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PEER-REVIEW | SKIN ANALYSIS | Lipids


The stratum corneum is rich in corneocytes, which are embedded in a matrix of ceramides, cholesterol, fatty acids and smaller amounts of cholesterol sulphate, glucosylceramide and phospholipids in multilamellar sheets2


epidermis and quantitative variation of the ischaemic compounds induces xerosis and possible atopic dermatitis10


content of human skin decreases with age10–12


Table 2 Skin Tester optimal parameters


. They create a waterproof barrier for the


. Many authors agree that the overall lipid .


Skin detection and ageing The techniques available for skin examination and its follow-up include histological analysis and more recently, direct immunohistochemical studies with regard to CD31 antigen and platelet endothelial cell adhesion molecule (PECAM) staining. Immunohistochemistry is preferred to synthase


phosphatase evaluation as it supplies semi-quantitative results. Intravital capillaroscopy can be performed either ex vivo or in vivo with luminescence microscopy and fluorescent angiography, photoplethysmography, and laser Doppler flowmetry for the arterial or dermal plexus. Some dynamic tests such as finger


immersion in cold water and finger circulation measurement show a blood-flow reduction with age progression, while


in vivo


fluorescine angiography showed an age-related decrease to the papillary dermis and little change in horizontal vessels (Table 1). Epidermal thickness has been


measured using confocal miscroscopy, or with ultrasound by Richard et al18


, who performed


an ultrasound analysis in 30 elderly women. Electrical conductance, colour, microrelief, skin thickness and subepidermal non-echogenic band (SENEB) were measured on the neck skin, which was damaged as a result of exposure to sunlight and on an adjacent part not exposed to the sun. Changes in SENEB, skin thickness, skin extensibility and elasticity, and colour heterogeneity were more evident in the sun-exposed skin, demonstrating that the cumulative effect of sun exposure can be the cause of atrophy or solar elastosis in older people. Pellacani and Seidenari19


enrolled 40 women (aged


25–90 years) in order to study 12 different facial skin sites with a 20 mHz B echographic scanner, demonstrating an increase in facial skin thickness in old patients compared with the younger subjects. To demonstrate a significant variation of skin


parameters between different age groups, Seidenari et al20 performed an echographic evaluation of skin modifications on 48 patients (24 aged 27–30 years, and 24 over 60 years) with a 20 mHz B scanner at six different


48 ❚ May/June 2013 | prime-journal.com


Skin Tester Total water


Intracellular water Extracellular water pH


Elasticity Sebometry


Range 58–64 56 44


5.5–5.7 > 26


20–21


sites, showing an important regional variation of ultrasound reflection in older skin compared with the young skin. A consistent shift from low-intensity ultrasound echoes in the dermis of young subjects, to intermediate or high reflection amplitudes in older skin, was observed. Gniadecka et al21


enrolled 10 older individuals (five


men and five women; age range 74–87 years) and 10 control individuals (five men and five women; age range 22–29 years) to identify the role of structural protein ageing modifications to induce wrinkles, loss of elasticity and dryness. There was evidence that protein-specific amide I, amide III, and carbon–hydrogen stretching bands were shifted in photoaged forearm skin, suggesting an increase in protein folding. In contrast, significant changes were seen only in the amide I peak in chronologically aged skin. The intensity of the stretching band was increased in photoaged skin, but


not in chronologically aged skin. The same authors21


also


investigated the water content and found that in young skin and chronologically aged skin, water was detectable in the bound form. In the photoaged skin, however, there was an increase in intensity, which reflects an increase in the non-protein-bound water (tetrahedron water clusters), concluding that proteins


in photoaged skin are more compact and interact with water to a limited degree.


The authors


developed a non-invasive


multi-parametric point of care


diagnostic tool to provide an


evaluation of a number of skin parameters.


Materials and methods For an objective assessment of the quality of the skin in cosmetic medicine, it is relevant to perform qualified clinical investigations with pre- and post-treatment comparisons in order to support the patient’s judgement with the instrumental detection of skin parameters. Therefore, the authors developed a non-invasive multi-parametric point of care diagnostic tool (Skin Tester, manufactured by Selenia Italia and distributed by Dermal Institute), to provide an evaluation of a number of skin parameters, such as hydration, pH, elasticity, and sebometry.


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