Hasil untuk "Dermatology"

Hindreen Aqrawi, Dindar Qurtas, Barzan Sharaf

Objective: To assess the efficacy and safety of two picosecond-laser wavelengths, 1064 nm neodymium-doped yttrium aluminium garnet with a micro-lens array and 595 nm, in the treatment of PAE using a split-face design. Methods: Each of them received three sessions of Picosecond laser every two weeks using two Handpieces, the short wave fractional 1064 nm applied to the right side of the face, and the 595 nm dye picosecond handpiece used for the left side of the face. All the patients were observed through multiple photos taken before, during, and two months after the last session. Results: Treatment with both wavelengths demonstrated significant (p<0.05) reductions in erythema. Still, the comparison of results between left and right laser treatments revealed that the larger mean difference (1.750) for the right side compared to the left side (1.200) suggests that the laser treatment had a more substantial effect on reducing right clinician erythema assessment scores (p=0.0001). No severe adverse events were reported, highlighting the safety of both modalities. Conclusion: The micro-lens array 1064 nm handpiece of the picosecond laser demonstrated superior efficacy compared to the short pulse 595 nm handpiece for treating post-acne erythema (PAE). The picosecond laser also exhibited an excellent safety profile with minimal adverse effects, making it a valuable and recommended treatment modality for PAE management.

Zhong-Zhou Huang, MD, PhD, Jian-Chi Ma, MD, PhD, Ping Huang, MD, PhD et al.

Lina Song, Zuo Chen, Zhiyu Zhou et al.

Jia L, Xiong J, Zhao C et al.

Lingling Jia,1,2,&amp;ast; Jiachao Xiong,1,2,&amp;ast; Changjiang Zhao,1,2 Hua Jiang,1,2 Yufei Li1,2 1Department of Plastic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People’s Republic of China; 2Medical College, Tongji University, Shanghai, 200331, People’s Republic of China&amp;ast;These authors contributed equally to this workCorrespondence: Hua Jiang, Email dosjh@126.com Yufei Li, Email lufylee@hotmail.comBackground: Hyaluronic acid injections, commonly used for anti-aging purposes, carry potential risks, including transient or permanent alopecia, a complication not yet fully characterized. This adverse effect can result from various mechanisms, such as pressure, ischemia, inflammation, and necrosis.Objective: This study aimed to present a case report of a patient treated with Concentrated Growth Factor combined with microneedling and minoxidil for alopecia following hyaluronic acid injection in the left temporal scalp and to systematically review literature from January 2000 to December 2024 on alopecia secondary to hyaluronic acid injections.Methods: A 23-year-old woman developed a 5× 6.5 cm alopecic patch on the left temporal scalp just four days after receiving 5 mL of Restylane hyaluronic acid filler in the frontal area. Despite initial treatment with 1500 units of hyaluronidase, alopecia progressed. A multimodal therapy was then initiated, including Concentrated Growth Factor injections, microneedling, and topical 5% minoxidil, delivered over three sessions at 1– 2-week intervals. A systematic literature search (PubMed/Web of Science/Embase, 2000– 2024) identified 13 relevant articles reporting on 19 cases of hyaluronic acid-induced alopecia for analysis.Results: In the case report, the patient experienced full hair regrowth after treatment with Concentrated Growth Factor, microneedling, and minoxidil. Additionally, thirteen full-text articles involving 19 patients with hyaluronic acid-induced alopecia were analyzed. Data collected included filler type, injection site, complication site, onset of alopecia, associated symptoms, diagnostic tests, proposed mechanisms, treatment approaches, and outcomes. Various treatments were employed across studies, with variable success rates.Conclusion: Prompt diagnosis and early intervention are crucial in preventing irreversible hair loss after HA injections. Knowledge of scalp anatomy and injectable materials is essential. This case suggests that combining Concentrated Growth Factor, microneedling, and minoxidil may offer a promising therapeutic strategy for HA-induced alopecia.Keywords: alopecia, cosmetic procedures, fillers, dermal fillers, hyaluronic acid, hair loss

Urszula Maińska, Jakub Żółkiewicz, Michał Sobjanek et al.

Lillian McCampbell, BS, David Jun Fei-Zhang, BA, Daniel Chelius, MD et al.

Background: Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH. Objective: Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States. Methods: This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database. Results: A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI scores and SDH themes. For several melanoma subtypes, higher social vulnerability significantly decreased odds (lowest for amelanotic, odds ratio 0.74; 95% confidence interval, 0.63-0.86) for indicated surgery, increased odds of indicated radiation (highest for epithelioid cell, 1.44; 1.08-1.96), and advanced staging on first presentation (highest for acral lentiginous, 1.13; 1.01-1.27). Household composition, followed by socioeconomic status and minority-language status contributed significantly to the overall trend. Limitations: Limitations include unknown cause of death and SVI score calculation based on county of residency. Conclusions: This investigation highlights significant detrimental trends in HNM management with overall social vulnerability while showcasing the quantifiable associations of specific SDH themes on HNM-disparities.

Szu-Jung Chen, Cheng-Chang Tsai, Sing-Ru Lin et al.

Abstract Background Normal cells express functional tumor suppressor WW domain-containing oxidoreductase (WWOX), designated WWOXf. UV irradiation induces WWOXf cells to undergo bubbling cell death (BCD) — an event due to the accumulation of nuclear nitric oxide (NO) gas that forcefully pushes the nuclear and cell membranes to form one or two bubbles at room temperature (22 °C) and below. In contrast, when WWOX-deficient or -dysfunctional (WWOXd) cells are exposed to UV and/or cold shock, the cells undergo nuclear pop-out explosion death (POD). We aimed to determine the morphological and biochemical changes in WWOXf cells during BCD versus apoptosis. Methods WWOXf and WWOXd cells were exposed to UV followed by measuring BCD or POD by time-lapse microscopy and/or time-lapse holographic microscopy at 4, 22, or 37 °C to visualize morphological changes. Live cell stains were used to measure the kinetics of nitric oxide (NO) production and Ca2+ influx. Extent of cell death was measured by uptake of propidium iodide and by internucleosomal DNA fragmentation using agarose gel electrophoresis. Results WWOXf cells were exposed to UV and then cold shock, or cold shock and then UV, and cultured at 4, 10, and 22 °C, respectively. Initially, UV induced calcium influx and NO production, which led to nuclear bubbling and final death. Cold shock pretreatment completely suppressed UV-mediated bubbling at 37 °C, so the UV/cold shock-treated cells underwent apoptosis. Without cold shock, UV only induced bubbling at all temperatures, whereas the efficiency of bubbling at 37 °C was reduced by greater than 50%. Morphologically, the WWOXf cell height or thickness was significantly increased during cell division or apoptosis, but the event did not occur in BCD. In comparison, when WWOXd cancer cells received UV or UV/cold shock, these cells underwent NO-independent POD. UV/cold shock effectively downregulated the expression of many proteins such as the housekeeping α-tubulin (> 70%) and β-actin (< 50%), and cortactin (> 70%) in WWOXf COS7 cells. UV/cold shock induced relocation of α-tubulin to the nucleus and nuclear bubbles in damaged cells. UV induced co-translocation of the WWOX/TRAF2 complex to the nuclei, in which the prosurvival TRAF2 blocked the proapoptotic WWOX via its zinc finger domain. Without WWOX, TRAF2 did not relocate to the nuclei. Cold shock caused the dissociation of the WWOX/TRAF2 complex in the nucleus needed for BCD. In contrast, the formation of the WWOX/TRAF2 complex, plus p53, was strengthened at 37 °C required for apoptosis. Conclusions The temperature-sensitive nuclear WWOX/TRAF2 complex acts as a molecular switch, whose dissociation favors BCD at low temperatures, and the association supports apoptosis at 37 °C in UV-treated WWOXf cells.

Kyle Seigel, MSc, David Croitoru, MD, Orli M. Silverberg, BSc et al.

Zaida Garcia-Casado, Cristina Pellegrini, William C. Cho

Rajashree Sriram, V Gopal

The skin aging which entails modifications in the entire skin and skin support system is caused as a result of complex blend of intrinsic and extrinsic factors. The main objective of this review is to provide critical insights into the effect of the aging determinants (intrinsic and extrinsic) on aging skin and to focus on a few classes of natural bioactives that were reported to counteract symptoms of cutaneous aging, pose potential, and beneficial health effect on aging skin supported with relevant scientific evidence. The narrative review of this cutaneous antiaging study incorporating the literature findings was retrieved from the search of computerized databases PubMed and Scopus, hand searches, and authoritative books. The antiaging skin care approach of using bioactives are basically nutritional hormetins, available from our natural heritage, identified as potent free radical scavengers, antioxidants, moisturizers, cell repairing agents, and ultraviolet protectives which have started to seek considerable attention among researchers and consumers due to the undesirable effect of chemical-based constituents on human health and environment. With the booming antiaging strategies, beauty has become the prime factor in considering one's health and overall “wellness”. As promoting healthy aging is essential, the objective of aesthetic dermatology should shift from cosmetic interventions to the betterment of quality of life of aging society. The paper also discusses on certain artificial learning/machine-based algorithms, useful in screening of bioactive ingredients, helpful in developing of more tailored formulations. This narrative overview on skin antiaging natural bioactives and artificial learning–based bioactive screening approaches contributes for the improvement in dermatological drug discovery, in the development of novel targeted lead compounds and accelerates aging research and pharmaceutical research.

F. Dalgard, Å. Svensson, J. A. Halvorsen et al.

Itch is a highly prevalent and multi-dimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multi-center study is observational cross-sectional conducted in dermatological clinics across 13 European countries. A total of 3530 patients and 1094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity and intensity), the Hospital Anxiety and Depression Scale, EQ5D-VAS, sociodemographics, suicidal ideation, stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression, suicidal ideation and economic difficulties (odds ratios respectively OR 1.53 (95% CI 1.15 to 2.02), OR 1.27 (95% CI 1.01 to 1.60), OR 1.24 (95% CI 1.10 to 1.50). The mean score of reported generic health status assessed by the EQ5D-VAS was 65.9 (SD=20.1) in patients with itch, compared to 74.7 (SD= 18.0) in patients without itch, p value < .001 and 74.9 (SD= 15.7) in controls with itch compared to 82.9 (SD= 15.6) in controls without itch, p value <.001. Itch contributes substantially to the psychological disease burden in dermatological patients and the management of patients should include access to multidisciplinary care.

Jesús García-Silva, MD, PhD, Petunia Clavo Escribano, MD

J. Marcoval, A. Bauer-Alonso, C. Llobera-Ris et al.

Resumen: Introducción: El tumor de células granulares (TCG) suele desarrollarse en la piel o en la mucosa oral, pero se ha descrito en muchos otros órganos. Suele ser único, pero puede ser múltiple y asociarse a otras enfermedades. Objetivos: Analizar las características clínicas de nuestros pacientes con TCG en la piel y la mucosa oral y su posible asociación con otras afecciones. Material y métodos: Estudio retrospectivo de los pacientes con TCG diagnosticados entre 1995-2019. Se revisaron las historias clínicas para obtener los siguientes datos: edad, sexo, localización, número de lesiones, diámetro, tiempo de evolución, diagnóstico clínico de sospecha, estado de los márgenes de resección, desarrollo de recidiva, tiempo de seguimiento y enfermedades asociadas. Resultados: Ochenta y un pacientes presentaron 89 TCG en la piel y la mucosa oral (43 mujeres/38 varones, edad media 40,21años). El diámetro medio fue de 1,34 cm. Contabilizando los tumores extracutáneos 5 de los 81 pacientes presentaban TCG múltiple (6,2%). La edad media de los pacientes con TCG múltiple fue significativamente inferior a la de los pacientes con un único tumor (p = 0,004). Solamente un paciente presentó recidiva local y ninguno desarrolló metástasis a distancia. No hemos detectado ningún caso asociado a otras enfermedades. Conclusiones: La mayoría de TCG son benignos, y a pesar de tener los márgenes afectados no suelen presentar recidivas locales. Sin embargo, hay que tener en cuenta la posibilidad de presentar TCG múltiples, tanto en la piel y en la mucosa oral como en órganos internos, especialmente en pacientes jóvenes. Abstract: Introduction: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases. Objectives: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases. Material and methods: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients’ medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases. Results: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34 cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P = .004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases. Conclusions: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients.

A. Privalle, T. Havighurst, KyungMann Kim et al.

BACKGROUND There are too few board-certified dermatologists to manage all patients with skin disease. Primary care physicians often serve at the frontline of skin cancer screening. OBJECTIVE To compare biopsy utilization between dermatologists (MDs), dermatology advanced practice professionals (APPs), primary care physicians (PCPs), and other non-dermatology clinicians. METHODS Pathology reports, requisition forms, and clinical notes of skin biopsies submitted to our institution during the study period were reviewed. Skin biopsies for inflammatory conditions, cosmetic or functional purposes, and re-excisions were excluded. The number needed to biopsy (NNB) was calculated as the number of biopsied lesions divided by histologically-proven skin cancers. RESULTS The NNB by clinician type was 2.82 for dermatology MDs, 4.69 for dermatology APPs, 4.55 for non-dermatology PCPs, and 6.55 for other non-dermatology clinicians (P < 0.001). The NNB was significant between clinician groups for NMSC (Derm MD 2.00, Derm APP 2.71, Non-Derm PCP 2.36, and Non-Derm Other 3.47; P < 0.001) but not for melanoma (Derm MD 14.33, Derm APP 20.78, Non-Derm PCP 27.80, and Non-Derm Other 53.56; P=0.061). LIMITATIONS The NNB represents a measure of utilization but gives no insight into the number of malignant lesions that go unbiopsied and, therefore, undiagnosed. The prevalence of skin cancer varies among dermatology and nondermatology practices. The results are not generalizable to all practice settings. CONCLUSIONS AND RELEVANCE Dermatology physicians had the lowest number needed to biopsy of all clinician groups. Primary care physicians performed similarly to dermatology advanced practice professionals.

Raman K Madan, J. Levitt

Reinaldo Tovo Filho, MD, PhD, Francisco César Carnevale, MD, PhD, Tatiane Zago Curi, MD et al.

Pawit Phadungsaksawasdi, Shinsuke Nakazawa, Reiko Kageyama et al.

M. Lacouture, J. Wolchok, G. Yosipovitch et al.

Susan C. Taylor

Hyunsun Park, Min-Woo Kim, J. Lee et al.