Current Issue : October-December Volume : 2023 Issue Number : 4 Articles : 7 Articles
Confluent and reticulated papillomatosis (CARP) is a rare keratinization disorder that presents with asymptomatic, reticulated papules coalescing into plaques, which adversely affect, most often, young black persons. Minocycline is considered the drug of choice, but it is not without its host of potential side effects, including drug hypersensitivity, drug-induced lupus/vasculitis/ hepatitis, blue-gray skin hyperpigmentation, acute eosinophilic pneumonia, pseudotumor cerebri, and vestibular instability, among others. Alternatively, doxycycline might be considered as another first-line agent for CARP as it can effectively clear lesions while offering a more favorable side effect profile in select patients. Herein, we present a case of CARP successfully resolved with doxycycline after a protracted treatment history of topical and oral antifungal medications for suspected tinea versicolor (TV)....
Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved; however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study....
Objectives Skin from people with psoriasis has been extensively studied and is assumed to be identical to skin from those with psoriatic arthritis (PsA). Chemokines and the CC chemokine scavenger receptor ACKR2 are upregulated in uninvolved psoriasis. ACKR2 has been proposed as a regulator of cutaneous inflammation in psoriasis. The aim of this study was to compare the transcriptome of PsA skin to healthy control (HC) skin and evaluate ACKR2 expression in PsA skin. Methods Full-thickness skin biopsies from HC, lesional and uninvolved skin from participants with PsA were sequenced on NovaSeq 6000. Findings were validated using qPCR and RNAscope. Results Nine HC and nine paired PsA skin samples were sequenced. PsA uninvolved skin was transcriptionally similar to HC skin, and lesional PsA skin was enriched in epidermal and inflammatory genes. Lesional PsA skin was enriched in chemokine-mediated signalling pathways, but uninvolved skin was not. ACKR2 was upregulated in lesional PsA skin but had unchanged expression in uninvolved compared with HC skin. The expression of ACKR2 was confirmed by qPCR, and RNAscope demonstrated strong expression of ACKR2 in the suprabasal layer of the epidermis in PsA lesions. Conclusion Chemokines and their receptors are upregulated in lesional PsA skin but relatively unchanged in uninvolved PsA skin. In contrast to previous psoriasis studies, ACKR2 was not upregulated in uninvolved PsA skin. Further understanding of the chemokine system in PsA may help to explain why inflammation spreads from the skin to the joints in some people with psoriasis....
Background. Tranexamic acid (TA) has emerged as a promising treatment for melasma without serious adverse effects. Ethosomes have been reported as the carriers for transdermal drug delivery systems to increase the amount of drug permeation through the skin. However, few studies of the local usage of TA-loaded ethosomes exist. Objectives. To evaluate the efficacy of a mask containing 0.5% TA-loaded ethosomes in the treatment of melasma in the Asian skin. Methods. In a double-blind, placebocontrolled, randomized, prospective study, 88 Asian participants with melasma were randomized 1 :1 to two groups as follows: the TA or control. The TA group was treated with moisturizing masks with 0.5% TA-loaded ethosomes, and the control was treated with moisturizing masks only. Masks were applied once daily for the first two weeks and once every other day for the third and fourth weeks. The primary outcome was measured by the modified melasma area and severity index (mMASI) and a visual analog scale (VAS) for vessels. The secondary outcomes were VAS for skin texture and satisfaction. Results. The reduction of VAS vessel scores at the end of treatment in the TA group was significantly greater than that in the control group (P < 0.001). The mMASI scores and skin texture scores decreased over time in both groups, but no significant differences were found between the two groups (P > 0.05). The score of participant satisfaction in the TA group was significantly higher than that in the control group (P < 0.01). Conclusions. Masks containing TA-loaded ethosomes appear to be an effective treatment for Asian melasma in terms of angiogenesis and skin texture. It improves the pigmentation to some extent but has no significance. This trial is registered with ChiCTR1900024257....
Background Regorafenib, a multikinase inhibitor, causes a high frequency of hand-foot skin reactions (HFSRs). The present study evaluated the efficacy of topical aluminum chloride, a perspiration suppressant, in reducing the severity of hand-foot skin reactions (HFSRs) caused by regorafenib. Methods The present single-arm study included patients with metastatic colorectal cancer receiving regorafenib. Aluminum chloride ointment was applied topically one week prior to the start of regorafenib treatment, and the observation period was 12 weeks. The primary endpoint was the incidence of regorafenib-related grade 3 HFSR. Secondary endpoints were the incidence of all grades of HFSR, time to any grade of HFSR, time to improvement from grade 2 or higher to grade 1 or lower, treatment discontinuation rate, treatment interruption rate or dosage reduction due to HFSR, and incidence of adverse effects of aluminum chloride. Results In total 28 patients were enrolled, and 27 patients were analyzed. The incidence of grade 3 HFSR was 7.4%, meeting the primary endpoint. The incidence of all grades of HFSR was 66.7%, and the median time to the occurrence of any grade of HFSR was 15 days. No patients discontinued or reduced the regorafenib dosage because of HFSR. The most common reason for the interruption of regorafenib therapy was liver dysfunction in nine patients (33%) and HFSR in three patients (11%). No serious adverse events related to aluminum chloride were observed. Conclusions Aluminum chloride ointment, a drug commonly used in routine practice to treat hyperhidrosis, is safe to use, has no serious side effects, and may be effective in reducing the occurrence of severe, regorafenib-related HFSR. Trail registration ClinicalTrials.gov. identifier: jRCTs031180096, Registered on 25/01/2019....
LEOPARD syndrome (LS) is a rare autosomal dominant inherited or sporadic genetic disorder caused commonly by missense mutations in the protein-tyrosine phosphatase-nonreceptor type 11 (PTPN11) gene. Due to its rarity and a high chance of misdiagnosis, the epidemiological profile of LS is poorly established. To the best of our knowledge, this is the second report with a documented PTPN11 gene mutation in Saudi Arabia....
Background. Radiofrequency treatment improves skin aging-related concerns by promoting collagen production. However, studies of the efficacy of multifrequency radiofrequency (MFRF) are lacking. Objectives. This study aimed to analyze the efficacy of MFRF for patients with aging skin. Methods. Three MFRF treatment sessions were performed for patients with concerns about skin aging. During these sessions, MFRF was applied to the face (but not the forehead). Pores, wrinkles, subjective satisfaction, and side effects were evaluated at the first visit and 4 weeks after the last treatment. Additionally, histological and immunohistochemical evaluations of collagen, elastic fibers, and STRO-1 were performed. Results. Wrinkles and the subjective satisfaction of patients were significantly improved (p 0.034 and p 0.001, respectively). However, there was no significant effect on the number of pores (p 0.429). All side effects that occurred after treatment were tolerable and transient. Histological findings revealed thickening of collagen bundles and elastic fibers. Additionally, increases in collagen I, collagen III, and STRO-1 levels were observed using immunohistochemistry. Conclusions. MFRF treatment uses less energy than the existing radiofrequency equipment and can be an effective clinicopathologic modality for facial rejuvenation....
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