Skin health and disease最新文献

Background: The most common forms of hair loss in men, alopecia areata (AA) (an autoimmune condition) and androgenetic alopecia (AGA) (pattern baldness), alter individuals' appearance in ways that may impact psychological and social wellbeing. We currently have a limited understanding about this impact of alopecia in men, their support needs, and preferences.

Objectives: We sought to investigate and explore the psychosocial impact of alopecia on men, alongside their experiences of treatment and support.

Methods: The study used a mixed methods cross-sectional online survey with 177 men aged 17-79: 83 with AGA and 94 with AA. Quantitative questions included purpose-made rating scales of men's support experiences, and standardised measures of wellbeing and appearance-focused anxiety. Qualitative data comprised participants' answers to an open-ended question asking about their subjectively salient experiences related to their alopecia.

Results: The combined findings indicate that while participants in both subsamples had sought minimal support for psychosocial concerns, such concerns were in fact commonplace. Over half of participants (56%-57%) shared qualitative accounts of depleted confidence, while wellbeing scores were on average lower than matched norms. Participants identifying as sexual minority also reported greater appearance-focused anxiety compared to those identifying as straight.

Conclusions: The apparent contrast between participants' minimal help-seeking and accounts of affected wellbeing suggests an unmet support need for men with alopecia. Masculine norms may impede men from accessing psychosocial support, both by discouraging help-seeking behaviours and by encouraging minimisation of appearance concerns. The findings also suggest sexual minority status may pose a greater risk of distress in affected men.

Background & objective: Numerous evidence has attributed diets with a high fatty acids (FAs) intake to be associated with atopic dermatitis (AD) development. Therefore, this study investigated the association between intake frequencies of five dietary FAs and AD exacerbations among young Chinese adults from Singapore and Malaysia.

Methods: A validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was investigator-administered to 13,561 subjects to collect information on socioeconomic, anthropometric, dietary and lifestyles habits, and personal/family medical histories. Six novel dietary indices were derived to analyse the associations between total FAs, trans fatty acids (TFAs), saturated fatty acids (SFAs), monounsaturated fatty acids, linoleic acids, and alpha-linolenic acids in diets and AD exacerbation. Synergy factor (SF) analysis was used to identify interactions between the dietary FAs to influence disease susceptibility.

Results: In our multivariable model adjusted for age, gender, BMI, parental eczema, and lifestyle factors, a diet high in total estimated FAs was strongly associated with AD (Adjusted Odds Ratio (AOR): 1.227; 95% Confidence Interval (CI): 1.054-1.429; adjusted p-value <0.01). Particularly, high estimated total TFAs and SFAs were significantly associated with AD exacerbations including chronic and current moderate-to-severe AD. The association between TFAs and AD remained strong even controlled for the total FAs in diets and false discovery rate corrected (AOR: 1.516; 95% CI: 1.094-2.097; adjusted p-value <0.05). Similarly, having a high SFAs in diets was associated with AD (AOR: 1.581; 95% CI: 1.106-2.256; adjusted p-value <0.05) independently on the total FAs in diets. FAs in diets do not interact to influence AD.

Conclusion: Overall, these results highlighted an association between high dietary TFAs and SFAs and AD exacerbations in an Asian population.

Background: Lichen sclerosus (LS) is a chronic, inflammatory skin disease with a predilection for the genitalia. Although, the association between squamous cell cancer and genital LS is well established, a link with genital melanoma has not been thoroughly explored. However, we have recently published a case series of penile melanoma where 9/11 (82%) of patients seen over a 10 year period with penile melanoma were retrospectively found to have histological and/or clinical evidence of genital LS on review.

Objectives: The aim of this study was to illuminate further the relationship between vulval melanoma and genital LS by reviewing all the cases managed by our hospital and undertaking a literature review.

Methods: We identified all the cases with a diagnosis of vulval melanoma over a 16-year period (2006-2022) where histology was available. The clinical notes were retrospectively reviewed, and the histological features of all cases were reassessed by two independent mutually 'blinded' histopathologists. We also performed a literature review of genital LS in patients with vulval melanoma.

Results: A total of 11 patients with vulval melanoma were identified for the review. Histopathological review found evidence of genital LS in seven of them (64%). Genital LS was not documented in any of the original histology reports. Clinical notes and letters were available in nine cases. The literature review identified 12 relevant studies with a total of 18 patients. Twelve cases concerned adult women, and six concerned female children.

Conclusion: The presence of genital LS in as high as 64% of our vulval melanoma cases might indicate a causative relationship between genital LS and vulval melanoma. The pathogenesis of vulval melanoma remains largely unknown. Although ultraviolet radiation is an important pathogenic factor for cutaneous melanoma, it cannot be a factor in vulval melanoma. While possible mechanisms behind this association remain unclear, it is possible that chronic inflammation from genital LS leads to melanocytic distress and increased mutagenesis.

We herein report an atypical case of shingles caused by varicella zoster virus after surgery. The virus, which goes along with the cutaneous nerve from the ganglia, was unable to spread across the previous surgical scar due to damage of the cutaneous nerves, but made a detour to the upper left direction from the scar.

Background: RASopathies, which include neurofibromatosis type 1 (NF1), are defined by Ras/mitogen-activated protein kinase (Ras/MAPK) pathway activation. They represent a group of clinically related disorders often characterised by multiple Café au Lait Macules (CALMs).

Objectives: To determine, using in depth transcriptomic analysis of NF1 melanocytes from CALM and unaffected skin, (1) the gene(s) responsible for melanocyte proliferation and migration, and (2) the activated signalling pathway(s) in NF1 melanoma.

Methods: Classical NF1 (n = 2, who develop tumours) and 3bp deletion NF1 (p. Met992del, who do not develop tumours) (n = 3) patients underwent skin biopsies from CALM and unaffected skin. Melanocytes were isolated and propagated, with five replicates from each tissue sample. DNA and RNA were extracted for mutational analysis and transcriptomic profiling with six replicates per sample. Mechanistic determination was undertaken using melanocyte and melanoma cell lines.

Results: All CALMs in NF1 were associated with biallelic NF1 loss, resulting in amplification of Ras/MAPK and Wnt pathway signalling. CALMs were also associated with reduced SERPINF1 gene expression (and pigment epithelium-derived factor (PEDF) levels, the reciprocal protein), a known downstream target of the master regulator of melanocyte differentiation microphthalmia-associated transcription factor (MITF), leading to increased melanocyte proliferation, migration and invasion. In classical NF1 and melanoma, but not 3bp deletion NF1, there was also activation of the PI3K/AKT pathway. Pigment epithelium-derived factor was found to reduce cell proliferation and invasion of NF1 melanoma.

Conclusions: Melanocyte proliferation and migration leading to CALMs in NF1 arises from biallelic NF1 loss, resulting in RAS/MAPK pathway activation, and reduced expression of the tumour suppressor PEDF. Activation of the PI3K/AKT pathway in classical NF1 and NF1 melanoma may facilitate tumour growth.

Glomus tumour is a rare benign neoplasm originating from the glomus body, clinically presenting as a violet-coloured, painful nodule more sensitive when exposed to cold or hot. This hamartoma is typically solitary and predominantly affects the limbs, extremities and nail beds. The appearance of multiple tumours and lesions not placed in the extremities is rare and frequently misdiagnosed. At dermoscopy, it appears as a homogeneous, structureless, purplish area surrounded by a whitish region. Skin ultrasound shows a well-defined, round, hypoechoic mass. We report a case of numerous blue-purplish painful nodules distributed in the trunk and arms while sparing the extremities, with typical dermoscopy and ultrasound findings. A biopsy was performed, confirming the diagnosis of glomangioma. We call attention to this rare condition to help dermatologists make this diagnosis when facing multiple painful nodules.