Dermatology Research and Practice最新文献

Background: For dry skin, the application of a hypoallergenic moisturizer twice daily is recommended in elderly individuals. However, it is not known which is the most effective and appropriate moisturizer among the commercially available moisturizers.

Aims: In this study, we aimed to investigate the efficacy of the three widely used moisturizers for the treatment of senile dry skin. Patients/Methods. This interventional study involved elderly individuals aged >65 years who were living in a nursing home. The participants were randomly divided into the interventional (moisturizers A, B, and C) and conventional care groups. Moisturizers A, B, and C were applied on the skin of each member of the three intervention groups twice daily for 8 weeks. The water content of the stratum corneum and transepidermal water loss (TEWL) were evaluated before and after the intervention. Changes in these parameters among the groups were compared using two-way analysis of variance and a posthoc test.

Results: Moisturizers A, B, and C and conventional care groups comprised six, seven, five, and four participants, respectively. The water content of the stratum corneum was significantly higher in the moisturizer A (p = 0.01) and B (p = 0.047) groups than in the conventional care group. There was no significant difference in TEWL among the groups.

Conclusions: In terms of the appearance of the skin, white powder and small scales were both reduced in group A. Taken together with the water content, this was considered a clinically significant change.

Basal cell carcinoma (BCC) is the most common human malignancy. The biological behavior of this entity is remarkably indolent. Claudin plays an important role in tight junctions, regulating paracellular passage of variable substance including growth factors and maintaining the polarity of epithelia. Up- or downregulated claudin expression has been reported in many cancers. Nevertheless, claudin expression in BCC of the skin remains unclear. We therefore examined the status of claudin 1 and 4 expressions in BCC and adjacent normal skin by immunohistochemistry (IHC). Our IHC results demonstrated high claudin 1 expression and low claudin 4 expression in 33 of 34 lower-grade BCCs. In lower-grade BCC, claudin 1 was increased and claudin 4 was decreased compared with the normal skin. Claudin 1 was inclined to be highly expressed in the membrane and cytoplasm of tumour cells in the periphery of tumour nest. Conversely, almost all lower-grade BCCs (33/34) and one of two higher-grade BCC lacked or showed focal positivity for claudin 4. These results imply that the expression pattern is characteristics of lower-risk BCC. Interestingly, one of the two higher-grade BCCs demonstrated the converse expression patterns of claudins, with decreased claudin 1 and increased claudin 4. The combination of immunohistochemical claudin 1 and 4 expression may offer a useful ancillary tool for the pathological diagnosis of BCC. Furthermore, membranous and intracellular claudins may present future therapeutic targets for uncontrollable BCC.

Skin damage among healthcare workers has been reported by many centers around the world. Occupational hand dermatitis is one of the most commonly known occupational skin diseases and a socially significant health issue. The use of gloves is one of the risk factors for the occurrence and/or aggravation of hand dermatitis. This cross-sectional study involved healthcare workers in 14 referral hospitals for COVID-19 throughout Indonesia. Questionnaires were distributed to the participants, which consisted of the subject's characteristics, glove-related skin problems, history of glove use, and clinical history. This study involved a total of 845 healthcare workers. Approximately 156 healthcare workers (18.46%) had glove-induced hand dermatitis during the pandemic. Itchy skin was the most common symptom (44.23%), and the palm was the most frequently complained area (48.72%). There was a significant association between glove use and glove-induced hand dermatitis among healthcare workers. In particular, equal to or more than 2 hours per day of glove use was significantly associated with hand dermatitis. Glove-induced hand dermatitis also had a significant association with the subject's history of atopic dermatitis and previous history of hand dermatitis. The use of gloves by healthcare workers should be considered carefully, especially in individuals at increased risk, including those who use gloves for 2 hours or more per day and those who have a history of atopic or hand dermatitis, in order to prevent the incidence of glove-induced hand dermatitis among healthcare workers, as well as to provide a safe working environment.

Health care spending in Italy is high and continues to increase; assessing the long-term health and economic outcomes of new therapies is essential. Atopic dermatitis (AD) is a chronic, pruritic, immune-mediated inflammatory dermatosis, a clinical condition that significantly affects patients' quality of life at a high cost and requires continuous care. This retrospective study aimed to assess the direct cost and adverse drug reactions (ADRs) of Dupilumab and patients' clinical outcomes. All AD patients treated with Dupilumab at the Sassari University Hospital, Italy, between January 2019 and December 2021 were included. Eczema Area Severity Index, Dermatology Life Quality Index, and Itch Numeric Rating Scale scores were measured. ADRs and drug expenses were analyzed. A statistically significant posttreatment improvement was observed for all the indices measured: EASI (P < 0.0001), DLQI (P < 0.0001), NRS (P < 0.0001). The total expenditure for Dupilumab, in the observed period, amounted to € 589.748,66 for 1358 doses, and a positive correlation was shown between annual expenditure and delta percentage of variation pre- and posttreatment for the clinical parameters evaluated.

Glomus tumours are painful superficial tumours, and ultrasonography is an extremely useful and noninvasive diagnostic technique for superficial organs. In this study, we retrospectively examined glomus tumours using ultrasonography. Among 18 patients histopathologically diagnosed with glomus tumours via ultrasonography, we observed five different development sites: subungual areas or those surrounding the nail bed (12), other areas on the finger surface (3), abdominal wall (1), upper arm (1), and forearm (1). The ultrasonographic images revealed significant differences in tumour size, indicating that tumours on other body surfaces tended to be smaller than those on patients' fingers (p < 0.01). The depth/width ratios of tumours on the other body surfaces were significantly higher than those on the fingers (p < 0.05). The tumours showed a regular shape (72.2%) and clear border (100%). Furthermore, most tumours were low-echo tumours with a diameter of up to 15 mm, clear margins, and no lateral shadows. Abundant blood flow and vessels in and out of the tumours were also observed. In conclusion, our study describes the ultrasonographic characteristics of glomus tumours and reveals that they cannot be ruled out when diagnosing small painful subcutaneous tumours.

Background: Nail psoriasis is a challenging chronic condition affecting patients functionally and psychologically. Nail involvement is observed in 15-80% of psoriatic patients with occasional presence of isolated nail psoriasis.

Objectives: To evaluate dermoscopic features of nail psoriasis and correlate them clinically.

Methods: The study included fifty subjects with nail psoriasis. Psoriasis skin and nail severity was evaluated using psoriasis area severity index (PASI) and nail psoriasis severity index (NAPSI). Dermoscopy of the nails (onychoscopy) was performed, and features were recorded and analyzed.

Results: The most common clinical and dermoscopic findings were pitting (86%) and onycholysis (82%). Among all dermoscopic features of nail psoriasis, only longitudinal striations and subungual hyperkeratosis were significantly higher in patients with moderate to severe psoriasis than in patients with mild psoriasis (P=0.028; P=0.042, respectively). PASI scores correlated positively but none significantly with NAPSI scores (r = 0.132, P=0.360), and similarly, no significant correlation was observed between the duration of psoriasis and the dermoscopic NAPSI (r = 0.022, P=0.879).

Conclusion: Dermoscopy can serve as a useful tool for early diagnosis of psoriatic nail changes not always visible to the naked eye and is a non-invasive easy-to-use confirmatory tool for nail changes in psoriatic disease or in isolated nail involvement.

Background: Severe cutaneous adverse drug reactions (SCARs), although rare, are known to be associated with significant morbidity and mortality. SCARs include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and acute generalized exanthematous pustulosis (AGEP). Studies on SCARs are limited in Saudi Arabia. This study aims to characterize SCARs at a tertiary care center in Saudi Arabia.

Methods: A cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. All inpatient and emergency department consultations to dermatology were electronically reviewed during the period from January 2016 to December 2020. All patients who developed an adverse cutaneous drug reaction were enrolled. Detailed analysis was performed only for SCARs. The culprit medication was determined based on the latency period, history of previous intake of the medication, and drug notoriety.

Results: There were 3050 hospital consultations to dermatology during the study period. Cutaneous adverse drug reactions constituted 253 (8.3%) cases. A total of 41 patients with SCARs were identified, accounting for 16.2% of all cutaneous drug reactions. Antibiotics and anticonvulsants were the most common causative drug groups accounting for 28 (68.3%) and 9 (22%) cases, respectively. DRESS was the most common SCAR. The latency period was the longest for DRESS and shortest for AGEP. Vancomycin was responsible for approximately a third of DRESS cases. Piperacillin/tazobactam was the most common cause for SJS/TEN and AGEP. The majority of drugs causing AGEP were antibiotics. The mortality rate was the highest in SJS/TEN (5/11 (45.5%)), followed by DRESS (1/23 (4.4%)) and AGEP (1/7 (14.3%)).

Conclusion: SCARs are rare in Saudis. DRESS appears to be the most common SCAR in our region. Vancomycin is responsible for most cases of DRESS. SJS/TEN had the highest mortality rate. More studies are required to further characterize SCARs in Saudi Arabia and Arabian Gulf countries. More importantly, thorough studies of HLA associations and lymphocyte transformation tests among Arabs with SCARs are likely to further improve patient care in the Arabian Gulf region.

Background: Molluscum contagiosum (MC) is a common viral skin infection primarily affecting children which is difficult to treat using available therapeutic approaches. The sulfated polysaccharide named calcium spirulan (Ca-SP) has demonstrated antiviral effects against herpes simplex virus in keratinocytes in vitro, and a cream containing 1.5% Ca-SP and 1% of a defined microalgae extract (Spiralin^®) effectively prevented herpes labialis in a trial with susceptible individuals. This observational study aimed to show antiviral effects of a similar formulation (Spirularin^® VS) against MC in children.

Methods: Children with active MC lesions were treated with Spirularin^® VS cream twice daily on affected skin over several months and asked to return for follow-up visits after 1 to 3 months. Clinical status of MC infection was documented at baseline and follow-up visits.

Results: Of the 31 children enrolled in the study, 26 completed treatment and returned for control visits. Spirularin^® VS cream was applied twice daily over a period of 1 to 9 months (mean treatment duration 3.9 months). 19/26 (73.1%) children achieved complete clearance of MC lesions with no clinical evidence of bacterial skin infection during treatment. No irritative skin reactions or unpleasant symptoms were observed or reported.

Conclusion: This open-label observational study suggests that a cream formulation containing 1.5% Ca-SP and 1% Spiralin® may be an effective and safe treatment option for children with active MC lesions. The high rate of complete clearance of MC lesions and lack of adverse reactions warrant further investigation in larger, controlled trials.