Strategies for assessing the degree of photodamage to skin: a systematic review of the literature

Please cite this article as: Trivisonno, A.; Rossi, A.; Monti, M.; Di Nunno, D.; Desouches, C.; Cannistra, C.; Toietta, G. Facial skin rejuvenation by autologous dermal microfat transfer in photoaged patients: Clinical evaluation and skin surface digital profilometry analysis. Journal of Plastic Reconstructive and Aesthetic Surgery 2017, 70, 1118-1128. DOI: 10.1016/j.bjps.2017 http://www.sciencedirect.com/science/article/pii/S1748681517301559 M A N U S C R I P T A C C E P T E D M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 2 SUMMARYCumulative, long-term exposure to solar ultraviolet radiation promotes premature skin aging characterized by wrinkle formation and reduced skin elasticity. In this study, we assessed whether microfat transfer could improve dermal and subcutaneous tissue thickness loss associated with photoaging. Twenty one patients affected by facial photoaging (photodamage grade II-IV; age range 35-62 years; 19 females, 2 males; all of Caucasian origin) were treated using minimally-invasive autologous dermal white fat transfer harvested with a recently designed microcannula. The results were determined by clinical assessment, patient self-evaluation and quantified by the Antera 3D ® dermal digital device for non-invasive, objective, reliable and accurate assessment of facial skin texture, color and wrinkle characteristics. Compared with the pretreatment condition, the increment in soft tissue volume and improvement in skin quality and texture was assessed by a dermatologist after treatment. In addition, instrumental evaluation by digital skin profilometry of the treated areas revealed:a 41% reduction in average wrinkle depth (7.29 ± 1.04 x 10 -2 mm pre-treatment vs. 4.31 ± 1.16 x 10 -2 mm at 90 days post-treatment; p < 0.001), improved skin texture, more homogeneous and uniform skin color and declined facial hemoglobin and melanin concentrations. The majority of patients (above 90%) reported improvements in self-perception. No significant complications were reported throughout the study. In conclusion, by using digital profilometry analysis as an objective and innovative tool to determine the outcome of treatment, we demonstrated that autologous microfat transfer is a safe and well-tolerated procedure with measurable beneficial effects on facial skin aging.

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“…33 In fact, there is no broad consensus on the use of a validated facial grading scale M A N U S C R I P T…”

Section: Discussionmentioning

confidence: 99%

Facial skin rejuvenation by autologous dermal microfat transfer in photoaged patients: Clinical evaluation and skin surface digital profilometry analysis

Trivisonno¹,

Rossi²,

Monti³

et al. 2017

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…[1][2][3][4] Skin cancers are among the most dangerous [cutaneous malignant melanoma (CMM)] and the most numerous [basal cell carcinoma (BCC), actinic keratosis (AK) and invasive squamous cell carcinoma (SCC)] of all neoplasms in the caucasian population worldwide. [5][6][7] Furthermore, a notable increase in the incidence of these cancers is indicated.…”

Section: Discussionmentioning

confidence: 99%

“…26,27 The negative effects of UVR and their strong association with cutaneous malignancies have led to the official recognition of UVR as an environmental carcinogen. [1][2][3][4] On the other hand, there are psychological effects, with many people reporting enhanced wellbeing after sun exposure, and also social influences, with 20th and 21st century fashion in some cultures dictating that a suntan is attractive and a sign of increased socioeconomic status. 28 …”

Section: Biological Effects Of Ultraviolet Radiationmentioning

confidence: 99%

Photoprotection in immunocompetent and immunocompromised people

Surber

Ulrich

Hinrichs³

et al. 2012

British Journal of Dermatology

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SummaryUltraviolet radiation (UVR) exposure from the sun and artificial UV sources has been widely acknowledged as the major culprit for skin cancer and premature skin ageing. Skin cancers are among the most dangerous (cutaneous malignant melanoma) and the most numerous (basal cell carcinoma, actinic keratosis and invasive squamous cell carcinoma) of all neoplasms in the caucasian population worldwide. Skin cancers therefore have a significant impact on public health and healthcare costs, and will continue to do so. It is obvious that adequate photoprotection -seeking shade, wearing protective clothing and using sunscreens -is the key to reducing the harmful effects of UVR in both immunocompetent and immunocompromised people. This article provides background information on UVR, photoprotection (including the concept of topical sunscreen formulations), associated concerns regarding efficacy and safety, and behavioural and educational aspects of photoprotection and skin cancer prevention in immunocompetent and immunocompromised people. Certain persistent misconceptions and mistakes regarding photoprotection are also addressed.Ultraviolet radiation (UVR) exposure from the sun and artificial UV sources has been widely acknowledged as the major culprit for skin cancer and premature skin ageing.

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“…In case of extrinsic skin aging, these structural changes can also be observed [7]. Especially the accumulation of elastin in the dermis represents the degree of extrinsic skin aging [8,9]. Solar radiation is the most important environmental factor causing skin aging [10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Impact of Body Site, Age, and Gender on the Collagen/Elastin Index by Noninvasive in vivo Vertical Two-Photon Microscopy

Czekalla

Schönborn

Döge

et al. 2017

Skin Pharmacol Physiol

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Background/Aims: Extrinsic and intrinsic skin aging is subject to constant remodeling and degradation processes, primarily in components of the extracellular matrix. While collagen fibers thin out during the aging process, the amorphous elastin fibers accumulate. These are essential formative components of the dermis. So far, these processes have been detected in vertical histological sections of invasive biopsies and recently in noninvasive horizontal scans. Methods: In this pilot study, a modified noninvasive 2-photon microscope was applied to measure the collagen/elastin index of skin in vivo. The obtained images permit an immediate vertical survey and allow a conclusion on the dermal composition at once. The collagen/elastin index was quantified by the second harmonic to autofluorescence aging index of dermis (SAAID) depending on volunteers' age (18-66 years), gender, and body area. Results: The highest SAAID was measured at the volar forearm as compared to the abdominal SAAID, which was significantly lower (p < 0.05). The gluteal region showed the significantly lowest SAAID (p < 0.05). The SAAID in female skin was higher compared to male skin and decreased with increasing age. Conclusion: These effects are to be considered in subsequent studies to be able to specifically detect and evaluate influences.

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Strategies for assessing the degree of photodamage to skin: a systematic review of the literature

Cited by 38 publications

References 45 publications

Facial skin rejuvenation by autologous dermal microfat transfer in photoaged patients: Clinical evaluation and skin surface digital profilometry analysis

Facial skin rejuvenation by autologous dermal microfat transfer in photoaged patients: Clinical evaluation and skin surface digital profilometry analysis

Photoprotection in immunocompetent and immunocompromised people

Impact of Body Site, Age, and Gender on the Collagen/Elastin Index by Noninvasive in vivo Vertical Two-Photon Microscopy

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