BACKGROUND:Predominance of myeloperoxidase immunoreactive mononucleated cells in the dermal infiltrate defines histiocytoid Sweet's syndrome. These cells are believed to represent immature myeloid cells of granulocytic lineage, and the authors suppose that they could be present in other neutrophil-rich inflammatory dermatoses. AIM:This report aimed to investigate CD163 and/or MPO expression on mononuclear cells in dermatoses with tissue neutrophilia not previously considered. METHODS:A double immunostaining protocol with CD163 and MPO primary antibodies was applied to skin biopsies of 4 groups of neutrophil-rich dermatoses: Sweet's syndrome, acute neutrophilic vasculitis, type 2 leprosy reaction, and sporotrichosis. RESULTS:CD163 + MPO- and CD163 + MPO+ macrophages were present in all groups, ranging from less than 10% to more than 50% and from less than 10% to 10%‒50% of positive cells, respectively. CD163 - MPO+ histiocytoid cells were detected in all groups, except in the acute neutrophilic vasculitis group. STUDY LIMITATIONS:The present study was unicentric with a small number of cases, and then loss of a more refined statistical analysis. CONCLUSIONS:Besides the identification of MPO immunoreactive macrophages by a double immunostaining protocol, CD163 - MPO+ histiocytoid cells were found not to be restricted to classic neutrophilic dermatosis, and tissue neutrophilia does not imply the presence of immature myeloid cells.
BACKGROUND:Systemic metabolic and cardiovascular alterations have been reported in vitiligo, yet Epicardial Fat Thickness (EFT) and echocardiographic structural changes remain understudied. This study compares these parameters between vitiligo patients and healthy controls and examines their association with disease severity. METHODS:In this case-control study, 90 adults with vitiligo and 90 matched controls underwent standardized transthoracic echocardiography with multi-window EFT assessment (parasternal, apical, subcostal). Clinical and lipid indices were recorded. Associations with disease severity were evaluated using Spearman correlations and multivariable linear regression, adjusting for age, sex, BMI, blood pressure, LDL, fibrinogen and CRP. ROC analyses assessed the discriminatory value of biomarkers for high-severity disease. RESULTS:Vitiligo patients demonstrated significantly higher EFT across all echocardiographic windows (p ≤ 0.002) and larger left atrial and ascending aorta diameters (p ≤ 0.010). In multivariable models, vitiligo independently predicted mean EFT (B = 0.82, p = 0.003) and aortic valve gradient (B = 1.13, p = 0.019). VASI/BSA correlated strongly with triglycerides, VLDL, TG/HDL ratio, and atherogenic index of plasma (r = 0.574-0.681, all p < 0.001), and with both aortic gradient and EFT. The acrofacial phenotype exhibited the most adverse metabolic and echocardiographic profiles. STUDY LIMITATIONS:Comorbidity-based exclusion criteria enhance internal validity but limit generalizability, and systematic lifestyle data were unavailable. CONCLUSIONS:Vitiligo is independently associated with increased epicardial fat, adverse triglyceride-related atherogenic indices, and subtle cardiac structural alterations, even without overt comorbidities. These findings are most pronounced in patients with higher VASI severity and acrofacial or widely distributed disease, supporting consideration of cardiovascular assessment in these subgroups.
Background Lichen planopilaris (LPP) is the most common form of primary cicatricial alopecia. Areas of alopecia are permanent; thus, hair transplantation becomes a potential cosmetic alternative. Objective To review the evidence of the efficacy of hair transplantation in patients with LPP. Methods The authors conducted a systematic review across four databases: Web of Science, PubMed, SciELO, and Cochrane. The authors analyzed studies describing the use of hair transplantation in patients with LPP, in any of its subtypes. Articles published from the inception of each database through October 2025 were included. Data from each study were summarized in tables. When possible, quantitative variables were grouped and expressed as frequencies or means. Results The authors included thirteen studies (113 patients): eight were case series (61.5%) and five articles were individual case reports (38.5%). 64.8% patients had frontal fibrosing alopecia, while 35.2% had the classic subtype. Hair transplantation was performed in patients with no clinically active disease in ten studies (101 patients). Nevertheless, the duration of quiescence prior to transplantation varied widely, ranging from 0 to 60 months. In most cases, survival rates were between from 80%‒100% at 6‒12 months, 71%‒100% up to 24-months, and below 41% after the second year. Study limitations No prospective studies or clinical trials were identified. There was a marked heterogeneity in the reported data, and follow-up times were inconsistent. Conclusions Hair transplantation may be considered as a cosmetic alternative for patients with LPP. However, a clear decline in graft survival rate was noted after the second year.
Psoriasis is a chronic inflammatory condition with systemic comorbidities and significant impacts on quality of life. Its prevalence in indigenous populations is poorly understood, limiting targeted health interventions. This scoping review aims to review the prevalence of psoriasis in indigenous communities globally, identify genetic, environmental, and socioeconomic influences, and explore barriers to accurate diagnosis and care. A search of PubMed, Ovid MEDLINE, Cochrane Library, and Scopus identified 30 studies, of which 15 met inclusion criteria, encompassing 13 Indigenous populations across six continents. Almost all indigenous groups exhibited markedly lower psoriasis prevalence compared to global estimates, with zero prevalence reported in the Taiwan Ami, Tanzanian Maasai, and Aboriginal groups in Brazil and Peru, and anecdotally rare in Aboriginal people of Australia, Native Alaskans, First Nation Canadians, and Native Americans. The majority of indigenous populations demonstrated a lower prevalence of psoriasis than their respective national population. Factors including protective genetic and environmental triggers, degrees of ultraviolet exposure, environmental influences, and cultural and traditional lifestyles are postulated explanations. However, limited access to specialists, diagnostic challenges in skin of colour, and cultural differences impede accurate estimation of prevalence. Standardised research methodologies and culturally sensitive healthcare strategies are crucial to address disparities and improve recognition in these communities.
Background Eosinophilic Fasciitis (EF) is a rare immune-mediated fibrosing disorder of the fascia. Immune Checkpoint Inhibitors (ICIs) have transformed oncologic therapy but may precipitate immune-related Adverse Events (irAEs), including dermatologic and rheumatologic manifestations. ICI-associated EF has been increasingly reported, yet remains poorly characterized. Objective To systematically summarize the clinical features, diagnostic approaches, management strategies, and outcomes of ICI-associated EF. Methods A systematic review was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, EMBASE, and Web of Science were searched from inception through January 2026. Eligible studies were case reports, case series, or observational studies describing adult cancer patients who developed EF temporally associated with ICI therapy. Two reviewers independently screened studies, extracted data, and assessed methodological quality using Joanna Briggs Institute tools. Results Among 148 records identified, 93 remained after removal of 55 duplicates; 28 full-text articles were assessed and 18 met inclusion criteria, representing 22 unique patients. Nivolumab and pembrolizumab were the most frequently implicated agents. EF onset ranged from several weeks to months after ICI initiation. The most commonly affected regions were the extremities. Diagnosis was confirmed by histopathology and/or imaging in most cases. Systemic corticosteroids were the main treatment, with additional immunosuppressive agents used in selected patients. Most cases showed partial or complete clinical improvement. Study limitations Evidence is limited to case reports and small case series, with heterogeneous reporting, precluding incidence estimation and limiting generalizability. Conclusions ICI-associated EF is a rare but clinically relevant irAE with dermatologic and connective tissue involvement. Early recognition and multidisciplinary management are essential to prevent long-term morbidity.
