Clinical, Cosmetic and Investigational Dermatology最新文献

Background: The mechanism underlying skin photoaging remains elusive because of the intricate cellular and molecular changes that contribute to this phenomenon, which have yet to be elucidated. In photoaging, the roles of keratinocytes and fibroblasts are vital for maintaining skin structure and elasticity. But these cells can get photo-induced damage during photoaging, causing skin morphological changes. Recently, the function of natural active ingredients in treating and preventing photoaging has drawn more attention, with researches often focusing on keratinocytes and fibroblasts.

Methods: We searched for studies published from 2007 to January 2024 in the Web of Science, PubMed, and ScienceDirect databases through the following keywords: natural plant, natural plant products or phytochemicals, traditional Chinese Medicine or Chinese herbal, plant extracts, solar skin aging, skin photoaging, and skin wrinkling. This review conducted the accordance of Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Results: In total, 87 researches were included in this review (Figure 1). In keratinocytes, natural compounds may primarily regulate signal pathways such as the NF-κB, MAPK, PI3K/AKT, and Nrf2/ARE pathways, reducing inflammation and cellular damage, thus slowing skin photoaging. Additionally, in fibroblasts, natural active ingredients primarily promote the TGF-β pathway, inhibit MMPs activity, and enhance collagen synthesis while potentially modulating the mTOR pathway, thereby protecting the dermal collagen network and reducing wrinkle formation. Several trials showed that natural compounds that regulate keratinocytes and fibroblasts responses have significant and safe therapeutic effects.

Conclusion: The demand for natural product-based ingredients in sunscreen formulations is rising. Natural compounds show promising anti-photoaging effects by targeting cellular pathways in keratinocytes and fibroblasts, providing potential therapeutic strategies. However, comprehensive clinical studies are needed to verify their efficacy and safety in mitigating photoaging, which should use advanced pharmacological methods to uncover the complex anti-photoaging mechanisms of natural compounds.

Background: The existing observational research on the relationship between physical activity (PA) and skin cancer (SC) is contentious, which points to the intricate nature of their association and underscores the imperative for more nuanced research to untangle the causal dynamics at play. The aim of this article is to delve deeper into this complex relationship, seeking to clarify whether PA serves as a protective factor against SC, or contributes to its risk.

Methods: We utilized data from the genome-wide association study (GWAS) of PA from GWAS Catalog (include self-reported moderate to vigorous PA (MVPA), self-reported vigorous PA (VPA), and accelerometer-based average-accelerated PA). The data of SC is from FinnGen. All of the participants are of European ancestry. We used two-sample Mendelian Randomization (TSMR) to analyze the causal relationship between PA and SC.The research was conducted using inverse variance weighted (IVW) method as the primary approach, and MR Egger regression as supplementary analytical method. To ensure the robustness of the results, Cochran's Q-test and MR pleiotropy residual sum and outlier (MR-PRESSO) global tests were used to measure sensitivity.

Results: Our analysis indicated that average-accelerated PA was associated with an increased risk of SC (OR_IVW = 0.94, 95% CI 0.93-0.96, P < 0.001). While neither MVPA (OR_IVW = 0.99, 95% CI 0.67-1.47, P = 0.962) nor VPA (OR_IVW = 0.80, 95% CI 0.29-2.18, P = 0.656) shows causal relationship on risk of SC.

Conclusion: Our research suggests that PA is associated with a decrease in SC, provides a new perspective for future SC prevention. Our research findings bolster the hypothesis that increased levels of PA, characterized by average acceleration, are associated with a reduced risk of developing skin cancer. This has filled the gap of research on the causal relationship between PA and SC, and could pave the way for novel preventive strategies against skin cancer.

Background and aims: Acne vulgaris remains one of the most common and problematic dermatological conditions. Recently, a fractional 1927 nm thulium laser has been developed with specific water absorption characteristics which may be of interest in the treatment of acne.

Subjects and methods: Nine consecutive Korean subjects, 6 females and 3 males, ages ranging from 13 to 33 yr, presented with a mixture of inflammatory and noninflammatory acne. Baseline clinical photography, image analysis and lesion counts were performed. A fractional 1927 nm thulium laser (FTL) delivered 6 treatment sessions in 5 subjects and 5 sessions in 4 subjects, 4 weeks between sessions. Pain during treatment was assessed. At 32 weeks after the last treatment session, an independent Investigator Global Assessment (IGA) performed lesion counts and graded the severity of the acne at baseline and the final assessment on a quintile scale. Data were analyzed statistically.

Results: All 9 subjects completed the study with significant reductions in the inflammatory and noninflammatory lesions (P values 0.0012 and 0.0081, respectively) with overall lesion counts at the final assessment ranging from 60% to 97.1%, and acne grades in the IGA dropping by an average of 1.67 (range 1 to 3 grades). There was no significant difference in lesion counts or acne grades between the subjects who had 6 treatments and those who had 5 (P = 0.7695). Mild pain was reported during treatment, and no adverse events were reported by either the subjects or investigator.

Conclusions: The FTL at the parameters used in the present study caused disruption to the upper portion of the affected follicles and sebaceous glands under an intact stratum corneum, thereby destroying or damaging the causative Cutibacterium acnes. The superficial controlled coagulation additionally induced follicular remodeling and tissue regeneration, potentially contributing to the noticeable results in inflammatory and noninflammatory acne lesions.

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue tumor involving the dermis and subcutaneous fat that rarely occurs in children, manifested as a slowly growing firm plaque on the trunk. A 12-year-old girl patient presented with dark patch on the nasal root after finishing 25 sessions of radiotherapy. Initially, patient came to Oncology Surgery Clinic at Hasan Sadikin General Hospital Bandung with the chief complaint of a large exophytic mass located in the nasal area, which was neither itchy nor painful. A large, firm, painless mass with no sign of localized heat or redness was found on physical examination. There were no palpable cervical or axillary lymph nodes. Wide local excision and frontal flap procedure were performed by Oncology Surgery Department leaving a pedicle with 2×1.5×1 cm on size was observed. Upon histopathological examination, tumor mass was found in the subepithelium and consisted of oval to spindle-shaped cells that were hyperplastic, compacted, diffuse, forming fasciculus, whorled, and cartwheel. Cell nuclei were pleomorphic (oval to wavy), hyperchromatic, with clear nucleolus, and occasion mitotic figures. Hyalinisation was seen between the tumor masses. On immunohistochemical stains, there were diffuse positivity for epithelial membrane antigen (EMA) and vimentin. Based on the histological and immunohistochemical findings, the diagnosis of stage II DFSP was made. Until now, there is no established algorithm for treatment of DFSP. Wide local excision and radiotherapy for 25 sessions was performed on this patient, resulting in complete tumor mass removal. After three months of observation, the second surgery was done to remove a pedicle; however, there is no recurrence of tumor growth. Despite its rarity, DFSP should be considered as a differential diagnosis to avoid underdiagnosis or misdiagnosis.

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) significantly affect patients' quality of life (QoL). Cultural differences may lead to different patient-reported outcomes across countries. The current study aims to evaluate the detrimental impact of HZ and PHN on QoL in China.

Methods: This prospective study was conducted from January 2020 to April 2023. We used the Zoster Brief Pain Inventory (ZBPI) and 5-level EuroQol-5 Dimension (EQ-5D-5L) questionnaire to assess the QoL of HZ and PHN patients. Patients were required to complete the questionnaires at 15, 30, 60, and 90 days after the onset of the HZ rash. Additional questionnaires were administered at 120, 150, and 180 days for those who developed PHN within three months of the rash's onset.

Results: A cohort of 633 patients with a median age of 63 years were included in the study. The mean delay from the appearance of the initial HZ rash to the first medical consultation was 5.1 ± 2.8 days. Approximately 30% of the HZ patients (189/633) went on to develop PHN. For patients with HZ who did not progress to PHN, the ZBPI worst pain score and impaired QoL had nearly resolved by day 90 post-rash onset. Conversely, there was no significant improvement in the ZBPI worst pain score and QoL for those with PHN, even by day 180 post-rash onset.

Conclusion: Both HZ and PHN significantly impaired patients' QoL. However, the impairment caused by PHN was more severe in both intensity and duration.

Purpose: At present, we have entered the era of using biological agents and small molecule targeted drugs to treat diseases. Although there have been many reports of biological agents treating pityriasis rubra pilaris recently, the clinical application of the JAK inhibitors in the treatment of pityriasis rubra pilaris has been rarely reported, and there is a lack of evidence on the safety and efficacy of these drugs. We explore the use of the JAK inhibitor tofacitinib in the treatment of pityriasis rubra pilaris with significant efficacy and no significant side effects, providing new ideas for the clinical treatment of pityriasis rubra pilaris.

Methods: We cover a case of pityriasis rubra pilaris treated with the JAK inhibitor tofacitinib, which showed significant efficacy without any adverse effects.

Results: This case report showed that the JAK inhibitor tofacitinib had significant clinical efficacy in the treatment of pityriasis rubra pilaris. We speculated that the treatment of pityriasis rubra pilaris with the JAK inhibitors may be related to blocking the activation of the JAK/STAT pathway, thereby blocking the high expression of cytokines IL-17, IL-12/IL-23, IL-23, TNF-α.

Conclusion: The JAK inhibitor tofacitinib can become a new option for treating pityriasis rubra pilaris.

Objective: To assess the accuracy of HSV1and HSV2 antibody testing in identifying genital herpes infection.

Methods: A cohort of 299 patients previously diagnosed with recurrent genital herpes, confirmed via PCR, were tested using ELISA for HSV1 and HSV2 IgM and IgG antibodies. The study compared the accuracy of HSV1 and HSV2 antibody tests in diagnosing genital herpes.

Results: Among 299 patients, 14 tested positives for HSV1 DNA. Of these, 9 had HSV1 IgG antibodies, but none had HSV2 IgG antibody. Among 278 patients with HSV2 DNA, 149 had HSV1 IgG, 9 had HSV2 IgG, and 97 had both. Seven patients had both HSV1 and HSV2 DNA; 3 had HSV1 IgG, 1 had HSV2 IgG, and 3 had both. The accuracy of HSV1 IgG for HSV1 infection was 64.2%, and for HSV1 and HSV2 co-infection, 85.7%. The accuracy of HSV2 IgG for HSV2 infection was 38.1%, and for HSV1 and HSV2 co-infection, 57.1%. The combined antibody positivity accuracy was 34.9%.

Conclusion: Genital herpes is primarily caused by HSV2 (92.98%). A smaller percentage is HSV1 (4.67%) or co-infection (2.34%). Despite relatively low diagnostic accuracy (34.9-85.7%) for antibody detection, combined antibody testing is necessary. Herpes DNA testing is recommended for accurate diagnosis. Absence of antibodies does not rule out genital herpes and clinical assessment is essential.

Familial Reactive Perforating Collagenosis (FRPC) is a very rare form of benign dermatosis frequently presented during early childhood and not associated with systemic diseases. Less than 50 FRPC patients have been reported in the literature. Due to the limited number of cases, the pathophysiology of this unique entity remains elusive; moreover, no standard treatment has been agreed upon. Here, we report a case of FRPC in a 20-year-old male who was presented with generalized multiple discrete papules covered with central keratotic plugs in all regions of his body, particularly in the facial area, neck, abdominal, and extensor region of the extremities for more than 7 years. Similar symptoms were acknowledged in the patient's family members. Histopathological analyses identified the crateriform shape invagination in the epidermis filled with inflammatory lymphocytes and basophilic debris and perforated by basophilic collagen bundles from the underlying dermis. Based on the clinical and histopathological findings, the patient was diagnosed with FRPC. He was treated with topical desoximetasone 0.25% cream applied 2-3 times daily. A follow-up evaluation after 4 weeks revealed a near-complete resolution of skin papules. To our knowledge, this is the first report of FRPC case from Indonesia. Unlike the majority of FRPC patients who had their disease onsets during infancy or early childhood, FRPC skin manifestations in our patient started during the adolescence period. The resolution of skin manifestations after daily application of topical desoximetasone suggests that topical corticosteroids are a potential treatment option for FRPC patients.

Objective: Particular attention is given to the enhancement of melanin-related pigmentation (dark circles, photoaging) and vascular circles, which are commonly located in the tear trough. The objective of the study is to provide an objective evaluation of the impact of carboxytherapy and the treatment regimen combining carboxytherapy with lactobionic acid (20%, pH 2.1) or ferulic acid (14%, pH 4.0-5.0) and ascorbic acid (12%) on skin defects in the eye area.

Materials and methods: A group of 39 Caucasian people were subjected to a series of five carboxytherapy treatments (right eye area) and five treatments combining carboxytherapy with a selected chemical peel for the skin around the eyes (left eye area). The efficacy of therapy was assessed based on parameters (MI and EI) measured with the Mexameter probe. Measurements were made in the tear trough and the middle of the lower eyelid.

Results: We demonstrated that a series of carboxytherapy (right side) significantly statistically influenced the EI parameter (in different measurement points: P <0.0001, P = 0.015, P = 0.002), which reflects the intensity of vascular circles under the eyes. Improvement of this parameter by 7.2 units was also shown in the tear trough in 82.1% of participants after the application of carboxytherapy combined with acids (left side) on the valley of tears for this parameter (EI). Lactobionic acid and carboxytherapy were associated with a statistically significant improvement (P = 0.011) in the tear trough. In this study, a reduction in the combined pigmentation (MI plus EI) for both the right and left sides (p = 0.001 and p = 0.015, respectively) was observed.

Conclusion: The study provides objective evidence for the effectiveness of sole carboxytherapy and carboxytherapy combined with acids in the reduction of dark circles, in particular vascular circles in the tear trough. Lactobionic acid, ferulic acid, and ascorbic acid can be used as safe supplements to enhance carboxytherapy.