1
|
Li Y, Wang SW, Liu YH, Zou MY, Wu JX, Luo SK, Hong WJ. Efficacy and safety of non-cross-linked hyaluronic acid compound in the treatment of keratosis pilaris: A split-body randomized clinical trial. J Cosmet Dermatol 2024. [PMID: 39177015 DOI: 10.1111/jocd.16532] [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: 05/23/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Keratosis pilaris (KP) is a prevalent benign dermatological condition characterized by small bumps at the hair follicles alongside surrounding redness, significantly impacting both aesthetics and mental well-being. OBJECTIVE This study investigated the potential benefits of a non-cross-linked hyaluronic acid (HA) compound for treating KP. METHODS A split-body, investigator-blinded, randomized, intraindividual comparative clinical trial was conducted. The non-cross-linked HA compound was injected into KP-affected regions on both upper arms. The treatment was delivered across four sessions scheduled at 4-week intervals. Blinded physicians and patients assessed differences in erythema, skin roughness, and overall scores between treated and control areas at the final follow-up visit. At the 12th and 24th weeks post-treatment, a four-point scale was utilized to assess subjects' perceived treatment efficacy. Additionally, dermoscopic images, histological alterations, and adverse events were monitored. RESULTS Physician assessments revealed a significant reduction in roughness and overall scores for treated areas compared to controls. Patient self-assessments also reflected improvements in roughness, redness, and overall scores for treated sides at the final visit, with 35.71% of patients demonstrating sustained improvement in redness and 71.43% reporting persistent improvements in roughness at 24th weeks post-treatment. The dermatoscopic examinations revealed a notable enhancement in both the quantity of follicular plugs and the extent of erythema among the subjects in the treatment group. Histopathological outcomes also demonstrated improvement. CONCLUSION This study suggests that the non-cross-linked HA compound effectively improves skin roughness and promotes hair shaft growth in KP treatment, demonstrating a favorable safety profile. These findings position it as a potentially viable alternative therapy in clinical practice.
Collapse
Affiliation(s)
- Yao Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| | - Shi-Wei Wang
- Medical Department, Imeik Technology Development Co., Ltd, Beijing, China
| | - Yan-Hua Liu
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| | - Mu-Yan Zou
- Medical Department, Imeik Technology Development Co., Ltd, Beijing, China
| | - Jia-Xu Wu
- Medical Department, Imeik Technology Development Co., Ltd, Beijing, China
| | - Sheng-Kang Luo
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| | - Wei-Jin Hong
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Chen C, Ke Y. Applications of Long-Pulse Alexandrite Laser in Cosmetic Dermatology: A Review. Clin Cosmet Investig Dermatol 2023; 16:3349-3357. [PMID: 38021435 PMCID: PMC10661922 DOI: 10.2147/ccid.s441169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
The long-pulse alexandrite laser uses Cr3+:BeAl2O4 crystals as the activation medium and has a 755nm wavelength and millisecond pulse duration. The long-pulse alexandrite laser has been utilized for hair removal, vascular lesions, pigmented lesions, and other conditions because melanin and hemoglobin in the skin, subcutaneous tissues, and skin appendages can specifically absorb this type of laser. To serve as a guide and source of inspiration for the clinical use of this type of laser, we review the present research status and advancement of the long-pulse alexandrite laser in the treatment of the aforementioned categories of disorders.
Collapse
Affiliation(s)
- Changhan Chen
- Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
- Wenzhou Key Laboratory of Laser Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
| | - Youhui Ke
- Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
| |
Collapse
|
3
|
Wang MA, Wilson A, Murrell DF. A Review of the Scoring and Assessment of Keratosis Pilaris. Skin Appendage Disord 2023; 9:241-251. [PMID: 37564689 PMCID: PMC10410087 DOI: 10.1159/000529487] [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: 10/04/2022] [Accepted: 01/22/2023] [Indexed: 08/12/2023] Open
Abstract
Disease severity assessment tools play a large part in evaluating skin conditions in dermatology. Currently, there is no existing validated assessment tool for keratosis pilaris (KP), a benign yet highly prevalent follicular disorder. A range of proposed scoring tools have been used in different clinical trials for the assessment of potential treatments for KP. A literature review of the current scoring systems used for KP shows that there is a lack of consistency with most studies using varying versions of unvalidated investigator global assessment (IGA) scores and quartile grading systems. A review of these studies shows that current methods of evaluating KP in clinical trials are subjective, unreliable, and inconsistent. A standardised and validated scoring system would be significant as it could be used in clinical trials to advance the current knowledge of KP.
Collapse
Affiliation(s)
- Madeline A. Wang
- Department of Dermatology, St George Hospital, Sydney, NSW, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Anna Wilson
- Department of Dermatology, St George Hospital, Sydney, NSW, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Dédée F. Murrell
- Department of Dermatology, St George Hospital, Sydney, NSW, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
4
|
Shakshouk H, Tosti A. Trichoscopy beyond scalp. A narrative review. Int J Dermatol 2023; 62:416-427. [PMID: 35511549 DOI: 10.1111/ijd.16226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/03/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
Dermoscopy is becoming an indispensable tool in everyday practice, with an expanding range of applications. Trichoscopy is effective not only in establishing the diagnosis of scalp disorders but also in the follow-up of treatment. The MEDLINE database was searched using the terms "dermoscopy" and "trichoscopy" in combination with each of the following: "axilla," "pubic area," "beard," "eyebrows," "eyelashes," and "body hairs." We included case reports, case series, and review articles mentioning the previous terms. By providing an updated review from the literature, we aimed to emphasize the potential uses of trichoscopy in detecting diseases in hairy locations other than the scalp. Various inflammatory conditions, infections, and infestations are discussed.
Collapse
Affiliation(s)
- Hadir Shakshouk
- Department of Dermatology, Alexandria University, Alexandria, Egypt
| | - Antonella Tosti
- Department of Dermatology, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
5
|
Chatterjee M, Rajput G, Hemdani R. Review article: Dermoscopy in pediatric dermatosis. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_178_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
|
6
|
Ikonnikova EV, Kruglova LS. Follicular Keratosis in Adolescents: Diagnostic Features and Cosmetological Aspects of Therapy. CURRENT PEDIATRICS 2022. [DOI: 10.15690/vsp.v21i5.2451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Follicular keratosis (FK) is one of the most common dermatological diseases in children. FK manifests usually in early childhood and worsen frequently, thus, symptoms are more prominent during puberty. The skin of proximal extensors of upper and lower limbs is mainly affected, while skin of cheeks, back and buttocks is affected more rarely. FK is just a cosmetic defect which significantly affects adolescents’ self-esteem and emotional state up to the development of severe depressive syndrome and obsessive conditions accompanied by pathomimia. FK can be associated with other nosologies such as: atopic dermatitis, vulgar ichthyosis, obesity, diabetes mellitus, and even aggravate Down and Noonan syndromes. Spontaneous improvement is still possible with age. We can use topical therapy with emollient, keratolytic, anti-inflammatory drugs, as well as various types of laser and phototherapy to alleviate the disease symptoms. This article provides basic information on etiology, pathogenesis, and treatment of FK with clinical case description.
Collapse
Affiliation(s)
- Evgenia V. Ikonnikova
- Central State Medical Academy of Department of Presidential Affairs; Institute of Plastic Surgery and Cosmetology
| | - Larisa S. Kruglova
- Central State Medical Academy of Department of Presidential Affairs; Institute of Plastic Surgery and Cosmetology
| |
Collapse
|
7
|
Li M, Bai Y, Duan Z, Yuan R, Liu X, Liu Y, Liang X, Wu H, Zhuo F. Efficacy and Safety of Long-Pulsed 755-nm Alexandrite Laser for Keratosis Pilaris: A Split-Body Randomized Clinical Trial. Dermatol Ther (Heidelb) 2022; 12:1897-1906. [PMID: 35838863 PMCID: PMC9357583 DOI: 10.1007/s13555-022-00771-5] [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: 05/21/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Keratosis pilaris (KP) is a disfiguring disease and is resistant to treatment. Several treatment methods are available, but the efficacy is limited. This prospective, rater-blinded, split-body comparative study investigated the efficacy and safety of long-pulsed 755-nm alexandrite laser in the treatment of KP. Methods Twenty-two patients with KP of bilateral arms were enrolled in this study. All participants were randomized and treated with a long-pulsed 755-nm alexandrite laser on the left or right arm in four sessions held 3 weeks apart. The unified moisturizing lotion was applied on both left and right arms once a day. Physicians’ assessment scores and patients’ self-assessment scores were recorded, and skin imaging changes in dermoscopy, high-frequency ultrasound, and skin biopsy were obtained at baseline and 4 weeks after the fourth treatment. Results Of the 21 patients who completed the study, 15 were women and 6 were men. At 4 weeks after the fourth treatment, the laser side showed significantly lower total (2.0 versus 4.5), roughness (1.0 versus 2.0), and redness (1.0 versus 2.0) scores according to physicians’ assessment (all P < 0.05). Furthermore, the laser side showed significantly lower total (2.0 versus 4.0), roughness (1.0 versus 2.0), and redness scores (1.0 versus 2.0) according to the patients’ self-assessment (all P < 0.05). The proportions of patients who achieved dermoscopically and ultrasonographically showed excellent improvements in follicular plugs (57.1% versus 14.3%), perifollicular erythema (52.4% versus 9.5%), perifollicular hyperpigmentation (47.6% versus 14.3%), and the number of epidermal bulges (57.1% versus 19.1%) in the laser side was significantly higher than those who achieved such improvements in the control side (all P < 0.05). Histopathology showed that the follicular plugs and inflammatory cell infiltration were improved at the final visit. Three patients exhibited reversible postinflammatory hyperpigmentation. Conclusion Long-pulsed 755-nm alexandrite laser treatment is effective and safe in treating both skin roughness and redness in KP. Trial Registration Number: ChiCTR2100054489.
Collapse
Affiliation(s)
- Man Li
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Yue Bai
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Zhixuan Duan
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Ruofei Yuan
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Xiaoduo Liu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Yi Liu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Xuelei Liang
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Haixuan Wu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Fenglin Zhuo
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China.
| |
Collapse
|
8
|
Gołacki J, Matuszek M, Matyjaszek-Matuszek B. Link between Insulin Resistance and Obesity—From Diagnosis to Treatment. Diagnostics (Basel) 2022; 12:diagnostics12071681. [PMID: 35885586 PMCID: PMC9321808 DOI: 10.3390/diagnostics12071681] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 11/25/2022] Open
Abstract
Insulin resistance (IR) has become a common health issue in medical practice. There are no detailed data on IR prevalence, but it is an increasing problem due to its close association with obesity. However, IR is not considered as a separate nosological entity and the diagnostic criteria are not well defined, which leads to overdiagnosis of IR and an inappropriate approach. This review aims to summarize the available literature on IR pathophysiology, its relationship with obesity, as well as diagnostic methods, clinical presentation and treatment. Excessive energy intake results in cell overload that triggers mechanisms to protect cells from further energy accumulation by reducing insulin sensitivity. Additionally, hypertrophied adipocytes and macrophage infiltration causes local inflammation that may result in general inflammation that induces IR. The clinical picture varies from skin lesions (e.g., acanthosis nigricans) to metabolic disorders such as diabetes mellitus or metabolic-associated fatty liver disease. There are numerous IR laboratory markers with varying sensitivities and specificities. Nutrition changes and regular physical activity are crucial for IR management because a reduction in adipose tissue may reverse the inflammatory state and consequently reduce the severity of insulin resistance. In cases of obesity, anti-obesity medications can be used.
Collapse
Affiliation(s)
- Jakub Gołacki
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
- Correspondence:
| | - Małgorzata Matuszek
- Student’s Scientific Society at the Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Beata Matyjaszek-Matuszek
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| |
Collapse
|
9
|
Clinical and Dermoscopic Evaluation of Trichloroacetic Acid 20% Versus Long-Pulsed 1064-nm Nd-YAG Laser in the Treatment of Keratosis Pilaris. Dermatol Surg 2022; 48:838-842. [DOI: 10.1097/dss.0000000000003488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Arumilli P, Tatavarthi R, Kolalapudi S, Prasad Arumilli K, Gandikota R, Saka S. Efficacy of tacrolimus 0.1% ointment in keratosis pilaris: A prospective hospital based interventional study. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/jmedsci.jmedsci_356_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Gangadhar M, Adya KA, Inamadar AC. A Study of Clinical, Dermoscopic and Histopathological Correlation in Follicular Keratotic Diseases: Preliminary Observations in 30 Cases. Indian Dermatol Online J 2021; 12:731-740. [PMID: 34667761 PMCID: PMC8456266 DOI: 10.4103/idoj.idoj_96_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/11/2021] [Accepted: 04/15/2021] [Indexed: 11/15/2022] Open
Abstract
Context: Follicular keratotic disorder is an abnormal keratinization affecting the follicular orifices and clinically characterized by hyperkeratotic follicular papules affecting various sites. Dermoscopy is a non-invasive diagnostic tool and differentiates closely resembling diseases as well as possibly prevents need for an invasive biopsy. Aim: This study was aimed to find the correlation between clinical, dermoscopic and histopathological findings in follicular keratotic diseases and to establish the dermoscopic criteria in the diagnosis of primary follicular keratotic diseases. Materials and Methods: This was a hospital-based prospective cross-sectional study of 30 consecutive patients clinically diagnosed with follicular keratotic diseases, irrespective of age and duration of the disease. Results: The study consisted of 30 patients with a mean age of 19.57 ± 9.69 years. The most common primary follicular keratotic disease observed was phrynoderma and secondary follicular keratotic disease was follicular lichen planus (lichen planopilaris). The predominant dermoscopic finding among all the follicular keratotic diseases was perifollicular scaling 29 (96.7%) followed by keratotic plug 28 (93.3%). The most common histopathological feature was dilated follicular infundibulum 22 (73.3%) followed by follicular plug 15 (50%) and dermal perivascular infiltration 22 (73.3%). The clinical and dermoscopic features showed a significant statistical association with the histopathological findings. Conclusion: Dermoscopy is a simple, non-invasive diagnostic tool that helps in differentiating and diagnosing the closely resembling follicular keratotic diseases.
Collapse
Affiliation(s)
- Meghana Gangadhar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| |
Collapse
|
12
|
Tognetti L, Carraro A, Cinotti E, Suppa M, Del Marmol V, Perrot JL, Rubegni P. Line-field confocal optical coherence tomography for non-invasive diagnosis of lichenoid dermatoses of the childhood: A case series. Skin Res Technol 2021; 27:1178-1181. [PMID: 34227706 DOI: 10.1111/srt.13075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Linda Tognetti
- Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Andrea Carraro
- Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy.,Groupe d'imagerie cutanée non invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
| | - Mariano Suppa
- Groupe d'imagerie cutanée non invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France.,Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Veronique Del Marmol
- Groupe d'imagerie cutanée non invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France.,Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean Luc Perrot
- Groupe d'imagerie cutanée non invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France.,Department of Dermatology, CHU St.Etienne, Saint-Etienne, France
| | - Pietro Rubegni
- Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| |
Collapse
|
13
|
Shibata Y, Sano S. Keratosis pilaris caused by dupilumab for the treatment of bronchial asthma. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2021. [DOI: 10.1002/cia2.12172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yuka Shibata
- Department of Dermatology Kochi Medical School Kochi University Nankoku Japan
| | - Shigetoshi Sano
- Department of Dermatology Kochi Medical School Kochi University Nankoku Japan
| |
Collapse
|
14
|
Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon 2020; 67:101103. [PMID: 33041056 DOI: 10.1016/j.disamonth.2020.101103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.
Collapse
|
15
|
Maghfour J, Ly S, Haidari W, Taylor SL, Feldman SR. Treatment of keratosis pilaris and its variants: a systematic review. J DERMATOL TREAT 2020; 33:1231-1242. [PMID: 32886029 DOI: 10.1080/09546634.2020.1818678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Keratosis pilaris (KP) is a common, benign skin condition of follicular hyperkeratosis. Although KP is asymptomatic, the cosmetic appearance of KP can lead to psychosocial distress among patients. New emerging treatments are increasingly being utilized. Yet, there is little to no summative data on the treatments of KP and its subtypes. OBJECTIVE To summarize existing literature on treatments for KP and its subtypes. METHODS A comprehensive search was performed using Pubmed/MEDLINE, Embase and Web of Science databases. The search identified 1150 non-duplicated articles, and 47 articles were included in the review. The primary outcomes measured were KP treatment type and the degree of improvement following therapy. FINDINGS Our findings demonstrate that the most supported form of treatment for KP is laser therapy, particularly the QS:Nd YAG laser. Topical treatments - including Mineral Oil-Hydrophil Petrolat, tacrolimus, azelaic acid, and salicylic acid - are also effective at least for improving the appearance of KP. CONCLUSION While the measured treatment outcomes varied among studies, laser therapy appears to be the most effective form of treatment. Use of topicals also improved KP lesions.
Collapse
Affiliation(s)
- Jalal Maghfour
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sophia Ly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wasim Haidari
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah L Taylor
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Departments of Pathology and Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
16
|
Daruwalla SB, Dhurat RS, Agrawal S, Mahobia S, Naidu Kona S. "Extraction Dermoscopy": Expanding the Utility of Epiluminescence Microscopy. Skin Appendage Disord 2020; 6:220-223. [PMID: 32903886 DOI: 10.1159/000508518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many dermatological conditions require extraction of material from the lesion followed by visualization under a microscope. However, visualization of the extracted material can be done using a dermoscope instead. We propose "extraction dermoscopy" as an addition to the already existing treasury that dermoscopy holds. METHODS After approval from the institutional ethics committee, a cross-sectional study was carried out in a tertiary care hospital. Polarized and non-polarized versions of in vivo dermoscopy, as well as extraction dermoscopy, were performed on a total of 77 lesions, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Heine Delta 20T and Dino-Lite Premier AM4113T were employed for dermoscopic examination. RESULTS A total of 77 lesions were selected, including 5 eruptive vellus hair cysts, 2 cilia incarnata externum, 10 trichostasis spinulosa, 20 keratosis pilaris, 20 molluscum contagiosum, and 20 lesions of milia. Extraction dermoscopy of the eruptive vellus cysts revealed skin color to brownish colored cysts with a bunch of pigmented hair. Similarly, findings of all other lesions were described and recorded post-extraction. CONCLUSION Extraction dermoscopy helps confirm the diagnosis without visualization under a microscope. Its application in recent times makes the explanation of the nature of many disorders to patients easier, and demonstration of extracted lesions may further improve doctor-patient communication.
Collapse
Affiliation(s)
| | - Rachita S Dhurat
- Department of Dermatology, LTMMC and LTMGH, Sion West, Mumbai, India
| | - Sandip Agrawal
- Department of Dermatology, LTMMC and LTMGH, Sion West, Mumbai, India
| | - Shraddha Mahobia
- Department of Dermatology, LTMMC and LTMGH, Sion West, Mumbai, India
| | - Sradda Naidu Kona
- Department of Dermatology, LTMMC and LTMGH, Sion West, Mumbai, India
| |
Collapse
|
17
|
Jassi R, Yadav A, Chander R. Dermoscopy of Lichen Scrofulosorum. Indian Dermatol Online J 2020; 11:876-877. [PMID: 33235878 PMCID: PMC7678513 DOI: 10.4103/idoj.idoj_191_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 07/26/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Rubina Jassi
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospital, New Delhi, India
| | - Anuja Yadav
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospital, New Delhi, India
| | - Ram Chander
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospital, New Delhi, India
| |
Collapse
|
18
|
Maitriwong P, Tangkijngamvong N, Asawanonda P. Innovative 1064-nm Nd:YAG Laser Significantly Improves Keratosis Pilaris, A Randomized, Double-Blind, Sham-Irradiation-Controlled Trial. Lasers Surg Med 2019; 52:509-514. [PMID: 31713266 DOI: 10.1002/lsm.23184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE Keratosis pilaris (KP) is a common follicular disorder for which various topical agents and energy-based devices have been used with some efficacy. To evaluate the efficacy of a novel 1064-nm Nd:YAG laser for the reduction of skin roughness, erythema, and hyperpigmentation in KP subjects. STUDY DESIGN/MATERIALS AND METHODS Twenty-three subjects with untreated KP on the upper outer arms participated in a randomized, single-blind fashion. One arm of each subject was divided into upper and lower parts. One part was randomized to be treated with an innovative 1064-nm Nd:YAG laser, while the other part received sham irradiation. Subjects received four consecutive treatments at 4-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and 4 weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subjects' Global Improvement Score (GIS) and subjects' satisfaction grading scores. RESULTS Twenty-three subjects completed the study. There was statistically significant reduction of skin roughness measured by Antera3D compared with control group (P < 0.001). There were statistically significant improvements of skin roughness, erythema, hyperpigmentation, and overall appearances graded by subjects' Global Improvement Score (P < 0.001 all). Subjects' satisfaction scores were graded significantly better in treatment parts (P < 0.001). No adverse events including burning, bulla, erosion, post-inflammatory hyper/hypopigmentation, and scar formation developed in any subjects throughout the study period. CONCLUSION This innovative 1064-nm Nd:YAG laser has proved to significantly and safely reduce skin roughness in Thai KP subjects compared with control after four sessions. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Praewvanid Maitriwong
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Natsinee Tangkijngamvong
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Pravit Asawanonda
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| |
Collapse
|
19
|
Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol 2019; 81:1037-1057. [DOI: 10.1016/j.jaad.2018.12.070] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
|
20
|
Maitriwong P, Tangkijngamvong N, Asawanonda P. Intense Pulsed-light Therapy Significantly Improves Keratosis Pilaris: A Randomized, Double-blind, Sham Irradiation-controlled Trial. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2019; 12:E53-E57. [PMID: 32038750 PMCID: PMC6937144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Keratosis pilaris (KP) is a common benign follicular disorder for which various topical and laser treatments have been used, with limited efficacy. Objective: We evaluated the efficacy of intense pulsed light (IPL) therapy for the reduction of skin roughness, erythema, and hyperpigmentation in Thai subjects with KP. Material and Methods: Twenty-four Thai patients with untreated KP on the upper outer arms were enrolled in a randomized, double-blind study. Only one arm of each subject was included and divided into upper and lower parts (25 cm2 per each part). One part was randomized to be treated with IPL using 645 to 950-nm cutoff filter and fluences of 15 to 18 J/cm2, while the other part was treated with sham irradiation. Subjects received four consecutive treatments at four-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and four weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subject Global Improvement Scores (GIS) and subject satisfaction grading scores. Results: Twenty-three subjects completed the study. There was statistically significant reduction of skin roughness, measured by Antera3D, compared to control group (p<0.001). However, the reduction of skin erythema was not significantly different between two groups (p=0.660). Skin hyperpigmentation significantly increased in the control group compared with intervention group (p=0.01). There were statistically significant improvements in skin roughness, erythema, hyperpigmentation, and overall appearance, graded by subject Global Improvement Scores (p<0.001). Subject satisfaction scores were significantly better in treatment parts (p<0.001). No adverse events, including burning, bulla, erosion, postinflammatory hyper/hypopigmentation, and scar formation developed in any subjects throughout study period. Conclusion: IPL has demonstrated the ability to significantly and safely reduce skin roughness in subjects with KP compared to control after four sessions.
Collapse
Affiliation(s)
- Praewvanid Maitriwong
- Drs. Maitriwong, Tangkijngamvong, and Asawanonda are with Division of Dermatology in the Department of Medicine, Faculty of Medicine at the Chulalongkorn University in Bangkok, Thailand
| | - Natsinee Tangkijngamvong
- Drs. Maitriwong, Tangkijngamvong, and Asawanonda are with Division of Dermatology in the Department of Medicine, Faculty of Medicine at the Chulalongkorn University in Bangkok, Thailand
| | - Pravit Asawanonda
- Drs. Maitriwong, Tangkijngamvong, and Asawanonda are with Division of Dermatology in the Department of Medicine, Faculty of Medicine at the Chulalongkorn University in Bangkok, Thailand
| |
Collapse
|
21
|
Ismail S, Omar SS. Clinical and dermoscopic evaluation of fractional carbon dioxide laser in management of keratosis pilaris in Egyptian type skin. J Cosmet Dermatol 2019; 19:1110-1120. [DOI: 10.1111/jocd.13140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/27/2019] [Accepted: 08/15/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Shaimaa Ismail
- Department of Dermatology, Venereology & Andrology Faculty of Medicine Alexandria University Alexandria Egypt
| | - Salma Samir Omar
- Department of Dermatology, Venereology & Andrology Faculty of Medicine Alexandria University Alexandria Egypt
| |
Collapse
|
22
|
Affiliation(s)
| | - Jushya Bhatia
- Department of Dermatology, Venereology and Leprosy, Sri Aurobindo Medical College and Post-graduate Institute, Indore, Madhya Pradesh, India
| | - Mary Thomas
- Department of Dermatology, Poornima Hospital, HMT Layout, RT Nagar, Bengaluru, Karnataka, India
| |
Collapse
|
23
|
Kim WI, Jin H, You HS, Shim WH, Kim GW, Kim HS, Kim BS, Kim MB, Ko HC. Unilateral Linear Keratosis Pilaris on Hypopigmented Patches: An Additional Case of a New Variant of Keratosis Pilaris in an Asian Male. Ann Dermatol 2019; 31:S7-S9. [PMID: 33911678 PMCID: PMC7997059 DOI: 10.5021/ad.2019.31.s.s7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 10/01/2018] [Accepted: 10/07/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Woo-Il Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyunju Jin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyang-Suk You
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Woo-Haing Shim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Gun-Wook Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| |
Collapse
|
24
|
Nair PA, Sheth N. Dermoscopy of Juvenile Circumscribed Pityriasis Rubra Pilaris. Indian Dermatol Online J 2018; 9:474-476. [PMID: 30505800 PMCID: PMC6233002 DOI: 10.4103/idoj.idoj_334_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Pragya A Nair
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Niral Sheth
- Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India
| |
Collapse
|
25
|
Wang JF, Orlow SJ. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol 2018; 19:733-757. [PMID: 30043128 DOI: 10.1007/s40257-018-0368-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies. Histopathologic, genomic, and epidemiologic evidence points to keratosis pilaris as a primary disorder of the pilosebaceous unit as a result of inherited mutations or acquired disruptions in various biomolecular pathways. Recent data highlight aberrant Ras signaling as an important contributor to the pathophysiology of keratosis pilaris and its subtypes. We also evaluate data on treatments for keratosis pilaris and its subtypes, including topical, systemic, and energy-based therapies. The effectiveness of various types of lasers in treating keratosis pilaris and its subtypes deserves wider recognition.
Collapse
Affiliation(s)
- Jason F Wang
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA.
| |
Collapse
|
26
|
Jakhar D, Kaur I, Chaudhary R. Dermoscopy of pityrosporum folliculitis. J Am Acad Dermatol 2018; 80:e43-e44. [PMID: 30244060 DOI: 10.1016/j.jaad.2018.08.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 08/05/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Deepak Jakhar
- Department of Dermatology and STD, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India.
| | - Ishmeet Kaur
- Department of Dermatology and STD, ESI - Post Graduate Institute of Medical Science and Research, New Delhi, India
| | - Richa Chaudhary
- Department of Dermatology and STD, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| |
Collapse
|
27
|
Purnak S, Topçu V, Çavdarlı B, Kadan E, Yalçın B. Widespread keratosis pilaris in a patient with Noonan syndrome with multiple lentigines. Int J Dermatol 2018; 57:e140-e141. [PMID: 30152106 DOI: 10.1111/ijd.14209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Seda Purnak
- Department of Dermatology, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Vehap Topçu
- Department of Medical Genetics, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Büşranur Çavdarlı
- Department of Medical Genetics, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Elçin Kadan
- Department of Pathology, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Başak Yalçın
- Department of Dermatology, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
28
|
Abstract
Atopic dermatitis is a common chronic pruritic inflammatory skin disorder, characterized by an abnormal skin barrier, immune dysfunction, and an altered skin microbiome. Atopic dermatitis may be seen in conjunction with a variety of other skin disorders due to the complex pathogenesis of atopic dermatitis, involving genetic and environmental factors that are associated with immune dysfunction, barrier defects, and altered skin microbiomes. Skin disorders associated with atopic dermatitis include diseases sharing similar genetic origins like ichthyosis vulgaris, infectious diseases such as impetigo, and eczema herpeticum, in addition to the cutaneous autoimmune diseases, alopecia areata, and vitiligo. Atopic dermatitis is also often linked to such benign conditions as pityriasis alba and keratosis pilaris. This review discusses the cutaneous comorbidities of atopic dermatitis and their relationship via their occurrence in conjunction with atopic dermatitis.
Collapse
Affiliation(s)
- Justine Fenner
- Department of Dermatology, Mt Sinai West, Icahn School of Medicine at Mt Sinai, New York, NY
| | - Nanette B Silverberg
- Department of Dermatology, Mt Sinai West, Icahn School of Medicine at Mt Sinai, New York, NY.
| |
Collapse
|
29
|
Dermoscopic assessment of skin toxicities in patients with melanoma during treatment with vemurafenib. Postepy Dermatol Alergol 2018; 35:39-46. [PMID: 29599670 PMCID: PMC5872245 DOI: 10.5114/ada.2018.73163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/15/2017] [Indexed: 01/16/2023] Open
Abstract
Introduction The use of vemurafenib in melanoma has improved the survival of patients; however, it is associated with skin toxicities. Aim To assess skin toxicities by dermoscopy in patients treated with vemurafenib. Material and methods Eight patients with BRAF V600 mutation positive metastatic melanoma were examined dermoscopically during vemurafenib treatment. All skin lesions occurring during therapy were assessed clinically and dermoscopically using a hand-held dermoscope with polarised and non-polarised light. Skin lesions suspected for malignancy appearing during therapy were totally surgically excised with consecutive histopathological examination. Results All 8 examined patients developed skin toxicity. The majority of patients (7/8) presented G1 skin toxicity according to CTCAE version 4.3. Only 1 of them had G2 skin toxicity. The most common dermoscopy findings in our study were hyperkeratotic verrucas in 5 patients (5/8) with structureless pattern. In some of them we also observed central dots, exophytic proliferation, hairpin vessels and homogeneous haemorrhage. Other findings were hyperkeratosis of the nipples (5/8) with brownish to yellowish, angular clods with a tendency to be more confluent in dermoscopy. Palmar plantar erythrodysaesthesia (3/8) showed dermoscopically a yellowish, homogeneous pattern. Four melanocytic skin lesions in 2 patients were surgically excised due to suspected malignant transformation. In most of them we observed an atypical pigmented network (abrupt cut-off, big holes), atypical globules and a homogeneous blue pattern; however, histopathological diagnosis excluded any malignancy. Conclusions Dermoscopy seems to be an easily performed and valuable method for assessment of skin toxicities during oncological therapy, at any time of the treatment.
Collapse
|
30
|
Ma H, Xu Q, Zhu G, Su X, Yin S, Lu C, Lai W. Unilateral keratosis pilaris occurring on linear hypopigmentation patches: a new variant of keratosis pilaris in an Asian? J Dermatol 2015; 42:437-8. [PMID: 25753262 DOI: 10.1111/1346-8138.12821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Han Ma
- Department of Dermatology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | | | | | | | | | | | | |
Collapse
|
31
|
Sebaceous gland, hair shaft, and epidermal barrier abnormalities in keratosis pilaris with and without filaggrin deficiency. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:1012-21. [PMID: 25660180 DOI: 10.1016/j.ajpath.2014.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/19/2014] [Accepted: 12/17/2014] [Indexed: 01/07/2023]
Abstract
Although keratosis pilaris (KP) is common, its etiopathogenesis remains unknown. KP is associated clinically with ichthyosis vulgaris and atopic dermatitis and molecular genetically with filaggrin-null mutations. In 20 KP patients and 20 matched controls, we assessed the filaggrin and claudin 1 genotypes, the phenotypes by dermatoscopy, and the morphology by light and transmission electron microscopy. Thirty-five percent of KP patients displayed filaggrin mutations, demonstrating that filaggrin mutations only partially account for the KP phenotype. Major histologic and dermatoscopic findings of KP were hyperkeratosis, hypergranulosis, mild T helper cell type 1-dominant lymphocytic inflammation, plugging of follicular orifices, striking absence of sebaceous glands, and hair shaft abnormalities in KP lesions but not in unaffected skin sites. Changes in barrier function and abnormal paracellular permeability were found in both interfollicular and follicular stratum corneum of lesional KP, which correlated ultrastructurally with impaired extracellular lamellar bilayer maturation and organization. All these features were independent of filaggrin genotype. Moreover, ultrastructure of corneodesmosomes and tight junctions appeared normal, immunohistochemistry for claudin 1 showed no reduction in protein amounts, and molecular analysis of claudin 1 was unremarkable. Our findings suggest that absence of sebaceous glands is an early step in KP pathogenesis, resulting in downstream hair shaft and epithelial barrier abnormalities.
Collapse
|