Annals of dermatology最新文献

Background: Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papillomavirus (HPV). In recent years, research on anal CA has primarily focused on treatment rather than underlying mechanisms. The mechanism of HPV persistence and recurrence in CA require further exploration. It needs multiple researches in mechanisms to focalize treatment targets.

Objective: To investigate the relationship between intestinal mucosal immunity and the relapse of anal CA and persistent infection.

Methods: Levels of interferon gamma (IFN-γ) and secretory immunoglobulin A (sIgA) were measured using enzyme-linked immunosorbnent assay in anal mucosal cells obtained from patients treated at Tianjin Union Medical Center from September 2022 to December 2024. All the participants signed Informed Consent and the whole plan was approved by Institutional Review Board in Tianjin Union Medical Center (No. B155).

Results: The levels of IFN-γ and sIgA significantly decreased after infection, and persistent infection exhibited even lower levels. These two factors increased following treatment, reaching peak concentrations at 4 weeks before decreasing again.

Conclusion: These findings demonstrate a significant association between persistent anal CA infection and dysregulation of intestinal mucosal immunity.

Background: Skin rejuvenation has become an increasingly popular noninvasive approach to address age-related changes such as sagging, wrinkles, and skin laxity. Energy-based devices (EBDs) and injectables are widely used, but their application requires careful customization based on individual patient characteristics to optimize outcomes and minimize potential adverse effects.

Objective: This study aimed to explore clinical practice patterns among board-certified dermatologists in South Korea, focusing on their strategies for tailoring skin rejuvenation treatments to individual patients, including the integration of EBDs, injectables, and senotherapeutics.

Methods: A structured survey comprising 10 questions was administered to 13 experienced dermatologists specializing in skin rejuvenation. The survey covered treatment strategies for patients with varying facial fat volumes, pain management approaches, and the use of EBDs, injectables and senotherapeutics.

Results: High-intensity focused ultrasound (HIFU) and radiofrequency (RF) were the most employed EBDs, often combined with injectables for enhanced outcomes. For patients with higher facial fat, HIFU and deoxycholic acid injections were preferred for contouring and tightening. For those with lower facial fat, biostimulatory agents such as poly-D, L-lactic acid and microneedle RF were favored to restore volume and elasticity. Pain management strategies included topical anesthetics and stepwise protocols. Although less commonly used, senotherapeutics were occasionally prescribed for specific conditions, such as melasma and extensive photoaging.

Conclusion: Dermatologists in South Korea employ a variety of patient-specific strategies for skin rejuvenation, combining various EBDs, injectables, and senotherapeutics. These findings highlight the importance of personalized treatment protocols and the need for further research to optimize treatment efficacy and safety.

Background: Despite various therapeutic modalities for keloids have been introduced; however, their therapeutic effects are limited. Therefore, the development of a new approach for inhibiting collagen production by scar fibroblasts is needed.

Objective: To investigate the effect of electrical stimulation using a low-frequency and low-intensity alternating current on collagen and MMP-1 levels in human dermal fibroblasts.

Methods: Low-frequency (20 kHz) and low-intensity (1 V/cm) electrical stimulations were applied to primary dermal fibroblasts. The production of type I procollagen and expression of matrix metalloproteinase-1 were evaluated. Transcriptomic analyses were conducted to explore the possible modes of action of electrical stimulation.

Results: Electrical stimulation effectively suppressed type I procollagen production and increased MMP-1 expression. In addition, transcriptomic analyses revealed that electrical stimulation altered the gene expression associated with membrane permeability and the structure of cellular membranes. Validation using real-time polymerase chain reaction revealed that electrical stimulation significantly altered the expression of mechanosensitive ion channels (PIEZO2) and membrane-bound protein organizing caveolae (CAVIN2).

Conclusion: Electrical stimulation using low-frequency and low-intensity alternating currents effectively modulates extracellular matrix homeostasis by altering the cellular membrane structure and function. Our findings suggest a promising therapeutic approach for the management of keloids and hypertrophic scars.

Background: Biologics effectively improve psoriatic skin lesions, but their impact on itch relief remains unclear.

Objective: To evaluate itch improvement in severe psoriasis patients treated with ustekinumab or guselkumab.

Methods: This retrospective study analyzed patients with severe psoriasis who completed initial efficacy evaluations after treatment with either biologic. Itch severity was assessed using numerical rating scale (NRS), visual analog scale, and verbal rating scale. NRS improvement was evaluated after three injections.

Results: Among 108 patients (74 on ustekinumab, 34 on guselkumab), 77 (71.3%) had moderate-to-severe itch (NRS ≥4) at baseline. Of these, 63 (81.8%) achieved an NRS improvement of ≥4 points. Ustekinumab showed greater itch relief compared to guselkumab in NRS (p=0.033). On the other hand, guselkumab showed more reduction for psoriatic skin lesions than ustekinumab in the Psoriasis Area and Severity Index (p=0.040). In the moderate-to-severe itch group, patients with large plaques experienced significantly greater improvement in NRS than those with small plaques (p=0.012).

Conclusion: While guselkumab is generally preferred for psoriatic skin lesions, ustekinumab may provide superior itch relief.

Background: Primary cutaneous CD30+ lymphoproliferative disorders (pcCD30-LPDs) are a diseases with various clinical and prognostic characteristics.

Objective: Increasing our knowledge of the clinical characteristics of pcCD30-LPDs and identifying potential prognostic variables in an Asian population.

Methods: Clinicopathological features and survival data of pcCD30-LPD cases obtained from 22 hospitals in South Korea were examined.

Results: A total of 413 cases of pcCD30-LPDs (lymphomatoid papulosis [LYP], n=237; primary cutaneous anaplastic large cell lymphoma [C-ALCL], n=176) were included. Ninety percent of LYP patients and roughly 50% of C-ALCL patients presented with multiple skin lesions. Both LYP and C-ALCL affected the lower limbs most frequently. Multiplicity and advanced T stage of LYP lesions were associated with a chronic course longer than 6 months. Clinical morphology with patch lesions and elevated serum lactate dehydrogenase were significantly associated with LPDs during follow-up in LYP patients. Extracutaneous involvement of C-ALCL occurred in 13.2% of patients. Lesions larger than 5 cm and increased serum lactate dehydrogenase were associated with a poor prognosis in C-ALCL. The survival of patients with C-ALCL was unaffected by the anatomical locations of skin lesions or other pathological factors.

Conclusion: The multiplicity or size of skin lesions was associated with a chronic course of LYP and survival among patients with C-ALCL.

Background: Atopic dermatitis (AD) is a chronic eczematous disorder characterized by intense itchiness. Systemic therapies for AD include Janus kinase (JAK) inhibitors and various biological agents. The effects of transitioning from the JAK1 inhibitor, upadacitinib, to the anti-interleukin 13 antibody, tralokinumab, remain unclear.

Objective: This study evaluated the transition from 15 mg of upadacitinib to tralokinumab in patients with moderate-to-severe AD.

Methods: This analysis included 20 patients who switched from 15 mg of upadacitinib to tralokinumab due to an inadequate response or adverse events (AEs). We assessed the total and regional eczema area and severity index (EASI), which included assessments of the head and neck, trunk, and upper and lower limbs, along with erythema, edema/papulation, excoriation, lichenification, and the peak pruritus numerical-rating scale (PP-NRS), initially (start of 15 mg of upadacitinib), at the transition point (week 0), and during follow-up at weeks 4 and 12.

Results: The EASI, EASI of the four anatomical regions, and EASI of the four clinical manifestations significantly declined from baseline at weeks 4 and 12, with no substantial reductions from week 0. The PP-NRS score notably decreased from baseline at week 4. Achieving EASI of 50 and 75 improved post-switching.

Conclusion: Transitioning to tralokinumab substantially alleviated rash in patients with AD who experienced suboptimal responses or AEs to 15 mg of upadacitinib.

Background: Comprehensive studies on the tumor burden of soft-tissue sarcoma (STS) by anatomical site are lacking in Asian populations.

Objective: To investigate the anatomical distribution of STS via relative tumor density (RTD) in a Korean cohort.

Methods: The RTDs of patients with STS at a single-institution from 2007-2022 were retrospectively analyzed. To describe the STS locations, the body was divided into 4 anatomical sites, and the RTD of each was calculated to the compare topographic tumor burden.

Results: Fifty-nine cases in 58 individuals, 35 male (60.3%) and 23 female (39.7%), with a mean age of 56.5±20.4 were analyzed. Overall, the most frequent STS site was the lower extremity (LE, n=22, 37.3%), and the highest RTD was in the head and neck (H&N, 2.44; 95% confidence interval, 1.39-3.77). Dermatofibrosarcoma protuberans (DFSP), Kaposi's sarcoma (KS), and angiosarcoma (AS) accounted for 76.3% of all the cases. DFSP, KS, and AS showed significantly higher RTD on the trunk (2.55, p=0.025), LE (3.88, p<0.001), and H&N (7.42, p<0.001), respectively, than elsewhere.

Conclusion: Each STS displays topographic variability and produces different topographic tumor burdens by body site in an Asian population.

Background: Evidence on the effectiveness, long-term safety and longevity of biologic therapies in pediatric psoriasis patients is sparse.

Objective: This study aims to compares the efficacy, safety and drug survival (DS) rates of etanercept (ETA), adalimumab (ADA), infliximab (INF), ustekinumab (UST), secukinumab (SEC) and ixekizumab (IXE) in pediatric and adult psoriasis patients.

Methods: 293 biologic treatment cycles of 198 patients (62 pediatric and 136 adult) from three academic psoriasis referral centres were analysed.

Results: The following were the Psoriasis Area and Severity Index 90 response scores of pediatric and adult psoriasis patients, respectively: ETA, 42.3% vs. 34.6%; ADA, 53.8% vs. 59.8%; INF, 33.3% vs. 33.3%; UST, 76.5% vs. 56.8%; SEC, 60% vs. 60%; and IXE, 50% vs. 87.5%. The differences of responses between the two groups were statistically insignificant (p>0.05). ETA had the longest mean DS time in the pediatric group but it was related to a significantly shorter DS in pediatric patients than in adults (pediatrics: 30.58 [18.64-42.52] months vs. adults: 72.34 [54.70-89.99] months; p=0.025). ADA had the longest mean DS time in the adult group with 101.28 [84.88-117.68] months. All treatments had favorable safety profiles. No specific severe adverse effects necessitating treatment discontinuation were observed in pediatric patients.

Conclusion: Although responses to ETA and UST were numerically better among children, the difference was insignificant. The DS rates in each group were comparable, and no specific safety signals, limiting the long-term use of these agents, were detected in the pediatric group.

Air pollution is a widespread environmental issue, with substantial global implications for human health. Recent epidemiological studies have shown that exposure to air pollution exacerbates various inflammatory skin conditions, including atopic dermatitis, psoriasis, or acne. Furthermore, air pollutants are associated with accelerated skin aging, hair loss, and skin cancer. The aim of this review is to elucidate the current understanding of the impact of air pollution on skin health, emphasizing the underlying mechanisms involved and existing therapeutic and cosmetic interventions available to prevent or mitigate these effects. A pivotal factor in the harmful effects of air pollution is the formation of reactive oxygen species and the resulting oxidative stress. The aryl hydrocarbon receptor signaling pathway also substantially contributes to mediating the effects of air pollutants on various skin conditions. Moreover, air pollutants can disrupt the skin barrier function and trigger inflammation. Consequently, antioxidant and anti-inflammatory therapies, along with treatments designed to restore the skin barrier function, have the potential to mitigate the adverse effects of air pollutants on skin health.