Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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38 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY august 2017 • Volume 10 • number 8 B r i E F r E p o r T standardized digital photography, and demonstrate a potential novel approach to improving the aesthetics of aging hands. C ASES Case 1. case 1 was a 62-year-old woman with moderate photodamage of the hands treated for five weeks (Figures 1 and 2, Table 1). Case 2. case 2 was a 59-year-old woman with severe photodamage of the hands treated for 12 weeks (Figures 3 and 4, Table 2). Case 3. case 3 was a 60-year-old woman with moderate photodamage of the hands treated for 12 weeks (Figures 5 and 6, Table 3). Case 4. case 4 was a 64-year-old woman with moderate photodamage of the hands treated for 11 weeks (Figures 7 and 8, T able 4). DISCUSSION There has been a huge growth in topical facial rejuvenation treatment products over the past decade. Until recently, however, readily visible areas of the body, other than the face, have been largely neglected. The appearance of the hands, which impacts the perceived age of the individual, 3,4 is becoming an area of increasing interest with physicians and patients alike. Topical urea has a long histor y of use in dermatology. it is one of the key components in natural moisturizing factor (nMF) of the stratum corneum. 2 0 Urea readily decomposes to yield ammonium ions and cyanate, which undergo fur ther conversion to carbon dioxide and ammonia. 21 The hand product formulation utilized in the presented cases employs a stabilized form of urea in high concentrations (hydroxyethyl urea 25%) and a vegetable-derived, skin-identical lipid concentrate featuring a combination of three ceramides (1, 3, and 6), cholesterol, free fatty acids, and phytosphingosine. The formulation also employs a liposomal cHlcu, which has been shown in previous studies to decrease clinical signs of facial photodamage 16 and to repair photoaged skin by stimulating biomarkers in the extracellular matrix. 19 The cases presented in this brief report show improvements in photodamaged skin on the hands, namely fine lines/wrinkles, tactile roughness, skin tone unevenness, and mottled pigmentation. The skin assessment summary for all eight subjects (Table 5) shows mean improvements in various photodamage parameters. Global improvement (which was based on a combination of photographic assessment and visual clinical evaluation) was rated as moderate improvement for all eight subjects. FIGURE 1. case 1, a 62-year-old woman with moderate photodamage of the hands treated for 5 weeks. standard view, baseline (left) and at Week 5 (right) FIGURE 2. case 1—cross-polarized view (brown channel), baseline (left) and at Week 5 (right) TABLE 1. case 1 PHOTODAMAGE PARAMETERS SCORE 0=NONE, 1–3=MILD, 4–6=MODERATE, 7–9=SEVERE BASELINE SCORE POST-TREATMENT SCORE Fine lines/wrinkles 5 4 Tactile roughness 5 4 skin tone unevenness 6 4 Mottled pigmentation 5 4 Global Improvement 0 = Worse 1 = no improvement 2 = Mild improvement 3 = Moderate improvement x 4 = Marked improvement 3

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