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1 Volume 21 - Number January/March 200 iz. Abb. Postale 70% Filiale di

2 Lotion Diet supplement Shampoo For the treatment of hair loss The right solution to an old problem Llll. ma VI BIOESSE I> " BIOESSE -- BIOESSE t PLUS i "

3 Clinical studies demonstrated Bioesse efficacy to treat mild to moderate hair loss in the frontal parietal scalp (l J,( 2 J,( 3 l lncreases hair mass and number in a short period (lj,( 2 J,( 3 l BI O ESSE MEAN PERCENTAGE VARIATION OF TOT AL HAIR MASS PER cm 2 OF PATIENTS W ITH ANOROGENETIC ALOPECIA TREATEO BY GELATIN- CYSTINE ANO SERENOA REPENS TOPICAL ANO/OR B Y ORAL ROUTE n 60 60% 1ncrease 1n hair mass : ~-1-~~---,~~~~-::;;,J.,.... m!!!!!!!!!t~=-~~-l-~~~.:::::i. e u E Jo+-~--:#---i:~...,::.~-:::=_._--::--:--:_.. ~ 20+-~,_.,, ~~~-+~~~~+-~~~-+~~~--! " ~ 10 >t k Plocebo(LotJon) O Plocebo(Dlot)...-ActlvoLotJon "*-ActlvoOlet """* ActlvoLotlon+ActlvoOlet All p values are hlghly 1lgnlflc1nt {p < ) 11 ba1ellne valu a s to groups MEAN PERCENTAGE VARIATION OF HAIR NUMBER PER cm 2 OF PATIENTS WITH ANOROGENETIC ALOPECIA TREATED BY GELATIN-CYSTINE A NO SERENOA REPENS TOPICAL ANO/OR BY ORAL ROUTE n 60 38% 1ncrease 1n hair number :1) Morganti P, Fabrizi G, James B, Bruno C, J. Appl. Cosmetol.16,57,1998 2) Fabrizi G, Morganti P, (1999),SOFW-Jouma/, 125, 2/3 : "3) Morganli P, (1999),Eurocosmetics 9: I -+-Placobo {Lotion) Plac.t>o (Oiet) -+-Active Lotlon - AcUve Dttt ~ Activ Lotlon+Actfv1 Dlet I All p valu1s are hlghly 1lgniflcant (p < 0.005) u ba11lln1 value a s to groups * NoUl"'H~ NO SIDE EFFECT WAS RECORDED MAVI sud srl V.le dell'industria, Aprilia (LT) ltaly Tel. 06/ Fax 06/ URL=http://www.mavicosmetlcs.it

4 TRATTAMENTO INTEGRATO COSMETICO-DIETOLOGICO PER CUTE ATOPICA E XEROTICA THE INNOVATIVE COSMETICS LINE FOR ATOPIC DERMATITIS luj mav1 MAVI sud - V.le dellflndustria, Aprilia LT Tel Fax

5 ~. ' THE SYSNTHESIS OF PR~STAG:~NDINES OF DRUGS ~ RIPRISTINA l'integrità della barriera cutanea la sintesi delle prostaglandine ~POTENZIA lattività dei trattamenti terapeutici 'Wl-Jf;N TO usç To ameliorate skin hydration in dry, dehydrated and sensitive skin and/or in psoriasis, atopic dermatitis, etc. 1-jO'W TO USt; 1 or 2 pillsl a day or according to medicai prescription. INDICAZIONI In tutti i casi di cute secca, disidratata e sensibile e come coadiuvante di patologie quali psoriasi atopia ecc. MODOD'USO 1 o 2 capsule al di secondo il parere del medico. EFAGEr. BALANCED DIET SUPPLEMENT Of LINOLENIC ANO HEARIDONIC ACID INTEGRATORE DIETETICO BILANCIATO DI ACIDO LINOLENICO E ACIDO STEARIDONICO llv Mavi sud srl - V.le dell'industria, 1 -Aprilia (LT) ltaly mavi Fax www.mavicosmetics.it-

6 !XIJ 1n oermattologia mav1 1 n 0 erma o 1 ogy 1 r OICnSC IUW..,

7 Trimestrale di Dermatologia Cosmetologica Quarterly Review of Cosmetic Dermatology EDITOR-IN-C HIEF P. MORGANTI. Ph.D. Secrc1ary Generai lntcmational Socicty of Cosme1ic Dem1a1ology Via Innocenzo Xl Roma (h;il y) Fax EDITING ASSISTA 'T M.L. NUNZIATA Via Innocenzo X l, Roma (ltaly) Fax ASSOCIATE EDITORS F.M. KEMPER. M.D. C. JACOBSON. M.D. Professor Emcri1us. Past Prcsidcni - ln1cma1ional Socic1y of Cosmclic Dcnnatology Pharmacology and Toxicology 3600Gas1011 Avc.Sui1c 1051 Dallas D MUns1cr. Domagk~1r. 11 TX USA Fax Fax M.B. JAMES. M.D. Program Dircc1or - lnlcmational Socicty of Cosrnclic Dem1atology 157 Beacon S1rcc1 #2 Bosion, Ma Phonc/Fax SCIENTIFIC SECTIONS AND EDITORIAL BOARD Celi :rnd Tissue Colture G. Biagini (I) L. Di Silvio (UK) N. Stark (USA) Molecular Biology L. Bruckncr-Tudcrman (D) V. Calabrese (I) T. Krieg (D) J. Ui110 (USA) Skin Biology B.Bcrra (I) M. Ponce (NL) Photobiology H. Honigsmann (A) F.P.Noonan (USA) Y.K.Park (Korca) G. Prota (I) S kin lmmunology A. Gianncui (I) Skin Permeation J.P. Many (F) G. Puglisi (I) Skin Pharmacology F.H. Kcmper (D) R. Paolctti (I) Skin Toxicology S. Paglialunga (I) M.G. Rozen (USA) Skin Ageing S. Jablonska (PL) M. Noszczyk (PL) M. Versehoore (F) Natural Cosmesis a nd Balncology G. Agostini (I) B.R. Balda (D) Non lnvasive Methods and Diotechnologics H. Tronnicr (D) W. Gchring (D) U. Hcinrich (D) E. Bcrardesca (I) P. Elsncr (D) Skin and Cosmetk Microbiology J. Kabara (USA} D.Onh (USA) D. Stcinbcrg (USA) Skin Bioengineering L. Andrcassi (I) L. Rodrigues (P) P. Elsncr (D) Allergy Testing F.K.E. Andcrsen (NL) B. Santucci (I) A. Senoli (I) Cosm etic Manufacture and Contro) L. Ntcta (SA) A. Parsons (SA) H.C. Roos (SA} Cosmetics and Fragrances G. Angclini (I) Cosmetics and Environmcnt Rcu10 l.s. Tranggono (Indonesia) P. Suvanprakom (Thailand) Aromatherapy and Natural Raw Malerials G. Salvatore (I) Cosmelics' Safety Evaluation E. Chiacchcrini (I) Clinical lnvestigutions in Cosmetic Oermatology H. Maibach (USA) Oral Mucosa and Oenla l Care Problems E. Benagiano (I) Nail Care Cosmelics R. Baran (F) B. Richen (B) A. Tosti ( I) Hair Care Cosmelics S. Calvieri (I) W.A.D. Grifri1hs (UK) C.E. Orfanos (D) Cosmetics and Skin Oisorders V. Mordovstcv ( R) W. Raab (A) T. Ruzicka (D) Plastic and Aesthetic S urgery P. Palombo (I) Cosmelic Pediatry G. Fabriz.i (I) Y. Kazuya (J) A. Taicb (F) Cosmetic Gynaecology A. Lanzone (I) S. Mancuso (I) M. Massobrio (I)

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9 GENERAL INFORMATION The J OUR AL OF APPLIED COSMETOLOGY is an intemational joumal devoted to publishing originai papers. reviews and other materiai which represent a useful contribution lo research on the skin and on cosmetics. Il is aimed at cosmetic chernists. dermatologists. microbiologists. pharmacists, experimental biologists. toxicologists, plastic surgeons. and ali other scientists working on products which will come into contaci with the skin and its appendagcs. The Journal is published quancrly in English. lt is distributed to cosmetic chemists, derrnatologists. plastic surgeons, medicai and pharmaceutical schools. medicai libraries. selected hospitals and research institutions throught the world. and by subscription to any other interestcd individuals or organizations. Statements and opinions cxpressed are persona I to thc respective contributors andare not necessarily endorsecl by the Editor(s). Advisers. Publishers of Distri butors of this Joumal. COPYRIGHT Subrnittccl materiai rnust be the originai work of thc autor(s) and must not ha ve been submilled for publication elsewhcre. By submitting a manuscript. the authors agree thai the copyright far their aniclcs is transferred 10 the publisher if and when the anicle is acceptecl for publication. None of the contcnt of this publication may be reproduced in whole or in pan. translated. stored in a retrieval system. or transmiued or distributed in any form or by any means (electronic, mechanical. photocopy. recording or otherwise) without the prior written pcrmission of the Publishers. Sections of J ournal The following sections will be features of the Journal: Origi11al Laboratory Studies: descriptions of originai investigative laboratory research in cosmetics and rclatcd areas. Special Reports: ltems of special interest 10 the readers. including repon s on meetings. societics. lcgislation. etc. Ge11eral Articles: scientific anicles of generai interest to our readers will be considcrcd far publication. These anicles should be concern ecl with newer clcvcloprncnts in such relateci fielcls as clennatology. biology. toxicology. etc. Short Co icatio11s: the lenght should noi excced 5 typewritten pages with not more than 3 fi gures includcd. Hcadings ("Matcrials". "Discussion". etc.) as well as Summaries are to be omitted. lf accepted. these submission will appear in print in a very shon time. l..eller to the Editor: comments on Journal anicles are invited as well as brief contributions on any aspccts of cosrnetic science. Letters may include ligures. and/or referenccs. but brevity is neccssary. G11est Editorials: concise. authoritative. substantiated commentary on specilic topics of contemporary interest. Book Reviews: book and monographs (clomcstic ancl foreign) will be reviewecl depending on their interest and valuc 10 subscribers. Send materiai for review to the Editor. Dr. P. Morganti. No such materiai will be returned. Address: al l 1apers shoulcl be submittccl 10: Dr. P. Morganti INTERNATIONAL EDIEMME Via Innocenzo Xl Rame - ltaly Fax. 0039/6/ INFORMATION FOR AUTHORS Papers must be submitted in English. Authors whosc mothcr tongue is English should arrange for their manuscripts 10 be written in propcr English prior to submission. Procedure of S11b111issio11 of /11a1111scrivts: submit three copies of both thc manuscript and ali illustrative materiai to the abovc address. Orga11izatio11 of the Mmmscript: investigative studics should be organizcd as follow: tille. abstract pagc. introduction. materiai and methods. rcsults. cliscussion. acknowlcdgments. references. legend for fi gures. tables. Ali pages should be numerccl consccutively starting with thc abslract. Thc cntirc manuscri pt is to be typcwri11en. doublc-spaccd. :md with 3 cm margins. Tracie namcs must be capitalizcd: the common name far compounds may be used if the formai chemical narne as established by intcrnational convention is given aft er the lirst use. Any abbrcviations other than those which are gcnerally accepted must be clclincd. In the text. references to dual authors will use both surnames throughout. For multiple authors. use the surnames of ali authors al the first refercnce and only the lirst author followed by "et al'' thereafter. Please mark in the margin of the manuscript thc desired position of the figurcs and tables. To allow fastcr publication only set of proofs will be fumishecl 10 the author including the figures and tables in thcir linal position. Tille page: list the tille. name(s) and degree(s) of author(s). depanment(s) a ncl institution(s) al which the work was done. city. state. and postai code. Any preliminary repon or abstract of thc work should be referred to as a footnote to thc tille. S ary: each paper must be headed by an English language titlc of not aver 70 characters (including spaccs) suitable for use as a running head and must also be proceded by an English summary not excceding 300 words typed double-spaced. T hc summary will include statements of the problem. rnethod of study. rcsults. and conclusions. Since this sumrnary will be used by abstracting journals. it must be self-cxplanatory and shoulcl not inlcudc abbreviations, footnotes. and rcfercnces. FooMotes: should be listed consecutively al thc bottom of the page on which they fall, designated by the following symbols in ordcr **.etc. Key Words: key words far computcriscd storagc and retrieval of information should be incorporated in the summary. Refere11ces: the references have to be abbreviateci as listcd in the lndex Medicus. The stylc of the refercnces rnust conforrn to the examplcs given bclow: I) Robbins CR. Kellych ( 1970) Aminoacid composition of Mman hair. Tcxt Res J 40: ) Strehler BL ( 1977) Time. cells and aging 2nd cdn. Academic Press. New York 3) Ebling FJ. Rook ( 1972) Ciclic activity of the follicle. In: Textbook ofdermatology 11. Blackwell. Oxford. p ll/11stratio11s: fi gurcs should be numberecl consecutively using Arabic nurnerals Tables should be numbered consecutively. using Rornan numerais. Ali photographs should be black and white. glossy and unrnounted. The number and size of illustration should be restricted to the minimum needed 10 clarify the 1ex1. Authors rcquiring extra space for illustrations will be charge accordingly. This is also the case for color illustrations. All ligures, photographs. graphs. or diagrams should be submitted on separate sheets. A11i111al Exeri111e11ts: descriptions of animai experiments should include full cletails of the types of ani mai used (inbred. etc.) and thc conclitions under which they wcre kept (standard diett. etc.) Trade Names: ali common cosmctic ingrcdients should be referred to by their generic names. as indicated in the latest edition of CTFA Cosmctic lngredient Dictionary. and thc European Pharrnacopeia. lf a materials is not listed. then the tradcmarkcd name can be used. with the chemical composition given in footnotes.

10 INFORMAZIONI PER L'ABBONAMENTO L'abbonamento annuale comprende quattro numeri. É possibile ottenere abbonamenti a prezzo ridotto da parte dei ricercatori che lavorano presso Istituti che abbiano sottoscritto almeno un abbonamento a prezzo normale. L' Editore potrà fornire a richiesta notizie più dettagliate. Le sottoscrizioni di abbonamento possono essere effettuate mediante assegni postali, bancari, di conto corrente o per contanti indirizzandoli a: INTERNATIONAL EDIEMME - Via Innocenzo XI, 41, ROMA - ITALIA c/c bancario n. 3184/51 Banca di Roma Ag. 1 - Aprilia (LT) - ITALIA L' IVA è a carico dell'editore, non detraibile dall'abbonato a norma art. 74 lett. C DPR 633/72 SOTTOSCRIZIONI ANNUALI 2003 Europa Altre Nazioni US $ 120 Numero singolo 36 Numero arretrato 40 Numero Speciale 50 Sconto Agenzia I 0% Membri ISCD Gratuito SUBSCRIPTION INFORMATION Subscriptions are entered on a calendar years basis only and include four regular quarterly issues. Half-price subscriptions are available to research scientists whose institutions already subscribe at full rate. Details on application from publisher. Payment must be made using bank draft, international postai money order only. Italian residents only may pay by persona! check: INTERNATIONAL EDIEMME - Via Innocenzo XI, 41, ROMA - ITALY c/c bancario n. 3184/51 Banca di Roma Ag. 1 - Aprilia (LT) - ITALY ANNUAL SUBSCRIPTION RATE 2003 Europe Other Countries, US $ 120 Single Issue 36 Back Issue 40 Special lssue 50 ISCD Members Free of charge Discount Agency I 0% Statements and opinions expressed in the articles and communications herein are those of the author(s) and not necessarily those of the Editor(s), or publisher. The Editor(s) and publisher, disclaim any responsability or liability for such materiai and do not guarantee, warrant, or endorse any product or service advertised in this publication nor do guarantee any claim made by the manufacturer of such product or service

11 Quarterly Review of Cosmetic Dermatology INFORMAZIONI PER L'ABBONAMENTO L'abbonamento Annuale comprende quauro numeri. È possibile ouenere abbonamcmi a prezzo rido no da parte dci ricercatori che lavorano presso islituti che abbiano $Ottoscri110 almeno un abbonamento a prezzo nom1alc. L.Edi1ore potrà fornire a richiesta notilic più dcuaglime. Le souoscritioni di abbonamento possono essere effettuale mcdi:rntc assegni postali. bancari di conto corrente o per contanti indirizzati a: INTERNATIONAL EDlEMME - Via Innocenzo Xl Roma c/c bancario n. 3184/51 Banca di Ronrn Ag. I - Aprilia (LT) - llalia -AB(; CAB; Abbonamento JOURNAL OF APPLIED COSMETOLOGY Europa altre Nazioni US $ 120!stru:ioni per /'abbo11ame11to: O desidero abbonarmi a quesra rivisra per /'a11110 in corso O rinnovo automaticamente il mio c1bbo11ame1110 per gli a1111i f uturi (questa forma di abbonamento può essere comunque disdeua in ogni e11to). Odesidero ricevere le 11o r111e editoriali per eventuali col/abora:io11i (Scrivere i11 stampatello) Nome Indirizzo Città CAP _ Nazione Quarterly Review of Cosmetic Dermatology SUBC Rll'TION INFORMATION Subcripcions are cnlcrcd on a calcndar ycar ba..~is only ;md include four quancrly issucs. Halr-price subscriptions are availablc 10 rcscarch scicn1is1 whose ins1iiu1ions alrcady subsribc al lull raie. De1ail ~ on applicalion from publishcr. Paymcnt mu'ol be made in U.S. dollars utiiing bank draft inlcmational pos1al moncy ordcr only. llalian rcsidcnls only may pay by persona! check: dc bancario n Banca di Roma Ag. I -Aprilia (LT) - lta ly -ABJ; CAB; Order Form JOURNAL OF APPLIED COSMETOLOGY Annual subscription rate: Europe, Other Countries US$ 120 Plcase Check O I Yet1r subscription O Renelt" my s11bscr;p1io11 automatically in fwure years (1/J;s comùwation order is ùjtended /or subscribers com enience 011/y a1ui my be ca11celled at a11y time). O Sell{/ 111e a copy of infomwtion for Awlwrs. Name Addres City Postal Code Country

12 STAMP spett. Direzione "Journal of Applied Cosmetology" lnternational Ediemme Via Innocenzo Xl, Roma (ltaly) STAMP Spett. Direzione "Journal of Applied Cosmetology" lnternational Ediemme Via Innocenzo Xl, Roma (ltaly)

13 Trimestrale di Dermatologia Cosmetologica Quarterly Review of Cosmetic Dermatology Contents Generai Articles 1 Hair and nail structure and function A. Rossi, L. Barbieri, G. Pistola, P. Bonaccorsi and S. Calvieri 9 Botanicals for Innovative Cosmenutriceuticals A. Cristoni and P. Morazzoni 23 Prevention/ Repair cream: What s new? M. Fr sc hl e Originai Laboratory Studies 35 Clinica! study on the effect of a cosmetic emulsion in irritateci skin A. Sparavigna, M. Setaro, S. Sormani, M. Bergamasc hi XVI Announcements ISCD National Professional Workshop Efficacia e Sicurezza d uso dei prodotti Topic o-lniettivi nella Dermatologia e Ginecologia Cosmetologica ltaly th World Congress on Cancers of the Skin Sevilla, Spain, 7-10 May, 2003 First World Congress on Work Relateci and Environmental Allergy (1 st WOREAL) & Fourth lnternational Symposium on lrritant Contact Dermatitis (ICD) Helsinki, Finland, 9-12 July, 2003 The 13th lnternational Hair Science Symposium HairS'03 Potsdam - Germany, l 0-12 September, 2003 CARTA ECOLOGICA- ENVIRONMENTALLY PAPER - PAPIER ECOLOGIQUE - PAPEL ECOL6GICO

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15 Trimestrale di Dermatologia Cosmetologica Quarterly Review of Cosmetic Dermatology Dear Readers, l'm informing you that on our website is open the forum "Are carotenoids really effective as skin and eyes protectants?" Sunlight causes wzwanted and deleterious stresses 011 skin resulting in changes to DNA and oxidation of nucleic acid proteins and lipids. The worst consequence of photodamage is aging and skin cancer Hu111a11 antioxidant network can keep oxidative damage to cells at a minimum by enzymes and enzymic compounds such as hydrosoluble vitamin C, and liposoluble vitamin E, ubiquinol and carotenoids. In Cosmetic Dermatology these antioxidant compounds provided to the skin both topically and systemica/ly, 111ay supplement sunscreen protection with additional antiaging and anticarcinogenic protection. Many are the scient(fic papers supporting topica/ and systemic activity of normai and oxygenated carotenoids as skin and eye photoprotectants, but many are also scientists who are against this opini on. Are carotenoids really effective as skin and eyes protectants? l'm looking forward to know your opinion about it To reply and!or to read some published papers on this challenging topic, please enter 011 Yours Pierfrancesco Morganti Editor-in-Chief

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17 J. Appl. Cosmetol. 21, (Jonuory/Morch 2003) Hair and nail structure and function Alfredo Rossi, PhD, Luca Barbieri, MD, Giuseppe Pistola, MD, Paola Bonaccorsi, MD, and Stefano Calvieri, PhD Department of Dermatology and Plastic Surgery - Policlinico Umberto I - Univ. La Sapienza -Rome - ltaly Received: February, 2002 Key words: Hair; Naif; UV Protection Summary The hair and nail are skin appendages that share with the skin a common origin from the ectoderma] layer. They fulfil important protective and cosmetic physiologic function. After intrauterine!ife, hairs are di vided, by size in two maj or types: vellus and terminal. Terminal hair is described as being substantial or large in size with a diameter of about 60mm. The scalp hair is a typical terminal hair. Vellus hairs are smaller, more lightly pigmented and the diameter is less than 30mm. The hair has a growth cycle consisting in different phases: anagen, telogen, catagen. The nail provides protection to the distai digit as well as aesthetic adornment and dexterity. Hair and nail disorders have a deep impact in the patient self-confidence and relation!ife. A vast spectrum of nail or hair alterations can be observed during the course of systemic disease although a causative association is seldom proved. A deep knowledge of the structure and physiology of the nail is necessary to correctly approach the pathogenesis of nail disorders. Riassunto I capelli e le unghie sono annessi cutanei che con la cute hanno in comune la deri vazione ectodermica. Questi rivestono un importante fu nzione fisiologica di protezione e vestigiale. I peli terminali presentano un diametro di circa 60 micron. Il capello è un tipico pelo tenninale. I peli vello sono più sottili, depigmentati, con diametro di circa 30 micron. Il ciclo del pelo consta di diverse fasi: anagen, telogen, catagen. Le unghie forniscono protezione alle falangi distali delle mani e dei piedi, sono un adornamento estetico e favoriscono l'esecuzione dei movimenti fini. Le malattie dei capelli e delle unghie hanno un considerevole impatto sulla vita sociale e di relazione del paziente. Un vasto spettro di alterazioni delle unghie e dei capelli può essere osservato in corso di malattie sistemiche sebbene il nesso causale sia raramente provato. Una approfondita conoscenza della struttura anatomica e della fisiologia dell'unghia consentirà un corretto approccio patogenetico. l

18 Hair and naif structure and function HAIR ANATOMY Two main types of hair are present after birth, although intermediate forms are also seen: vellus hair (fig. I), unmedullated, unpigmented or lightly pigmented, growing to a maximum of 2 cm, are usually located in body areas normally considered "hairless", such as a child's cheek; on the contrary, terminal hair (fig.2) are medullated and variously pigmented... ' A Fig. 2 Histological aspects of a rerminal lwir The hair follicle consists of a complex system of multiple tissue compartments that ai e clearly distinguishable by their morphology and type of differentiation. As hair fo llic le is associated with a sebaceous gland, arrector pili muscle and apocrine sweat gland, the conventional designation for the pilo-sebaceous unit fails to do justice to it, both linguistically and morphologically. In fact the unit is not a "hair-sebaceous" one, but it is a folliculo-sebaceous-apocrine smoothmuscled and nervous and vascular unit [l]. On average, the entire body surface of an adult contains follicles [2] (Tab. I). Table I. Hair follicles 11umbe1: Tota! hair follicles 5,000,000 Head 1,000,000 Scalp 100,000 Fig. I Histological aspects of a vellus lwù: They can grow to considerable length and a~e best defined by their size relative to vellus hair (ca. 2x diameter). Terminal hair is the typical hair of the scalp throughout life in normai individuals. Each hair shaft is produced by an hair follicle, a mainly epithelial structure which protrudes down through the dermis, often into subcutaneous adipose tissue. The maximum number of hair follicles is present at birth. Scalp biopsies have shown follicles per cm2 at birth, that decrease approssimately to 300 per cm2 in adult life. As seen in Tab. II, hair follicle morphology varies according with race. A wide range of variation is also present in hair colour. Depending on the of presence of eumelanin, pheomelanin or oxymelanin the hair can be black or brown, blond or red respectively. 2

19 A. Rossi, L. Barbieri, G. Pistola, P.Bonaccorsi, and S. Ca/vieri Table I. Hair follicle mo1phology: racial variarions. Caucasoids Negroids Mongolian Variable from straight to helical Helical follicle Straight follicle Anatomically, each hair can be divided in two parts: an external one, named hair shaft and an inner one, named hair follicle. The mayor structure of the hair shaft is the cortex. It consists of elongated cells that run parai lei to the fiber axis. Within lhese cells are Iocated the tonofilaments and interfilamentous matrix materiai that are responsible for most of the physicochemical properties characteristic of who le hair. It is surrounded by a cuticle of overlapping flattened cells with their free margins pointing upwards to the hair tip. Thick hairs have a centrai zone of more loosely organized keratinised materiai, the medulla (figg.3a-3b) [3]. In the hair follicle, the hair shaft is surrounded (from centrai to peripheral) by the inner root s heath, the outer root sheath, the baseme nt membrane and the perifollicular sheath of connective tissue. A mature follicle in anagen, as viewed in sections oriented vertically and by conventio nal microscopy, can be divided in two parts: an upper segment and a lower segment. This subdi vis io n has a relevance even from a biologica) point of view. In fact, while the upper segment is permanent, the lower segment is the part o f a follicle that undergoes changes during the hair cycle, marked by g rowing, involuting and resting. The upper segme nt exte nds fro m the ostium of the foll icle to the attachment site of the arrector pili muscle. It is dividend in two parts: the upper infundibulum, from the ostium of the follicle to the point at which the sebaceous duct enters the fo llicle, and the isthmus which extends from the inferior boundary of the infundibulum to the insertion of the an-ector pili muscle (fig.4). Fig. 3A Histological aspect of a transverse sec1io11 of hair: I) medulla, 2) cortex, 3) cuticle. Fig. 38 Ultrastrnc t11ral aspecl of hair shaft transverse sectio11: i) 111ed11/la, 2) cortex, 3) culicle. 3

20 Hair and noi/ structure and function. This proliferation is more marked at the site of attachment of the arrector pili muscle. The bulge is probably the source of germinati ve cells that enables a follicle to be reconstituited at the end of telogen (4-6). The lower segment extends from the insertion of the anector pili muscle to the base of the follicle and is divided in the stem and the bulb. The stem [ l] is the upper part of the lower segment. It extends from the upper boundary of the bulb to the base of the isthmus. The lowest part of the follicle is named the bulb (fig.6). Fig. 4 Hisrological aspecrs of the upper seg111e111 of a hair follie/e: I ) i11fi111dibulu111, 2) isthmus. The bulge (fig.5) is a localized thickening of the outer sheath and it is a proliferation of cells of the outer sheath at isthmus. Fig. 5 Histological aspecr ofthe bulge. Fig. 6 Hislological aspect of J/Je bui b. It is composed by the mat.rix, the supramatrical zone and the keratogenous zone. The matricial zone extends from the base of the bulb to the site where the bulb has the widest diameter which is called the criticai line of Auber. The supramatrical zone spans from the criticai line of Auber to the B-Fringe which defines the area where keratinization in the Henle's layer of the inner root sheath begins and where the outer root sheath becomes stratified. The keratogenous zone boundaries are defined by the B-fringe proximally and the A-Fringe (Adamson's fringe) distally. The A-fringe is the site where the comification of the cortical keratinocytes is first observed and where Huxley's layer loses its trichohyajin granules (fig.7). 4

21 A. Rossi, L. Barbieri, G. Pistola, PBonaccorsi, and S. Calvieri Fig, 8 The derma/ papilla. Fig, 7 T/Je three areas ofthe b11/b: I ) criticai li11e of Aubet; 2) 8 -fri11ge, 3) A-fringe, a) malrical zone, b) supra- 111t1 Jrical :one, e) kera1ogeno11s zone. The matrix contains the proliferating pool of undifferentiated cells that give rise to the three components of the inner sheath and to the hair shaft Although the matrix has been assumed to be the source of the outer root sheath, that has not yet been demonstrated, Above the matrix, in the supramatrical zone, begins the differentiation of the progenitor cells. In the keratogenous zone the cells begin to die and cornify. The anagen hair follicle contains an assembly of speciali zed fibrobl asts, the derma! papilla (fig.8), which is located in the center of the hair bulb and surrounded by the epidermally derived germinative epithelium. The dermal papilla is composed by various cel- 1 u I ar types (fibrobla sts, Langherans ce lls, lymphocytes, mast cell s), extracellular matrix, blood vessels and nervous fibres and is probably responsible for inducing differentiation of the hair bulb matrix [7-8]. This parallels embryologic events, where development of the epithelial component is dependent upon inductive stimuli from the mesenchyme [9]. There is also evidence that the size of the hair follicle and the volume of the hair fiber are determined by the volume of the derma I papi I la [ I 0-1 I]. In the hai r foll icle, hair shaft is surrounded by the inner root sheath, which is composed, moving inward, of Henle's layer, Huxley's layer and the cuticle of the inner root sheath. The inner root sheath stretches from the base of the bulb to the isthmus, where the cornified cells desquamate. The outer root sheath is located from the inner root sheath and extends from the base of the follicle to the lower boundary of the infundibulum. It is composed by epithelial cells that changes gradually in width and colour, through the follicle length. At last, the dermal sheath is a connecti ve tissue that surrounds the outside of the hair follicle (fig.9), 5

22 Hair and naif structure and function forrn a rnelanocyte reservoir in the skin. Under certain circurnstances, for exarnple durina re-. b p1gmentation of vitiligo, outer root rnelanocytes proliferate and migrate to the epidermis [ 18]. At last hair offers a valid UV protection of the scalp skin. NAIL ANATOMY Fig. 9 Hisrological aspect of the root sheaths: J) in11er root shearh, 2) outer root sheath, 3) derma/ sheath, the baseme11t membrane ( arrow ). HUMAN HAIR FUNCTIONS Hair is an important element of human appea '. ance that is commonly used for recognition and 1s o ne determinant of physical attractiveness [12]. Across the centuries, the decoration of scalp hair has been a medium of socia! communication and a display of socia! identity or status. Severa! studies have shown the negative psychological impact of various conditions associated with hair loss [13-1 5]. For many years hair has been regarded as important only for these aesthetic functions, but recently hair follicle epithelial cells and their contribution to healing skin ha ve attracted particular attention [ 16]. It is believed that epi thel ial outer root sheath cells provide replacement cells for the epidermi s in response to wounding. Moreover, the derma! sheath probably contains progenitor cells that become important in the wound healina b process [ 17]. Hair plays an important rote even in skin repigrnentation. In adult follicle, rnelanocytes are found in the bulb epitheliurn, and in the epithelial outer root sheath cells at the infundibulurn and at the lower part of the follicle. While only active (DOPA-positive) rnelanocytes exist in the epiderrnis of normai skin, there are some inactive (DOPA-negative) rnelanocytes in the outer root sheath of the lower part of a normai hair follicle. These latter cell s appear to Like hair, the nail unit forrns by invagination of the epiderrnis into the derrnis. It consists of the nail plate and the tissues that surround it. The nail plate is a fully keratinized structure that covers the dorsal distai phalanges of the fingers and toes. It results frorn rnaturation and differentiation of the epithelial nail matrix cells and is firrnly attached to the nail bed, which partially contributes to its forrnation. The nail bed is the structure upon which the nai l rests. It extends from the distai rnargin of the lunula to the epidermis of the hyponychium and, normally, appears pink because of a blood-filled vascular network that is visible through the translucent plate. The nail bed keratinization produces one fifth of the tota! mass of the nail plate which consists of a thin, horny layer that forms the ventral nail plate. The nail rnatrix is a specialized epithelial structure that lies underneath the proxirnal nail fold. The epitheliurn of the nail rnatrix consists of basai cells that differentiate into spinous cells and subsequently into the orthokeratotic cells that compose the nail plate. The matrix appears as a convex crescent and consists of a proxirnal or dorsal portion and a distai or ventral portion. The proxirnal portion of the matrix is the predominant supplier of cornified cells that consti tute the dorsal nail plate, whereas the distai rnatrix (lunula) contributes the interrnediate nail plate. Proxirnally and Jaterally the nail plate is surrounded by the nail folds, which cover its lateral and proxirnal rnargins. The hyponichiurn is the anatomie limit between the nail bed and the free rnargin of the nail plate. 6

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