Ulcers in polarized-light dermoscopy images of 49 biopsy-proven basal cell carcinomas were identified and manually selected. For 153 polarized-light dermoscopy images of benign lesions, those areas that most closely mimicked ulcers were similarly selected. Fifteen measures were analyzed over the areas of ulcers and ulcer mimics. Six of those measures were texture measures: energy, variance, smoothness, skewness, uniformity, and entropy. Nine of those measures were color measures: relative measures of red, green, and blue; chromaticity of red, green, and blue; and the ratios blue-to-green, blue-to-red, and green-to-red.

A back-propagation artificial neural network was able to discriminate most of the basal cell carcinoma from benign lesions, with an area under the ROC curve as high as 92.46%, using color and texture features of ulcer areas.

Separation of basal cell carcinoma from benign cutaneous lesions using image analysis techniques applied to ulcers is feasible. As ulcers are a critical feature in malignant lesions, this finding may have application in the automatic detection of basal cell carcinoma.

To evaluate the effectiveness and reliability of a newly developed full-field LDI technology, 15 consecutive patients presenting with intermediate depth burns were assessed both clinically and by FluxExplorer LDI technology. Comparison between the two methods of assessment was carried out.

Image acquisition was done within 6 s. FluxEXPLORER LDI technology achieved a significantly improved accuracy of burn depth assessment compared to the clinical judgement performed by board certified plastic and reconstructive surgeons (P < 0.05, 93% of correctly assessed burns injuries vs. 80% for clinical assessment).

Technological improvements of LDI technology leading to a decreased image acquisition time and reliable burn depth assessment allow the routine use of such devices in the acute setting of burn care without interfering with the patient's treatment. Rapid and reliable LDI technology may assist clinicians in burn depth assessment and may limit the morbidity of burn patients through a minimization of the area of surgical debridement. Future technological improvements allowing the miniaturization of the device will further ease its clinical application.

The parameters investigated were: history of skin loading before test loading (preconditioning), direction of test loading (anisotropy) and posture (pre-stress). If a sample of skin is loaded, its stiffness will temporarily change. Finally, the reproducibility of skin stiffness and anisotropy measurements, using the developed techniques, was investigated.

By measuring how the stiffness changed with different time delays between loading cycles, the time required for healthy skin to return to its original pre-loaded state was in the region of 125 s. A second finding, which supports and extends previous work, was that skin stiffness varied with direction, by an approximate factor of 2, and that anisotropy was less apparent with preconditioned skin than non-preconditioned skin. Study of the effect of posture showed that care needs to be taken over which stiffness measure is used. For example, measurement of the load at a given displacement was found to be highly dependent on posture, whereas measurement of the phase III stiffness was independent of posture.

It was shown that when the measurement variables and methods of analysis were standardised, skin stiffness could be measured reproducibly enough to distinguish

between the stiffest and softest directions, and that these methods allowed formation of skin elastograms free from confounding influences.

The main goal was to develop a new platform to reconstruct complex mosaic serial data, interact with it in an immersive 3D environment, and give to the observers a feeling of ‘presence’ inside the skin.

We have developed novel methods that transform the data into alternative representation, well-suited to explore cutaneous structures in detail and to observe fields of data from different points of view. This new way of data reconstruction in volume requires optimization of intensities, automatic matching algorithms and depth alignment.

The new platform – SkinExplorer^TM evolves as a 3D exploration prototype. This technology provides an immersive virtual environment to explore cutaneous microstructures. Several serial histological sections can be matched by stacks, aligned in depth by sections and merged together to be visualized as a whole. All these time-consuming steps have been dramatically speed-up using rapid image processing. The advantages of using virtual reality technologies such as the ones used in the SkinExplorer^TM platform are automatic matching, precise alignment, better data perception, lower memory requirement, and higher quantity of simultaneously displayed data. This platform can render volumetric data and isosurfaces, separately or both at the same time. Lighting and depth perception are enhanced using ‘Sphere Mapping’, ‘Ambient Occlusion’, and ‘Halo’ methods when displaying iso-surfacic volume models with high complexity depth. The assets of the platform are to interpret complex three-dimensional data, to observe and explore 3D virtual models, and to show effects of cosmetic treatments.

In this study, we developed a method for assessing colors in a lesion. Twenty-seven perceptible color regions based on the multi-thresholding method in each color channel were constructed, and dominant color region (DCR), bluish dominant region (BDR), and the number of colors were assessed as three diagnostic parameters from these perceptible color regions on 150 dermoscopy images.

Diagnostic accuracy was calculated by combination of three diagnostic parameters derived from DCR, BDR, and the number of colors. Diagnostic accuracy with 73.33% sensitivity and 90.67% specificity was obtained in case of positive features in more than two parameters.

The digital method uses Independent Component Analysis (ICA) to generate melanin-based images representing skin areas due to melanin followed by Region Growing process to segment vitiligo lesion from normal skin.

Based on 41 digital images of vitiligo lesions taken from 18 patients, the proposed method achieved sensitivities of 0.9105 ± 0.0161, specificities of 0.9973 ± 0.0009 and accuracies of 0.9901 ± 0.0028 at 95% confidence level.

With the proposed method, physicians are able to assess vitiligo treatment efficacies objectively.

The mechanical compression test of facial skin was carried out for 102 Japanese women aged 25–56 years. The test was performed on the right temple area skin, and the area of wrinkles induced by the compression was measured using a digital video camera. The rate of increase in wrinkle area during compression was defined as the skin wrinkling rate, and it was calculated for all subjects automatically by image processing.

The test results showed that the skin wrinkling rate underwent a step increase at the age 33, which means that the wrinkling morphologies of young and old skins are completely different, and so it changes suddenly in the early 30s.

A new skin measurement system was developed to validate our theory of wrinkle formation mechanism with aging. The results demonstrated the wrinkling morphology changes suddenly at early 30s.

Ex vivo experiments were carried out on pigs, in neck tissue comparable to human skin at typical injection sites. Six pigs were included and a total of 72 randomized injections were given, i.e. 24 subcutaneous injections given with each needle type. Accordingly, 400 μL was injected including 70% NovoRapid^® (Novo Nordisk A/S, Bagsvμrd, Denmark) and 30% Xenetix^® (Guerbet, Villepinte, France) contrast including 1 mg/mL Alcian blue. Surgical biopsies of injection sites were sampled and computer topographic (CT)-scanned in 3D to assess deposition and local distribution. Biopsies were prepared and stained to evaluate deposition in comparison to the CT-scanning findings. The backflow of each injection was collected with filter paper. The blue stains of filter paper were digitized and volume estimated by software calculation vs. control staining.

CT-scanning (n = 57) and histology (n = 10) showed that, regardless of injection depth, the bulk of the injection was in the subcutaneous tissue and did not propagate from subcutis into dermis. With the 8 mm 30G needle all injections apart from one intramuscular injection were located in the subcutaneous layer. The volume depositions peaked in 4–5 mm depth for the 3 mm 34G needle, in 5–6 mm depth for the 5 mm 32G needle, and in 9–10 mm depth for the 8 mm 30G needle. In general, injection depositions evaluated by histology and CT-scans compared well for the individual biopsies. The amount of backflow (n = 69) from the 3 mm 34G needle was smaller (P < 0.05) as compared to the 5 mm 32G and the 8 mm 30G needles. Analysis showed a correlation between backflow and the needle's outer dimension with the needle diameter being the pivotal parameter. Furthermore, CT-scanning and histology confirmed that local propagation of the injection and final distribution followed a route of less mechanical resistance as determined by connective tissue barriers preset in the site of injection.

Needles as short as 3 mm efficiently delivered injections into the subcutaneous target. The amount of backflow was smaller with thinner needles. Local distribution was variable and determined by mechanical barriers preset in the tissue. CT-scans and histology were concordant.

In the present article, curcumin was successfully encapsulated into two different safe and inexpensive polymers, ethyl cellulose and methyl cellulose blended ethyl cellulose with a loading capacity of ~ 46–48%. In addition, the in vitro skin penetration of the two curcumin encapsulated particular systems, which were applied each in three different formulations, an o/w, w/o lotion, and water suspension, was investigated on porcine ear skin using Laser scanning microscopy.

It was found that in comparison to water suspensions, o/w and w/o lotions enhanced, especially the follicular penetration of the encapsulated curcumin particles into porcine skin, whereas the w/o enhanced the penetration better than the o/w lotion. Furthermore, the application of ethyl cellulose blended with methyl cellulose improved the penetration of curcumin in all formulations.

High loaded encapsulated curcumin systems, prepared from a simple and highly efficient encapsulation system can be used to transport curcumin effectively into the skin.

In this research, we explore a dirt trail detection and analysis algorithm for extracting, measuring, and characterizing dirt trails based on size, distribution, and color in dermoscopic skin lesion images. These dirt trails are then used to automatically discriminate BCC from benign skin lesions.

For an experimental data set of 35 BCC images with dirt trails and 79 benign lesion images, a neural network-based classifier achieved a 0.902 are under a receiver operating characteristic curve using a leave-one-out approach.

Results obtained from this study show that automatic detection of dirt trails in dermoscopic images of BCC is feasible. This is important because of the large number of these skin cancers seen every year and the challenge of discovering these earlier with instrumentation.

Subjects comprised 173 Japanese men and women, divided into four groups according to age. Photographs were taken from nine facial regions and used to classify the intensity of wrinkles into five grades. In addition, replicas were taken from five facial sites and used to measure surface roughness. Data were compared between men and women within each age group.

In all age groups, men showed increased forehead wrinkles compared with women. In contrast, no gender-dependent differences were found in upper eyelid wrinkles. Other facial wrinkles were greater in men than in women in all except the oldest group (age, 65–75 years), in which wrinkles in women were greater than or equal to those in men.

Our results showed that gender-dependent differences exist in the degree of facial wrinkles. In general, men tend to have more severe wrinkles than women. This tendency disappeared or was reversed in some regions of the face and in individuals more than 60 years old.

Dyes’ permeation ability through liposome membrane (as a model of stratum corneum) with side-by-side cells was assessed.

It has been shown that the chosen dyes are capable of permeating the membrane. High penetration coefficients (Kp) were obtained for a simple nitrophenylenediamines and nitroaminophenols. Their N-, O-hydroxyalkyl substitution significantly limits penetration. H-bonding capability has a major impact on the investigated dyes’ permeation ability. Substituents with H-bonding properties can significantly limit dyes’ penetration, even in the case of lipophilic structures. Special attention should be placed into compounds with strong intramolecular H-bonding properties, which improve transmembrane transport.

Substitution patterns have an influence on selected nitro dyes’ permeation through a model stratum corneum. Permeation is limited by dyes diffusive properties (mostly by its H-bonding properties). Hydroxyalkylation results in hindered dyes permeation: purple, violet and blue nitrophenylenediamine or nitroaminophenol derivatives are less permeable than its not substituted analogues.

The aim of this study was to investigate the differences on the hair surface in SP and SD for a clinical diagnosis, using atomic force microscopy (AFM).

The hair shafts of 14 patients and 28 patients with SP and SD respectively, were taken from the lesional region. Hairs from healthy adults not having any hair diseases were also examined in the same way for the controls. Surface characteristics of SP and SD-affected hair shafts such as, pitting, scale thickness, and roughness, were observed on the AFM images.

One hundred percentage and four percentage of the patients with SP and SD respectively had macropits on their hair shafts. In both the SP and SD-affected hairs, the scale thickness was more than 4-fold than that in the control hairs. The surface of SP-affected hairs was rougher than that of SD-affected and control hairs.

The differences in hair shafts between SP and SD were investigated noninvasively using AFM. The presence of macropits could be helpful in the differentiation between SP and SD.

To assess the correlation between facial pores and possible relating factors such as age, gender, sebum secretion, skin elasticity, and the presence of acne, using objective bioengineering instruments.

Sixty volunteers, 30 males and 30 females, participated in this study. Various parameters of facial pores were assessed using the Robo Skin Analyzer^®. The facial sebum secretion and skin elasticity were measured using the Sebumeter^® and the Cutometer^®, respectively. These data were compared and correlated to examine the possible relationship between facial pores and age, sebum secretion and skin elasticity, according to gender and the presence of acne.

Male gender and the existence of acne were correlated with higher number of facial pores. Sebum secretion levels showed positive correlation with facial pores. The R7 parameter of skin elasticity was negatively correlated with facial pores, suggesting increased facial pores with decreased skin elasticity. However, the age and the severity of acne did not show a definite relationship with facial pores.

Male, increased sebum and decreased skin elasticity were mostly correlated with facial pore development. Further studies on population with various demographic profiles and more severe acne may be helpful to elucidate the potential effect of aging and acne severity on facial pores.

In this article, a novel hair-restoration algorithm is presented, which has a capability to preserve the skin lesion features such as color and texture and able to segment both dark and light hairs. Our algorithm is based on three major steps: the rough hairs are segmented using a matched filtering with first derivative of gaussian (MF-FDOG) with thresholding that generate strong responses for both dark and light hairs, refinement of hairs by morphological edge-based techniques, which are repaired through a fast marching inpainting method. Diagnostic accuracy (DA) and texture-quality measure (TQM) metrics are utilized based on dermatologist-drawn manual hair masks that were used as a ground truth to evaluate the performance of the system.

The hair-restoration algorithm is tested on 100 dermoscopy images. The comparisons have been done among (i) linear interpolation, inpainting by (ii) non-linear partial differential equation (PDE), and (iii) exemplar-based repairing techniques. Among different hair detection and removal techniques, our proposed algorithm obtained the highest value of DA: 93.3% and TQM: 90%.

The experimental results indicate that the proposed algorithm is highly accurate, robust and able to restore hair pixels without damaging the lesion texture. This method is fully automatic and can be easily integrated into a CAD system.

To review therapeutic applications and benefits of nanomedicine in esthetic dermatology, treatment of malignancies, and inflammatory skin diseases.

Twenty-one healthy Japanese women aged in their 20s (n = 7) or 50s (n = 14) were recruited for this study. Moving images of facial skin motions (closing the eyes tightly, raising the eyebrows) were captured using a single infrared camera under infrared ray irradiation of the skin. PIV analysis was then carried out using Flow-Vec32^™ software to determine the velocity and the direction of skin surface movements.

All skin movements caused by those motions were finished within 0.20 s. During the motion of closing the eyes, skin at the eye periphery did not move in a superior–inferior direction, but did move toward the center of the eye (pupilla) with complex flows. There was no significant difference between either age group of subjects. During the motion of raising the eyebrows, the forehead skin moved upwards (direction to parietal) with relatively uniform flows. The velocity of movement at the top was lower than at the bottom, and that difference is likely to cause a deformation on the skin surface. A significant difference between the two age groups in the velocity was observed.

The results show that the deformation of older skin on the forehead is greater than that in younger skin. The PIV analysis method is a useful tool to investigate some aspects of the relationship between facial skin movements and wrinkle formation.

Near infrared and skin impedance spectroscopic data were analysed multivariately. In the first study, the skin characteristics of 15 healthy individuals were examined related to body location, gender, individual differences, and consumption of coffee or alcohol. The second study included five patients diagnosed with dysplastic naevi syndrome. Measurements were taken on DN and reference skin over time.

In the first study, body location and gender had a major influence on measurement scores. Inter-individual skin characteristics and coffee or alcohol effects on skin characteristics were of minor importance. In the second study, it was shown that DN can be differentiated from reference skin and the measurements are stable over time.

Moderate consumption of alcohol and coffee did not influence the results of the measurements. It is possible to follow, stable or changed, characteristics of DN over time.

To differentiate irritant from allergic patch test reactions to quaternary ammonium compounds.

Eight subjects who were considered likely to react based on history of rash after exposure to disinfectants or a history of prior positive patch test to BAC were recruited, as well as two patients undergoing routine patch testing. BAC (0.15% aq), BAC (0.15% pet), BEC (0.05% aq), BEC (0.15% pet), BEC (0.15% aq), BEC (0.5% aq), sodium lauryl sulfate (2.0%), and deionized water were applied under Finn chambers for 48 h. Four days and 7 days after application, the sites were examined visually and then by in vivo reflectance confocal microscopy (RCM) which was interpreted by blinded experts.

Two patients with definite allergic reactions according to visual patch test reads and RCM were clinically relevant. Cross-reaction between BEC and BAC was demonstrated in one patient. RCM imaging correlated well with clinical scoring and interpretation of patch test reactions in terms of irritancy vs. allergy for BEC and BAC.

Relevant allergic reactions to quats occur in humans. Possible cross-reaction was noted to occur between BAC and BEC. RCM appears to be a useful tool in distinguishing between irritancy and sensitization during patch testing to BAC and BEC. Further study of prevalence and best test concentration and vehicle is needed.

TDC was measured at forehead, cheek, and forearm in 60 young adults (30 men) to a 1.5-mm depth. Measured TDC-values were compared with TDC-values calculated using skin-thickness data.

Measured TDC-values ranged from 39.6 ± 2.9 at male-forehead to 28.2 ± 2.4 at female forearm and were significantly different (P < 0.001) among each site in the order forehead > cheek >forearm. Male TDC-values were greater than female TDC-values (P < 0.01) with differences from 5.6% at forehead to 11.3% at forearm. Calculated TDC-values incorporating site and gender skin-thickness differences yielded TDC-values at the most 3% different from measured values.

Gender differences should be considered in clinical studies in which men and women are included in a common study population with respect to experimental design and data interpretation. This is especially true if absolute TDC-values are of interest rather than changes in TDC-values on the same subject subsequent secondary to an intervention.

A biologically inspired reinforcement learning approach is investigated in an adaptive critic design framework to apply action-dependent heuristic dynamic programming (ADHDP) for discrimination based on computed features using different skin lesion contrast variations to promote the discrimination process. Lesion discrimination results for ADHDP are compared with multilayer perception backpropagation artificial neural networks.

This study uses a data set of 498 dermoscopy skin lesion images of 263 BCCs and 226 competitive benign images as the input sets. This data set is extended from previous research [Cheng et al., Skin Research and Technology, 2011, 17: 278]. Experimental results yielded a diagnostic accuracy as high as 84.6% using the ADHDP approach, providing an 8.03% improvement over a standard multilayer perception method.

We have chosen BCC detection rather than vessel detection as the endpoint. Although vessel detection is inherently easier, BCC detection has potential direct clinical applications. Small BCCs are detectable early by dermoscopy and potentially detectable by the automated methods described in this research.

Objective of this study was to determine the kinetics of the protective function of a topically applied, fluorescent-containing lotion in a 24 h everyday setting in healthy volunteers using fluorescence confocal laser scanning microscopy imaging.

Fifteen volunteers received a standardized application of a sodium fluoresceine containing lotion. At several time points of a 24 h interval confocal laser imaging in the multi-wave mode was performed. Fluorescence was measured by a semiquantitative score and by one based on the intensity of light.

CLSM images in the depths of the stratum corneum and of the upper epidermis of all 15 panelists showed a detectable fluorescence after 30 min and 4 h and after 24 h, a partial fluorescence was still visible in 10 of 15 persons. Similar results were achieved using a semiquantitative score and by measuring the intensity of light.

Sodium fluoresceine as a safe and efficient fluorophore for in vivo fluorescence CLSM was able to visualize the kinetics of a topically applied protective lotion and was able to be detected for up to 4 h in all panelists and even up to 24 h in two-thirds of the healthy volunteers showing the long duration of the fluorescence on the skin surface, even in an everyday setting.

This prospective study included 30 skin tumors treated by surgery. MR images of skin samples were acquired on a 7-T MR scanner using a fast spin-echo T₂-weighted and an isotropic 3D gradient-echo T₁-weighted sequence. Length, width, Breslow index and margins of the lesions were measured. The presence or absence of the following was noted: healthy margins, ulceration of the dermis, in situ lesions, superficial and deep dermis involvement, subcutaneous involvement, superficial and intratumoral keratin. MR results were compared to histopathology.

Interclass correlation coefficient (ICC) was very good for the evaluation of the width (ICC = 0.86) and Breslow index (ICC = 0.87). The ICC was good for the evaluation of the margins (ICC = 0.70) but for length, ICC was lower (ICC = 0.67). Mean bias between MRI and histopathology was inferior to 1 mm for width, Breslow index and margin.

In vitro 7-T MRI of keratinocytic skin cancer allows delineation of lesions with good correlation with histopathology. After in vivo confirmation it could have a diagnostic role regarding the delineation of surgical margins but its actual limitations prevent its practical adoption at this time.

Twelve patients with stable plaque psoriasis were studied and compared with a control group of eight healthy individuals. Fluorescein sodium was used as fluorophore. A hand held fibre-optic laser scanner (Stratum^®; Optiscan Pty., Melbourne, Australia) was used. The study included morphometric analyses.

The confocal in vivo images demonstrated characteristic features of epidermis and keratinocytes in lesional and non-lesional skin vs. healthy skin. Morphometry based on FOCI demonstrated an approximately 30% increased width of keratinocytes of psoriatic skin vs. healthy control, and the number of keratinocytes per viewing field was reduced. FOCI allowed non-invasive visualization of cell nuclei and parakeratosis of psoriatic epidermis. The horizontal width of dermal papillae of psoriatic skin was increased by approximately 50% as compared with healthy skin, and the flow of erythrocytes in the papillar vessels could be observed in real-time.

FOCI can directly visualize essential epidermal structures of plaque psoriasis in vivo, in real-time and with cellular resolution without the need of taking biopsies and thus without disturbing the natural state of the skin. FOCI is a versatile future tool for non-invasive microscopic diagnosis and therapy follow-up of psoriasis.

This study included 21 healthy adult volunteers, aged 32–81 years, Raman spectra were obtained from sun-protected and sun-exposed skin, also three millimeter punch biopsies of sun-exposed skin were collected and analyzed. The Raman spectra were analyzed using principal component analysis and the results were correlated with clinical and histological findings.

The principal component analysis of the Raman spectra shows that the first principal component (PC1) obtained from the sun-protected skin is related to the age of the subject, which can be taken as a measure of chronological aging, the second (PC2) and fourth (PC4) principal components obtained from Raman spectra of sun-exposed skin are related to the amount of solar elastosis and collagen, respectively.

In this work a relationship was found between histological properties of photoaged skin and noninvasive measurements based on Raman and principal components analysis (PCA). These relationships can be used to assess noninvasively the photoinduced damage and chronological characteristics of skin.

To explore the field distribution of melanin on the scalp of fair-skinned Caucasian subjects.

The scalp was examined in 43 men with androgenic alopecia. The Visioscan^® camera provided the ULEV pictures. Another optical (Visioface^® Quick) device was used under white light illumination followed by colour contrast enhancement. This was reached after specific computer filtration of the cyan hue wavelengths.

Under white light illumination, the scalp looked normal. MSM patterns were disclosed by both optical procedures as evenly scattered discrete patchy fields of hypermelanosis. The smaller rounded spots were restricted to the lips of the hair infundibula. Larger irregularly shaped spots predominated in the interfollicular areas. A few hypomelanotic spots were scattered over the scalp.

The present observations based on dual optical methods possibly provide information about a patterned pathobiology of melanocytes on the scalp. The spotty MSM pattern looked similar to the reported aspects on the face. It somewhat resembled the widespread PUVA-induced lentiginosis.

Activity of the sympathetic nerve (ASN) is evaluated by quantitative measurement of mental sweating.

Optical coherence tomography (OCT) is highly potential for in vivo observation of human sweating dynamics which affects ASN. We demonstrate dynamic OCT analysis of mental sweating of a group of eccrine sweat glands. The sweating dynamics is tracked simultaneously for 19 sweat glands by time-sequential piled-up en-face OCT images with the frame spacing of 3.3 s. The en-face OCT images of the spiral lumen of the eccrine sweat gland are constructed by data acquisition of the 128 B-mode OCT images.

It is thus found that the response to mental stress is different for each sweat gland even though the sweat glands are adjacent to each other. Such strong non-uniformity is observed in mental sweating where the amount of excess sweat is different for each sweat gland although the sweat glands are adjacent to each other.

The non-uniformity should be necessary to adjust as precisely the total amount of excess sweat as possible through the sympathetic nerve in response to strength of the stress.

Fourteen EPP patients took zinc sulphate (3 × 200 mg/day) during spring and summer. Using a photomultiplier (PM), UPE was measured from the buttock skin and dorsal hand before and after solar-simulated light (SUN) exposure. Blood samples were analysed routinely for plasma zinc, iron, ferritin, transferrin, haemoglobin, erythrocyte PPIX and Zn-PPIX.

UPE in EPP patients resembled that seen in healthy individuals. Without treatment, a seasonal decrease was seen from spring to summer in four control patients. However, oral zinc treatment reduced ROS formation significantly regardless of SUN exposure. After SUN exposure, the initial burst was correlated to plasma iron and erythrocyte PPIX. During treatment, an inverse correlation was found between plasma zinc concentration and the initial burst.

Measurements of UPE can be used for monitoring UVA-induced oxidative processes in vivo in the skin of EPP patients.

Twenty-five volunteers participated in this study. Changes in oxygen content of the facial skin were measured before and after 30 min of cigarette smoking. Skin temperature and oxygen content were evaluated in the periorbital and periolar regions.

There was a significant increase in temperature after smoking. The oxy hemoglobin and partial pressure of oxygen decreased in both the periocular and perioral areas after smoking. There were no changes in deoxy hemoglobin and partial pressure of carbon dioxide at these areas.

Significant changes were seen in temperature and oxygen content after only 30 min of smoking. The results from this study suggest that alterations in the skin temperature and oxygen content in facial skin after smoking may be an underlying cause of premature skin aging.

The aim of this study was the investigation of the penetration behaviour of four vegetable oils and of paraffin oil into the stratum corneum by laser scanning microscopy. In addition, the occlusion capacity of these substances was assessed by transepidermal water loss (TEWL) measurements. Petrolatum served as a positive control for skin occlusion. The study was conducted in vivo and included six healthy volunteers.

Paraffin oil, as well as the vegetable oils, penetrated only into the first upper layers of the stratum corneum. TEWL measurements indicated that the application of the vegetable oils (except jojoba oil) as well as paraffin oil, led to a similar occlusion of the skin surface. The most effective occlusion was found for petrolatum.

For the investigated oils, a deeper penetration than into the first upper layers of the stratum corneum could be excluded. The decreased TEWL values indicate that the application of the oils leads to a semi-occlusion of the skin surface as it is intended by the use of oils to retain moisture in skin.

Model urticants, benzoic acid (BA) and hexyl nicotinate (HN) with 3 concentrations of each were applied to marked skin of 10 bald males during 6 weeks. One urticant was applied to one side of nasolabial fold, back, and scalp and the other applied to the contralateral side. Reactivity was assessed by visual scores (VS) and biophysical instruments. Subjects ranked skin sensation with a 10-point visual analogue scale.

With 0.25% HN application, upper back VS significantly (p<0.05) exceeded scalp and back VS also showed significantly (p<0.05) stronger reaction than face at 60 min post-application; however, at 2.5% BA site, VS of face exhibited significantly (p<0.05) higher than back at 15 min post-application but with 0.625% BA site, VS of back was significantly (p<0.05) higher than face. The a* value was significantly (p<0.05) higher on back than scalp with 0.625% BA treatment.

Thus symptoms and measurements vary among sites. Differences may be related to solubility related percutaneous penetration. We encourage investigation into this relatively neglected but clinically important arena, to help explain difference in consumer/patient acceptance of topical formulations.

In a double blind evaluation of the segmentation of 77 digital dermatoscopic images, we observed a significant inter-operator variability.

The area of the disagreement region was on average 15.28% of the area of the lesion itself, and in 10% of the cases it was more than 28%. More experienced dermatologists showed greater agreement among themselves than with less experienced dermatologists, and a slight tendency toward ‘tighter’ segmentations.

The evaluation methodology addresses a number of crucial difficulties encountered in previous studies and may be of independent interest. Our results underscore the necessity of taking into account inter-operator variability in large epidemiological studies, in particular those involving less experienced dermatologists, and of striving toward techniques allowing greater standardization and replicability in the evaluation of the fundamental visual parameters of lesions.

The study was performed on four healthy Caucasian, and on four Japanese women aged 29–39 years, travelling on long distance flights. They had stopped using skin care products at least 12 h before, and did not apply them during the flights. The air temperature and relative humidity inside the cabin, as well as skin capacitance of the face and forearm of participants, were registered at several time points before and during the flights.

Relative humidity of the aircraft cabin dropped to levels below 10% within 2 h after take-off and stayed at this value throughout the flight. Skin capacitance decreased rapidly on both the face and forearms with most pronounced changes on the cheeks where it decreased by up to 37%.

Our results demonstrate that during long distance flights, the aircraft cabin environment leads to a rapid decrease in stratum corneum hydration, an alteration, which probably accounts for the discomfort experienced by long distance aircraft travellers.

Twenty-seven scars in 14 subjects were included between January and June 2003. One observer performed two times both measurements with 10 min apart. The intra-observer agreement is quantified by means of the intra-class correlations (ICC) and the standard errors of measurement (SEM) for both the LDI and the chromameter.

Ignoring one outlier, the ICC of the LDI = 0.856 and the SEM = 34.56. The chromameter shows a better reproducibility with an ICC of 0.93 and a SEM of 0.79.

This pilot-study with a limited number of measurements shows a moderate reproducibility of the LDI compared to the chromameter measurements, in the assessment of respectively flux and redness in scars.

Vacuum alone and vacuum plus plasma at different energies were applied to rat skin and biopsies collected at different time intervals after treatments. Skin integrity, collagen arrangement, inflammation and myofibroblast differentiation were assessed by Masson's trichrome staining. Procollagen synthesis was evaluated by immunohistochemistry.

Vacuum alone induced significant and temporary alterations in the distribution of collagen bundles, with concomitant procollagen synthesis in the dermis; no myofibroblasts and no signs of inflammation were observed. Vacuum plus plasma determined an important spatial modification of collagen bundles, more intense than vacuum or plasma alone. Significant increase of procollagen synthesis, numerous myofibroblasts but slight sign of inflammation appeared after the treatment.

Vacuum mechanically stimulated fibroblasts, producing changes in collagen arrangement and procollagen synthesis. Plasma led to the same effects through thermal damage. Application of a combined treatment consisting in vacuum plus plasma induced more remarkable effects on skin regeneration with relatively low plasma energies and no relevant side effects.

Volar forearm skin hydration and transepidermal water loss (TEWL) were measured and user satisfaction was evaluated by questionnaires, after application in 31 healthy, female volunteers. The cooling effect was investigated for 40 min with thermal imaging on 12 forearm sites of six healthy subjects.

Voltaren vehicle gel application increased skin hydration by 13.1% (P = 0.0002) when compared with the untreated site, 8 h after the final treatment after 2 weeks. TEWL decreased on both treated (0.37 g/m²/h) and untreated (0.74 g/m²/h) forearm sites after 2 weeks (8 h after last treatment), demonstrating a relative increase of 6.5% in water loss. Voltaren vehicle gel application resulted in a rapid reduction of skin surface temperature by 5.1°C after only 3 min with an average maximum reduction of 5.8°C after 10 min. The cooling effect was experienced by 94% subjects, while 74% felt that their skin became softer. No adverse events, including skin irritation, were reported during the study and by the 37 participants.

This study showed a statistically significant increase in skin hydration as well as a rapid cooling effect lasting approximately 30 min, after application of Voltaren vehicle gel. The small relative increase in water loss may be attributed to an additional skin surface water loss secondary to the increased water content brought into the skin by the Voltaren vehicle gel. The use did not induce any skin irritation and was found acceptable to use by the majority of participants.

Using the KC-Tie2 doxycycline-repressible psoriasiform skin disease mouse model, OCT imaging was completed on diseased back skin of adult KC-Tie2 (n = 3–4) and control (n = 3–4) mice, followed immediately by the surgical excision of the same region for histologic analyses. Animals were then treated with doxycycline to suppress transgene expression and to reverse the skin disease and additional OCT images and tissues were collected 2 and 4 weeks following. Epidermal thickness was measured using OCT and histology.

Optical coherence tomography and histology both demonstrated that KC-Tie2 mice had significantly thicker epidermis (~4-fold; P < 0.0001) than control animals. By 2 weeks following gene repression, decreases in epidermal thickness were observed using both OCT and histology, and were sustained through 4 weeks. Correlation analyses between histology and OCT values at all time points and in all animals revealed high significance (R² = 0.78); with correlation being highest in KC-Tie2 mice (R² = 0.92) compared to control animals (R² = 0.16).

Non-invasive OCT imaging provided similar values as those collected using standard histologic measures in thick skin of KC-Tie2 mice but became less reliable in thinner control mouse skin, possibly reflecting limitations in resolution of OCT. Future advances in resolution of OCT may improve and allow greater accuracy of epidermal thickness measurements.

Twenty-one healthy volunteers with acne lesions were recruited for the study and treated with an ‘anti-acne cream’ for 4 weeks. Acne symptoms on the facial skin were graded by the visual evaluation of photographs taken before and after the treatment. Skin color of acne lesions was and measured by a spectrophotometer. In addition, a 3D image analysis system was used to quantify skin surface roughness and acne volumes.

Both visual and spectrophotometric assessments of acne lesions provided similar results indicating that the cream treatment improved acne symptoms significantly. The 3D image analysis of acne lesions confirmed that the cream treatment decreased skin surface roughness and acne volumes.

The current study demonstrated that the 3D image-based analysis of the skin may be useful for the quantification of acne symptoms of cosmetic relevance.

This study was a retrospective study, designed as a before and after trial with a single arm. A total of 18 patients were enrolled who had been treated with a 308 nm excimer laser as monotherapy twice a week for 20 sessions. The repigmentation percentage was calculated by measuring changes in area before and after treatment using digital image analysis and graded on a five-point ordinal scale [global assessment scale (GAS)]. GAS was also measured by physician and patient for comparison with our estimates. Additional GASs were also measured by four different evaluators for inter-rater variability.

The mean repigmentation percentage after treatment was 45.3% (range, 0.7–100%). The changes in area after treatment were statistically significant (P < 0.05). A substantial agreement of outcomes was observed between physicians and digital image analysis (κ_w = 0.78), but lower agreement was observed between patients and digital image analysis (κ_w = 0.49). The inter-rater variability for GAS was substantially low (Krippendorff's α = 79.3%).

Measurement of changes in area using digital image analysis could be used as a quantitative method in evaluating efficacy of treatment for vitiligo. Because vitiligo lesions can occur in any location with various shapes and sizes, digital image analysis would be a more objective method for measuring treatment response than a GAS.

We developed an automatic segmentation program for detecting borders of skin lesions in dermoscopy images. The method consists of a pre-processing phase, general lesion segmentation phase, including illumination correction, and bright region segmentation phase.

We tested our method on a set of 107 NoMSLs and a set of 319 MSLs. Our method achieved precision/recall scores of 84.5% and 88.5% for NoMSLs, and 93.9% and 93.8% for MSLs, in comparison with manual extractions from four or five dermatologists.

The accuracy of our method was competitive or better than five recently published methods. Our new method is the first method for detecting borders of both non-melanocytic and melanocytic skin lesions.

Six healthy volunteers were pre-treated using the body lotion, Nivea Body (Beiersdorf AG, Hamburg, Germany). The sunscreen was an oil/water (o/w) emulsion, Roc SPF 8 (RoC SA, Paris, France). The tape stripped tesa films were measured with a modified UV/VIS spectrometer Lambda 5 (PerkinElmer, Frankfurt/Main, Germany), the data of which were used to calculate both measurands.

The obtained results made clear that the original spectroscopic data must be corrected taking into account the changed amounts of horny layer particles removed with the individual tape strips after pre-treatment. As a consequence of the correction, the factors of inhomogeneity as well as the sum transmissions confirm a more homogeneous distribution of the applied sunscreen.

The findings confirm that the applied method is well suited to obtain information on the distribution of topically applied substances, and furthermore that the influence of the pre-treatment of the skin with the body lotion enhances the homogeneity of distribution and thus the sunscreen efficacy.

The role of excimer light therapy in practice and modes of action are not completely understood. We wanted to investigate a 307 nm ELD for plaque psoriasis in comparison with topical dithranol therapy twice daily.

We conducted a pilot trial in 21 adult patients with moderate plaque-type psoriasis. Two target lesions of comparable size and plaque-modified Psoriasis Activity and Severity Index (PSI) scores were selected. Lesion A was treated three times using a newly developed 307 nm ELD. Lesion B was treated twice daily with dithranol ointment. The mean period of treatment was 9 days. Clinical evaluation included PSI scores, safety, time needed to treat, and patient's satisfaction. In addition, fluorescence-remission imaging technique was used for objective evaluation.

Both treatments improved the PSI score (mean 3.0 points). The treatments were safe but ELD was more convenient for patients. The time needed to treat the target lesion was significantly shorter with ELD. Targeted UVB therapy normalized NADH fluorescence in lesional skin.

The 307 nm excimer light therapy for plaque type psoriasis was equipotent to twice daily topical dithranol. Efficacy, safety, and convenience suggest that targeted UVB therapy with quasi monochromatic light is a new useful treatment option for patients with limited psoriatic plaques.

The index expresses the disordered nature of each lesion including variegation in color based on variation in spectral information obtained from each lesion. Performance of the index in discriminating melanomas from other pigmented skin lesions has been studied in five cases of melanoma (41 HSD sets), one case of Spitz nevus (13 HSD sets), 10 cases of seborrheic keratosis (78 HSD sets), three cases of basal cell carcinoma (16 HSD sets), and nine cases of melanocytic nevus (21 HSD sets), obtained from patients and volunteers, all of whom were Japanese.

Performance of the index, which reflects the disordered nature of a lesion, discriminates melanomas with a sensitivity of 90%, a specificity of 84%, and an area under the receiver operating characteristic curve of 0.93, on resubstitution.

An objective melanoma discrimination index at a molecular pigmentary level, derived from HSD, has been proposed, and its performance evaluated. This index was highly successful in discriminating MM from non-melanoma, although the statistical population was small.

To counteract the natural retraction of CDE and to maintain it under tension, different biomaterials were tested. Selection criteria were biocompatibility, bioadhesion properties, ability to induce differentiation of fibroblasts into myofibroblasts and mechanical characterization, considering that of skin in vivo. These assays led to the selection of honeycomb of polyester. CDE constructed on this biomaterial was further characterized mechanically using tensile tests.

The results showed that mechanical features of the obtained dermal equivalent, including myofibroblasts, were similar to skin in vivo.

The original model of dermal equivalent presented herein may be a useful tool for clinical use and as an in vitro model for toxicological/pharmacological research.

Thirty patients (18 with PV and 12 with PF) were included into the study. In total, 36 PV lesions and 29 PF lesions were examined. Healthy-appearing skin adjacent to skin lesions and not adjacent to skin lesions was also investigated.

Intraepidermal clefts (bullae) with acantholytic cells were observed in 47% of PV lesions and 59% of PF lesions. Multiple dilated blood vessels in the upper dermis were observed using RCM in 61% of PV lesions and in 86% of PF lesions. RCM features of pemphigus also included presence of inflammatory infiltrates, loss of typical honeycomb pattern of the epidermis, and detachment of the outer root sheath in hair follicles. In 20–64% of cases, RCM features, which are characteristic for PV and PF lesions were also observed in the proximity of these lesions within the healthy-appearing skin. Following criteria for RCM diagnosis of pemphigus were developed: (i) acantholytic clefts in RCM of a lesion, (ii) acantholytic clefts in RCM of healthy-appearing skin adjacent to a lesion, (iii) multiple-dilated blood vessels in RCM of a lesion. Fulfillment of two of these three criteria is sufficient to establish a RCM diagnosis of pemphigus. These criteria do not differentiate between PV and PF.

RCM is useful for rapid, non-invasive, in-office differential diagnosis of pemphigus. RCM does not replace immunologic and histopathologic examinations, which remain the gold standard for establishing the final diagnosis of PV and PF.

Wrinkles were graded on the faces of Japanese female subjects when they made strong voluntary facial movements (eyes closed tightly, raised eyebrows, and frowns) and also when they were at rest using a set of photos (a photo scale) obtained from subjects with different degrees of wrinkles in the static and dynamic states. Scores obtained were compared between the dynamic and static states, and were analyzed in relation to age and to facial region.

We found that the levels of wrinkles in both states showed a significant positive correlation with age. Further, the distribution of wrinkles in the dynamic state was found to be similar to those in the static states. Finally, the correlations between static and dynamic wrinkles in the same facial sites were higher than those in different facial sites.

Facial movements cause wrinkling in both the dynamic and the static states and also that static wrinkles may work at the kinetic origins of dynamic wrinkles.

A Reviscometer RVM600 and Corneometer CM 825 were used to measure CRRTs and SC hydration, respectively, in psoriatic lesions (psoriasis vulgaris) on the extensor of forearm in 111 subjects (58 men, 53 women), aged 23–80 years (50.42 ± 1.23 years). The contralateral uninvolved sites served as control.

In comparison with contralateral uninvolved sites, CRRTs in psoriatic lesions were reduced significantly in all directions. There was neither gender nor age difference in the extent of reduction in CRRTs. However, the reduction of CRRTs varied with measurement directions. Positive correlations of SC hydration with CRRTs were found at some directions in uninvolved and involved sites in young men whereas CRRTs in psoriatic lesions were not correlated with SC hydration in either aged or young women. Moreover, CRRT at 0–6 o'clock direction was positively correlated with SC hydration in involved sites of aged men.

Cutaneous resonance running times are decreased in psoriatic lesions. Reduction of CRRTs varies with measurement directions, but not gender or age. Measurement of CRRTs could be another valuable approach to assess the severity of psoriasis and the efficacy of its treatment.

Facial images of 45 subjects were evaluated visually by 30 respondents and were also computer analyzed in terms of their image histogram parameters. A partial least squares regression model was created to explain visual perceptions in terms of the image histogram parameters.

Visual perceptions of subsurface reflections can be explained in terms of the mean from the subsurface reflection image histogram, and visual perceptions of surface reflections can be explained in terms of the standard deviation (SD) and skewness from the surface reflection image histogram. Skin radiance can be explained in terms of the mean from the subsurface reflection and the SD from the surface reflection.

To acquire skin radiance, a surface reflection component that makes the skin look shiny and a subsurface reflection component that is in line with skin fairness are both needed. A balance of these features provides the origin of skin radiance.

Laser Doppler flow (FluxExplorer) and mole analyser (MA) score (FotoFinder) were applied to histologically verified melanocytic nevi (33) and malignant melanomas (12).

Mean perfusion and MA scores were significantly increased in melanoma compared to nevi. However, applying an empirically determined threshold of 16% perfusion increase only 42% of the melanomas fulfilled the criterion of malignancy, whereas with the mole analyzer score 82% of the melanomas fulfilled the criterion of malignancy.

Laser Doppler imaging is a highly sensitive technology to assess skin and skin tumor perfusion in vivo. Although mean perfusion is higher in melanomas compared to nevi the high numbers of false negative results hamper the use of this technology for early melanoma detection.

In vitro calibration was carried out on filter pads using different solvents, measurements over different layers of plastic foils, and evaluation of desorption kinetics. In vivo measurements were carried out on skin sites covering a range of very dry to well-hydrated skin areas.

Conductance measurements are influenced by electrolytes while capacitance measurements are not. Dielectric constant of the solvents influences the values of both instruments (r respectively 0.92 and 0.99). The capacitance method carries information from deeper layers (up to 45 μm) compared with the conductance instrument (up to 15 μm). Desorption experiments show a strong relation between the amount of water and respectively the capacitance and the conductance values. The in vivo experiments revealed a strong relation between the two methods (r = 0.97). Sensitivity of the capacitance method is limited for the highest hydration values.

Both instruments allow a certain calibration and both give good estimates of the SC hydration.

An electronic scanning probe was developed and fabricated to simulate an open-ended coaxial probe suitable for two-dimensional dielectric imaging of human skin in real time. A clinical study was undertaken to demonstrate proof-of-concept for the instrumentation. A select group of normal healthy subjects as well as a subject with diagnosed squamous cell carcinoma participated in this study. The electronic scanning probe was found to be a potentially useful tool for providing two-dimensional images from diseased skin.

The electronic scanning probe used for the present study addresses existing limitations with current coaxial probes. Measurements of healthy and diseased areas of skin are provided to illustrate the feasibility of the approach.

In this article, a novel pattern classification system (PCS) based on the clinical CASH rule is presented to classify among six classes of patterns. The PCS system consists of the following five steps: transformation to the CIEL*a*b* color space, pre-processing to enhance the tumor region and removal of hairs, tumor-area segmentation, color and texture feature extraction, and finally, classification based on a multiclass support vector machine.

The PCS system is tested on a total of 180 dermoscopic images. To test the performance of the PCS diagnostic classifier, the area under the receiver operating characteristics curve (AUC) is utilized. The proposed classifier achieved a sensitivity of 91.64%, specificity of 94.14%, and AUC of 0.948.

The experimental results demonstrate that the proposed pattern classifier is highly accurate and classify between benign and malignant lesions into some extend. The PCS method is fully automatic and can accurately detect different patterns from dermoscopy images using color and texture properties. Additional pattern features can be included to investigate the impact of pattern classification based on the CASH rule.

Ninety-two patients affected by wounds dressed with adhesive tapes or plasters have been studied. Measurement of skin conductance under tape/plaster and in the surrounding healthy skin, immediately after removal of dressing has been performed. Dressing age, wound localization, and characteristics were also considered.

Adhesive dressings alter significantly stratum corneum conductance. Although healthy skin hydration has significant variations throughout the body, cutaneous conductance under adhesive dressing in different areas displays no significative changes. Moreover, the increase in hydration due to adhesive tapes/plasters showed no association with wound dehiscence.

Adhesive dressings cause a significative increase in stratum corneum conductance, acting as a barrier to apocrine secretions. Although different hydration levels have been observed in healthy skin throughout the body, no difference exists under adhesive dressing among different regions, suggesting no contraindications in their employment throughout the body.

Increase in cutaneous hydration showed no correlations with wound dehiscence, thus confirming safety and practicality of these dressings.

To clarify the mechanism of nasolabial fold formation, we established grading criteria for severity and explored the influence of dermal elasticity and subcutaneous adipose mass. We also investigated the involvement of facial morphological changes, such as wrinkling and sagging.

Faces of 108 healthy Japanese female volunteers (age range: 20–60) were photographed at the angle of 45°, and a six-grade photograph-based grading scheme for nasolabial fold severity was established and evaluated. In 70 Japanese female volunteers (middle-aged: 30–50), dermal elasticity was measured with a Cutometer MPA 580^® and subcutaneous adipose layer thickness was measured by ultrasound using a Prosound alpha 5^®.

Nasolabial fold severity was significantly and positively correlated with age in subjects in their twenties to sixties (R = 0.777, P < 0.001). Nasolabial folds were drastically reduced, or disappeared, when the facial position was changed (subjects lay down instead of sitting) to reduce sagging; only 13.8% of subjects showed fixed wrinkles at the positions of the nasolabial folds after the facial position change. Nasolabial fold severity in middle-aged volunteers was significantly and negatively correlated with dermal elasticity parameters, i.e., net elasticity excluding viscoelastic creep (Ur/Ue), overall elasticity including creep and creep recovery (Ua/Uf), ratio of elastic recovery to total deformation (Ur/Uf), and the negative value of the amount of deformation that did not recover to the original state [−Uf−Ua)], all of which were significantly and negatively correlated with age. Subcutaneous adipose layer thickness was significantly and negatively correlated with dermal elasticity parameter Ua/Uf, and also significantly and positively related to nasolabial fold severity (R = 0.285, P < 0.017).

Nasolabial fold severity increases with decreasing dermal elasticity and with increment of the subcutaneous adipose layer. These changes might induce sagging formation in the upper cheek area, promoting fold formation at the border between the inner and outer nasolabial areas.

The biosensor comprises of a disposable test strip and a desktop-sized reader (260 × 150 × 290 mm³, 1.9 kg), incorporating a charge-coupled device image sensor (CCD) unit to measure the reflectance of the test strip. A novel immuno-chromatographic test strip was proposed for CatL analysis in the stratum corneum. In order to realize the test strip, a colloidal gold technique was selected as the molecular recognition method for the CatL. A human skin sample was collected noninvasively by adhesive tape stripping.

Based on optimal assay conditions, the sensitivity of the biosensor was evaluated. It required 10 min from a sample dropping to appear the test line on the test strip. The optical density was proportion to the CatL. Bioanalytical validation indicated that, within the biosensor's detection limit (172.2 μU/mL), its accuracy (R² = 0.94), and precision (CV = 15%) approach more elaborate laboratory-based analyzers. In addition, the truncated sampling-reporting cycle (<15 min) allows speedy reporting of CatL levels.

It was indicated that this noninvasive and easy-to use biosensor might be a novel tool for the semi-quantitative analysis of CatL in the stratum corneum.