Dermatology practical & conceptual最新文献

{"title":"Management of Local Skin Reactions Caused by 5-FU 4% Cream for the Treatment of Actinic Keratosis: A Delphi Consensus.","authors":"Gabriella Brancaccio, Giulia Briatico, Zoe Apalla, Reinhard Dummer, Jan Eklind, Nicole Basset Seguin, Brigitte Dreno, Maria Concetta Fargnoli, Pascale Guitera, Markus V Heppt, Christoph Hoeller, Thomas Jouary, Aimilios Lallas, Ulrikke Lei, Ulrike Leiter, Josep Malvehy, David Moreno Ramírez, John Paoli, Ketty Peris, Susanna Puig, Philippe Saiag, Eggert Stockfleth, Wilhelm Stolz, Alexander J Stratigos, Class Ulrich, Ann-Marie Wennberg, Iris Zalaudek, Giuseppe Argenziano","doi":"10.5826/dpc.1502a5787","DOIUrl":"10.5826/dpc.1502a5787","url":null,"abstract":"<p><strong>Introduction: </strong>Treatments such as 4% 5-fluorouracil (5-FU) cream have demonstrated strong efficacy in lesion clearance of actinic keratosis; however, local skin reactions (LSR) during treatment remain a significant challenge, potentially affecting patient adherence.</p><p><strong>Objective: </strong>We sought to build consensus on management of LSR associated with 4% 5-FU using the Delphi methodology.</p><p><strong>Methods: </strong>Twenty-eight expert dermatologists participated in a 3-round Delphi process. Experts evaluated LSR management strategies, including emollients, antibiotics, steroids, and treatment discontinuation. Agreement levels were measured using a 7-point Likert scale. Consensus was categorized as high if >80% of votes were within the 5-7 rating range and low when >25% were in the 1-3 rating range, with <25% of the votes in the 6-7 rating range. Other combinations of votes were considered as having moderate agreement.</p><p><strong>Results: </strong>High agreement was achieved for the following statements: the approved daily schedule (once daily for 4 weeks) is the most appropriate (92.9%); mild LSR generally do not require intervention and do not impact treatment adherence (96.4%); severe LSR may benefit from temporary treatment interruption and emollient use, ensuring adherence without compromising efficacy (92.9%). The use of emollients (in parallel with the treatment with 5-FU) was considered not needed by most (moderate consensus, 64.3%). Experts emphasized the importance of clear communication about LSR during baseline consultation to enhance patient compliance.</p><p><strong>Conclusion: </strong>This consensus provides practical guidance for managing LSR induced by 4% 5-FU, ensuring high adherence and optimizing treatment outcomes. Further research is needed to validate these findings and explore alternative management approaches.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119245","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":"Diversity Gaps in Clinical Practice Guidelines for Cutaneous Malignancies: A Focus on Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma.","authors":"Courtney A Chau, Subin Lim, Rachel Granovsky, Lillian Sidky, Eudora Lee, Gabriela A Cobos","doi":"10.5826/dpc.1502a5219","DOIUrl":"10.5826/dpc.1502a5219","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119018","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":"Applications of UV-Induced Fluorescence (UVF) Dermoscopy in Infectious Dermatoses (UVF-Infectiouscopy).","authors":"Noemi Plozner, Yasmeen J Bhat, Enzo Errichetti","doi":"10.5826/dpc.1502a5441","DOIUrl":"10.5826/dpc.1502a5441","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119037","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":"Association Between Periostin Expression and Disease Progression in Lichen Planopilaris: Insights Into Pathophysiology.","authors":"Şenay Ağırgöl, Ceyda Çaytemel, Burak Ünlü, Elif Çetinkaya, Baran Cayhan, Begüm Çalım, Zafer Türkoğlu","doi":"10.5826/dpc.1502a4813","DOIUrl":"10.5826/dpc.1502a4813","url":null,"abstract":"<p><strong>Introduction: </strong>Lichen planopilaris (LPP) is the most prevalent form of scarring alopecia and lymphocytic infiltration that affects the infundibulum and isthmus, perifollicular melanophages, and perifollicular constrictive fibrosis OBJECTIVE: We aimed to assess the contribution of periostin tissue levels to the pathogenesis of LPP and its association with disease severity.</p><p><strong>Methods: </strong>A total of 30 cases diagnosed with LPP between July 15 and October 15, 2022 were studied. Patient age, disease duration, disease severity, and periostin levels were recorded, and periostin immunohistochemistry was performed to obtain histoscores for the perifollicular area, dermoepidermal junction, fibroblasts, and inflammatory cells, and these were compared with the control group.</p><p><strong>Results: </strong>The female sex predominated, with the majority (67%); 25 patients were classified with mild disease and five with severe LPP. Statistically significant differences were found in keratinocyte staining intensities between the mild and severe groups (P=0.023; P<0.01), with the LPP group exhibiting a higher rate of moderate staining intensity compared to the control group. In terms of perifollicular staining intensities, the rate of non-staining was higher in the control group compared to the LPP group. Statistically significant differences were also observed in fibroblast (P=0.001) and inflammatory cell (P=0.001) staining intensities between the groups. No statistically significant difference was found between the patients with mild or severe disease in the LPP group.</p><p><strong>Conclusion: </strong>The relationship between periostin and disease severity could not be conclusively established. The presence of periostin staining in all histopathologically-affected areas of patients with LPP suggests that periostin may serve as a promising marker in LPP.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119052","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":"Autophagy and Premature Graying of Hair: The Role of LC3 as a Biomarker in a Case-Control Study.","authors":"Wafaa Mohamed Abd-Elmagid, Khalda S Amr, Hoda A Ahmed, Dina Ali, Amr Abdelhamed","doi":"10.5826/dpc.1502a4876","DOIUrl":"10.5826/dpc.1502a4876","url":null,"abstract":"<p><strong>Introduction: </strong>Premature graying of hair (PGH) is a common disorder with a multifactorial etiology. Autophagy, which is self-cellular digestion, has been linked to melanin pigment formation; however, the role of autophagy in PGH has not been investigated well.</p><p><strong>Objectives: </strong>The study aimed to evaluate the relationship between PGH and autophagy by measuring gene expression and serum microtubule-associated protein light chain 3 (LC3) concentration.</p><p><strong>Methods: </strong>A case-control study was conducted on 39 PGH patients and 21 controls. Patients clinically diagnosed with PGH and aged <30 years were included in the study. Blood samples were taken to detect LC3B protein by ELISA in the serum of both groups. White hairs from both groups were collected to detect LC3B gene expression by PCR.</p><p><strong>Results: </strong>There was a statistically significant difference between the two groups as regards expression levels of the LC3 gene by PCR (P<0.001), with the mean in the control group (0.71± 0.3) lower than in the PGH group (5.1 ± 1.4). Also, there was a positive significant correlation between LC3 concentration and LC3 gene expression in control (r=0.867, P< 0.001) and in PGH patients (r=0.954, P≤0.001). Multivariate logistic regression analysis for PGH predictors using age, sex (female), hemoglobin level, LC3 concentration, and LC3 gene expression revealed that the only predictor of PGH was LC3 gene expression.</p><p><strong>Conclusions: </strong>Premature graying of hair may have a link with autophagy. LC3 gene expression was increased in PGH patients as compared to the control. LC3 gene expression may be an independent predictor of PGH development. Autophagy modulation may be a therapeutic target for PGH.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119055","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":"Psoriasis and Emotional Dysregulation: A Multicenter Analysis of Psychodermatology Outcomes.","authors":"Tonia Samela, Gaia Moretta, Alessia Provini, Gianluca Pagnanelli, Claudio Bonifati, Dario Graceffa, Viviana Lora, Diego Orsini, Arianna Zangrilli, Domenico Giordano, Annunziata Dattola, Antonio Richetta, Nicoletta Bernardini, Giacomo Caldarola, Eleonora De Luca, Cinzia Masini, Mauro Bavetta, Paola Tribuzi, Vincenzo Panasiti, Damiano Abeni","doi":"10.5826/dpc.1502a4644","DOIUrl":"10.5826/dpc.1502a4644","url":null,"abstract":"<p><strong>Introduction: </strong>Psychological symptoms associated with psoriasis include depression, anxiety, and social phobia, often exacerbated by high rates of alexithymia. Treatment decisions should consider not only clinical severity but also patient characteristics and quality of life. However, the psychosocial burden of psoriasis may not always align with clinical severity.</p><p><strong>Objectives: </strong>This study aimed to assess emotional regulation difficulties in outpatients with psoriasis, comparing these difficulties to those of the general population and examining associations with sociodemographic factors, comorbidities, and treatment options.</p><p><strong>Methods: </strong>A cross-sectional, multicenter study enrolled 107 consecutive patients with psoriasis from dermatological centers in Lazio, Italy. For every patient the Psoriasis Area Severity Index (PASI), Investigator's Global Assessment (IGA), and Difficulties in Emotional Regulation scale (DERS) were recorded.</p><p><strong>Results: </strong>Analysis revealed that patients with psoriasis reported significantly higher emotional regulation difficulties compared to the general Italian population, even those with mild disease. A significant association was found between psoriasis severity and emotional regulation difficulties, particularly in patients with higher PASI scores. Biological treatments were associated with lower levels of emotional regulation difficulties.</p><p><strong>Conclusions: </strong>This study corroborates the existing literature on the association between psoriasis severity and emotional regulation difficulties. However, it diverges from prior findings regarding the association between body mass index (BMI) and emotional dysregulation. Assessing emotional regulation difficulties may aid clinicians in identifying vulnerable patients and optimizing treatment decisions to improve overall quality of life and treatment adherence. Further research is needed to validate these findings and to explore longitudinal associations between emotional regulation and psoriasis outcomes.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119220","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":"Unsealed¹⁸⁸ Rhenium Resin Brachytherapy in Non-Surgical Candidates With Refractory Basal Cell Carcinoma: Clinical Outcomes.","authors":"Marco Adriano Chessa, Carlotta Baraldi, Francesco Savoia, Lorenzo Maltoni, Giacomo Clarizio, Federica Filippi, BiancaMaria Piraccini, Emi Dika, Annalisa Pitino, Giovanni Tripepi, Federico Zagni, Lidia Strigari, Luigia Vetrone, Stefano Fanti, Paolo Castellucci","doi":"10.5826/dpc.1502a4933","DOIUrl":"10.5826/dpc.1502a4933","url":null,"abstract":"<p><strong>Introduction: </strong>High-dose brachytherapy using a non-sealed ¹⁸⁸Rhenium resin (¹⁸⁸Re) is a new treatment option for difficult-to-treat basal cell carcinoma (BCC) that ensures a radical oncological outcome minimizing side effects.</p><p><strong>Objectives: </strong>The aim of this retrospective study was to evaluate the clinical efficacy of high-dose standardized brachytherapy using an unsealed ¹⁸⁸Re in the management of difficult-to-treat BCCs and to evaluate the risk factors of relapses.</p><p><strong>Methods: </strong>Between October 2017 and December 2022, patients affected by difficult-to-treat BCC were selected.</p><p><strong>Inclusion criteria: </strong>histologically proven cutaneous BCC; thickness invasion no deeper than 3 mm; lesion located in the scalp, face, ears, or fingers or other areas in which surgery would have been difficult to perform or to destroy with scarce cosmetic-functional result; contraindication or refusal of surgery. All patients performed follow-up visits with videodermoscopy every 4-6 months.</p><p><strong>Results: </strong>Sixty-four consecutive patients affected by 82 histologically proven high-risk BCCs, were enrolled: 60 were nodular, 9 sclerodermiform, and 13 superficial. Average follow-up was 24 months. Brachytherapy with ¹⁸⁸Re resin achieved a complete response in 93% of \"difficult-to-treat\" BCCs, with relapses occurring on average 24 months after the initial treatment. No statistically significant difference in response to brachytherapy was found in the anatomical area treated, size of the tumor, or previously treated vs. naive BCCs. The sclerodermiform histotype had a 7-fold higher risk of recurrence than nodular histotype; recurrence occurred approximately 12 weeks earlier.</p><p><strong>Conclusion: </strong>High-dose ¹⁸⁸Re brachytherapy is a noninvasive, easy to perform, well-tolerated approach to treat difficult BCC when surgery or other therapy techniques are not feasible.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119285","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":"Age-related Survival Declines in Turkish Patients with Cutaneous Melanoma: A Retrospective Analysis.","authors":"Faruk Tas, Kayhan Erturk","doi":"10.5826/dpc.1502a4936","DOIUrl":"10.5826/dpc.1502a4936","url":null,"abstract":"<p><strong>Introduction: </strong>In cancer patients, the age of a patient at the time of diagnosis is considered among the important clinical indicators.</p><p><strong>Objectives: </strong>We aimed to investigate this significance in melanoma patients by creating patient age groups.</p><p><strong>Methods: </strong>A total of 1,496 adult skin melanoma patients were evaluated retrospectively. Patients were divided into six age groups: under 30 (<30), 31-39 (30s), 40-49 (40s), 50-59 (50s), 60-69 (60s), and 70 and older (70+).</p><p><strong>Results: </strong>The median age was 52 years (range 16-104), and the most common age group was the 50s (n=340, 22.7%). As age increased, so did the Clark level (P=0.0001), the rate of ulceration (P=0.0001), and the rate of BRAF wild-type (P=0.002). The recurrence rates of early-stage patients were similar for all age groups. A significant overall survival (OS) advantage was found only between the following age groups: <30 and 60s (P=0.04) and <30 and 70+ (P=0.01). Five-year OS were, from young to old: 70.5%, 66%, 63.1%, 66.3%, 57.2%, and 46.8%. A significant OS advantage was found only between the following age groups: <30 and 60s (P=0.04) and <30 and 70+ (P=0.01). The 70+ group had significantly worse OS rates in all age groups (<30: P=0.0001; 30s P=0.0001; 40s: P= 0.001; 50s: P=0.0001; and 60s: P=0.04).</p><p><strong>Conclusion: </strong>While some unfavorable histopathological prognostic factors are associated more frequently with increasing age, clinical stage and recurrence do not differ significantly between age groups. A possible explanation for this might be that the elderly have more comorbidities and die of different causes.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119033","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":"Congenital Langerhans Cell Histiocytosis Masquerading as Neonatal Herpes Simplex Virus Infection: A Diagnostic Challenge.","authors":"Luca Bettolini, Stefano Rossi, Salvatore Aversa, Stefano Bighetti, Valeria Boccaletti","doi":"10.5826/dpc.1502a4911","DOIUrl":"10.5826/dpc.1502a4911","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119065","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":"Diagnostic Dermoscopy in Pityriasis Lichenoides Chronica and Pityriasis Lichenoides et Varioliformis Acuta: A Case Series.","authors":"Erika Alba-Rojas, Andrea Sarahi Guerra-Garza, Jorge Ocampo-Candiani","doi":"10.5826/dpc.1502a5078","DOIUrl":"10.5826/dpc.1502a5078","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":"15 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119083","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}