Dermatologic Therapy最新文献

Objective: To investigate the distribution characteristics of specific immunoglobulin E (IgE) to dust mite components in patients with atopic dermatitis (AD), aiming to provide a reference basis for the development of microarray protein chips for allergen component discrimination diagnosis and personalized desensitization therapy.

Methods: A total of 55 patients who visited Huishan District People’s Hospital of Wuxi City, Xishan People’s Hospital of Wuxi City, and People’s Hospital of Wuxi City from January 2023 to December 2023 were selected. The results of serum total IgE (total IgE) and specific IgE detection were analyzed.

Results: Among the 55 patients, 54 (98.2%) were positive (cutoff value > 0.35 Ua/mL, the normal value for serum total IgE is under 150–400 IU/mL) for serum total IgE antibodies, 52 (94.6%) were positive for Dermatophagoides pteronyssinus (Dp)–specific IgE antibodies, and 50 (90.9%) were positive for Dermatophagoides farinae (Df)–specific IgE antibodies. The protein chip results were consistent with the existing Phadia detection results.

Conclusion: The development of chips based on CRD (component-resolved diagnosis) cannot only rely on IgE binding rate to assist in precise treatment of patients but also choose personalized desensitization therapy, providing more practical recommendations for preventing cross-allergy, avoiding allergic environments, or ingesting sensitizing foods for susceptible individuals.

Dermatophyte infections of the skin and nails are frequent, but current antimycotics have several drawbacks. In search of new treatments, we looked into the vast array of herbal active agents. Derived from plants, they are sustainable, agreeable for patients, and may have less side effects than traditional antimycotics. In this study, we assessed 43 herbal agents for their effectiveness against Trichophyton rubrum (T. rubrum), Trichophyton benhamiae (T. benhamiae), Trichophyton tonsurans (T. tonsurans), and Microsporum canis (M. canis), four major human dermatophyte pathogens. The antifungal effect was tested by incorporating the agents into agar plates and measuring the dermatophyte growth after 7 days. Against T. rubrum, 16 out of 43 herbal agents showed total inhibition of dermatophyte growth. 14 out of 43 herbal agents inhibited the growth of T. benhamiae completely. 18 out of 43 herbal agents were effective against T. tonsurans. Against M. canis, 15 out of 43 herbal agents showed total growth inhibition. Twelve herbal agents inhibited the growth of all tested dermatophytes completely. This study demonstrates the high antimycotic potential of herbal therapeutics and identified promising candidates for the topical treatment of dermatomycoses. Substances are highly agreeable and should be tolerated well. Some might even provide new options for the systemic treatment of fungal diseases.

Studies find climate therapy (CT) at the Dead Sea of psoriasis efficient for induction therapy, but few studies address disease relapse, long-term maintenance using CT, confounders, and the patient perspective. CT combines sunlight, balneotherapy, stress reduction, and education. This study aimed to examine Dead Sea CT and relapse of psoriasis over a 2 years period, patients’ satisfaction, and treatment outcome and preference relative to other therapies. A structured questionnaire was offered to patients, who during the recent 2 years had undergone a 4 week course of CT at the Dead Sea. Patients included applied for a new CT session due to relapse of their psoriasis. Questionnaire items covered their recall of relapse, disease severity, potential triggers of relapse and patient’s preference relative to other treatment options. The study enrolled 40 patients, with an average age of 55.5 years. CT was highly effective and resulted in marked reduction in the affected skin area, from 16% to less than 1% of the body surface. The median time from CT to first visible new lesion was 4.8 months, to first bothersome relapse 6.1 months and to full blown relapse 8.0 months. Patient satisfaction with conventional therapeutic modalities, especially oral methotrexate, was reserved, and CT was generally preferred. Relapse after CT was an inclusion criterion, and patients with long-lasting healing were not assessed. CT for 4 week treatment course of moderate to severe psoriasis at the Dead Sea which was studied in patients with relapsing disease was highly efficient for induction for clearing of the skin, matching new biologicals. In the studied group, return to prestate level took median 8 months on average. Patients’ satisfaction with CT scored high, and maintenance through repeated Dead Sea treatments often is best treatment of this segment having intolerance or poor effect of other treatments, or fear of medicines as a personal attitude.

Background. Keloids are benign fibroproliferative tumors that are unique to humans. However, the exact mechanism of keloid formation remains unclear. The inflammatory cytokines released by immune cells can activate fibroblasts, connective tissue cell proliferation, and angiogenesis. Hypoxia is common in the process of fibrosis in many diseases. This study aimed to investigate the relationship between immune response, hypoxia, and keloid formation. Methods. Gene methylation and expression data were downloaded from the GEO database. Thereafter, differentially methylated genes associated with immunity and hypoxia were identified. Machine learning was performed to identify potential diagnostic/immunity/hypoxia-related differentially methylated/expressed genes, followed by analysis of functional enrichment, transcription factors, protein-protein interactions, and expression validation by reverse transcription quantitative polymerase chain reaction and immunohistochemistry. Results. In total, 16 immunity/hypoxia-related hypermethylated low-expression genes and 18 immunity/hypoxia-related hypomethylated high-expression genes were identified in keloids. Based on machine learning, nine differentially methylated and expressed genes were selected as potential diagnostic markers for keloids, including two hypoxia-related genes (CDKN1A and PGAM2) and seven immunity-related genes (DCD, PTGDS, WFIKKN1, SEMA5A, IL1R1, ITGAL, and SOS1). Some significantly enriched signaling pathways were identified, including the FoxO, PI3K-Akt, focal adhesion, and ErbB signaling pathways. SOS1 is involved in disease regulation with 65 transcription factors and has a higher interaction score with other molecules. Conclusions. Two hypoxia-related genes (CDKN1A and PGAM2) and seven immunity-related genes (DCD, PTGDS, WFIKKN1, SEMA5A, IL1R1, ITGAL, and SOS1) could be considered potential diagnostic markers for keloids, and may be helpful in understanding the importance of oxygen balance and immune regulation in keloids.

The treatment of keloids, particularly in high-tension areas, is challenging due to their extension beyond the original wound boundaries and high recurrence rates, thereby rendering traditional treatments ineffective. In this study, we investigated the effectiveness of a novel single-stage treatment approach that combined acellular dermal matrix (ADM) with keloid-specific epidermal skin grafting. To further prevent recurrence after neo-skin formation, the treatment was followed by fractionated laser and radiation therapy (LCR). Seven patients with high-tension keloids, including one with keloids at two locations, were treated and followed-up for an average of 15.9 months. The patients showed significant improvements in wound healing and skin appearance, with a marked reduction in the Patient and Observer Scar Assessment Scale (POSAS) (scores from 91.1 ± 5.6 to 23.8 ± 6.1 (p < 0.001)). This approach effectively minimizes tension, reduces the likelihood of keloid recurrence, and serves as a viable alternative to conventional methods that often involve challenges related to donor-site acquisition. No recurrence was observed during the follow-up period, indicating a promising innovation in the management of extensive keloids and offering improved healing and esthetic outcomes, particularly in high-tension areas.

Palmoplantar pustulosis (PPP) is often considered as pustular psoriasis of extremities. Benvitimod has been approved for mild to moderate psoriasis. We thus designed this study to evaluate the efficacy and safety of benvitimod for treating PPP. Of 47 PPP patients recruited from 4 hospitals, 40 finished 8 weeks visit and completed 4 weeks safety follow-up visit. The Palmoplantar Pustular Psoriasis Area and Severity Index (PPPASI) and Dermatology Life Quality Index (DLQI) scores fell continuously. At week 8, mean ± SD PPPASI and DLQI were 3.39 ± 3.86 (p < 0.0001) and 2.49 ± 3.34 (p < 0.0001), respectively. At week 8, 70% (28/40) achieved PPPASI-50 response, 35% (14/40) achieved PPPASI-75 response, and 17.5% (7/40) achieved PPPASI-90 response. Relapse occurred in 7.5% (3/40) of the patients. Of 47 patients enrolled, self-reported compliance was 12.77% (6/47). Common drug-related adverse events (5/47) included xerosis cutis. Only one patient’s disease progressed during treatment. Our study demonstrated the efficacy and safety of benvitimod.

Background: Neurofilament light chain (NfL) has been identified as a biomarker in neuroaxonal injury. Cutaneous nerve injury resulting from inflammation and/or forced scratching may also potentially affect serum NfL (sNfL) levels.

Objectives: We aimed to explore the relationship between sNfL levels and the severity of skin inflammation and scratch lesions in patients with pruritus.

Methods: In this cross-sectional pilot study, we measured the sNfL levels of 10 patients with pruritus of different aetiologies, and calculated age- and BMI-adjusted sNfL percentiles based on a normative database consisting of 4532 control individuals. Next, we investigated the relationship between the levels of sNfL and the severity of skin inflammation and scratching injuries in these patients using a newly-created Skin Inflammation and Scratch Lesions (SISL) score.

Results: A positive correlation was observed between sNfL levels and the severity of skin inflammation and scratch lesions as measured by the SISL score (Spearman’s rho = 0.70, p = 0.031). When correlated separately, both the “skin inflammation only” and “scratch lesions only” scores correlated positively with sNfL levels (Spearman’s rho = 0.68, p = 0.031; Spearman’s rho = 0.66, p = 0.041, respectively).

Conclusions: sNfL may be a potential biomarker for cutaneous nerve injury associated with skin inflammation and/or scratching.

Advanced hidradenitis suppurativa (HS) is often irresponsive to conservative treatment and requires extensive surgery to improve the clinical symptoms and prevent recurrence. This study aimed to assess the effectiveness of single-stage split-thickness skin grafting in patients with Hurley Stage III HS. A retrospective review of all cases of Hurley Stage III HS received skin grafting was done. Data on patient demographics, lesion characters, surgical details, and follow-up information were collected. Fifty-two cases of Hurley Stage III HS located in the axillary, groin, perineum, buttock, and penis were treated with split-thickness skin grafting. There were 20 male and 3 female patients included with a mean age of 38.7 years (range: 24–77). The overall success rate was 96.2% at a mean follow-up time of 29.3 months (range: 2–86). Early complications and late complications were observed in 30.7% (n = 16) and 59.6% (n = 31) of the cases, respectively. Wound scarring was the most common complication reported in 32.7% (n = 17) of the cases. Only one case (1.9%) of recurrence was reported in the perianal region at the postoperative 4.4 months. The satisfaction survey showed that 78.3% (18 of 23) patients were satisfied or very satisfied with the surgical result. Despite the advances in HS surgery, the recurrence rates continue to be high. Single-stage split-thickness skin grafting is a feasible approach for treating Hurley Stage III HS with a high success rate, low HS recurrence rates, and high patient satisfaction during long-term follow-up.

Background. Epstein–Barr virus (EBV) associated skin lesions have been mentioned in case report studies under multiple kinds of lymphoproliferative disorders/lymphoma diagnoses. However, due to the rarity and scattered reporting of cases, it is still unclear whether the related skin symptoms and their pathological findings can guide the clinical diagnosis and treatment of EBV-associated lymphoproliferative disease/lymphoma. Methods. In this review, we summarized the skin symptoms and clinicopathological features mentioned by previously reported cases of EBV-associated lymphoproliferative disorders/lymphoma to assist future clinical diagnosis. The inclusion criteria were based on the population, intervention, comparator, outcomes, and study designs. An electronic search was conducted by September 2023, and the following databases were used: PubMed, EMBASE, Cochrane Library, and Web of Science. Search keywords included “Epstein-Barr Virus Infections,” “Herpesvirus 4, Human,” “Lymphoma,” “Lymphoproliferative Disorders,” and “skin.” Results. The primary outcome was the clinical skin features and pathological findings of EBV-associated lymphoproliferative disease/lymphoma patients. Although it seems unrealistic to differentiate between patients with EBV-related lymphoproliferative disorders/lymphomas with different diagnoses on the basis of cutaneous symptoms and pathological findings alone, based on the evidence summarized in previous case reports, the clinical importance of EBV detection and identification in the differential diagnosis of lymphomas and lymphoproliferative disorders should be recognized. Conclusion. Given the homogeneity of risk factors associated with disease progression found in EBV-associated lymphoproliferative disease/lymphoma patients during the review, future studies can focus on summarizing skin symptoms and pathological outcomes based on possible risk factors for further deterioration in these patients.

Psoriasis is a prevalent chronic inflammatory skin disease impacting 1 to 3% of the general population in the Western World. Topical therapies are the most often used treatment in psoriasis, frequently as ancillary treatments to traditional systemic or biologic treatments in individuals with severe disease. Topical therapy with fixed-dose combination of a vitamin D analogue (calcipotriol (Cal)) and corticosteroid (betamethasone dipropionate (BD)) has been recommended as first-line topical treatment, and its efficacy and safety are supported by an increasing body of evidence. Ointment, gel, cream, and foam are the four distinct formulations of fixed-dose Cal/BD combination that have been authorized for the treatment of psoriasis. Several studies have compared these formulations in terms of efficacy, safety, and patients’ satisfaction. The objective of this study is to review all the comparative studies performed in patients with psoriasis of the Cal/BD foam formulation with respect to other topical treatments containing Cal and BD, either individually or in combination. The results of the studies published on this topic have shown that Cal/BD foam is more efficacious than both individual Cal/BD and Cal/BD ointment, gel, and cream. The safety profile, QoL, patient satisfaction, and cost-effectiveness were also higher for the Cal/BD foam formulation in different studies. Although more real-world clinical experience is required to validate the available data, Cal/BD foam may be the treatment of choice for both flare management and proactive maintenance treatment of psoriasis.