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Skin exposure to high-dose irradiation, as commonly practiced in radiotherapy, affects the different skin layers, causing dry and wet desquamation, hyperkeratosis fibrosis, hard to heal wounds and alopecia and damaged hair follicles. Fetal tissue mesenchymal stromal cells (f-hPSC) were isolated from excised human fetal placental tissue, based on their direct migration from the tissue samples to the tissue dish. The current study follows earlier reports on for the mitigation of acute radiation syndrome following whole body high-dose exposure with remotely injected f-hPSC. Both the head only and a back skin flap of mice were irradiated with 16 &18 Gy, respectively, by 6MeV clinical linear accelerator electron beam. In both locations, the irradiated skin areas developed early and late radiation induced skin damages, including cutaneous fibrosis, lesions, scaring and severe hair follicle loss and reduced hair pigmentation. Injection of 2 × 106 f-hPSC, 3 and 8 weeks following 16 Gy head irradiation, and 1 and 4 weeks following the 18 Gy back skin only irradiation, resulted in significantly faster healing of radiation induced damages, with reduction of wet desquamation as measured by surface moisture level and minor recovery of the skin viscoelasticity. Detailed histological morphometry showed a clear alleviation of radiation induced hyperkeratosis in f-hPSC treated mice, with significant regain of hair follicles density. Following 16 Gy head irradiation, the hair follicles density in the scalp skin was reduced significantly by almost a half relative to the controls. A nearly full recovery of hair density was found in the f-hPSC treated mice. In the 18 Gy irradiated back skin, the hair follicles density dropped in a late stage by ~70% relative to naïve controls. In irradiated f-hPSC treated mice, it was reduced by only ~30% and was significantly higher than the non-treated group. Our results suggest that local injections of xenogeneic f-hPSC could serve as a simple, safe and highly effective non-autologous pro-regenerative treatment for high-dose radiation induced skin insults. We expect that such treatment could also be applied for other irradiated organs.

We studied CD34+ stromal cells/telocytes (CD34+SCs/TCs) in pathologic skin, after briefly examining them in normal conditions. We confirm previous studies by other authors in the normal dermis regarding CD34+SC/TC characteristics and distribution around vessels, nerves and cutaneous annexes, highlighting their practical absence in the papillary dermis and presence in the bulge region of perifollicular groups of very small CD34+ stromal cells. In non-tumoral skin pathology, we studied examples of the principal histologic patterns in which CD34+SCs/TCs have (1) a fundamental pathophysiological role, including (a) fibrosing/sclerosing diseases, such as systemic sclerosis, with loss of CD34+SCs/TCs and presence of stromal cells co-expressing CD34 and αSMA, and (b) metabolic degenerative processes, including basophilic degeneration of collagen, with stromal cells/telocytes in close association with degenerative fibrils, and cutaneous myxoid cysts with spindle-shaped, stellate and bulky vacuolated CD34+ stromal cells, and (2) a secondary reactive role, encompassing dermatitis—e.g., interface (erythema multiforme), acantholytic (pemphigus, Hailey–Hailey disease), lichenoid (lichen planus), subepidermal vesicular (bullous pemphigoid), psoriasiform (psoriasis), granulomatous (granuloma annulare)—vasculitis (leukocytoclastic and lymphocytic vasculitis), folliculitis, perifolliculitis and inflammation of the sweat and sebaceous glands (perifolliculitis and rosacea) and infectious dermatitis (verruca vulgaris). In skin tumor and tumor-like conditions, we studied examples of those in which CD34+ stromal cells are (1) the neoplastic component (dermatofibrosarcoma protuberans, sclerotic fibroma and solitary fibrous tumor), (2) a neoplastic component with varying presentation (fibroepithelial polyp and superficial myxofibrosarcoma) and (3) a reactive component in other tumor/tumor-like cell lines, such as those deriving from vessel periendothelial cells (myopericytoma), epithelial cells (trichoepithelioma, nevus sebaceous of Jadassohn and seborrheic keratosis), Merkel cells (Merkel cell carcinoma), melanocytes (dermal melanocytic nevi) and Schwann cells (neurofibroma and granular cell tumor).

Introduction and objective Polychlorinated biphenyls (PCBs) have been used commercially since 1929 as dielectric and insulating non-flammable substances, additives for paints, etc. In Slovakia, 60 chemical production workers highly exposed to PCBs (mainly to Delor 103) were studied with duration of exposure ranging from 3 months to 19 years. Material and methods Clinical examinations of skin, skin histology and laboratory tests concerning lipid metabolism, iron metabolism and levels of copper provided comparisons with a control group of healthy individuals and/or the upper limits of normal values. Results Skin changes were found in 47 % of individuals. In most cases, milia-like efflorescences (57.14 %) occurred, as well as comedones (55.35 %); other symptoms occurred in a smaller number of workers. Hyperkeratosis, acanthosis of the epidermis (particularly in hair follicles), and a cellular infiltration of the corium were all found through histology. The intensity of cutaneous affections was associated with the changes in laboratory tests. Elevated triglycerides, cholesterol, and phospholipids were found in exposed workers. After a further two years, a significant increase in triglycerides was found in exposed individuals when compared with the control group. In addition, a significant increase in serum levels of copper, and total and unsaturated iron-binding capacity was detected. Conclusions Anamnesis showed that some people directly exposed to PCBs may develop skin changes after three months of occupational exposure. The results represent a unique snapshot of worker exposure at a given location, representing the basis for comparison with the population who grew up in the area and still live there today.

Skin histology is traditionally carried out using two-dimensional tissue sections, which allows for rapid staining, but these sections cannot accurately represent three-dimensional structures in skin such as nerves, vasculature, hair follicles, and sebaceous glands. Although it may be ideal to image skin in a three-dimensional manner, it is technically challenging to image deep into tissue because of light scattering from collagen fibrils in the dermis and refractive index mismatch owing to the presence of differing biological materials such as cytoplasm, and lipids in the skin. Different optical clearing methods have been developed recently, making it possible to render tissues transparent using different approaches. Here, we discuss the steps involved in tissue preparation for three-dimensional volumetric imaging and provide a brief overview of the different optical clearing methods as well as different imaging modalities for three-dimensional imaging.

Skin involvement in SSc is an important marker of disease activity, severity and prognosis, making the assessment of skin a key issue in SSc clinical research. We reviewed the published data assessing skin involvement in clinical trials and summarized the major conclusions important in SSc clinical research. A systematic literature review identified randomized controlled trials using skin outcomes in SSc. Analysis examined the validity of the different skin measures based on literature findings. Twenty-two randomized controlled trials were found. The average study duration was 10.2 (s.d. 4.5) months, mean (s.d.) sample size 32.4 (32.6) and 26.7 (27.8) in intervention and control arms, respectively. The 17-site modified Rodnan skin score is a fully validated primary outcome measure in diffuse cutaneous SSc. Skin histology seems to be an appropriate method for evaluation of skin thickness. These findings have important implications for clinical trial design targeting skin involvement in SSc.

It is important to understand the histology and physiology of skin for the prediction and optimization of wound healing. Optimal postoperative wound healing to minimize scarring entails minimizing local, systemic, and environmental factors that lead to poor wound healing. Keeping the wound clean and moist, minimizing trauma, and infection are the local wound tenets. Systemic tenets include minimizing medications that inhibit processes of wound healing, maintaining adequate nutrition, pain palliation, UV protection, and smoking cessation. This article presents the dynamic process of wound healing and the basic tenets to minimize scarring.

Skin is a complex organ covering the entire surface of the body. Aged skin is characterized by appearance of wrinkles, laxity, and pigmentary irregularities. These changes occur under the influence of intrinsic and extrinsic factors, with sun exposure being the most deleterious to the skin. Skin changes associated with aging are the focus of many surgical and nonsurgical procedures aimed to improve the appearance of skin. Knowledge of skin histology and physiology will deepen the understanding of cutaneous changes associated with aging and will promote optimal cosmetic and functional patient outcomes.

We describe here 4 patients with Sézary syndrome masquerading as adult-onset atopic dermatitis. The patients presented with a clinical picture compatible with wide-spread atopic dermatitis and did not fulfil the criteria for Sézary syndrome (lack of lymphoadenopathy and blood involvement, skin histology without presence of atypical cells). In our patients, overt Sézary syndrome developed after immunosuppressive treatment (including cyclosporine). These cases support the validity of the concept of pre-Sézary syndrome, which is a long-lasting, pre-malignant condition, and which may develop to true malignancy in a state of immunosuppression.

This study sought to determine if microdermabrasion can selectively remove stratum corneum to increase skin permeability. Although, microdermabrasion has been used for cosmetic treatment of skin for decades, no study has assessed the detailed effects of microdermabrasion conditions on the degree of skin tissue removal. Therefore, we histologically characterized the skin of rhesus macaques and human volunteers after microdermabrasion at different conditions. Using mobile tip microdermabrasion, an increase in the number of treatment passes led to greater tissue removal ranging from minimal effects to extensive damage to deeper layers of the skin. Of note, these data showed for the first time that at moderate microdermabrasion conditions selective yet full-thickness removal of stratum corneum could be achieved with little damage to deeper skin tissues. In the stationary mode of microdermabrasion, selective stratum corneum removal was not observed, but micro-blisters could be seen. Similar tissue removal trends were observed in human volunteers. As proof of concept for drug delivery applications, a model fluorescent drug (fluorescein) was delivered through microdermabraded skin and antibodies were generated against vaccinia virus after its topical application in monkeys. In conclusion, microdermabrasion can selectively remove full-thickness stratum corneum with little damage to deeper tissues and thereby increase skin permeability.

A case of pemphigoid gestationis occurring in a 40 year old female who developed HELLP syndrome during her fourth pregnancy is reported. Seven days after emergency Caesarean section for pre-eclampsia, she developed a pruritic blistering eruption which clinically resembled pemphigoid gestationis. The diagnosis was supported by skin histology and immunofluorescence. She responded rapidly to oral corticosteroids, with no evidence of recurrence after 12 weeks of follow up. In the current case report, the previously unreported simultaneous occurrence of two uncommon conditions is described.

The most effective treatment for morbid obesity has demonstrated to be bariatric surgery. Despite enormous benefits, skin tissue aberrations are inevitable consequences. Our study was focused on micro- and macroscopic modifications in patients who had previously undergone gastric bypass. These preliminary data suggest that tissue alterations, partly responsible for high wound complications rate, may differ among patients undergoing both different and same weight loss procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The nuclear magnetic resonance (NMR) mobile-universal-surface-explorer (MOUSE) was evaluated in a pilot study to determine its ability to detect physiological changes in human skin caused by physical or pharmacological interventions.The left lower arm skin thicknesses of ten male subjects were measured five times using a Profile NMR-MOUSE(®) ((1)H, 19 MHz) before and after a venous occlusion manoeuvre. In five of the subjects, the T(2eff) relaxation times were derived from a bi-exponential fitting and were determined in the dermis and subcutis before and after applying a salve containing capsaicin.The dermis (including the epidermis) showed rather homogeneous signal amplitudes. The subcutis was characterised by higher and more variable amplitudes. The full-skin thickness values were affirmed by ultrasound imaging. The NMR profiles did not show significant skin swelling due to venous occlusion. In the dermis, capsaicin caused significant (p0.05) decreases in both components of T(2eff) (100 ± 19 ms-19 ± 10 ms; 9.5 ± 0.5 ms-7.2 ± 1.6 ms). In the subcutis, the T(2eff) was not affected.In principle, NMR-MOUSE profiles are capable of detecting skin structure. However, precise measurements are jeopardised by poor reproducibility, long acquisition times, and incompatibility between the geometries of the sensitive area of the instrument and the non-planar structure of the skin. In the dermis, T(2eff) contrast could be used to detect the changes in tissue composition caused by inflammatory reactions.

A 61-year-old woman presented with a 2-year history of asymptomatic, erythematous to pink papules with central porcelain-white atrophic scars and a telangiectactic rim ([Figure 1][1]). A progressive number of lesions had developed on her abdomen, back and thighs. Skin histology showed epidermal

In a prospective study, eight patients with 15 hands affected by both vibration white finger and carpal tunnel syndrome were treated by surgical decompression of the carpal tunnel. On review six months later, the symptoms of carpal tunnel syndrome were improved in all cases and the symptoms of white finger were improved in half of the cases. Nerve conduction studies and palmar skin histology are discussed.

A 24-year-old male presented with a 4 year history of a crusted erythematous papular eruption of the scalp and external auditory meati and a 12 month history of painful perianal ulceration. A diagnosis of Langerhans cell histiocytosis was made and confirmed by skin histology. Extensive investigation revealed no systemic involvement. Rapid improvement occurred after intravenous 2-chlorodeoxyadenosine but relapse of perianal lesions occurred within 5 months. Local radiotherapy to the perianal region resulted in a complete remission sustained over 12 months.

Discrepancies have been noted in the histopathological findings between skin and nerve lesions of leprosy patients in some recent works. We studied concurrent skin and nerve biopsies in 27 randomly selected leprosy patients to correlate the histopathological features of skin and nerve lesions, and to assess the importance of neural histology in the classification of leprosy. Skin and nerve biopsies were diagnostic of leprosy in 23 and 26 patients, respectively. A discrepancy was found between the two in 15 cases. Neural histology was helpful in the classification of determinate forms in 24 cases while dermal histology was significant only in 16 patients. A multibacillary nerve and paucibacillary skin picture was observed in 3 patients. It was concluded that nerve biopsy is more informative and specific than skin biopsy in the diagnosis of leprosy and further helps to classify the patients when the skin histology is indeterminate or nonspecific.

Concurrent skin and nerve histology was evaluated in 60 leprosy patients (25 BT, 28 BL and 7 LL). The twin aims were to study the comparative histology and the usefulness of nerve histology in the classification of the disease. In BT patients, clinical and histological classification was in agreement in 11 (44%) skin and 17 (68%) nerve biopsies. Concurrent skin and nerve histology was in consonance in 14 (56%) BT patients, while in 6 (24%) patients, only nerve histology was helpful in the classification of the disease, the skin histology being non-specific. Nerve histology was classified as BL in 3 (12%) BT patients, the skin histology was non-specific. In the BL group, the histology of 23 (82.4%) nerve biopsies correlated with the clinical classification, in contrast to skin histology which correlated with clinical assessment in 19 (68%) patients only. In the LL patients, the histology of nerve correlated with the clinical classification in 5 patients (71.4%), compared to histology of the skin in 4 (57%) patients only. The GF was higher in the nerves than in the skin throughout the leprosy spectrum (BT, BL, LL); the difference was, however, marginal in BL leprosy. The average bacteriological index (BI) was higher in nerves (4+) compared to that of skin histology and slit skin smears (3+) in BL leprosy. There was, however, no difference in the BI of the slit skin smears, skin and nerve biopsies in lepromatous leprosy.(ABSTRACT TRUNCATED AT 250 WORDS)

A 4 year old boy is reported with tyrosinase positive hypopigmentation, mental retardation, ataxia, and myopia. Radiological investigation showed occipital cerebral atrophy, coxa valga, and generalised osteoporosis. The skin histology and electron microscopy are reported and discussed. The clinical features are similar to those of the oculocerebral hypopigmentation syndrome described by Preus et al.

We report a unique angiosarcoma of the skin of the face in which a large part of the tumour was of granular cell appearance. Histologically the granular cells resembled those of conventional granular cell tumours. By electron microscopy the granules were identical to those of granular cell tumours but other features were lacking. Stains for vimentin and factor VIII related antigen were positive, but for S-100 protein and CEA were negative. The occurrence of granular cell change in an angiosarcoma supports the view that granular cell tumours are histogenetically diverse.

This is a report of a failure of tissue expansion in a 43-year-old patient suffering from a mild form of osteogenesis imperfecta tarda. Filling of the expander was not possible. Skin histology showed thrombosis of the blood vessels and vessel wall necrosis. This finding supports the theory that tissue expansion does not depend as much on mechanical skin laxity as on the proliferative potential of the skin.

Skin histology and ultrastructure have become diagnostically crucial in relatively few genetic diseases with major or prominent skin manifestations. In some diseases, these morphologic evaluations have increased our understanding of the disease process and provided a basis for interpretation of biochemical and physiologic studies. This review aims at illustrating some of the prominent accomplishments of histologic and, especially, ultrastructural studies in selected genetic diseases. The most widely studied disease group is the epidermolysis bullosa group in which histology and ultrastructure have provided the basis for currently used classifications of the diseases within the group. 1,2 The histologic and ultrastructural findings have also suggested hypotheses concerning the nature of the primary defects in several of these diseases, thus focusing investigations at the physiologic and/or biochemical level. The ichthyoses have been a disappointment from a histologic and ultrastructural point of view, with the exception of epidermolytic hyperkeratosis, in which striking alterations have been noted, although they have yet to lead to a clearer understanding of the nature of the primary defect in the disease.

A patient with follicular and dermal mucinosis is described. Although the skin histology was of a benign nature the patient died from an associated underlying reticulosis. Spontaneous mucinorrhoea subsided with therapy for Hodgkin's disease.

Normal and abnormal human skin echograms were made using new 25-MHz and 40-MHz ultrasonic sector scanners, and were compared with histologic sections. The malpighian layer of the epidermis was demonstrated as an echolucent zone under a strongly echogenic, linear corneo-malpighian junction in normal palms and soles. Cross sections and longitudinal sections of hair follicles and hypertrophic sebaceous glands were also demonstrated as echolucent structures.

SUMMARY We carried out ophthalmological examinations, and histopathological examinations of skin biopsies in 32 male patients affected by X-linked ichthyosis. We found corneal opacities in only five patients, and their presence was not related to the age of the patients. Skin histology revealed a reduction of the granular layer in nine cases, a finding previously thought to be typical of autosomal dominant ichthyosis vulgaris.

The syndrome of chronic pigmented purpura (CPP) consists of pigmented macular lesions, predominantly involving the lower extremities. An 11-year-old girl was diagnosed initially as suffering from vasculitic purpura, but the clinical course and the skin histology proved to be consistent with CPP. This syndrome should be included in the differential diagnosis of childhood purpura.