Skin health and disease最新文献

{"title":"Successful management of recalcitrant cutaneous warts with low-dose acitretin monotherapy in a patient with idiopathic CD4⁺ lymphocytopenia.","authors":"Moe Latt, Alex Langrish, Alison M Layton, Charles J N Lacey","doi":"10.1093/skinhd/vzaf025","DOIUrl":"10.1093/skinhd/vzaf025","url":null,"abstract":"<p><p>A 50-year-old man with a background of idiopathic CD4⁺ lymphocytopenia (ICL) was successfully treated with acitretin monotherapy for recalcitrant viral warts on the hands and right cheek. Treatment duration was 35 months, with sustained effects at 15 months post-acitretin therapy. Side-effects were mild and included mild cheilitis and dryness of nasal mucosa. CD4⁺ lymphocytes play an important role in enabling host responses to human papillomavirus (HPV) and, consequently, lower CD4 counts correspond to a higher risk of chronic HPV infection, including viral warts. HPV represents the most common opportunistic infection in patients with ICL. Acitretin is an oral retinoid with affinity for retinoic acid and retinoid X receptors, and works through downregulation of signal transducer and activator of transcription (STAT)1- and STAT3-dependent signalling, with resultant increases in keratinocyte differentiation. As HPV evades the Janus kinase/STAT pathway to promote keratinocyte proliferation, acitretin may work through reversal of this mechanism. This case demonstrates effectiveness of acitretin in treating recalcitrant viral warts, specifically in a patient with ICL.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"236-239"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of treatment survival in patients with plaque psoriasis treated with phototherapy: registry analysis.","authors":"Thomas Graier, Natalie Bordag, Angelika Hofer, Alexandra Gruber-Wackernagel, Franz Legat, Alice Widnig, Katharina Falkensteiner, Wolfgang Weger, Wolfgang Salmhofer, Peter Wolf","doi":"10.1093/skinhd/vzaf021","DOIUrl":"10.1093/skinhd/vzaf021","url":null,"abstract":"<p><strong>Background: </strong>Little is known about treatment survival in patients with plaque psoriasis who have received phototherapy.</p><p><strong>Objectives: </strong>to analyse treatment survival in patients with plaque psoriasis who had received photother-apy, irrespective of the number of sessions and type of phototherapy, and to identify factors that influence the risk of treatment discontinuation.</p><p><strong>Methods: </strong>Data from the Psoriasis Registry Austria and the phototherapy registry of the Centre of Phototherapy at the Department of Dermatology and Venereology, Medical University of Graz, were retrospectively analysed using Kaplan-Meier curves (logrank test) and a Cox (proportional hazards) regression analysis, irrespective of the number of phototherapy sessions or type of phototherapy.</p><p><strong>Results: </strong>The analysis revealed an overall treatment survival rate of 70% and 66% after 1 and 3 years, respectively, with a median treatment survival of 5.5 years. However, treatment survival rates have significantly decreased compared with the rates reported in the prebiologic era [hazard ratio (HR) 1.98, <i>P</i> < 0.001]. While female sex did not influence overall treatment survival (HR 0.87, <i>P</i> = 0.28), the risk of treatment discontinuation was significantly lower in women aged ≥ 60 years (HR 0.49, <i>P</i> = 0.009). Moreover, patients with arthritis had an increased risk of treatment discontinuation (HR 1.69, <i>P</i> = 0.003). The involvement of high-impact body areas (including scalp, nail, or inverse and/or genital body areas) did not alter treatment survival; however, palmar and/or plantar involvement increased the risk of treatment discontinuation (HR 1.48, <i>P</i> = 0.006), especially in men (HR 2.19, <i>P</i> < 0.001). No significant differences in the treatment survival of phototherapy in patients were observed regarding the duration of the psoriasis.</p><p><strong>Conclusion: </strong>Male patients with psoriasis with palmar and/or plantar involvement have the highest risk of treatment discontinuation, whereas women aged ≥ 60 years at treatment start have the lowest risk. Therefore, early treatment escalation should be considered in men with palmar and/or plantar involvement and treatment-resistance disease forms. However, the current treatment survival rates reported for patients with psoriasis treated with phototherapy (median survival 30 months) are similar to the treatment survival rates reported for patients receiving tumour necrosis factor inhibitors.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"214-222"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHD reviewers January 2024-December 2024.","authors":"","doi":"10.1093/skinhd/vzaf035","DOIUrl":"https://doi.org/10.1093/skinhd/vzaf035","url":null,"abstract":"","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 2","pages":"167-169"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into basal cell carcinoma with bone metastasis: a comprehensive review.","authors":"Azadeh Khayyat, Mohammad Ali Esmaeil Pour, Milad Moqadam, Seyed Amir Zohouri, Amir-Reza Khalili-Toosi, Amir Behzad Heidari, Parvaneh Hatami, Bruce R Smoller","doi":"10.1093/skinhd/vzae021","DOIUrl":"10.1093/skinhd/vzae021","url":null,"abstract":"<p><p>Basal cell carcinoma (BCC), the most common skin cancer worldwide, is closely associated with sunlight exposure and generally exhibits a low metastatic potential, with a frequency ranging from 0.0028% to 0.55%. Despite its rarity, BCC with bony metastases causes important clinical complications. We collected information on published patients with a diagnosis of BCC with bony metastases, and examined patient demographics, tumour characteristics, histological features and treatment modalities to define patterns and outcomes. Our study encompassed 108 patients: 68 men and 40 women with a mean (SD) age of 66.9 (6.4) years. Histologically identified subtypes included 42 nodular, 28 infiltrative, 9 morphoeaform, 5 metatypical and 1 superficial BCC, with 23 patients having a mixed histopathology pattern. The main treatments were -surgery (<i>n</i> = 98), chemotherapy (<i>n</i> = 31), immunotherapy (<i>n</i> = 16) and radiotherapy (<i>n</i> = 34). BCC with bone metastases, although rare, requires more attention due to the complexity of management. Histological subtypes such as infiltrative, sclerosing, morphoeaform, basosquamous and micronodular are associated with aggressive behaviour and the detection of symptoms such as bone pain or hypercalcaemia in patients at high risk of metastasis is important for timely diagnosis. Because of the aggressive potential and clinical implications of some subtypes, a personalized management approach with comprehensive histological and molecular profiling is essential to optimize outcomes in patients with BCC with bone metastasis.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"171-177"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single-centre, prospective, qualitative analysis of knowledge, attitudes and behaviour of sunbed use among patients attending a pigmented lesion clinic in a tertiary referral centre.","authors":"Fei Ya Lai, Claire Quigley, Gregg Murray, Amanda Gordon, Ji Fung Yong, Helena Yoo, Claudine Howard-James, Kelly Impey, Carmel Blake, Anne-Marie Tobin","doi":"10.1093/skinhd/vzaf014","DOIUrl":"10.1093/skinhd/vzaf014","url":null,"abstract":"<p><strong>Background: </strong>Indoor tanning through sunbeds is linked to a heightened risk of skin cancers, particularly cutaneous squamous cell carcinoma and basal cell carcinoma, with significant increases in risk for users aged < 35 years. Despite regulations established by the Public Health (Sunbeds) Act 2014 in Ireland, sunbed use persists, primarily for cosmetic reasons.</p><p><strong>Objectives: </strong>To analyse the characteristics, attitudes and behaviours of sunbed users attending an Irish dermatology outpatient clinic.</p><p><strong>Methods: </strong>We undertook a prospective qualitative analysis of 104 consecutive patients attending a pigmented lesion clinic in a tertiary referral dermatology department in Ireland. This was done using a self-reported anonymous survey where respondents answered questions relating to their own demographic data, frequency of sunbed use, motivation for sunbed use and use of unregulated tan-enhancing agents (namely Melanotan I and II).</p><p><strong>Results: </strong>The results showed that patient demographics were consistent with previous studies on sunbeds use, namely younger female patients living in urban areas. Many sunbed premises did not comply with safety regulations; over half lacked protective goggles, and nearly half received no health risk information. The reasons for sunbed use included improving appearance and confidence, with a significant number using tan-enhancing agents. Surprisingly, increased awareness of health risks did not correlate with reduced usage; many users continued tanning practices despite concerns about its adverse effects. Users of tan-enhancing agents also used sunbeds more frequently compared with nonusers.</p><p><strong>Conclusions: </strong>This study suggests a potential psychopathological aspect of tanning behaviours similar to addictive disorders like smoking and alcohol. Patients may benefit from psychological and behavioural interventions such as cognitive behavioural therapy to address their compulsive behaviour. Furthermore, there was a concerning lack of compliance with regulations in tanning salons, highlighting a public health issue. The rising use of unregulated tanning agents, especially among younger people, poses additional risks, including blood-borne infections. This study underscores the need for targeted educational interventions among younger age groups and stricter enforcement of regulations to mitigate health risks associated with indoor tanning. Understanding the complex motivations behind sunbed use is crucial for developing effective strategies to reduce its prevalence and promote safer alternatives.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"210-213"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence rate analysis of cutaneous soft tissue sarcomas in the USA.","authors":"Fadi Touma, Zhuo Ran Cai, Shawheen J Rezaei, Neil Rajan, Konstantinos Linos, Eleni Linos","doi":"10.1093/skinhd/vzaf030","DOIUrl":"10.1093/skinhd/vzaf030","url":null,"abstract":"<p><p>Soft tissue sarcomas (STS) are rare and heterogeneous, with cutaneous STS (CSTS) lacking recent epidemiological data. This study analyses CSTS incidence from 2000 to 2019 using SEER data, identifying 18 181 cases. CSTS was more common in men and non-Hispanic Whites, with Kaposi sarcoma (KS) and dermatofibrosarcoma protuberans (DFSP) being predominant. The overall CSTS incidence was 11.2 per 1 000 000 person-years, with KS having the highest rate. The study reveals a 1.4% annual decline in CSTS rates and highlights ethnic disparities, especially in KS incidence among Non-Hispanic Black patients.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"244-246"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of how frequently UK-based dermatology clinicians apply sun protection factor and the variables influencing this.","authors":"Amber Blood, Áine Kelly, Emma Craythorne","doi":"10.1093/skinhd/vzaf031","DOIUrl":"10.1093/skinhd/vzaf031","url":null,"abstract":"<p><p>This study evaluates sunscreen application practices among UK dermatology clinicians, revealing that only 10% meet recommended reapplication guidelines. Factors such as skin type, gender, product preferences and topical treatments significantly influence sun protection factor (SPF) use. Findings underscore the need for clearer clinical guidelines and practical solutions to enhance adherence and inform patient education.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 3","pages":"241-244"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A red nodule in the umbilicus of an older man.","authors":"Sarah Winter, Sally Ashton, Daniel Housa, Avad Mughal","doi":"10.1093/skinhd/vzaf018","DOIUrl":"10.1093/skinhd/vzaf018","url":null,"abstract":"<p><p>This case report describes an interesting example of a syringocystadenoma papilliferum lesion presenting in a 72-year-old man. He presented with a 10-month history of a red nodule in his umbilicus with unexplained weight loss and reduced appetite. The patient had a background of chronic obstructive pulmonary disease, treated prostate cancer and pemphigus vulgaris that had previously been treated with azathioprine. The nodule would occasionally bleed with trauma, but there were otherwise no associated symptoms. Physical examination revealed a 12 × 12 mm firm red nodule within the umbilicus with some creamy exudate overlying it. Given the clinical presentation, differentials at the time included Sister Mary Joseph nodule, amelanotic melanoma and pyogenic granuloma. A shave biopsy was arranged to help diagnose the nodule and further investigations including computed tomography (CT) and colonoscopy were undertaken. CT and colonoscopy did not indicate any sinister pathology. Histopathological findings demonstrated mildly cystic invaginations arising from a papillomatous epidermis that were lined by rows of cuboidal-to-columnar epithelial cells, with oval nuclei and a pale eosinophilic cytoplasm with squamous metaplasia. The stroma contained a dense mononuclear infiltrate, which was comprised predominantly of plasma cells and lymphocytes. The histopathological findings were of syringocystadenoma papilliferum. This report discusses the clinical and histopathologicial presentation of syringocystadenoma papilliferum and the investigations and management to consider with this diagnosis. We also discuss the various differentials that should be considered for a red nodule in the umbilicus.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 2","pages":"158-160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can oral minoxidil be the game changer in androgenetic alopecia? A comprehensive review and meta-analysis comparing topical and oral minoxidil for treating androgenetic alopecia.","authors":"Faizan Fazal, Bilal Haider Malik, Haris Mumtaz Malik, Beenish Sabir, Haris Mustafa, Mushood Ahmed, Areesha Abid, Maham Leeza Adil, Umar Shafi, Muhammad Saad","doi":"10.1093/skinhd/vzaf009","DOIUrl":"10.1093/skinhd/vzaf009","url":null,"abstract":"<p><p>Androgenetic alopecia (AGA) is a hair disorder seen in both sexes. Its aetiology is multifactorial. Treating AGA has always been a challenge for dermatologists. Only a few drugs such as topical minoxidil and finasteride are U.S. Food and Drug Administration-approved for treating AGA. Thus, looking for new and more effective treatment options for AGA is imperative. This review was conducted to compare the efficacy of oral with topical minoxidil in treating AGA. Only clinical trials that compared oral with topical minoxidil in treating AGA were included in this review. PubMed, Cochrane, Scopus and ClinicalTrials.gov were searched. A total of 2063 studies were retrieved from the databases. Four studies met the inclusion criteria and were included in this systematic review. Outcomes such as hair density, terminal hair density, hair count, global photographic assessment and negative hair pull were studied in this review. The results showed that there was no significant difference between oral and topical minoxidil in terms of improving the hair density of patients with AGA (overall mean difference 0.95, 95% confidence interval -24.98 to 26.87). Two studies showed that the mean difference in terminal hair density was greater in patients treated with oral minoxidil, but there was no significant difference between the two treatments in terms of improving terminal hair density. The efficacy of oral minoxidil is comparable to that of topical minoxidil in terms of improving hair density and terminal hair density in patients with AGA. Oral minoxidil can be used as an adjunct or as a second-line treatment option for AGA.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 2","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous small vessel vasculitis in the COVID-19 era: a systematic review.","authors":"Katherine Oakley Olson, Siddharth Patel, Prutha Pathak, Lucy Page Kelly, Mc Anto Antony, Mrudula Thiriveedi","doi":"10.1093/skinhd/vzaf004","DOIUrl":"10.1093/skinhd/vzaf004","url":null,"abstract":"<p><strong>Background: </strong>Dermatological adverse effects may occur after COVID-19 infection or vaccine administration. Since the beginning of the pandemic, several case reports and systematic reviews have been published on vasculitis associated with both COVID-19 infection and vaccination. Fever, malaise, urticaria, and rash are common symptoms of COVID-19. These symptoms can also occur as adverse reactions to COVID-19 vaccines. However, the occurrence of serious autoimmune reactions due to COVID-19 infection or its vaccine is rare. Cutaneous small vessel vasculitis (CSVV) is an autoimmune disorder that manifests with palpable purpura and petechiae involving the extremities. It results from neutrophilic inflammation within and around dermal vessels and is usually self-limited.</p><p><strong>Objective: </strong>We provide a thorough systematic review on CSVV occurring in the COVID-19 era.</p><p><strong>Methods: </strong>We followed the PRISMA 2020 checklist for systematic review, searching PubMed, Google Scholar, Cochrane, and Embase. We included case reports, case series, correspondence articles, and letters to the editor written in English. Characteristics of each were then summarized and analyzed.</p><p><strong>Results: </strong>39 cases were included in our review - 27 due to the COVID-19 vaccine and 12 due to COVID-19 infection. Mean age of onset was similar, but mean time to onset was sooner in the vaccination group. Common treatments included systemic steroids, and almost all patients experienced complete recovery with the exception of a few patients in the COVID-19 infection cohort.</p><p><strong>Conclusion: </strong>While most cases are self-limiting and resolve with no long-term sequalae, the occurrence of more severe reactions appears to be associated with COVID-19 infection rather than with vaccination.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 2","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}