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Impact of psoriatic disease on women aged 18 to 45: Results from a multinational survey across 11 European countries

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Aug 28;7(5Part B):697-707. doi: 10.1016/j.ijwd.2021.08.011. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Plaque psoriasis (PSO) is a long-term inflammatory condition that can cause concomitant joint symptoms (psoriatic arthritis [PsA]) in up to 30% of patients. The impact of psoriatic disease on disease outcomes and quality of life is greater in women than men.

OBJECTIVE: We evaluated the impact of psoriatic disease on women aged 18 to 45 years across Europe.

METHODS: Women aged 18 to 45 years with moderate to severe PSO, PsA, or PSO + PsA (PSO with progression to PsA) and prior biologic experience were recruited from market research panels and patient association groups of the International Federation of Psoriasis Associations, European Federation of Psoriasis Patient Associations, and Arthritis Ireland and asked to complete a survey. Questions covered social and psychological wellbeing, employment, and family planning. Question types included 5- or 7-point agreement scales, where the highest/lowest two ratings were considered agreement/disagreement, respectively. The results are reported as proportions of those who selected the answer, divided by overall respondents for each question. Women were not required to answer all questions.

RESULTS: Survey respondents (N = 573) had a diagnosis of PSO (n = 236), PsA (n = 173), or PSO + PsA (n = 164). Women self-reported similar mean scores for physical (57.0 of 100) and mental (59.0 of 100) health. A fifth (21%) had not achieved their desired career due to PSO/PsA; career dissatisfaction and increased sick leave were linked to poor mental health. Some women reported having a limited social life (33%), smaller families (34%), and being more likely to adopt children (27%) due to PSO/PsA. A quarter of women (27%) reported not understanding enough about PSO/PsA (nonmembers vs. members of patient association groups: 37% vs. 8%).

CONCLUSION: Our findings highlight the considerable burden of psoriatic disease on women of childbearing age. Increased provision of information tailored to women, training for health care professionals, and shared decision-making between patients and health care professionals may help better support women with psoriatic disease.

PMID:35028368 | PMC:PMC8714576 | DOI:10.1016/j.ijwd.2021.08.011

Категории: MedLine

Hormone therapy and melanoma in women

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Jun 25;7(5Part B):692-696. doi: 10.1016/j.ijwd.2021.06.005. eCollection 2021 Dec.

ABSTRACT

Although primary cutaneous melanoma accounts for approximately 3% of all malignant skin tumors, it has the greatest contribution to skin cancer-related death. Sex-specific differences in melanoma tumor behavior have been described, and melanoma pathogenesis may be hormonally mediated. This review aims to summarize the literature to date regarding the effects of hormone therapy on melanoma in women. Women's exogenous hormone use has changed dramatically over the past few decades. Thus, we focus on studies investigating the associations between oral contraception, fertility treatments, menopausal hormone therapy (MHT), and melanoma. Across hormone therapy types, there does not appear to be a well-established association between exogenous female hormones and melanoma incidence. However, MHT practices and formulations vary significantly across countries. Although MHT does not appear to increase melanoma risk in studies from the United States, conflicting results have been observed in Europe. Unopposed estrogen MHT formulations require further investigation to determine a clear pattern between hormone use and the development of melanoma.

PMID:35028367 | PMC:PMC8714603 | DOI:10.1016/j.ijwd.2021.06.005

Категории: MedLine

Negative perceptions and emotional impact of striae gravidarum among pregnant women

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Nov 3;7(5Part B):685-691. doi: 10.1016/j.ijwd.2021.10.015. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: The impact of striae gravidarum (SG), or stretch marks of pregnancy, on quality of life (QoL) is unclear.

OBJECTIVE: The purpose of this study was to investigate how SG affect QoL in pregnant women.

METHODS: In this cross-sectional survey study of healthy pregnant women who developed SG during their current pregnancy, we asked about the impact of lesions on emotional, psychological, and life-quality facets. Spearman product-moment correlation coefficients were generated to determine the strength of relationships between variables.

RESULTS: We analyzed 116 valid surveys. Participants reported permanency of SG as the top physical concern (n = 87; 75%). With regard to severity, nearly three-quarters of participants rated their lesions as very prominent (n = 24; 21%) or moderate (n = 57; 49%). Among the life-quality facets queried, embarrassment/self-consciousness was the most frequently associated with SG, with over one-third of participants reporting "a lot" (n = 19; 16%) or a "moderate" (n = 26; 22%) amount of embarrassment/self-consciousness related to having SG. Lesion severity significantly correlated with the degree of embarrassment/self-consciousness (r = .543), as well as the impact of SG on other life-quality facets, including overall QoL (r = .428), clothing choice (r = .423), self-image/self-esteem (r = .417), feelings of anxiety/depression (r = .415), and social activities (r = .313; all p ≤ .001). Nearly one-quarter of participants believed that emotional distress related to SG was similar or greater than that caused by other skin problems, such as acne, psoriasis, or eczema.

CONCLUSION: SG can be associated with a host of negative reactions reflecting increased psychological and emotional distress, including embarrassment and decreased QoL. These consequences may compound the emotional stress of pregnancy, potentially warranting psychological support and adjustment strategies.

PMID:35028366 | PMC:PMC8714569 | DOI:10.1016/j.ijwd.2021.10.015

Категории: MedLine

Identification of skin signs in human-trafficking survivors

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Oct 2;7(5Part B):677-682. doi: 10.1016/j.ijwd.2021.09.011. eCollection 2021 Dec.

ABSTRACT

Human-trafficking survivors suffer significant physical, mental, and social health consequences, prompting them to seek health care services. Although there is research regarding identification protocols for human-trafficking victims, there is no framework outlining the dermatologic patterns of survivors of human trafficking. We sought to identify the dermatologic signs reported in human-trafficking victims to create a framework for dermatologists and the broader medical community to appropriately screen patients at risk. After screening 577 pertinent records in the PubMed and Google Scholar databases for information about the physical signs of human trafficking in health care, 10 final studies were selected. Significant findings of rashes and brandings, such as tattoos, were more likely in sex-trafficked patients, whereas burns, injuries, and deep cuts were more likely to be found in labor-trafficked patients. This review outlines important identification guidelines that dermatologists and the broader medical community can use to recognize victims and take appropriate action while also raising awareness of human trafficking as an emerging public health issue.

PMID:35028364 | PMC:PMC8714580 | DOI:10.1016/j.ijwd.2021.09.011

Категории: MedLine

Clinical considerations in the management of hidradenitis suppurativa in women

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Oct 29;7(5Part B):664-671. doi: 10.1016/j.ijwd.2021.10.012. eCollection 2021 Dec.

ABSTRACT

Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the skin with a predilection for women. The role of sex hormones, including estrogen and progesterone, is incompletely understood, but alterations in hormone levels may play a role in disease activity for many patients. Specific clinical considerations should be made for women with HS, particularly in the setting of pregnancy, childbirth, breastfeeding, and menopause. Current knowledge gaps regarding HS include the cumulative impact of disease across an individual's lifespan, as well as the mechanistic role of sex hormones in the disease. An improved understanding of the pathophysiologic role of hormones in HS would optimize our ability to use targeted therapies for hormonally driven disease. Psychological and psychosexual support for women with HS is an important facet of any holistic management strategy for the disease. This article integrates up-to-date pathogenic and mechanistic insights with evidence-based clinical management to optimize care for women with HS.

PMID:35028361 | PMC:PMC8714605 | DOI:10.1016/j.ijwd.2021.10.012

Категории: MedLine

Cutaneous metastasis of bladder urothelial carcinoma; A rare conditions

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Urol Case Rep. 2021 Nov 22;41:101955. doi: 10.1016/j.eucr.2021.101955. eCollection 2022 Mar.

ABSTRACT

Cutaneous is an extremely rare metastatic area of bladder urothelial carcinoma. Pure cutaneous metastasis without systemic metastasis is very rare and less than ten cases have been reported in the literature. Our patient had various lymphatic fistulas to her skin due to pelvic lymphadenectomy and radiotherapy in her previous cervical cancer. We believe that the most probable mechanism underlying our patient's cutaneous metastasis is a lymphatic spread via those lymphatic fistulas. Immunotherapy is a very important option for patients who cannot receive cisplatin. This is the second case in the literature to apply immunotherapy in the setting of cutaneous metastasis of bladder cancer.

PMID:35028295 | PMC:PMC8739474 | DOI:10.1016/j.eucr.2021.101955

Категории: MedLine

Pleomorphic Appearance of Breast Cancer Cutaneous Metastases

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Cureus. 2021 Dec 9;13(12):e20301. doi: 10.7759/cureus.20301. eCollection 2021 Dec.

ABSTRACT

Cutaneous metastases occur in approximately 10% of oncology patients as a feature of a persistent solid tumor or the harbinger of recurrent neoplastic disease. However, they can be the presenting manifestation of an unsuspected visceral malignancy in one percent of previously cancer-free individuals. Metastatic skin lesions from breast carcinoma are diverse in their appearance. The clinical presentation of cutaneous metastases in three women with breast cancer is described and both the morphology of skin metastases caused by breast carcinoma and the conditions that are mimicked by breast cancer cutaneous metastases are reviewed. Skin metastases from breast carcinoma commonly appear as firm, flesh-colored to red, smooth or ulcerated or crusted, nodules, papules, and plaques on the ipsilateral chest wall and breast. However, unique sites of breast cancer cutaneous metastases are the eyelids, inframammary folds, ipsilateral lymphedematous arm, scalp, subungual nail bed, and umbilicus; in addition, skin metastases can occur in mastectomy scars and radiation therapy ports. Carcinoma erysipelatoides, carcinoma telangiectoides, and carcinoma en cuirasse are classic patterns of skin metastases that can be observed in breast cancer patients; carcinoma hemorrhagiectoides is a recently observed skin metastases pattern that has also been noted in oncology patients with breast carcinoma. The pleomorphic skin lesions of breast cancer metastases can masquerade as benign cutaneous lesions and tumors (such as a collision tumor, cyst, dermatofibroma, and milia-en-plaque), cutaneous malignancies (such as melanoma and non-melanoma skin cancers), infections (such as cellulitis, folliculitis, herpes zoster, and paronychia), reactive erythema (such as erythema annulare centrifugum, and urticaria), skin conditions (such as alopecia areata, dermatitis, hidradenitis suppurativa, and scleroderma), and vascular lesions (such as angiokeratoma, angiosarcoma, lymphangioma circumscriptum, purpura, and pyogenic granuloma). In addition, breast carcinoma cutaneous metastases can not only mimic other miscellaneous conditions such as erosions and ulcers, Paget's disease, and papillomatosis cutis lymphostatica but also have unusual morphology such as targetoid lesions or a sharply demarcated red infiltration of the nasal tip similar to a clown's nose. The possibility of a breast cancer cutaneous metastasis should be considered in the evaluation of a patient with breast cancer--and although less likely, in a cancer-free individual--who develops a new and/or a treatment-unresponsive cutaneous lesion. A biopsy of the skin lesion is necessary to confirm the diagnosis of breast cancer cutaneous metastasis.

PMID:35028206 | PMC:PMC8747974 | DOI:10.7759/cureus.20301

Категории: MedLine

Giant congenital melanocytic nevus in an Afghan child

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Clin Case Rep. 2022 Jan 9;10(1):e05258. doi: 10.1002/ccr3.5258. eCollection 2022 Jan.

ABSTRACT

We report an 8-year-old Afghan female with giant congenital melanocytic nevus (GCMN) which covered the entire back. The GCMN extended to anterolateral parts of the trunk surrounded by multiple satellite melanocytic nevi.

PMID:35028147 | PMC:PMC8743421 | DOI:10.1002/ccr3.5258

Категории: MedLine

Bart's syndrome associated with a disorder of sexual differentiation: An atypical presentation in a Cameroonian newborn

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Clin Case Rep. 2022 Jan 7;10(1):e05234. doi: 10.1002/ccr3.5234. eCollection 2022 Jan.

ABSTRACT

Bart's syndrome consists of congenital aplasia of the skin affecting only the lower limbs, associated with bullae over the skin and/or mucous membranes, as well as a nail anomaly. It is an extremely rare genetic disorder, which can be associated with other birth defects. We report the case of a newborn baby admitted at day 0 of life in the neonatal department, for multifocal skin detachment predominantly at the lower limbs. In addition, examination of the external genitalia revealed a clitoridomegaly genital bud measuring 14 mm, scrotalized and unfused genital bulges with the presence of 2 orifices. No gonad was palpated. The clinical diagnosis of Bart's syndrome associated with a disorder of sexual differentiation was retained. We hereby report the first case of Bart's syndrome described in Cameroon in association with a disorder of sexual differentiation.

PMID:35028143 | PMC:PMC8741868 | DOI:10.1002/ccr3.5234

Категории: MedLine

Circulating CD8<sup>+</sup> mucosal-associated invariant T cells correlate with improved treatment responses and overall survival in anti-PD-1-treated melanoma patients

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Clin Transl Immunology. 2022 Jan 10;11(1):e1367. doi: 10.1002/cti2.1367. eCollection 2022.

ABSTRACT

OBJECTIVES: While much of the research concerning factors associated with responses to immune checkpoint inhibitors (ICIs) has focussed on the contributions of conventional peptide-specific T cells, the role of unconventional T cells, such as mucosal-associated invariant T (MAIT) cells, in human melanoma remains largely unknown. MAIT cells are an abundant population of innate-like T cells expressing a semi-invariant T-cell receptor restricted to the MHC class I-like molecule, MR1, presenting vitamin B metabolites derived from bacteria. We sought to characterise MAIT cells in melanoma patients and determined their association with treatment responses and clinical outcomes.

METHODS: In this prospective clinical study, we analysed the frequency and functional profile of circulating and tumor-infiltrating MAIT cells in human melanoma patients. Using flow cytometry, we compared these across metastatic sites and between ICI responders vs. non-responders as well as healthy donors.

RESULTS: We identified tumor-infiltrating MAIT cells in melanomas across metastatic sites and found that the number of circulating MAIT cells is reduced in melanoma patients compared to healthy donors. However, circulating MAIT cell frequencies are restored by ICI treatment in responding patients, correlating with treatment responses, in which patients with high frequencies of MAIT cells exhibited significantly improved overall survival.

CONCLUSION: Our results suggest that MAIT cells may be a potential predictive marker of responses to immunotherapies and provide rationale for testing MAIT cell-directed therapies in combination with current and next-generation ICIs.

PMID:35028137 | PMC:PMC8743567 | DOI:10.1002/cti2.1367

Категории: MedLine

Allergy to polyethylene glycol and polysorbates in a patient cohort: Diagnostic work-up and decision points for vaccination during the COVID-19 pandemic

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Clin Transl Allergy. 2022 Jan 8;12(1):e12111. doi: 10.1002/clt2.12111. eCollection 2022 Jan.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic focus has been on polyethylene glycol (PEG) and polysorbate as these excipients are constituents in the first vaccines and possible elicitors of allergic reactions to the vaccines. We aimed to evaluate the possibility of vaccinating patients with PEG and/or polysorbate allergy against COVID-19.

METHODS: Twenty-five patients with a history of an allergic reaction to drugs, vaccines and mouth hygiene products containing PEG or polysorbate and sensitization (skin test or in vitro test) or a positive challenge were included. We re-evaluated 19 of 21 patients diagnosed before 2021 and four new patients by skin prick tests (SPT) and Basophil Histamine Release (BaHR) for PEGs, polysorbates and approved COVID-19 vaccines as well as measurement of specific IgE (PEG 2000, 10,000). Patients were offered vaccination based on decision points from the primary diagnosis and re-evaluation.

RESULTS: Most common primary elicitors were depot-steroids and laxatives. Most patients had experienced more than one reaction. SPT was superior to BaHR test although many SPTs became negative over time. After careful re-evaluation three patients were successfully vaccinated with the Pfizer/BioNTech vaccine. Three were vaccinated before referral. Eleven were offered the Johnson-Johnson vaccine; four were vaccinated successfully, seven abstained. Six patients could not be vaccinated with PEG or polysorbate containing vaccines.

CONCLUSION: Hypersensitivity to excipients in COVID-19 vaccines constitutes a risk to patients with allergy to PEG or polysorbates. After diagnostic evaluation, a safe COVID-19 vaccine could be offered to most patients, the remainders will await new vaccines containing different excipients.

PMID:35028130 | PMC:PMC8742452 | DOI:10.1002/clt2.12111

Категории: MedLine

Candidate Genes of Allergic Dermatitis Are Associated with Immune Response

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

J Healthc Eng. 2022 Jan 4;2022:8745722. doi: 10.1155/2022/8745722. eCollection 2022.

ABSTRACT

Allergic dermatitis (AD) is a common and burdensome inflammatory skin disease, and diagnosis is challenging. This study was conducted to identify candidate genes for AD diagnosis and underlying molecular mechanisms. Gene expression profiles were obtained from datasets GSE121212, GSE130588, and GSE157194. Use differential analysis to identify differentially expressed genes (DEGs) between AD and control. Use enrichment analysis to identify potential molecular dysregulation mechanisms. Comprehensive least absolute shrinkage and selection operator (LASSO) logistic regression, receiver operator characteristic (ROC) curve, and logistic regression analysis are used to identify candidate genes. In addition, ssGSEA and ImmPort database were used to identify AD-related immune response abnormalities. In this study, a total of 60 common genes were identified. Enrichment analysis found that these genes are mainly involved in Th17 cell immune and complement and coagulation cascades. LASSO regression analysis identified 18 feature genes, and screened genes with AUC >0.75 were selected as candidate genes. Finally, PLA2G4D, IFI6, AGR3, IGFL1, SPRR3, ATP13A5, SERPINB13, KRT16, HAS3, and CH25H were recognized as candidate genes and may be able to diagnose AD. PLA2G4D, CH25H, and IFI6 may be risk factors for AD based on logistic analysis. Furthermore, we identified the abnormalities of immune response activation in AD patients. Interestingly, PLA2G4D, CH25H, and IFI6 had positive correlations with immune cells and signaling pathways. PLA2G4D, CH25H, and IFI6 may be candidate diagnostic genes for AD. This may be related to their promotion of abnormal immune activation, especially Th17 cell immune.

PMID:35028126 | PMC:PMC8752225 | DOI:10.1155/2022/8745722

Категории: MedLine

Trends in the molecular epidemiology and population genetics of emerging <em>Sporothrix</em> species

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Stud Mycol. 2021 Dec 17;100:100129. doi: 10.1016/j.simyco.2021.100129. eCollection 2021 Sep.

ABSTRACT

Sporothrix (Ophiostomatales) comprises species that are pathogenic to humans and other mammals as well as environmental fungi. Developments in molecular phylogeny have changed our perceptions about the epidemiology, host-association, and virulence of Sporothrix. The classical agent of sporotrichosis, Sporothrix schenckii, now comprises several species nested in a clinical clade with S. brasiliensis, S. globosa, and S. luriei. To gain a more precise view of outbreaks dynamics, structure, and origin of genetic variation within and among populations of Sporothrix, we applied three sets of discriminatory AFLP markers (#3 EcoRI-GA/MseI-TT, #5 EcoRI-GA/MseI-AG, and #6 EcoRI-TA/MseI-AA) and mating-type analysis to a large collection of human, animal and environmental isolates spanning the major endemic areas. A total of 451 polymorphic loci were amplified in vitro from 188 samples, and revealed high polymorphism information content (PIC = 0.1765-0.2253), marker index (MI = 0.0001-0.0002), effective multiplex ratio (E = 15.1720-23.5591), resolving power (Rp = 26.1075-40.2795), discriminating power (D = 0.9766-0.9879), expected heterozygosity (H = 0.1957-0.2588), and mean heterozygosity (Havp = 0.000007-0.000009), demonstrating the effectiveness of AFLP markers to speciate Sporothrix. Analysis using the program structure indicated three genetic clusters matching S. brasiliensis (population 1), S. schenckii (population 2), and S. globosa (population 3), with the presence of patterns of admixture amongst all populations. AMOVA revealed highly structured clusters (PhiPT = 0.458-0.484, P < 0.0001), with roughly equivalent genetic variability within (46-48 %) and between (52-54 %) populations. Heterothallism was the exclusive mating strategy, and the distributions of MAT1-1 or MAT1-2 idiomorphs were not significantly skewed (1:1 ratio) for S. schenckii (χ2 = 2.522; P = 0.1122), supporting random mating. In contrast, skewed distributions were found for S. globosa (χ2 = 9.529; P = 0.0020) with a predominance of MAT1-1 isolates, and regional differences were highlighted for S. brasiliensis with the overwhelming occurrence of MAT1-2 in Rio de Janeiro (χ2 = 14.222; P = 0.0002) and Pernambuco (χ2 = 7.364; P = 0.0067), in comparison to a higher prevalence of MAT1-1 in the Rio Grande do Sul (χ2 = 7.364; P = 0.0067). Epidemiological trends reveal the geographic expansion of cat-transmitted sporotrichosis due to S. brasiliensis via founder effect. These data support Rio de Janeiro as the centre of origin that has led to the spread of this disease to other regions in Brazil. Our ability to reconstruct the source, spread, and evolution of the ongoing outbreaks from molecular data provides high-quality information for decision-making aimed at mitigating the progression of the disease. Other uses include surveillance, rapid diagnosis, case connectivity, and guiding access to appropriate antifungal treatment.

PMID:35027980 | PMC:PMC8693333 | DOI:10.1016/j.simyco.2021.100129

Категории: MedLine

The Effects of Hedgehog Signaling Pathway on the Proliferation and Apoptosis of Melanoma Cells

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

J Oncol. 2022 Jan 4;2022:4984866. doi: 10.1155/2022/4984866. eCollection 2022.

ABSTRACT

BACKGROUND: Studies have found that the abnormality of the Hedgehog signaling pathway is related to the occurrence and development of a variety of tumors, but the effect of this signaling pathway on melanoma cells is still unclear.

METHODS: This study aimed to discuss the effect of Hedgehog signaling pathway on the proliferation and apoptosis of human malignant melanoma A375 cells and explore its possible mechanism in the proliferation and apoptosis of melanoma cells. Different concentrations of Hedgehog signaling pathway inhibitor cyclopamine (5, 10, 20 and 40 μM) were used to treat human melanoma A375 cells for 24, 48, and 72 h, and set a blank control group (0 μM). Trypan blue cell counting method was used to detect cell viability. MTT method was used to detect the inhibition rate of cell proliferation. Transwell was used to detect cell invasion, and flow cytometry was used to detect cell apoptosis.

RESULTS: Through the trypan blue cell counting method and MTT experiment, it was found that the Hedgehog signaling pathway inhibitor cyclopamine has an inhibitory effect on the proliferation and viability of melanoma A375 cells (P < 0.05), and the proliferation inhibitory effect is enhanced with prolonged action time in a dose- and time-dependent manner. Transwell experiment showed that compared with the blank control group, the invasion and migration ability of the treated melanoma A375 cells are significantly reduced, and the difference is statistically significant (P < 0.05). Cell apoptosis experiment showed that compared with the blank control group, the apoptosis rate of A375 cells is significantly higher after treated by 40 μM cyclopamine for 24 h, and the difference is statistically significant (P < 0.05). Gli1 and Bcl-2 protein are highly expressed in melanoma A375 cells, and their expressions show a downward trend (P < 0.05) after being treated by cyclopamine.

CONCLUSION: Cyclopamine inhibits cell proliferation and induces cell apoptosis by downregulating Gli1. Hedgehog signaling pathway can be used as a new target for the treatment of malignant melanoma, and multiple measures can be used to inhibit the signaling pathway to achieve a therapeutic effect.

PMID:35027924 | PMC:PMC8752239 | DOI:10.1155/2022/4984866

Категории: MedLine

Modulation of Ryanodine Receptors Activity Alters the Course of Experimental Autoimmune Encephalomyelitis in Mice

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Front Physiol. 2021 Dec 17;12:770820. doi: 10.3389/fphys.2021.770820. eCollection 2021.

ABSTRACT

Ryanodine receptors (RyRs), the intracellular Ca2+ release channels, are expressed in T lymphocytes and other types of immune cells. Modulation of RyRs has been shown to affect T cell functions in vitro and immune responses in vivo. The effects of modulation of RyRs on the development of autoimmune diseases have not been investigated. Here we studied how modulation of RyRs through administration of RyR inhibitor dantrolene or introducing a gain-of-function RYR1-p.R163C mutation affects clinical progression of experimental autoimmune encephalomyelitis (EAE) in mice, a T cell-mediated autoimmune neuroinflammatory disease. We found that daily intraperitoneal administration of 5 or 10 mg/kg dantrolene beginning at the time of EAE induction significantly reduced the severity of EAE clinical symptoms and dampened inflammation in the spinal cord. The protective effect of dantrolene on EAE was reversible. Dantrolene administration elicited dose-dependent skeletal muscle weakness: mice that received 10 mg/kg dose developed a waddling gait, while 5 mg/kg dantrolene dose administration produced a reduction in four-limb holding impulse values. Mice bearing the gain-of-function RYR1-p.R163C mutation developed the EAE clinical symptoms faster and more severely than wild-type mice. This study demonstrates that RyRs play a significant role in EAE pathogenesis and suggests that inhibition of RyRs with low doses of dantrolene may have a protective effect against autoimmunity and inflammation in humans.

PMID:35027891 | PMC:PMC8751758 | DOI:10.3389/fphys.2021.770820

Категории: MedLine

Accuracy and Quality of YouTube Videos as a Source of Information on Vitiligo

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Clin Cosmet Investig Dermatol. 2022 Jan 7;15:21-25. doi: 10.2147/CCID.S330015. eCollection 2022.

ABSTRACT

PURPOSE: Vitiligo is a skin condition characterized by patchy depigmentation in the skin, affecting not just the physical well-being of patients, but also the mental, emotional, and social aspects of their lives. Social media provides a platform where patients can interact and share experiences, and for physicians and experts to disseminate knowledge on the disease. This study aimed to evaluate the accuracy and overall quality of vitiligo-related content on YouTube.

METHODS: Thirty videos were screened by relevance according to the inclusion criteria. Videos were categorized as either healthcare or non-healthcare sources, and viewer engagement ratio was calculated for each. Three independent vitiligo experts rated the content using the following assessment tools: DISCERN, Accuracy in Digital-health Instrument (ANDI), and Global Quality Scale (GQS). Lastly, Cronbach's alpha was used to estimate the inter-rater reliability and consistency.

RESULTS: Most of the screened videos came from health-care sources (57%). Non-healthcare sources achieved a slightly higher viewer engagement ratio, although the difference is not statistically significant (p = 0.23). DISCERN score was low overall in most videos. However, DISCERN score was higher for health-care sources as compared to non-healthcare sources (30.5 ± 9.4 vs 22.7 ± 4,2, p = 0.009). Scores of ANDI and GQS were higher for health-care sources but not statistically significant. There was a good internal consistency in DISCERN rating among the evaluators (0.86).

CONCLUSION: Our study shows a low overall accuracy and quality of YouTube videos on vitiligo. It is recommended that health-care sources improve their information material in terms of quality and viewer engagement, as very little can be done to prevent non-healthcare sources in publishing their own videos. Efforts in educating the public on making distinction between evidence and non-evidence-based claims should also be taken.

PMID:35027834 | PMC:PMC8751976 | DOI:10.2147/CCID.S330015

Категории: MedLine

Intramuscular Corticosteroid Therapy in the Treatment of Alopecia Areata: A Time-to-Event Analysis

Pubmed free full-text with abstracts - пт., 14/01/2022 - 14:00

Drug Des Devel Ther. 2022 Jan 7;16:107-116. doi: 10.2147/DDDT.S342179. eCollection 2022.

ABSTRACT

INTRODUCTION: Intramuscular corticosteroids (IMC) have gained popularity for the treatment of severe alopecia areata (AA) in recent years; however, evidence on their efficacy and safety is still limited.

OBJECTIVE: To evaluate the efficacy, relapse rate, and tolerability of IMC in the treatment of AA, as well as factors associated with treatment outcomes.

METHODS: Time-to-event analysis was performed on patients with severe, extensive, or rapidly progressive AA receiving IMC. The IMC regimen comprised triamcinolone acetonide 20-40 mg/mL injected every 4-6 weeks. The evaluated outcomes included initial (25% regrowth), significant (75% regrowth), and complete hair regrowth (100% regrowth). Relapse and adverse events were also noted. Factors associated with treatment outcomes and relapse were analyzed using the Cox proportional hazards model.

RESULTS: A total of 101 patients were eligible for analysis. Significant hair regrowth was obtained in 80.2% of the patients (n = 81), in a median time of 3.4 months (95% confidence interval [CI] = 2.9-4.4). Complete hair regrowth was achieved in 48.5% of the subjects (n = 49), and relapse was observed in 47.5% (n = 48). Acneiform eruption was the most common adverse effect. Multivariable analysis revealed that nail involvement was a negative predictor of significant hair regrowth (adjusted hazard ratio [HR] = 0.04, 95% CI = 0.01-0.55; P = 0.015), whereas duration of AA longer than 6 months was associated with disease recurrence (adjusted HR = 4.02, 95% CI = 1.52-4.66; P = 0.005).

CONCLUSION: This study demonstrated the efficacy and safety of IMC in the treatment of severe or active AA; however, the relapse rate remained relatively high after discontinuation of the therapy. Nail involvement was a negative predictor of significant hair regrowth, while disease duration longer than 6 months predicted AA relapse.

PMID:35027820 | PMC:PMC8752075 | DOI:10.2147/DDDT.S342179

Категории: MedLine

Cushing's syndrome due to ectopic adrenocorticotropin secretion by a parotid carcinoma

Публикации по акне - пт., 14/01/2022 - 14:00

Arch Endocrinol Metab. 2022 Jan 13:2359-3997000000426. doi: 10.20945/2359-3997000000426. Online ahead of print.

ABSTRACT

We report a rare case of Cushing's syndrome in a 37-year-old female who initially presented with localized acinic cell carcinoma of the parotid gland. In January 2014, she underwent a right parotidectomy with facial nerve preservation and adjuvant radiotherapy. In August 2018, she presented a histologically-proven local regional relapse. The patient was considered for salvage surgery with facial nerve sacrifice and remained with no evidence of disease. One year later the patient developed pulmonary dissemination and started to gain weight and developed facial plethora and acne on the face and upper trunk. In a physical examination, the patient presented moon face, buffalo hump, acne and stage 2 hypertension. Biochemical evaluation confirmed ACTH-dependent Cushing's syndrome. IHC for ACTH in the lung biopsy revealed strong positive staining for ACTH confirming a diagnosis of ectopic ACTH secretion by a metastatic parotid acinic cell carcinoma. Ketoconazole (600 mg/d) was started to treat the CS. In addition, as chemotherapy was initiated to treat the metastatic disease. After the fifth cycle of chemotherapy, ketoconazole was suspended and the patient remained in remission of CS for four months, when CS recurred. A unique feature of this case is related to the clinical CS relapse associated with disease progression, which needed prompt treatment with ketoconazole, resulting in a significant improvement in the patient's condition. Although rare, should be attentive for possible CS features in patients with high-grade salivary gland carcinomas, since the diagnosis of ectopic secretion of ACTH may significantly impact their management and outcomes.

PMID:35029850 | DOI:10.20945/2359-3997000000426

Категории: MedLine, Специальные

Seasonal and gender variation in skin disease: A cross-sectional study of 3120 patients at Razi hospital

Публикации по акне - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Oct 6;7(5Part B):799-802. doi: 10.1016/j.ijwd.2021.09.014. eCollection 2021 Dec.

ABSTRACT

Objective: We aimed to determine the prevalence of different skin diseases and their seasonal variations at the Razi dermatology hospital from 2019 to 2020. Methods: In this cross-sectional study, we obtained data from the medical records of 3120 patients visiting the dermatology clinic of Razi hospital. The prevalence of skin diseases was evaluated using meteorologically defined seasons. We looked for significant equally distributed results during each season. Results: During all seasons, women were referred to our clinic more frequently than men. Some diseases demonstrated significant seasonality with a peak during the winter, including acne, eczema, wart, seborrheic dermatitis, nevus, vitiligo, lentigo, and dermatophytosis. Atopic dermatitis was more frequent during the spring and winter compared with other seasons (p < .05). Actinic keratosis and lichen planus showed a significant seasonal trend with a peak during the summer (p < .05). Infections, including viral, bacterial, and fungal skin diseases, were more frequent during the winter than the summer (p = .001). Conclusion: This study provides an overview of the seasonal distribution of dermatology visits at our referral hospital, which will aid in developing better policies to prevent and manage skin disorders in outpatient visits.

PMID:35028385 | PMC:PMC8714557 | DOI:10.1016/j.ijwd.2021.09.014

Категории: MedLine, Специальные

Life after lockdown: Zooming out on perceptions in the post-videoconferencing era

Публикации по акне - пт., 14/01/2022 - 14:00

Int J Womens Dermatol. 2021 Aug 27;7(5Part B):774-779. doi: 10.1016/j.ijwd.2021.08.009. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has deeply disrupted daily life across the globe, with profound effects on mental and physical health. After more than a year of isolation and communication via videoconferencing, people are returning to in-person activities.

OBJECTIVE: This study aimed to investigate worsening self-perception, mental health, and anxiety with the return to in-person activities, with a focus on the influence of videoconferencing, social media, and the use of filters.

METHODS: An anonymous survey was distributed online through social media platforms and student network pages.

RESULTS: A total of 7295 participants responded to the survey. Seventy-one precent reported anxiety or stress related to returning to in-person activities, and nearly 64% sought mental health support services. Thirty-percent stated they plan to invest in their appearance as a coping strategy to deal with the anxiety of returning to in-person, and >30% plan to take action in changing their appearance. The most reported dermatologic concerns were skin discoloration (32.36%), wrinkles (24.45%), and acne (14.85%). The prevalence of anxiety and mental health services increased relative to the use of filters in 18- to 24 year-olds.

CONCLUSION: This survey study of >7000 participants across the country elucidates worsening self-perception, anxiety, and mental health as we return to in-person activities in relation to increased videoconferencing, social media usage, and the use of filters. Physicians should be aware of these effects to better serve their patients.

PMID:35028381 | PMC:PMC8714587 | DOI:10.1016/j.ijwd.2021.08.009

Категории: MedLine, Специальные
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