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Eyelid Skin (eyelid + skin)

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Medical Sciences100%

Selected Abstracts

Treatment of Idiopathic Cutaneous Hyperchromia of the Orbital Region (ICHOR) with Intense Pulsed Light

DERMATOLOGIC SURGERY, Issue 6 2006
NATALIA CYMROT CYMBALISTA MD
BACKGROUND Idiopathic cutaneous hyperchromia of the orbital region (ICHOR) does not have a clear etiopathogenesis. Genetic factors, increased melanin, prominent vasculature, and eyelid skin slackness seem to be involved. OBJECTIVE To evaluate individuals with ICHOR clinically and histologically, before and after treatment with high-energy pulsed light (HEPL), considering epidermal and dermal melanin, in order to evaluate HEPL efficacy in clearing away ICHOR, and 1 month and 1 year later to check whether improvement was maintained. METHODS Twelve individuals with ICHOR underwent clinical and histological evaluation before and after HEPL application, with photographic comparison. They underwent one to four HEPL sessions on the lower eyelid at approximately 30-day intervals. Melanin quantification by area, before and after treatment was performed by digital image morphometry. RESULTS Eyelid skin was significantly lightened (p=.24), and was maintained 1 year later with no ICHOR reincidence. All individuals (100%) showed postinflammatory hyperchromia (average 6-month duration), while 58.33% presented hypochromia (7-month duration). There was significantly decreased epidermal and dermal melanin after treatment. CONCLUSION HEPL was shown to be useful in clearing up ICHOR. This was maintained after 1 year. Epidermal and dermal histopathology showed decreased melanin following treatment. Longer follow-up is needed to evaluate possible later recurrence of ICHOR. [source]

Forehead Donor Site Full-Thickness Skin Graft

DERMATOLOGIC SURGERY, Issue 3 2005
Vassilios Dimitropoulos MD
Background Full-thickness skin grafts (FTSGs) are useful for reconstructing nasal defects. Traditional reported donor sites include the preauricular, postauricular, supraclavicular, clavicular, conchal bowl, melolabial fold, and upper eyelid skin. Selection of the "best" donor site is based on the "best" tissue match and ability to camouflage the donor scar. Objective The purpose was to report our experience with FTSGs harvested from the forehead for reconstruction of nasal defects following Mohs' surgery. Methods A retrospective query of the Mohs' surgery database was performed to identify nasal defects repaired with a FTSG harvested from the forehead skin. The research record contained the patient age and gender, defect size, and cosmetic and functional outcomes interpreted by the patient and surgeon. Results FTSGs from forehead skin were used to repair the nasal defects in three patients. The functional and cosmetic outcome of all three cases was deemed excellent by the patient and surgeon. Donor site scars were well concealed within preexisting rhytids. Conclusion FTSGs harvested from the forehead, although limited in practical utility, may offer an optimal FTSG match for limited select defects while also providing an easily camouflaged donor site scar within a forehead rhytid. VASSILIOS DIMITROPOULOS, MD, CHRISTOPHER K. BICHAKJIAN, MD, AND TIMOTHY M. JOHNSON, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source]

Upper Eyelid Full-Thickness Skin Graft in Facial Reconstruction

DERMATOLOGIC SURGERY, Issue 1 2005
Dogan Tuncali MD
Background The potentially available upper eyelid skin, as an alternative donor site, deserves more attention in clinical use. Objective The objective of this study was to prospectively evaluate the clinical behavioral characteristics of upper eyelid full-thickness skin grafts in facial reconstruction. Methods Sixteen patients who concluded the 12-month follow-up period were included in the study. Graft dimensions were measured in place before the graft harvest. Defect sizes were measured following lesion excision and postgrafting. Graft sizes were measured postoperatively at 1, 3, 6, and 12 months. Results The largest and smallest grafts were 46 × 22 mm and 40 × 15 mm (average 43.1 × 19.3 mm) in size, respectively. The largest and smallest defect dimensions were 33 × 23 mm and 17 × 9 mm (average 22.6 × 15.6 mm), respectively. The average postgrafting size was 21.1 × 14.6 mm. Grafts and donor sites healed very well. Generally, an acceptable to good texture and color match was observed beyond 6 months. Wound bed contraction was not observed beyond the first month (p < .05). Conclusion Special characteristics of hairless skin, good color and texture matching, and inconspicuous and hidden donor scar make the upper eyelid a good alternative donor site for small- to medium-sized facial skin defects. The main disadvantages that limit its clinical use are the age of the patient, a lack of adnexal structures, comparatively limited sun exposure, and possible insufficient thickness, especially when deep defects are of concern. DOGAN TUNCALI, MD, LEVENT ATES, MD, AND GÜRCAN ASLAN, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source]

Location-related differences in structure and function of the stratum corneum with special emphasis on those of the facial skin

INTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 6 2008
H. Tagami
Synopsis Between the two different kinds of the skin covering the body, the glabrous skin is found only on the palmo-plantar surface because of its rather simple function to protect the underlying living tissue with its remarkably thick stratum corneum (SC) from strong external force and friction. Thus, its barrier function is extremely poor. In contrast, the hair-bearing skin covers almost all over the body surface regardless of the presence of long hair or vellus hair. In regard to its SC, many dermatologists and skin scientists think that it is too thin to show any site-specific differences, because the SC is just present as an efficient barrier membrane to protect our body from desiccation as well as against the invasion by external injurious agents. However, there are remarkable regional differences not only in the living skin tissue but also even in such thin SC reflecting the function of each anatomical location. These differences in the SC have been mostly disclosed with the advent of non-invasive biophysical instruments, particularly the one that enables us to measure transepidermal water loss (TEWL), the parameter of the SC barrier function, and the one that evaluates the hydration state of the skin surface, the parameter of the water-holding capacity of the SC that brings about softness and smoothness to the skin surface. These in vivo instrumental measurements of the SC have disclosed the presence of remarkable differences in the functional properties of the SC particularly between the face and other portions of the body. The SC of the facial skin is thinner, being composed of smaller layers of corneocytes than that of the trunk and limbs. It shows unique functional characteristics to provide hydrated skin surface but relatively poor barrier function, which is similar to that observed in retinoid-treated skin or to that of fresh scar or keloidal scars. Moreover, there even exist unexpected, site-dependent differences in the SC of the facial skin such as the forehead, eyelid, cheek, nose and perioral regions, although each location occupies only a small area. Between these locations, the cheek shows the lowest TEWL in contrast to the perioral region that reveals the highest one. Moreover, these features are not static but change with age particularly between children and adults and maybe also between genders. Among various facial locations, the eyelid skin is distinct from others because its SC is associated with poor skin surface lipids and a thin SC cell layer composed of large corneocytes that brings about high surface hydration state but poor barrier function, whereas the vermillion borders of the lips that are covered by an exposed part of the oral mucosa exhibit remarkably poor barrier function and low hydration state. Future studies aiming at the establishment of the functional mapping in each facial region and in other body regions will shed light on more delicate site-dependent differences, which will provide us important information in planning the strategy to start so called tailor-made skin care for each location of the body. Résumé Entre les deux types différents de peau couvrant le crops, on trouve la peau glabre uniquement sur la surface palmo-plantaire du fait de sa fonction plutôt simple de protection du tissu vivant sous-jacent par un stratum corneum (SC) trés épais vis-à-vis des forces extérieures et de la friction. De ce fait, sa fonction barrière est extrêmement pauvre. Au contraire, la peau velue courve la presque totalité de la surface du crops, que ce soit par la présence de longs cheveux ou de duvet. En ce qui concerne son SC, la plupart des dermatologues et des scientifiques de la peau pensent qu'il est trop mince pour montrer une différence spécifique au site, attendu que le SC est simplement présent en tant que membrane barriére efficace pour protéger notre corps de la dessiccation ainsi que pour lutter contre l'invasion d'agents nuisibles externes. Cependant, il existe des différences importantes entre les sites, non seulement dans la peau vivante, mais également dans ce SC aussi mince, qui révèlent la fonctin de chaque site anatomique. Ces différences dans le SC ont surtout été révélées avec l'apparition d'instruments biophysiques non invasifs, en particulier celui qui nous permet de mesurer la perte transépidermale en eau (TEWL), le paramétre de la fonction barrière du SC et celui qui évalue l'état d'hydratation de la surface de peau, le paramètre de la capacité en rétention de l'eau du SC qui est liéà la souplesse et à la douceur à la surface de peau. Ces mesures instrumentales in vivo du SC ont révélé la présence de différences remarquables entre les propriétés fonctionnelles du SC particulièrement entre le visage et d'autres parties du corps. Le SC de la peau de la face est plus mince, car li est composé de couches plus petites de corneocytes que celui du tronc et des membres. Il montre des caractéristiques fonctionnelles uniques pour permettre l'hydratation de la surface de peau, mais une fonction barrière relativement faible, semblable à celle observée dans la peau traitée avec un rétinoïde ou à celle d'une cicatrice récente ou de cicatrices kéloidales. De plus, il existe des différences sites-dépendantes inattendues dans le SC de la peau de la face comme le front, la paupière, la joue, le nez et les régions périorales, et ce, bien que chaque emplacement occupe seulement un petit secteur. Entre ces divers emplacements, la joue montre le TEWL le plus bas par comparaison avec la région périorale qui montre le plus élevé. De plus, ces caractéristiques ne sont pas fixes, mais changent avec l'âge en particulier entre enfants et adultes et peut-être aussi entre sexes. Entre les diverses régions de la face, la peau de la paupière se distingue parce que son SC est associéà une peau pauvre en lipides de surface constituée par une mince couche de cellule composée de grand cornéocytes qui provoquent un haut état d'hydratation superficiel, mais une faible fonction barrière. A l'inverse les bordures vermillion des lévres recouvertes par une partie exposée de muqueuse orale, possèdent une fonction barrière très faible et un état d'hydratation bas. Les études futures visant àétablir la configuration fonctionnelle de chaque région de la face et d'autres régions du corps mettrons en lumière des différences sites-dépendantes plus subtiles, qui nous fourniront des informations importantes pour planifier la stratégie pour commencer le soin de la peau sur mesure si attendu pour chaque partie du corps. [source]

4361: Management of orbital tumours with adjuvant iodine brachytherapy using "inverted" plaques

ACTA OPHTHALMOLOGICA, Issue 2010
T KIVELÄArticle first published online: 23 SEP 2010
Purpose To describe our experience in using "inverted" iodine plaques as adjuvant treatment after resection of orbital tumours. Methods Between 1999 and 2007, three patients (ages 17-48 years) underwent resection of an lacrimal gland tumour followed by application of an "inverted" iodine plaque manage any microscopic infiltration, i.e. a gold plaque carrying iodine-125 seeds on its convex rather than concave surface. In a fourth instance, the seeds were placed on the convex surface of a ruthenium rather than a gold plaque to manage an eye with a late extraocular recurrence of an irradiated uveal melanoma following resection of the extension. Results The diameter of the plaque was 20 mm. It was sutured to the sclera so that when the eye was in primary position the lacrimal fossa was targeted. When the eye moved, the irradiated volume naturally enlarged. A 40-56 Gy dose was calculated to the depth of 10 mm, and the dose at 5 mm was then calculated as 80-134 Gy. Treatment time was 59-154 hours. In one case, the iodine seeds were placed asymmetrically to limit radiation damage to the eyelid skin. In two patients, transient erythema of the upper eyelid developed, which resolved in a few months time. In case of the extraocular melanoma, dose was the same. Recurrent tumours have not developed. Conclusion An "inverted" iodine plaque is one option for adjuvant irradiation of the orbit which shields the eye from radiation damage. [source]