COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE in Visual Studio .NET

Creation QR-Code in Visual Studio .NET COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE

COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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Papillary dermis Oxytalan fibers
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Reticular dermis Elaunin fibers Deep reticular dermis
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FIGURE 2-5 The elastic ber network in the dermis consists of immature oxytalan bers in the super cial dermis and the more mature elaunin bers in the middle dermis The most mature elastic bers are unnamed and are found in the deep reticular dermis
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(PXE), elastosis perforans serpiginosa (also known as Lutz-Miescher s syndrome), and dermatofibrosis lenticularis (also known as Buschke-Ollendorf syndrome) Studies have demonstrated a reduction in the elastin content in protected areas of the skin with aging In a study performed on Egyptian subjects, the relative amount of elastin in the non-UVexposed abdominal skin significantly decreased from 492% 06% in the first decade to 304% 08% in the ninth decade34 Another study on elastin content in the nonexposed buttock skin of 91 Caucasians between 20 and 80 years of age showed a reduction of 51% in elastin tissue31 Although UV exposure may result in elastosis and a higher content of elastin tissue, the elastic fibers are rendered structurally abnormal,34 which is microscopically seen as thickened and twisted granular deposits of elastin in the dermis Replacing the elastin component of the ECM has always posed a challenge in skin rejuvenation approaches Researchers have investigated the production of recombinant and cross-linked tropoelastin in great detail35 However, since it is very difficult to have elastin pass through human skin, stimulating the dermis to produce elastin may be an alternative option Recently, zinc has become a subject of interest as an elastin tissue stimulator in the skin Zinc has been shown to increase the epidermal growth factor (EGF) receptor signaling pathway36 It increases protein tyrosine phosphorylation by inhibiting protein tyrosine phosphatase (PTPase),37 and activates mitogen-activated protein (MAP) kinases,38 which are important for cosignaling in ECM production Clinical studies have suggested improvement in the elasticity of periocular skin following use of a patented zinc complex topical preparation39 In a 4-week study of 27 female subjects with a zinc complex-containing eye product, overall improvement of the eye area was noted by 78%, reduction of fine lines by 74%, and firmer skin by 70% of the patients39 These studies, although promising, need to be conducted in a larger patient population
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FIGURE 2-6 HA is made of repeating dimers of glucuronic acid and N-acetyl glucosamine assembled into long chains
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bolin are also present in the dermis Fibronectin is a filamentous GP that mediates platelet binding to collagen, development of granulation tissue, and reepithelialization Chemotactic for monocytes, fibronectin contains six binding sites including one for collagen, two for heparin, and a region that binds fibrin Tenascin is abundant in developing skin but found only in the papillary dermis in adult skin These matrix components play a significant role in tissue remodeling and are important in wound healing following cosmetic procedures
GLYCOSAMINOGLYCANS
Glycosaminoglycans (GAGs) are polysaccharide chains composed of repeating disaccharide units linked to a core protein Together the GAGs and attached core protein form proteoglycans All GAGs except for HA are synthesized in Golgi apparatus HA is the only GAG that is not produced on a core protein; rather, it is synthesized by an enzyme complex of the plasma membrane40 Although all the functions of GAGs are not understood, it is known that these compounds avidly bind water and may contribute to the maintenance of salt and water balance GAGs are found in areas with a fibrous matrix where cells are closely associated but have little space for free movement Most studies on human skin show an age-related decline in GAG content The most abundant GAGs in the dermis are HA, which is the only nonsulfated GAG, and dermatan sulfate The other GAGs include heparin sulfate, heparin, keratan sulfate, chondroitin-4, and chondroitin-6-sulfate HA is a very important component of the dermis that is responsible for attracting water and giving the dermis its volume The name reflects its glassy appearance (the Greek word for glass is hyalos) and the presence of a sugar known as uronic acid HA is known to be important in cell growth, membrane receptor
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