Dermatology Reports最新文献

Pemphigus is a severe autoimmune blistering disorder that significantly affects patients' quality of life. While corticosteroids and immunosuppressive agents are commonly used, they have substantial side effects, highlighting the need for safer alternatives. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, has shown efficacy in treating other autoimmune diseases and may offer promise for pemphigus. This systematic review evaluated the clinical outcomes, safety, and potential role of apremilast in the treatment of pemphigus by synthesizing available case reports and series. A literature search was conducted across multiple databases (PubMed, EMBASE, Cochrane, Web of Science, ScienceDirect, and Google Scholar) for case reports and series involving apremilast in pemphigus. Inclusion criteria were a confirmed pemphigus diagnosis and apremilast treatment. Five studies (four case reports and one case series) involving 7 patients were included. Apremilast led to significant clinical improvement in 4 patients, with reductions in disease activity, lesion severity, and symptom scores (Pemphigus Disease Area Index [PDAI], Autoimmune Bullous Skin Disorder Intensity Score [ABSIS], Visual Analog Scale [VAS], and Numerical Rating Score [NRS]). Increases in regulatory T cells and decreases in anti-desmoglein antibodies were observed. No serious adverse events were reported, although one study noted treatment failure, possibly due to short follow-up or concurrent infections. Apremilast appears to be a promising treatment for therapy-resistant or corticosteroid-intolerant pemphigus patients. Although the evidence is limited, it supports apremilast's efficacy and favorable safety profile. Further research with larger sample sizes and randomized controlled trials is necessary to confirm these findings.

Nevus of Ota and nevus flammeus are distinct congenital pigmentary and vascular anomalies, respectively, with different etiologies and clinical implications. While both conditions can present unilaterally, their bilateral coexistence is rare. We report a 39-year-old Filipino female with a medical history of type 2 diabetes mellitus and dyslipidemia who presented to the dermatology clinic with concerns over a newly appearing benign nevus on the sole of her hand. Incidentally, dermatological examination revealed two significant congenital pigmentary lesions: bilateral nevus of Ota and a widespread nevus flammeus. The nevus of Ota manifested as well-defined blue-gray macules and patches symmetrically distributed across her face, involving both nasal nostrils and conjunctiva. The nevus flammeus, a congenital vascular malformation commonly known as a port-wine stain, extended over both arms, the upper back, and the chest, presenting as a well-demarcated reddish-purple discoloration. These lesions had been present since birth, remained asymptomatic, and had never been previously evaluated. No systemic involvement was detected, and laboratory investigations were unremarkable. The diagnosis was made clinically. As the patient was not interested in treating the nevi, no treatment was planned. This case highlights the importance of obtaining a detailed family history in all similar cases to aid in understanding the genetic basis of these conditions and their potential coexistence with other congenital dermal anomalies.

Myiasis is derived from the Greek word "myia", which means "fly". Zumpt, a German entomologist, defined this condition as the infestation of living humans and vertebrate animals by dipterous larvae that feed on living and dead host tissue, liquid body substances, or ingested food for a certain period. Myiasis is a rare complication that can occur in advanced squamous cell carcinoma (SCC). This report describes a rare cutaneous SCC of the face complicated by myiasis. A 70-year-old male patient presented with cutaneous SCC that involved the left lateral side of the nose, medial canthus, and left lower eyelid. The patient complained of multiple live maggots crawling out from a large wound. The larvae were isolated, examined microscopically, and identified as Dermatobia spp. The patient was treated with ivermectin, albendazole, and clindamycin, which were associated with the mechanical removal of the larvae. In the past decade, several case reports have described instances of cutaneous myiasis in head and neck malignancies. These cases were primarily linked to squamous cell carcinoma and involved patients over the age of 60. Additionally, the majority of the reported cases were from India. Myiasis can complicate SCC, particularly in patients who refuse treatment. Combining ivermectin, albendazole, and clindamycin may be a practical approach to managing myiasis.

Focal facial dermal dysplasias (FFDDs) encompass four rare inherited disorders. FFDD types I, II, and III are characterized by bitemporal scar-like lesions present from birth, while FFDD IV is identified by analogous lesions localized in the periauricular area. Most FFDD IV cases show autosomal-recessive inheritance with mutations in the CYP26C1 gene. We describe three infants with bilateral, oval-shaped, hypopigmented preauricular lesions indicative of FFDD IV. It is crucial for physicians to recognize these rare conditions at an early stage to ensure proper diagnosis and to rule out associated malformations.

Deep cutaneous and subcutaneous infections caused by dermatophytes are exceptionally uncommon, typically occurring through traumatic inoculation. This clinical report details the complex dermatological journey of a young, immunocompetent 24-year-old girl who reported a rare case of a subcutaneous mycosis caused by Microsporum gypseum. The patient presented with an annular erythematous plaque with centered papules on her left hand, which she referred to as stemming from an insect bite. Initial evaluation at another hospital included a biopsy, which resulted in a preliminary diagnosis of pyoderma gangrenosum. Appropriate treatment with topical steroids and later oral cyclosporine provided no response, leading clinicians to perform a new biopsy and cultural examination; the patient was diagnosed with epidermomycosis and pustular folliculitis caused by M. gypseum, a geophilic dermatophyte. In our patient's case, terbinafine proved effective, resulting in complete remission. This article aims to emphasize the importance of considering rare conditions such as subcutaneous epidermomycosis when the patient's medical history provides suggestive clues, particularly if the clinical manifestation aligns with the hypothesis.

Acne vulgaris is a common inflammatory dermatosis and the most prevalent disorder of the pilosebaceous unit. It primarily affects the face and has an estimated global prevalence of about 9.4%. Many patients treated for acne vulgaris experience symptoms of anxiety, depression, and social withdrawal, often accompanied by feelings such as anger. This can be particularly exacerbated when dermatological treatment fails to have the expected effect. Given the significant psychosocial effects of the aforementioned dermatosis, early intervention is crucial. The survey was conducted between September 2023 and July 2024. The participants were patients at a cosmetology and aesthetic medicine clinic in Katowice, Poland. The Teenagers' Quality of Life Index (T-QoL) and Rosenberg Self-Esteem Scale (RSES) were used to conduct the survey. The study confirmed the significant impact of acne vulgaris on psycho-social aspects in women of different ages. Acne significantly lowers self-esteem and negatively affects the sufferers' perception of themselves and their appearance. The impact was shown to be more severe in a group of women over 27 years of age, who exhibited lower self-esteem compared to the younger group. Women with acne often feel the need to hide skin lesions and pay a lot of attention to their appearance, which can lead to reduced quality of life and emotional disturbances. A significant number of women have disturbed self-esteem and negative beliefs about themselves, which may be related to current beauty canons and social pressure for an unblemished appearance. The study underscores the need for a holistic approach to female patients with acne vulgaris, considering both medical and psychological aspects, in order to effectively treat and improve psychological well-being.

This study explores the single-nucleotide polymorphism (SNP) variants rs2304365 and rs4074067 in the ST18 gene and their relationship with clinical manifestations of pemphigus vulgaris (PV) in Vietnamese patients. A case series was conducted with PV patients treated from March to October 2023 at the Ho Chi Minh City Hospital of Dermato-Venereology (Vietnam). Clinical data and patient histories were documented. Blood samples (2 mL) were analyzed for SNP variants rs2304365 and rs4074067 using Sanger sequencing at the Biomedical Research Center, Pham Ngoc Thach University of Medicine. Among 34 patients, two alleles, C and T, were identified in both SNPs. For rs2304365, allele C accounted for 91.2% and T for 8.8%. In rs4074067, allele C constituted 88.2% and T 11.8%. Patients carrying the T allele in rs2304365 exhibited moderate to severe disease. Additionally, the T allele in either SNP was associated with higher Pemphigus Disease Area Index (PDAI) scores compared to the C allele. SNP variants rs2304365 and rs4074067 in the ST18 gene may influence disease severity in PV among Vietnamese patients, underscoring the need for further research into their role in personalized treatment strategies.

Dear Editor, Atrophic lichen sclerosus (ALS) is a chronic inflammatory dermatosis with significant morbidity, primarily affecting the genital area. The disease is often misdiagnosed or underdiagnosed, resulting in delayed treatment and progression to atrophic stages and permanent scars. While corticosteroids remain the first-line treatment, their long-term use may lead to adverse effects such as skin atrophy, prompting the need for alternative therapies. [...].

Skin aging is characterized by loss of elasticity, wrinkles, and textural changes. Treatments range from non-invasive options, such as alpha-hydroxy acids and retinoic acid, to invasive procedures like chemical peels and laser therapies. Plasma radiofrequency (PRF) offers a minimally invasive solution with a favorable balance of efficacy and tolerability. This study assessed the clinical and microscopic outcomes of combining PRF ablation with a galenic cream containing 5% resorcinol in NourivanTM Antiox for facial skin aging. Forty-one patients with visible signs of aging underwent a single PRF session followed by weekly applications of a 5% resorcinol cream for six weeks. Outcomes were evaluated using digital photography and line-field confocal optical coherence tomography (LC-OCT) at baseline, three months, and six months. Primary endpoints included wrinkle reduction and texture improvement; secondary endpoints included adverse effects and patient satisfaction. At six months, 92% of patients showed significant wrinkle reduction and improved collagen organization in LC-OCT images. Skin texture improvements were reported by 85% of patients. Adverse effects, such as mild erythema and peeling, were transient and resolved without discontinuation. PRF ablation combined with 5% resorcinol cream is an effective and well-tolerated treatment for facial skin aging, offering significant improvements in skin texture and appearance. Further research is needed to confirm these findings and explore long-term effects.

The purpose of this study was to evaluate the quality of life (QoL) and psychosocial burden in adult Greek patients with atopic dermatitis (AD) using validated tools and to investigate factors that influence AD's humanistic burden. This observational, cross-sectional study was conducted in Greece (January-September 2023) with 150 adult members of the patient association "Epidermia", all diagnosed with AD. Data was collected through a structured questionnaire, including socio-demographic details, clinical history, AD severity (using the Patient-Oriented Eczema Measure [POEM]), QoL, sleep disorders, and psychological health. Based on POEM scores, 11% of participants had clear/almost clear skin, 27% had mild eczema, 51% had moderate eczema, and 12% had severe/very severe eczema. AD had a moderate or very/extremely large impact on QoL for 29% and 42% of participants, respectively. Insomnia affected 55%, while 31% had mild anxiety, 23% had moderate/severe anxiety, 10% had moderate depression, and 8% had moderately severe/severe depression. AD severity was associated with reduced QoL and higher rates of insomnia, anxiety, and depression. Our study highlights significant associations between AD severity, QoL, and psychosocial factors, emphasizing the need for comprehensive management strategies.