Archives of Dermatological Research最新文献

Melasma is a chronic hyperpigmentation disorder that affects sun-exposed skin, particularly the face, and is most common in adult women with darker skin phototypes (Fitzpatrick III-VI). It is notoriously difficult to treat and can adversely impact quality of life This study examined psychosocial associations of melasma in the National Institutes of Health’s All of Us Research Program. Participants (n = 746) with melasma who completed the “Overall Health” survey were matched with controls on age, sex, race, and income. Duration of melasma, sunlight intensity, treatment history, and pre-existing psychiatric conditions were accounted for in multivariable logistic regression analyses within melasma and between cases and controls. Self-reported Asian Americans with melasma had lower psychosocial health scores compared with both non-Hispanic White Americans with melasma (low mental health odds ratio 4.9 [95% confidence interval 1.9–13], p = 0.002; low ability to complete social roles 3.5 [1.4–9.2], p = 0.01; low social satisfaction 4.7 [2.0–11], p = 0.002) and Asian Americans without melasma (low mental health 4.0 [1.3–13], p = 0.04; low ability to complete social roles 3.5 [1.2–10], p = 0.04; low social satisfaction 3.1 [1.1–8.3], p = 0.04). This association may reflect beauty ideals in Asian American communities, where lighter skin is associated with privilege. Additionally, individuals with melasma and pre-existing anxiety reported poorer mental health than those with anxiety alone (1.4 [1.1–1.8], p = 0.04). Limitations include the retrospective design, reliance on diagnostic codes, and small sample size. These findings suggest that the psychosocial impact of melasma may be magnified in Asian Americans and people with anxiety disorders, identifying a potential need for individualized psychological support.

This study aimed to investigate the prevalence of Cognitive Disengagement Syndrome (CDS) symptoms in children diagnosed with atopic dermatitis (AD) and to examine their associations with attention-deficit/hyperactivity symptoms and emotional, behavioral, and social functioning. A cross-sectional design was used with 182 children aged 7–13 years: 88 with AD and 94 healthy controls matched for age and sociodemographic factors. Parent-reported measures included the Barkley Child Attention Scale (BCAS), the Turgay DSM-IV-Based Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), and the Strengths and Difficulties Questionnaire (SDQ). Children with AD showed significantly higher BCAS daydreaming and sluggishness scores than controls (p < 0.001), suggesting greater CDS symptom tendencies in this group. In attention scores were significantly higher in the AD group (p < 0.001), while hyperactivity/impulsivity scores did not differ (p = 0.777). SDQ inattention-hyperactivity (p = 0.022), emotional problems (p < 0.001), and total difficulties (p < 0.001) were also higher in the AD group. The proportion of children with CDS symptoms but without ADHD symptoms was greater in the AD group (p = 0.002). Children with AD exhibited higher levels of CDS symptoms accompanied by attentional, emotional, and behavioral difficulties. Recognizing these neuropsychological characteristics alongside dermatologic management may contribute to more comprehensive care. However, the cross-sectional design and reliance on parent-reported data should be considered when interpreting the findings.

Acne excoriée (AE) is a psychodermatological condition involving compulsive manipulation of acne lesions, often accompanied by psychiatric comorbidities. This study examined emotional dysregulation, impulsivity, and psychopathological features in adolescents with AE compared with peers who had acne vulgaris (AV) without excoriation. In this cross-sectional study, 123 adolescents with AE and 89 age- and sex-matched AV controls were assessed using the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS-PL-DSM-5) and a standardized battery including the Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale-Brief (BIS-Brief), Revised Child Anxiety and Depression Scale (RCADS; child and parent forms), Strengths and Difficulties Questionnaire (SDQ), Acne Quality of Life Scale (AQLS-11), and Clinical Global Impression (CGI). Acne severity was rated with the Global Acne Grading System (GAGS). Statistical analyses included independent t-tests with Benjamini–Hochberg FDR correction, effect sizes (Cohen’s d, 9% CI), and multivariable linear and logistic regression models. Adolescents with AE showed significantly greater emotion-regulation difficulties (DERS-Total: M = 76.5 ± 14.8 vs. 64.5 ± 8.6; d = 0.99, p < 0.001), higher psychopathology scores (RCADS-TAD, SDQ Total, CGI-S), and poorer acne-related quality of life (p < 0.001) than controls. Trait impulsivity measured by BIS-Brief did not differ significantly between groups (p = 0.27). In multivariable regression, AE status independently predicted higher DERS-Total scores after controlling for age, sex, acne severity (GAGS), depressive symptom severity (RCADS-MDD), and comorbid ADHD/MDD (β = − 0.50, p < 0.001). Logistic regression confirmed that DERS-Total and RCADS-Child scores significantly predicted AE status (AUC = 0.988, p < 0.001). Adolescents with AE experience marked emotional dysregulation and elevated psychiatric symptom burden, whereas global trait impulsivity is not elevated. Emotion-driven impulsivity under distress appears central to AE’s psychopathology. Routine psychiatric screening and emotion-regulation–focused interventions (e.g., HRT-skills, emotion-focused CBT, ACT) should be integrated into dermatologic care.

Minoxidil, originally developed as an oral antihypertensive, was later reformulated as a topical treatment for androgenetic alopecia due to its hair growth promoting side effect. While it has proven beneficial, its widespread use facilitated by over-the-counter availability and lack of strict regulation raises safety concerns. Despite being contraindicated in pregnant and breastfeeding women, reports indicate cases of infantile hypertrichosis linked to maternal exposure. Additionally, associations with ocular adverse effects among general population have brought its safety profile into question. This study aims to investigate global reports of infantile hypertrichosis related to maternal Minoxidil exposure and assess serious and non-serious eye disorder cases reported in India, with the goal of raising awareness about the risks of early-life or accidental exposure. A retrospective, post-market observational study was conducted using data collected from VigiBase^® until March 2025, using mapped terms under Medical Dictionary for Regulatory Activities (MedDRA). Among 2,664 global cases of minoxidil-suspected infantile hypertrichosis, 45 involved children aged 0–23 months: 22.2% due to maternal exposure, 44.4% accidental, and 33.3% unknown. No cases were reported from India. A total of 1,669 global cases among the general population involved eye disorders, with 25 from India. Common symptoms included eyelid oedema, blurred vision, and central serous chorioretinopathy (CSCR). Of 9 serious cases, 4 remained after de-duplication (3 CSCR, 1 retinal artery occlusion). Minoxidil, though effective for adult alopecia, poses risks of adverse events in children and potential eye disorders in others. Caregiver education and counselling are essential to prevent accidental exposure. Stricter regulations on dispensing and clearer usage guidelines are needed to curb misuse and misinformation.

Background

Given the relationship between vitamin A consumption and skeletal changes, there have been concerns about whether isotretinoin may be associated with decreased bone mineral density.

Objective

The objective of this study was to evaluate changes in bone mineral density among those treated with isotretinoin.

Methods

PubMed and Web of Science were searched for relevant studies. Two investigators independently screened abstracts and performed full-text review. Data were synthesized using random-effects models.

Results

Eight studies were identified, including 729 individuals. For studies including a comparison to a control cohort, there was a mean difference in bone mineral density of − 0.037 g/cm² (95% CI -0.074 to 0.000) at the spine, − 0.048 g/cm² (95% CI − 0.103 to 0.007) at the total hip, and − 0.075 g/cm² (95% CI -0.138 to -0.011) at the femoral neck. For studies with a pre-post design, there was a percent change of 1.367% (95% CI 0.532 to 2.201) at the spine, -0.137% (95% CI -1.609 to 1.335) at total hip, and − 0.903% (95% CI -2.417 to 0.610) at the femoral neck.

Conclusions

There do not appear to be negative effects of isotretinoin on bone mineral density, though there may be some slight effects at the femoral neck. Longer-term studies are needed to further evaluate potential effects on bone mineral density.

Ultraviolet B (UVB) exposure represents a significant environmental pathogenic factor of skin photodamage. Kaempferol (KFL) is a natural polyphenolic compound with significant antioxidant properties, but its effects on photodamage and associated molecular pathways remain incompletely elucidated. This study investigates the function of KFL in UVB-induced photodamage and its related mechanisms. Prior to UVB exposure, Human Immortalized Epidermal Cells (HaCaT cells) underwent KFL treatment. The shielding capacity of KFL against UVB-mediated photodamage in HaCaT cells was assessed by analyzing cell damage indicators, oxidative stress levels, and inflammation. Furthermore, the expression of Phosphoinositide3-kinase/Protein kinase B/Nuclear factor erythroid 2-related factor 2(PI3K/AKT/Nrf2)-related proteins was analyzed, and the use of the PI3K-specific inhibitor LY294002 was employed to verify whether the photoprotective effects of KFL in HaCaT cells occur via the PI3K/AKT/Nrf2 signaling cascade. Our results suggest that KFL markedly alleviated UVB-induced HaCaT cell damage, reactive oxygen species (ROS) production, and inflammation levels. Additionally, KFL appeared to upregulate PI3K/AKT/Nrf2-related protein expression, while the use of LY294002 partially reversed these KFL-induced effects. This investigation indicates that KFL may exert protective effects against UVB-induced photodamage by activating the PI3K/AKT/Nrf2 pathway, enhancing the endogenous defense mechanisms in HaCaT cells, and reducing UVB-induced ROS generation.

Erythromelalgia (EM) is a rare condition characterized by episodic erythema, warmth, and pain, typically at the extremities. Despite known associations with myeloproliferative and autoimmune disorders, comprehensive analysis of comorbidities has been limited by EM’s rarity. This study aims to identify significant comorbid associations to improve recognition and understanding of this challenging condition. We conducted a retrospective cohort study using the TriNetX research network, identifying 7,145 patients diagnosed with EM from February 2005 to February 2025. We evaluated associations between EM and selected myeloproliferative disorders, autoimmune conditions, mental health disorders, and metabolic conditions using odds ratios with 95% confidence intervals. The study cohort was predominantly female (73.15%) and white (78.93%). EM showed strongest associations with polycythemia vera (OR 27.05, 95% CI 14.37–50.92), essential thrombocythemia (OR 10.94, 95% CI 7.19–16.64), and Raynaud’s phenomenon (OR 17.28, 95% CI 13.20-22.65). Significant associations were also found with polyneuropathy (OR 6.76, 95% CI 5.91–7.74), systemic lupus erythematosus (OR 5.36, 95% CI 3.78–7.59), systemic sclerosis (OR 4.68, 95% CI 2.52–8.34), and mental health disorders including recurrent major depressive disorder (OR 1.41, 95% CI 1.24–1.61) and suicidal ideation (OR 1.48, 95% CI 1.08–2.05). Type I diabetes showed a positive but non-significant association (OR 1.31, 95% CI 1.00-1.73). This large-scale analysis confirms and quantifies EM’s strong associations with myeloproliferative and autoimmune conditions, while revealing unexpected negative correlations with several metabolic disorders. The significant association with mental health conditions underscores the impact of EM on quality of life. These findings may improve clinical recognition and guide future investigations into EM’s pathophysiology.

Venous stasis dermatitis represents a prevalent dermatological manifestation of chronic venous insufficiency (CVI) that disproportionately affects older adults, yet limited data exist on how geriatric physicians approach its management. This national survey, distributed via the Irish Gerontological Society, explored current clinical practices among geriatricians in the assessment and treatment of venous disease. Forty-eight responses were received, comprising 31 Consultant Geriatricians and 17 Specialist Registrars. Most respondents frequently examined the lower limbs and recognised venous manifestations such as eczema, lymphoedema and haemosiderin deposition. However, fewer than one in eight routinely recommended compression therapy despite robust evidence supporting its efficacy (Yosipovitch et al. in Am J Clin Dermatol 24:275–286, 2023). Reported barriers included impaired mobility, fall risk and limited access to wound-care resources. The findings reveal heterogeneous practice patterns, therapeutic uncertainty and underutilisation of compression strategies. Strengthened interdisciplinary collaboration and targeted educational initiatives are warranted to optimise evidence-based venous care for ageing populations.

Background

Acne vulgaris is a chronic, inflammatory disease of the pilosebaceous unit. This study aimed to investigate serum inflammatory markers in acne patients and compare the anti-inflammatory effects of systemic isotretinoin and doxycycline by evaluating their effects on these markers.

Medhods

This study was designed as a retrospective study. 100 patients with moderate to severe acne vulgaris were treated with either doxycycline (100 mg/day) or isotretinoin (0.5–1 mg/kg/day) and compared with 50 age- and sex-matched healthy controls. Serum inflammatory markers, including Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Aggregated Systemic Inflammation Index (AISI), Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), and Monocyte/HDL Ratio (MHR), were measured at baseline and during treatment.

Results

No significant baseline difference was found between groups. In the doxycycline group, SII, SIRI, and AISI levels significantly decreased at 2 months. In the isotretinoin group, no significant within-group changes were observed. Between-group comparisons revealed lower inflammatory marker values in the doxycycline group at 2 months.

Conclusion

Doxycycline treatment led to significant short-term reductions in serum inflammatory markers, suggesting more rapid anti-inflammatory effects than isotretinoin. These findings highlight the potential utility of these indices in monitoring treatment response.