Dermatologica Sinica最新文献

Cutaneous metaplastic synovial cyst (CMSC) is a rare cutaneous cystic lesion, which frequently occurs subsequent to trauma or surgery, forming through the reparative and healing process. It is often misdiagnosed as foreign body granuloma or recurrent epidermoid cyst. Histologically, it is characterized by a cystic structure with multiple villous projections pointing toward the cystic space, lined by cells resembling hyperplastic synovium. To date, only 32 cases have been reported in the English literature. In this article, we present two cases of CMSC with distinctive clinical features and ultrasonic findings. Furthermore, we found only three case reports of CMSC in the gluteal region. All of these cases were elderly patients and developed CMSC at the medial aspect of the buttock. Based on their unique clinical and ultrasonic characteristics, we propose that CMSC in the buttock may be considered a distinct subgroup within CMSC, demonstrating a spectrum of degenerative diseases along with ischiogluteal bursitis.

Background: 

It is unclear whether women with psoriasis who receive adequate management or achieve better control of their psoriasis before and during pregnancy could eliminate the negative effects.

Objectives: 

The objective of this study was to investigate the association between physician visits for psoriasis and adverse pregnancy outcomes.

Methods: 

This study used the National Health Insurance database and Birth Certificate Application in Taiwan. This research further categorized the study subjects into mothers with mild/severe psoriasis who visited physicians for psoriasis before delivery, mothers with mild/severe psoriasis who did not visit a physician for psoriasis before delivery, and mothers without psoriasis. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of adverse pregnancy outcomes, including maternal and neonatal outcomes.

Results: 

3,339 mothers with severe psoriasis, 41,296 mothers with mild psoriasis, and 2,017,271 mothers without psoriasis were included in this study. The mothers with mild/severe psoriasis demonstrated a significantly higher risk of labor complications and maternal risk factors. After adjusting for confounders, mothers with severe psoriasis who did not visit a physician for psoriasis demonstrated significantly higher odds of labor complications (OR 1.217), maternal risk factors (OR 1.507), having low-birth weight infants (OR 1.236), etc., than mothers without psoriasis.

Conclusion: 

This study demonstrated that mothers with psoriasis had a higher risk of adverse pregnancy outcomes. In addition, seeking medical care for psoriasis, particularly for women with severe psoriasis, appeared to exert a protective effect against adverse pregnancy outcomes.

Acne scars are the unfortunate outcome of acne vulgaris. It is a common problem that faces many young adults and can cause severe distress and impair their quality of life. Different therapeutic modalities have been tried for atrophic acne scars; however, no standard treatment has been identified yet. In this review, we are focusing on fractional CO2 laser (FCL), whether used as monotherapy or combined with platelet-rich plasma (PRP), trying to highlight the efficacy and safety of such modalities in the treatment of atrophic acne scarring. PubMed, Embase, and Cochrane Library databases were used to search for relevant studies that were published in the period from January 2017 to December 2022. We used a combination of the following keywords: “acne scar,” “acne scars,” “modalities for acne scars” in addition to the names of additional therapies studied in this review, such as “laser and acne scars,” “plateletrich plasma,” “platelet-rich plasma,” “PRP,” and “platelet-rich plasma therapy and acne scars”. Twelve studies were found utilizing the use of FCL whether used as monotherapy or combined with PRP in the treatment of atrophic acne scarring. Most of the studies showed that acne scars improved with both treatment modalities, but the combination approach yielded better results with less incidence of side effects.

Background: 

Shared decision-making (SDM) is becoming more popular in various medical specialties as a core component of patient-centered care. However, patients’ lack of sufficient disease knowledge remains a barrier to implementing SDM.

Objectives: 

This study aims to examine the effectiveness of two educational approaches for atopic dermatitis (AD) patients, a pamphlet and pamphlet plus video, using assessments of knowledge level and satisfaction.

Methods: 

From August 2021 to February 2023, patients with AD from the dermatology outpatient clinic at Tri-Service General Hospital were included. Educational pamphlets were provided before educational videos, and patients were asked to complete an identical five-question test postpamphlet and postpamphlet plus video, respectively. A questionnaire was used to evaluate patients’ satisfaction. The two test scores were compared, and the satisfaction levels were analyzed.

Results: 

The mean postpamphlet plus video score (94.84 ± 10.20) was significantly higher than the mean postpamphlet score (77.42 ± 17.17, P < 0.001) across 62 eligible samples. Gender and age subgroups showed similar trends. In addition, most patients preferred educational pamphlet plus videos (ranging from 37.5% to 75.0% in different subgroups) compared with educational pamphlets (ranging from 0.0% to 3.85%). The educational pamphlet plus video demonstrated high satisfaction in promoting disease knowledge and treatment options for AD.

Conclusion: 

Adding educational video is an efficient approach toward reinforcement of patients’ knowledge of AD and further facilitates the implementation of SDM in dermatology practice.

Cutaneous delayed drug hypersensitivity reactions (DHRs) are common iatrogenic events with potentially life-threatening consequences. Delayed DHRs encompass diverse phenotypes and can be classified by their distinct T-cell responses to drug antigens. Interaction between the immune receptors, human leukocyte antigen (HLA) and T-cell receptor (TCR), and the complementary antigenic peptide is required for the development of delayed DHRs. These idiosyncratic interactions can be elicited by the formation of antigenic drug-protein adducts (hapten hypothesis) or from direct interactions of drugs with the immune receptors (pharmacological interaction of drugs with immune receptors concept, altered peptide repertoire model, and altered TCR model). In addition, viral infections may play a role by providing co-stimulatory signals or enhancing TCR/HLA expression on T-cells. The associations of HLA allele polymorphisms and DHRs are phenotype and ethnicityspecific. The discovery of genetic polymorphisms associated with DHRs has provided a strategy to prevent and diagnose potentially life-threatening reactions. Recently, advances in next-generation sequencing technologies, such as the incorporation of whole-exome or whole-genome sequencing, enabled the comprehensive detection of susceptibility loci. Several HLA associations have shown clinical utility and cost-effectiveness, such as HLA-B*15:02 (carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in Han Chinese), HLA-B*58:01 (allopurinol-induced severe cutaneous adverse reactions in Han Chinese), HLA-B*57:01 (abacavir hypersensitivity reactions in Caucasians), and HLA-B*13:01 (dapsone-induced drug reaction with eosinophilia and systemic symptoms in Han Chinese). Herein, we summarize the current knowledge of the pathogenesis, antigen presentation models, and HLA associations of cutaneous delayed DHRs.