Cutaneous and Ocular Toxicology最新文献

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: Basal cell carcinoma (BCC) is the most common form of skin cancer, with increasing incidence worldwide. Although anatomical site-based risk stratification is commonly used in clinical practice, the potential role of systemic inflammatory markers in predicting tumor behavior remains unclear.

Objective: To compare the systemic inflammatory markers between patients with BCC and healthy controls, and to assess their association with histopathological subtypes and anatomical risk groups.

Methods: This retrospective analytical study included 55 patients with histopathologically confirmed BCC and 55 age- and sex-matched healthy controls. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), were calculated from complete blood counts. Subgroup analyses were performed based on BCC subtype and anatomical risk classification. Receiver operating characteristic (ROC) analysis and logistic regression were used to evaluate predictive performance.

Results: Hemoglobin levels were significantly lower in BCC patients than controls (p = 0.048), but inflammatory indices did not differ between groups. Among BCC subtypes, only hemoglobin varied significantly, with higher levels in the superficial subtype. NLR and SIRI were significantly elevated in patients with high-risk tumors compared to those with low/moderate-risk lesions (p = 0.024 and p = 0.046, respectively). ROC analysis showed modest discriminatory power for NLR (AUC = 0.689) and SIRI (AUC = 0.667), but neither marker was a significant predictor of high-risk status in multivariate logistic regression.

Conclusion: NLR and SIRI were found to be associated with high-risk tumor localization in BCC, indicating their potential utility as supportive tools in preoperative risk assessment.

Purpose: The purpose of this study was to evaluate the effects of a bovine colostrum-based gel (CG) and a carnosine-based gel (BepanGel, BG) on wound healing in a full-thickness excisional wound model in rats.

Materials and methods: Male Sprague-Dawley rats (n = 27) were randomly assigned to three groups (n = 9 for each): Control (0.9% NaCl), CG, and BG. Four standardized full-thickness excisional wounds were created on the dorsal surface of each rat. Treatments were applied topically once daily for 14 days. Wound surface area measurements were performed on days 3, 7, and 14. Histopathological assessments and immunohistochemical analyses (Caspase-3, TGF-α, TNF-α, and VEGF expression) were conducted at each time point.

Results: By day 14, wound surface area values in the BG (0.059 ± 0.034) and CG (0.073 ± 0.063) groups were significantly lower than in the control group (0.128 ± 0.074; p < 0.05)(p < 0.05). No significant difference was found between BG and CG (p > 0.05). Histopathologically, epithelialization, fibrosis, and angiogenesis were significantly improved, while edema, hemorrhage, and inflammatory infiltration were reduced in the treatment groups (p < 0.05). Immunohistochemical analysis revealed that BG and CG were associated with downregulation of Caspase-3 (BG: 0.50 ± 0.16; CG: 0.90 ± 0.16) and TNF-α (BG: 1.60 ± 0.16; CG: 1.20 ± 0.20), while upregulating VEGF (BG: 2.70 ± 0.15; CG: 2.60 ± 0.16) and TGF-α expression (BG: 2.20 ± 0.20; CG: 1.60 ± 0.16).

Conclusion: Both colostrum-based and carnosine-based gels enhanced wound healing by promoting epithelial regeneration, collagen formation, and angiogenesis while modulating inflammation and apoptosis. BepanGel showed slightly superior performance in several parameters, suggesting its potential as an effective topical agent in wound management.

Objective: In this study, we aimed to examine the responses given by ChatGPT (OpenAI), Copilot (Microsoft), and Gemini (Bard) artificial intelligence applications to questions about the active ingredient isotretinoin in terms of accuracy, readability, applicability, and understandability.

Material and methods: The readability of the answers given by the artificial intelligence programs was evaluated using the Flesch-Kincaid ease score, and the applicability and understandability levels were evaluated using the Patient Education Materials Evaluation Tool scales. The accuracy of the answers was compared by two dermatologists who scored them between 1 and 5.

Results: No significant difference was found between the groups in terms of Flesch Kincaid reading ease scores (p = 0.671), and all three programs were found to be at a difficult level of reading. In the Patient Education Materials Evaluation Tool scales, it was observed that Gemini and ChatGPT rates were >70% and there was a significant difference in favor of these programs between the groups (p < 0.001). In the accuracy scores of the answers, Gemini (4.90 ± 0.31) and ChatGPT (4.60 ± 0.69) had high scores and there was a significant difference between the groups (p < 0.001).

Conclusion: While the AI chatbots we used in the study demonstrated reasonable accuracy in answering questions about isotretinoin, they performed limited in terms of readability and usability. These findings suggest that AI programs alone are not sufficient for patient education and need to be improved to simplify responses.

Background: Existing research lacks a systematic investigation of the complete gene expression profile in hypertrophic scars (HS). This study aimed to systematically explore the differences in mRNA expression profiles between human HS and normal skin tissues using bioinformatics analysis methods.

Methods: GSE236983 and GSE229848 were downloaded from Gene Expression Omnibus (GEO) to screen differentially expressed genes (DEGs). Protein-protein interaction (PPI) network was constructed using STRING (search tool for recurring instances of neighboring genes), followed by gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of the DEGs. Three surgical samples of HSs and adjacent normal skin tissues were selected from 3 HS patients for comparative analysis of DEGs.

Results: Venn diagram of two datasets showed an intersection, revealing 31 DEGs. GO enrichment results unveiled that DEGs were mainly involved in keratinization, keratinization cell differentiation, epidermal cell differentiation (ECD), and skin development. Cellular components (CCs) were mainly enriched in cell desmosomes, intermediate filament cytoskeleton (IFC), keratin filament (KF), and intermediate filament (IF). KEGG analysis signified that the main involved pathways encompassed tight junctions, extracellular matrix-receptor interaction, arachidonic acid metabolism, and terpenoid backbone biosynthesis. mRNA levels of 10 core genes (MVD, ACAT2, HMGCS1, HMGCR, FASN, MSMO1, DHCR7, DHCR24, and AACS) in HS and normal skin tissues were different (P < 0.05), with MVK showing non-significant differences (P > 0.05).

Conclusion: this study identified ten core DEGs associated with HS through systematic bioinformatics analysis. These genes are involved in biological processes and cellular components such as keratinization, cell differentiation, lipid metabolism, cholesterol biosynthesis, and cell adhesion.

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.

Objective: Topical anesthetic eye drops are widely used in ophthalmology; however, improper use may result in serious complications, including blindness.

Materials and methods: This descriptive, cross-sectional study examined patients presenting with foreign body sensation, exposure to ultraviolet (UV) radiation, or misuse of topical anesthetic drops at Sina Hospital's Ophthalmology Emergency Department from September 2019 to September 2020. After obtaining informed consent, participants completed questionnaires under the supervision of an ophthalmologist. Patients with anesthetic-related complications received appropriate treatment and were followed up for one month. Data were analyzed using SPSS version 21.

Results: Of 192 patients (185 men and 7 women; mean age: 42.69 ± 12.45 years), 76.56% reported foreign body sensation. The most common symptoms were lacrimation (84.37%) and photophobia (73.95%). Many patients used non-medical remedies such as closing their eyes (63.15%) and applying tea (45.31%). Pharmacy staff (38.27%) and colleagues (33.33%) were the most frequent sources of advice. Tetracaine misuse was significantly more common among patients with a prior history of use (P < 0.001) and was significantly associated with ocular complications, including keratopathy and vision loss (P = 0.011).

Conclusion: Arbitrary use of topical anesthetic drops-often based on non-specialist recommendations-significantly increases the risk of ocular complications. Awareness of potential side effects does not appear to prevent misuse, underscoring the need for stronger educational efforts regarding the risks of topical anesthetics.

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.

Purpose of the article: Snail mucin (SM) has garnered significant attention in dermatology, particularly for its potential in scar therapy and wound healing, due to its bioactive compounds, like allantoin, glycolic acid, and hyaluronic acid. These compounds are known to promote tissue regeneration, enhance skin hydration, and reduce scarring.

Materials and methods: However, despite growing interest, significant gaps remain in the clinical understanding of SM's therapeutic potential, including a lack of standardised formulations and limited clinical trials. There is a urgent need for more extensive human clinical trials to fully explore SM's potential in scar therapy, particularly given the potential safety concerns, such as skin irritation, sensitisation, and allergic reactions, these issues highlight the importance of toxicological evaluations and regulatory scrutiny.

Result and conclusion: While current regulatory frameworks, such as from FDA and CIR, emphasise the importance of safety substantiation for SM-based products, no formal toxicological monographs exist. This review discusses the therapeutic relevance of SM, identifies research gaps, and emphasises the need for rigorous safety testing and clinical validation to support its use in dermatology.