While it is widely known that stress affects patients at both a psychological and a physical level, few consider the effect that it can have on the skin, and the extent that it can contribute to dermatological problems.
Flor A. Mayoral (University of Miami, Miller School of Medicine, FL, USA) recently advised at the American Academy of Dermatology’s Skin Academy on how to manage the observed symptoms of stress on the skin, nails and hair.
Mayoral points out that through his experience of treating hundreds of patients with skin conditions, such as eczema, rosacea, acne and psoriasis, he has observed “how stress can aggravate the skin and trigger unexpected flare-ups that, in effect, create more stress for patients.” He adds, “learning how to manage the effects of stress on your skin can help alleviate some of the anxiety and symptoms.”
Cortisol, the body’s stress hormone, rises when patients undergo stress. The resultant increase in oil production can lead to oily skin, acne and other related skin problems. Mayoral has observed in patients, with skin that usually remains unaffected by acne, temporary stress-related acne due to increased oil production.
Stress, Mayoral believes is also the primary cause of unexplained hair loss by causing the hair to enter the telogen phase, which is when it falls out. This condition, known as telogen effluvium, is very common and can occur up to 3 months after a stressful event. After the initial period of hair loss the hair usually returns within 6–9 months.
Nails also display outward signs of stress that can be caused by nervous habits, such as nail biting or rubbing fingers over nails, causing ridges, or picking at them. These were all discussed by Mayoral.
Mayoral also offers advice on how to overcome stress and the dermatological symptoms caused by its effects. “Being in control of your situation can help relieve stress,” he advises. “For instance, I teach my acne patients who use a topical acne medication once a day how to safely use the medication more frequently to counter the effects of stress.” Mayoral believes that giving patients “the power to fix the problem is very empowering to them.”
Mayoral also advises on the benefits of exercise, soap usage and avoiding stress triggers to reduce stress and its dermatological effects.
Source: American Academy of Dermatology www.aad.org
Treating advanced wounds with honey
The first USFDA-approved honey-based product is currently being distributed to physicians, hospitals and acute rehabilitation clinics. MEDIHONEY™ is a dressing for advanced wounds and is made with Leptospermum honey, which is made from the pollen and nectar of the Manuka bush, a wild shrub native to New Zealand.
“Clinical studies of MEDIHONEY™ have shown it has promise over current treatments because of its strong wound healing benefit,” said Ed Quilty, CEO of Derma Sciences who manufacture and market MEDIHONEY™ along with other advanced wound care products.
MEDIHONEY™ helps to heal wounds when it is applied to bandages or directly to wounds. The dressing is versatile in that it can be used at any phase of the healing process and can be used to treat wounds, such as diabetic foot ulcers, leg ulcers, pressure sores and first- and second-degree partial thickness burns.
“Medical-grade Leptospermum honey is particularly effective in managing difficult-to-heal wounds because it promotes removal of dead tissue without damaging re-growing cells, while also promoting cellular proliferation,” explained Rose Cooper (Cardiff School of Health Sciences, University of Wales Institute, UK). Cooper also believes that the lack of toxicity in this treatment, combined with the strong healing benefits, make this a unique treatments for advanced wound care.
Source: www.dermasciences.com
Psoriasis patients should be screened for comorbidities
Patients suffering from psoriasis ought to be screened for comorbidities, it was recently advised. The advice follows results from various research demonstrating a strong correlation between psoriasis and multiple co-morbidities. An increased mortality risk has also been demonstrated in psoriasis patients.
Wayne Gulliver (Memorial University of Newfoundland in St. John’s, NL, Canada) made the recommendation at a journalists workshop held in support of World Psoriasis Day (29th October).
Gulliver and co-workers have been undertaking research that examines the link between psoriasis and comorbidities based on data from four databases covering the population of Newfoundland and Labrador founder totaling 713,000 individuals.
To date, results have demonstrated that although diabetes occurs in 4% of the general population, this increases to 10% in those with mild-to-moderate psoriasis and 12% in individuals with severe psoriasis. In addition the amount of cardiovascular deaths in the general population totals 36%, but it is as high as 44% in those with psoriasis.
It has also been noted that psoriasis patients have a reduction of 10 years in their average life expectancy compared with those who did not suffer from psoriasis. This deficit increases to 25–30 years if the patient develops psoriasis before they are 25 years of age.
Gulliver explains this link by the shared pathogenetic mechanisms between psoriasis and various chronic illnesses. “In short, cytokines in the skin are also driving the risk for cardiovascular disease, hypertension and diabetes.”
Gulliver believes that this information conveys an obvious message to physicians who are treating those affected with psoriasis. “You need to check their blood pressure, blood sugar and lipids, and you also need to do an electrocardiogram. Essentially, what you need to do is screen patients for these common, complex diseases that are occurring at a much higher rate in psoriasis patients than in the general population.”
There is currently no cure for the disease but the symptoms can be managed with topical therapies, phototherapy and systemic therapy. It is hoped, therefore, that this message will help to highlight the need for monitoring psoriasis patients for comorbidities so that they can be treated as soon as they are presented to the physician to improve the patients’ prognosis.
Source: World Psoriasis day website: www.worldpsoriasisday2007.com
Skin cancer detection tool under development
A tool that will analyze skin and aid in the diagnosis of malignant melanoma and burn severity is being developed at the University of the West of England (UWE, Bristol, UK). A total of GB£650K has been awarded in sponsorship to this project known as ‘PhotoDerm’, which comprises of UWE, Frenchay Hospital (Bristol, UK) and Astron Clinica Ltd. (Cambridge, UK) by the DTI Technology Programme.
The incidence of skin cancer has dramatically increased since the 1930’s and the overall cost and time spent on diagnosis has risen accordingly. It is hoped that this new tool will aid in reducing both the time spent and the costs incurred in diagnosing skin cancer and performing skin analysis for other conditions.
The device is being created by experts in photometric stereo imaging or 3D imaging at UWE’s Machine Vision Laboratory, which is part of the Centre for Innovative Manufacturing and Machine Vision Systems (CIMMS). Melvyn Smith, Director of CIMMS at UWE explains, “We are collaborating with Astron Clinica and specialists at Frenchay Hospital in Bristol to produce a new low-cost hand-held skin analyzer tool that will improve the vision of the clinician. We aim to make explicit the characteristics of the appearance of the skin that are not obvious to the naked eye. This will make it easier for a nonspecialist to make an early diagnosis.”
The 3D imaging tool will also be useful in burns units as it will enable specialists to effectively assess the depth and, therefore, the severity of the burn. “The tool builds on previous research by academics in CIMMS who developed a rather cumbersome tool some years ago. We aim to refine the principles adopted in the earlier model so that the imaging available to the practitioners is easier to observe” adds Smith.
The device resembles a hair-dryer in appearance and is held over the skin, directing high resolution camera and six light sources at the affected area. USB connects the device to a computer screen where a 3D image is observed. Smith explains “this is called 6-light photometric stereo and we intend to develop this idea by fusing this information with a hand held spectrometer developed by Astron Clinica.”
The UWE team have been working in collaboration with skin cancer experts from Frenchay Hospital to ensure that the finished product is suitable for practitioners. Experts from the Frenchay Hospital believe that the skin analyzer may have the potential to be very effective in assisting future diagnosis by nonspecialists. They believe that as the incidence of skin cancer increases any tool that will aid in the difficult diagnosis procedure will be extremely valuable.
“It is anticipated that the skin analyzer may ultimately provide primary health care practitioners and hospitals with a low-cost tool that will save lives as more health professionals will be able to assist in accurate diagnosis without unnecessary referral to specialist skin cancer units in hospitals”, concludes Smith.
Source: www.uwe.ac.uk
Common antioxidants protect against all-purpose radiation
DNA could be protected from the harmful effects of radiation by two common dietary molecules, which are found in legumes and bran.
Researchers from the University of Maryland (MD, USA) have discovered that inositol and inositol hexaphosphate (IP6) defend human keratinocytes and a skin cancer-prone mouse from the harmful effects of ultraviolet B (UVB) radiation. The team reported these findings at the American Association for Cancer Research Centennial Conference on Translational Cancer Medicine.
The researchers believe that inositol and IP6 may reduce the effects of radiation therapy by preserving the healthy cells and also enhancing the effect of the treatment against cancerous cells. The molecules are able to do this as they are potent antioxidants that have the ability to prevent the reactive molecules from damaging DNA and consequently turning cells cancerous.
“Both of these potent antioxidants have been shown to have broad-spectrum anti-tumor capabilities, and now our studies confirm the degree to which these molecules protect against the DNA-damaging effects of ionizing radiation,” explained Abulkalam M Shamsuddin (University of Maryland School of Medicine, MD, USA). “Radiation damage is radiation damage, regardless of the source, so there could also be a protective role for IP6 in any form of radiation exposure, whether it is from a therapeutic dose or from solar, cosmic or nuclear sources.”
Currently inositol and IP6 are not regarded as being essential dietary nutrients despite the discovery in the 1980s that these molecules protect against colorectal cancer. This study intended to discover the extent that IP6 affected human skin cells when exposed to UVB radiation.
The researchers observed lower apoptosis in skin cells treated with IP6 that had been exposed to UVB radiation. These cells would usually have undergone apoptosis, indicating that these cells were irreparably damaged. Instead the treated cells were observed to take an extended pause in their life cycle at the point when cells repair the damaged DNA before dividing, indicating that the damage was repaired rather than the cell being deemed irreparable. The keratinocytes that had not been treated underwent apoptosis as before.
“IP6 certainly has some interactivity with DNA, but how exactly it works to repair DNA is still something of a mystery. There are reports that IP6 binds with DNA repair molecule Ku to bring about the repair process,” advised Shamsuddin. “More importantly, we still don't know how IP6 can appear to help healthy cells live while also enhancing the ability of radiation to kill cancer cells.”
Shamsuddin and his team also introduced a 2% solution of IP6 into the drinking water of mice that had been genetically engineered to be prone to skin cancer. The incidence of skin cancer in these mice was much lower than would have been expected. A total of 23% of treated mice developed cancer compared with 51% of control mice. In addition, the 51% of control mice that did develop cancer developed approximately twice as many tumors as the treated mice.
Shamsruddin hopes that IP6 could be used to treat those who are routinely exposed to ionizing radiation, such as airline pilots, frequent fliers or people who handle radioactive materials as a preventative treatment.
The team also believe that IP6 may be able to offer protection against accidents or purposeful incidents that involve nuclear material. “It could also be advisable to use IP6 plus inositol as a cautionary treatment following a nuclear disaster or dirty bomb,” Shamsuddin added.
Source: American Association for Cancer Research www. aacr.org