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Dermatology printISSN 1018–8665

onlinee-ISSN 1421–9832

www.karger.com/drm235 | 4 | 19235(4) 263–354 (2019)

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The concept of expressing acidity as the negative logarithm of the hydrogen ion concentration was defined and termed pH in the beginning of the 20th century. The general usefulness of the pH concept for life science was recognized and later gained im-portance to analytical research. Reports on results of pH measurements from living skin established the term acid mantle – the skin’s own protective shield that maintains a naturally acid pH.

It is invisible to the eye but crucial to the overall well-being of skin. Chronic alkalization can throw this acid mantle out of balance, leading to inflammation, der-matitis, and atopic skin diseases. It is therefore no surprise, that skin pH shifts have been observed in various skin pathologies. It is also obvious that the pH in topically applied preparations may play an impor-tant role. Optimal pH and buffer capacity within topical preparations not only support stability of ac-tive ingredients and auxiliary materials, but may also increase absorption of the non-ionized species of an acidic or a basic active ingredient. They may even open up opportunities to modify and “correct” skin pH and hence accelerate barrier recovery and main-tain or enhance barrier integrity. Further efforts are needed to standardize and improve pH measure-ments in biological media or pharmaceutical/cos-metic vehicles to increase and ensure quality, com-parability, and relevance of research data.

In this volume, we present a unique collection of pa-pers that address past, present and future issues of the pH of healthy and diseased skin. It is hoped that this collection will foster future efforts in clinical and experimental skin research.

Contents

• Preface: Surber, C.; Abels C.; Maibach, H.

Background and Introduction• The Acid Mantle: A Myth or an Essential Part of Skin Health?

Surber, C.; Humbert, P. Abels C.; Maibach, H.

Chemistry of pH/pH Measurement• Buffering Capacity: Proksch, E.• Measurement of Skin Surface pH: du Plessis, J.L.;

Stefaniak, A.B.; Wilhelm, K.-P.

Physiology of the Skin pH• Skin Surface pH in Newborns: Origin and Consequences:

Fluhr, J.W.; Darlenski, R.• Intrinsic and Extrinsic Factors Affecting Skin Surface pH:

Farage, W.A.; Hood, W.; Berardesca, E.; Maibach, H.• Gender, Age, and Ethnicity as Factors That Can Influence

Skin pH: Choi, E.H.• Endogenous Factors That Can Influence Skin pH:

Bíró, T.; Oláh, A.; Tóth, B.I.; Szöllősi, A.G.• Lipids in the Skin and pH: Wohlrab, J.; Gebert, A.;

Neubert, R.H.H.• Influence of pH on Skin Stem Cells and Their

Differentiation: Charruyer, A.; Ghadially, R.• The Influence of Calcium on the Skin pH and Epidermal

Barrier During Aging: Rinnerthaler, M.; Richter, K.

pH in Skin Pathophysiology• pH and Microbial Infections: Rippke, F.; Berardesca, E.;

Weber, T.M.• pH in Atopic Dermatitis: Danby, S.G.; Cork, M.J.• Role of Skin pH in Psoriasis: Bigliardi, P.L.• pH and Acne: Schürer, N.

pH in Cosmetic Products/Topical Formulations• pH and Buffer Capacity of Topical Formulations:

Wohlrab, J.; Gebert, A.• The Relation of pH and Skin Cleansing: Blaak, J.; Staib, P.• pH and Drug Delivery: Østergaard Knudsen, N.;

Pommergaard Pedersen, G.• Metamorphosis of Vehicles: Mechanisms and

Opportunities: Surber, C.; Knie, U.• Influence of Topical Formulations: Lipid Lamella

Organization and Lipid Composition of Stratum Corneum as a Surrogate Marker for Barrier Integrity: Dähnhardt, D.; Surber, C.; Dähnhardt-Pfeiffer, S.

• Skin Care Products: Age-Appropriate Cosmetics: Abels, C.; Angelova-Fischer, I.

• Skin Care Products for Healthy and Diseased Skin: Surber, C.; Dragicevic, N.; Kottner, J.

Author Index / Subject Index

pH of the Skin: Issues and ChallengesEditorsChristian SurberChristoph AbelsHoward Maibach

pH of the Skin: Issues and ChallengesEditors: Surber, C. (Basel/Zurich); Abels, C. (Bielefeld); Maibach, H. (San Francisco, CA)VIII + 206 p., 41 fig., 32 in color, 13 tab., 2018CHF 198.00 / EUR 185.00 / USD 233.00Hard cover or online prices for personal customersPrices subject to change, VAT not included EUR price for eurozone countries, USD price for USA and Latin America onlyISBN 978–3–318–06384–4 e-ISBN 978–3–318–06385–1

Current Problems in Dermatology, Vol. 54Series Editors: Itin, P. (Basel); Jemec, G.B.E. (Roskilde)ISSN 1421–5721 / e-ISSN 1662–2944

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pH of the Skin: Issues and Challenges Editors

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An International Journal founded as “Dermatologische Zeitschrift’ by Oskar Lassar (1893–1907)Continued by Erich Hoffmann (1908–1938), continued as “Dermatologica’ (1939–1991),by Wilhelm Lutz (1939–1958), Rudolf Schuppli (1959–1985) and J.-H. Saurat (1986–2015), continued as “Dermatology’ since 1992

Official Organ of

Swiss Society for Dermatology and VenereologySchweizerische Gesellschaft für Dermatologie und Venerologie

Société Suisse de Dermatologie et Vénéréologie

Editor-in-Chief

Gregor B.E. Jemec – Zealand University Hospital, Roskilde, Denmark

Section Editor “Atopic Dermatitis”

Tove Agner – Bispebjerg University Hospital, Copenhagen, Denmark

Section Editor “Dermato-Endocrinology”

Jörg Reichrath – Saarland University, Homburg, Germany

Section Editor “Dermoscopy and Clinical Imaging”

Giuseppe Argenziano – University of Campania, Naples, Italy

Section Editor “Genetics”

Pierre Vabres – CHU Dijon Bourgogne, Dijon, France

Section Editor “Outcome Measures”

Amit Garg – Hofstra Northwell School of Medicine, Lake Success, USA

Section Editor “Skin Cancer”

Ketty Peris – Catholic University, Rome, Italy

Section Editor “Tattoo and Body Art”

Jørgen Serup – Bispebjerg University Hospital, Copenhagen, Denmark

(Continued on next page)

© 2019 S. Karger AG, [email protected]

Associate Editors

Perla Calderón – University of Chile, Santiago, ChileLars E. French – University Hospital Munich, Munich, GermanyRobert Gniadecki – University of Alberta, Edmonton, CanadaQiang Ju – Renji Hospital, Shanghai Jiao Tong University, Shanghai, ChinaBrian Kirby – St. Vincent’s University Hospital, Dublin, IrelandDan Lipsker – University of Strasbourg, Strasbourg, FranceBranka Marinović – University Hospital Center Zagreb, Zagreb, CroatiaTetsuo Shiohara – Kyorin University, Tokyo, JapanH. Peter Soyer – The University of Queensland, Brisbane, AustraliaDae Hun Suh – Seoul National University, Seoul, Republic of KoreaJacek C. Szepietowski – University of Wroclaw, Wroclaw, PolandChristos C. Zouboulis – Dessau City Clinic, Dessau, Germany

Editorial Board

Tania Cestari – Federal University of Rio Grande do Sul, Porto Alegre, BrazilMaja-Lisa Clausen – Bispebjerg University Hospital, Copenhagen, DenmarkVeronique del Marmol – Université Libre de Bruxelles, Brussels, BelgiumLennart Emtestam – Karolinska University Hospital and Institutet, Stockholm, SwedenAlice Gottlieb – New York Medical College, Valhalla, USADimitrios Ioannides – Aristotle University Medical School, Thessaloniki, GreeceJürgen Lademann – Charité – Universitätsmedizin Berlin, Berlin, GermanySirkku Peltonen – University of Turku and Turku University Hospital, Turku, FinlandErrol P. Prens – Erasmus Medical Center, Rotterdam, NetherlandsLuis Puig – Autonomous University of Barcelona, Barcelona, SpainJean Revuz – Private Practice – Dermatology, Paris, FranceDevinder Mohan Thappa – Jawaharlal Institute of Postgraduate Medical Education and

Research, Puducherry, India

© 2019 S. Karger AG, [email protected]

Journal Information

Aims and ScopePublished since 1893, Dermatology provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform read-ers of the implications of recent research, reviews prepared by invited, internationally rec-ognized scientists are regularly featured. In addition, the journal publishes papers on novel treatments, surgical pearls, consensus guidelines and industry news.Dermatology offers the analytical dermatologist a broad range of information, from practical problem solving to a deeper mechanistic understanding of skin diseases, while at the same time providing space for further hypotheses that may help to find new solutions to old prob-lems. The journal publishes contributions from across the globe on a wide range of skin-related topics including epidemiology, skin biology, clinical dermatology, and therapy. It enjoys a high reputation in the field of dermatology.

ISSN Print Edition: 1018–8665ISSN Online Edition: 1421–9832

Journal Homepage: www.karger.com/drmBibliographic Indices: This journal is listed in biblio-graphic services, including PubMed, MEDLINE, Web of Science, Science Citation Index, Science Citation Index Expanded, Current Contents – Clinical Medi-cine, BIOSIS Previews, Google Scholar, Chemical Ab-stracts Service, FSTA: Food Science and Technology Abstracts, CAB Abstracts, Global Health, Scopus, Em-base, Pathway Studio, CINAHL Complete, Health Re-search Premium Collection, Medical Database, Health & Medical Collection, ProQuest Central, WorldCat.

Publication Data: Dermatology is published 6 times a year. Volume 235 with 6 issues appears in 2019.

Copyright: © 2019 S. Karger AG, Basel (Switzerland). All rights reserved. No part of this publication may be translated into other languages, reproduced or uti-lized in any form or by any means, electronic or me-chanical, including photocopying, recording, micro-copying, or by any information storage and retrieval system, without permission in writing from the pub-lisher.

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Skin Appendage Disorders provides a wide range of original and review articles dealing with all aspects of hair, nail and skin glands. The section “Novel Insights from Clinical Practice” introduces special case examples and their treatments. Innovative therapies are presented under the heading “Novel Treatments”, and in “Clinical Investigations” the latest findings are discussed. A special highlight are the articles in the section “Guidelines” that present the consensus treatments, and which are a must-read for everyone who wants to stay up-to-date. The section “Ad-nexal Surgery” focuses on both established and approved as well as new surgical treatments. Pathological evaluation of skin appendage disor-ders requires specific training and the “Pathology” section will be open to original papers and reviews on this topic.Covering all aspects of the field, Skin Appendage Disorders is of primary importance for dermatologists in clinics and research, dermatological surgeons as well as cosmetic dermatologists.

Skin Appendage DisordersFounded: 2015Category: Clinical and Basic ResearchField of Interest: Dermatology

Listed in bibliographic services, including:PubMed/PubMed Central, Google Scholar

2019: Volume 56 issues per volumeLanguage: EnglishISSN 2296–9195 e-ISSN 2296–9160

The first journal exclusively dedicated to research and treatment of hair, nail and skin gland diseases

Editors-in-ChiefD. Rigopoulos, AthensA. Tosti, Miami, FL

Editorial Board MembersR. Arenas, Mexico CityD. Asz Sigall, Mexico CityR. Baran, CannesV. Bettoli, FerraraU. Blume-Peytavi, BerlinA. Campanati, AnconaR. Daniel, Jackson, MIJ. Q. Del Rosso,

Henderson, NVN. Di Chiacchio, São PauloJ. Dominguez-Cherit,

Mexico City, Mexico Z. D. Draelos, High Point, NCB. Elewski, Birmingham, AL

G. Fabbrocini, NaplesH. Farber, Philadelphia, PAS. Feldman,

Winston-Salem, NC S. Gregoriou, AthensR. Grimalt,

Sant Cugat del VallèsC. Grover, DelhiA. K. Gupta, London, ONE. Haneke, FreiburgM. K. Hordinsky,

Minneapolis, MND. Ioannides, ThessalonikiM. Iorizzo, BellinzonaA. Kaminsky, Buenos AiresA. Katoulis, AthensD.-Y. Lee, SeoulB. C. Markinson, New York, NYA. McMichael, Winston-Salem, NC

A. G. Messenger, SheffieldG. Micali, CataniaM. Miteva, Miami, FLB. Maria Piraccini, BolognaP. Rich, Portland, ORB. Richert, BrusselsR. Romiti, São PauloA. I. Rubin, Philadelphia, PAL. Rudnicka, WarsawR. K. Scher, New York, NYJ. Shapiro, New York, NYA. Shemer, Tel AvivR. Sinclair, East Melbourne, VICS. Sonthalia, GurugramD.-H. Suh, Seoul R. M. Trüeb, WallisellenT. Vlahovic, Philadelphia, PAU. Wollina, DresdenM. Zaiac, Miami Beach, FL

More information at w w w.karger.com/sad

Selected articles in the first issues:• A Review of the Use of Biotin for Hair Loss: Patel, D.P. (Philadelphia, PA/

Louisville, KY); Swink, S.M.; Castelo-Soccio, L. (Philadelphia, PA)• A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification: Alves, R; Grimalt, R. (Barcelona)

• Effectiveness of Platelet-Rich Plasma for Androgenetic Alopecia:A Review of the Literature: Cervantes, J.; Perper, M.; Wong, L.L.; Eber, A.E. (Miami, FL); Villasante Fricke A.C. (Providence, RI); Wikramanayake, T.C.; Jimenez, J.J. (Miami, FL)

• Alopecia and Associated Toxic Agents: A Systematic Review: Yu, V. (Cincinnati, OH); Juhász, M.; Chiang, A.; Atanaskova Mesinkovska, N. (Irvine, CA)

• Scalp Itch: A Systematic Review: Vázquez-Herrera, N.E. (Monterrey);Sharma, D. (Providence, RI); Aleid, N.M. (Riyadh); Tosti, A. (Miami, FL)

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THEMES:

karger_academy.indd 1 08/01/2019 16:38

F190

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Workshop der Arbeitsgruppen SGDV / Ateliers des groupes de travail SSDV

Klinisch-pathologische Korrelationen / Corrélations anatomo-cliniques

Thematische Fallvorstellungen und Diskussion aus den Kliniken /Présentations thématiques et discussion de cas cliniques par les services

Symposien und Workshops / Symposia et ateliersOrganisiert von / Organisé par:AbbVie AG, Almirall AG, Celgene GmbH, Eli Lilly (Suisse) SA, Galderma SA, Janssen-Cilag AG, LEO Pharma, MSD Merck Sharp & Dohme AG, Novartis Pharma Schweiz AG, Pierre Fabre (Suisse) SA,Pierre Fabre Pharma AG, Sanofi-Aventis (Schweiz) AG

Rahmenprogramm / Programme cadreSchiffahrt mit Apéritiv und Nachtessen an Bord des Rheinschiffs «Rystärn» (Donnerstag, 19.9.2019)Croisière avec apéritif et dîner au bord du bateau «Rystärn» (Jeudi, 19.9.2019)

Wissenschaftliches Programm / Programme scientifique

Plenarvorträge / Session plénière

Key Lecture 1: Der Tarif im Fokus der Politik – Herausforderungen an die Ärzteschaft(Dr. med. Jürg Schlup, Bern)

Key Lecture 2: Herausforderung Melanom – Was ist unsere Rolle?(Prof. Reinhard Dummer, Zürich)

Key Lecture 3: Psoriasis – Wohin steuern wir?(Prof. Kilian Eyerich, München)

Key Lecture 4: Atopische Dermatitis – Neuste Therapieansätze für die Praxis(Prof. Thomas Werfel, Hannover)

Key Lecture 5: Durchbrüche in der systemischen Sklerose(Prof. Oliver Distler, Zürich)

Key Lecture 6: Behandlung von schwerer Akne(Prof. Jean-Hilaire Saurat, Genève)

Key Lecture 7: Ästhetische Dermatologie: Wie verändert sich unser Tätigkeitsspektrum?(Dr. med. Bettina Rümmelein, Zürich)

ANMELDUNG/INSCRIPTION:www.ctlag-sgdv.ch

Deadline Hotel Reservation: 15.6.2019

Bevorzugte Anmeldung für die Jahreseversammlung: 5.8.2019

Inscription pour la réunion annuelle de préférence avant le 5.8.2019

101. Jahresversammlung SGDV101ème Réunion annuelle SSDVBasel, 19.–20.9.2019Congress Center Basel

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Information: Convention Team Lucerne AG | Oberseeburg 10 | 6006 Lucerne | Tel. +41 41 371 18 60 | [email protected]

Vague d‘immunodermatologie: Implémentation réussie des nouveaux outils dans mon cabinetWelle Immundermatologie: Erfolgreicher Einsatz der neuen Werkzeuge in meiner Praxis

SAVE THE DATE

Wissenschaftliche Organisation /Organisation scientifique Prof. Alexander NavariniProf. Peter Häusermann (Tagungspräsidenten /Présidents du congrès)

Wissenschaftliches Komitee /Comité scientifiqueProf. Karin HartmannDr. med. Simon MüllerPD Dr. Kathrin SchererDr. med. Andreas Volz

Administrative Organisation /Secrétariat administratifConvention Team Lucerne AG Oberseeburg 10, 6006 LuzernTel. +41 41 371 18 60email: [email protected]

This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of dermatology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diag-nosis and treatment. Supplementary material is welcomed.The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information.Following the open access principle, the entire contents can be re-trieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.

More information at www.karger.com/cde

The first dermatology journal dedicated exclusively to case reports

Case Reports in DermatologyFounded: 2009Category: Clinical ResearchField of Interest: Dermatology

Listed in bibliographic services, including:PubMed/PubMed Central, Web of Science, Google Scholar, DOAJ, Scopus, Embase

2019: Vol. 113 issues per volumeonline only Language: Englishe-ISSN 1662–6567

Editorial BoardR. Antaya,

New Haven, CTC. Berking, MunichK.K. Clemmensen,

CopenhagenF. Dalgard, OsloF.W. Danby,

Hanover, NHM.A. de Rie, AmsterdamV. del Marmol, BrusselsL. Emtestam, StockholmF. Furukawa, WakayamaU. Gieler, GiessenR. Gniadecki,

Edmonton

D. Ioannides, ThessalonikiP. Itin, BaselG.B.E. Jemec, RoskildeL. Kemeny, SzegedJ. Lademann, BerlinR.A. Lee, La Jolla, CAK. Matsunaga, NagoyaR. Na, BeijingE.P. Prens, RotterdamH. Riad Kottb, DohaT. Satoh, Tokorozawa, T. Shiohara, TokyoH.H. van der Zee,

RotterdamT. Yamamoto, Fukushima

www.karger.com/cde

• open access• peer-reviewed• fast online publication

Editor-in-ChiefK.S. Ibler, Roskilde

KF 1

9016

(Continued from back cover)

Skin Cancer – Research Articles

334 Disease-Free Survival for Patients with Thin Melanomas according to the American Joint Committee on Cancer 8th EditionGambra Michel, L.E.; Uña Gorospe, J.; López Figueroa, A. L.; Mullor Nogales, R.; Martínez Cedrés, J.C.; Cabrera Suárez, M.Á.; Garrido Ríos, S.; Hernández Hernández, N.; Suárez Hernández, J.; Allende Riera, A. (Santa Cruz de Tenerife)

The 8th AJCC staging edition predicts more accurately disease-free survival in patients with thin melanomas.

340 A Retrospective Cohort Study on Patients with Lentigo Maligna MelanomaFröhlich, S.M. (Bern); Cazzaniga, S. (Bern/Bergamo); Kaufmann, L.S. (Bern/Frankfurt); Hunger, R.E.; Seyed Jafari, S.M. (Bern)

Although lentigo maligna melanoma showed a low potential for malignant spreading and recurrence, diagnosed patients should undertake regular follow-ups to prevent a metastatic disease.

Skin Cancer – Letter

346 A Comparative Study of Google Search Trends for Melanoma, Breast Cancer and Prostate Cancer in FinlandKluger, N.; Bouchard, L.J. (Helsinki)

Google Trends analysis reveals that the interest of the Finnish population for melanoma increases with the arrival of summer. Melanoma awareness campaigns may act as an additional booster.

Outcome Measures – Research Article

348 Exploration of the Product of the 5-Point Investigator’s Global Assessment and Body Surface Area (IGA × BSA) as a Practical Minimal Disease Activity Goal in Patients with Moderate-to-Severe PsoriasisGottlieb, A.B. (New York, NY); Germino, R.; Herrera, V.; Meng, X. (East Hanover, NJ); Merola, J.F. (Boston, MA)

IGA × BSA may provide clinicians with a simple tool to measure treat-to-target goals.

www.karger.com/drm 235 | 4 | 19

Review Article

263 Hereditary Angio-Oedema for DermatologistsBygum, A. (Odense)

Physicians treating angio-oedema should be familiar with bradykinin-mediated angio-oedema and be able to recognise hereditary angio-oedema.

Research Article

276 Association of Psoriasis with Psychiatric Hospitalization in United States Children and AdultsPatel, K.R.; Lee, H.H.; Rastogi, S.; Singam, V.; Vakharia, P.P.; Silverberg, J.I. (Chicago, IL)

This study found that psoriasis was associated with higher odds of and substantial excess costs from multiple mental health disorders and primary hospitalization for multiple mental health disorders in children and adults.

Review Articles

287 Staphylococcus epidermidis: A Potential New Player in the Physiopathology of Acne?Claudel, J.-P. (Tours); Auffret, N. (Paris); Leccia, M.-T. (Grenoble); Poli, F. (Paris); Corvec, S.; Dréno, B. (Nantes)

S. epidermidis limits C. acnes-induced colonisation of the skin, thus potentially playing a role in the physiopathology of acne.

295 Staphylococcus aureus and Host Immunity in Recurrent FurunculosisNowicka, D. (Wroclaw); Grywalska, E. (Lublin)

Immunological and inflammatory responses to S. aureus pathogenicity factors contribute to chronic furunculosis.

Atopic Dermatitis – Commentary

306 Dupilumab and Alopecia: Causative or Therapeutic?Hendricks, A.J. (Tucson, AZ); Lio, P.A. (Chicago, IL); Shi, V.Y. (Tucson, AZ)

Both hair loss and regrowth have been observed with dupilumab use in atopic dermatitis patients.

Research Articles

308 The Broad-Spectrum Impact of Hidradenitis Suppurativa on Quality of Life: A Comparison with PsoriasisSampogna, F.; Fania, L.; Mazzanti, C.; Caggiati, A.; Pallotta, S.; Panebianco, A.; Mastroeni, S.; Didona, B.; Pintori, G.; Abeni, D. (Rome)

The impact of hidradenitis suppurativa on quality of life is high at all levels of clinical severity and is greater than that of psoriasis, especially at lower levels of clinical severity.

315 Attenuation of Severe Generalized Junctional Epidermolysis Bullosa by Systemic Treatment with GentamicinHammersen, J.; Neuner, A. (Erlangen); Wild, F. (Neuburg an der Donau); Schneider, H. (Erlangen)

Gentamicin injections may reduce burden of disease by overcoming premature termination codons underlying epidermolysis bullosa.

323 The Recurrence of Onychocryptosis when Treated with Phenolization: Does Phenol Application Time Play a Role? A Follow-Up Study on 622 ProceduresMontesi, S. (Rome); Lazzarino, A.I. (London); Galeone, G.; Palmieri, R.; Montesi, M. (Rome)

The application time of phenol in the treatment of ingrowing nail is important.

327 The Impact of Focality and Centricity on Vulvar Intraepithelial Neoplasia on Disease Progression in HIV+ Patients: A 10-Year Retrospective StudyAyakannu, T. (Guildford/Liverpool); Murugesu , S. (Uxbridge); Taylor, A.H. (Leicester); Sokhal, P.; Ratnasekera, L.; Wilhelm-Benartzi , C.S.M.; Lyons, D. (London); Chatterjee, J. (Guildford/Liverpool/London)

Multicentricity and multifocality of VIN lesions should be considered as poor prognostic indicators at diagnosis.

(Continued on inside back cover)