No description available.

Acne is an extremely common condition, affecting almost 80% of adolescents and young adults. It is an inflammatory disease, characterised by comedones, papules, pustules and sometimes cysts. Factors causing acne include enhanced sebum excretion, hypercornification of the sebaceous duct, ductal coloniazation with Propionibacterium acnes and production of inflammation (Gollnick & Cunliffe, 2003:1). Because of the widespread use of topically applied antimicrobial agents in the treatment of inflammatory acne, resistance of disease-related micro-organisms developed. Therefore new strategies for the treatment of moderate inflammatory acne are necessary. Nicotinamide is a new approach to topical treatment of moderate inflammatory acne without the development of resistant micro-organisms (Otte et al., 2005:257). Using the skin as an alternative route for the administration of nicotinamide for the treatment of acne, may be beneficial. When nicotinamide permeates through the skin, it is directly delivered to the dermis, the place where action is needed and better results can thus be expected after the treatment has started. Another benefit is that smaller amounts of the drug are absorbed systemically with decreased adverse reactions. Unfortunately, using the skin as an alternative route for administering drugs (transdermal drug delivery), has numerous limitations. One of these limitations is the barrier function of the skin (Naik et al., 2000:319). Because of the skin's outstanding ability to protect the body against unwanted substances from its surroundings, it is necessary to use methods to enhance drug penetration through the skin. A new technology, named Pheroid™ technology, was used in this study to enhance penetration through the skin. This technology is based on the use of vesicular structures with no phospholipids or cholesterol to enhance penetration (Grobler et al., 2008:283). The aim of this study was to formulate four different semi-solid formulations with nicotinamide as the active ingredient, and to determine which of the formulations deliver nicotinamide best to the target site. Stability tests over a six months period were also performed on the different formulations. A 3% nicotinamide cream, with and without Pheroid™ vesicles, and a 3% nicotinamide gel, with and without Pheroid™ vesicles, were formulated. / Thesis (M.Sc. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2010.

Acne is an extremely common condition, affecting almost 80% of adolescents and young adults. It is an inflammatory disease, characterised by comedones, papules, pustules and sometimes cysts. Factors causing acne include enhanced sebum excretion, hypercornification of the sebaceous duct, ductal coloniazation with Propionibacterium acnes and production of inflammation (Gollnick & Cunliffe, 2003:1). Because of the widespread use of topically applied antimicrobial agents in the treatment of inflammatory acne, resistance of disease-related micro-organisms developed. Therefore new strategies for the treatment of moderate inflammatory acne are necessary. Nicotinamide is a new approach to topical treatment of moderate inflammatory acne without the development of resistant micro-organisms (Otte et al., 2005:257). Using the skin as an alternative route for the administration of nicotinamide for the treatment of acne, may be beneficial. When nicotinamide permeates through the skin, it is directly delivered to the dermis, the place where action is needed and better results can thus be expected after the treatment has started. Another benefit is that smaller amounts of the drug are absorbed systemically with decreased adverse reactions. Unfortunately, using the skin as an alternative route for administering drugs (transdermal drug delivery), has numerous limitations. One of these limitations is the barrier function of the skin (Naik et al., 2000:319). Because of the skin's outstanding ability to protect the body against unwanted substances from its surroundings, it is necessary to use methods to enhance drug penetration through the skin. A new technology, named Pheroid™ technology, was used in this study to enhance penetration through the skin. This technology is based on the use of vesicular structures with no phospholipids or cholesterol to enhance penetration (Grobler et al., 2008:283). The aim of this study was to formulate four different semi-solid formulations with nicotinamide as the active ingredient, and to determine which of the formulations deliver nicotinamide best to the target site. Stability tests over a six months period were also performed on the different formulations. A 3% nicotinamide cream, with and without Pheroid™ vesicles, and a 3% nicotinamide gel, with and without Pheroid™ vesicles, were formulated. / Thesis (M.Sc. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2010.

Acne inversa (AI), in der englischen Literatur auch als Hidradenitis suppurativa (HS) bezeichnet, ist eine chronische, entzündliche und schmerzhafte Hautkrankheit, die re- zidivierende Knoten, Fisteln, Abszesse und Vernarbungen vor allem in den Intertrigines verursacht. Es zeigen sich bei Betroffenen neben schwerwiegenden somatischen, auch psychologische Komorbiditäten. Das Ziel der vorliegenden wissenschaftlichen Arbeit war es, an einem an AI erkrankten Patientenkollektiv prospektiv systematisch Komor- biditäten, Lebensqualität und psychische Verfassung zu analysieren und auf Korrelatio- nen zu untersuchen, um daraus Handlungsempfehlungen abzuleiten. Mittels dermatolo- gischer und psychologischer Fragebögen mit Fragebögen zur Lebensqualität wurden pseudonymisierte Daten von 110 Studienteilnehmern gewonnen, statistisch aufbereitet und ausgewertet. Es konnte eine statistisch signifikante Korrelation der Visuellen Ana- logskala Schmerz (VAS-Schmerz) mit dem Hospitality Anxiety Depression Scale (HADS) bzw. dem Skindex-29 aufgezeigt werden. Der Zeitraum zwischen Erstsymp- tomen und Diagnosestellung der AI erfolgte im Median nach 6 Jahren. Weiterhin erfuh- ren AI-Patienten häufig eine nicht leitliniengerechte Therapie und zeigten psychische Belastungen anhand von Schlafstörungen, besonderen Stresssituationen und eine damit einhergehende Verschlechterung der AI. Body Mass Index (BMI), „Waist-to-hip-ratio“ und Bluthochdruck waren oftmals erhöht. Die VAS-Schmerz-Skala könnte ergänzend als Instrument zur ersten Quantifizierung der Krankheitsschwere angewandt werden. Internisten, Chirurgen, Allgemeinmediziner, Gynäkologen und Urologen sollten mit der Dermatose AI besser vertraut gemacht werden, um den Patienten eine schnellere, leitli- niengerechte Therapie zukommen zu lassen. AI-Patienten benötigen neben der dermato- logischen eventuell eine psychologische bzw. psychiatrische Therapie, um das Stressni- veau zu senken, was sich auf die Lebensqualität positiv auswirken könnte. / Hidradenitis suppurativa (HS) is a chronic, inflammatory and painful skin disease that causes recurrent nodules, fistulas, abscesses and scarring, especially in the intertriginous areas. Besides serious somatic comorbidities a considerable psychological burden is observed in affected persons. The aim of the present scientific work was to systemati- cally analyse comorbidities, quality of life and psychological conditions of a group of patients suffering from HS and to investigate correlations in order to derive recommen- dations for action. By means of dermatological and psychological questionnaires pseu- donymized data of 110 study participants were prospectively collected, statistically pro- cessed and evaluated. A statistically significant correlation of the Visual Analog Scale for Pain (VAS pain) with the Hospitality Anxiety Depression Scale (HADS) and the Skindex-29 could be shown. The median time between first symptoms and diagnosis of HS was 6 years. In addition, HS patients often experienced a therapy that did not follow the guidelines and showed psychological stress due to sleep disorders, special stress situations and the associated deterioration of HS. Body mass index (BMI), waist-to-hip- ratio and high blood pressure were often detected. The VAS pain could be used as a complementary tool for initial quantification of disease severity. Internists, surgeons, general practitioners, gynecologists and urologists should be better familiarized with HS in order to provide patients with a faster, guideline-driven therapy. In addition to derma- tological therapy, HS patients may require a psychological or psychiatric therapy to reduce their stress level, which could have a positive effect on the quality of life.

No description available.

Trotz der ursprünglichen Bezeichnung der Acne inversa als "hidrosadénite phlegmoneuse", die eine inflammatorische Fehlfunktion der apokrinen Schweißdrüsen impliziert, geriet die Rolle der Schweißdrüsen hinsichtlich der Pathogenese der AI in Vergessenheit. Ziel dieser Studie war die Evaluierung der Rolle der Schweißdrüsen im Hinblick auf die für die AI charakteristischen proinflammatorischen Mediatoren. Zu diesem Zweck wurden gravimetrische Schweißmessungen, Multiplex-Zytokin-Assays von Schweißproben, sowie immunfluoreszenzoptische Zytokin-/Chemokin-Untersuchungen von läsionaler AI-Haut durchgeführt. Die gravimetrische Untersuchung von 17 AI-Patienten zeigte, dass AI nicht mit Hyperhidrose assoziiert ist. Allerdings scheinen sich AI-Patienten durch ihr Schwitzen im Vergleich zu einer gesunden Kontrollgruppe subjektiv stärker beeinträchtigt zu fühlen. Unsere Daten zeigen eine komplexe proinflammatorische Signatur im AI-Schweiß, die durch eine signifikant erhöhte Konzentration von Monozyten-Chemoattraktant-Protein-1 (MCP-1), Interleukin-8 (CXCL8) und Interferon-γ gekennzeichnet ist. Passend dazu konnten wir eine erhöhte Expression dieser Mediatoren in apokrinen Schweißdrüsen läsionaler AI-Haut nachweisen. Diese Ergebnisse werfen ein neues Licht auf die proinflammatorische Kapazität apokriner Schweißdrüsen bei AI, was zu einem Überdenken der Rolle der Schweißdrüsen im Hinblick auf die Pathogenese der AI führen kann. / The role of sweat glands in hidradenitis suppurativa has been largely neglected, despite the fact that its original designation, as “hidrosadénite phlegmoneuse”, implied an inflammatory malfunction of the apocrine sweat glands as the underlying pathogenic driver. The aim of this study was to evaluate the role of apocrine sweat glands with respect to the proinflammatory environment of hidradenitis suppurativa. Therefore, gravimetric assessment and multiplex cytokine assays from sweat obtained from patients with hidradenitis suppurativa along with immunofluorescence cytokine/chemokine analysis of lesional apocrine glands-bearing hidradenitis suppurativa skin were performed. Gravimetric assessment of 17 patients with hidradenitis suppurativa revealed that the condition is not associated with hyperhidrosis. However, patients seem to be more affected by subjective sweating. The current data identified a complex proinflammatory signature in hidradenitis suppurativa sweat characterized by a significant upregulation of monocyte chemoattractant protein-1, interleukin-8 (CXCL8), and interferon-γ. In agreement with this, a strong in situ expression of these mediators could be observed in apocrine glands of lesional hidradenitis suppurativa skin. These data shed new light on the proinflammatory capacity of apocrine sweat glands in hidradenitis suppurativa, which may lead to reconsideration of the role of sweat glands in hidradenitis suppurativa pathology.

A acne vulgar é uma das doenças cutâneas mais comuns, apresentando como um de seus fatores fisiopatológicos primários a colonização pelo microrganismo Propionibacterium acnes. Atualmente, têm-se buscado terapias alternativas para o combate ao P. acnes, destacando-se alguns ácidos graxos, como o ácido laúrico (LA). O LA é uma molécula pouco solúvel em água, sendo possível sua incorporação em lipossomas. Os lipossomas apresentam capacidade de encapsulação/ liberação de ativos e impedem a desidratação da pele, tornando-se ingredientes inovadores na área de cosméticos. Foram preparados lipossomas de dipalmitoilfosfatidilcolina (DPPC) contendo diferentes concentrações de LA, que variaram de 0 a 50% da concentração total em mol, em quatro pHs: 9,0, 7,4, 5,0 e 3,0. Nestes pHs o estado de protonação do LA muda variando de 0 a -1. Os lipossomas foram extrusados por filtros com poros de 100 nm de diâmetro visando à obtenção de vesículas unilamelares grandes (LUV). As LUV foram caracterizadas quanto a sua estabilidade em condições de prateleira, temperatura de transição de fase da bicamada, encapsulamento no interior aquoso, liberação do LA, difusão das vesículas na pele e seus aspectos morfológicos foram caracterizados por espalhamento de raios-X a baixo ângulo (SAXS) e crio-microscopia eletrônica de transmissão. Estudos de estabilidade mostraram que independentemente da concentração de LA, as formulações são mais estáveis em pHs mais altos, quando LA está em sua maioria na forma de laurato. Os experimentos de DSC revelaram que em pHs 3,0 e 5,0 e concentrações maiores de LA, a interação deste ácido graxo com as bicamadas é favorecida, havendo um aumento da temperatura de transição de fase (Tm) e diminuição da cooperatividade. Análises de taxa de incorporação de sondas hidrofílicas confirmaram a presença de um compartimento aquoso interno para as vesículas de DPPC:LA. O LA conseguiu permear a pele no período avaliado e pouco LA foi liberado das vesículas em condições de temperatura ambiente. A morfologia das LUV se mostrou bem diferente da esperada e se observaram vesículas com mais de uma bicamada e outros formatos que não o esférico. Estes resultados podem auxiliar na otimização das condições para uma formulação que poderá ser usada no tratamento da acne, aumentando a eficácia do LA no sítio alvo. / Acne vulgaris is one of the most common skin diseases, presenting as one of its causes the microorganism Propionibacterium acnes colonization. Currently, it has been sought alternatives therapies against P. acnes, especially some fatty acids, like the lauric acid (LA). LA is a molecule with low water solubility, allowing its incorporation in liposomes. Liposomes have encapsulation/release capacity of drugs and promote skin lipids regeneration, becoming an innovative ingredient in cosmetics area. Dipalmitoylphosphatidylcholine (DPPC) vesicles containing different LA concentrations were prepared at pHs: 9.0, 7.4, 5.0 and 3.0. At these pHs the LA protonation changes and its charge varies from 0 to -1. The vesicles were extruded through filters containing pores of 100 nm to obtain large unilamellar vesicles (LUV) that were characterized for stability in shelf conditions, bilayer phase transition temperature, aqueous internal compartment encapsulation, LA release and in vitro skin permeation. Its morphological features were characterized by small angle X-ray scattering (SAXS) and cryo-electron transmission microscopy. Stability assays showed that, regardless LA concentration, formulations were more long-term stable in higher pHs, when LA is mostly in the form of laurate. The differential scanning calorimetry, DSC, experiments showed that, at pHs 3.0 and 5.0 and higher LA concentrations, the interaction between the bilayer and LA is favored, increasing phase transition temperature (Tm) and reducing cooperativity. Incorporation of hydrophilic probes confirmed the presence of an internal aqueous compartment in DPPC:LA vesicles. The LA managed to permeate the skin on the period evaluated and, in ambient conditions, low LA concentration was released from the vesicles. LUV containing more than one bilayer and non-spherical structures were observed. The obtained results may help in the optimization of the conditions for a formulation that can be used in the treatment of acne and improving the effectiveness of LA delivery to the target site.

Introdução: As cicatrizes de acne representam um problema difícil para médico e paciente. Os tratamentos das cicatrizes atróficas, embora numerosos, têm sido dificultados pelas inadequadas respostas clínicas e prolongados períodos de pós-opératório. O tratamento com os lasers não-ablativos tem mostrado significante efeito na remodelação do colágeno com mínimos efeitos colaterais pós-tratamento. Objetivos: Avaliar a eficácia e segurança do laser Nd:Yag 1064 nm no tratamento das cicatrizes de acne. Casuística e Método: Doze patientes (fototipo II-V) apresentando cicatrizes de acne, moderadas a severas, foram submetidos a cinco sessões mensais com o laser Nd:Yag 1064 nm (120J/cm2, pulso triplo, 7.0/7.0/7.0 milisegundos de duração e intervalo entre os pulsos de 75 milisegundos). Os pacientes foram avaliados por três dermatologistas, através de fotografias digitais que foram tiradas antes, no meio do tratamento e 6 meses após o último tratamento realizado. Avaliações histológicas de biópsias cutâneas foram obtidas antes do tratamento e 1 mês após a última sessão. A quantificação das fibras colágenas e elásticas, por área, antes e depois do tratamento foi feita pela morfometria com a análise de imagens analisadas por computador (método digital). A satisfação do patiente usando uma escala de graduação foi obtida no final do estudo. Resultados: Melhora suave a moderada foi observada depois dos cinco tratamentos na maioria dos pacientes estudados. A avaliação objetiva comparando as fotografias antes e depois do tratamento revelou melhora cosmética visível em 11 dos pacientes. A quantificação das fibras colágenas pela morfometria mostrou aumento delas após o tratamento, com significância estatística. Os efeitos colaterais foram limitados a um eritema transitório e suave, além de um aumento na sensibilidade da pele logo após o procedimento. Conclusões: O laser Nd:Yag 1064 nm é uma técnica não-ablativa, segura e eficaz para o tratamento das cicatrizes de acne. Ele pode ser usado em peles escuras e se constitui numa alternativa para pacientes que não desejam passar por um longo período de recuperação e estão satisfeitos com resultados menores que os obtidos com as técnicas de resurfacing / troduction: Post-acne scarring is a very distressing and difficult problem for both physicians and patients. Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has shown significant effect on dermal collagen remodeling with minimal posttreatment side effects. Objectives: To study the efficacy and safety of the nonablative 1064 nm neodymium: yttrium-aluminum-garnet (Nd:Yag) laser in the treatment of facial atrophic scars: a histological and clinical analysis. Casuistry and Method: Twelve subjects (skin phototypes II-V) with mild to severe atrophic facial acne scars received five-monthly treatment with 1064 nm Nd:Yag laser (120 J/cm², triple pulse, 7.0/7.0/7.0- millisecond pulse duration, 75-millisecond delay). Patients were evaluated by using digital photography that were taken before treatment, in the middle of the treatment and 6 months after the last treatment was performed. Histologic evaluations of cutaneous biopsies were obtained before treatment and 1 month after the last session.The quantification of collagen and elastic fibers, per area, was carried out through the use of morphometry before and after the treatment, with image analysis by computer (digital method). Patient satisfaction surveys and clinical assessment by three dermatologists using a standard grading scale were obtained at the end of the study. Results: Mild to moderate clinical improvement was observed after the series of five treatments in the majority of patients studied. Objective assessment of scar improvement by comparing baseline to posttreatment photographs reported visible cosmetic improvement in eleven patients. All patients were satisfied with the treatment. The collagen quantification, per morphometry, showed a statistically significant increase after treatment. Side effects were limited to mild transient erythema and an increase in skin sensibility after the procedure. Conclusions: The 1064 nm Nd:Yag laser is a safe and effective nonablative modality for the treatment of atrophic scars. It can be safely used in darker skin. It could be an alternative in pacients who do not want a long downtime recovery and are satisfied with less significant results than those obtained by the resurfacing techniques

Introdução: As cicatrizes de acne representam um problema difícil para médico e paciente. Os tratamentos das cicatrizes atróficas, embora numerosos, têm sido dificultados pelas inadequadas respostas clínicas e prolongados períodos de pós-opératório. O tratamento com os lasers não-ablativos tem mostrado significante efeito na remodelação do colágeno com mínimos efeitos colaterais pós-tratamento. Objetivos: Avaliar a eficácia e segurança do laser Nd:Yag 1064 nm no tratamento das cicatrizes de acne. Casuística e Método: Doze patientes (fototipo II-V) apresentando cicatrizes de acne, moderadas a severas, foram submetidos a cinco sessões mensais com o laser Nd:Yag 1064 nm (120J/cm2, pulso triplo, 7.0/7.0/7.0 milisegundos de duração e intervalo entre os pulsos de 75 milisegundos). Os pacientes foram avaliados por três dermatologistas, através de fotografias digitais que foram tiradas antes, no meio do tratamento e 6 meses após o último tratamento realizado. Avaliações histológicas de biópsias cutâneas foram obtidas antes do tratamento e 1 mês após a última sessão. A quantificação das fibras colágenas e elásticas, por área, antes e depois do tratamento foi feita pela morfometria com a análise de imagens analisadas por computador (método digital). A satisfação do patiente usando uma escala de graduação foi obtida no final do estudo. Resultados: Melhora suave a moderada foi observada depois dos cinco tratamentos na maioria dos pacientes estudados. A avaliação objetiva comparando as fotografias antes e depois do tratamento revelou melhora cosmética visível em 11 dos pacientes. A quantificação das fibras colágenas pela morfometria mostrou aumento delas após o tratamento, com significância estatística. Os efeitos colaterais foram limitados a um eritema transitório e suave, além de um aumento na sensibilidade da pele logo após o procedimento. Conclusões: O laser Nd:Yag 1064 nm é uma técnica não-ablativa, segura e eficaz para o tratamento das cicatrizes de acne. Ele pode ser usado em peles escuras e se constitui numa alternativa para pacientes que não desejam passar por um longo período de recuperação e estão satisfeitos com resultados menores que os obtidos com as técnicas de resurfacing / troduction: Post-acne scarring is a very distressing and difficult problem for both physicians and patients. Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has shown significant effect on dermal collagen remodeling with minimal posttreatment side effects. Objectives: To study the efficacy and safety of the nonablative 1064 nm neodymium: yttrium-aluminum-garnet (Nd:Yag) laser in the treatment of facial atrophic scars: a histological and clinical analysis. Casuistry and Method: Twelve subjects (skin phototypes II-V) with mild to severe atrophic facial acne scars received five-monthly treatment with 1064 nm Nd:Yag laser (120 J/cm², triple pulse, 7.0/7.0/7.0- millisecond pulse duration, 75-millisecond delay). Patients were evaluated by using digital photography that were taken before treatment, in the middle of the treatment and 6 months after the last treatment was performed. Histologic evaluations of cutaneous biopsies were obtained before treatment and 1 month after the last session.The quantification of collagen and elastic fibers, per area, was carried out through the use of morphometry before and after the treatment, with image analysis by computer (digital method). Patient satisfaction surveys and clinical assessment by three dermatologists using a standard grading scale were obtained at the end of the study. Results: Mild to moderate clinical improvement was observed after the series of five treatments in the majority of patients studied. Objective assessment of scar improvement by comparing baseline to posttreatment photographs reported visible cosmetic improvement in eleven patients. All patients were satisfied with the treatment. The collagen quantification, per morphometry, showed a statistically significant increase after treatment. Side effects were limited to mild transient erythema and an increase in skin sensibility after the procedure. Conclusions: The 1064 nm Nd:Yag laser is a safe and effective nonablative modality for the treatment of atrophic scars. It can be safely used in darker skin. It could be an alternative in pacients who do not want a long downtime recovery and are satisfied with less significant results than those obtained by the resurfacing techniques

<p><strong>Introduction:</strong> Today creativity is a very crucial part in many organizations. Media companiesneed to be creative in order to satisfy customers and therefore there's a need to constantlydevelop the products and services as the competition gets harder and the demandsincreases. The leadership has an important role when it comes to motivating the creativityamong employees.</p><p><strong>Purpose:</strong> The purpose of this thesis was to explore how the leadership looks like in anorganization where creativity is very important. We wanted to enhance our knowledge abouthow leadership affects the creative motivation.</p><p><strong>Problem statement:</strong> How does leaders in an organization work with creativity? Whatmethods are used by the leader in order to motivate the creativity in the organization?How does the leadership affect the creativity?</p><p><strong>Approach:</strong> We have done a case study of Acne Digital with a qualitative approach for thisthesis. We've conducted five interviews at Acne Digital and a small observation.</p><p><strong>Conclusions: </strong>Our conclusions are that Acne Digital is a successful company regardingmanagement of creativity. The leadership has a very important role when it comes tomotivating the creativity in different manners. Our thesis shows that participation andoperating freedom are factors among others that are important for creative motivation.</p>