Dermatology Research and Practice最新文献

Introduction: Pruritus is a frequent and debilitating complication in hemodialysis patients. Its pathophysiology remains poorly understood. This study aimed to describe the factors associated with pruritus in three hemodialysis centers in 2023.

Methods: This was a prospective, descriptive, and analytical cross-sectional study. It included 245 patients aged 18 years and older, undergoing hemodialysis for at least three months, hemodynamically stable, and who had provided informed consent. Pruritus intensity was assessed using the Itch-Numeric Rating Scale (Itch-NRS). Statistical analysis was performed using Stata 17, with a significance level set at p < 0.05.

Results: The prevalence of pruritus among hemodialysis patients was 40.41%. The mean age of participants was 52.75 years, with a sex ratio of 1.78. Pruritus was most often mild to moderate (90.91%), generalized (48.48%), or diffuse (51.52%) and had been present for at least 1 year in 67.67% of cases. The most frequently associated dermatoses were xeroderma (88.88%), nail abnormalities (77.14%), and diffuse hyperpigmentation (27.27%).Univariate analysis identified protective factors such as vitamin D supplementation, absence of anuria, absence of diffuse skin hyperpigmentation, absence of alopecia, and absence of nail abnormalities (p = 0.003-0.042; OR = 0.17-0.58). Multivariate analysis showed that prolonged duration of hemodialysis, the use of an arteriovenous fistula, severe xeroderma, and the presence of Beau's lines (p ≤ 0.039) increased the risk of pruritus in hemodialysis patients. Conversely, the use of oral antidiabetic agents was significantly associated with a reduced risk of pruritus (p = 0.003; OR = 0.25).

Conclusion: Pruritus is a common and chronic condition in hemodialysis patients, adversely affecting their quality of life. The main risk factors identified were severe xeroderma, prolonged duration of hemodialysis, use of an arteriovenous fistula, and the presence of Beau's lines, whereas the use of oral antidiabetic medications appeared to be protective. A better understanding of the pathophysiology of pruritus in hemodialysis patients could help improve its management and enhance patient comfort.

Background: Topical corticosteroid phobia (CSP) is a significant barrier to the effective treatment of atopic dermatitis (AD). This is the first study to evaluate the CSP prevalence among parents of children with AD in Slovenia and to identify contributing factors.

Methods: We conducted a cross-sectional study between March 2021 and December 2023. Parents of children with dermatologist-confirmed AD, aged 3 months to 18 years, completed the validated TOPICOP questionnaire, supplemental questions and the (F)DLQI questionnaire. The SCORAD index was used to assess the severity of their children's AD disease. Statistical analyses included the Shapiro-Wilk test, two-tailed independent t-test, ANOVA, followed by Tukey post hoc testing and the Pearson correlation coefficient.

Results: Among 117 parents (81.2% mothers), the mean TOPICOP score was 48.2% (SD 15.1). Fear was the highest-scoring TOPICOP domain (53.7%). CSP was significantly higher in parents of children with more severe AD based on SCORAD (p = 0.033) and in families with higher (F)DLQI scores (r = 0.311, p = 0.002). Notably, our results suggest that parents of children in single-parent households had significantly higher CSP (p = 0.035), a novel finding that warrants cautious interpretation due to the small subgroup size. Information obtained online about the potential dangers of topical corticosteroids (TCS) correlated with higher CSP (p < 0.001).

Conclusion: CSP is prevalent among Slovenian parents of children with AD and is particularly pronounced in cases of more severe disease and single-parent households, a novel and previously undescribed finding. Given that CSP is often influenced by nonmedical information sources, structured education and support by all healthcare providers is essential.

It is known that when an electrical stimulus is greater than 10 kHz, our body converts this electrical energy into thermal energy, and due to this fact, one of the therapies that has been showing good results is therapeutic, capacitive, and resistive energy transfer (tecar therapy), but there is still little evidence about its action on area of aesthetics. Therefore, the objective of this study was to evaluate the safety and efficacy of tecar therapy for the reduction of localized fat and improvement of skin flaccidity in the abdomen region. A controlled clinical trial was carried out with 48 women equally divided into 2 distinct groups, with (G-1) received treatment with tecar therapy and (G-2) considered the control. Ten treatment sessions were performed once a week. The volunteers were evaluated at three different times using anthropometric data, adipometry, and ultrasound (US), in addition to histological analysis of the adipose tissue performed on one of the volunteers. In the results of the adipometry and US, a decrease was observed both in the comparison between the groups and between the baseline and the end of the treatment for the supra and infra umbilical region. In the histological analysis, it was observed that the G1 showed positive markers for moderate chronic inflammation, indicating degeneration of the adipose tissue with a large number of fibroblasts and newly formed blood vessels in the integumentary tissue. With this, it was possible to conclude that tecar therapy proved to be a safe and effective resource in the treatment of sagging skin and reduction of superficial adipose tissue. Trial Registration: ClinicalTrials.gov identifier: NCT05020054.

Background: Melasma is chronic, acquired hypermelanosis that commonly appears on sun-exposed areas of the skin. Although it is asymptomatic, it can significantly affect patients' psychosocial and emotional well-being, ultimately reducing their quality of life. This study aimed to assess the factors associated with quality of life and treatment practices among melasma patients in Nepal.

Methods: A hospital-based cross-sectional study was conducted among 174 melasma patients visiting Nepal Skin Hospital, Kathmandu, from March to August 2023. The Melasma Area and Severity Index (MASI) score and the Melasma Quality of Life (MELASQoL) scale were used to evaluate melasma severity and quality of life, respectively. Statistical analyses included descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression to identify factors associated with quality of life among women with melasma.

Results: The mean (±SD) MELASQoL score was 51.89. Most participants reported feeling frustrated (81.5%), embarrassed (78.8%), depressed (95.40%), and less productive (83.9%) due to melasma. Female gender, illiteracy, both current and previous OCP use, women with multiple pregnancies, lighter skin Types (III and IV), longer disease duration, and moderate MASI scores were significantly associated with higher MELASQoL values (p < 0.05). Sunscreen (97.7%) was the most prescribed treatment, followed by tranexamic acid (78.7%), hydroquinone (76.4%), antioxidants (71.3%), and chemical peels (69.0%).

Conclusion: Melasma has a significant psychosocial impact on affected individuals in Nepal. Disease severity, use of oral contraceptive pills, number of pregnancies, disease duration, education, and skin type significantly influenced quality of life. The strong association between disease severity and MELASQoL underscores the importance of integrating psychosocial assessment into clinical management. Sunscreen followed by tranexamic acid, hydroquinone, antioxidants, chemical peels, multivitamins, and retinoids was the predominant treatment approaches.

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.