Hasil untuk "Dermatology"

D. Thiboutot, H. Gollnick, V. Bettoli et al.

S. Swetter, H. Tsao, C. Bichakjian et al.

The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.

H. Lim, S. Collins, J. Resneck et al.

Achdiat PA, Wibowo RG, Larasati R et al.

Pati Aji Achdiat,1 Raka Ghufran Wibowo,1 Ranisa Larasati,1 Rasmia Rowawi,1 Hermin Aminah Usman,2 Retno Hesty Maharani1 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia; 2Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, West Java, IndonesiaCorrespondence: Pati Aji Achdiat, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Email pati.aji.achdiat@unpad.ac.idAbstract: Sexual abuse is any non-consensual sexual act or behavior using force, with significant concern in “men who have sex with men” (MSM), and younger individuals. The incidence of sexually transmitted infections (STI) is also prevalent in the cases of sexual abuse in this population, showing the need for comprehensive medical and psychological intervention. This study presents a case of a 15-year-old Indonesian MSM adolescent who experienced three forced sexual intercourse with a mid-thirties male friend 6 months before the consultation. Psychological evaluation showed signs of moderate depression, then the patient reported erythematous macules and collarettes on the palms and soles. These symptoms appeared 1 month before consultation, without associated pain or pruritus. Additionally, moist, skin-colored verrucous papules and plaques were observed in the perianal area, along with a history of unintentional weight loss. The Kinsey score was calculated as three, showing bisexuality. Testing confirmed positive results for both HIV and syphilis, leading to the secondary diagnosis. The patient tested negative for additional STI and was treated with benzathine benzylpenicillin G 2.4 million international unit (IU) and antiretroviral therapy. After one month, the skin lesions improved and the patient was referred to the psychiatric department for psychological treatment. Syphilis and HIV are the predominant infections, showing the critical necessity of administering appropriate medical treatment, such as antiretroviral therapy and comprehensive STI management, with psychological assessment and management to enhance the psychological well-being of sexually abused individuals.Keywords: bisexual, human immunodeficiency virus, Indonesian, men sex with men, secondary syphilis, sexual abuse

Marc Perrussel, Bruno Sassolas

ABSTRACT Background Psoriatic hard‐to‐treat areas (scalp, palmoplantar, genital and nails) are associated with lower efficacy, treatment discontinuation and impaired quality of life. Recent biotherapies offer a new perspective for their treatment. Among them brodalumab is indicated for the treatment of moderate‐to‐severe plaque psoriasis in adults requiring systemic therapy. No French data are available on the effectiveness of brodalumab on hard‐to‐treat areas. Objectives To assess the effectiveness and safety of brodalumab in real life on psoriatic hard‐to‐treat areas. Methods Retrospective multicenter study including 42 psoriasis adults which received at least one injection of brodalumab from January 2022 through May 2024 and were followed for a minimum period of 2 months after initiation. Scores were collected at baseline and between 2 and 20 months after treatment initiation: BSA (body surface area), PASI (psoriasis area severity index), PGA‐G (Physician's Global Assessment of genitalia), ppPASI (Palmoplantar Psoriasis Area and Severity Index), NAPSI (Nail Psoriasis Severity Index) and PSSI (Psoriasis Scalp Severity Index). DLQI (Dermatology Life Quality Index) was calculated to assess the impact on quality of life. Tolerance and potential adverse events were reported. Results The mean BSA at baseline was 16.3%; mean baseline scores: PASI 11.9; PGA‐G 2.3; ppPASI 14.9; NAPSI 16.3; PSSI 20.2. 92.9% of patients had DLQI ≥ 10. All patients had hard‐to‐treat areas: scalp 69.0%; nail 50.0%; genital 50.0%; palmoplantar 35.7%. At the end of the follow‐up, the mean scores were, respectively: PASI 0.8; PGA‐G 0.3; ppPASI 1.1; NAPSI 2.2; PSSI 1.2. PASI < 1 was achieved by 69.0% of patients. Adverse events were reported in 9.5% of patients. Conclusions Brodalumab demonstrated clinical efficacy on hard‐to‐treat areas in just 3 months of treatment, with a median treatment duration of 4.0 months. This important and rapid clinical efficacy was associated with an improvement in quality of life and good tolerance.

Chantal E. Holtkamp, Dawid Warmus, Klaudia Bonowicz et al.

Melatonin (<i>N</i>-acetyl-5-methoxytryptamine) is recognized as an effective antioxidant produced by the pineal gland, brain and peripheral organs, which also has anti-inflammatory, immunomodulatory, and anti-tumour capacities. Melatonin has been reported as a substance that counteracts ultraviolet radiation B (UVB)-induced intracellular disturbances. Nevertheless, the mechanistic actions of related molecules including its kynurenic derivatives (<i>N</i>¹-acetyl-<i>N</i>²-formyl-5-methoxykynurenine (AFMK)), its indolic derivatives (6-hydroxymelatonin (6(OH)MEL) and 5-methoxytryptamine (5-MT)) and its precursor <i>N</i>-acetylserotonin (NAS) are only poorly understood. Herein, we treated human epidermal keratinocytes with UVB and assessed the protective effect of the studied substances in terms of the maintenance of mitochondrial function or their radical scavenging capacity. Our results show that UVB caused the significant elevation of catalase (CAT) and superoxide dismutase (Mn-SOD), the dissipation of mitochondrial transmembrane potential (mtΔΨ), a reduction in ATP synthesis, and the enhanced release of cytochrome <i>c</i> into cytosol, leading subsequently to UVB-mediated activation of the caspases and apoptosis (appearance of sub-G₁ population). Our findings, combined with data reported so far, indicate the counteracting and beneficial actions of melatonin and its molecular derivatives against these deleterious changes within mitochondria. Therefore, they define a path to the development of novel strategies delaying mitochondrial aging and promoting the well-being of human skin.

Xiaoguang Li, Giovanni Di Zenzo, Enno Schmidt et al.

Samiksha Shankar Shetty, Ruta Ujjval Joshi, Ashwini Padubidri Kombettu et al.

Background: AV is a chronic disease with flares and remissions requiring regular follow-ups. Image-based lesion counting (LC) is useful when in-person consultations are not possible, like the COVID- 19 pandemic. Objective: The aim of this study is to validate the proposed scoring system for teledermatology consultation and compare it with face to face. Materials and Methods: The face was divided into three zones which was further divided by drawing the imaginary lines from fixed points. AV (Grade 1 and 2) lesions were counted by co-investigator in person at baseline, first, and second follow-up visits. The images of the same were evaluated and scored by the principal investigator. Acne scores obtained were compared and statistically analyzed. Results: Two hundred cases were enrolled. Mean acne scores for in-person were 945.37, 647.57, and 550.81 and for teledermatology 1044.99, 718.79, and 654.36 for baseline, 1st, and 2nd follow-up, respectively. The mean decrease from baseline, 1st and 2nd follow-up, independent sample t-test and correlation analysis was significant in both groups (P = 0.001). Limitations: AV grade 3 and 4 are not included. Conclusion: During the 1st follow-up, a decrease in acne scores was observed, along with consistency in the scores between the evaluators. Image-based lesion counting is a promising approach. The proposed scoring system can be used for both modes of consultation-face-to-face and teledermatology.

Rolf-Markus Szeimies, Thomas Dirschka, Maria Concetta Fargnoli et al.

Abstract Methyl aminolevulinate (MAL) is a topical compound approved for use with photodynamic therapy (PDT) for the treatment of actinic keratosis (AK) and field cancerization in certain countries. There exists a high burden of disease for patients with AK: repeated treatments are required, there is a known risk of progression to keratinocyte carcinoma, and cosmetic appearance is affected. Delivery of PDT using MAL is a flexible treatment strategy available in many forms; red light, daylight, or artificial daylight can be used for illumination, all of which result in high AK clearance rates and low recurrence. MAL-PDT protocols continue to evolve to further improve adherence and treatment outcomes. Here, we used PubMed to search MEDLINE to identify guidelines, consensus recommendations, and studies describing the use of MAL for the treatment of AK. The aim of this targeted review is to consider various MAL-PDT treatment strategies on the basis of published literature, with a focus on personalizing treatment for the heterogeneous AK population.

Shanxin Zhou, Qianqian Zhang, Yiwen Deng et al.

Background/purpose: Pemphigus and pemphigoid are systemic bullous autoimmune diseases affecting skin and/or mucosal membranes with the life-threatening nature, especially pemphigus vulgaris. The papers published by dermatologists and stomatologists preferentially represent their concerns of a mucocutaneous disease. Materials and methods: The objective of this study was to compare the scientometric characteristics of pemphigus and pemphigoid publications by dermatologists and stomatologists in the Scopus database. Results: There are 9276 and 760 papers published by dermatologists and stomatologists, respectively. The annual number of the publications by dermatologists stably raised from 218 to 526 during 2007–2022; while the number by stomatologists raised with a small amount from 18 to 51 during this period. For the most-cited top-200 papers, the total citation count is 42,766 and the h index is 148 for pemphigus publications by dermatologists; whereas the count is 14,689 and h index is 63 for publications by stomatologists. Notably, first signs of pemphigus often appear in oral mucosa, manifesting as erythema, blisters, as well as mouth ulcer, gingivitis, lichen planus-like pemphigus. Conclusion: This study firstly reports the scientometric characteristics of pemphigus publications by dermatologists and stomatologists. The scale and citations of dermatologists' publications greatly outweigh stomatologists’ ones, suggesting stomatologists can learn from and more cooperate with dermatologists regarding pemphigus research.

Wu X, Hu Y, Lu Y et al.

Xuelin Wu,1,2 Yanqing Hu,1,2 Yan Lu,1,2 Xiuling Ke,1,2 Kangxing Liu,1,2 Xianyi Zhou,1,2 Yongxuan Hu1,2 1Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of ChinaCorrespondence: Xianyi Zhou; Yongxuan Hu, Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Road, Guangzhou, People’s Republic of China, Tel/Fax + 86 20 62784561 ; + 86 20 62784560, Email zxy1962@163.com; huyongxuan2003@163.comAbstract: Verruca plantaris (plantar wart) is a type of benign feet hyperplasia that is caused by a human papillomavirus (HPV) infection. In this study, we aimed to assess the clinical efficacy underlying cantharidin cream in the treatment of Verruca plantaris compared to CO2 laser and liquid nitrogen cryotherapy. One hundred and fifty patients affected with Verruca plantaris were enrolled in this retrospective clinical study. The treatment efficacy rate in the three groups was assessed 4 and 12 weeks after treatment. After 4 weeks of treatment, 46 cases in the externally applied cantharidin cream therapy group were cured with an apparent efficiency of 92.0% (46/50). Contrarily, 42 cases in the CO2 laser group were cured with 84.0% (42/50) efficiency, while 40 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 80.0% (40/50). Although the clinical cure rate of Verruca plantaris in the Cantharidin group was greater than in the CO2 laser group and in the liquid nitrogen cryotherapy group, there were no statistical differences found among the three groups (P = 0.225). After 12 weeks of treatment, 43 cases in the external cantharidin cream therapy group were cured with an apparent efficiency of 86.0% (43/50). Similarly, 39 cases in the CO2 laser group were cured with an apparent efficiency of 78.0% (39/50), while 36 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 72.0% (36/50). The statistical differences among the three groups were not found (P =0.230), but the resolution rate of warts in Cantharidin group was the highest among the three groups. The results from this study demonstrated that external cantharidin cream therapy could be served as an alternative treatment for Verruca plantaris.Keywords: cantharidin, HPV, verruca plantaris, plantar wart

Ruina Zhang, Junying Zhao, Linfeng Li

Abstract Background According to the results of the clinical trials, laser therapy is effective for the treatment of onychomycosis, but the in vitro findings are inconsistent among studies. This study aimed to explore the experimental conditions of laser for the inhibition of Trichophyton rubrum growth in vitro. A 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser was used to irradiate colonies using a small (6-mm diameter) or large (13-mm diameter) area, and using 300, 408, or 600 J/cm2. The surface temperature of the colony was measured after irradiation and every 2 min. The growth area was calculated until the 7th or 10th day of incubation daily. Results For the small area group, at 300 J/cm2, the immediate surface temperature was 25.2 ± 0.2°C, but without effect on growth (P = 0.516). At 408 J/cm2, the immediate surface temperature was 32.0 ± 0.4°C; growth was inhibited for 7 days (P < 0.001). At 600 J/cm2, the immediate surface temperature was 38.1 ± 0.4°C; the growth was completely stopped for at least 10 days (P < 0.001). For the large area group, the temperature patterns were similar to those of the small area group, but the highest temperature was lower than in the small area groups, and no growth inhibition effect was observed (all P > 0.05). Conclusions When the irradiation area is small, a 1064-nm Nd:YAG laser at 408 or 600 J/cm2 can be effective in suppressing T. rubrum growth in vitro.

Ximena Wortsman

A. Giacaman, L.J. Del Pozo Hernando

Emi Dika, Elisabetta Broseghini, Elisa Porcellini et al.

Abstract Malignant cutaneous melanoma (CM) is a potentially lethal form of skin cancer whose worldwide incidence has been constantly increasing over the past decades. During their lifetime, about 8% of CM patients will develop multiple primary melanomas (MPMs), usually at a young age and within 3 years from the first tumor/diagnosis. With the aim of improving our knowledge on MPM biology and pathogenesis, we explored the miRNome of 24 single and multiple primary melanomas, including multiple tumors from the same patient, using a small RNA-sequencing approach. From a supervised analysis, 22 miRNAs were differentially expressed in MPM compared to single CM, including key miRNAs involved in epithelial–mesenchymal transition. The first and second melanoma from the same patient presented a different miRNA profile. Ten miRNAs, including miR-25-3p, 149-5p, 92b-3p, 211-5p, 125a-5p, 125b-5p, 205-5p, 200b-3p, 21-5p, and 146a-5p, were further validated in 47 single and multiple melanoma samples. Pathway enrichment analysis of miRNA target genes revealed a more differentiated and less invasive status of MPMs compared to CMs. Bioinformatic analyses at the miRNA isoform (isomiR) level detected a panel of highly expressed isomiRs belonging to miRNA families implicated in human tumorigenesis, including miR-200, miR-30, and miR-10 family. Moreover, we identified hsa-miR-125a-5p|0|−2 isoform as tenfold over-represented in melanoma than the canonical form and differentially expressed in MPMs arising in the same patient. Target prediction analysis revealed that the miRNA shortening could change the pattern of target gene regulation, specifically in genes implicated in cell adhesion and neuronal differentiation. Overall, we provided a putative and comprehensive characterization of the miRNA/isomiR regulatory network of MPMs, highlighting mechanisms of tumor development and molecular features differentiating this subtype from single melanomas.

Fengyuan Wang, Guopu Chen, Yuanjin Zhao

Pandemic virus infections pose a major public health threat globally. Much efforts have been devoted to suppress the virus, including vaccine prevention, autoimmunity enhancement, and anti-virus drugs treatment. Among these strategies, development of novel and improved vaccine technologies attracts broad attention as they can nip the virus outbreak in the bud and avoid the appearance of public health emergency. However, current influenza vaccines only provide protection against homologous viruses. Therefore, chemical technologies are being employed for the development of new and improved vaccine, such as chitosan, plant polysaccharides and virus-like particles. In addition, recently, Wang et al. offered a promising means to develop universal viral vaccine through biomimetic nanoparticles and heterosubtypic protection could be achieved. These strategies with multidisciplinary collaboration are promising to make conceptual and technological advances of modern vaccinology to address pandemic virus infections.

Li-Wen Zhang, Wen-Ju Wang, Cong-Hui Li et al.

Allison Blumenfeld, Andrew Velic, Elizabeth K. Bingman et al.

Introduction Sterile technique is a basic technical skill used for a number of bedside procedures. Proper use of sterile technique improves patient safety by reducing infection risk. Methods We applied the principles of mastery learning to develop a simulation-based mastery learning module for sterile technique that was used as part of a 2-week internship preparatory course for fourth-year medical students. Forty-one medical students entering surgical or emergency medicine internships completed the module. Learners demonstrated baseline skills with a pretest, watched a didactic online video, participated in supervised deliberate practice sessions, and then completed a posttest. Physicians evaluated performance using a nine-item mastery checklist validated by a multispecialty panel of board-certified physicians. Learners who did not demonstrate mastery by correctly performing all nine checklist items received formative feedback and repeated the posttest as needed until mastery was achieved. Results No learners demonstrated mastery of sterile technique during pretesting. A total of 100% of learners demonstrated mastery of sterile technique during either their first or second attempt of the posttest. The learners reported statistically significantly higher levels of confidence at the end of the module. Discussion Our module highlights the skills gap that exists in the transition from undergraduate to graduate medical education and offers a cheap, effective, and easily reproducible curriculum for sterile technique that could be widely adopted for many learner populations.

Amanda H Wilkerson, Hunter O Thomas, Vinayak K Nahar

Introduction: Physical activity (PA) has been shown to protect against adverse health outcomes, and factors influencing physical activity vary among different populations. Previous research suggests nurses have an increased risk of being physically inactive, which may contribute to increased risk of musculoskeletal disorders. The purpose of this investigation was to use a systematic search process to determine previously identified correlates of nurses’ physical activity. Methods: The study utilized a systematic search process to identify studies for the review. The search was performed using three electronic databases: MEDLINE, CINAHL Complete, and Web of Science. The authors extracted and synthesized information regarding physical activity levels, significant correlates of physical activity, and measures of physical activity using a narrative approach. Results: Twelve articles were included in this review. All had predominately female samples and reported statistically significant findings. The majority determined nurses’ physical activity using self-report methods (n = 11) and explored the relationship between nurses’ physical activity and individual-level variables (n = 7). Few studies explored the difference between leisure-time and work-related physical activity, and many did not assess muscle-strengthening physical activity. Discussion and Conclusions: Demographic and non-modifiable work-related factors were the most frequently assessed correlates of behaviour. The reviewed studies showed that demographic variables, such as age and BMI, were significantly associated with nursing professional’s PA. There is a need for more studies to assess factors influencing nursing professionals’ PA beyond the individual level, using theoretical designs, and including objective measures of PA. Future studies should also include assessments of nursing professionals’ muscle-strengthening PA and involve adequate representation of the United States nursing population. Practitioners and researchers working to improve nurses’ physical activity behaviour should target efforts to those more likely to engage in less physical activity, such as those with greater BMI, older age, and working night shifts, in order to tailor intervention efforts to high-risk groups.

Catherine Baker, Katherine R. Lee, Anh Khoa Pham et al.