Journal of Cutaneous Medicine and Surgery最新文献

Background: Hidradenitis suppurativa (HS) is a physically debilitating skin disease characterized by nodules and abscesses in intertriginous areas. There is a profound psychosocial element to HS, as it contributes to higher mental comorbidities, lower self-esteem, and diminished quality of life. TikTok represents an active space for HS patients to share their experiences.

Objectives: This study aims to perform a reflexive thematic analysis of HS-related videos on TikTok to explore the themes within videos shared by content creators.

Methods: This study utilized Braun & Clarke's protocol for reflexive thematic analyses. The first 108 consecutive videos identified by searching #HidradenitisSuppurativa on TikTok were included in the pool. Included videos were posted from 2020 to 2025, in English, and conceptually related to HS.

Results: Ninety-three of the original 108 videos were retained, with a total of 109.3 million views. 69.9% of the included videos were generated by lived experience creators, followed by medical professionals (17.2%). The majority of content creators were female (67.7%), and 23.7% of videos were sponsored product endorsements. Ultimately, 6 themes emerged: Promoting Products (29%), Educational Empowerment (27%), HS as Lived Reality (23%), Advocacy Through Visibility (13%), Medical Mistrust (3%), and Internalized Stigma & Self-Blame (3%).

Conclusion: This analysis underscores the importance of addressing facets of HS, which may be routinely overlooked in clinical evaluations, including the role of alternative therapies and patient education. Clinicians should recognize TikTok as a platform for self-expression among patients with HS and use this awareness to support the psychosocial needs revealed in this study.

Livedoid vasculopathy (LV) is a chronic microvascular thrombosis disorder with poorly understood pathogenesis, potentially involving hypercoagulability and inflammation. The aim of this study included analyzing the association between these indices and disease severity, as well as evaluating the real-world efficacy of rivaroxaban, to determine optimal personalized treatment strategies for LV. This retrospective analysis was conducted on 41 patients with LV and 19 healthy controls. Patients were treated with 10 mg daily rivaroxaban and assessed using the Livedoid Vasculopathy Activity/Severity Score and the Numerical Rating Scale. Thirty-two females (78.0%) were included, with a mean age of 26.1 years. The platelet count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR) and plateletcrit levels were significantly increased in patients with LV compared with those in healthy controls. Platelet count, plateletcrit and PLR positively showed a positive correlation with clinical severity scores, which can serve as simple and cost-effective measures for assessing disease severity. Rivaroxaban at 10 mg daily resulted in disease control in 78.0% of patients within 3 weeks. Patients with inadequate responses exhibited higher severity scores and required dose adjustments or combination therapy. Adverse effects were generally mild, comprising 6 instances of menorrhagia, 2 cases of bleeding hematochezia and 1 allergic reaction.

Background: Psoriasis is a systemic inflammatory disease associated with cardiopulmonary comorbidities. Nail psoriasis, quantified by the Nail Psoriasis Severity Index (NAPSI), is a marker of severe disease. While pulmonary arterial hypertension (PAH) is reported more frequently in psoriasis, the specific correlation between nail psoriasis severity and PAH remains underexplored.

Objective: To investigate the correlation between NAPSI scores and the presence or severity of PAH in patients with psoriasis.

Methods: A prospective, cross-sectional study was conducted at a tertiary care centre involving 100 patients with chronic plaque psoriasis (50 with and 50 without nail psoriasis). All participants underwent dermatological evaluation [Psoriasis Area and Severity Index (PASI) and NAPSI scoring], transthoracic echocardiography to estimate pulmonary artery systolic pressure (PASP), and measurement of inflammatory markers [C-reactive protein (CRP), IL-17, TNF-α]. PAH was defined as PASP > 35 mmHg. Statistical analyses included correlation tests, comparative analyses, and multivariate logistic regression.

Results: PAH was identified in 29% (n = 29) of patients, with a significantly higher prevalence in the nail psoriasis group (40% vs 18%, P = .01). Patients with PAH had higher mean NAPSI scores than those without (29.5 ± 13.4 vs 18.2 ± 10.6, P = .001). A moderate positive correlation was found between NAPSI scores and PASP (r = 0.44, P < .001). PASI scores and CRP levels were also significantly elevated in patients with PAH and correlated with PASP (r = 0.38, P = .001 and r = 0.41, P < .001, respectively).Multivariate analysis confirmed NAPSI score as an independent predictor of PAH [odds ratio (OR): 1.07/unit increase, 95% CI: 1.03-1.11, P = .002], after adjusting for confounders including PASI score and comorbidities. PASI (OR: 1.05, P = .01) and CRP (OR: 1.13, P = .008) were also independent predictors. Nail matrix involvement was more strongly associated with PAH than nail bed involvement (P = .03). Inflammatory markers (CRP, IL-17, TNF-α) were significantly elevated in patients with PAH.

Conclusion: NAPSI scores, PASI scores, and CRP levels are all significantly correlated with and independently predict PAH in patients with psoriasis. Assessment of nail psoriasis severity may serve as a valuable, noninvasive clinical tool to identify psoriasis patients at increased risk of pulmonary vascular complications, warranting further cardiological evaluation.