Dermatology最新文献

Background Few previous studies have examined subgroups of patients with cellulitis for differences in patterns of predisposing factors. Objectives This retrospective study was designed to examine the characteristics and predisposing factors of patients treated for cellulitis at the Oulu University Hospital, Finland from 2019 to 2023 in subgroups based on sex and age. Results Of the 907 included patients, 56.8% were male; mean age at diagnosis was 57.5 years, and was higher in females than in males (61.2 and 54.7 years, respectively; p<0.001). History of cellulitis was reported in 35.5%. Cellulitis was most commonly located in the lower leg (40.8% patients) and its frequency at this site increased with age (p<0.001). Systemic symptoms were present at diagnosis in 37.4% patients. Compared with other sites, face cellulitis less frequently associated with CRP level >150mg/l (p<0.001). Analysis of risk factors found that sores and intravenous drug usage were most common in males whereas malignancies were more frequent in females. Intravenous drug use was associated with younger age (<49 years) whereas obesity, diabetes, malignancies and lymphedema were more common in older patients. Conclusion The findings of this study highlight the need for more focus on the risk factors for cellulitis and on preventing the infection.

The article "Evaluation of the Effect of Clobetasol Propionate on Circulating Cortisol and Growth Velocity in Children with Atopic Dermatitis: A Modelling and Simulation Study" [Dermatology. 2025; https://doi.org/10.1159/000549781] by Duong et al. was published with the wrong open access license. The correct license of the article is CC-BY.The original article has been updated.

Background: Although patch testing (PT) is not contraindicated during pregnancy, most dermatologists defer testing due to lack of data and possibility that immunological changes might influence outcomes. In our center we routinely perform PT during pregnancy as it is not known to be teratogenic and may lead to significant improvements in quality of life.

Objective: To assess whether pregnancy alters the outcome of PT.

Methods: Retrospective, single-center case-control study was conducted at a tertiary Israeli dermatology clinic (2009-2023). Women who gave birth within 40 weeks of PT were identified, and for each, three age-, year-, and atopic dermatitis-matched controls were selected.

Results: Of 3351 women tested, 54 (1.6%) were pregnant at the time of PT. Most were tested during the first trimester (63%). No significant differences were found in the frequency of positive patch test reactions between pregnant women and matched controls. The most common allergens in pregnant patients were nickel sulfate (61.1%), 2-hydroxyethyl methacrylate (13.64%), and fragrance mix II (5.5%).

Limitations: Sample size was insufficient to detect differences in low-prevalence allergens. Potential referral and selection biases limit generalizability.

Conclusion: Pregnancy does not appear to affect patch test outcomes in early and mid-gestation. Due to limited third-trimester representation, further studies are needed to determine whether reactivity remains consistent throughout all stages of pregnancy.

Introduction Seborrheic keratoses (SK) are common benign epidermal tumors. Their pathogenesis is unknown, and no pathological significance is ascribed to them, although they could be part of paraneoplastic syndromes, in addition to presenting a variety of somatic mutations. SKs are associated with increased age, family history and sun-exposure. Methods This study aimed to analyze if SK was related to DNA repair genes polymorphisms and analyze if any epidemiological, clinical or environmental characteristics could modify their prevalence. It was conducted an epidemiological, analytical, observational, cross-sectional, retrospective case-control study. Both univariate and multivariate logistic regression models were used to evaluate which characteristics were associated with having >50 SKs versus <10. Results A total of 294 patients with melanoma were studied, 270 (91.8%) having had less than 10 SKs, while 24 (8.2%) >50. Of all the polymorphisms studied, only rs25487 in XRCC1 reached statistical significance (OR=3.56; 95% CI 1.36-9.33; p=0.01). In addition, an increasing age (OR=1.07; 95% CI 1.03-1.11; p=0.001) and the phototype (III-V vs. I-II) (OR=0.28; 95% CI 0.12-0.68; P=0.005) were related to the presence of >50 SKs. Conclusion We identified that increasing age, having a phototype I-II and the existence of the rs25487 polymorphism could be associated with the occurrence of KS.

Ultraviolet radiation (UVR) is a major environmental stressor to the epidermal barrier, extending beyond erythema or photoaging. Emerging evidence reframes barrier impairment as an early and central event, integrating DNA and oxidative injury with inflammatory, immune, and microbial disturbances in a self-reinforcing cycle of fragility. This perspective challenges the traditional view of UVR damage as isolated mechanisms and highlights the need for barrier-focused research. Sunscreens remain essential, and recent formulations now extend beyond optical filtering by incorporating biologically active components such as antioxidants and photolyase that enhance photostability and support DNA lesion clearance. Emerging research also suggests that microbiome-preserving compositions may help maintain commensal balance during UVR exposure. Together, these developments point to a shift toward multifunctional photoprotection, although evidence is still accumulating. This review synthesizes recent advances alongside remaining gaps in the field. By integrating mechanistic evidence on UVR-induced barrier injury, it identifies directions that can support the design of more biologically grounded photoprotective strategies and delineates priority topics for future research.

Background: General Practitioners (GPs) act as primary gatekeepers for patients with psoriasis and their screening practice for cardiovascular disease (CVD) and psoriastic arhtiris (PsA) y. This study aimed to assess the awareness and screening routines of Danish GPs regarding CVD and PsA in patients with psoriasis.

Methods: A nationwide cross-sectional survey on screening practice was conducted involving 490 randomly selected Danish GPs. Data were analyzed descriptively based on 101 responses (21% response rate).

Results: The survey revealed a high level of awareness regarding CVD risk (84%), with 60% of GPs reporting routine screening for cardiovascular issues. Commonly assessed parameters included blood pressure (93%) and cholesterol (67%). Conversely, screening for PsA was notably less frequent, with only 32% of GPs actively screening for PsA.

Conclusion: While screening and awareness of CVD risk among primary care professionals, PsA screening remains suboptimal. The findings suggest an urgent need for updated guidelines endorsing simple, validated PsA screening tools and targeted education to prevent missed opportunities for early diagnosis.

Introduction: Pain is the most impactful symptom of hidradenitis suppurativa (HS), and understanding its management practices can guide improvements in care. This study aims to describe HS pain severity and associated factors, evaluate pain management practices, and identify barriers to pain management.

Methods: A cross-sectional survey of self-identified adults with HS was conducted from 6/13/2021 to 6/30/2021. Participants were 18 years or older with a confirmed HS diagnosis by a medical provider or a validated questionnaire.

Exposures: demographic, clinical factors.

Primary outcomes: quality of life (QoL), assessed using the Skindex Mini (0-18 scale), and pain severity, measured via numerical rating scale (NRS, 0-10).

Secondary outcomes: pain treatments used and barriers to care.

Results: 890 eligible respondents resided in 5 countries. 96.9% self-identified as female, 74.0% White, 8.3% Black, 2.6% Asian, 5.3% Hispanic, 1.3% American Indian and Native Alaskan, and 7.1% mixed race. Moderate (NRS 4-6) and severe pain (NRS≥7) were significantly associated with reduced QoL, with Skindex Mini scores that were higher for moderate (14.6; 95% CI: 14.0, 15.2) and severe pain (16.1; 95% CI: 15.4, 16.7) compared to mild pain on average (NRS≤3, 10.8; 95% CI: 10.3, 11.3). Younger age, Asian race, difficulty accessing care, and severe disease were independently associated with higher pain (p≤0.002 for all). Reported barriers to pain management included providers not asking about pain, poor provider knowledge, and perceived unwillingness to treat pain. 38.4% of participants reported they had never received a prescription for pain medication. Pain prescriptions were most commonly received from primary care physicians (22.5%) or dermatologists (13.3%), with severe pain linked to increased use of opioids, tramadol, and antiepileptics to treat HS pain (p<0.05 for all).

Conclusion: Pain in HS is linked to lower QoL and barriers to management, emphasizing the need for evidence-based, patient-centered approaches to enhance pain care and address treatment gaps.

Hormones exert complex regulatory effects on the hair follicle and local follicular environments. Hormonal replacement therapy (HRT) is recommended to treat vasomotor symptoms in menopausal and post-menopausal women and is also used off-label to manage low sexual function. Given the increasing prevalence of HRTs, there is a growing interest in understanding their impact on hair. This review summarizes the role of key hormones (estrogen and androgen) in hair biology, the types of HRTs and their clinical indications, and current evidence regarding HRT's effects on hair. HRT such as estrogen-based therapies, testosterone-based therapies, and bioidentical hormones are being utilized to provide relief for undesirable vasomotor and sexual symptoms, although the risks and benefits have been debated over the years. Despite its increasing clinical relevance, HRT's impact on hair remains poorly understood due to the complex interplay of hormones, hair follicles, and local follicular environment.

Introduction: Smoking is associated with worse skin cancer outcomes yet smoking cessation after skin cancer diagnosis remains poorly characterized. This study aimed to examine and compare prevalences of smoking and cessation among skin cancer and internal cancer survivors using nationally representative data.

Methods: This survey-weighted analysis included 2003-2018 National Health and Nutrition Examination Survey data from adults (age 20+) with self-reported cancer history (skin cancers only or internal cancers only). Skin cancer survivors were categorized as those who had non-melanoma skin cancer (NMSC) only or any melanoma. Smoking cessation after first cancer diagnosis was the primary outcome, with smoking status confirmed using serum cotinine. Prevalence outcomes were age-standardized using the direct method and compared by cancer type using age-adjusted logistic regression.

Results: Among 3,711 cancer survivors, 1,098 (29.6%) had skin cancer exclusively. Age-standardized smoking prevalence at cancer diagnosis did not differ by cancer type and was 29.7% (22.8%-36.6%) among skin cancer survivors and 42.3% (37.9%-46.7%) among internal cancer survivors. Among those who smoked at diagnosis, age-standardized post-diagnosis cessation prevalences were low and did not differ between survivors of skin cancers and internal cancers, with 18.1% (12.5%-23.6%) for skin cancer survivors, 20.6% (10.7%-30.5%) for NMSC-only survivors, 11.9% (4.07%-19.6%) for melanoma survivors, and 18.7% (13.9%-23.4%) for internal cancer survivors.

Conclusion: Smoking at skin cancer diagnosis was common with low cessation prevalence across all skin cancer types, highlighting opportunities for dermatologists and clinic staff to implement targeted smoking cessation interventions for skin cancer survivors.