Clinical, Cosmetic and Investigational Dermatology最新文献

Purpose: To evaluate the effectiveness of standard therapy for acne vulgaris based on Indonesian guidelines.

Patients and methods: New patients with acne vulgaris at Dr. Cipto Mangunkusumo National Central General Hospital, the national referral center in Indonesia, who met the criteria were included in this study. Patients were treated with standard therapy for acne vulgaris based on the 2017 guidelines of Dr. Cipto Mangunkusumo Hospital, depending on severity. Changes in the number of non-inflammatory, inflammatory, and total lesions and the proportion of acne severity after three months of therapy were analyzed retrospectively.

Results: Among the 131 subjects, 63.4% had moderate acne; 20.6% had mild acne, and 16% had severe acne at baseline. Most patients (29 (22.2%)) received a combination of retinoic acid, benzoyl peroxide, and topical or oral antibiotics. Standard therapies reduced the median of non-inflammatory (25 (5-135) vs 8 (0-53)), inflammatory (10 (0-93) vs 2 (0-22)), and total lesions (41 (10-160) vs 10 (1-71)) at week 12 (all p < 0.001). The proportion of acne severity differed significantly after three months, with an increasing proportion of mild acne (20.6% vs 93.1%) and a decreasing percentage of moderate and severe acne (moderate = 63.6% vs 6.1%; severe, 16% vs 0.8%; p < 0.001).

Conclusion: Standard therapy for acne vulgaris based on the clinical practice guidelines in Indonesia improved acne lesions and severity after 12 weeks. These results support the implementation of national guidelines for acne management in Indonesia, with the practice of improving antimicrobial stewardship.

Background: Acral melanoma presents distinct biological characteristics compared to cutaneous melanoma. While adjuvant therapeutic strategies for high-risk resected acral melanoma closely resemble those for cutaneous melanoma, the evidence supporting the clinical application of adjuvant therapy for acral melanoma remains inadequate. Our aim was to systematically analyze the efficacy and safety profile of adjuvant therapy in acral melanoma.

Methods: This systematic review adhered to a pre-registered protocol. We comprehensively searched four electronic databases and reference lists of included articles to identify eligible studies. The primary outcome was therapeutic efficacy, and the secondary outcome was adverse events (AEs).

Results: This systematic review included 11 studies with 758 acral melanoma patients undergoing adjuvant therapy. High-dose interferon α-2b (IFN) regimens showed no significant difference in recurrence-free survival (RFS), though the longer regimen was linked to increased hepatotoxicity. Adjuvant anti-PD-1 therapy demonstrated varying efficacy, with improved RFS in patients who experienced immune-related AEs. Targeted therapy with dabrafenib plus trametinib achieved high 12-month RFS in patients with BRAF-mutated acral melanoma. Comparative studies suggested that adjuvant anti-PD-1 therapy is similarly effective to IFN in prolonging survival for high-risk acral melanoma patients. Additionally, prior treatment with pegylated IFN enhanced RFS in patients receiving adjuvant pembrolizumab.

Conclusion: High-dose IFN was widely used as adjuvant therapy for acral melanoma, but serious AEs prompted the search for alternatives. Adjuvant anti-PD-1 therapy shows promise, though it may be less effective than in non-acral melanoma. Further prospective studies are needed to determine the optimal adjuvant treatment for acral melanoma.

Tranexamic acid (TXA), a synthetic lysine analog, is a commonly used antifibrinolytic and procoagulant agent. Based on its good hemostatic efficacy, it is mainly used clinically for bleeding in trauma, various types of surgical and dental procedures and prevention of bleeding in patients with hemophilia. In recent years, studies have shown that TXA has the effects of anti-melanogenesis, anti-inflammation, anti-angiogenesis and promotes the recovery of the skin barrier, so it has been tried to be used as a treatment for hyperpigmentation and telangiectatic diseases. Oral, topical, intradermal injections and microneedling are all commonly used modes of administration. TXA for melasma is the most studied and has achieved indications in some countries, whereas it is still an off-label drug for many other dyschromia. We review the clinical use of TXA in hyperpigmentation and telangiectatic disorders other than melasma, such as post-inflammatory hyperpigmentation, Riehl's melanosis, rosacea, and post-acne erythema, to provide more evidence for the use of TXA in these disorders, and to provide safer and more cost-effective alternatives for the treatment of these diseases.

Background: Depigmentation of specific areas of the skin is a persistent and long-lasting dermatologic disorder known as vitiligo, stemming from the impairment and disruption of melanocytes both structurally and functionally, leading to the loss of pigmentation in those regions.

Aim: Our objective was to identify the pivotal genes and upstream regulators, transcription factors (TFs), microRNAs (miRNAs), and pathways implicated in the pathogenesis of vitiligo.

Methods: An integrated analysis was conducted using microarray datasets on vitiligo obtained from the Gene Expression Omnibus (GEO) database. The functional annotation and potential pathways of differentially expressed genes (DEGs) were additionally investigated through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Various bioinformatics approaches were utilized, making use of publicly accessible databases to identify appropriate TFs and miRNAs.

Results: Our investigation identified TYR, MLANA, TYRP1, PMEL, OCA2, SLC45A2, GPR143, DCT, TRPM1, and EDNRB as the most appropriate genes associated with vitiligo. Our suggestion is that the identified biological processes include developmental pigmentation (GO:0048066) and pigment metabolic processes (GO:0042440) as the most suitable biological processes. In contrast, the KEGG pathways that showed significance in our analysis are Tyrosine metabolism (Path: hsa00350) and Melanogenesis (Path: hsa04916). We hypothesized the involvement of ten TFs and 73 miRNAs in the regulation of genes related to vitiligo.

Conclusion: TYR, MLANA, TYRP1, PMEL, OCA2, SLC45A2, GPR143, DCT, TRPM1, and EDNRB are the top ten genes that are pivotal in the progression and exhibition of vitiligo. The biological, cellular, molecular, and KEGG pathways of those genes has an imperative role in the pathogenesis of vitiligo. TFs and miRNAs that interact with this gene are listed, shedding light on the regulatory mechanisms governing the expression of these key genes in vitiligo.

The patient, a 77-year-old Asian male presented with herpes zoster in the left lumbar and abdominal regions 9 weeks before presentation. The infection dried up after 2 weeks but was followed by an erythematous scaly rash in the same region with left-sided abdominal elevation. Pathological examination revealed continuous parakeratosis and Munro microabscesses. Abdominal computer tomography revealed no abnormalities, suggesting psoriasis with herpes zoster and Wolf's isotopic response to the pseudohernia of the abdominal wall.

The increasing use of hyaluronic acid (HA) implants has made adverse effects more apparent. Here, we present a rare case of massive allergic dermatitis due to HA injections. We performed dermoscopy and color ultrasound, which clarified that this was an allergic dermatitis caused by fillers, and analyzed the possible causes of the allergy. Common treatments were compared, and the advantages of 5-FU-based treatment regimens and their associated mechanisms were noted. A low dose of 5-fluorouracil and triamcinolone acetonide was administered to the patient's entire face and neck, and significant efficacy was achieved. We aimed to gather evidence on extensive dermatitis caused by HA injection, provide new perspectives and solutions for subsequent HA injections, and promote further research on the potential mechanisms of extensive skin inflammation and allergies caused by local HA injections.

Purpose: To evaluate the efficacy and safety of abdominal fat reduction in mini-pigs, utilizing at 1060 nm diode laser with a wavelength of 1060 nm.

Patients and methods: The laser system non-invasively disrupts adipose tissue; its effectiveness and safety were evaluated by ultrasound imaging and histological analysis. Laser irradiation was performed with various powers, and the cooling function was activated to prevent skin surface damage.

Results: The dermal tissue temperature increased to at least 43°C during laser exposure, leading to a decrease in abdominal fat thickness after 30 days. Blood tests revealed no significant changes in kidney and liver function but showed increased blood levels of nonessential free acids (NEFAs), likely due to the release of fatty tissue-derived free fatty acids. Histological evaluation demonstrated rapid transformation of adipose tissue into collagen, muscle fibers, and intracellular fibrous tissue.

Conclusion: The 1060 nm laser showed promise as a non-invasive and safe tool for reducing abdominal fat.