Skin health and disease最新文献

This report describes an unusual clinical case of extensive syringoma involvement spanning multiple anatomical regions, offering insights into diagnostic challenges and management strategies for this rare manifestation.

In 1806, French physician Baron Jean-Louis Alibert saw a man with a desquamating rash and skin tumours. Alibert considered this to be a variant of yaws. In 1829 Alibert named the condition mycosis fungoides (MF), meaning 'mushroom-like fungal disease'. Over 100 years later, French dermatologist Albert Sézary published papers from 1938 to 1949 detailing a mysterious disease containing 'cellules monstrueuses', describing cutaneous 'monster cells'. In 1961, these clinical findings were collated together into 'Sézary syndrome'. In the 1870s English dermatologist William Tilbury Fox published a dermatology atlas detailing cases similar to what we know now as MF, with the name 'fibroma fungoides'. The atlas described MF as a type of fungus, before giving a description of yaws and painting a clinical picture that differed from that of a lymphoma. Over the twentieth century, our understandings of the origins of MF were changing and by 1975 the classification system and term we now recognize as cutaneous T-cell lymphoma (CTCL) was developed. Neoplastic cells have been thought to arise from chronic activation of T cells via antigen-presenting cells due to inappropriate cytokines and C-C chemokine receptors. In 2018, the World Health Organization and European Organisation for Research and Treatment of Cancer officially recognized four variants of MF. These are the classic Alibert-Bazin variant and its three variants: folliculotropic MF, pagetoid reticulosis and granulomatous slack skin. Developments in immunohistochemistry for the T-cell receptor gene in the 1990s improved the diagnosis of CTCL; however, diagnosis is still challenging. Advanced MF therapies have evolved from cytotoxic chemotherapy to novel monoclonal antibodies such as mogamulizumab, targeting proteins on T-cell lymphoma cells.

Pemphigus vulgaris (PV) is a rare, potentially life-threatening autoimmune blistering disorder primarily affecting the skin and mucous membranes. We present a unique case of delayed diagnosis in a patient with PV, initially manifesting as isolated, extensive and therapy-resistant paronychia. PV was only considered after the appearance of mucocutaneous lesions - first oral, then cutaneous - more than 1 year after symptom onset. Diagnosis was ultimately established through histopathological examination, direct immunofluorescence and serological testing. Following diagnosis, the patient received rituximab therapy, resulting in a rapid and sustained clinical remission. This case underscores the importance of considering PV in the differential diagnosis of severe, chronic and treatment-resistant paronychia. Early recognition and diagnosis are crucial for timely intervention, which can significantly improve patient outcomes. Rituximab proved highly effective in this case, aligning with current evidence supporting its use as a first-line treatment for PV. We aim to raise awareness of atypical PV presentations and stress the need for thorough evaluation of persistent, treatment-resistant paronychia to prevent delayed diagnosis.

In an increasingly urbanized world, environmental pollution is recognized for its adverse effects on both systemic and skin health. While its role in conditions such as atopic dermatitis and psoriasis is well documented, its impact on acne vulgaris remains less clear. This review aims to evaluate existing literature examining the association between environmental pollutants - such as particulate matter (PM_2.5, PM₁₀), nitrogen oxides (NO₂, NO_x) and traffic-related emissions - and the development, severity or exacerbation of acne. A systematic search of peer-reviewed English-language studies published between 2010 and 2025 was conducted using PubMed. Search terms included 'air pollution', 'particulate matter', 'PM_2.5', 'PM₁₀', 'NO₂', 'NO_x', 'environmental pollution', 'traffic pollution', 'acne' and 'acne vulgaris'. Studies were included if they investigated the relationship between environmental pollutants and acne in human populations. Of the 27 studies identified, 17 met inclusion criteria. Systematic reviews were also incorporated to provide broader context. Several studies demonstrated significant associations between pollutant exposure and acne exacerbation. A time-series study in China involving 71 625 outpatient visits found that each 10 μg m^-3 increase in SO₂ and NO₂ correlated with 1.02% and 2.13% increases in acne-related visits, respectively. Other studies appear to show pollutants being associated with increased sebum production and reduction of antioxidants. Proposed mechanisms include oxidative stress, microbiome disruption and follicular hyperkeratinization. However, study heterogeneity, lack of diversity and limited control for confounders limit generalizability. Longitudinal research is needed to clarify pollution's role in acne and inform targeted prevention strategies.

Background: The Dermatology Life Quality Index (DLQI) is a widely used instrument to assess the health-related quality of life associated with skin conditions. Afan Oromo is spoken by 40% of Ethiopians. Objectives This study aimed to translate, culturally adapt and validate the DLQI in Afan Oromo.

Methods: This study was nested in a large hospital-based cohort study of cutaneous leishmaniasis (CL). Forward-backward translation followed by content validity, responsiveness to change, known group comparison, and convergent and discriminant validity were done. Internal consistency and inter-rater reliability were assessed using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively.

Results: The DLQI showed acceptable content validity with modified kappa between 0.8 and 1.0. One hundred individuals with confirmed active CL with a mean (SD) age of 36.81 (17.46) years, were interviewed using the translated draft of the Afan Oromo DLQI. The DLQI mean (SD) score was 11.93 (7.32). The instrument showed excellent internal consistency with a Cronbach alpha of 0.87 and inter-rater reliability ICC of 0.96. The median DLQI scores were significantly different between those with different physicians determined severity (P = 0.01) and lesion size (P = 0.004). There was high convergent validity (0.74-0.93). DLQI scores on day 90 were significantly lower than scores at enrolment prior to treatment (P = 0.0001).

Conclusions: This translation of the DLQI to Afan Oromo is a valid and reliable patient-reported outcome measure instrument for research or clinical practice.

Background: Artificial intelligence (AI) and telemedicine are rapidly changing the way dermatological care is delivered. As these tools are increasingly used in tandem, understanding how patients perceive the integration of AI across different care settings is important for responsible implementation.

Objectives: To assess patient perceptions of AI in dermatology across five care modalities and examine how demographic factors influence acceptance.

Methods: A cross-sectional survey was conducted among 130 adults at a US academic dermatology clinic between December 2024 and April 2025. Participants rated trust, comfort, perceived quality, privacy and confidence in equitable performance across three AI-involved modalities: standalone AI apps, AI-assisted in-person visits and AI-assisted telemedicine visits. Differences in perception outcomes across the three care modalities were analysed using repeated measures Anova. Logistic and linear regressions analysed predictors of acceptance, including age, race, skin tone, socioeconomic status, rurality and technology experience.

Results: Patients strongly preferred dermatologist-involved care over standalone AI, with 73.8% trusting dermatologist-guided AI and only 1.5% trusting AI apps alone. Comfort and perceptions of equal performance across skin tones were significantly higher for telemedicine and AI-assisted visits compared with AI apps (P < 0.001). Darker skin tone and Black race predicted lower acceptance of AI-assisted care (P = 0.01 and P = 0.003, respectively), while greater technology familiarity predicted higher acceptance (P = 0.05). Comfort varied by clinical scenario, with in-person visits showing dramatically higher odds of patient comfort compared with AI apps alone [odds ratio (OR) 232.8 for new concerns, OR 137.3 for serious concerns, OR 18.4 for sensitive concerns]. AI-assisted in-person visits also showed significantly higher odds of comfort over AI apps (OR 18.4 for serious concerns, OR 3.6 for ongoing concerns).

Conclusions: Patients strongly prefer AI as clinical support systems rather than autonomous decision-makers, especially for high-stakes and sensitive concerns. Differences in acceptance by race and skin tone point to the need for better representation in datasets and clearer communication about how these tools perform. Moving forward, development and implementation should emphasize clinician and patient involvement, fairness and patient choice to ensure AI is integrated into dermatology in a way that earns patient trust.

Photothermal conditioning of platelet-rich plasma (PRP) is an emerging innovation in regenerative medicine, particularly in the field of hair restoration. By using controlled electromagnetic energy, this technique modulates the biological activity of PRP, potentially enhancing the release of growth factor, production of exosomes and communication between cells. This review aims to explore the mechanisms behind photothermal PRP, summarize current preclinical and clinical findings, and evaluate its applications in hair regeneration. A comprehensive literature review was conducted across multiple databases to evaluate mechanistic data, clinical outcomes and technology platforms. Preliminary evidence suggests that photothermal conditioning enhances the bioactivity of PRP, leading to potential increases in hair density and follicular regeneration. Additionally, it may help reduce inflammation and prolong the anagen phase of the hair cycle. However, there is currently a lack of standard protocols, dosage regimens and clear understanding of the mechanisms involved. Despite these limitations, photothermal PRP shows promise as an adjunctive or alternative treatment for androgenic and inflammatory alopecia. Future clinical studies with standardized protocols and larger cohorts are necessary to confirm its efficacy, optimize treatment parameters and ensure long-term safety.

Psoriasis is a systemic autoimmune disease with roles in the innate and adaptive immune systems. Histological features include aberrant vascularization with dilated, tortuous, thin-walled capillaries and a mixed inflammatory infiltrate with mononuclear cells and neutrophils. There is increasing evidence that oxidative stress (hypoxia) plays an important role in vascular and inflammatory processes in the pathogenesis of psoriasis. In addition, it appears that systemic inflammation and oxidative stress could be a mechanistic link between psoriasis and concomitant cardiometabolic disorders. To present a unifying overview of the current literature on the general concept on the interrelationship between oxidative stress, vascular alternations and inflammation within the pathogenesis of psoriasis. More particularly, we aimed to gain insight into the pathomechanisms related to cardiovascular comorbidities - an important and distressing component of psoriatic disease. Standardized literature searches in PubMed and Embase were carried out with a focus on oxidative stress, inflammation and vascularization in psoriasis. In this article, the current knowledge on the role of oxidative stress in the inflammatory and vascular aspects of the pathogenesis of psoriasis are stated. Moreover, contemporary awareness of the pathomechanisms related to cardiovascular diseases are pointed out. The review presents arguments to underline the importance of hypoxia and oxidative stress in the inflammatory and vascular response within the pathogenesis of psoriasis and associated various cardiovascular and metabolic diseases.

Background: Microvascular changes and angiogenesis play a key role in psoriasis and atopic dermatitis (AD), affecting lesional and, in AD, also nonlesional skin. Studies on nonlesional psoriatic skin show conflicting results. Both diseases involve inflammation-driven vascular changes. Optical coherence tomography angiography (OCTA) is a noninvasive tool for assessing capillary morphology and disease progression.

Objectives: To examine microvascular alterations in psoriasis and AD using OCTA, assessing differences in lesional and nonlesional skin compared with healthy control skin; and to examine the potential of laser speckle contrast imaging (LSCI)-guided OCTA in monitoring skin in the same populations.

Methods: Ten patients with psoriasis, 10 patients with AD and 5 healthy control participants were recruited. OCTA was used to measure microvascular parameters, including capillary loop depth, superficial plexus depth, vessel diameter, vessel density, vessel length and fractal dimension. LSCI-guided OCTA identified areas with the highest degree of inflammation within lesional skin. Comparisons were made between lesional and nonlesional skin in patients with psoriasis and AD.

Results: Significant differences in microvascularity were found between lesional and nonlesional skin in patients with psoriasis and AD, as well as in comparison with healthy control participants. Differences in microvascular morphology were also identified in nonlesional skin of patients with psoriasis and healthy control participants, indicating systemic capillary changes. LSCI-guided OCTA did not enhance capillary detection.

Conclusions: Our results suggest that psoriasis may involve systemic microvascular changes beyond local inflammation. While OCTA is a promising noninvasive tool, further research is needed to elucidate its clinical value.

Papular mucinosis (PM), or lichen myxoedematosus, is a rare skin disorder characterized by mucin deposition in the dermis, resulting in papules and nodules. It can present as scleromyxoedema, often with systemic complications, or localized PM, which typically follows a benign course. Atypical cases may present with unique features. We present an atypical case of PM in a 23-year-old woman with concurrent Hashimoto thyroiditis and papillary thyroid carcinoma. The patient presented with numerous progressive papules on her chest and abdomen, alongside systemic symptoms, including fatigue and weight loss. Diagnosis was confirmed through skin biopsy revealing mucin deposition. Initial treatment with isotretinoin yielded minimal improvement. However, significant improvement was observed following ablative erbium:YAG laser therapy, resulting in a marked reduction of lesions with no recurrence. This case highlights the classification of PM and demonstrates the potential effectiveness of laser therapy as a treatment option for this challenging condition.