P8010Short-term and noninvasive assessment of antiaging effects of retinol0.3% and retinoic acid 0.025% using in vivo multiphoton microscopy

Emmanuelle Tancr�ede-Bohin, MD, L’Or�eal Research and Innovation - Centre deRecherche Bioclinique, Paris, France; Ana-Maria Pena, PhD, L’Or�eal Research andInnovation, Aulnay sous Bois, France; Raquel Dalmaschio, PhD, L’Or�eal Researchand Innovation - Centre de Recherche Bioclinique, Paris, France; S�ebastienBrizion, L’Or�eal Research and Innovation, Aulnay sous Bois, France; SteeveVictorin, L’Or�eal Research and Innovation - Centre de Recherche Bioclinique,Paris, France; Th�er�ese Baldeweck, PhD, L’Or�eal Research and Innovation, Aulnaysous Bois, France

We previously showed that, in an occlusive patch test initially developed forassessing the effects of topical retinoids on human skin, in vivo multiphotonmicroscopy (MPM), a recent noninvasive skin imaging technique, could be used forassessment as an alternative to invasive biopsies. The objective of this new studywasto confirm these results with a larger cohort of subjects. Accordingly, a randomized,double-blind, monocentre comparative study was performed involving 20 volun-teers, aged 50-65 years, with photodamaged skin. Two products, retinol (RO, retinol0.3%, Skinceuticals) and retinoic acid 0.025% (RA, Retacnyl, Galderma)were appliedto the dorsal side of the forearm under occlusive patches for 12 days, as previouslydescribed. A patch alone was applied to a third area as control. Evaluation of the 3areas was performed at D0, D12, (end of the occlusion period), D18 and D32 usingMPM and other noninvasive techniques including colorimetry. The followingquantitative parameters were extracted from MPM images using recently developed3D image processing tools: epidermal thickness, normalized area of the dermoepi-dermal junction (DEJ), melanin density. Main results (P\.05, with moderate to verystrong effect sizes) are: (1) a thickening of the epidermis on retinoid treated areas atD12, D18, and D32 with RO and at D12, D18 with RA versus baseline and versuscontrol, with RO[RA at D32. Cutaneous irritation which could be responsible ofedema was noted in 19 out of 20 RO-treated areas, and in 14 out of 20 RA-treatedareas at D12, but resolved within a few days and could not be responsible ofepidermal thickening observed at D32; (2) an increase in the DEJ undulation at D32on RO treated area and at D12 on RA treated area versus baseline and versus control,with RO[RA at D32; (3) a decrease in melanin density at D12, D18, and D32 on ROtreated area and at D12 on RA treated area versus baseline, associated with a visiblewhitening. This study shows that such short term protocol combined with in vivomultiphoton microscopy allows some cutaneous effects induced by retinoids to bedetected, followed over time posttreatment, and compared noninvasively.

MAY 201

cial support: None identified.

Commer

P8348Topically applied human like epidermal growth factors in aging skin:Randomized, placebo controlled trail by evaluating skin physiology andskin surface parameters

Meike Streker, PhD, University of Hamburg, Hamburg, Germany; MartinaKerscher, MD, University of Hamburg, Hamburg, Germany

Background: Skin aging is mediated by the effect of both intrinsic and extrinsic aginghaving biochemical and molecular pathways. Epidermal growth factors areregulatory proteins that mediate signaling pathways between and within cells anddirectly initiate activity on skin repair. According to their role in skin repair there is abig interest regarding their role in skin rejuvenation.

Methods: In this randomized, half-side, placebo controlled trial of 8 weeks’ duration,30 healthy females aged 30 to 65 years were included. Serum and vehicle wereapplied twice a day at 1 side of the face; allocation of treatment side was at random.Efficacy was assessed by using a 3D surface imaging analysis systems, as well asbiophysical measurements for skin physiology and surface parameters.

Results: Clinical evaluation shows a clear improvement in skin roughness andwrinkle volume. Moreover skin thickness increased and density and skin elasticityimproved significantly.

Conclusion: EGF serum improves age-related skin changes as assessed clinically andby biophysical measurements. This might be caused by a stimulation of epidermalcells and a neosynthesis of collagen and elastin. Moreover, treatment with EGF isaccompanied with a high patients’ satisfaction and a high tolerability.

cial support: None identified.

Commer

4

ARTS, HISTORY, AND HUMANITIES OFDERMATOLOGY

P8171Anthropodermic bibliopegy: Lessons from a different sort of dermato-logic text

Navya Nambudiri, MBBS, Cochin Cooperative Medical College, Cochin, Kerala,India, India; Vinod Nambudiri, MD, MBA, Harvard Combined DermatologyProgram, Brookline, MA, United States

The practice of anthropodermic bibliopegy—the use of human skin for the bindingof books and manuscripts—dates back several centuries. Examples of anthropo-dermic texts have been reported from nations in Europe, Asia, and the Americassince the late 16th century. The selection of individuals whose skin would be used inthe process ranged from authors and scientists arranging for willing donation upontheir death to the corpses of criminals and the infirm. Several texts from the 17th,18th, and 19th centuries bound in tanned, leatherized human skin are preserved andheld in private and academic collections around the world. The preservation of suchtexts in modern libraries provides a unique and intriguing series of works from bothan academic and humanistic standpoint from which dermatologists, historians, andanthropologists can learn. We investigated an anthropodermic book in thecollection of the Houghton Library at Harvard University dating to the mid-19thcentury. The text is a French manuscript from the 1880s that focuses on the afterlifeand theories of the human soul. The author of the text, in an inscription along withthe book, stated his belief that the subject of the manuscript warrantedjuxtaposition with a binding of human skin. On examination of the bookbinding,numerous follicular ostia are clearly visible and consistent with the author’sdescription. While focal areas of dark pigmentation are present on the binding,these do not show any melanocytic pattern on epiluminescence microscopy, andare more consistent with variations in the literal ‘‘skin tanning’’ process. Two otherworks in the collection of the Harvard University libraries which are putativeantropodermic texts dating from 16th century Spain and France were alsoexamined. While an uncommon undertaking, anthropodermic bibliopegy repre-sents an historical practice of interest to dermatologists and provides insights intothe preservation of and fascination with human skin over the last several centuries.

cial support: None identified.

Commer

P8499How common is ‘‘common?’’ The frequency and precision of the terms‘‘common’’ and ‘‘rare’’ in the dermatologic literature

Lucy Fu, Department of Dermatology, Emory University School of Medicine,Atlanta, GA, United States; Benjamin Stoff, MD, Department of Dermatology,Emory University School of Medicine, Atlanta, GA, United States; RobertSwerlick, MD, Department of Dermatology, Emory University School ofMedicine, Atlanta, GA, United States; Suephy Chen, MD, MS, Department ofDermatology, Emory University School of Medicine, Atlanta, GA, United States

Background: Academic medical journals are the primary information source forhealth care providers and form the foundation of patient education toward the goalof shared decision making. Readers may assume that language used to convey suchinformation is objective and precise. However, scrutiny of medical language in manydomains, particularly related to probability, reveals subjectivity and imprecision.This scrutiny has not been applied to the dermatologic literature.

Objective: To establish the frequency of use of terms of probability, ‘‘common’’ and‘‘rare,’’ in recent dermatologic literature, to determine whether use of these termsare specified by a precise number or numeric range, and to compare results toliterature from internal medicine.

Methods: All peer-reviewed articles spanning 5 years (Jan 2008 e Dec 2012) werereviewed from 2 journals: Archives of Dermatology (AD) and Archives of InternalMedicine (AIM)— totaling 318 and 840 manuscripts, respectively. The PDF file ofeach article was searched for the terms ‘‘common’’ and ‘‘rare.’’ Each occurrence wasdocumented and analyzed for (a) reference to a specific numeric reference value, (b)whether the specific value was stated within the paper or externally in a citation,and (c) the range of values (probabilities) that the word was intended to represent.Probabilities and percentages were converted to decimals for consistency. Uses aspart of a title or other proper phrase were excluded.

Results: There were 713 instances of ‘‘common’’ (2.24 per paper) in AD; 1647 (1.96per paper) in AIM. There were 204 instances of ‘‘rare’’ (0.64 per paper) in AD; 273(0.33 per paper) in AIM. Only 174 of the 713 instances (24.4%) of ‘‘common’’ in ADhad a numeric reference; 377 of 1647 (22.9%) in AIM. Only 14 of 204 (6.9%)instances of ‘‘rare’’ in AD had a numeric reference; 26 of 273 (9.5%) in AIM. Therange of values that ‘‘common’’ represented was 4 3 10-6 e 1; which overlappedwith ‘‘rare,’’ 10-3 e 0.3.

Discussion: There appears to be substantial subjectivity and imprecision in the useof the terms ‘‘common’’ and ‘‘rare’’ in the academic journals in dermatology andinternal medicine. The majority of uses did not refer to specific numeric ranges. Forthose that did, ranges were broad and overlapping (ie, common and rare referred tosimilar frequencies). These findings raise concerns about rhetoric in scientificmedical writing.

cial support: None identified.

Commer

J AM ACAD DERMATOL AB27