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Kuai L, Huang F, Mao L, Ru Y, Jiang J, Song J, Chen S, Li K, Li Y, Dong H, Lu X, Li B, Shi J. Single-Atom Catalysts with Isolated Cu 1-N 4 Sites for Atopic Dermatitis Cascade Catalytic Therapy via Activating PPAR Signaling. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2407365. [PMID: 39363827 DOI: 10.1002/smll.202407365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 09/23/2024] [Indexed: 10/05/2024]
Abstract
Atopic dermatitis (AD) is one of the most common allergic skin disorders affecting over 230 million people worldwide, while safe and efficient therapeutic options for AD are currently rarely available. Reactive oxygen species (ROS) accumulation plays a key role in AD's disease progression. Therefore, a novel single-atom catalyst is designed with isolated Cu1-N4 sites anchored on carbon support (Cu1-N4 ISAC), featuring triple antioxidant enzyme-mimicking activities, for efficient AD cascade catalytic therapy (CCT). The excellent superoxide dismutase (SOD)-, glutathione peroxidase (GPx)-, and ascorbate peroxidase (APx)-like activities of Cu1-N4 ISACs enable the sequential conversion of O2•- to H2O2 and then to harmless H2O, thereby protecting keratinocytes from oxidative stress damage. Notably, two novel experimental methods are developed to directly prove the SOD-GPx and SOD-APx cascade catalytic activities for the first time. In vivo experiments show that Cu1-N4 ISACs are more potent than a recommended typical medicine (halcinonide solution). Additionally, RNA sequencing and bioinformatic analysis reveal that Cu1-N4 ISACs reduce inflammation and inhibit ROS production by activating PPAR signaling, which is aberrantly reduced in AD. Therefore, the synthesized catalytic medicine offers an alternative to alleviate AD and has the potential to serve as PPAR agonists for treating similar diseases.
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Affiliation(s)
- Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Institute of Dermatology, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Fang Huang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Lijie Mao
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai Frontiers Science Center of Nanocatalytic Medicine, School of Medicine, Tongji University, Shanghai, 200331, China
| | - Yi Ru
- Shanghai Skin Disease Hospital, Institute of Dermatology, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jingsi Jiang
- Shanghai Skin Disease Hospital, Institute of Dermatology, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jiankun Song
- Shanghai Skin Disease Hospital, Institute of Dermatology, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Si Chen
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai Frontiers Science Center of Nanocatalytic Medicine, School of Medicine, Tongji University, Shanghai, 200331, China
| | - Ke Li
- School of Materials Science and Engineering, Hainan University, Haikou, 570228, China
| | - Yongyong Li
- Shanghai Skin Disease Hospital, Institute of Dermatology, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Haiqing Dong
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Xiangyu Lu
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai Frontiers Science Center of Nanocatalytic Medicine, School of Medicine, Tongji University, Shanghai, 200331, China
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Institute of Dermatology, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
- Shanghai Skin Disease Hospital, Institute of Dermatology, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jianlin Shi
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
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Tchatchouang S, Basing LA, Kouadio-Aboh H, Handley BL, G-Beiras C, Amanor I, Ndzomo P, Bakheit M, Becherer L, Knauf S, Müller C, Njih-Tabah E, Njamnshi T, Crucitti T, Borst N, Lüert S, Frischmann S, Gmoser H, Landmann E, Sylla A, Kouamé-Sina MS, Arhinful D, Awondo P, Menguena G, Harding-Esch EM, Tano A, Kaloga M, Koffi-Aboa P, Konama-Kotey N, Mitjà O, Eyangoh S, Kwasi-Addo K, Ngazoa-Kakou S, Marks M. An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana. PLoS Negl Trop Dis 2024; 18:e0011790. [PMID: 39365827 DOI: 10.1371/journal.pntd.0011790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 09/06/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs. METHODS From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management. RESULTS Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries. CONCLUSION This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.
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Affiliation(s)
| | - Laud A Basing
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Hugues Kouadio-Aboh
- Institut Pasteur de Cote d'Ivoire, Abidjan, Lagunes, Côte d'Ivoire
- National Program of African Trypanosomiasis Elimination, Abidjan, Côte d'Ivoire
| | - Becca L Handley
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Camila G-Beiras
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Hospital Universitari Germans Trías i Pujol; Fight Infectious Diseases Foundation,Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Ivy Amanor
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | | | | | - Lisa Becherer
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | - Sascha Knauf
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
- Professorship for One Health/International Animal Health, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
| | - Claudia Müller
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | - Earnest Njih-Tabah
- National Buruli Ulcer, Leprosy, Yaws and Leishmaniasis Control Program, Ministry of Public Health, Yaounde, Centre Region, Cameroon
- Public Health & Epidemiology, University of Dschang, Dschang, West Region, Cameroon
| | - Theophilus Njamnshi
- National Buruli Ulcer, Leprosy, Yaws and Leishmaniasis Control Program, Ministry of Public Health, Yaounde, Centre Region, Cameroon
| | - Tania Crucitti
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Nadine Borst
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
- Hahn-Schickard, Freiburg, Germany
| | - Simone Lüert
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | | | - Helena Gmoser
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | | | - Aboubacar Sylla
- Institut Pasteur de Cote d'Ivoire, Abidjan, Lagunes, Côte d'Ivoire
| | | | - Daniel Arhinful
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | | | | | - Emma-Michèle Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, United Kingdom
| | - Adingra Tano
- Institut Pasteur de Cote d'Ivoire, Abidjan, Lagunes, Côte d'Ivoire
| | - Mamadou Kaloga
- Programme National de Lutte contre l'Ulcère de Buruli, Abidjan, Côte d'Ivoire
| | - Paul Koffi-Aboa
- Programme National de Lutte contre l'Ulcère de Buruli, Abidjan, Côte d'Ivoire
| | - Nana Konama-Kotey
- National Yaws Eradication Program, Ghana Health Service, Accra, Ghana
| | - Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Hospital Universitari Germans Trías i Pujol; Fight Infectious Diseases Foundation,Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | | | - Kennedy Kwasi-Addo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | | | - Michael Marks
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Clinical Research Department, London School of Hygiene & Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, United Kingdom
- Hospital for Tropical Diseases, London, United Kingdom
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Fernando DD, Mounsey KE, Bernigaud C, Surve N, Estrada Chávez GE, Hay RJ, Currie BJ, Chosidow O, Fischer K. Scabies. Nat Rev Dis Primers 2024; 10:74. [PMID: 39362885 DOI: 10.1038/s41572-024-00552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 10/05/2024]
Abstract
Scabies is one of the most common and highest-burden skin diseases globally. Estimates suggest that >200 million people worldwide have scabies at any one time, with an annual prevalence of 455 million people, with children in impoverished and overcrowded settings being the most affected. Scabies infection is highly contagious and leads to considerable morbidity. Secondary bacterial infections are common and can cause severe health complications, including sepsis or necrotizing soft-tissue infection, renal damage and rheumatic heart disease. There is no vaccine or preventive treatment against scabies and, for the past 30 years, only few broad-spectrum antiparasitic drugs (mainly topical permethrin and oral ivermectin) have been widely available. Treatment failure is common because drugs have short half-lives and do not kill all developmental stages of the scabies parasite. At least two consecutive treatments are needed, which is difficult to achieve in resource-poor and itinerant populations. Another key issue is the lack of a practical, rapid, cheap and accurate diagnostic tool for the timely detection of scabies, which could prevent the cycle of exacerbation and disease persistence in communities. Scabies control will require a multifaceted approach, aided by improved diagnostics and surveillance, new treatments, and increased public awareness.
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Affiliation(s)
- Deepani D Fernando
- Scabies Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Kate E Mounsey
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Charlotte Bernigaud
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Nuzhat Surve
- Department of Microbiology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, India
| | - Guadalupe E Estrada Chávez
- State Institute of Cancer "Dr. Arturo Beltrán Ortega", Faculty of Medicine, Universidad Autónoma de Guerrero, Community Dermatology Mexico, Acapulco, Guerrero, Mexico
| | - Roderick J Hay
- St Johns Institute of Dermatology, King's College London, London, UK
| | - Bart J Currie
- Global and Tropical Health, Menzies School of Health Research, Charles Darwin University and Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Olivier Chosidow
- Hôpital Universitaire La Pitié-Salpêtrière, AP-HP, Paris, France
| | - Katja Fischer
- Scabies Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
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Zhou Z, Yang J, Liu Q, Gao J, Ji W. Patho-immunological mechanisms of atopic dermatitis: The role of the three major human microbiomes. Scand J Immunol 2024:e13403. [PMID: 39267301 DOI: 10.1111/sji.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 09/17/2024]
Abstract
Atopic dermatitis (AD) is a genetically predisposed allergic inflammatory dermatosis with chronic, pruritic, and recurrent features. Patients with AD have dry and itchy skin, often accompanied by chronic eczematous lesions, allergic rhinitis, or asthma, which has a considerable impact on their daily lives. With advances in genome sequencing technology, it has been demonstrated that microorganisms are involved in this disease, and the microorganisms associated with AD are attracting considerable research attention. An increasing number of studies conducted in recent years have demonstrated that an imbalanced microbiome in AD patients has substantial impact on disease prognosis, and the causes are closely tied to various immune mechanisms. However, the involvement of microorganisms in the pathogenesis of AD remains poorly understood. In this paper, we review the advances in research on the immunological mechanisms of the skin microbiome, intestinal microbiome, and lung microbiome that are related to AD prognosis and immunotherapy protocols. It is hoped that this approach will lay the foundation for exploring the pathogenesis of and emerging treatments for AD.
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Affiliation(s)
- Zhaosen Zhou
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Nursing in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qin Liu
- Department of Nursing in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Gao
- Department of Nursing in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wenting Ji
- Department of Nursing in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Fan H, Tuo H, Xie Y, Ju M, Sun Y, Yang Y, Han X, Ren Z, Zheng Y, He D. Comparison of blue laser and red light-emitting diode-mediated aminolevulinic acid-based photodynamic therapy for moderate and severe acne vulgaris: A prospective, split-face, nonrandomized controlled study. Photodiagnosis Photodyn Ther 2024; 49:104325. [PMID: 39245305 DOI: 10.1016/j.pdpdt.2024.104325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/21/2024] [Accepted: 08/28/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Acne is a chronic inflammatory skin disease. Photodynamic therapy (PDT) is a highly effective and safe drug-device combination treatment, typically using red and blue light. However, direct comparisons of aminolevulinic acid (ALA)-based PDT using these two light sources are lacking. Therefore, we compared the efficacy and adverse effects of ALA-based 450 nm blue laser-mediated PDT (BL-PDT) and 630 ± 10 nm red light-emitting diode-mediated PDT (RL-PDT) in the treatment of moderate-to-severe acne vulgaris, including analyses of different lesion types. METHODS Sixteen patients with moderate-to-severe acne vulgaris were recruited. All patients underwent BL-PDT on the left side of the face and RL-PDT on the right side. Treatments were administered thrice at 2-week intervals, and follow-up continued for 2 weeks after the final treatment. The average rates of improvement in inflammatory and non-inflammatory acne lesions, IGA (Investigator's Global Assessment) scales, and IGA success rates were calculated. In addition, adverse effects during and after each treatment were recorded. RESULTS At the 2-week follow-up after the final treatment, the average rates of improvement in total acne, inflammatory, and non-inflammatory lesions were 48.0 %, 63.0 %, and 30.0 % in the BL-PDT group and 42.2 %, 58.1 %, and 27.5 % in the RL-PDT group, respectively. The IGA scores for the two groups decreased by 1.8 and 1.7 points, respectively, and the IGA success rate was 53.3 % in both groups. There were no significant differences between the BL-PDT and RL-PDT groups in any measure of effectiveness. However, the BL-PDT group exhibited more severe adverse effects, especially pain and hyperpigmentation. CONCLUSIONS BL-PDT and RL-PDT have similar efficacies in moderate-to-severe acne vulgaris and are particularly effective for inflammatory acne lesions. RL-PDT benefits from milder adverse effects than those of BL-PDT.
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Affiliation(s)
- Hengtong Fan
- Department of Urology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Huihui Tuo
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Yuhan Xie
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Manyu Ju
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Yan Sun
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Yajie Yang
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Xinnan Han
- Department of Urology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Zejun Ren
- Department of Urology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China
| | - Yan Zheng
- Department of Dermatology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China.
| | - Dalin He
- Department of Urology, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an 710061, China.
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Lax SJ, Van Vogt E, Candy B, Steele L, Reynolds C, Stuart B, Parker R, Axon E, Roberts A, Doyle M, Chu DK, Futamura M, Santer M, Williams HC, Cro S, Drucker AM, Boyle RJ. Topical Anti-Inflammatory Treatments for Eczema: A Cochrane Systematic Review and Network Meta-Analysis. Clin Exp Allergy 2024. [PMID: 39219446 DOI: 10.1111/cea.14556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Eczema is the most burdensome skin condition worldwide and topical anti-inflammatory treatments are commonly used to control symptoms. The relative effectiveness and safety of different topical anti-inflammatory treatments is uncertain. DESIGN Network meta-analysis performed within a Cochrane systematic review to compare and statistically rank efficacy and safety of topical anti-inflammatory eczema treatments. DATA SOURCES Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries to June 2023. ELIGIBILITY CRITERIA FOR SELECTED TRIALS Included trials were within-participant or between-participant randomised controlled trials. Participants had eczema that was not clinically infected and was not contact dermatitis, seborrheic eczema or hand eczema. Interventions were topical anti-inflammatory treatments but not complementary treatments, antibiotics alone, wet wraps, phototherapy or systemic treatments. Comparators were no treatment/vehicle or another topical anti-inflammatory. RESULTS We identified 291 trials (45,846 participants), mainly in high-income countries. Most were industry-funded with median 3 weeks treatment duration. Risk of bias assessed using the Cochrane Risk of Bias 2.0 tool was high in 89% of trials, mainly due to risk of selective reporting. Network meta-analysis of binary outcomes ranked potent and/or very potent topical steroids, tacrolimus 0.1% and ruxolitinib 1.5% among the most effective treatments for improving patient-reported symptoms (40 trials, all low confidence) and clinician-reported signs (32 trials, all moderate confidence). For investigator global assessment, the Janus kinas inhibitors ruxolitinib 1.5%, delgocitinib 0.5% or 0.25%, very potent/potent topical steroids and tacrolimus 0.1% were ranked as most effective (140 trials, all moderate confidence). Continuous outcome data were mixed. Local application site reactions were most common with tacrolimus 0.1% (moderate confidence) and crisaborole 2% (high confidence) and least common with topical steroids (moderate confidence). Skin thinning was not increased with short-term use of any topical steroid potency (low confidence) but skin thinning was reported in 6/2044 (0.3%) participants treated with longer-term (6-60 months) topical steroids. CONCLUSION Potent topical steroids, Janus kinase inhibitors and tacrolimus 0.1% were consistently ranked as among the most effective topical anti-inflammatory treatments for eczema.
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Affiliation(s)
- Stephanie J Lax
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Eleanor Van Vogt
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Bridget Candy
- Department of Dermatology, Royal Free Hospital, London, UK
| | | | - Clare Reynolds
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Beth Stuart
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Roses Parker
- Cochrane MOSS Network, c/o Cochrane Pain Palliative and Supportive Care Group, Oxford, UK
| | - Emma Axon
- Cochrane Methods Support Unit, Cochrane, London, UK
| | - Amanda Roberts
- Nottingham Support Group for Carers of Children With Eczema, Nottingham, UK
| | - Megan Doyle
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Derek K Chu
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Miriam Santer
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Aaron M Drucker
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Research and Innovation Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Robert J Boyle
- Section of Inflammation and Repair, National Heart & Lung Institute, Imperial College London, London, UK
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Zorec TM, Skubic L, Poljak M. A novel digital PCR assay for detection and comprehensive characterization of Molluscum contagiosum virus genotypes MOCV1, MOCV2, and MOCV3 and recombinant lineages. J Virol Methods 2024; 329:114993. [PMID: 38960327 DOI: 10.1016/j.jviromet.2024.114993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Molluscum contagiosum virus (MOCV) is an important human pathogen causing a high disease burden worldwide. It is the last exclusively human-infecting poxvirus still circulating in its natural reservoir-a valuable model of poxviral evolution. Unfortunately, MOCV remains neglected, and little is known about its evolutionary history and circulating genomic variants, especially in non-privileged countries. The design weaknesses of available MOCV detection/genotyping assays surfaced with recent accumulation of abundant sequence information: all existing MOCV assays fail at accurate genotyping and capturing sub-genotype level diversity. Because complete MOCV genome characterization is an expensive and labor-intensive task, it makes sense to prioritize samples for whole-genome sequencing by diversity triage screening. To meet this demand, we developed a novel assay for accurate MOCV detection and genotyping, and comprehensive sub-genotype qualification to the level of phylogenetic groups (PGs). The assay included a novel set of oligonucleotide primers and probes, and it was implemented using digital polymerase chain reaction (dPCR). It offers sensitive, specific, and accurate detection, genotyping (MOCV1-MOCV3), and PG qualification (PG1-6) of MOCV DNA from clinical samples. The novel dPCR assay is suitable for MOCV diversity triage screening and prioritization of samples for complete MOCV genome characterization.
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Affiliation(s)
- Tomaž M Zorec
- Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia; Celica Biomedical, Tehnološki park 24, Ljubljana, Slovenia
| | - Lucijan Skubic
- Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia
| | - Mario Poljak
- Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia.
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8
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Deng K, Tong X, Chen S, Wu G, Shi K, Chen H, Tan Y, Liao J, Zhou J, Zhao J. Exploration of the Changes in Facial Microbiota of Maskne Patients and Healthy Controls Before and After Wearing Masks Using 16 S rRNA Analysis. J Epidemiol Glob Health 2024; 14:947-961. [PMID: 38771488 PMCID: PMC11442795 DOI: 10.1007/s44197-024-00240-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
Whether in the field of medical care, or in people's daily life and health protection, the importance of masks has been paid more and more attention. Acne, the most common complication after wearing masks, which is also called maskne, has been successfully introduced into the common language as a common topic of dermatologist consultations. This study aims to study the changes of microflora in maskne patients and healthy controls before and after wearing masks. In the summer of 2023, we collected a total of 50 samples from 15 maskne patients and 10 healthy controls before and after wearing surgical masks for a long time. 16 S ribosomal DNA sequencing and identification technology with V3-V4 variable region were adopted to explore the microbiome changes caused by mask wearing, analyze the changes in microbial diversity, and make interaction network. LDA effect size analysis was used to identify which bacteria showed significant changes in their relative abundance from phylum to genus. After wearing a mask, the microbiome of the maskne patients changed significantly more than that of the healthy controls, with both α diversity and β diversity lower than those of maskne patients before wearing masks and those of healthy controls after wearing masks. Co-occurrence network analysis showed that compared with other groups, the network of maskne patients after wearing masks for a long time had the lowest connectivity and complexity, but the highest clustering property, while the opposite was true for healthy controls. Many microbes that are potentially beneficial to the skin decreased significantly after wearing a mask. There was almost no difference in healthy controls before and after wearing a mask.
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Affiliation(s)
- Kexin Deng
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Xiaofei Tong
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Shuyue Chen
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Guojun Wu
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Ke Shi
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Hao Chen
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Yurong Tan
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Junlin Liao
- Center of Burn & Plastic and Wound Healing Surgery, The First Affiliated Hospital, Hengyang Medical School Hengyang, NO.69, Chuanshan Road, Hengyang, Hunan, China
| | - Jianda Zhou
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China.
| | - Junxiang Zhao
- Department of Burn and Plastic Surgery, Nanshi Hospital Affiliated to Henan University, No. 1081, Zhongzhou West Road, Nanyang City, Henan Province, China.
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9
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Khurana A, Grover A, Pandhi D, Khaitan B, George R, De D, Mahajan R, Gupta V, Srivastava S, Cherian JJ, Dhaliwal RS, Kumar D, Kumar N, Bajaj A, Kant M, Sharma LK, Singh R, Bhargava B, Bahl R. Development of Indian Council of Medical Research (ICMR) Standard Treatment Workflows for Skin Diseases: A Step Toward Universal Health Coverage. Indian Dermatol Online J 2024; 15:794-800. [PMID: 39359295 PMCID: PMC11444446 DOI: 10.4103/idoj.idoj_741_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/25/2024] [Accepted: 03/10/2024] [Indexed: 10/04/2024] Open
Abstract
Background Skin conditions form a major bulk of diseases in the community. With a disproportionately low number of dermatologists in the country, and a greatly unequal distribution between urban versus rural areas, ineffective treatment and mismanagement of skin conditions are, however, commonplace. Objective To develop standard treatment workflows (STWs) for certain skin diseases for use by clinicians at primary, secondary, and tertiary care centers. Methodology Seven members, from various academic institutes across the country, were selected for formulation of the STWs. They were provided logistic and technical support by the ICMR, Department of Health Research (DHR), and WHO India office. Multiple rounds of online and physical discussions were performed to identify topics that would be most useful in the management of skin diseases for the health care personnel (HCP) and subsequently to frame the STW content. Results The selected diseases included acne and rosacea, alopecia, bacterial skin infections, cutaneous adverse drug reactions, dermatophytosis, eczema/dermatitis, immunobullous dermatoses, psoriasis, scabies, varicella and herpes, vitiligo, and urticaria. There was one separate module on rational use of topical corticosteroids. The STWs for these conditions have been finalised and are available as physical posters in health centers and can also be accessed online and through mobile applications. Conclusion Thirteen STW modules have been prepared with a view to optimize management of skin diseases at various levels of health care system of the country.
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Affiliation(s)
- Ananta Khurana
- Department of Dermatology STDs and Leprosy, Dr Ram Manohar Lohia Hospital, and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Ashoo Grover
- Scientist "F," Indian Council of Medical Research (ICMR), New Delhi, India
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Binod Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dipankar De
- Department of Dermatology, Venereology, and Leprology, PGIMER, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology, and Leprology, PGIMER, Chandigarh, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Saumya Srivastava
- Project Scientist C, Indian Council of Medical Research (ICMR), New Delhi, India
| | | | | | - Dhiraj Kumar
- Project Consultant (Graphic Design), ICMR, New Delhi, India
| | | | - Anjali Bajaj
- Medical Officer, Himachal Pradesh Government, India
| | | | | | | | - Balram Bhargava
- Ex-Secretary (Department of Health Research) Govt. of India and Ex-Director General, ICMR, New Delhi, India
| | - Rajiv Bahl
- Secretary to Government of India, Department of Health Research, and Director General, ICMR New Delhi, India
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10
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El Genedy‐Kalyoncu M, Kottner J. The uptake of the international pressure ulcer/injury prevention and treatment guidelines: An updated systematic citation analysis. Int Wound J 2024; 21:e70036. [PMID: 39254059 PMCID: PMC11386271 DOI: 10.1111/iwj.70036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/12/2024] [Accepted: 08/12/2024] [Indexed: 09/11/2024] Open
Abstract
The European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance collaboratively developed three editions of the International Clinical Practice Guidelines for preventing and treating pressure ulcers/injuries in 2009, 2014, and 2019. Dissemination and uptake of these guidelines are important to improve care. The aim of this work was to provide an updated and expanded citation analysis of the three published guidelines. Referencing formats, citation counts, and global distribution of citations of the 2009, 2014, and 2019 guidelines were searched in the citation database Scopus from 2009 to 2023. Duplicates were removed manually. The search identified 330 referencing formats with 2887 citations from 2009 to 2023 for the three guideline editions. Citations displayed geographical diversity, with citation peaks observed approximately 4 years after each edition's release and ongoing citations to the present. The International Clinical Practice Guidelines for preventing and treating pressure ulcers/injuries updated since 2009 were cited more than 2800 times in the scientific literature exceeding the thresholds of highly cited papers in the field of clinical medicine. This indicates successful dissemination worldwide.
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Affiliation(s)
| | - Jan Kottner
- Institute of Clinical Nursing ScienceCharité—Universitätsmedizin BerlinBerlinGermany
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11
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Xiao Y, Zhang C, Jing D, Yang S, Su J, Chen AJ, Tao J, Zhang F, Wang G, Gao X, Chen X, Shen M. Prevalence and burden of skin diseases in college students: A nationwide cross-sectional survey in China. J Eur Acad Dermatol Venereol 2024; 38:e787-e789. [PMID: 38372385 DOI: 10.1111/jdv.19893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Chengcheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Danrong Jing
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Songchun Yang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Ai-Jun Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xinghua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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12
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Liang XY, Wang Y, Zhu YW, Zhang YX, Yuan H, Liu YF, Jin YQ, Gao W, Ren ZG, Ji XY, Wu DD. Role of hydrogen sulfide in dermatological diseases. Nitric Oxide 2024; 150:18-26. [PMID: 38971520 DOI: 10.1016/j.niox.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/30/2024] [Accepted: 07/04/2024] [Indexed: 07/08/2024]
Abstract
Hydrogen sulfide (H2S), together with carbon monoxide (CO) and nitric oxide (NO), is recognized as a vital gasotransmitter. H2S is biosynthesized by enzymatic pathways in the skin and exerts significant physiological effects on a variety of biological processes, such as apoptosis, modulation of inflammation, cellular proliferation, and regulation of vasodilation. As a major health problem, dermatological diseases affect a large proportion of the population every day. It is urgent to design and develop effective drugs to deal with dermatological diseases. Dermatological diseases can arise from a multitude of etiologies, including neoplastic growth, infectious agents, and inflammatory processes. The abnormal metabolism of H2S is associated with many dermatological diseases, such as melanoma, fibrotic diseases, and psoriasis, suggesting its therapeutic potential in the treatment of these diseases. In addition, therapies based on H2S donors are being developed to treat some of these conditions. In the review, we discuss recent advances in the function of H2S in normal skin, the role of altering H2S metabolism in dermatological diseases, and the therapeutic potential of diverse H2S donors for the treatment of dermatological diseases.
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Affiliation(s)
- Xiao-Yi Liang
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Yan Wang
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Yi-Wen Zhu
- School of Clinical Medicine, Henan University, Kaifeng, Henan, 475004, China
| | - Yan-Xia Zhang
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Hang Yuan
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Ya-Fang Liu
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Yu-Qing Jin
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Wei Gao
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China
| | - Zhi-Guang Ren
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China; Kaifeng Key Laboratory of Infectious Diseases and Biosafety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, 475004, China.
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China; Kaifeng Key Laboratory of Infectious Diseases and Biosafety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, 475004, China; Faculty of Basic Medical Subjects, Shu-Qing Medical College of Zhengzhou, Zhengzhou, Henan 450064, China.
| | - Dong-Dong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China; Kaifeng Key Laboratory of Infectious Diseases and Biosafety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, 475004, China; Department of Stomatology, Huaihe Hospital of Henan University, School of Stomatology, Henan University, Kaifeng, Henan, 475004, China.
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13
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Santer M, Lawrence M, Pyne S, Renz S, Stuart BL, Sach T, Ridd M, Thomas KS, Nuttall J, Permyakova N, Eminton Z, Francis N, Little P, Muller I, Soulsby I, Thomas K, Griffiths G, Layton AM. Clinical and cost-effectiveness of spironolactone in treating persistent facial acne in women: SAFA double-blinded RCT. Health Technol Assess 2024; 28:1-86. [PMID: 39268864 PMCID: PMC11418016 DOI: 10.3310/myjt6804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024] Open
Abstract
Background Acne is common, can cause significant impact on quality of life and is a frequent reason for long-term antibiotic use. Spironolactone has been prescribed for acne in women for many years, but robust evidence is lacking. Objective To evaluate whether spironolactone is clinically effective and cost-effective in treating acne in women. Design Pragmatic, parallel, double-blind, randomised superiority trial. Setting Primary and secondary healthcare and community settings (community and social media advertising). Participants Women aged 18 years and older with facial acne persisting for at least 6 months, judged to potentially warrant oral antibiotic treatment. Interventions Participants were randomised 1 : 1, using an independent web-based procedure, to either 50 mg/day spironolactone or matched placebo until week 6, increasing to 100 mg/day spironolactone or matched placebo until week 24. Participants continued usual topical treatment. Main outcome measures Primary outcome was the adjusted mean difference in Acne-Specific Quality of Life symptom subscale score at 12 weeks. Secondary outcomes included Acne-Specific Quality of Life total and subscales; participant self-assessed improvement; Investigator's Global Assessment; Participant's Global Assessment; satisfaction; adverse effects and cost-effectiveness. Results Of 1267 women assessed for eligibility, 410 were randomised (201 intervention, 209 control), 342 in the primary analysis (176 intervention, 166 control). Mean age was 29.2 years (standard deviation 7.2) and 7.9% (28/356) were from non-white backgrounds. At baseline, Investigator's Global Assessment classified acne as mild in 46%, moderate in 40% and severe in 13%. At baseline, 82.9% were using topical treatments. Over 95% of participants in both groups tolerated the treatment and increased their dose. Mean baseline Acne-Specific Quality of Life symptom subscale was 13.0 (standard deviation 4.7) across both groups. Mean scores at week 12 were 19.2 (standard deviation 6.1) for spironolactone and 17.8 (standard deviation 5.6) for placebo [difference favouring spironolactone 1.27 (95% confidence interval 0.07 to 2.46) adjusting for baseline variables]. Mean scores at week 24 were 21.2 (standard deviation 5.9) in spironolactone group and 17.4 (standard deviation 5.8) in placebo group [adjusted difference 3.77 (95% confidence interval 2.50 to 5.03) adjusted]. Secondary outcomes also favoured spironolactone at 12 weeks with greater differences at 24 weeks. Participants taking spironolactone were more likely than those taking placebo to report overall acne improvement at 12 weeks {72.2% vs. 67.9% [adjusted odds ratio 1.16 (95% confidence interval 0.70 to 1.91)]} and at 24 weeks {81.9% vs. 63.3% [adjusted odds ratio 2.72 (95% confidence interval 1.50 to 4.93)]}. Investigator's Global Assessment was judged successful at week 12 for 31/201 (18.5%) taking spironolactone and 9/209 (5.6%) taking placebo [adjusted odds ratio 5.18 (95% confidence interval 2.18 to 12.28)]. Satisfaction with treatment improved in 70.6% of participants taking spironolactone compared with 43.1% taking placebo [adjusted odds ratio 3.12 (95% confidence interval 1.80 to 5.41)]. Adverse reactions were similar between groups, but headaches were reported more commonly on spironolactone (20.4% vs. 12.0%). No serious adverse reactions were reported. Taking account for missing data through multiple imputation gave an incremental cost per quality-adjusted life-year of £27,879 (adjusted) compared to placebo or £2683 per quality-adjusted life-year compared to oral antibiotics. Conclusions Spironolactone resulted in better participant-reported and investigator-reported outcomes than placebo, with greater differences at week 24 than week 12. Trial registration This trial is registered as ISRCTN12892056 and EudraCT (2018-003630-33). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/13/02) and is published in full in Health Technology Assessment; Vol. 28, No. 56. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Miriam Santer
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Megan Lawrence
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Sarah Pyne
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Susanne Renz
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Beth L Stuart
- Pragmatic Trials Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Tracey Sach
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Matthew Ridd
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Kim S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jacqueline Nuttall
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Natalia Permyakova
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Zina Eminton
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Nick Francis
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Ingrid Muller
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | | | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Alison M Layton
- Skin Research Centre, Hull York Medical School, University of York, York, UK
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14
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Prajapati S, Flemming JP, Khan D, Han H, How B, Rozenberg SS, Feldman SR. The role of nemolizumab in the treatment of atopic dermatitis for the adult population. Immunotherapy 2024; 16:925-935. [PMID: 39119679 DOI: 10.1080/1750743x.2024.2383554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024] Open
Abstract
Atopic dermatitis (AD) often requires long-term treatment that may be associated with adverse effects. This review aims to characterize nemolizumab as a treatment for AD in adults. A literature search was performed to assess nemolizumab's role in moderate-to-severe AD in adults. Currently, clinical trials are being conducted to evaluate the clinical efficacy, safety profile and optimal dosing of nemolizumab for adults with moderate-to-severe AD. The most common adverse effects include nasopharyngitis, AD exacerbation and increased blood creatinine phosphokinase. Recent data from clinical trials suggest nemolizumab may be an acceptable treatment in adults with moderate-to-severe AD.
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Affiliation(s)
- Stuti Prajapati
- Wake Forest School of Medicine, Dermatology Department, Winston-Salem, NC 27104, USA
| | | | - Danyaal Khan
- Rowan School of Osteopathic Medicine, Stratford, NJ 08084, USA
| | - Haowei Han
- St. John's Episcopal Hospital, Dermatology Department, Far Rockaway, NY 11691, USA
| | - Brian How
- St. John's Episcopal Hospital, Dermatology Department, Far Rockaway, NY 11691, USA
| | | | - Steven R Feldman
- Wake Forest School of Medicine, Dermatology Department, Winston-Salem, NC 27104, USA
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15
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Zhou B, Chen Q, Zhang Q, Tian W, Chen T, Liu Z. Therapeutic potential of adipose-derived stem cell extracellular vesicles: from inflammation regulation to tissue repair. Stem Cell Res Ther 2024; 15:249. [PMID: 39113098 PMCID: PMC11304935 DOI: 10.1186/s13287-024-03863-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/27/2024] [Indexed: 08/10/2024] Open
Abstract
Inflammation is a key pathological feature of many diseases, disrupting normal tissue structure and resulting in irreversible damage. Despite the need for effective inflammation control, current treatments, including stem cell therapies, remain insufficient. Recently, extracellular vesicles secreted by adipose-derived stem cells (ADSC-EVs) have garnered attention for their significant anti-inflammatory properties. As carriers of bioactive substances, these vesicles have demonstrated potent capabilities in modulating inflammation and promoting tissue repair in conditions such as rheumatoid arthritis, osteoarthritis, diabetes, cardiovascular diseases, stroke, and wound healing. Consequently, ADSC-EVs are emerging as promising alternatives to conventional ADSC-based therapies, offering advantages such as reduced risk of immune rejection, enhanced stability, and ease of storage and handling. However, the specific mechanisms by which ADSC-EVs regulate inflammation under pathological conditions are not fully understood. This review discusses the role of ADSC-EVs in inflammation control, their impact on disease prognosis, and their potential to promote tissue repair. Additionally, it provides insights into future clinical research focused on ADSC-EV therapies for inflammatory diseases, which overcome some limitations associated with cell-based therapies.
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Affiliation(s)
- Bohuai Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Qiuyu Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Qiuwen Zhang
- The Affiliated Stomatological Hospital Southwest Medical University, Luzhou, 646000, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Tian Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Zhi Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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16
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Burke C, Reidy K, Ryan P, Jennings AA. GPs' attitudes towards and experiences of using the Dermabuddy health app for the management of patients with dermatological conditions: a descriptive cross-sectional study. BJGP Open 2024:BJGPO.2024.0038. [PMID: 38580390 DOI: 10.3399/bjgpo.2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Dermatological presentations are common in primary care. The digital health space is growing in investment, revenue, and in usership numbers. Doctors utilise mobile health apps for referencing, communicating, and for clinical decision making. Dermabuddy is a secure mobile health app by which information and expertise around skin problems can be shared among a group of medical professionals with the aim of finding the best treatment and management plan. AIM To assess the utility of the Dermabuddy health app for GPs and associated trainees in the Republic of Ireland. DESIGN & SETTING This is a descriptive cross-sectional study, which involved a survey link distributed by email to GPs with Irish Medical Council membership. METHOD GPs were surveyed on their experiences of using the dermatology mobile application, Dermabuddy. RESULTS In total, 203 members took this questionnaire (13.5% response rate). Ninety-six per cent who responded to the statement, 'The app was easy to use', agreed it was 'easy' or 'very easy'. Eighty-seven per cent of those who responded to the statement, 'I would use this app again', agreed they 'definitely would'. Fifty-eight per cent of those who responded to the statement, 'The app is useful for my healthcare practice', gave it a five-star rating. The content of 36 comments included advice for improvement and positive feedback. CONCLUSION The Dermabuddy app was well received by participants in this study. Across all sections of the questionnaire looking at aspects of the app, including ease of use, interface and satisfaction, and usefulness, there was a positive response. Mobile health apps, such as Dermabuddy, may provide alternative solutions to meet the rising challenge of managing patients with dermatological conditions in primary care.
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Affiliation(s)
- Caroline Burke
- Department of General Practice, University College Cork, Cork, Republic of Ireland
| | - Karen Reidy
- Department of Dermatology, University Hospital Galway, Galway, Republic of Ireland
| | - Paul Ryan
- Department of General Practice, University College Cork, Cork, Republic of Ireland
| | - Aisling A Jennings
- Department of General Practice, University College Cork, Cork, Republic of Ireland
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17
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Lax SJ, Van Vogt E, Candy B, Steele L, Reynolds C, Stuart B, Parker R, Axon E, Roberts A, Doyle M, Chu DK, Futamura M, Santer M, Williams HC, Cro S, Drucker AM, Boyle RJ. Topical anti-inflammatory treatments for eczema: network meta-analysis. Cochrane Database Syst Rev 2024; 8:CD015064. [PMID: 39105474 PMCID: PMC11301992 DOI: 10.1002/14651858.cd015064.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Eczema (atopic dermatitis) is the most burdensome skin condition worldwide and cannot currently be prevented or cured. Topical anti-inflammatory treatments are used to control eczema symptoms, but there is uncertainty about the relative effectiveness and safety of different topical anti-inflammatory treatments. OBJECTIVES To compare and rank the efficacy and safety of topical anti-inflammatory treatments for people with eczema using a network meta-analysis. SEARCH METHODS We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries on 29 June 2023, and checked the reference lists of included studies. SELECTION CRITERIA We included within-participant or between-participant randomised controlled trials (RCTs) in people of any age with eczema of any severity, but excluded trials in clinically infected eczema, seborrhoeic eczema, contact eczema, or hand eczema. We included topical anti-inflammatory treatments used for at least one week, compared with another anti-inflammatory treatment, no treatment, or vehicle/placebo. Vehicle is a 'carrier system' for an active pharmaceutical substance, which may also be used on its own as an emollient for dry skin. We excluded trials of topical antibiotics used alone, complementary therapies, emollients used alone, phototherapy, wet wraps, and systemic treatments. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Primary outcomes were patient-reported eczema symptoms, clinician-reported eczema signs and investigator global assessment. Secondary outcomes were health-related quality of life, long-term control of eczema, withdrawal from treatment/study, and local adverse effects (application-site reactions, pigmentation changes and skin thinning/atrophy were identified as important concerns through patient and public involvement). We used CINeMA to quantify our confidence in the evidence for each outcome. MAIN RESULTS We included 291 studies involving 45,846 participants with the full spectrum of eczema severity, mainly conducted in high-income countries in secondary care settings. Most studies included adults, with only 31 studies limited to children aged < 12 years. Studies usually included male and female participants, multiple ethnic groups but predominantly white populations. Most studies were industry-funded (68%) or did not report their funding sources/details. Treatment duration and trial participation were a median of 21 and 28 days (ranging from 7 days to 5 years), respectively. Interventions used were topical corticosteroids (TCS) (172), topical calcineurin inhibitors (TCI) (134), phosphodiesterase-4 (PDE-4) inhibitors (55), janus kinase (JAK) inhibitors (30), aryl hydrocarbon receptor activators (10), or other topical agents (21). Comparators included vehicle (170) or other anti-inflammatory treatments. The risk of bias was high in 242 of the 272 (89.0%) trials contributing to data analyses, most commonly due to concerns about selective reporting. Network meta-analysis (NMA) was only possible for short-term outcomes. Patient-reported symptoms NMA of 40 trials (6482 participants) reporting patient-reported symptoms as a binary outcome ranked tacrolimus 0.1% (OR 6.27, 95% CI 1.19 to 32.98), potent TCS (OR 5.99, 95% CI 2.83 to 12.69), and ruxolitinib 1.5% (OR 5.64, 95% CI 1.26 to 25.25) as the most effective, all with low confidence. Mild TCS, roflumilast 0.15%, and crisaborole 2% were the least effective. Class-level sensitivity analysis found potent/very potent TCS had similar effectiveness to potent TCI and was more effective than mild TCI and PDE-4 inhibitors. NMA of 29 trials (3839 participants) reporting patient-reported symptoms as a continuous outcome ranked very potent TCS (SMD -1.99, 95% CI -3.25 to -0.73; low confidence) and tacrolimus 0.03% (SMD -1.57, 95% CI -2.42 to -0.72; moderate confidence) the highest. Direct information for tacrolimus 0.03% was based on one trial of 60 participants at high risk of bias. Roflumilast 0.15%, delgocitinib 0.25% or 0.5%, and tapinarof 1% were the least effective. Class-level sensitivity analysis found potent/very potent TCS had similar effectiveness to potent TCI and JAK inhibitors and mild/moderate TCS was less effective than mild TCI. A further 50 trials (9636 participants) reported patient-reported symptoms as a continuous outcome but could not be included in NMA. Clinician-reported signs NMA of 32 trials (4121 participants) reported clinician signs as a binary outcome and ranked potent TCS (OR 8.15, 95% CI 4.99, 13.57), tacrolimus 0.1% (OR 8.06, 95% CI 3.30, 19.67), ruxolitinib 1.5% (OR 7.72, 95% CI 4.92, 12.10), and delgocitinib 0.5% (OR 7.61, 95% CI 3.72, 15.58) as most effective, all with moderate confidence. Mild TCS, roflumilast 0.15%, crisaborole 2%, and tapinarof 1% were the least effective. Class-level sensitivity analysis found potent/very potent TCS more effective than potent TCI, mild TCI, JAK inhibitors, PDE-4 inhibitors; and mild TCS and PDE-4 inhibitors had similar effectiveness. NMA of 49 trials (5261 participants) reported clinician signs as a continuous outcome and ranked tacrolimus 0.03% (SMD -2.69, 95% CI -3.36, -2.02) and very potent TCS (SMD -1.87, 95% CI -2.69, -1.05) as most effective, both with moderate confidence; roflumilast 0.15%, difamilast 0.3% and tapinarof 1% were ranked as least effective. Direct information for tacrolimus 0.03% was based on one trial in 60 participants with a high risk of bias. For some sensitivity analyses, potent TCS, tacrolimus 0.1%, ruxolitinib 1.5%, delgocitinib 0.5% and delgocitinib 0.25% became some of the most effective treatments. Class-level analysis found potent/very potent TCS had similar effectiveness to potent TCI and JAK inhibitors, and moderate/mild TCS was more effective than mild TCI. A further 100 trials (22,814 participants) reported clinician signs as a continuous outcome but could not be included in NMA. Investigator Global Assessment NMA of 140 trials (23,383 participants) reported IGA as a binary outcome and ranked ruxolitinib 1.5% (OR 9.34, 95% CI 4.8, 18.18), delgocitinib 0.5% (OR 10.08, 95% CI 2.65, 38.37), delgocitinib 0.25% (OR 6.87, 95% CI 1.79, 26.33), very potent TCS (OR 8.34, 95% CI 4.73, 14.67), potent TCS (OR 5.00, 95% CI 3.80, 6.58), and tacrolimus 0.1% (OR 5.06, 95% CI 3.59, 7.13) as most effective, all with moderate confidence. Mild TCS, crisaborole 2%, pimecrolimus 1%, roflumilast 0.15%, difamilast 0.3% and 1%, and tacrolimus 0.03% were the least effective. In a sensitivity analysis of low risk of bias information (12 trials, 1639 participants), potent TCS, delgocitinib 0.5% and delgocitinib 0.25% were most effective, and pimecrolimus 1%, roflumilast 0.15%, difamilast 1% and difamilast 0.3% least effective. Class-level sensitivity analysis found potent/very potent TCS had similar effectiveness to potent TCI and JAK inhibitors and were more effective than PDE-4 inhibitors; mild/moderate TCS were less effective than potent TCI and had similar effectiveness to mild TCI. Longer-term outcomes over 6 to 12 months showed a possible increase in effectiveness for pimecrolimus 1% versus vehicle (4 trials, 2218 participants) in a pairwise meta-analysis, and greater treatment success with mild/moderate TCS than pimecrolimus 1% (based on 1 trial of 2045 participants). Local adverse effects NMA of 83 trials (18,992 participants, 2424 events) reporting application-site reactions ranked tacrolimus 0.1% (OR 2.2, 95% CI 1.53, 3.17; moderate confidence), crisaborole 2% (OR 2.12, 95% CI 1.18, 3.81; high confidence), tacrolimus 0.03% (OR 1.51, 95%CI 1.10, 2.09; low confidence), and pimecrolimus 1% (OR 1.44, 95% CI 1.01, 2.04; low confidence) as most likely to cause site reactions. Very potent, potent, moderate, and mild TCS were least likely to cause site reactions. NMA of eight trials (1786 participants, 3 events) reporting pigmentation changes found no evidence for increased pigmentation changes with TCS and crisaborole 2%, with low confidence for mild, moderate or potent TCS and moderate confidence for crisaborole 2%. NMA of 25 trials (3691 participants, 36 events) reporting skin thinning found no evidence for increased skin thinning with short-term (median 3 weeks, range 1-16 weeks) use of mild TCS (OR 0.72, 95% CI 0.12, 4.31), moderate TCS (OR 0.91, 95% CI 0.16, 5.33), potent TCS (OR 0.96, 95% CI 0.21, 4.43) or very potent TCS (OR 0.88, 95% CI 0.31, 2.49), all with low confidence. Longer-term outcomes over 6 to 60 months showed increased skin thinning with mild to potent TCS versus TCI (3 trials, 4069 participants, 6 events with TCS). AUTHORS' CONCLUSIONS Potent TCS, JAK inhibitors and tacrolimus 0.1% were consistently ranked as amongst the most effective topical anti-inflammatory treatments for eczema and PDE-4 inhibitors as amongst the least effective. Mild TCS and tapinarof 1% were ranked amongst the least effective treatments in three of five efficacy networks. TCI and crisaborole 2% were ranked most likely to cause local application-site reactions and TCS least likely. We found no evidence for increased skin thinning with short-term TCS but an increase with longer-term TCS.
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Affiliation(s)
- Stephanie J Lax
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Eleanor Van Vogt
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Bridget Candy
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Lloyd Steele
- Department of Dermatology, Royal Free London, London, UK
- Wellcome Sanger Institute, Cambridge, UK
| | - Clare Reynolds
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Beth Stuart
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Emma Axon
- Cochrane Methods Support Unit, Cochrane, London, UK
| | - Amanda Roberts
- Nottingham Support Group for Carers of Children with Eczema, Nottingham, UK
| | - Megan Doyle
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Derek K Chu
- Department of Medicine, and Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Miriam Santer
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Aaron M Drucker
- Department of Medicine, University of Toronto, Toronto, Canada
- Research and Innovation Institute and Department of Medicine, Women's College Hospital, Toronto, Canada
| | - Robert J Boyle
- National Heart & Lung Institute, Section of Inflammation and Repair, Imperial College London, London, UK
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Brazel D, Larocca C, Shinohara MM. Assessing Health-Related Quality of Life in Mycosis Fungoides and Sézary Syndrome: Unmet Needs. Cancers (Basel) 2024; 16:2757. [PMID: 39123484 PMCID: PMC11312166 DOI: 10.3390/cancers16152757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) can impair multiple dimensions of health-related quality of life (HRQoL). Currently, there is no standardized assessment tool for measuring HRQoL in patients with MF/SS. Here, we describe the existing literature on multiple dimensions of HRQoL in MF/SS with a special focus on the gaps in the current knowledge and identify future directions necessary to assess the HRQoL of patients with this disease.
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Affiliation(s)
- Danielle Brazel
- Department of Hematology/Oncology, Scripps Clinic/Scripps Green Hospital, La Jolla, CA 92037, USA
| | - Cecilia Larocca
- Brigham and Women’s Department of Dermatology, Dana Farber Cancer Center, Boston, MA 02215, USA
| | - Michi M. Shinohara
- Department of Dermatology, University of Washington, 1959 Northeast Pacific Street BB-1353, Box 356524, Seattle, WA 98195, USA
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Zeidler C, Kupfer J, Dalgard FJ, Bewley A, Evers AWM, Gieler U, Lien L, Sampogna F, Tomas Aragones L, Vulink N, Finlay AY, Legat FJ, Titeca G, Jemec GB, Misery L, Szabó C, Grivcheva Panovska V, Spillekom van Koulil S, Balieva F, Szepietowski JC, Reich A, Ferreira BR, Lvov A, Romanov D, Marron SE, Gracia Cazaña T, Elyas A, Altunay IK, Thompson AR, van Beugen S, Ständer S, Schut C. Dermatological patients with itch report more stress, stigmatization experience, anxiety and depression compared to patients without itch: Results from a European multi-centre study. J Eur Acad Dermatol Venereol 2024; 38:1649-1661. [PMID: 38468596 DOI: 10.1111/jdv.19913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses. RESULTS 3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes. CONCLUSION This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment.
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Affiliation(s)
- C Zeidler
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - J Kupfer
- Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany
| | - F J Dalgard
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University of London, London, UK
| | - A W M Evers
- Faculty of Social and Behavioural Sciences, Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | | | - L Lien
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
- Aragon Psychodermatology Research Group Zaragoza, Zaragoza, Spain
| | - N Vulink
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - G Titeca
- Clinique Notre Dame de Grâce, Gosselies, Belgium
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - C Szabó
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - V Grivcheva Panovska
- School of Medicine, PHI University Clinic of Dermatology, University St Cyril and Methodius, Skopje, North Macedonia
| | - S Spillekom van Koulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - F Balieva
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - B R Ferreira
- Centre for Philosophy of Science of the University of Lisbon, Lisbon, Portugal
- Department of Dermatology, Coimbra Hospital and University Centre, Portugal
- University of Brest, Lien, France
| | - A Lvov
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
- Medical Research and Educational Centre, Lomonosov Moscow State University, Moscow, Russia
| | - D Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Boundary Mental Conditions and Psychosomatic Disorders, Mental Health Research Centre, Moscow, Russia
- International Institute of Psychosomatic Health, Moscow, Russia
| | - S E Marron
- Aragon Psychodermatology Research Group Zaragoza, Zaragoza, Spain
- Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain
| | - T Gracia Cazaña
- Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain
| | - A Elyas
- Department of Dermatology, Skåne University Hospital, Malmö, Sweden
| | - I K Altunay
- Şişli Hamidiye Etfal Training and Research Hospital, Dermatology and Venereology Clinic, University of Health Sciences, Istanbul, Turkey
| | - A R Thompson
- South Wales Clinical Psychology Training Programme, Cardiff & Vale University Health Board & School of Psychology, Cardiff University, Cardiff, UK
| | - S van Beugen
- Faculty of Social and Behavioural Sciences, Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Schut
- Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany
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Chen X, Wen J, Wu W, Tu Y, Peng Q, Tao S, Yang H, He L. Non-linear association between air pollutants and secondary sensitive skin in acne patients. J Cosmet Dermatol 2024. [PMID: 39057602 DOI: 10.1111/jocd.16487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 07/08/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND There is a growing number of patients suffering from sensitive skin secondary to acne, but its prevalence and influencing factors are not yet well-understood. OBJECTIVE The aim of this study is to investigate the nonlinear relationship between air pollutants and secondary sensitive skin in acne patients. METHODS A cross-sectional study comprising 4325 acne outpatients in China was carried out between September 2021 and December 2022, employing a simple random sampling approach. Air pollutants data was derived from the nearest air quality monitoring station corresponding to the subjects' residential locations. Furthermore, socio-economic characteristics, biological attributes, and lifestyle data of patients were acquired via questionnaire surveys. The data were subsequently analyzed utilizing the XGBoost machine learning model. RESULTS A nonlinear relationship has been observed between secondary sensitive skin in acne patients and various factors, including particulate matter (PM2.5), inhalable particulate matter (PM10), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), the severity of depression, different levels of exercise intensity, acne grading, frequency of sunscreen application, gender, and age. CONCLUSION The occurrence of secondary sensitive skin in acne patients be mitigated through the implementation of measures such as the control of air pollutant emissions, regulation of negative emotions, and improvement of personal lifestyle.
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Affiliation(s)
- Xiangfeng Chen
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jing Wen
- Liwa Institute of Skin Health, East China Normal University, Shanghai, China
- School of Geographic Sciences, East China Normal University, Shanghai, China
- Zhejiang Economic Information Center, Hangzhou, China
| | - Wenjuan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiuzhi Peng
- Faculty of Land Resources Engineering, Kunming University of Science and Technology, Kunming, China
| | - Sifan Tao
- School of Mathematical Sciences, East China Normal University, Shanghai, China
| | - Haoran Yang
- Liwa Institute of Skin Health, East China Normal University, Shanghai, China
- School of Geographic Sciences, East China Normal University, Shanghai, China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
- Skin Health Research Center, Yunnan Characteristic Plant Extraction Laboratory, Kunming, China
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21
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Kuryłło M, Mojs E, Woźniak N, Wiśniewska-Szeplewicz D. Do Psoriasis and Atopic Dermatitis Affect Memory, Attention, Stress and Emotions? Brain Sci 2024; 14:747. [PMID: 39199442 PMCID: PMC11352270 DOI: 10.3390/brainsci14080747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Psoriasis and atopic dermatitis are chronic skin diseases found all over the world that cause a lot of suffering to patients. OBJECTIVES The aim of this study was to answer the following questions: whether people suffering from psoriasis and AD have greater problems with recognizing emotions, the effectiveness of attention and memory processes, and whether they use different strategies of coping with stress than healthy people. METHODS This study involved 90 patients, including 30 patients with psoriasis, 30 patients with AD and 30 healthy patients, aged 21 to 63 years, including 54 women and 36 men. This study used a battery of the CANTAB Cognitive Tests, Mini-COPE Questionnaire Inventory, Toronto Alexithymia Scale TAS Questionnaire, Psoriasis Area and Severity Index, and Eczema Area and Severity Index. RESULTS People with psoriasis and AD had higher total scores on the alexithymia scale and had greater difficulty in identifying and verbalizing emotions. People with psoriasis and AD are less likely to choose the correct stimulus and achieve a shorter length of the sequence that should be remembered. Psoriasis patients with more severe symptoms are less likely to use the strategy of a sense of humor in stressful situations. AD patients with more severe symptoms are less likely to use strategies of operative thinking, denial and self-blame, and the strategy of seeking instrumental support is used more often. CONCLUSIONS Patients with psoriasis and AD require a holistic approach; in addition to dermatological treatment, psychological support, psychotherapeutic support and possible psychiatric treatment are recommended.
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Affiliation(s)
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, 60-812 Poznań, Poland; (M.K.)
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Xing D, Xia G, Tang X, Zhuang Z, Shan J, Fang X, Qiu L, Zha X, Chen XL. A Multifunctional Nanocomposite Hydrogel Delivery System Based on Dual-Loaded Liposomes for Scarless Wound Healing. Adv Healthc Mater 2024:e2401619. [PMID: 39011810 DOI: 10.1002/adhm.202401619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/21/2024] [Indexed: 07/17/2024]
Abstract
Increased inflammatory responses and oxidative stress at the wound site following skin trauma impair healing. Furthermore, skin scarring places fibroblasts under severe mechanical stress and aggravates pathological fibrosis. A novel liposomal composite hydrogel is engineered for wound microenvironment remodeling, incorporating dual-loaded liposomes into gelatin methacrylate to create a nanocomposite hydrogel. Notably, tetrahydrocurcumin (THC) and hepatocyte growth factor (HGF) are encapsulated in the hydrophobic and hydrophilic layers of liposomes, respectively. The composite hydrogel maintains porous nanoarchitecture, demonstrating sustainable THC and HGF release and enhanced mechanical properties and biocompatibility. This system effectively promotes cell proliferation and angiogenesis and attenuates apoptosis. It decreases the expression of the inflammatory factors by inhibiting the high-mobility group box /receptor for advanced glycation end product/NF-κB (HMGB1/RAGE/NF-κB)pathway and increases macrophage polarization from M1 to M2 in vitro, effectively controlling inflammatory responses. It exhibits remarkable antioxidant properties by scavenging excess reactive oxygen species and free radicals. Most importantly, it effectively prevents scar formation by restraining the transforming growth factor beta (TGF-β)/Smads pathway that downregulates associated fibrotic factors. It demonstrates strong therapeutic effects against inflammation and fibrosis in a rat skin wound model with biosafety, advancing the development of innovative hydrogel-based therapeutic delivery strategies for clinical scarless wound therapy.
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Affiliation(s)
- Danlei Xing
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Guoqing Xia
- Institute for Liver Diseases of Anhui Medical University, The Key Laboratory of Anti-inflammatory and Immune Medicines, Ministry of Education, Hefei, 230022, P. R. China
| | - Xudong Tang
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Zhiwei Zhuang
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Jie Shan
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Xiao Fang
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Le Qiu
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
| | - Xiaojun Zha
- Department of Biochemistry & Molecular Biology, School of Basic Medicine, Anhui Medical University, Hefei, 230022, P. R. China
| | - Xu-Lin Chen
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China
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Knöps E, Spuls P, Duijnhoven R, Dijkgraaf M, van Barreveld M, Arents B, van Enst A, Garritsen F, Merkus M, Middelkamp-Hup P, Musters A, Bosma A, Hyseni A, Dijkstra J, Hijnen DJ, Gerbens L. The UPDATE trial (UVB Phototherapy in Dermatology for ATopic Eczema): study protocol for a randomized controlled trial of narrowband UVB with optimal topical therapy versus optimal topical therapy in patients with atopic eczema. Trials 2024; 25:482. [PMID: 39014498 PMCID: PMC11253338 DOI: 10.1186/s13063-024-08334-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Narrowband ultraviolet B (NB-UVB) phototherapy is commonly prescribed for patients with moderate-to-severe atopic eczema (AE). The efficacy of NB-UVB, however, has not yet properly been established, as current evidence is of low certainty. Our aim is to assess the short-term and long-term (cost-)effectiveness and safety of NB-UVB in adult AE patients by performing a pragmatic, multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) trial. This protocol outlines its methodology. METHODS A pragmatic, multicenter, PROBE trial will be performed with 1:1 randomization of 316 adult patients with moderate-to-severe AE who have inadequate disease control with topical therapy and who are eligible for optimal topical therapy (OTT) or NB-UVB in combination with OTT as a next step. Participants in the interventional arm will receive a minimum of 3 months of OTT combined with 8 to 16 weeks of NB-UVB. The control group receives 3 months of OTT. Following the interventional phase, follow-up will continue for 9 months. Physician-reported and patient-reported outcomes (according to the Harmonising Outcome Measures for Eczema (HOME) Core Outcome Set) and adverse events are assessed at 4 weeks, 3, 6, 9, and 12 months. DISCUSSION The UPDATE trial aims to provide high-quality evidence regarding the (cost-)effectiveness and safety of NB-UVB phototherapy in moderate-to-severe AE patients. Challenges that are addressed in the protocol include the possible bias arising from applying open-label treatment and the necessity of introducing OTT into the study design to prevent a high dropout rate. TRIAL REGISTRATION ClinicalTrials.gov NCT05704205. Registered on December 8, 2022.
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Affiliation(s)
- Eva Knöps
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.
| | - Phyllis Spuls
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruben Duijnhoven
- Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam Reproduction & Development Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Marcel Dijkgraaf
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Marit van Barreveld
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Bernd Arents
- Dutch Association for People With Atopic Dermatitis, Nijkerk, the Netherlands
| | - Annefloor van Enst
- Nederlandse Vereniging Voor Dermatologie en Venereologie, NVDV, Utrecht, the Netherlands
| | - Floor Garritsen
- Department of Dermatology, HagaZiekenhuis, The Hague, the Netherlands
| | - Maruschka Merkus
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Pina Middelkamp-Hup
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Annelie Musters
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela Bosma
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Ariënna Hyseni
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Jitske Dijkstra
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk Jan Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Louise Gerbens
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
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Tewelde T, Abdu N, Weldemariam DG, Bereket N, Russom M, Tesfamariam EH. Quality of life of dermatology outpatients and its associated factors in Halibet National Referral Hospital in Asmara, Eritrea. Sci Rep 2024; 14:16272. [PMID: 39009662 PMCID: PMC11250796 DOI: 10.1038/s41598-024-67224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
Skin diseases are prevalent globally and can have detrimental effects on the individual's health-related quality of life (HRQoL). The treatment of dermatological patients typically focuses on clinical signs and symptoms and a subjective view of the impact of the disease on the patient's life. Assessing quality of life can help provide patients with better service, by acknowledging their real needs and interfering with treatment decisions. The aim of the study was therefore to assess quality of life of dermatology outpatients and its associated factors. An analytical cross-sectional study was conducted in the dermatology clinic of Halibet National Referral Hospital in Asmara, Eritrea. HRQoL data were collected between May 6 and August 18, 2022 using a validated standard tool (Skindex-29). Descriptive statistics, logistic regression and paired t-test were employed using Statistical Package for Social Sciences (Version-26.0). A total of 375 dermatology clinic out-patients with a median age of 29 (Interquartile range: 25) were included in the study. The most commonly seen skin diseases were eczema, seborrhoeic dermatitis and tinea pedis. Emotion, symptom, and functioning domains of HRQoL were severely impaired in 75.7%, 50.4% and 57.6% of all dermatology outpatients, respectively. More than half of the respondents (57.9%) had a severely impaired overall HRQoL. In the overall HRQoL, being a rural resident [Adjusted Odds Ratio (AOR) 1.98, 95% CI 1.18, 3.33] and presence of chronic illness (AOR 2.16, 95% CI 1.22, 3.82) were significantly associated with severely impaired overall quality of life. A significantly higher mean score (p < 0.001) was observed in emotion [Mean (M) = 55.60, Standard Deviation (SD) = 21.0] as compared to functioning (M = 46.89, SD = 21.2). On the other hand, significantly higher mean score (p < 0.001) was observed on symptom (M = 54.08, SD = 20.5) as compared to functioning (M = 46.89, SD = 21.2). Skin diseases severely affected the emotion, functioning, and symptom domains of health-related quality of life. This highlights the importance of providing physical and psychosocial support to patients with dermatologic problems.
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Affiliation(s)
- Tomas Tewelde
- Pharmacy Unit, Department of Medical Sciences, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Nuru Abdu
- Department of Pharmacy, Adi-Tekelezan Community Hospital, Ministry of Health, Adi-Tekelezan, Eritrea
| | - Dawit G Weldemariam
- Department of Pharmacy, Hazhaz Zonal Referral Hospital, Ministry of Health, Asmara, Eritrea.
| | - Natnael Bereket
- Pharmacy Unit, Department of Medical Sciences, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Mulugeta Russom
- Eritrean Pharmacovigilance Centre, National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
- Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
- European Program for Pharmacovigilance and Pharmacoepidemiology, University of Bordeaux, Bordeaux, France
| | - Eyasu H Tesfamariam
- Biostatistics and Epidemiology, Department of Statistics, College of Sciences, Mai-Nefhi, Eritrea
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25
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Zhou J, He X, Sun L, Xu J, Chen X, Chu Y, Zhou L, Liao X, Zhang B, Afvari S, Gao X. Pre-trained multimodal large language model enhances dermatological diagnosis using SkinGPT-4. Nat Commun 2024; 15:5649. [PMID: 38969632 PMCID: PMC11226626 DOI: 10.1038/s41467-024-50043-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
Large language models (LLMs) are seen to have tremendous potential in advancing medical diagnosis recently, particularly in dermatological diagnosis, which is a very important task as skin and subcutaneous diseases rank high among the leading contributors to the global burden of nonfatal diseases. Here we present SkinGPT-4, which is an interactive dermatology diagnostic system based on multimodal large language models. We have aligned a pre-trained vision transformer with an LLM named Llama-2-13b-chat by collecting an extensive collection of skin disease images (comprising 52,929 publicly available and proprietary images) along with clinical concepts and doctors' notes, and designing a two-step training strategy. We have quantitatively evaluated SkinGPT-4 on 150 real-life cases with board-certified dermatologists. With SkinGPT-4, users could upload their own skin photos for diagnosis, and the system could autonomously evaluate the images, identify the characteristics and categories of the skin conditions, perform in-depth analysis, and provide interactive treatment recommendations.
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Affiliation(s)
- Juexiao Zhou
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- DermAssure, LLC, New York, NY, USA
| | - Xiaonan He
- Emergency Critical Care Center, Beijing AnZhen Hospital, Affiliated to Capital Medical University, Beijing, China.
| | - Liyuan Sun
- Department of Dermatology, Beijing AnZhen Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Jiannan Xu
- Department of Dermatology, Beijing AnZhen Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Xiuying Chen
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Yuetan Chu
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Longxi Zhou
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Xingyu Liao
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Bin Zhang
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia
| | - Shawn Afvari
- DermAssure, LLC, New York, NY, USA
- Department of Dermatology, Brigham and Women's Hospital, Harvard University, Boston, MA, USA
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Xin Gao
- Computer Science Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia.
- Computational Bioscience Research Center, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Kingdom of Saudi Arabia.
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26
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Cornman HL, Haque EK, Tamburro L, Driscoll MS. A well-demarcated hyperpigmented plaque of the posterior neck. JAAD Case Rep 2024; 49:55-58. [PMID: 38883176 PMCID: PMC11176600 DOI: 10.1016/j.jdcr.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Hannah L Cornman
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Emily K Haque
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Lo Tamburro
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Marcia S Driscoll
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland
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27
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Roso-Mares A, Andújar I, Díaz Corpas T, Sun BK. Non-coding RNAs as skin disease biomarkers, molecular signatures, and therapeutic targets. Hum Genet 2024; 143:801-812. [PMID: 37580609 DOI: 10.1007/s00439-023-02588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/23/2023] [Indexed: 08/16/2023]
Abstract
Non-coding RNAs (ncRNAs) are emerging as biomarkers, molecular signatures, and therapeutic tools and targets for diseases. In this review, we focus specifically on skin diseases to highlight how two classes of ncRNAs-microRNAs and long noncoding RNAs-are being used to diagnose medical conditions of unclear etiology, improve our ability to guide treatment response, and predict disease prognosis. Furthermore, we explore how ncRNAs are being used as both as drug targets and associated therapies have unique benefits, risks, and challenges to development, but offer a distinctive promise for improving patient care and outcomes.
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Affiliation(s)
- Andrea Roso-Mares
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
- Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Isabel Andújar
- Department of Pharmacology, University of Valencia, Valencia, Spain
| | - Tania Díaz Corpas
- Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- Department of Dermatology, Hospital Dr Peset, Valencia, Spain
| | - Bryan K Sun
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
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28
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Mashi A, Daghriri SA, Mobarki OA, Otaif F, Suwaid OA, Alharbi RH, Adawi KA, Alanazi MA, Hurubi M, Qadiri BA, Alnami AG, Alfaifi BA, Moafa AY, Alqahtani HA. Prevalence and Contributing Factors of Acne Vulgaris Among the General Population in the Jazan Region, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e65407. [PMID: 39184770 PMCID: PMC11344885 DOI: 10.7759/cureus.65407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Acne vulgaris is one of the most prevalent inflammatory conditions in the world that primarily affects teenagers. Its prevalence and the contributing factors vary across different regions and populations. Genetic predisposition, hormonal influences, dietary habits, lifestyle choices, and environmental factors are believed to be significant contributors. METHODS This was a cross-sectional study involving 419 participants from the Jazan region, Saudi Arabia. The study employed non-probability convenience sampling techniques. Data were collected through online questionnaires and analyzed using Statistical Product and Service Solutions (SPSS, version 27; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS The study found that acne prevalence was high, affecting more than half (66.8%) of the participants, with mild severity reported by 51.8%. Pimples were most commonly found on the face (65.2%), followed by the back (45.3%) and chest (29.6%). Participants with oily skin had twice the likelihood of acne compared to those with dry skin (OR=2.14). Increasing age was associated with a 5% decrease in acne risk per year. Significant associations were found for age (p=0.010), female gender (p=0.017), and oily skin (p<0.001) with acne development. CONCLUSION The study found a high prevalence rate of acne vulgaris among the young population in the Jazan region, Saudi Arabia. Age, female gender, and having oily skin were predictors for developing acne vulgaris. Complications such as acne scarring and psychological impacts such as shyness underscore the significant burden of acne on social and psychological well-being. Enhanced treatment and improved quality of life necessitate heightened awareness campaigns concerning acne vulgaris, its treatments, and associated complications, as revealed by the study.
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Affiliation(s)
- Amany Mashi
- Department of Dermatology, Armed Forces Hospital, Jazan, SAU
| | | | | | - Faisal Otaif
- College of Medicine, Jazan University, Jazan, SAU
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29
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Salle R, Del Giudice P, Skayem C, Hua C, Chosidow O. Secondary Bacterial Infections in Patients with Atopic Dermatitis or Other Common Dermatoses. Am J Clin Dermatol 2024; 25:623-637. [PMID: 38578398 DOI: 10.1007/s40257-024-00856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
Secondary bacterial infections of common dermatoses such as atopic dermatitis, ectoparasitosis, and varicella zoster virus infections are frequent, with Staphylococcus aureus and Streptococcus pyogenes being the bacteria most involved. There are also Gram-negative infections secondary to common dermatoses such as foot dyshidrotic eczema and tinea pedis. Factors favoring secondary bacterial infections in atopic dermatitis, ectoparasitosis, and varicella zoster virus infections mainly include an epidermal barrier alteration as well as itch. Mite-bacteria interaction is also involved in scabies and some environmental factors can promote Gram-negative bacterial infections of the feet. Furthermore, the bacterial ecology of these superinfections may depend on the geographical origin of the patients, especially in ectoparasitosis. Bacterial superinfections can also have different clinical aspects depending on the underlying dermatoses. Subsequently, the choice of class, course, and duration of antibiotic treatment depends on the severity of the infection and the suspected bacteria, primarily targeting S. aureus. Prevention of these secondary bacterial infections depends first and foremost on the management of the underlying skin disorder. At the same time, educating the patient on maintaining good skin hygiene and reporting changes in the primary lesions is crucial. In the case of recurrent secondary infections, decolonization of S. aureus is deemed necessary, particularly in atopic dermatitis.
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Affiliation(s)
- Romain Salle
- Service de Dermatologie Générale et Oncologique, UVSQ, EA4340-BECCOH, AP-HP, Hôpital Ambroise-Paré, Université Paris-Saclay, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France.
| | - Pascal Del Giudice
- Unité D'Infectiologie et Dermatologie, Centre Hospitalier Intercommunal de Fréjus-Saint-Raphaël, Fréjus, France
| | - Charbel Skayem
- Service de Dermatologie Générale et Oncologique, UVSQ, EA4340-BECCOH, AP-HP, Hôpital Ambroise-Paré, Université Paris-Saclay, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Camille Hua
- AP-HP, Service de Dermatologie, Hôpital Henri Mondor, Créteil, France
| | - Olivier Chosidow
- Consultation Dermatoses Faciales, Service d'ORL, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
- UPEC Créteil, Créteil, France
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30
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Lee JH, Yoon JY, Kim DH, Kwon YG, Kim GH, Park BJ, Suh DH. Potential of cannabidiol as acne and acne scar treatment: novel insights into molecular pathways of pathophysiological factors. Arch Dermatol Res 2024; 316:428. [PMID: 38904694 PMCID: PMC11192675 DOI: 10.1007/s00403-024-03131-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 06/22/2024]
Abstract
Cannabidiol (CBD), which is derived from hemp, is gaining recognition because of its anti-inflammatory and lipid-modulating properties that could be utilized to treat acne. We conducted experiments to quantitatively assess the effects of CBD on acne-related cellular pathways. SEB-1 sebocytes and HaCaT keratinocytes were exposed to various CBD concentrations. CBD exhibited a concentration-dependent impact on cell viability and notably reduced SEB-1 viability; furthermore, it induced apoptosis and a significant increase in the apoptotic area at higher concentrations. Additionally, CBD remarkably reduced pro-inflammatory cytokines, including CXCL8, IL-1α, and IL-1β. Additionally, it inhibited lipid synthesis by modulating the AMPK-SREBP-1 pathway and effectively reduced hyperkeratinization-related protein keratin 16. Simultaneously, CBD stimulated the synthesis of elastin, collagen 1, and collagen 3. These findings emphasize the potential of CBD for the management of acne because of its anti-inflammatory, apoptotic, and lipid-inhibitory effects. Notably, the modulation of the Akt/AMPK-SREBP-1 pathway revealed a novel and promising mechanism that could address the pathogenesis of acne.
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Affiliation(s)
- Jun Hyo Lee
- Department of Dermatology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Ji Young Yoon
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Dong Hyo Kim
- Department of Dermatology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Yoon Gyung Kwon
- Skin and Natural Products Laboratory, Kolmar Korea Co., Ltd, Seoul, Republic of Korea
| | - Geun-Hyeong Kim
- Skin and Natural Products Laboratory, Kolmar Korea Co., Ltd, Seoul, Republic of Korea
| | - Byoung Jun Park
- Skin and Natural Products Laboratory, Kolmar Korea Co., Ltd, Seoul, Republic of Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
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31
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Chiesa Fuxench Z, Mitra N, Del Pozo D, Hoffstad O, Shin DB, Langan SM, Petersen I, Bhate K, Margolis DJ. In utero or early-in-life exposure to antibiotics and the risk of childhood atopic dermatitis, a population-based cohort study. Br J Dermatol 2024; 191:58-64. [PMID: 37897530 PMCID: PMC11055935 DOI: 10.1093/bjd/ljad428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common inflammatory disease of the skin that begins early in life and can be lifelong. The purpose of our study was to evaluate whether fetal exposure and/or early-life exposure of a child to antibiotics increases the risk of early-onset AD. OBJECTIVES We hypothesize that antibiotic exposure in utero or early in life (e.g. first 90 days) increases the likelihood that children develop AD. METHODS Utilizing a large, prospectively collected electronic medical records database, we studied the association of antibiotic exposure received in utero or very early in life and the relative risk of onset of AD in a population-based cohort study. Associations were estimated using proportional hazards models as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS The risk of AD in childhood was increased after in utero or early-life antibiotic exposure. For any in utero antibiotic exposure the HR (CI) was 1.38 (1.36-1.39). However, penicillin demonstrated the strongest association with AD for both in utero exposure [1.43 (1.41-1.44)] and for childhood exposure [1.81 (1.79-1.82)]. HRs were higher in children born to mothers without AD than in those with AD pointing to effect modification by maternal AD status. CONCLUSIONS Children born to mothers exposed to antibiotics while in utero had, depending on the mother's history of AD, approximately a 20-40% increased risk of developing AD. Depending on the antibiotic, children who received antibiotics early in life had a 40-80% increased risk of developing AD. Our study supports and refines the association between incident AD and antibiotic administration. It also adds population-based support to therapeutic attempts to treat AD by modifying the skin microbiome.
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Affiliation(s)
- Zelma Chiesa Fuxench
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
| | - Nandita Mitra
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
| | | | - Ole Hoffstad
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
| | - Daniel B. Shin
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
| | - Sinéad M. Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine
| | - Irene Petersen
- Department of Primary Care & Population Health, University College of London, United Kingdom
- Department of Clinical Epidemiology, Aarhus University, Denmark
| | - Ketaki Bhate
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine
| | - David J Margolis
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia Pennsylvania
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Trzeciak M, Rudnicka L, Arenberger P, Engin B, L'vov A, Alper S, Alpsoy E, Benáková N, Bobko S, Borlu M, Czarnecka-Operacz M, Elisyutina O, Ergun T, Ertam I, Fedenko E, Filipovská O, Fomina D, Gadzhigoroeva A, Kojanová M, Lesiak A, Michenko A, Murashkin N, Owczarek W, Özkaya E, Plzáková Z, Reich A, Selerova M, Gurbuz BA. Disease burden, clinical management and unmet treatment need of patients with moderate to severe atopic dermatitis; consensus statements, insights and practices from CERTADE (Central/Eastern EU, Russia, Turkiye AD Experts) Delphi panel. Front Med (Lausanne) 2024; 11:1402493. [PMID: 38962737 PMCID: PMC11220254 DOI: 10.3389/fmed.2024.1402493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Background There is limited insight into the current disease burden and everyday clinical management of moderate-to- severe AD in Poland, Czechia, Russia, and Turkiye. Therefore, this study aimed to get information-driven insights regarding the current disease burden and clinical management of patients with moderate-to-severe AD with common and differentiating aspects of the patient journey and establish a consensus. Methods In this modified 2-round Delphi panel, 133 questions were asked in total to 27 dermatologists. A consensus was achieved when 70% of the panel members strongly agreed or agreed (or strongly disagreed or disagreed) with an item. Statements with <40% agreement dropped from the Delphi rounds and were not repeated. Results The results state that AD has a significant impact on the quality of life for both patients and their families with social and economic consequences in these countries. While there were significant dissimilarities regarding the current treatment approach by preference order and treatment duration among participants, there was also a high percentage of consensus on literature and guideline-based statements. Current topical therapies and the immune response modifiers were not found to be sufficient by panelists to cover the therapeutic needs of patients with moderate-to-severe AD. Moreover, panelists highlighted the significant burden of adverse events with the off-label use of currently available immunosuppressants. Conclusions These results underlined that there is a significant disease burden with an unmet treatment need for patients with moderate-to-severe AD in Poland, Czechia, Russia, and Turkiye.
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Affiliation(s)
- Magdalena Trzeciak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Petr Arenberger
- Department of Dermatovenerology, Third Faculty of Medicine, Charles University of Prague, Prague, Czechia
| | - Burhan Engin
- Department of Dermatology and Venerology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Andrey L'vov
- Department of Dermatology, Federal State Budgetary Institution of Continuing Professional Education “Central State Medical Academy”, Moscow, Russia
- Department of Dermatology, Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Sibel Alper
- Department of Dermatology and Venereology, Koç University, İstanbul, Türkiye
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University, Antalya, Türkiye
| | - Nina Benáková
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Svetlana Bobko
- Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Türkiye
| | | | | | - Tulin Ergun
- Department of Dermatology, Marmara University, İstanbul, Türkiye
| | - Ilgen Ertam
- Department of Dermatology, Ege University, İzmir, Türkiye
| | - Elena Fedenko
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Olga Filipovská
- Department of Dermatology, Hospital in Ústí nad Labem, Ústí nad Labem, Czechia
| | - Daria Fomina
- Centre of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russia
- Department of Dermatology, I. M. Sechenov Moscow Medical University, Moscow, Russia
| | - Aida Gadzhigoroeva
- Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Martina Kojanová
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Aleksandra Lesiak
- Dermatology and Venereology Clinic, Medical University, Łodź, Poland
| | - Anna Michenko
- Department of Dermatology, Federal State Budgetary Institution of Continuing Professional Education “Central State Medical Academy”, Moscow, Russia
- Department of Dermatology, Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Nikolay Murashkin
- Department of Dermatology, Federal State Autonomous Institution, Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Esen Özkaya
- Istanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul University, İstanbul, Türkiye
| | - Zuzana Plzáková
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Adam Reich
- Department of Dermatology, University of Rzeszow, Rzeszów, Poland
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Gordon S, Layton AM, Fawcett S, Ross K. A microRNA focus on acne. Dermatol Reports 2024; 16:9902. [PMID: 38957637 PMCID: PMC11216150 DOI: 10.4081/dr.2024.9902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/03/2023] [Indexed: 07/04/2024] Open
Abstract
Acne (syn. acne vulgaris) is a common inflammatory skin disorder associated with puberty and adolescence. The disease is characterized by comedoneous lesions, papules, pustules, and nodules that are mostly found on the face. These lesions are caused by intricate interactions between the pilosebaceous unit and the Cutibacterium acnes (C. acnes) bacteria. Unhealthy acne and its aftereffects, like pigment changes and scarring, have a detrimental impact on one's quality of life. Recent years have seen a sharp increase in the approval of nucleic acid therapies (NATs), such as antisense oligonucleotides and short-interfering RNA medications, for rare diseases for which there are few or no effective treatments. These developments suggest that NATs may be useful in acne treatment plans down the road, as do clinical trials for microRNA (miRNA) modulation in skin contexts. We highlight promising miRNA targets for anti-acne therapy in this review. We outline the pathophysiology of acne in brief and emphasize the functions of C. acnes. Next, we concentrate on the distinct impacts of biofilm and planktonic C. acnes on a Toll-like receptor 2 axis that spans miR-146a-5p, which was recently discovered. Before discussing the potential contributions of miR-21-5p, miR-233-3p, and miR-150-5p to inflammatory axes in acne, we evaluate miR-146a-5p in sebocytes. Finally, we address patient involvement in miRNA-related acne research and translational perspectives.
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Affiliation(s)
| | - Alison M. Layton
- Skin Research Centre, Hull York Medical School, University of York
- Harrogate and District NHS Foundation Trust, Harrogate
| | - Sandra Fawcett
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University
- Institute for Health Research, Liverpool John Moores University, United Kingdom
| | - Kehinde Ross
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University
- Institute for Health Research, Liverpool John Moores University, United Kingdom
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Brooks SG, Yosipovitch G. Unmet needs in treating itch: reaching beyond eczema. J DERMATOL TREAT 2024; 35:2351487. [PMID: 38945542 DOI: 10.1080/09546634.2024.2351487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Pruritus is an unpleasant sensation that creates the urge to scratch. In many chronic conditions, relentless pruritus and scratching perpetuates a vicious itch-scratch cycle. Uncontrolled itch can detrimentally affect quality of life and may lead to sleep disturbance, impaired concentration, financial burden, and psychological suffering. Recent strides have been made to develop guidelines and investigate new therapies to treat some of the most common severely pruritic conditions, however, a large group of diseases remains underrecognized and undertreated. The purpose of this article is to provide a comprehensive review of the challenges hindering the treatment of pruritus. METHODS An online search was performed using PubMed, Web of Science, Google Scholar, and ClinicalTrials.gov from 1994 to 2024. Included studies were summarized and assessed for quality and relevance in treating pruritus. RESULTS Several barriers to treating pruritus emerged, including variable presentation, objective measurement of itch, and identifying therapeutic targets. Itch associated with autoimmune conditions, connective tissue diseases, genodermatoses, cutaneous T-cell lymphoma, and pruritus of unknown origin were among the etiologies with the greatest unmet needs. CONCLUSION Treating pruritus poses many challenges and there are many itchy conditions that have no yet been addressed. There is an urgent need for large-scale controlled studies to investigate potential targets for these conditions and novel therapies.
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Affiliation(s)
- Sarah G Brooks
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gil Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Ruchti F, Zwicky P, Becher B, Dubrac S, LeibundGut-Landmann S. Epidermal barrier impairment predisposes for excessive growth of the allergy-associated yeast Malassezia on murine skin. Allergy 2024; 79:1531-1547. [PMID: 38385963 DOI: 10.1111/all.16062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/15/2024] [Accepted: 01/20/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The skin barrier is vital for protection against environmental threats including insults caused by skin-resident microbes. Dysregulation of this barrier is a hallmark of atopic dermatitis (AD) and ichthyosis, with variable consequences for host immune control of colonizing commensals and opportunistic pathogens. While Malassezia is the most abundant commensal fungus of the skin, little is known about the host control of this fungus in inflammatory skin diseases. METHODS In this experimental study, MC903-treated mice were colonized with Malassezia spp. to assess the host-fungal interactions in atopic dermatitis. Additional murine models of AD and ichthyosis, including tape stripping, K5-Nrf2 overexpression and flaky tail mice, were employed to confirm and expand the findings. Skin fungal counts were enumerated. High parameter flow cytometry was used to characterize the antifungal response in the AD-like skin. Structural and functional alterations in the skin barrier were determined by histology and transcriptomics of bulk skin. Finally, differential expression of metabolic genes in Malassezia in atopic and control skin was quantified. RESULTS Malassezia grows excessively in AD-like skin. Fungal overgrowth could, however, not be explained by the altered immune status of the atopic skin. Instead, we found that by upregulating key metabolic genes in the altered cutaneous niche, Malassezia acquired enhanced fitness to efficiently colonise the impaired skin barrier. CONCLUSIONS This study provides evidence that structural and metabolic changes in the dysfunctional epidermal barrier environment provide increased accessibility and an altered lipid profile, to which the lipid-dependent yeast adapts for enhanced nutrient assimilation. Our findings reveal fundamental insights into the implication of the mycobiota in the pathogenesis of common skin barrier disorders.
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Affiliation(s)
- Fiorella Ruchti
- Section of Immunology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
- Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
| | - Pascale Zwicky
- Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
| | - Burkhard Becher
- Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
| | - Sandrine Dubrac
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Salomé LeibundGut-Landmann
- Section of Immunology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
- Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland
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Paller AS, Rangel SM, Chamlin SL, Hajek A, Phan S, Hogeling M, Castelo-Soccio L, Lara-Corrales I, Arkin L, Lawley LP, Funk T, Castro Porto Silva Lopes F, Antaya RJ, Ramien ML, Vivar KL, Teng J, Coughlin CC, Rehmus W, Gupta D, Bercovitch L, Stein SL, Boull C, Tom WL, Liang MG, Hunt R, Luu M, Holland KE, Schoch JJ, Cella D, Lai JS, Griffith JW. Stigmatization and Mental Health Impact of Chronic Pediatric Skin Disorders. JAMA Dermatol 2024; 160:621-630. [PMID: 38656377 PMCID: PMC11044010 DOI: 10.1001/jamadermatol.2024.0594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/16/2024] [Indexed: 04/26/2024]
Abstract
Importance Chronic skin disorders in children frequently are visible and can cause stigmatization. However, the extent of stigmatization from chronic skin disease and association with mental health needs further study. Objective To examine the extent of stigma, dependence on disease visibility and severity, and association with mental health and quality of life (QOL) in chronic pediatric skin disease. Design, Setting, and Participants A cross-sectional, single-visit study was conducted at 32 pediatric dermatology centers in the US and Canada from November 14, 2018, to November 17, 2021. Participants included patients aged 8 to 17 years with chronic skin disease and 1 parent. Main Outcomes and Measures Using the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) Stigma-Skin, the extent of stigma with child-, caregiver-, and physician-assessed disease visibility (primary outcome) and severity was compared, as well as reduced QOL (assessed by Skindex-Teen), depression, anxiety, and poor peer relationships (PROMIS child and proxy tools) (secondary outcomes). Results The study included 1671 children (57.9% female; mean [SD] age, 13.7 [2.7] years). A total of 56.4% participants had self-reported high disease visibility and 50.5% had moderate disease severity. Stigma scores significantly differed by level of physician-assessed and child/proxy-assessed disease visibility and severity. Among children with chronic skin disorders, predominantly acne, atopic dermatitis, alopecia areata, and vitiligo, only 27.0% had T scores less than 40 (minimal or no stigma) and 43.8% had at least moderate stigma (T score ≥45) compared with children with a range of chronic diseases. Stigma scores correlated strongly with reduced QOL (Spearman ρ = 0.73), depression (ρ = 0.61), anxiety (ρ = 0.54), and poor peer relationships (ρ = -0.49). Overall, 29.4% of parents were aware of bullying of their child, which was strongly associated with stigma (Cohen d = -0.79, with children who were not bullied experiencing lower levels of stigma). Girls reported more stigma than boys (Cohen d = 0.26). Children with hyperhidrosis and hidradenitis suppurativa were most likely to have increased depression and anxiety. Conclusions and Relevance The findings of this study suggest that physician assessment of disease severity and visibility is insufficient to evaluate the disease impact in the patient/caregiver. Identifying stigmatization, including bullying, and tracking improvement through medical and psychosocial interventions may be a key role for practitioners.
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Affiliation(s)
- Amy S. Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Stephanie M. Rangel
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sarah L. Chamlin
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Aleena Hajek
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sheshanna Phan
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Marcia Hogeling
- Department of Medicine/Dermatology, University of California, Los Angeles
| | - Leslie Castelo-Soccio
- Department of Pediatric Dermatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Irene Lara-Corrales
- Department of Pediatric Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Arkin
- Department of Pediatric Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Tracy Funk
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon
| | | | | | - Michele L. Ramien
- Department of Pediatrics, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Karina L. Vivar
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Joyce Teng
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Carrie C. Coughlin
- Department of Medicine/Dermatology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Wingfield Rehmus
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Deepti Gupta
- Department of Pediatric Dermatology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle
| | - Lionel Bercovitch
- Department of Pediatric Dermatology, Hasbro Children’s Hospital, Brown University, Providence, Rhode Island
| | - Sarah L. Stein
- Departments of Medicine/Dermatology and Pediatrics, University of Chicago, Chicago, Illinois
| | - Christina Boull
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Wynnis L. Tom
- Department of Pediatric Dermatology, Rady’s Children’s Hospital, University of California, San Diego
| | - Marilyn G. Liang
- Department of Pediatric Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raegan Hunt
- Department of Dermatology, Texas Children’s Hospital, Baylor College of Medicine, Houston
| | - Minnelly Luu
- Department of Pediatric Dermatology, Children’s Hospital Los Angeles, Los Angeles
| | - Kristen E. Holland
- Department of Pediatric Dermatology, Children’s Wisconsin, Medical College of Wisconsin, Milwaukee
| | | | - David Cella
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jin-Shei Lai
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James W. Griffith
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Dellière S, Jabet A, Abdolrasouli A. Current and emerging issues in dermatophyte infections. PLoS Pathog 2024; 20:e1012258. [PMID: 38870096 PMCID: PMC11175395 DOI: 10.1371/journal.ppat.1012258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Affiliation(s)
- Sarah Dellière
- Service de Parasitologie-Mycologie, Hôpital Saint-Louis, AP-HP, Paris, France
- Institut Pasteur, Immunobiology of Aspergillus, Université Paris-Cité, Paris, France
| | - Arnaud Jabet
- Service de Parasitologie-Mycologie, Hôpital La Pitié-Salpêtrière, AP-HP, Paris, France
- Service de Parasitologie-Mycologie, Hôpital Saint-Antoine, AP-HP, Paris, France
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Alireza Abdolrasouli
- Department of Medical Microbiology, King’s College Hospital, London, United Kingdom
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
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38
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Asbóth D, Bánfi B, Kocsis D, Erdő F. Rodent models of dermatological disorders. Ital J Dermatol Venerol 2024; 159:303-317. [PMID: 38287740 DOI: 10.23736/s2784-8671.23.07700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
To assess the possible beneficial effects of drugs and drug candidates, different dermatological disease models are available in rodents. These models are able to mimic one or more characteristic features of the disorders, but not completely recapitulate the pathogenesis of the human skin diseases. Therefore, to improve the technology many new models have been developed both by genetic engineering and by chemical or physical induction. Currently the in vivo rodent models provide the physiologically most relevant approach to produce the pathology related to the majority of dermatological diseases. In this short review some widely used animal techniques (psoriasis, allergic contact dermatitis, atopic dermatitis, wound healing, melanoma and non-melanoma type skin cancers and UV erythema) are shown which are currently applied in pharmacological, pharmacokinetic, pharmaceutical and dermatological research. First the main points of the human pathomechanism are shown and afterwards the rodent models are briefly discussed. Finally critical evaluation is provided by the authors. However, according to the 3R rule the number of experimental animals is strongly suggested to be reduced, therefore the advanced in vitro and ex vivo techniques become more and more important contrary to in vivo preclinical methods also in dermatological research. As it is described in the outlook section, although the 2D/3D in vitro and skin on-a-chip techniques are promising and have many advantages they are not able to completely substitute the animal models in their vascular, immunological, secretory and neural complexity.
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Affiliation(s)
- Dorottya Asbóth
- Pediatric Dermatology Center, Szent János Center Hospital in North Buda, Budapest, Hungary
| | - Barnabás Bánfi
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
- Faculty of Science, Eötvös Loránd University, Budapest, Hungary
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary -
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Hu C, Zeng D, Huang Y, Deng Q, Liu S, Zhou W, Zhou W. Sodium Butyrate Ameliorates Atopic Dermatitis-Induced Inflammation by Inhibiting HDAC3-Mediated STAT1 and NF-κB Pathway. Inflammation 2024; 47:989-1001. [PMID: 38159175 DOI: 10.1007/s10753-023-01955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
A topic dermatitis (AD) is a common chronic and recurrent skin disorder. The protective effects of sodium butyrate (NaB), a metabolite of short-chain fatty acid breakdown by the gut microbiota, have been widely reported in numerous inflammatory diseases. However, the effect of NaB treatment alone on AD has not been reported. In the current study, AD was induced in BALB/c mice with 2,4-dinitrochlorobenzene (DNCB) for 28 days with NaB (200 mg/kg) treatment by gavage. NaB attenuated AD-induced skin bleeding, scarring, dryness, abrasions and erosions. In addition, NaB inhibited inflammatory cells infiltration and attenuated the expression of inflammatory cytokines and chemokines. Mechanistically, NaB reduced histone deacetylase 3 (HDAC3) expression and NF-κB p65 nuclear translocation by increasing the lysine acetylation levels of STAT1 and NF-κB p65 in AD. Taken together, our study suggests that NaB inhibits inflammatory mediators and ameliorates AD by inhibiting HDAC3 expression, thereby upregulating STAT1 and NF-κB p65 lysine acetylation levels and reducing NF-κB p65 nuclear translocation. Therefore, this study provides a new theoretical basis for NaB in the treatment of AD.
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Affiliation(s)
- Chaoqun Hu
- Department of Gastroenterology, Chongqing General Hospital, Chongqing, 400014, China
| | - Dan Zeng
- Department of Allergy, Chongqing General Hospital, Chongqing, 400014, China
| | - Yunxia Huang
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Qian Deng
- Department of Gastroenterology, Chongqing General Hospital, Chongqing, 400014, China
| | - Shunan Liu
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Weikang Zhou
- Department of Allergy, Chongqing General Hospital, Chongqing, 400014, China
| | - Wei Zhou
- Department of Allergy, Chongqing General Hospital, Chongqing, 400014, China.
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Kong Y, Xing P, Huai P, Zhang F. The burden of skin diseases in China: global burden of Disease Study 2019. Arch Dermatol Res 2024; 316:277. [PMID: 38796625 DOI: 10.1007/s00403-024-03046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/28/2024]
Abstract
Skin diseases continue to affect human health and cause a significant disease burden on the healthcare system.We aimed to report the changing trends in the burden of skin disease in China from 1990 to 2019, Which has an important role in developing targeted prevention strategies. We applied Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 analytical tools to calculate the age-standardized Prevalence and Incidence in 2019, number of years lived with disability (YLDs) and age-standardized YLDs from 1990 to 2019 of skin and subcutaneous diseases, notifiable infectious skin diseases and skin tumors in China. Among the skin and subcutaneous diseases in China in 2019, dermatitis contributed to the greatest YLD (2.17 million, 95% uncertainty interval[UI]: 1.28-3.36). Age-standardized YLD rates for leprosy decreased from 0.09 (95%UI: 0.06-0.13) in 1990 to 0.04 (95%UI: 0.03-0.06) in 2019; the proportional decrease was 55.56% over 30 years. Age-standardized YLDs for HIV and sexually transmitted infections increased by 26% during the same time period. Age-standardized YLDs for non-melanoma skin cancer increased at a much higher rate than melanoma between 1990 and 2019. Dermatitis and scabies continue to have an important role in the burden of skin and subcutaneous disease burden in China. The burden of non-melanoma cell cancer has increased most significantly over the past three decades.
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Affiliation(s)
- Yaoyao Kong
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
| | - Peiye Xing
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
| | - Pengcheng Huai
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China.
| | - Furen Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, No.27397 of Jingshi Road, Jinan, 250022, China
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Liao Z, Yeoh YK, Parumasivam T, Koh WY, Alrosan M, Alu'datt MH, Tan TC. Medium-chain dicarboxylic acids: chemistry, pharmacological properties, and applications in modern pharmaceutical and cosmetics industries. RSC Adv 2024; 14:17008-17021. [PMID: 38808239 PMCID: PMC11130641 DOI: 10.1039/d4ra02598a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024] Open
Abstract
Succinic (SUA), glutaric (GLA), pimelic (PA), suberic (SUBA), adipic (ADA), azelaic (AZA), and sebacic acids (SA) make up the majority of medium-chain dicarboxylic acids (MCDAs) with chain lengths of C4-C10, and are widely utilised in the chemical, food, textile, pesticide, pharmaceutical, and liquid crystal sectors. The MCDAs' two carboxyl groups provide them with an incredibly broad variety of applications. The focus of significant scientific research now is on the increasingly varied pharmacological effects of MCDAs. However, only a few studies have compared the biological characteristics of MCDAs in the contemporary pharmaceutical and cosmetic sectors and thoroughly examined the most recent research and marketing initiatives for MCDAs. This review's objective is to offer a thorough analysis of academic works on MCDAs, to assess the usefulness of these substances' chemical-pharmacological properties for use in the contemporary pharmaceutical and cosmetic industries, and to investigate the direction of their possible applications in these two disciplines. In addition, this review investigates how these compounds are metabolised in the human body.
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Affiliation(s)
- Zhengrui Liao
- Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia 11800 USM Penang Malaysia
| | - Yu-Kee Yeoh
- School of Housing, Building and Planning, Universiti Sains Malaysia 11800 USM Penang Malaysia
| | | | - Wee Yin Koh
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah Jalan UMS 88400 Kota Kinabalu Sabah Malaysia
| | - Mohammad Alrosan
- College of Health Sciences, QU Health, Qatar University P.O. Box 2713 Doha Qatar
- Applied Science Research Center, Applied Science Private University Al-Arab St. 21 Amman 11931 Jordan
| | - Muhammad H Alu'datt
- Department of Food Science & Nutrition, College of Life Sciences, Kuwait University P.O. Box. 5969 Safat 13060 Kuwait
| | - Thuan-Chew Tan
- Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia 11800 USM Penang Malaysia
- Renewable Biomass Transformation Cluster, School of Industrial Technology, Universiti Sains Malaysia 11800 USM Penang Malaysia +604-653 6375 +604-653 6217
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Chen T, Liu Q, Yang J. Few-Shot Classification with Multiscale Feature Fusion for Clinical Skin Disease Diagnosis. Clin Cosmet Investig Dermatol 2024; 17:1007-1026. [PMID: 38737944 PMCID: PMC11088239 DOI: 10.2147/ccid.s458255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024]
Abstract
Introduction Skin disease is one of the most common diseases and can affect people of all ages and races. However, the diagnosis of skin diseases via observation is a highly challenging task for both doctors and patients, and would benefit from the use of an intelligent system. Building a large benchmark with professional dermatologists is resource-intensive, and we believe that few-shot learning (FSL) methods would be helpful in solving the problem of annotated data scarcity. In this paper, we propose CDD-Net (Context Feature Fusion and Dual Attention Dermatology Net), a plug-in module for FSL clinical skin disease classification. Methods Current FSL methods used in skin disease classification are limited to nonuniversal approaches and few disease classes. Our CDD-Net has a flexible structure, including a context feature-fusion module and dual-attention module to extract discriminating texture feature and emphasize contributive regions and channels. The context feature-fusion module localizes discriminatory texture details of skin lesions by integrating features from different layers, while the dual-attention module highlights discriminative regions via channel-wise and pixel-wise depictions based on weight vectors and restrains the contributions of irrelevant areas. We also present Derm104, a new clinical skin disease data benchmark that has significant coverage of rare diseases and reliable annotation between primary species and subspecies for better validation of our approach. Results Our experiments validated the versatility of CDD-Net for different FSL methods and achieved an improvement in accuracy of up to 9.14 percentage points compared with the vanilla network, which can be considered state of the art. The ablation study also showed that the dual-attention module and context feature-fusion module worked efficiently in CDD-Net.
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Affiliation(s)
- Tianle Chen
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, People’s Republic of China
| | - Qi Liu
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, People’s Republic of China
| | - Jie Yang
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, People’s Republic of China
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Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024; 90:1006.e1-1006.e30. [PMID: 38300170 DOI: 10.1016/j.jaad.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. OBJECTIVE The objective of this study was to provide evidence-based recommendations for the management of acne. METHODS A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. LIMITATIONS Analysis is based on the best available evidence at the time of the systematic review. CONCLUSIONS These guidelines provide evidence-based recommendations for the management of acne vulgaris.
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Affiliation(s)
- Rachel V Reynolds
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Carol E Cheng
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Fran Cook-Bolden
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Seemal R Desai
- Innovative Dermatology, Plano, Texas; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelly M Druby
- Penn State Health Hampden Medical Center, Enola, Pennsylvania
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonette E Keri
- University of Miami, Miller School of Medicine, Miami, Florida; Miami VA Medical Center, Miami, Florida
| | | | - Jerry K L Tan
- Western University, London, Ontario, Canada; Windsor Clinical Research Inc., Windsor, Ontario, Canada
| | - Megha M Tollefson
- Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Jonathan S Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Georgia Dermatology Partners, Snellville, Georgia
| | - Peggy A Wu
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrea L Zaenglein
- Departments of Dermatology and Pediatrics, Penn State/Hershey Medical Center, Hershey, Pennsylvania
| | - Jung Min Han
- American Academy of Dermatology, Rosemont, Illinois.
| | - John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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Mullen SA, Myers EL, Brenner RL, Nguyen KT, Harper TA, Welsh D, Keffer S, Mueller J, Whitley MJ. Systematic Review of Intralesional Therapies for Cutaneous Warts. JID INNOVATIONS 2024; 4:100264. [PMID: 38585192 PMCID: PMC10990969 DOI: 10.1016/j.xjidi.2024.100264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 01/05/2024] [Indexed: 04/09/2024] Open
Abstract
Intralesional therapies are used for recalcitrant warts, but no Food and Drug Administration-approved treatment exists nor is there consensus regarding the most efficacious therapy. Therefore, this systematic review aims to summarize efficacy and adverse events reported in 62 randomized controlled trials (RCTs) of intralesional therapies for cutaneous warts. The most studied intralesional therapies included measles, mumps, rubella (MMR) vaccine (n = 24 studies), purified protein derivative (PPD) (n = 19 studies), vitamin D3 (n = 15 studies), and Candida antigen (n = 14 studies). Most studies included adult and pediatric patients or adults alone, with only 4 studies on pediatric patients alone. MMR vaccine was the most studied treatment (n = 853 patients). MMR had a complete response rate of 27-90%. The next most common treatment, PPD, had a complete response rate of 45-87%. Other treatments included Candida antigen and vitamin D3, with complete response rates of 25-84% and 40-96%, respectively. The most frequent side effects were injection-site reactions and flu-like symptoms. This systematic review represents a useful summary of intralesional therapy RCTs for clinician reference. This study also highlights the lack of large multi-institutional RCTs, despite many patients being treated for this widespread problem.
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Affiliation(s)
- Sarah A. Mullen
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Emma L. Myers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rebecca L. Brenner
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kim T. Nguyen
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Tara A. Harper
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Darby Welsh
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Storm Keffer
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jenna Mueller
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA
| | - Melodi Javid Whitley
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina, USA
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Konsila K, Assavalapsakul W, Phuwapraisirisan P, Chanchao C. Anti- Malassezia globosa (MYA-4889, ATCC) activity of Thai propolis from the stingless bee Geniotrigona thoracica. Heliyon 2024; 10:e29421. [PMID: 38660263 PMCID: PMC11041017 DOI: 10.1016/j.heliyon.2024.e29421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
Malassezia globosa, a lipophilic pathogen, is known to be involved in various chronic skin diseases. Unfortunately, the available treatments have unwanted side effects and microbial drug resistance is evolving. As the antimicrobial activity of propolis is outstanding, this study aimed to examine the potential of propolis from the stingless bee Geniotrigona thoracica against the yeast. Anti-M. globosa growth activity was ascertained in agar well diffusion and broth microdilution assays and the inhibitory concentration value at 50 % (IC50) was determined. Since the yeast cannot synthesize its own fatty acids, extracellular lipase is important for its survival. Here, anti-M. globosa extracellular lipase activity was additionally investigated by colorimetric and agar-based methods. Compared to the crude hexane and crude dichloromethane extracts, the crude methanol partitioned extract (CMPE) exhibited the best anti-M. globosa growth activity with an IC50 of 1.22 mg/mL. After CMPE was further enriched by silica gel column chromatography, fraction CMPE1 (IC50 of 0.98 mM or 184.93 μg/mL) presented the highest activity and was later identified as methyl gallate (MG) by nuclear magnetic resonance analysis. Subsequently, MG was successfully synthesized and shown to have a similar activity, and a minimal fungicidal concentration of 43.44 mM or 8.00 mg/mL. However, lipase assay analysis suggested that extracellular lipase might not be the main target mechanism of MG. This is the first report of MG as a new anti-Malassezia compound. It could be a good candidate for further developing alternative therapeutic agents.
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Affiliation(s)
- Kawisara Konsila
- Program in Biotechnology, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Bangkok, 10330, Thailand
| | - Wanchai Assavalapsakul
- Department of Microbiology, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Bangkok, 10330, Thailand
| | - Preecha Phuwapraisirisan
- Center of Excellence in Natural Products, Department of Chemistry, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Bangkok, 10330, Thailand
| | - Chanpen Chanchao
- Department of Biology, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Bangkok, 10330, Thailand
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Zhu J, Zhong X, Liao H, Cong J, Wu Q, Liang S, Xiang Q. A Novel Recombinant Human Filaggrin Segment (rhFLA-10) Alleviated a Skin Lesion of Atopic Dermatitis. Bioengineering (Basel) 2024; 11:426. [PMID: 38790293 PMCID: PMC11117537 DOI: 10.3390/bioengineering11050426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Atopic dermatitis (AD), a prevalent chronic inflammatory skin disorder, is marked by impaired skin barrier function and persistent pruritus. It significantly deteriorates patients' quality of life, making it one of the most burdensome non-lethal skin disorders. Filaggrin plays a crucial role in the pathophysiology of barrier disruption in AD, interacting with inflammatory mediators. It is an integral part of the extracellular matrix architecture, serving to protect the skin barrier and attenuate the inflammatory cascade. In this study, we engineered a novel recombinant human filaggrin (rhFLA-10) expression vector, which was subsequently synthesized and purified. In vitro and ex vivo efficacy experiments were conducted for AD. rhFLA-10, at low concentrations (5 to 20 μg/mL), was non-toxic to HACaT cells, significantly inhibited the degranulation of P815 mast cells, and was readily absorbed by cells, thereby exerting a soothing therapeutic effect. Furthermore, rhFLA-10 demonstrated anti-inflammatory properties (p < 0.05). In vivo, efficacy experiments further substantiated that rhFLA-10 could effectively ameliorate AD in mice and facilitate the repair of damaged skin (p < 0.001). These findings underscore the considerable potential of rhFLA-10 in the treatment of AD.
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Affiliation(s)
- Jiawen Zhu
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Xinhua Zhong
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Hui Liao
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Jianhang Cong
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Qiqi Wu
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Shuang Liang
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
| | - Qi Xiang
- State Key Laboratory of Bioactive Molecules and Drug Gability Assessment, Jinan University, Guangzhou 510632, China; (J.Z.); (X.Z.); (H.L.); (J.C.); (Q.W.); (S.L.)
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China
- Biopharmaceutical R&D Center, Jinan University, Guangzhou 510632, China
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Ortiz de Frutos J, Serra Baldrich E, Tribó Boixareu MJ, Armario Hita JC, Carrascosa Carrillo JM, Nart IF, Menéndez ÁF, Pinto PH, Francisco Silvestre J. Consensus on the diagnostic algorithm for chronic nodular prurigo. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00342-9. [PMID: 38663729 DOI: 10.1016/j.ad.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/08/2024] [Accepted: 03/17/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic nodular prurigo (CNP) is a chronic dermatological disease characterized by the presence of chronic pruritus and pruritic nodular lesions. The aim of this study was to reach consensus among a group of experts based on a non-systematic literature review and an algorithm for the clinical diagnosis of CNP. The resulting algorithm is structured in 3 blocks: 1) early identification of the patient with a possible diagnosis of CNP; 2) diagnosis and assessment of CNP; and 3) categorization of CNP (identification of the underlying causes or associated comorbidities). We believe that this clinical algorithm can facilitate the correct diagnosis of patients with CNP. Additionally, it raises awareness on the need for a multidisciplinary approach and specific treatment of CNP, steps of paramount importance to make better therapeutic decisions.
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Affiliation(s)
| | | | | | | | - J M Carrascosa Carrillo
- Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona (UAB), Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, España
| | | | - Á Flórez Menéndez
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | | | - J Francisco Silvestre
- Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
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Wilkinson C, Brooks J, Stander MA, Malgas R, Roodt-Wilding R, Makunga NP. Metabolomic profiling of wild rooibos (Aspalathus linearis) ecotypes and their antioxidant-derived phytopharmaceutical potential. Metabolomics 2024; 20:45. [PMID: 38615312 PMCID: PMC11016507 DOI: 10.1007/s11306-024-02103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/16/2024] [Indexed: 04/15/2024]
Abstract
INTRODUCTION Aspalathus linearis (commonly known as rooibos) is endemic to the Cape Floristic Region of South Africa and is a popular herbal drink and skin phytotherapeutic ingredient, with health benefits derived primarily from its unique phenolic content. Several, seemingly habitat-specific ecotypes from the Cederberg (Western Cape) and Northern Cape have morphological, ecological, genetic and biochemical differences. OBJECTIVES AND METHODS Despite the commercial popularity of the cultivated variety, the uncultivated ecotypes are largely understudied. To address gaps in knowledge about the biochemical constituency, ultra-performance liquid chromatography-mass spectrometry analysis of fifteen populations was performed, enabling high-throughput metabolomic fingerprinting of 50% (v/v) methanolic extracts. Antioxidant screening of selected populations was performed via three assays and antimicrobial activity on two microbial species was assessed. The metabolomic results were corroborated with total phenolic and flavonoid screening of the extracts. RESULTS AND DISCUSSION Site-specific chemical lineages of rooibos ecotypes were confirmed via multivariate data analyses. Important features identified via PLS-DA disclosed higher relative abundances of certain tentative metabolites (e.g., rutin, aspalathin and apiin) present in the Dobbelaarskop, Blomfontein, Welbedacht and Eselbank sites, in comparison to other locations. Several unknown novel metabolites (e.g., m/z 155.0369, 231.0513, 443.1197, 695.2883) are responsible for metabolomic separation of the populations, four of which showed higher amounts of key metabolites and were thus selected for bioactivity analysis. The Welbedacht and Eselbank site 2 populations consistently displayed higher antioxidant activities, with 2,2-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical scavenging activities of 679.894 ± 3.427 µmol Trolox/g dry matter and 635.066 ± 5.140 µmol Trolox/g dry matter, respectively, in correlation with a high number of phenolic and flavonoid compounds. The contribution of the individual metabolites to the pharmacological effectiveness of rooibos remains unknown and as such, further structural elucidation and phytopharmacological testing is thus urgently needed.
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Affiliation(s)
- C Wilkinson
- Department of Botany and Zoology, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa
| | - J Brooks
- Department of Botany and Zoology, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa
| | - M A Stander
- Department of Biochemistry, and Mass Spectrometry Unit, Central Analytical Facility, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa
| | - R Malgas
- Department of Conservation Ecology and Entomology, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa
| | - R Roodt-Wilding
- Department of Genetics, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa
| | - N P Makunga
- Department of Botany and Zoology, Stellenbosch University, Private Bag X1, Matieland, 7600, South Africa.
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Starace M, Pampaloni F, Lazaridou E, Kyrmanidou E, Stratigos A, Lallas A, Katoulis A, Sgouros D, Quadrelli F, Rapparini L, Cedirian S, Bruni F, Ala L, Rossi A, Piraccini BM, Apalla Z. Current Diagnostic and Therapeutic Practices in Alopecia Areata in Two Mediterranean Countries: A Survey-Based Study. Dermatol Ther (Heidelb) 2024; 14:953-970. [PMID: 38598171 PMCID: PMC11052953 DOI: 10.1007/s13555-024-01141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Alopecia areata (AA) affects approximately 2% of the general population and is associated with significant psychosocial morbidity and poor health-related quality of life. Despite the high incidence of the disease the available clinical practice guidelines to help clinicians and improve patients' care are very poor and of a low methodological quality, as compared to other high-burden dermatoses. The aim of this survey is to capture the current clinical practice in AA management, as performed by dermatologists, in two Mediterranean countries to identify potential disparities and gaps in diagnosis and treatment. METHODS A 50-item questionnaire was created in the English language and then translated into Greek and Italian language and sent to the Greek and Italian dermatologists via email. RESULTS A total of 490 dermatologists from Italy and 234 from Greece participated in the survey. The diagnosis of AA is usually based on history and clinical examination, supported by trichoscopy. The rate of use of severity scores and scales to evaluate impact on quality of life by dermatologists was low. Treatment of patchy AA, in both adult and pediatric populations, is based on use of topical steroids as first-line treatment. Results on special site involvement (eyebrows, beard, and ophiasis), chronic cases, and the pediatric population highlight extreme heterogeneity in treatment approach. CONCLUSIONS Our results highlight that management of AA, in terms of diagnosis and treatment, is still challenging.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elisabeth Lazaridou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Kyrmanidou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Ala
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Alfredo Rossi
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Zoe Apalla
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Amoako YA, Laryea DO, Agbanyo A, Agbavor B, Oppong MN, Kyem G, Abass KM, van Bentum R, Phillips RO, Stienstra Y. Prevalence and determinants of impetigo in Ghana: a cross-sectional study. BMC Infect Dis 2024; 24:349. [PMID: 38528449 DOI: 10.1186/s12879-024-09242-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Skin diseases such as impetigo pose a significant public health challenge in low resource settings. Despite this, there is a dearth of epidemiological data on the prevalence of this condition in Ghana. METHODS We conducted a cross sectional study in three settings in Ghana: community members in East Mamprusi district in the North East region, a secondary school in Sekyere East district, and inmates of the Kumasi central prisons both in the Ashanti region. Following a period of training, we performed a standardised skin examination on each participant to assess for scabies and impetigo. We calculated the prevalence of each skin condition and investigated determinants of impetigo. RESULTS/ FINDINGS Of the 1327 participants [males 64.1% and median age 22 (16-29) years], 746 (56.2%) had scabies and 186 (14%) had impetigo which was usually very mild or mild in severity. Most participants with impetigo also had scabies (161/186, 86.6%). Having an itch [RR 6.05 (95% CI 2.53-14.47)], presence of scabies burrows [RR 1.99 (95% CI 1.54-2.59)], clinical scabies [RR 3.15 (2.11-4.72)] or being in preschool [RR 4.56 (1.78-11.67)] increased the risk for impetigo. A combination of the presence of clinical scabies, age, sex and itch most accurately predicted the odds of having impetigo. CONCLUSIONS There is substantial burden of impetigo and scabies in Ghana. There is a need to institute measures to improve detection and control of these common dermatoses as part of Universal Health Coverage package to reduce the scourge of the diseases in this setting.
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Affiliation(s)
- Yaw Ampem Amoako
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Komfo Anokye Teaching Hospital, Kumasi, Ghana.
| | | | - Abigail Agbanyo
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernadette Agbavor
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ntiamoah Oppong
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gloria Kyem
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Renee van Bentum
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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