Hasil untuk "Dermatology"

William E. Damsky, B. King

T. Bernhardt, M. Semmler, M. Schäfer et al.

The ability to produce cold plasma at atmospheric pressure conditions was the basis for the rapid growth of plasma-related application areas in biomedicine. Plasma comprises a multitude of active components such as charged particles, electric current, UV radiation, and reactive gas species which can act synergistically. Anti-itch, antimicrobial, anti-inflammatory, tissue-stimulating, blood flow-enhancing, and proapoptotic effects were demonstrated in in vivo and in vitro experiments, and until now, no resistance of pathogens against plasma treatment was observed. The combination of the different active agents and their broad range of positive effects on various diseases, especially easily accessible skin diseases, renders plasma quite attractive for applications in medicine. For medical applications, two different types of cold plasma appear suitable: indirect (plasma jet) and direct (dielectric barrier discharge—DBD) plasma sources. The DBD device PlasmaDerm® VU-2010 (CINOGY Technologies GmbH), the atmospheric pressure plasma jet (APPJ) kINPen® MED (INP Greifswald/neoplas tools GmbH), and the SteriPlas (Adtec Ltd., London, United Kingdom) are CE-certified as a medical product to treat chronic wounds in humans and showed efficacy and a good tolerability. Recently, the use of plasma in cancer research and oncology is of particular interest. Plasma has been shown to induce proapoptotic effects more efficiently in tumor cells compared with the benign counterparts, leads to cellular senescence, and—as shown in vivo—reduces skin tumors. To this end, a world-wide first Leibniz professorship for plasmabiotechnology in dermatology has been introduced to establish a scientific network for the investigation of the efficacy and safety of cold atmospheric plasma in dermatooncology. Hence, plasma medicine especially in dermatology holds great promise.

Anna Kurek-Górecka, M. Górecki, A. Rzepecka-Stojko et al.

Honey, propolis, bee pollen, bee bread, royal jelly, beeswax and bee venom are natural products which have been used in medicine since ancient times. Nowadays, studies indicate that natural bee products can be used for skin treatment and care. Biological properties of these products are related to flavonoids they contain like: chrysin, apigenin, kaempferol, quercetin, galangin, pinocembrin or naringenin. Several pharmacological activities of phenolic acids and flavonoids, and also 10-hydroxy-trans-2-decenoic acid, which is present in royal jelly, have been reported. Royal jelly has multitude of pharmacological activities: antibiotic, antiinflammatory, antiallergenic, tonic and antiaging. Honey, propolis and pollen are used to heal burn wounds, and they possess numerous functional properties such as: antibacterial, anti-inflammatory, antioxidant, disinfectant, antifungal and antiviral. Beeswax is used for production of cosmetics and ointments in pharmacy. Due to a large number of biological activities, bee products could be considered as important ingredients in medicines and cosmetics applied to skin.

A. Young, Mulin Xiong, J. Pfau et al.

Artificial intelligence (AI) is becoming increasingly important in dermatology, with studies reporting accuracy matching or exceeding dermatologists for the diagnosis of skin lesions from clinical and dermoscopic images. However, real-world clinical validation is currently lacking. We review dermatological applications of deep learning, the leading AI technology for image analysis, and discuss its current capabilities, potential failure modes, and challenges surrounding performance assessment and interpretability. We address three primary applications: (1) teledermatology, including triage for referral to dermatologists, (2) augmenting clinical assessment during face-to-face visits, and (3) dermatopathology. We discuss equity and ethical issues related to future clinical adoption and recommend specific standardization of metrics for reporting model performance.

Sivakanth Gopakumar , Nima Teresa Andrew , Maria Jose et al.

Background: Pemphigus and pemphigoid are autoimmune blistering disorders characterized by autoantibodies attacking skin and mucous membranes. Rituximab, targeting CD20-positive B cells, has emerged as a treatment option for resistant cases. Aims and Objectives: To evaluate the treatment outcomes and safety profile of rituximab in patients with pemphigus and pemphigoid diseases treated at a tertiary care center over 6 years. Materials and Methods: This retrospective study analyzed the outcomes of 23 patients treated with rituximab for pemphigus and pemphigoid diseases at a tertiary care hospital between February 2017 and February 2023. Data included demographics, disease characteristics, treatment specifics, and adverse reactions. Treatment response was evaluated using the Nikolsky sign, and the World Health Organization causality assessment scale classified adverse events. Statistical analysis was conducted with SPSS version 25.0. Results: The study included 23 patients (52.2% male), with a mean age of 50.48 years. Majority of the patients were diagnosed with pemphigus vulgaris (60.9%). Of the 23 patients, 17 (73.9%) achieved complete remission, while 6 (26.1%) attained partial remission. Most patients (43.5%) required two cycles of rituximab, with complete remission achieved after two cycles in 52.9% of those in remission. Patients with partial remission required more infusions, with 33.3% receiving three or more cycles. Adverse drug reactions (ADRs) were observed in 5 patients (21.7%), all of whom experienced mild, infusion-related symptoms, such as pruritus (8.7%) and dyspnea (4.3%). A significant association between gender and ADRs was found, with females more prone to ADRs (P=0.008). No severe reactions were reported, and all ADRs were resolved. Conclusion: Rituximab shows high efficacy in inducing remission in pemphigus and pemphigoid patients, with a manageable safety profile. Individualized treatment regimens, including the number of cycles, may optimize outcomes.

Katharine Hopkins, Annarita Antelmi, Jakob Dahlin et al.

Fibromyalgia is a chronic syndrome characterized by pain, fatigue, and cognitive disturbances. The increased prevalence of contact allergy to gold in individuals with fibromyalgia when compared with the general population has previously been described. Gold contact allergy can manifest as a systemic contact dermatitis, with cutaneous and extracutaneous manifestations presenting upon systemic administration of gold. This study aimed to establish whether gold allergy is of significance in the fibromyalgia population. Prior to patch testing with the Swedish baseline series and an extended dental series, 119 females with fibromyalgia answered questionnaires including details of past medical history, dental history, and previous cutaneous and mucous membrane intolerance to metals. Prevalence of allergy to gold sodium thiosulphate (2.0% and 5.0%) was 33.6% (40 individuals). There was a statistically significant overrepresentation of gold allergy among individuals who experienced cutaneous symptoms upon direct contact with gold (p = 0.010). Contact allergy to gold was more frequent among patients with oral symptoms (p = 0.024). This study demonstrates concordance between reported cutaneous symptomatology related to gold exposure and gold allergy in the fibromyalgia population. Whether individuals with oral symptoms and gold allergy have objective oral clinical findings and relevant gold exposure is the focus of ongoing study.

Jana K. Dickter, Yuqi Zhao, Vishwas Parekh et al.

ABSTRACT We investigated the presence of viral DNA and RNA in cutaneous squamous cell carcinoma (cSCC) tumor and normal tissues from nine individuals with a history of hematopoietic stem cell transplantation (HCT). Microbiome quantification through DNA and RNA sequencing (RNA-seq) revealed the presence of 18 viruses in both tumor and normal tissues. DNA sequencing (DNA-seq) identified Torque teno virus, Saimiriine herpesvirus 1, Merkel cell polyomavirus, Human parvovirus B19, Human gammaherpesvirus-4, Human herpesvirus-6, and others. RNA-seq revealed additional viruses such as Tobamovirus, Pinus nigra virus, Orthohepadnavirus, Human papillomavirus-5, Human herpesvirus-7, Human gammaherpesvirus-4, Gammaretrovirus, and others. Notably, DNA-seq indicated that tumor samples exhibited low levels of Escherichia virus in three out of nine subjects and elevated levels of Human gammaherpesvirus-4 in one subject, while normal samples frequently contained Gammaretrovirus and occasionally Escherichia virus. A comparative analysis using both DNA- and RNA-seq captured three common viruses: Abelson murine leukemia virus, Murine type C retrovirus, and Human gammaherpesvirus-4. These findings were corroborated by an independent data set, supporting the reliability of the viral detection methods utilized. The study provides insights into the viral landscape in post-HCT patients, emphasizing the need for comprehensive viral monitoring in this vulnerable population.IMPORTANCEThis study is important because it explores the potential role of viruses in the development of cSCC in individuals who have undergone allogeneic HCT. cSCC is common in this population, particularly in those with chronic graft-versus-host disease on long-term immunosuppression. By using advanced metagenomic and metatranscriptomic next-generation sequencing, we aimed to identify viral pathogens present in tumor and adjacent normal tissue. The results could lead to targeted preventive or therapeutic interventions for these high-risk people, potentially improving their outcomes and management of cSCC.

Dandan Zhu, Guo Chen, Guo Chen et al.

IntroductionSchistosomiasis japonica, a zoonotic parasitic disease, induces complex immune regulation during infection. The inflammatory responses and immunosuppressive mechanisms co-exist to maintain immune homeostasis in schistosomiasis. B7-H4 is a critical immune checkpoint molecule that modulates T cell activation and exerts immunosuppressive effects. Our previous investigations revealed that B7-H4 mRNA expression was elevated in mice infected with Schistosoma japonicum, with interleukin-10 (IL-10) demonstrating regulatory capacity to enhance B7-H4 expression in RAW264.7 macrophages. In this study, we further explore the mechanism underlying IL-10-mediated B7-H4 upregulation.MethodsWestern blot was performed to detect B7-H4 expression levels, both in mice infected with Schistosoma japonicum and in RAW264.7 cells stimulated with IL-10. RT-qPCR was performed to screen microRNAs (miR-140 et al.) in RAW264.7 cells stimulated with IL-10. Then dual-luciferase reporter assay was performed to confirm that miR-140 can directly bind to the 3’UTR of B7-H4. miR-140 promoter activity in RAW264.7 cells was also detected via dual-luciferase reporter assays. In addition, ChIP was performed to confirm the binding of transcription factors and miR-140 promoter.ResultsNotably, miR-140 was decreased in IL-10-treated microphages, accompanied by B7-H4 expression was upregulated. miR-140 can directly bind to the 3’UTR of B7-H4 and then inhibit the expression of B7-H4 in RAW264.7 cells. Meanwhile, miR-140 mimics can also attenuate IL-10-induced B7-H4 expression in RAW264.7 cells. Then we found that IL-10 may inhibit miR-140 promoter activity in RAW264.7 cells through transcription factors that binding to the - 576/- 94 bp region of the miR-140 promoter. Results by Western blot and ChIP further indicated that IL-10 could downregulate miR-140 promoter activity in a STAT5 dependence manner. After the sequence of STAT5 binding site within the - 456/- 446 bp region of the miR-140 promoter was mutated, IL-10 failed to suppress the activity produced by mutant miR-140 promoter.DiscussionIn summary, IL-10 can inhibit miR-140 through STAT5, thereby upregulating the expression of B7-H4 in RAW264.7 cells. This study may suggest a new mechanism underlying IL-10-mediated B7-H4 upregulation in macrophages.

Rieke Löper, Lennart Abels, Daniel Otero Baguer et al.

Lentigo maligna (LM) is a melanoma in situ with high cumulative sun damage. Histological evaluation of resection margins is difficult and time-consuming. Melanocyte density (MD) is a suitable, quantifiable, and reproducible diagnostic criterion. In this retrospective single-centre study, we investigated whether an artificial intelligence (AI) tool can support the assessment of LM. Training and evaluation were based on MD in Sox-10-stained digitalised slides. In total, 86 whole slide images (WSIs) from LM patients were annotated and used as a training set. The test set consisted of 177 slides. The tool was trained to detect the epidermis, measure its length, and determine the MD. A cut-off of ≥30 melanocytes per 0.5 mm of epidermis length was defined as positive. Our AI model automatically recognises the epidermis and measures the MD. The model was trained on nuclear immunohistochemical signals and can also be applied to other nuclear stains, such as PRAME or MITF. The WSI is automatically visualised by a three-colour heat map with a subdivision into low, borderline, and high melanocyte density. The cut-offs can be adjusted individually. Compared to manually counted ground truth MD, the AI model achieved high sensitivity (87.84%), specificity (72.82%), and accuracy (79.10%), and an area under the curve (AUC) of 0.818 in the test set. This automated tool can assist (dermato) pathologists by providing a quick overview of the WSI at first glance and making the time-consuming assessment of resection margins more efficient and more reproducible. The AI model can provide significant benefits in the daily routine workflow.

Manuel P Pereira, S. Steinke, C. Zeidler et al.

R. Daneshjou, Catarina Barata, B. Betz‐Stablein et al.

Importance The use of artificial intelligence (AI) is accelerating in all aspects of medicine and has the potential to transform clinical care and dermatology workflows. However, to develop image-based algorithms for dermatology applications, comprehensive criteria establishing development and performance evaluation standards are required to ensure product fairness, reliability, and safety. Objective To consolidate limited existing literature with expert opinion to guide developers and reviewers of dermatology AI. Evidence Review In this consensus statement, the 19 members of the International Skin Imaging Collaboration AI working group volunteered to provide a consensus statement. A systematic PubMed search was performed of English-language articles published between December 1, 2008, and August 24, 2021, for "artificial intelligence" and "reporting guidelines," as well as other pertinent studies identified by the expert panel. Factors that were viewed as critical to AI development and performance evaluation were included and underwent 2 rounds of electronic discussion to achieve consensus. Findings A checklist of items was developed that outlines best practices of image-based AI development and assessment in dermatology. Conclusions and Relevance Clinically effective AI needs to be fair, reliable, and safe; this checklist of best practices will help both developers and reviewers achieve this goal.

D. Ioannides, E. Vakirlis, L. Kemény et al.

Lichen planus (LP) is a chronic inflammatory and immune‐mediated disease that affects the skin, hair, nails and mucous membranes. Although there is a broad clinical spectrum of lichen planus manifestations, the skin and oral cavity remain the major sites of involvement. A group of European dermatologists with a long‐standing interest and expertise in lichen planus has sought to define therapeutic guidelines for the management of patients with LP. The clinical features, diagnosis and possible medications that clinicians can use, in order to control the disease, will be reviewed in this manuscript. The revised final version of the lichen planus guideline was passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV).

A. Adelekun, G. Onyekaba, J. Lipoff

Douglas C Wu, M. Goldman, Heidi Wat et al.

The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence‐based recommendations are developed for the use of picosecond laser in dermatology.

M. Hesseler, N. Shyam

The field of dermatology has seen numerous therapeutic innovations in the past decade with platelet-rich plasma (PRP) recently garnering significant interest particularly in alopecia, acne scarring and skin rejuvenation. In other conditions of dermatology, such as chronic wounds and vitiligo, PRP has been investigated but has received less attention. The objective of this literature review was to focus on conditions of medical dermatology and to consolidate the available evidence of platelet-rich plasma for the practicing dermatologist. This review evaluates the literature up to October 31, 2018, and a search was conducted in the PubMed database for "platelet-rich plasma" or "platelet releasate" or "platelet gel" or "platelet rich fibrin" or "PRP" and "dermatology" or "skin" or "cutaneous" or "wound" or "ulcer." Fourteen articles met the inclusion criteria for this review. In studies representing 1b-4 grades of evidence according to the Centre for Evidence-Based Medicine, Oxford, platelet-rich plasma significantly improved wound healing in chronic diabetic ulcers, venous ulcers, pressure ulcers, leprosy ulcers, acute traumatic wounds and ulcers of multifactorial etiologies. Two studies also documented benefits of adjunctive PRP in stable vitiligo. Platelet-rich plasma warrants further investigation as it represents a potential therapeutic adjunct or alternative with a favorable side effect profile.

M. Murphy, J. Cohen, M. Vesely et al.

BACKGROUND Antibody-based therapies that inhibit pro-inflammatory cytokine signaling are commonly used in dermatology. Paradoxically, these medications may induce or exacerbate inflammatory disorders. OBJECTIVE To summarize the spectrum of manifestations, incidence, timing, potential mechanisms, and general management approaches to paradoxical cutaneous reactions induced by cytokine-targeted antibodies in dermatology. METHODS We performed a systematic review and analysis of published cases of cutaneous paradoxical reactions reported in association with TNF-α, IL-12/23 (p40), IL-17A/17R, IL-23 (p19), and IL-4Rα inhibitors. RESULTS We identified 313 articles reporting 2049 cases of paradoxical reactions. TNF-α inhibitors resulted in 91.2% (1869/2049) of all cases, followed by IL-17/17R (3.5%), IL-4Rα (2.7%), IL-12/23 (2.4%), and IL-23 (0.01%) inhibitors. Psoriasiform and eczematous eruptions were the most commonly reported, but a wide spectrum of patterns are described. Phenotypically overlapping reaction patterns were common. Time to onset typically ranges from weeks to months, but can occur up to 1-2 years later. Improvement or resolution upon discontinuation of the inciting drug is common. LIMITATIONS This is a retrospective analysis. CONCLUSIONS Dermatologists should be familiar with the clinical features of paradoxical reactions from cytokine blocking antibodies to facilitate efficient recognition and management.

Z. Apalla, V. Nikolaou, D. Fattore et al.

The introduction of immune checkpoint inhibitors (ICIs) opened a new era in oncologic therapy. The favourable profile of ICIs in terms of efficacy and safety can be overshadowed by the development of immune‐related adverse events (irAEs). Dermatologic irAEs (dirAEs) appear in about 40% of patients undergoing immunotherapy and mainly include maculopapular, psoriasiform, lichenoid and eczematous rashes, auto‐immune bullous disorders, pigmentary disorders, pruritus, oral mucosal lesions, hair and nail changes, as well as a few rare and potentially life‐threatening toxicities. The EADV task force Dermatology for Cancer Patients merged the clinical experience of the so‐far published data, incorporated the quantitative and qualitative characteristics of each specific dirAEs, and released dermatology‐derived, phenotype‐specific treatment recommendations for cutaneous toxicities (including levels of evidence and grades of recommendation). The basic principle of management is that the interventions should be tailored to serve the equilibrium between patients’ relief from the symptoms and signs of skin toxicity and the preservation of an unimpeded oncologic treatment.

Daniel T. Hogarty, John C. Su, K. Phan et al.

Martyna Zagórska-Dziok, M. Sobczak

Hydrogels are playing an increasingly important role in medicine and pharmacy. Due to their favorable physicochemical properties, biocompatibility, and designed interaction with living surroundings, they seem to be one of the most promising groups of biomaterials. Hydrogel formulations from natural, semi, or synthetic polymeric materials have gained great attention in recent years for treating various dermatology maladies and for cosmetology procedures. The purpose of this review is to present a brief review on the basic concept of hydrogels, synthesis methods, relevant mechanisms, and applications in dermatology or cosmetology. This review discusses transdermal therapies and the recent advances that have occurred in the field.

Chun-Sheng Chen, Po-Yuan Wu