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Thermal Physiology and Thermoregulation
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Skin can be divided into two basic types: glabrous and nonglabrous skin. In some disciplines, glabrous skin is referred to as acral (distal), while nonglabrous skin is labeled non-acral. Glabrous skin is smooth and hairless; the type found on the palms, soles, penis, eyelids, and lips. Glabrous skin is innervated mainly by adrenergic sympathetic vasoconstrictor nerves, which increase their tone in response to cold, causing vasoconstriction. Warm conditions increase cutaneous blood flow through passive vasodilation when adrenergic sympathetic activity decreases.37 Nonglabrous (hair-bearing) skin covering most of the body's surface is innervated by both cholinergic vasodilator and adrenergic vasoconstrictor nerves.
Wearable Sensors for Blood Perfusion Monitoring in Patients with Diabetes Mellitus
Published in Andrey V. Dunaev, Valery V. Tuchin, Biomedical Photonics for Diabetes Research, 2023
Evgenii A. Zherebtsov, Elena V. Zharkikh, Yulia I. Loktionova, Angelina I. Zherebtsova, Viktor V. Sidorov, Alexander I. Krupatkin, Andrey V. Dunaev
The selected areas represent two main skin types: glabrous and non-glabrous skin. Glabrous skin mostly covers the palms, soles, and face. This type of skin is primarily involved in the mechanisms of thermoregulation of the body and contains a large number of arteriovenous anastomoses (AVA). Sympathetic regulation is the dominant mechanism involved in blood flow in glabrous skin [56].
Management of Difficult Vitiligo (Acral, Genital, Lips, Palms, and Soles)
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Sanjeev Gupta, Swetalina Pradhan
Treatment of genital vitiligo is difficult, as hair follicles are absent in glabrous skin of genitalia [34]. There have been reports of genital vitiligo treated with topical pimecrolimus and other various surgical procedures like melanocyte transplantation (cultured and noncultured melanocytes) [35–38]. However, other procedures like suction blister grafts, thin split-thickness skin grafts, and minipunch grafts can be tried in genital vitiligo depending on the size of the vitiligo patch and the expertise of the surgeon. Before undertaking surgical treatment of vitiligo, a history of genital herpes should be ruled out, and in all such cases long-term prophylaxis with acyclovir should be given and the prognosis should be explained to the patient [39].
Cardiovascular responses to hot skin at rest and during exercise
Published in Temperature, 2023
Ting-Heng Chou, Edward F. Coyle
While several excellent comprehensive reviews on cardiovascular responses to heat stress at rest [5–11] and during exercise [5,6,12–14] have been published, this review provides unique and additional discussions on the effect of increasing skin temperature independent of core temperature on cardiovascular responses at rest and during endurance exercise, since this topic has been relatively less completely addressed yet could be significant when skin is hot. Additionally, the mechanism of how stroke volume is lowered by heat stress has been a contentious topic. Our recent studies [15,16] provided additional and critical evidence to assist in clarifying the controversy between the two mechanisms, but no recent review has comprehensively discussed this topic. Current evidence suggests that exercise intensity (i.e. from resting to intense exercise) plays a significant role in the integrative cardiovascular response to hot skin. Specifically, we will elaborate on the different mechanisms of how hot skin affects cardiovascular responses at different exercise intensities, which are summarized in Figure 1. The exercise referred to in this review is whole-body dynamic submaximal exercise (i.e. running, walking, and cycling) unless specified, and the study populations are young healthy adults. Additionally, the skin referred to in this review is nonglabrous skin (i.e. most of the body surface, including the limbs, head, and trunk) which is regulated differently from glabrous skin (i.e. palms and soles) regarding thermoregulation [17,18].
Comparison of the effectiveness of local anesthesia for the digital block between single-volar subcutaneous and double-dorsal finger injections: a systematic review and meta-analysis of randomized control trials
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Che-Hsiung Lee, Mo-Han Lin, Yu-Te Lin, Chung-Chen Hsu, Cheng-Hung Lin, Shih-Heng Chen, Ren-Wen Huang
The classic double-dorsal injection, first proposed by Braun and Harris [14], involves an injection on each side of the digit, and it has been used for a long time. In this review, the general approach was to inject 1-3 ml of local anesthesia into the base of the proximal phalanx on each side of the finger from the dorsal side. The reason for injecting the dorsal skin of the finger is because volar skin is considered to be more sensitive than dorsal skin [37]. The pooled meta-analysis of the 9 RCTs in the present study showed a statistically significantly higher painful sensation with a dorsal injection (p = 0.041), which contrasts with the previous hypothesis. The reason may result from two puncture sites of the double-dorsal injection and the more extended pathway from dorsal injection than the volar injection. The other method to evaluate the pain sensation of the skin is by assessing the intraepidermal nerve fiber density (IENFD). The previous study showed that IENFD is higher in hairy skin than glabrous skin at the wrist level, but no study evaluated at the palm level yet [38]. Also, the other study found that the fingertip skin has more than twice the nerve fiber density in the papillary dermis than the volar skin of the palm [39]. These results may explain that volar injection has less pain than dorsal skin at the palm level, but further anatomical and histological studies were needed to verify it.
Cost-utility study of home-based cryotherapy device for wart treatment: a randomized, controlled, and investigator-blinded trial
Published in Journal of Dermatological Treatment, 2022
Nattanichcha Kulthanachairojana, Suthira Taychakhoonavudh, Kanokvalai Kulthanan, Sumanas Bunyaratavej, Sasima Eimpunth, Bawonpak Pongkittilar, Suthasanee Prasertsook, Supisara Wongdama, Charussri Leeyaphan
This randomized controlled trial was carried out at Siriraj Hospital, Bangkok, Thailand. Participants aged 18 or more with cutaneous warts on glabrous skin or in the palmoplantar area were included in the study. The exclusion criteria were as follows:patients with warts >1 cm in diameterpatients with warts on their face, scalp, anogenital area, or joint areapatients with abnormal skin around the wart area, such as erythema, wound, and puspatients with immunocompromised status, including poorly controlled diabetes mellituspatients with conditions that can be aggravated by cold, such as cryoglobulinemia and Raynaud’s phenomenonpatients with a history of wart treatment within 3 months prior to the studypatients with pregnancy or lactation