Hasil untuk "Dermatology"

Huang H, Chen X, Pan Y et al.

Hong Huang, Xin Chen, Yun Pan, Yichi Zhang, Rentao Yu, Aijun Chen Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Aijun Chen, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Chongqing, CN 4000000, People’s Republic of China, Email chenaijun@hospital.cqmu.edu.cn Rentao Yu, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Chongqing, CN 4000000, People’s Republic of China, Email rentaoyu@hotmail.comObjective: Our study aims to identify risk factors that predict an abnormally prolonged duration of abdominal pain relief (DAPR) in patients with abdominal Henoch–Schönlein purpura (A-HSP) and to construct a nomogram for early prediction.Methods: We reviewed data of all patients (n = 375) with confirmed A-HSP from the Chongqing Medical University platform, from 22 January 2011 to 18 November 2022. After applying rigorous inclusion and exclusion criteria, 220 patients were ultimately enrolled. We split them into two groups by the DAPR: < 1 week and ≥ 1 week. Multivariate relogit regression was performed to select factors associated with DAPR lasting ≥ 1 week, including demographics, symptoms, laboratory results, and treatment. We then constructed a nomogram to estimate risk probability and internally validated its performance via bootstrapping using discrimination, calibration, and clinical utility.Results: There were 220 patients in the training. Multivariate relogit regression analysis demonstrated that age, initial onset, neutrophil-to-lymphocyte ratio (NLR), and bowel wall thickening were independent risk factors for DAPR ≥ 1 week. The Area Under the Curve (AUC) of the nomogram constructed based on the above factors was 0.849. Both the Calibration curve and Decision Curve Analysis (DCA) of the nomogram showed that the model exhibited good fitness.Conclusion: The nomogram can effectively predict the prolonged duration of abdominal pain (≥ 1 week) in A-HSP patients, helping clinicians distinguish high-risk patients at an early stage and optimize treatment plans. However, external validation remains essential before clinical implementation.Plain Language Summary: What is already known about this topic?Abdominal Henoch–Schönlein purpura (A-HSP) typically presents with abdominal pain. Persistent pain raises the risk of dangerous digestive problems, severe illness, or death, resulting in poorer short-term outcomes, particularly in adults.Persistent abdominal pain also raises the risk of kidney involvement. Monitoring pain duration can help in the early detection of kidney damage.We currently lack reliable tools to predict cases of abnormally prolonged abdominal pain for A-HSP patients.What does this study add?Our study found that age, initial onset, bowel wall thickening, and elevated NLR blood levels were linked to abdominal pain lasting ≥ 1 week in A-HSP patients.A scoring tool based on these four factors could help doctors make early treatment decisions. However, it must first be tested in other patient groups before being used in practice.Keywords: IgA vasculitis, allergic purpura, gastrointestinal involvement, predictive model, prognostic factors

Li B, Yao W, Diao R et al.

Bohui Li,1 Wo Yao,1 Ran Diao,1 Boyun Yang,1 Yongfang Wang,1 Ting Li,1 Liuya Ge,2 Huiying Wang1 1Department of Allergy and Clinical Immunology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, People’s Republic of China; 2Outpatient Care Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310009, People’s Republic of ChinaCorrespondence: Huiying Wang, Department of Allergy and Clinical Immunology, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang Province, 310009, People’s Republic of China, Email marywang@zju.edu.cnBackground: Prurigo nodularis (PN), while rare, presents significant clinical challenges due to its diverse pathogenesis and presentation. Effective therapy recommendations for PN remain limited. Upadacitinib, an oral highly selective type 1 Janus-associated kinase (JAK, Intracellular tyrosine kinases that phosphorylate cytokine receptors). Inhibitor plays an excellent role in alleviating itching in atopic dermatitis (AD). This is a report on the treatment of PN with upadacitinib, which offers a new option for refractory PN.Case Presentation: We share our successful treatment experience of upadacitinib on a 43-year-old female patient with refractory PN failing to conventional therapies. She showed significant improvement at the follow-up visits and no obvious adverse effects happened. We also reviewed published case reports of PN patients and PN-related review researches and made a comprehensive discussion of the potential mechanism of JAK1 inhibitors in treating PN.Conclusion: Upadacitinib may be a safe and potent alternative for patients with refractory PN.Keywords: prurigo nodularis, upadacitinib, janus kinase inhibitor, immunotherapy, dermatology

Yonit Wohl, Amir Bentov, Yarden Drutin et al.

Dahlan NH, Sitohang IBS, Indriatmi W et al.

Nelly Herfina Dahlan,1,* Irma Bernadette S Sitohang,1,* Wresti Indriatmi,1 Heri Wibowo,2 Liani Elisabeth Enggy3 1Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 2Department of Integrated Laboratory, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 3Faculty of Medicine, Hasanuddin University, Makassar, Indonesia*These authors contributed equally to this workCorrespondence: Irma Bernadette S Sitohang, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo Hospital, Jalan Salemba Raya No. 6, Jakarta, 10430, Indonesia, Email irma_bernadette@yahoo.comBackground: The inflammatory process in acne vulgaris (AV) is characterized by the upregulation of specific pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6, and IL-8, within sebocytes and keratinocytes. Sebocytes have been identified as target cells for bioactive vitamin D. Experimental studies on animal models have demonstrated the potent comedolytic effects of topical vitamin D. However, further research is required to specifically evaluate the impact of vitamin D on inflammatory lesions in acne vulgaris (AV).Objective: To evaluate the effectiveness of topical vitamin D in treating acne vulgaris (AV) lesions by investigating its anti-inflammatory effects on pro-inflammatory cytokine modulation, specifically assessing the correlation between IL-1β levels in acne lesions and the reduction in AV severity.Materials and Methods: This study is a double-blind, randomized, placebo-controlled clinical trial with a 2-arm design over an 8-week intervention period. Participants were randomly assigned to either the topical vitamin D group (cholecalciferol 50 mcg) or the topical placebo group, with each group comprising 32 subjects. All participants received concomitant treatment with topical adapalene 0.1%. Cytokine levels within acne lesions were assessed using Luminex Polystyrene Screening Assays to detect and quantify IL-1β levels. The effectiveness of the treatment was evaluated by monitoring the reduction in the number of inflammatory lesions, while the safety of topical vitamin D was assessed by documenting and analyzing any reported side effects.Results: The study found a significant correlation between the reduction in IL-1β levels within acne lesions and the decrease in moderate and severe inflammatory lesions in acne vulgaris (p = 0.028). The topical application of vitamin D led to a significant reduction in inflammatory AV lesions (p = 0.045). No significant topical side effects were observed in either the vitamin D or placebo groups.Conclusion: This study demonstrates that the topical administration of vitamin D in acne vulgaris (AV) lesions is effective in reducing pro-inflammatory cytokine levels within acne lesions and in decreasing the severity of AV.Trial Registration: NCT05758259. September 5, 2022.Keywords: acne vulgaris, topical vitamin D, IL-1β, Luminex

Carlo Contini, John Charles Rotondo, Benedetta Perna et al.

Coronavirus Disease 2019 (COVID-19) is a life-threatening disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus which was first reported in late 2019 in China, from where it then spread worldwide [...]

Ana Rostaher, Nina Maria Fischer, Alessio Vigani et al.

Hymenoptera allergens are the main triggers for anaphylaxis in susceptible dogs and humans. Hymenoptera venom specific immunotherapy (VIT), the only disease-modifying treatment, has the potential to prevent future life-threatening reactions in human patients. Prospective clinical data on VIT efficacy in dogs are currently lacking. Therefore, the aim of this study was to show that VIT is not only safe but also efficacious in preventing anaphylaxis in dogs allergic to Hymenoptera. This uncontrolled prospective clinical trial included 10 client-owned dogs with a history of anaphylaxis following repeated Hymenoptera stings. The sensitization to bee and wasp allergens was demonstrated by intradermal testing (IDT) and allergen-specific IgE serology. For VIT induction (induction phase), dogs received a shortened rush immunotherapy protocol with aqueous allergens, which was then followed by monthly injections of 100 µg of alum-precipitated allergen (maintenance phase). VIT efficacy was determined by observing patients’ clinical reactions to re-stings. No systemic adverse events were seen during the induction and maintenance phases. From the seven re-stung dogs, only one developed a mild angioedema at the site of the sting; the remaining dogs were asymptomatic. These results show that VIT represents a safe and effective treatment option for Hymenoptera-allergic dogs.

Chaiwat Washirasaksiri, Naruemit Sayabovorn, Pinyapat Ariyakunaphan et al.

Abstract Few studies have identified the metabolic consequences of the post-acute phase of nonsevere COVID-19. This prospective study examined metabolic outcomes and associated factors in nonsevere, RT-PCR-confirmed COVID-19. The participants’ metabolic parameters, the prevalence of long-term multiple metabolic abnormalities (≥ 2 components), and factors influencing the prevalence were assessed at 1, 3, and 6 months post-onset. Six hundred individuals (mean age 45.5 ± 14.5 years, 61.7% female, 38% high-risk individuals) with nonsevere COVID-19 attended at least one follow-up visit. The prevalence of worsening metabolic abnormalities was 26.0% for BMI, 43.2% for glucose, 40.5% for LDL-c, 19.1% for liver, and 14.8% for C-reactive protein. Except for lipids, metabolic-component abnormalities were more prevalent in high-risk hosts than in healthy individuals. The prevalence of multiple metabolic abnormalities at the 6-month follow-up was 41.3% and significantly higher in high-risk than healthy hosts (49.2% vs 36.5%; P = 0.007). Factors independently associated with a lower risk of these abnormalities were being female, having dyslipidemia, and receiving at least 3 doses of the COVID-19 vaccine. These findings suggest that multiple metabolic abnormalities are the long-term consequences of COVID-19. For both high-risk and healthy individuals with nonsevere COVID-19, healthcare providers should monitor metabolic profiles, encourage healthy behaviors, and ensure complete vaccination.

Anastasia Schleiger, Peter Kramer, Hannes Sallmon et al.

BackgroundDespite improved survival a substantial number of Fontan patients eventually develop late failure. Fontan-associated liver disease (FALD) is the most frequent end-organ dysfunction. Although impaired hemodynamics and Fontan failure correlate with FALD severity, no association between hepatic functional metabolic impairment and Fontan hemodynamics has been established.HypothesisMetabolic liver function measured by liver maximum function capacity test (LiMAx®) correlates with Fontan hemodynamics and Fontan failure.MethodsFrom 2020 to 2022, 58 adult Fontan patients [median age: 29.3 years, IQR (12.7), median follow-up time after Fontan operation: 23.2 years, IQR (8.7)] were analyzed in a cross-sectional study. Hemodynamic assessment included echocardiography, cardiopulmonary exercise testing and invasive hemodynamic evaluation. Fontan failure was defined based on commonly applied clinical criteria and our recently composed multimodal Fontan failure score.ResultsLiMAx® test revealed normal maximum liver function capacity in 40 patients (>315 μg/h*kg). In 18 patients a mild to moderate impairment was detected (140–314 μg/h*kg), no patient suffered from severe hepatic deterioration (≤ 139 μg/kg*h). Fontan failure was present in 15 patients. Metabolic liver function was significantly reduced in patients with increased pulmonary artery pressure (p = 0.041. r = −0.269) and ventricular end-diastolic pressure (p = 0.033, r = −0.325), respectively. In addition, maximum liver function capacity was significantly impaired in patients with late Fontan failure (289.0 ± 99.6 μg/kg*h vs. 384.5 ± 128.6 μg/kg*h, p = 0.007).ConclusionMaximum liver function capacity as determined by LiMAx® was significantly reduced in patients with late Fontan failure. In addition, elevated pulmonary artery pressure and end-diastolic ventricular pressure were associated with hepatic functional metabolic impairment.

Anne Sofie Frølunde, Anne Braae Olesen, Rikke Riber‐Hansen et al.

Abstract Remember EPFI as a differential diagnosis in children with a rash on the scalp and no effect of antibiotic treatment.

Ülker Gül, Zehra Dagli

INTRODUCTION: The use of alcohol-based hand disinfectants (ABHD) is recommended in the COVID-19 pandemic. In this study, it was aimed to analyze the content of ABEDs in our country and to discuss the findings in the light of literature. METHODS: ABHDs in our country were searched on the Google search engine. Content information of the commercial product was saved. Data were analyzed under 5 headings: according to the alcohol ratio, the presence of ethyl and / or isopropyl alcohol, the presence of other disinfectants, the presence of the moisturizer and the formulation recommended according to the World Health Organization (WHO). RESULTS: The most frequently observed alcohol ratios were as follows: 70%, 75%, 65% and 80%. 21% of the products have only ethanol, 15% have only isopropyl alcohol, 34% have ethanol and isopropyl alcohol. Hydrogen peroxide was observed in 6.5% of the products. 44% of the products had glycerin, 10% had glycerin and lanolin. The formulation suggested by WHO was exactly observed in one product. DISCUSSION AND CONCLUSION: Sars-CoV-2 virus can be inactivated by ethanol (> 75%) and isopropanol (> 70%). One of the WHO formulations contains 80% ethanol and the other 75% isopropanol. Alcohol ratio was 70% and above in more than half of ABHDs in our country. These were ethyl and / or isopropyl alcohol. Only one product complied with the WHO formulation. As a result, the most important step for hand hygiene in the COVID-19 pandemic should be the selection of ABHD with the appropriate formulation.

Takaaki Mine, MD, Yuta Koike, MD, PhD, Daisuke Ehara, MD et al.

Anna M. Morenz, Siobhan Wescott, A. Mostaghimi et al.

Importance Understanding geographic and financial barriers to health care is an important step toward creating more accessible health care systems. Yet, the barriers to dermatological care access for American Indian populations in rural areas have not been studied extensively. Objective To evaluate the driving distances and insurance coverage for dermatological care and the current availability of teledermatological programs within the Indian Health Service (IHS) or tribal hospitals system. Design, Setting, and Participants This mixed-methods study was conducted from May 7, 2018, to September 1, 2018, and did not take place in any IHS or tribal health care facility in the continental United States. The study design involved a geographic analysis and a cross-sectional telephone survey with brick-and-mortar dermatology clinics (n = 27) and teledermatological programs (n = 49). Brick-and-mortar clinics were selected for their proximity to a rural IHS or tribal hospital. Main Outcomes and Measures Mean driving distance from rural IHS or tribal hospital to nearest dermatology clinic, number of dermatology clinics within a 35-mile or 90-mile radius of IHS or tribal hospitals, insurance and referral types accepted by dermatology clinics, and number of teledermatological programs collaborating with IHS or tribal hospitals or health centers. Results In total, 27 brick-and-mortar dermatology clinics and 49 teledermatological programs were identified and contacted for the survey. The median (interquartile range [IQR]) driving distance between rural IHS or tribal hospitals and the nearest dermatology clinic was 68 (30-104) miles. Of the 27 dermatology clinics in closest proximity to rural IHS or tribal hospitals (median [IQR] driving distance, 82.4 [31-114] miles), 25 (93%) responded to the survey, 6 (22%) did not accept patients with Medicaid, and 6 (22%) did not accept IHS referrals for patients without insurance. Of the 49 teledermatological programs, 45 (92%) responded and 14 (29%) were no longer active. Ten (20%) teledermatology programs were currently partnering (n = 6), previously partnered (n = 2), or were setting up services (n = 2) with an IHS or tribal site. Only 9% (n = 27) of the 303 rural IHS or facility in the continental United States reported receiving teledermatological services. Conclusions and Relevance Substantial geographic and insurance coverage barriers to dermatological care exist for American Indian individuals in rural communities; teledermatological innovations could represent an important step toward minimizing the disparities in dermatological care access and outcomes.

P. Chernyshov, M. D. Linder, N. Pustišek et al.

Hertz-Kleptow D, Hanschmann A, Hofmann M et al.

Dominique Hertz-Kleptow,1 Angelika Hanschmann,2 Matthias Hofmann,2 Tilmann Reuther,1 Martina Kerscher11University of Hamburg, Division of Biochemistry and Molecular Biology, Cosmetic Science, D-20146 Hamburg, Germany; 2Global Clinical Development, Merz Pharmaceuticals GmbH, Frankfurt, GermanyBackground: Hyaluronic acid (HA) fillers are popular for the treatment of signs of facial skin aging.Objective: The objective of this study was to confirm the performance and safety of a new cohesive polydensified matrix HA filler ([CPM®-HA20G, Belotero Revive,® lidocaine-free], Merz Pharmaceuticals GmbH, Frankfurt, Germany) for the treatment of early signs of facial skin aging by use of biophysical measurements as well as subject and investigator satisfaction.Methods: Twenty-five healthy female subjects with signs of facial skin aging were enrolled in this open-label, rater-blinded, observational post-market clinical follow-up study, and received 20 micropuncture treatments of 50 μL CPM®-HA20G each into the lower cheek area at three injection visits 4 weeks apart. Objective biophysical assessments were conducted to demonstrate effects on viscoelastic properties of the skin, surface roughness, tone and radiance, and hydration, at baseline and at all follow-up visits up to 36 weeks.Results: CPM®-HA20G significantly increased gross elasticity of the skin (at weeks 9 and 12), skin firmness (up to week 24), skin tone and radiance and skin hydration (all up to 36 weeks). Significant reduction of skin fatigue (up to 9 weeks), skin roughness (up to 28 weeks), and redness (up to 36 weeks) was also observed. Subjects and blinded investigator were highly satisfied with the treatment outcomes. The treating investigator reported a high level of satisfaction with the ease of injection and the clinical performance of the device. Moreover, data demonstrated a good safety profile of the device.Conclusion: CPM®-HA20G is considered to be an effective and safe HA injectable for skin revitalization in patients suffering from signs of skin aging and loss of skin elasticity. It seems to be a perfect early intervention approach in patients that do not need volumizing treatment and a combination approach in older patients with more pronounced aging.Keywords: hyaluronic acid, filler, cohesive polydensified matrix, skin revitalization

Paula Andrea López, Alejandro Posada

Se trata de un paciente de sexo masculino de 35 años de edad con una masa no dolorosa de crecimiento progresivo, en el hélix de la oreja derecha, de un año de evolución.

Gustav Boelsgaard Christensen, Christian Ingvar, Linda Werner Hartman et al.

The incidence of cutaneous squamous cell carcinoma has increased rapidly in Sweden in the past decades. Here, we present a prospective study of the Melanoma in Southern Sweden (MISS)-cohort, with 29,460 participating women in southern Sweden that investigates the risk factors for cutaneous squamous cell carcinoma. Data on the host and skin cancer risk factors were collected through questionnaires and then matched with the National Cancer Registry. Statistical analyses were based on uni- and multivariable Cox proportional hazards models, using age as the time-scale. We found that sunbed use (hazard ratio (HR) 1.2, 95% CI: 1.1–1.4), red and light blond hair (HR 1.6, 95% CI: 1.1–2.3), freckles (HR 1.4, 95% CI: 1.1–1.8) and immunosuppressive medications (HR 2.1, 95% CI: 1.3–4.5) were independent risk factors. Furthermore, we observed a dose-dependent relationship between sunbed use and the development of cutaneous squamous cell carcinoma. Our findings support the idea of integrating dermatological follow-up examinations for immunosuppressed patients and banning the use of sunbeds in order to prevent cutaneous squamous cell carcinoma.

A. Di Landro, S. Cazzaniga, F. Parazzini et al.

I. Deckers, I. Janse, H. H. van der Zee et al.

Sanjeev Gupta, R. Bansal, Sunita Gupta et al.

Nanotechnology (nano: One billionth) is a novel arena with promising applications in the field of medicine, especially pharmaceuticals for safe and targeted drug delivery. The skin is a phenomenal tool for investigation of nanocarriers for drug delivery for topical and dermatological application. The physicochemical characteristics of the nanoparticles, such as rigidity, hydrophobicity, size and charge are crucial to the skin permeation mechanism. Many nanocarriers such as polymeric, inorganic and lipid nanoparticles and nanoemulsions have been developed and some like carbon nanotubes and fullerenes still need further exploration for future use in skin care and dermatological treatments. Risks of nanopollution and cytotoxicity also need to be kept in mind while exploring various nanoparticles for medical use.