Dermatology Research and Practice最新文献

Introduction: Fixed pigmented erythema (FPE) is a common toxidermia characterized by the appearance of one or more annular, erythematous and hyperpigmented spots, following the systemic administration of a drug. The main aim of this study was to describe the epidemiological and clinical aspects of fixed pigmented erythema at the Departmental University Hospital Center Borgou/Alibori (DUHC-B/A) from 2009 to 2022.

Methods: This was a descriptive cross-sectional study with retrospective data collection, based on the records of patients seen in the Dermatology-Venerology Unit for FPE. Initially, all files bearing the diagnosis of toxidermia were identified; then, those with the diagnosis of FPE with usable data were retained. Data were entered using EpiData 3.1 and analyzed using EpiData Analysis.

Results: Sixty-four patients were enrolled during the study period. The prevalence of FPE was 0.73%, with a male predominance. The most common drug identified was cotrimoxazole, followed by paracetamol and quinine. Over half of the patients (52.9%) were self-medicating.

Conclusion: Although FPE occurs rarely, it remains the most frequent toxidermia at the DUHC-B/A. It can be severe in its generalized bullous form. Avoiding the practice of self-medication could help reduce its prevalence.

Keloid scars represent a complex fibroproliferative disorder characterized by abnormal wound healing and excessive collagen deposition. Central to keloid pathogenesis are dynamic fibroblast populations that undergo extensive phenotypic transitions, including heterogeneous subpopulation differentiation, enhanced migration, myofibroblast transdifferentiation, and sustained activation states. This review examines fibroblast dynamics as the central orchestrator of keloid formation, analyzing how these cells interact with keratinocytes, immune cells, endothelial cells, and melanocytes to drive pathological scarring. We focus on key signaling pathways that directly regulate fibroblast function, including TGF-β/Smad, VEGF, Wnt, and emerging regulators such as miR-3606-3p that integrate multiple fibrotic cascades. Current therapeutic approaches show variable efficacy, with surgical excision alone resulting in 45%-100% recurrence rates, while combination therapies incorporating radiation, intralesional injections, and novel molecular targets achieve improved outcomes. Emerging strategies include COX-2 inhibition for dual antiproliferative and proapoptotic effects on keloid fibroblasts, stem cell therapies, and precision medicine approaches based on molecular profiling. Through deeper understanding of fibroblast dynamics and their regulatory networks, more effective therapeutic strategies can be developed to improve patient outcomes and quality of life.

Prurigo pigmentosa (PP) is a rare inflammatory dermatosis first described in 1971 by Nagashima, classically predominantly affecting young women, particularly those of East Asian descent. Clinically, PP presents with pruritic, erythematous papules, which eventually form a reticulated pattern and resolve into post-inflammatory hyperpigmentation. The exact pathogenesis of PP remains unclear, but it is frequently linked to ketosis-inducing conditions, including strict dieting, fasting, and metabolic changes, such as those observed in diabetic ketoacidosis or anorexia nervosa. In recent years, PP has been increasingly reported in patients undergoing bariatric surgery, likely due to the rapid weight loss and subsequent ketosis that often follow these procedures. This review aims to take a closer and deeper look at the emerging connection between PP and bariatric surgery, particularly laparoscopic sleeve gastrectomy.

Introduction: Psoriasis, as a common inflammatory skin disease, is characterized by hyperproliferation of epidermal keratinocytes and induction of an inflammatory response. Apoptosis induction and prevention of the proliferation of keratinocytes can help to treat and manage this disease. Thymoquinone (TQ), a bioactive compound with antioxidant and anti-inflammatory properties, has also been reported as a natural antitumor agent. This study aimed to evaluate the effects of TQ on proliferation and apoptosis in human keratinocyte cells (HaCaT).

Methods: HaCaT cells were treated with increasing concentrations of TQ (1, 2, 4, 6, 8, 16, 32, and 64 μg/mL), and cell viability was assessed using the MTT assay. Apoptosis was analyzed via flow cytometry using Annexin V-FITC/PI staining. Expression levels of p53, Bax, and BCL-xl genes were measured by real-time PCR.

Results: TQ significantly reduced cell viability in a dose-dependent manner, with an IC50 of 11.64 μg/mL after 72 h. Flow cytometry revealed a marked increase in early apoptotic cells following treatment with 8 μg/mL TQ (41.00% ± 5.04%) compared to control (17.8% ± 2.26%, P ≤ 0.001). Gene expression analysis showed significant upregulation of p53, while Bax and BCL-xl levels showed no significant changes.

Conclusion: TQ induces apoptosis in human HaCaT cells primarily through p53-dependent pathways, suggesting its potential as a therapeutic agent for skin-related disorders.

Acne is a chronic inflammatory skin disease of the sebaceous unit of the facial hair follicle that occurs mainly in adolescence. The four major pathogenesis of acne are excessive secretion of sebum by sebaceous glands, abnormal keratosis of sebaceous glands in hair follicles, reproduction of skin microorganisms such as Cutibacterium acnes (C. acnes), and inflammatory reaction. Among the skin microbiota, C. acnes and Malassezia affect the secretion of sebaceous glands, mediate inflammation, and are closely related to the pathogenesis of acne. With the development of the theory of "Gut-skin axis," the role of intestinal microbiota and skin microecology in acne regulation has gradually become the focus of researchers. The purpose of this study is to investigate the influence of skin microbiota and the interaction between gut and skin on the pathogenesis of acne and to analyze the potential mechanism of skin microbiota during the pathogenesis of acne. It is expected that further understanding of skin microbiota (including its potential mechanism) will help clarify its role in acne and provide new ideas for the pathogenesis and clinical treatment of acne and other inflammatory skin diseases.

The rising incidence of dermatophytosis, marked by atypical presentations and increasing resistance to treatment, has posed significant challenges to effective clinical management, particularly in regions like Nepal, where localized guidance is limited. In response, a panel of dermatology experts in Nepal conducted a structured literature review and employed a modified Delphi process to develop updated consensus recommendations. These guidelines aim to assist clinicians in making informed decisions regarding diagnosis and treatment, with an emphasis on improving patient outcomes. The consensus highlights key treatment principles, including the potential role of combination therapy and considerations for both localized and more complex presentations of the disease.

Acne scars, particularly in individuals with pigmented skin, can lead to significant psychosocial distress, yet the extent of this impact remains underexplored. This study aimed to assess the psychosocial effects of acne scars on patients with skin Phototypes IV-VI. This retrospective multicenter observational study involved 86 patients with acne scars who had previously consulted general practitioners. Scar severity was assessed using the Echelle d'évaluation Clinique des Cicatrices d'Acné (ECCA). Validated measures were used to evaluate psychological and quality-of-life impacts: the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Dermatology Life Quality Index (DLQI) for quality of life. The study revealed that 62% of patients exhibited depressive symptoms according to the PHQ-9, and 84% reported a diminished quality of life according to the DLQI. A significant correlation was observed between acne scar severity and both psychosocial measures: ECCA and DLQI (r = 0.31, p=0.003), and ECCA and PHQ-9 (r = 0.27, p=0.010). Many participants had modified their clothing and daily activities due to their scars. The findings illustrate the profound psychosocial burden of acne scars, with a notable percentage of individuals experiencing depressive symptoms and reduced quality of life. The strong correlation between scar severity and psychosocial outcomes emphasizes the need for early, comprehensive care that addresses both dermatological and psychological aspects.

For a given skin cancer, a number of treatment options are often available. The decision of which method to use is usually made by the treating physician. Despite significant changes to the healthcare system of the United States over the past 10 years, healthcare costs continue to rise. These costs often affect patients in the form of higher deductibles, copays, and insurance premiums. The goal of this study was to determine patient attitudes regarding discussion of cost of skin cancer removal procedures and repairs. A 12-question survey was administered to 100 patients presenting for treatment of a skin cancer at an academic center. The first six questions addressed the importance the patient placed on treatment cost and related discussions, and the final six questions addressed repair cost. Greater than two-thirds of respondents felt that cost of both treatment (76%) and repair (67%) is somewhat or very important. Most patients reported that the cost of skin cancer treatment (56%) and repair (54%) should be considered by their surgeon. Furthermore, a majority of participants felt that cost differences should be discussed prior to treatment (67%) or repair (67%). Most respondents believed that cost discussion prior to treatment (64%) and repair (67%) would not affect their level of procedural anxiety. In conclusion, patients value cost discussions for treatment and repair of skin cancer. Surgeons should consider discussing these issues with patients in the appropriate clinical setting.

Background: Tinea of vellus hair is a rare condition that is recalcitrant to treatment. It is typically caused by nonanthropophilic dermatophytes. Extant data on this disease remain scarce. Aims/Objectives: This study aimed to delineate the clinical features and treatment outcomes of patients with tinea of vellus hair and to compare the characteristics of patients infected by anthropophilic and nonanthropophilic species. Methods: A 10-year retrospective study was conducted at the Department of Dermatology in a tertiary hospital in Thailand. The study included all patients with tinea of glabrous skin involving vellus hair. Baseline characteristics, clinical data, and treatment outcomes were analyzed. Results: Of the 31 patients in the study, two-thirds of the patients (69%) had a history of using topical medications, mainly steroids and antifungals. The face and extremities were the most common locations for lesions with positive vellus hair. There were no significant differences in data between patients infected with anthropophilic and nonanthropophilic species. Most patients received oral antifungals (80.6%). There was no significant difference in the cure rate between patients who were administered oral antifungals and those who solely utilized topical antifungals. Kaplan-Meier analysis demonstrated the overall median duration to achieve a cure was 5 weeks. Conclusion: The diagnosis of tinea of vellus hair should be considered in cases of tinea of the glabrous skin in exposed areas, especially in patients with a history of topical treatments. Nonanthropophilic dermatophytes are the primary causative agents of tinea of vellus hair. Systemic antifungals with prolonged duration are recommended.