Dermatologic Therapy最新文献

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.

Aim

This study aims to develop a five-dimensional skin color evaluation system and analyze the characteristics of Chinese women’s skin color across these dimensions, focusing on age and key change points. The findings will provide scientific evidence for personalized skin tone management for Chinese women.

Method

Using noninvasive skin parameter measurements and image processing, 13 facial skin color parameters were collected from 300 Chinese women aged between 18 and 60. A correlation analysis was used to verify the construct validity of the system, exploring interrelationships within and between dimensions. Additionally, polynomial fitting was used to model the five-dimensional skin tone characteristics by age, and ANOVA was used to assess these characteristics across different age stages.

Results

Skin pigmentation issues in the Chinese female population are categorized into five dimensions: T (skin tolerance), M (skin moisturizing), U (uniformity of skin color), O (skin optical transmittance), and B (skin brightness). T reflects the skin’s ability to respond to stimuli, while M indicates optimal skin hydration and sebum production. U assesses skin color uniformity, O measures light diffusion within the skin, and B indicates the light reflection intensity of the skin. Correlation analysis suggests that poor tolerance (T) may relate to inadequate moisturization (M), and that U, O, and B positively influence each other. The study identified four different stages of skin color changes in the female population aged between 18 and 60: latent stage (18–25), pigmentation appearance (26–30), accelerated pigmentation (31–43), and pigmentation explosion (44–60). ANOVA results show that Chinese women of varying ages exhibit divergent five-dimensional skin color characteristics, with a common issue of uneven skin tone observed in all participants.

Conclusion

The five-dimensional skin color evaluation system provides an objective method for assessing changes in Chinese women’s skin with age. Dimensions T and M reflect skin condition and underpin management practices, while U, O, and B represent skin tone. As women age, skin pigmentation problems become more noticeable, with an increase in pigmented spots, a decline in translucency, and increased skin unevenness. The most dramatic change occurs during the accelerated pigmentation period between the ages of 31 and 43.

Background

Kaposi’s sarcoma (KS) is a rare neoplasm whose prevalence increased with the occurrence of the human immunodeficiency virus (HIV). We aimed to assess the demographic and clinical characteristics of patients with KS who had HIV.

Methods

This retrospective study was performed on 2750 patients in Nairobi, Kenya. The characteristics of the KS were assessed in patients.

Results

From 2750 patients, 124 (4.50%) had KS, of which 68 (54.8%) were males and 56 (45.2%) were females. The mean age of patients was 34.63 ± 8.65 (range 17–62) years. The level of CD4 was less than 100 in 62/124 (50%). Of the patients, 87.9% had skin KS, 50% had mucous membranes, and 17.7% had reticuloendothelial KS. The locations of the lesions were mainly on the lower limbs (78, 62.9%), followed by the head and neck (53, 42.7%). Eye involvement was statistically more prevalent among females than males (p value = 0.029). Sixty-one patients (49.1%) had more than 10 KS lesions. Nodules (98, 79.0%) and edema (75, 60.4%) were the most common presentations of KS. Fifty-three patients (42.7%) had tuberculosis infection. There was a significant relationship between TB and CD4 levels (p value < 0.001). Patients with lower CD4 levels were more likely to have mucus membrane involvement (p value = 0.002) and ulceration (p value = 0.017).

Conclusions

Our study revealed the various clinical characteristics of KS, suggesting that patients in endemic regions require a thorough clinical examination to rule out this potentially malignant condition. This article will help physicians manage patients with KS more effectively.