E Proksch’s research while affiliated with Universitätsklinikum Schleswig - Holstein and other places

A deficient epidermal barrier is a key feature of atopic dermatitis (AD) and comprises altered lipid and protein content and composition of the stratum corneum resulting in disturbed water balance. Clinically, eczematous lesions on dry skin and pruritus develop. Pruritic nodules occur in prurigo nodularis (PN), another chronic skin disease, which can be associated with atopy. We aimed at comparing the three clinical pictures, classic AD, atopic prurigo (AP), and non-atopic PN, to healthy controls regarding the epidermal barrier. We determined clinical parameters and performed biophysical measurements, histology/immunohistochemistry, electron microscopy, and molecular biological analysis. We found distinctively elevated clinical scores, reduced hydration and increased transepidermal water loss, epidermal hyperplasia and inflammation reduced filaggrin and increased loricrin and involucrin expression, as well as reduced intercellular lipid lamellae in all three disease groups. These findings show a severe disruption in epidermal barrier structure and function in all three disorders so that epidermal barrier impairment is now proven not only for AD but also for PN.

Background: Aged skin is the sum of chronological und UV-induced aging. Light-exposed skin is unattractive, with irregular pigmentation, roughness und scaliness. The skin is often dry and itches. Methods: The present paper provides an overview of diseases of aging skin and describes how to prevent or reduce disease by prophylactic and therapeutic skin care. Results: Aged skin can develop into several skin diseases, e.g., different types of eczema and skin cancer. In the body folds we often find an irritant contact eczema caused by friction from skin to skin, sweating, and urinary and fecal incontinence. In the bedridden, bed sores can also develop. Furthermore, there is a delay in wound healing owing to old age. Use of adequate creams and ointments is very helpful in preventing and improving most skin diseases of mature skin. However, the knowledge of aged people and healthcare professionals about the importance of skin care is low. Older people are often unable to care for their skin because they are lacking the physical and mental ability. Conclusion: Healthcare professionals are not sufficiently trained about the value of proper skin care. Adequate studies on the role of skin care and selection of the correct preparation in various aged-related diseases are lacking.

Topical therapy should always be adapted to patients' age due to changes in skin physiology. This is particularly applicable when choosing a cream or ointment and the active substances. The expectations for therapy also change with age. The motivation to perform therapy as well as the physical ability to do so also changes with age. Children and elderly patients often need help in applying topical agents. In addition, range and cause of diseases varies considerably within age groups. Finally, the penetration of the active substance from creams and ointments may also change with age.

Dietary consumption of food supplements has been found to modulate skin functions and can therefore be useful in the treatment of skin aging. However, there is only a limited number of clinical studies supporting these claims. In this double-blind, placebo-controlled study, the effectiveness of the specific bioactive collagen peptide (BCP) VERISOL® on eye wrinkle formation and stimulation of procollagen I, elastin and fibrillin biosynthesis in the skin was assessed. A hundred and fourteen women aged 45-65 years were randomized to receive 2.5 g of BCP or placebo, once daily for 8 weeks, with 57 subjects being allocated to each treatment group. Skin wrinkles were objectively measured in all subjects, before starting the treatment, after 4 and 8 weeks as well as 4 weeks after the last intake (4-week regression phase). A subgroup was established for suction blister biopsies analyzing procollagen I, elastin and fibrillin at the beginning of the treatment and after 8 weeks of intake. The ingestion of the specific BCP used in this study promoted a statistically significant reduction of eye wrinkle volume (p < 0.05) in comparison to the placebo group after 4 and 8 weeks (20%) of intake. Moreover a positive long-lasting effect was observed 4 weeks after the last BCP administration (p < 0.05). Additionally, after 8 weeks of intake a statistically significantly higher content of procollagen type I (65%) and elastin (18%) in the BCP-treated volunteers compared to the placebo-treated patients was detected. For fibrillin, a 6% increase could be determined after BCP treatment compared to the placebo, but this effect failed to reach the level of statistical significance. In conclusion, our findings demonstrate that the oral intake of specific bioactive collagen peptides (Verisol®) reduced skin wrinkles and had positive effects on dermal matrix synthesis. © 2014 S. Karger AG, Basel.

Various dietary supplements are claimed to have cutaneous anti-aging properties; however, there are a limited number of research studies supporting these claims. The objective of this research was to study the effectiveness of collagen hydrolysate (CH) composed of specific collagen peptides on skin biophysical parameters related to cutaneous aging. In this double-blind, placebo-controlled trial, 69 women aged 35-55 years were randomized to receive 2.5 g or 5.0 g of CH or placebo once daily for 8 weeks, with 23 subjects being allocated to each treatment group. Skin elasticity, skin moisture, transepidermal water loss and skin roughness were objectively measured before the first oral product application (t0) and after 4 (t1) and 8 weeks (t2) of regular intake. Skin elasticity (primary interest) was also assessed at follow-up 4 weeks after the last intake of CH (t3, 4-week regression phase). At the end of the study, skin elasticity in both CH dosage groups showed a statistically significant improvement in comparison to placebo. After 4 weeks of follow-up treatment, a statistically significantly higher skin elasticity level was determined in elderly women. With regard to skin moisture and skin evaporation, a positive influence of CH treatment could be observed in a subgroup analysis, but data failed to reach a level of statistical significance. No side effects were noted throughout the study. © 2013 S. Karger AG, Basel.

The climate influences the development of dry skin, and the treatment of dry skin must be adapted according to the climate. Therefore, it is important to know how the climate influences the development of xerosis. It is well known that dry skin most often occurs during winter at temperatures below freezing point. That means that dry skin occurs more often in the colder climate zones of the earth, well known from northern Europe, northern states of the USA, and Canada. Also, a high altitude predisposes to dry skin, not only high in the mountains, but also in the highland of Mexico. In the cold climate zones in Europe, often people have the impression that indoor radiator heating leads to dry skin, whereas heating by an old fashion oven as was often used in private homes until the 1970s was more pleasant to the skin. It is also known that strong winds lead to dryness of the skin. Also, artificial ventilation by air condition may lead to dry skin. Air condition may lead to a pronounced skin drying because it reduces the water content of the air. This is a desirable effect in hot and wet climate, for example, on the east cost of the USA in summer time, but it may lead to problems in desert zones like in the US southern mountain region (e.g., in Phoenix) where the relative humidity is low. © 2012 Springer-Verlag GmbH Berlin Heidelberg. All rights are reserved.

Many persons in the developed countries report sensitive skin. Persons with sensitive skin have a predisposition to several skin diseases, most importantly dry skin, but also atopy, seborrheic dermatitis, acne vulgaris, rosacea, and perioral dermatitis. Their complaints may be triggered by environmental factors such as low temperature, wind, high temperature, sun exposure and stress. Various skin care products and cosmetics are not tolerated. A disturbed skin barrier function and reduced stratum corneum water content are most important in the pathophysiology of sensitive skin. Environmental factors and cosmetics may induce irritation of the skin because of the disturbed skin barrier. Of further importance for the pathogenesis are neurogenic factors including stress and hyper-excitability. Mechanisms in signal transduction involve cytokines and neurotransmitters, but the exact pathways are unknown.