Archives of Dermatological Research最新文献

While psychological factors such as stress have been reported to aggravate the course of seborrheic dermatitis (SD), there is limited evidence about its underlying pathogenesis. We sought to identify the pathophysiological role of stress and sleep quality in SD. In this case-control study, we collected data on quality of life, stress, and sleep quality from 80 scalp SD patients and 13 controls using clinical records and questionnaires. An Internet-of-Things (IoT)-based wearable health monitoring device was worn by 14 patients and 12 controls to monitor sleep cycle. Scalp tissue samples from 15 patients and 10 normal biospecimens were analyzed for expression of mediators related to skin stress response and pruritus using immunofluorescence staining. The patient group had significantly worse quality of life, higher stress levels and poorer sleep quality compared with controls. No statistically significant difference was found in sleep metrics between the two groups. Immunofluorescence staining showed higher dermal infiltration of nerve growth factor (NGF) (+) cells, mast cells, and substance P (SP) (+) cells in the patient group. The number of NGF (+) cells and SP (+) cells correlated with stress level. Dermal interleukin (IL)-31 (+) cells were increased in the patient group which, together with SP (+) cells, showed a positive trend with pruritus severity. In conclusion, SD patients had higher psychological burden than healthy controls. Stress-triggered neurogenic inflammation and pruritus, involving NGF, SP, mast cells, and IL-31, may contribute to the pathogenesis of SD. These factors could be useful therapeutic targets.

Patients with psoriasis often pursue complementary approaches, including dietary and lifestyle modifications, alongside medical treatments to alleviate their symptoms. The anti-inflammatory features of the Mediterranean Diet (MD) show promise in psoriasis management.

A cross-sectional study was conducted with 205 psoriasis patients. A questionnaire was developed to assess dietary behaviors, lifestyle habits, and perceptions of patients. Adherence to MD was evaluated using the Mediterranean Diet Adherence Scale (MEDAS).

A total of 71% of patients reported avoiding specific foods after diagnosis, most commonly spicy foods, nightshades, acidic beverages, salt or pickles, white flour, sweets, and fried foods. Among them, 52.4% reported symptom relief; however, no statistically significant impact on treatment response was observed. Patients with moderate-to-severe psoriasis at baseline were more likely to use supplements (p = 0.015), primarily fish oil, vitamin D, and probiotics or yogurt. The Low-Calorie Diet (LCD) was the most commonly followed special diet (53.9%), while MD was associated with the highest perceived benefit (66.7%). Reported lifestyle changes after diagnosis included smoking cessation (13.6%), quitting alcohol consumption (10.2%), and starting regular exercise (28.8%). No statistically significant difference in disease severity or treatment response based on adherence to the MD.

This study examines dietary and lifestyle behaviors in psoriasis patients after diagnosis. Incorporating lifestyle assessments into routine care may contribute to more comprehensive psoriasis management. Further prospective controlled studies are needed to establish evidence-based guidelines.

Solar lentigo is a common benign pigmented skin lesion from chronic sun exposure, particularly in aging populations. Various treatment modalities, including chemical peels, cryotherapy, and laser therapy, have improved its appearance. Trichloroacetic acid (TCA) is widely used for its exfoliative and pigment-reducing effects, but its efficacy and safety compared to other treatment options remain unclear. This systematic review and meta-analysis aim to evaluate the efficacy and safety of TCA in treating solar lentigo. While some included studies compare TCA with alternative treatment modalities, others focus solely on TCA outcomes. A systematic review was conducted following PRISMA guidelines. Studies assessing the use of TCA for solar lentigo treatment were identified from multiple databases. Data on study design, patient demographics, intervention characteristics—including TCA strength, number of treatments, and downtime between sessions—and treatment outcomes were extracted. A meta-analysis was performed to estimate the pooled prevalence of clinical improvement, complete lesion clearance, and adverse events associated with TCA treatment. Heterogeneity among studies was assessed using the I² statistic. A total of 13 studies were included, comprising various study designs with follow-up durations ranging from 4 to 26 weeks. The pooled prevalence of clinical improvement with TCA treatment was 80.8% (95% CI: 73.1–88.4, p < 0.001), indicating a high effectiveness rate. However, the prevalence of complete lesion clearance was 24.8% (95% CI: -5.4–55.0, p = 0.107), suggesting that while TCA significantly improves lesion appearance, total clearance is less frequent. The prevalence of adverse effects, including erythema and post-inflammatory hyperpigmentation, was 17.9% (95% CI: 4.1–31.6, p = 0.011). Efficacy and side effects appeared influenced by the TCA concentration, number of applications, and treatment intervals. TCA is an effective treatment option for solar lentigo, demonstrating a high rate of clinical improvement. However, complete lesion clearance remains limited, and adverse effects are notable, particularly in patients with darker skin tones. The variability in treatment outcomes observed across studies may be attributed to differences in treatment protocols, including TCA strength, number of treatments, skin phototypes, lesion locations, and practitioner experience. Standardized treatment protocols and further randomized controlled trials are needed to optimize efficacy while minimizing risks. Combination therapies may enhance outcomes and warrant further investigation.

Compensation models for cosmetic procedures in academic dermatology vary widely across institutions, reflecting differences in pricing strategies, revenue distribution, and physician incentives. To better understand current practices, the Association of Academic Cosmetic Dermatology (AACD) conducted a survey of AACD members, who were academic dermatology faculty responsible for resident education and patient care in cosmetic dermatology. A total of 52 dermatologists from 24 US states responded. Most respondents (88.5%) practiced exclusively in an academic setting. Pricing for cosmetic procedures was commonly benchmarked against local competitors (82.7%), with less frequent use of institutional financial teams (50%) or regional cost-of-living data (25%). Of respondents with facility fees, more than half reported that the degree of direct and indirect support provided was at least partially determined by institutional financial or administrative teams. Compensation models also varied: 65.4% of respondents reported hybrid salary and productivity-based models, while 17.3% each received either fixed salary or productivity-only compensation. Among productivity-based systems, 46.5% used work Relative Value Units (wRVUs), 41.9% used percent collections, and 9.3% used both. Respondent comments highlighted shared challenges, including limited pricing flexibility due to electronic medical record constraints, unclear or evolving funds flow systems, and barriers to implementing pricing changes. Many respondents emphasized the importance of exceeding revenue thresholds to trigger productivity bonuses and noted that facility fees often dilute direct compensation to physicians. Despite institutional variation, several participants reported satisfaction with their compensation structures. These results may assist faculty in negotiating more transparent, equitable, and sustainable compensation models in academic cosmetic dermatology.

Androgenetic alopecia (AGA) stems from the reaction of hair follicles to circulating testosterone and its derivatives, resulting in progressive hair loss. It is the most common cause of hair loss in both men and women. Human amniotic mesenchymal stem cells (hAMSCs) have multilineage differentiation, immunosuppressive, and anti-inflammatory potential which makes them suitable for treating AGA. This study aimed to explore the effect and mechanism of hAMSCs conditional medium (hAMSC-CM) and lysate (hAMSC-Lys) on AGA. hAMSCs were isolated from the amniotic membrane and characterized by flow cytometry, immunofluorescence, and adipogenic and osteogenic differentiation. We assessed the effects of hAMSC-Lys and hAMSC-CM on the normal hair growth cycle and AGA mice, respectively. We then explored its underlying mechanisms by assessing angiogenesis, proliferation of dermal papilla cells (DPCs), and inflammation levels in the skin tissues of normal mice and AGA mice treated with water, minoxidil, hAMSC-CM, or hAMSC-Lys. Antibody array assay and mass spectrometry were respectively used to identify the cytokines in hAMSC-CM and the proteins in hAMSC-Lys that may promote hair regeneration in AGA mice. hAMSCs expressed various markers of embryonic stem cells and MSCs and have the potential to differentiate into adipocytes and osteocytes. hAMSC-CM and hAMSC-Lys microneedle treatment significantly promoted the hair growth cycle of normal mice and hair regeneration in AGA mice. Furthermore, we demonstrated that hAMSC-CM and hAMSC-Lys promoted hair regeneration in AGA mice through enhancing angiogenesis, proliferation of DPCs, and suppressing inflammation. Antibody array assay and mass spectrometry showed that hAMSC-CM and hAMSC-Lys contain a panel of cytokines or proteins that can promote hair regeneration in AGA mice. Our results demonstrated that hAMSC-CM and hAMSC-Lys significantly prevented hair regression induced by androgen stimulation by promoting angiogenesis, increasing the proliferation of DPCs, and suppressing inflammation, suggesting that hAMSC-CM and hAMSC-Lys may provide an alternative therapeutic approach for the treatment of AGA.

Bullous pemphigoid (BP) is a subepidermal autoimmune blistering disease characterized by erythema, tense blisters, pruritus, and pain. The pathogenesis of BP involves antibodies targeting structural proteins at the dermal-epidermal junction. Prior studies have identified IL-17 as a potential therapeutic target in BP. We hypothesize IL-17 blockade with ixekizumab, an IL-17 A inhibitor, may have a targeted, disease-modifying effect on BP. We conducted a single-center, exploratory, open-label, single-arm pilot study using ixekizumab treatment for 12 weeks. Treatment response was assessed by new blister formation, Bullous Pemphigoid Disease Area Index (BPDAI), and use of prednisone rescue. A total of 4 patients were recruited, with 3 withdrawing during the treatment phase with worsening disease. All 3 withdrawn patients required oral prednisone rescue therapy. One patient completed the study with a 60% improvement in blister/erosion BPDAI on ixekizumab and rescue oral prednisone. RNA levels in baseline disease tissue and control samples were analyzed using a NanoString^® panel of 249 inflammatory genes. Cytokine analysis was performed on serum and blister fluid for interleukin (IL)-1b, -2, -4, -5, -6, -12p70, -17a, -18, -21, -22. Array-based ELISAs were used for transforming growth factor beta (TGF-β) and matrix-metalloprotease-2 (MMP-2), MMP-9, and MMP-13 expression. There were 24 statistically significant differentially expressed genes (DEGs) identified. Type I and II IFNs as well as the Th2 chemokine CCL13 were upregulated in BP. Serum pre-treatment IL-17 A was elevated in 1 patient and was no longer detectable after week 12. Cytokine analysis demonstrated elevated serum IFN-γ, MMP-13, and Th2 cytokines in BP patients after receiving ixekizumab relative to pre-treatment levels, with a decrease in MMP-2. Our clinical data, RNA, and cytokine analysis suggest that IL-17 A inhibition with ixekizumab may not target the critical pathways in BP and support Type I and II IFN and the Th2 pathway as potential future therapeutic targets. Trial Registration: NCT03099538.

Patient anxiety and satisfaction are crucial factors in Mohs Micrographic Surgery (MMS). Anxiety often arises from concerns about the diagnosis, pain, complications, cosmetic outcomes, and operating room environment. Additionally, Mohs patients may also question physician competency and experience. Treatment specific factors including drapes and anesthesia are also associated with anxiety, which can negatively impact patient experience. Our scoping review aimed to assess the effectiveness of preoperative and perioperative interventions in reducing anxiety and improving patient experience during MMS. Our findings showed that video education improved patient experience but did not decrease anxiety. 3D models showed inconsistent results. Pharmacologic interventions, such as anxiolytics and acetaminophen, were somewhat effective in reducing anxiety but had no significant impact on pain. Acetaminophen + carbohydrate loading was effective in reducing anxiety. Non-pharmacologic strategies, including music therapy, weighted blankets, and virtual reality consistently reduced anxiety. Our study is limited by small sample sizes and studies lacking blinding. Evidence on interventions for reducing anxiety in MMS is limited, but several hold promise. Further research with larger sample sizes is needed to comprehensively evaluate these therapies along with evaluating a combination of therapies.

Skin injury refers to the disruption of skin integrity, resulting in the loss of normal tissue, which can occur due to wounds, diseases, or surgeries. The repair of skin injuries is a highly regulated process involving cell migration, proliferation, collagen matrix deposition, and tissue remodeling, all of which are intricately linked to inflammation and angiogenesis. Angiogenesis—the formation of new blood vessels—plays a pivotal role in this process by ensuring the delivery of oxygen and nutrients that are essential for healing. Key angiogenic factors, such as vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor, are crucial in regulating vascular formation. Recent advances have shed light on the complex interactions between angiogenesis and inflammatory responses, emphasizing their critical roles in wound healing, scar formation, and tissue remodeling. However, effectively regulating angiogenesis in clinical settings remains challenging due to the complexity of its underlying mechanisms. This review offers a comprehensive analysis of angiogenesis in skin injury repair, focusing on its regulatory mechanisms, functional roles during different stages of healing, and therapeutic strategies aimed at optimizing vascularization for enhanced clinical outcomes. By advancing our understanding of angiogenesis, we seek to contribute to the development of innovative treatments for skin injuries.