The Epistemology of Wrinkles: From Geology and Anatomy to Physiology

Paul, Sharad P.

doi:10.21103/article6(3)_pv1

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Of course, anatomical sites like knees and elbows have wrinkles that can be considered 'tension' wrinkles (two-dimensional, due to geometry, pretension and joint action) and in other areas like the forehead, muscle action causes 'compression' wrinkles (one-dimensional due to muscle action only), but in our view, BEST lines for surgical excisions may not be along these lines. (21) Add to this, other's findings that in keloid scars the increase of both elastin and collagen occurs in deep dermis, whereas a sharp decrease of elastin is found in the upper dermis of keloid, (22) and we have the beginnings of new insights and research into cutaneous surgery and wound healing.…”

Section: Discussionmentioning

confidence: 92%

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

Paul¹

2017

IJBM

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Background: Since Langer's first foray into studying cutaneous lines, although people have studied skin lines across the body, there has not been a study that elucidates changes to skin structure of elastin and collagen at different load levels. This study set out to look at whether incisional lines and excisional lines have different biodynamics and have to be considered differently.Materials and Methods: For this study, we used a two-photon microscopic camera using optimal wavelengths to detect collagen and elastin. Measurements were taken in 5 patients at the center of the excisional wound (high-load) and at the ends of the wound (tapered end of the ellipse) where effectively the wound is an incisional wound.Results: Wounds were observed after they were surgically closed. When incisional wounds were observed, where there was minimal tension (<1.5N force) we found that, in each case, elastin stretched and collagen buckled, revealing mostly elastin. Where larger defects were created after excisions (as in the figure where a skin cancer had been removed, where forces to close wounds were typically greater than 2N), we noted that the image revealed mostly collagen, suggesting that the reverse had occurred (i.e. collagen stretched and elastin buckled). Conclusion:This difference between tension loads on skin and the interplay between collagen and elastin has never before been elucidated for incisional and excisional wounds, and in the author's view has great research interest for a cutaneous surgeon seeking to identify the best skin lines to utilize to minimize scarring.

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Section: Discussionmentioning

confidence: 92%

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

Paul¹

2017

IJBM

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“…Value 3 is given if wrinkles appear to be deep (Figure 2). 11,12 The severity of coronary lesions was assessed using a modified Gensini score. 13,14 Statistical analysis was done using R statistical software version 3.5.2.…”

Section: Methodsmentioning

confidence: 99%

Correlation of Earlobe Crease and Clinically Identified Forehead Wrinkles with Severity of Coronary Artery Lesions in Patients with Stable Angina Pectoris

Panda¹,

Pangemanan²,

Kojansow³

2022

eCL

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Identification of high-risk subjects is crucial in prevention of coronary heart disease. Ear lobe crease and forehead wrinkles are easily identifiable physical signs that could potentially be an indicator of coronary artery lesion severity. This study aimed to determine the relationship between earlobe crease and forehead wrinkles morphology with severity of coronary artery stenosis in patients with stable angina pectoris using modified Gensini score. This was an observational study with a cross-sectional approach. All subjects who met the inclusion criteria were taken photos of their forehead area and both right and left ears. Assessment of scores and correlation analysis of earlobe crease and forehead wrinkles assessment with the severity of coronary artery stenosis using Gensini modification scores were later done. The results showed that from a total of 40 study subjects, 28 patients (70%) were male. Forehead wrinkle scores in patients with stable angina pectoris were mainly classified into score 1 and 2, totalling 32 (80%) patients. Earlobe crease form were dominated by type A (65% vs 35%). Patients with type B morphology on average have a Gensini value of 9 points lower than type A (reference) (p <0.001). As for the Gensini modified score in patients with non-zero forehead wrinkle scores, it was clearly 4−5 units greater than those with a zero score. However, the sample size of patients with zero forehead wrinkle score was indeed too small (n=3) to make the difference meaningful (p=0.507). In conclusion, there is a significant positive relationship between identification of earlobe crease and the severity of coronary artery stenosis but there is no strong relationship between the identification of forehead wrinkles and the severity of coronary artery stenosis in patients with stable angina pectoris, in this case with a modified Gensini score.Keywords: stable angina; earlobe crease; forehead wrinkles; modified Gensini score

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“…If we consider human skin as a mere physical membrane, wrinkles fundamentally occur because a keratinocyte-stiffened epidermis drapes a softer and thicker dermis [1]. Skin aging-either extrinsic mainly due to ultraviolet (UV) damage, or intrinsic due to physiological factors-is characterized by features such as wrinkling, loss of elasticity, and rough-textured appearance of skin [2].…”

Section: Introductionmentioning

confidence: 99%

Evaluation and Measurement of the Wrinkle-Reduction Performance of a NonToxin Based Topical Skin Serum on Volunteers

Am¹,

Paul²

2021

J Clin Cosmet Dermatol

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The Epistemology of Wrinkles: From Geology and Anatomy to Physiology

Cited by 5 publications

References 10 publications

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

Correlation of Earlobe Crease and Clinically Identified Forehead Wrinkles with Severity of Coronary Artery Lesions in Patients with Stable Angina Pectoris

Evaluation and Measurement of the Wrinkle-Reduction Performance of a NonToxin Based Topical Skin Serum on Volunteers

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