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      Biophysical and ultrasonographic changes in lichen planus compared with uninvolved skin ☆☆

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          Abstract

          Background

          Lichen planus (LP) is a chronic inflammatory disease of the skin. Currently, noninvasive techniques are used to evaluate biophysical properties of the skin in vivo.

          Objective

          In this study, we aimed to evaluate skin biophysical properties in patients with LP and make a comparison between involved and uninvolved skin to provide a better understanding of the pathogenesis of LP.

          Methods

          The stratum corneum hydration, transepidermal water loss, pH, erythema, melanin, sebum, friction, temperature, elasticity parameters (R0, R2, R5), and thickness and echo-density of the epidermis, dermis, and subepidermal low echogenic band were measured on lesions of classic LP in 21 patients and compared with the average of perilesional and symmetrical uninvolved skin (as control) with a paired t test.

          Results

          Stratum corneum hydration ( p = .002), sebum ( p = .04), R0 ( p = .005), and echo-density of the dermis ( p = .005) were significantly lower, but pH ( p = .007), melanin content ( p < .001), erythema ( p < .001), temperature ( p = .01), thickness of dermis ( p = .02), and subepidermal low echogenic band ( p < .001) were significantly higher in LP lesions.

          Conclusion

          An evaluation of its biophysical, biomechanical, and ultrasonographic characteristics showed that the skin is an objective, noninvasive, and quantitative measuring tool that can be used to provide valuable information about skin changes in classic LP.

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          Most cited references39

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          Structure and function of the epidermis related to barrier properties.

          The most important function of the skin is the formation of a barrier between the "inside" and the "outside" of the organism, which prevents invasion of pathogens and fends off chemical assaults as well as the unregulated loss of water and solutes. The physical barrier is mainly localized in the stratum corneum, which consists of protein-enriched cells and lipid-enriched intercellular domains. Any modifications in epidermal differentiation and lipid composition results in altered barrier function, a central event in various skin alterations and diseases. This contribution presents a brief description of the structure of the skin, paying attention to the most important components responsible for skin barrier function. Copyright © 2012. Published by Elsevier Inc.
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            Variation of Biophysical Parameters of the Skin with Age, Gender, and Body Region

            Background. Understanding the physiological, chemical, and biophysical characteristics of the skin helps us to arrange a proper approach to the management of skin diseases. Objective. The aim of this study was to measure 6 biophysical characteristics of normal skin (sebum content, hydration, transepidermal water loss (TEWL), erythema index, melanin index, and elasticity) in a normal population and assess the effect of sex, age, and body location on them. Methods. Fifty healthy volunteers in 5 age groups (5 males and females in each) were enrolled in this study. A multifunctional skin physiology monitor (Courage & Khazaka electronic GmbH, Germany) was used to measure skin sebum content, hydration, TEWL, erythema index, melanin index, and elasticity in 8 different locations of the body. Results. There were significant differences between the hydration, melanin index, and elasticity of different age groups. Regarding the locations, forehead had the highest melanin index, where as palm had the lowest value. The mean values of erythema index and melanin index and TEWL were significantly higher in males and anatomic location was a significant independent factor for all of 6 measured parameters. Conclusion. Several biophysical properties of the skin vary among different gender, age groups, and body locations.
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              Non-invasive in vivo methods for investigation of the skin barrier physical properties.

              Skin as an organ of protection covers the body and accomplishes multiple defensive functions. The intact skin represents a barrier to the uncontrolled loss of water, proteins, and plasma components from the organism. Due to its complex structure, the epidermal barrier with its major component, stratum corneum, is the rate-limiting unit for the penetration of exogenous substances through the skin. The epidermal barrier is not a static structure. The permeability barrier status can be modified by different external and internal factors such as climate, physical stressors, and a number of skin and systemic diseases. Today, different non-invasive approaches are used to monitor the skin barrier physical properties in vivo. The quantification of parameters such as transepidermal water loss, stratum corneum hydration, and skin surface acidity is essential for the integral evaluation of the epidermal barrier status. Novel methods such as in vivo confocal Raman microspectroscopy offer the possibility for precise and detailed characterization of the skin barrier. This paper will allow the readership to get acquainted with the non-invasive, in vivo methods for the investigation of the skin barrier.
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                Author and article information

                Contributors
                Journal
                Int J Womens Dermatol
                Int J Womens Dermatol
                International Journal of Women's Dermatology
                Elsevier
                2352-6475
                16 November 2018
                June 2019
                16 November 2018
                : 5
                : 2
                : 100-104
                Affiliations
                [a ]Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
                [b ]Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [c ]Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
                [d ]Centre d’Etudes et de Recherche sur le Tégument, INSERM UMR1098, SFR FED 4234 IBCT, University of Franche-Comté, Besançon, France
                [e ]Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                [* ]Corresponding Author. firozali@ 123456sina.tums.ac.ir
                Article
                S2352-6475(18)30046-7
                10.1016/j.ijwd.2018.10.001
                6451735
                30997382
                4c746bde-49c2-4f19-a27e-51adf8875ddd
                © 2018 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 23 July 2018
                : 5 September 2018
                : 1 October 2018
                Categories
                Article

                lichen planus,biophysical properties,biomechanical properties,ultrasonography

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