Bosentan, a dual-endothelin (ET) receptor antagonist, has emerged as a valuable therapeutic option in dermatology, despite its primary approval for pulmonary arterial hypertension. Bosentan has diverse applications in dermatological conditions, particularly its role in managing digital ulcers (DUs), non-DUs, Raynaud’s phenomenon (RP), and skin fibrosis in scleroderma patients are quite useful. The drug has shown promising results in preventing and treating DUs, with variable efficacy in RP and skin fibrosis. Limited evidence suggests potential benefits of bosentan in dermatomyositis-associated ulcers and port wine stains. The review also discusses bosentan’s pharmacokinetics, dosing regimens, safety profile, and monitoring requirements, highlighting the importance of regular hepatic function surveillance.
Ilknur Yorğun Özdemir, Zeynep Tas Cengiz, Gokturk Dere
et al.
INTRODUCTION: This study aims to investigate whether topical drugs and cosmetic products in dermatological diseases in the facial area increase Demodex infestation and to determine the associated risk factors. METHODS: This cross-sectional study included 193 patients with facial involvement and 102 healthy volunteers who applied to the dermatology outpatient clinic between January 2014 and December 2015. Demographic data, topical medication use, cosmetic product preferences, and facial cleansing habits were recorded. Demodex spp. samples were obtained from five face areas by the standard superficial skin biopsy method, and microscopic examination was performed. RESULTS: The mean age of Demodex positive patients (36.84+-16.4 years) was significantly higher than negative patients (29.84+-13.46 years). Demodex positivity was higher in males (64.9%) than females (44.7%) (p=0.008). Among the diseases, the highest Demodex positivity was found in seborrhoeic dermatitis (70%) and rosacea (66.25%) (p=0.005). Among topical products, the highest Demodex positivity was observed in corticosteroid users (70.37%) and the lowest in tetracycline users (18.18%). In multivariate analysis, male gender (OR=2.27), increasing age (OR=1.38/decad), high body weight (OR=1.17/5kg), rosacea (OR=3.62), seborrheic dermatitis (OR=4.28), topical corticosteroid use (OR=3.87), and face washing with water only (OR=2.31) were determined as independent risk factors. DISCUSSION AND CONCLUSION: Topical corticosteroids, sunscreens, and moisturisers have been shown to increase Demodex infestation in facial dermatological diseases. A strong positive correlation was found between disease severity and Demodex density. Non-irritating cleansing products should be recommended for patients with facial dermatological diseases.
Laura Garriga-Cerda, Alberto Pappalardo, Charlotte Y. Lee
et al.
Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin disorder caused by mutations in COL7A1 . Patient-derived induced pluripotent stem cells (iPSCs) enable the personalized study of RDEB pathogenesis and potential therapies. However, current skin cell differentiation protocols via 2D culture perform suboptimally when applied to engineered 3D skin constructs (ESC). Here, we present an approach to source fibroblasts (iFBs) and keratinocytes (iKCs) from iPSC-derived skin organoids using an optimized differentiation protocol, and utilize them to engineer ESCs modeling wild-type and RDEB phenotypes. The resulting iPSC-derived skin cells display marker expression consistent with primary counterparts and produce ESCs exhibiting significant extracellular matrix remodeling, protein deposition, and epidermal differentiation. RDEB constructs recapitulated hallmark disease features, including absence of collagen VII and reduced iFB proliferation. This work establishes a robust and scalable strategy for generating physiologically-relevant, iPSC-derived skin constructs, offering a powerful model for studying RDEB mechanisms and advancing personalized regenerative medicine.
Deng Huiyan, Tian Xin, Li Huaping, Chen Jiaoquan, Zhu Huilan
Objective To evaluate the degree of skin injury caused by different doses of UVA1 irradiation and balance the relationship between UVA1 phototherapy and photodamage， aiming to maximize the therapeutic benefits. Methods Different doses of UVA1 irradiation were simulated to treat immune-contact sensitized mouse models. The degree of skin photodamage during treatment was observed and photodamage-related indexes were detected. Results With the increase of dose and irradiation times， the proportion of mice with black spots on the skin was significantly higher than that of mice without sunburn or erythema （both P < 0.05）. However， there were no significant changes in skin thickness and histomorphology compared with the non-photosensitized mouse model group. The detection of malondialdehyde （MDA） and reduced glutathione （GSH） on the skin showed that the increase of doses and irradiation times would cause the increase of MDA content （P < 0.05）； For GSH， the increase of doses would cause the decrease of GSH content （P < 0.05）；and the irradiation time exerted no effect （P > 0.05）. Conclusions Different doses of UVA1 phototherapy can cause skin photodamage， which is aggravated with the increase of dose and frequency. However， this photodamage is mild in the short term， especially with low-dose UVA1 irradiation. The balance between phototherapy effect and photodamage needs to be considered for moderate- and high-dose UVA1 irradiation.
Simon F. Thomsen, Ellen C. Pritzier, Chris D. Anderson
et al.
The AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) study investigated outcomes in patients with chronic urticaria refractory to H1-antihistamine. The objective of the current study was to analyse the effects of treatment on patients’ symptoms and quality of life for a period of up to 2 years. Over the 2 years, there was clear improvement in the high rates of disease burden from baseline, as evidenced by lower scores for disease severity scales, better quality of life, and a decreasing rate of medical resource utilization. However, this is the result of treatment adherence to the guidelines in highly specialized Scandinavian urticaria centres, and has its basis in the relatively low treatment intensity and control at enrolment. There is a need for greater adherence to the treatment guidelines and better management of antihistamine-refractory chronic urticaria.
Matteo Doglio, Rachel E. Crossland, Ana C. Alho
et al.
Hematopoietic allogeneic stem cell transplantation (allo-SCT) is a curative option for patients with hematological malignancies. However, due to disparities in major and minor histocompatibility antigens between donor and recipient, severe inflammatory complications can occur, among which chronic graft-versus-host disease (cGVHD) can be life-threatening. A classical therapeutic approach to the prevention and treatment of cGVHD has been broad immunosuppression, but more recently adjuvant immunotherapies have been tested. This review summarizes and discusses immunomodulatory approaches with T cells, including chimeric antigen receptor (CAR) and regulatory T cells, with natural killer (NK) cells and innate lymphoid cells (ILCs), and finally with mesenchymal stromal cells (MSC) and extracellular vesicles thereof. Clinical studies and pre-clinical research results are presented likewise.
Abstract Intravascular large B-cell lymphoma is a rare, non-mass-forming, extranodal large B-cell lymphoma subtype characterized by the presence of tumor cells in the lumens of vessels. It is divided into two major types: classical and Asian. Patients presenting only with skin involvement are mostly female, at a younger age than classical intravascular large B-cell lymphoma patients, and have a better prognosis. Since the diagnosis of cases with isolated skin involvement is difficult, keeping this entity in mind, performing a careful microscopic examination, and applying new, effective treatment regimens will make it possible to achieve better clinical outcomes in these cases.
Abstract Background: Reports regarding the causative drugs of drug-induced cutaneous adverse reactions in China are indistinct, such that different regions have reported the spectrum of drugs differs substantially in different clinical conditions. Objective: To explore the causative drugs that led to cutaneous reactions. Methods: Adverse drug reaction reports from central China were collected and divided into cutaneous adverse reactions and severe cutaneous adverse reactions groups. Cases were reviewed retrospectively for causative drugs. Results: The male:female ratio was equal in both cutaneous adverse reactions and severe cutaneous adverse reactions. In cutaneous adverse reactions (n = 482), the highest incidence happened between 51 and 60 years of age and the top three causative drugs were antibiotics (48%), Chinese medicine (16%), and allopurinol (9%). In severe cutaneous adverse reactions (n = 126), the highest incidence happened between 41 and 50 years of age and the top three causative drugs were sedative-hypnotics and antiepileptics (39%), antibiotics (22%), and allopurinol (15%). Carbamazepine was the most frequently used single-drug (16/18) in sedative-hypnotics and antiepileptics. β-lactams were the most frequently used antibiotics that induced both cutaneous adverse reactions and severe cutaneous adverse reactions. Study limitations: The small sample size, retrospective design, collection of cutaneous adverse reactions and severe cutaneous adverse reactions at different time frames and locations, and exclusion of patients taking more than five medications are limitations of the study. Conclusions: Gender does not affect cutaneous adverse reactions and severe cutaneous adverse reactions. The top three drugs to induce cutaneous adverse reactions are antibiotics, Chinese medicine, and allopurinol, while those that triggered severe cutaneous adverse reactions are sedative-hypnotics and antiepileptics, antibiotics, and allopurinol. Carbamazepine is the most frequent single drug that induces severe cutaneous adverse reactions. β-lactams are the most frequently used antibiotics that induce both cutaneous adverse reactions and severe cutaneous adverse reactions.
La enfermedad IgA lineal es un padecimiento ampolloso de origen autoinmune caracterizado histológicamente por el desarrollo de ampollamiento subepidérmico y por el depósito de inmunoglobulina A (IgA) con patrón lineal y de la fracción C3 del complemento, dirigidos contra antígenos presentes en la zona de membrana basal (ZMB). La heterogeneidad clínica de esta enfermedad se refleja en los dos grupos de edad descritos, pues se reconoce una forma de la infancia y otra del adulto. Adicionalmente se reconoce una diversidad de antígenos implicados en su fisiopatología, de tal manera que estos se podrían agrupar en dos variedades de presentación antigénica en la ZMB: una con antígenos localizados en la lámina lúcida, es decir, en el lado epitelial de la ampolla, y otra con los antígenos localizados en el lado dérmico, en la sublámina densa.
Se muestran dos casos que ilustran las dos variedades de presentación y que permiten también revisar el polimorfismo etiológico de esta enfermedad ampollosa. Se describen adicionalmente dos asociaciones nuevas de esta enfermedad en la forma de la infancia: el lupus eritematoso sistémico y la combinación amoxicilina - ácido clavulánico.
Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences. Ultimately, physicians should strive to make their office a more accommodating environment for transgender individuals.