A comparison of wire brush and diamond fraise superficial dermabrasion for photoaged skin : A clinical, immunohistologic, and biochemical study

• Published in: Journal of the American Academy of Dermatology 1996-02, Vol.34 (2), p.235-243
• Main Authors: NELSON, B. R, METZ, R. D, GOPA MAJMUDAR, HAMILTON, T. A, GILLARD, M. O, RAILAN, D, GRIFFITHS, C. E. M, JOHNSON, T. M
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Biopsy; Blotting, Western; Dermabrasion - adverse effects; Dermabrasion - instrumentation; Dermatologic Surgical Procedures; Diamond; Diseases of the skin. Cosmetics; Epidermal Cyst - etiology; Equipment Design; Face - surgery; Fibroblasts - pathology; Humans; Immunohistochemistry; Keratosis - metabolism; Keratosis - pathology; Keratosis - surgery; Lentigo - metabolism; Lentigo - pathology; Lentigo - surgery; Male; Medical sciences; Middle Aged; Peptide Fragments - analysis; Procollagen - analysis; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Skin - chemistry; Skin - pathology; Skin Aging - pathology; Skin Diseases - etiology; Transforming Growth Factor beta - analysis
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(96)80118-6

Superficial dermabrasion has a proven beneficial effect on photoaged skin, but little is known about the differences between the two major modalities used in dermabrasion, the diamond fraise (DF) and the wire brush (WB). We compared the clinical, immunohistologic, and biochemical changes after superficial dermabrasion with DF and WB. Eight photoaged patients (mean age, 68 years; range, 49 to 80 years) underwent facial dermabrasion to the level of the papillary dermis. Clinical assessments were performed at baseline and at 3 and 12 weeks after dermabrasion. Biopsy specimens were taken from both dermabraded halves at the same time points and assessed by routine histologic and immunohistologic examinations, western blot analysis, and radioimmunoassay. Scoring of intracellular and extracellular transforming growth factor-beta 1 was based on a semiquantitative ordinal scale (0 = no staining to 4 = maximum staining) in half-unit increments. The score for each specimen represents the average of values obtained from four high-power fields. Both methods of dermabrasion resulted in significant resolution of actinic keratoses, lentigines, and wrinkling. No statistical significance was noted between the two methods in regard to clinical efficacy. Significantly fewer milia occurred after DF than after WB. Solar elastosis decreased with both the WB and DF. Immunohistologic examination demonstrated a highly significant increase in papillary dermal fibroblast staining for amino terminal procollagen I (type I pN-collagen) at 3 weeks for both DF and WB compared to baseline. Staining at 12 weeks had decreased from the peak noted at week 3, but was still significantly increased from baseline. Western blotting of type I pN-collagen demonstrated a 5.4-fold (p = 0.01) increase from baseline at 3 weeks and a 4.9-fold (p = 0.002) increase at 12 weeks after dermabrasion with the WB. Similarly, the DF produced a 4.9-fold (p = 0.006) increase at 3 weeks and a 5.1-fold (p = 0.008) increase at 12 weeks after dermabrasion. Western blotting of amino terminal procollagen III (type III pN-collagen) showed a 6.1-fold (p = 0.07) increase from baseline at 3 weeks and a 3.9-fold (p = 0.04) increase at 12 weeks after dermabrasion with the DF. The WB showed a 3.8-fold (p = 0.07) increase from baseline at 3 weeks and a 5.1-fold (p = 0.05) increase at 12 weeks. Transforming growth factor-beta 1 demonstrated a significant increase in extracellular staining with DF (3.3 +/- 0.2) and WB (3.7 +/- 0.2)