Article

Evaluation of gender difference in skin type and pH

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Zhao et al. (2021), observed that the biophysical properties of the skin are influenced by gender, age, and unhealthy lifestyles. In contrast, studies by Jacobi et al. (2005), Kim et al. (2006), Man et al. (2009), andLuebberding et al. (2013) observed higher pH values in females than males. Additionally, Kim et al. (2006) found significant gender differences in skin sebum content. ...
... In contrast, studies by Jacobi et al. (2005), Kim et al. (2006), Man et al. (2009), andLuebberding et al. (2013) observed higher pH values in females than males. Additionally, Kim et al. (2006) found significant gender differences in skin sebum content. ...
... Females showed a higher skin pH than males. These findings were also supported by Zhao et al. (2021), Man et al. (2009), Jacobi et al. (2005, Luebberding et al. (2013), and Kim et al. (2006). Such difference in pH between women and men might be due to differences in hormonal status (Jacobi et al., 2005), and also biochemical differences (Luebberding et al., 2013). ...
Article
Full-text available
Once the pandemic started, there were no clues regarding overall COVID-19 infections. There are no studies that demonstrate the effects of COVID-19 on skin surface pH, moisture, sebum, and temperature in terms of gender differences and body mass index (BMI) among infected people. The goal of this study was to investigate some of the skin biophysical scores of patients infected with COVID-19 and evaluate the impact of gender differences and the body mass index on them. Skin surface sebum, pH, temperature, and hydration (moisture), were measured in 30 COVID-19 patients using employing non-invasive portable devices. Insignificant effects of gender differences and BMI on skin biophysical properties were observed. In addition, females showed higher skin biophysical characteristics than males. Moreover, obese patients had higher skin biophysical parameter values than normal-weight patients. However, all the study results were statistically insignificant (p > 0.05). Further investigations are required to recognize other skin biophysical parameters such as transepidermal water loss and elasticity that may aid in the early identification of skin damage in COVID-19 patients.
... It could also be due to improved immune function in females and differences in skin colonization between males and females. 19,20 Obesity is also an important risk factor for the development of SSI. Obesity has been correlated with prolonged wound healing which is a known risk factor for SSIs. ...
... Grading of the patients with SSI (n= 65).Free Full Text Articles are Available at www.jnma.com.np Disturbance in healing (Scores:[11][12][13][14][15][16][17][18][19][20]. ...
Article
Full-text available
Introduction: Surgical site infection is defined by the Centres for Disease Control and Prevention as a wound infection that occurs within 30 days of an operative procedure or within a year if an implant is left in place and the infection is thought to be secondary to surgery. It occupies 20% to 39% of all the infections acquired in hospitals. The aim of this study is to find out the prevalence of postoperative surgical site infections in the Department of General Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 384 post-operative patients of abdominal surgery was conducted in the Department of General Surgery of a tertiary care centre from August 1, 2020 to July 30, 2021 with ethical approval from the Institutional Review Committee (Reference number: 267). Convenience sampling was done. Post-operative patients fulfilling the inclusion and exclusion criteria were included in the study. Data were entered in Microsoft Excel and analyzed using the Statistical Package for the Social Sciences version 21.0. Point estimate was done at a 95% Confidence Interval along with frequency and percentages for binary data and mean with standard deviation for continuous data. Results: Among 384 patients, the prevalence of surgical site infection was found to be 65 (16.92%) (13.15-20.65 at a 95% Confidence Interval). The patients had a mean age of 42.06±21.92 years. Conclusions: The prevalence of surgical site infection was higher in our study in comparison to other similar studies conducted in similar settings.
... Hormonal faktörlerle ilişkili olan bu durumun birçok biyolojik ve biyokimyasal süreci, nihayetinde de derinin yüzeyel pH'sını etkilediği düşünülmektedir. 20 Buna göre, erkeklerde kadınlara göre deri yüzey pH'sının daha düşük olması beklenmektedir. Ancak literatüre bakıldığında bu konuda yapılan çalışmaların birbiri ile tezat sonuçlar içerdiği görülmektedir. ...
... Ancak literatüre bakıldığında bu konuda yapılan çalışmaların birbiri ile tezat sonuçlar içerdiği görülmektedir. 12,14,[20][21][22][23] MİKROsİRKÜLAsYOn, pİgMEnTAsYOn Cinsiyet farklılığının derinin fizyolojik yapısında çok sayıda farklı unsurda etkili olduğu anlaşılmaktadır. Ancak hormonal faktörler dışında bu farklılıklara sebep olan diğer etmenler henüz tüm yönleriyle aydınlatılamamıştır. ...
... Many studies support that the gender of the patients is a reasonable factor for the different ratio of postoperative complications between men and women 30 . Differences in skin characteristics, like skin pH, subcutaneous fat distribution, skin thickness, and circulating hormones are the more obvious reasons 30 . ...
... Many studies support that the gender of the patients is a reasonable factor for the different ratio of postoperative complications between men and women 30 . Differences in skin characteristics, like skin pH, subcutaneous fat distribution, skin thickness, and circulating hormones are the more obvious reasons 30 . Skin normal flora differs between the two genders, as cultures from skin samples show that men are more prone in Staphylococcus Aureus colonization compared with women, and decolonization stills more difficult in men 31 . ...
... 1) Endogenous factors, such as the anatomical site, gender, ethnicity and age (Zlotogorski, 1987;Berardesca et al., 1998;Ehlers et al., 2001b;Kobayashi and Tagami, 2004) 2) Exogenous factors, such as washing and occlusion (Voegeli, 2008;Moldovan and Nanu, 2010) 3) Environmental factors, such as ambient temperature and humidity (Abe et al., 1980) It is well-established that skin surface pH varies not only between anatomical sites but also between areas of the same anatomical region (Kobayashi and Tagami, 2004;Kim et al., 2006;Marrakchi and Maibach, 2007;Kleesz et al., 2012). In particular, it has been reported that in the forearm, sites close to the elbow should be avoided as they generally produce higher pH values (Braun-Falco and Korting, 1986;Fluhr et al., 2006a). ...
... Additionally, it has been reported that the dominant arm presents a lower skin pH than the non-dominant arm (Treffel et al., 1994). In addition, some studies have reported lower pH values in male subjects (Jacobi et al., 2005;Kim et al., 2006;Man et al., 2009;Luebberding et al., 2013). By contrast, another study reported the reverse finding, whereas others reported no differences in skin pH values between genders (Zlotogorski, 1987;Wilhelm et al., 1991b;Ehlers et al., 2001a). ...
Thesis
Incontinence-associated dermatitis (IAD) is an inflammatory response caused by the prolonged contact of the skin to urine and/or faeces. Although several theories exist to explain the pathophysiology of IAD, most are based on animal models, or derived from studies on the related condition of diaper dermatitis (‘nappy rash’) that occurs in babies. Thus, their relevance to IAD in adults is limited and the underlying mechanisms of IAD remain poorly understood. The motivation for this novel work was to develop and validate both in vivo and in vitro techniques to simulate IAD to provide empirical evidence on the biophysical and biochemical disruption of skin in IAD. The integrity of the skin was evaluated by measuring changes in skin blood flow, transepidermal water loss (TEWL), hydration of the stratum corneum (SC) and skin surface pH. Synthetic-urine (s-urine) and a proteolytic solution were used to simulate the effects of urinary- and faecal- incontinence, respectively. The release of inflammatory biomarkers was investigated in vivo by two distinct sampling techniques, namely microdialysis and Sebutape™. In vitro investigations were also conducted with human keratinocytes to support in vivo studies, with cell viability and the secretion of inflammatory cytokines serving as output measures. Results of the current study showed that while urine disrupts the integrity of intact skin, causing a significant increase in skin blood flow, TEWL, SC hydration and skin surface pH (p<0.05), its effects are not pH dependent. In contrast, exposure of the skin to the proteolytic solution led to an enhanced increase in these biophysical parameters. This was also supported by in vitro keratinocyte experiments which indicated that the proteolytic solution is more deleterious than urine, as revealed by a decreased cell viability. Of particular importance is the finding that the permeability and susceptibility of the skin to urine depends on skin condition, with chemically-irritated skin, exacerbated by frequent cleansing activities, presenting an increased risk of IAD. Increased skin permeability was also associated with an elevated skin surface pH. In this respect, in vitro investigations highlighted that pH is an important regulator for the function of keratinocytes and consequently the maintenance of skin barrier function. Additionally, it was shown that the effects of urinary pH are time-dependent. Importantly, exposure of skin to urine and the proteolytic solution resulted in an increase in the release of pro-inflammatory biomarkers and indeed during exposure there was a time-dependent accumulation of biomarkers in the interstitium. In particular, a significant increase was estimated in the ratio of IL-1α/IL-1RA (p<0.05) following exposure to s-urine. Additionally, results demonstrated that s-urine resulted in an increase in IL-1α, whereas the proteolytic solution caused a marked increase in TNF-α. The increase in pro-inflammatory cytokines following exposure to urine was further supported by the in vitro studies. In these studies, an increase in the pH upregulated the release of inflammatory biomarkers, more particularly IL-1α. These data propose that in future studies, IL-1α and TNF-α have the potential to serve as responsive markers of skin damage caused by incontinence. The findings presented in this thesis extend current knowledge on IAD, with noteworthy implications for the direction of future IAD research and the development of targeted clinical interventions. Additionally, the data add to the scientific body of evidence and propose that the damage caused by frequent cleansing activities and the release of inflammatory biomarkers are two mechanisms implicated in the pathophysiology of IAD. Additionally, an internal pH mechanism for keratinocytes function is also proposed, which needs to be further examined. Overall, this work establishes the methods to investigate IAD in an experimental setting, which can be translated to clinical studies
... This gender-based difference is consistent with findings from several other study. [22,23,24,25] Microbiological cultures of swabs from infected wounds indicated a predominance of gram-positive bacteria, including Staphylococcus aureus, Staphylococcus spp., and Enterococcus spp. Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. ...
Article
Full-text available
Introduction: Surgical wound infections (SWIs) remain a significant risk to patients due to their high morbidity and mortality rates. Moreover, they pose substantial economic challenges for both developing and developed countries. The global impact of these infections is staggering, with the World Health Organization (WHO) reporting that millions of patients worldwide are affected by hospital-acquired infections annually, with many succumbing to these infections. This study aims to analyze the incidence of surgical site infections (SSIs) based on the type of surgical intervention, identify the most frequent causes of these infections, and explore effective management strategies. The findings of this study will provide valuable insights into the prevention and management of SSIs, thereby enlightening the medical community and empowering them to improve patient outcomes. Material and Methods: This study, conducted with meticulous attention to detail, focuses on patients operated on in our clinic from January to October 2024. It will reflect the incidence of SSI according to the type of surgical intervention, the most frequent causes of these infections, and the way of their treatment. Results: From January 2023 to June 2024, 788 patients were hospitalized, and 408 were operated on in the Surgery Department of the Clinical Hospital of Tetovo. Three hundred fifty were male, and 438 were female. The ages of the patients included in the study ranged from 21 to 81. Most of the patients were operated on because of cholecystolithiasis, inguinal, ventral, and umbilical hernias, breast cancer, acute appendicitis, and neoplasia of the colon and ileus. From the total number of operated patients (408), the infection of operative wounds was recorded in 49, representing an incidence of 11.76 %. Conclusion: The findings of this study underscore the serious global implications of SSIs, including increased morbidity and mortality rates and the strain on healthcare budgets. Therefore, the prevention and reduction of these infections should be a priority for all countries, irrespective of their economic status.
... Most studies reported higher incidence of SSI in males 5,12,14 . The reason for this is not known, it has been postulated that there are sex differences in skin colonization which may be associated with differences in skin thickness, sebum production and skin pH 15,16 . ...
Article
Full-text available
Background Abdominal surgeries especially open surgeries are associated with high risk of surgical site infections. This invariably leads to increased morbidity, prolonged hospital stay with its attendant financial burden and mortality. Objectives To describe the incidence, risk factors and outcome in patient with surgical site infection following open abdominal surgery. Methods This was a prospective study involving consecutive 100 patients across surgical sub-specialties and gynaecology over 6 month period. Variables analyzed included; biodata, type of surgery, American Society of Anaesthesiologists (ASA) grade, hair removal at wound site, specialty, degree of intraoperative contamination, presence of surgical site infection (SSI) and mortality. Results Majority of the patients (64%) were women and the age range was 11 to 73 years, mean age was 36.41 ± 10.9 years. About 60% of the cases were emergency procedures, indication for surgery were benign in 89 (89%) patients, malignant in 7% and trauma in 4%. Majority (55%) had clean-contaminated wounds while 45% had contaminated and dirty wounds, 54% were solely general surgery patients, 66% of the patients had hair removal before theatre arrival. SSI was recorded in 20% of the patients and mortality rate was 7% at 30 days follow up. The risk of SSI was higher in emergency procedures, (p =0.041) with an odd ratio of 2. SSI risk increases with the ASA grade, general surgical procedures, hair removal at wound site before theatre arrival and also in contaminated and dirty wounds. Emergency procedures and SSI were found to increase the odds of mortality. Conclusion Emergency procedures, general surgery (bowel surgeries), and significant degrees of intraoperative contamination are associated with higher risk of SSI, which is an independent predictor of mortality. More efforts should be put in place to prevent SSI in these categories of patients. Keywords: surgical site infections, Abdominal Surgery. DOI: https://dx.doi.org/10.4314/ahs.v24i4.12 Cite as: Ojewuyi OO, Ojewuyi AR, Fasanu AO, Asafa OQ, Taiwo OA, Folami EO. Surgical site infections following abdominal surgery: incidence , risk factors and outcomes. Afri Health Sci. 2024;24(4). 91-98. https://dx.doi.org/10.4314/ahs.v24i4.12
... Our study showed a significant association between gender and incidence with a higher predisposition among male participants. This finding agrees with that of Alkaaki et al. [15] These gender differences may be due to skin colonisation that may be associated with differences in skin thickness, sebum production, and the skin PH. [16,17] Hence, SSI surveillance plays an important role in hospital infection control and quality improvement programs, with feedback on SSI rates being an important component of SSI reduction strategies. [18] The overall incidence of SSI in this study was 12.3%. ...
Article
Full-text available
Background Surgical site infection (SSI) is the second most common cause of nosocomial infection, after urinary tract infection. Sequelae of SSI include increased healthcare costs and worse patient outcomes. There is a paucity of research studies on the impact of anaerobic organisms on SSIs in Nigeria. The aim of this study was to determine the role of anaerobic bacteria in SSI encountered at the Lagos University Teaching Hospital (LUTH). Materials and Methods A total of 438 patients were consecutively recruited into this study from general surgery, obstetrics and gynaecology and paediatric units of the LUTH from 1 July through 31 December 2019. Two surgical wound specimens were collected from all patients with suspected SSIs. One was for anaerobic culture using Brucella blood agar incubated in an anaerobic jar that secured anaerobiosis using the anaerobic gas pack. The other swab was used for aerobic culture on blood agar incubated on air at 37oC. Identifications and antibiotic sensitivity testing were performed according to standard laboratory procedures. Result The overall incidence of SSI in the study was 12.3%. The incidence of anaerobic SSI was 1.1%. The distribution of anaerobic infections by medical specialty unit was as follows; general surgery (1.6%), obstetrics and gynaecology (0.8%) and paediatrics (0.9%). Bacteroides species was the only anaerobic isolate. The risk factors associated with the development of SSI by multiple logistic regression analysis were duration of surgery greater than 2 h (OR 1.418; 95% CI 1.834–9.286; P = 0.001) and NNIS risk index 2 and 3 – (OR 2.165; 95% CI 2.366–32.086; P = 0.001). Conclusions The prevalence of anaerobic SSI was 1.1%. Duration of surgery greater than 2 h and NNIS risk index 2 and 3 were independent predictors of SSI.
... The low lipid solubility and heat sensitivity of anthocyanins present considerable obstacles in the formulation of cosmetics, particularly creams, lipsticks, and powders. Additionally, light degradation and easy oxidation can reduce color durability (Jokioja et al. 2021).The structural transformation and color variation of the product may not be suitable for different skin types, with pH values ranging from 4.0 to 6.0 (Kim et al. 2006). Anthocyanins can potentially be exposed to environments of varying pH in the skin through food residues and perspiration, which may differ from the pH of normal skin or the intended formulation. ...
Article
Full-text available
The skin undertakes a safeguard against external dangers, sensations, and symbols of beauty and health, and different cosmetics provide targeted solutions to various skin problems. However, synthetic pigment and chemical components in cosmetics can harm sensitive skin, resulting in further damage to the skin. Anthocyanins are natural pigments that possess vivid colors, excellent bioactivity, and the absence of toxicity. Therefore, anthocyanins have garnered considerable interest owing to their potential applications in cosmetics for dermatological conditions and aesthetic purposes. This review aims to comprehensively summarize studies and advancements in the use of anthocyanins in cosmetics and their potential future directions. These findings confirmed the bioactivity of anthocyanins against photodamage and melanogenesis and revealed the underlying mechanism. Additionally, anthocyanins were found to have great potential as one colorant, but their use is limited by their low lipophilicity and susceptibility to high temperature and variations in pH. Future research should prioritize anthocyanin stabilization, pyranoanthocyanin use, and investigation of the effects of anthocyanins on the gut-skin axis. This review advances our understanding of the application of anthocyanins as functional pigments in cosmetics and provides a scientific basis for the potential use of anthocyanins to improve skin function.
... Sebum excretion is an important skin biophysical parameter that affects the adherence of dust/soil particles to the hand skin (Kim et al., 2006;Xin et al., 2007). Xin et al. demonstrated that the forehead sebum content did not differ between males and females under 12 years old, while the forehead sebum Hand-washing method Our study content of males was higher than that of females over 13 years old (Xin et al., 2007). ...
Article
Full-text available
An accurate assessment of human exposure to pollutants through the ingestion of dust and/or soil particles depends on a thorough understanding their rate of human ingestion. To this end, we investigated the load and size distribution patterns of dust/soil particles on the hands of three typical subpopulations, including preschoolers, college students, and security guards (outdoor workers). The geometric mean diameter of dust/soil particles on hands was observed to be 38.7 ± 11.2, 40.0 ± 12.1, and 36.8 ± 10.4 μm for preschoolers, college students, and security guards, respectively. The particle size distribution differed between subpopulations: Preschoolers were more exposed to fine particles, whereas security guards were exposed to more coarse particles. The geometric means of dust/soil particle loading on the hands were 0.126, 0.0163, and 0.0377 mg/cm² for preschoolers, college students, and security guards, respectively. Males had statistically higher dust/soil particle loadings on hands than females, notably for preschoolers and college students; preschoolers with frequent hand contact with the bare ground had higher dust/soil particle loadings compared to those of peers in contact with commercial and residential grounds. The mean total dust/soil particle ingestion rate was estimated to be 245, 19.7, and 33.1 mg/day for preschoolers, college students, and security guards, respectively. Our estimates for college students and security guards are close to the consensus central-tendency values recommended by the U.S. EPA’s Exposure Factor Handbook for American adults, whereas the estimates for children are much higher than the upper percentile values recommended for American children.
... The sebum pH and secretion in subjects without and with acne are studied by Kim et al.. The acne patients had a slightly higher skin pH than without acne subjects [17]. The current study showed that sebum production and composition of acne patients was significantly higher than apparently healthy group. ...
Article
Full-text available
Background: The treatment selection in acne vulgaris (AV) is difficult due to challenging assessing severity; therefore, it should depend on a proper history, physical examination, previous treatment and response to treatment. Aims: The aim of this study is to investigate the differences in sebum composition and skin pH in patients with moderate to severe acne vulgaris to identify lipid markers in comparison with the apparently healthy group and to study the effects of isotretinoin or azithromycin on the level lipid profile, liver enzymes, in addition to sebum composition. Methods and Material: This study was conducted on sixty women patients with AV and thirty, apparently healthy individuals as a control group. The patients were allocated into two groups, A and B, group A was given 500 mg of azithromycin taken on alternative days for 3 months and group B was given 40mg/day isotretinoin for 3 months. Before and after therapy serum cholesterol, TG, ALP, ALT, GGT, creatinine additional to sebum cholesterol and squalene levels were measured. In the healthy control group, these parameters were assessed only once. Results:The results of the study showed significant differences (p<0.05) in serum levels of cholesterol, TG, sebum cholesterol, Squalene and skin pH in patient group when compared to control group. A statistically significant increase was detected in isotretinoin group post-treatment liver enzymes, lipid profile and sebum cholesterol, while sebum squalene was a significant decrease. While the results detected there was no significant effect of azithromycin on TG concentration. Conclusions: Both isotretinoin and azithromycin has side effects but isotretinoin has more effects on squalene concentration.
... Furthermore, we performed a comparative analysis of SSL-RNA profiles in male and female individuals known to have different sebum production levels 41 . The levels of casual sebum on the cheek and the recovered sebum on the forehead and cheek at 60 min after washing the face in male were significantly higher than those in female ( Supplementary Fig. 4a). ...
Article
Full-text available
Non-invasive acquisition of mRNA data from the skin can be extremely useful for understanding skin physiology and diseases. Inspired by the holocrine process, in which the sebaceous glands secrete cell contents into the sebum, we focused on the possible presence of mRNAs in skin surface lipids (SSLs). We found that measurable levels of human mRNAs exist in SSLs, where the sebum protects them from degradation by RNases. The AmpliSeq transcriptome analysis was modified to measure SSL-RNA levels, and our results revealed that the SSL-RNAs predominantly comprised mRNAs derived from sebaceous glands, the epidermis, and hair follicles. Analysis of SSL-RNAs non-invasively collected from patients with atopic dermatitis revealed increased expression of inflammation-related genes and decreased expression of terminal differentiation-related genes, consistent with the results of previous reports. Further, we found that lipid synthesis-related genes were downregulated in the sebaceous glands of patients with atopic dermatitis. These results indicate that the analysis of SSL-RNAs is a promising strategy to understand the pathophysiology of skin diseases.
... implying the difference in the physiological environment between males and females. 55,56 Finally, the anti-interference capability of the three sensing modes in the same wearable device is demonstrated in Movie S1. Obviously, UV, temperature, and sweat pH sensing in our device do not show interference with each other and no false positive signals are observed, indicative of their high reliability and specificity. ...
Article
Full-text available
Wearable devices are now recognized as a powerful tool to collect physiological and environmental information in a smart, noninvasive, and real-time manner. Despite the rapid progress of wearable devices especially wearable electronic devices, there are still several challenges that limit their further development, for example, a complicated electrical signal acquisition and processing process to eliminate the interference from the surrounding signals, bulky power supply, inevitable e-waste, and environmental pollution. Herein, we report a 3D-printed recyclable, flexible, and wearable device for visualized UV, temperature, and sweat pH sensing. Compared with wearable electronic devices, our visualized wearable device senses environmental (UV light, ambient temperature), biophysical (skin temperature), and biochemical (sweat pH) signals via stimuli-responsive color change, which does not require complicated electronic circuit design/assembly, time-consuming data processing and additional power source. In addition, this visualized wearable device is fabricated via a 3D support bath printing technology by printing UV-, temperature-, and sweat pH-sensing inks containing photochromic, thermochromic, and pH-chromic materials, respectively, into/onto sustainable starch solution, resulting in a multi-functional, recyclable, and flexible sensing device with high reproducibility. Our results reveal that UV light intensities under sunlight (0-2500 μW/cm2), ambient, and skin temperatures (0-38 °C) as well as sweat pH (4.0-7.0) can be successfully monitored.
... The sebum pH and secretion in subjects without and with acne are studied by Kim et al.. The acne patients had a slightly higher skin pH than without acne subjects [17]. The current study showed that sebum production and composition of acne patients was significantly higher than apparently healthy group. ...
Article
Full-text available
Background: The treatment selection in acne vulgaris (AV) is difficult due to challenging assessing severity; therefore, it should depend on a proper history, physical examination, previous treatment and response to treatment. Aims: The aim of this study is to investigate the differences in sebum composition and skin pH in patients with moderate to severe acne vulgaris to identify lipid markers in comparison with the apparently healthy group and to study the effects of isotretinoin or azithromycin on the level lipid profile, liver enzymes, in addition to sebum composition. Methods and Material: This study was conducted on sixty women patients with AV and thirty, apparently healthy individuals as a control group. The patients were allocated into two groups, A and B, group A was given 500 mg of azithromycin taken on alternative days for 3 months and group B was given 40mg/day isotretinoin for 3 months. Before and after therapy serum cholesterol, TG, ALP, ALT, GGT, creatinine additional to sebum cholesterol and squalene levels were measured. In the healthy control group, these parameters were assessed only once. Results:The results of the study showed significant differences (p<0.05) in serum levels of cholesterol, TG, sebum cholesterol, Squalene and skin pH in patient group when compared to control group. A statistically significant increase was detected in isotretinoin group post-treatment liver enzymes, lipid profile and sebum cholesterol, while sebum squalene was a significant decrease. While the results detected there was no significant effect of azithromycin on TG concentration. Conclusions: Both isotretinoin and azithromycin has side effects but isotretinoin has more effects on squalene concentration.
... The sebum pH and secretion in subjects without and with acne are studied by Kim et al.. The acne patients had a slightly higher skin pH than without acne subjects [17]. The current study showed that sebum production and composition of acne patients was significantly higher than apparently healthy group. ...
Article
Full-text available
Background: The treatment selection in acne vulgaris (AV) is difficult due to challenging assessing severity; therefore, it should depend on a proper history, physical examination, previous treatment and response to treatment. Aims: The aim of this study is to investigate the differences in sebum composition and skin pH in patients with moderate to severe acne vulgaris to identify lipid markers in comparison with the apparently healthy group and to study the effects of isotretinoin or azithromycin on the level lipid profile, liver enzymes, in addition to sebum composition. Methods and Material: This study was conducted on sixty women patients with AV and thirty, apparently healthy individuals as a control group. The patients were allocated into two groups, A and B, group A was given 500 mg of azithromycin taken on alternative days for 3 months and group B was given 40mg/day isotretinoin for 3 months. Before and after therapy serum cholesterol, TG, ALP, ALT, GGT, creatinine additional to sebum cholesterol and squalene levels were measured. In the healthy control group, these parameters were assessed only once. Results:The results of the study showed significant differences (p<0.05) in serum levels of cholesterol, TG, sebum cholesterol, Squalene and skin pH in patient group when compared to control group. A statistically significant increase was detected in isotretinoin group post-treatment liver enzymes, lipid profile and sebum cholesterol, while sebum squalene was a significant decrease. While the results detected there was no significant effect of azithromycin on TG concentration. Conclusions: Both isotretinoin and azithromycin has side effects but isotretinoin has more effects on squalene concentration.
... These results are consistent with previous studies, which have shown that the forehead region has a higher secretion of sebum, while the chin region has a medium to high secretion and the malar region a low to medium secretion. 16,17 A higher porphyrin count was also observed in this last region. ...
Article
Full-text available
Background: Oily skin and hair not only contain a large amount of sebum, but also exhibit other changes that compromise their physiology. The immediate effects of dermocosmetics are very important for adhesion to treatment. Aim: The aim of the present study was to characterize oily skin and scalp, to evaluate the correlation of sebum production with porphyrin counts and the immediate effects of topical formulations for sebum control. Patients/methods: A total of 100 women aged 18-49 years were recruited. Sebaceous gland activity, sebum amount, stratum corneum water content (SCWC) transepidermal water loss (TEWL), skin gloss, amount of porphyrins and pores were determined in the face and SCWC, sebum amount, porphyrin count, and TEWL were also determined in the scalp. The immediate effects of formulations containing a guarana extract were determined after 2 hours of application. Results: A correlation between sebaceous gland activity and presence of porphyrins in the frontal region of the face was detected. Low gloss values and large amounts of pores in the malar region were related to lower skin uniformity. High sebum values and low SCWC and porphyrin count were also observed in the vertex region. The studied formulations reduced the sebum content of face and scalp after 2 hours of application. Conclusion: Oily skin and hair showed high sebum values, which were correlated with porphyrin count and with the activity of sebaceous glands. Finally, the studied formulations had immediate reducing effects on sebum amounts on the skin and scalp.
... The pH of HG-CO and HG-COMS gels were observed from 5.3 to 5.6, which are close to physiological pH of skin. Slightly acidic range of skin pH (4.6-5.8) is due to skin secretions, which play significant role in skin protection against microbes (Kim et al., 2006). The gel also demonstrated optimum viscosity and good spreadability at 1% Carbopol concentration. ...
Article
Background: Citronella Oil (CO) was used by the Indian army as mosquito repellant to repel mosquitoes at the beginning of the 20th century and later in 1948, it was registered in the USA for commercial purposes. Due to its ecofriendly nature, CO possesses immense potential as a mosquito repellent. Methods: Citronella oil is a valuable alternative to synthetic mosquito repellents commonly used nowadays. However, its volatile nature, poor stability in air and high temperature restrict its application. Its direct application on skin may lead to skin irritation. To surmount the above-mentioned issues, the present research aims to develop Microsponge (MS), a novel dosage form for enhancing the utility and safety of CO. Quasi emulsion solvent diffusion method was chosen for crafting MS using ethyl cellulose with various drug-polymer ratios and characterized. In vitro cytotoxicity evaluation was also carried out to check the dermal safety of COMS. Results: The present results revealed that the size of all prepared formulation lies in the micro range (20 ± 3 to 41 ± 4 μm), with good payload (42.09± 3.24 to 67.08± 6.43%). The results of FE-SEM depicted that MS were spherical in shape with porous nature. Cytotoxicity results indicated that COMS were safe on skin cells, when compared to pure CO. The optimized MS were also assessed for larvicidal assay against larvae of Anopheles culicifacies. Conclusion: The CO micro-formulations were found to possess enhanced stability of this oil. Entrapment of CO in MS resulted in a better vehicle system in terms of safety, stability and handling benefits of this oil.
... [17][18][19] In addition, it is known that there are sex differences in skin colonization that may be associated with differences in skin thickness, sebum production and skin pH. 20,21 Among the 3 components of the National Nosocomial Infections Surveillance System risk index, only the duration of surgery was an independent predictor for SSI in our study. A patient who had an operation lasting longer than the 75th percentile (> 3 h in our cohort) had double the risk of SSI in contrast to an operation lasting less than the 25th percentile (86 min). ...
Article
Full-text available
Background: Surgical site infection (SSI) is one of the most common complications of abdominal surgery and is associated with substantial discomfort, morbidity and cost. The goal of this study was to describe the incidence, bacteriology and risk factors associated with SSI in patients undergoing abdominal surgery. Methods: In this prospective cohort study, all patients aged 14 years or more undergoing abdominal surgery between Feb. 1 and July 31, 2016, at a single large academic hospital were included. Patients undergoing vascular, gynecological, urological or plastic procedures were excluded. Patients were followed prospectively for 30 days. Wound assessment was done with the Centers for Disease Control and Prevention definition of SSI. We performed multivariate analysis to identify factors associated with SSI. Results: A total of 337 patients were included. The overall incidence of SSI was 16.3% (55/337); 5 patients (9%) had deep infections, and 25 (45%) had combined superficial and deep infections. The incidence of SSI in open versus laparoscopic operations was 35% versus 4% (p < 0.001). The bacteria most commonly isolated were extended-spectrum β-lactamase-producing Escherichia coli, followed by Enterococcus species. Only 23% of cultured bacteria were sensitive to the prophylactic antibiotic given preoperatively. The independent predictors of SSI were open surgical approach, emergency operation, longed operation duration and male sex. Conclusion: Potentially modifiable independent risk factors for SSI after abdominal surgery including open surgical approach, contaminated wound class and emergency surgery should be addressed systematically. We recommend tailoring the antibiotic prophylactic regimen to target the commonly isolated organisms in patients at higher risk for SSI.
... After standardized washing procedures with pure tap water, the mean axillary pH decreased significantly in the women at all measurement times (lowest value 60 min after washing: 5.51 ± 0.7 [right] and 5.64 ± 0.7 [left]), while it slightly increased in the men (highest value 240 min after washing: 6.7 ± 0.59 [right] and 6.78 ± 0.69 [left]) [4] . One Korean group reported on the gender differences with respect to skin type and pH [7] . Forty-six healthy Korean women and 37 men were included. ...
Chapter
Several studies have generally described the existence of differences of skin surface pH according to gender, age, and ethnicity, but these studies have reported inconsistent results, depending on anatomical sites, methods, and time of measurement. Overall, it could be summarized that female sex, younger age, and black skin have a lower skin pH compared to male sex, older age, and white skin.
... Establishing an understanding of these biophysical properties and their normal range is important as it provides a baseline for future research, and has relevance for studies into areas ranging from product testing to skin physiology, the microbiome and barrier function where environmental conditions, pH, TDC and gender can play a pivotal role [37]. ...
Article
Full-text available
There is increasing interest in the development of non-invasive tools for studying the properties of skin, due to the potential for non-destructive sampling, reduced ethical concerns and the potential comparability of results in vivo and in vitro. The present research focuses on the use of a range of non-invasive approaches for studying skin and skin barrier properties in human skin and human skin equivalents (HSE). Analytical methods used include pH measurements, electrical sensing of the epidermis and detection of volatile metabolic skin products. Standard probe based measurements of pH and the tissue dielectric constant (TDC) are used. Two other more novel approaches that utilise wearable platforms are also demonstrated here that can assess the electrical properties of skin and to profile skin volatile species. The potential utility of these wearable tools that permit repeatability of testing and comparability of results is considered through application of our recently reported impedance-based tattoo sensors and volatile samplers on both human participants and HSEs. The HSE exhibited a higher pH (6.5) and TDC (56) than human skin (pH 4.9–5.6, TDC 29–36), and the tattoo sensor revealed a lower impedance signal for HSEs, suggesting the model could maintain homeostasis, but in a different manner to human skin, which demonstrated a more highly resistive barrier. Characterisation of volatiles showed a variety of compound classes emanating from skin, with 16 and 27 compounds identified in HSEs and participants respectively. The continuing development of these tools offers potential for improved quality and relevance of data, and potential for detection of changes that are undetectable in traditional palpable and visual assessments, permitting early detection of irritant reactions.
... Sex differences could also be explained in part by cutaneous differences in pH and/or use of skin products, which might influence microbial colonization and barrier integrity. 34,35 Unfortunately, these variables were not available in the Rotterdam Study and therefore were not investigated. Other studies will be needed to assess the behavioural or biological differences underlying the statistical associations between sex and seborrhoeic dermatitis. ...
Article
Full-text available
Background: Seborrheic dermatitis is a chronic relapsing inflammatory skin disease with unclear pathophysiological mechanisms. Objective: To establish which lifestyle and physiological determinants are associated with seborrheic dermatitis. Methods: Seborrheic dermatitis was diagnosed by a trained physician during a full body skin examination within the Rotterdam Study, a prospective population-based cohort study in middle aged and elderly. The current design is a comparative cross-sectional study embedded in the Rotterdam Study. Potential factors were identified from the literature and analysed in a multivariable logistic regression, including: age, sex, obesity, skin colour, stress, depression, education level, hypertension, climate, xerosis cutis, alcohol and tobacco use. Results: Of the 5,498 participants, 788 participants were diagnosed with seborrheic dermatitis (14.3%). We found associations between seborrheic dermatitis and male sex (adjusted OR 2.09; 95% CI: 1.77-2.47), darker skin (adjusted OR 0.39; 95% CI: 0.22-0.69), season (summer vs winter: adjusted OR 0.63; 95% CI: 0.48-0.82) and generalized xerosis cutis (adjusted OR 1.41; 95% CI 1.12-1.80). Conclusion: Seborrheic dermatitis is one of most common inflammatory dermatoses in middle and elderly aged individuals, especially during winter period. Men, and people with a light and dry skin were most likely to have seborrheic dermatitis. This article is protected by copyright. All rights reserved.
Article
Background Elderly-onset seborrheic dermatitis (SD) seriously affects the quality of life. However, associations between air pollution exposures and elderly-onset SD incidence have not been elucidated. Objectives Investigate air pollution's role in the incidence of elderly-onset SD. Methods We engaged a prospective cohort analysis utilizing the UK Biobank database. Exposure data for specific air pollutants (PM2.5, PM2.5-10, NOX, NO2, and PM10) spanning various years was incorporated. Through a composite air pollution score constructed from five pollutants and employing Cox proportional hazards models, the relationship between pollution and SD was delineated. Results Our examination of 193,995 participants identified 3,363 SD cases. Higher concentrations of specific pollutants, particularly in the upper quartile (Q4), were significantly linked to an elevated SD risk. Notably, PM2.5, PM10, NO2, and NOX exhibited hazard ratios of 1.11, 1.15, 1.22, and 1.15, respectively. The correlation was further solidified with a positive association between air pollution score increments and SD onset. Intriguingly, this association was accentuated in certain demographics, including younger males, the socioeconomically deprived, smokers, daily alcohol consumers, and those engaging in regular physical activity. Conclusions Our findings revealed that air pollution exposures were associated with elderly-onset SD incidence. These results emphasize the importance of preventing environmental exposures to the risk of SD development.
Article
Background: Whether symptomatic benign prostatic hyperplasia (sBPH), which is common among middle-aged and older men, affects the risk of periprosthetic joint infection (PJI) remains controversial. The present study explored this question among men undergoing total knee and hip arthroplasty (TKA/THA). Methods: We retrospectively analyzed medical data from 948 men who underwent primary TKA or THA at our institution between 2010 and 2021. We compared the incidence of postoperative complications such as PJI, urinary tract infection (UTI), and postoperative urinary retention (POUR) between 316 patients (193 hips and 123 knees) who did and 632 patients who did not have sBPH; the two groups of patients were matched to each other in a 1:2 ratio based on numerous clinical demographic variables. In the subgroup analyses, we stratified sBPH patients according to whether they began anti-sBPH medical therapy prior to arthroplasty. Results: Periprosthetic joint infection following primary TKA was significantly more common among sBPH patients than among patients who did not have sBPH (4.1 vs 0.4%; P = 0.029), as were UTI (P = 0.029), and POUR (P < 0.001). Patients who had sBPH also had an increased incidence of UTI (P = 0.006) and POUR (P < 0.001) following THA. Among sBPH patients, those who started anti-sBPH medical therapy before TKA suffered significantly lower incidence of PJI than those who did not. Conclusion: Symptomatic BPH is a risk factor for PJI after primary TKA among men, and starting appropriate medical therapy before surgery can reduce the risk of PJI following TKA and postoperative urinary complications following TKA and THA.
Article
Unlabelled: The objective of this study was to determine the frequency of wound infection among patients with abdominal surgeries and to compare the surgical site infection following elective versus emergency abdominal surgeries in a tertiary care hospital. Subjects and methods: All patients who fulfilled the inclusion criteria in the Department of General Surgery were included in the study. After taking informed written consent history was taken, clinical examination and patients were divided into two groups: group A (elective abdominal surgery) and group B (emergency abdominal surgery), patients in both groups were compared for the outcome that is surgical site infection. Result: A total of 140 patients who underwent abdominal surgery were included. Wound infection in abdominal surgeries was noted in 26 patients (18.6%), in group A wound infection was noted in 7 (5%), while in group B wound infection was seen in 19 (13.6%). Conclusion: The rate of wound infection in patients with abdominal surgeries was not low among the study population and the rate of wound infection was higher in emergency abdominal surgeries as compared with elective abdominal surgeries.
Article
Purpose: Surgical site infection following total knee replacement is considered as one of the most severe postoperative complications. The presence of bacteria at the surgical site is the most important risk factor and therefore it is essential to prevent infection through appropriate preoperative skin preparation. The purpose of this study was to examine the presence and type of native bacteria on the incision site and to assess which skin preparation is most effective to sterilize those native bacteria. Methods: Scrub-and-paint 2 step method was used for standard preoperative skin preparation. 150 patients who underwent total knee replacement were grouped into 3 groups- Group 1 (povidone-iodine scrub-and-paint), Group 2 (chlorhexidine gluconate paint after povidone-iodine scrub), and Group 3 (povidone-iodine paint after chlorhexidine gluconate scrub). 150 specimens of post-preparation swabs were obtained and cultured. To analyze the native bacteria at the total knee replacement incision site, 88 additional swaps were performed before skin preparation and cultured. Results: The positive rate of bacterial culture after skin preparation was 5.3% (8/150). Positive rates of the groups were 12% (6/50) in group 1, 2% (1/50) in group, 2 and 2% (1/50) in group 3 and positive rates of bacterial culture after skin preparation in group 2 and group 3 were lower than in group 1 (p = 0.037). Among the 55 patients who had positive bacterial culture prior to skin preparation, 26.7% (4/15) in group 1, 5.6% (1/18) in group 2, and 4.5% (1/22) in group 3 were positive. Group 1 showed 7.64 times higher positive bacterial culture rate after skin preparation than group 3 (p = 0.084). Conclusion: During skin preparation prior to total knee replacement surgery, chlorhexidine gluconate paint after povidone-iodine scrub or povidone-iodine paint after chlorhexidine gluconate scrub had a superior effect on sterilizing native bacteria compared to povidone-iodine scrub-and-paint method.
Chapter
The sebaceous gland is a holocrine system composed of acini and excretory ducts and different cell layers, which produce sebum. The rate and pattern of sebum excretion differ throughout different stages of life. Sebum has various functions in humans and its development is affected by different factors such as steroid synthesis, growth factors, hormones, etc. Sebocytes, the components of sebaceous glands, synthesize and store lipids. Sebum is unique in some aspects and differs in composition with other lipids. It is also species-specific. Different immortalized sebaceous gland cell lines have been produced for usage in research studies. Sebocytes produce hormones and are affected by hormones and other factors; different types of receptors play major roles in processes involving sebocytes of sebaceous glands.
Chapter
The sebaceous gland is a holocrine system composed of acini and excretory ducts and different cell layers, which produce sebum. The rate and pattern of sebum excretion differ throughout different stages of life. Sebum has various functions in humans and its development is affected by different factors such as steroid synthesis, growth factors, hormones, etc. Sebocytes, the components of sebaceous glands, synthesize and store lipids. Sebum is unique in some aspects and differs in composition with other lipids. It is also species-specific. Different immortalized sebaceous gland cell lines have been produced for usage in research studies. Sebocytes produce hormones and are affected by hormones and other factors; different types of receptors play major roles in processes involving sebocytes of sebaceous glands.
Article
Full-text available
A significant loss of microbial biodiversity on the skin has been linked to an increased prevalence of skin problems in the western world. The primary objective of this study was to obtain a benchmark value for the microbial diversity found on healthy western skin, using the Chao1 index. This benchmark was used to update our 2017 skin health measuring mechanism in line with standardised methodology. It used 50 human participants from Graz in Austria and at a read depth of 6600 sequences, we found the average Chao1 diversity to be ~180, with upper and lower quartiles of ~208 and ~150, respectively. Previous work with a larger sample size was unsatisfactory to use as a benchmark because different diversity indices and evaluation methodologies were used. The Medical University of Graz used the most recent version of the Chao1 index to obtain diversity results. Because of this study, we can transfer other benchmarks of skin microbiome diversity to the methodology used in this work from our 2017 study, such as “unhealthy western skin” and “caveman/perfect skin”. This could aid with the diagnostic assessment of susceptibility to cutaneous conditions or diseases and treatment. We also investigated the effect of sex and age, which are two known skin microbiome affecting factors. Although no statistical significance is seen for sex- and age-related changes in diversity, there appear to be changes related to both. Our preliminary results (10 in each of the five age groups) show adults aged 28–37 have the highest average diversity, and adults aged 48–57 have the lowest average diversity. In future work, this could be improved by obtaining benchmark diversity values from a larger sample size for any age, sex, body site, and area of residence, to which subjects can be compared. These improvements could help to investigate the ultimate question regarding which environmental factors in the western world are the main cause of the huge rise in skin problems. This could lead to future restrictions of certain synthetic chemicals or products found to be particularly harmful to the skin.
Article
Citronella oil has been frequently used as an insect repellant and antibacterial agent for management of vector borne diseases. In this study, the fabrication of citronella oil microsponge loaded hydrogel (HG-COMS) was conceptualized in order to provide future insight for developing delayed release formulation. The hydrogel was characterized for drug content, drug interaction studies, spreadability, texture analysis and in vitro occlusive behaviour and results were found satisfactory. Further, in vitro antimicrobial studies were carried out to compare the antimicrobial inhibitory potential of the HG-COMS against citronella oil loaded hydrogel (HG-CO). HG-COMS formulation showed better antimicrobial efficacy than HG-CO (zone of inhibition of E. coli, P. aeruginosa and S. aureus; with P value less than 0.01, 0.001 and 0.05, respectively). In addition, the safety (irritation potential) of the oil loaded hydrogel formulation was assessed by Hen’s Egg Test Chorioallantoic Membrane (HAT-CAM) method. Mosquito repellent activity against Anopheles stephensi (malaria vector mosquito) was also performed in a net cage having blood starved female mosquitoes. The repellent potential of prepared HG-COMS (34% repellency for 6 h) was found dependent on release of CO from the microsponges as well as from the gel matrix. HET-CAM test revealed that HG-COMS (irritation score: 6.43 ± 0.77) was found very promising in comparison to HG-CO (irritation score: 12.77 ± 0.36), and was thus, considered safer for dermal use. HG-COMS showed reduced frequency of application, no skin irritation and potential for controlling A. stephensi for longer time periods. Hence, HG-COMS is found as a promising eco-friendly protective option, to minimize the burden of mosquito-transmitted diseases, especially malaria in future.
Article
Full-text available
Introduction: Epidermal enzymes and processes that maintain skin barrier integrity and defence are optimal at acidic pH whilst enzymes involved in barrier lipid degradation have alkaline optima. Skin surface pH is therefore vital in skin barrier homeostasis, in the assessment and preservation of skin health and management of skin disorders; but this is yet to translate adequately into clinical care. Moreover, skin biophysical parameters are known to have racial variations yet very few studies document these in healthy black Africans living in Africa. Some unmet needs in the cosmetic and disease management of African skin may be addressed by better understanding of variations in skin pH. Aim: To determine average pH of the skin of healthy Nigerians and variations with gender, age and anatomic location. Methods: We measured the skin surface pH in 1075 healthy Nigerian volunteers, without skin pathology, residing in Lagos, Nigeria, aged one to eighty-five years;611 of whom were females. A scientific skin pH meter was used to take readings from the forehead and left volar forearm during the months of March to November under controlled room temperature. Results: The average skin pH was 4.87; 95% CI [4.85, 4.89]. There were statistically significant differences at different age groups and genders. The values obtained were compared with other studies on skin surface pH. Conclusion: Average skin surface pH of healthy Nigerians in this study was slightly lower than what is documented in Caucasians, Asians and even Africans elsewhere, for the same anatomic locations. The variation with gender, age and anatomic locations is however similar. Exogenous factors particularly the low pH of domestic water supply may have influenced the observed data. These results should influence future studies on skin pH as well as the development of ethnically appropriate skin care and treatment products for the African skin.
Article
Full-text available
Self-touch may promote the transfer of microorganisms between body parts or surfaces to mucosa. In overt videography of a post-graduate office, students spent 9% of their time touching their own hair, face, neck, and shoulders (HFNS). These data were collected from 274,000 s of surveillance video in a Chinese graduate student office. The non-dominant hand contributed to 66.1% of HFNS-touches. Most importantly, mucous membranes were touched, on average, 34.3 (SE = 2.4) times per hour, which the non-dominant hand contributed to 240% more than the dominant hand. Gender had no significant effect on touch frequency, but a significant effect on duration per touch. The duration per touch on the HFNS was fitted with a log–log linear distribution. Touch behaviour analysis included surface combinations and a probability matrix for sequential touches of 20 sub-surfaces. These findings may partly explain the observed variation in the literature regarding the microbiome community distribution on human skin, supporting the importance of indirect contact transmission route in some respiratory disease transmission and providing data for risk analysis of infection spread and control.
Article
Background: Regional differences in skin characteristics are well known. Significant differences in skin physiology between the forehead and cheek have also been reported. However, there are few studies based on lipidomics at the molecular level. Additionally, there is no study focusing on the lipid profile variations of skin surface lipid (SSL) in forehead and cheek. Purpose: This study analyzed the differences in facial SSL between forehead and cheek of men aged 18-25 years to explain the distinct physiological parameters between forehead and cheek resulting in different skin status. Methods: Facial SSL was identified by ultra-performance liquid chromatography-quadrupole time of flight-mass spectrometry (UPLC-QTOF-MS). Multivariate data analysis was used to investigate the SSL difference in forehead and cheek. Results: Significant differences in facial SSL composition were detected between the forehead and cheek. Multivariate data analysis suggested that 21 entities contributed most significantly toward the discrimination and phosphatidylserines (PS) constituted the majority of differentiating lipid species. Subsequent analysis showed a marked increase in the amounts of unsaturated and saturated free fatty acids (FFAs), and a significant increase in average FFAs chain length in the forehead as compared to that in the cheek. Conclusions: Phosphatidylserines exposure might be one of the most important reasons for the increased amount of forehead SSL secretion. The different FFAs chain length and FFAs content lead to altered skin barrier functions in forehead and cheek, consequently resulting in altered trans-epidermal water loss (TEWL) and pH at the two anatomical sites.
Article
Background: Male patients undergoing total joint arthroplasty have a higher risk of periprosthetic joint infection (PJI) compared with female patients. The exact reason for this finding is not well known. This study aimed to determine if patients with symptomatic benign prostatic hyperplasia (BPH) are at increased risk of PJI. Methods: A total of 12,902 male patients who underwent primary or revision total joint arthroplasty from January 2006 to April 2017 were retrospectively identified. The mean patient age was 62.47 years and the mean patient body mass index was 30.1 kg/m. The majority of patients were Caucasian or African American. Most surgical procedures involved the hip joints (57.8%) and were primary arthroplasties (86%). Of these patients, 386 (3%) had symptomatic BPH. Among this group, 250 patients with symptomatic BPH were identified and were matched in an approximate 1:3 ratio with 708 control patients. Using the International Consensus Meeting criteria, patients who developed PJI were identified. Results: The PJI rate was 7.9% in the symptomatic BPH group and 2.8% in the control group. Multivariate regression analysis in unmatched groups showed that symptomatic BPH was a strong independent risk factor for PJI. After matching for variables related to outcomes, symptomatic BPH remained a significant risk factor for PJI (p = 0.01). Conclusions: Patients with symptomatic BPH had a higher risk of PJI compared with the control patients. This may partly explain the higher rate of PJI that is seen in male patients. Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Article
The aim of the present study is to examine the readmission rate within 90 days of a cohort of patients, who underwent an arthroscopic anterior cruciate ligament (ACL) reconstruction with a lateral extraarticular tenodesis, from a single highly specialized sports traumatology department. From our institutional database, we identified 2,559 patients (78.5% males and 21.5% females, with a mean age at surgery of 30.9 ± 11.5 years) who underwent primary ACL reconstruction with the same “over-the-top” technique plus lateral extraarticular tenodesis (LET) from January 2010 to December 2017. From this count, we extracted all patients who were readmitted within 90 days and focused on causes of readmission and reoperation rate. Moreover, a multivariate logistic regression was performed to identify possible variables, such as gender, age, and concomitant meniscus surgery, which could predict the risk of early readmission. From the aforementioned cohort, 58 patients (2.27%) were readmitted within 90 days from surgery after a mean time of 31 ± 23 days. The most common cause of readmission was fever and knee swelling (0.78%), followed by superficial infection (0.63%), deep infection (0.55%), and joint stiffness (0.23%). The patients' age and meniscal lesions requiring concomitant arthroscopic treatment were found to be correlated to an increased risk of early readmission. Superficial infections were more common in female patients (odds ratio [OR] = 3.01), whereas the meniscal treatment was also a significant risk factor specifically for deep infections (OR = 3.56). In conclusion, this technique of arthroscopic ACL reconstruction with LET showed a low readmission rate within 90 days from surgery. However, patients and physicians should be aware of the risk of serious complications, such as deep and superficial infections, mostly in female patients and in cases of concurrent meniscal treatments. This is a Level IV, retrospective case series study.
Article
Purpose: To investigate the submandibular soft tissue changes related to the hard tissue changes after mandibular set-back surgery in skeletal Class III patients. Methods: The subjects were adults with skeletal Class III malocclusion who underwent orthognathic surgery including mandibular set-back between June 2007 and January 2011 at Kyung Hee University Dental Hospital at Gandong. Standardized lateral cephalograms that were taken before and 6 to 12 months after surgery were collected. Sixty samples were selected. Each lateral cephalograms was traced and lines, angles and areas associated with submandibular soft tissues were measured and analyzed statistically. Results: Anteroposterior submandibular soft tissue length was reduced with reduction of mandibular body length. FH to mandibular plane angle was decreased and FH to submandibular line angle was increased. A gender difference was found in soft tissue changes. Males showed altered vertical soft tissue thickness and submandibular tissue area reduction after surgery. Several hard tissue changes were correlated with soft tissue changes and through multiple regression models with stepwise selection method, several regression equation models to predict soft tissue changes related to hard tissue changes were made. Conclusion: After orthognathic surgery including mandibular set-back, the submandibular soft tissue profile changes. Equations to predict submandibular soft tissue changes after mandibular set-back surgery were developed.
Article
Background Studies have begun to investigate the complex relationship between host and microorganisms in non‐infectious pathologies such as acne, atopic dermatitis, and psoriasis. Though the skin is exposed to environmental stressors such as ultraviolet radiation (UVR), no studies exist examining the effects of both UVA and UVB on the skin microbiome. Objective To test the effect of UVA and UVB on human skin microbiome. Methods To test whether UV will alter the cutaneous microbiome, participants were exposed to doses of UVA (22‐47 J/cm²) or UVB (100‐350 mJ/cm²) and samples were collected. DNA was isolated and sequenced to identify the microbial composition of each sample. Results There was vast intra‐ and inter‐subject variation at all time points and phylum and species‐level differences were identified. These included an increase in the phylum Cyanobacteria and a decrease in the family Lactobacillaceae and Pseudomonadaceae. The sensitivity of microbes to UVR and their re‐colonization potential following exposure differed in UVA vs UVB samples. Limitations The sample size was small, and the study was limited to males. Conclusion The results demonstrate that UVR has profound qualitative and quantitative influences on the composition of the skin microbiome, possibly effecting skin pathology in which UVR is a factor. This article is protected by copyright. All rights reserved.
Article
The skin microbiota is an inseparable component of the skin barrier structure, which participates in the stabilization or impairment of the barrier function as well as the development of many skin diseases. To characterize the normal skin microbiota and its association with skin sites, age and sex, we recruited 50 volunteers divided into children, adolescents, young adults, middle‐aged adults and the elderly. The skin sites consisted of cheeks, volar forearms (representing dry environments) and upper back (representing sebaceous environments). A total of 9 574 365 high‐quality sequences of the V3 to V4 region of the 16S rRNA gene were annotated with taxonomic information related to two archaeal phyla (Thaumarchaeota and Euryarchaeota) and five dominant bacterial phyla (Actinobacteria, Proteobacteria, Firmicutes, Bacteroidetes and Cyanobacteria). The skin bacteria community structure was influenced by skin sites, and was closely related to age and sex. The upper back was dominated by Propionibacterium and Staphylococcus, and the cheeks facilitated the survival of Betaproteobacteria, while Alphaproteobacteria were prevalent on the volar forearms. Regarding the effects of age, after sexual maturity, the cheek microbiota became more similar to sebaceous sites (i.e. the upper back). The volar forearms appeared to experience the aging process earlier than the other two sites. The elderly had greater species richness and diversity and their community composition no longer had skin‐site selectivity. Males had a greater species richness than females, but the sex differences in the community structure only present at certain age groups and skin sites.
Article
Full-text available
Introduction The skin is important for the perception of health and beauty. Knowledge of the physiological, chemical, and biophysical differences between the skin of male and female patients helps dermatologists develop a proper approach not only for the management of skin diseases but also to properly take care of cosmetic issues. The influence of genetic and environmental factors on skin characteristics is also critical to consider. Methods A literature search of PubMed and Google was conducted to compare the biophysical and biomechanical properties of the skin of male and female patients using the keywords "skin", "hydration", "water loss", "sebum", "circulation", "color", "thickness", "elasticity", "pH", "friction", "wrinkle", "sex", "male", and "female". Results A total of 1070 titles were found. After removing duplications and non-English papers, the number was reduced to 632. Of the 632 titles, 57 were deemed suitable for inclusion in this review. The studies show that the skin parameters of hydration, transepidermal water loss, sebum, microcirculation, pigmentation, and thickness are generally higher in men but skin pH is higher in women. Conclusions These parameters can be considered as age markers in some cases and are susceptible to change according to environment and life style. Biometrological studies of the skin provide useful information in the selection of active principles and other ingredients of formulations to develop a specific approach for cosmetic treatments.
Chapter
There are many differences between male and female patients, regarding dermatological treatments and procedures, such as facial anatomy, skin biology, and aging skin process. Sex steroids modulate skin thickness, skin surface pH, wound healing, and potencial for infection and diseases. Men’s skin is usually thicker and oilier than women’s. Androgenetic alopecia is the most common cause of hair loss in men, and it usually has a considerable psychosocial impact and emotional distress. Other common problems related to hair are the pseudofolliculitis barbae and superficial folliculitis on the beard area secondary to the coiled hair shafts repenetrating the skin and to the frequent habit of shaving. All these conditions should have different approach and are going to be discussed in this chapter.
Chapter
The sebaceous gland is a holocrine system composed of acini and excretory ducts and different cell layers, which produce sebum. The rate and pattern of sebum excretion differ throughout different stages of life. Sebum has various functions in humans and its development is affected by different factors such as steroid synthesis, growth factors, hormones, etc. Sebocytes, the components of sebaceous glands, synthesize and store lipids. Sebum is unique in some aspects and differs in composition with other lipids. It is also species-specific. Different immortalized sebaceous gland cell lines have been produced for usage in research studies. Sebocytes produce hormones and are affected by hormones and other factors; different types of receptors play major roles in processes involving sebocytes of sebaceous glands.
Chapter
Skin surface pH plays an important role in the maintenance of skin barrier integrity and epidermal homeostasis. In workplace environments, myriad exposures may alter the skin surface pH and influence development of skin diseases. Unlike well-controlled clinical settings, workplaces and other nonclinical settings are more variable and present unique measurement challenges, making guidelines necessary for accurate determination of skin surface pH in these environments. The standard approach for the measurement of skin surface pH is the use of a glass planar electrode. Good measurement practices for nonclinical settings include: (1) minimizing the influences of relevant endogenous, exogenous, and environmental factors that affect measurements (e.g., anatomical position, hand washing, occlusion from use of protective garments such as gloves); (2) reporting pH measurement results on a relative basis, e.g., percent change rather than absolute values; and (3) capturing any events that may influence measurements. It is envisaged that these guidelines will promote better understanding of skin barrier integrity, particularly in occupational environments, and consequentially enable intercomparison of future study results.
Chapter
There are many differences between male and female patients, regarding dermatological treatments and procedures, such as facial anatomy, skin biology, and aging skin process. Sex steroids modulate skin thickness, skin surface pH, wound healing, and potencial for infection and diseases. Men’s skin is usually thicker and oilier than women’s. Androgenetic alopecia is the most common cause of hair loss in men, and it usually has a considerable psychosocial impact and emotional distress. Other common problems related to hair are the pseudofolliculitis barbae and superficial folliculitis on the beard area secondary to the coiled hair shafts repenetrating the skin and to the frequent habit of shaving. All these conditions should have different approach and are going to be discussed in this chapter.
Article
In questo inizio di millennio, l’uomo si interessa sempre di più al suo aspetto esteriore. Questo crescente interesse ha suscitato nuove ricerche che hanno permesso di mettere in evidenza le specificità della pelle maschile. Un maggiore spessore cutaneo e una migliore resistenza all’elastosi solare, con un invecchiamento cronologicamente più tardivo ma più accentuato, un’architettura del tessuto adiposo differente con un ipoderma meno spesso e un’attività più elevata della lipoproteina lipasi nel grasso addominale, un sudore più acido, una secrezione sebacea più attiva e delle fanere influenzate dagli ormoni. Data questa situazione, l’offerta cosmetica è aumentata, in modo da rispondere in maniera rigorosa ma anche allettante ai bisogni della pelle dell’uomo. L’uomo ha a sua disposizione, oltre ai prodotti di base (detergenti, creme idratanti, prodotti per la rasatura e lozioni per capelli), maschere, scrub, esfolianti, correttori, cosmetici detossificanti e defaticanti ed è interessato soprattutto alle tecniche di ringiovanimento (peeling, laser, iniezioni, chirurgia).
Chapter
Genetic differences between men and women are the cause of many phenotypic and functional differences. In addition, men and women generally lead different lifestyles. How this affects various aspects of aging skin is an extensive area of study. Analyzing gender’s influence in characteristics of the skin, including structural and anatomical characteristics, biochemical composition, mechanical properties, and skin color, has been a primary topic. Homeostatic and functional variations such as in sweat rate, blood flow, pH, sensory response, response to irritants, and reparative abilities affect the integrity of the skin. In addition, there are many hormone-dependent mechanisms related to the skin, thereby suggesting sex-based differences of these mechanisms. Seasonal variation, also, alters skin physiology. Taken together, research suggests gender does, indeed, affect skin properties. However, some studies report no difference or contradicting results. This is likely due to varied experimental designs. Thus, emphasis should be placed on maintaining standard methods for results to be comparable and taking note of parameters such as types of population, age, lifestyle, and environment. Overall, elucidating which aspects of aging skin are affected and how they are affected will improve sex-specific approaches toward skin care treatment.
Chapter
It is known that elderly skin has an increased pH and decreased buffering capacity. These two changes in the physiochemical nature of elderly skin arguably contribute to the fragility of elderly skin by influencing barrier homeostasis, skin integrity/cohesion, susceptibility to infection, and skin sensitivity to topical acids and alkalis. This chapter briefly reviews the basic science of pH, the buffering capacity, and the changes seen in the epidermis of aging skin before presenting a more in-depth review of experimentation investigating the source and characteristics of human skin buffering capacity. These studies are reviewed in an attempt to illuminate the source of the diminished buffering capacity of aged skin. Experimentation reviewed here suggests that AAs are primarily responsible for the neutralization capacity of the skin. The exact sources of the amino acids as well as the types of AA that are primarily responsible for the neutralization capacity remain still rather speculative. From what is known to date, filaggrin breakdown products may play an important role in skin buffering capacity, and the decrease in filaggrin as we age may explain, at least in part, why the skin buffering capacity decreases with age. Additional components of the epidermis such as sebum and CO2 seem not to significantly participate as buffering agents of the epidermis, yet they still may play a role in the protection of skin from the harm of acids and bases.
Article
Full-text available
Facial skin is usually classified as dry, normal, and oily in the cosmetics field. However, there is no standard objective method for classifying facial skin. We measured sebum excretion with Sebumeter at four sites on the face. Based on the amount of sebum secretion, we reclassified skin type according to the guidelines provided by the manufacturer. The mean of sebum excretion (mean facial sebum excretion; MFSE) was also calculated. People secrete varying amounts of sebum at different skin sites. Reclassification of skin type based on sebum secretion revealed that most participants underestimated the amount of facial sebum excretion. When sebum secretion amounts were compared, a statistically significant difference was apparent between the oily and dry skin types. However, there were no statistical differences between oily and normal, and normal and dry skin. We showed that subjective skin type does not match the amount of sebum secreted. Thus, this simple and subjective classification is of very limited use and it should be re-evaluated by using an objective and standardized measuring tool.
Article
Sebaceous gland activity has four distinct components which are sebum production (a secretion rate function), storage (a volume function), surface output (a delivery rate function) and stratum corneum permeation (an influx rate function). The oily appearance of skin results from an excess of sebum excretion and spreading over the body surface and its interaction with the skin surface. A multi-pronged approach is often useful to assess skin greasiness with precision. The clinical evaluation of skin greasiness and its shiny appearance should be further complemented by quantifying the large pores, follicular plugs and comedones. The sebum amount present at the skin surface can be measured non-invasively using one of several methods based on solvent extraction, cigarette paper pads, photometric assessment, bentonite clay and lipid-sensitive tapes. Quantitative parameters include the sebum casual level, the sebum excretion rate, the sebum replacement time, the instant sebum delivery, the follicular excretion rate, the density in sebum-enriched reservoirs and the sustainable rate of sebum excretion. A series of environmental and biological features influence the data. Hence rigorous methodological designs are mandatory to support claims. As a rule, accuracy of the methods is adversely affected by skin temperature, degree of hydration and surface roughness. An additional confounding factor is the inherent difficulty of collecting the surface lipids without a contribution from the follicular reservoir. A better understanding of factors that alter the sebum amount at the skin surface may well assist in the development of sebosuppressive agents to help the reduction of the skin greasiness and improve acne.
Article
The skin surface pH on the forehead and cheek of 574 men and women aged 18-95 was measured. No differences were found between men and women regarding forehead and cheek pH distribution. The group over the age of 80 showed higher pH values on both the forehead and the cheek. In 89% of the subjects measured, the skin surface pH on the cheek was higher than that on the forehead. The central 90%, i.e., the "representative range", for the population below the age of 80 is between 4.0-5.5 on the forehead and between 4.2-5.9 on the cheek.
Article
Topical erythromycin is a standard regimen for inflammatory acne vulgaris because of its action against Propionibacterium acnes. Changes in P. acnes colonization are inducible by long-lasting changes of skin surface pH. Therefore, the influence of six erythromycin preparations with approximative pH values of 7.5 (preparation A) to 10.2 (C) on the skin surface pH was evaluated in healthy volunteers using a cross-over design. Following a 14-day run-in period, a constant skin surface pH (5.0) was found. Ten subjects received single doses 2-3 days apart; 20 volunteers applied preparations A and C for 28 days. Single doses of preparations A and E (pH 8.0) increased skin pH to 6.99 and 8.61, respectively, at 15 min; it then gradually declined. The other preparations induced only a minor rise of short duration. At the end of the long-term application, the skin surface pH amounted to 5.73 (A) and 5.39 (C). There was no correlation between the effect on skin surface pH and the approximative pH of the preparations. A close relation of single-dose and long term-effects was observed, however. The skin surface pH during the application of preparation A is high enough to increase P. acnes growth about fourfold as compared with normal skin and thus may counteract the antibacterial effect. Clinical relevance should be evaluated in a controlled clinical trial comparing the efficacy of preparation A with that of preparation C.
Article
Sebaceous gland activity has four distinct components which are sebum production (a secretion rate function), storage (a volume function), surface output (a delivery rate function) and stratum corneum permeation (an influx rate function). The oily appearance of skin results from an excess of sebum excretion and spreading over the body surface and its interaction with the skin surface. A multi-pronged approach is often useful to assess skin greasiness with precision. The clinical evaluation of skin greasiness and its shiny appearance should be further complemented by quantifying the large pores, follicular plugs and comedones. The sebum amount present at the skin surface can be measured non-invasively using one of several methods based on solvent extraction, cigarette paper pads, photometric assessment, bentonite clay and lipid-sensitive tapes. Quantitative parameters include the sebum casual level, the sebum excretion rate, the sebum replacement time, the instant sebum delivery, the follicular excretion rate, the density in sebum-enriched reservoirs and the sustainable rate of sebum excretion. A series of environmental and biological features influence the data. Hence rigorous methodological designs are mandatory to support claims. As a rule, accuracy of the methods is adversely affected by skin temperature, degree of hydration and surface roughness. An additional confounding factor is the inherent difficulty of collecting the surface lipids without a contribution from the follicular reservoir. A better understanding of factors that alter the sebum amount at the skin surface may well assist in the development of sebosuppressive agents to help the reduction of the skin greasiness and improve acne.
Article
The effect of pH on the excised skin permeability towards two model lipophilic compounds was studied in the range of pH 1.0-10.0 and 1.0-12.0, for hydrocortisone and testosterone, respectively. Suspensions of the model compounds in appropriate buffers (0.1-0.2 M) were applied to the intact skin, delipidized skin, skin pretreated with Azone or sodium lauryl sulfate solution and the percutaneous penetration was observed for 28 h. Within the studied pH range, up to pH 11.0 no change in the penetration through the skin and skin accumulation was observed for both compounds. Significant, 3-4-fold, increase of penetration of testosterone was noted only at pH 12.0, however the change was neither fast not progressing with time. None of the pretreatment procedure influenced the observed relationship between pH and skin permeability. It is concluded that the lipoidal route of penetration is not affected by solutions at pH within the range 1.0-11.0.
Article
The effects of nonphysiological pH on stratum corneum lipid content and structure have been studied. Human stratum corneum samples were soaked in solutions at pH 1, 2, 6, 11, or 12 for up to 24 h. After removal of the stratum corneum, the buffer solutions were analyzed for lipid composition using thin-layer chromatography analysis and the stratum corneum sheets were examined using differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) spectroscopy. The results demonstrate that only buffers of pH 11 or higher affect the stratum corneum lipids. No large difference in the contents of ceramides and cholesterol extracted by buffers of varying pH was observed. In contrast, free fatty acid extraction was pH dependent; amounts removed by 24-h treatment with pH 11 or 12 buffers were comparable, and were similar to amounts extracted with a methanol-chloroform mixture for 15 min. No appreciable changes in DSC and FTIR spectra were detected between untreated stratum corneum and stratum corneum samples treated with buffers at pHs in the range 1-6. For tissue treated with pH 11 and 12, the position of the endothermal melting peak T2 shifted from 72 to 74 degrees C on the DSC thermograms. Small changes in the broadness of spectral peaks at 2855 cm(-1) [attributable to upsilon(CH(2)) stretching of stratum corneum lipids and 1655 cm(-1) upsilon(C=O) stretching amide I band] can be seen in the FTIR spectra from the treated stratum corneum samples, although no shifts in peak positions were observed. Intensity changes in peaks from extraneous lipids [upsilon(C=O) stretching mode at 1735 cm(-1)] were observed after buffer treatments. The changes provoked by the alkaline buffers are not dramatic and it may be concluded that the stratum corneum appears remarkably resilient to extended exposure in both highly acidic (pH 1) and highly alkaline (pH 12) environments.
Article
Both exposure of stratum corneum to neutral pH buffers and blockade of acidification mechanisms disturb cutaneous permeability barrier homeostasis and stratum corneum integrity/cohesion, but these approaches all introduce potentially confounding variables. To study the consequences of stratum corneum neutralization, independent of hydration, we applied two chemically unrelated superbases, 1,1,3,3-tetramethylguanidine or 1,8-diazabicyclo [5,4,0] undec-7-ene, in propylene glycol:ethanol (7:3) to hairless mouse skin and assessed whether discrete pH changes alone regulate cutaneous permeability barrier function and stratum corneum integrity/cohesion, as well as the responsible mechanisms. Both 1,1,3,3-tetramethylguanidine and 1,8-diazabicyclo [5,4,0] undec-7-ene applications increased skin surface pH in parallel with abnormalities in both barrier homeostasis and stratum corneum integrity/cohesion. The latter was attributable to rapid activation (<20 min) of serine proteases, assessed by in situ zymography, followed by serine-protease-mediated degradation of corneodesmosomes. Western blotting revealed degradation of desmoglein 1, a key corneodesmosome structural protein, in parallel with loss of corneodesmosomes. Coapplication of serine protease inhibitors with the superbase normalized stratum corneum integrity/cohesion. The superbases also delayed permeability barrier recovery, attributable to decreased beta-glucocerebrosidase activity, assessed zymographically, resulting in a lipid-processing defect on electron microscopy. These studies demonstrate unequivocally that stratum corneum neutralization alone provokes stratum corneum functional abnormalities, including aberrant permeability barrier homeostasis and decreased stratum corneum integrity/cohesion, as well as the mechanisms responsible for these abnormalities.
Article
Facial sebum secretions are known to change under various circumstances. Facial skin types have been categorized as oily, normal, dry, and combination types. However, these have been evaluated subjectively by individuals to date, and no objective accepted standard measurement method exists. The combination skin type is most common, but its definition is vaguer than the definitions of the other skin types. We measured facial sebum secretions with Sebumeter. Sebum secretions were measured at five sites of the face seasonally for a year, in the same volunteers. Using the data obtained we developed a set of rules to define the combination skin type. Regional differences in sebum secretion were confirmed. Sebum secretions on forehead, nose, and chin were higher than on both cheeks. Summer was found to be the highest sebum-secreting season, and seasonal variations were found in the T- and U-zones. A mismatch of skin type in the T- and U-zones in more than two seasons appears to be close to subjective ratings of what is described as the 'combination' skin type. We showed that the face shows definitive regional and seasonal variations in sebum secretion. To define the combination skin type, seasonal variations in sebum secretion should be considered in addition to regional variations.