Clinical, Cosmetic and Investigational Dermatology最新文献

Introduction: Changes in the skin microbiome are associated with acne vulgaris (AV), a condition characterized by comedones, papules, and pustules. While some bacteria have been studied, many others remain unexplored, highlighting the need to understand the microbiome differences between acne-prone and normal skin. This study aimed to compare skin microbiome profiles between AV patients and healthy individuals and to explore associations with microbial diversity and specific bacterial populations involved in AV pathogenesis.

Methods: A total of 144 participants were recruited, comprising 36 AV patients and 108 healthy controls. Skin samples were collected from the left cheek after standardized preconditioning. DNA was extracted using the DNeasy PowerSoil Kit™, and the V3-V4 region of 16S rRNA was amplified and sequenced. Microbial diversity was assessed by the Shannon index, and correlations with sebum levels were analyzed.

Results: The results revealed significant differences in microbial diversity, with AV patients exhibiting a markedly lower Shannon index compared to controls, indicating decreased microbial diversity and potential dysbiosis. While the relative abundance of Cutibacterium acnes, a bacterium commonly associated with AV, showed no significant differences between the two groups, the prevalence of Staphylococcus epidermidis was notably higher in AV patients. This suggests that S. epidermidis may play a complex role in the inflammatory processes associated with AV. Moreover, the study identified a negative correlation between microbial diversity and sebum levels, suggesting that increased sebum production may favor the growth of S. epidermidis, potentially exacerbating the condition.

Conclusion: These findings highlight the interaction between host factors and microbial composition. This study emphasizes the role of skin microbiome dysbiosis in acne vulgaris and provides insights for future microbiome-based therapeutic strategies. Further research is needed to clarify microbial mechanisms and potential interventions targeting the microbiome in the management of acne vulgaris.

Objective: Intrinsic atopic dermatitis (AD) is a chronic inflammatory skin disease with pruritus and eczematous lesions of skin. A long-lasting cycle of itch-scratch roots results in substantial morbidities and discomfort. Treatment of patients with moderate to severe dermatitis is a challenge. To evaluate the efficacy of a treatment based on mineral salts and natural antioxidants agents in patients with AD.

Patients and methods: In this prospective study, 34 patients with AD were treated for 14 days. Patients were evaluated before and after treatment. The effects were studied by the following clinical measurements: Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD), Body Surface Area (BSA), and Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD). Patient-reported measurements were also assessed: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), and the pruritus Numeric Rating Scale (NRS). Biopsies were performed in 10 patients and immunohistochemistry tests in 7 patients.

Results: All clinical and patient-reported measurements showed a strong difference before and after treatment. The epidermis thickness was significantly reduced, as well as the lymphocyte infiltration and the reduction of CD3, CD4, CD8, CD20 and CD117 cells. No adverse events were observed.

Conclusion: This study shows that the severity of intrinsic dermatitis was drastically reduced with the treatment of mineral salts and natural antioxidants agents. This topic treatment was very well tolerated without adverse events.

Skin aging is a multifactorial process driven by a combination of intrinsic genetic programming and extrinsic environmental exposures. Recent advances in epigenetics have illuminated how changes in DNA methylation, histone modifications, and non-coding RNAs regulate skin aging, with the epigenetic clock emerging as a powerful tool to quantify biological age. This review aims to synthesize current evidence on how environmental and lifestyle factors - particularly ultraviolet radiation, pollution, smoking, diet, and stress - accelerate skin aging through epigenetic mechanisms, while also evaluating the potential of skin-specific epigenetic clocks as biomarkers for early detection of premature aging and for guiding therapeutic interventions. We further discuss the expanding field of epigenetic-targeted therapies in dermatology, encompassing topical agents, energy-based devices, and systemic approaches that may reverse or delay visible signs of cutaneous aging. By integrating insights from molecular biology, environmental science, and clinical dermatology, this review positions skin aging not as an irreversible outcome but as a modifiable, biologically regulated process with promising avenues for personalized prevention and rejuvenation.

Subacute cutaneous lupus erythematosus (SCLE) is a clinical subtype of cutaneous lupus erythematosus (CLE), an autoimmune connective tissue disease characterized by photosensitive rashes. This report presents a rare case of SCLE involving the chin. The patient presented with an annular, erythematous, scaling plaque on the left chin, which had been repeatedly misdiagnosed. Through integrated analysis of dermoscopic features, reflectance confocal microscopy (RCM) findings, and skin biopsy, a definitive diagnosis was established. Combination therapy with systemic corticosteroids and immunomodulators was initiated. Significant lesion regression was observed at the 19-week follow-up. The combined application of dermoscopy and RCM optimizes clinical management by reducing diagnostic errors and enabling real-time treatment monitoring.

Keloids have traditionally been classified as fibroproliferative disorders; however, emerging evidence establishes chronic inflammation and immune dysregulation as the central pathogenic nexus, orchestrating a self-sustaining cycle of pathological healing. This review proposes a paradigm shift toward understanding keloids as a spectrum of auto-inflammatory fibrotic disorders. We synthesize recent advances to demonstrate how genetic predisposition and epigenetic modifications prime a hyperinflammatory response, which is then amplified by endocrine factors and executed through aberrant signaling pathways. Crucially, this inflammatory milieu drives the metabolic reprogramming of fibroblasts toward a Warburg-like phenotype, providing the bioenergetic and biosynthetic substrate for relentless proliferation and extracellular matrix (ECM) deposition. Infiltration and skewed polarization of immune cells further fuel this fibro-inflammatory cascade. Our integrative framework, positioning dysregulated immunity as the disease core, explains keloid persistence, recurrence, and heterogeneity, thereby providing a rationale for combination-based, mechanism-driven therapies. Ultimately, this perspective illuminates novel therapeutic strategies that target the inflammatory core (eg, biologic agents against Th2 cytokines and mast cell products) and its downstream consequences (eg, metabolic inhibitors), offering hope for more effective, mechanism-based interventions against this recalcitrant condition.

Background: Poly-L-Lactic acid (Sculptra^®, PLLA-SCA^®) is a biodegradable bio-stimulating agent composed of irregularly shaped PLLA particles capable of inducing extracellular matrix regeneration. Beyond traditional volumisation, emerging evidence suggests broader epigenetic and adipogenic effects, positioning PLLA as a key agent in regenerative aesthetics.

Objective: To retrospectively evaluate long-term outcomes of PLLA-SCA treatment in 28 female patients using 3D imaging analysis, focusing on two protocols; (1) full-face skin firming and (2) skin firming with additional targeted volumisation and/or asymmetry correction.

Methods: A retrospective review of clinical data and standardised 3D stereophotogrammetric imaging was performed two years post-treatment. Patients were divided into the two treatment strategy groups. Volume differences were quantified using validated reconstruction software, and clinical outcomes were assessed through physician evaluation and patient-reported satisfaction.

Results: All patients demonstrated measurable soft tissue volume formation at two years, ranging from 0.75cc to 6.4cc per vial of PLLA-SCA. Skin quality improvement and facial harmonisation were consistently observed. No untoward effects, such as vascular compromise, nodules, or granulomas, were reported.

Conclusion: PLLA-SCA produces sustained soft-tissue formation and skin firming effects, persisting for at least two years. The findings support PLLA-SCA as an effective regenerative agent with long-lasting volumising and tissue enhancing properties.

Purpose: This study aims to develop and validate machine learning models for predicting hyperglycemia risk in psoriasis patients.

Methods: Clinical data from 575 psoriasis patients admitted to the Department of Dermatology were collected and randomly split into a training set and an internal test set in a 7:3 ratio. An external test set was derived from 135 psoriasis patients enrolled in the National Health and Nutrition Examination Survey (NHANES) during 2003-2004 and 2011-2012. Eleven machine learning algorithms, including decision trees, random forests, extreme gradient boosting (XGboost), light gradient boosting machine, support vector machines, multilayer perceptron, K-nearest neighbors, logistic regression, lasso regression, ridge regression, and elastic net, were systematically compared. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), calibration curves and clinical decision curve (DCA).

Results: The extreme gradient boosting (XGboost) was selected as the final predictive model due to its robust performance across multiple evaluation metrics. The area under the curve values for the training, internal, and external test sets were 0.821 (95% confidence Interval (CI): 0.775-0.866), 0.820 (95% CI: 0.751-0.888), and 0.788 (95% CI: 0.695-0.881), respectively. Calibration and clinical decision curve analysis confirmed the model's accuracy and clinical utility. Additionally, a web-based calculator was developed to improve the model's accessibility and application.

Conclusion: The XGBoost-based model effectively predicts hyperglycemia risk in psoriasis patients, emphasizing personalized treatment plans for high-risk individuals to manage hyperglycemia progression and psoriasis-related inflammation.

Cheilitis simplex is a prevalent form of cheilitis that is characterized by the presence of cracked lips, fissures, or desquamation, due to various etiologies. Utilization of "boosters" as a treatment for chapped lips has not been extensively researched. This case report aimed to describe the efficacy of lip booster injection comprising active ingredients of 1% hyaluronic acid (HA) and 1% polynucleotides (PN), with 0.3% lidocaine as anesthetic agent. A 30-year-old female patient presented with a chief complaint of dry and chapped lips that occasionally bleed. This condition had recently deteriorated, and the application of topical treatment had not yielded substantial improvement, which led to a state of distress for the patient. She was diagnosed with cheilitis simplex and was subsequently treated with a single subdermal injection of a combination of 1% HA, 1% PN, and 0.3% lidocaine. Lip hydration was increased gradually, as measured by tewameter, with peak rate of hydration (26.218 g/m²/h) occurred two weeks after injection, and subsequently decreased gradually until six weeks after injection (29.926 g/m²/h); however, the rate of hydration remained higher than the baseline value (34.386 g/m²/h). Additionally, the lips exhibited an increase in brightness and a shift in pigmentation toward a rosier hue, as substantiated by spectrophotometric analysis. The mechanism of HA and PN include providing hydration and stimulating dermal fibroblast activity. However, PN may also exert an additional effect of improving lip pigmentation by reducing melanin and increasing hemoglobin levels. In conclusion, the lip booster injection, comprising 1% PN, 1% non-cross-linked HA, and 0.3% lidocaine, is an efficacious and practical treatment option for cheilitis simplex. This treatment option offers the additional benefits of being pain-free and enhancing lip pigmentation. Further studies are required to confirm these findings.

Purpose: Dermatofibrosarcoma protuberans (DFSP) and dermatofibroma (DF) are cutaneous lesions with overlapping clinical features, often requiring histopathological confirmation. This study aims to evaluate and compare the diagnostic utility of high-frequency ultrasound (HFUS) and ultra-high-frequency ultrasound (UHFUS) in distinguishing these two entities over 15-year period.

Methods: A retrospective analysis was conducted on 334 patients (127 DFSP, 207 DF) with pathologically confirmed diagnoses. HFUS or UHFUS was used to assess lesion characteristics, including demographics, location, size, morphology, echogenicity, homogeneity, posterior acoustic features, and vascularity. Univariate and multivariate logistic regression analyses were performed to identify significant predictors.

Results: DFSP patients were significantly older than DF patients (40.99 years vs 34.00 years; P < 0.001). DFSP lesions were predominantly on the trunk, while DF was more common on the extremities (P < 0.001). DFSP lesions were significantly larger (mean 43.02 mm vs 10.34 mm; P < 0.001), and exhibited more aggressive sonographic features, including tentacle-like borders, internal hyperechoic areas, peripheral hyperechoic rims, mixed echogenicity, irregular shape, ill-defined margins, internal heterogeneity, and frequent posterior enhancement (all P < 0.005). DFSP also showed higher vascularity with random, peripheral, or arborizing patterns and higher Adler grades (all P < 0.001). Multivariate analysis identified tumor location (extremities favoring DF), size, ultrasound pattern (tentacle-like border pattern, internal hyperechoic area, peripheral hyperechoic rim, and mixed echogenicity pattern favoring DFSP) as independent predictors.

Conclusion: HFUS and UHFUS demonstrates strong diagnostic utility in differentiating DFSP from DF based on key clinical and sonographic features. These findings support the use of HFUS and UHFUS as a valuable non-invasive tool for preoperative diagnosis. Future studies should validate these criteria in multi-center settings and exploring artificial intelligence integration to further enhance diagnostic accuracy and standardization.

Background: Vitiligo is a chronic pigmentary disorder characterized by the progressive loss of melanocytes, resulting in skin depigmentation. Although UV-based therapies, such as narrowband UVB, are commonly used for treatment, excessive sun exposure may aggravate the disease. Understanding patients' perceptions and behaviors related to sun exposure is crucial, particularly in tropical countries like Thailand, where UV levels are high.

Purpose: To assess the knowledge, attitudes, and photoprotection behaviors of Thai vitiligo patients compared to healthy controls.

Patients and methods: A cross-sectional study was conducted from January to August 2025 using a self-administered questionnaire. The questionnaire assessed participants' demographics, vitiligo-related characteristics, knowledge and attitudes toward sun exposure, perceived skin cancer risk, and sun protection practices. Data from 105 vitiligo patients and 85 controls were analyzed using chi-square and descriptive statistics.

Results: Vitiligo patients showed greater awareness of the effects of sunlight on their condition than the control group. A higher proportion thought mild sunlight may improve vitiligo (57.1% vs 31.8%, p < 0.001). Only 25.7% of patients believed they had an increased risk of skin cancer. Vitiligo patients were more likely to use sunscreen regularly (53.3% vs 37.6%, p = 0.031) and during outdoor activities (61.0 vs 40.0%, p = 0.004) compared to control. However, reapplication rates were suboptimal with 75.2% of vitiligo patients never reapplied sunscreen, and fewer patients reapplied occasionally compared to controls (18.1% vs 37.6%, p = 0.002).

Conclusion: Thai vitiligo patients demonstrated moderate understanding of photoprotection and skin cancer risk, but significant behavioral gaps exist, notably in terms of sunscreen reapplication and comprehensive sun protection methods. These findings underscore the need for focused educational efforts to close the knowledge-practice gap, highlighting both the benefits and risks of UV exposure in vitiligo treatment.