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Intradermal Local Injection of Autologous Cell-Free Fat Extract for the Treatment of Refractory Postinflammatory Hyperpigmentation 皮内局部注射自体无细胞脂肪提取物治疗难治性炎症后色素沉着症
IF 3.6 4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-17 DOI: 10.1155/2023/9561809
Yizuo Cai, Zhuoxuan Jia, Jiancheng Gu, Bijun Kang, Hongjie Zheng, Wei Li, Wenjie Zhang
Current treatment modalities for postinflammatory hyperpigmentation (PIH) often fall short in delivering satisfactory results for some patients. Therefore, this study aimed to assess the efficacy and tolerability of autologous cell-free fat extract (CEFFE) in the treatment of PIH. We enrolled 15 patients with PIH and administered them with five intracutaneous CEFFE injections, each at a two-week interval. Evaluation included efficacy assessment using objective (standard two-dimensional photos, VISIA®-photos, brown spot (BS) index, lesion lightness, lesion color, and trans-epidermal water loss) and subjective (Global Aesthetic Improvement Scale and Likert satisfaction scale) parameters and tolerance assessment. Following CEFFE treatment, significant reductions were observed in the BS index ( p < 0.05 ) and transepidermal water loss ( p < 0.05 ), while skin lightness and lesion color showed significant improvements ( p < 0.05 ) at the 12-month follow-up. Subjectively, 93.33% of patients reported improved or greatly improved conditions after 12 months of treatment. Transient local bruising and stinging were the only observed treatment-related adverse events, with no serious complications reported. These findings demonstrate that intradermal injections of CEFFE are well-tolerated and effective for the treatment of PIH. This trial is registered with ChiCTR2000039381.
目前治疗炎症后色素沉着(PIH)的方法往往不能为一些患者带来满意的效果。因此,本研究旨在评估自体无细胞脂肪提取物(CEFFE)治疗 PIH 的疗效和耐受性。我们招募了 15 名 PIH 患者,对他们进行了五次皮内 CEFFE 注射,每次间隔两周。评估包括客观(标准二维照片、VISIA®-照片、褐斑(BS)指数、皮损亮度、皮损颜色和跨表皮失水)和主观(全球美学改善量表和李克特满意度量表)参数的疗效评估以及耐受性评估。CEFFE 治疗后,BS 指数(P < 0.05)和经表皮失水率(P < 0.05)明显下降,而皮肤亮度和皮损颜色在 12 个月的随访中也有明显改善(P < 0.05)。主观上,93.33%的患者在治疗 12 个月后表示病情有所改善或大为改善。短暂的局部瘀伤和刺痛是唯一观察到的与治疗相关的不良反应,没有严重并发症的报告。这些研究结果表明,皮内注射CEFFE对治疗PIH具有良好的耐受性和有效性。该试验的注册号为ChiCTR2000039381。
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引用次数: 0
A Topical Scalp Serum Containing Adenosine, MgSO4, Vitamin CG, and Pre- and Probiotic Fractions Reduces Discomfort and Associated Symptoms of Sensitive Scalp 含有腺苷、MgSO4、维生素CG和益生菌前组分的局部头皮血清可减轻敏感头皮的不适和相关症状
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-13 DOI: 10.1155/2023/7225231
Philippe Massiot, Françoise Magne, Florence Weisgerber, Anais Thomet, Florence Pouradier, Geneviève Loussouarn, Delphine Kerob
Purpose. Sensitive scalp (SScalp) is characterized by abnormal and nociceptive sensations, such as stinging and itching, that lead to scalp discomfort. This study assessed the benefit of a once-daily serum containing Adenosine, Magnesium Sulfate (MgSO4), Vitamin C Glucoside (CG), and pre- and probiotic fractions in subjects with SScalp. Methods. An open-label, single center study in adult subjects with a Global Scalp Discomfort (GSD) score of ≥8 (0–27), defined as the sum of individual symptom scores (0–9) for itching, stinging, and warming sensations. The frequency of scratching was self-declared. Evaluations were performed immediately after the 1st application (D0Timm) and at D21, during which the cosmetic acceptability was additionally assessed. Transepidermal water loss and skin hydration were assessed at baseline, D21, and D28. Squalene (SQ) and SQOOH were analyzed at D0T0, D21T0, and D28. Tolerance was assessed throughout the study. Results. 42 subjects (30 women and 12 men) participated in this study. The mean age was 44.0 ± 13.0 years. At baseline, the mean GSD was 13.9 ± 3.28. The GSD and symptoms significantly p < 0.0001 improved at D0Timm and lasted until the end of the study (D28), with insignificant worsening. There was a significant reduction of SQOOH at D21 and D28. Subject satisfaction was high, associated with a good tolerance. A similar and significant p < 0.0001 improvement was observed for subjects with more severe symptoms and a GSD score ≥14 at baseline. Conclusion. The topical serum significantly reduces SScalp, global discomfort, and oxidative stress and is beneficial in the management of sensitive scalp. This TRIAL is registered with NCT05630027.
目的。敏感头皮(s头皮)的特点是异常和伤害性的感觉,如刺痛和瘙痒,导致头皮不适。本研究评估了s头皮患者每日一次含腺苷、硫酸镁(MgSO4)、维生素C葡萄糖苷(CG)和益生菌前组分的血清的益处。方法。一项开放标签、单中心研究,纳入整体头皮不适(GSD)评分≥8(0-27)的成人受试者,定义为瘙痒、刺痛和温热感觉的个体症状评分(0-9)的总和。抓挠的频率是自己宣布的。在第一次应用(D0Timm)和D21后立即进行评估,在此期间对美容可接受性进行额外评估。在基线、D21和D28时评估经皮失水和皮肤水化。在D0T0、D21T0和D28分析角鲨烯(SQ)和SQOOH。在整个研究过程中对耐受性进行了评估。结果:42名受试者(30名女性,12名男性)参加了本研究。平均年龄44.0±13.0岁。基线时,平均GSD为13.9±3.28。GSD与症状显著p <0.0001在D0Timm时改善,并持续到研究结束(D28),无显著恶化。在D21和D28时,SQOOH显著减少。受试者满意度高,与良好的耐受性相关。一个相似且重要的p <症状更严重且基线时GSD评分≥14的受试者改善0.0001。结论。局部血清可显著减少s头皮、全身不适和氧化应激,有利于敏感头皮的治疗。该试验注册号为NCT05630027。
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引用次数: 0
Risk of Schizophrenia in Patients with Psoriasis: A Systematic Review and Meta-Analysis 牛皮癣患者精神分裂症的风险:一项系统回顾和荟萃分析
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-11 DOI: 10.1155/2023/6624793
Peixin Zhu, Qi He, Xiyan Liu, Chunyue Huo
Background. Several studies have shown that psoriasis patients have a higher prevalence rate of schizophrenia, but none has thoroughly examined this association across different ages and genders. Thus, our systematic review and meta-analysis aims to combine all available evidence and evaluate the risk of schizophrenia in psoriasis patients. Methods. Two independent investigators extracted published studies from PubMed, Embase, Medline, and Web of Science databases from inception until May 2023 and screened 160 articles for eligibility. We included 8 studies in this meta-analysis. A random-effects model was employed to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) for schizophrenia in patients with psoriasis. The study protocol is registered with PROSPERO, number CRD42023428576. Results. A total of eight studies with 889,747,79 participants met the eligibility criteria. The pooled OR of psoriasis in patients with schizophrenia versus subjects without schizophrenia was 1.66 (95% CI: [1.20, 2.29]) with a significant level of heterogeneity ( I 2 = 97%). Specifically, the OR for psoriasis in children with schizophrenia was 12.90 (95% CI: [1.97, 84.64]), with an I 2 combined value of 98% and psoriasis in adults with schizophrenia 2.57 (95% CI: [1.44, 4.58]), with an I 2 combined value of 61.3%. The combined OR for all age groups was 5.27 (95% CI: [3.02, 9.19]). Additionally, we found that the OR value for psoriasis in females with schizophrenia was 1.74 (95% CI: [1.74, 2.11]), with an I 2 combined value of 59%. For male patients, the OR value was 1.58 (95% CI: [1.25, 2.01]), with an I 2 combined value of 77%. Conclusions. Our study shows an increased risk of schizophrenia in people with psoriasis. We demonstrated a significantly increased risk of schizophrenia among children with psoriasis and found that females with psoriasis were more likely to have schizophrenia than men with psoriasis under the same conditions.
背景。几项研究表明,牛皮癣患者患精神分裂症的患病率较高,但没有一项研究彻底研究了不同年龄和性别之间的这种联系。因此,我们的系统回顾和荟萃分析旨在结合所有现有证据并评估牛皮癣患者精神分裂症的风险。方法。两名独立研究人员从PubMed、Embase、Medline和Web of Science数据库中提取了从成立到2023年5月的已发表研究,并筛选了160篇文章的合格性。我们在这项荟萃分析中纳入了8项研究。采用随机效应模型估计牛皮癣患者精神分裂症的合并优势比(OR)和95%置信区间(CI)。研究方案已在PROSPERO注册,注册号为CRD42023428576。结果。共有8项研究,889,747,79名参与者符合资格标准。精神分裂症患者与非精神分裂症患者牛皮癣的合并OR为1.66 (95% CI:[1.20, 2.29]),异质性显著(I 2 = 97%)。其中,精神分裂症患儿牛皮癣的OR值为12.90 (95% CI: [1.97, 84.64]), i2联合值为98%;精神分裂症成人牛皮癣的OR值为2.57 (95% CI: [1.44, 4.58]), i2联合值为61.3%。所有年龄组的综合OR为5.27 (95% CI:[3.02, 9.19])。此外,我们发现女性精神分裂症患者牛皮癣的OR值为1.74 (95% CI: [1.74, 2.11]), i2综合值为59%。男性患者OR值为1.58 (95% CI: [1.25, 2.01]), i2综合值为77%。结论。我们的研究表明牛皮癣患者患精神分裂症的风险增加。我们证明了患有牛皮癣的儿童患精神分裂症的风险显著增加,并发现在相同条件下,患有牛皮癣的女性比患有牛皮癣的男性更容易患精神分裂症。
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引用次数: 0
The Role of Long Pentraxin 3 and Nuclear Factor Kappa Beta in Vitiligo Occurrence and Disease Severity 长戊甲素3和核因子Kappa β在白癜风发生和病情严重程度中的作用
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-11 DOI: 10.1155/2023/6303637
Şule Gençoğlu, Zekiye Kanat
Objectives. To reveal the role of long pentraxin 3 (PTX3) and nuclear factor kappa beta (NF-kB) in vitiligo and their relationship with disease severity. Materials and Methods. The study groups consisted of a total of 54 patients, including 27 patients diagnosed with vitiligo and 27 healthy controls without any cutaneous disease. Patients with amelanotic, sharply demarcated, and chalk-white macular lesions were defined as vitiligo. The diagnosis of vitiligo was confirmed by Wood’s lamp examination. No biopsies were taken from the lesions, and no additional laboratory testing was performed. Skin and hair pigmentations in lesions other than hands and feet were evaluated. Vitiligo grading was done using the largest macules overall. Spreading rates were evaluated in selected lesions with Wood’s lamp. The long pentraxin 3 and NF-kB levels in serum samples of participants were measured by the ELISA method. Results. According to the Vitiligo European Task Force consensus 16 of 27, vitiligo patients were in the slow progressive phase, and 11 patients were in the active progressive phase. The serum PTX3 levels of the patients in the vitiligo group were found to be significantly higher than those of the control group (8.21 ± 2.11 ng/ml vs. 6.76 ± 1.90 ng/ml, p < 0.03). Similarly, the serum NF-kB levels of the patients in the vitiligo group were significantly higher than those of the patients in the control group (15.03 ± 3.45 ng/ml vs. 12.19 ± 4.20 ng/ml, p < 0.01). A positive and significant correlation was found between serum NF-kB and PTX3 (r = 0.677 and p < 0.01). PTX3 and NF-kB levels were significantly higher in patients in the active progressive phase than in patients in the slow progressive phase. PTX3 and NF-kB values in the active progressive phase tended to be higher than those detected when the disease was in the slow progressive phase. Conclusions. High serum PTX3 and NF-kB levels in vitiligo are evidence of impaired proinflammatory activity and innate and adaptive immunity.
目标。目的:探讨长pentxin 3 (PTX3)和核因子κ β (NF-kB)在白癜风发病中的作用及其与病情严重程度的关系。材料与方法。研究组共有54名患者,包括27名诊断为白癜风的患者和27名没有任何皮肤疾病的健康对照。无色素、界限分明、白垩白色的黄斑病变被定义为白癜风。伍德灯检查证实了白癜风的诊断。没有对病变进行活组织检查,也没有进行额外的实验室检查。评估除手和脚以外病变部位的皮肤和头发色素沉着。白癜风分级使用最大的斑点总体。用Wood灯评估选定病变的扩散率。采用酶联免疫吸附试验(ELISA)测定受试者血清中长戊烷素3和NF-kB水平。结果。根据白癜风欧洲工作组的共识,27例白癜风患者中有16例处于缓慢进展期,11例处于活跃进展期。白癜风组患者血清PTX3水平明显高于对照组(8.21±2.11 ng/ml vs. 6.76±1.90 ng/ml, p <0.03)。同样,白癜风组患者血清NF-kB水平显著高于对照组(15.03±3.45 ng/ml vs. 12.19±4.20 ng/ml, p <0.01)。血清NF-kB与PTX3呈显著正相关(r = 0.677, p <0.01)。活跃进展期患者的PTX3和NF-kB水平明显高于缓慢进展期患者。活跃进展期PTX3和NF-kB值倾向于高于缓慢进展期。结论。白癜风患者血清PTX3和NF-kB水平高是促炎活性、先天免疫和适应性免疫受损的证据。
{"title":"The Role of Long Pentraxin 3 and Nuclear Factor Kappa Beta in Vitiligo Occurrence and Disease Severity","authors":"Şule Gençoğlu, Zekiye Kanat","doi":"10.1155/2023/6303637","DOIUrl":"https://doi.org/10.1155/2023/6303637","url":null,"abstract":"Objectives. To reveal the role of long pentraxin 3 (PTX3) and nuclear factor kappa beta (NF-kB) in vitiligo and their relationship with disease severity. Materials and Methods. The study groups consisted of a total of 54 patients, including 27 patients diagnosed with vitiligo and 27 healthy controls without any cutaneous disease. Patients with amelanotic, sharply demarcated, and chalk-white macular lesions were defined as vitiligo. The diagnosis of vitiligo was confirmed by Wood’s lamp examination. No biopsies were taken from the lesions, and no additional laboratory testing was performed. Skin and hair pigmentations in lesions other than hands and feet were evaluated. Vitiligo grading was done using the largest macules overall. Spreading rates were evaluated in selected lesions with Wood’s lamp. The long pentraxin 3 and NF-kB levels in serum samples of participants were measured by the ELISA method. Results. According to the Vitiligo European Task Force consensus 16 of 27, vitiligo patients were in the slow progressive phase, and 11 patients were in the active progressive phase. The serum PTX3 levels of the patients in the vitiligo group were found to be significantly higher than those of the control group (8.21 ± 2.11 ng/ml vs. 6.76 ± 1.90 ng/ml, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> < 0.03). Similarly, the serum NF-kB levels of the patients in the vitiligo group were significantly higher than those of the patients in the control group (15.03 ± 3.45 ng/ml vs. 12.19 ± 4.20 ng/ml, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> </math> < 0.01). A positive and significant correlation was found between serum NF-kB and PTX3 (r = 0.677 and <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> </math> < 0.01). PTX3 and NF-kB levels were significantly higher in patients in the active progressive phase than in patients in the slow progressive phase. PTX3 and NF-kB values in the active progressive phase tended to be higher than those detected when the disease was in the slow progressive phase. Conclusions. High serum PTX3 and NF-kB levels in vitiligo are evidence of impaired proinflammatory activity and innate and adaptive immunity.","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"45 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135042814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality of Life Assessments Utilized in Vitiligo Clinical Trials 生活质量评估在白癜风临床试验中的应用
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-08 DOI: 10.1155/2023/9948769
Gaurav N. Pathak, Rithi J. Chandy, Vidisha Naini, Steven R. Feldman, Babar K. Rao
Introduction. Vitiligo is an acquired autoimmune disease associated with high psychosocial burden. As novel treatments are being developed in clinical trials, assessing vitiligo disease burden extends beyond physical manifestations. Including quality of life (QoL) measures in vitiligo clinical trials can better capture disease-specific psychosocial concerns and facilitate cross comparisons amongst interventions. Objective. To determine the frequency and types of QoL measures utilized in vitiligo clinical trials and comment on how this has changed longitudinally. Methods. A search of vitiligo clinical trials using clinicaltrials.gov was conducted. Phase 2 and phase 3 trials published in English from January 2000 to July 2023 were eligible for this review. Characteristics of clinical trial parameters were compared to those of non-QoL reporting clinical trials using Pearson’s χ2 tests (or Fisher’s if low n). Results. A total of 60 clinical trials were eligible for this review, of which 40% included a QoL measure in their study design. Phase 3 clinical trials ( p = 0.002), larger (100+ participants) trials ( p = 0.063), U.S. trials ( p = 0.029), and pharmaceutical interventions ( p = 0.022) were more likely to include QoL measures in their design. The number of clinical trials has been increasing over time, with 8 trials from 2000 to 2010, 32 total trials from 2011 to 2020, and 20 trials from 2021 to 2023. The most commonly used QoL measures were the Dermatology Life Quality Index (DLQI, 55.2%), Children's Dermatology Life Quality Index (CDLQI, 13.8%), and Vitiligo-specific quality of life instrument (VitiQoL, 13.8%). Over time, the VitiQoL and CDLQI have been used more frequently. Conclusion. Although vitiligo is associated with high psychological and emotional burden, less than half of vitiligo trials utilize QoL measures. The general dermatology QoL measures, namely the DLQI and CDLQI, are the most commonly used QoL assessments. As the number of clinical trials is increasing, vitiligo-specific questionnaires may better capture unique vitiligo-specific concerns. Standardizing the types of and implementation of QoL questionnaires in clinical trials can aid in assessing outcome measures across clinical trials worldwide and allow for better data interpretation, comparability, and clinical application of results.
介绍。白癜风是一种与高社会心理负担相关的获得性自身免疫性疾病。随着新的治疗方法正在临床试验中开发,评估白癜风的疾病负担已经超出了身体表现。在白癜风临床试验中纳入生活质量(QoL)测量可以更好地捕捉疾病特异性心理社会问题,并促进干预措施之间的交叉比较。目标。确定白癜风临床试验中使用的生活质量测量的频率和类型,并对其纵向变化进行评论。方法。在clinicaltrials.gov网站上搜索白癜风临床试验。2000年1月至2023年7月以英文发表的2期和3期临床试验纳入本综述。将临床试验参数的特征与非生活质量报告临床试验的特征进行比较,使用Pearson χ2检验(如果n低,则使用Fisher检验)。共有60项临床试验符合本综述,其中40%在其研究设计中纳入了生活质量测量。3期临床试验(p = 0.002)、大型(100+参与者)试验(p = 0.063)、美国试验(p = 0.029)和药物干预(p = 0.022)更有可能在其设计中包括生活质量测量。随着时间的推移,临床试验的数量不断增加,2000年至2010年有8项试验,2011年至2020年有32项试验,2021年至2023年有20项试验。最常用的生活质量指标是皮肤病生活质量指数(DLQI, 55.2%)、儿童皮肤病生活质量指数(CDLQI, 13.8%)和白癜风特异性生活质量仪器(VitiQoL, 13.8%)。随着时间的推移,VitiQoL和CDLQI的使用越来越频繁。结论。虽然白癜风与高心理和情绪负担有关,但不到一半的白癜风试验使用生活质量测量。一般皮肤病生活质量测量,即DLQI和CDLQI,是最常用的生活质量评估。随着临床试验数量的增加,白癜风特异性问卷可能更好地捕捉到独特的白癜风特异性问题。标准化临床试验中生活质量问卷的类型和实施有助于评估全球临床试验的结果测量,并允许更好的数据解释、可比性和结果的临床应用。
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引用次数: 0
Improvement of Nonlesional Skin Tone and Skin Barrier in Severe Atopic Dermatitis after Dupilumab Treatment Dupilumab治疗后严重特应性皮炎患者非损伤性肤色和皮肤屏障的改善
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-07 DOI: 10.1155/2023/6218587
Hye-Jin Ahn, Min Kyung Shin
Dupilumab, approved for the treatment of moderate-to-severe atopic dermatitis (AD), has been proven to improve skin barrier and postinflammatory hyperpigmentation on nonlesional areas. Previous studies, however, are only based on subjective visual assessments rather than objective biophysical measurements. We aimed to objectively measure transepidermal water loss (TEWL) and skin tone improvements after dupilumab treatment through bioengineering devices. Nineteen patients with severe AD were enrolled. Biophysical measurements were conducted in three nonlesional skin areas, the cheek, forearm, and lower abdomen, on a monthly basis for 5 months since the first dupilumab injection. TEWL was measured using a Tewameter®. Skin tones represented by <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1"> <msup> <mrow> <mi mathvariant="normal">L</mi> </mrow> <mi>∗</mi> </msup> </math> (lightness), <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2"> <msup> <mrow> <mi mathvariant="normal">a</mi> </mrow> <mi>∗</mi> </msup> </math> (redness), and <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3"> <msup> <mrow> <mi mathvariant="normal">b</mi> </mrow> <mi>∗</mi> </msup> </math> (yellowness) parameters were measured by the spectrophotometer®; the erythema and melanin index measured by the narrow-band reflectance spectrophotometer® were additionally assessed. Improvement from baseline was evaluated by the Wilcoxon’s rank-sum test and Bonferroni correction. Correlation among biophysical parameters was evaluated by Pearson’s correlation. <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4"> <mi>p</mi> </math> < 0.05 was considered statistically significant. TEWL and skin tone parameters in all anatomical regions showed significant improvement. The <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5"> <msup> <mrow> <mi mathvariant="normal">L</mi> </mrow> <mi>∗</mi> </msup> </math> and <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6"> <msup> <mrow> <mi mathvariant="normal">a</mi> </mrow> <mi>∗</mi> </msup> </math> values of the arm and trunk significantly improved after 2 months of dupilumab therapy and the face 3 months after. Similarly, <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7"> <msup> <mrow> <mi mathvariant="normal">b</mi> </mrow> <mi>∗</mi> </msup> </math> value of all anatomical regions significantly decreased after 1 month of treatment, and the TEWL did so after 2 months. When compared between anatomic regions, the trunk demonstrated higher improvement in <math xmlns="http://www.w3.org/1998/Math/MathML" id="M8"> <msup> <mrow> <mi mathvariant="normal">L</mi> </mrow> <mi>∗</mi> </msup> </math> value, the arm in erythema index, and the face in melanin index. TEWL positively correlated with erythema index (r = 0.51, <math xmlns="http://www.w3.org/1998/Math/MathML" id="M9"> <mi>p</mi> </math> < 0.05), melanin index (r = 0.45, <math xmlns="http://www.w3.org/1998/Math/MathML" id="M10"> <mi>p</mi> </math> < 0.05), and <math
Dupilumab被批准用于治疗中度至重度特应性皮炎(AD),已被证明可以改善非病变区域的皮肤屏障和炎症后色素沉着。然而,以前的研究只是基于主观的视觉评估,而不是客观的生物物理测量。我们的目的是通过生物工程装置客观地测量杜匹单抗治疗后经皮失水(TEWL)和肤色改善。19例重度AD患者入组。自首次注射杜匹单抗后5个月,在三个非病变皮肤区域,脸颊、前臂和下腹进行生物物理测量。Tewameter®测量TEWL。用分光光度计®测量以L *(亮度)、a *(红度)和b *(黄度)参数表示的肤色;另外用窄带反射分光光度计测量红斑和黑色素指数。通过Wilcoxon秩和检验和Bonferroni校正来评估基线的改善。采用Pearson相关法评价生物物理参数之间的相关性。p & lt;0.05认为有统计学意义。各解剖区域TEWL和肤色参数均有显著改善。dupilumab治疗2个月后,手臂和躯干的L∗和a∗值显著改善,治疗3个月后,面部的L∗值显著改善。同样,治疗1个月后各解剖区域的b *值均显著降低,治疗2个月后TEWL也显著降低。在各解剖区域间比较,躯干的L *值、手臂的红斑指数和面部的黑色素指数均有较高的改善。TEWL与红斑指数呈正相关(r = 0.51, p <0.05),黑色素指数(r = 0.45, p <0.05), a * (r = 0.50, p <0.05);与L *呈负相关(r = - 0.48, p <0.05)。在AD症状缓解的基础上,dupilumab客观上改善了非病变区域的皮肤屏障和肤色。
{"title":"Improvement of Nonlesional Skin Tone and Skin Barrier in Severe Atopic Dermatitis after Dupilumab Treatment","authors":"Hye-Jin Ahn, Min Kyung Shin","doi":"10.1155/2023/6218587","DOIUrl":"https://doi.org/10.1155/2023/6218587","url":null,"abstract":"Dupilumab, approved for the treatment of moderate-to-severe atopic dermatitis (AD), has been proven to improve skin barrier and postinflammatory hyperpigmentation on nonlesional areas. Previous studies, however, are only based on subjective visual assessments rather than objective biophysical measurements. We aimed to objectively measure transepidermal water loss (TEWL) and skin tone improvements after dupilumab treatment through bioengineering devices. Nineteen patients with severe AD were enrolled. Biophysical measurements were conducted in three nonlesional skin areas, the cheek, forearm, and lower abdomen, on a monthly basis for 5 months since the first dupilumab injection. TEWL was measured using a Tewameter®. Skin tones represented by &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;L&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; (lightness), &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;a&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; (redness), and &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;b&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; (yellowness) parameters were measured by the spectrophotometer®; the erythema and melanin index measured by the narrow-band reflectance spectrophotometer® were additionally assessed. Improvement from baseline was evaluated by the Wilcoxon’s rank-sum test and Bonferroni correction. Correlation among biophysical parameters was evaluated by Pearson’s correlation. &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;/math&gt; &lt; 0.05 was considered statistically significant. TEWL and skin tone parameters in all anatomical regions showed significant improvement. The &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;L&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; and &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M6\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;a&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; values of the arm and trunk significantly improved after 2 months of dupilumab therapy and the face 3 months after. Similarly, &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M7\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;b&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; value of all anatomical regions significantly decreased after 1 month of treatment, and the TEWL did so after 2 months. When compared between anatomic regions, the trunk demonstrated higher improvement in &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M8\"&gt; &lt;msup&gt; &lt;mrow&gt; &lt;mi mathvariant=\"normal\"&gt;L&lt;/mi&gt; &lt;/mrow&gt; &lt;mi&gt;∗&lt;/mi&gt; &lt;/msup&gt; &lt;/math&gt; value, the arm in erythema index, and the face in melanin index. TEWL positively correlated with erythema index (r = 0.51, &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M9\"&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;/math&gt; &lt; 0.05), melanin index (r = 0.45, &lt;math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M10\"&gt; &lt;mi&gt;p&lt;/mi&gt; &lt;/math&gt; &lt; 0.05), and &lt;math ","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"87 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135432701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Biologics Be Discontinued in Patients with Psoriatic Arthritis in Stable Remission? A Prospective Single-CenterClinical and Ultrasound Study 银屑病关节炎稳定缓解期患者可以停用生物制剂吗?一项前瞻性单中心临床和超声研究
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-04 DOI: 10.1155/2023/5655687
Dario Graceffa, Francesca Sperati, Claudio Bonifati, Gabriele Spoletini, Fulvia Elia, Mauro Caterino, Antonio Cristaudo, Aldo Morrone
Biologic disease-modifying antirheumatic drugs (bDMARDs) and particularly tumor necrosis factor inhibitors (TNFi) have dramatically changed the natural history of psoriatic arthritis (PsA), making complete clinical remission possible in most patients. However, TNFi drugs are not without potential adverse effects such as increased infectious risk. In addition, their extensive use is associated with a significant economic burden. This prospective longitudinal cohort study involving 45 PsA patients treated with TNFi in stable remission aimed to evaluate by both clinical examination and ultrasound timing and predictive factors of disease relapse after discontinuation of TNFi treatment. Thirty-nine (86.6%) of 45 enrolled patients experienced disease relapse during the follow-up period, while six patients (13.4%) maintained remission beyond the scheduled 104 weeks. The median survival time of drug-free remission after TNFi discontinuation was 24 weeks (95% confidence interval (CI): 22.6–25.4). Disease relapse was characterized by marked clinical and ultrasound worsening of dermatologic and rheumatologic conditions. However, resuming previously discontinued treatment allowed all patients to quickly regain clinical remission. Interestingly, axial involvement was a key feature of the symptomatological pattern of disease relapse, being the main reason for treatment restart in 26% of our cohort. Based on a multivariate Cox model, three variables (VAS pain, tender joint count, and swollen joint count) of the clinical assessment performed at the time point of TNFi treatment onset negatively influenced the time to disease relapse. In conclusion, temporary discontinuation of TNFi drugs is feasible and relatively safe. However, as few predictors of the risk and timing of disease relapse have been identified, patients should be closely monitored when therapy is discontinued.
生物疾病改善抗风湿药物(bDMARDs),特别是肿瘤坏死因子抑制剂(TNFi),极大地改变了银屑病关节炎(PsA)的自然史,使大多数患者的临床完全缓解成为可能。然而,TNFi药物并非没有潜在的副作用,例如增加感染风险。此外,它们的广泛使用带来了巨大的经济负担。本前瞻性纵向队列研究纳入45例经TNFi治疗稳定缓解的PsA患者,旨在通过临床检查和超声时间以及TNFi治疗停止后疾病复发的预测因素来评估。45名入组患者中有39名(86.6%)在随访期间出现疾病复发,而6名(13.4%)患者在预定的104周后保持缓解。TNFi停药后无药缓解的中位生存时间为24周(95%可信区间(CI): 22.6-25.4)。疾病复发的特征是皮肤和风湿病条件的明显临床和超声恶化。然而,恢复先前停止的治疗使所有患者迅速恢复临床缓解。有趣的是,轴向受累是疾病复发症状模式的关键特征,是26%的队列患者重新开始治疗的主要原因。基于多变量Cox模型,在TNFi治疗开始时间点进行临床评估的三个变量(VAS疼痛、压痛关节计数和肿胀关节计数)对疾病复发时间有负相关影响。总之,暂时停用TNFi药物是可行的,也是相对安全的。然而,由于很少发现疾病复发的风险和时间预测因素,因此在停止治疗时应密切监测患者。
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引用次数: 0
A Phase IIIb, Multicentre, Interventional, Randomised, Placebo-Controlled Clinical Trial Investigating the Efficacy and Safety of Guselkumab for the Treatment of Nonpustular Palmoplantar Psoriasis (G-PLUS) 一项多中心、介入、随机、安慰剂对照的iii期临床试验,研究Guselkumab治疗非脓疱性掌跖银屑病(G-PLUS)的疗效和安全性
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-11-01 DOI: 10.1155/2023/9967747
Thierry Passeron, Jose Manuel Carrascosa, Richard B. Warren, Andreas Pinter, Marco Romanelli, Patricia Gorecki, Michela Efficace, Steve Fakharzadeh, Ya-Wen Yang, Ahlem Azzabi, Maria Jazra, Katya Lemos, Monica Leung, Yanqing Chen, Diamant Thaçi
Introduction. Despite the availability of effective biologic therapies for psoriasis, there is no gold-standard treatment for nonpustular palmoplantar psoriasis (ppPsO). Methods. G-PLUS, a phase IIIb, double-blind, placebo-controlled, multicentre clinical trial, randomised adults with moderate-to-severe nonpustular ppPsO and limited plaque psoriasis (Psoriasis Area and Severity Index (PASI) ≥3 but <10) to guselkumab (an interleukin-23p19 blocker) or placebo. Placebo participants were crossed over to receive guselkumab at week (Wk) 16. The primary efficacy endpoint was the proportion of participants achieving palmoplantar PASI (ppPASI) 75 response at Wk16; clinical, biomarker, and quality-of-life endpoints were assessed through Wk48 and safety through Wk56. Results. At Wk16, ppPASI75 response was achieved by 35.9% of the guselkumab participants compared with 28.2% in the placebo group, resulting in a 7.7% difference in response rates (95% confidence interval: −11.5 and 24.7), which was not statistically significant ( p = 0.533 ). More pronounced numerical improvements favouring guselkumab were observed for more stringent efficacy endpoints, such as Wk16 palmoplantar Investigator’s Global Assessment (ppIGA) 0/1 response (guselkumab 34.6% vs. placebo 15.4%). Through Wk48, further improvements were observed in ppPASI75 response (55.1% and 64.1%) and ppIGA 0/1 response (42.3% and 48.7%) for the guselkumab and placebo-crossover groups, respectively. Dermatology Life Quality Index responses showed comparable trends at both timepoints. Safety and pharmacodynamic findings were consistent with the established profile for guselkumab. Serum biomarker levels were significantly reduced with guselkumab and correlated with the baseline PASI score but not the ppPASI score. Conclusion. Although the primary endpoint was not met, analysis of stringent secondary endpoints and post hoc analyses showed numerical improvements favouring guselkumab at Wk16. There were no new safety signals. Further studies are warranted to better understand the impact of guselkumab treatment in patients with ppPsO. This trial is registered with NCT03998683.
介绍。尽管银屑病有有效的生物治疗方法,但对于非脓疱性掌跖银屑病(ppPsO)尚无金标准治疗方法。方法。G-PLUS是一项IIIb期、双盲、安慰剂对照、多中心临床试验,随机将中度至重度非脓疱性ppPsO和有限斑块性银屑病(银屑病面积和严重程度指数(PASI)≥3但≤10)的成人患者分配到guselkumab(一种白细胞介素-23p19阻滞剂)或安慰剂组。安慰剂参与者在第16周接受guselkumab治疗。主要疗效终点是在Wk16时达到掌跖PASI (ppPASI) 75反应的参与者比例;临床、生物标志物和生活质量终点通过Wk48评估,安全性通过Wk56评估。结果。在Wk16时,35.9%的guselkumab参与者达到ppPASI75应答,而安慰剂组为28.2%,导致应答率差异为7.7%(95%置信区间:- 11.5和24.7),无统计学意义(p = 0.533)。在更严格的疗效终点,如Wk16掌跖研究者全球评估(ppIGA) 0/1反应(guselkumab 34.6% vs安慰剂15.4%),观察到更明显的数值改善有利于guselkumab。通过Wk48,分别观察到guselkumab组和安慰剂-交叉组ppPASI75反应(55.1%和64.1%)和ppIGA 0/1反应(42.3%和48.7%)的进一步改善。皮肤科生活质量指数反应在两个时间点显示出可比较的趋势。安全性和药效学结果与guselkumab的既定概况一致。血清生物标志物水平显著降低,与基线PASI评分相关,但与ppPASI评分无关。结论。虽然没有达到主要终点,但严格的次要终点分析和事后分析显示,在Wk16时,guselkumab的数值改善有利于患者。没有新的安全信号。为了更好地了解guselkumab治疗对ppPsO患者的影响,需要进一步的研究。本试验注册号为NCT03998683。
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引用次数: 0
Evaluation of E-Cadherin Expression in Patients with Pemphigus Vulgaris via Immunohistochemistry 免疫组化评价寻常型天疱疮患者E-Cadherin的表达
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-31 DOI: 10.1155/2023/5592117
Saeid Ghorbanivalikchali, Azadeh Rakhshan, Fariba Ghalamkarpour, Fahimeh Abdollahimajd
Pemphigus is a group of autoimmune bullous diseases that can affect the skin and mucous membranes, and it is vital to recognize the exact pathogenesis of this disease. This study aimed to investigate the role of E-cadherin in the pathogenesis of pemphigus vulgaris (PV) and compare the expression of E-cadherin in the lesions of PV patients with that in healthy individuals’ skin. Thirty tissue samples from histopathologically confirmed PV patients as the case group and 30 skin samples from healthy individuals as the control group were evaluated for E-cadherin expression via the immunohistochemical method. Data analysis was performed using SPSS software version 25; chi-squared and Fisher’s exact tests were used to examine the relationship between qualitative variables. Immunohistochemical staining revealed decreased E-cadherin expression in the basal and suprabasal layers of the epidermis of PV patients compared with healthy individuals ( P < 0.001 ). E-cadherin expression was 1+ in 53.3% of patients, 2+ in 40% of patients, and 3+ in only one (3.3%) patient. On the other hand, the expression of E-cadherin in other layers of the epidermis was 1+ in one patient, 2+ in five patients (25%), and 3+ in 14 patients (70%). Also, the expression of E-cadherin in all layers of the epidermis was 3+ in all controls. E-cadherin expression in the basal and suprabasal layers of the epidermis appears to be lower in patients with PV compared with controls. Therefore, E-cadherin immunohistochemical staining helps diagnose PV along with other diagnostic methods. Moreover, these findings may shed light on the role of E-cadherin as a potential target for disease treatment aiming at disease stabilization. However, more studies are needed to clarify this issue.
天疱疮是一组可影响皮肤和粘膜的自身免疫性大疱性疾病,认识这种疾病的确切发病机制至关重要。本研究旨在探讨E-cadherin在寻常型天疱疮(pemphigus vulgaris, PV)发病机制中的作用,并比较E-cadherin在p疱疮患者皮损与健康人皮肤中的表达。采用免疫组化方法检测E-cadherin的表达,选取经组织病理学证实的PV患者的30个组织样本作为病例组,健康个体的30个皮肤样本作为对照组。数据分析采用SPSS软件25版;卡方检验和费雪精确检验用于检验定性变量之间的关系。免疫组化染色显示,与健康人相比,PV患者表皮基底层和基底上层E-cadherin表达降低(P <0.001)。53.3%的患者E-cadherin表达为1+,40%的患者E-cadherin表达为2+,仅有1例(3.3%)患者E-cadherin表达为3+。E-cadherin在表皮其他层的表达1例为1+,5例为2+(25%),14例为3+(70%)。E-cadherin在各表皮层的表达均为3+。与对照组相比,PV患者表皮基底层和基上层的E-cadherin表达似乎较低。因此,e -钙粘蛋白免疫组化染色与其他诊断方法一起有助于诊断PV。此外,这些发现可能揭示了e -钙粘蛋白作为疾病治疗的潜在靶点的作用,旨在稳定疾病。然而,需要更多的研究来澄清这个问题。
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引用次数: 0
The Safety and Efficacy of Macrofocused Ultrasound without Visualization on Enlarged Facial Pores among Thai Patients: A Pilot Study 大聚焦超声对泰国患者面部毛孔粗大的安全性和有效性:一项初步研究
4区 医学 Q1 DERMATOLOGY Pub Date : 2023-10-31 DOI: 10.1155/2023/8154175
Rungsima Wanitphakdeedecha, Katrina Kashmyr Borjal Kua-Uy, Chadakan Yan, Ya-Nin Nokdhes, Panittra Suphatsathienkul, Thrit Hutachoke, Noldtawat Viriyaskultorn, Thanyaporn Leesanguankul
Introduction. Visibly enlarged facial pores are familiar dermatologic concerns. Macrofocused ultrasound energy without visualization (MaFU-WV) showed efficacy in facial tightening and an improvement in skin textural irregularities which opened the potential of the positive effects in reducing the appearance of facial pores. This study aims to assess the safety and efficacy of MaFU-WV in tightening facial pores. Methods. This was a prospective, single-blinded pilot study. Thirty-four Thai subjects with enlarged pores received a single treatment of MaFU-WV using a 2.0 mm transducer on bilateral malar areas of the face. Primary outcome measures included the pore count, pore volume, and pore index measurements using an instrument with a camera for image acquisition and software for analysis of skin. Secondary outcome measures incorporated two blinded dermatologists’ evaluation of clinical photographs and the subjects’ perception of improvement in their facial pores using a 6-point scale. Measurements were taken at baseline, 1 week, 1 month, 3 month, and 6 month after treatment. Results. The pore count significantly decreased from baseline to 6 month after treatment ( p < 0.001 ). Pore volume was significantly lowered from baseline to 1 week and 1, 3, and 6 months after treatment ( p < 0.05 ). The pore index was likewise significantly reduced from baseline in every visit ( p < 0.05 ). The majority of photographic evaluations by blinded dermatologists were scored as a 1–25% pore minimizing effect across nearly all follow-up visits. On the other hand, patient satisfaction kept improving until the end of the study at 6 months. No adverse events occurred throughout the conduct of the study. Conclusion. Macrofocused ultrasound energy using a 2 mm transducer is a safe and effective treatment for facial pore tightening. The trial is registered with registration number: TCTR20220719001.
介绍。明显扩大的面部毛孔是常见的皮肤病问题。大聚焦超声能量无可视化(MaFU-WV)显示出面部紧致和改善皮肤纹理不规则的功效,这为减少面部毛孔的出现开辟了积极作用的潜力。本研究旨在评估MaFU-WV在收缩面部毛孔方面的安全性和有效性。方法。这是一项前瞻性、单盲先导研究。34名泰国受试者在双侧颧区使用2.0 mm传感器接受MaFU-WV单次治疗。主要结果测量包括毛孔计数、毛孔体积和毛孔指数测量,使用带有相机图像采集和皮肤分析软件的仪器。次要结果测量包括两位盲法皮肤科医生对临床照片的评估,以及受试者使用6分制对面部毛孔改善的感知。在治疗后的基线、1周、1个月、3个月和6个月进行测量。结果。从基线到治疗后6个月,毛孔计数显著减少(p <0.001)。治疗后1周、1、3、6个月,孔体积较基线显著降低(p <0.05)。同样,孔隙指数在每次访问中都比基线显著降低(p <0.05)。在几乎所有的随访中,盲法皮肤科医生的大多数照片评估得分为1-25%的毛孔最小化效果。另一方面,患者满意度不断提高,直到研究结束6个月。在整个研究过程中未发生不良事件。结论。使用2毫米换能器的大聚焦超声能量是一种安全有效的面部毛孔收紧治疗方法。试验注册注册号:TCTR20220719001。
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Dermatologic Therapy
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