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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2015 ; 10
(9
): e0138117
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Histopathology of Incontinence-Associated Skin Lesions: Inner Tissue Damage Due
to Invasion of Proteolytic Enzymes and Bacteria in Macerated Rat Skin
#MMPMID26407180
Mugita Y
; Minematsu T
; Huang L
; Nakagami G
; Kishi C
; Ichikawa Y
; Nagase T
; Oe M
; Noguchi H
; Mori T
; Abe M
; Sugama J
; Sanada H
PLoS One
2015[]; 10
(9
): e0138117
PMID26407180
show ga
A common complication in patients with incontinence is perineal skin lesions,
which are recognized as a form of dermatitis. In these patients, perineal skin is
exposed to digestive enzymes and intestinal bacterial flora, as well as excessive
water. The relative contributions of digestive enzymes and intestinal bacterial
flora to skin lesion formation have not been fully shown. This study was
conducted to reveal the process of histopathological changes caused by proteases
and bacterial inoculation in skin maceration. For skin maceration, agarose gel
containing proteases was applied to the dorsal skin of male Sprague-Dawley rats
for 4 h, followed by Pseudomonas aeruginosa inoculation for 30 min. Macroscopic
changes, histological changes, bacterial distribution, inflammatory response, and
keratinocyte proliferation and differentiation were examined. Proteases induced
digestion in the prickle cell layer of the epidermis, and slight bleeding in the
papillary dermis and around hair follicles in the macerated skin without
macroscopic evidence of erosion. Bacterial inoculation of the skin macerated by
proteolytic solution resulted in the formation of bacteria-rich clusters
comprising numerous microorganisms and inflammatory cells within the papillary
dermis, with remarkable tissue damage around the clusters. Tissue damage expanded
by day 2. On day 3, the proliferative keratinocyte layer was elongated from the
bulge region of the hair follicles. Application of proteases and P. aeruginosa
induced skin lesion formation internally without macroscopic erosion of the
overhydrated area, suggesting that the histopathology might be different from
regular dermatitis. The healing process of this lesion is similar to
transepidermal elimination.