Cutaneous and Ocular Toxicology最新文献

Purpose: Acne vulgaris is a very prevalent dermatological condition, especially among adolescents and young adults up to 25 years old, classifying it as juvenile acne. One of the most effective treatments for severe acne is isotretinoin, a derivative of retinoic acid. Despite its high efficacy, this drug has been linked to several side effects including psychiatric adverse alterations, such as anxiety, depression and even suicide. With this systematic review we aim to determine if it is possible to establish a causal relation between oral isotretinoin in the treatment of juvenile acne and the appearance of psychiatric adverse effects.

Materials and methods: We searched two distinct databases, PubMed and Web of Science, and considered the work published between January 2000 and November 2021.

Results: Out of the 599 identified articles, we included 19 studies in this systematic review. Globally, the results we found do not support an association between the use of isotretinoin for acne treatment and mental side effects and the safety of this drug appears to be assured. However, the individual characteristics of each adolescent and their environment should be considered; the personal and family history of mental disorders are pointed out as red flags we should look out for when treating these patients.

Conclusion: Despite this being a highly debated topic, especially among the dermatology community, more studies with larger populations and randomised controlled trials are necessary to increase the strength of the evidence presented.

Purpose: The study aimed to investigate the electrophysiological effects of hyperbaric oxygen treatment (HBOT) on the retina after ten sessions in healthy eyes.

Methods: This prospective, interventional study evaluated forty eyes of twenty patients who were treated with HBOT of ten sessions with the diagnosis of an extraocular health problem. All patients underwent a complete ophthalmologic examination, including assessments of best-corrected visual acuity (BCVA), slit-lamp and pupil-dilated fundus examinations, full-field electroretinography (ffERG) measurements before and after HBOT within 24 h of the 10th session. The ffERG was recorded according to the International Society for Clinical Electrophysiology of Vision protocol using the RETI-port system.

Results: The mean age of patients was 40.5 years ranging from 20 to 59 years. Thirteen patients were administered HBOT for avascular necrosis, six patients for sudden hearing loss, and one patient for chronic osteomyelitis of the vertebra. BCVA acuity was 20/20 in all eyes. The mean spherical refractive was 0.56 dioptre (D), and the mean cylindrical refractive error was 0.75 D. Dark-adapted b-wave amplitude in 3.0 ERG was the only variable for the b-wave that showed a statistically significant decrease (p = 0.017). The amplitude of the a-waves in dark-adapted 10.0 ERG and light-adapted 3.0 ERG reduced significantly (p = 0.024, p = 0.025). The amplitude of N 1-P 1 in light-adapted 30 Hz Flicker ERG also demonstrated a statistically significant decrease (p = 0.011). Implicit times did not differ significantly in any of the ffERG data (p > 0.05).

Conclusions: HBOT caused the deterioration of a-wave and b-wave amplitudes in ffERG after ten treatment sessions. The results showed that photoreceptors were adversely affected in the short term after HBOT treatment.

Purpose: To evaluate the vascular structure of the choroid and each retinal layer in patients with breast cancer on tamoxifen therapy and compare them with healthy subjects.

Materials and methods: 124 eyes of 62 patients with breast cancer who were on tamoxifen therapy (group 1) and 80 eyes of 40 healthy controls (group 2) were included in this prospective cohort study. The structure of the choroid was evaluated using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and choroidal binarisation. Spectral-domain OCT (SD-OCT) was performed to analyse the peripapillary nerve fibre layer thickness (pRNFL) and each retinal layer thickness. A subgroup analysis was performed based on chemotherapy history in Group 1. All parameters were compared between Group 1 and the healthy controls and between the subgroups of Group 1.

Results: The subfoveal choroidal thickness and temporal and nasal directions were increased in Group 1 when compared with Group 2 (p < 0.05, each comparison). Choroidal vascularity index was significantly decreased in Group 1 compared with Group 2 (63.15 ± 3.11% and 65.37 ± 4.63%, p < 0.001). There were no significant differences in each retinal layer, pRNFL thickness, and choroid structural parameters between the subgroups of Group 1.

Conclusions: Increased choroidal thickness may be the initial finding of subclinical tamoxifen-induced retinopathy. Patients with breast cancer undergoing tamoxifen therapy may be screened prior to tamoxifen therapy and followed during treatment by SD-OCT.

Objective: The objective of this study was to evaluate some toxic levels of nail cosmetics marketed in Seoul, Korea and health risk assessment on humans.

Methods: We collected 45 random nail cosmetics and analysed for lead, cadmium, arsenic and antimony by inductively coupled plasma-optical emission spectrometry (ICP-OES).

Results: Four metals concentrations were Pb 0.037 ± 0.083 (p < 0.05) and Sb concentrations in 6 samples were above the acceptable limits in Korea. As the result of the health risk assessment, MoS, HQ and HI values for Pb, As and Cd were within the permissible limit, but outside the acceptable range of Sb. LCR value was lower than the allowed limit for all nail cosmetics.

Discussion and conclusion: Six nail cosmetics had high antimony concentrations which were higher than the current legal limit in Korea. Because of 6 high antimony concentrations, MoS, HQ and HI were outside the acceptable range. LCR value for Pb, As and Cd was below 1 0 ^-6 which was lower than the permissible limit and nail cosmetics may not possess lifetime cancer risk. Our results suggested that metals were present in nail cosmetics at diverse concentrations and some nail cosmetics appeared to pose a harmful impact on health.

Purpose: To evaluate retinal thickness (RT), retinal nerve fiber layer thickness (RNFLT), and choroidal thickness (CT) changes in synthetic cannabinoid (SC) users.

Methods: This prospective study evaluated the RT, RNFLT, and CT values of 56 SC users and 58 healthy controls. The individuals using SCs were referred to us by our hospital's forensic medicine department. Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). Measurements (one subfoveal, three temporals, three nasal) were taken at 500 μm intervals up to 1500 μm using the caliper system. Only the right eye was used for subsequent analysis.

Results: Mean ages were 27.7 ± 5.7 years in the SC-user group and 25.4 ± 6.7 in the control group. Subfoveal Global RNFLT was in the SCs group 102.3 ± 10.5 μm and 105.6 ± 20.2 μm in the control group (p = 0.271). Subfoveal CT was in the SC group mean of 316.1 ± 100.2 μm and in the control group mean 346.4 ± 81.8 μm (p = 0.065). RT, T500 (283.3 ± 36.7 μm, 296.6 ± 20.5 μm, p = 0.011) and N1500 (355.1 ± 14.3 μm, 349.3 ± 18.1 μm, p = 0.049) were significantly higher in the SC group than in the control group, respectively.

Conclusion: Analysis of OCT findings of individuals who had been using SC for more than one year revealed no statistically significant difference between RNFLT and CT, although N1500 was significantly higher in RT. Further studies in the field of OCT are important to explore the pathology of SC.

Introduction: Due to their ubiquitous use, isothiazolinones caused allergic contact dermatitis epidemics and their use was restricted by legal regulations.

Objectives: We aimed to evaluate demographic data, clinical findings, and patch test features of patients with methylisothiazolinone (MI) and/or methylchloroisothiazolinone(MCI) sensitivity in our study.

Methods: This study is a bidirectional and cross-sectional study, between July 2020 and September 2021. A total of 616 patients, including prospective and retrospective populations, demographic data, clinical findings, and patch test results were reviewed. Patients' demographics, patch test results, allergen sources, presence of occupational contact, and the characteristics of dermatitis attacks were recorded.

Results: A total of 50 patients with MI and MCI/MI sensitivity, 36 male (72%) and 14 female (28%), were included in our study. The overall prevalence of MI and MCI/MI between 2014 and 2021 was 8.4% (52/616) with two peak levels in 2015(21%) and 2021 (20%). A statistically significant relationship was found between shampoo use and facial involvement (p = 0.031), shower gel use and arm involvement (p = 0.027), wet wipe use and hand involvement (p = 0.049), detergent use and the pulps (p = 0.026) and the lateral aspects of fingers involvement (p = 0.048), water-based dye use and periungual involvement (p = 0.047).

Conclusion: Although legal regulations related to MI and MCI/MI cause a decrease in the frequency of their sensitivities were still common causes of allergic contact dermatitis.

Objective: To evaluate the effect of ketorolac-soaked contact lenses (CLs) on postoperative pain after photorefractive keratectomy (PRK) and their potential side effects including conjunctival hyperaemia and delayed epithelial healing.

Methods: This is a prospective, randomised, double-blind, contralateral eye study. A total of 310 eyes of 155 patients who underwent PRK in both eyes were included in the study. After photoablation, a 0.4% ketorolac-soaked bandage CL was placed over the cornea in Group 1, while a drug-free soft bandage CL was placed over the cornea in Group 2. The postoperative pain was evaluated using a verbal numerical rating scale. The ocular redness was compared using the black pixels (veins, and areas of redness) and white pixels (remaining areas) of the images. The complications and time to corneal wound healing were also recorded.

Results: The mean pain score was significantly lower in Group 1 (2.7 ± 1.3) than in Group 2 (7.4 ± 1.4) on postoperative day 1 (p < 0.001). However, on the 3rd postoperative day, there was no significant difference between the groups in terms of pain scores (p = 0.42). Preoperative eye redness was 199.2 ± 16.0 pixels in Group 1 and 200.1 ± 17.6 pixels in Group 2 (p = 0.65). There was no statistically significant difference between the two groups in terms of eye redness at the postoperative 24th and 72nd hours (p = 0.43 and p = 0.39, respectively).

Conclusion: Soaking the bandage CL in a solution containing ketorolac 0.4% for 15 minutes could significantly lower pain scores on the first postoperative day after PRK, with no serious complications.

Purpose: Immune checkpoint inhibitors (ICIs) have emerged as a novel class of drugs carrying a potential risk of uveitis. Due to the rarity, current knowledge on this safety issue is still incomplete. This study employed the post-marketing surveillance data to comprehensively describe and assess the uveitis events after the use of ICIs.

Methods: Data between 2004 and 2021 were downloaded from the Food and Drug Administration Adverse Event Reporting System (FAERS), and the uveitis events reported for ICIs were identified and included in this study. Clinical details of these reports were collected and analysed. Four data mining methods were utilised to investigate the potential associations between uveitis and different ICI regimens.

Results: Overall, 461 uveitis cases after exposure to ICI therapies were reported. Melanoma (58.79%) was revealed as the most common indication for receiving ICIs. The median onset time of uveitis was 41 (interquartile range 18-91) days after ICI initiation. 9.54% of these cases resulted in disability. Data mining results showed 5 ICIs generated positive uveitis signals when used alone. Ipilimumab yielded the most noticeable uveitis signal with the highest reporting odds ratio (ROR = 6.73, 95% two-sided CI = 5.26, 8.60), proportional reporting ratio (PRR = 6.69, χ²=308.52), information component (IC = 2.74, IC025 = 2.14) and empirical Bayes geometric mean (EBGM = 6.66, EBGM05 = 5.42), followed by pembrolizumab, cemiplimab, nivolumab and atezolizumab. When nivolumab, pembrolizumab or atezolizumab was administrated together with ipilimumab, obviously stronger uveitis signal was detected than that for either of them.

Conclusions: This study provided an overview of the clinical features of ICI-related uveitis cases in the FAERS. Data mining results revealed that positive uveitis signals commonly existed within this drug class, but signal strength varied among ICIs. When ICIs were used in a combined way, uveitis signals became obviously stronger. Therefore, early ophthalmic monitoring is important when applying ICIs to patients, especially those with a tendency for uveitis, such as melanoma patients.

Objective: Ultraviolet-B (UVB) radiation is an important factor in causing skin damage. The study is to explore whether 1,25-Dihydroxvitamin D3(1,25(OH)₂D₃) will attenuate the damage of human immortalised keratinocytes (HaCaT) cells caused by UVB and relevant underlying mechanisms.

Methods: CCK-8 was employed to determine the UVB irradiation intensity and 1,25(OH)₂D₃ concentration. Western blot was used to detect the expression of NF-κB, Caspase9, Caspase3, Bax, Bcl2, FADD, CytC, Beclin-1; Flowcytometry was applied to measure the production of ROS.

Results: The concentration of 1,25(OH)₂D₃ used in the study was 100 nM and the UVB irradiation intensity was 20 mJ/cm². Compared with the HaCaT cells irradiated with UVB, the HaCaT cells that were pre-treated with 1,25(OH)₂D₃ had lower production of ROS, lower expression of NF-κB, Caspase9, Caspase3, Bax, FADD, CytC and Beclin-1(P < 0.05).

Conclusion: 1,25(OH)₂D₃ could inhibit the development of oxidative stress and apoptosis in HaCaTs triggered by UVB. This inhibition might be achieved through the suppression of mitochondria-modulated apoptosis and autophagy. Vitamin D may be a potential UVB protective component.

Purpose: The purpose of the current study was to evaluate the effect of Triticum vulgare (TVE) alone or combined with therapeutic ultrasound (TUS) on wound healing in a diabetic rat model.

Materials and methods: A total of 72 male Wistar rats were randomly divided into four groups: Group Control, wounded rats without treatment; Group TUS, wounded rats with TUS application; Group TVE, wounded rats treated with TVE; and Group TVE + TUS, wounded rats treated with TVE + TUS. Wound healing was assessed using wound area calculation and thermographic, biochemical, histopathologic, immunohistochemical, and immunofluorescence analyses on post-wounding days 7, 14, and 21.

Results: On day 21, the wound surface area was significantly decreased in Group TVE + TUS (0.18 ± 0.07 cm²) compared to the other groups (p < 0.001). A significant increase in wound area temperature was recorded on days 7, 14, and 21 in all groups compared to day 0 (p < 0.001). On day 21, Group TVE + TUS (35.4 ± 0.2 °C) had the most significantly highest wound area temperature compared to the other groups (p < 0.001). The highest histopathological scores were recorded in Group TVE + TUS on days 7, 14, and 21 (p = 0.04). The highest vascular endothelial growth factor expression was observed in Group TVE + TUS (82.53 ± 1.98) on day 7 (p = 0.03).

Conclusion: In conclusion, treatment with a combination of TVE and TUS effectively enhanced wound healing in diabetic rats compared with other treatment groups.