Dermatology practical & conceptual最新文献

Introduction: Xanthelasma palpebrarum is considered to be a cutaneous marker for cardiovascular diseases, and there is a known association with hypertension, insulin resistance, diabetes mellitus, obesity, and stroke.

Objectives: Our aim was to study the association and identify the predictors of metabolic syndrome in patients with xanthelasma palpebrarum.

Methods: An observational study was conducted on 55 patients in which patients of both sexes ages 20-70 years without any other skin condition were included after written informed consent. After history and examination, blood pressure and waist circumference were measured in all the subjects. Investigations were sent for fasting blood sugar levels and serum lipid profile. The 2006 IDF Definition of metabolic syndrome was used as assessment criteria.

Results: Among the 55 patients, metabolic syndrome was present in 23 patients (41.82%). There was a statistically significant (P<0.05) difference in the values of waist circumference (100% vs. 59.38%, P=0.0003), elevated blood pressure (82.61% vs. 9.38%, P<.0001), raised fasting blood sugar (47.83% vs. 18.75%, P=0.021), and raised triglyceride levels (56.52% vs. 25%, P=0.018) between patients with metabolic syndrome and those without. However, HDL cholesterol levels (34.78% vs. 50%, P=0.262) were comparable between groups. Also, a patient aged 41 years or more with even a single xanthelasma of more than one year's duration has a 76.1% chance of developing metabolic syndrome.

Conclusions: Metabolic syndrome develops in a sizeable number of xanthelasma palpebrarum patients, and this therefore gives us an opportunity for early diagnosis and intervention to prevent the development of cardiovascular complications.

Introduction: Seborrheic dermatitis manifests as greasy itchy lesions commonly affecting sebum-rich areas like the scalp and face. Its prevalence is 11.6% in the general population, with various internal and environmental factors contributing to its development.

Objectives: This study aimed to compare the efficacy of rosemary extract lotion in the treatment of seborrheic dermatitis in comparison with topical 2% ketoconazole lotion.

Methods: This double-blind randomized controlled clinical trial included 42 patients with scalp seborrheic dermatitis, divided into rosemary lotion and ketoconazole lotion groups. Both lotions were applied twice daily for two months. The severity of scalp dandruff was assessed using the Adherent Scalp Flaking Score (ASFS). The itchiness of the scalp and quality of life were assessed using itchy quant and the Dermatology Life Quality Index (DLQI), respectively. Stata software version 14.2 was applied for statistical analysis.

Results: The reduction in ASFS score was statistically significant in patients in the ketoconazole group in comparison with the patients in the rosemary group (P = 0.011). However, the reduction in itching score was statistically significant more in the rosemary group at the end of the first and second months in comparison with the ketoconazole group (P < 0.001). The statistical analysis demonstrated no significant difference in the reduction of DLQI scores between the rosemary and ketoconazole groups at the end of one and two months after stating the treatment in both crude and adjustment with base-line score analysis.

Conclusion: Both rosemary and ketoconazole lotions were effective in treating scalp seborrheic dermatitis and in decreasing patients' DLQI score.

Introduction: Vitiligo is a common acquired depigmenting dermatosis resulting from a loss of epidermal melanocytes. The academic attention to vitiligo has gradually increased over the past two decades.

Objective: We aimed to explore the current research structure and trends of vitiligo.

Methods: Publications about vitiligo from the Web of Science Core Collection (WoSCC) database were searched. VOSviewer, CiteSpace, GraphPad Prism 8, ArcGIS, and Charticulator were implemented for data description and visual analysis.

Results: A total of 3,037 publications authored by 10,993 individuals from 2,753 institutions across 88 countries/regions were collected. These publications were published in 616 journals and cited a total of 39,433 references. China was the most productive country. Cairo University and Ezzedine Khaled were the most prolific institution and author, respectively. Additionally, the British Journal of Dermatology stood out as the journal with the highest number of publications. According to the analysis of keywords and references, "quality of life," "depression," and "validation" were hotspots in terms of clinical characteristics, while "prevalence", "comorbidity," "association," and "immunotherapy" gained more research interest with respect to epidemiology and genetics. The frontiers of pathogenesis focused on "unfolded protein response," "migration," "biomarkers," and "CXCL10." As far as treatment is concerned, there was increasing attention to "janus kinase inhibitor," "fractional carbon dioxide laser," "platelet-rich plasma," and "5-fluorouracil."

Conclusion: The bibliometric analysis elucidates the foundational knowledge structure on research forces and unveiled the hotspots and frontiers, aiding researchers in gaining a deeper comprehension of the future development trends in the field of vitiligo.

Introduction: Having many melanocytic nevi on the skin is a risk factor for melanoma. However, the reproducibility of nevus counts in previous studies is limited due to high inter- and intraobserver variation. Despite the introduction of a protocol for counting and reporting of nevi in 1990 by the International Agency for Research on Cancer (IARC), significant variations in nevus counting methods persist across studies.

Objectives: We sought to review the variations in nevus counting and reporting methods, adherence and deviations from the IARC protocol, and the reproducibility of nevus counting studies.

Methods: A systematic search of Embase, PubMed, and Web of Science was conducted. The review was limited to nevus (>2 mm) counting studies of general population adults conducted between 2000 and 2022 and studies using skilled examiners.

Results: Out of the eight studies which were eligible for inclusion, none followed the IARC protocol. Three studies used a predefined criterion to count nevi. Five studies provided training for their observers. Three studies assessed the inter- or intraobserver variation using the correlation coefficient (>0.75), and three studies attempted to verify the validity and the reproducibility of the counts. There was little to no agreement in nevus counting and reporting procedures in the reviewed studies, and most studies did not report their procedures adequately.

Conclusion: This review highlights the need for an easily accessible and feasible protocol for the identification, counting, and reporting of nevi, which also considers nevus counting from total-body imaging and automated nevus counts since these technologies are expected to become widely available for future studies.

Introduction: Pyoderma gangrenosum (PG) poses a significant dermatological challenge due to its rapidly evolving painful necrotic ulcerations. Understanding its multifaceted pathogenesis and diverse clinical presentation is crucial for effective management.

Objectives: We aimed to analyze demographic characteristics, clinical manifestations, lesion distributions, systemic disease associations, therapeutic interventions, and patient outcomes in PG cases.

Methods: Medical records from 2017 to 2023 of PG patients at IRCCS Sant'Orsola Malpighi Hospital, Bologna, Italy, were retrospectively analyzed. Inclusion criteria encompassed persistent ulcers with clinical and histological evidence of PG, excluding cases with alternative diagnoses or inadequate follow-up. Clinical evaluations, including pain assessment and lesion measurements, were conducted at diagnosis and follow-up visits.

Results: A total of 44 patients were evaluated. Pain was a universal symptom, and tissue pathergy was documented in 28.6% of patients. Ulcerative PG was the most common subtype (88.1%). Associations with inflammatory bowel diseases (25%), rheumatoid arthritis (9.1%), and hematological diseases (17.2%) were noted. Lower limbs were frequently affected (63.6%). Treatment approaches included wound management, topical and systemic corticosteroids, and immunosuppressive therapy, with varying response rates.

Conclusion: Advanced dressing and steroid therapy were pivotal in mild PG cases, while moderate-to-severe cases often associated with systemic diseases showed incomplete healing despite treatment, especially in patients with inflammatory bowel diseases and hematological disorders. This study contributes to the understanding of PG's complexities, suggesting the use of biological therapy as first line in moderate-to-severe PG.

Introduction: Psoriasis is a chronic inflammatory disease affecting 2-3% of the global population via immune-mediated mechanisms. Osteopontin plays a crucial role in T-helper 1- and T-helper 17-mediated illnesses, including psoriasis. Ocular complications in psoriasis have been reported, and their assessment is of significant importance. Osteopontin is normally expressed constitutively in ocular structures and is linked to ocular homeostasis.

Objectives: The study aimed to clarify the role of osteopontin (OPN) in psoriasis (PS) and its correlation with disease severity and ocular manifestations.

Methods: A case-control study involving 40 psoriatic patients and an equal number of age- and sex- matched healthy subjects was conducted. We used the psoriasis area severity index (PASI) to assess disease severity and performed a comprehensive ophthalmological examination. Additionally, we measured serum osteopontin levels using enzyme-linked immunosorbent assay (ELISA) in both groups.

Results: A significant elevation in serum OPN levels in psoriatic patients compared to controls was found (P= 0.000). Furthermore, there was a highly significant positive correlation between serum OPN levels and patient age, disease duration, and PASI scores. Notably, a higher prevalence of ocular complications, including blepharitis, corneal affection, conjunctivitis, keratoconjunctivitis sicca, and cataract was observed in psoriatic patients compared to controls. Importantly, significant associations between serum OPN levels and the presence of cataracts and intraocular pressure (IOP) were identified. Additionally, significant correlations between serum OPN levels and measures of visual acuity and ocular surface health were found.

Conclusions: Osteopontin is considered a marker of psoriasis severity and is associated with ocular comorbidities in psoriasis.