Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors. Because of the fact that skin health and beauty is considered one of the principal factors representing overall “well-being” and the perception of “health” in humans, several anti-aging strategies have been developed during the last years. It is the intention of this article to review the most important anti-aging strategies that dermatologists have nowadays in hand, including including preventive measurements, cosmetological strategies, topical and systemic therapeutic agents and invasive procedures.

Atrophic papulosis, previously called malignant atrophic papulosis, should be classified into a malignant, systemic form and a benign, cutaneous one, the latter being more common. The probability of having a benign form of the disease at onset is approximately 70%, increasing to 97% after 7 years of monosymptomatic cutaneous course.

Definition of the diseaseMalignant atrophic papulosis (MAP), described independently by Köhlmeier and Degos et al., is a rare, chronic, thrombo-obliterative vasculopathy characterized by papular skin lesions with central porcelain-white atrophy and surrounding teleangiectatic rim.EpidemiologyLess than 200 cases have been described in the literature. The first manifestation of MAP usually occurs between the 20th and 50th year of life.Clinical descriptionThe cutaneous clinical picture is almost pathognomonic. The histology is not consistent but in most cases it shows a wedge-shaped connective tissue necrosis in the deep corium due to a thrombotic occlusion of the small arteries. In the systemic variant, manifestations mostly occur at the intestine and central nervous system.EtiologyThe etiopathogenesis of the disease remains unknown, a genetic predisposition may occur. Vasculitis, coagulopathy or primary dysfunction of the endothelial cells have been implicated.Diagnostic methodsDiagnosis is only based on the characteristic skin lesions.Differrential diagnosisIt depends on the clinical presentation of MAP, but systemic lupus erythematosus and other connective tissue diseases need to be considered.ManagementNo effective treatment exists for the systemic manifestations, while compounds that facilitate blood perfusion have achieved a partial regression of the skin lesions in single cases.PrognosisAn apparently idiopathic, monosymptomatic, cutaneous, benign variant and a progressive, visceral one with approx. 50% lethality within 2–3 years have been reported. Systemic manifestations can develop years after the occurrence of skin lesions leading to bowel perforation and peritonitis, thrombosis of the cerebral arteries or massive intracerebral hemorrhage, meningitis, encephalitis, radiculopathy, myelitis.

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Background Atrophic papulosis is a very rare vascular disease of unknown pathogenesis, mostly described by case reports. Objective To assess demographic data and prognosis in patients with atrophic papulosis. Methods A single‐centre study was performed on a series of 105 patients with atrophic papulosis, diagnosed 2000–2021. Patients were referred and diagnosed at the evaluation centre and patients' clinical data were provided by the Degos Support Network and evaluated by the authors for confirming the diagnosis of skin lesions and fulfilling the diagnostic criteria for a malignant subset. A unique set of variables were collected from all patients. Results The mean age of disease onset was 33.3 ± 18.3 years and the male‐to‐female ratio was 1:1.6. The family history rate was 8.1%. The classification into a benign, merely cutaneous disease (benign atrophic papulosis), and malignant atrophic papulosis, associating cutaneous and visceral lesions was confirmed due to their striking prognostic difference. Benign atrophic papulosis was detected in 41% of the patients with no deaths occurring throughout the follow‐up period (median 3.00 years; range 0.13–23). Malignant atrophic papulosis was reported in 59% of patients with 47.5% multisystemic involvement and a median skin lesion onset to systemic symptoms duration of 0.54 years (−6 to 20). The gastrointestinal tract and central nervous system were equally involved; however, the neurological involvement‐caused death rate was slightly higher. The disease‐specific mortality rate of malignant atrophic papulosis was 22.6%. Conclusions Atrophic papulosis presents with a striking prognostic difference of benign – merely cutaneous – involvement or quickly developing – into less than 1 year – malignant subset, associating cutaneous and visceral lesions and multiorgan involvement in 1/2 of the patients, which leads to premature, disease‐specific mortality in 1/4 of the cases. Central nervous system and gastrointestinal tract complications are the major reasons for disease‐specific death. Over the years, the diagnosis of severe nervous system involvement has become more common.

Background Although the merely cutaneous, benign form of the extremely rare disease atrophic papulosis (K€ ohlmeier-Degos disease) may occasionally develop into the systemic, malignant form with time, it is unclear whether it exhibits any systemic characteristics.Objective To determine whether benign atrophic papulosis exhibits inflammatory and thrombo-occlusive signals and to classify it according to the Chapel-Hill classification of vasculitis.Methods In a monocentric, controlled study, levels of cytokines (IL-1b, IL-6, IL-8, IFNc, MCP-1, VEGF, TNFa, TGF-b1), antiphospholipid antibodies (cardiolipin IgG/A/M, cardiolipin IgG, cardiolipin IgM, b2-glycoprotein IgG/A/M, phosphatidyl choline, phosphatidyl serine, phosphatidyl inositol, phosphatidyl ethanolamine and sphingomyelin A), antibodies against proteinase-3 IgG and myeloperoxidase IgG, antinuclear antibodies and extractable nuclear antigen were assessed in blood samples of six benign atrophic papulosis patients and six age-and sex-matched healthy controls.Results IL-8 was only detectable in patients' serum. VEGF was reduced and cardiolipin IgG/A/M and b2-glycoprotein antibodies were increased in the patients' group. ANA were only detected in three patients, and ENA were negative throughout. No differences were detected between the other investigated markers.Conclusions This is the first study evaluating systemic inflammatory and thrombo-occlusive vessel signalling in benign atrophic papulosis and provides evidence of a non-antineutrophil cytoplasmatic antibodies immune-complex small vessel vasculitis according to the Chapel-Hill classification. These findings corroborate its systemic character despite the apparent missing involvement of systemic organs.

BAP not only exhibits an excellent prognosis, but resolution of lesions can also occur after a considerable period of time.

The polarity of all-cis-multifluorinated cyclohexanes can be fine-tuned by the number and relative orientation of fluoro substituents, giving rise to a series of compounds with strong dipole moments. Simulations provided the energetics, the dipole moments, and the respective molecular polarizabilities, while dielectric spectroscopy gave information on the dielectric permittivities and the molecular dynamics. In special cases, dipole moments in excess of 6 D and dielectric permittivities of over 300 were obtained by simulation and experiment. Melting temperatures within a given family of multifluorinated cyclohexanes were found to scale with the molecular volume. The less-symmetric all-cis-octa­fluoro­tetra­hydro­naphthalene did not readily crystallize, permitting an investigation of the molecular dynamics in an energetically unfavorable yet rigid and facially polarized isomer. The resulting dynamics above the glass temperature conform to the structural α-relaxation and to the celebrated Johari–Goldstein β-relaxation.