Composite tissue allotransplantations can be indicated when autologous transfers fail to restore human appearance. We report the reproducibility, difficulties, serious adverse events and outcomes of our patients. Five patients were included in a registered clinical research protocol after thorough screenings assessed by an independent expert committee systematically discussing the alternative options. One patient suffered from plexiform neurofibromas, two from third degree burns and two from gunshot injuries.They were included on a national waiting list with a dedicated face procurement procedure. Transplants were harvested from heart beating brain-dead donors before other tissues and organs. Induction immunosuppressive therapy included antithymocyte globulins, steroids, mycophenolate mophetil and tacrolimus. Maintenance therapy included the last three ones associated with extracorporeal-photopheresis. Four patients were transplanted with 7-to 38-month followup. One could not due to multiple panel reactive antibodies after 18 months on waiting list. Acute cellular rejections were controlled by conventional treatment. Opportunistic infections affected all patients and lead one patient to die two month after the transplantation. Voluntary facial activity appeared from 3 to 5 month. Face transplantation has been reproducible under conventional immunosuppression. Major improvements in facial aesthetic and function allowed patients to recover social relations and improved their quality of life.

This study compared in man the in vivo barrier function of stratum corneum in three racial groups: black, Caucasian and Asian, by two noninvasive technics. They were transepidermal water loss (TEWL) determination measured with an evaporimeter and laser Doppler velocimetry (LDV) to measure the lag time before the vasodilatation induced by application of methyl nicotinate (10 μl of 0.5% solution in ethanol/propylene glycol 95/5 v/v). Both methods were performed simultaneously on each forearm of 7 black, 8 Caucasian and 6 Asian subjects before and after removal of the stratum corneum by stripping. TEWL measurements were higher (p < 0.01) in Asians and Blacks compared to Caucasians. Stripping (8 or 12 strips) increased TEWL in all groups; TEWL increase percentage was higher (p < 0.05) in Asians compared to Caucasians. Vasodilatation lag times assessed by LDV showed that skin permeability was more important in Asians (p < 0.01) and in Caucasians (p < 0.05) than in blacks. Lag times decreased with stripping. After 8 or 12 strips, the order of sensitivity was: Asian > Caucasian > black. Our study showed that, with both noninvasive methods, removal of the stratum corneum increased permeability, with racial differences.

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Green tea (Camellia sinensis) and Ginkgo biloba extracts in cosmetic formulations have been suggested to protect the skin against UV-induced damage and skin ageing. Thus, it is very important to assess the human skin penetration of their major flavonoids to verify if they penetrate and remain in the skin to exert their proposed effects. The aim of this study was to evaluate the human skin penetration of epigallocatechin-3-gallate (EGCG) and quercetin from green tea and G. biloba extracts vehiculated in cosmetic formulations. This study was conducted with fresh dermatomed human Caucasian skin from abdominal surgery mounted on static Franz diffusion cells. Skin samples were mounted between two diffusion half-cells and 10 mg/cm² of formulations supplemented with 6% of green tea or G. biloba extract were applied on the skin surface. The receptor fluid was removed after 6 and 24 h and analyzed by high-performance liquid chromatography for the quantification of the flavonoids. The stratum corneum was removed by tape stripping and immersed in methanol and the epidermis was mechanically separated from the dermis and triturated in methanol to extract EGCG and quercetin. The results showed that the flavonoids under study penetrated into the skin, without reaching the receptor fluid. The majority of EGCG was quantified in the stratum corneum (0.87 μg/cm²), which was statistically higher than the EGCG concentrations found in viable epidermis (0.54 μg/cm²) and in the dermis (0.38 μg/cm²). The majority of quercetin was quantified in the viable epidermis (0.23 μg/cm²), which was statistically higher than the EGCG concentration found in the stratum corneum layer (0.17 μg/cm²). Finally, it can be concluded that EGCG and quercetin from green tea and G. biloba extracts vehiculated in cosmetic formulations presented good skin penetration and retention, which can favor their skin effects.

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This article gives the results of a study whose aim was to compare the compartmental distribution and absorption of 5 UV filters, in vitro, by fresh human skin, after exposure times of 30 min and 16 h. These UV filters from BASF (octyl methoxycinnamate, benzophenone 4, benzophenone 3, octyl triazone and octocrylene) were incorporated separately in a simple oil-in-water emulsion. The composition of the emulsions was designed in order to obtain a sun protection factor of 5. Therefore the UV filters were introduced into the emulsions at different concentrations. We show that the affinity for each skin level [stratum corneum (SC), viable epidermis, dermis and receptor fluid] is different according to the test substance used. Some substances accumulated in the SC, whereas others passed through the skin very quickly and were quantified in the receptor fluid. The stripping technique allowed us to see that more than 94% of the chemical compound in the SC was in the first eight tapes. The problem of individual values below the limit of detection was raised, a correlation between the two exposure times was found (y = 1.702x – 0.105; R = 0.94) and a classification of products according to their affinity for the SC was determined.

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