European Journal of Dermatology最新文献

Lentigo maligna (LM) often poses a diagnostic challenge due to its clinical and dermoscopic mimicry of benign lesions, leading to delayed diagnosis. Focal areas of reticular disruption have been described as one of the earliest dermoscopic signs observed. To describe a novel dermoscopic sign in LM, namely the presence of a parallel pigmented network. Case series of 22 histopathologically-proven LM and lentigo maligna melanoma (LMM), diagnosed between 2018 and 2023, at a tertiary centre. All lesions showed a parallel network upon dermoscopy, in the form of parallel reticular lines, light or dark brown in colour, not emanating from the follicle, with an asymmetrical distribution. Reflectance confocal microscopy (RCM) images were reviewed to correlate these areas. The median age of patients was 73 years old. The majority of lesions were in situ (91%) and extrafacial (82%). Lesions showed minimal signs of atypia other than a parallel network and mostly focal erased areas (100%), followed by perifollicular linear projections (18%) and asymmetrical follicular pigmentation (18%). On RCM, focally areas correlated with atypical junctional thickenings distributed in a parallel fashion (100%) and mitochondria-like structures (23%). Most cases (88%) showed atypical cells in the epidermis, mostly in the form of isolated dendritic cells (41%). Parallel network emerges as a potential dermoscopic sign associated with LM. We hypothesize that in early stages of LM transformation, disruption of the reticular network manifests as parallel lines and/or radial perifollicular lines. Validation with larger studies is warranted.

Herpes zoster (HZ) is a very common disease associated with a considerable individual and public health burden. To evaluate prognostic clinical and laboratory parameters, including systemic immune inflammatory biomarkers (SIIB) in inpatients with HZ. We investigated clinical and laboratory data of 520 inpatients with HZ. Complete blood count was determined at baseline. SIIB was assessed based on neutrophil-to-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP). Both uni- and multivariable statistics were performed. NRL and PIV were significantly (p < 0.0001) higher in HZ patients vs. healthy controls and. The presence of absolute eosinopenia (OR: 3.9, 95 % CI: 1.9 to 8.3) was a strong predictor of herpes zoster ophthalmicus (HZO). Ramsay-Hunt syndrome (OR: 4.3, 95 % CI: 1.8 to 10.3), bacterial superinfection (OR: 2.3, 95 % CI: 1.3 to 4.1), and age < 65 (OR: 0.51, 95 % CI: 0.33 to 0.78) were associated with length of hospitalisation. The presence of immunosuppression predicted herpes encephalitis (OR: 22.4, 95 % CI: 2.3 to 221) as well as treatment outcome in the intensive care unit (OR: 8.9, 95 % CI: 1.3 to 61.8). Postherpetic neuralgia was associated with absence of intravenous antiviral therapy (OR: 55.2 [16.5 to 184.9]). We identified several clinical and laboratory-based independent predictors that may aid prognostication of HZ patients. The increase in SIIB reflects the possible role of systemic inflammatory alterations in HZ. However, the only effective SIIB studied was AEP which was independently associated with HZO. The use of intravenous antiviral therapy decreases the risk of postherpetic neuralgia.

Keloids are fibroproliferative diseases featuring abnormal fibroblast proliferation and extracellular matrix (ECM) deposition. Current therapeutic methods for keloids are unsatisfactory, and the recurrence rates of keloids are high. Astragaloside IV (AS-IV) is a key active component of Astragalus membranaceus Bunge, and has been reported to exert potent anti-fibrotic effects. Accordingly, our research aimed to explore whether AS-IV suppresses fibroblast dysfunction and skin fibrosis during the development of keloids. Human keloid-derived fibroblasts (KFs) were stimulated by TGF-β1 to evaluate the influence of AS-IV on abnormal proliferation, migration, and accumulation of ECM in vitro. A bleomycin (BLM)-induced skin fibrosis model was established to assess the influence of AS-IV on ECM deposition and skin fibrosis in vivo. TGF-β1 stimulation enhanced the proliferation, migration, and accumulation of ECM in KFs, which were abolished by AS-IV treatment. The in vivo assay revealed that AS-IV administration restrained ECM accumulation and skin fibrosis in mouse models. AS-IV plays an anti-fibrotic role in keloids by suppressing fibroblast dysfunction and reducing ECM deposition.