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Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to rate the certainty of evidence of study outcomes from systematic reviews: A quick tutorial 使用分级推荐评估、发展和评价(GRADE)来评价系统评价研究结果证据的确定性:一个快速教程
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00154
S. Shao, Liang-Tseng Kuo, Yen-Ta Huang, P. Lai, Ching-Chi Chi
The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework offers a structured approach to assess the certainty of evidence (CoE) in systematic reviews (SRs). The CoE for each outcome falls into one of the four categories: very low, low, moderate, or high. The judgment of CoE is based on five downgrading factors (including the risk of bias, indirectness, inconsistency, imprecision, and publication bias) and three upgrading factors (including large effect size, dose-response relationship, and opposing plausible residual bias and confounding). To improve the transparency of SRs, authors should indicate how they grade the CoE for each outcome and provide a rationale for downgrading or upgrading the CoE.
分级建议评估、发展和评价(GRADE)框架提供了一种结构化的方法来评估系统评价(SRs)中证据的确定性(CoE)。每个结果的CoE属于四种类别之一:非常低、低、中等或高。CoE的判断基于5个降级因素(包括偏倚风险、间或性、不一致性、不精确性和发表偏倚)和3个升级因素(包括大效应量、剂量-反应关系、反对似是而非的残留偏倚和混淆)。为了提高SRs的透明度,作者应该指出他们如何为每个结果对CoE进行评级,并提供降级或升级CoE的理由。
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引用次数: 4
How to prevent mask-related adverse skin reactions 如何预防与面膜相关的皮肤不良反应
4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.v41-3-editorial
Shang-Hung Lin
The prolonged use of masks has been reported to cause adverse skin reactions in both health-care workers (HCWs) and the public. In this issue of Dermatol Sinica, Ku et al. conducted a narrative review to identify different adverse skin reactions and associated risk factors in HCW and the public with prolonged use of masks during the COVID-19 pandemic.[1] They reported that retroauricular dermatitis, cheilitis, rosacea, acne vulgaris, nasal bridge damage, itch, allergic contact dermatitis, and irritant contact dermatitis are common mask-related adverse skin reactions. In addition, the long duration of wearing masks, preexisting skin diseases, and being HCWs are highlighted as definite risk factors. This review summarized the mask-related dermatoses and the associated risk factors. Therefore, it helps HCWs and the public adopt appropriate preventative measures based on their individualized circumstances. Vitiligo is a chronic autoimmune depigmenting skin disorder resulting from the selective destruction of melanocytes. The pathogenesis of vitiligo is complex and the therapeutic choice for vitiligo was limited in the past. The wood’s light, dermoscopy, and clinical photography were traditionally used to diagnose vitiligo. Interestingly, several potential biomarkers and advanced noninvasive skin imaging such as reflectance confocal microscopy and optical coherence tomography have recently assisted in evaluating vitiligo disease activity and severity. The clinical management of vitiligo is aimed at halting disease progression and facilitating repigmentation. In this issue of Dermatol Sinica, Shen et al. update the pathogenesis of vitiligo, discuss emerging biomarkers for the assessment of vitiligo disease activity and severity, and summarize prospective targeted therapies in treating vitiligo.[2] Various scientific and technological breakthroughs have been achieved in the field of medicine, especially in the field of dermatology, improving the accuracy of disease diagnosis and treatment to a new stage, in which the application of Artificial Intelligence (AI) has played an indispensable role. However, a study in 2020 found that while 85% of dermatologists were aware that AI is an emerging technology conducive to the development of dermatology, only 24% had a better understanding of the field.[3] In this issue of Dermatol Sinica, Ye and Chen review the recent new development of AI in dermatology, to promote dermatologists in the better understanding and mastering of it.[4] In this issue of Dermatol Sinica, Song et al. reported that hypertrophic scar patients owned elevated HOX transcript antisense intergenic RNA (HOTAIR) and decreased miR-30a-5p.[5] HOTAIR knockdown can inhibit the proliferation, migration, and collagen synthesis of scar fibroblasts by negatively regulating the expression of miR-30a-5p. Ye et al. reported that dupilumab showed good efficacy and safety in patients with photodermatoses through light-induced type 2 inflammatory response.[6
据报告,长期使用口罩会在卫生保健工作者和公众中引起不良皮肤反应。在本期《Dermatol Sinica》上,Ku等人进行了一项叙述性综述,以确定COVID-19大流行期间HCW和长期使用口罩的公众的不同皮肤不良反应及其相关危险因素。[1]他们报告了耳后皮炎、口唇炎、酒渣鼻、寻常性痤疮、鼻桥损伤、瘙痒、过敏性接触性皮炎和刺激性接触性皮炎是常见的与口罩相关的皮肤不良反应。此外,长时间佩戴口罩、既往患有皮肤病以及作为卫生保健工作者被强调为明确的危险因素。本文就口罩相关皮肤病及相关危险因素进行综述。因此,有助医护人员及市民因应个别情况采取适当的预防措施。白癜风是一种由黑色素细胞选择性破坏引起的慢性自身免疫性皮肤脱色疾病。白癜风的发病机制复杂,过去白癜风的治疗选择有限。木材的光,皮肤镜和临床摄影传统上用于诊断白癜风。有趣的是,一些潜在的生物标志物和先进的无创皮肤成像,如反射共聚焦显微镜和光学相干断层扫描,最近有助于评估白癜风疾病的活动性和严重程度。白癜风的临床管理旨在阻止疾病进展和促进重新着色。在这期《Dermatol Sinica》上,Shen等人更新了白癜风的发病机制,讨论了评估白癜风疾病活动性和严重程度的新兴生物标志物,并总结了治疗白癜风的前瞻性靶向治疗方法[2]。在医学领域,特别是在皮肤病学领域取得了各种科技突破,将疾病诊断和治疗的准确性提高到一个新的阶段,其中人工智能(AI)的应用发挥了不可或缺的作用。然而,2020年的一项研究发现,虽然85%的皮肤科医生意识到人工智能是一项有利于皮肤科发展的新兴技术,但只有24%的人对该领域有更好的了解。[3]在这期《Dermatol Sinica》中,Ye和Chen回顾了人工智能在皮肤科的最新发展,以促进皮肤科医生更好地理解和掌握它。[4]在这一期的《Dermatol Sinica》中,Song等人报道了增生性瘢痕患者HOX转录反义基因间RNA (HOTAIR)升高,miR-30a-5p降低[5]。HOTAIR敲低可通过负调控miR-30a-5p的表达抑制瘢痕成纤维细胞的增殖、迁移和胶原合成。Ye等报道dupilumab通过光致2型炎症反应对光性皮肤病患者表现出良好的疗效和安全性[6]。Lee等人报道了一例副肿瘤大疱性类天疱疮,并提醒了伴有全身症状的中青年大疱性类天疱疮患者潜在恶性肿瘤的可能性[7]。Solon和Guevara报告了一例皮下泛膜炎样t细胞淋巴瘤,表现为溃疡肿块,伴有持续高热、苍白、易疲劳、体重减轻和用力呼吸困难。[8]Luo等人报道了一例被诊断为婴儿皮肤音乐病的临床表现和组织学发现[9]。Ma等人报道了baricitinib在一例大疱性类天疱疮患者中的成功治疗。[10]然而,确切的机制尚不清楚,值得进一步研究Janus激酶抑制剂治疗大疱性类天疱疮的机制。最近引起全球疫情的猴痘(mpox)患者中95%出现皮肤表现。[11]在这一期的《皮肤科学》中,Wang等人报道了一例mpox的临床表现,最初表现为急性扁桃体炎,随后上肢出现少量囊疱性病变。m痘皮肤病变的皮肤镜特征显示出独特的皮肤镜下脓疱病变的“旭日”征,其特征是中心均匀的黄色区域被明亮的红斑晕包围,这可能是m痘的诊断标志。[12]财政支持及赞助无。利益冲突没有利益冲突。
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引用次数: 0
Successful treatment of bullous pemphigoid with baricitinib: A case report 巴比替尼成功治疗大疱性类天疱疮1例
4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-23-00101
Yi-Hsien Chen, Jun Ma, Chien-Ping Chiang, Wei-Ming Wang, Chih-Tsung Hung
Dear Editor, A 64-year-old Taiwanese male, nonsmoker, with a history of hypertension and type 2 diabetes mellitus has been regularly taking metformin for glycemic control. The patient was previously diagnosed with biopsy-proven bullous pemphigoid after experiencing multiple itchy erythema and blisters all over the whole body for 3 months. He was treated with prednisolone 10 mg three times daily and azathioprine 25 mg daily. Lesions showed improvement during the first 2-week follow-up. However, while the prednisolone dose was tapered down to 10 mg daily, the disease flared up again. He presented at our hospital with multiple tense bullae and erosions on erythematous pruritic wheals over the neck, trunk, and limbs without mucosal involvement [Figure 1]. Laboratory tests revealed eosinophilia and elevated levels of immunoglobulin E (IgE). There were no positive findings for potential infectious risk factors such as hepatitis B virus, hepatitis C virus, and Cytomegalovirus, as well as tumor markers. The score of Bullous Pemphigoid Disease Area Index (BPDAI) is 69 and the Visual Analog Scale (VAS) of pruritus is 9.Figure 1: Multiple tense bullae and erosions on erythematous pruritic wheals over the (a) neck, anterior chest, and (b) bilateral thighs.Initially, we treated the patient with intravenous methylprednisolone 4 mg/day, doxycycline 100 mg twice daily, systemic antihistamines, and topical steroids. However, we observed hyperglycemia, with poor-controlled blood sugar levels increasing up to 480 mg/dL. After discussing the options with the patient, we prescribed oral baricitinib 4 mg/day. Subsequently, we initiated the tapering of the systemic steroid in 2 days. At 1-week follow-up, the erythema on the body has disappeared and no new blisters have formed. The pruritus has also subsided, leaving only the wounds from the ruptured blisters [Figure 2]. No flare-up was noted after 8-week follow-up without any adverse event, and the BPDAI and VAS of pruritus have decreased to 0 points.Figure 2: (a and b) After 2 weeks of baricitinib treatment, the lesions showed resolution with residual erythema and scarring.Baricitinib is a first-generation Janus kinase (JAK) inhibitor. It works by targeting JAK1 and JAK2 proteins, which play a key role in regulating the immune response and inflammatory pathways.[1] To date, baricitinib has been found to be effective in treating rheumatoid arthritis, alopecia areata, and atopic dermatitis. Although the mechanism of JAK inhibitors in treating blood pressure (BP) is not yet established, several studies have shown its efficacy. Xiao et al. reported successful treatment of concurrent BP and plaque psoriasis with baricitinib in an 83-year-old man, who showed significant improvement and complete remission without adverse effects.[2] Fan and Wang have reported that seven cases of recalcitrant BP were successfully treated with tofacitinib and maintained complete remission during 9 months of follow-up.[3] In the pathogenesis of
然而,尽管关于使用JAK抑制剂是否会增加静脉血栓栓塞和带状疱疹的风险仍存在争议,但这些潜在风险仍然值得关注。总之,我们回顾的病例证明了巴西替尼对BP的成功治疗。JAK抑制剂可能为BP提供了一种有希望的治疗选择,没有明显的副作用,但确切的机制尚不清楚。进一步的调查研究是必要的,以更好地了解JAK抑制剂的作用机制,其潜在的副作用,以及在BP治疗中的复发率。伦理批准:由三院综合医院机构审查委员会(TSGHIRB No. 518)审查和批准。: B202315086)。患者同意声明作者证明他们已经获得了所有适当的患者同意表格。在这张表格中,患者已经同意他的图像和其他临床信息将在杂志上报道。患者明白,他的姓名和首字母不会被公布,并将尽力隐藏他的身份,但不能保证匿名。数据可用性声明在当前研究期间生成和/或分析的数据集是公开的。财政支持及赞助无。《中国皮肤杂志》编委会成员王伟明教授未参与本文的同行评议过程或发表决定。其他作者声明在撰写这篇论文时没有利益冲突。
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引用次数: 1
Mask-related adverse skin reactions and risk factors: A literature review 面膜相关皮肤不良反应及危险因素的文献综述
4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-23-00100
Ching-Chi Chi, Jin-Ling Ku, Min-Hao Sun, Yi-Chang Yen
Wearing facial masks is a commonly used personal protection measure during the COVID-19 pandemic. However, prolonged use of masks has caused adverse skin reactions in both health-care workers (HCWs) and the public. In this study, we conducted a narrative review of mask-related adverse skin reactions and risk factors. Common mask-related adverse skin reactions include retroauricular dermatitis, cheilitis, rosacea, acne vulgaris, nasal bridge damage, itch, allergic contact dermatitis, and irritant contact dermatitis. Urticaria, facial pigmentation, and maceration were also reported as mask-related adverse skin reactions while the association was rarely reported. Long duration of wearing masks, preexisting skin diseases, and being HCWs are highlighted as definite risk factors. Skin conditions for example oily, dry, and sensitive skin lead to an increased risk of mask-related adverse skin reactions. In conclusion, this review provides a summary of mask-related dermatoses and their prevalence and risk factors. This article can inform the HCWs and the public to better identify mask-related adverse skin reactions and risk factors. Thus, they may adopt appropriate preventative measures based on their individualized circumstances.
佩戴口罩是新冠肺炎大流行期间常用的个人防护措施。然而,长期使用口罩已在卫生保健工作者和公众中引起皮肤不良反应。在这项研究中,我们对口罩相关的皮肤不良反应和危险因素进行了综述。常见的与口罩相关的皮肤不良反应包括耳后皮炎、口唇炎、酒渣鼻、寻常性痤疮、鼻桥损伤、瘙痒、过敏性接触性皮炎和刺激性接触性皮炎。荨麻疹、面部色素沉着和浸渍也被报道为与口罩相关的皮肤不良反应,而这种关联很少被报道。长时间戴口罩、既往存在皮肤病和作为卫生保健工作者被强调为明确的危险因素。皮肤状况,如油性、干性和敏感性皮肤,会增加与面膜相关的皮肤不良反应的风险。综上所述,本文综述了口罩相关皮肤病及其患病率和危险因素。这篇文章可以帮助卫生保健工作者和公众更好地识别与口罩有关的皮肤不良反应和危险因素。因此,他们可根据个人情况采取适当的预防措施。
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引用次数: 1
Acrocyanosis and retiform purpura as the first manifestation of catastrophic antiphospholipid syndrome in a child: A case report Acrocyanosis和retiform紫癜是儿童灾难性抗磷脂综合征的第一表现:1例报告
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00086
CHIH-KAI Wong, Li-Ching Fang, Wei Hung, Yu-Hung Wu
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引用次数: 0
Coexistence of scleredema adultorum of Buschke and psoriatic arthritis: A case report 布施克硬化水肿伴银屑病关节炎1例
4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-23-00093
Yoshio Kawakami, Toshiyuki Yamamoto
1Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 2Department of Dermatology, Fukushima Medical University, Fukushima, Japan Address for correspondence: Dr. Yoshio Kawakami, Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan. E-mail: [email protected] Received May 15, 2023 Received in revised form July 17, 2023 Accepted August 07, 2023
2日本福岛医科大学皮肤学系,日本福岛。通讯地址:冈山大学医学、牙科和制药研究生院皮肤学系,川上义夫博士,冈山市北区志田町2-5-1,日本冈山市700-8558。邮箱:[email protected] 2023年5月15日收稿2023年7月17日收稿2023年8月07日收稿
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引用次数: 0
Anti-transcription intermediary factor 1-γ neuromyositis: A case report 抗转录中介因子1-γ神经肌炎1例报告
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00078
Hui-En Chuo, Hsiao-Yu Li, Wen-Hsiu Wang, Yu-Hung Wu
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引用次数: 0
Mortality and cause of death in patients with dermatologic diseases: An 11-year record-based observational study 皮肤病患者的死亡率和死亡原因:一项基于记录的11年观察性研究
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00134
M. Saber, G. Faghihi, Seyed-Amirmohammad Seyedghafouri, S. Hosseini
Background: Information on the cause of death is critical in guiding decisions on health infrastructure. However, there is a relative paucity of mortality data in patients with dermatologic diseases. Objectives: We aim to assess the overall mortality from dermatological disorders in a third-level university hospital which serves as a dermatology referral center. Methods: A retrospective medical note review of patients with dermatologic diseases who died during an 11-year period (from March 2008 to February 2020) was undertaken. Results: There were 63 death cases out of 2810 admissions for patients with dermatologic diseases (crude mortality 2.24%). The average age was 61.8 years and the male-to-female ratio was 2.3. Cutaneous malignancies (53.96%) were the primary causes of death, followed by drug reactions (23.8%). Among skin cancers, squamous cell carcinoma (SCC; 47.05%) and melanoma (35.29%) were the leading causes of death. Toxic epidermal necrolysis (53.33%) was the leading cause of death among drug reactions. Sepsis (30.74%) was the most common immediate cause of mortality in this series. A large fraction of patients (73%) had significant underlying comorbidities. Conclusion: The principal cause of mortality was cutaneous malignancies (mainly SCC and melanoma) followed by drug reactions. Sepsis was the most common immediate cause of death.
背景:关于死亡原因的信息对于指导有关卫生基础设施的决定至关重要。然而,皮肤病患者的死亡率数据相对缺乏。目的:评估某三级大学医院皮肤科转诊中心皮肤科疾病的总体死亡率。方法:对11年间(2008年3月至2020年2月)死亡的皮肤病患者的病历进行回顾性分析。结果:2810例住院皮肤病患者中死亡63例(粗死亡率2.24%)。平均年龄为61.8岁,男女比例为2.3岁。皮肤恶性肿瘤是主要死亡原因(53.96%),其次是药物反应(23.8%)。在皮肤癌中,鳞状细胞癌(SCC;47.05%)和黑色素瘤(35.29%)是主要死亡原因。中毒性表皮坏死松解(53.33%)是药物反应的主要死亡原因。脓毒症(30.74%)是该系列中最常见的直接死亡原因。很大一部分患者(73%)有明显的潜在合并症。结论:死亡的主要原因是皮肤恶性肿瘤(主要是鳞状细胞癌和黑色素瘤),其次是药物反应。败血症是最常见的直接死亡原因。
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引用次数: 2
Dyshidrotic bullous pemphigoid developing after Moderna mRNA-1273 vaccination 现代mRNA-1273疫苗接种后发生的多水性大疱性类天疱疮
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00121
T. Hsieh, Jau‐Shiuh Chen, T. Tsai
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引用次数: 1
Biocomputational-mediated screening and molecular docking platforms for discovery of coumarin-derived antimelanogenesis agents 香豆素衍生抗黑色素生成药物的生物计算介导筛选和分子对接平台的发现
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.4103/ds.ds-d-22-00087
Jing Lim, L. Gew, Yin-Quan Tang
Background: Hyperpigmentation occurs when excess melanin accumulates in the skin and causes the skin to become darker in color. Pursuing attractive appearance and colorism have promoted the development of the skin whitening market globally. The proteins targeted in this research are tyrosinase-related protein 1, cyclic adenosine monophosphate response element-binding protein, receptor tyrosine kinase, and endothelin receptor type B. Objectives: This study aims to identify the potential of coumarin derivatives as novel effective, safe, and natural antimelanogenesis agents for whitening purposes or therapeutical intention to treat hyperpigmentation disorders. Methods: Four three-dimensional structures of the targeted proteins and 94 ligands were obtained from Protein Data Bank and PubChem, respectively. The ligands were docked against modified targeted proteins to examine the binding affinity and protein-ligand interactions using PyRx and BIOVIA Discovery Studio. The top 13 derivatives were selected for further analysis on the pharmacokinetic properties through SwissADME and pkCSM web servers. A total of eight compounds were further chosen to conduct multiple ligand simultaneous docking (MLSD). Results: Difenacoum is the most potential antimelanogenesis agent due to its strong inhibitory binding affinity in targeted protein models (5M8M, 4TQN, 5X93), but it does not exhibit favorable behavior pharmacokinetic properties. From the in silico pharmacokinetics screening, novobiocin sodium is the most potent derivative due to its relatively appropriate and safer properties. However, none of the ligand pairs investigated in MLSD possesses a synergistic effect on the binding affinity. Conclusion: Our findings identified colladin, farnesiferol C and novobiocin sodium may be promising natural resources for developing antimelanogenesis agents.
背景:当过多的黑色素在皮肤中积累并导致皮肤颜色变深时,就会发生色素沉着。追求漂亮的外表和色彩主义推动了全球美白市场的发展。本研究的目标蛋白是酪氨酸酶相关蛋白1、环腺苷单磷酸反应元件结合蛋白、酪氨酸激酶受体和内皮素受体b型。目的:本研究旨在确定香豆素衍生物作为新型有效、安全、天然的抗黑色素生成药物的潜力,用于美白目的或治疗色素沉着症。方法:分别从Protein Data Bank和PubChem中获取目标蛋白的4个三维结构和94个配体。利用PyRx和BIOVIA Discovery Studio将这些配体与修饰后的靶蛋白对接,检测它们的结合亲和力和蛋白质与配体的相互作用。通过SwissADME和pkCSM网络服务器对前13个衍生物的药代动力学特性进行进一步分析。共选择8个化合物进行多配体同时对接(MLSD)。结果:Difenacoum在靶向蛋白模型(5M8M, 4TQN, 5X93)中具有较强的抑制结合亲和力,是最有潜力的抗黑色素生成药物,但其没有表现出良好的行为药代动力学特性。从计算机药代动力学筛选来看,新生物素钠具有相对合适和安全的性质,是最有效的衍生物。然而,在MLSD研究的配体对中,没有一个对结合亲和力具有协同作用。结论:胶原蛋白、法尼铁酚C和新生物素钠可能是开发抗黑色素生成药物的有前途的天然资源。
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引用次数: 1
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Dermatologica Sinica
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