Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Wound Infection After Keloid Excision and Adjuvant Radiotherapy: Two Case Reports and Literature Review.","authors":"Qinyuan Zhao, Yuyan Wang, Jinsheng Li, Chuanbo Liu","doi":"10.2147/CCID.S545846","DOIUrl":"10.2147/CCID.S545846","url":null,"abstract":"<p><strong>Introduction: </strong>The combination of surgical excision and adjuvant radiotherapy is widely accepted as one of the most effective treatments for keloids. Although wound infection following radiotherapy has been reported in several studies, no study has investigated how such infections are managed or whether they ultimately lead to keloid recurrence.</p><p><strong>Case reports: </strong>Two patients, one male with an anterior chest keloid and one female with a mons pubis keloid, underwent surgical excision followed by adjuvant radiotherapy (20 Gy in four fractions) at our institution. Both patients developed wound infections following combined therapy, both of which were successfully treated using a comprehensive protocol. This protocol involved wound drainage and debridement, antibiotic administration, and moist wound healing. Complete healing was achieved in both cases, with no recurrence observed during the 18-month follow-up period.</p><p><strong>Discussion: </strong>The possible causes of radiation-induced infection were analyzed, including radiation itself, atopic dermatitis and specific surgical areas (such as the mons pubis region). Our study successfully addressed wound infection by adopting an effective treatment protocol involving wound drainage and debridement, antibiotic administration, and moist wound healing. Although favorable results were obtained in the two keloid cases, optimizing radiotherapy in terms of radiation mode, dosage, fraction and timing is still necessary to reduce the incidence of radiation-induced wound infections.</p><p><strong>Conclusion: </strong>Neither of the two patients experienced keloid recurrence when treated with an effective therapy for wound infection. This result demonstrates that a favorable outcome can be achieved with the appropriate and timely treatment protocol, even if an infection occurs after radiotherapy. Further clinical studies and basic research are needed to investigate the underlying mechanisms of the favorable outcome following radiation-induced infections.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1943-1951"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871791","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":"Clinical and Molecular Insights Into Anti-MDA5 Antibody-Positive Dermatomyositis: A Single-Center Retrospective and Transcriptomic Study.","authors":"Yunli Ren, Tianqi Wu, Weiwei Shi","doi":"10.2147/CCID.S535704","DOIUrl":"10.2147/CCID.S535704","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively characterize clinical features, diagnostic challenges, and prognostic biomarkers of anti-MDA5 antibody-positive dermatomyositis (MDA5-DM), incorporating transcriptomic analysis to elucidate underlying molecular mechanisms.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 29 MDA5-DM patients, collecting detailed clinical and laboratory data. Prognostic factors were identified using LASSO regression, validated by Cox proportional hazards and Kaplan-Meier survival analyses. Public transcriptomic dataset (GSE143323) was analyzed to identify differentially expressed genes and enriched immune pathways.</p><p><strong>Results: </strong>Patients exhibited a high misdiagnosis rate (62.1%) and prevalent interstitial lung disease (96.6%), with 41.4% developing rapidly progressive ILD (RP-ILD). Serum KL-6 level emerged as an independent predictor of mortality (HR=2.96, p<0.01). Transcriptomic profiling revealed upregulation of IL-17, Toll-like receptor, and cytokine-receptor interaction pathways.</p><p><strong>Conclusion: </strong>MDA5-DM presents formidable diagnostic challenges with high misdiagnosis rates and substantial mortality risk predominantly driven by RP-ILD. Serum KL-6 represents a robust, clinically applicable prognostic biomarker warranting integration into risk stratification protocols. Transcriptomic findings illuminate critical immune-inflammatory cascades, particularly cytokine networks and IL-17 signaling, offering mechanistic insights and potential therapeutic targets. Future multicenter prospective studies are essential to validate these biomarker findings and develop composite prognostic models incorporating clinical, radiographic, and molecular parameters.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1917-1929"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871789","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":"Spesolimab Treatment in GPP: Impact of IL-36RN Mutations and Concomitant Plaque Psoriasis.","authors":"Wei Li, Jingyao Liang, Yuwu Luo, Shuting Chen, Manqi Xia, Hui Ye, Bin Yang, Quan Luo","doi":"10.2147/CCID.S533564","DOIUrl":"10.2147/CCID.S533564","url":null,"abstract":"<p><p>We present a case series involving five patients with generalized pustular psoriasis (GPP) who received a single intravenous dose of 900 mg spesolimab in our department from September 2023 to January 2024. Spesolimab was effective in three patients, regardless of their IL-36RN gene mutation status. Two patients with concomitant plaque psoriasis, despite initially poor responses to spesolimab, achieved resolution of pustules after switching their therapy to ixekizumab or secukinumab. This study highlights the potential of spesolimab in managing GPP, especially in genetically distinct groups, and emphasizes the importance of tailored therapeutic approaches. These findings suggest that spesolimab can effectively treat GPP, regardless of IL-36RN gene mutation status. However, its therapeutic efficacy may be suboptimal in patients with concomitant plaque psoriasis, indicating the need for further investigation to optimize treatment outcomes in this subgroup.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1931-1935"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871790","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":"Pigmented Extramammary Paget's Disease of the Axilla: Two Case Reports and a Literature Review.","authors":"Yi-Xiao Wang, Xiao-Mei Cui, Qing Zhang, Xiao-Qing Xu, Yao Sun, Min Gao, Li-Xiong Gu","doi":"10.2147/CCID.S535004","DOIUrl":"10.2147/CCID.S535004","url":null,"abstract":"<p><p>Extramammary Paget's disease is a rare intraepithelial adenocarcinoma that mainly occurs in areas rich in apocrine sweat glands, such as the vulva, perianal region, and, less commonly, in the axillary skin. Owing to the varied manifestations of extramammary Paget's disease, it is often misdiagnosed. Particularly, pigmented extramammary Paget's disease (PEMPD) can be mistaken for superficial spreading melanoma, Bowen's disease, pigmented superficial basal cell carcinoma, or seborrheic keratosis. Here, we report two cases of women with axillary pigmented plaques who were confirmed as PEMPD through histopathological and immunohistochemical analyses. One of these patients was only 31 years old, which makes her the youngest reported case of PEMPD to date. All patients underwent Mohs micrographic surgery, and no recurrence or metastasis was observed postoperatively. PEMPD is a rare clinical variant that can resemble other pigmented lesions, both clinically and histopathologically. Therefore, this report underscores the importance of accurate differential diagnosis through immunohistochemistry.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1909-1915"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834353","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":"Comparative Morphometric and Histometric Evaluation of Power-Dependent Tissue Ablation Using Fractional Carbon Dioxide Laser.","authors":"Hye Guk Ryu, Jinyoung Park, Hyemin Kim, Wanil Kim, Hwa-Rim Lee, Jeongah Ko, Sung Bin Cho","doi":"10.2147/CCID.S534637","DOIUrl":"10.2147/CCID.S534637","url":null,"abstract":"<p><strong>Background: </strong>Fractional carbon dioxide (CO₂) lasers are commonly used in dermatological resurfacing, offering precise ablation and controlled dermal remodeling. Although clinical outcomes vary with the energy and pulse settings, comparative morphometric and histometric data on power-dependent tissue interactions are limited.</p><p><strong>Objective: </strong>To evaluate and compare fractional CO₂ laser-induced microscopic thermal zones (MTZs) ablation characteristics at peak powers of 30 W and 40 W using an ex vivo porcine skin model.</p><p><strong>Methods: </strong>Ex vivo porcine skin was treated with a fractional CO₂ laser at energy levels ranging from 40 to 240 mJ under 30 W and 40 W settings. Frozen tissue was used for dermoscopic assessment of ablation diameters, while unfrozen tissue at physiological temperature (30-32°C) was analyzed histologically for ablation depth. Morphometric and histometric measurements were performed and statistically analyzed.</p><p><strong>Results: </strong>The 30 W and 40 W settings demonstrated energy-dependent increases in ablation depth and diameter. The 40 W laser consistently generated deeper ablation columns (average 11.8% deeper) with narrower surface diameters (average 7.3% narrower) and reduced peripheral carbonization. Linear regression showed strong correlations between energy and ablation depth (r > 0.91) and diameter (r > 0.91), with higher slope coefficients in the 40 W group, indicating greater ablation efficiency.</p><p><strong>Conclusion: </strong>The 40 W fractional CO₂ laser system offers enhanced precision, deeper dermal penetration, and reduced thermal diffusion compared with the 30 W, despite delivering equivalent total energy. These findings suggest that higher peak power settings may improve fractional resurfacing procedures' safety and clinical outcomes, particularly in populations with darker skin phototypes.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1901-1907"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820707","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":"Geometric-Marking Quantification for First-Stage Excision of Large Congenital Melanocytic Nevi.","authors":"Kaixi Tan, Jianfei Zhang","doi":"10.2147/CCID.S533955","DOIUrl":"10.2147/CCID.S533955","url":null,"abstract":"<p><strong>Background: </strong>Staged excision is often needed for large CMN. Accurately determining the first-stage excision volume is critical.</p><p><strong>Objective: </strong>To introduce and evaluate a geometric-marking quantification method for precise preoperative planning of the first-stage excision volume in staged CMN removal.</p><p><strong>Methods: </strong>A prospective study was conducted on 21 patients undergoing staged excision of large CMN between January and June 2023. Preoperatively, a novel geometric-marking quantification technique was employed to calculate the maximum feasible first-stage excision volume. Surgical execution, intraoperative conditions, and postoperative recovery were observed. Relevant surgical techniques and postoperative care were examined.</p><p><strong>Results: </strong>All first-stage excisions resulted in successful tension-free primary closure. No instances of insufficient excision, suture dehiscence, or other immediate complications occurred. Postoperative recovery was favorable across all patients. All patients proceeded to successful second-stage excision for complete nevus removal.</p><p><strong>Conclusion: </strong>The geometric-marking quantification method provides a reliable, reproducible, and objective approach for planning the first-stage excision in large CMN. It achieved 100% technical success in this cohort, eliminating complications related to inaccurate volume estimation. This standardized protocol warrants clinical adoption to replace subjective estimation methods, significantly enhancing surgical outcomes and reducing complication risks.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1865-1872"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815930","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":"Dermatofibroma: Reappraisal and Updated Review.","authors":"Leo Wan, Aileen Park, Lanah Almatroud, Amor Khachemoune","doi":"10.2147/CCID.S526191","DOIUrl":"10.2147/CCID.S526191","url":null,"abstract":"<p><p>Dermatofibromas (DF), also known as fibrous histiocytomas, are common benign cutaneous lesions characterized histologically by dermal proliferation of spindle-shaped fibrocytes, with the overlying epidermis often demonstrating hyperplasia with acanthosis, basal layer hyperpigmentation, and a characteristic \"collarette\" of epidermal hyperplasia surrounding the lesion. The etiology of DF remains debated, with theories ranging from reactive processes triggered by local trauma, such as insect bites, to spontaneous development. DF typically presents as a hyperkeratotic nodule or plaque, most often on the lower extremities, and can exhibit a wide spectrum of clinical appearances. Variants such as hemosiderotic, epithelioid, aneurysmal, and cellular DF show distinct clinical and histopathological features that may sometimes mimic malignant lesions. Dermoscopic findings can aid in diagnosis, although biopsy is often required for definitive classification. Discrepancies in the literature persist regarding the pathogenesis and classification of DF, and while DF is generally benign, rare cases of metastasizing DF have been reported. This review aims to provide an examination of DF, including its clinical manifestations, etiology, subtypes, histological features, and differential diagnoses. It also discusses dermoscopic findings, controversies in the literature, and current treatment options. A clearer understanding of its diverse presentations, along with refined diagnostic criteria, will enhance clinical management and treatment strategies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1873-1887"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815929","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 Review: Causes, Consequences, and Management Strategies of Facial Overfilling.","authors":"Cheng-Xiang Peng, Wang Xv, Yin-Jie Ao","doi":"10.2147/CCID.S539888","DOIUrl":"10.2147/CCID.S539888","url":null,"abstract":"<p><p>In recent years, Overfilled Syndrome and the associated \"Bread Bun\" phenomenon have garnered significant attention in the field of aesthetic medicine, particularly among younger populations. This article systematically reviews the causes, consequences, and management strategies of facial overfilling, aiming to provide a scientific basis for the prevention and correction of this phenomenon. The causes of overfilling involve technical, patient, and physician-related factors: technical factors include improper injection dosage, depth, and point design; patient factors primarily stem from the excessive pursuit of \"perfect\" facial features and unrealistic expectations; while physician factors are related to insufficient experience, lack of technical proficiency, and misinterpretation of aesthetic standards. The consequences of overfilling include aesthetic imbalance, health risks, and psychological issues. To effectively prevent and manage overfilling, this article proposes detailed preventive strategies, including preoperative assessment and design, patient education, intraoperative layered injection techniques, and regular postoperative follow-ups. For cases where overfilling has already occurred, non-surgical correction and surgical correction are the primary treatment methods. Additionally, psychological support and the application of portable ultrasound technology play important roles in the correction process. Future research directions include the development of quantitative assessment tools, optimization of prevention and management strategies, and the development of new filler materials and technologies. Through scientific preventive strategies, precise treatment plans, and ongoing research and innovation, the occurrence of overfilling can be effectively reduced, advancing facial filler procedures toward greater safety and naturalness.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1857-1864"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815928","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":"Successful Treatment of Nail Lichen Planus by the Janus Kinase 1 Upadacitinib and Literature Review.","authors":"Xingyun Zhao, Jianbo Zhong, Yanzhen Xu, Yingzhi Luo, Yunmi Qiu, Liming Wu, Ping Yang","doi":"10.2147/CCID.S534496","DOIUrl":"10.2147/CCID.S534496","url":null,"abstract":"<p><p>Nail lichen planus (NLP) is a chronic inflammatory condition that can lead to considerable cosmetic and functional impairment. Failure to administer prompt and effective treatment may result in the development of permanent scarring and nail loss. The precise pathogenesis of NLP remains poorly understood, and there is currently an absence of safe and effective treatment options. Although not FDA-approved for the treatment of lichen planus, Janus kinase (JAK) inhibitors have shown considerable promise as therapeutic agents for a variety of dermatoses. This case report describes a patient with NLP who showed improvement after six months of treatment with upadacitinib, a selective JAK1 inhibitor. Changes were assessed using the Nail Lichen Planus Severity Index (NALSI) score. Following medication administration, the total score of the NALSI for the patient's nail involvement decreased from 146 to 37. However, a mild recurrence was observed following the reduction of the medication dosage (NALSI score to 47).</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1849-1855"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815931","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 Palmoplantar Keratodermas Complicated by Pseudoainhum and Literature Review.","authors":"Junhong Ye, Wen Li, Xianxu Yang, Yanhai Shi, Wen Lv","doi":"10.2147/CCID.S534631","DOIUrl":"10.2147/CCID.S534631","url":null,"abstract":"<p><p>A 43-year-old man who had presented diffuse plaques on both hands and feet for 10 years and constriction of the fifth digit of the right foot for 1 year was included in this case report. Diffuse hyperplastic yellow-brown plaques were observed in the palms of both hands and soles of both feet in this man. Yellowish crusting formed on the plaques. There was much white debris on the surface lesions. The fifth phalanx of the right foot was ring-shaped and narrowed, and the toe was globular. Color Doppler ultrasound examination revealed arteriosclerosis and multiple small plaques in the right lower limb vessel. An antero-posterior radiograph of the right foot showed constriction of the fifth phalanx. The man was diagnosed with palmoplantar keratodermas complicated by pseudoainhum.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1827-1831"},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788422","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}