Cutaneous and Ocular Toxicology最新文献

Background: Psoriasis is a chronic systemic inflammatory disease mediated by the immune system. Interleukin-23 (IL-23) plays a key role in its pathogenesis by amplifying inflammation, triggering atherogenic dyslipidemia and insulin resistance, and thereby increasing cardiovascular and cerebrovascular risk. This study aimed to evaluate the effect of the IL-23 inhibitors risankizumab and guselkumab, used in psoriasis treatment, on cardiovascular and cerebrovascular risk through the plasma atherogenic index (PAI) and triglyceride-glucose (TyG) index.

Methods: This retrospective study included 110 patients diagnosed with psoriasis and treated with risankizumab (n = 61) or guselkumab (n = 49). Psoriasis Area and Severity Index (PASI) scores, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C) levels and fasting blood glucose (FBG) values at baseline and at 6 months of treatment were obtained from patient records. The plasma atherogenic index (PAI) was calculated as log₁。(TG/HDL-C), and the triglyceride-glucose (TyG) index as log₁。(TG × FBG / 2).

Results: In both IL-23 inhibitor groups included in the study, PASI scores, PAI, and TyG index values showed a significant decrease from baseline at the 6th month of treatment (p < 0.05). However, there was no significant difference in the reduction of index levels between the groups (p > 0.05).

Conclusion: IL-23 inhibitors can reduce atherogenic dyslipidemia and insulin resistance alongside dermatological improvement in the treatment of psoriasis. This suggests a potential role for these agents in reducing the risk of cardiovascular and cerebrovascular disease. However, large-scale, long-term studies are needed to confirm these beneficial effects.

Purpose: Methanol toxicity outbreaks have been a recurring problem around the world, and the recent pandemic has contributed to an increase in their incidence. The resulting toxic optic neuropathy may lead to complete permanent blindness. Erythropoietin (EPO) has demonstrated potential neuroprotective and neuroregenerative capabilities, which may improve the outcomes of patients with methanol-induced optic neuropathy (MTON). This work aimed to understand the efficacy and practical applications of EPO in cases of MTON.

Materials and methods: We included all original studies if they had patients with MTON, treated with EPO, and reported the outcomes of interest for clinical questions, including the end visual outcome. MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched with no date restriction to obtain records.

Results: We included 9 articles in our review, with a total of 192 patients, all of whom had been diagnosed with MTON. Erythropoietin treatment started 2 to 29 days after the onset of visual symptoms. Most studies reported an improvement in visual acuity compared to baseline. However, compared to the standard corticosteroid treatment alone, the results of EPO were conflicting. No adverse events were reported.

Conclusion: The result of adding EPO to corticosteroid treatment in the management of MTON had variable improvements in visual acuity. EPO has potential beneficial effects if used early on in the acute phase of exposure to methanol. The role of repeating or maintaining therapy for a longer duration to enhance the protective effects or prevent relapses remains unknown. Future clinical trials to investigate these options.

Objective: This study aimed to investigate the development of a chitosan-alginate hydrogel wound dressing enriched with Hypericum scabrum extract due to its antioxidant and antimicrobial properties. Natural polymer-based hydrogels are ideal for wound healing due to their biocompatibility and capacity for controlled drug delivery.

Methods: Methanolic, ethanolic, and aqueous extracts of H. scabrum were evaluated for antioxidant and phenolic content. Cytotoxicity was assessed using MTT assay, and antimicrobial activity was determined by MIC testing. Physicochemical properties, including swelling, drug release, porosity (SEM), and molecular interactions (FTIR), were analysed.

Results: The methanolic extract showed the highest antioxidant activity (95.41%) and phenolic content (118 mg GAE/g). It was non-toxic up to 1000 ppm (73.6% cell viability). When loaded into the hydrogel, MIC decreased from 6.25 mg to 0.781 mg. The hydrogel showed a swelling ratio of 4016.6%, 80% drug release in 48 hours, reduced porosity (32.26% to 11.59%), and confirmed chitosan-alginate interactions via FTIR.

Discussion: The hydrogel formulation demonstrates strong antimicrobial, antioxidant, and biocompatible properties, making it a promising wound dressing. To improve the manuscript, more detailed methodology, statistical support for cytotoxicity, enhanced FTIR visualisation, and inclusion of recent literature and mechanistic discussion are recommended.

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.

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.

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.