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Biomedical subjects

H C Wulf

Publications and source records attributed to H C Wulf.

At least 55 records · Page 3Linked to original sources
PubMed1999

Sunscreen protection against cis-urocanic acid production in human skin.

Commercial sunscreens may offer some protection from immunosuppression induced by ultraviolet (UV) radiation, but agreement concerning the degree of protection is lacking. Cis-urocanic acid, formed by the photoisomerization of transurocanic acid is considered an important mediator of the cutaneous immunomodulation resulting from exposure to UV radiation. We investigated the effect of sunscreens on the isomerization of urocanic acid in 17 human subjects. Two sunscreens containing chemical filters, sun protection factor (SPF) 4 and SPF 10, and a SPF 10 sunscreen with a physical filter were applied at a thickness of 2 mg/cm2. The effect of a thin layer (0.5 mg/cm2) of the chemical SPF 10 sunscreen was also evaluated, as the amount of sunscreen applied in practice may be considerably less than recommended. All areas were irradiated with a single UV dose of 3.6 SED (standard erythema doses). In irradiated unprotected skin the median net production of cis-urocanic acid was 52% (relative amount). In the sites treated with the chemical sunscreens, the production of cis-urocanic acid was 7.4% (SPF 4) and 3.5% (SPF 10), and isomerization was thus reduced more efficiently at a higher SPF (p<0.01). The physical sunscreen reduced the formation of cis-UCA to 15%, and was significantly less effective than both the chemical SPF 10 sunscreen (p<0.01) and the SPF 4 sunscreen (p<0.01). The production of cis-urocanic acid in the area treated with the thin layer of the chemical SPF 10 sunscreen was 22%. The protection against the production of cis-urocanic acid was therefore reduced significantly (p<0.01) when the sunscreen was applied in an amount lower than recommended.

Administration, Cutaneous↗
PubMed1999

Naevi as a risk factor for basal cell carcinoma in Caucasians: a Danish case-control study.

The number of melanocytic naevi in Caucasians is related to previous exposure to the sun and is a well-documented major risk factor for cutaneous malignant melanoma. Basal cell carcinoma, which is the most common form of skin cancer, has also been shown to be related to exposure to the sun. To investigate whether the number of common naevi is a risk factor for basal cell carcinoma in Caucasians we performed whole-body counting of naevi > or =2 mm in a Danish case-control study with 145 cases of primary basal cell carcinoma and 119 controls matched on age, gender and place of residence. Naevi were recorded according to size and body region and the skin phototype was assessed. There was no correlation between self-reported skin type and the number of naevi. Females with basal cell carcinoma had more naevi than did female controls (median number of naevi: 65 and 32, respectively) while males with basal cell carcinoma did not differ from male controls (median number of naevi: 48 and 43, respectively). Female cases had more small size naevi (2 mm), intermediate size naevi (3-4 mm) and large size naevi (> or =5 mm) than did female controls. Females with basal cell carcinoma had a substantially higher number of naevi on the arms and the legs than did female controls, but also had more naevi on the trunk. For females, the risk for basal cell carcinoma increased with increasing number of naevi. Naevi were not a risk factor for basal cell carcinoma in males.

Adult↗
PubMed1999

Correlation between the greasiness and the plasticizing effect of moisturizers.

Moisturizers are used as cosmetics and as adjuvant therapy in dermatology. The strength or relative efficacy of moisturizers is poorly described and thus advising patients is difficult. It has been suggested that lipidization of the skin by moisturizers and the changes in skin mechanics following the application of a moisturizer may be useful measures of outcome. The aim of this study is to describe the relative efficacy of 5 different moisturizers, a barrier cream and a gel in terms of changes in skin mechanics and electrical capacitance before and after application. Assessment of the greasiness or absorption of the cream was made by standardized blotting of unabsorbed residue. Lipid-rich creams (Vaseline, Locobase and Decubal creme) caused increased skin distensibility, while no differences were found in hysteresis changes. In contrast, the relative efficacy in increasing skin capacitance was significantly greater in the moisturizers with a lower lipid content (Clinique, Nivea) and gel. The results suggest that lipidization is of major importance to the plasticity of the skin. When moisturizers are used to improve skin plasticity it is suggested that lipid-rich formulations be used. Cosmetically more acceptable creams and gel were however better at increasing skin capacitance which has been interpreted as a measure of skin hydration. The difference may reflect a design adaptation of these creams to a specific outcome measure and our results raise the question of appropriate outcome measures and our results raise the question of appropriate outcome measures in future moisturizer studies.

Adult↗
PubMed1999

Eye and hair colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma. A Danish case-control study.

To assess the importance of hair and eye colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma in fair-skinned Caucasians, we conducted two identical case-control studies in Denmark. We studied 145 cases with basal cell carcinoma and 174 matched controls, and 168 cases with cutaneous malignant melanoma and 176 matched controls. Controls were matched on age, gender and place of residence. Subjects indicated their hair colour before 7 years of age, and at 25 years of age and their skin phototype. Interviewers assessed the present hair colour and eye colour, and the constitutive skin pigmentation was measured objectively by skin reflectance of UV unexposed buttock skin. There were no differences between basal cell carcinoma cases and controls in hair colour or eye colour or constitutive skin pigmentation, but more cases were of skin type II than skin type IV; skin type 11 was a risk factor for basal cell carcinoma with an odds ratio (OR) of 2.3. For cutaneous malignant melanoma, more cases than controls were red-haired or blond and of skin type II, but there was no difference in constitutive skin pigmentation. Hair colour and skin type were found to be independent risk factors for cutaneous malignant melanoma; red hair vs. black/brown: OR >9.7, blond hair vs. brown/black: OR = 2.4, and skin type 11 vs. type IV: OR=2.0. There were no gender-related differences in risk factors for basal cell carcinoma and cutaneous malignant melanoma.

Adult↗
PubMed1998

Evaluation of X-radiation and UV-B radiation for elimination of 3H-thymidine incorporation into responder cells in the IL-2 producing helper T lymphocyte precursor assay.

The helper T lymphocyte precursor (HTLp) assay is of value for predicting graft-vs.-host disease after allogeneic bone marrow transplantation. The assay is based on limiting dilution analysis and requires detection of the amount of interleukin 2 (IL-2) produced by one activated T cell. IL-2 is detected by 3H-thymidine (3H-TdR) incorporation into the IL-2 dependent cell line, CTLL-2. Detection of IL-2 in the whole culture volume of the wells in the microtiter plates increases sensitivity, but requires elimination of 3H-TdR incorporation into the responder cells in the HTLp assay. We have compared the ability of X-radiation and ultraviolet B (UV-B) radiation to eliminate 3H-TdR incorporation. X-irradiation of the cells reduced 3H-TdR incorporation by 90% with doses up to 400 Gy, but the incorporation was still 10 times higher than in wells with stimulator cells only. UV-B irradiation (with Philips TL 12 tubes) of the cells with > or = 2 J/cm2 decreased 3H-TdR incorporation to the level of wells with stimulator cells only. Neither X-irradiation nor UV-B irradiation of the cultures affected IL-2 produced in the assay or human recombinant IL-2 measured by 3H-TdR incorporation into the IL-2 dependent cell line, CTLL-2. HTLp frequencies determined after 25 Gy X-irradiation were higher (mean 1.5, range 1.02-2.2 times higher) than HTLp frequencies determined after UV-B irradiation with 2 J/cm2.

Biological Assay↗
PubMed1998

Changes in skin redness, pigmentation, echostructure, thickness, and surface contour after 1 pulsed dye laser treatment of port-wine stains in children.

BACKGROUND: The pulsed dye laser is the treatment of choice for children with port-wine stains (PWSs). Evaluation of treatment outcome and adverse effects is traditionally based on subjective clinical scoring systems. We intend to objectify treatment results and adverse reactions after 1 treatment with the pulsed dye laser. DESIGN: A before-and-after trial using skin reflectance to detect changes in skin redness and pigmentation, ultrasonography to evaluate changes in echostructure and skin thickness, and 3-dimensional surface contour analysis to detect changes in surface texture. PATIENTS: Twelve children with PWSs. SETTING: A university dermatological department. RESULTS: The skin reflectance-determined change in skin redness correlated with the clinical response (r = 0.46, P < .002). The percentage of reflectance-determined lightening was equal for pink, red, and dark red PWSs (median, 42.9%). Skin pigmentation increased after laser treatment (P < .007). Ultrasonography revealed lower dermal echogenicity of preoperative PWSs than of postoperative PWSs (P < .007) and healthy skin (P < .001). An increase in echogenicity reflected a decrease in the dermal water (blood) content. Variations were found in the dermal localization of the PWS. Skin thickness was significantly higher in the PWS before treatment than after (P < .001). The preoperative lesional thickness correlated inversely with the ultrasound-assessed treatment response (r = 0.35, P < .04). The surface contour parameters decreased significantly after laser treatment, indicating a flattening of the skin surface. The contour changes correlated positively with treatment response. By clinical evaluation, no hypopigmentation or texture changes were detected. CONCLUSION: The evaluation of treatment outcome and adverse effects is refined by the use of skin reflectance, ultrasonographic, and surface contour analysis.

Blood↗
PubMed1998

Impact of epidermal thickness on purpura from the pulsed dye laser.

BACKGROUND AND OBJECTIVE: To clarify whether epidermal thickness is of importance to the purpuric reaction from treatment with the pulsed dye laser (PDL). STUDY DESIGN/MATERIALS AND METHODS: Fifteen fairly pigmented volunteers were laser treated in two test regions of varying epidermal thicknesses: normal buttock skin and ultraviolet B (UVB)-exposed buttock skin. Laser treatments were performed with the flashlamp-pumped PDL (585 nm). Fluences ranged from 3-6.5 J/cm2, spot size was 7 mm, and each volunteer received at least six fluences in each treatment region. Assessment of the response was based on clinical evaluation (threshold dose to purpura 10 minutes and 1 day after treatment) and skin reflectance-evaluated redness (1 and 6 days, 2 and 6 weeks after treatment). RESULTS: The total epidermal thickness differed between the unexposed buttock skin (median, 72.7 microm) and the UVB-exposed buttock skin (87.2 microm) (P < 0.01). There was no correlation between the epidermal thickness and the threshold dose to induce purpura 10 minutes and 1 day after laser exposure. Skin reflectance revealed no correlation between the epidermal thickness and the skin reflectance evaluated redness on 1, 6 days, and 2 weeks postoperatively. A dose-response relation was seen within the two test regions; 6 weeks after laser exposure, there was no remaining laser-induced skin redness. CONCLUSION: The epidermal thickness is unimportant to the purpuric reaction after PDL treatment.

Adult↗
PubMed1998

Facultative skin pigmentation in caucasians: an objective biological indicator of lifetime exposure to ultraviolet radiation?

To investigate age and gender trends in facultative and constitutive skin pigmentation we measured skin pigmentation non-invasively and objectively by skin reflectance spectroscopy in 653 caucasians (336 females and 317 males; mean age 38 years, range 0-85) who were not using artificial tanning devices. In all subjects, measurements were performed in the late winter and pre-spring period at five sites exposed to ultraviolet (UV) radiation: the forehead, the upper chest, the upper back and the lateral and medial aspects of the upper arm, and in UV-unexposed buttock skin. Constitutive pigmentation at the buttocks was highest in the first years of life and then decreased substantially during the first two decades of life (P < 0.01). After the age of 25 years, buttock pigmentation remained at a constant level (P = 0.20). There was no gender difference in constitutive pigmentation. Facultative skin pigmentation increased with age for all the measured sites with the highest levels found at the lateral aspect of the upper arm. Based on observations in this study we propose the idea of a 'sun exposure index' (SEI) for individuals, based on objective measurements of skin pigmentation. The SEI is calculated as the increase in facultative pigmentation above the constitutive level and is expressed as a percentage of the constitutive level. The SEI appeared to be related to cumulative lifetime UV exposure and may be used in epidemiological research as an objective estimate of UV exposure at different body sites in caucasians.

Adolescent↗
PubMed1998

Urocanic acid isomers in patients with basal cell carcinoma and cutaneous malignant melanoma.

Urocanic acid (UCA) is a major chromophore for ultraviolet (UV) radiation in the skin. On UV exposure, the naturally occurring trans-isomer converts to the cis-isomer in a dose-dependent manner. Accumulating evidence indicates that cis-UCA acts as an initiator of the UV-induced suppression of certain skin immune functions. This immunomodulation is recognized as an important factor in the development of skin cancer. In this study, pigmentation and UCA isomers were measured in 29 patients with previous basal cell carcinoma (BCC), 23 patients with previous cutaneous malignant melanoma (MM), and 32 healthy controls. Measurements were performed on UV-exposed (forehead, upper back) and UV non-exposed (buttock) skin. No significant differences in pigmentation percentage, total UCA concentration, relative (%) or absolute (nmol/cm2) cis-UCA concentration were observed between the groups in any of the body sites studied. The net production of cis-UCA after irradiation with a single test UV dose was evaluated. The relative production of cis-UCA following irradiation was significantly higher in both cancer groups when compared with the control group, while no significant difference was found between the BCC and the MM patients.

Adult↗
PubMed1998

Urocanic acid isomers and photosensitivity in healthy children.

Episodes of intense sun exposure, particularly in childhood, seem to carry a risk for the development of malignant melanoma in later life. However, little is known about photosensitivity and natural photoprotection in children. In adult subjects, photoprotection is provided mainly by the epidermal content of melanin and the thickness of the stratum corneum, while the amount of urocanic acid (UCA), a major ultraviolet-absorbing component of the stratum corneum, is not thought to contribute significantly to photoprotection. The minimal erythema dose (MED) was determined in 22 healthy children aged 6-13 years and in 36 healthy adults (mean age 28.1 years). Pigmentation was measured at six body sites by use of reflectance spectroscopy and the concentration of UCA isomers was measured in a sun-exposed area (upper back) and in unexposed buttock skin. No significant differences between children and adults were found, either in pigmentation at exposed and unexposed body sites, or in MED. The concentration of total UCA was significantly higher in the children than in the adults on the buttock (median 22.2 vs. 13.6 nmol/cm2), but not on the back. On exposed back skin, the children had a significantly higher percentage of cis-UCA than the adults (median 60.1 vs. 28.3%), while no difference was found on the buttock. In both groups, a significant correlation was found between pigmentation and MED (children: Spearman correlation coefficient 0. 58, P = 0.006; adults: Spearman correlation coefficient 0.69, P < 0. 0001), indicating that pigmentation is of major importance in determining photosensitivity in children as well as in adults. The concentration of total UCA did not correlate with the MED in either group.

Adolescent↗
PubMed1998

The measurement of constitutive and facultative skin pigmentation and estimation of sun exposure in Caucasians with basal cell carcinoma and cutaneous malignant melanoma.

In two identical and simultaneously performed case-control studies of basal cell carcinoma (BCC) and cutaneous malignant melanoma (CMM) with age-matched, sex-matched and residence-matched controls, skin pigmentation was measured objectively by skin reflectance spectroscopy in 145 BCC patients and 174 matched controls and in 168 CMM patients and 176 matched controls. Measurements were performed at the forehead, the upper chest, the upper back, the lateral and medial aspects of the upper arm, and the buttocks. Self-estimation of sun exposure in childhood, in youth and in adulthood was performed by all subjects. There were no statistically significant differences in constitutive skin pigmentation at the buttocks between BCC patients and controls (P = 0.96) or between CMM patients and controls (P = 0.13). Facultative skin pigmentation in ultraviolet-exposed sites was not significantly different between BCC patients and controls except that women patients had higher pigmentation at the lateral side of the upper arm. For CMM, men patients had higher pigmentation at the lateral side of the upper arm. Self-estimations of sun exposure did not show differences between patients and controls but indicated high exposure levels in childhood and youth and in adult leisure time. Sun exposure estimated by increase in facultative pigmentation above the constitutive level (the Sun Exposure Index) was not significantly different between BCC patients and controls, whereas CMM men patients had higher estimates for the lateral side of the upper arm, the chest and the back.

Adolescent↗
PubMed1998

Evidence-based dermatologic out-patient treatment.

OBJECTIVE: To determine the evidence base for routine therapeutic decisions in dermatologic out-patients. DESIGN: A retrospective review of a random sample of primary therapy and literature. SETTING: University hospital, dermatologic out-patient clinic in Copenhagen MATERIAL: A random sample of the case notes from 115 out-patients. METHOD: The evidence base of therapy prescribed when the diagnosis was ascertained was studied in literature searches in MEDLINE and EMBASE. Evidence was structured into primary evidence consisting of randomized controlled trials, and secondary evidence consisting of follow-up studies or the application of trial results between diseases with pathogenic or clinical similarities, e.g. atopic and seborrheic dermatitis. RESULTS: Randomized controlled trials could be found describing 38% (95% confidence interval: 30-47) of all treatments. Secondary evidence was found for 33% (24-41), while no evidence was found for 23% (16-31) of the given treatments. CONCLUSIONS: Approximately three-quarters of dermatologic out-patient therapy is based on scientific evidence ranging from randomized controlled trials to logical deduction from analogous clinical situations. The proportion of evidence-based medicine in dermatologic therapy therefore appears to be comparable with that of internal medicine and may thus be above expectations.

Adolescent↗
PubMed1998

Structure of water, proteins, and lipids in intact human skin, hair, and nail.

Raman spectroscopy is a nondestructive analytical method for determining the structure and conformation of molecular compounds. It does not require sample preparation or pretreatment. Recently, near-infrared Fourier transform Raman spectroscopy has emerged as being specially suited for investigations of biologic material. In this study, we obtained near-infrared Fourier transform Raman spectra of intact human skin, hair, nail, and stratum corneum. We disclosed major spectral differences in conformational behavior of lipids and proteins between normal skin, hair, and nail. The amide I and III band location indicated that the majority of proteins in all samples have the same secondary alpha-helix structure. Positions of (S-S) stretching bands of proteins revealed a higher stability of the disulfide bonds in the hair and the nail. Analysis of vibrations of protein -CH groups showed that in the hair and the nail the proteins are apparently highly folded, interacting with the surroundings only to a small degree. The position of lipid specific peaks in spectra of hair, nail, and stratum corneum suggested a highly ordered, lamellar crystalline lipid structure. A greater lipid fluidity was found in whole skin. Assessment of the structure of water clusters revealed that mainly bound water is present in the human skin, stratum corneum, and nail. In conclusion, structural changes of water, proteins, and lipids in intact skin and skin appendages may be analyzed by Raman spectroscopy. This technique may be used in the future in a noninvasive analysis of structural changes in molecular compounds in the skin, hair, and nail associated with different dermatologic diseases.

Adolescent↗
PubMed1998

Water and protein structure in photoaged and chronically aged skin.

Changes in the structural proteins and hydration during aging is responsible for altered skin morphologic and mechanical properties manifested as wrinkling, sagging, loss of elasticity, or apparent dryness. To gain insight into the age-related alterations in protein conformation and water structure, we obtained Raman spectra from the sun-protected buttock skin representing chronologic aging and the sun-exposed forearm skin representing combined effects of photoaging and chronologic aging. Ten aged individuals (five men, five women; age range 74-87) and 10 control young individuals (five men, five women; age range 22-29) entered the study. In the photoaged forearm skin the positions of protein-specific amide I, amide III, and CH stretching bands were shifted, suggesting increased protein folding. In contrast, major changes were seen only in the amide I peak in chronologically aged skin. The intensity of the 3250 cm(-1) OH stretching band was increased in photoaged skin (but not in chronologically aged skin) indicating an increased water content. R(v) representation of the low-frequency region of Raman spectra was applied to determine water structure. In the young skin and chronologically aged skin water was mostly present in the bound form. In the photoaged skin, however, an increase in intensity at 180 cm(-1) was noted, which reflects an increase in the not-protein bound water (tetrahedron water clusters). In conclusion, it seems that proteins in the photoaged skin are more compact and interact with water to limited degree. Impairment in protein hydration may add to the understanding of ultrastructural, mechanical, and biochemical changes in structural proteins in the aged skin.

Adult↗
PubMed1998

Interdependence of eye and hair colour, skin type and skin pigmentation in a Caucasian population.

Eye colour, hair colour and skin colour are important risk factors for malignant melanoma and non-melanoma skin cancers. There are few studies in which the distribution of these pigmentary factors in risk populations has been assessed. The purpose of this study was to investigate the prevalence of the major eye and hair colours and the distribution of skin types and skin pigmentation in a Caucasian population. In 892 Danish Caucasians, eye colour, hair colour and skin type were assessed and facultative and constitutive skin pigmentation were measured objectively using skin reflectance spectroscopy. Blue eye colour and blond hair colour and skin type II were the most frequent (60%, 67% and 33% of subjects, respectively). All four major eye colours and four major hair colours (with the exception of red hair colour) were found within skin types I-IV and we could not predict the skin type or the constitutive skin pigmentation. Skin type could not be taken to classify individuals reliably according to their facultative or constitutive skin pigmentation.

Adolescent↗
PubMed1998

Variable expression of apoptotic phenotype in keratinocytes treated with ultraviolet radiation, ceramide, or suspended in semisolid methylcellulose.

Apoptosis is a form of cellular suicide and is activated in various cells, including keratinocytes, in response to physiological and pathological stimuli. A current hypothesis holds that apoptotic cells in a concerted manner express characteristic phenotypic features comprising cytoplasmic budding, pyknosis, chromatin condensation, karyorhexis and internucleosomal DNA fragmentation. In this study we investigated the effects of different potential inducers of apoptosis on cultured human keratinocytes. Viability was determined with vital dyes (ethidium bromide, trypan blue), cell morphology was investigated with electron microscopy, and nuclear and DNA integrity was assessed with TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling) or DNA gel electrophoresis. Irradiation with 50 mJ/cm2 ultraviolet B (UVB), treatment with C8 ceramide, or suspension in a semisolid medium caused apoptosis which was ultrastructurally different from necrotic induced by very high (300 mJ/cm2) doses of UVB. However, the phenotype of dying cells did not exhibit all typical features of apoptosis and cell morphology depended on the method used to induce apoptosis. Cells irradiated with ultraviolet B or treated with C8 ceramide developed large and small budding and DNA nicks but not chromatin condensation or classical karyorhexis. In UVB-irradiated cells a novel form of karyorhexis was observed manifested by formation of a few very small chromatin fragments in nuclear periphery. Cells suspended in methylcellulose developed DNA nicks and pyknosis, but not budding or karyorhexis. In neither case could the typical internucleosomal DNA fragments be detected by gel electrophoresis. These morphological results indicate that in keratinocytes induction of effect or death mechanisms is not concerted but depends on the stimulus inducing apoptosis.

Apoptosis↗
PubMed1998

Side effects from the pulsed dye laser: the importance of skin pigmentation and skin redness.

The pulsed dye laser is the treatment of choice for port-wine stains. In this study we evaluate the importance of preoperative skin pigmentation and skin redness for the development of side effects from one treatment with the pulsed dye laser. A risk assessment is performed and skin reflectance measurement objectifies postoperative pigmentary changes. Fourteen human volunteers (skin types I to V) were laser-treated on the inside of the proximal brachium. Photographic documentation was used for blinded, clinical evaluation of side effects 3 and 6 months postoperatively. Skin was artificially reddened using topical application of 10% nicotinic acid cream. The development of pigmentary alterations and texture changes depended on the preoperative pigmentation and redness degrees. The risk of inducing clinically visible pigmentary alterations and texture changes increased with higher preoperative skin pigmentation and redness degrees, and with the application of increasing laser doses. Pigmentary alterations were induced at a lower fluence level than texture changes. The risk of side effects was higher 3 months postoperatively than 6 months postoperatively, substantiating a gradual disappearance of side effects. Skin reflectance measurements documented postoperative hyperpigmentation that faded partially from 3 to 6 months postoperatively. This is the first human experimental model for port-wine stains which provides quantitative data on the relationship between preoperative skin colours and postoperative clinically disturbing side effects.

Administration, Cutaneous↗