Dermatologic Therapy最新文献

Purpose

To investigate anatomical site-specific differences in the minimal erythema dose (MED) of 308-nm excimer laser therapy among Asian patients with vitiligo.

Methods

A retrospective analysis of MED data from 378 patients was conducted. Nonparametric tests were used to compare MED values across six anatomical sites and facial subregions, while Spearman correlation assessed influencing factors.

Results

MED values in lesional skin were significantly higher than in normal skin. Site-specific MED variations were observed, ranked from lowest to highest as follows: face, trunk, neck, scalp, extremities, and acral regions (hands/feet). Within facial subregions, periorbital and perioral mucosal areas exhibited 15%–25% lower MED values compared with other regions. Skin phototype, season, and age were independent predictors of MED (P < 0.05), whereas sex, family history, and lesion size showed no significant correlation.

Conclusion

MED values vary significantly across anatomical sites in Asian patients with vitiligo. Clinical phototherapy protocols should incorporate site-specific and skin type–adjusted dosing strategies, with particular attention to the lower MED thresholds of mucosal regions.

Background

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a rare hypersensitivity reaction characterized by symmetric erythematous rashes in intertriginous regions, triggered by systemic drugs. Although self-limiting, SDRIFE can significantly impact quality of life, requiring accurate diagnosis and management.

Objectives

This study aimed to describe the clinical characteristics, diagnostic approaches, and implicated pharmacological agents in the largest reported SDRIFE series, providing insights to improve diagnosis and treatment.

Materials and Methods

A retrospective observational study was conducted between 2018 and 2024. Data on demographics, clinical features, implicated drugs, and diagnostic tests—including drug provocation tests (DPTs), lymphocyte transformation tests (LTTs), and intradermal tests—were analyzed.

Results

Among 41 patients, the mean age was 66.6 years, with frequent polypharmacy complicating diagnosis. Beta-lactam antibiotics and iodinated contrast agents were the most implicated drugs. Nine previously unreported drugs were identified as triggers. DPT confirmed causality in six cases, and LTT aided in three complex cases. Avoidance of the suspected drug or pharmacological group was the main therapeutic measure.

Conclusions

Systematic medication reviews and standardized protocols are crucial for SDRIFE diagnosis. DPT remains the gold standard, while LTT adds value in complex cases, avoiding unnecessary drug restrictions and expanding therapeutic options.

Background

While the importance of skin tension lines in planning excisions is well-documented, its importance in planning grafts is less investigated. This study investigates the effect of orienting grafts along with skin tension lines on quality of life.

Methods

Patients with basal cell carcinoma and treated with either no specific attention for orientation (Group 1, n = 40) or skin tension line–oriented grafting (Group 2, n = 31) were evaluated by Skin Cancer Quality of Life Impact Tool (SCQOLIT) and the Dermatology Quality of Life Index (DLQI) 3 months after surgery. Cosmetic outcome was evaluated by a visual analog scale (VAS).

Results

Seventy-one patients were included (34 males [47.9%] and 37 females [52.1%]; mean age 66.55 ± 9.43). The mean VAS score was 5.64 ± 0.94 for Group 1 and 6.13 ± 0.99 for Group 2. The mean DLQI score was 1 (0–22) for both groups, and the mean SCQOLIT scores were 10 (0–27) for Group 1 and 10 (0–32) for Group 2. While VAS scores significantly differed between groups (p < 0.05), no difference in quality of life was observed.

Conclusion

Tension line–oriented grafting yielded better cosmetic outcomes without demonstrating superiority in terms of quality of life.

Trial Registration: ClinicalTrials.gov identifier: NCT06894056.

Background

Syringoma has been known to recur following conventional treatments like cryotherapy and CO₂ laser. The risk of side effects, such as erythema, edema, scarring, and postinflammatory hyperpigmentation, results in unsatisfactory outcomes.

Objective

To evaluate the efficacy and safety of 1550-nm nonablative fractional laser for treating syringoma.

Methods

We retrospectively analyzed the medical records of syringoma patients who underwent 1550-nm fractional laser treatment. Two blinded dermatologists assessed the treatment efficacy of syringoma based on randomized clinical photographs before and after treatment, using the Periorbital Syringoma Severity Index (PSSI) score and a Global Improvement Scale. Additionally, the types and duration of any side effects occurring after the treatment were evaluated.

Results

A total of 8 patients underwent 22 sessions of 1550-nm fractional laser treatment, averaging 2.75 sessions per patient (median, 2 sessions; range, 1–6 sessions). The female-to-male ratio was 7 : 1, with 3 patients (37.5%) having prior experience with CO₂ laser. The pretreatment PSSI score improved from 4.00 to 2.88 after treatment (p = 0.03). Notably, 2 patients (25.0%) showed marked improvement, and 3 patients (37.5%) exhibited a moderate response. There was a strong correlation between the number of sessions and both the Global Improvement Scale (r = 0.783, p = 0.02) and PSSI score reduction (r = 0.619, p = 0.10). No scarring or dyspigmentation was observed postlaser treatment, and transient edema in 3 patients resolved on average after 13.7 days (median, 7 days).

Conclusion

Although this study is limited by its retrospective design and small sample size, its findings underscore the clinical efficacy of the 1550-nm nonablative fractional laser for the treatment of syringoma. Considering its nonablative nature and short downtime, the 1550-nm fractional laser is a safe and effective treatment alternative.

Background

Alopecia areata (AA) is a prevalent nonscarring hair loss disease affecting the scalp and body hair. However, previous studies have reported conflicting findings regarding its epidemiology. We aimed to quantify the global, regional, and country-specific estimates of AA epidemiology.

Methods

We conducted a comprehensive systematic review of published studies reporting on the incidence and prevalence of AA. We searched four electronic databases from January 1, 1992 to October 20, 2023: PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. A Bayesian hierarchical linear mixed model was employed to determine the epidemiological estimates, accounting for variations in regions, diagnostic types, and age groups.

Results

73 studies met the inclusion criteria. The incidence varied across different geographical locations and age strata. The overall point prevalence and diagnosed population of AA were estimated at 1.93% (0.17%–5.91%) and 15.05 million people, respectively. The United Kingdom, Saudi Arabia, Iraq, and Egypt exhibited the highest prevalence. Globally, approximately 10.29 million adults and 4.76 million children had AA, with a prevalence of 1.98% (0.17%–6.07%) for adults and 1.83% (0.16%–5.58%) for children. Women were more likely to suffer from it. The global prevalence in females was 2.25% (0.20%–7.03%), affecting 8.69 million individuals, whereas for males, the estimates were 1.62% (0.14%–4.80%), impacting 6.36 million individuals. Variations in the epidemiological results might also stem from the chosen method of prevalence estimation.

Conclusion

Epidemiological data for AA were absent in 89.1% of countries globally. The epidemiology varied across gender and age groups and was unevenly distributed among geographical regions.

Background

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD) is a rare lymphoid proliferation whose dermoscopic features are poorly defined, making diagnosis challenging. This study aims to identify the most common dermoscopic features of PCSM-LPD, assess their diagnostic accuracy, and evaluate interobserver reproducibility.

Methods

We conducted a retrospective study in a referral clinic, including patients with histologically confirmed PCSM-LPD and a control group of various cutaneous lymphomas. Two experienced dermatologists independently reviewed dermoscopic images. Key dermoscopic features were identified and compared between the groups. Interoperator reproducibility was measured using Cohen’s Kappa. Diagnostic accuracy and agreement were the primary outcome measures.

Results

We analysed 18 PCSM-LPD cases and 18 controls. Serpentine vessels were the most common feature in PCSM-LPD, with a sensitivity of 100% and specificity of 76.5%. Keratin plugs had a sensitivity of 88.9% and a specificity of 77.8%. A yellow-orange background was also significant, with 100% sensitivity and 77.8% specificity. Interoperator agreement showed low to moderate Kappa values, with better agreement for vessel presence and keratin plugs but lower for vessel type and distribution.

Discussion

Serpentine vessels, keratin plugs, and yellow-orange background characteristics were found to be very sensitive and specific; however, their usability needs to be contextualised for diagnosing PCSM-LPD. Finally, despite high diagnostic accuracy, the interobserver agreement seems inconsistent, highlighting the need for standardised training. Further studies are necessary to validate these findings and improve diagnostic consistency in clinical practice.

Introduction

PHACE syndrome is a neurocutaneous syndrome characterized by large facial segmental hemangiomas as the most typical manifestation. Its prevalence in East Asian is not well studied.

Methods

The retrospective study included 98 infants with facial segmental hemangiomas who underwent brain MRI/MRA, cardiac ultrasound, and ophthalmology examinations. The prevalence along with documentation of its clinical characteristics of PHACE syndrome was analyzed.

Results

Among 98 patients, 5 (5.1%) were diagnosed with “definite” PHACE, while none (0.0%) exhibited “possible” PHACE. Most patients with PHACE syndrome had 2 or more segments, of which the frontotemporal segment was most frequently involved. Structural brain anomalies were identified in two patients, four exhibited cerebrovascular anomalies, four displayed cardiovascular anomalies, and two presented ocular anomalies. Following standardized oral propranolol therapy, all patients showed significant regression. One patient received laser treatment for a residual hemangioma.

Conclusion

The prevalence of PHACE syndrome in facial segmental hemangiomas was 5.1%, predominantly characterized by anomalies in the cerebrovascular and cardiovascular systems. Collaborative multidisciplinary diagnosis and treatment are critical for PHACE patients.

Background

Warts are common skin growths, viral in origin. In fact, many infections arise from members of the human papillomavirus (HPV) family. Traditional treatments for warts have existed to date, but all such procedures can be expensive, invasive, painful, and sometimes ineffective. Recently, there has been growing interest in remedies that can be considered alternatives to mainstream treatments.

Aim of the study

This review discusses the complementary and alternative medicinal (CAM) properties that are gaining popularity as a therapeutic approach, of the Ficus carica (fig) tree latex, its possible modes of action against warts, and anecdotal evidence about its effectiveness.

Method

Data were obtained from clinical and animal studies published in English between 1997 and September 2025 and collected from Google Scholar, PubMed, Scopus, and the Cochrane Library.

Results

F. carica latex contains proteolytic enzymes (ficins) that digest keratin and destroy the hyperkeratotic structure of warts, exposing infected tissue to immune clearance. In addition, polyphenols and flavonoids provide antioxidant and anti-inflammatory effects, while furocoumarins such as psoralen and bergapten exert antiviral and phototoxic actions that inhibit viral replication within wart tissue. While individual results may vary, many users report a reduction in the wart size or a complete clearance.

Conclusion

F. carica (fig) tree latex can be introduced as a novel treatment for cutaneous warts. Further studies are needed for the establishment of a standardized treatment approach, assessment of long-term efficacy, and elucidation of the exact mechanisms of action of F. carica latex.