Archives of Dermatological Research最新文献

Telogen effluvium (TE), a form of non-scarring hair loss, has been increasingly reported following COVID-19 infection. This study sought to investigate the relationship between COVID-19 severity and TE development. We performed a single-institution retrospective analysis of health records from patients who were diagnosed with COVID-19 between January 2020–June 2022 with ≥ 1 dermatology visit within 180 days post-infection. Treatment setting was used as a proxy for COVID-19 infection severity (outpatient vs. emergency/inpatient). The association between severity and TE development was evaluated with multivariate logistic regression. Time-to-TE diagnosis was also compared using Kaplan–Meier analysis. Among 10,861 patients, 168 were diagnosed with TE. Patients who received emergency/inpatient care for COVID-19 were more likely to develop TE compared to those managed as outpatients (3.0% vs. 1.4%, p < 0.001) and exhibited higher odds of TE on multivariate analysis (aOR: 2.56; 95% CI: 1.72–3.72, p < 0.001). TE is a potential sequela of COVID-19 infection, particularly among patients who initially present with more severe COVID-19 infection. Clinicians should monitor and counsel patients on TE following COVID-19 infection, particularly those who were hospitalized for COVID-19.

Melanoma incidence is rising, underscoring the importance of early detection to enhance patient survival status. However, notable disparities influenced by socioeconomic status (SES) and race continue to affect diagnosis timing and treatment outcomes. This study analyzed data from 55,644 melanoma cases from the Surveillance, Epidemiology, and End Results (SEER) database spanning 2004 to 2020. Statistical methods included Kaplan-Meier survival analyses, t-tests, Chi-Squared tests, and ANOVA, with significance defined at p < 0.05. Results showed significant associations between SES and age at melanoma diagnosis, as well as survival outcomes. Hispanic Whites and Asian/Pacific Islanders were generally diagnosed at younger ages compared to Non-Hispanic Whites, while no significant age differences were observed among Black and American Indian/Alaskan Native populations. Higher income was strongly linked to earlier diagnosis and improved survival, particularly among females earning over $50,000 annually. Patients who underwent lymph node evaluations demonstrated better survival outcomes, although these associations may reflect underlying differences in disease characteristics or access to care rather than a direct effect of the procedure. Biopsy rates did not vary significantly across income groups; however, White patients were notably more likely to receive indicated lymph node biopsies than patients from other racial groups. Study limitations included smaller subgroup sizes, restricting detailed analyses of income ranges outside the $35,000-$75,000 bracket. Additionally, the use of combined staging categories might obscure nuanced disease progression distinctions. In conclusion, lymph node evaluations were associated with improved survival in several groups, though causality cannot be determined from these data. A range of factors related to access, diagnosis timing, and treatment pathways may contribute to observed disparities. Yet, disparities in lymph node biopsy performance linked to socioeconomic and racial factors persist. Addressing these disparities through targeted educational programs and policy initiatives aimed at healthcare providers and patients of lower SES is critical. Increasing awareness and promoting equitable healthcare practices can substantially reduce these disparities and improve melanoma outcomes across diverse patient populations.

Dermatomyositis (DM) is a chronic inflammatory disorder that affects both the skin and muscles. While it primarily affects adults, with a higher prevalence in females, it can also occur in children. DM is characterized by the presence of circulating autoantibodies which are divided mainly into two subgroups: myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs). Furthermore, DM has been strongly associated with a high risk of malignancy, with the majority of cancers occurring in the first year following the diagnosis of the disease. Notably, certain MSAs are associated with this increased cancer risk. Specifically, anti-transcription intermediary factor 1 (TIF1-γ) autoantibodies have been strongly linked with cancer-associated DM. Due to this strong association, the detection of these autoantibodies is valuable for stratifying the risk of underlying cancer. However, a considerable portion of anti-TIF1-γ–positive DM patients develop malignancy outside of the timeframe used to define cancer-associated DM, or even never go on to develop cancer. Here we summarize the role of TIF1-γ in tumorigenesis, examine the pathogenic mechanisms and clinical implications of anti-TIF1-γ-positive cancer-associated DM and provide the latest developments in identifying predictive biomarkers for cancer development in this subgroup of patients.

The exact etiopathogenesis of rosacea remains unclear, although various factors have been implicated, including oxidative stress. Dietary total antioxidant capacity (DTAC) reflects the cumulative antioxidant potential of consumed foods and may influence systemic oxidative stress. The aim of this study is to investigate dietary antioxidant capacity and systemic oxidative stress parameters in patients with rosacea. This prospective, single-center, case-control study included 51 rosacea patients and 46 healthy controls. DTAC values were significantly lower in the rosacea group than in the controls (6.95 ± 1.98 versus 11.55 ± 4.77; p < 0.001). Serum levels of total antioxidant capacity (TAC) were significantly lower in the rosacea patients than in the controls (p < 0.001), while serum total oxidant capacity (TOC) and oxidative stress index (OSI) values were significantly higher in the rosacea patients (p < 0.001, for both). Serum TOC and OSI levels were significantly higher in papulopustular rosacea patients than in erythematotelangiectatic rosacea patients (p = 0.001, p = 0.011, respectively). The small sample size, the cross-sectional design, and the relatively short dietary recall period represent limitations of the study. A diet rich in antioxidants may be beneficial in the treatment of rosacea by decreasing oxidative stress.

Autoimmune Blistering Diseases are characterized by autoantibody binding to skin components, causing blisters and erosions. Common subtypes include pemphigus vulgaris (PV), pemphigus foliaceus (PF), and bullous pemphigoid. Rituximab is the first-line treatment, particularly for pemphigus, but has rarely been linked to paradoxical exacerbations. We aim to investigate the characteristics of patients with pemphigus who experienced exacerbations following rituximab treatment. A systematic search was conducted using PubMed/Medline, Scopus, Web of Science, and Embase. Patients with unexplained disease exacerbations after rituximab treatment were included, while those with exacerbations due to treatment withdrawal and rapid steroid tapering were excluded. A total of 63 patients from 12 studies were analyzed, including 62 with PV and one with PF. Post-rituximab exacerbations are described as increased severity scores or the need for higher steroid doses. Across 76 rituximab cycles, 68 exacerbation episodes were reported, typically occurring within 5–15 days post-infusion. Management strategies included escalating prednisolone, intravenous immunoglobulin, and immunosuppressants. Among 25 patients with documented outcomes, 15 achieved complete remission, seven had partial remission, and one had persistent disease. Two patients died from sepsis. Post-rituximab exacerbations pose a significant challenge in pemphigus management, potentially driven by immune dysregulation and genetic factors. Identifying risk factors through further research and ensuring long-term follow-up is crucial for optimizing treatment outcomes.

Background

Acanthosis nigricans (AN) is a cutaneous disorder characterized by brown to black, poorly circumscribed, velvety hyperpigmentation that is sometimes associated with hyperkeratotic plaques. Treatment options for AN have not been well studied; however, smaller powered clinical trials and case reports exist in the literature.

Objective

to compare clinical efficacy, tolerability and safety of intralesional vitamin D3 cholecalciferol solution versus GA 70% peeling in the treatment of obesity associated AN of the neck.

Patients and methods

This prospective randomized comparative study was carried on 20 patients with AN. All patients had split-neck therapy, with one side receiving 70% glycolic acid peeling and the other side receiving intralesional vitamin D3 injections over the course of six sessions every two weeks. Follow up for three months after the final session was done. Acanthosis nigricans area and severity index (ANASI) score before, after treatment and after follow up was used for objective evaluation beside the dermoscopic evaluation.

Results

There was a statistically significant reduction of ANASI score in both vitamin D3 injection and glycolic acid 70% peeling sides after treatment and after the follow up compared with ANASI score before treatment with p-value = 0.000 in each. A statistically significant superior reduction of ANASI score in the glycolic 70% peeling side after treatment (p-value = 0.039) and after the follow up (p-value = 0.042) compared with vitamin D3 injection side. Also, a statistically significant improvement of dermoscopic signs with both vitamin D3 injection and glycolic acid 70% peeling after treatment with a p-value = 0.000 in each. No statistically significant difference was found between vitamin D3 injection side and glycolic acid 70% peeling side after treatment regarding dermoscopic signs. The vitamin D3 injection side had a slightly higher incidence of side effects, including hyperpigmentation (5%), erythema (10%), and injection site pain (15%). The GA side only reported erythema (15%) as a side effect.

Conclusion

Both Intralesional vitamin D3 and glycolic acid 70% peeling are effective, tolerable and safe for acanthosis nigricans treatment. GA peeling shows higher clinical efficacy irrespective of age, duration, BMI and severity.