Dermatologic Therapy最新文献

Laser tattoo removal is an effective technique, but multiple rounds of treatment are required to eliminate tattoos, which can be a challenge for patients who do not have the time. Additionally, there is relatively limited research on the mechanisms of laser tattoo removal, necessitating further in-depth studies. This study aimed to investigate the efficacy of an Er:YAG laser combined with a 755-picosecond laser for tattoo removal and the changes in skin diffuse reflection, pigment particle size, macrophage recruitment, and inflammatory factor levels during combined laser treatment. Our experiments used three sets of lasers—an Er:YAG laser, a 755 nm picosecond laser, and an Er:YAG laser combined with a 755 nm picosecond laser—for tattoo removal. The effects of tattoo removal at different time points were evaluated. Moreover, the mechanisms were explored using HE staining, immunohistochemistry, diffuse reflectance measurements, in vitro gel tests, mass spectrometry, and ELISA experiments. The combined treatment was more effective for tattoo removal in rats. The combined laser treatment effectively reduced diffuse reflection from the skin, thereby increasing the effective laser power, reducing the size of the pigment particles, allowing for easier removal of the pigment, and increasing the recruitment of dermal macrophages and the release of inflammatory factors, thus increasing the rate of tattoo removal in vivo.

Objective. To analyse the clinical and pathologic features, discuss therapeutic strategies, and possibly cause and identify prognostic factors of scrotal basal cell carcinoma (BCC) in Chinese patients. Materials and Methods. Between January 2012 and December 2022, 12 patients with scrotal BCC were diagnosed and treated at our institution. A review was conducted based on the clinical characteristics, pathology slides, and tissues of these patients. Results. The median patient age was 69.26 ± 11.23 years. The skin lesions presented as red papules, blue-grey polypoid nodules, erythematous patches, brownish plaques, and so on. All patients were treated using wide excision, but the margins varied from 0.5 cm to 2 cm. HPV infection was checked in all lesions, with 4 out of 12 testing positive for P16 and 1 for HPV16 DNA. We found mottled positive expression of P16 in the cytoplasm and membrane. One patient developed left inguinal lymph node metastasis and was successfully treated using bilateral inguinal lymphadenectomy. The rest recovered well without relapse. Conclusions. BCC of the scrotum is rare, but long-term surveillance is recommended for BCC patients, and whether genital HPV infection is a noteworthy feature for these patients remains under investigation.

Background. Amoxicillin was associated with acute generalized exanthematous pustulosis (AGEP), and the clinical characteristics were not clear. The purpose of this study was to explore the clinical characteristics of amoxicillin-induced AGEP and to provide a basis for prevention and treatment. Methods. Case reports and case series of amoxicillin-induced AGEP were collected for retrospective analysis by searching the Chinese and English databases from inception to January 31, 2023. Results. A total of 46 patients were included with a median age of 40 years (range 1.4, 87). The onset time of AGEP ranged from 6 hours to 28 days, with a median of 2.5 days. Fever occurred in 32 patients (69.6%), and pruritus occurred in 13 patients (28.3%). Ten patients (21.7%) had mucous membrane involvement and systemic involvement, respectively. Twenty-two patients had elevated neutrophils, with a median of 12850/mm³ (range 7880, 29140). Skin biopsy mainly showed subcorneal pustules (22 cases, 47.8%), spongy pustules (14 cases, 30.4%), and inflammatory cell infiltration (26 cases, 56.5%). Skin lesions disappeared in a median of 10 days (range 2, 42) after discontinuation of amoxicillin and administration of topical steroids (26 cases, 56.5%) as well as systemic corticosteroids (13 cases, 28.3%). Conclusions. AGEP is a rare complication of amoxicillin and is self-limiting. Clinicians should correctly identify AGEP and should avoid represcribing amoxicillin. Clinicians should correctly identify AGEP and avoid represcribing amoxicillin, which can prevent unnecessary treatment measures.

Treatment of progressive vitiligo aims to halt the spread of the disease and facilitate repigmentation of lesions. JAK inhibitor has been shown some therapeutic effects on vitiligo, but the data for the progressive vitiligo are limited. This retrospective study was performed to evaluate the efficacy and safety of oral tofacitinib in 25 refractory progressive vitiligo patients who experienced failure to previous steroid treatments. 16 (64%) of the 25 patients noted stopping disease progression, and nearly half of the 16 cases halted progression within one month. 10 (40%) patients had repigmentation in varying degrees. Combination with phototherapy was a key factor affecting the rate of repigmentation. Oral tofacitinib might be a potentially effective treatment for intractable progressive vitiligo. The limitations of the study include the retrospective, single-centre study with small sample size and lack of comparison with other systemic therapies.

Background. Psoriasis, a persistent inflammatory condition, is linked to several concurrent health issues. Among these, obesity stands out as a significant contributing factor, significantly influencing the development and seriousness of psoriasis. Furthermore, behavioral elements such as eating styles could potentially contribute to the activity of the disease. Objective. To investigate the relationships between eating styles and the clinical severity of psoriasis. Materials and Methods. A cross-sectional study among 158 chronic plaque psoriasis patients was conducted. Sociodemographic data and clinical presentation of psoriasis including risk factors and treatment, eating, stress, and sleep data were obtained from questionnaires. Psoriasis disease severity, weight, and height measurements, including bioelectrical impedance analysis were assessed. A multivariate logistic regression analysis was employed to assess eating patterns and identify notable factors linked to the severity of the disease. Results. After adjusting for the potential confounder, the emotional eating style was significantly associated with an increase in risk of psoriasis severity when compared to the restrained eating style (odds ratio, 3.9; 95% confidence interval, 1.52–9.81). Body mass index, body fat mass, eating attitude, alcohol consumption, nail involvement, psoriasis treatment, smoking status, duration of sleep, and stress status were not significant risk factors for disease severity. Conclusions. There is a significant correlation between emotional eating style and the severity of chronic plaque-type psoriasis in Asian patients. Further exploration into utilizing cognitive-behavioral therapy to address emotional eating styles as part of psoriasis management is warranted.

Alopecia areata (AA) significantly impacts mental health and quality of life in children. While current treatments often offer limited efficacy, noticeable remission occurs in responsive cases. Recent advancements in understanding AA’s pathogenesis have sparked hope for Janus kinase (JAK) inhibitors as potential treatments. However, studies on this promising avenue remain limited. Our retrospective evaluation of pediatric patients treated with systemic tofacitinib for alopecia showed significant improvements, notably at the 12-month mark, with only one patient experiencing an upper respiratory infection as a side effect. Nevertheless, our study’s retrospective design and small patient cohort highlight limitations. Larger randomized studies are crucial to comprehensively explore the efficacy and potential of JAK inhibitors in pediatric AA treatment.