Cutaneous and Ocular Toxicology最新文献

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.

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: This study aimed to investigate the levels of ischaemia-modified albumin, an oxidative stress marker, and antioxidant vitamins and minerals in patients with Alopecia Areata (AA) to measure total antioxidant and oxidant capacity and to determine whether the obtained values were related to the severity of the disease.

Methods: This prospective, controlled study has enrolled 30 patients admitted to our institution's outpatient clinic with a clinical or histopathological diagnosis of AA and 30 individuals as the control group. Serum ischaemia-modified albumin, vitamin E, selenium, copper, zinc, total antioxidant capacity (TAC), and total oxidant capacity (TOC) levels of the individuals included in the study were evaluated, and their relationship with the severity of the disease was determined.

Results: Ischaemia-modified albumin level was significantly higher in the patient group compared to the control group (p = 0.002), and vitamin E level was significantly lower in the patient group compared to the control group (p = 0.017). Ischaemia-modified albumin levels were significantly higher in patients with severe disease than in those with mild disease (p = 0.027), while Zn was significantly lower (p = 0.014). No significant difference was found between Se, Cu, Zn, TAC, and TOC levels in the patient and control groups. No significant difference was found between the disease severity and vitamin E, Se, Cu, TAC, and TOC levels.

Conclusion: In our study, the high ischaemia-modified albumin and low vitamin E levels in AA patients indicate that the oxidant-antioxidant balance in AA patients has shifted towards the oxidant state, and oxidative stress may be effective in the pathogenesis of the disease. We believe new studies conducted in larger patient groups may shed light on the relationship between Se, Cu, Zn, TAC, and TOC levels and oxidative stress in AA patients.

Objectives: Hidradenitis suppurativa (HS) causes pain, discharge, odor, and scarring, potentially worsening sleep quality and psychological health. This study evaluated sleep, mood, and quality of life in HS patients compared to healthy controls, considering disease severity. We hypothesized that increased HS severity significantly impairs these outcomes.

Methods: This case-control study involved 55 HS patients from a university hospital and 55 healthy controls. Participants completed the Dermatology Life Quality Index (DLQI), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). HS severity was assessed using the Hurley staging system, and pain was measured with the Visual Analog Scale (VAS).

Results: HS patients had significantly higher anxiety, depression, DLQI, and PSQI scores than controls (p < 0.001). Depression scores correlated with Hurley stage (p = 0.041), but anxiety, DLQI, and PSQI scores did not (p > 0.05). VAS pain scores over the past week correlated with anxiety (p = 0.005), depression (p = 0.020), and DLQI scores (p < 0.001). DLQI scores positively correlated with depression, anxiety, and PSQI scores (p < 0.001, p < 0.001, p = 0.004, respectively). Depression scores correlated with anxiety and PSQI scores (p < 0.001 for both). Anxiety and PSQI scores also showed a positive correlation (p < 0.001).

Conclusion: HS is associated with poorer mood, sleep quality, and quality of life compared to healthy controls.

Purpose: Portable UV-C disinfection devices for domestic use have been widely commercially available since COVID-19 pandemic. Concerns regarding their safety have been expressed, while there is a lack of actual data regarding the health effects of commercial hand-held UV-C disinfection devices. Herein, the acute effects of two commercial UV-C devices for domestic disinfection are evaluated in vitro, under realistic exposure conditions.

Materials and methods: Skin cells were exposed to an LP-Hg wand and an LED disinfection device for 10s, 30s, 5, 10 and 15 min. The devices measured the erythema effective irradiance was 5 W m^-2. Cellular viability, oxidative stress, protein oxidation and lipid peroxidation were evaluated right after irradiation.

Results: A dose-dependent cellular viability decrease and oxidative stress, protein oxidation and lipid peroxidation increase were demonstrated, while the LP-Hg wand seemed to induce more severe effects than the LED. Lipid peroxidation has been shown to be the dominant photooxidation mechanism, even at a sublethal radiant exposure.

Conclusion: The results provide evidence regarding the cutaneous photodamaging effects of commercially available UV-C disinfection devices for domestic use at the cellular level, contributing to the UV-C disinfection devices' risk management.

Background and objective: Psoriasis vulgaris (PV) and lichen planus (LP) are inflammatory skin diseases. Systemic inflammatory markers, which may indicate inflammation in these diseases, have been investigated in various studies. This research focused on analysing the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and RDW values in patients with PV and LP. Additionally, we investigated their associations with comorbidities and assessed the diagnostic value of NLR in identifying psoriatic arthritis (PsA).

Material and methods: The study included 110 patients with LP and 140 patients with PV who presented to the dermatology outpatient clinic between 2022 and 2024. Age, gender, NLR, PLR, SII, RDW values, and accompanying comorbid diseases of the patients were recorded. Differences in NLR based on disease type and comorbid conditions were analysed. Additionally, in patients with PV, the relationship between the presence of (PsA) and NLR was evaluated. Cut-off values, sensitivity, specificity, and AUC values were calculated.

Results: We observed that the PV group had significantly elevated NLR and PLR values in comparison to the LP group (p < 0.001, p = 0.027). For NLR: (AUC: 0.669; 95% CI: 0.607-0.727); cut-off value: ≤2, sensitivity: 66.36%, specificity: 66.43%; p < 0.0001. For PLR: (AUC: 0.584; 95% CI: 0.520-0.646); cut-off value: ≤109.35, sensitivity: 55.45%, specificity: 63.57%; p = 0.0221. In the group with PsA, A significant elevation in NLR was observed (p = 0.043). For NLR in this group: (AUC: 0.621; 95% CI: 0.535-0.701); cut-off value: >2.15, sensitivity: 83.33%, specificity: 47.27%; p = 0.0175.

Conclusions: NLR and PLR may be useful markers in distinguishing PV. NLR, with a higher AUC and specificity compared to PLR, may be considered a stronger marker. Furthermore, due to its high sensitivity for PsA, NLR could be more suitable for screening purposes rather than diagnosis.

Purpose: Primary immune deficiencies (PIDs) can present with a wide range of clinical findings. This review aims to evaluate PIDs in which cutaneous findings are common.

Materials and methods: English literature regarding cutaneous manifestations of primary immunodeficiencies was reviewed using PubMed between January 2005 and March 2023.

Results: Cutaneous findings in PIDs can be broadly classified into two main groups: infectious and non-infectious. The most prevalent skin finding in PIDs is cutaneous infections (bacterial, fungal, and viral), and these infections often manifest as early-onset, recurrent, treatment-resistant, or atypical cases. Eczema is being the most frequent among non-infectious findings. Cutaneous manifestations, such as erythroderma, telangiectasia, granulomatous dermatitis, and autoimmune symptoms like alopecia and vitiligo can also occur.

Conclusion: Cutaneous manifestations in PIDs can assist clinicians in making early diagnoses, enabling patients to receive appropriate therapy promptly.

Purpose: The objective of this study, the first study of its kind conducted in Morocco, was to evaluate mercury concentrations in skin whitening products using the MA-3000 direct mercury analyser.

Context: Mercury is widely recognised as one of the most dangerous elements to human health. Despite the well-known risks, skin whitening creams and soaps containing this toxic substance continue to be produced and purchased, especially in the Middle East, Asia, and Africa. This practice constitutes a global public health issue due to the widespread distribution of these products. In Morocco, these items are commonly found in beauty stores and boutiques, which are frequently used for their skin-lightening effects.

Materials and methods: Twenty-nine samples of skin whitening products were collected from the local market in Rabat. The mercury content in these products was measured using the MA-3000 direct mercury analyser, in accordance with USEPA Method 7473. The method has a Limit of Detection (LOD) of 0.002 µg/g and a Limit of Quantification (LOQ) of 0.008 µg/g, ensuring the reliability and validity of the results. Moreover, the method demonstrated a recovery rate of 105%, further confirming its accuracy and precision. The mercury concentration was measured in micrograms per gram (µg/g). This unit is equivalent to parts per million (ppm), a unit commonly used to express very low concentrations.

Results: The analysis revealed that 25 out of 29 samples contained mercury concentrations ranging from 1.01 µg/g to 10.47 µg/g, exceeding the 1 µg/g limit established by the Minamata Convention on Mercury. Conversely, 4 samples showed no detectable traces of mercury.

Conclusions: This study reveals the concerning presence of mercury in skin-lightening products available on the Moroccan market. The continued circulation and frequent use of mercury-containing creams and soaps, both in Morocco and in other developing countries, underscore the pressing need for strengthened regulatory frameworks and stricter control of hazardous substances in cosmetic products. These findings raise significant public health concerns, particularly for vulnerable populations who may be unknowingly exposed to toxic levels of mercury through daily use of skin-lightening products.

Background: Laser therapy is widely used in scar repair, and the use of 5-fluorouracil (5-FU) as an adjuvant treatment has also attracted attention. This study aimed to compare the therapeutic efficacy of 5-FU combined with ultra-pulsed fractional carbon dioxide laser (UFCL) treatment and UFCL treatment alone for hypertrophic scars after burns, and to analyse influencing factors to provide evidence for clinical practice.

Methods: A total of 150 patients with hypertrophic scars from burns were randomly divided into an observation group (OG) and a control group (CG). Assessments were based on the Vancouver scar scale (VSS), patient scar assessment scale (PSAS), and records of adverse reactions (AR).

Results: There were no statistically significant differences between the two groups in terms of burn causes, disease duration, hypertrophic scar formation time, and wound healing time (P > 0.05). After treatment, the OG showed greater improvements in VSS and PSAS scores compared to the CG. In terms of clinical efficacy, 11 cases in the OG achieved complete recovery, and 42 cases showed visible improvement, with a total effective rate of 93.33%, higher than that of the CG. The incidence of AR in the OG (6.67%) was lower as against the CG. Multivariate regression analysis indicated that advanced age, longer disease duration, and higher pre-treatment VSS scores were negatively correlated with treatment effectiveness (P < 0.05).

Conclusion: The combination of 5-FU and UFCL treatment is significantly more effective than laser treatment alone. Risk factors affecting clinical efficacy include advanced age, longer disease duration, and higher pre-treatment VSS scores.