Clinical, Cosmetic and Investigational Dermatology最新文献

Background: Multiple methods have been used to treat hypertrophic scarring; however, an optimal treatment method remains to be established. We aimed to research and compare the effects of cell-free fat extract (CEFFE) and platelet-rich fibrin (PRF) on hypertrophic scar formation based on histomorphological analysis in this study.

Methods: Twelve rabbits were divided into four groups randomly. (CEFFE+PRF group, n=3; CEFFE group, n=3, PRF group, n=3 and Control group, n=3). After the ear hypertrophic scar model were established, the two ears of each rabbit in the four groups were injected with CEFFE 0.05 mL/cm² + PRF 0.05 mL/cm², CEFFE 0.1 mL/cm², PRF 0.1 mL/cm², and saline 0.1 mL/cm², respectively. The scar elevation index and histological analysis using hematoxylin-eosin and Masson staining were evaluated after injection on day 40.

Results: The CEFFE+PRF group was significantly more effective in the prevention of pathological scar formation than the CEFFE-only, PRF-only, and control groups in terms of capillary count, collagen organization, fibroblast count, and scar elevation index (p<0.05).

Discussion: CEFFE combined with PRF was the most effective treatment for the prevention of hypertrophic scar formation in our study.

Background: Vitiligo is a common disease. Limited studies in Saudi Arabia have explored the detailed clinical characteristics of vitiligo, as outlined in recent consensus reports by vitiligo experts.

Objective: To determine vitiligo prevalence and detailed clinical characteristics in a Saudi cohort.

Methods: Cross-sectional study over six years. All cases were electronically identified and manually verified. Prevalence and sex were determined based on all vitiligo cases. Detailed analysis was done only for patients seen in a specialized vitiligo clinic with standardized documentation.

Results: There were 1555 vitiligo cases (prevalence 0.235% [95% confidence interval 0.224-0.247], 938 [60.32%] were female). Detailed analysis for other variables was done in 573 patients. Onset before age 20 years was found in 49%. Family history of vitiligo was reported in 42.15%. Triggering factors were present in 32% with stress being the most common (24%). Proportion of clinical characteristics was as follows: nonsegmental vitiligo (88%), signs of activity (49%), lesional pruritus (25%), halo nevi (4%), leukotrichia (19%). Some patients had isolated facial involvement and others had leukotrichia on the eyelids (not eyelashes). Atopy and hypothyroidism were the most prevalent systemic diseases, while alopecia areata, atopic dermatitis, and psoriasis were the top skin conditions. Antithyroid antibodies were high in approximately a third of patients and the majority of patients had low vitamin D. Elevated erythrocyte sedimentation rate (ESR) was observed more in patients with clinical signs of activity (70% vs 54%, p-value 0.0007).

Conclusion: Prevalence of vitiligo was found to be similar to worldwide figures, with a higher proportion having affected family members. Stress as a trigger, lesional pruritus, signs of activity, thyroid disease, and low vitamin D were all common and should be routinely checked. Novel findings include isolated facial involvement, eyelid leukotrichia, and high ESR in active vitiligo.

Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enhancing the immune system's ability to target cancer cells. However, ICIs can lead to immune-related adverse events (irAEs), including dermatologic manifestations such as bullous pemphigoid (BP).

Objective: To evaluate the efficacy and safety of omalizumab and other biologics in the treatment of ICI-induced refractory bullous pemphigoid and to derive a strategy for selecting biologic treatments for this condition.

Methods: A 48-year-old female with pulmonary squamous cell carcinoma developed erythema and blisters following tislelizumab treatment. Despite initial steroid therapy (1.8 mg/kg/day), new blisters formed. Laboratory tests revealed elevated BP180/230 levels, confirming BP diagnosis. Treatments with intravenous corticosteroids, cyclosporine, and dapsone were ineffective. Omalizumab 300 mg every four weeks was initiated based on elevated serum IgE levels. The patient's response was monitored over four weeks. A comprehensive literature review was conducted, including 4 relevant articles.

Results: Omalizumab treatment resulted in the cessation of blister formation and significant symptom alleviation within one week. The overall treatment duration was four weeks, with stable improvement observed. Follow-up for 4 months with no recurrence.

Conclusion: This case illustrates the challenges of managing ICI-induced BP and highlights omalizumab as a potentially effective treatment option. The study proposes a personalized therapeutic strategy for refractory ICI-induced BP, emphasizing the selection of biologic agents based on specific immune profiles, including serum markers like IgE, eosinophils, and cytokine levels.

Liposuction has been popular with the public since its inception. The fat accumulated in the body is sucked outside the body through negative pressure suction, thereby reducing the fat cells in the body and achieving the effect of local plasticity. Although liposuction is a relatively safe procedure, due to the lack of correct judgment of the patient's condition and treatment by quite a few cosmetic practitioners, the complications of liposuction are gradually increasing. We describe a case of subcutaneous hydrops after lumboabdominal liposuction, which was found to have multi-layer tissue defects of the right lower abdominal wall and local peritoneal rupture after multiple sclerosing agent injections and two debridement procedures. This case provides us with a warning about the use of sclerosing agents.

A 69-year-old man with severe atopic dermatitis (AD) received a single 600 mg subcutaneous injection of dupilumab, which resulted in a psoriatic rash on day 10. He was then given 30 mg of oral upadacitinib daily, and after 10 weeks of treatment, both the AD and the psoriasis had significantly improved. However, at week 16, the patient had no bowel movement for a week, and paralytic ileus was suspected based on the patient's symptoms and laboratory findings. Without surgery or other treatment, one week after stopping upadacitinib, the patient resumed bowel movements and the ileus improved, suggesting a possible link between the drug and the ileus, which was considered to be possibly due to the off-target effect of Janus kinase inhibitor (JAKi). This case illustrates the complexity of the immunomodulatory effects of targeted therapies and the need for long-term observation of their mechanisms of action and side effects.

Inflammatory skin diseases impose a significant burden on patients and healthcare systems worldwide. Among these, hidradenitis suppurativa (HS) is particularly notable for its chronic and recurrent nature. Recurrent nodules, abscesses, and scarring in apocrine gland-rich areas characterize the disease, including the groin, axillae, and perianal regions. Despite its considerable physical and psychological impact, the precise mechanisms driving HS remain elusive. Recent advancements in understanding the inflammatory processes involved in HS have highlighted the TNF-alpha, IL-1β, and IL-17/IL-23 pathways, which play crucial roles in initiating and perpetuating the disease. Moreover, specific microRNAs (miRNAs), such as miR-24-1-5p, miR146a-5p, mirR-26a-5p, miR-206, miR-338-3p, and miR-338-5p, are involved in these inflammatory processes. Dysregulation of these miRNAs contributes to aberrant cytokine expression and persistent inflammation, foreseeably exacerbating HS disease progression. This narrative review hypothesizes that miRNA dysregulation triggers aberrant expression in specific inflammatory pathways, contributing to HS's clinical manifestations and progression. We explore the implicated miRNAs' potential as biomarkers for earlier disease detection and as novel therapeutic targets. Identifying miRNA dysregulation offers new opportunities for earlier and more accurate diagnosis, potentially allowing clinicians to intervene before severe disease manifestations occur. Furthermore, therapeutic strategies to modulate miRNA expression could target the inflammatory pathways driving HS, leading to more personalized and effective treatments. This review also discusses future research directions to enhance the clinical management of HS. A better understanding of miRNA involvement in HS offers new avenues for research and management, ultimately improving patient outcomes and quality of life.

We describe a case involving a 50-year-old male with who presented with a facial lesion on the left cheek of zygomatic region for 7 years. The diagnosis of primary cutaneous mucinous carcinoma (PCMC) was established through immunohistochemistry and histopathology. And the patient underwent wide excision of the tumor, has no evidence of recurrence after 15 months of follow-up.

Eruptive syringoma, a rare subtype of syringoma, is a benign adnexal tumor arising from the eccrine sweat glands. It is characterized by multiple asymptomatic, flat-topped, brown-pigmented papules. The disease typically occurs during adolescence and young adulthood. The clear cell variant of syringoma, which histologically features ductal epithelial cells with clear cytoplasm, is relatively rare, while eruptive clear cell syringoma is even more infrequent. In this report, we present a case of a 64-year-old Thai woman who developed multiple erythematous to brownish papules on her right cheek, which eventually spread to the periorbital region, face, neck, and chest over five years. The diagnosis of late-onset eruptive clear cell syringoma was made based on the patient's clinical manifestations and confirmed by histopathological examination. Notably, the patient was found to have impaired fasting plasma glucose upon screening, highlighting the potential association between clear cell syringoma and glucose metabolism abnormalities. This case report emphasizes the importance of considering this diagnosis in elderly patients presenting with eruptive papular dermatoses and underscores the need for metabolic screening in affected individuals.

Purpose: To explore antimicrobial resistance profiles and mupA gene characterization of Staphylococcus epidermidis recovered from facial skin of healthy females in Shanghai, China.

Patients and methods: In this study, we collected facial skin samples from 107 healthy females in Shanghai, China, and S. epidermidis isolation was performed. The minimal inhibitory concentrations of 10 antibiotics were determined for the S. epidermidis isolates using the agar dilution method. High-level mupirocin-resistant isolates were subjected to whole-genome sequencing and bioinformatics analysis. A total of 94 un-duplicated S. epidermidis isolates were obtained from 107 facial skin samples.

Results: Antimicrobial susceptibility tests revealed that 23.4% of the 94 S. epidermidis isolates were resistant to oxacillin and positive for the mecA gene, which could be cauterized as methicillin-resistant S. epidermidis (MRSE). Resistance rates for erythromycin, clindamycin, tetracycline, ciprofloxacin, and gentamicin were 8.5%, 11.7%, 10.6%, 12.8%, and 1.1%, respectively. For mupirocin, the rates of low- and high-level resistance were 3.2% (3/94) and 11.7% (11/94), respectively. Resistance to vancomycin or linezolid was not observed. High-level mupirocin resistance in facial skin isolates is mediated by mupA. WGS and SNP-based phylogenetic analyses revealed diverse phylogenies among the 11 mupA-positive S. epidermidis isolates. Additionally, various resistance and virulence genes were identified in mupA-positive isolates. A new hybrid plasmid carrying mupA genes was found in two S. epidermidis isolates.

Conclusion: We observed a considerable level of antimicrobial resistance to several antibiotics and the prevalence of abundant and diverse resistance and virulence genes in the facial skin-origin S. epidermidis isolates. This may pose a potential risk for both public health and S. epidermidis infection.

Objective: In this single-centre, retrospective, pragmatic, longitudinal case-series clinical study triple-frequency LDM (TF-LDM) technology with frequencies of 1/3/10 MHz and 3/10/19 MHz was applied for treatment of cellulite to reveal the effect of these waves on the cellulite skin and assess the sustainability of treatment outcomes during the long-term follow-up controls.

Methods: Twenty Caucasian females with mild-to-severe gynoid lipodystrophy aged 27-53 years who received cellulite monotherapy with TF-LDM were included in this study. All participants were evaluated at three time points: baseline (T1), on the day of the last treatment (T2), and during the last follow-up (T3). Cellulite severity was assessed by six independent clinicians using the five-grade Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS). Patient satisfaction was evaluated using a 10-grade GAIS scale, ranging from 0 to 10 (0 - dissatisfied; 10 - fully satisfied). To objectify the treatment outcomes, 17 subjects were investigated using B-mode ultrasonography and real-time compression elastography at baseline and during follow-up.

Results: The average values of CR-PCSS (T1), CR-PCSS (T2) and CR-PCSS (T3) over all participants were 2.22±0.82, 1.18±0.77, and 0.84±0.77, respectively, which corresponded to the skin improvement between T1 and T2 of 0.93±0.27 (p < 0.0001) as well as between T1 and T3 of 1.38±0.47 (p < 0.0001). Assessment of elasticity of the dermis and adipose tissue on the basis of the 5-grade coloration scale revealed significant reinforcement of both tissues as well as of the superficial fascia at follow-up as compared to their baseline values. The obtained treatment outcomes were long-lasting and could be clearly observed even in individuals with a long-term follow-ups. Assessment of the satisfaction of participants with the treatment results revealed a high satisfaction of 8.95 ± 1.49. The method demonstrated no side effects, was pain-free, well-tolerated, and highly accepted by patients.