Classification and possible bacterial infection in outpatients with eczema and dermatitis in China: A cross-sectional and multicenter study

Radiation-induced skin injury in the head and neck region: pathogenesis, clinics, prevention, treatment considerations and proposal for management algorithm

Worldwide increase of head and neck cancers ranks these malignancies among top causes of cancer in human population. Radiation induced skin injury (RISI) is one of the major side effects of radiotherapy (RT). Skin of the neck is exposed to radiation due to necessity of therapeutic or prophylactic (elective) irradiation of neck lymph nodes and target organs, including the larynx and hypopharynx. The location of the neck exposes these regions of the skin to various additional exposomes such as ultraviolet radiation (UVR), pollution and cigarette smoke. There are many controversies or inconsistencies regarding RISI, from molecular aspects and therapy to terminology. There is lack of high-quality and large-sample studies in both forms of RISI: acute (aRISI) and chronic (cRISI). Finally, no gold standards in the management of aRISI and cRISI have been established yet. In this article, the authors discuss the pathogenesis, clinical picture, prevention and clinical interventions and present a proposed treatment algorithm.

Risk Factors in Outpatients with Dermatitis and Eczema in Tertiary Hospitals of China Who Have Clinically Suspected Bacterial Infection

Skin bacterial infections are often observed in eczema patients, but the risk factors are not fully understood. The current study evaluated the prevalence of clinically suspected bacterial infection and its associated risk factors. Moreover, we investigated the practice of skin infection diagnosis in China. A hospital-based, multicenter, cross-sectional epidemiologic survey of bacterial infection was performed in a total of 6208 outpatients diagnosed with dermatitis and eczema from 39 tertiary hospitals of 15 provinces and municipalities in China. All patients completed a specific questionnaire regarding their demographic characteristics, disease duration, distribution of lesions, severity of itching, and medical history. Univariate analysis and multivariate analysis were used to evaluate risk factors associated with bacterial infection in patients with different types of eczema. The prevalence of clinically suspected bacterial infection was 47.0% in patients with eczema. Compared to atopic dermatitis, widespread eczema (OR = 1.50, P < 0.001) and other eczema (OR = 1.42, P < 0.001) were more likely to suffer bacterial infection. The itching grade was positively associated with the infection (OR = 2.11, 7.04, and 12.3 in patients with mild, moderate, and severe itching, respectively; P < 0.001). Lesion distribution in the cubital fossa, popliteal fossa, ear, shoulder and back, axillary, foot, and pudendum was positively associated with bacterial infection (all OR > 1.0, P < 0.05). In contrast, the face and abdomen were reversely associated with bacterial infection (OR < 1.0, P < 0.005). History of asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, infantile eczema, and flexion dermatitis was positively associated with bacterial infection (all OR > 1.0, P < 0.005), while the history of dry skin was reversely associated with bacterial infection (OR = 0.76, 95% CI: 0.64-0.90; P = 0.002). Patients with eczema were easily infected with bacteria. Widespread eczema and other eczema were more likely to have bacterial infection than atopic dermatitis. The high rate of infection may attribute to the lack of corresponding bacterial detection, suggesting the need of guideline development in China to prevent overuse of topical antibiotics.

A novel eco-friendly green approach to produce particalized eggshell membrane (PEM) for skin health applications

The eggshell membrane (ESM) is a natural bioactive material, which is increasingly utilized for various biomedical applications. However, the poor solubility of ESM limits the bioavailability of its constituents and reduces the expression of their potential bioactivity. In this study, we utilized an innovative green strategy to separate ESM from shell, and processed ESM for size reduction by cryo-grinding and homogenization to produce particalized eggshell membrane (PEM) approaching submicron dimensions, with enhanced anti-inflammatory activity and increased antimicrobial activity against skin associated pathogens. Gram-positive Staphylococcus aureus (log₁₀ reduction = 4.5 ± 0.3) was more sensitive to PEM as compared to Gram-negative Pseudomonas aeruginosa (log₁₀ reduction = 2.1 ± 0.3). PEM elicited a dose-dependent reduction in NO accumulation in LPS-induced RAW 264.7 macrophages, suggesting an anti-inflammatory response to ESM particles. These findings suggest that processed PEM possesses great potential as a topical ingredient in skincare applications to maintain skin health by reducing bacterial infections and inflammation.