Skin health and disease最新文献

Introduction: Hip dips, often referred to as the pronounced trochanteric depression, can be caused by athletic muscular definition or the ageing process. This depression might impact the desirable contour of the buttocks in some female patients.

Patients and methods: A technique is described for female patients exhibiting moderate to severe degrees of lateral trochanteric depression. This technique utilizes a specific marking, a well-thought-out plan and a designated product. Eleven patients were selected to use this technique to improve their trochanteric depression and enhance their buttocks contour without undergoing surgery. The product used was Sofiderm Subskin, which was applied at the intermediate subcutaneous layer.

Results: The authors report favourable aesthetic results with the proposed technique, and the patients expressed high satisfaction levels.

Discussion: Though safe for injection, the lateral gluteal depression can still be challenging to expand. The product chosen has both a high G prime and a large molecular size, contributing to its resistance to deformation.

Conclusion: The hip dips technique using hyaluronic acid for the augmentation of lateral depression has shown to be minimally invasive; it provides quick results without significant risks or downtime.

A 33-year-old female presented with coryzal symptoms, facial swelling, severe haemorrhagic stomatitis, blistering oral mucositis, conjunctival injection and a sparse targetoid rash on the back and face, requiring admission to hospital. She had received the seasonal influenza vaccination 3 days prior to feeling unwell. Differential diagnosis included erythema multiforme major (EMM) secondary to the influenza vaccine or Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Oropharyngeal swabs were negative on PCR for cutaneous viruses and Mycoplasma pneumoniae (MP). A skin biopsy from a targetoid lesion on the body showed full thickness epidermal necrosis with epidermal-dermal clefting, numerous civatte bodies and a moderate perivascular infiltrate of lymphocytes and plasma cells in the papillary dermis. She was successfully treated with oral prednisolone and azithromycin. Following discharge from hospital, the paired serological testing for MP returned positive, confirming a diagnosis of MIRM. Our case highlights the difficulties in detecting MP as two diagnostic methods yielded different results, and so we advocate performing both MP PCR and serology to maximise the yield and speed of diagnosis. Secondly, our case highlights the clinical challenge in differentiating MIRM from EMM or Stevens-Johnson syndrome, particularly if there is a potential drug trigger (in our case the influenza vaccine), as all these conditions can feature a severe mucositis with often indistinguishable histological findings. Correct diagnosis of MIRM is important for appropriate and timely administration of anti-MP antibiotic therapy to facilitate recovery and minimise complications.

There is a need to understand the journey of patients with melanoma, including any associated gender differences, to identify aspects in the patient journey that could be improved. We used data collected from an online survey completed by adults with stage III or IV melanoma at three Swiss melanoma centres to understand patients' perceptions of their healthcare journeys from melanoma diagnosis to treatment and the relevance of treatment attributes (Figure 1). We identified that there is a need to improve communication about the testing process and gender differences in terms on information needs, relevance of treatment attributes and attitudes towards psychological support.

Background: Filaggrin-2 (FLG2) and hornerin (HRNR) are members of the S100 fused-type protein family, which share many properties with filaggrin (FLG). A previous study demonstrated that the expression of FLG2 was significantly decreased in psoriatic skin relative to that in normal skin. In contrast, the HRNR expression in psoriatic skin varied among studies.

Objectives: We aimed to investigate the effect of tumour necrosis factor-α (TNF-α), IL-17A and IL-22 on the expression of FLG2 and HRNR using a three-dimensional psoriatic skin model.

Methods: In the present study, we generated a 3D psoriatic skin model that was stimulated with TNF-α, IL-17A and IL-22 for 3D skin equivalents. Using this model, we examined the altered expression of FLG2 and HRNR by quantitative reverse transcription polymerase chain reaction and immunostaining.

Results: In the 3D psoriatic skin model, the expression of FLG2 and HRNR was significantly reduced compared with that in the 3D control skin. FLG2 expression was significantly decreased by stimulation with TNF-α, IL-17A and IL-22. In contrast, the expression of HRNR was markedly increased by stimulation with IL-22, although it was slightly decreased by TNF-α or IL-17A compared to the 3D control skin.

Conclusion: TNF-α, IL-17A and IL-22 have different effects on FLG2 and HRNR expression and epidermal structure formation. Furthermore, FLG2 and HRNR may play different roles in barrier formation and the pathogenesis of psoriasis.

Background: Male genital lichen sclerosus (MGLSc) is a chronic and acquired inflammatory dermatosis associated with substantial sexual dysfunction and urological morbidity and mortality. The age incidence of MGLSc is held to be biphasic, with a peak in infancy and another in adulthood. A recent review has implied two peaks in adulthood (making it triphasic overall); this triphasicity has been our emergent clinical impression from a voluminous practice. Furthermore, a link between MGLSc and smoking has been suggested, but this has not been our clinical impression.

Objectives: The primary objective was to clarify the age-specific incidence of adult men with GLSc; the secondary objective was to explore the relationship between MGLSc and smoking.

Methods: We retrospectively reviewed the medical notes of 487 adult MGLSc patients from a large specialist male genital dermatology clinic. We abstracted data about the age of diagnosis and smoking history.

Results: A biphasic U-shaped age distribution was identified with two clear peaks at the end of the third decade and another in the sixth decade of life (Hartigan's dip-stat = 0.03; p < 0.01). Thirty-six percent of the patients had been smokers at some point in their lives.

Conclusions: These findings confirm that MGLSc is biphasic in its adult incidence, confirming an earlier supposition; including the previously well-acknowledged paediatric peak, it is thus triphasic. The smoking data are probably unremarkable compared with the available data for smoking habits from the United Kingdom. These findings indirectly support what is postulated about the likely pathogenesis of MGLSc, that is, urinary micro-incontinence, occlusion and epithelial susceptibility.

Background: Various studies have revealed that there is a disproportionately low representation of skin of colour (SOC) in medical school dermatologic curriculum and board study resources.

Methods: First-year and second-year medical students were emailed an 18-question survey regarding (1) identifying correct diagnoses of dermatologic conditions on either White skin or SOC and (2) their confidence in identifying dermatologic conditions on SOC.

Results: 15% of the images of dermatologic conditions included in the institutional preclinical curriculum show images of patients with SOC. Regarding overall scores for diagnosing dermatologic diseases, students performed similarly on both the White image survey (61.73%) and SOC image survey (66.20%) with no statistically significant differences between surveys (p = 0.14). Second-year medical students performed better than first-year medical students overall (p = 0.01) and on White skin image survey scores (p = 0.02) but not on people of colour image survey scores (p = 0.09). Students largely agreed that they were more comfortable identifying dermatologic diagnoses on White skin and that their school could benefit from increased SOC dermatological resources.

Conclusion: The overall low scores for the diagnosis of common skin conditions on both the White image and SOC image survey by first- and second-year students are not surprising given the results of a prior study and support the need for re-exposure to dermatology presentations in all skin types during the preclinical curriculum. The low scores support the need for changes in the pre-clinical dermatology curriculum to improve diagnostic ability. Second-year students performed better at diagnosing dermatologic conditions overall and on White skin compared to SOC at the end of their didactic years, possibly due to an underrepresentation of SOC images in institutional and outside educational resources. Attitudes towards school-specific dermatologic SOC education demonstrated a clear desire amongst students for more exposure to dermatologic conditions in various skin colours throughout the curriculum.

Deforming nodular lesions in an indigenous person from western Mexico compatible with leishmaniasis.

Several eczematous eruptions have been described during treatment with anti-IL17A and anti-IL17 receptor drugs. In our case, however, the patient had been treated for 2 years with an IL-17A inhibitor without ever developing eczematous reactions, which occurred, however, shortly after starting therapy with bimekizumab, an IL-17A, F and A/F inhibitor.

Background: Oral antibiotics are a mainstay of treatment for hidradenitis suppurativa (HS) primarily due to their anti-inflammatory and anti-microbial properties. Because antibiotics are frequently prescribed to treat HS, concerns exist regarding antibiotic stewardship. There is a paucity of literature comparing how antibiotic prescribing patterns for HS differ between dermatology and non-dermatology clinicians in the ambulatory setting.

Objective: This study aims to compare the antibiotic prescribing patterns of dermatology versus non-dermatology clinicians treating HS in the ambulatory setting.

Methods: We utilised the National Ambulatory Medical Care Survey (NAMCS) to identify visits for HS patients from 2005 to 2016. We performed multivariate logistic regression analysis to compare the likelihood of prescribing (1) antibiotics and (2) tetracyclines between dermatology and non-dermatology clinicians in the ambulatory setting.

Results: We identified a total of 2 424 125 (weighted) HS visits. Approximately 28.0% of visits were conducted by dermatology clinicians, while 72.0% were conducted by non-dermatology clinicians. Antibiotics were prescribed in 51.9% of visits. Tetracyclines were the most commonly prescribed antibiotics among visits with dermatology clinicians (33.4%), while penicillins/cephalosporins were the most commonly prescribed antibiotic among visits with non-dermatology clinicians (14.9%). Multivariate logistic regression analysis demonstrated no difference in the overall likelihood of prescribing antibiotic therapy between dermatology and non-dermatology clinicians (p = 0.35). However, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians (OR 5.48, 95% CI 1.19-25.26, p = 0.03).

Conclusion: In conclusion, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians for HS patient visits.