Abstract Background Body dysmorphic disorder is a common mental disorder among dermatology patients and causes significant psychological distress. However, its screening is usually missed in clinical settings. Moreover, limited studies have been conducted in sub-Saharan Africa, including Ethiopia. Hence, this study aimed to assess the magnitude and associated factors of body dysmorphic symptoms among dermatology patients in an Ethiopian setting. Objective The objective of this study was to assess the magnitude and associated factors of body dysmorphic disorder among dermatology patients during follow-up. Methods A hospital-based cross-sectional study was conducted on a total of 404 study participants from September 1 to 30, 2023. Systematic random sampling was utilized to recruit participants. The Body Dysmorphic Disorder Questionnaire (BDDQ), a screening tool based on DSM-IV criteria, was used to assess body dysmorphic disorders. Multivariable regression analysis was performed to evaluate the strength of associations. A P-value less than 0.05 indicated statistical significance. Results A total of 399 patients participated in the study, for a response rate of 98.8%. The prevalence of body dysmorphic disorder was 70(17.5%) with a 95% CI: (13.8, 21.30). Female sex (AOR = 2.81, 95% (CI = 1.30–6.08), low family income (AOR = 2.26, 95% (1.09–4.69), sexual abuse (AOR = 3.65, 95% (CI = 1.45–9.15), physical abuse (AOR = 2.85, 95% (CI = 1.10–7.39), low self-esteem (AOR = 3.31, 95% (CI = 1.14–9.61), depression (AOR = 2.64; 95% (CI = 1.26–5.53), anxiety (AOR = 2.23, 95% (CI = 1.07–4.63), stress (AOR = 2.76, 95% (CI = 1.34–5.684) and perceived stigma (AOR = 2.46, 95% (CI = 1.20–5.02) were factors associated with body dysmorphic disorder. Conclusion The prevalence of body dysmorphic disorder among dermatology patients was high and positively associated with symptoms such as depression, anxiety, stress, sexual and physical abuse, low self-esteem, and perceived stigma. Therefore, skin health care providers are recommended to screen the patients for body dysmorphic disorder among dermatology patients and facilitate referral to mental health care.
ABSTRACT Non-receptor tyrosine kinase c-Abl is critical for host defense against bacterial and viral infections, yet its role in antifungal immunity remains elusive. Here, we report that inhibition of c-Abl with flumatinib mesylate significantly impairs the survival rate and exacerbates fungal burden in mice infected with Candida albicans. Our findings reveal that c-Abl inhibition reduces production of TNF-α, IL-10, and IL-12 in bone marrow-derived dendritic cells (BMDCs) after stimulation with fungal β-glucan or α-mannan. Mechanistically, c-Abl inhibition significantly blocks p38 and extracellular signal-regulated kinases 1/2 (ERK1/2) activation in BMDCs after α-mannan stimulation in a c-Cbl dependent manner. Collectively, our study uncovers a c-Abl/c-Cbl/MAPK signaling axis in dendritic cells that governs antifungal innate immunity, highlighting c-Cbl as a critical downstream mediator linking c-Abl to host defense against C. albicans. Our findings provide a mechanistic basis for fungal risk assessment in cancer patients treated with c-Abl inhibitors.
Sebastiano Recalcati, Alberto Vassallo, Marta Villanova
et al.
Petrified ear is a rare clinical entity characterized by the progressive hardening of normal flexible auricular cartilage, leading to partial or complete auricular stiffness. In many cases, it provides a valuable clinical clue that allows the clinician to detect endocrinopathies (particularly Addison’s disease) in a patient who has not received a diagnosis. We present the first documented case of petrified ears, which resulted in the diagnosis of both secondary hypoadrenalism and growth hormone deficiency (GHD). Additionally, we review the relevant literature. Petrified ears syndrome is probably an underreported clinical manifestation of other systemic disorders. It may, at times, serve as a useful and simple clinical clue to suspect underlying endocrinopathies even in the absence of typical features.
Ghassan Barnawi, Sarah Kashkari, Arieh Gomolin
et al.
This case report describes a 61-year-old female who developed cutaneous small vessel vasculitis following a calcium-hydroxyapatite-based filler injection. The patient presented with a generalized purpuric and petechial rash, along with arthralgia. A skin biopsy confirmed features consistent with cutaneous small vessel vasculitis. Treatment with a 6-week prednisone taper resulted in complete symptom resolution. This observation warrants further investigation into the potential role of dermal fillers in triggering inflammatory conditions like cutaneous small vessel vasculitis.
Neha Sharma, Harshita Shrivastava, Swati Joshi
et al.
Eczema Herpeticum (EH) or Kaposi’s Varicelliform eruption (KVE) is a severe viral infection that occurs when herpes simplex virus infects an inflamed skin, most often occurring in patients with atopic dermatitis (AD) or other inflammatory skin conditions. To discern various primary dermatoses in which KVE occurred and to study the clinical features, course, and response to specific antiviral treatment along with a course of the primary dermatoses during the episode of KVE. Data was collected in the Dermatology Out-patient department of a tertiary care center in Northern India from December 2017 to March 2024, and it was tabulated and analysed. Out of 14 patients in our study, 57% (n = 8) were male, and 43% (n = 6) were female, with an M:F ratio of 1.3:1. The mean age of presentation was 44.8 years. Eczema herpeticum was present underlying the following primary diseases where, in our study, the maximum patients were of Contact dermatitis 22% (n = 3), followed by Tinea corporis 14.5% (n = 2), Psoriasis 14.5% (n = 2), 7% each of Pemphigus vulgaris (n = 1), Atopic dermatitis (n = 1), Seborrheic dermatitis (n = 1), Burn (n = 1), Lichen simplex chronicus (n = 1), Hansen’s disease with Dapsone hypersensitivity syndrome (n = 1) and Tuberculosis (n = 1). KVE underscores the importance of vigilant management, especially when it is associated with any dermatological disorder where the integrity of the skin is compromised. Early diagnosis and prompt treatment are important to avoid mortality. Careful management of underlying dermatoses also helps in preventing recurrence and complications.
Tatiane Assone, Tatiane Assone, Tatiane Assone
et al.
Human T-Lymphotropic Virus type-1 (HTLV-1) is a unique retrovirus associated with both leukemogenesis and a specific neuroinflammatory condition known as HTLV-1-Associated Myelopathy (HAM). Currently, most proposed HAM biomarkers require invasive CSF sampling, which is not suitable for large cohorts or repeated prospective screening. To identify non-invasive biomarkers for incident HAM in a large Brazilian cohort of PLwHTLV-1 (n=615 with 6,673 person-years of clinical follow-up), we selected all plasma samples available at the time of entry in the cohort (between 1997–2019), in which up to 43 cytokines/chemokines and immune mediators were measured. Thus, we selected 110 People Living with HTLV-1 (PLwHTLV-1), of which 68 were neurologically asymptomatic (AS) at baseline and 42 HAM patients. Nine incident HAM cases were identified among 68 AS during follow-up. Using multivariate logistic regression, we found that lower IL-10, IL-4 and female sex were independent predictors of clinical progression to definite HAM (AUROC 0.91), and outperformed previously suggested biomarkers age, sex and proviral load (AUROC 0.77). Moreover, baseline IL-10 significantly predicted proviral load dynamics at follow-up in all PLwHTLV-1. In an exploratory analysis, we identified additional plasma biomarkers which were able to discriminate iHAM from either AS (IL6Rα, IL-27) or HAM (IL-29/IFN-λ1, Osteopontin, and TNFR2). In conclusion, female sex and low anti-inflammatory IL-10 and IL-4 are independent risk factors for incident HAM in PLwHTLV-1,while proviral load is not, in agreement with IL-10 being upstream of proviral load dynamics. Additional candidate biomarkers IL-29/IL-6R/TNFR2 represent plausible therapeutic targets for future clinical trials in HAM patients.
Layna Mager,1,* Samantha Gardeen,2,* David R Carr,3 Kathryn T Shahwan3– 5 1College of Medicine, The Ohio State University, Columbus, OH, USA; 2Division of Dermatology, HealthPartners, Minneapolis, MN, USA; 3Department of Dermatology, The Ohio State University Medical Center, Columbus, OH, USA; 4Department of Dermatology, Altru Health System, Grand Forks, ND, USA; 5Department of Internal Medicine, University of North Dakota, Grand Forks, ND, USA*These authors contributed equally to this workCorrespondence: Kathryn T Shahwan, Email kathryn.shahwan@osumc.eduAbstract: Five percent of patients with cutaneous squamous cell carcinoma develop locally advanced or metastatic disease that is not amenable to definitive surgical or radiation therapy. Cemiplimab, an antibody against programmed death receptor-1, was approved in the United States for the treatment of locally advanced and metastatic cutaneous squamous cell carcinoma in 2018. We performed a literature review on the use of cemiplimab in cutaneous squamous cell carcinoma, with an emphasis on efficacy, safety and tolerability, patient selection, and future directions. Embase and PubMed were searched for relevant terms, and 23 peer-reviewed journal articles presenting primary data on cemiplimab treatment in 5 or more subjects with cutaneous squamous cell carcinoma were included and summarized. Objective response rates in locally advanced and metastatic disease ranged from 42.9% to 50.8% in Phase I/II clinical trials and 32– 77% (median 58%) in post-approval observational studies. Phase II trials looking at neoadjuvant use also had favorable response rates. Real-world studies demonstrated cemiplimab efficacy in periorbital tumors, tumors with large caliber perineural invasion, and tumors in solid organ transplant recipients. Cemiplimab was safe and well-tolerated in most patients. While side effects such as fatigue, diarrhea, pruritus, and rash were fairly common, only 9.8% of adverse events required cessation of therapy in phase II trials. Severe adverse events were primarily immune-mediated, including pneumonitis, myocarditis, myositis, and autoimmune hepatitis; the risk of treatment-related death was 3% in clinical trials. Further research on cemiplimab therapy in cutaneous squamous cell carcinoma is needed, and trials are now underway to obtain Phase IV long-term real-world data, further data on adjuvant and neoadjuvant use, and additional data in special populations such as stem cell and solid organ transplant recipients.Keywords: cutaneous squamous cell carcinoma, cemiplimab, immunotherapy, immune checkpoint inhibitor, programmed death receptor-1 inhibitor
Barbosa ADP, Espasandin I, Pinheiro de Lima L
et al.
Antony de Paula Barbosa, Isabela Espasandin, Lucas Pinheiro de Lima, Caroline de Souza Ribeiro, Lara Raquel Silva, Thalita Faria Quintal, Evenny Nascimento Lima, Láila Catarina Duarte Vieira, Thaina Ribeiro Soares, Anna Raphaella Autran Colaço Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210 BrazilCorrespondence: Antony de Paula Barbosa, Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Marco Aurélio de Miranda Street, 406/1104, Buritis, Belo Horizonte, Minas Gerais, 30575-210, Brazil, Email drantonybarbosa@gmail.comAbstract: Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.Keywords: body harmonization, BHA, aesthetic dermatology, injectable pharmacotherapy, aesthetic dysfunctions, mesotherapy, bioestimulating fillers, thread
Xianjie Yang,* Juan Wang,* Huan Wang, Minmin Kong, Qiquann Chen Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiquann Chen, Email chenqq0548@163.comAbstract: Acute generalized pustular psoriasis (GPP) is a severe but rare variant of psoriasis, characterized by an acute eruption of extensive erythema with numerous non-follicular pustules. In rare cases, local pustular psoriasis like acrodermatitis continua of Hallopeau (ACH) may progress into acute GPP if improperly treated. ACH and GPP are rare in the clinic and their treatment is more complex and often treatment-resistant compared to psoriasis vulgaris (PV). A variety of anti-psoriasis biologics emerging in recent years have been reported for the treatment of ACH and acute GPP. Biologics is considered to be an upgraded treatment option for traditional anti-psoriasis agents. But there are few reports of GPP patients developing resistance to biologics, or what if biologics fails. Herein, we report a case of acute GPP that developed from ACH, initially responded extremely well to adalimumab, but the treatment failed when the patient treated with the drug again, which is thought to have developed resistance to adalimumab, finally successfully treated with narrowband ultraviolet B (NB-UVB) and acitretin.Keywords: acute generalized pustular psoriasis, acrodermatitis continua of hallopeau, adalimumab, narrowband ultraviolet B, acitretin
Quentin Beauvillain, Catherine Lok, Camille Joachim
et al.
Leprosy is currently uncommon in Europe: the diagnosed cases are almost all imported from endemic areas.We report on an autochthonous case of borderline lepromatous leprosy in a 71-year-old Portuguese woman. The case was complicated by a reversal reaction and then by erythema nodosum leprosum.A literature review identified 18 reported cases of European autochthonous leprosy since 2000; all but one were observed in Mediterranean countries. Therefore, active clusters of leprosy persist in Europe, particularly in Spain, Greece, Portugal, and Italy.
Nobuyuki Maruyama, Yuko Okubo, Masato Umikawa
et al.
Currently, Kaposi’s sarcoma (KS) is treated following the recommendations of international guidelines. These guidelines recommend esophagogastroduodenoscopy/colonoscopy for detecting multicentric KS of visceral lesions. Second primary malignancies (SPMs) are also a common KS complication; however, information on their detection and treatment is unfortunately not yet indicated in these guidelines. This paper reports on an 86-year-old man who suffered from quadruple primary malignancies: skin classic KS with colon adenocarcinoma, oral squamous cell carcinoma (maxilla), and well-differentiated stomach adenocarcinoma. Gastric cancer was incidentally detected during esophagogastroduodenoscopy, which was performed to detect visceral KS. We suggest that esophagogastroduodenoscopy/colonoscopy be routinely performed during the follow-up of patients with KS. As SPMs are crucial complications in patients with KS, these malignancies should be detected as early as possible.
Parvin MANSOURI, Zahra S. NARAGHI, Maliheh AMANI
et al.
Herein we report three married women referred to Dermatology Clinic of Loghman Hakim Hospital, Tehran, Iran in 2017 for evaluation and treatment of genital warts. Two patients were complaining of flat-topped papules on their labia major and the third one was presented with asymptomatic papillary projections on her vestibule and inner aspect of both labia minora. Histological examination revealed the diagnosis of syringoma, lymphangioma circumscriptum (LC) and vestibular papillomatosis respectively. Familiarity with these uncommon conditions which clinically mimic genital warts helps to prevent labeling a patient with sexually transmitted disease before histological confirmation and prevent unnecessary treatment.
Abstract: Background: The behaviour of each basal cell carcinoma is known to be different according to the histological growth pattern. Among these aggressive lesions, sclerodermiform basal cell carcinomas are the most common type. This is a challenging-to-treat lesion due to its deep tissue invasion, rapid growth, risk of metastasis and overall poor prognosis if not diagnosed in early stages. Objective: To investigate if sclerodermiform basal cell carcinomas are diagnosed later compared to non-sclerodermiform basal cell carcinoma Method: All lesions excised from 2000 to 2010 were included. A pathologist classified the lesions in two cohorts: one with specimens of non-aggressive basal cell carcinoma (superficial, nodular and pigmented), and other with sclerodermiform basal cell carcinoma. For each lesion, we collected patient's information from digital medical records regarding: gender, age when first attending the clinic and the tumor location. Results: 1256 lesions were included, out of which 296 (23.6%) corresponded to sclerodermiform basal cell carcinoma, whereas 960 (76.4%) were non-aggressive subtypes of basal cell carcinoma. The age of diagnosis was: 72.78±12.31 years for sclerodermiform basal cell and 69.26±13.87 years for non-aggressive basal cell carcinoma (P<.0001). Sclerodermiform basal cell carcinomas are diagnosed on average 3.52 years later than non-aggressive basal cell carcinomas. Sclerodermiform basal cell carcinomas were diagnosed 3.40 years and 2.34 years later than non-aggressive basal cell carcinomas in younger and older patients respectively (P=.002 and P=.03, respectively). Study limitations: retrospective design. Conclusion: The diagnostic accuracy and primary clinic conjecture of sclerodermiform basal cell carcinomas is quite low compared to other forms of basal cell carcinoma such as nodular, superficial and pigmented. The dermoscopic vascular patterns, which is the basis for the diagnosis of non-melanocytic nonpigmented skin tumors, may not be particularly useful in identifying sclerodermiform basal cell carcinomas in early stages. As a distinct entity, sclerodermiform basal cell carcinomas show a lack of early diagnosis compared to less-aggressive subtypes of BCC, and thus, more accurate diagnostic tools apart from dermatoscopy are required to reach the goal of early-stage diagnosis of sclerodermiform basal cell carcinomas.
Background/Aims: Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV), in a population without chronic kidney disease (CKD). This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known. Methods: Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr) and brachial-ankle PWV (baPWV) at baseline examination. The mean of the right and left baPWV (mPWV) was used as a marker of arterial stiffness. Results: The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, PConclusion: Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.
Dermatology, Diseases of the circulatory (Cardiovascular) system
The regulatory role of epidermal permeability barrier function in cutaneous inflammation has been well appreciated. While barrier disruption induces cutaneous inflammation, improvement of permeability barrier function alleviates inflammation. Studies have demonstrated that improvement of epidermal permeability barrier function not only prevents the development of atopic eczema, but also delays the relapse of these diseases. Moreover, enhancing the epidermal permeability barrier also alleviates atopic eczema. Furthermore, co-applications of barrier enhancing products with glucocorticoids can increase the therapeutic efficacy and reduce the adverse effects of glucocorticoids in the treatment of atopic eczema. Therefore, utilization of permeability barrier enhancing products alone or in combination with glucocorticoids could be a valuable approach in the treatment of atopic eczema. In this review, we discuss the benefits of improving the epidermal permeability barrier in the management of atopic eczema.