Dermatology Research and Practice最新文献

The pathophysiology of lichen planopilaris (LPP), a lymphocytic primary cicatricial alopecia, is largely unknown. We evaluated RNA expression of lesional scalp biopsies taken before and after 6 months of treatment monotherapy with oral hydroxychloroquine (HCQ), narrow band ultraviolet B (NB-UVB), or low level laser light therapy (LLLLT). PTGER4 and DOCK2 were significantly increased in all patients after treatment. CYP1A2, a drug metabolism enzyme, and SSR2, a gene involved in B cell activation and maturation, were increased posttreatment for the HCQ arm. VEGFA, which has been reported to be downregulated by phototherapy was decreased post NB-UVB treatment, while SAA1, an apolipoprotein gene present in plasma that is upregulated in response to tissue injury, was increased posttreatment for the NB-UVB arm. No significant differentially expressed genes (DEGs) in the LLLLT arm before and after treatment. The expressions of CD68, COL5A1, MMP9, COL6A3, and CD44 were significantly higher at the baseline in biopsies from patients with a Lichen Planopilaris Activity Index (LPPAI) score ≥ 4 compared with those with an LPPAI < 4. These genes are involved in extracellular matrix organization and M2, or profibrotic, macrophage polarization, which is congruent with follicular scarring. Our data identify potential RNA biomarkers of LPPAI and suggest that M2 macrophages may play a role in LPP immunopathogenesis.

Background: Radiofrequency ablation (RFA) is an emerging technology for the effective treatment of cutaneous hemangioma and vascular malformation. However, there are few histopathological studies on the treatment of this disease with RFA. Objective: This study aimed to investigate the effect of RFA and associated histopathological changes in a cockscomb model of cutaneous hemangioma and vascular malformation. Methods: Thirty-two Leghorn chickens were randomly divided into two groups: RFA group (treated with RFA; 220 V, pulse rate: 15 ms) and control group (treated with 1 mg/mL bleomycin). At 3, 7, 14, and 28 days after treatment, histopathological changes in the cockscomb tissues were observed visually and microscopically using hematoxylin and eosin staining and Masson's trichrome staining. The rates of capillary reduction and collagen proliferation were examined. Results: The cockscomb in the RFA group developed scabs earlier than that in the bleomycin group, and the scabs were darker and more clearly defined. The RFA group showed a more severe inflammatory reaction than the bleomycin group. At 28 days, most scabs had fallen off in both groups, and the boundary was clearer in the RFA group. At 3, 7, and 14 days, the number of capillaries decreased in both groups, with a more obvious decrease in the RFA group. From Days 3 to 28, the number of capillaries in the RFA group showed a trend of gradual increase, whereas that in the bleomycin group showed a trend of gradual decrease, but there was no significant difference between the two groups at 28 days (p > 0.05). The collagenous fibers of cockscomb showed a trend of gradual increase in both groups. The collagenous fiber hyperplasia was higher in the RFA group than in the bleomycin group at 14 and 28 days (p < 0.01). Conclusion: RFA significantly reduced the capillary number and promoted tissue fibrosis. Compared with bleomycin, RFA showed a better effect and with no obvious side effects in treating a cockscomb model of cutaneous hemangioma and vascular malformation.

Background: Chronic spontaneous urticaria (CSU) is a prevalent skin disorder characterized by frequent recurrences. While its pathogenesis is closely associated with histamine and vascular activating mediators released by mast cells, some research suggests cytokines, notably tumor necrosis factor-alpha (TNF-alpha), could play a pivotal role in its pathology and symptom presentation. Objective: This study evaluated serum levels of TNF-alpha in CSU patients and explored its correlation with clinical symptoms and severity at the University Medical Center at Ho Chi Minh City. Methods: We enrolled 60 adult patients (age ≥ 18) with CSU, assessing their clinical symptoms using the UAS7 scoring system. TNF-alpha levels were determined utilizing the Avi Bion Human TNF-alpha kit. For comparative purposes, we also studied TNF-alpha levels in 30 healthy adult participants as a control group. Results: The male-to-female ratio stood at roughly 1:2.3, and the median age was 36 (28-42). Notably, the mean serum concentrations of TNF-alpha in the patient group were considerably elevated compared to the control group (p < 0.001). A significant positive moderate correlation was found between serum concentrations of TNF-alpha and UAS7 score (r = 0.57; p < 0.001). Similarly, a notable positive moderate correlation between serum levels of TNF-alpha and pruritus scores was observed (r = 0.45; p < 0.001). Conclusion: Serum levels of TNF-alpha are markedly increased in patients with CSU and show a moderate correlation with both UAS7 and pruritus scores. These findings suggest that TNF-alpha might play a potential role in the pathogenesis of CSU. However, further research involving a more extensive sample size is essential to draw definitive conclusions.

Background: Acne is a common and often chronic skin condition that requires prolonged treatment. Conventional topical therapies are limited by their inability to effectively penetrate the deeper layers of the skin, reducing their effectiveness in treating comedones and inflammatory acne lesions. This study aimed to fabricate dissolvable microneedles (MNs) as a novel approach for delivering clindamycin directly to the obstructed sebaceous glands beneath the skin's surface. Methods: MNs were fabricated using 3D-printed molds of various shapes and lengths, employing materials such as chitosan, polyvinylpyrrolidone (PVP), and polyvinyl alcohol (PVA). Pyramid-shaped MNs, 2500 μm in length, were created using PVA soaked in sodium sulfate. Their physical properties, insertion capabilities, and dissolution profiles were evaluated through texture analysis, in vitro penetration testing, and drug release studies. Results: Pyramid-shaped MNs made from PVA demonstrated the highest mechanical strength and structural integrity, confirmed through scanning electron microscopy and texture analysis. In vitro penetration testing showed that these MNs penetrated beyond four layers of Parafilm, simulating their ability to breach the stratum corneum. Dissolution studies indicated complete MN dissolution within 7-8 min, with rapid drug release occurring within 3 min. Conclusion: The study demonstrates the feasibility of creating dissolvable MNs for delivering clindamycin, offering a promising alternative to conventional therapies by improving drug penetration and providing rapid drug release for the treatment of acne.

Nail polishes were developed in 1920, and since 1940, it has been known that these cosmetics contain toxic and sensitizing components. Over the years, nail polishes have undergone several changes in their formulation to avoid this problem, but new components have also been considered toxic and allergenic. The growing demand for gel nails has also been highlighted in cases of allergy to (meth)acrylates, and the biggest concern that was previously related to the presence of toluene sulfonamide-formaldehyde resin (TSFR) in traditional nail polish formulations is now also part of (meth)acrylate-based cosmetics. The beautification caused by nail polish is the main factor behind its constant use throughout the world, but studies have demonstrated its use for other purposes, such as treating fungal diseases, sun protection factor in cancer patients, and as a possible ally in forensic area. This review brings the beginning of the discovery of nail polish and its trajectory to the present day, including its effects on health and its inadequate labeling. Therefore, it is extremely important that legislation monitors the composition of nail cosmetics and that new formulations are studied to make them safe for health and the environment.

Melasma, a pigmentary disorder that particularly affects Asian women, has been clinically proven to respond effectively to combination therapy of Q-switched lasers and tranexamic acid (TXA), especially with the advancements in laser aesthetics in recent years. However, treatment outcomes can be influenced by factors such as the wavelength and spot size of the Q-switched laser, the route of administration for TXA (including injectable, oral, or topical), as well as the dosage and duration of treatment. This article presents 13 different combination approaches from six randomized controlled trials, indicating that oral administration of TXA in combination with a 1064 nm Q-switched laser is currently the most widely used and effective treatment approach.

Background: Acrocyanosis is a functional peripheral vascular disorder, currently categorized under the canopy of acrosyndromes, i.e., a group of clinically similar and significantly overlapping vascular disorders involving the acral skin. The disorder might be primary or secondary, depending on the cause. Recently, there has been a remarkable surge in acrocyanosis prevalence along with the COVID-19 pandemic. Both COVID-19 infection and vaccines for COVID-19 have been affixed to the list of disorders instigating acrocyanosis. Objectives: The goal of this narrative review was to evaluate the existing literature, project acrocyanosis from the viewpoint of dermatologists in the face of the COVID-19 pandemic, and assess the need for targeted research, education, and/or clinical practice. Methods: An English literature search was conducted using PubMed and Google. All abstracts on acrocyanosis, irrespective of the article type and publication date, were retrieved and reviewed and those most relevant for the focus of this article were selected and summarized. Discussion/Results: A narrative review was carried out. There is paucity of randomized, double-blind, placebo-controlled studies on acrocyanosis in the English literature, implicating the need for targeted research. Pertinent information still relies on anecdotal observations, case reports, case series, or scarce reviews, which are dated rather old and published in vascular-oriented journals. The scarcity of published literature on acrocyanosis in dermatology-oriented journals points to the necessity of professional education and improvement of clinical diagnostic skills for dermatologists. Conclusions: Although acrocyanosis is the least known and the least studied acrosyndrome, it is increasingly more commonly confronted in the COVID-19 era. The diagnosis still largely relies on clinical findings. Accordingly, it has become a growing necessity for a dermatologist to remain updated on this peculiar disorder and be able to differentiate acrocyanosis from clinically similar cold-induced or cold-exacerbated acrosyndromes. Acrocyanosis is still misdiagnosed, underdiagnosed, underreported, and undertreated by the dermatology community.

SCORring atopic dermatitis (SCORAD) is widely used to assess the severity of atopic eczema, but score systems based on the entire body may be limited in effective monitoring and intervention. It is crucial to monitor moisture levels in each affected body part, but empirical research is still lacking. The objective of this study was to analyze the levels of stratum corneum hydration (SCH) and transepidermal water loss (TEWL) in atopic dermatitis (AD) patients, focusing on the presence and location of atopic lesions at different body sites. The levels of TEWL and SCH were measured using the AF200 AquaFlux and the Corneometer, respectively, at 15 body sites. 98 children under the age of 10 were measured, including 83 AD patients and 15 in the control group. Patients were also assessed with SCORAD and for the presence of atopic lesions at each body site. 58.7% of AD patients had lesions in the antecubital fossa and popliteal fossa, with corresponding low SCH levels and high TEWL in the upper body. The differences in TEWL between the control group and AD patients were confirmed significant in the neck and antecubital fossa regions, while differences in SCH were identified in the face, antecubital fossa, and popliteal fossa regions. A higher TEWL was found among AD patients with atopic lesions in the face and ankle. This study suggests that continuous monitoring of SCH and TEWL levels at specific body sites can provide insights into identifying vulnerable body areas to AD and supplement the SCORAD system for more effective clinical intervention and prevention strategies.

Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by eczema lesions and dry, itchy skin. Recent guidelines for the management of AD emphasize the importance of using moisturizers in the management of AD. This study is a double-blind clinical trial to determine the effectiveness of moisturizers containing anti-inflammatory ingredients compared with moisturizers without anti-inflammatory ingredients for skin hydration in mild to moderate adult AD patients for 14 days at the Dermatology and Venereology Outpatient Clinic at Dr. Soetomo General Academic Hospital. There was a significant difference (p < 0.05) at the baseline and day 14 skin hydration values in the experiment group with anti-inflammatory ingredients (35.97 ± 6.04-66.06 ± 15.84) and the control group without anti-inflammatory ingredients (40.74 ± 10.94-56.12 ± 8.34). After comparison, there was a significant difference (p < 0.05) in the skin hydration value between the experiment group and the control group on the 14th day. There was also a significant difference in the improvement of skin hydration outcomes between both groups (p < 0.05). The severity of the disease using Scoring Atopic Dermatitis (SCORAD) showed a significant difference (p < 0.05) between the experiment group and the control group after 2 weeks of intervention. The addition of anti-inflammatory ingredients in the moisturizer, namely, shea butter, bacterial lysate, allantoin, bisabolol, Phragmites kharka extract, Poria cocos, and Mirabilis jalapa in a moisturizer containing occlusive (dimethicone), humectants (glycerin, saccharide, butylene glycol, and hyaluronic acid), and emollient (shea butter and squalane) was shown to be significantly better in improving skin hydration in patients with mild to moderate AD.

Background: Rosacea, a chronic facial dermatosis, poses a substantial global prevalence burden. Its impact extends beyond physical symptoms, affecting patient quality of life, self-esteem, and psychosocial functioning. This study aims to assess the health-related quality of life and emotional well-being in Jordanian rosacea patients in comparison to healthy controls. Methods: A case-control study, matching for age and sex, was conducted among rosacea patients attending the outpatient department at a governmental secondary hospital in the north of Jordan between September 2022 and November 2023. Adult patients with a confirmed rosacea diagnosis for a duration of ≥ 3 months were paired with healthy controls. Health-related quality of life, anxiety, and depression were evaluated using the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS), respectively. Disease severity was assessed using the Clinician's Erythema Assessment (CEA) grading system. Results: The study included 198 rosacea patients and 198 healthy controls. Rosacea patients exhibited significantly higher DLQI scores (mean 11.32 ± 5.4) compared to controls (mean 4.28 ± 2.3), indicating diminished quality of life. Subscale analysis revealed prominent differences in symptoms/feelings and daily activities. Additionally, rosacea patients reported elevated scores on the HADS anxiety (mean 9.38 ± 3.2) and depression (mean 8.19 ± 4.3) subscales in contrast to controls (mean 3.88 ± 2.18 and mean 3.41 ± 1.87, respectively). More than half (57%) of rosacea patients experienced moderate or severe anxiety, and nearly a third (31%) reported moderate or severe depression. Regression analyses revealed that higher disease severity significantly predicted worse quality of life (β = 0.384), anxiety (β = 0.352), and depression (β = 0.312). Conclusion: The study demonstrated that rosacea patients in Jordan experience significantly diminished quality of life and higher rates of anxiety and depression compared to healthy controls. Disease severity and multiple facial lesions emerged as strong predictors of poor psychological outcomes, while female gender increased vulnerability and longer disease duration showed a protective effect. These findings emphasize the need for routine psychological screening and a holistic treatment approach, particularly for newly diagnosed patients with severe disease manifestations.