EFFECT OF TOPICAL HORMONES ON SKIN 555 ./:- .?•. i?-,:...•:-' .•? ... .:s •.•.. :.?:. •.• .,?.,....--•..:,• :: - . ..:5 .. •.... ', :.. • . .•.' ?' :.. . :- . ...:'•: --.•:'. . ,..•.. ./:. •:-: :• ..7 :.: . •-t :. - ' ,.': ß --• , .•: •:•'• •:•::.: .•'( •- •,:. i(•½ g:'i '•': ...:•: -• :•..•,•:¾.:.':•.•. ..... :•' 7f" :' :'"'• •-•'..-5•:, t'..•'• • ......... ..... :•.: .: ?.: .. •:• ' -: •: .•',: t:)• •:2.'.: • •:... '•.: Figure 5. Senile purpura-like lesions produced by topical application of corticosteroids. The left extensor forearm has been treated with triamcinolone acctonide cream for one year, the right with its control vehicle the basement membrane, which normally is a sharp, serrated structure inserting into the basal layer at the dertoo-epidermal junction, appears as a blunted, hazy, attenuated, and discontinuous structure (Fig. 7A). Dermal degradation is most prominent in the sun-exposed sites. Murky masses of dense, basophilic, elastotic material occupy the major portion of the dermis, sparing but a thin subepidermal zone. Elastic staining, particularly in thick sections, reveals a tangled skein of coarse fibers, while the delicate, finely branched sub epidermal strands are reduced. The acid mucopolysaccharide (AMP) ground substance, defined by Hale staining, is greatly diminished, surviving in small quantity in the papillary dermis. Correspondingly, there exists a depletion of fibro-

556 JOURNAL OF THE SOC1ET¾ OF COSMETIC CHEMISTS : :.•.. ,,:,,-" ½- '5'-', .,•,, •' .•: :•, ,,,,•.' •-• :- '-L .• :.-' • . .•.• •- . •. . ...... . ...... ,..•: . • - ½. ½ :- ............ '•. '=, :"-,• *"-• ,•/'•a,,: - - • , •.. . ½ %•7• • . * *•" "'• :• '• '• • .•' - .... ' .... L• •:"• • '"• :-* ,"½• •" -. ,.:. • -• • %• .... . .... -•½ ,.... . ½ 2..:.½•..• .... •, .,.-: ..... •. •:: .,m .:.: ,.. •. ..- .• - • :,.? - •[: "...•':. . .,•' j:• '•.• :...[ ,•- ..... . .... , .: ..:• • rr• • . .•.• ..... .:.•: :-•. :-.?-..• •. _• ' . , :.,.. .... .•,.. ...... •,.Y' :• •.. ½- -• . , ...5• .-" ..."'-.%:• ,•-.. •-. .... ": ?:¾' :"::':::('I. :'•' .... .'.. ' ::::2. ':•% :• . .., ' :::. e'- .• *• ...... . ::" ' ...' . :":.::•. :•,,•. .•.(::• :::• '•:".• '•2•:-• '•:- :z . x : : .%.. . . . ..•.. • : • ..... :-. -. .-. .•:.&. -• ..' .*½: z-•, • ..}-.•:... ': '. ß .: ':•,. '•. '..y• .......,•.:.. ' -•. .."•:... •' .:. ::•:' • .... (A) ..... "• ..-%-.• ...... ...... (t•) Figure 6. Enhancement of epidermal structure by testostcrone. The control specimen (A) from the face of an 80-year-old white woman typifies the chaotic, atrophic epidermis of exposed aged skin. Some of the dc.gradative dermal changes are also evident The testo- sterone-treated side (B) has undergone remarkable "rejuvenation." Both specimens are photographed at the identical magnification (H & E X400)