside of the lips. The in vitro tests showed a coefficient of variation of 5% within a range of 1-5 mm from the probe to the surface. The elasticity data showed no differences between vocal folds, lips or cheek. The hand data showed a significantly higher stiffness as compared to the other 3 measuring points (p < 0.001). The coefficient of variation was about 35% for all measuring points, but in ideal conditions on skin it was 9%. The results show that the technique allows automatic, quantitative, noninvasive vocal fold pliability measurements on awake subjects. Copyright © 2010 S. Karger AG, Basel.

Skin problems after a tsunami.

PubMed

Lee, S H; Choi, C P; Eun, H C; Kwon, O S

2006-08-01

On December 26, 2004, the biggest earthquake for 40 years, measuring 9.0 on the Richter scale, triggered a tsunami that pounded the coastal areas of South Asia and East Africa. The effects of the tsunami on skin conditions have not been evaluated. To determine the influence of the tsunami on skin conditions by evaluating the skin problems of patients presenting at hospitals after the tsunami. Between 5 and 25 January 2005, two dermatologists evaluated patients who complained of skin problems at an outpatient clinic and emergency room of a general hospital in Banda Aceh, Aceh Province, Indonesia. The total number of patients that presented during the study period was 235 (131 males and 104 females), and they had a total of 265 skin problems. In terms of age distribution, most subjects were in their fourth decade (23.0%), followed by the third (22.6%) and fifth decade (16.6%). The most prevalent skin problems were infections-infestations (32.5%), followed by eczemas (29.8%) and traumatic skin disorders (29.4%). In males, traumatic skin disorders were most common. The great majority of infection-infestation cases involved superficial fungal infections. Contact dermatitis accounted for three-quarters of eczema cases, and mainly involved the arms (40.0%) and legs (27.1%). The majority of traumatic skin disorders were lacerations, punctures and penetrations, and the feet (44.7%) and hands (18.8%) were most frequently affected. Unhygienic conditions, exposure to a hazardous environment and contact with various objects during and after the tsunami probably increased the prevalence of infections-infestations, traumatic skin disorders and contact dermatitis. To prevent these problems and associated secondary bacterial infections, health-related education and early medical management are required.

Histological and Immunohistochemical Evaluation of the Efficacy of a New Cosmetic Formulation in the Treatment of Skin Photoaging

PubMed Central

Jiménez, N.; Miguel-Gomez, L.; Hermosa, A.; Sánchez-Neila, N.; Cuevas, J.

2017-01-01

Objective. Mechanism of action of cosmetic products is not often studied. The aim of this study is to determine the histological, immunohistochemical, and clinical changes of a new cosmetic formulation. Methods. Prospective, single-blind, patient-controlled, randomized study in 10 volunteers with mild to moderate skin photoaging on the back of their hands. The product was applied on one hand and a standard cream on the other hand, twice a day for three months. Standardized photographs were taken on basal (T0) and final visit (T1) and skin biopsies were performed. Changes on histological and immunohistochemical markers were studied. Subjective clinical changes were determined. Results. After treatment, a 26.3% improvement on epidermal thickness was detected and a significant increase on collagens I and III, elastin, and fibronectin fibers was achieved (p < 0.05). As the expression of MMPs remained stable, this improvement of dermal matrix was attributed to the stimulation of their synthesis. A significant clinical improvement on the treated hand was obtained, compared to control hand. Conclusion. This new cosmetic product with combination of three registered technologies (IFC-CAF, WGC, and RetinSphere), focused on regenerating dermal matrix and activating proliferation of skin cells, has shown to be efficient in the reversion of skin photoaging. PMID:28167957

The influence of selected ingredients of dietary supplements on skin condition

PubMed Central

Łepecka-Klusek, Celina; Kozłowicz, Katarzyna; Jazienicka, Iwona; Krasowska, Dorota

2014-01-01

Introduction and aim of the article. Healthy skin is an excellent barrier maintaining balance between the internal and external environment of the body. Because it is constantly changing as a result of, on the one hand, environmental factors and, on the other hand, the process associated with skin aging, it requires many nutrients and minerals that help maintain its homeostasis. The aim of this dissertation is to discuss the most commonly used ingredients in dietary supplements that improve the appearance and quality of the skin. Brief description of the state of the art. Quick pace of life, unbalanced diet and stress make it impossible to provide all the necessary components, which affects the proper functioning of the skin. That is why, the interest in dietary supplements as products that help to reduce the deficiencies of individual components is increasing. Supplements that affect the skin, hair and nails mainly consist of: vitamins C, E, A, B-vitamins, micro- and macronutrients and fatty acids. In this paper, some of the ingredients of skin affecting dietary supplements are discussed. A varied and proper diet should provide all the nutrients necessary for the correct functioning of the body. Dietary supplements are intended to supplement the normal daily food intake of nutrients which are not supplied with food in a sufficient quantity. Therefore, their use becomes relevant. PMID:25097490

Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants: a randomized trial.

PubMed

Svensson, Kristin E; Velandia, Marianne I; Matthiesen, Ann-Sofi T; Welles-Nyström, Barbara L; Widström, Ann-Marie E

2013-03-11

Infants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding. Healthy newborns experiencing skin-to-skin contact at birth are pre-programmed to find the mother's breast. This study investigates if skin-to-skin contact between mothers with older infants having severe latching on problems would resolve the problem. Mother-infant pairs with severe latch-on problems, that were not resolved during screening procedures at two maternity hospitals in Stockholm 1998-2004, were randomly assigned to skin-to-skin contact (experimental group) or not (control group) during breastfeeding. Breastfeeding counseling was given to both groups according to a standard model. Participants were unaware of their treatment group. Objectives were to compare treatment groups concerning the proportion of infants regularly latching on, the time from intervention to regular latching on and maternal emotions and pain before and during breastfeeding. On hundred and three mother-infant pairs with severe latch-on problems 1-16 weeks postpartum were randomly assigned and analyzed. There was no significant difference between the groups in the proportion of infants starting regular latching-on (75% experimental group, vs. 86% control group). Experimental group infants, who latched on, had a significantly shorter median time from start of intervention to regular latching on than control infants, 2.0 weeks (Q1 = 1.0, Q3 = 3.7) vs. 4.7 weeks (Q1 = 2.0, Q3 = 8.0), (p-value = 0.020). However, more infants in the experimental group (94%), with a history of "strong reaction" during "hands-on latch intervention", latched-on within 3 weeks compared to 33% in the control infants (Fisher Exact test p-value = 0.0001). Mothers in the experimental group (n = 53) had a more positive breastfeeding experience according to the Breastfeeding Emotional Scale during the intervention than mothers in the control group (n = 50) (p-value = 0.022). Skin-to-skin contact

Characterising the variations in ethnic skin colours: a new calibrated data base for human skin.

PubMed

Xiao, K; Yates, J M; Zardawi, F; Sueeprasan, S; Liao, N; Gill, L; Li, C; Wuerger, S

2017-02-01

Accurate skin colour measurements are important for numerous medical applications including the diagnosis and treatment of cutaneous disorders and the provision of maxillofacial soft tissue prostheses. In this study, we obtained accurate skin colour measurements from four different ethnic groups (Caucasian, Chinese, Kurdish, Thai) and at four different body locations (Forehead, cheek, inner arm, back of hand) with a view of establishing a new skin colour database for medical and cosmetic applications. Skin colours are measured using a spectrophotometer and converted to a device-independent standard colour appearance space (CIELAB) where skin colour is expressed as values along the three dimensions: Lightness L*, Redness a* and Yellowness b*. Skin colour differences and variation are then evaluated as a function of ethnicity and body location. We report three main results: (1) When plotted in a standard colour appearance space (CIELAB), skin colour distributions for the four ethnic groups overlap significantly, although there are systematic mean differences. Between ethnicities, the most significant skin colour differences occur along the yellowness dimension, with Thai skin exhibiting the highest yellowness (b*) value and Caucasian skin the lowest value. Facial redness (a*) is invariant across the four ethnic groups. (2) Between different body locations, there are significant variations in redness (a*), with the forehead showing the highest redness value and the inner arm the lowest. (3) The colour gamut is smallest in the Chinese sample and largest in the Caucasian sample, with the Chinese gamut lying entirely the Caucasian gamut. Similarly, the largest variability in skin tones is found in the Caucasian group, and the smallest in the Chinese group. Broadly speaking, skin colour variation can be explained by two main factors: individual differences in lightness and yellowness are mostly due to ethnicity, whereas differences in redness are primarily due to

Skin manifestations of growth hormone-induced diseases.

PubMed

Kanaka-Gantenbein, Christina; Kogia, Christina; Abdel-Naser, Mohamed Badawy; Chrousos, George P

2016-09-01

The human skin is a well-organized organ bearing different types of cells in a well-structured interference to each other including epidermal and follicular keratinocytes, sebocytes, melanocytes, dermal papilla cells and fibroblasts, endothelial cells, sweat gland cells as well as nerves. Several hormones act on different cell types of the skin, while it is also considered an endocrine organ secreting hormones that act at several sites of the organism. GH receptors are found in almost all cell types forming the skin, while IGF-1 receptors' expression is restricted to the epidermal keratinocytes. Both Growth Hormone (GH) excess, as in the case of Acromegaly in adults, or Gigantism in growing children, and GH deficiency states lead to skin manifestations. In case of GH excess the main dermatological findings are skin thickening, coarsening of facial features, acrochordons, puffy hands and feet, oily skin and hyperhidrosis, while GH deficiency, on the contrary, is characterized by thin, dry skin and disorder of normal sweating. Moreover, special disorders associated with GH excess may have specific characteristics, as is the case of café-au-lait spots in Neurofibromatosis, or big café-au-lait skin hyperpigmented regions with irregular margins, as is the case in McCune-Albright syndrome. Meticulous examination of the skin may therefore contribute to the final diagnosis in cases of GH-induced disorders.

Prosthetic finger phalanges with lifelike skin compliance for low-force social touching interactions

PubMed Central

2011-01-01

Background Prosthetic arms and hands that can be controlled by the user's electromyography (EMG) signals are emerging. Eventually, these advanced prosthetic devices will be expected to touch and be touched by other people. As realistic as they may look, the currently available prosthetic hands have physical properties that are still far from the characteristics of human skins because they are much stiffer. In this paper, different configurations of synthetic finger phalanges have been investigated for their skin compliance behaviour and have been compared with the phalanges of the human fingers and a phalanx from a commercially available prosthetic hand. Methods Handshake tests were performed to identify which areas on the human hand experience high contact forces. After these areas were determined, experiments were done on selected areas using an indenting probe to obtain the force-displacement curves. Finite element simulations were used to compare the force-displacement results of the synthetic finger phalanx designs with that of the experimental results from the human and prosthetic finger phalanges. The simulation models were used to investigate the effects of (a) varying the internal topology of the finger phalanx and (b) varying different materials for the internal and external layers. Results and Conclusions During handshake, the high magnitudes of contact forces were observed at the areas where the full grasping enclosure of the other person's hand can be achieved. From these areas, the middle phalanges of the (a) little, (b) ring, and (c) middle fingers were selected. The indentation experiments on these areas showed that a 2 N force corresponds to skin tissue displacements of more than 2 mm. The results from the simulation model show that introducing an open pocket with 2 mm height on the internal structure of synthetic finger phalanges increased the skin compliance of the silicone material to 235% and the polyurethane material to 436%, as compared to a

Complement System in Dermatological Diseases – Fire Under the Skin

PubMed Central

Panelius, Jaana; Meri, Seppo

2015-01-01

The complement system plays a key role in several dermatological diseases. Overactivation, deficiency, or abnormality of the control proteins are often related to a skin disease. Autoimmune mechanisms with autoantibodies and a cytotoxic effect of the complement membrane attack complex on epidermal or vascular cells can cause direct tissue damage and inflammation, e.g., in systemic lupus erythematosus (SLE), phospholipid antibody syndrome, and bullous skin diseases like pemphigoid. By evading complement attack, some microbes like Borrelia spirochetes and staphylococci can persist in the skin and cause prolonged symptoms. In this review, we present the most important skin diseases connected to abnormalities in the function of the complement system. Drugs having an effect on the complement system are also briefly described. On one hand, drugs with free hydroxyl on amino groups (e.g., hydralazine, procainamide) could interact with C4A, C4B, or C3 and cause an SLE-like disease. On the other hand, progress in studies on complement has led to novel anti-complement drugs (recombinant C1-inhibitor and anti-C5 antibody, eculizumab) that could alleviate symptoms in diseases associated with excessive complement activation. The main theme of the manuscript is to show how relevant the complement system is as an immune effector system in contributing to tissue injury and inflammation in a broad range of skin disorders. PMID:25688346

Distally based posterior interosseous flap: primary role in soft-tissue reconstruction of the hand.

PubMed

Agir, Hakan; Sen, Cenk; Alagöz, Sahin; Onyedi, Murat; Isil, Eda

2007-09-01

A series of 15 consecutive patients with various hand defects requiring flap coverage was reviewed in this study. The defects were all covered with the distally based posterior interosseous flap. Its main indications were in complex hand trauma, severe burn injury, or skin cancer ablation, either acute or postprimary. In 12 of the patients, flaps survived completely. In 3 patients, there was partial necrosis of the distal part of the flap, which did not require additional surgical procedure. Radial nerve palsy was noted in one of the cases, with a complete recovery after 3 months. Donor site was closed directly in up to 4-cm-wide flaps, while larger flaps required skin grafting. No major anatomic variation was observed. Distally based posterior interosseous flap is a reliable choice for various types and areas of hand defects, with very low donor-site morbidity, and should be more commonly considered in clinical practice.

Compression under a mechanical counter pressure space suit glove

NASA Technical Reports Server (NTRS)

Waldie, James M A.; Tanaka, Kunihiko; Tourbier, Dietmar; Webb, Paul; Jarvis, Christine W.; Hargens, Alan R.

2002-01-01

Background: Current gas-pressurized space suits are bulky stiff shells severely limiting astronaut function and capability. A mechanical counter pressure (MCP) space suit in the form of a tight elastic garment could dramatically improve extravehicular activity (EVA) dexterity, but also be advantageous in safety, cost, mass and volume. The purpose of this study was to verify that a prototype MCP glove exerts the design compression of 200 mmHg, a pressure similar to the current NASA EVA suit. Methods: Seven male subjects donned a pressure measurement array and MCP glove on the right hand, which was placed into a partial vacuum chamber. Average compression was recorded on the palm, the bottom of the middle finger, the top of the middle finger and the dorsum of the hand at pressures of 760 (ambient), 660 and 580 mmHg. The vacuum chamber was used to simulate the pressure difference between the low breathing pressure of the current NASA space suits (approximately 200 mmHg) and an unprotected hand in space. Results: At ambient conditions, the MCP glove compressed the dorsum of the hand at 203.5 +/- 22.7 mmHg, the bottom of the middle finger at 179.4 +/- 16.0 mmHg, and the top of the middle finger at 183.8 +/- 22.6 mmHg. The palm compression was significantly lower (59.6 +/- 18.8 mmHg, p<0.001). There was no significant change in glove compression with the chamber pressure reductions. Conclusions: The MCP glove compressed the dorsum of the hand and middle finger at the design pressure.

Compression under a mechanical counter pressure space suit glove.

PubMed

Waldie, James M A; Tanaka, Kunihiko; Tourbier, Dietmar; Webb, Paul; Jarvis, Christine W; Hargens, Alan R

2002-12-01

Current gas-pressurized space suits are bulky stiff shells severely limiting astronaut function and capability. A mechanical counter pressure (MCP) space suit in the form of a tight elastic garment could dramatically improve extravehicular activity (EVA) dexterity, but also be advantageous in safety, cost, mass and volume. The purpose of this study was to verify that a prototype MCP glove exerts the design compression of 200 mmHg, a pressure similar to the current NASA EVA suit. Seven male subjects donned a pressure measurement array and MCP glove on the right hand, which was placed into a partial vacuum chamber. Average compression was recorded on the palm, the bottom of the middle finger, the top of the middle finger and the dorsum of the hand at pressures of 760 (ambient), 660 and 580 mmHg. The vacuum chamber was used to simulate the pressure difference between the low breathing pressure of the current NASA space suits (approximately 200 mmHg) and an unprotected hand in space. At ambient conditions, the MCP glove compressed the dorsum of the hand at 203.5 +/- 22.7 mmHg, the bottom of the middle finger at 179.4 +/- 16.0 mmHg, and the top of the middle finger at 183.8 +/- 22.6 mmHg. The palm compression was significantly lower (59.6 +/- 18.8 mmHg, p<0.001). There was no significant change in glove compression with the chamber pressure reductions. The MCP glove compressed the dorsum of the hand and middle finger at the design pressure.

Effects of a vitamin pool (vitamins A, E, and C) on the tissue necrosis process: experimental study on rats.

PubMed

Porto da Rocha, Rogério; Lucio, Daniela Pettinato; Souza, Thiago de Lima; Pereira, Sérgio Tavolaro; Fernandes, Geraldo José Medeiros

2002-01-01

During surgical procedures on the epidermis, either aesthetic or reconstructive, the medical literature shows that certain technical standards and skin flap proportions should be followed, unless the risk of necrosis increases, in different degrees, directly related to the trauma. This study evaluates the evolution of skin flaps on the dorsum of rats treated with a vitamin pool (VP) (vitamins A, E, and C). Twenty-six rats, divided into two groups, were used: (A) the treated group (13 specimens), in which we performed a dorsal skin flap and applied the VP, and (B) the control group (13 specimens), in which we performed a flap on the dorsum without application of the VP. Our results demonstrate that, at the macroscopic level, the group treated with the VP had more tissue sufferance, whereas at the microscopic level, small statistical differences were observed between the groups and also between the vertex and the middle of the flap. Despite these small differences, better results were obtained in group A, showing that in this study the clinical aspect did not correspond to the histological features.

Sclerotherapy of Diffuse and Infiltrative Venous Malformations of the Hand and Distal Forearm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guevara, Carlos J., E-mail: guevarac@mir.wustl.edu; Gonzalez-Araiza, Guillermo; Kim, Seung K.

PurposeVenous malformations (VM) involving the hand and forearm often lead to chronic pain and dysfunction, and the threshold for treatment is high due to the risk of nerve and skin damage, functional deterioration and compartment syndrome. The purpose of this study is to demonstrate that sclerotherapy of diffuse and infiltrative VM of the hand is a safe and effective therapy.Materials and MethodsA retrospective review of all patients with diffuse and infiltrative VM of the hand and forearm treated with sclerotherapy from 2001 to 2014 was conducted. All VM were diagnosed during the clinical visit by a combination of physical examinationmore » and imaging. Sclerotherapy was performed under imaging guidance using ethanol and/or sodium tetradecyl sulfate foam. Clinical notes were reviewed for signs of treatment response and complications, including skin blistering and nerve injury.ResultsSeventeen patients underwent a total of 40 sclerotherapy procedures. Patients were treated for pain (76 %), swelling (29 %) or paresthesias (6 %). Treatments utilized ethanol (70 %), sodium tetradecyl sulfate foam (22.5 %) or a combination of these (7.5 %). Twenty-four percent of patients had complete resolution of symptoms, 24 % had partial relief of symptoms without need for further intervention, and 35 % had some improvement after initial treatment but required additional treatments. Two skin complications were noted, both of which resolved. No motor or sensory loss was reported.ConclusionSclerotherapy is a safe and effective therapy for VM of the hand with over 83 % of patients experiencing relief.« less

Percutaneous absorption of aromatic amines in rubber industry workers: impact of impaired skin and skin barrier creams

PubMed Central

Korinth, G; Weiss, T; Penkert, S; Schaller, K H; Angerer, J; Drexler, H

2007-01-01

Background Several aromatic amines (AA) could cause bladder cancer and are an occupational hygiene problem in the workplace. However, little is known about the percutaneous absorption of chemicals via impaired skin and about the efficacy of skin protection measures to reduce internal exposure. Aims To determine the impact of skin status and of skin protection measures on the internal exposure to AA in workers manufacturing rubber products. Methods 51 workers occupationally exposed to aniline and o‐toluidine were examined. The workplace conditions, risk factors for skin and the use of personal protective equipment were assessed by means of a self‐administered questionnaire. The skin of hands and forearms was clinically examined. Exposure to aniline and o‐toluidine was assessed by ambient air and biological monitoring (analyses of urine samples and of haemoglobin adducts). Results Haemoglobin‐AA‐adduct levels in workers with erythema (73%) were significantly higher (p<0.04) than in workers with healthy skin (mean values: aniline 1150.4 ng/l vs 951.7 ng/l, o‐toluidine 417.9 ng/l vs 118.3 ng/l). The multiple linear regression analysis showed that wearing gloves significantly reduced the internal exposure. A frequent use of skin barrier creams leads to a higher internal exposure of AA (p<0.03). However, the use of skincare creams at the workplace was associated with a reduced internal exposure (p<0.03). From these findings we assume that internal exposure of the workers resulted primarily from the percutaneous uptake. Conclusions The study demonstrates a significantly higher internal exposure to AA in workers with impaired skin compared with workers with healthy skin. Daily wearing of gloves efficiently reduced internal exposure. However, an increased use of skin barrier creams enhances the percutaneous uptake of AA. Skincare creams seem to support skin regeneration and lead to reduced percutaneous uptake. PMID:17182646

High sensitivity optical measurement of skin gloss

PubMed Central

Ezerskaia, Anna; Ras, Arno; Bloemen, Pascal; Pereira, Silvania F.; Urbach, H. Paul; Varghese, Babu

2017-01-01

We demonstrate a low-cost optical method for measuring the gloss properties with improved sensitivity in the low gloss regime, relevant for skin gloss properties. The gloss estimation method is based on, on the one hand, the slope of the intensity gradient in the transition regime between specular and diffuse reflection and on the other on the sum over the intensities of pixels above threshold, derived from a camera image obtained using unpolarized white light illumination. We demonstrate the improved sensitivity of the two proposed methods using Monte Carlo simulations and experiments performed on ISO gloss calibration standards with an optical prototype. The performance and linearity of the method was compared with different professional gloss measurement devices based on the ratio of specular to diffuse intensity. We demonstrate the feasibility for in-vivo skin gloss measurements by quantifying the temporal evolution of skin gloss after application of standard paraffin cream bases on skin. The presented method opens new possibilities in the fields of cosmetology and dermatopharmacology for measuring the skin gloss and resorption kinetics and the pharmacodynamics of various external agents. PMID:29026683

High sensitivity optical measurement of skin gloss.

PubMed

Ezerskaia, Anna; Ras, Arno; Bloemen, Pascal; Pereira, Silvania F; Urbach, H Paul; Varghese, Babu

2017-09-01

We demonstrate a low-cost optical method for measuring the gloss properties with improved sensitivity in the low gloss regime, relevant for skin gloss properties. The gloss estimation method is based on, on the one hand, the slope of the intensity gradient in the transition regime between specular and diffuse reflection and on the other on the sum over the intensities of pixels above threshold, derived from a camera image obtained using unpolarized white light illumination. We demonstrate the improved sensitivity of the two proposed methods using Monte Carlo simulations and experiments performed on ISO gloss calibration standards with an optical prototype. The performance and linearity of the method was compared with different professional gloss measurement devices based on the ratio of specular to diffuse intensity. We demonstrate the feasibility for in-vivo skin gloss measurements by quantifying the temporal evolution of skin gloss after application of standard paraffin cream bases on skin. The presented method opens new possibilities in the fields of cosmetology and dermatopharmacology for measuring the skin gloss and resorption kinetics and the pharmacodynamics of various external agents.

Sustained antibacterial effect of a hand rub gel incorporating chlorhexdine-loaded nanocapsules (Nanochlorex).

PubMed

Nhung, Dang Thi Tuyet; Freydiere, Anne-Marie; Constant, Hélène; Falson, Françoise; Pirot, Fabrice

2007-04-04

In the present study, an original chlorhexidine-loaded nanocapsule-based gel (Nanochlorex) was tested as hand rub gel against the resident skin flora in comparison with 2-propanol 60% (v/v) and 62% (v/v) ethanol-based gel (Purell). After 30-s hand rub, the immediate bactericidal effect of Nanochlorex was found comparable to 2-propanol 60% (v/v) (reduction factor, RF: 0.30+/-0.35 versus 0.38+/-0.55, P>0.05) against aerobic bacteria, whereas the post-values of surviving anaerobes were shown significantly lower from Nanochlorex (P<0.001) and insignificant from 2-propanol 60% (v/v) (P>0.05). Sustained antibacterial effect of Nanochlorex was confirmed against the resident and transient hand flora in two sets of experiment. In the first, the results obtained with the glove-juice technique showed that the bactericidal effect induced by Nanochlorex hand rub persisted throughout 3-h period, while Purell failed to reduce significantly the post-values of surviving bacteria. In the second, repeated artificial contaminations with Staphylococcus epidermidis was carried out onto ex vivo human skin pre-treated by either Nanochlorex or Purell for 5min, then maintained in cell diffusion apparatus for 4h. The log(10) reduction of surviving bacteria was significantly higher with Nanochlorex than that determined with Purell after three successive contaminations (from approximately 5.5 to 1.5 log(10) reduction for Nanochlorex between the first and the third contamination; approximately 1log(10) reduction for Purell throughout the experiment), confirming the sustained antibacterial effect of chlorhexidine-loaded nanocapsule-based gel. The immediate and sustained antibacterial effect of Nanochlorex was explained by chlorhexidine carrier system which improved the drug targeting to bacteria and reduced from osmotic gel further bacterial growth on the skin. Nanochlorex) might constitute a promising approach for hygienic hand disinfection in care practice performing multiple procedures.

Clinical Features and Awareness of Hand Eczema in Korea

PubMed Central

Park, Jae Beom; Lee, Seung Ho; Kim, Kea Jeung; Lee, Ga-Young; Yang, Jun-Mo; Kim, Do Won; Lee, Seok Jong; Lee, Cheol Heon; Park, Eun Joo; Kim, Kyu Han; Eun, Hee Chul; Chang, Sung Eun; Moon, Kee Chan; Kim, Seong Hyun; Kim, Seong Jin; Kim, Byung-Soo; Lee, Jun Young; Kim, Hyung-Ok; Kang, Hoon; Lee, Min Geol; Kim, Soo-Chan; Ro, Young Suck; Ko, Joo Yeon; Park, Mi Youn; Kim, Myung Hwa; Shin, Jeong Hyun; Choi, Hae Young; Hong, Chang Kwun; Lee, Sung Yul; Bak, Hana

2016-01-01

Background Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. Objective To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. Methods To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. Results The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. Conclusion Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment. PMID:27274632

Newly Designed Upper Lateral Cartilage Flap for Preventing Depression of the Keystone Area in Large-Nose Septorhinoplasty.

PubMed

Sharafi, Maryam; Jalessi, Maryam; Adamson, Peter A

2015-01-01

Because large dorsal reduction may weaken the keystone area, later notching of this area should be prevented while reducing large humps during septorhinoplasty. To determine whether a triangular-shaped flap of upper lateral cartilages (ULCs) that we designed can prevent secondary deformity of the nasal dorsum in the keystone area following large hump reduction. In this retrospective study, medical records as well as preoperative and postoperative photographs of septorhinoplasty cases in which triangular flaps had been used between April 1, 2012, and March 3, 2013, were reviewed. Data analysis was conducted from March 3 to May 10, 2014. Demographic data, amount of hump reduction, and any irregularity of the dorsum in the keystone area mentioned in the medical record or identified in postoperative profile view photographs were assessed. The study was conducted in a research center, and the operations were performed in a private setting. Patients had been scheduled for septorhinoplasty with flap reconstruction if more than 3 mm of dorsal hump reduction was planned and their skin was not thin. Of 41 identified patients, 3 could not be monitored for 1 year; 38 patients were included in the analysis. Open septorhinoplasty had been performed, and more than 3 mm of dorsum had been removed in all patients whose data were analyzed. During stepwise resection of the nasal dorsum, a triangular-shaped remnant of the most cephalomedial part of the ULC was maintained intact on each side over the keystone area. Irregularity of the nasal dorsum over the keystone area in postoperative profile view photographs. More than 3 mm of hump reduction had been made in all 38 patients. No irregularities were observed in the postoperative photographs or had been found on digital examination of the keystone area after at least 12 months of follow-up. Maintaining a remnant of the ULC over the keystone area in the form of a triangular-shaped flap on each side is a simple, reliable, and durable way

Human fetal skin fibroblasts: Extremely potent and allogenic candidates for treatment of diabetic wounds.

PubMed

Larijani, Bagher; Ghahari, Aziz; Warnock, Garth L; Aghayan, Hamid Reza; Goodarzi, Parisa; Falahzadeh, Khadijeh; Arjmand, Babak

2015-06-01

The number of patients with diabetes has been expected around 300 million by 2025 and 366 million by 2030 by WHO. On the other hand, diabetic wounds as one of the common complications of diabetes represent major health challenges. Recently, wound care biological products have been proposed for treatment of chronic wounds such as the diabetic wound. Accordingly, tissue-engineered skin substitutes have demonstrated promising effects. Some of these products have used adult skin and neonatal foreskin fibroblasts to produce a tissue-engineered skin substitute. Although adult skin and neonatal foreskin fibroblasts have demonstrated promising effects, but fetal skin fibroblasts and keratinocytes have depicted some unique and considerable properties over adult and neonatal skin cells for instance, skin regeneration with no inflammation and scar formation, low immunogenicity, more VEGF-A secretion than their adult counterparts, immunomodulatory effect by the expression of Indoleamine 2,3 dioxygenase, more resistance to oxidative and physical stresses, etc. On the other hand fetal dermal cells with intrinsic IDO-dependent immunosuppressive activity have introduced them as an allogeneic alternative for treatment of chronic wounds. Therefore, based on the mentioned advantages they are ideal skin substitutes. Accordingly, we suggest that using these cells alone or in combination with biocompatible scaffolds for treatment of different types of ulcers such as diabetic wounds. Copyright © 2015 Elsevier Ltd. All rights reserved.

Use of smartphones and portable media devices for quantifying human movement characteristics of gait, tendon reflex response, and Parkinson's disease hand tremor.

PubMed

LeMoyne, Robert; Mastroianni, Timothy

2015-01-01

Smartphones and portable media devices are both equipped with sensor components, such as accelerometers. A software application enables these devices to function as a robust wireless accelerometer platform. The recorded accelerometer waveform can be transmitted wireless as an e-mail attachment through connectivity to the Internet. The implication of such devices as a wireless accelerometer platform is the experimental and post-processing locations can be placed anywhere in the world. Gait was quantified by mounting a smartphone or portable media device proximal to the lateral malleolus of the ankle joint. Attributes of the gait cycle were quantified with a considerable accuracy and reliability. The patellar tendon reflex response was quantified by using the device in tandem with a potential energy impact pendulum to evoke the patellar tendon reflex. The acceleration waveform maximum acceleration feature of the reflex response displayed considerable accuracy and reliability. By mounting the smartphone or portable media device to the dorsum of the hand through a glove, Parkinson's disease hand tremor was quantified and contrasted with significance to a non-Parkinson's disease steady hand control. With the methods advocated in this chapter, any aspect of human movement may be quantified through smartphones or portable media devices and post-processed anywhere in the world. These wearable devices are anticipated to substantially impact the biomedical and healthcare industry.

Tactile sensitivity of gloved hands in the cold operation.

PubMed

Geng, Q; Kuklane, K; Holmér, I

1997-11-01

In this study, tactile sensitivity of gloved hand in the cold operation has been investigated. The relations among physical properties of protective gloves and hand tactile sensitivity and cold protection were also analysed both objectively and subjectively. Subjects with various gloves participated in the experimental study during cold exposure at different ambient temperatures of -12 degrees C and -25 degrees C. Tactual performance was measured using an identification task with various sizes of objects over the percentage of misjudgment. Forearm, hand and finger skin temperatures were also recorded throughout. The experimental data were analysed using analysis of variance (ANOVA) model and the Tukey's multiple range test. The results obtained indicated that the tactual performance was affected both by gloves and by hands/fingers cooling. Effect of object size on the tactile discrimination was significant and the misjudgment increased when similar sizes of objects were identified, especially at -25 degrees C.

[Study of skin retraction applied to the treatment of skin tumors. Mapping of the human body].

PubMed

Dumas, P; Benatar, M; Cardot-Leccia, N; Lebreton, E; Chignon-Sicard, B

2012-04-01

Skin, the main organ of the human body, is equipped with own biomechanical characteristics, highly variable depending on intra-individual factors (location, weight status, dermatological diseases…) and interindividual (age, sex…). Despite some recent cutometric studies, our review of the literature shows that there is no currently reliable analytical model representing the biomechanical behavior of the skin. Yet, this is a central issue in dermatology surgery, especially in the treatment of skin tumors, for the proper observance of surgical margins. We studied prospectively on 75 resection specimens (about 71 patient(s)), for the treatment of skin lesions tumor suspicious or known malignant or benign. Room dimensions were measured before and 5 minutes after excision, leading us to calculate a ratio of retraction of the skin surface. This retraction was correlated with age, gender, tumor type, and anatomic location of the site of excision. The power of retraction of the skin varies significantly by region of the body. It is maximum in the upper limb (hand excluded) and in the cervical region. At the cephalic region, skin of the ear and periorbital skin have capacities of important early retraction. Unlike the lower limb (foot excluded), the back skin of the nose and face appear to be a minimum of shrinkage. Age also seems to change on that capacity shrinkage, sex would have no influence. Our study confirms the variations in the ability of skin retraction based on a number of factors. In dermato-oncology, that power retraction could cause significant differences between clinical surgical margins and final pathologist margins. We believe it must be taken into account by the couple surgeon-pathologist, especially in the context of invasive and/or recurrent tumors. Copyright © 2012. Published by Elsevier SAS.

Detection and characterization of Histoplasma capsulatum in a German badger (Meles meles) by ITS sequencing and multilocus sequencing analysis

USDA-ARS?s Scientific Manuscript database

A wild badger (Meles meles) with a severe nodular dermatitis was presented for post mortem examination. Numerous cutaneous granulomas with superficial ulceration were present especially on head, dorsum, and forearms were found at necropsy. Histopathological examination of the skin revealed a severe ...

Psoriasis skin biopsy image segmentation using Deep Convolutional Neural Network.

PubMed

Pal, Anabik; Garain, Utpal; Chandra, Aditi; Chatterjee, Raghunath; Senapati, Swapan

2018-06-01

Development of machine assisted tools for automatic analysis of psoriasis skin biopsy image plays an important role in clinical assistance. Development of automatic approach for accurate segmentation of psoriasis skin biopsy image is the initial prerequisite for developing such system. However, the complex cellular structure, presence of imaging artifacts, uneven staining variation make the task challenging. This paper presents a pioneering attempt for automatic segmentation of psoriasis skin biopsy images. Several deep neural architectures are tried for segmenting psoriasis skin biopsy images. Deep models are used for classifying the super-pixels generated by Simple Linear Iterative Clustering (SLIC) and the segmentation performance of these architectures is compared with the traditional hand-crafted feature based classifiers built on popularly used classifiers like K-Nearest Neighbor (KNN), Support Vector Machine (SVM) and Random Forest (RF). A U-shaped Fully Convolutional Neural Network (FCN) is also used in an end to end learning fashion where input is the original color image and the output is the segmentation class map for the skin layers. An annotated real psoriasis skin biopsy image data set of ninety (90) images is developed and used for this research. The segmentation performance is evaluated with two metrics namely, Jaccard's Coefficient (JC) and the Ratio of Correct Pixel Classification (RCPC) accuracy. The experimental results show that the CNN based approaches outperform the traditional hand-crafted feature based classification approaches. The present research shows that practical system can be developed for machine assisted analysis of psoriasis disease. Copyright © 2018 Elsevier B.V. All rights reserved.

Acute compartment syndrome of hand resulting from radiographic contrast iohexol extravasation

PubMed Central

Vinod, Kolar Vishwanath; Shravan, Rampelli; Shrivarthan, Radhakrishnan; Radhakrishna, Pedapati; Dutta, Tarun Kumar

2016-01-01

Intravenous (IV) administration of iodinated contrast agents (ICAs) is frequently employed for image enhancement while performing radiographic studies such as computed tomography and angiography. Complications related to IV administration of ICAs such as immediate hypersensitivity reactions and nephrotoxicity are well-known. However, severe skin and soft tissue injuries and acute compartment syndrome resulting from contrast extravasation are rare. This is especially so with small volume extravasation of a low osmolar, nonionic ICA such as iohexol. Here, we report a 63-year-old woman who developed acute compartment syndrome of left hand following iohexol extravasation and had swelling, blistering, cutaneous and soft tissue necrosis. She underwent fasciotomy for acute compartment syndrome of hand and later surgical debridement of necrotic skin and soft tissues was carried out. Clinical pharmacology of ICAs, extravasation injuries following their IV administration, their management and measures to reduce them are discussed in brief. PMID:27127398

Acute compartment syndrome of hand resulting from radiographic contrast iohexol extravasation.

PubMed

Vinod, Kolar Vishwanath; Shravan, Rampelli; Shrivarthan, Radhakrishnan; Radhakrishna, Pedapati; Dutta, Tarun Kumar

2016-01-01

Intravenous (IV) administration of iodinated contrast agents (ICAs) is frequently employed for image enhancement while performing radiographic studies such as computed tomography and angiography. Complications related to IV administration of ICAs such as immediate hypersensitivity reactions and nephrotoxicity are well-known. However, severe skin and soft tissue injuries and acute compartment syndrome resulting from contrast extravasation are rare. This is especially so with small volume extravasation of a low osmolar, nonionic ICA such as iohexol. Here, we report a 63-year-old woman who developed acute compartment syndrome of left hand following iohexol extravasation and had swelling, blistering, cutaneous and soft tissue necrosis. She underwent fasciotomy for acute compartment syndrome of hand and later surgical debridement of necrotic skin and soft tissues was carried out. Clinical pharmacology of ICAs, extravasation injuries following their IV administration, their management and measures to reduce them are discussed in brief.

Dose Assessments to the Hands of Radiopharmaceutical Workers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ilas, Dan; Eckerman, Keith F; Sherbini, Sami

This paper describes the characterization of radiation doses to the hands of nuclear medicine technicians resulting from the handling of radiopharmaceuticals. Radiation monitoring using ring dosimeters indicates that finger dosimeters may overestimate or underestimate the radiation doses to the skin that are used to show compliance with applicable regulations depending on the nature of the particular procedure and the radioisotope being handled. To better understand the parameters governing the absorbed dose distributions, a detailed model of the hands was created and used in Monte Carlo simulations of selected nuclear medicine procedures. Simulations on realistic configurations typical for workers handling radiopharmaceuticalsmore » were performed for a range of energies of the source photons. The lack of charged-particle equilibrium necessitated full photon-electron coupled transport calculations. The results show that the dose to different regions of the fingers can differ substantially from the dosimeters' readings when the dosimeters are located at the base of the finger. We tried to identify consistent patterns that relate the actual dose to the dosimeter readings. These patterns depend on the specific work conditions and can be used to better assess the absorbed dose to different regions of the exposed skin.« less

A new species of Scinax from the Purus-Madeira interfluve, Brazilian Amazonia (Anura, Hylidae).

PubMed

Ferrão, Miquéias; Moravec, Jiří; de Fraga, Rafael; de Almeida, Alexandre Pinheiro; Kaefer, Igor Luis; Lima, Albertina Pimentel

2017-01-01

A new tree frog species of the genus Scinax from the interfluve between the Purus and Madeira rivers, Brazilian Amazonia, is described and illustrated. The new species is diagnosed by medium body size, snout truncate in dorsal view, ulnar and tarsal tubercles absent, nuptial pads poorly developed, skin on dorsum shagreen, dorsum light brown with dark brown spots and markings, white groin with black spots, anterior and posterior surfaces of thighs black, and iris bright orange. The advertisement call consists of a single short note, with 16-18 pulses and dominant frequency at 1572-1594 Hz. Tadpoles are characterized by body ovoid in dorsal view and triangular in lateral view, tail higher than body, oral disc located anteroventrally and laterally emarginated, dorsum of body uniformly grey-brown with dark brown eye-snout stripe in preservative, fins translucent with small to large irregular diffuse dark brown spots.

A new species of Scinax from the Purus-Madeira interfluve, Brazilian Amazonia (Anura, Hylidae)

PubMed Central

Ferrão, Miquéias; Moravec, Jiří; de Fraga, Rafael; de Almeida, Alexandre Pinheiro; Kaefer, Igor Luis; Lima, Albertina Pimentel

2017-01-01

Abstract A new tree frog species of the genus Scinax from the interfluve between the Purus and Madeira rivers, Brazilian Amazonia, is described and illustrated. The new species is diagnosed by medium body size, snout truncate in dorsal view, ulnar and tarsal tubercles absent, nuptial pads poorly developed, skin on dorsum shagreen, dorsum light brown with dark brown spots and markings, white groin with black spots, anterior and posterior surfaces of thighs black, and iris bright orange. The advertisement call consists of a single short note, with 16−18 pulses and dominant frequency at 1572−1594 Hz. Tadpoles are characterized by body ovoid in dorsal view and triangular in lateral view, tail higher than body, oral disc located anteroventrally and laterally emarginated, dorsum of body uniformly grey-brown with dark brown eye-snout stripe in preservative, fins translucent with small to large irregular diffuse dark brown spots. PMID:29118625

Increased susceptibility of skin from HERDA (Hereditary Equine Regional Dermal Asthenia)-affected horses to bacterial collagenase degradation: a potential contributing factor to the clinical signs of HERDA.

PubMed

Rashmir-Raven, Ann; Lavagnino, Michael; Sedlak, Aleksa; Gardner, Keri; Arnoczky, Steven

2015-12-01

Hereditary equine regional dermal asthenia (HERDA) is a genetic disorder of collagen resulting in fragile, hyper-extensible skin and ulcerative lesions. The predominance of skin lesions have been shown to occur on the dorsum of HERDA-affected horses. While this has been postulated to be due to increased exposure to sunlight of these areas, the precise pathological mechanism which causes this to occur is unclear. We hypothesized that an increase in collagenase activity, that has been associated with the exposure of dermal fibroblasts to sunlight, will significantly degrade the material properties of skin from HERDA-affected horses when compared to unaffected controls. Six unaffected and seven HERDA-affected horses, all euthanized for other reasons. Full-thickness skin samples from similar locations on each horse were collected and cut into uniform strips and their material properties (tensile modulus) determined by mechanical testing before (n = 12 samples/horse) or after (n = 12 samples/horse) incubation in bacterial collagenase at 37°C for 6 h. The change in modulus following treatment was then compared between HERDA-affected and unaffected horses using a Student's t-test. The modulus of skin from HERDA-affected horses decreased significantly more than that from unaffected horses following collagenase treatment (54 ± 7% versus 30 ± 16%, P = 0.004). The significant decrease in the modulus of skin from HERDA-affected horses following collagenase exposure suggests that their altered collagen microarchitecture is more susceptible to enzymatic degradation and may explain the localization of skin lesions in HERDA-affected horses to those areas of the body most exposed to sunlight. These findings appear to support the previously reported benefits of sunlight restriction in HERDA-affected horses. © 2015 ESVD and ACVD.

Dry skin conditions are related to the recovery rate of skin temperature after cold stress rather than to blood flow.

PubMed

Yoshida-Amano, Yasuko; Nomura, Tomoko; Sugiyama, Yoshinori; Iwata, Kayoko; Higaki, Yuko; Tanahashi, Masanori

2017-02-01

Cutaneous blood flow plays an important role in the thermoregulation, oxygen supply, and nutritional support necessary to maintain the skin. However, there is little evidence for a link between blood flow and skin physiology. Therefore, we conducted surveys of healthy volunteers to determine the relationship(s) between dry skin properties and cutaneous vascular function. Water content of the stratum corneum, transepidermal water loss, and visual dryness score were investigated as dry skin parameters. Cutaneous blood flow in the resting state, the recovery rate (RR) of skin temperature on the hand after a cold-stress test, and the responsiveness of facial skin blood flow to local cooling were examined as indices of cutaneous vascular functions. The relationships between dry skin parameters and cutaneous vascular functions were assessed. The RR correlated negatively with the visual dryness score of skin on the leg but correlated positively with water content of the stratum corneum on the arm. No significant correlation between the resting state of blood flow and dry skin parameters was observed. In both the face and the body, deterioration in skin dryness from summer to winter was significant in subjects with low RR. The RR correlated well with the responsiveness of facial skin blood flow to local cooling, indicating that the RR affects systemic dry skin conditions. These results suggest that the RR but not blood flow at the resting state is associated with dry skin conditions and is involved in skin homeostasis during seasonal environmental changes. © 2016 The Authors. International Journal of Dermatology published by John Wiley & Sons Ltd on behalf of International Society of Dermatology.

Spectral radiative properties of a living human body

NASA Astrophysics Data System (ADS)

Terada, N.; Ohnishi, K.; Kobayashi, M.; Kunitomo, T.

1986-09-01

Spectral radiative properties of the human body were studied experimentally in the region from the ultraviolet to the far-infrared to know the thermal response of the human body exposed to solar radiation and infrared radiation. The measuring equipment for reflectance and transmittance of a semitransparent scattering medium was developed and measurement on a living human skin was performed in vivo. The measured parts are forearm, cheek, dorsum hand, hip, and hair. The values obtained by the present study are much different from those of previous in vitro measurements. Fairly large values for hemispherical reflectances are observed in the visible and near-infrared regions but very small values for hemispherical reflectances are observed in the infrared region, below 0.05. By applying the four-flux treatment of radiative transfer, the absorption coefficient and scattering coefficient in the human skin are determined. The scattering coefficient is large in the visible region but negligible in the infrared region. The absorption coefficient is very close to that of water and large in the infrared region.

Skin care: Historical and contemporary views

PubMed Central

AlGhamdi, Khalid M.; AlHomoudi, Fahad A.; Khurram, Huma

2013-01-01

Primary prevention, specifically skin care, is an important principle in Islamic theology just as it is emphasized in contemporary medicine. Many skin diseases can be prevented by a proactive approach to skin care, such as proper hygiene and routine inspections, principles that are constantly highlighted in the Islamic literature. Islam promotes primary prevention of disease, including recommendations for skin care practices. The recommendations for skin care practices in Islamic teachings are analogous to current medical guidelines. Sun avoidance, which is recommended by Islam, is mandatory for diseases such as systemic lupus erythematosus, melasma and skin cancers. Skin care and hygiene practices are recommended in Islam and it is considered an important mechanism for reducing the transmission of infections in modern medicine. The body creases and hair are ideal sites for malicious infestations to grow. The practice of “Wudu” includes washing the hands, feet, and hair with clean water. It is an indispensible part of daily prayers which is mandatory for every Muslim. Oral hygiene is also an integral part of both preventive medicine and Islamic teachings. Genital hygiene, particularly after urination and defecation, is recommended in Islamic teachings and is known to prevent urinary and vaginal infections in contemporary medicine. Male circumcision is an Islamic practice. Recently, it was proven that circumcised men are less likely to have sexually transmitted diseases, including HIV. This paper reviews skin care from an Islamic perspective and its relevance to contemporary medicine by translating the simple self care principles into practical guidelines in everyday use. PMID:25061400

Cold hands, warm feet: sleep deprivation disrupts thermoregulation and its association with vigilance.

PubMed

Romeijn, Nico; Verweij, Ilse M; Koeleman, Anne; Mooij, Anne; Steimke, Rosa; Virkkala, Jussi; van der Werf, Ysbrand; Van Someren, Eus J W

2012-12-01

Vigilance is affected by induced and spontaneous skin temperature fluctuations. Whereas sleep deprivation strongly affects vigilance, no previous study examined in detail its effect on human skin temperature fluctuations and their association with vigilance. In a repeated-measures constant routine design, skin temperatures were assessed continuously from 14 locations while performance was assessed using a reaction time task, including eyes-open video monitoring, performed five times a day for 2 days, after a normal sleep or sleep deprivation night. Participants were seated in a dimly lit, temperature-controlled laboratory. Eight healthy young adults (five males, age 22.0 ± 1.8 yr (mean ± standard deviation)). One night of sleep deprivation. Mixed-effect regression models were used to evaluate the effect of sleep deprivation on skin temperature gradients of the upper (ear-mastoid), middle (hand-arm), and lower (foot-leg) body, and on the association between fluctuations in performance and in temperature gradients. Sleep deprivation induced a marked dissociation of thermoregulatory skin temperature gradients, indicative of attenuated heat loss from the hands co-occurring with enhanced heat loss from the feet. Sleep deprivation moreover attenuated the association between fluctuations in performance and temperature gradients; the association was best preserved for the upper body gradient. Sleep deprivation disrupts coordination of fluctuations in thermoregulatory skin temperature gradients. The dissociation of middle and lower body temperature gradients may therefore be evaluated as a marker for sleep debt, and the upper body gradient as a possible aid in vigilance assessment when sleep debt is unknown. Importantly, our findings suggest that sleep deprivation affects the coordination between skin blood flow fluctuations and the baroreceptor-mediated cardiovascular regulation that prevents venous pooling of blood in the lower limbs when there is the orthostatic

Acral peeling skin syndrome: a case of two brothers.

PubMed

Wakade, Oojwala; Adams, Beth; Shwayder, Tor

2009-01-01

We report two brothers of Middle Eastern descent with consanguineous parents who present with numerous fragile, flaccid blisters on the hands and feet. In addition to spontaneous peeling, they can manually peel skin from acral areas without pain. The symptoms worsen with warm temperatures, excessive water exposure, and perspiration. Two biopsies from flaccid blisters on the feet were taken from the older brother, which revealed cleavage at the level of the stratum corneum. A diagnosis of acral peeling skin syndrome was made.

Method and apparatus to measure the depth of skin burns

DOEpatents

Dickey, Fred M.; Holswade, Scott C.

2002-01-01

A new device for measuring the depth of surface tissue burns based on the rate at which the skin temperature responds to a sudden differential temperature stimulus. This technique can be performed without physical contact with the burned tissue. In one implementation, time-dependent surface temperature data is taken from subsequent frames of a video signal from an infrared-sensitive video camera. When a thermal transient is created, e.g., by turning off a heat lamp directed at the skin surface, the following time-dependent surface temperature data can be used to determine the skin burn depth. Imaging and non-imaging versions of this device can be implemented, thereby enabling laboratory-quality skin burn depth imagers for hospitals as well as hand-held skin burn depth sensors the size of a small pocket flashlight for field use and triage.

Chemically induced skin carcinogenesis: Updates in experimental models (Review)

PubMed Central

NEAGU, MONICA; CARUNTU, CONSTANTIN; CONSTANTIN, CAROLINA; BODA, DANIEL; ZURAC, SABINA; SPANDIDOS, DEMETRIOS A.; TSATSAKIS, ARISTIDIS M.

2016-01-01

Skin cancer is one of the most common malignancies affecting humans worldwide, and its incidence is rapidly increasing. The study of skin carcinogenesis is of major interest for both scientific research and clinical practice and the use of in vivo systems may facilitate the investigation of early alterations in the skin and of the mechanisms involved, and may also lead to the development of novel therapeutic strategies for skin cancer. This review outlines several aspects regarding the skin toxicity testing domain in mouse models of chemically induced skin carcinogenesis. There are important strain differences in view of the histological type, development and clinical evolution of the skin tumor, differences reported decades ago and confirmed by our hands-on experience. Using mouse models in preclinical testing is important due to the fact that, at the molecular level, common mechanisms with human cutaneous tumorigenesis are depicted. These animal models resemble human skin cancer development, in that genetic changes caused by carcinogens and pro-inflammatory cytokines, and simultaneous inflammation sustained by pro-inflammatory cytokines and chemokines favor tumor progression. Drugs and environmental conditions can be tested using these animal models. keeping in mind the differences between human and rodent skin physiology. PMID:26986013

[Acute skin infections and their imitators in children : A photo quiz].

PubMed

Theiler, M; Schwieger-Briel, A; Weibel, L

2017-10-01

Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed. To illustrate frequent pediatric skin infections and pitfalls in view of imitators and differential diagnoses. A photo quiz is presented with the discussion of a selection of acute pediatric skin infections in comparison to their infectious or noninfectious differential diagnoses. The following infectious skin conditions and imitators are described and clinical clues for differentiation highlighted: eczema herpeticum and bacterial superinfection of atopic dermatitis; exanthematous hand, foot and mouth disease and varicella infection; erythema chronicum multilocularis and anular urticaria; Gianotti-Crosti syndrome and Gianotti-Crosti-like reaction; bacterial folliculitis of the scalp and kerion celsi and eosinophilic pustular folliculitis of the scalp; cutaneous Leishmaniasis and idiopathic facial aseptic granuloma; allergic and bacterial lymphangitis; bullous impetigo contagiosa and nonaccidental scalding. Careful anamnesis and skin examination with attention to the here illustrated differential diagnoses are essential to avoid pitfalls in the evaluation of acute pediatric skin infections.

The effect of an instant hand sanitizer on blood glucose monitoring results.

PubMed

Mahoney, John J; Ellison, John M; Glaeser, Danielle; Price, David

2011-11-01

People with diabetes mellitus are instructed to clean their skin prior to self-monitoring of blood glucose to remove any dirt or food residue that might affect the reading. Alcohol-based hand sanitizers have become popular when soap and water are not available. The aim of this study was to determine whether a hand sanitizer is compatible with glucose meter testing and effective for the removal of exogenous glucose. We enrolled 34 nonfasting subjects [14 male/20 female, mean ages 45 (standard deviation, 9.4)] years, 2 with diagnosed diabetes/32 without known diabetes]. Laboratory personnel prepared four separate fingers on one hand of each subject by (1) cleaning the second finger with soap and water and towel drying (i.e., control finger), (2) cleaning the third finger with an alcohol-based hand sanitizer, (3) coating the fourth finger with cola and allowing it to air dry, and (4) coating the fifth finger with cola and then cleaning it with the instant hand sanitizer after the cola had dried. Finger sticks were performed on each prepared finger and blood glucose was measured. Several in vitro studies were also performed to investigate the effectiveness of the hand sanitizer for removal of exogenous glucose.z Mean blood glucose values from fingers cleaned with instant hand sanitizer did not differ significantly from the control finger (p = .07 and .08, respectively) and resulted in 100% accurate results. Blood glucose data from the fourth (cola-coated) finger were substantially higher on average compared with the other finger conditions, but glucose data from the fifth finger (cola-coated then cleaned with hand sanitizer) was similar to the control finger. The data from in vitro experiments showed that the hand sanitizer did not adversely affect glucose meter results, but when an exogenous glucose interference was present, the effectiveness of the hand sanitizer on glucose bias (range: 6% to 212%) depended on the surface area and degree of dilution. In our study

The Effect of an Instant Hand Sanitizer on Blood Glucose Monitoring Results

PubMed Central

Mahoney, John J; Ellison, John M; Glaeser, Danielle; Price, David

2011-01-01

Background People with diabetes mellitus are instructed to clean their skin prior to self-monitoring of blood glucose to remove any dirt or food residue that might affect the reading. Alcohol-based hand sanitizers have become popular when soap and water are not available. The aim of this study was to determine whether a hand sanitizer is compatible with glucose meter testing and effective for the removal of exogenous glucose. Methods We enrolled 34 nonfasting subjects [14 male/20 female, mean ages 45 (standard deviation, 9.4)] years, 2 with diagnosed diabetes/32 without known diabetes]. Laboratory personnel prepared four separate fingers on one hand of each subject by (1) cleaning the second finger with soap and water and towel drying (i.e., control finger), (2) cleaning the third finger with an alcohol-based hand sanitizer, (3) coating the fourth finger with cola and allowing it to air dry, and (4) coating the fifth finger with cola and then cleaning it with the instant hand sanitizer after the cola had dried. Finger sticks were performed on each prepared finger and blood glucose was measured. Several in vitro studies were also performed to investigate the effectiveness of the hand sanitizer for removal of exogenous glucose.z Results Mean blood glucose values from fingers cleaned with instant hand sanitizer did not differ significantly from the control finger (p = .07 and .08, respectively) and resulted in 100% accurate results. Blood glucose data from the fourth (cola-coated) finger were substantially higher on average compared with the other finger conditions, but glucose data from the fifth finger (cola-coated then cleaned with hand sanitizer) was similar to the control finger. The data from in vitro experiments showed that the hand sanitizer did not adversely affect glucose meter results, but when an exogenous glucose interference was present, the effectiveness of the hand sanitizer on glucose bias (range: 6% to 212%) depended on the surface area and degree of

Heat loss through the glabrous skin surfaces of heavily insulated, heat-stressed individuals.

PubMed

Grahn, D A; Dillon, J L; Heller, H C

2009-07-01

Insulation reduces heat exchange between a body and the environment. Glabrous (nonhairy) skin surfaces (palms of the hands, soles of the feet, face, and ears) constitute a small percentage of total body surface area but contain specialized vascular structures that facilitate heat loss. We have previously reported that cooling the glabrous skin surfaces is effective in alleviating heat stress and that the application of local subatmospheric pressure enhances the effect. In this paper, we compare the effects of cooling multiple glabrous skin surfaces with and without vacuum on thermal recovery in heavily insulated heat-stressed individuals. Esophageal temperatures (T(es)) and heart rates were monitored throughout the trials. Water loss was determined from pre- and post-trial nude weights. Treadmill exercise (5.6 km/h, 9-16% slope, and 25-45 min duration) in a hot environment (41.5 degrees C, 20-30% relative humidity) while wearing insulating pants and jackets was used to induce heat stress (T(es)>or=39 degrees C). For postexercise recovery, the subjects donned additional insulation (a balaclava, winter gloves, and impermeable boot covers) and rested in the hot environment for 60 min. Postexercise cooling treatments included control (no cooling) or the application of a 10 degrees C closed water circulating system to (a) the hand(s) with or without application of a local subatmospheric pressure, (b) the face, (c) the feet, or (d) multiple glabrous skin regions. Following exercise induction of heat stress in heavily insulated subjects, the rate of recovery of T(es) was 0.4+/-0.2 degrees C/h(n=12), but with application of cooling to one hand, the rate was 0.8+/-0.3 degrees C/h(n=12), and with one hand cooling with subatmospheric pressure, the rate was 1.0+/-0.2 degrees C/h(n=12). Cooling alone yielded two responses, one resembling that of cooling with subatmospheric pressure (n=8) and one resembling that of no cooling (n=4). The effect of treating multiple surfaces was

Cutaneous reflexes in small muscles of the hand

PubMed Central

Caccia, M. R.; McComas, A. J.; Upton, A. R. M.; Blogg, T.

1973-01-01

A study has been made of the responses of motoneurones innervating small muscles of the hand to electrical and mechanical stimulation of the skin. Both excitatory and inhibitory effects could be observed in the same muscle after a single stimulus to a given area of skin. The earliest excitatory and inhibitory responses are probably mediated by group III and the smaller group II afferent nerve fibres. A later inhibition results from activity in the larger group II fibres which are connected to cutaneous mechanoreceptors, especially those in the tips of the fingers and thumb. This late inhibitory reflex may operate through the fusimotor system. The possible roles of these reflexes are discussed in relation to previous investigations in man and the cat. PMID:4272546

[Prevention of acute purulent inflammatory diseases of the fingers and hand with decamethoxine].

PubMed

Kravets, V P

1992-01-01

Resulting from disease-prevention work among population of the district, use of BF-6D glue for treatment of microtraumas to skin of the hands, the number of patients with inflammatory diseases reduced by 14.7%.

Evolution of instruments for harvest of the skin grafts

PubMed Central

Ameer, Faisal; Singh, Arun Kumar; Kumar, Sandeep

2013-01-01

Background: The harvest of autologous skin graft is considered to be a fundamental skill of the plastic surgeon. The objective of this article is to provide an interesting account of the development of skin grafting instruments as we use them today in various plastic surgical procedures. Materials and Methods: The authors present the chronological evolution and modifications of the skin grafting knife, including those contributions not often cited in the literature, using articles sourced from MEDLINE, ancient manuscripts, original quotes, techniques and illustrations. Results: This article traces the evolution of instrumentation for harvest of skin grafts from free hand techniques to precise modern automated methods. Conclusions: Although skin grafting is one of the basic techniques used in reconstructive surgery yet harvest of a uniform graft of desired thickness poses a challenge. This article is dedicated to innovators who have devoted their lives and work to the advancement of the field of plastic surgery. PMID:23960303

Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review protocol.

PubMed

Papadatou, Zoi; Cooper, Kay; Klein, Susan; MacDuff, Colin; Steiner, Markus

2016-10-01

The objective of this quantitative systematic review is to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed) in preventing occupational irritant hand dermatitis (OIHD) in wet workers. These interventions will be compared to an alternative intervention or to usual care (workers regular skin care regime). The specific review question is: "What is the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions in preventing OIHD in wet workers?"

A proposed protocol for hand and table sanitizing in chiropractic clinics and education institutions

PubMed Central

Evans, Marion Willard; Ramcharan, Michael; Floyd, Rod; Globe, Gary; Ndetan, Harrison; Williams, Ronald; Ivie, Ronald

2009-01-01

Abstract Objective By nature, chiropractic is a hands-on profession using manipulation applied to the joints with direct skin-to-skin contacts. Chiropractic tables are designed with a face piece to accommodate the prone patient's head in a neutral position and hand rests to allow for relaxed shoulders and upper spine so treatment is facilitated. The purpose of this article is to present a proposed guideline for hand and treatment table surface sanitizing for the chiropractic profession that is evidence-based and can easily be adopted by teaching institutions and doctors in the field. Methods A review of the chiropractic literature demonstrated that pathogenic microbes are present on treatment tables in teaching clinics at multiple facilities, yet no standardized protocols exist in the United States regarding table sanitizing and hand hygiene in chiropractic clinics or education institutions. This article reviews the scientific literature on the subject by using several search engines, databases, and specific reviews of documents pertaining to the topic including existing general guidelines. Results The literature has several existing guidelines that the authors used to develop a proposed protocol for hand and table sanitizing specific to the chiropractic profession. Recommendations were developed and are presented on hand hygiene and table sanitizing procedures that could lower the risk of infection for both clinical personnel and patients in chiropractic facilities. Conclusion This article offers a protocol for hand and table sanitizing in chiropractic clinics and education institutions. The chiropractic profession should consider adoption of these or similar measures and disseminate them to teaching clinics, institutions, and private practitioners. PMID:19646384

Adult Kawasaki's disease with myocarditis, splenomegaly, and highly elevated serum ferritin levels.

PubMed

Cunha, Burke A; Pherez, Francisco M; Alexiadis, Varvara; Gagos, Marios; Strollo, Stephanie

2010-01-01

Kawasaki's disease is a disease of unknown cause. The characteristic clinical features of Kawasaki's disease are fever> or =102 degrees F for> or =5 days accompanied by a bilateral bulbar conjunctivitis/conjunctival suffusion, erythematous rash, cervical adenopathy, pharyngeal erythema, and swelling of the dorsum of the hands/feet. Kawasaki's disease primarily affects children and is rare in adults. In children, Kawasaki's disease is more likely to be associated with aseptic meningitis, coronary artery aneurysms, and thrombocytosis. In adult Kawasaki's disease, unilateral cervical adenopathy, arthritis, conjunctival suffusion/conjunctivitis, and elevated serum transaminases (serum glutamic oxaloacetic transaminase [SGOT]/serum glutamate pyruvate transaminase [SGPT]) are more likely. Kawasaki's disease in adults may be mimicked by other acute infections with fever and rash, that is, group A streptococcal scarlet fever, toxic shock syndrome (TSS), and Rocky Mountain Spotted Fever (RMSF). Because there are no specific tests for Kawasaki's disease, diagnosis is based on clinical criteria and the syndromic approach. In addition to rash and fever, scarlet fever is characterized by circumoral pallor, oropharyngeal edema, Pastia's lines, and peripheral eosinophilia, but not conjunctival suffusion, splenomegaly, swelling of the dorsum of the hands/feet, thrombocytosis, or an elevated SGOT/SGPT. In TSS, in addition to rash and fever, there is conjunctival suffusion, oropharyngeal erythema, and edema of the dorsum of the hands/feet, an elevated SGOT/SGPT, and thrombocytopenia. Patients with TSS do not have cervical adenopathy or splenomegaly. RMSF presents with fever and a maculopapular rash that becomes petechial, first appearing on the wrists/ankles after 3 to 5 days. RMSF is accompanied by a prominent headache, periorbital edema, conjunctival suffusion, splenomegaly, thrombocytopenia, an elevated SGOT/SGPT, swelling of the dorsum of the hands/feet, but not oropharyngeal

Skin-specific training experience of workers assessed for contact dermatitis.

PubMed

Zack, B; Arrandale, V; Holness, D L

2018-05-17

Contact dermatitis is a common and preventable work-related disease. Skin-specific training may be effective for preventing occupational contact dermatitis, but little information is available regarding actual workplace training and its effectiveness. To describe workplace skin-specific training among workers with suspected contact dermatitis. Patch test patients being assessed for suspected contact dermatitis at an occupational health clinic in Toronto, Canada, completed a questionnaire on training experiences, workplace characteristics, exposures and skin protection practices. Of 175 patients approached, 122 (71%) workers completed questionnaires. Many (80%) had received general occupational health and safety and hazardous materials training (76%). Fewer (39%) received skin-specific training. Of those with work-related contact dermatitis, 52% did not receive skin-specific training. Skin-specific training was commonly provided by health and safety professionals or supervisors using video, classroom and online techniques. Content included glove use, exposure avoidance and hand washing information. Workers that received skin-specific training found it memorable (87%), useful (85%) and common sense in nature (100%). This study indicates gaps in workplace training on skin disease prevention for workers with contact dermatitis. Workers perceived skin-specific training to be useful. Understanding worker training experiences is important to prevention programme development and reducing work-related skin disease.

Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza.

PubMed

Inaida, S; Shobugawa, Y; Matsuno, S; Saito, R; Suzuki, H

2016-09-01

Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010. We suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay. We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap. The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.

Acral peeling skin syndrome resembling epidermolysis bullosa simplex in a 10-month-old boy.

PubMed

Kavaklieva, S; Yordanova, I; Bruckner-Tuderman, L; Has, C

2013-01-01

The acral peeling skin syndrome (APSS) is a rare autosomal recessive disorder clinically characterized by asymptomatic desquamation of the skin limited to the hands and feet and histologically by cleavage at the stratum granulosum and stratum corneum level [Kiritsi et al.: J Invest Dermatol 2010;130:1741-1746]. We report on a 10-month-old boy with a history of skin peeling limited to the hands and feet since 2 months of age. Clinical examination revealed erythematous erosions with peripheral desquamation and flaccid blisters. DNA mutation analysis detected two heterozygous TGM5 mutations: c.2T>C, p.M1T in exon 1 and c.337G>T, p.G113C in exon 3 in keeping with the diagnosis of APSS. The clinical presentation of APSS alone might be confusing and strongly resemble epidermolysis bullosa simplex making the differential diagnosis difficult.

Self-reported skin diseases, quality of life and medication use: a nationwide pharmaco-epidemiological survey in Sweden.

PubMed

Lindberg, Magnus; Isacson, Dag; Bingefors, Kerstin

2014-03-01

The aim of this study was to determine self-reported consumption of dermatological pharmaceuticals and quality of life (QoL), measured with Short Form 36, in relation to eczema, acne, psoriasis and other inflammatory skin conditions in the Swedish population. A questionnaire containing questions on the occurrence of skin diseases, health-related QoL and the use of pharmaceuticals was sent to a cross-sectional sample of the Swedish population, age range 18-84 years (n = 8,000). The response rate was 61%. The 1-year prevalence of skin diseases was 30-35%, with females reporting a higher prevalence. The prevalence was 11.5% for eczema other than hand eczema, 10.2% for acne, 7.5% for hand eczema, 3.9% for psoriasis and 3.1% for urticaria. QoL was significantly affected and 25% of females and 19% of males had used a dermatological drug. Compared with hand eczema, persons with psoriasis and other eczema reported significantly more use of topical steroids on prescription and more use of dermatological pharmaceuticals in total. Skin conditions are common; they affect QoL and lead to a high consumption of dermatological drugs; which deserves increased awareness in the society.

A new recreational mechanism for the boxer's knuckle: cause for concern?

PubMed

Javed, M; Hemington-Gorse, S; Shokrollahi, K

2011-07-01

Traumatic injuries of the metacarpophalangeal joints are a common occurrence in professional and recreational sports such as boxing and martial arts, especially the fourth and fifth metacarpals. Injury usually results from a forceful impact with a clenched fist. The spectrum of injuries varies from simple skin laceration to extensor mechanism disruption, dorsal capsule rupture, metacarpal fractures and carpometacarpal joint injuries. These injuries are well documented in boxers as well as in patients who had been involved in fights and assaults. We report on two patients sustaining similar injuries to the dorsum of the hand but following punching of a recreational 'punching machine'. We describe the patterns of injury encountered and summarise the treatment. For clinical and safety reasons as well as the potential medicolegal implications, we believe it is important to highlight this mechanism of injury.

A new recreational mechanism for the boxer’s knuckle: cause for concern?

PubMed Central

Hemington-Gorse, S; Shokrollahi, K

2011-01-01

Traumatic injuries of the metacarpophalangeal joints are a common occurrence in professional and recreational sports such as boxing and martial arts, especially the fourth and fifth metacarpals. Injury usually results from a forceful impact with a clenched fist. The spectrum of injuries varies from simple skin laceration to extensor mechanism disruption, dorsal capsule rupture, metacarpal fractures and carpometacarpal joint injuries. These injuries are well documented in boxers as well as in patients who had been involved in fights and assaults. We report on two patients sustaining similar injuries to the dorsum of the hand but following punching of a recreational ’punching machine’. We describe the patterns of injury encountered and summarise the treatment. For clinical and safety reasons as well as the potential medicolegal implications, we believe it is important to highlight this mechanism of injury. PMID:21943451

Laypersons' perceptual discrimination of pigmented skin lesions.

PubMed

Bränström, Richard; Hedblad, Mari-Anne; Krakau, Ingvar; Ullén, Henrik

2002-05-01

Most cutaneous malignant melanomas of the skin are visible and should, at least in theory, be possible to detect with the naked eye. This study was conducted to learn more about laypersons' ability to discriminate between benign pigmented lesions and malignant ones. Four groups of laypersons (n = 120) were asked to evaluate pictures of different types of pigmented skin lesions, before and after they received information about the ABCD (asymmetry, border irregularity, color variegation, and diameter greater than 6 mm) criteria, with respect to the necessity of action. The respondents made adequate assessments of melanomas but overestimated the danger of benign pigmented skin lesions. Information about the ABCD criteria enhanced their ability to make adequate assessments. People seem to make adequate decisions concerning how to act if they have a melanoma. On the other hand, common moles and dysplastic nevi were harder to discriminate. Providing information to the public about the features of melanomas, in accordance with the ABCD criteria, might help laypersons in their perceptual discrimination of skin lesions.

[Reparative regeneration of rat skin under influence of hollow cathode lamp (HCL) with manganese and copper line spectrum emission].

PubMed

Mel'nikova, V I; Izvol'skaia, M S; Voronova, S N; Sharipova, M M; Rukin, E M; Zakharova, L A

2010-01-01

Influence of local light exposure by hollow cathode lamp with typical manganese and copper (HCL-Mn, Cu) line emission spectrum on posttraumatic regeneration rate of rat skin has been investigated. We performed the comparative analysis of the morphology and the differentiation ability of rat skin on the 15th and 24th days after full-thickness skin wound had been inflicted on rat dorsums. On the 15th day after injury, the experimental group (daily 30 s exposure for two weeks) showed scab loss, re-epithelialization, and hair regrowth, in contrast to the control rats, where scabs were still observed on the 24th day. Histological analysis revealed that in contrast to the control group the treatment with HCL-Mn, Cu resulted in the increased number of hair follicles and sebaceous glands, the decreased number of blood vessels and horizontal orientation of collagen fibers. The immunohistochemistry for OX-62 revealed that the number of dermal dendritic cells in the experimental groups was maximal on the 15th day, and then decreased to the 24th day after injury. The number of dermal dendritic cells was significantly lower in the control group. The immunohistochemistry for pan-keratins in the control animals revealed a high number of cells expressing different types of keratins, distributed in the main part of the epidermis on the 15th day after surgery, whereas in the experimental group the number of such cells was significantly lower and the cells were concentrated more close to the external part of the epidermis. The number of cells stained for keratin 19 was higher in the experimental group on the 15th day after surgery, whereas this number decreased in this group on the 24th day after surgery as compared to the control group. Thus, typical manganese and copper line spectrum emission emitted by hollow cathode lamp stimulates innate immunity, accelerates restoration of derma, skin epithelium and other skin derivates, and stimulates wound healing in general.

Projecting sensations to external objects: evidence from skin conductance response.

PubMed

Armel, K Carrie; Ramachandran, V S

2003-07-22

Subjects perceived touch sensations as arising from a table (or a rubber hand) when both the table (or the rubber hand) and their own real hand were repeatedly tapped and stroked in synchrony with the real hand hidden from view. If the table or rubber hand was then 'injured', subjects displayed a strong skin conductance response (SCR) even though nothing was done to the real hand. Sensations could even be projected to anatomically impossible locations. The illusion was much less vivid, as indicated by subjective reports and SCR, if the real hand was simultaneously visible during stroking, or if the real hand was hidden but touched asynchronously. The fact that the illusion could be significantly diminished when the real hand was simultaneously visible suggests that the illusion and associated SCRs were due to perceptual assimilation of the table (or rubber hand) into one's body image rather than associative conditioning. These experiments demonstrate the malleability of body image and the brain's remarkable capacity for detecting statistical correlations in the sensory input.

Projecting sensations to external objects: evidence from skin conductance response.

PubMed Central

Armel, K Carrie; Ramachandran, V S

2003-01-01

Subjects perceived touch sensations as arising from a table (or a rubber hand) when both the table (or the rubber hand) and their own real hand were repeatedly tapped and stroked in synchrony with the real hand hidden from view. If the table or rubber hand was then 'injured', subjects displayed a strong skin conductance response (SCR) even though nothing was done to the real hand. Sensations could even be projected to anatomically impossible locations. The illusion was much less vivid, as indicated by subjective reports and SCR, if the real hand was simultaneously visible during stroking, or if the real hand was hidden but touched asynchronously. The fact that the illusion could be significantly diminished when the real hand was simultaneously visible suggests that the illusion and associated SCRs were due to perceptual assimilation of the table (or rubber hand) into one's body image rather than associative conditioning. These experiments demonstrate the malleability of body image and the brain's remarkable capacity for detecting statistical correlations in the sensory input. PMID:12965016

[Hand injuries in the ready-made clothing industry].

PubMed

Khelil, E; Hichem, C; Saïd, B; Moez, B; Mahdi, D; Lamjed, T; Hichem, B

1999-11-01

We collect during 1997, 30 work accidents in the ready-wade clothe sector. These accidents have concerned 28 females and 2 males with a mean age of 21 years. Injury affect predominatly the left hand (17 patients) and the finger of pince. Severity of the lesions was variable according to the traumatic cause. In the distal fingers trauma, skin cicatrisation have been observed after 21 days and bone consolidation within 45 days.

Effect of venous and lymphatic congestion on lymph capillary pressure of the skin in healthy volunteers and patients with lymph edema.

PubMed

Gretener, S B; Läuchli, S; Leu, A J; Koppensteiner, R; Franzeck, U K

2000-01-01

The aim of the present study was to assess the influence of venous and lymphatic congestion on lymph capillary pressure (LCP) in the skin of the foot dorsum of healthy volunteers and of patients with lymph edema. LCP was measured at the foot dorsum of 12 patients with lymph edema and 18 healthy volunteers using the servo-nulling technique. Glass micropipettes (7-9 microm) were inserted under microscopic control into lymphatic microvessels visualized by fluorescence microlymphography before and during venous congestion. Venous and lymphatic congestion was attained by cuff compression (50 mm Hg) at the thigh level. Simultaneously, the capillary filtration rate was measured using strain gauge plethysmography. The mean LCP in patients with lymph edema increased significantly (p < 0.05) during congestion (15.7 +/- 8.8 mm Hg) compared to the control value (12.2 +/- 8.9 mm Hg). The corresponding values of LCP in healthy volunteers were 4.3 +/- 2.6 mm Hg during congestion and 2.6 +/- 2.8 mm Hg during control conditions (p < 0.01). The mean increase in LCP in patients with lymph edema was 3.4 +/- 4.1 mm Hg, and 1.7 +/- 2.0 mm Hg in healthy volunteers (NS). The maximum spread of the lymph capillary network in patients increased from 13.9 +/- 6.8 mm before congestion to 18.8 +/- 8.2 mm during thigh compression (p < 0.05). No increase could be observed in healthy subjects. In summary, venous and lymphatic congestion by cuff compression at the thigh level results in a significant increase in LCP in healthy volunteers as well as in patients with lymph edema. The increased spread of the contrast medium in the superficial microlymphatics in lymph edema patients indicates a compensatory mechanism for lymphatic drainage during congestion of the veins and lymph collectors of the leg. Copyright 2000 S. Karger AG, Basel

Optimizing skin protection with semipermeable gloves.

PubMed

Wulfhorst, Britta; Schwanitz, Hans Joachim; Bock, Meike

2004-12-01

Occlusion due to gloves is one important cause of glove irritation. Macerated softened skin gives poor protection against microbes and chemical injuries. The introduction of a breathable protective glove material would represent a significant step toward improved prevention of occupational skin disease. Performance levels of semipermeable and occlusive gloves were examined under conditions typical of the hairdressing profession. In two studies, tests comparing breathable semipermeable gloves to single-use gloves made of occlusive materials were conducted. In an initial study, a user survey was carried out in conjunction with bioengineering examinations. Values at baseline and values after gloves were worn were recorded by measuring transepidermal water loss (TEWL), skin humidity (SH), and skin surface hydrogen ion concentration (pH) in 20 healthy volunteers. In a second study, the gloves were tested for penetrability and permeability with three chemical compounds typically used in the hairdressing profession. Bioengineering examination objectively confirmed users' reports of reduced hand perspiration when semipermeable gloves were worn. The TEWL, SH, and skin surface pH values remained largely stable after 20 minutes of wearing semipermeable gloves, in contrast to the reactions observed with gloves of occlusive materials. Permeability tests indicated that the semipermeable material is effective, with some restrictions. Air leakage testing revealed that all 50 gloves tested were not airtight. Following the optimization of manufacturing methods, additional tests of the penetrability of semipermeable gloves will be necessary.

Skin sensitization quantitative risk assessment for occupational exposure of hairdressers to hair dye ingredients.

PubMed

Goebel, Carsten; Diepgen, Thomas L; Blömeke, Brunhilde; Gaspari, Anthony A; Schnuch, Axel; Fuchs, Anne; Schlotmann, Kordula; Krasteva, Maya; Kimber, Ian

2018-06-01

Occupational exposure of hairdressers to hair dyes has been associated with the development of allergic contact dermatitis (ACD) involving the hands. p-Phenylenediamine (PPD) and toluene-2,5-diamine (PTD) have been implicated as important occupational contact allergens. To conduct a quantitative risk assessment for the induction of contact sensitization to hair dyes in hairdressers, available data from hand rinsing studies following typical occupational exposure conditions to PPD, PTD and resorcinol were assessed. By accounting for wet work, uneven exposure and inter-individual variability for professionals, daily hand exposure concentrations were derived. Secondly, daily hand exposure was compared with the sensitization induction potency of the individual hair dye defined as the No Expected Sensitization Induction Levels (NESIL). For PPD and PTD hairdresser hand exposure levels were 2.7 and 5.9 fold below the individual NESIL. In contrast, hand exposure to resorcinol was 50 fold below the NESIL. Correspondingly, the risk assessment for PPD and PTD indicates that contact sensitization may occur, when skin protection and skin care are not rigorously applied. We conclude that awareness of health risks associated with occupational exposure to hair dyes, and of the importance of adequate protective measures, should be emphasized more fully during hairdresser education and training. Copyright © 2018 Elsevier Inc. All rights reserved.

Exposure of amateur gardeners to pesticides via the non-gloved skin per day.

PubMed

Beránková, Martina; Hojerová, Jarmila; Melegová, Linda

2017-10-01

To predict a risk to gardeners not wearing protective gloves, the dermal absorption of three active insecticides was assessed in vitro using porcine ear-skin simulating 1-h handling of diluted plant protection products. Acetamiprid and Pirimicarb were found in the receptor fluid immediately after 1-h skin exposure, whereas Chlorpyrifos-methyl absorbed in the skin was not released into the receptor fluid even after 23 hours. The Estimated Gardener Exposure Level (EGEL) at 23 hours after 1-h exposure for two worst-case scenarios (i) non-gloved hands; (ii) non-gloved hands/uncovered forearms, was (i) 0.002, 0.042, and 0.057; (ii) 0.006, 0.101, and 0.135 mg/kg bw/day for Acetamiprid, Pirimicarb, and Chlorpyrifos-methyl, respectively, although the systemically available Chlorpyrifos-methyl amount, due to retention in the skin, is probably lower than determined. The Gardener Exposure Risk (GER), as a ratio of Acceptable Operator Exposure Level (databased values) to EGEL, for Acetamiprid was (i) 35 and 12-fold higher than the limit 1, so the risk via the skin is assumed to be low. Based on the GER values of (i) 0.83 and 0.18; (ii) 0.34 and 0.07 (i.e.<1) for Pirimicarb and Chlorpyrifos-methyl, respectively there is a level of concern regarding the health risk to gardeners handling pesticide products without skin protection. Copyright © 2017 Elsevier Ltd. All rights reserved.

Am I Still too Black for You?: Schooling and Secular Change in Skin Tone Effects

ERIC Educational Resources Information Center

Loury, Linda Datcher

2009-01-01

Analysts disagree about whether the Civil Rights/Black Power eras lessened the influence of skin tone on education. The paper finds that, holding family background constant, the educational disadvantages of dark and very dark blacks persisted between younger and older age cohorts. On the other hand, younger medium skin blacks no longer achieved…

Acral Peeling Skin Syndrome Resembling Epidermolysis Bullosa Simplex in a 10-Month-Old Boy

PubMed Central

Kavaklieva, S.; Yordanova, I.; Bruckner-Tuderman, L.; Has, C.

2013-01-01

The acral peeling skin syndrome (APSS) is a rare autosomal recessive disorder clinically characterized by asymptomatic desquamation of the skin limited to the hands and feet and histologically by cleavage at the stratum granulosum and stratum corneum level [Kiritsi et al.: J Invest Dermatol 2010;130:1741–1746]. We report on a 10-month-old boy with a history of skin peeling limited to the hands and feet since 2 months of age. Clinical examination revealed erythematous erosions with peripheral desquamation and flaccid blisters. DNA mutation analysis detected two heterozygous TGM5 mutations: c.2T>C, p.M1T in exon 1 and c.337G>T, p.G113C in exon 3 in keeping with the diagnosis of APSS. The clinical presentation of APSS alone might be confusing and strongly resemble epidermolysis bullosa simplex making the differential diagnosis difficult. PMID:24019772

Influence of the ventilatory mode on acute adverse effects and facial thermography after noninvasive ventilation

PubMed Central

Pontes, Suzy Maria Montenegro; Melo, Luiz Henrique de Paula; Maia, Nathalia Parente de Sousa; Nogueira, Andrea da Nóbrega Cirino; Vasconcelos, Thiago Brasileiro; Pereira, Eanes Delgado Barros; Bastos, Vasco Pinheiro Diógenes; Holanda, Marcelo Alcantara

2017-01-01

ABSTRACT Objective: To compare the incidence and intensity of acute adverse effects and the variation in the temperature of facial skin by thermography after the use of noninvasive ventilation (NIV). Methods: We included 20 healthy volunteers receiving NIV via oronasal mask for 1 h. The volunteers were randomly divided into two groups according to the ventilatory mode: bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). Facial thermography was performed in order to determine the temperature of the face where it was in contact with the mask and of the nasal dorsum at various time points. After removal of the mask, the volunteers completed a questionnaire about adverse effects of NIV. Results: The incidence and intensity of acute adverse effects were higher in the individuals receiving BiPAP than in those receiving CPAP (16.1% vs. 5.6%). Thermographic analysis showed a significant cooling of the facial skin in the two regions of interest immediately after removal of the mask. The more intense acute adverse effects occurred predominantly among the participants in whom the decrease in the mean temperature of the nasal dorsum was lower (14.4% vs. 7.2%). The thermographic visual analysis of the zones of cooling and heating on the face identified areas of hypoperfusion or reactive hyperemia. Conclusions: The use of BiPAP mode was associated with a higher incidence and intensity of NIV-related acute adverse effects. There was an association between acute adverse effects and less cooling of the nasal dorsum immediately after removal of the mask. Cutaneous thermography can be an additional tool to detect adverse effects that the use of NIV has on facial skin. PMID:28538774

Characterization of suspected illegal skin whitening cosmetics.

PubMed

Desmedt, B; Van Hoeck, E; Rogiers, V; Courselle, P; De Beer, J O; De Paepe, K; Deconinck, E

2014-03-01

An important group of suspected illegal cosmetics consists of skin bleaching products, which are usually applied to the skin of the face, hands and décolleté for local depigmentation of hyper pigmented regions or more importantly, for a generalized reduction of the skin tone. These cosmetic products are suspected to contain illegal active substances that may provoke as well local as systemic toxic effects, being the reason for their banning from the EU market. In that respect, illegal and restricted substances in cosmetics, known to have bleaching properties, are in particular hydroquinone, tretinoin and corticosteroids. From a legislative point of view, all cosmetic products containing a prohibited whitening agent are illegal and must be taken off the EU market. A newly developed screening method using ultra high performance liquid chromatography-time off flight-mass spectrometry allows routine analysis of suspected products. 163 suspected skin whitening cosmetics, collected by Belgian inspectors at high risk sites such as airports and so-called ethnic cosmetic shops, were analyzed and 59% were classified as illegal. The whitening agents mostly detected were clobetasol propionate and hydroquinone, which represent a serious health risk when repeatedly and abundantly applied to the skin. Copyright © 2013 Elsevier B.V. All rights reserved.

Staphylococcus aureus colonization related to severity of hand eczema.

PubMed

Mernelius, S; Carlsson, E; Henricson, J; Löfgren, S; Lindgren, P-E; Ehricht, R; Monecke, S; Matussek, A; Anderson, C D

2016-08-01

Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the "glove juice" method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p < 0.001). This was also seen for bacterial density (p = 0.002). Patients with severe hand eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60-85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.

Change my body, change my mind: the effects of illusory ownership of an outgroup hand on implicit attitudes toward that outgroup.

PubMed

Farmer, Harry; Maister, Lara; Tsakiris, Manos

2014-01-13

The effect of multisensory-induced changes on body-ownership and self-awareness using bodily illusions has been well established. More recently, experimental manipulation of bodily illusions have been combined with social cognition tasks to investigate whether changes in body-ownership can in turn change the way we perceive others. For example, experiencing ownership over a dark-skin rubber hand reduces implicit bias against dark-skin groups. Several studies have also shown that processing of skin color and facial features play an important role in judgements of racial typicality and racial categorization independently and in an additive manner. The present study aimed at examining whether using multisensory stimulation to induce feelings of body-ownership over a dark-skin rubber hand would lead to an increase in positive attitudes toward black faces. We here show, that the induced ownership of a body-part of a different skin color affected the participants' implicit attitudes when processing facial features, in addition to the processing of skin color shown previously. Furthermore, when the levels of pre-existing attitudes toward black people were taken into account, the effect of the rubber hand illusion on the post-stimulation implicit attitudes was only significant for those participants who had a negative initial attitude toward black people, with no significant effects found for those who had positive initial attitudes toward black people. Taken together, our findings corroborate the hypothesis that the representation of the self and its relation to others, as given to us by body-related multisensory processing, is critical in maintaining but also in changing social attitudes.

Left-right and Yin-Yang balance of biophoton emission from hands.

PubMed

Yang, Joon-mo; Choi, Chunho; Hyun-hee; Woo, Won-myung; Yi, Seung-ho; Soh, Kwang-sup; Yang, Jong Soo; Choi, C

2004-01-01

Yearlong measurements of biophotons from palm and back of hand of three healthy people were performed. The detection of biophoton was done with two photomultiplier tubes whose spectral range was from 300 nm to 650 nm. The measurement was done on a circular area of diameter 46 mm whose centers were at the acupuncture point Laogong (PC8) of a palm and the mid-point of a back, respectively. The emission rates from the dorsa showed strong seasonal dependence which is consistent with the active nature of Yang meridians, while the palm sides show less seasonal dependence as they belong to the passive Yin meridians. This could be quantified simply by the standard deviations from the yearly average: They were 47.6 counts per second (cps), 66.1 cps and 66.0 cps from the dorsa, and 23.8 cps, 29.7 cps and 30.4 cps from the palms of subject 1, 2 and 3, respectively. Biophoton emission revealed qualitative individual tendencies: The subjects 1 and 2 emitted more strongly from the left dorsa, while the subject 3 from the right dorsum. The left-right balance of biophoton emission was well kept for normal people, which is in contrast with the severe imbalance for some stroke patients. Thus biophoton measurement has a diagnostic potential that encourages more studies.

Variation in skin biology to climate in Shanghai, China.

PubMed

Liu, Xiaoping; Gao, Yanrui; Zhang, Yiyi; Wang, Xuemin

2017-09-01

To explore the relationship between climate and skin condition, and to investigate the variation of skin biology to climatic change. In total, 2005 healthy Chinese volunteers living in Shanghai (aged 13-69 years) were recruited. Transepidermal water loss (TEWL) and SCH were tested on six sites (forehead, cheek, nasolabial, inner forearm, dorsal hand, and palm) by noninvasive devices between January 2005 and December 2012. The corresponding climate data were recorded by local Weather Bureau. TEWL was increased with atmospheric pressure and decreased with temperature, steam pressure, and relative humidity (p < 0.05). SCH was increased with steam pressure and decreased with atmospheric pressure (p < 0.05); there was no obvious trend between SCH and temperature and SCH and relative humidity. To investigate the climate parameters together, we introduced these correlated factors into the multivariate linear regression model which demonstrated that temperature and steam pressure were main factors related to skin biological parameters. At different sites, the effect of climatic factors on skin biology was diverse. Skin biological parameters are associated with climatic factors. Different sites have different sensitivity to climate factors.

Allogeneic cultured keratinocytes vs. cadaveric skin to cover wide-mesh autogenous split-thickness skin grafts.

PubMed

Monstrey, S; Beele, H; Kettler, M; Van Landuyt, K; Blondeel, P; Matton, G; Naeyaert, J M

1999-09-01

Improved shock therapy has extended the limits of survival in patients with massive burns, and nowadays skin coverage has become the major problem in burn management. The use of mesh skin grafts is still the simplest technique to expand the amount of available donor skin. However, very wide-mesh skin grafts take a very long time to heal, often resulting in unaesthetic scar formation. On the other hand, allogeneic cultured keratinocytes have been reported as a natural source of growth factors and thus could be useful to improve wound healing of these wide-mesh grafts. A clinical study was performed to compare the use of cryopreserved allogeneic cultured keratinocytes vs. the traditional cadaveric skin as a double layer over widely expanded autogenous skin grafts. This procedure was performed in 18 pairs of full-thickness burn wounds (with similar depth and location) in 11 severely burned patients. Early clinical evaluation was made at 2, 3, and 4 to 5 weeks. Parameters such as epithelialization, granulation tissue formation, infection, and scar formation were evaluated. Biopsies were taken to compare the histological characteristics of the epidermis, the epidermal-dermal junction, and the dermis. Late evaluations were performed at 6 and 12 months regarding color, softness, thickness, and subjective feeling of the scar tissue. Aside from a faster (p < 0.05) epithelialization in the keratinocyte group at 2 weeks, there were no statistically different results in any of the early evaluated parameters, neither clinically nor histologically. At long-term follow-up, clinical results and scar characteristics were not significantly different in the two compared groups. It is concluded from the results of this study that, during the early phase, epithelialization was faster with allogeneic cultured keratinocytes compared with cadaveric skin. However, taking into account the substantial difference in costs, the described use of cryopreserved allogeneic cultured keratinocytes

The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands.

PubMed

Heydorn, S; Menné, T; Andersen, K E; Bruze, M; Svedman, C; Basketter, D; Johansen, J D

2003-06-01

Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p.p.m.), whilst during the following 2 weeks, the concentration was relatively high (approximately 250 p.p.m.), imitating real-life exposure to a household product like dishwashing liquid diluted in water and the undiluted product, respectively. Evaluation was made using a clinical scale and laser Doppler flow meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger in a solution containing fragrance and development of clinically visible eczema on the finger in 15 participants previously diagnosed with hand eczema and with a positive patch test to the fragrance in question.

Prototype tactile feedback system for examination by skin touch.

PubMed

Lee, O; Lee, K; Oh, C; Kim, K; Kim, M

2014-08-01

Diagnosis of conditions such as psoriasis and atopic dermatitis, in the case of induration, involves palpating the infected area via hands and then selecting a ratings score. However, the score is determined based on the tester's experience and standards, making it subjective. To provide tactile feedback on the skin, we developed a prototype tactile feedback system to simulate skin wrinkles with PHANToM OMNI. To provide the user with tactile feedback on skin wrinkles, a visual and haptic Augmented Reality system was developed. First, a pair of stereo skin images obtained by a stereo camera generates a disparity map of skin wrinkles. Second, the generated disparity map is sent to an implemented tactile rendering algorithm that computes a reaction force according to the user's interaction with the skin image. We first obtained a stereo image of skin wrinkles from the in vivo stereo imaging system, which has a baseline of 50.8 μm, and obtained the disparity map with a graph cuts algorithm. The left image is displayed on the monitor to enable the user to recognize the location visually. The disparity map of the skin wrinkle image sends skin wrinkle information as a tactile response to the user through a haptic device. We successfully developed a tactile feedback system for virtual skin wrinkle simulation by means of a commercialized haptic device that provides the user with a single point of contact to feel the surface roughness of a virtual skin sample. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 9. Washing and drying of hands to reduce microbial contamination.

PubMed

Todd, Ewen C D; Michaels, Barry S; Smith, Debra; Greig, Judy D; Bartleson, Charles A

2010-10-01

During various daily activities at home and work, hands quickly become contaminated. Some activities increase the risk of finger contamination by pathogens more than others, such as the use of toilet paper to clean up following a diarrheal episode, changing the diaper of a sick infant, blowing a nose, or touching raw food materials. Many foodborne outbreak investigation reports have identified the hands of food workers as the source of pathogens in the implicated food. The most convenient and efficient way of removing pathogens from hands is through hand washing. Important components of hand washing are potable water for rinsing and soaps to loosen microbes from the skin. Hand washing should occur after any activity that soils hands and certainly before preparing, serving, or eating food. Antimicrobial soaps are marginally more effective than plain soaps, but constant use results in a buildup of the antimicrobial compound on the skin. The time taken to wash hands and the degree of friction generated during lathering are more important than water temperature for removing soil and microorganisms. However, excessive washing and scrubbing can cause skin damage and infections. Drying hands with a towel removes pathogens first by friction during rubbing with the drying material and then by wicking away the moisture into that material. Paper rather than cloth towels should be encouraged, although single-use cloth towels are present in the washrooms of higher class hotels and restaurants. Warm air dryers remove moisture and any surface microorganisms loosened by washing from hands by evaporation while the hands are rubbed together vigorously; however, these dryers take too long for efficient use. The newer dryers with high-speed air blades can achieve dryness in 10 to 15 s without hand rubbing.

A medical ontology for intelligent web-based skin lesions image retrieval.

PubMed

Maragoudakis, Manolis; Maglogiannis, Ilias

2011-06-01

Researchers have applied increasing efforts towards providing formal computational frameworks to consolidate the plethora of concepts and relations used in the medical domain. In the domain of skin related diseases, the variability of semantic features contained within digital skin images is a major barrier to the medical understanding of the symptoms and development of early skin cancers. The desideratum of making these standards machine-readable has led to their formalization in ontologies. In this work, in an attempt to enhance an existing Core Ontology for skin lesion images, hand-coded from image features, high quality images were analyzed by an autonomous ontology creation engine. We show that by exploiting agglomerative clustering methods with distance criteria upon the existing ontological structure, the original domain model could be enhanced with new instances, attributes and even relations, thus allowing for better classification and retrieval of skin lesion categories from the web.

Treatment of arteriovenous malformations involving the hand.

PubMed

Park, Ui-Jun; Do, Young-Soo; Park, Kwang-Bo; Park, Hong-Suk; Kim, Young-Wook; Lee, Byung-Boong; Kim, Dong-Ik

2012-07-01

Hand arteriovenous malformations (AVMs) are difficult to treat because of the necessity to maintain function and the high complication rate of treatment. The purpose of this study was to review the treatment of hand AVMs with embolo/sclerotherapy and the surgical procedures at a single institute. We retrospectively reviewed the medical records and identified the patients who were referred to the vascular division owing to hand AVMs between 1995 and 2009. The lesions were classified according to their affected areas. The treatments used at the clinic included conservative treatment, amputation, and embolo/sclerotherapy. We investigated the clinical data and assessed the treatment results. Sixty-four patients were involved in this study. The median follow-up duration was 26.9 months (range: 3.5-141.8 months). The median age of the patients was 31.5 years (range: 0.3-75.0 years). All of the lesions were of the extratruncal (ET) form, and 37 cases (57.8%) were of the infiltrating type. Sixteen patients were treated conservatively. Primary amputation was performed in seven cases with previous complications such as ulcer, bleeding, or functional limitations. Embolo/sclerotherapy with ethanol was performed in 41 patients. Sixteen (39.0%) of them showed clinical improvement. The treatment of 20 (48.8%) of the 41 patients was interrupted owing to a variety of complications, and 2 (4.9%) of these patients failed with embolo/sclerotherapy. Skin necrosis was the major complication, and this occurred in 17 patients treated with embolo/sclerotherapy--14 of these cases were small and the skin necrosis healed with conservative treatment; 1 patient had autoamputation owing to necrosis; and 2 patients underwent amputation surgery owing to gangrene. The risk for skin necrosis was higher for the AVMs that involved the subcutaneous layer and the AVMs that extended diffusely (P = 0.021, P = 0.011). Seven neuropathic complications developed after embolo/sclerotherapy, and all of them

Water-displacement plethysmography: a technique for the simultaneous thermal manipulation and measurement of whole-hand and whole-foot blood flows.

PubMed

Caldwell, Joanne N; Taylor, Nigel A S

2014-09-01

The purpose of this project was to design, construct and validate water-displacement plethysmographs for the forearm, hand and foot that could clamp segmental skin temperature whilst simultaneously measuring cutaneous blood flow. Two experiments were performed. In the first, the forearm plethysmograph was validated against a mercury-in-silastic plethysmograph under thermoneutral conditions, with and without forearm heating. Cutaneous vascular conductance was elevated almost three-fold by this treatment, however, there were no significant differences between the two forms of plethysmography in either state (P > 0.05). In study two, hand and foot blood flows were measured under clamped thermoneutral conditions, but with three local skin temperature treatments (5, 25, 40 °C). The hand had significantly higher blood flows than the foot at both 25 °C (4.07 versus 2.20 mL.100 mL( - 1).min( - 1); P < 0.05) and 40 °C (8.20 versus 4.47 mL.100 mL( - 1).min( - 1); P < 0.05). The foot was maximally constricted during the two lower temperatures, yet the cutaneous thermal sensitivity of the hand was almost two-fold greater (P < 0.05). This evidence supports the significant role played by these appendages in heat loss and conservation, and these plethysmographs will now be used to map cutaneous vascular responses (forearm, hand, calf, foot) across combinations of core and local skin temperatures.

Effect of Korean red ginseng on cold hypersensitivity in the hands and feet: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Cold hypersensitivity in the hands and feet (CHHF) is one of the most common complaints among Asians, especially in women. Korean red ginseng (KRG), which is a steamed form of Panax ginseng, has vasodilating action in the peripheral vessels and increases blood flow under cold stress. However, few studies have evaluated the effect of KRG on cold hypersensitivity. Methods/Design This trial is a randomized, double-blind, placebo-controlled trial in 80 CHHF patients. The trial will be implemented at Kyung Hee University Hospital at Gangdong in Seoul, Korea. The participants will take KRG or a placebo for eight weeks, after which they will be followed-up for four weeks. During the administration period, six capsules of 500 mg KRG or placebo will be provided twice a day. The primary outcome is change of skin temperature in the hands between baseline and after treatment. The secondary outcomes include the visual analogue scale scores of cold hypersensitivity in the hands, change of skin temperature and the VAS scores of cold hypersensitivity in the feet, the recovery rate of the skin temperature by the cold stress test of the hands, the distal-dorsal difference of the hands, power variables of heart rate variability, and the 36-item short form health survey. Discussion This study is the first trial to evaluate the efficacy of KRG on CHHF by using infrared thermography. Our study will provide basic evidence regarding CHHF. Trial registration CliniacalTrials.gov NCT01664156 PMID:24354675

Negative Pressure Wound Therapy with Surgical Gloves to Repair Soft Tissue Defects in Hands.

PubMed

Fujitani, Teruaki; Zenke, Yukichi; Shinone, Michitaka; Menuki, Kunitaka; Fukumoto, Keizo; Sakai, Akinori

2015-09-01

The efficacy of negative pressure wound therapy (NPWT) in the treatment of skin defect wounds has been established, but it is difficult to apply to hand surgery because of the easy occurrence of air leaks. We report two cases of performing NPWT with surgical gloves. Case1: A 37-year-old male was injured on his right dorsal hand from a punch. He presented to our hospital three days after the injury because of swelling and pain. The wound was infected and contused, so wound lavage and debridement (W&D) were performed under local anesthesia. The infected condition didn't improve after antimicrobial infusion, so W&D were performed again 8 days after the first visit. Then W&D were performed every day, and the infection subsided 15 days after the first visit. NPWT was initiated for the purpose of managing exudate and the wound condition, and healthy granulation tissue formed gradually. Finally, transpositional flap and full-thickness skin graft were performed on day 29. Case2: A 43-year-old male accidentally sustained a high pressure injection of oil into his dorsal hand. He presented to our hospital the next day, and W&D were performed. W&D were performed again two days after the first visit, and artificial dermis was applied over a part of the wound that was impossible to close. A decision was made to apply NPWT and a surgical glove for the purpose of reducing swelling and managing wound exudate. The swelling decreased and granulation tissue formed gradually, then nine days after the first visit a sural nerve graft was applied to bridge the defective area, and a full thickness skin graft was applied. We achieved good wound closure and hand function recovery after using NPWT and a surgical glove.

Complement Activation in Inflammatory Skin Diseases

PubMed Central

Giang, Jenny; Seelen, Marc A. J.; van Doorn, Martijn B. A.; Rissmann, Robert; Prens, Errol P.; Damman, Jeffrey

2018-01-01

The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Complement activity in diseases is rather complex and may involve both aberrant expression of complement and genetic deficiencies of complement components or regulators. The skin represents an active immune organ with complex interactions between cellular components and various mediators. Complement involvement has been associated with several skin diseases, such as psoriasis, lupus erythematosus, cutaneous vasculitis, urticaria, and bullous dermatoses. Several triggers including auto-antibodies and micro-organisms can activate complement, while on the other hand complement deficiencies can contribute to impaired immune complex clearance, leading to disease. This review provides an overview of the role of complement in inflammatory skin diseases and discusses complement factors as potential new targets for therapeutic intervention. PMID:29713318

Acral peeling skin syndrome associated with a novel CSTA gene mutation.

PubMed

Muttardi, K; Nitoiu, D; Kelsell, D P; O'Toole, E A; Batta, K

2016-06-01

Acral peeling skin syndrome (APSS) is a rare autosomal recessive condition, characterized by asymptomatic peeling of the skin of the hands and feet, often linked to mutations in the gene TGM5. However, more recently recessive loss of function mutations in CSTA, encoding cystatin A, have been linked with APSS and exfoliative ichthyosis. We describe the clinical features in two sisters with APSS, associated with a novel large homozygous deletion encompassing exon 1 of CSTA. © 2015 British Association of Dermatologists.

Tips Under the Skin: A Simple Modification of Extension Block Pinning for Mallet Fractures.

PubMed

Shin, Seung-Han; Lee, Yong-Suk; Kang, Jin-Woo; Kang, Wonwoo; Chung, Yang-Guk

2018-03-01

Pins exposed out of the skin after surgery for mallet fractures keep patients from washing their hands. The authors buried the tips of all pins under the skin while performing extension block pinning for 14 patients with mallet fractures. The patients were allowed to wash their hands 4 to 5 days postoperatively, without any dressing or splinting. The pins were removed at a mean of 8 weeks postoperatively. Solid union was achieved in all 14 fractures. No pull-out or subsidence of the pin was observed. No patient developed infection or other pin-related complications. Mean extension lag at final follow-up was 4°. [Orthopedics. 2018; 41(2):e299-e302.]. Copyright 2018, SLACK Incorporated.

Impact of different tongue cleaning methods on the bacterial load of the tongue dorsum.

PubMed

Bordas, Alice; McNab, Rod; Staples, Angela M; Bowman, Jim; Kanapka, Joe; Bosma, Marylynn P

2008-04-01

To assess the extent and duration of the effect of tongue cleaning procedures on bacterial load on the dorsal surface of the tongue. 19 subjects participated in this blinded crossover study. Subjects abstained from oral hygiene, eating and drinking from 22:00 h the previous evening. Tongue samples were collected at baseline and within 15 minutes of one of three procedures: teeth brushing alone; teeth brushing plus tongue scraping; teeth brushing plus tongue cleaning using a high speed vacuum ejector and irrigation with 20 ml antibacterial mouthwash. Subjects then brushed twice daily for 3 days apart from the second group who additionally scraped their tongue twice daily. On day 4, baseline and post-treatment samples were collected as per day 1. Bacteria (total anaerobes, Gram-negative anaerobes, VSC-producing bacteria and Streptococcus saliuarius) were enumerated using appropriate selective media. The tongue dorsum was colonized by all 4 bacterial categories (log(10) 6-8 cfu/sample). For subjects who brushed their teeth only, there was a significant reduction from baseline for S. saliuarius only. In contrast, tooth brushing plus tongue scraping resulted in statistically significant reductions from baseline for all bacterial categories (range log(10) 0.11-0.40 cfu/sample). Highly statistically significant reductions (log(10) 1.11-1.96 cfu/sample) were observed for subjects who underwent thorough tongue cleaning with the saliva ejector/mouthwash. To determine longevity of treatment effects, baseline bacterial loads for days 1 and 4 were compared. Only daily tongue scraping resulted in statistical significant reduction in baseline microbial loads on day 4. While mechanical tongue cleaning with or without chemical intervention can reduce bacterial load on the tongue, this effect is transient, and regular tongue cleaning is required to provide a long lasting (overnight) reduction in bacterial numbers. Nevertheless, tongue cleaning is an oral hygiene procedure that is

[Reconstruction of ankle and foot with combination of free perforator flaps and skin graft].

PubMed

Yin, Lu; Gong, Ketong; Yin, Zhonggang; Zhang, Bo; Xu, Jianhua

2017-03-01

To evaluate the clinical outcomes of free perforator flaps combined with skin graft for reconstruction of ankle and foot soft tissue defects. Between June 2014 and October 2015, 20 cases of ankle and foot soft tissue defects were treated. There were 16 males and 4 females, aged from 19 to 61 years (mean, 43.3 years). Injury was caused by traffic accident in 7 cases, by crashing in 9 cases, and machine twist in 4 cases. The locations were the ankle in 6 cases, the heel in 3 cases, the dorsum pedis in 4 cases, and the plantar forefoot in 7 cases of avulsion injury after toes amputation. The size of wound ranged from 15 cm×10 cm to 27 cm×18 cm. The time from injury to treatment was from 11 to 52 days (mean, 27 days). The anterolateral thigh perforator flap was used in 11 cases, thoracodorsal antery perforator flap in 3 cases, medial sural artery perforator flap in 4 cases, deep inferior epigastric perforator flap in 1 case, and anteromedial thigh perforator flap in 1 case, including 5 chimeric perforator flaps, 5 polyfoliate perforator flaps, 3 flow-through perforator flaps, and 3 conjoined perforator flaps. The size of the perforator flap ranged from 10.0 cm×6.5 cm to 36.0 cm×8.0 cm, the size of skin graft from 5 cm×3 cm to 18 cm×12 cm. Venous crisis occurred in 2 flaps which survived after symptomatic treatment; 18 flaps survived successfully and skin grafting healed well. The follow-up time ranged 4-18 months (mean, 8.3 months). The flaps had good appearance, texture and color, without infection. The patients could walk normally and do daily activities. Only linear scars were observed at the donor sites. Free perforator flap can be used to reconstruct defects in the ankle and foot, especially in the weight-bearing area of the plantar forefoot. A combination of free perforator flap and skin graft is ideal in reconstruction of great soft tissue defects in the ankle and foot.

A five-patient satisfaction pilot study of calcium hydroxylapatite injection for treatment of aging hands.

PubMed

Marmur, Ellen S; Al Quran, Hanadi; De Sa Earp, Ana Paula; Yoo, Jane Y

2009-12-01

The process of skin aging is not limited to the face but involves every part of the body, including the hands. A common manifestation of aging of the hands is the loss of volume, which occurs as the skin loses its subcutaneous fat. Injectable dermal fillers have surfaced as a popular method to address such deficiencies. To report the use of calcium hydroxylapatite (CaHA) to address lost volume. Five female subjects with soft tissue deficiency of the dorsa of the hands were enrolled at Mount Sinai Medical Center. A solution of CaHA with 2% lidocaine in amounts of 0.3 to 1.0 mL was injected interdigitally at each of three to five insertion sites; the sites were massaged and molded up to three times to ensure an optimal cosmetic end point. Subjects were seen for a follow-up visit after 1, 4, 16, and 24 weeks. With a single injection, all subjects reached their correction goals without requiring any touch-ups. At the 24-week visit, the subjects retained the filling effect, with no adverse events and high patient satisfaction. CaHA, a new, easily injectable, safe dermal filler, has emerged as an excellent option for soft tissue augmentation in aging hands.

[Hand burns in children and Aquacel(®) Burn gloves, an alternative to prolonged hospital stays].

PubMed

Ridel, P; Perrot, P; Truffandier, M V; Bellier-Waast, F; Duteille, F

2015-04-01

Occlusive dressings for second-degree hand burns in children must prevent infection and promote healing. For good management of analgesia, these treatments often require children to be hospitalized. Our goal was to find an alternative to conventional care protocol that would reduce the number of dressings and therefore the length of hospitalization. We report our experience with the use of Aquacel(®) Burn. Non-randomized monocentric prospective study was conducted from 2012 to 2014. The glove was used in the operating room within 72hours after the burn in children younger than 15 years old with isolated superficial to deep 2nd degree hand burns. Once the glove was perfectly stuck to the burn, the children could go back home. We saw them 10 to 12 days after the accident to be sure there was no indication of skin graft. Twenty gloves were used in 16 children aged from 16 months to 13 years. The average length of stay (ALOS) was five days to put the glove on and one day to remove it. Four hands were grafted. Once we get used to the product, Aquacel(®) Burn gloves have reduced the ALOS before skin graft in cases of isolated hand burns in children. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Gene Polymorphisms in the CCL5/CCR5 Pathway as a Genetic Biomarker for Outcome and Hand-Foot Skin Reaction in Metastatic Colorectal Cancer Patients Treated With Regorafenib.

PubMed

Suenaga, Mitsukuni; Schirripa, Marta; Cao, Shu; Zhang, Wu; Yang, Dongyun; Ning, Yan; Cremolini, Chiara; Antoniotti, Carlotta; Borelli, Beatrice; Mashima, Tetsuo; Okazaki, Satoshi; Berger, Martin D; Miyamoto, Yuji; Gopez, Roel; Barzi, Afsaneh; Lonardi, Sara; Yamaguchi, Toshiharu; Falcone, Alfredo; Loupakis, Fotios; Lenz, Heinz-Josef

2018-06-01

The C-C motif chemokine ligand 5/C-C motif chemokine receptor 5 (CCL5/CCR5) pathway has been shown to induce endothelial progenitor cell migration, resulting in increased vascular endothelial growth factor A expression. We hypothesized that genetic polymorphisms in the CCL5/CCR5 pathway predict efficacy and toxicity in patients with metastatic colorectal cancer (mCRC) treated with regorafenib. We analyzed genomic DNA extracted from 229 tumor samples from 2 different cohorts of patients who received regorafenib: an evaluation cohort of 79 Japanese patients and a validation cohort of 150 Italian patients. Single nucleotide polymorphisms of CCL5/CCR5 pathway-related genes were analyzed by PCR-based direct sequencing. CCL4 rs1634517 and CCL3 rs1130371 were associated with progression-free survival in the evaluation cohort (hazard ratio [HR] 1.54, P = .043; HR 1.48, P = .064), and progression-free survival (HR 1.74, P < .001; HR 1.66, P = .002) and overall survival (HR 1.65, P = .004; HR 1.65, P = .004) in the validation cohort. The allelic frequencies of CCL5 single nucleotide polymorphisms varied between the evaluation and validation cohorts (G/G variant in rs2280789, 21.5% vs. 1.3%, P < .001; T/T variant in rs3817655, 22.8% vs. 2.7%, P < .001). In the evaluation cohort, patients with the G/G variant in rs2280789 had a higher incidence of grade 3+ hand-foot skin reaction compared to any A allele (53% vs. 27%, P = .078), and similarly to the T/T variant in rs3817655 compared to any A allele (56% vs. 26%, P = .026). Genetic variants in the CCL5/CCR5 pathway may serve as prognostic markers and may predict severe hand-foot skin reaction in mCRC patients receiving regorafenib therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Skin graft loss resulting from collagenase clostridium histolyticum treatment of Dupuytren contracture: case report and review of the literature.

PubMed

Swanson, Jordan W; Watt, Andrew J; Vedder, Nicholas B

2013-03-01

Treatment of Dupuytren disease with collagenase clostridium histolyticum is increasingly used among hand surgeons. Although it is generally safe and efficacious, complications related to enzymatic fasciotomy occur. Postapproval surveillance and communication among hand surgeons continues to refine the indications, contraindications, and complications recognized in the treatment of Dupuytren disease with enzymatic therapy. Major treatment-related adverse events previously reported include flexor tendon rupture and complex regional pain syndrome. We report a patient who experienced total loss of a well-established volar ring finger skin graft following collagenase injection and propose a potential mechanism of vulnerability. This case may illustrate the susceptibility of type I collagen, which is uniformly present in a healed skin graft bed, to degradation with collagenase. We propose a cautious approach when considering treatment of a Dupuytren cord with collagenase in the presence of an overlying skin graft, regardless of the age of the graft. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Occupational skin diseases in cleaning and kitchen employees: course and quality of life after measures of secondary individual prevention.

PubMed

Soder, Stefanie; Diepgen, Thomas L; Radulescu, Magdalena; Apfelbacher, Christian J; Bruckner, Thomas; Weisshaar, Elke

2007-08-01

Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and disease-related data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98). One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand dermatitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease. QL was impaired in all age groups being lower with increasing age of the patients. The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role.

Seeking Clearer Recommendations for Hand Hygiene in Communities Facing Ebola: A Randomized Trial Investigating the Impact of Six Handwashing Methods on Skin Irritation and Dermatitis.

PubMed

Wolfe, Marlene K; Wells, Emma; Mitro, Brittany; Desmarais, Anne Marie; Scheinman, Pamela; Lantagne, Daniele

2016-01-01

To prevent disease transmission, 0.05% chlorine solution is commonly recommended for handwashing in Ebola Treatment Units. In the 2014 West Africa outbreak this recommendation was widely extended to community settings, although many organizations recommend soap and hand sanitizer over chlorine. To evaluate skin irritation caused by frequent handwashing that may increase transmission risk in Ebola-affected communities, we conducted a randomized trial with 91 subjects who washed their hands 10 times a day for 28 days. Subjects used soap and water, sanitizer, or one of four chlorine solutions used by Ebola responders (calcium hypochlorite (HTH), sodium dichloroisocyanurate (NaDCC), and generated or pH-stabilized sodium hypochlorite (NaOCl)). Outcomes were self-reported hand feel, irritation as measured by the Hand Eczema Score Index (HECSI) (range 0-360), signs of transmission risk (e.g., cracking), and dermatitis diagnosis. All groups experienced statistically significant increases in HECSI score. Subjects using sanitizer had the smallest increases, followed by higher pH chlorine solutions (HTH and stabilized NaOCl), and soap and water. The greatest increases were among neutral pH chlorine solutions (NaDCC and generated NaOCl). Signs of irritation related to higher transmission risk were observed most frequently in subjects using soap and least frequently by those using sanitizer or HTH. Despite these irritation increases, all methods represented minor changes in HECSI score. Average HECSI score was only 9.10 at endline (range 1-33) and 4% (4/91) of subjects were diagnosed with dermatitis, one each in four groups. Each handwashing method has benefits and drawbacks: soap is widely available and inexpensive, but requires water and does not inactivate the virus; sanitizer is easy-to use and effective but expensive and unacceptable to many communities, and chlorine is easy-to-use but difficult to produce properly and distribute. Overall, we recommend Ebola responders and

Methylisothiazolinone: An Emergent Allergen in Common Pediatric Skin Care Products

PubMed Central

Schlichte, Megan J.

2014-01-01

Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD) from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI). This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as “gentle,” “sensitive,” “organic,” or “hypoallergenic” often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children. PMID:25342949

Methylisothiazolinone: an emergent allergen in common pediatric skin care products.

PubMed

Schlichte, Megan J; Katta, Rajani

2014-01-01

Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD) from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI). This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as "gentle," "sensitive," "organic," or "hypoallergenic" often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children.

Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014.

PubMed

Higgins, Claire L; Palmer, Amanda M; Cahill, Jennifer L; Nixon, Rosemary L

2016-10-01

Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of using different regions of interest on local and mean skin temperature.

PubMed

Maniar, Nirav; Bach, Aaron J E; Stewart, Ian B; Costello, Joseph T

2015-01-01

The dynamic nature of tissue temperature and the subcutaneous properties, such as blood flow, fatness, and metabolic rate, leads to variation in local skin temperature. Therefore, we investigated the effects of using multiple regions of interest when calculating weighted mean skin temperature from four local sites. Twenty-six healthy males completed a single trial in a thermonetural laboratory (mean ± SD): 24.0 (1.2)°C; 56 (8%) relative humidity; <0.1 m/s air speed). Mean skin temperature was calculated from four local sites (neck, scapula, hand and shin) in accordance with International Standards using digital infrared thermography. A 50 mm × 50 mm, defined by strips of aluminium tape, created six unique regions of interest, top left quadrant, top right quadrant, bottom left quadrant, bottom right quadrant, centre quadrant and the entire region of interest, at each of the local sites. The largest potential error in weighted mean skin temperature was calculated using a combination of a) the coolest and b) the warmest regions of interest at each of the local sites. Significant differences between the six regions interest were observed at the neck (P<0.01), scapula (P<0.001) and shin (P<0.05); but not at the hand (P = 0.482). The largest difference (± SEM) at each site was as follows: neck 0.2 (0.1)°C; scapula 0.2 (0.0)°C; shin 0.1 (0.0)°C and hand 0.1 (0.1)°C. The largest potential error (mean ± SD) in weighted mean skin temperature was 0.4 (0.1)°C (P<0.001) and the associated 95% limits of agreement for these differences was 0.2-0.5 °C. Although we observed differences in local and mean skin temperature based on the region of interest employed, these differences were minimal and are not considered physiologically meaningful. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hand-foot skin reaction with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: A systematic review and meta-analysis.

PubMed

Li, Jing; Gu, Jian

2017-11-01

A meta-analysis was conducted to systematically review the risk of hand-foot skin reaction (HFSR) with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in patients with cancer. The relevant studies of the randomized controlled trials (RCTs) in cancer patients treated with VEGFR-TKIs were retrieved and the systematic evaluation was conducted. EMBASE, MEDLINE, and PubMed were searched for articles published till May 2017. Twenty-one RCTs and 9552 patients were included. The current analysis suggested that the use of VEGFR-TKIs increased the risk of all-grade HFSR (7.04;95%CI, 5.33-9.30;p<0.00001) and high-grade (≥grade 3) HFSR (21.62;95%CI, 15.19-30.78;p<0.00001). On subgroup analyses, the risk ratio (RR) of all-grade HFSR varies significantly according to cancer type, whereas the RR of high-grade HFSR did not. The risk of all-grade and high-grade HFSR did not affect by drug types, treatment line, median age and treatment duration. Copyright © 2017 Elsevier B.V. All rights reserved.

Measuring hemoglobin amount and oxygen saturation of skin with advancing age

NASA Astrophysics Data System (ADS)

Watanabe, Shumpei; Yamamoto, Satoshi; Yamauchi, Midori; Tsumura, Norimichi; Ogawa-Ochiai, Keiko; Akiba, Tetsuo

2012-03-01

We measured the oxygen saturation of skin at various ages using our previously proposed method that can rapidly simulate skin spectral reflectance with high accuracy. Oxygen saturation is commonly measured by a pulse oximeter to evaluate oxygen delivery for monitoring the functions of heart and lungs at a specific time. On the other hand, oxygen saturation of skin is expected to assess peripheral conditions. Our previously proposed method, the optical path-length matrix method (OPLM), is based on a Monte Carlo for multi-layered media (MCML), but can simulate skin spectral reflectance 27,000 times faster than MCML. In this study, we implemented an iterative simulation of OPLM with a nonlinear optimization technique such that this method can also be used for estimating hemoglobin concentration and oxygen saturation from the measured skin spectral reflectance. In the experiments, the skin reflectance spectra of 72 outpatients aged between 20 and 86 years were measured by a spectrophotometer. Three points were measured for each subject: the forearm, the thenar eminence, and the intermediate phalanx. The result showed that the oxygen saturation of skin remained constant at each point as the age varied.

Development of LLNA:DAE: a new local lymph node assay that includes the elicitation phase, discriminates borderline-positive chemicals, and is useful for cross-sensitization testing.

PubMed

Yamashita, Kunihiko; Shinoda, Shinsuke; Hagiwara, Saori; Itagaki, Hiroshi

2014-02-01

We developed a new local lymph node assay (LLNA) that includes the elicitation phase termed LLNA:DAE for discrimination of borderline-positive chemicals as classified by the LLNA modified by Daicel based on ATP content (LLNA:DA) and for cross-sensitization testing. Although the LLNA:DA method could help identify skin sensitizers, some skin irritants classified as non-sensitizers by the LLNA were classified as borderline positive. In addition, the evaluation for the cross-sensitization potential between chemicals was impossible. In the LLNA:DAE procedure, test group of mice received four applications of chemicals on the dorsum of the right ear for induction and one application on the dorsum of the left ear for elicitation. Control group of mice received one chemical application on the dorsum of the left ear. We evaluated the sensitizing potential by comparing the weights of the lymph nodes from the left ears between the two groups. The results of using the LLNA:DAE method to examine 24 chemicals, which contained borderline-positive chemicals, were consistent with those from the LLNA method, except for nickel chloride (NiCl2). Two chemical pairs, 2,4-dinitrochlorobenzene (DNCB) with 2,4-dinitrofluorobenzene (DNFB) and hydroquinone (HQ) with p-benzoquinone (p-BQ), showed clear cross-sensitization with each other, while another chemical pair, DNFB with hexylcinnamic aldehyde (HCA) did not. Taken together, our results suggest that the LLNA:DAE method is useful for discriminating borderline-positive chemicals and for determining chemical cross-sensitization.

The use of micro-plasma radiofrequency technology in secondary skin graft contraction: 2 case reports.

PubMed

Ding, Jin-Ping; Fang, Lin; Wang, Lian-Zhao

2015-01-01

Secondary skin graft contraction leading to cosmetic deformity remains a great challenge. These two case reports present serious skin graft contraction and the treatment with micro-plasma radiofrequency technology. Two patients presented with complaints of post-burn depigmentation on the forehead and the hand, respectively, and received dermabrasion and thin split-thickness skin grafting. Then, many localized contraction lesions occurred after 4 weeks. The treatment selected was non-surgical removal using micro-plasma radiofrequency technology with the following energy parameters: a roller tip at 80 watts, three passes in different directions. No complications were observed. The contracted skin was ablated without affecting the pigment distribution. The consequents were that the color, appearance, and texture of the grafted skin matched the adjacent skin well and had better patient acceptance.

Using postural synergies to animate a low-dimensional hand avatar in haptic simulation.

PubMed

Mulatto, Sara; Formaglio, Alessandro; Malvezzi, Monica; Prattichizzo, Domenico

2013-01-01

A technique to animate a realistic hand avatar with 20 DoFs based on the biomechanics of the human hand is presented. The animation does not use any sensor glove or advanced tracker with markers. The proposed approach is based on the knowledge of a set of kinematic constraints on the model of the hand, referred to as postural synergies, which allows to represent the hand posture using a number of variables lower than the number of joints of the hand model. This low-dimensional set of parameters is estimated from direct measurement of the motion of thumb and index finger tracked using two haptic devices. A kinematic inversion algorithm has been developed, which takes synergies into account and estimates the kinematic configuration of the whole hand, i.e., also of the fingers whose end tips are not directly tracked by the two haptic devices. The hand skin is deformable and its deformation is computed using a linear vertex blending technique. The proposed synergy-based animation of the hand avatar involves only algebraic computations and is suitable for real-time implementation as required in haptics.

Analysis of National Institutes of Health Funding in Hand Surgery.

PubMed

Silvestre, Jason; Ruan, Qing Z; Chang, Benjamin

2018-01-01

Federal research dollars help investigators develop biomedical therapies for human diseases. Currently, the state of funding in hand surgery is poorly understood. This study defines the portfolio of National Institutes of Health (NIH) grants awarded in hand surgery. This was a cross-sectional study of hand surgeons in the US. Faculty members of accredited hand surgery fellowships and/or members of the American Society for Surgery of the Hand were queried in the NIH RePORT database for awards obtained during 2005-2015. Of 2317 hand surgeons queried, only 18 obtained an NIH grant (0.8%). Thirty-eight unique grants were identified totaling $42 197 375. R01 awards comprised the majority of funding (78.0%) while K08 awards accounted for 1.1%. The K-to-R transition rate was zero. The National Institute of Arthritis and Musculoskeletal and Skin Disease supported the most funding (65.2%), followed by the National Institute of Neurological Disorders and Stroke (30.8%). There was no statistically significant difference in NIH funding totals with hand surgeon characteristics. Funding supported translational (46.0%), basic science (29.6%), clinical (21.0%), and education-based (3.4%) research. Peripheral nerve (33.3%) and bone and joint disease (30.1%) received the most research funding. Less than 1% of hand surgeons obtain NIH research grants. Of the 2 identified K08 awards, none led to a subsequent R award. Future research should identify barriers to grant procurement to design effective policies to increase NIH funding in hand surgery.

Total Body Photography as an Aid to Skin Self-examination: A Patient's Perspective.

PubMed

Secker, Lisanne J; Bergman, Wilma; Kukutsch, Nicole A

2016-02-01

Skin self-examination can help patients who are at high risk for developing melanoma to become more involved in their own surveillance and treatment. This study examined the use of total body photography as an aid to skin self-examination from the patients' perspective. A total of 179 individuals at high risk for developing melanoma who had undergone total body photography (60.5% response rate) completed a self-reported questionnaire assessing the frequency of skin self-examination, perceived usefulness of total body photography, and a variety of potential demographic, clinical and psychological factors. Only approximately half of the participants indicated skin self-examination as useful and 78.9% preferred clinical skin examination by a specialist. Finding total body photography useful was associated with having received instructions on how to perform skin self-examination, the use of a (hand)mirror, and confidence to detect changing moles. These findings allow us to develop strategies to further improve patients' self-screening behaviours.

Exploring the impact of skin tone on family dynamics and race-related outcomes.

PubMed

Landor, Antoinette M; Simons, Leslie Gordon; Simons, Ronald L; Brody, Gene H; Bryant, Chalandra M; Gibbons, Frederick X; Granberg, Ellen M; Melby, Janet N

2013-10-01

Racism has historically been a primary source of discrimination against African Americans, but there has been little research on the role that skin tone plays in explaining experiences with racism. Similarly, colorism within African American families and the ways in which skin tone influences family processes is an understudied area of research. Using data from a longitudinal sample of African American families (n = 767), we assessed whether skin tone impacted experiences with discrimination or was related to differences in quality of parenting and racial socialization within families. Findings indicated no link between skin tone and racial discrimination, which suggests that lightness or darkness of skin does not either protect African Americans from or exacerbate the experiences of discrimination. On the other hand, families displayed preferential treatment toward offspring based on skin tone, and these differences varied by gender of child. Specifically, darker skin sons received higher quality parenting and more racial socialization promoting mistrust compared to their counterparts with lighter skin. Lighter skin daughters received higher quality parenting compared with those with darker skin. In addition, gender of child moderated the association between primary caregiver skin tone and racial socialization promoting mistrust. These results suggest that colorism remains a salient issue within African American families. Implications for future research, prevention, and intervention are discussed.

HA metabolism in skin homeostasis and inflammatory disease.

PubMed

Kavasi, Rafaela-Maria; Berdiaki, Aikaterini; Spyridaki, Ioanna; Corsini, Emanuela; Tsatsakis, Aristidis; Tzanakakis, George; Nikitovic, Dragana

2017-03-01

Hyaluronan (HA), an unsulfated glycosaminoglycan, is an important component of the complex extracellular matrix network which surrounds and supports cells in tissues. HA is detected in all vertebrate tissues, but the bulk of HA is produced and deposited in the skin. In this review we focus on the role of HA in skin-associated inflammatory disease and wound healing. Properties of HA are directly dependent on its molecular weight. Thus, high molecular weight HA (HMWHA) is deposited in normal tissues during homeostasis and promotes their stability whereas low molecular weight HA fragments (LMWHA), on the other hand, may arise from enzymatic or chemical activities. The degradation of HMWHA to LMWHA fragments, often leads to the generation of biologically active oligosaccharides with different properties and postulated functions in wound scar formation and inflammation. More detailed studies of HA involvement in skin-associated inflammatory disease may result in novel treatment modalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Left hand polydactyly: a case report.

PubMed

Mumoli, Nicola; Gandini, Daniele; Wamala, Edris Kalanzi; Cei, Marco

2008-11-24

Polydactyly is a congenital anomaly with a wide range of manifestations that occurs in many forms, ranging from varying degrees of mere splitting to completely duplicated thumb. When duplication occurs alone, it is usually unilateral and sporadic. In this case report we describe an otherwise healthy 19-year-old woman of Tibetan heritage with isolated left hand preaxial polydactyly. She experienced working related difficulties in her daily yak's milking. She subsequently underwent surgical correction, and the over number thumb was removed with associated meticulous skeletal and soft tissue reconstruction. Polydactyly is the most common congenital digital anomaly of the hand and foot. It can occur in isolation or as part of a syndrome. Surgery is necessary to create a single, functioning thumb and is indicated to improve cosmesis. Skin, nail, bone, ligament, and musculoskeletal elements must be combined to reconstruct an optimal digit. In this case (Tibetan society is almost exclusively a sheep-breeding one) surgery was necessary to leave a single, functioning thumb for her work as yak milkmaid.

UVA-induced protection of skin through the induction of heme oxygenase-1.

PubMed

Xiang, Yuancai; Liu, Gang; Yang, Li; Zhong, Julia Li

2011-12-01

UVA (320-400 nm) and UVB (290-320 nm) are the major components of solar UV irradiation, which is associated with various pathological conditions. UVB causes direct damage to DNA of epidermal cells and is mainly responsible for erythema, immunosuppression, photoaging, and skin cancer. UVA has oxidizing properties that can cause damage or enhance UVB damaging effects on skin. On the other hand, UVA can also lead to high levels of heme oxygenase-1 (HO-1) expression of cells that can provide an antioxidant effect on skin as well as anti-inflammatory properties in mammals and rodents. Therefore, this review focuses on the potential protection of UVA wavebands for the skin immune response, instead of mechanisms that underlie UVA-induced damage. Also, the role of HO-1 in UVA-mediated protection against UVB-induced immunosuppression in skin will be summarized. Thus, this review facilitates further understanding of potential beneficial mechanisms of UVA irradiation, and using the longer UVA (UVA1, 340-400 nm) in combination with HO-1 for phototherapy and skin protection against sunlight exposure.

Polyomavirus BK: possibly associated skin eruption in a patient with hemorrhagic cystitis.

PubMed

Medeiros, Patricia V; Abagge, Kerstin T; Carvalho, Vânia O; Bonfim, Carmem M; Raboni, Sonia M

2011-01-01

A 14-year-old girl with Fanconi anemia was submitted to allogeneic hematopoietic stem cell transplantation. After 17 days she developed hemorrhagic cystitis due to polyoma BK virus (BKV), confirmed by PCR (polymerase chain reaction). Two weeks after the appearance of the urinary symptoms the patient presented numerous papules and vesicles on both hands and feet. PCR of the skin lesions and plasma was positive for BKV. The relationship of BKV with frequent infections in immunocompromised patients is well established. The positive PCR of vesicular fluid suggests that this was the causative agent of the skin lesion in this case. There are no reports of skin lesions with positive PCR for BKV. © 2011 Wiley Periodicals, Inc.

Pulling boat hands: a unique dermatosis from coastal New England.

PubMed

Toback, A C; Korson, R; Krusinski, P A

1985-04-01

We report a previously unrecognized hand dermatosis, pulling boat hands (PBH), occurring in thirteen participants at the Outward Bound School on Hurricane Island, Maine. Painful and pruritic macules, plaques, and vesicles developed exclusively while subjects lived aboard a pulling boat, the school's open rowing/sailing craft. Nine of those affected were women and eight had Raynaud's phenomenon or vasospasm. These subjects experienced thirty episodes of PBH during May through October, 1978 to 1982. Histopathology revealed a superficial and deep lymphohistiocytic perivascular infiltrate, subepidermal blister formation, red blood cell extravasation, and dermal capillary thrombosis compatible with cold injury to the skin. All patients experienced prolonged percussion to their hands while rowing as well as a continuous environmental exposure to cold air, wind, humidity, ocean spume, and precipitation. These clinical, histopathologic, and environmental findings suggest a unique syndrome that combines the vascular effects of mechanical trauma from rowing with those of nonfreezing cold injury.

Effectiveness of skin protection creams in the prevention of occupational dermatitis: results of a randomized, controlled trial.

PubMed

Winker, Robert; Salameh, Bayda; Stolkovich, Sabine; Nikl, Michael; Barth, Alfred; Ponocny, Elisabeth; Drexler, Hans; Tappeiner, Gerhard

2009-04-01

The aim of the trial was to investigate whether the publicized effects of skin protection creams can be replicated in a real occupational setting during activities that expose the skin. A prospective, randomized, four-tailed controlled pilot trial was performed to compare the effect of skin protection and skin care alone or in combination with cleansing against a control group (only cleansing). Two branches were selected for the investigation: the building industry and the timber industry. A total of 1,006 workers from these two branches were recruited, and out of these 485 workers were examined longitudinally for at least three time points over 1 year (lost for follow-up: 430 workers, exclusion: 91 workers). At each time point, as a primary outcome measure, we assessed the condition of the skin at both hands in a blinded manner and the individual was assigned to one of the following categories: no eczema, mild, moderate and severe eczema. As a secondary outcome measure, the worker's transepidermal water loss (TEWL) was measured under standardized conditions at the back of both hands. In addition, the workers were asked to evaluate their skin condition during the study. With regard to differences in the occurrence of eczemas, we found only in workers in building industry without application of skin protection or skin care creams a statistical significant increase in the incidence between the first and the second visit and a statistical significant decrease in the incidence between the second and third visit. When evaluating the secondary outcome-measurement changes in the TEWL values, an improvement was found for the group skin protection and skin care in combination and by skin care alone. Females in the timber industry started with better TEWL values than males, which may be due to better overall skin care. In this group we found an improvement for the group skin protection and skin care in combination and by skin protection alone. For skin protection alone, we

Avagard hand antisepsis vs. traditional scrub in 3600 pediatric urologic procedures.

PubMed

Weight, Christopher J; Lee, Michael C; Palmer, Jeffrey S

2010-07-01

Avagard is a waterless, scrubless, and brushless hand antiseptic approved by the Food and Drug Administration as a replacement for traditional presurgical brush hand scrubbing. We evaluated the use of Avagard compared with hand brush scrub preparation for inpatient and outpatient pediatric urological operations. We evaluated the first 1800 patients for whom we used Avagard as a preoperative hand antiseptic and compared them with the last 1800 consecutive patients for whom we performed traditional antiseptic-impregnated hand-brush scrubbing. All patients underwent a variety of inpatient and outpatient open, endoscopic, and laparoscopic pediatric urological procedures. Patients were monitored postoperatively for wound infection, and patients and surgeon were monitored for side effects. A cost analysis was performed. The incidence of wound infection was 2/1800 (0.11%) in the Avagard group and 3/1800 (0.17%) in the hand-scrub group (P > .99 Fisher's exact test). All wound infections were successfully treated with a single course of oral antibiotics. No side effects for the patients or surgeon were noted, including skin irritations or allergic reactions in either group. The traditional hand scrub is nearly 2 times more expensive per application than Avagard. The incidence of wound infections in pediatric urological procedures is low (0.09%). We observe that Avagard provides comparable hand antisepsis to the traditional surgical scrub in a variety of pediatric urological procedures. Avagard is superior to the surgical hand scrub in cost-effectiveness and time efficiency. Urologists should consider using Avagard for hand antisepsis before surgery. Copyright 2010 Elsevier Inc. All rights reserved.

Contact hypersensitivity in hand dermatitis.

PubMed

Li, Lin-feng; Wang, Jing

2002-10-01

Contact hypersensitivity (CHS) in hand dermatitis (HD) was studied by patch testing (PT) 105 consecutive adult HD patients and 361 cases of suspected non-hand allergic contact dermatitis (NHD). The suspected offending agents were also investigated by a questionnaire. Age and sex distribution was no different between the 2 groups. The total positivity rate of PT in the HD group was much lower than in the control group (46.7% versus 63.2%, p < 0.01, chi2-test). The most common allergens in HD were rubber mix(17.1%), p-phenylenediamine (PPD) (14.3%), fragrance mix (9.5%), nickel (9.5%), colophonium (6.7%) and potassium dichromate (2.9%), while those in the control group, in sequence, were nickel (20.5%), rubber mix (16.9%), PPD (14.1%), fragrance mix (12.7%), potassium dichromate (5.5%) and colophonium (5.0%). The positivity rate to nickel was lower in the HD group (9.5% versus 20.5%, p < 0.05, chi2-test), while there was no significant difference for the other allergens. HD was divided arbitrarily into 5 groups: (1) vesicular form, in which fine papules and vesicles can be detected. 65.7% of the HD was vesicular form and 55.1% of them were PT positive; (2) fissured form, in which dry skin with fine fissures or desquamation is seen. 8.6% of the HD was fissured form and 30% of them were PT positive; (3) hyperkeratotic form, in which the lesions are thick, hyperkeratotic plaques - 6.7% of the HD was this form and no positive reaction was found; (4) hand and foot dermatitis (HFD) - 12.4% of HD was HFD and 53.8% of them were PT positive; (5) pompholyx - 6.7% of the patients had pompholyx and one positive result to nickel was detected. The suspected offending agents were reported in only 13 (12.4%) patients. These results suggest that CHS is less common in HD than in NHD and that other factors, such as skin irritation, may play more of a role in HD. Nickel allergy is less common in HD than in NHD. CHS may play a role in more than 1/2 of vesicular form HD, HFD and in some

Workplace screening for hand dermatitis: a pilot study.

PubMed

Nichol, K; Copes, R; Spielmann, S; Kersey, K; Eriksson, J; Holness, D L

2016-01-01

Health care workers (HCWs) are at increased risk for developing occupational skin disease (OSD) such as dermatitis primarily due to exposure to wet work. Identification of risk factors and workplace screening can help early detection of OSD to avoid the condition becoming chronic. To determine risk factors and clinical findings for hand dermatitis using a workplace screening tool. Employees at a large teaching hospital in Toronto, Canada, were invited to complete a two-part hand dermatitis screening tool. Part 1 inquired about hand hygiene practices and Part 2 comprised a visual assessment of participants' hands by a health professional and classification as (i) normal, (ii) mild dermatitis or (iii) moderate/severe dermatitis. Risk factors were determined using chi-square and Cochran-Armitage analysis on a dichotomous variable, where Yes represented either a mild or moderate/severe disease classification. There were 183 participants out of 643 eligible employees; response rate 28%. Mild or moderate/severe dermatitis was present in 72% of participants. These employees were more likely to work directly with patients, have worked longer in a health care setting, wash hands and change gloves more frequently, wear gloves for more hours per day, have a history of eczema or dermatitis and report a current rash on the hands or rash in the past 12 months. There was a high percentage of HCWs with dermatitis and risk factors for dermatitis. These findings argue for increased attention to prevention and early identification of hand dermatitis and support further testing of the workplace screening tool. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Musculoskeletal disorders of the hand in type 2 diabetes mellitus: prevalence and its associated factors.

PubMed

Mustafa, Khader N; Khader, Yousef S; Bsoul, Amal K; Ajlouni, Kamel

2016-07-01

To assess the prevalence of musculoskeletal disorders of the hand among adult patients with type 2 diabetes mellitus (T2DM) and their relation to disease duration, glycemic control and microvascular complications. A cross-sectional study was conducted at the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan. One thousand patients with T2DM were included in this study (mean age 57.8 ± 9.5 years, 52.2% females and 47.8% males). Hand disorders were seen in 69.5% of patients, limited joint mobility (LJM) was the most prevalent (63.1%) condition followed by Dupuytren's contracture (DC) (18.6%). Trigger finger, thick skin and carpal tunnel syndrome (CTS) were found in 7.2%, 6.2% and 5.5% of patients, respectively. One disorder was seen in 45.4% of patients, two in18.2%, three in 4.9%, four in 0.9%, while only 0.1% of patients had all disorders. Female gender, age over 60 years and long duration of diabetes were associated with hand abnormalities. Hypertension was significantly associated with DC while retinopathy was associated with increased odds of thick skin, DC and CTS with P-values 0.037, < 0.005 and 0.002, respectively. Hand disorders are very common in T2DM. Female gender, old age, duration of diabetes, retinopathy and hypertension were significantly associated with hand disorders in T2DM. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Efficacy of long pulse Nd:YAG laser versus fractional Er:YAG laser in the treatment of hand wrinkles.

PubMed

Robati, Reza M; Asadi, Elmira; Shafiee, Anoosh; Namazi, Nastaran; Talebi, Atefeh

2018-04-01

There are different modalities for hand rejuvenation. Fractional Er:YAG laser and long pulse Nd:YAG laser were introduced for treating hand wrinkles. We plan to compare fractional Er:YAG laser and long pulse Nd:YAG laser in a randomized controlled double-blind design with multiple sessions and larger sample size in comparison with previous studies. Thirty-three participants with hand wrinkles entered this study. They were randomly allocated to undergo three monthly laser treatments on each hand, one with a fractional Er:YAG laser and the other with a long pulse Nd:YAG laser. The evaluations included assessment of clinical improvement determined by two independent dermatologists not enrolled in the treatment along with measuring skin biomechanical property of hands using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT). Moreover, potential side effects and patients' satisfaction have been documented at baseline, 1 month after each treatment, and 3 months after the final treatment session. Clinical evaluation revealed both modalities significantly reduce hand wrinkles (p value < 0.05), with no significant difference between two lasers. Mean CRRT values also decreased significantly after the laser treatment compared to those of the baseline in both laser groups. There was no serious persistent side effect after both laser treatments. Both fractional Er:YAG and long pulse Nd:YAG lasers show substantial clinical improvement of hand skin wrinkles with no serious side effects. However, combination treatment by these lasers along with the other modalities such as fat transfer could lead to better outcomes in hand rejuvenation. IRCT2016032020468N4.

The use of an extended ventilation tube as a countermeasure for EVA-associated upper extremity medical issues

NASA Astrophysics Data System (ADS)

Jones, J. A.; Hoffman, R. B.; Buckland, D. A.; Harvey, C. M.; Bowen, C. K.; Hudy, C. E.; Strauss, S.; Novak, J.; Gernhardt, M. L.

Introduction: Onycholysis due to repetitive activity in the space suit glove during Neutral Buoyancy Laboratory (NBL) training and during spaceflight extravehicular activity (EVA) is a common observation. Moisture accumulates in gloves during EVA task performance and may contribute to the development of pain and damage to the fingernails experienced by many astronauts. The study evaluated the use of a long ventilation tube to determine if improved gas circulation into the hand area could reduce hand moisture and thereby decrease the associated symptoms. Methods: The current Extravehicular Mobility Unit (EMU) was configured with a ventilation tube that extended down a single arm of the crew member (E) and compared with the unventilated arm (C). Skin surface moisture was measured on both hands immediately after glove removal and a questionnaire administered to determine subjective measures. Astronauts ( n=6) were examined pre- and post-run. Results: There were consistent trends in the reduction of relative hydration ratios at dorsum ( C=3.34, E=2.11) and first ring finger joint ( C=2.46, E=1.96) when the ventilation tube was employed. Ventilation appeared more effective on the left versus the right hand, implying an interaction with hand anthropometry and glove fit. Symptom score was lower on the hand that had the long ventilation tube relative to the control hand in 2/6 EVA crew members. Conclusions: Increased ventilation to the hand was effective in reducing the risks of hand and nail discomfort symptoms from moderate to low in one-third of the subjects. Improved design in the ventilation capability of EVA spacesuits is expected to improve efficiency of air flow distribution.

Where are my hands? Influence of limb posture on tactile extinction.

PubMed

Auclair, Laurent; Barra, Julien; Raibaut, Patrick

2012-05-01

Tactile localization on the skin involves both a somatotopic and a postural schema (body-schema) representation. The present study determines the extent to which body posture influences tactile perception in right-brain-damaged patients. In a first set of experiments, patients were asked to detect single tactile stimulation delivered to their left or right hands or to both hands simultaneously (double stimulation) in different arm postures. Only patients who had no difficulty localizing single and double tactile stimulations when their hands were placed in anatomic position were tested. Participant's hands were crossed, one over the other, and the tactile stimuli were delivered either to the hand (beyond the crossing point, Experiment 1) or to the forearm (before the crossing point, Experiment 2). In Experiment 3, the left hand was placed in the right hemispace and the right hand in the left hemispace without crossing over (opposite condition). In a second set of experiments, patients were asked to detect stimulation delivered to the forefinger. The fingers were crossed, one over the other at the level of the middle phalanx, and stimuli were delivered either beyond or before the crossing point. In all experimental conditions, control participants performed at ceiling. We observed a left-hand tactile extinction on double stimulation in the crossed condition. These results suggest that tactile stimuli can be encoded based on multiple specific body-part representations rather than on an integrated body-schema representation.

Colonisation with methicillin-resistant Staphylococcus aureus and associated factors among nurses with occupational skin diseases.

PubMed

Brans, Richard; Kolomanski, Katarzyna; Mentzel, Franziska; Vollmer, Ulrike; Kaup, Olaf; John, Swen Malte

2016-10-01

To evaluate the prevalence of colonisation with methicillin-resistant Staphylococcus aureus (MRSA), associated factors and the effectiveness of decolonisation procedures among nurses with occupational skin diseases (OSD). In a retrospective cohort study, the medical records of 319 nurses from Germany who were screened consecutively for MRSA when participating in a tertiary individual prevention programme (TIP) for severe OSD between July 2009 and December 2014 were evaluated. 90.3% of nurses with severe OSD suffered from hand eczema. 43 were colonised with MRSA on admission (13.5%), mainly in the nose (n=35, 81.4%). However, the hands were affected in more than half of the MRSA carriers (n=24, 55.8%). Risk factors for MRSA colonisation were atopic skin diathesis (OR 2.01, 95% CI 1.03 to 3.92, p=0.049) and presence of atopic dermatitis on other body parts than the hands (OR 4.33, 95% CI 2.23 to 8.43, p<0.001). Hand eczema was significantly more severe in MRSA carriers than in non-carriers (OR 1.23, 95% CI 1.10 to 1.37, p<0.001) and showed a higher prevalence of vesicles, erosions or fissures. MRSA eradication was successful in 67.4% after the first attempt. Nurses with OSD have a twofold to threefold higher prevalence of MRSA colonisation than what has been reported for point-prevalence screenings among healthcare workers in Germany. Atopic skin diathesis, atopic dermatitis and severe hand eczema are the main risk factors. Thus, prevention and treatment of OSD could be important elements in reduction of colonisation with MRSA among nurses and transmission to others. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry-based study assessing risk of disability pension.

PubMed

Heede, Nina G; Thuesen, Betina H; Thyssen, Jacob P; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Menné, Torkil; Johansen, Jeanne D

2017-08-01

Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Disability pension was associated with hand eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15-14.11; and OR 6.01 and 95%CI: 2.37-15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed hand eczema had experienced symptoms before adulthood. In the general population, self-reported hand eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An ecological study of skin biopsies and skin cancer treatment procedures in the United States Medicare population, 2000 to 2015.

PubMed

Wang, David M; Morgan, Frederick C; Besaw, Robert J; Schmults, Chrysalyne D

2018-01-01

Analyses of skin cancer procedures adjusted for population changes are needed. To describe trends in skin cancer-related biopsies and procedures in Medicare beneficiaries. An ecological study of Medicare claims for skin biopsies and skin cancer procedures in 2000 to 2015. Biopsies increased 142%, and skin cancer procedures increased 56%. Mohs micrographic surgery (MMS) utilization increased on the head/neck, hands/feet, and genitalia (increasing from 11% to 27% of all treatment procedures) but was low on the trunk/extremities (increasing from 1% to 4%). Adjusted for increased Medicare enrollment (+36%) between 2000 and 2015, the number of biopsies and MMS procedures performed per 1000 beneficiaries increased (from 56 to 99 and from 5 to 15, respectively), whereas the number of excisions and destructions changed minimally (from 18 to 16 and from 19 to 18, respectively). Growth in biopsies and MMS procedures slowed between each time period studied: 4.3 additional biopsies per year and 0.9 additional MMS procedures per year per 1000 beneficiaries between 2000 and 2007, 2.2 and 0.5 more between 2008 and 2011, and 0.5 and 0.3 more between 2012 and 2015, respectively. Medicare claims-level data do not provide patient-level or nonsurgical treatment information. The increased number of skin cancer procedures performed was largely the result of Medicare population growth over time. MMS utilization increased primarily on high- and medium-risk and functionally and cosmetically significant locations where tissue sparing and maximizing cure are critical. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Micro-patterned graphene-based sensing skins for human physiological monitoring

NASA Astrophysics Data System (ADS)

Wang, Long; Loh, Kenneth J.; Chiang, Wei-Hung; Manna, Kausik

2018-03-01

Ultrathin, flexible, conformal, and skin-like electronic transducers are emerging as promising candidates for noninvasive and nonintrusive human health monitoring. In this work, a wearable sensing membrane is developed by patterning a graphene-based solution onto ultrathin medical tape, which can then be attached to the skin for monitoring human physiological parameters and physical activity. Here, the sensor is validated for monitoring finger bending/movements and for recognizing hand motion patterns, thereby demonstrating its future potential for evaluating athletic performance, physical therapy, and designing next-generation human-machine interfaces. Furthermore, this study also quantifies the sensor’s ability to monitor eye blinking and radial pulse in real-time, which can find broader applications for the healthcare sector. Overall, the printed graphene-based sensing skin is highly conformable, flexible, lightweight, nonintrusive, mechanically robust, and is characterized by high strain sensitivity.

Hair patterns of the lower limb in Central Indian males.

PubMed

Chaurasia, B D

1977-08-01

The distribution of hair of the right lower limb has been studied in a random sample of 220 healthy Central Indian males 17 to 45 years of age. The common hair patterns observed are the proximal phalangeal hair in all toes in 55.45%, the middle phalangeal hair in the third toe in 8.18%, the tibial on the dorsum of foot in 69.55%, and the pedo-cruro-femoral in the lower limb in 70.00% subjects. Comparison of these findings with those of the right upper limb shows that hairiness of the two limbs is correlated, that the dorsum of foot is less hairy than the dorsum of hand, and that the third and second toes are comparable with the fourth and third fingers, respectively, as regards their middle phalangeal hair. Comparison with the available literature shows that the Central Indian males resemble the Whites in having greater frequency of middle phalangeal hair than those of the Negroes, that the dorsum of feet of this population is less hairy than the White and more hairy than the Negroes, and that the general hairiness of the lower limb is more or less equal in the three groups of persons.

Exploring the Impact of Skin Tone on Family Dynamics and Race-Related Outcomes

PubMed Central

Simons, Leslie Gordon; Simons, Ronald L.; Brody, Gene H.; Bryant, Chalandra M.; Gibbons, Frederick X.; Granberg, Ellen M.; Melby, Janet N.

2014-01-01

Racism has historically been a primary source of discrimination against African Americans but there has been little research on the role that skin tone plays in explaining experiences with racism. Similarly, colorism within African American families and the ways in which skin tone influences family processes is an understudied area of research. Utilizing data from a longitudinal sample of African American families (N= 767), we assessed whether skin tone impacted experiences with discrimination or was related to differences in quality of parenting and racial socialization within families. Findings indicated no link between skin tone and racial discrimination, which suggests that lightness or darkness of skin does not either protect African Americans from or exacerbate the experiences of discrimination. On the other hand, families displayed preferential treatment toward offspring based on skin tone and these differences varied by gender of child. Specifically, darker skin sons received higher quality parenting and more racial socialization promoting mistrust compared to their counterparts with lighter skin. Lighter skin daughters received higher quality parenting compared to those with darker skin. In addition, gender of child moderated the association between primary caregiver skin tone and racial socialization promoting mistrust. These results suggest that colorism remains a salient issue within African American families. Implications for future research, prevention and intervention are discussed. PMID:24040901

Skin Cancer in Skin of Color

PubMed Central

Bradford, Porcia T.

2009-01-01

Skin cancers in skin of color often present atypically or with advanced stage in comparison to Caucasian patients. Health care providers must maintain a high index of suspicion when examining skin lesions in skin of color. PMID:19691228

Tenosynovitis caused by Scedosporium apiospermum infection misdiagnosed as an Alternaria species: a case report.

PubMed

Kim, Choon-Mee; Lim, Sung-Chul; Kim, Joa; Jang, Hoe-Soo; Chung, Jong-Hun; Yun, Na-Ra; Kim, Dong-Min; Jha, Piyush; Jha, Babita; Kim, Seok Won; Jang, Sook Jin; Shin, Jong Hee

2017-01-14

Scedosporium apiospermum, which can usually be isolated from soil, polluted stream water and decaying vegetation, is increasingly recognized as an opportunistic dematiaceous fungus. The mortality rate of infection in immunocompromised hosts is over 50%. S. apiospermum is commonly responsible for dermal and epidermal infections (i.e., mycetoma) after traumatic penetration. A 73-year-old woman was admitted to our hospital complaining of painful swelling and tenderness on the dorsum of the proximal left wrist and hand. The symptoms had persisted for approximately 2 months. A physical examination revealed a 4 x 3 cm, poorly defined, erythematous papule, which was fluctuant, with pustules and crusts on the dorsum of the left hand. We report a very rare case of tenosynovitis caused by S. apiospermum infection. We identified the infectious agent via molecular DNA sequencing. The infectious agent was initially misidentified as an Alternaria species by microscopic examination with lactophenol cotton blue (LPCB) staining. The infection was successfully treated with debridement and adjuvant fluconazole therapy.

Talk to the Hand: U.S. Army Biophysical Testing.

PubMed

Santee, William R; Potter, Adam W; Friedl, Karl E

2017-07-01

Many people are unaware of the science underlying the biophysical properties of Soldier clothing and personal protective equipment, yet there is a well-refined biomedical methodology initiated by Army physiologists in World War II. This involves a methodical progression of systematic material testing technologies, computer modeling, and human testing that enables more efficient development and rapid evaluation of new concepts for Soldier health and performance. Sophisticated manikins that sweat and move are a central part of this testing continuum. This report briefly summarizes the evolution and use of one specialized form of the manikin technologies, the thermal hand model, and its use in research on Soldier hand-wear items that sustain dexterity and protect the hand in extreme environments. Thermal manikin testing methodologies were developed to provide an efficient and consistent analytical tool for the rapid evaluation of new clothing concepts. These methods have been upgraded since the original World War II and Korean War eras to include articulation and sweating capabilities, as characterized and illustrated in this article. The earlier "retired" versions of thermal hand models have now been transferred to the National Museum of Health and Science. The biophysical values from manikin testing are critical inputs to the U.S. Army Research Institute of Environmental Medicine mathematical models that provide predictions of soldier comfort, duration of exposure before loss of manual dexterity, and time to significant risk of freezing (skin temperature <-1°C) and nonfreezing cold injuries (skin temperature <5°C). The greater thickness of better insulated handwear reduces dexterity and also increases surface area which makes added insulation increasingly less effective in retaining heat. Measurements of both thermal resistance (insulation) and evaporative resistance (permeability) collectively characterize the biophysical properties and enable mathematical

Seasonal skin colour changes in a sample teenage population measured by reflection spectrophotometry

NASA Astrophysics Data System (ADS)

Stringer, M. R.; Cruse-Sawyer, J. E.

2007-11-01

As part of a classroom-based research project, reflectance spectra from the skin of a group of teenage school students were recorded over a four-month period, from early spring to mid-summer. The relative changes in skin colour during the course of the study were quantified by integrating over the full wavelength range of the normalized reflectance spectra. Measurements made upon the inner forearm and the back of the hand produce results which indicate a decrease in total reflectance (increase in absorption) corresponding to different levels of tanning for limited and extended exposure to ambient sunlight, respectively. The rate of change of skin colour qualitatively matches that of the solar illuminance.

Prefrontal oxygenation correlates to the responses in facial skin blood flows during exposure to pleasantly charged movie.

PubMed

Matsukawa, Kanji; Endo, Kana; Asahara, Ryota; Yoshikawa, Miho; Kusunoki, Shinya; Ishida, Tomoko

2017-11-01

Our laboratory reported that facial skin blood flow may serve as a sensitive tool to assess an emotional status. Cerebral neural correlates during emotional interventions should be sought in relation to the changes in facial skin blood flow. To test the hypothesis that prefrontal activity has positive relation to the changes in facial skin blood flow during emotionally charged stimulation, we examined the dynamic changes in prefrontal oxygenation (with near-infrared spectroscopy) and facial skin blood flows (with two-dimensional laser speckle and Doppler flowmetry) during emotionally charged audiovisual challenges for 2 min (by viewing comedy, landscape, and horror movie) in 14 subjects. Hand skin blood flow and systemic hemodynamics were simultaneously measured. The extents of pleasantness and consciousness for each emotional stimulus were estimated by subjective rating from -5 (the most unpleasant; the most unconscious) to +5 (the most pleasant; the most conscious). Positively charged emotional stimulation (comedy) simultaneously decreased ( P  <   0.05) prefrontal oxygenation and facial skin blood flow, whereas negatively charged (horror) or neutral (landscape) emotional stimulation did not alter or slightly decreased them. Any of hand skin blood flow and systemic cardiovascular variables did not change significantly during positively charged emotional stimulation. The changes in prefrontal oxygenation had a highly positive correlation with the changes in facial skin blood flow without altering perfusion pressure, and they were inversely correlated with the subjective rating of pleasantness. The reduction in prefrontal oxygenation during positively charged emotional stimulation suggests a decrease in prefrontal neural activity, which may in turn elicit neurally mediated vasoconstriction of facial skin blood vessels. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American

Human skin permeation of emerging mycotoxins (beauvericin and enniatins).

PubMed

Taevernier, Lien; Veryser, Lieselotte; Roche, Nathalie; Peremans, Kathelijne; Burvenich, Christian; Delesalle, Catherine; De Spiegeleer, Bart

2016-01-01

Currently, dermal exposure data of cyclic depsipeptide mycotoxins are completely absent. There is a lack of understanding about the local skin and systemic kinetics and effects, despite their widespread skin contact and intrinsic hazard. Therefore, we provide a quantitative characterisation of their dermal kinetics. The emerging mycotoxins enniatins (ENNs) and beauvericin (BEA) were used as model compounds and their transdermal kinetics were quantitatively evaluated, using intact and damaged human skin in an in vitro Franz diffusion cell set-up and ultra high-performance liquid chromatography (UHPLC)-MS analytics. We demonstrated that all investigated mycotoxins are able to penetrate through the skin. ENN B showed the highest permeation (kp,v=9.44 × 10(-6) cm/h), whereas BEA showed the lowest (kp,v=2.35 × 10(-6) cm/h) and the other ENNs ranging in between. Combining these values with experimentally determined solubility data, Jmax values ranging from 0.02 to 0.35 μg/(cm(2) h) for intact skin and from 0.07 to 1.11 μg/(cm(2) h) for damaged skin were obtained. These were used to determine the daily dermal exposure (DDE) in a worst-case scenario. On the other hand, DDE's for a typical occupational scenario were calculated based on real-life mycotoxin concentrations for the industrial exposure of food-related workers. In the latter case, for contact with intact human skin, DDE's up to 0.0870 ng/(kg BW × day) for ENN A were calculated, whereas for impaired skin barrier this can even rise up to 0.3209 ng/(kg BW × day) for ENN B1. This knowledge is needed for the risk assessment after skin exposure of contaminated food, feed, indoor surfaces and airborne particles with mycotoxins.

Risk Reduction and Measures of Injury for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeffrey A.; Hoffman, Ronald B.; Harvey, C. M.; Bowen, C. K.; Hudy, C. E.; Gernhardt, M. L.

2007-01-01

During Neutral Buoyancy Lab (NBL) training sessions, a large amount of moisture accumulates in the EVA gloves. The glove design restricts the extension of the EVA suit s ventilation/cooling system to the hand. Subungual redness and fingernail pain develops for many astronauts following their NBL training sessions with subsequent oncholysis occurring over succeeding weeks. Various attempts have been made to reduce or avoid this problem. The causal role of moisture has yet to be defined. Methods: To determine the contribution that moisture plays in the injury to the fingers and fingernails during EVA training operations in NBL, the current Extravehicular Mobility Unit (EMU), with a Portable Life Support System (PLSS) was configured with a ventilation tube that extended down a single arm of the crewmember during the test and compared with the unventilated contralateral arm; with the ventilated hand serving as the experimental condition (E) and the opposite arm as the control (C). A cross-over design was used with opposite handedness for the vent tube on a subsequent NBL training run. Moisture content measures were conducted at six points on each hand with three types of moisture meters. A questionnaire was administered to determine subjective thermal hand discomfort, skin moisture perception, and hand and nail discomfort. Photographs and video were recorded. Measures were applied to six astronauts pre- and post-run in the NBL. Results: The consistent trends in relative hydration ratios at the dorsum, from 3.34 for C to 2.11 for E, and first ring finger joint locations, from 2.46 for C to 1.96 for E, indicated the extended vent tube promoted skin drying. The experimental treatment appeared to be more effective on the left hand versus the right hand, implying an interaction with hand anthropometry and glove fit. Video analyses differentiated fine and gross motor training tasks during runs and will be discussed. Conclusions: This potential countermeasure was effective in

Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

PubMed

Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

2016-03-01

Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN. © 2015 Japanese Dermatological Association.

Newborn Skin: Common Skin Problems.

PubMed

Kutlubay, Zekayi; Tanakol, Ali; Engýn, Burhan; Onel, Cristina; Sýmsek, Ersin; Serdaroglu, Server; Tuzun, Yalçýn; Yilmaz, Erkan; Eren, Bülent

2017-01-01

The newborn skin can be separated from adult's skin in several ways. In dermatologic examination it can be easily observed that it is thinner, less hairy and has less sweat and sebaceous gland secretions. These differentiations present especially in preterm newborns. Their skin is exposed to mechanical trauma, bacteria and weather, heat alterations. At birth, newborn skin is protected by the coverage of vernix caseosa, which has lubricating and antibacterial features and its pH ranges from 6.7 to 7.4. Beneath the vernix caseosa the skin has a pH of 5.5-6.0. In newborn dermatologic examination it is very important to distinguish transient benign dermatoses and severe diseases, make early diagnosis and treat congenital skin disorders. Although the benign cases are common in this life period, clinical presentations can be much more exaggerated, dramatic and cause a great deal of anxiety to parents. Therefore, as a doctor, knowing the dermatological, pathological and non-pathological common skin rashes guides the family in the right direction, offers advice to reduce uncertainty and time for the treatment of severe conditions and builds a confidential doctor-patient relationship. In this review, our aim is to provide a general overview to common skin rashes in newborn period.

Skin disease in sheep farmers.

PubMed

Heathcote, K; Harris, E C; Brewster, V; Nevel, M A; Coggon, D

2011-10-01

An unusual inflammation of the pinna has been reported to occur in some sheep farmers at the time of lambing. To explore the prevalence of this disorder and its possible causal associations. While on attachment to sheep farms during lambing, veterinary students used a standardized questionnaire to interview a sample of farmers about their work and about symptoms of skin inflammation in their hands, face and ears. Interviews were completed by 76 (67%) of the farmers approached. Among 74 farmers who had carried out lambing, 3 (4%, 95% CI 1-11%) had experienced temporally related ear symptoms, all on multiple occasions. No farmers with ear symptoms had ever been involved in calving or farrowing, and no ear symptoms were reported in relation to shearing or dipping sheep. There was also an excess of hand symptoms related to lambing outdoors (24% of those who had done such work) and indoors (also 24%) compared with other farming activities. Our findings suggest that temporally related ear inflammation occurs in at least 1% of farmers who carry out lambing but not in association with the other farming activities investigated. Lambing appears to be associated also with hand inflammation, but the pathology may differ from that in the pinna.

Self-reported hand hygiene perceptions and barriers among companion animal veterinary clinic personnel in Ontario, Canada

PubMed Central

Anderson, Maureen E.C.; Weese, J. Scott

2016-01-01

The objective of this study was to describe the perceived importance of and barriers to hand hygiene among companion animal clinic staff. An anonymous, voluntary written questionnaire was completed by 356 of approximately 578 individuals (62%) from 49/51 clinics. On a scale of 1 (not important) to 7 (very important), the percentage of respondents who rated hand hygiene as a 5 or higher was at least 82% in all clinical scenarios queried. The most frequently reported reason for not performing hand hygiene was forgetting to do so (40%, 141/353). Specific discussion of hand hygiene practices at work was recalled by 32% (114/354) of respondents. Although veterinary staff seem to recognize the importance of hand hygiene, it should be emphasized more during staff training. Other barriers including time constraints and skin irritation should also be addressed, possibly through increased access to and use of alcohol-based hand sanitizers. PMID:26933265

Influence of body heat content on hand function during prolonged cold exposures.

PubMed

Flouris, A D; Cheung, S S; Fowles, J R; Kruisselbrink, L D; Westwood, D A; Carrillo, A E; Murphy, R J L

2006-09-01

We examined the influence of 1) prior increase [preheating (PHT)], 2) increase throughout [heating (HT)], and 3) no increase [control (Con)] of body heat content (H(b)) on neuromuscular function and manual dexterity of the hands during a 130-min exposure to -20 degrees C (coldEx). Ten volunteers randomly underwent three passive coldEx, incorporating a 10-min moderate-exercise period at the 65th min while wearing a liquid conditioning garment (LCG) and military arctic clothing. In PHT, 50 degrees C water was circulated in the LCG before coldEx until core temperature was increased by 0.5 degrees C. In HT, participants regulated the inlet LCG water temperature throughout coldEx to subjective comfort, while the LCG was not operating in Con. Thermal comfort, rectal temperature, mean skin temperature, mean finger temperature (T(fing)), change in H(b) (DeltaH(b)), rate of body heat storage, Purdue pegboard test, finger tapping, handgrip, maximum voluntary contraction, and evoked twitch force of the first dorsal interosseus muscle were recorded. Results demonstrated that, unlike in HT and PHT, thermal comfort, rectal temperature, mean skin temperature, twitch force, maximum voluntary contraction, and finger tapping declined significantly in Con. In contrast, T(fing) and Purdue pegboard test remained constant only in HT. Generalized estimating equations demonstrated that DeltaH(b) and T(fing) were associated over time with hand function, whereas no significant association was detected for rate of body heat storage. It is concluded that increasing H(b) not only throughout but also before a coldEx is effective in maintaining hand function. In addition, we found that the best indicator of hand function is DeltaH(b) followed by T(fing).

New method for determination of efficacy of health care personnel hand wash products.

PubMed Central

Mahl, M C

1989-01-01

A method of studying the effects of health care personnel hand wash products is described. The fingernail regions of the hands of volunteers are inoculated with a mixture of Escherichia coli and Serratia marcescens, and the areas are dried for a standard time. After routine hand washing, each fingernail region is individually scrubbed with an electric toothbrush which moves longitudinally to the handle into collection fluid contained in a petri dish. The test bacteria in the fluid are then enumerated. (Bacillus subtilis spores may be included as tracers to show degree of physical removal of the procedure.) This method has several advantages over the frequently used glove juice technique. Experimental designs with large numbers of volunteers, multiple sampling sites, and many hand wash products may be performed. Ten sampling sites (fingers) are available, versus the two gloved hands for testing products. (Efficiency is almost 100% in the recovery of spore tracers placed on the fingernails.) Many commercial health care personnel hand wash products containing antimicrobial agents substantive to the skin do not rapidly reduce numbers of inoculated bacteria in the fingernail regions to any greater extent than nonantimicrobial hand washes. Products containing isopropanol or ethanol are very effective in decreasing bacteria in areas around and under the fingernails. PMID:2685028

Prevention of hand eczema in the metal-working industry: risk awareness and behaviour of metal worker apprentices.

PubMed

Itschner, L; Hinnen, U; Elsner, P

1996-01-01

In the metal-working industry, occupational hand eczema is very common and often due to contact with cutting fluids. Since it can be avoided by adequate protective measures, prevention plays an important role. However, the effectiveness of prevention depends heavily on the employees' awareness of this health risk. The study aimed to collect information on the attitude of metal worker apprentices towards the risk of occupational skin disorders and skin protection since it is believed that their attitude at the beginning of the education will guide their future risk behaviour. By means of a questionnaire, 79 metal worker apprentices were interviewed about their awareness of dermal risk factors and their risk behaviour at work. The apprentices are very badly informed about skin diseases and skin care. Most of them are not concerned about developing occupational skin problems, and they declared having obtained very little information about this subject. Considering this finding, it seems urgent to intensify health and safety education already at the beginning of the apprenticeship.

The Skin Microbiome: Is It Affected by UV-induced Immune Suppression?

PubMed Central

Patra, VijayKumar; Byrne, Scott N.; Wolf, Peter

2016-01-01

Human skin apart from functioning as a physical barricade to stop the entry of pathogens, also hosts innumerable commensal organisms. The skin cells and the immune system constantly interact with microbes, to maintain cutaneous homeostasis, despite the challenges offered by various environmental factors. A major environmental factor affecting the skin is ultraviolet radiation (UV-R) from sunlight. UV-R is well known to modulate the immune system, which can be both beneficial and deleterious. By targeting the cells and molecules within skin, UV-R can trigger the production and release of antimicrobial peptides, affect the innate immune system and ultimately suppress the adaptive cellular immune response. This can contribute to skin carcinogenesis and the promotion of infectious agents such as herpes simplex virus and possibly others. On the other hand, a UV-established immunosuppressive environment may protect against the induction of immunologically mediated skin diseases including some of photodermatoses such as polymorphic light eruption. In this article, we share our perspective about the possibility that UV-induced immune suppression may alter the landscape of the skin’s microbiome and its components. Alternatively, or in concert with this, direct UV-induced DNA and membrane damage to the microbiome may result in pathogen associated molecular patterns (PAMPs) that interfere with UV-induced immune suppression. PMID:27559331

Postural vascular response in human skin: passive and active reactions to alteration of transmural pressure.

PubMed

Jepsen, H; Gaehtgens, P

1993-09-01

Laser-Doppler (LD) fluxmetry was performed in the palmar finger skin of healthy subjects to study the mechanisms contributing to the postural vascular response. Local transmural pressure in the skin blood vessels of the region studied was altered for 1 min in two experimental series either by passive movement of the arm to different vertical hand positions relative to heart level or by application of external pressure (-120-180 mmHg) to the finger. Heart and respiratory rate, arterial blood pressure, and LD flux in the contralateral finger (kept at heart level) were measured. The measurements suggest a compound reaction of local (myogenic) and systemic (neurogenic) mechanisms: the local regulatory component appears as a graded active vascular response elicited by passive vessel distension or compression. A systemic component, associated with a single deep inspiration, is frequently observed during the actual movement of the arm. In addition, prolonged holding of the test hand in a given vertical position also elicits a delayed vascular response in the control hand at heart level, which may be generated by volume receptors in the intrathoracic low-pressure system.

A new species of Brachycephalus (Anura: Brachycephalidae) from the Quiriri mountain range of southern Brazil.

PubMed

Pie, Marcio R; Ribeiro, Luiz F

2015-01-01

A new miniaturized toadled of the genus Brachycephalus (Anura: Brachycephalidae) is described from Serra do Quiriri in the municipality of Campo Alegre, Santa Catarina, southern Brazil. Specimens were collected from the leaf litter between from 1,263 and 1,318 m above sea level. The new species is distinguished from all its congeners by the combination of the following characters: snout-vent length 9.9-13.1 mm; skin on head and dorsum without dermal co-ossification; snout mucronate in dorsal view; dorsum rugose; general color brown, with a narrow orange vertebral stripe. The region where the new species is located is also shared with other endemic anuran species and has experienced strong anthropogenic impacts,suggesting that immediate actions should be taken to ensure their long-term preservation.

Dressed in black. A New Ansonia Stoliczka, 1870 (Lissamphibia: Anura: Bufonidae) from Gunung Murud, Sarawak, East Malaysia (Borneo).

PubMed

Hertwig, Stefan T; Min, Pui Yong; Haas, Alexander; Das, Indraneil

2014-06-10

A new species of stream toad of the genus Ansonia is described from Gunung Murud, Pulong Tau National Park, of northern Sarawak, Malaysia, Borneo. Ansonia vidua, sp. nov., is morphologically distinguished from its Bornean congeners by the following combination of characters: medium size (SVL of adult females 33.5-34.4 mm); body uniformly black-brown in life; absence of a visible pattern on dorsum or limbs; presence of two low interorbital ridges; shagreened skin on dorsum, sides and upper surfaces of the limbs with numerous homogeneously small, rounded warts; first finger shorter than second; reduced webbing between the toes and an absence of a sharp tarsal ridge. Uncorrected genetic distances between related taxa of > 4.3% in 16S rRNA gene support its status as a hitherto undescribed species.

A new species of Brachycephalus (Anura: Brachycephalidae) from the Quiriri mountain range of southern Brazil

PubMed Central

Ribeiro, Luiz F.

2015-01-01

A new miniaturized toadled of the genus Brachycephalus (Anura: Brachycephalidae) is described from Serra do Quiriri in the municipality of Campo Alegre, Santa Catarina, southern Brazil. Specimens were collected from the leaf litter between from 1,263 and 1,318 m above sea level. The new species is distinguished from all its congeners by the combination of the following characters: snout–vent length 9.9–13.1 mm; skin on head and dorsum without dermal co-ossification; snout mucronate in dorsal view; dorsum rugose; general color brown, with a narrow orange vertebral stripe. The region where the new species is located is also shared with other endemic anuran species and has experienced strong anthropogenic impacts,suggesting that immediate actions should be taken to ensure their long-term preservation. PMID:26339556

A new species of arboreal toad (Anura : Bufonidae : Chaunus) from Madidi National Park, Bolivia

USGS Publications Warehouse

Padial, J.M.; Reichle, S.; McDiarmid, R.; De la Riva, I.

2006-01-01

A new arboreal species of the Chaunus veraguensis group is described for the humid montane forest of Madidi National Park, in northern Bolivia. The new species differs from other species in the group by the combination small size, long and slender extremities, webbed hands, conspicuous tympanic membrane, well developed parotoid glands, absence of large glands on dorsum and extremities, nuptial excrescences of males composed of pungent spines on dorsal surface of thumb, greenish-brown coloration on dorsum with red warts in life, and green iris. It is only known from two nearby localities in the Serran Eslabon, Department La Paz. An operational key for species in the C. veraguensis group is provided.

Sensitizing Clostridium difficile Spores with Germinants on Skin and Environmental Surfaces Represents a New Strategy for Reducing Spores via Ambient Mechanisms

PubMed Central

Nerandzic, Michelle M.; Donskey, Curtis J.

2017-01-01

Background Clostridium difficile is a leading cause of healthcare-associated infections worldwide. Prevention of C. difficile transmission is challenging because spores are not killed by alcohol-based hand sanitizers or many commonly used disinfectants. One strategy to control spores is to induce germination, thereby rendering the spores more susceptible to benign disinfection measures and ambient stressors. Methods/Results C. difficile spores germinated on skin after a single application of cholic acid-class bile salts and co-germinants; for 4 C. difficile strains, recovery of viable spores from skin was reduced by ~0.3 log10CFU to 2 log10CFU after 2 hours and ~1 log10CFU to > 2.5 log10CFU after 24 hours. The addition of taurocholic acid to 70% and 30% ethanol significantly enhanced reduction of viable spores on skin and on surfaces. Desiccation, and to a lesser extent the presence of oxygen, were identified as the stressors responsible for reductions of germinated spores on skin and surfaces. Additionally, germinated spores became susceptible to killing by pH 1.5 hydrochloric acid, suggesting that germinated spores that remain viable on skin and surfaces might be killed by gastric acid after ingestion. Antibiotic-treated mice did not become colonized after exposure to germinated spores, whereas 100% of mice became colonized after exposure to the same quantity of dormant spores. Conclusions Germination could provide a new approach to reduce C. difficile spores on skin and in the environment and to render surviving spores less capable of causing infection. Our findings suggest that it may be feasible to develop alcohol-based hand sanitizers containing germinants that reduce spores on hands. PMID:29167835

Assessing United States Patient and Dermatologist Experiences with Severe Chronic Hand Eczema

PubMed Central

Baranowski, Eileen; Zelt, Susan; Reynolds, Maria; Sherrill, Beth

2015-01-01

Objective: Patients with severe chronic hand eczema often have persistent symptoms that interfere with daily activities, social functioning, and employment. Many patients are refractory to topical corticosteroids. This survey-based study was performed to characterize treatment experiences, impact on productivity, and quality of life of patients with severe chronic hand eczema; understand dermatologists’ severe chronic hand eczema treatment patterns. Design: A web-based survey in the United States queried pre-identified patients with severe chronic hand eczema regarding symptoms, treatment history, quality of life, work productivity, treatment satisfaction, and healthcare utilization. In a separate survey, dermatologists were asked about treatment patterns and satisfaction with currently available therapies. Results: The most commonly reported symptoms currently experienced by patients (n=163) were dryness/flaking (81%), itchiness (75%), and cracking/tearing of the skin (71%). Over the last three months, 84 percent of patients with severe chronic hand eczema self-reported using topical steroids, and 30 percent used systemic corticosteroids or retinoids. Approximately 30 percent reported impairment while working and productivity loss. Patient quality of life was negatively impacted. Dermatologists (n=125) reported most often treating severe chronic hand eczema with topical corticosteroids (99%), followed by topical immunomodulators (71%) and systemic treatments (70%). Only two percent were very satisfied with currently available products. Conclusion: Patients with severe chronic hand eczema experience symptoms that negatively impact work productivity and quality of life. Few dermatologists are very satisfied with currently available severe chronic hand eczema treatment options. PMID:26705436

Myelodysplastic syndrome precedes the onset of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome.

PubMed

Matsunaga, Takafumi; Izumi, Yasumori; Iwanaga, Nozomi; Kawahara, Chieko; Shigemitsu, Yoshika; Yoshida, Shinichiro; Kawakami, Atsushi; Ogawa, Daisuke; Migita, Kiyoshi

2015-01-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is characterized by symmetrical synovitis predominantly involving the wrists, and is associated with marked pitting edema of the dorsum of the hands. Although the etiology of RS3PE syndrome is still unknown, several putative associations with malignancies and hematological disorders have been reported. Myelodysplastic syndrome (MDS) is characterized by infective hematopoiesis with possible transformation to leukemia; however, an association between RS3PE syndrome and MDS has been rarely reported. Here, we describe a 67-year-old man with MDS with refractory anemia who developed RS3PE syndrome 3 months after the diagnosis of MDS. The patient presented with polyarthritis with pitting edema at the dorsum of the hands, the elevated serum levels of C-reactive protein and a proinflammatory cytokine, interleukin-6, and the elevated plasma levels of vascular endothelial growth factor (VEGF). VEGF has been shown to be involved in the pathogenesis of RS3PE syndrome. Treatment with low doses of corticosteroids resulted in the regression of polyarthritis and pitting edema of the dorsum of the hands, as well as a reduction in the elevated levels of plasma VEGF. Partial resolution of refractory anemia was also observed with steroid therapy. In summary, RS3PE syndrome developed shortly after MDS was identified in this patient. The sequence of clinical events suggests that MDS-mediated immunological abnormalities including inflammatory cytokine induction may be responsible for the association between MDS and RS3PE syndrome. Patients with RS3PE syndrome should be screened for hematological disorders that promote proinflammatory mediators.

Predicting chemically-induced skin reactions. Part II: QSAR models of skin permeability and the relationships between skin permeability and skin sensitization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alves, Vinicius M.; Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599; Muratov, Eugene

Skin permeability is widely considered to be mechanistically implicated in chemically-induced skin sensitization. Although many chemicals have been identified as skin sensitizers, there have been very few reports analyzing the relationships between molecular structure and skin permeability of sensitizers and non-sensitizers. The goals of this study were to: (i) compile, curate, and integrate the largest publicly available dataset of chemicals studied for their skin permeability; (ii) develop and rigorously validate QSAR models to predict skin permeability; and (iii) explore the complex relationships between skin sensitization and skin permeability. Based on the largest publicly available dataset compiled in this study, wemore » found no overall correlation between skin permeability and skin sensitization. In addition, cross-species correlation coefficient between human and rodent permeability data was found to be as low as R{sup 2} = 0.44. Human skin permeability models based on the random forest method have been developed and validated using OECD-compliant QSAR modeling workflow. Their external accuracy was high (Q{sup 2}{sub ext} = 0.73 for 63% of external compounds inside the applicability domain). The extended analysis using both experimentally-measured and QSAR-imputed data still confirmed the absence of any overall concordance between skin permeability and skin sensitization. This observation suggests that chemical modifications that affect skin permeability should not be presumed a priori to modulate the sensitization potential of chemicals. The models reported herein as well as those developed in the companion paper on skin sensitization suggest that it may be possible to rationally design compounds with the desired high skin permeability but low sensitization potential. - Highlights: • It was compiled the largest publicly-available skin permeability dataset. • Predictive QSAR models were developed for skin permeability. • No concordance between

Cardiovascular and ventilatory responses to dorsal, facial, and whole-head water immersion in eupnea.

PubMed

Gagnon, Dominique D; Pretorius, Thea; McDonald, Gerren; Kenny, Glen P; Giesbrecht, Gordon G

2013-06-01

Facial cooling can regulate reflexes of the dive response whereas further body cooling generally induces the cold-shock response. We examined the cardiovascular and ventilatory parameters of these responses during 3-min immersions of the head dorsum, face, and whole head in 17 degrees C water while breathing was maintained. From a horizontal position, the head was inserted into a temperature controlled immersion tank in which the water level could be changed rapidly. On four occasions, either the head dorsum, face or whole head (prone and supine) were exposed to water. Mean decrease in heart rate (14%) and increases in systolic (9%) and diastolic (5%) blood pressures were seen during immersion. Relative mean finger skin blood flow had an early transient decrease (31%) for 90 s and then returned to baseline values. A strong transient increase was seen in minute ventilation (92%) at 20 s of immersion via tidal volume (85%). There were no consistent differences between the head dorsum, face, and whole head for all variables in response to immersion. The cold-shock response (increased minute ventilation and tidal volume) predominated over the dive response in the initial moments of immersion only. The order of emergence of these responses provides further recommendation to avoid head submersion upon cold water entry. It is important to protect the face, with a facemask, and the head dorsum, with an insulative hood, in cold water.

Quantitative analysis of macrophages in wound healing of rat skin subjected to loud noise stress.

PubMed

Rafi, Aisha; Khan, Muhammad Yunus; Minhas, Liaqat Ali

2014-01-01

Factors affecting skin wound healing have always been a central consideration in medical practice. Loud noise is biological stressor affecting the body systems at various levels. The present study was taken to study the effect of loud noise stress on the macrophages during wound healing process in male rat skin. One hundred and eighty male Sprague Dawley rats were randomly divided into control group-A and experimental group-B. Each group comprised 90 animals. Control and experimental groups were further subdivided into three subgroups of 30 animals each, corresponding to the day of sacrifice of animals, i.e., day 3, 5 and 7 after surgery. After induction of local anaesthesia a linear full thickness incision paravertebral to thoracic spine was made on the dorsum of rat. The experimental group B was exposed to loud noise stimulus (recorded noise of aero planes and gun fire) set at 97dBA to 102 dBA with a sound level meter. The animals were decapitated on day 3, 5 and 7 after surgery. Tissue was processed for paraffin embedding and stained by Hematoxylin and Eosin and Mallory's trichrome stain. Data was collected for the incisional space of the wound. Quantitative data of number of macrophages was analysed by Student's' test for the detection of any significant differences between the mean number in the experimental and control groups. All the quantitative data was expressed as means ± SE. A p-value of ≤ 0.05 was considered statistically significant. In this study macrophages were decreased statistically significantly at day 3 after surgery and thereafter increased significantly on day 5 and 7 after surgery in the experimental subgroups as compared to their match control subgroups. These results show that loud noise stress affects the cells (macrophages) involved in the healing of the wound therefore it is expected to have impact on the stages of wound healing.

Efficacy of Low Level Laser Therapy After Hand Flexor Tendon Repair

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ayad, K. E.; Abd El Mejeed, S. F.; El Gohary, H. M.

Flexor tendon injury is a common problem requiring suturing repair followed by early postoperative mobilization. Muscle atrophy, joint stiffness, osteoarthritis, infection, skin necrosis, ulceration of joint cartilage and tendocutaneous adhesion are familiar complications produced by prolonged immobilization of surgically repaired tendon ruptures. The purpose of this study was to clarify the importance of low level laser therapy after hand flexor tendon repair in zone II. Thirty patients aging between 20 and 40 years were divided into two groups. Patients in group A (n = 15) received a conventional therapeutic exercise program while patients in group B (n = 15) receivedmore » low level laser therapy combined with the same therapeutic exercise program. The results showed a statistically significant increase in total active motion of the proximal and distal interphalangeal joints as well as maximum hand grip strength at three weeks and three months postoperative, but improvement was more significant in group B. It was concluded that the combination of low level laser therapy and early therapeutic exercises was more effective than therapeutic exercises alone in improving total active motion of proximal and distal interphalangeal joints and hand grip strength after hand flexor tendon repair.« less

A Study of the Skin Absorption of Ethylbenzene in Man

PubMed Central

Dutkiewicz, Tadeusz; Tyras, Halina

1967-01-01

The absorption of ethylbenzene through the skin of the hand and the forearm in men was investigated experimentally. Both the absorption of liquid ethylbenzene and the absorption from aqueous solutions were studied. The rate of absorption of liquid ethylbenzene was 22 to 33 mg./cm.2/hr, and the rates from aqueous solutions were 118 and 215 μg./cm.2/hr from mean concentrations of 112 and 156 mg./litre. The mandelic acid excreted in urine was equivalent to about 4·6% of the absorbed dose—much less than after lung absorption. Urinary mandelic acid does not provide a reliable index of absorption when there is simultaneous skin and lung exposure. PMID:6073092

Skin deposition of nickel, cobalt, and chromium in production of gas turbines and space propulsion components.

PubMed

Julander, Anneli; Skare, Lizbet; Mulder, Marie; Grandér, Margaretha; Vahter, Marie; Lidén, Carola

2010-04-01

Skin exposure to nickel, cobalt, and chromium may cause sensitization and allergic contact dermatitis and it is known that many alloys and platings may release significant amounts of the metals upon contact with skin. Occupational exposure to these sensitizing metals has been studied in different settings with regards to airborne dust and different biological end points, but little is known about deposition on skin from airborne dust and direct contact with materials containing the metals. In this study, skin deposition was studied in 24 workers in an industry for development and manufacturing of gas turbines and space propulsion components. The workers were employed in three departments, representing different exposure scenarios: tools sharpening of hard metal items, production of space propulsion structures, and thermal application of different metal-containing powders. A novel acid wipe sampling technique was used to sample metals from specific skin surfaces on the hands and the forehead of the workers. Total amounts of nickel, cobalt, and chromium were measured by inductively coupled plasma mass spectrometry. The result showed that nickel, cobalt, and chromium could be detected on all skin surfaces sampled. The highest level of nickel was 15 microg cm(-2) h(-1), the highest for cobalt was 4.5 microg cm(-2) h(-1), and for chromium 0.6 microg cm(-2) h(-1). The three departments had different exposures regarding the metals. The highest levels of nickel on the skin of the workers were found in the thermal applications department, cobalt in the tools sharpening department, and chromium in the space propulsion components department. In conclusion, the workers' exposure to the metals was more likely to come from direct skin contact with items, rather than from airborne dust, based on the fact that the levels of metals were much higher on the fingers than on the back side of the hands and the forehead. The skin exposure levels of nickel and cobalt detected are judged

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

PubMed Central

Kampf, Günter; Kramer, Axel

2004-01-01

The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data

Remitting seronegative symmetrical synovitis with pitting edema associated with parvovirus B19 infection: two new cases and review of the comorbidities.

PubMed

Drago, Francesco; Ciccarese, Giulia; Agnoletti, Arianna F; Cogorno, Ludovica; Muda, Alessandro; Cozzani, Emanuele; Parodi, Aurora

2015-10-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare syndrome consisting of acute symmetrical tenosynovitis of the hands and wrists associated with pain and marked pitting edema of the dorsum of the hands or the feet. Persistent rheumatoid factor seronegativity and elevated acute phase reactants are the rule, while radiographic findings are characterized by the absence of bony erosions. The syndrome has occasionally been associated with a wide range of diseases including solid and hematological malignancies, polymyalgia rheumatica, and other inflammatory rheumatic diseases. Two patients with skin eruption on hands and feet associated with arthromyalgias have been investigated to confirm diagnosis of RS3PE and to detect comorbidities. A revision of all the possible medical conditions correlated to RS3PE has been performed. We report two cases of RS3PE associated with Parvovirus B19 infection/reactivation. There are very few reports on the association between RS3PE and infectious agents, and in only one case the syndrome has been correlated to parvovirus infection. We want to underline the importance for patients with RS3PE to be seen by dermatologists who should become familiar with this syndrome and remark that Parvovirus B19 infection may be a potential cause of RS3PE. © 2015 The International Society of Dermatology.

Upper limb amputees can be induced to experience a rubber hand as their own

PubMed Central

Rosén, Birgitta; Stockselius, Anita; Ragnö, Christina; Köhler, Peter; Lundborg, Göran

2008-01-01

We describe how upper limb amputees can be made to experience a rubber hand as part of their own body. This was accomplished by applying synchronous touches to the stump, which was out of view, and to the index finger of a rubber hand, placed in full view (26 cm medial to the stump). This elicited an illusion of sensing touch on the artificial hand, rather than on the stump and a feeling of ownership of the rubber hand developed. This effect was supported by quantitative subjective reports in the form of questionnaires, behavioural data in the form of misreaching in a pointing task when asked to localize the position of the touch, and physiological evidence obtained by skin conductance responses when threatening the hand prosthesis. Our findings outline a simple method for transferring tactile sensations from the stump to a prosthetic limb by tricking the brain, thereby making an important contribution to the field of neuroprosthetics where a major goal is to develop artificial limbs that feel like a real parts of the body. PMID:19074189

Optical clearing of human skin for the enhancement of optical imaging of proximal interphalangeal joints

NASA Astrophysics Data System (ADS)

Kolesnikova, Ekaterina A.; Kolesnikov, Aleksandr S.; Zabarylo, Urszula; Minet, Olaf; Genina, Elina A.; Bashkatov, Alexey N.; Tuchin, Valery V.

2014-01-01

We are proposing a new method for enhancement of optical imaging of proximal interphalangeal (PIP) joints in humans at skin using optical clearing technique. A set of illuminating laser diodes with the wavelengths 670, 820, and 904 nm were used as a light source. The laser diodes, monochromatic digital CCD camera and specific software allowed for detection of the finger joint image in a transillumination mode. The experiments were carried out in vivo with human fingers. Dehydrated glycerol and hand cream with urea (5%) were used as optical clearing agents (OCAs). The contrast of the obtained images was analyzed to determine the effect of the OCA. It was found that glycerol application to the human skin during 60 min caused the decrease of contrast in 1.4 folds for 670 nm and the increase of contrast in 1.5 and 1.7 folds for 820 nm and 904 nm, respectively. At the same time, the hand cream application to the human skin during 60 min caused the decrease of contrast in 1.1 folds for 670 nm and the increase of contrast in 1.3 and 1.1 folds for 820 nm and 904 nm, respectively. The results have shown that glycerol and the hand cream with 5% urea allow for obtaining of more distinct image of finger joint in the NIR. Obtained data can be used for development of optical diagnostic methods of rheumatoid arthritis.

Deletion of epidermal Rac1 inhibits HPV-8 induced skin papilloma formation and facilitates HPV-8- and UV-light induced skin carcinogenesis

PubMed Central

Deshmukh, Jayesh; Pofahl, Ruth; Pfister, Herbert; Haase, Ingo

2016-01-01

Overexpression and increased activity of the small Rho GTPase Rac1 has been linked to squamous cell carcinoma of the epidermis and mucosa in humans. Targeted deletion of Rac1 or inhibition of Rac1 activity in epidermal keratinocytes reduced papilloma formation in a chemical skin carcinogenesis mouse model. However, a potential role of Rac1 in HPV- and UV-light induced skin carcinogenesis has not been investigated so far, solar UV radiation being an important carcinogen to the skin. To investigate this, we deleted Rac1 or modulated its activity in mice with transgenic expression of Human papilloma virus type-8 (HPV-8) in epidermal keratinocytes. Our data show that inhibition or deletion of Rac1 results in reduced papilloma formation upon UV-irradiation with a single dose, whereas constitutive activation of Rac1 strongly increases papilloma frequency in these mice. Surprisingly, we observed that, upon chronic UV-irradiation, the majority of mice with transgenic expression of HPV-8 and epidermis specific Rac1 deletion developed squamous cell carcinomas. Taken together, our data show that Rac1 exerts a dual role in skin carcinogenesis: its activation is, on one hand, required for HPV-8- and UV-light induced papilloma formation but, on the other, suppresses the development of squamous cell carcinomas. PMID:27506937

Deletion of epidermal Rac1 inhibits HPV-8 induced skin papilloma formation and facilitates HPV-8- and UV-light induced skin carcinogenesis.

PubMed

Deshmukh, Jayesh; Pofahl, Ruth; Pfister, Herbert; Haase, Ingo

2016-09-06

Overexpression and increased activity of the small Rho GTPase Rac1 has been linked to squamous cell carcinoma of the epidermis and mucosa in humans. Targeted deletion of Rac1 or inhibition of Rac1 activity in epidermal keratinocytes reduced papilloma formation in a chemical skin carcinogenesis mouse model. However, a potential role of Rac1 in HPV- and UV-light induced skin carcinogenesis has not been investigated so far, solar UV radiation being an important carcinogen to the skin.To investigate this, we deleted Rac1 or modulated its activity in mice with transgenic expression of Human papilloma virus type-8 (HPV-8) in epidermal keratinocytes. Our data show that inhibition or deletion of Rac1 results in reduced papilloma formation upon UV-irradiation with a single dose, whereas constitutive activation of Rac1 strongly increases papilloma frequency in these mice. Surprisingly, we observed that, upon chronic UV-irradiation, the majority of mice with transgenic expression of HPV-8 and epidermis specific Rac1 deletion developed squamous cell carcinomas. Taken together, our data show that Rac1 exerts a dual role in skin carcinogenesis: its activation is, on one hand, required for HPV-8- and UV-light induced papilloma formation but, on the other, suppresses the development of squamous cell carcinomas.

Skin Diseases: Cross-section of human skin

MedlinePlus

Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Cross-section of human skin Past Issues / Fall 2008 Table of Contents For ... Logical Images, Inc. I n the areas of skin health and skin diseases, the NIH's National Institute ...

Noninvasive measuring methods for the investigation of irritant patch test reactions. A study of patients with hand eczema, atopic dermatitis and controls.

PubMed

Agner, T

1992-01-01

The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and

A new biomechanical hand prosthesis controlled by surface electromyographic signals.