Annals of dermatology最新文献

Background: The treatment landscape for melanoma, a particularly malignant skin cancer, is constrained by notable drug resistance and toxicity. β-Asarone, a natural compound from Acorus tatarinowii, has shown anticancer potential. Disruption of calcium homeostasis and mitochondrial dysfunction are key regulators of tumor cell survival and death.

Objective: This research was conducted to investigate the impact of β-Asarone on B16F10 melanoma cells, focusing on its potential to induce apoptosis by modulating calcium signaling and mitochondrial function.

Methods: Cell proliferation and apoptosis were evaluated using CCK-8, colony formation, EdU, and TUNEL assays. Intracellular calcium levels and mitochondrial membrane potential were measured using Fluo-4 AM, Rhod-2 AM, and JC-1 staining. Reactive oxygen species (ROS) generation and adenosine triphosphate (ATP) levels were assessed by fluorescent probes and ATP assay. Western blotting was utilized to detect apoptosis-related proteins, AMP-activated protein kinase (AMPK) pathway activation, and mitochondrial dynamics (OPA1, DRP1, FIS1).

Results: Treatment with β-Asarone notably inhibited the proliferation of B16F10 cells while simultaneously inducing apoptosis. Fluorescent probe analysis revealed that β-Asarone triggered cytosolic and mitochondrial Ca²⁺ overloaded in both the cytosol and mitochondria, accompanied by decreased mitochondrial membrane potential, elevated ROS levels, and reduced ATP production. Western blot analysis showed increased expression of DRP1 and FIS1, decreased OPA1, and enhanced AMPK phosphorylation, indicating that β-Asarone promotes mitochondrial fission through AMPK activation, likely driven by intracellular calcium imbalance.

Conclusion: This study demonstrates that β-Asarone induces apoptosis in B16F10 melanoma cells by triggering Ca²⁺ overload and mitochondrial dysfunction.

Atopic dermatitis (AD) is a chronic skin condition influenced by genetic, environmental, and immune factors, with notable ethnic variations in its prevalence and mechanisms. In Asian populations, distinct immunopathogenic features include the significant roles of helper (Th) 17 and Th22 cytokine pathways, differing from other ethnic groups. Key genetic variations related to immune regulation and skin barrier function are more prevalent in Asians. Microbiome studies reveal the role of Staphylococcus aureus in AD skin and emerging microbial species linked to microbiome dysbiosis and the gut-skin axis. Environmental factors like pollution and fine dust further exacerbate symptoms in Asia. This study consolidates findings to highlight the genetic, immunological, microbiome, and environmental factors contributing to AD's unique characteristics in Asians. Tailored treatment approaches are essential for improving outcomes and management of AD in diverse populations.

Androgenetic alopecia (AGA) is a common nonscarring hair loss condition that affects both men and women, often resulting in psychological distress and reduced quality of life. AGA pathogenesis involves genetic predisposition and androgen influence, primarily dihydrotestosterone (DHT), which leads to hair follicle miniaturization and progressive hair thinning. AGA remains challenging to manage due to its chronic progression and the combined influence of genetic and environmental factors. Topical minoxidil and oral finasteride are the most widely used treatments for AGA, addressing follicular miniaturization. However, their reliance on long-term use and potential for side effects or inconvenience has prompted increasing interest in alternative therapies. The mainstream of current AGA treatment can be categorized into androgen-targeting and non-androgen-targeting approaches. Finasteride and dutasteride, both 5-α-reductase inhibitors that reduce DHT levels in hair follicles, are key androgen-targeting treatments, with newer formulations like topical and injectable options emerging alongside traditional oral forms. Topical minoxidil remains central to non-androgen-targeted AGA treatments, though growing evidence supports the efficacy and safety of its low-dose oral form. Additionally, therapies like low-level light therapy, platelet-rich plasma, and exosome treatments are being explored. Recently, therapies targeting the androgen receptor, including small interfering RNA-based approaches, have been developed and are currently in clinical trial stages, offering innovative potential for AGA treatment. This review explores current and emerging treatments for AGA, addressing both androgen-targeted and non-androgen-targeted approaches with an emphasis on their mechanisms, efficacy, and safety. It ultimately aims to provide a comprehensive update on the latest advancements in AGA management.

Background: Scalp micropigmentation (SMP) is a non-surgical procedure used to camouflage hair loss or scalp scars. Although SMP is legally permitted only when performed by licensed medical professionals in South Korea, it is frequently administered in non-medical settings, raising safety and regulatory concerns.

Objective: This study aimed to evaluate the awareness, perceptions, legal knowledge, treatment experiences, and provider preferences related to SMP among dermatology outpatients with alopecia in South Korea.

Methods: A structured 13-item questionnaire was administered to 131 adult dermatology outpatients with hair loss at Incheon St. Mary's Hospital. The survey assessed participants' awareness of SMP, sources of information, willingness to undergo the procedure, legal knowledge, and previous experiences.

Results: Among the respondents, 90.8% had heard of SMP, most commonly through the Internet or family and friends. A majority (65.6%) were aware that SMP is legally restricted to licensed medical professionals. However, all five participants (3.8%) who had undergone SMP received the procedure in non-medical settings. Notably, 82.5% of participants without prior SMP experience preferred medically supervised settings, and all individuals with prior SMP experience indicated they would choose a hospital for future procedures.

Conclusion: This study reveals a disconnect between legal awareness and actual treatment behavior regarding SMP. While most patients understand that SMP is a medical procedure requiring physician oversight, many still receive treatment in non-medical environments. The findings highlight the need to expand access to physician-led SMP services, enhance public education, and reinforce regulatory enforcement to ensure patient safety and align practices with clinical standards.

Background: Three-dimensional (3D) skin displacement vector analysis method provides a deeper understanding of dynamic muscle anatomy. Understanding the dynamic muscle anatomy in the glabellar area during frowning can facilitate safer and effective botulinum toxin injections for treating glabellar wrinkles.

Objective: We aimed to investigate the skin displacement patterns of the glabellar area and adjacent skin during contraction of the glabellar muscles using 3D skin vector displacement analysis.

Methods: Twenty-nine healthy individuals (26 female, 3 male; median age 40.5 years) participated in the study. Photographs of the face were taken at rest and during maximal contraction of the glabellar muscles. Each expression image was aligned to its respective static image to compute the differences in the skin position.

Results: Two skin displacement patterns were identified during frowning: lateral pattern (89.66%), in which main skin vector displacement located on the eyebrow area and central pattern (10.34%), in which skin vector displacement mostly located between eyebrows. 62.07% showed asymmetric skin displacement. Analysis of the glabellar patterns showed that the 'U', '11', 'X', and 'π' patterns were observed in 38%, 38%, 14%, and 10% of cases, respectively, with corresponding skin vector displacement angles of 48°, 32°, 74°, and 24°. Additionally, 20.69% of subjects exhibited upward skin movement in the medial frontalis area during frowning. In 48% of subjects, the lateral and inferior portions of the orbicularis oculi muscle contracted, along with the upper medial portion.

Conclusion: This data will serve as an important guide for Botulinum Toxin treatment of glabella wrinkles in Korean patients.

Background: Hydrochlorothiazide (HCTZ) has carcinogenic effects owing to its photosensitizing properties. Recent studies have reported inconsistent results regarding the association between HCTZ and skin cancer.

Objective: This study aimed to clarify the effects of HCTZ on the risk of developing nonmelanoma skin cancer (NMSC) in Korean patients with hypertension.

Methods: This multicenter, retrospective cohort study was conducted using clinical data from 11 hospitals in Korea, and converted to the Observational Medical Outcomes Partnership-Common Data Model. Large-scale 1:1 propensity score-matching was conducted to balance the target and comparator cohorts. Cox regression analysis was used to examine the hazard ratio (HR) for NMSC in HCTZ users compared to HCTZ never-users.

Results: 8,821 patients and same number of controls were pooled from 11 databases. HCTZ use was not associated with a decreased risk of NMSC (HR, 1.01; 95% confidence interval [CI], 0.70-1.47). In the dose-response analysis, no significant correlation was found between NMSC risk and HCTZ dose for <1 year (HR, 1.17; 95% CI, 0.64-2.17) and ≥1 year (HR, 1.02; 95% CI, 0.64-1.61). No significant increase in the risk of NMSC was observed in the subgroup analyses for either age or sex.

Conclusion: HCTZ was not associated with the development of NMSC in a Korean hypertensive population, regardless of the duration of drug exposure.

Background: Observational studies have suggested associations between dietary polyunsaturated fatty acids (PUFAs) and cancer risk; however, causal inference regarding skin cancer remains limited due to potential recall bias, confounding, and reverse causation.

Objective: This study aimed to evaluate the causal association between genetically predicted circulating PUFA levels and the risk of skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.

Methods: We conducted a 2-sample Mendelian randomization (MR) study using genome-wide association study summary statistics from the UK Biobank (PUFAs, n=115,006) and the FinnGen consortium (BCC, n=26,272; SCC, n=4,663; melanoma, n=5,753). Genetic instruments were derived for omega-3, docosahexaenoic acid, omega-6, linoleic acid, and the omega-6:3 ratio. Multiple MR methods-including inverse-variance weighted, MR-Egger, weighted median, weighted mode, and MR-PRESSO-were applied to test for consistency and assess pleiotropy and heterogeneity.

Results: A higher genetically predicted linoleic acid to total fatty acid ratio was associated with a significantly lower risk of BCC and SCC. Conversely, higher genetically proxied serum omega-3 levels were associated with increased risks of BCC, SCC, and melanoma. The risk effect on SCC was attenuated upon exclusion of rs174528, a variant in the fatty acid desaturase 1 (FADS1) gene, suggesting a role for endogenous PUFA metabolism in carcinogenesis.

Conclusion: This MR analysis supports a causal role of circulating PUFAs in skin cancer development and highlights the importance of FADS-mediated endogenous PUFA metabolism. These findings provide novel insights into the genetic and metabolic underpinnings of skin cancer susceptibility.

Background: Psoriasis is a persistent systemic inflammatory condition mediated by the interleukin (IL)-23/IL-17 signaling pathway. Existing murine models, including imiquimod (IMQ)-applied wild-type (WT) mice, may not reflect chronicity and systemic comorbidities of psoriasis, particularly gut-related manifestations linked to the gut-skin axis.

Objective: To establish a murine model that more accurately reflects chronic psoriasis, its systemic comorbidities, and associated gut environment alterations.

Methods: C57BL/6 IL-10-deficient (IL-10 knockout [KO]) and WT mice received topical IMQ or vehicle for 6 weeks. Subsequently, tissue samples from skin, colon, joints, kidneys, liver, abdominal aortas, lymph nodes, and spleens, as well as fecal and blood samples, were collected for histopathologic, immunologic, gut environment analysis.

Results: IMQ-treated IL-10 KO mice developed prolonged psoriatic inflammatory responses with increased epidermal thickness and higher infiltration of CD45+, myeloperoxidase+, and IL-17+ cells. They also exhibited early-onset, severe colitis with marked weight loss, shortened colon length, and elevated colitis severity scores. While IMQ induced systemic inflammation in multiple organs, IL-10 KO mice did not show more severe joint, liver, or kidney involvement than WT mice. Elevated serum tumor necrosis factor alpha and plasminogen activator inhibitor-1 levels, increased heart/body weight ratio, enhanced gut permeability, and distinct gut microbiota profiles were observed in IL-10 KO mice.

Conclusion: The 6-week IMQ-applied IL-10 KO model may better reflect chronic and severe psoriasis with gut-related comorbidities, offering a valuable platform to investigate the gut-skin axis.

Background: Nipple eczema (NE) manifests as pruritic or painful erythema, often accompanied by oozing, erosion, and lichenification. NE is observed in 6%-23% of patients with atopic dermatitis (AD); its prevalence is higher among adolescent and young adult women.

Objective: To determine the prevalence and clinical correlates of NE in patients with AD.

Methods: We conducted a retrospective cross-sectional study from July to December 2023, enrolling patients diagnosed with AD. Participants completed a questionnaire regarding their symptoms of AD and NE, as well as the impact of NE on their daily lives.

Results: Of the 200 patients, 55 (27.5%) reported of having experienced NE. The mean age at NE onset was 22.75±9.77 years. The proportion of females with NE (70.9%) was significantly higher relative to those without NE (38.6%) (p<0.001). Factors significantly associated with the presence of NE in AD patients included female sex (odds ratio [OR], 4.90; 95% confidence interval [CI], 1.99-12.07; p=0.001), increased AD itch numerical rating scale (NRS) score (OR, 1.46; 95% CI, 1.11-1.91; p=0.007), increased AD pain NRS score (OR, 1.20; 95% CI, 1.01-1.44; p=0.041) and higher Investigator Global Assessment score (OR, 5.38; 95% CI, 2.07-13.99; p=0.001). Regarding nipple-specific health-related quality of life (HRQoL), 35.8% of patients reported severe impairment in HRQoL due to NE, and 45.3% experienced severe emotional distress.

Conclusion: Although the area affected by NE is small, dermatologists should be aware of its association with severe AD characteristics, and its significant impact on patient HRQoL.