This review provides a comprehensive overview of perianal eczema, a chronic inflammatory cutaneous disorder that significantly impacts patients’ quality of life. The paper explores the multiple factors involved in its etiology, including immune imbalance, microbiota dysbiosis, and neuroimmunomodulation. It discusses the clinical manifestations of perianal eczema, which are diverse and often require differentiation from other perianal diseases. The review also outlines the various treatment strategies, ranging from topical medications and systemic therapies to physical or surgical interventions. Furthermore, it highlights future directions in treatment, such as fecal microbiota transplantation, precision medicine, and multidisciplinary collaboration. By summarizing the current research and advances in the field, this review aims to improve the understanding and management of perianal eczema.
Psoriasis is a chronic, immune-mediated, hereditary inflammatory disease involving the integumentary and musculoskeletal systems. Globally, it is recognized as a challenging and currently incurable condition that significantly impairs patients’ quality of life. Therefore, elucidating its underlying pathogenesis and identifying novel, effective therapeutic strategies are of great importance. Genomic studies have shown that the majority of human gene sequences encode noncoding RNAs, among which circular RNAs (circRNAs) represent a unique and functionally diverse subclass. CircRNAs are involved in the regulation of immune responses, inflammation, and cell proliferation through various molecular mechanisms. Increasing evidence suggests that circRNAs play critical roles in the pathogenesis of psoriasis. Numerous circRNAs have been found to be differentially expressed in psoriatic lesions compared with healthy, nonlesional skin. As such, specific circRNAs may serve as potential diagnostic biomarkers or therapeutic targets in psoriasis. In this review, we summarize the circRNAs that are differentially expressed in psoriasis and discuss their associated biological functions, with a focus on their potential roles in diagnosis and treatment.
Background Pemphigus is an immune-mediated bullous skin disorder that can be fatal. It is typified by flaccid blisters and erosions of the skin and mucous membranes. The majority of pemphigus patients develop an immunoglobulin E autoantibody response. Galectin-3 (Gal-3) and soluble CD23 are the two primary components of the immunoglobulin E. It is unclear exactly what role Gal-3 plays in pemphigus disease. One of the vital body fluids that can indicate a person's illness or normal internal features is saliva. Neither the serum nor salivary Gal-3 roles have been identified in pemphigus. Objectives We aimed to measure the serum and salivary levels of Gal-3 in pemphigus patients and to find out if there are any relationships between their levels and the Autoimmune Bullous Skin Disease Intensity Score, which measures disease activity. Patients and methods Thirty patients with a confirmed diagnosis of pemphigus disease and 30 healthy controls were enrolled. Human Gal-3 enzyme-linked immunosorbent assay was used to measure Gal-3 levels in serum and saliva. Results A statistically significant increase in serum and salivary Gal-3 levels among cases (mean +/- SD: 18.58 +/- 3.50 and 117.09 +/- 32.83) relative to healthy controls (mean +/- SD: 6.69 +/- 1.92 and 93.06 +/- 26.60; P<0.001 and P=0.003, respectively). Statistically significant positive correlations were found between serum and salivary Gal-3 levels versus Autoimmune Bullous Skin Disease Intensity Scores. Conclusion Pemphigus patients had higher serum and salivary Gal-3 levels compared to healthy controls. Thus, measuring Gal-3 levels in serum and saliva might be a future tool in pemphigus diagnosis and monitoring disease severity.
BackgroundThe hallmark of chronic obstructive pulmonary disease (COPD) is excessive systemic inflammation that impacts the skin and other body systems. Growth hormone (GH) is known to be a characteristic biological marker of aging. Red cell distribution width (RDW) has emerged as a biomarker of the aging process and for evaluating the severity of COPD.ObjectiveThis study aimed to evaluate skin aging in COPD patients using GH as a biological marker of aging, in addition, to assessing the relationship between RDW values and skin aging in COPD patients.Patients and methodsForty-five patients diagnosed with COPD and 45 healthy controls were enrolled in this study. The SCINEXA score was used to measure clinical skin aging. A peripheral blood sample was collected from each patient and control to perform complete blood count, including RDW and analyze GH level.ResultsIntrinsic, extrinsic, and total SCINEXA aging scores, RDW-coefficient of variation (CV%) and GH level were significantly higher in the patients than the control group. There was a statistically significant relation between total SCINEXA score and age, smoking history, RDW-CV%, and GH. The smoking history and RDW-CV% were significantly independent variables related to the total SCINEXA score.ConclusionOur study pointed out that the age and smoking history of the COPD patients may have an impact on the relationship between skin aging and COPD. As indicated by elevated GH, systemic inflammation in COPD may result in some endocrine changes. Furthermore, the RDW% value may be used as a biomarker to determine the degree of skin aging.
Xeroderma pigmentosum (XP) is a rare DNA repair disorder characterized by hypersensitivity to ultraviolet light and increased risk of skin malignancies. We report a 12-year-old boy presenting with an ulcerated lesion over the nasal bridge with photosensitivity and freckling with no neurological or ocular complaints. Dermoscopy from ulcerated plaque showed keratotic plugs, white structureless areas, and glomerular vessels. Histopathology confirmed the diagnosis as moderately differentiated squamous cell carcinoma. Genetic testing, using whole-genome sequencing, confirmed a pathogenic novel XP group C mutation, expanding the known phenotypic spectrum of XP. The patient was managed by excision of squamous cell carcinoma after staging by ENT surgeon, followed by placement of a myocutaneous rotatory flap. The patient was also started on acitretin as chemoprophylaxis.
Background Neurodermatitis, a prevalent neuropsychiatric dermatological disorder, is characterized by severe and paroxysmal pruritus, as well as skin lichenification. This chronic condition follows a prolonged and progressive course, with recurring episodes that persist for several years without resolution. Furthermore, there is a significant probability of relapse after remission, greatly affecting the patients' quality of life and overall satisfaction. Aims This study aims to formulate Piyanling Liniment and evaluate its clinical efficacy in comparison with Halcinonide Solution for the treatment of neurodermatitis. Patients and methods Piyanling Liniment, a prescription formulation incorporating resorcinol, salicylic acid, fluocinolone acetate, and borneol as its primary constituents, was formulated. A randomized controlled trial was conducted involving 100 patients diagnosed with neurodermatitis seeking treatment at the outpatient dermatology department of our hospital. The patients were divided into two groups: the Piyanling Liniment group, comprising 50 patients treated with Piyanling Liniment, and the Halcinonide Solution group, comprising 50 patients treated with Halcinonide Solution. Both groups applied the respective treatments twice daily at a dosage of 0.5 ml/cm(2). Clinical symptoms, including the skin lesion area, skin lesion degree, pruritus degree, and pigmentation degree, were assessed before treatment and after 4, 7, 10, and 14 days of treatment to evaluate therapeutic efficacy and compare the occurrence of adverse drug reactions. Results After 14 days of treatment, it was observed that Piyanling Liniment exhibited superior therapeutic efficacy in terms of reducing skin lesions, alleviating pruritus, and restoring pigmentation compared with Halcinonide Solution, with a total effective rate of 98.0 and 92.0% in the respective groups. The occurrence of adverse drug reactions was 4.0 and 2.0% in the Piyanling Liniment and Halcinonide Solution groups, respectively. Based on the comprehensive analysis, a significant statistical difference in treatment outcomes was observed between the two patient cohorts (P<0.05). However, no significant disparity was detected in terms of the occurrence of adverse drug reactions between the two groups (P>0.05). Conclusion The formulation procedure of Piyanling Liniment is uncomplicated, demonstrating a favorable safety profile and noteworthy efficacy in the treatment of neurodermatitis. Piyanling Liniment demonstrates promising clinical outcomes, primarily through the reduction of skin lesions, alleviation of pruritus, and restoration of pigmentation. Consequently, it presents itself as a viable therapeutic option for individuals seeking relief from symptoms associated with neurodermatitis.
Background Acne vulgaris (AV) is a persistent inflammatory skin condition most commonly affecting teenagers and young adults. AV pathogenesis is a multifactorial process in which inflammation plays a significant role. Calcitonin gene-related peptide (CGRP) is a neuropeptide that participates in inflammation and vasodilation. Emerging evidence suggests that CGRP may contribute to the pathophysiology of inflammatory skin conditions such as AV. Objective This study assesses CGRP serum levels in patients with AV and analyses its possible influence on acne severity. Patients and methods With the exclusion of patients receiving neurotropic drugs within the past year, patients who were undergoing any form of systemic medical treatment for acne for a minimum of 3 months before the beginning of the study, a case-control study was carried out, including 40 patients with AV and 40 apparently healthy controls matched by age and sex. Serum CGRP levels were estimated using enzyme-linked immunosorbent assay (ELISA) and correlated with acne severity based on standardized clinical grading. Results Patients with AV exhibited significantly higher serum CGRP levels than controls (P<0.001). Moreover, CGRP levels showed a positive correlation with acne severity. Conclusion Elevated CGRP levels in acne patients indicate that CGRP might play a role in the inflammatory processes underlying AV. Targeting CGRP could be explored as a potential therapeutic approach for acne management. Further research is warranted to elucidate the precise mechanisms involved.
BackgroundBoth Tranexamic acid (TXA) and vitamin C have been proved to decrease skin melanin formation and have been prescribed as a treatment for melasma. The work aimed to assess and compare the clinical efficacy of fractional carbon dioxide (CO2) laser with topical TXA versus fractional CO2 laser with topical vitamin C in the treatment of melasma.Patients and methodsA total of 40 female patients with melasma were involved in the study. For each patient, a fractional CO2 laser with TXA solution was applied to the right side of the face, and a fractional CO2 laser with topical Pure L-Ascorbic acid 20% was applied to the left side. Total of four sessions with intervals of 3 weeks in between. Wood's lamp examination, dermoscopy and modified melasma area and severity index (mMASI) before treatment, every session and 3 months after treatment had been done.ResultsThe median values of hemi-mMASI decreased over time for both treatments, in TXA from 3.78 +/- 1.81 to 1.58 +/- 1.19, and in topical vitamin c from 3.71 +/- 1.58 to 1.65 +/- 1.25 indicating an improvement in melasma. There was a statistically insignificant difference between TXA and topical vitamin C at any visit. Still, at the 3-month follow-up after the last session, the median mMASI for TXA remained the same (1.58 +/- 1.32), while it increased for topical vitamin c (1.98 +/- 1.15) with a P value of 0.024.ConclusionTXA plus fractional CO2 laser treatment resulted in a higher percentage of individuals achieving better improvement grades after 3 months of follow-up, indicating a better long-term outcome for TXA.
Angiokeratoma of Fordyce is a benign vascular proliferation localized to the genitalia, often presenting with bleeding or cosmetic concerns. Treatment options vary in efficacy and side effects.To assess the clinical efficacy, safety, and cosmetic outcome of argon plasma coagulation (APC) in the treatment of angiokeratoma of Fordyce, we report a case series of four patients (three males and one female) with clinically diagnosed angiokeratoma of Fordyce, treated using APC under local anesthesia. APC parameters and postprocedure outcomes were recorded. Follow-up was conducted over 8 weeks to evaluate healing, adverse events, and recurrence. All patients achieved complete lesion resolution with excellent cosmetic outcomes and no recurrence or adverse effects within the follow-up period. The procedure was well-tolerated and required minimal downtime. APC represents a safe, effective, and cosmetically favorable option for managing angiokeratoma of Fordyce, particularly in settings lacking laser equipment.
Background Varicocele, characterized by abnormal dilation of the pampiniform venous plexus, is a leading cause of male infertility. Emerging evidence suggests that inflammation, particularly via activation of Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, may play a critical role in varicocele-associated testicular dysfunction. Objective To evaluate seminal NLRP3 inflammasome levels and NLRP3 rs10754558 gene polymorphism in varicocele patients, and assess their association with semen parameters and varicocele grades. Patients and methods This case-control study included 40 patients with varicocele and 40 age-matched healthy controls. Semen analysis assessed sperm concentration, motility, morphology, and leukocytospermia. Seminal NLRP3 levels were measured by enzyme-linked immunosorbent assay, and NLRP3 rs10754558 polymorphism was genotyped using PCR-restriction fragment length polymorphism. Results Varicocele patients showed significantly lower sperm concentration (44.9 +/- 43.9 vs. 53.2 +/- 21.3 million/ml, P=0.019) and motility (10.3 +/- 9.5 vs. 16.0 +/- 10.8%, P=0.014), and higher abnormal morphology (62.4 +/- 13.5 vs. 29.8 +/- 12.1%, P<0.001) than controls. Seminal NLRP3 levels were markedly elevated in varicocele patients (551.9 +/- 134.2 pg/ml) compared to controls (316.7 +/- 66.1 pg/ml, P<0.001), correlating positively with varicocele grade. The GG genotype of NLRP3 rs10754558 was more frequent in varicocele patients (35 vs. 12.5%, P=0.019), and was associated with worse semen parameters and higher seminal NLRP3 levels. Conclusion Elevated seminal NLRP3 levels and GG genotype of NLRP3 rs10754558 are associated with impaired semen quality and higher varicocele grades, indicating that NLRP3 inflammasome activation may contribute to varicocele pathophysiology and infertility risk.
Background The treatment of vitiligo remains challenging. Prostaglandin F2 alpha analogs have emerged as a promising treatment option for vitiligo. Bimatoprost and latanoprost have shown efficacy in previous studies. However, the research on travoprost remains limited. Objectives This research aimed to compare the safety and efficacy of topical travoprost 0.004% ophthalmic solution alone and in combination with either 308 nm excimer light, fractional CO2 laser, or both in treating vitiligo patches in patients with generalized nonsegmental vitiligo refractory to phototherapy. Patients and methods Twenty-six patients complaining of generalized nonsegmental vitiligo refractory to phototherapy completed the study. Four vitiligo patches were randomly chosen in each patient and assigned to one of the following treatment groups: (1) topical travoprost 0.004% ophthalmic solution alone, (2) topical travoprost combined with 308 nm excimer light, (3) topical travoprost combined with fractional CO2 laser, or (4) a combination of the three treatment modalities. The changes in the surface area, Vitiligo Area Scoring Index (VASI score), dermoscopic features, and immunohistochemical analysis using Melan A were assessed. Results The excimer light and travoprost group showed the highest mean percentage of reduction in surface area and VASI score, followed by the triple combination group. Combining fractional CO2 laser and travoprost was associated with an increase in the mean surface area and the mean VASI score of vitiligo lesions. Conclusion Combining excimer light with topical travoprost presents a promising and safe therapeutic option for vitiligo lesions that are unresponsive to conventional phototherapy.
