Dermatology practical & conceptual最新文献

Introduction: Acne, a common inflammatory skin disorder, is influenced by factors like hormones, age, and stress. Sleep also affects acne, as poor sleep quality can exacerbate skin issues.

Objective: This review aimed to explore the relationship between acne and sleep quality, examining the mechanisms, extent, and implications of this connection.

Methods: A systematic review of 18 studies was conducted to assess the link. Studies were retrieved from PubMed using predefined search criteria and evaluated for relevance.

Results: The findings indicate a bidirectional relationship between acne and sleep. Acne is associated with poor sleep quality, insomnia, and increased stress, while sleep deprivation exacerbates acne through hormonal imbalances, inflammation, and immune dysregulation.

Conclusion: There is a complex, bidirectional link between acne and sleep, requiring further research. Standardized metrics and behavioral interventions such as cognitive-behavioral therapy for insomnia could improve acne and sleep outcomes.

Introduction: Patients with active vitiligo are treated with systemic immunosuppressants to halt disease progression. However, clinical features associated with patients whose condition is more difficult to control are unknown.

Objective: This study aimed to identify the clinical features of patients requiring extended periods of systemic immunosuppressants and the real-world clinical course of active vitiligo patients receiving systemic treatments.

Methods: This was a single-center retrospective study. Records of actively progressing vitiligo patients from September 2017 to August 2023 were reviewed.

Results: One hundred and fifty-nine patients with non-segmental actively progressing vitiligo were enrolled. In the six-month follow-up period, 101 (63.52%) patients required oral systemic immunosuppressants for ≤ 16 weeks without reactivation (Group 1), 51 (32.08%) patients required continuous systemic immunosuppressants for more than 16 weeks to achieve disease stabilization (Group 2), and seven (4.4%) patients achieved disease stabilization ≤16 weeks of oral immunosuppressants but recurred within nine months after stabilization (Group 3). Patients in Group 2 were significantly younger (39.69±11.51 vs. 46.47±14.91 years old; P=0.013) and had a lower proportion of facial involvement (56.86% vs. 76.24%; P=0.016) compared to Group 1. Similarly, both age (odds ratio (OR): 0.968; P=0.016) and facial involvement (OR: 0.432; P=0.023) were identified as significant factors associated with decreased risk for Group 2. At one-year follow-up, 10.89% of Group 1 patients experienced disease reactivation.

Conclusions: Older patients and patients with facial involvement were more likely to achieve disease stabilization. Careful photo documentation is essential to optimal vitiligo management as disease reactivation is common after systemic treatment, even if initial disease stabilization is achieved.

Introduction: Large congenital melanocytic nevi (LCMNs) are mainly classified according to their distribution patterns, which are thought to reflect their embryological development.

Objectives: We aimed to test the validity of previously described clinical classification systems of LCMNs in a large, well-documented case series.

Methods: The retrospective cohort study including 111 LCMN patients focused on the anatomical distribution of the nevus's main mass.

Results: The trunk was most commonly affected (N=68), followed by the lower extremities (N=35). When the locations of the nevi were evaluated according to the previously described 6B (bolero, back, bathing trunk, breast/belly, body extremity, body patterns) and 7B (6B with the addition of bonce pattern) classification systems, 15 showed the typical bolero pattern, 13 back pattern, 23 bathing trunk pattern, five breast/belly pattern, 25 body extremity pattern, 14 bonce (head) pattern, and one body pattern. Among the 15 patients who could not be fully classified according to these patterns, five were grouped as "hood" (head and neck) pattern, eight as "half-bathing trunk," and two as "atypical bolero" sub-patterns. Isolated lesions on the extremities also exhibited two different sub-patterns: encircling the extremity or not.

Conclusion: Most of our cases demonstrated distribution patterns consistent with the 6B and 7B classification systems. However, the isolated head and neck involvement observed in our series may be described as hood pattern. Furthermore, certain variations, such as those seen in the bathing trunk and breast/belly patterns, may be considered subgroups of these patterns. Isolated extremity lesions of LCMNs exhibited two distinct patterns. These findings suggest that, although existing classification systems provide a valuable framework, further subclassifications may be necessary to account for regional variations observed in clinical practice.

Introduction: Claudins are integral transmembrane proteins that play a pivotal role in regulating tight junctions within epithelial and endothelial cells. In addition to their fundamental function in preserving cell-cell adhesion and barrier integrity, claudins are implicated in various biological processes, including those critical to cancer development and dermatological disorders. However, the role of claudin-1 and claudin-3 in mycosis fungoides (MF) pathogenesis remains unexplored and has yet to be comprehensively studied.

Objectives: This study aimed to investigate the serum levels of claudin-1 and claudin-3 in MF patients and assess their potential clinical significance as biomarkers for disease progression.

Methods: A total of 88 MF patients and 88 healthy controls were included in this case-control study. Serum claudin-1 and claudin-3 levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed to compare claudin levels between groups and examine correlations with disease stage and duration.

Results: Serum claudin-3 levels were significantly higher in MF patients compared to controls (P<0.001), while no significant difference was observed in claudin-1 levels (P=0.448). Additionally, a weak but statistically significant positive correlation was found between claudin-3 levels and MF stage (r=0.219, P=0.041), suggesting its potential role in disease progression. No significant correlation was observed between claudin-1 levels and MF stage.

Conclusion: Our findings indicate that elevated serum claudin-3 levels are associated with MF and correlate with disease severity, suggesting that claudin-3 may serve as a valuable biomarker for monitoring disease progression. Further research is required to elucidate its underlying mechanisms and assess its potential as a therapeutic target in MF.

Introduction: Melanoma is an aggressive skin cancer with high metastatic potential. The oncogenic protein GRWD1 has been implicated in various cancer types, but its role in melanoma remains unclear.

Objectives: To examine the effects of GRWD1 knockdown on melanoma cell proliferation, apoptosis, and migration and to evaluate its prognostic significance in melanoma patients.

Methods: A combination of in vitro and clinical analyses was performed. A2058 melanoma cells were treated with GRWD1-specific siRNA, and cell proliferation, apoptosis, and migration assays were conducted. Western blotting was used to assess alterations in key oncogenic pathways. Additionally, clinical tissue samples from melanoma patients were analyzed for GRWD1 expression, and Kaplan-Meier survival analysis was performed to determine its prognostic value.

Results: GRWD1 was highly expressed in melanoma cells. GRWD1 knockdown significantly reduced cell proliferation (by 63%), impaired colony formation, and induced apoptosis (cleaved caspase-3 levels increased by 17.3%). Migration capacity decreased by 70%, and NF-κB pathway activity was suppressed, leading to reduced expression of Bcl-2, Src, and MDM2, while stabilizing p53. TCGA-based analyses revealed that high GRWD1 expression was significantly associated with shorter survival in metastatic melanoma cases (P=0.00029) but showed no correlation with melanoma subtypes. However, in immunohistochemical analysis of clinical samples, no statistically significant correlation was found between GRWD1 staining intensity and survival.

Conclusions: GRWD1 plays a crucial role in melanoma progression by enhancing NF-κB activity, promoting proliferation, and suppressing apoptosis. While high GRWD1 expression is associated with poor prognosis in public datasets, further clinical validation with larger patient cohorts is needed to confirm its utility as a prognostic biomarker and therapeutic target.