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The different characteristics of facial skin aging in Caucasian, African American, Indian, Hispanic, and East Asian women
ART, HISTORY, AND HUMANITIES OF DERMATOLOGY
P233 Evaluation of a moisturizer containing sodium lactate and urea to ameliorate senile xerosis Teresa Weber, PhD, Beiersdorf Inc, Norwalk, CT, United States; Alexandra Kowcz, Beiersdorf Inc, Norwalk, CT, United States; Nathan Trookman, MD, Rocky Mountain Laser Center, Colorado Springs, CO, United States; Ronald Rizer, PhD, TJ Stephens & Associates, Colorado Springs, CO, United States Objective: To assess the ability of a commercially available moisturizing cream to ameliorate the dry skin condition of subjects 65 to 86 years of age. Methods: In this 7-week, single-blinded, controlled clinical study, 29 subjects with moderate to severe xerosis were treated twice daily for 6 weeks with a moisturizing cream containing 10% urea and 5% sodium lactate. At the end of the 6 weeks, there was a 5-day treatment regression phase. Evaluation of efficacy included clinical grading of scaling and cracking, and assessment of objective and subjective irritation at baseline, weeks 3 and 6, and 3 and 5 days after treatment discontinuation. Biophysical measurements included quantification of skin scales, instrumental assessment of skin hydration and transepidermal water loss, and videomicroscopic imaging of the skin surface. Results: Statistically significant improvements relative to baseline clinical scores for cracking, scaling, itching, tightness and erythema were observed after 3 and 6 weeks of treatment. Statistical improvements were also obtained for the instrumental measures of skin hydration, transepidermal water loss, and the number of fine and coarse skin scales. In addition, substantial improvements in the appearance of the skin surface were observed. With the exception of transepidermal water loss, these statistical differences persisted through the 1 week treatment regression period. Conclusion: A commercially available moisturizing cream containing 10% urea and 5% sodium lactate is safe and effective in ameliorating the symptoms of xerotic skin in elderly subjects. 100% sponsored by Beiersdorf Inc.
P300 Cutaneous manifestation of evil: An art history dissection Iren Kossintseva, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada Art history provides more than a poignant record of social attitudes, religious constructs, and reflections of political atmosphere: it gives an insight into how at the time of an artwork’s creation it is able to not only reflect but also shape the society in situ. Whether used along or against the grain of societal beliefs of the time, art often illustrates in a critical manner very stark attitudes towards certain principles. Principles at stake then are symbolized, personified, and metamorphosized into humanoid form that simply take on either a good or an evil stance. Depiction of cutaneous disease frequently was and continues to be one of the techniques that artists turn to when exemplifying evil. Here I present illustrated examples of art and discuss how they use dermatologic imagery as a tool for symbolic means. Dermatologic conditions, regardless of their malignancy, seem to be used as icons of madness, vice, disorder, corruption, and sin. They are starkly contrasted to the ideas of not only physical but more so spiritual purity and beauty. Innumerably, as seen in depictions of Virgin Mary, Venus, or other objects of aspiration and desire (consider Titian’s ‘‘Venus of Urbino’’ or Ingres’ ‘‘Grande Odalisque’’), flawless skin is a symbol of good. Whether it is Otto Dix’s criticism of 1933 Germany impersonated with perianal warts as the face of Nazism in ‘‘7 Deadly Sins,’’ the saddened satire of dysfunctional post-Franco-Prussian war in Spain by Francisco de Goya in his ‘‘Los Caprichos’’ etchings, or Honore Daumier’s caricatures of corrupt politicians and human folly: they all present disease as an allegory for social conscience. Likewise, suffering and emotional distress is externalized onto canvas as bruised figures which are often seen in the works of German Expressionists like Egon Schiele, reacting to the harrowing reality of World War I. Alternatively, some works personify mythological evil with skin disease, be it prints of witches by Albercht Durer, or the symbolic examination of vice by Aubrey Beardsley. Such symbolism further stretches into religious territory, where even renaissance minds like those of Michelangelo illustrate their analogy of sin to human flesh, as seen in ‘‘The Last Judgment.’’ It is obvious to this audience that cutaneous disease does not equal evil, but it is both curious and sad to note how through such analogies art has been able to deliver a misguided caution and distrust to the observer regarding those who bear skin conditions. Commercial support: None identified.
P301
P234 The different characteristics of facial skin aging in Caucasian, African American, Indian, Hispanic, and East Asian women Alexis Perkins, Harvard Medical School, Boston, MA, United States; Alexa Kimball, MD, MPH, Harvard Medical School, Boston, MA, United States; Greg Hillebrand, Procter & Gamble, Cincinatti, OH, United States; Kukizo Miyamoto, Procter and Gamble, Kobe, Japan Facial aging can be divided into intrinsic aging and photoaging. In Caucasian skin, skin lines, furrows, dryness, and laxity characterize intrinsic aging, whereas photoaging is marked by fine wrinkles and dyspigmentation. Therefore, assessments of facial aging, most of which have been conducted on Caucasian populations, focus on quantification of fine and coarse wrinkles, skin texture, and solar lentigines. Signs of intrinsic and photoaging in ethnic skin have not been well characterized. Some data suggest that perception of facial aging in East Asian women is mediated by hyperpigmentation more so than by wrinkling, and that wrinkling tends to appear a decade later on Asian skin than on Caucasian skin. Likewise, it is likely that facial aging in African American, Indian, and Hispanic skin is characterized by different skin changes at different time points, with fine wrinkling caused by photoaging being less common in darker skin types. To our knowledge, there is no published grading scale of facial aging that can be used to predict actual age or apparent age. This study is based on high-resolution digital images of the faces of 1300 Caucasian, 375 African American, 400 Indian, 570 East Asian, and 250 Hispanic women between the ages of 5 and 70. Each face will be divided into regions and graded on fine wrinkles, coarse wrinkles, skin texture, dryness, evenness of pigmentation, erythema, telangiectases, ephelids, lentigines, hyper- and hypopigmentation, pore size, actinic and seborrheic keratoses, solar comedones, hirsutism, undereye pigment and edema, and skin tone. For each subject we have data on age, race, BMI, sun exposure, smoking, years since menopause, pregnancies, hormone replacement, education, self assessment of apparent age, and hours of sleep as well as measurements of skin color, hyperpigmentation, pore size, sebum, pH, and hydration. Our primary aim is to define the characteristics and timeline of facial skin aging across these five different ethnicities. Our secondary aim is to create facial skin grading scales specific to each ethnicity that are predictive of subject age. Commercial support: None identified.
FEBRUARY 2007
The effect of the number of children on work patterns of female dermatologists Yoon Soo Bae, Brigham and Women’s Hospital, Department of Dermatology, Boston, MA, United States; Alexandra Boer Kimball, MD, MPH, Brigham and Women’s Hospital, Department of Dermatology, Boston, MA, United States; Kerry Parker, CAE, Women’s Dermatologic Society, San Francisco, CA, United States Objective: Previous studies have shown differences in work pattern between male and female dermatologists. These differences in recent trainees were magnified by parenting. Methods: Workforce data was collected from an anonymous survey given out by the Women’s Dermatologic Society at their annual luncheon meeting. Trends in current and desired work hours, number of children and the most important factor determining how many hours respondents will work in the future were analyzed by number of children. Results: One hundred and thirty-nine people responded, of whom 14 (10.7%) were male and 46 were residents (33%), representing an overall response from approximately 18.5% of the luncheon attendees. Among all women who responded, the number of children had an effect on both the current work hours (105 respondents, P \ .0324) and desired work hours (n = 105, P \ .0284). Practicing female dermatologists (n = 15, average age of 40) with no children currently work 41.53 hours, desire 34.73 hours, and were mostly likely to choose job satisfaction as the most important factor determining how many hours they will work in the future . Those with 1 child (n = 18, average age 46) currently work 34.28 hours, desire 28.61 hours, and consider family/children to be the most important factor (majority). Similar to dermatologists with no children, dermatologists (n = 26, average age of 48) with 2 children currently work 41.98 hours, desire 34.81 hours, and chose job satisfaction. Dermatologists (n = 9, average age of 52) with 3 children currently work 31.3 hours, desire 24.78 hours, and also choose job satisfaction (majority). Lastly, dermatologists (n = 2, average age of 62) with 4 children currently work 47.5 hours and desire 35 hours. The two respondents chose family/children and job satisfaction as their most important factor determining how many hours they will work in the future. Conclusion: Female dermatologists with no children consistently work more, but those with two or more children work more than dermatologists with just one child. The relationship between the number of children and work hours is more than complicated than a simple linear correlation. Further studies will need to be done to further elucidate this relationship. Commercial support: None identified.
J AM ACAD DERMATOL
AB33
P233 Evaluation of a moisturizer containing sodium lactate and urea to ameliorate senile xerosis Teresa Weber, PhD, Beiersdorf Inc, Norwalk, CT, United States; Alexandra Kowcz, Beiersdorf Inc, Norwalk, CT, United States; Nathan Trookman, MD, Rocky Mountain Laser Center, Colorado Springs, CO, United States; Ronald Rizer, PhD, TJ Stephens & Associates, Colorado Springs, CO, United States Objective: To assess the ability of a commercially available moisturizing cream to ameliorate the dry skin condition of subjects 65 to 86 years of age. Methods: In this 7-week, single-blinded, controlled clinical study, 29 subjects with moderate to severe xerosis were treated twice daily for 6 weeks with a moisturizing cream containing 10% urea and 5% sodium lactate. At the end of the 6 weeks, there was a 5-day treatment regression phase. Evaluation of efficacy included clinical grading of scaling and cracking, and assessment of objective and subjective irritation at baseline, weeks 3 and 6, and 3 and 5 days after treatment discontinuation. Biophysical measurements included quantification of skin scales, instrumental assessment of skin hydration and transepidermal water loss, and videomicroscopic imaging of the skin surface. Results: Statistically significant improvements relative to baseline clinical scores for cracking, scaling, itching, tightness and erythema were observed after 3 and 6 weeks of treatment. Statistical improvements were also obtained for the instrumental measures of skin hydration, transepidermal water loss, and the number of fine and coarse skin scales. In addition, substantial improvements in the appearance of the skin surface were observed. With the exception of transepidermal water loss, these statistical differences persisted through the 1 week treatment regression period. Conclusion: A commercially available moisturizing cream containing 10% urea and 5% sodium lactate is safe and effective in ameliorating the symptoms of xerotic skin in elderly subjects. 100% sponsored by Beiersdorf Inc.
P300 Cutaneous manifestation of evil: An art history dissection Iren Kossintseva, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada Art history provides more than a poignant record of social attitudes, religious constructs, and reflections of political atmosphere: it gives an insight into how at the time of an artwork’s creation it is able to not only reflect but also shape the society in situ. Whether used along or against the grain of societal beliefs of the time, art often illustrates in a critical manner very stark attitudes towards certain principles. Principles at stake then are symbolized, personified, and metamorphosized into humanoid form that simply take on either a good or an evil stance. Depiction of cutaneous disease frequently was and continues to be one of the techniques that artists turn to when exemplifying evil. Here I present illustrated examples of art and discuss how they use dermatologic imagery as a tool for symbolic means. Dermatologic conditions, regardless of their malignancy, seem to be used as icons of madness, vice, disorder, corruption, and sin. They are starkly contrasted to the ideas of not only physical but more so spiritual purity and beauty. Innumerably, as seen in depictions of Virgin Mary, Venus, or other objects of aspiration and desire (consider Titian’s ‘‘Venus of Urbino’’ or Ingres’ ‘‘Grande Odalisque’’), flawless skin is a symbol of good. Whether it is Otto Dix’s criticism of 1933 Germany impersonated with perianal warts as the face of Nazism in ‘‘7 Deadly Sins,’’ the saddened satire of dysfunctional post-Franco-Prussian war in Spain by Francisco de Goya in his ‘‘Los Caprichos’’ etchings, or Honore Daumier’s caricatures of corrupt politicians and human folly: they all present disease as an allegory for social conscience. Likewise, suffering and emotional distress is externalized onto canvas as bruised figures which are often seen in the works of German Expressionists like Egon Schiele, reacting to the harrowing reality of World War I. Alternatively, some works personify mythological evil with skin disease, be it prints of witches by Albercht Durer, or the symbolic examination of vice by Aubrey Beardsley. Such symbolism further stretches into religious territory, where even renaissance minds like those of Michelangelo illustrate their analogy of sin to human flesh, as seen in ‘‘The Last Judgment.’’ It is obvious to this audience that cutaneous disease does not equal evil, but it is both curious and sad to note how through such analogies art has been able to deliver a misguided caution and distrust to the observer regarding those who bear skin conditions. Commercial support: None identified.
P301
P234 The different characteristics of facial skin aging in Caucasian, African American, Indian, Hispanic, and East Asian women Alexis Perkins, Harvard Medical School, Boston, MA, United States; Alexa Kimball, MD, MPH, Harvard Medical School, Boston, MA, United States; Greg Hillebrand, Procter & Gamble, Cincinatti, OH, United States; Kukizo Miyamoto, Procter and Gamble, Kobe, Japan Facial aging can be divided into intrinsic aging and photoaging. In Caucasian skin, skin lines, furrows, dryness, and laxity characterize intrinsic aging, whereas photoaging is marked by fine wrinkles and dyspigmentation. Therefore, assessments of facial aging, most of which have been conducted on Caucasian populations, focus on quantification of fine and coarse wrinkles, skin texture, and solar lentigines. Signs of intrinsic and photoaging in ethnic skin have not been well characterized. Some data suggest that perception of facial aging in East Asian women is mediated by hyperpigmentation more so than by wrinkling, and that wrinkling tends to appear a decade later on Asian skin than on Caucasian skin. Likewise, it is likely that facial aging in African American, Indian, and Hispanic skin is characterized by different skin changes at different time points, with fine wrinkling caused by photoaging being less common in darker skin types. To our knowledge, there is no published grading scale of facial aging that can be used to predict actual age or apparent age. This study is based on high-resolution digital images of the faces of 1300 Caucasian, 375 African American, 400 Indian, 570 East Asian, and 250 Hispanic women between the ages of 5 and 70. Each face will be divided into regions and graded on fine wrinkles, coarse wrinkles, skin texture, dryness, evenness of pigmentation, erythema, telangiectases, ephelids, lentigines, hyper- and hypopigmentation, pore size, actinic and seborrheic keratoses, solar comedones, hirsutism, undereye pigment and edema, and skin tone. For each subject we have data on age, race, BMI, sun exposure, smoking, years since menopause, pregnancies, hormone replacement, education, self assessment of apparent age, and hours of sleep as well as measurements of skin color, hyperpigmentation, pore size, sebum, pH, and hydration. Our primary aim is to define the characteristics and timeline of facial skin aging across these five different ethnicities. Our secondary aim is to create facial skin grading scales specific to each ethnicity that are predictive of subject age. Commercial support: None identified.
FEBRUARY 2007
The effect of the number of children on work patterns of female dermatologists Yoon Soo Bae, Brigham and Women’s Hospital, Department of Dermatology, Boston, MA, United States; Alexandra Boer Kimball, MD, MPH, Brigham and Women’s Hospital, Department of Dermatology, Boston, MA, United States; Kerry Parker, CAE, Women’s Dermatologic Society, San Francisco, CA, United States Objective: Previous studies have shown differences in work pattern between male and female dermatologists. These differences in recent trainees were magnified by parenting. Methods: Workforce data was collected from an anonymous survey given out by the Women’s Dermatologic Society at their annual luncheon meeting. Trends in current and desired work hours, number of children and the most important factor determining how many hours respondents will work in the future were analyzed by number of children. Results: One hundred and thirty-nine people responded, of whom 14 (10.7%) were male and 46 were residents (33%), representing an overall response from approximately 18.5% of the luncheon attendees. Among all women who responded, the number of children had an effect on both the current work hours (105 respondents, P \ .0324) and desired work hours (n = 105, P \ .0284). Practicing female dermatologists (n = 15, average age of 40) with no children currently work 41.53 hours, desire 34.73 hours, and were mostly likely to choose job satisfaction as the most important factor determining how many hours they will work in the future . Those with 1 child (n = 18, average age 46) currently work 34.28 hours, desire 28.61 hours, and consider family/children to be the most important factor (majority). Similar to dermatologists with no children, dermatologists (n = 26, average age of 48) with 2 children currently work 41.98 hours, desire 34.81 hours, and chose job satisfaction. Dermatologists (n = 9, average age of 52) with 3 children currently work 31.3 hours, desire 24.78 hours, and also choose job satisfaction (majority). Lastly, dermatologists (n = 2, average age of 62) with 4 children currently work 47.5 hours and desire 35 hours. The two respondents chose family/children and job satisfaction as their most important factor determining how many hours they will work in the future. Conclusion: Female dermatologists with no children consistently work more, but those with two or more children work more than dermatologists with just one child. The relationship between the number of children and work hours is more than complicated than a simple linear correlation. Further studies will need to be done to further elucidate this relationship. Commercial support: None identified.
J AM ACAD DERMATOL
AB33