Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Successful Treatment of Immune Checkpoint Inhibitor-Induced Bullous Pemphigoid with Omalizumab: A Case Report and Review of the Literature.","authors":"Jiazhen Chen, Duanni Xu, Zezhi He, Shaoyin Ma, Jiahui Liu, Xiangnong Dai, Yuwu Luo, Xingdong Ye","doi":"10.2147/CCID.S487711","DOIUrl":"https://doi.org/10.2147/CCID.S487711","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enhancing the immune system's ability to target cancer cells. However, ICIs can lead to immune-related adverse events (irAEs), including dermatologic manifestations such as bullous pemphigoid (BP).</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of omalizumab and other biologics in the treatment of ICI-induced refractory bullous pemphigoid and to derive a strategy for selecting biologic treatments for this condition.</p><p><strong>Methods: </strong>A 48-year-old female with pulmonary squamous cell carcinoma developed erythema and blisters following tislelizumab treatment. Despite initial steroid therapy (1.8 mg/kg/day), new blisters formed. Laboratory tests revealed elevated BP180/230 levels, confirming BP diagnosis. Treatments with intravenous corticosteroids, cyclosporine, and dapsone were ineffective. Omalizumab 300 mg every four weeks was initiated based on elevated serum IgE levels. The patient's response was monitored over four weeks. A comprehensive literature review was conducted, including 4 relevant articles.</p><p><strong>Results: </strong>Omalizumab treatment resulted in the cessation of blister formation and significant symptom alleviation within one week. The overall treatment duration was four weeks, with stable improvement observed. Follow-up for 4 months with no recurrence.</p><p><strong>Conclusion: </strong>This case illustrates the challenges of managing ICI-induced BP and highlights omalizumab as a potentially effective treatment option. The study proposes a personalized therapeutic strategy for refractory ICI-induced BP, emphasizing the selection of biologic agents based on specific immune profiles, including serum markers like IgE, eosinophils, and cytokine levels.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2865-2874"},"PeriodicalIF":1.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Layer Tissue Injury of the Abdominal Wall Caused by Improper Treatment of Subcutaneous Hydrops After Liposuction.","authors":"Guangdi Li, Guiwen Zhou, Qiang Fu, Minliang Chen","doi":"10.2147/CCID.S490065","DOIUrl":"https://doi.org/10.2147/CCID.S490065","url":null,"abstract":"<p><p>Liposuction has been popular with the public since its inception. The fat accumulated in the body is sucked outside the body through negative pressure suction, thereby reducing the fat cells in the body and achieving the effect of local plasticity. Although liposuction is a relatively safe procedure, due to the lack of correct judgment of the patient's condition and treatment by quite a few cosmetic practitioners, the complications of liposuction are gradually increasing. We describe a case of subcutaneous hydrops after lumboabdominal liposuction, which was found to have multi-layer tissue defects of the right lower abdominal wall and local peritoneal rupture after multiple sclerosing agent injections and two debridement procedures. This case provides us with a warning about the use of sclerosing agents.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2859-2863"},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Upadacitinib-Associated Ileus Secondary to Psoriasis Induced by Treatment of Atopic Dermatitis with Dupilumab.","authors":"Xiaoyang Liu, Zhanglei Mu, Lin Cai","doi":"10.2147/CCID.S488354","DOIUrl":"https://doi.org/10.2147/CCID.S488354","url":null,"abstract":"<p><p>A 69-year-old man with severe atopic dermatitis (AD) received a single 600 mg subcutaneous injection of dupilumab, which resulted in a psoriatic rash on day 10. He was then given 30 mg of oral upadacitinib daily, and after 10 weeks of treatment, both the AD and the psoriasis had significantly improved. However, at week 16, the patient had no bowel movement for a week, and paralytic ileus was suspected based on the patient's symptoms and laboratory findings. Without surgery or other treatment, one week after stopping upadacitinib, the patient resumed bowel movements and the ileus improved, suggesting a possible link between the drug and the ileus, which was considered to be possibly due to the off-target effect of Janus kinase inhibitor (JAKi). This case illustrates the complexity of the immunomodulatory effects of targeted therapies and the need for long-term observation of their mechanisms of action and side effects.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2855-2858"},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the Mechanisms of Hidradenitis Suppurativa: Inflammation and miRNA Insights.","authors":"Emily Ames, Maggie Sanders, Marley Jacobs, Thomas A Vida","doi":"10.2147/CCID.S483871","DOIUrl":"10.2147/CCID.S483871","url":null,"abstract":"<p><p>Inflammatory skin diseases impose a significant burden on patients and healthcare systems worldwide. Among these, hidradenitis suppurativa (HS) is particularly notable for its chronic and recurrent nature. Recurrent nodules, abscesses, and scarring in apocrine gland-rich areas characterize the disease, including the groin, axillae, and perianal regions. Despite its considerable physical and psychological impact, the precise mechanisms driving HS remain elusive. Recent advancements in understanding the inflammatory processes involved in HS have highlighted the TNF-alpha, IL-1β, and IL-17/IL-23 pathways, which play crucial roles in initiating and perpetuating the disease. Moreover, specific microRNAs (miRNAs), such as miR-24-1-5p, miR146a-5p, mirR-26a-5p, miR-206, miR-338-3p, and miR-338-5p, are involved in these inflammatory processes. Dysregulation of these miRNAs contributes to aberrant cytokine expression and persistent inflammation, foreseeably exacerbating HS disease progression. This narrative review hypothesizes that miRNA dysregulation triggers aberrant expression in specific inflammatory pathways, contributing to HS's clinical manifestations and progression. We explore the implicated miRNAs' potential as biomarkers for earlier disease detection and as novel therapeutic targets. Identifying miRNA dysregulation offers new opportunities for earlier and more accurate diagnosis, potentially allowing clinicians to intervene before severe disease manifestations occur. Furthermore, therapeutic strategies to modulate miRNA expression could target the inflammatory pathways driving HS, leading to more personalized and effective treatments. This review also discusses future research directions to enhance the clinical management of HS. A better understanding of miRNA involvement in HS offers new avenues for research and management, ultimately improving patient outcomes and quality of life.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2829-2846"},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Cutaneous Mucinous Carcinoma of the Left Zygomatic Region: A Case Report.","authors":"Qingan Huang, Mu Niu, Xifeng Xiong, Nan Tang, Weilun Wen","doi":"10.2147/CCID.S485926","DOIUrl":"https://doi.org/10.2147/CCID.S485926","url":null,"abstract":"<p><p>We describe a case involving a 50-year-old male with who presented with a facial lesion on the left cheek of zygomatic region for 7 years. The diagnosis of primary cutaneous mucinous carcinoma (PCMC) was established through immunohistochemistry and histopathology. And the patient underwent wide excision of the tumor, has no evidence of recurrence after 15 months of follow-up.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2847-2853"},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Eruptive Clear Cell Syringoma: A Case Report and Literature Review.","authors":"Tanat Eittidachachote, Korn Triyangkulsri, Suthinee Rutnin, Poonkiat Suchonwanit","doi":"10.2147/CCID.S497426","DOIUrl":"https://doi.org/10.2147/CCID.S497426","url":null,"abstract":"<p><p>Eruptive syringoma, a rare subtype of syringoma, is a benign adnexal tumor arising from the eccrine sweat glands. It is characterized by multiple asymptomatic, flat-topped, brown-pigmented papules. The disease typically occurs during adolescence and young adulthood. The clear cell variant of syringoma, which histologically features ductal epithelial cells with clear cytoplasm, is relatively rare, while eruptive clear cell syringoma is even more infrequent. In this report, we present a case of a 64-year-old Thai woman who developed multiple erythematous to brownish papules on her right cheek, which eventually spread to the periorbital region, face, neck, and chest over five years. The diagnosis of late-onset eruptive clear cell syringoma was made based on the patient's clinical manifestations and confirmed by histopathological examination. Notably, the patient was found to have impaired fasting plasma glucose upon screening, highlighting the potential association between clear cell syringoma and glucose metabolism abnormalities. This case report emphasizes the importance of considering this diagnosis in elderly patients presenting with eruptive papular dermatoses and underscores the need for metabolic screening in affected individuals.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2823-2828"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Resistance Profiles and <i>mupA</i> Gene Characterization of <i>Staphylococcus epidermidis</i> Recovered from Facial Skin of Healthy Females in Shanghai, China.","authors":"Bingqing Chen, Lingyun Yao, Rongjuan Cai, Wei Chen, Yue Wang","doi":"10.2147/CCID.S481517","DOIUrl":"10.2147/CCID.S481517","url":null,"abstract":"<p><strong>Purpose: </strong>To explore antimicrobial resistance profiles and <i>mupA</i> gene characterization of <i>Staphylococcus epidermidis</i> recovered from facial skin of healthy females in Shanghai, China.</p><p><strong>Patients and methods: </strong>In this study, we collected facial skin samples from 107 healthy females in Shanghai, China, and <i>S. epidermidis</i> isolation was performed. The minimal inhibitory concentrations of 10 antibiotics were determined for the <i>S. epidermidis</i> isolates using the agar dilution method. High-level mupirocin-resistant isolates were subjected to whole-genome sequencing and bioinformatics analysis. A total of 94 un-duplicated <i>S. epidermidis</i> isolates were obtained from 107 facial skin samples.</p><p><strong>Results: </strong>Antimicrobial susceptibility tests revealed that 23.4% of the 94 <i>S. epidermidis</i> isolates were resistant to oxacillin and positive for the <i>mecA</i> gene, which could be cauterized as methicillin-resistant <i>S. epidermidis</i> (MRSE). Resistance rates for erythromycin, clindamycin, tetracycline, ciprofloxacin, and gentamicin were 8.5%, 11.7%, 10.6%, 12.8%, and 1.1%, respectively. For mupirocin, the rates of low- and high-level resistance were 3.2% (3/94) and 11.7% (11/94), respectively. Resistance to vancomycin or linezolid was not observed. High-level mupirocin resistance in facial skin isolates is mediated by <i>mupA</i>. WGS and SNP-based phylogenetic analyses revealed diverse phylogenies among the 11 <i>mupA</i>-positive <i>S. epidermidis</i> isolates. Additionally, various resistance and virulence genes were identified in <i>mupA</i>-positive isolates. A new hybrid plasmid carrying <i>mupA</i> genes was found in two <i>S. epidermidis</i> isolates.</p><p><strong>Conclusion: </strong>We observed a considerable level of antimicrobial resistance to several antibiotics and the prevalence of abundant and diverse resistance and virulence genes in the facial skin-origin <i>S. epidermidis</i> isolates. This may pose a potential risk for both public health and <i>S. epidermidis</i> infection.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2813-2821"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Pragmatic Longitudinal Case-Series Clinical Study to Evaluate the Clinical Outcome of Triple-Frequency Ultrasound in Treatment of Cellulite.","authors":"Irina Chervinskaya, Nadezhda I Kuprina, Ilja Kruglikov","doi":"10.2147/CCID.S488977","DOIUrl":"10.2147/CCID.S488977","url":null,"abstract":"<p><strong>Objective: </strong>In this single-centre, retrospective, pragmatic, longitudinal case-series clinical study triple-frequency LDM (TF-LDM) technology with frequencies of 1/3/10 MHz and 3/10/19 MHz was applied for treatment of cellulite to reveal the effect of these waves on the cellulite skin and assess the sustainability of treatment outcomes during the long-term follow-up controls.</p><p><strong>Methods: </strong>Twenty Caucasian females with mild-to-severe gynoid lipodystrophy aged 27-53 years who received cellulite monotherapy with TF-LDM were included in this study. All participants were evaluated at three time points: baseline (T1), on the day of the last treatment (T2), and during the last follow-up (T3). Cellulite severity was assessed by six independent clinicians using the five-grade Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS). Patient satisfaction was evaluated using a 10-grade GAIS scale, ranging from 0 to 10 (0 - dissatisfied; 10 - fully satisfied). To objectify the treatment outcomes, 17 subjects were investigated using B-mode ultrasonography and real-time compression elastography at baseline and during follow-up.</p><p><strong>Results: </strong>The average values of CR-PCSS (T1), CR-PCSS (T2) and CR-PCSS (T3) over all participants were 2.22±0.82, 1.18±0.77, and 0.84±0.77, respectively, which corresponded to the skin improvement between T1 and T2 of 0.93±0.27 (p < 0.0001) as well as between T1 and T3 of 1.38±0.47 (p < 0.0001). Assessment of elasticity of the dermis and adipose tissue on the basis of the 5-grade coloration scale revealed significant reinforcement of both tissues as well as of the superficial fascia at follow-up as compared to their baseline values. The obtained treatment outcomes were long-lasting and could be clearly observed even in individuals with a long-term follow-ups. Assessment of the satisfaction of participants with the treatment results revealed a high satisfaction of 8.95 ± 1.49. The method demonstrated no side effects, was pain-free, well-tolerated, and highly accepted by patients.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2779-2794"},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Very-High-Frequency Ultrasound Imaging Characteristics of Dermatofibroma.","authors":"Bin Dong, Hongsheng Xia, Ying Liu, Hailiang Tao, Yan Xia, Feifei Zhu","doi":"10.2147/CCID.S493437","DOIUrl":"10.2147/CCID.S493437","url":null,"abstract":"<p><strong>Background: </strong>Dermatofibroma (DF) is one of the common dermatosis, which is so challenging to diagnose that its misdiagnostic incidence is quite high. The very-high-frequency (VHF) ultrasound is particularly relevant to the diagnosis of <i>DF</i>. Herein, we analyze the sonographic features and application value of VHF ultrasound in the diagnosis of <i>DF</i>.</p><p><strong>Methods: </strong>Clinical data from 153 patients with pathologically confirmed <i>DF</i> from January 2019 to December 2023 were retrospectively analyzed using high-resolution VHF ultrasound, including size, location, shape, edge, boundary, interior echo, blood supply and so on.</p><p><strong>Results: </strong>The VHF sonographic features of <i>DF</i> showed that the maximum diameter of the lesions was about 7.29 ±2.85 mm (mean ± standard deviation). In addition, most lesions were located in the middle and lower part of dermis (49%), with ill-defined (84%) and irregular shape (51%), 19% of which were serrated. Forty-four percent of lesions were hypo-echoic and heterogeneous, and 8% were complicated with calcifications. Nineteen percent of lesions presented as thickened dermal epidermal junction. Dermatofibroma are mostly hypovascular on color Doppler ultrasound. Forty-three percent of lesions were detected with punctate dotted blood flow signals. The correlation analysis showed blood flow classification and maximum diameter were not relevant.</p><p><strong>Conclusion: </strong>The <i>DF</i> based on VHF ultrasonographic findings is characteristic, such as <10mm, ill-defined, located in the dermis, thickened DEJ, serrated shape, punctute or no flow on Doppler, which provide crucial indicators for differential diagnosis, potentially reducing the rate of <i>DF</i> misdiagnosis.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2795-2802"},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Causal Effect Between Human Microbiota and Scabies: A Study from the Genetic Perspective.","authors":"Qi Zheng, Yuetong Li, Wenfeng Zhu, Xiang Xu, Guoping Sheng, Lanjuan Li","doi":"10.2147/CCID.S491660","DOIUrl":"10.2147/CCID.S491660","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have indicated that human flora may affect the development of scabies, however, no studies have proven a causal relationship between human flora and scabies, which would be detrimental to future in-depth studies on human flora and scabies.</p><p><strong>Methods: </strong>Mendelian randomization (MR) was used to analyze the causal effect between human microbiota and scabies, with data on intestinal flora and skin flora from two large published studies and data on scabies from the FinnGen database. Five MR analysis methods were used to increase the reliability of the results, and sensitivity analyses were conducted to increase the robustness of the results.</p><p><strong>Results: </strong>Our results suggest that 13 intestinal flora as well as 7 skin flora can have a causal effect on scabies.</p><p><strong>Conclusion: </strong>Overall, our results demonstrate a causal relationship between intestinal and skin flora and scabies and are consistent with previous observational findings. This will contribute to the future development of probiotic agents for the prevention or treatment of scabies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2803-2812"},"PeriodicalIF":1.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}