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Notes: Background/purpose: Sensitive skin has been described as a skin type with higher reactivity than normal skin and exaggerated reactions to external irritants. Washing with soaps is harmful for barrier-related parameters. Cutaneous irritation induced by cleansing products under exaggerated test conditions, e.g. patch testing, is not necessarily predictive of the irritation occurring under standardized daily use conditions. The purpose of the study was to assess the effect of an improved washing solution for sensitive skin in a half-site comparison on barrier-related parameters.Methods: Thirty healthy volunteers with self-reported sensitive and so-called problematic skin performed standardized washings with a soap-free washing emulsion with mild acidity (pH 5.5) for 3 weeks. Test areas were both forearms and the cheek. Non-invasive biophysical measurements of the following skin parameters, epidermal permeability barrier function measured as transepidermal water loss (TEWL), stratum corneum (SC) hydration, pH value, skin surface lipids, skin temperature and SC integrity/cohesion, were assessed prior to the first washing, on days 7, 14 and 21 after beginning the washing procedure. SC cohesion was quantified using two independent methods on D-Squame tapes: optical spectroscopy measuring the absorbance and a protein assay assessing the total protein (Bradford). Both methods showed a good correlation. SC integrity was quantified by measuring TEWL after sequential stripping with D-Squame tapes.Results: The use of the washing emulsion led to a mild damage of the epidermal permeability barrier function with no marked difference to water application. Furthermore, a mild but significant dehydration was assessed after 21 days vs. baseline without any differences between the water-treated and the washing emulsion-treated forearm. On the cheek no dehydration was detectable but the lipid content was reduced under the washing emulsion. The pH value increased in all three test areas after 21 days, again without significant differences between water and the washing solution. SC cohesion was quantified using two independent methods on D-Squame tapes: optical spectroscopy measuring the absorbance and a protein assay assessing the total protein (Bradford). Both methods showed a good correlation. The SC cohesion decreased after 21 days on the water-treated as well as on the washing emulsion-treated arm. The decrease over time was significant when used the optical spectroscopy measuring. A standardized questionnaire revealed positive characteristics of the washing emulsion and good acceptance.Conclusion: The investigated standardized washing model with the endpoints epidermal barrier function, SC hydration, surface pH, skin surface lipids, skin temperature and SC integrity/cohesion showed only mild damage comparable to washing with water.

Notes: Summary The role of regular skin cleansing with soap or syndet in pre-acne is ill-defined. The intention of this study was to assess the relative value of an acidic syndet bar and a conventional soap bar in the prevention of acne lesions in acne-prone patients. In a randomized, open, comparative trial the three months' application of either an acidic syndet bar or a conventional soap to facial skin for 1 min each in the morning and in the evening was compared in 120 adolescents and young adults with inflammatory acne grade I or II according to thePlewig andKligman classification. It was a confirmatory trial with the number of inflammatory lesions being the prime parameter of concern. In addition, non-inflammatory acne lesions were analyzed as were parameters of safety such as itching, redness and scaling. While the number of inflammatory acne lesions, i.e., papulopustules, did not differ in the two trial groups composed of 57 evaluable cases each, this was the case from 4 weeks of application onward: in the group using soap the mean number of inflammatory lesions increased from 14.6 (±5.3) to 15.3 (±6.0), while it decreased in the other group from 13.4 (±5.2) to 10.4 (±5.8) (p〈0.0001). Symptoms or signs of irritation were seen in 40.4% of individuals belonging to the former and 1.8% belonging to the latter group. The number of papulopustules characteristic of inflammatory acne thus is clearly lower when a syndet bar of the acidic type is regularly used for cleansing the face as compared to a (necessarily alkaline) soap. Hence, acidic cleansers should be preferred for skin care in adolescents and young adults if there is no reason for a different decision. Better tolerability might add further to an increased benefit-to-risk ratio. Whether acne patients who apply an anti-acne drug would also profit from cleansing the skin with an acidic syndet bar still needs further investigation.

Notes: Abstract Genetic typing of class I major histocompatibility complex (MHC) antigens (HLA-A, -B and -C) was performed in 22 patients with Fuch's heterochromic cyclitis (FHC) and in a control group of 339 healthy subjects in order to ascertain whether there are any genetic factors that protect against or increase the risk of developing this disease. The frequency of only one HLA-antigen was found to differ significantly in the patients with FHC as compared with the normal subjects: HLA-A2 had a negative association with FHC (9.09% in FHC versus 47.47% in the control group; p〈0.01, Fisher's exact test with correction for the number of antigens studied) with an odds ratio of 0.11 (95% confidence limits 0.03 and 0.50). Other HLA antigens also showed a negative or positive association with FHC but not to a statistically significant level. Our results suggest a possible role for HLA genetic factors in the pathogenesis of FHC.