International Journal of Dermatology最新文献

A 26-year-old previously healthy, non-pregnant female presented with a 1-week history of a highly pruritic blistering eruption predominantly affecting the trunk and upper limbs. This was preceded by a viral upper respiratory tract illness for which she had taken oral ibuprofen some 2 weeks prior. Clinical examination revealed multiple tense bullae on an erythematous base arranged in some areas in a "string-of-pearls" distribution, with sparing of the mucosa. Laboratory studies showed raised inflammatory markers and marked peripheral eosinophilia. Serology identified high-titre antibodies directed against the NC16A domain of BP180 by enzyme-linked immunosorbent assay (ELISA), and histopathological examination demonstrated a subepidermal blister with an eosinophil-rich infiltrate, together with linear IgG and C3 deposition along the basement membrane zone on direct immunofluorescence. This case illustrates an uncommon autoimmune blistering disorder presenting in a young adult, potentially triggered by viral infection and ibuprofen exposure, achieving sustained remission with rituximab.

Background: Psoriasis is a chronic immune-mediated disease associated with multiple systemic comorbidities. Biologic therapies have transformed the management of moderate-to-severe psoriasis; however, their high cost remains a major barrier for uninsured and socioeconomically disadvantaged individuals. The Psoriasis Biologics Center for Indigent Patients at Jackson Memorial Hospital provides a structured dermatology access model for underserved populations.

Methods: We conducted a descriptive retrospective cohort study of patients with moderate-to-severe psoriasis receiving biologic therapy through a dedicated safety-net access program between 2005 and 2025. Patient demographics, comorbidities, and management strategies were obtained from electronic medical records and standardized intake questionnaires. Only descriptive statistics were performed; standardized disease severity and quality-of-life measures such as the Psoriasis Area and Severity Index (PASI) or the Dermatology Life Quality Index (DLQI) were not available.

Results: A total of 450 patients (mean age 52.6 years; 54% female) were included. Nearly half (49.8%) presented with at least one systemic comorbidity. The most common were psoriatic arthritis (35.1%), hypertension (31.3%), diabetes mellitus (20%), cardiovascular disease (19.1%), obesity (13.8%), and dyslipidemia (12.2%). Psychiatric comorbidities included depression (9.6%) and anxiety (3.8%). Infectious conditions occurred at higher-than-expected frequencies, including hepatitis B/C (3.8%), latent tuberculosis (3.6%), and human immunodeficiency virus (HIV) (2.7%). Care delivery was organized within a structured safety-net model that incorporated standardized screening protocols, referral pathways, and multidisciplinary coordination to support biological access for uninsured patients.

Conclusions: This 20-year descriptive cohort characterizes comorbidity burden and biologic access within an indigent psoriasis population. This study does not assess clinical outcomes or treatment effectiveness. These findings describe a care delivery framework that may inform future health system and health equity-focused initiatives.

Background: Cutaneous melanoma remains a major public health issue with increasing incidence among fair-skinned populations. Beyond well-established risk factors such as ultraviolet exposure, there is evidence suggesting female sex hormone influence in melanoma biology and prognosis. Although several epidemiological studies have explored the relationship between exogenous hormones and melanoma risk, findings remain inconsistent. This study aims to investigate the association between exogenous hormonal use and Breslow thickness assessing differences across female life stages.

Methods: A retrospective study of 464 female patients with histologically confirmed primary superficial spreading melanoma (SSM) diagnosed from 2010 to 2021 in Andreas Sygros Hospital of Cutaneous and Venereal Diseases was conducted. Multiple linear regression models were performed to examine the association of hormonal use and thickness among females of different age groups (< 45, 45-59, and ≥ 60 years).

Results: Significant inverse associations between hormone use and Breslow thickness were found for women aged 45-59 years, with oral contraceptive (OC) use being associated with a 30% reduction in thickness (95% confidence interval [CI]: -47.9, -6.4) when considering all confounders. Exposure to any exogenous hormone was found to be positively associated (percent of change [PC]: 25.6, 95% CI: -7.2, 70.1) with tumor thickness among women above 60 years, indicating an effect modified by age. No significant associations were observed in females under 45 years.

Conclusions: These results indicate that the effect of exogenous hormone use on tumor thickness may be age-related, with an inverse association observed during the peri-menopausal period, and a positive relationship found among females above 60 years. Future research is needed to explore estrogen-mediated mechanisms influencing melanoma prognosis.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that significantly impairs quality of life, particularly in adolescents, a period marked by intense physical and psychosocial development. The burden of AD extends beyond dermatological symptoms, with growing evidence linking the condition to mental health disorders. As real-world data focused specifically on adolescent populations is scarce, this study aimed to evaluate the risk of psychiatric comorbidities among AD adolescents using a large electronic health records database.

Methods: A retrospective cohort study utilizing the TriNetX Analytics platform, including adolescents aged 10-18 years diagnosed with AD was conducted. Individuals with pre-existing psychiatric disorders were excluded. A matched control group was identified; propensity score matching (1:1) accounted for demographic, socioeconomic, and major systemic comorbidities. Incident psychiatric outcomes were captured using ICD-10 codes and analyzed with Cox proportional hazards models. Sensitivity and sex-stratified analyses were performed.

Results: After matching, 262,558 adolescents were included in each cohort. AD was associated with a significantly increased risk of any psychiatric disorder (17.3% vs. 6.2%; hazard ratio [HR] = 3.00, 95% confidence interval [CI]: 2.95-3.06). Anxiety (HR = 2.72), depression (HR = 2.66), sleep disorders (HR = 1.49), personality disorders (HR = 4.31), suicidality (HR = 1.62), and self-harm (HR = 1.47) were notably elevated. Findings remained consistent across sensitivity analyses. Female adolescents showed disproportionately higher risks of depression, anxiety, eating disorders, and self-harm.

Conclusions: Adolescents with AD exhibit a markedly elevated risk of diverse psychiatric disorders, with pronounced vulnerability among girls. These results highlight the importance of integrated dermatologic and psychological care to support mental health in this population.