Cutaneous and Ocular Toxicology最新文献

Background: Infected cutaneous wounds, such as those resulting from perianal abscess surgery, are prone to fecal contamination and delayed healing. Portulaca oleracea L. (POL) is a representative anti-diarrheal medicinal herb that has been reported to exert multiple biological activities, including anti-inflammatory and antioxidant effects, as well as protection of the gastrointestinal tract. However, the functions of the POL extract on perianal abscess progression, and the associated molecular pathways, remain unclear. This study aimed to investigate the function of POL in perianal abscesses and explore its potential related mechanisms.

Methods: Sprague-Dawley rats (n = 6 in each group) were used to establish a fecal contamination-induced wound infection model. Wounds were topically treated with POL extract (100 μg/mL) by applying extract-coated sterile gauze to fully cover the wound surface, with dressing changes performed once daily for 14 consecutive days. The mRNA expressions of potentially relevant genes were assessed by RT-qPCR. Levels of TNF-α, IL-6 and IL-1β were measured by ELISA. CD34 expression was assessed using immunohistochemistry (IHC), while the relative protein expression of VEGFA was evaluated by western blot.

Results: POL extract resulted in histopathological injury in the wound tissues of rats with perianal abscess. Moreover, treatment with POL extract reduced inflammatory responses, increased CD34 expression, and was associated with activation of VEGF-related markers in rats with fecal-contaminated skin wounds.

Conclusion: In a rat model of fecal-contaminated dorsal skin wound infection, topical POL treatment was associated with improved histological outcomes, reduced inflammation, and increased VEGF-related markers. These findings suggest a potential role for POL in promoting infected wound healing, although the VEGF involvement is based on associative expression data and requires further mechanistic validation.

Clinical relevance: Cadmium causes systemic inflammation and retinal damage, posing a serious threat to visual and public health.

Background: Cadmium is a harmful heavy metal that builds up in body tissues and cause systemic inflammation and organ damage. This research sought to explore the impact of subacute cadmium exposure on retinal morphology and inflammatory cytokine levels.

Method: A total of fourteen male Wistar albino rats were randomized into control and cadmium-exposed groups within the scope of the experiment. 3 mg/kg cadmium (CdCl₂) was administered intraperitoneally to the subjects in the cadmium group for 15 days. At the end of study, serum IL-6 and TNF-α levels were determined by ELISA method. In addition, retinal tissues were examined histopathologically after Hematoxylin and Eosin staining. Retinal apoptotic changes were assessed by semi-quantitative immunohistochemical analysis of Bax and Bcl-2 expression in the inner and outer nuclear layers.

Results: According to the findings, cadmium exposure caused a statistically significant increase in serum IL-6 and TNF-α levels. Histopathological examination revealed a marked decrease in the thickness of the inner plexiform layer (IPL), inner nuclear layer (INL), and outer nuclear layer (ONL), as well as focal vacuolization and cellular disorganization. Cadmium exposure significantly increased Bax immunoreactivity and the Bax/Bcl-2 ratio in both the INL and ONL, while significantly decreasing Bcl-2 expression.

Conclusion: In conclusion, cadmium exposure increased the systemic inflammatory response, leading to significant histopathological damage in the retinal layers and a dominant proapoptotic Bax/Bcl-2 balance, thereby triggering cellular apoptosis.

Objective: To observe the clinical efficacy of Quhong Zhiyang ointment via shortwave radiofrequency-assisted delivery in the treatment of facial seborrheic dermatitis.

Methods: Seventy-two individuals who were diagnosed with seborrheic dermatitis and who received treatment and completed a 3-month follow-up period were enrolled in this retrospective analysis, with 36 patients in each group. The control group was given oral compound glycyrrhizin tablets, vitamin b6 tablets, and topical butyl flufenamic acid ointment; the observation group was given shortwave radiofrequency-assisted delivery of Quhong Zhiyang ointment treatment on top of the control group, with 4 weeks as a course of treatment. The clinical efficacy, symptom score, VISIA score, and Malassezia score were compared between the two groups.

Results: The total effective rate in the observation group was 94.44% (34/36), which was greater than that in the control group (75.00% (27/36), and the difference was statistically significant (P < 0.05). The scores of the two groups decreased, the improvement in the observation group was greater than that in the control group, and the difference was statistically significant (P < 0.05). After treatment in the observation group, the VISIA-red zone score decreased, and the difference was statistically significant (P < 0.05). After treatment, there was no significant change in the VISIA-wrinkle, texture, and rhodopsin score, and the difference was not statistically significant (P > 0.05).

Conclusion: The shortwave radiofrequency-assisted delivery of Quhong Zhiyang ointment has significant efficacy in the treatment of seborrheic dermatitis and can effectively relieve clinical symptoms, improve local inflammation, and inhibit the growth of Malassezia.

Purpose: Chronic urticaria (CU) impacts patients through unpredictable episodes of hives and angioedema, affecting their quality of life. This study aims to evaluate tolerability and drug survival rates of omalizumab compared to second-generation H1 antagonists and to identify factors influencing the progression of CU.

Materials and methods: A single-center, retrospective study was conducted at our dermatology department, focusing on adults diagnosed with CU. Data were collected through clinical assessments, laboratory evaluations, and phone calls, with additional retrospective extraction from electronic health records. As recommended, omalizumab was first added to antihistamines and omalizumab survival was measured among all patients who had ever received it, regardless of whether they had discontinued antihistamines at any point.

Results: The study cohort consisted of 93 patients with CU, comprising 70 women and 23 men. Fifty-seven patients received omalizumab, with a median drug survival of nine months for the first cycle of therapy. The remaining 36 patients were treated exclusively with antihistamines, with a median drug survival of 67 months. Asthma and lower baseline basophil counts were significantly associated with longer disease duration. Baseline fibrinogen levels correlated with duration of omalizumab treatment. Complement 4 levels were significantly lower in the omalizumab group than in those treated exclusively with antihistamines.

Conclusions: Both Type 1 (asthma) and Type 2b (lower basophil counts and higher fibrinogen levels) CU features are associated with longer disease duration. These insights facilitate more personalized and effective management strategies for this challenging condition. Discontinuation was more often due to pregnancy or remission rather than safety concerns or lack of efficacy. Limitations of this retrospective single-center study include indirect assessment of disease severity, potential recall bias, heterogeneous treatment regimens, limited adverse event reporting, and lack of pretreatment biomarker measurements.

Background: Although multiple factors contribute to the development of melasma, there are reports suggesting a potential role of Demodex parasites in hyperpigmentation. This study aimed to compare the density and prevalence of Demodex infestation between patients with melasma and healthy controls.

Methods: This case-control study included 35 melasma patients and 35 healthy volunteers. Standard superficial skin biopsies using cyanoacrylate adhesive were taken from the malar regions. Samples were examined via light microscopy, with a density of ≥5 Demodex/cm² defined as positive.

Results: No statistically significant difference was found between the melasma and control groups in terms of Demodex mite density or positivity rates. Correlation analysis revealed no significant relationship between mMASI scores and Demodex mite density. As a secondary finding, the mean mMASI score was significantly higher in male participants compared to female participants.

Conclusion: In this case-control study, we found no statistically significant association between Demodex parasite density and melasma in our study population. While our findings do not support an association in this sample, future large-scale and multicenter studies could further explore the potential role of Demodex in skin disorders that have been suggested by other reports. The single-center design and moderate sample size should be considered when interpreting these results.

Purpose: This study aimed to investigate the chemopreventive potential of the ethanolic extract of Luisia tenuifolia Blume against skin cancer.

Methods: The ethanolic whole-plant extract of Luisia tenuifolia was tested for acute and sub-chronic dermal toxicity according to the OECD guidelines 402 and 411. Its chemopreventive efficacy, along with the antioxidant and histopathological changes, was assessed using DMBA/Croton oil-induced skin cancer model in mice.

Results: The toxicity studies indicated that the extract was safe up to 2000 mg/kg body weight. The 90-day repeated application of the extract at 500, 1000, and 2000 mg/kg b.w. showed no mortality or toxicity observations. Topical application of the extract at 200 and 400 mg/kg b.w. applied 10 minutes before DMBA/Croton oil treatment delayed the tumor onset. Importantly, there was a significant decrease in tumor incidence, tumor burden, tumor yield, decreased lipid peroxidation and restored superoxide dismutase, catalase, and glutathione peroxidase levels in extract-treated mice compared with the control. The histopathological observations further substantiated the chemopreventive effect, revealing a marked reduction in neoplastic alterations.

Conclusion: The ethanolic extract of Luisia tenuifolia was well tolerated up to 2000 mg/kg b.w. and, at 200 and 400 mg/kg b.w., reduced tumor incidence to 80% and 60%, while 5-fluorouracil showed the higher efficacy (50% tumor incidence). Our findings showed the significant chemopreventive activity by enhancing antioxidant defenses and suppressing skin tumorigenesis in mice, warranting further mechanistic and clinical investigations.

Objective: Tislelizumab frequently induces cutaneous immune-related adverse events (cirAEs), among which Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are rare but potentially life-threatening cutaneous reaction. The clinical characteristics of SJS/TEN induced by tislelizumab remain unclear.

Methods: This systematic review aims to clarify the clinical manifestations, therapeutic interventions, and outcomes of tislelizumab-related SJS/TEN in Chinese patients. Published case reports of SJS/TEN induced by tislelizumab were systematically collected (up to 10 May 2025). A total of 21 articles and 22 patients were included.

Results: A total of 22 patients were included, consisting of 14 males and 8 females, aged 42-81 years, with a median age of 71 years and a mean age of 68.59 ± 9.10 years. Lung cancer was the most common primary disease, affecting 12 patients (54.55%). 7 patients were treated with tislelizumab alone, while 15 underwent combination therapy (chemotherapy, radiotherapy, or targeted therapy). The time from treatment initiation to SJS/TEN onset ranged from 12 to 138 days. 20 patients experienced pain to varying degrees, with early symptoms primarily manifesting as erythema and rash. Mucocutaneous involvement was observed in 12 patients, and fever occurred in 11 patients. After drug discontinuation and symptomatic supportive care, the symptoms of 20 patients improved. Two patients died - one of septic shock and another of acute coronary syndrome.

Conclusions: This indicates that tislelizumab-related SJS/TEN mostly occurs days to months after treatment. Clinical practice should strengthen the evaluation and monitoring of early cutaneous adverse reactions, with timely detection and intervention to ensure safe medication use for patients.

Introduction: The global incidence of skin cancer is rising, emphasizing the need for early detection tools. Artificial intelligence (AI) models, including multimodal systems like ChatGPT-4o, can analyze visual data to assist clinicians in diagnosis. This study evaluated ChatGPT-4o's diagnostic accuracy in detecting melanoma and non-melanoma skin cancers from macroscopic and dermoscopic images.

Methods: Ninety patients with histopathologically confirmed lesions were included. For each patient, macroscopic images were first uploaded to ChatGPT-4o, followed by combined upload of macroscopic and dermoscopic images. ChatGPT-4o was instructed to provide a preliminary diagnosis and three differential diagnoses for each lesion. Accuracy was assessed at four levels: Level 1: preliminary diagnosis using macroscopic images; Level 2: preliminary diagnosis using macroscopic and dermoscopic images; Level 3: three differential diagnoses using macroscopic images; Level 4: three differential diagnoses using macroscopic and dermoscopic images.

Results: Overall Level 1 accuracy was 73.3%, with Level 2, Level 3, and Level 4 accuracies of 66.6%, 75%, and 76.6%, respectively. Dermoscopic images improved accuracy for squamous cell carcinoma (72.7% vs 81.8%, p = 1.00), reduced overall and basal cell carcinoma accuracy (73.3% vs 66.6%, p = 0.180 and 79.6% vs 67.8%, p = 0.065, respectively), and did not affect malignant melanoma (84.6% vs 84.6%) or lentigo maligna (0% vs 0%). Statistical analysis revealed that the addition of dermoscopic images did not significantly influence diagnostic accuracy, either overall or within individual diagnostic categories. The model recommended biopsy for all lesions, suggesting potential as a supportive diagnostic tool.

Conclusion: ChatGPT-4o showed variable diagnostic accuracy for melanoma and non-melanoma skin cancers. Dermoscopic images reduced performance for certain diagnostic categories. These misclassifications highlight the potential for unnecessary interventions and patient anxiety underscoring that AI-based systems should serve as supportive aids rather than standalone diagnostic tools.

Objective: To evaluate morphological and functional alterations of the meibomian glands in eyes treated with unilateral prostaglandin analogs (PGAs) and their association with prostaglandin-associated periorbitopathy (PAP), aiming to clarify the underlying mechanisms and clinical implications of PGA-induced periocular toxicity.

Methods: This cross-sectional study included 72 patients using unilateral topical PGAs for at least 3 months. The fellow untreated eyes served as controls. Each eye underwent standardized grading for eyelid margin abnormalities, meibomian gland expression, meibography scores, and gland morphology. PAP severity was graded using an established scale. ROC curve and correlation analyses assessed predictive relationships between meibomian gland parameters and PAP.

Results: Compared with untreated eyes, PGA-treated eyes showed significantly higher eyelid margin abnormality scores, meibomian gland expression grades, meibography scores, and meibomian gland loss areas (all p < 0.05). Morphological alterations, including distorted, tortuous, hooked, dropout, short, thin, and ghost glands, were significantly more frequent in treated eyes, alongside increased rates of abnormal gaps, fluffy areas, and absent lid margin extension (p < 0.05). These alterations became progressively more severe with increasing PAP grade (p < 0.001). Composite score (r = 0.51), ghost (r = 0.47), dropout (r = 0.45), and total mean score (r = 0.42) were most strongly correlated with PAP severity (p < 0.001). ROC analysis revealed that the total mean and composite scores were strong predictors of PAP (AUC = 0.739, p = 0.013 and AUC = 0.812, p = 0.004, respectively). Additionally, meibography scores, meibomian gland expressibility, and morphological features such as dropout and ghost glands were significantly associated with PAP (p < 0.05).

Conclusion: Topical PGA use is associated with significant meibomian gland dysfunction and morphological damage, which worsens with increasing PAP severity. These findings highlight a potential diagnostic role for detailed meibomian gland assessment in monitoring PGA-induced ocular surface toxicity and may contribute to improved therapeutic management in glaucoma patients.

Background: Rosacea is a chronic inflammatory skin disorder involving dysregulated innate immunity and microbial interactions. Procalcitonin (PCT) is a serum biomarker of bacterial inflammation but its role in rosacea remains unclear.

Objectives: To assess serum PCT levels in rosacea patients compared to healthy controls and explore associations with treatment modalities and clinical parameters.

Methods: This case-control study included 60 rosacea patients and 20 age- and sex-matched healthy individuals. Patients were grouped as untreated, topically treated with metronidazole, or systemically treated with doxycycline plus metronidazole. Serum PCT levels were measured by fluorescence immunoassay. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, and multivariate linear regression.

Results: Rosacea patients had significantly higher PCT levels than controls (0.18 ± 0.06 vs. 0.12 ± 0.04 ng/mL; p < 0.001). Elevated PCT was observed in untreated and topical-only groups, while systemic treatment was associated with reduced levels (0.10 ± 0.004 ng/mL; p < 0.001), comparable to controls. No differences were found based on sex, smoking, or alcohol use. Multivariate analysis identified systemic therapy as a negative predictor (β = -0.55, p < 0.001) and papulopustular subtype as a positive predictor of elevated PCT (β = 0.23, p = 0.039).

Conclusions: PCT may reflect underlying subclinical inflammation in rosacea and decrease with systemic therapy. These findings support further investigation of PCT as a biomarker in rosacea.