Skin health and disease最新文献

{"title":"Outcomes in an educational skin-model session on point-of-care ultrasound for diagnosing calciphylaxis.","authors":"Max E Oscherwitz, Christopher T Kelly, Bridget Francis, Casey Glass, John R Edminister, Steven Feldman, Lindsay C Strowd","doi":"10.1002/ski2.467","DOIUrl":"https://doi.org/10.1002/ski2.467","url":null,"abstract":"","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e467"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775317","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 cross-sectional study of the vulval dermatology clinic population over a 4-year period and development of a national vulval disease database.","authors":"Marianne de Brito, Lisa Kirby, Kate Lomas, Aysha Javed, Caroline Owen, Rosalind Simpson","doi":"10.1002/ski2.446","DOIUrl":"https://doi.org/10.1002/ski2.446","url":null,"abstract":"<p><strong>Background: </strong>Vulval disease significantly impacts quality of life but is historically under-researched. The epidemiology and aetiology of many vulval conditions is unclear. Data to optimise patient care are lacking.</p><p><strong>Objectives: </strong>To describe the population attending a specialist vulval dermatology clinic and achieve consensus amongst vulval experts on data items to be collected for a future national vulval database.</p><p><strong>Methods: </strong>This descriptive cross-sectional study analysed data that was prospectively collected during clinical contact with consecutive new patients at a vulval dermatology clinic over 4 years.A two-stage electronic-Delphi survey was performed with British vulval experts. Consensus was defined as ≥75% agreement on items for inclusion.</p><p><strong>Results: </strong>The database included 424 (including 29 paediatric) patients. Most patients were White British (71%), with a significant Asian population (13%). Long symptom duration (9.5% > 10 years) and multiple diagnoses, up to 4, were common. Exploratory associations were identified between irritant contact dermatitis and urinary and faecal incontinence, frequent vulval washing and lichen simplex, urinary incontinence and lichen sclerosus and a negative association between candidiasis and age.Following two rounds of the electronic-Delphi survey, consensus was achieved for 18 items that 28 participants agreed were important for a future database.</p><p><strong>Conclusions: </strong>We report disease incidence, patient pathways, outcome measures and potential associations. Though not generalisable, this large UK-based study could inform future projects to improve patient care and support ongoing research, such as a national vulval disease database, for which we also achieve expert consensus on the most valuable items to include.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e446"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775277","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":"Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials.","authors":"Arabella Baker, Beth Stuart, Laura Howells, Eleanor J Mitchell, Kim S Thomas","doi":"10.1002/ski2.470","DOIUrl":"https://doi.org/10.1002/ski2.470","url":null,"abstract":"<p><strong>Background: </strong>The Recap of atopic eczema (RECAP) is a patient-reported instrument designed to assess eczema control. There is a lack of evidence on the interpretability of change scores in clinical trials.</p><p><strong>Objectives: </strong>To calculate the smallest detectable change (SDC) in RECAP and estimate the minimal important change (MIC) for RECAP using various calculation methods in three eczema clinical trial datasets.</p><p><strong>Methods: </strong>In this study, four anchor-based methods (within-person score change, between-patient score change, predictive modelling, receiver operating characteristic curve) and a distribution-based method (effect size) was used to determine the MIC of RECAP. The trial datasets involved children (0-12 years), young people (13-25 years) and adults (>25 years) with all eczema severities.</p><p><strong>Results: </strong>A total of 698 participants were included in this study. The SDC was between 1.74 and 1.80. For the anchor-based methods, the patient global assessment anchor provided MIC values ranging from 2.35 to 3.94 and the patient oriented eczema measure anchor yielded values between 1.11 and 3.62. The MIC for the distribution-based method ranged from 2.66 to 3.06, respectively.</p><p><strong>Conclusions: </strong>The interpretability of RECAP was improved by establishing MIC values and the following thresholds are suggested for interpreting changes in RECAP scores: <2.0 points is possibly a measurement error; 2.0-2.9 points denotes a small improvement that may be clinically relevant; 3.0-3.9 points indicates an improvement that is likely to be clinically important and ≥4.0 points is highly likely to represent a clinically important change.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e470"},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775298","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":"Vascular endothelial growth factor A inhibition remodels the transcriptional signature of lipid metabolism in psoriasis non-lesional skin in 12 h ex vivo culture.","authors":"Andrea Luengas-Martinez, Dina Ismail, Ralf Paus, Helen S Young","doi":"10.1002/ski2.471","DOIUrl":"https://doi.org/10.1002/ski2.471","url":null,"abstract":"<p><strong>Background: </strong>Vascular endothelial growth factor A (VEGF-A)-mediated angiogenesis is involved in the pathogenesis of psoriasis. VEGF-A inhibitors are widely used to treat oncological and ophthalmological diseases but have not been used in psoriasis management. The molecular mechanisms underlying the effects of VEGF-A inhibition in psoriatic skin remain unknown.</p><p><strong>Objectives: </strong>To identify the genes and canonical pathways affected by VEGF-A inhibition in non-lesional and plaque skin ex vivo.</p><p><strong>Methods: </strong>Total RNA sequencing was performed on skin biopsies from patients with psoriasis (<i>n</i> = 6; plaque and non-lesional skin) and healthy controls (<i>n</i> = 6) incubated with anti-VEGF-A monoclonal antibody (bevacizumab, Avastin®) or human IgG₁ isotype control for 12 h in serum-free organ culture. Differentially expressed genes between paired control and treated samples with adjusted <i>p</i>-values <0.1 were considered significant. Gene ontology and ingenuity pathway analysis was used to identify enriched biological processes, canonical pathways and upstream regulators.</p><p><strong>Results: </strong>VEGF-A inhibition upregulated the expression of genes involved in lipid metabolism. Pathway enrichment analysis identified the activation of pathways involved in fatty acids and lipid biosynthesis and degradation in non-lesional skin and ferroptosis in plaque skin. VEGF-A inhibition downregulated endothelial cell apoptosis in non-lesional psoriasis skin and members of the interferon family were identified as potential regulators of the effects of VEGF-A inhibition in non-lesional skin.</p><p><strong>Conclusion: </strong>Early response to VEGF-A inhibition is associated with changes in lipid metabolism in non-lesional psoriasis skin and cellular stress in psoriasis plaque. More investigation is needed to validate these findings.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e471"},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775413","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":"Accuracy and confidence of Irish general practitioners in diagnosing skin disease in patients with darkly pigmented skin.","authors":"Rachel Rey, Eileen Duggan, Cathal O'Connor","doi":"10.1002/ski2.465","DOIUrl":"https://doi.org/10.1002/ski2.465","url":null,"abstract":"<p><p>Managing skin conditions in patients with darkly pigmented skin (DPS) can be challenging due to inadequate exposure to dermatology in DPS in clinical training. In this study, Irish GPs were less likely to correctly diagnose common skin conditions in patients with DPS (<i>p</i> < 0.001) and had lower confidence levels in diagnosis in DPS (<i>p</i> < 0.001). Lower diagnostic accuracy and confidence with common skin conditions in DPS in primary care may lead to misdiagnosis, suboptimal treatment and increased referrals to dermatology.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e465"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775346","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":"Need of a revised and succinct atopic dermatitis diagnostic criteria for busy outpatient department in Nepalese context.","authors":"Prajwal Pudasaini, Sagar Gc, Mauricio Salas-Garza","doi":"10.1002/ski2.468","DOIUrl":"https://doi.org/10.1002/ski2.468","url":null,"abstract":"","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e468"},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775389","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":"Safety and efficacy of the swift microwave device in patients with mild-to-moderate onychomycosis: Protocol of an open-label, randomized, dose-finding pilot study.","authors":"Aditya K Gupta, Elizabeth A Cooper, Tong Wang","doi":"10.1002/ski2.455","DOIUrl":"https://doi.org/10.1002/ski2.455","url":null,"abstract":"<p><strong>Background: </strong>Onychomycosis is a common fungal nail disease with a prevalence rate up to 14% in North America and 24% in Europe. The current treatment paradigm is limited by a high risk of disease recurrence, safety concerns for oral agents, and a low likelihood of patients achieving both clinical improvement and mycological cure. Recent advances in device-based treatments have allowed for the direct targeting of the infection site that bypasses drug resistance mechanisms while minimizing systemic side-effects. The Swift^® System is a microwave device that has demonstrated therapeutic potential in treating skin (e.g. verrucae vulgaris, actinic keratosis) and nail infections.</p><p><strong>Methods: </strong>We report the protocol of an open-label, randomized, pilot study that will be conducted at a single Canadian center. Our primary objective is to evaluate the safety and efficacy of microwave treatment (Swift^® System, Emblation Ltd, Scotland, U.K.), administered at three different dosing regimens, in 45 patients with mild-to-moderate distal subungual onychomycosis. Our secondary objective is to identify an optimal dosing regimen, if any, to better inform the conduct of a future pivotal trial. Patients will be randomized (1:1:1) to undergo either 9 treatment sessions (5 weekly sessions plus 4 monthly sessions), 7 treatment sessions (3 sessions every 2 weeks plus 4 monthly sessions), or 12 treatment sessions every 2 weeks. At each session microwave energy will be applied in 3-s intervals at 7-9 Watts, repeated up to 5 times at each treatment position on the nail. Overlapping treatment positions are used to ensure sufficient coverage of the infected area. Patients will be enrolled in the trial over a 12-month period. Efficacy will be evaluated based on visual improvement and mycology testing results. Adverse events will be recorded throughout the entire study period.</p><p><strong>Discussion: </strong>This study will be the first to report on the safety and efficacy of microwave treatment in onychomycosis patients in a trial setting; recruitment is ongoing.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05674747.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e455"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775324","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":"Risk factors for actinic keratosis, non-melanoma skin cancer and cutaneous malignant melanoma in persons with and without Parkinson's disease: A cross-sectional study.","authors":"Esther Azizi, Hana Feuerman, Idit Peleg, Felix Pavlotsky, Zvi Segal, Bernice Oberman, Nirit Lev, Emmilia Hodak, Ruth Djaldetti, Sharon Hassin-Baer, Rivka Inzelberg","doi":"10.1002/ski2.464","DOIUrl":"https://doi.org/10.1002/ski2.464","url":null,"abstract":"<p><strong>Background: </strong>An epidemiological link between Parkinson's disease (PD) and cutaneous malignant melanoma (CMM) has been widely reported. The role of CMM risk factors in this association is unclear.</p><p><strong>Objectives: </strong>To compare rates of risk factors for skin tumours, specifically actinic keratosis (AK), non-melanoma skin cancer (NMSC) and CMM, between persons with and without PD.</p><p><strong>Methods: </strong>In this cross-sectional observational study, patients attending tertiary PD clinics and community controls were interviewed for background/medical data and underwent dermatological examination. Logistic regression models assessed risk factors for skin tumours and their interactions with PD status.</p><p><strong>Results: </strong>Included were 141 persons with PD and 155 controls; mean age 71.7 and 72.6 years, respectively. In both groups, the majority were males of Ashkenazi origin. Altogether, AK, basal cell carcinoma, squamous cell carcinoma and CMM were recorded in 76 (53.9%) persons with PD and 92 (59.3%) controls (NS). CMM prevalence predominated in PD patients. In the PD group, prolonged sun exposure (<i>p</i> = 0.007), freckles (<i>p</i> < 0.001) and solar lentigines (<i>p</i> = 0.008) were associated with skin tumours. In the control group, dysplastic atypical moles were negatively associated with skin tumours (<i>p</i> = 0.017). Logistic regression of the whole cohort showed that older age (<i>p</i> < 0.001), fair complexion (<i>p</i> = 0.04) and prolonged sun exposure (<i>p</i> = 0.01) were associated with skin tumours, but PD status was not independently associated, and no interactions were found between PD status and CMM risk factors.</p><p><strong>Conclusions: </strong>Periodic dermatological screening of PD populations is mandatory, especially for carriers of major phenotypic risk factors or presenting with AK, NMSC or CMM.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e464"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775319","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":"Associations between dietary and supplemental vitamin A intake and melanoma and non-melanoma skin cancer.","authors":"Vaishali Mittal, Jodi Y So, Shufeng Li, Susan M Swetter, Eleni Linos, Linda Van Horn, Marian L Neuhouser, Marcia L Stefanick, Jean Y Tang","doi":"10.1002/ski2.462","DOIUrl":"https://doi.org/10.1002/ski2.462","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) are rising in postmenopausal women. Although high doses of oral vitamin A reduce NMSC risk in high-risk patients, the role of vitamin A in preventing skin cancer in this group remains unexplored.</p><p><strong>Objectives: </strong>To determine the association between total (dietary and supplemental) vitamin A and risk of CM and NMSC in postmenopausal women.</p><p><strong>Methods: </strong>This retrospective cohort study included 52 877 White women from the Women's Health Initiative cohort, spanning from 1993 to 2019. Exposures were intake of total vitamin A, retinol and provitamin A carotenoids. Cox proportional hazard models estimated hazard ratios for overall CM incidence, whereas logistic regression determined odds ratios (ORs) for melanoma subtypes and NMSC.</p><p><strong>Results: </strong>1154 cases of CM and 9085 cases of NMSC were identified over an average follow-up period of 17.8 years (SD 6.7). No associations were identified between total vitamin A intake and melanoma risk. Higher dietary vitamin A intake was associated with higher risk of NMSC (OR of 3rd vs. 1st tertile of dietary intake = 1.12, 95% confidence interval [CI] [1.06, 1.18]), as was dietary beta-cryptoxanthin, a provitamin A carotenoid (OR of 3rd vs. 1st tertile of dietary intake = 1.22, 95% CI [1.15, 1.29]); these results were consistent across both age- and fully adjusted regression models.</p><p><strong>Conclusions: </strong>Total vitamin A intake was not associated with lower risk of CM or NMSC. Dietary vitamin A and beta-cryptoxanthin intake were associated with a slightly higher risk of NMSC in postmenopausal women.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e462"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775355","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":"Vitiligo: From mechanisms of disease to treatable pathways.","authors":"Gaurav N Pathak, Isabella J Tan, Ge Bai, Jimmy Dhillon, Babar K Rao","doi":"10.1002/ski2.460","DOIUrl":"https://doi.org/10.1002/ski2.460","url":null,"abstract":"<p><p>Vitiligo is a chronic autoimmune-mediated disease characterised by the loss of pigmentary melanocytes in the epidermis. Vitiligo is associated with loss of functional epithelium and significant reductions in quality of life with limited long-term treatment options, highlighting a continued unmet clinical need. A comprehensive understanding of the pathophysiology and newly investigated treatment pathways may guide multimodal treatment strategies and identify future drug targets. The pathology of vitiligo is multifactorial; however, environmental insults in genetically susceptible populations may lead to disease development. Autoreactive CD8+ T-cells that target melanocytes and release inflammatory mediators, including interferon-γ and interleukins 2, 6, 15, 17 and 33 among others, have been identified in vitiligo pathogenesis. Treatment modalities for vitiligo revolve around six broad disease concepts, including procedural modalities (tissue and cellular grafting), phototherapy, stem cells, anti-inflammatories, genetic polymorphisms and antioxidants/vitamins/herbals. Genetic polymorphisms, such as catalase gene variations and toll-like receptor polymorphisms, along with stem cell targets such as melanocytes derived from stem cells, have been implicated in vitiligo onset and possible treatment. Novel JAK-STAT inhibitors have been recently investigated for vitiligo, whereas topical corticosteroids and calcineurin inhibitors continue to be used. Vitamin D, vitamin E, zinc, copper, piperine, pseudo catalase and other vitamins/herbals may improve vitiligo outcomes primarily through antioxidant supplementation pathways. Future studies should investigate alternative drug pathways and targets implicated in vitiligo in large patient cohorts, as well as treatments that target suspected causative immune cells, including memory T-cells, which may provide long-lasting disease-free remission.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e460"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775416","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}