Table of Contents

Volume 1, Issue 5

  September/October 2009

  Pages 249 - 279

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EDITOR'S CORNER

Open Access Article

Skin endocrinology and nutrition

Christos C. Zouboulis, Renata Strumia and Jörg Reichrath
Page 249
http://dx.doi.org/10.4161/derm.1.5.10166
PDF




REVIEWS

Open Access Article

The skin as an endocrine organ

Christos C. Zouboulis
Pages 250 - 252
http://dx.doi.org/10.4161/derm.1.5.9499
Abstract | PDF

Through the definition of novel biological activities of hormones and their diversity on different skin cell types, it has become apparent that the skin itself possesses the capacity to generate several hormones and substances with hormone-like activity. These substances appear to act through paracrine, autocrine, intracrine and endocrine mechanisms to fulfill their pleiotropic effects. Also new is the knowledge that the skin can metabolize hormones and produce derivatives with potentially systemic activity. These findings point towards novel concepts in our understanding of the skin role and of its hormones as important players in homeostasis and disorders of the entire human organism. Finally, the scientists active in the field of Dermato-Endocrinology expect that their activities will exploit the pharmacological and therapeutic function of hormone mediators, their receptors and antagonists. The latter idea has already been realized for corticosteroids, androgens, estrogens, topical vitamin D analogues and retinoids which today have an established place in Clinical Dermatology.

Open Access Article

Cutaneous vitamin D synthesis versus skin cancer development: The Janus-faces of solar UV-radiation

Jörg Reichrath and Bernd Nürnberg
Pages 253 - 261
http://dx.doi.org/10.4161/derm.1.5.9707
Abstract | PDF

In scientific and public communities, there is an ongoing discussion how to balance between positive and negative effects of solar UV-exposure. On the one hand, solar UV-radiation represents the most important environmental risk factor for the development of non-melanoma skin cancer. Consequently, UV protection is an important measure to prevent these malignancies, especially in risk groups. Otherwise, approximately 90% of all vitamin D needed by the human body has to be formed in the skin through the action of UV-radiation. This dilemma represents a serious problem, for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer, bone diseases, autoimmune diseases, infectious diseases, cardiovascular diseases and hypertension has now been reported in a large number of investigative and epidemiologic studies. As a consequence, it has been assumed that for the general population in the US, Europe and other countries, the net effects of solar UV B-radiation on human health are beneficial at or near current levels. We and others have shown that strict sun protection causes vitamin D-deficiency/insufficiency and that detection and treatment of vitamin D-deficiency in sun deprived risk groups is of high importance. Although further work is necessary to define an adequate vitamin D-status and adequate guidelines for solar and artificial UV-exposure, it is at present mandatory that public health campaigns and sun protection recommendations to prevent skin cancer consider these facts. In this review, we analyze the present literature to help developing well-balanced recommendations on sun protection that ensure an adequate vitamin D-status. These recommendations will hopefully protect us against adverse effects of UV protection without significantly increasing the risk to develop UV-induced skin cancer.

Open Access Article

The relationship of diet and acne


Apostolos Pappas
Pages 262 - 267
http://dx.doi.org/10.4161/derm.1.5.10192
Abstract | PDF

Nutrition and diet are affecting overall health; that statement needs no particular citation as every nutritional textbook advocates for this. But can diet affect acne? Acne is one of the most common dermatological conditions, affecting millions of young adult worldwide. It is generally accepted that excess sebum, hormones, bacteria and hyper proliferation of follicular cells are the major etiologic factors for acne.

Open Access Article

Skin signs in anorexia nervosa


Renata Strumia
Pages 268 - 270
http://dx.doi.org/10.4161/derm.1.5.10193
Abstract | PDF

Anorexia nervosa (AN) is a significant cause of morbidity and mortality among adolescent females and young women. AN is associated with severe medical and psychological consequences, including death, osteoporosis, growth delay, and developmental delay. Skin signs are almost always detectable in severe AN and awareness of them may help in the early diagnosis of hidden AN. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and diuretics, and of the psychiatric morbidity. They include xerosis, lanugo-like body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrhoeic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, acquired striae distensae, acral coldness.
The most characteristic cutaneous sign of vomiting is Russell's sign (knuckle calluses). Symptoms due to laxative or diuretic abuse include adverse reactions by drugs. Symptoms due to psychiatric morbidity (artefacta) include the consequences of self-induced trauma. The role of the dermatologist in the management of eating disorders is to make an early diagnosis of the "hidden"signs of eating disorders in patients who tend to minimize or deny their disorder.





REPORTS

Open Access Article

Nutrition and nutritional supplementation: Impact on skin health and beauty

Nathalie Piccardi and Patricia Manissier
Pages 271 - 274
http://dx.doi.org/10.4161/derm.1.5.9706
Abstract | PDF

Skin acts as a natural barrier between internal and external environments thus plays an important role in vital biological functions such as protection against mechanical/chemical damages, micro-organisms, ultraviolet damage. Nutrition has a critical impact on strengthening skins' capabilities to fight against these multiple aggressions.

Nutritional deficiencies are often associated with skin health disorders, while diets can either positively or negatively influence skin condition. More recently, the concept of nutritional supplementation has emerged as a new strategy in the daily practice of dermatology as well as a complementary approach to topical cosmetics in the field of beauty. Focusing on human clinical data, this paper proposes to illustrate the link between skin health and nutrition and to exemplify the beneficial actions of nutritional supplementation in skin health and beauty.

Open Access Article

Probiotics for photoprotection

Audrey Guéniche, Philippe David, Batien Philippe, Blum Stephanie, Buyukpamukcu Elif and Castiel-Higounenc Isabelle
Pages 275 - 279
http://dx.doi.org/10.4161/derm.1.5.9849
Abstract | PDF

Specific strains of probiotic lactic acid bacteria, have been shown to beneficially influence the composition and/or metabolic activity of the endogenous microbiota and some of these strains have been shown to inhibit the growth of a wide range of enteropathogens. The first aim of using probiotics has been to improve the composition of the intestinal microbiota from a potentially harmful composition towards a composition that would be beneficial to the host

Beyond their capacity to influence positively the composition of the intestinal microbiota, several lines of evidence suggest that some probiotic bacteria can modulate the immune system both at the local and systemic levels thereby improving immune defense mechanisms and/or down-regulate immune disorders such as allergies or intestinal inflammation.

Skin reflects the general health status and aging. Different human trials widely suggest that probiotic supplementation might be useful in the management of atopic dermatitis.  Based on these properties it appears that, beyond the gut, probiotics might exert their benefit at the skin level.

In a randomized double blind placebo-controlled clinical trial, we investigated whether the probiotic bacteria Lactobacillus johnsonii NCC 533 (La1) could modulate the cutaneous immune homeostasis altered after solar-simulated UV exposure in humans. After, UV exposure to twice 1.5 MED, we demonstrated that La1 intake facilitated an earlier recovery of EC allostimulatory function. Thus, this clinical data strengthen the assumption that certain probiotics can contribute to modulate skin immune system leading to the preservation of the skin homeostasis. Altogether the data affords the possibility of designing new strategies based on a nutritional approach for the prevention of UV-induced damaging effects.