INTRODUCTION:Acne vulgaris is a common inflammatory dermatosis with a multifactorial pathogenesis. Recent research suggests that alterations in the gut-skin axis and impaired intestinal barrier function may contribute to acne pathogenesis; however, direct evaluation of gut barrier integrity in acne patients remains limited. The objective of this study was to assess intestinal barrier integrity in patients with acne vulgaris by measuring serum intestinal fatty acid-binding protein (I-FABP) levels and to evaluate the association between I-FABP levels and acne severity. METHODS:This single-center, prospective case-control study included 77 patients with acne vulgaris and 77 age- and sex-matched controls without acne. Acne severity was assessed using the Global Acne Grading System. Serum I-FABP levels were measured using an enzyme-linked immunosorbent assay. RESULTS:Median serum I-FABP levels were significantly higher in patients with acne vulgaris than in controls (32.03 [7-107] pg/ml vs. 22.81 [12-189] pg/ml, p = 0.002). I-FABP levels differed significantly across acne severity grades (p < 0.001), with progressively higher levels observed from mild to very severe acne. A strong positive correlation was identified between acne severity and serum I-FABP levels (Spearman r = 0.797, p < 0.001). No significant association was found between I-FABP levels and body mass index. CONCLUSIONS:Serum I-FABP levels are significantly elevated in patients with acne vulgaris and correlate strongly with disease severity. These findings support the hypothesis that impaired intestinal barrier function may contribute to both the development and progression of acne vulgaris, highlighting the potential role of the gut-skin axis in acne pathogenesis.
Phacomatosis pigmentovascularis (PPV) is a term encompassing a group of disorders characterized by the coexistence of segmental pigmented nevi of melanocytic origin and segmental capillary nevi. Several variants are characterized by a hallmark nevus cesius. Systematic reviews on the topic are lacking. An extensive review and critical reassessment of worldwide literature was carried out. A total of 435, 17, 19, and 17 cases of phacomatosis cesioflammea, phacomatosis cesiomarmorata, phacomatosis cesioflammeomarmorata, and phacomatosis melanocesioflammea, respectively, were identified. Specific clinical manifestations emerged for each variant. Postzygotic mosaic mutations affecting the GNAQ or GNA11 genes have been identified for all these entities. Four cases of nevus cesius associated with nevus anemicus (NA) were also retrieved. Phacomatosis cesioflammea is confirmed to be the most common PPV type by far. Its extracutaneous manifestations mostly consist of Sturge-Weber-Klippel-Trénaunay syndrome-like abnormalities, and ocular melanoma is a rare but relevant occurrence. The clinical associations of phacomatosis cesioflammeomarmorata mostly seem to result from the presence of cutis marmorata telangiectatica congenita. Phacomatosis cesioflammeomarmorata seems to resemble phacomatosis cesioflammea in several respects. A high frequency of NA and the Klippel-Trénaunay phenotype (or leg-length discrepancy) was observed in phacomatosis melanocesioflammea. The existence of "pseudodidymosis cesioanemica" is also corroborated.
A well-defined jawline is an important aspect of facial aesthetics, contributing to overall appearance. This feature is particularly sought after by individuals, especially older adults, who are interested in enhancing their facial contours. This systematic review and meta-analysis evaluates safety and effectiveness following use of VYC-25L, a hyaluronic acid-based injectable gel, for restoration of jawline definition. VYC-25L is a soft tissue filler designed to add volume, lift, and contour to the jawline area, providing a non-surgical solution for improving facial aesthetics. This meta-analysis included two randomized controlled trials and three cohort studies of international databases-PubMed, EMBASE, Web of Science, and Cochrane Library-from January 2015 to May 2025, using keywords aligned with the study objective. The VYC-25L group had significantly higher responder rates on the Allergan Loss of Jawline Definition Scale (ALJDS) compared to the control group (71%; p < 0.001; 95% confidence interval [CI] [48%, 94%]). The most common event was swelling (effect size [ES]: 81%; 95% CI [69%, 92%]), lumps/bumps (ES: 83%; 95% CI [66%, 99%]), pain after injection (ES: 79%; 95% CI [62%, 96%]), and tenderness to touch (ES: 76%; 95% CI [61%, 92%]). In summary, VYC-25L appears to be an effective treatment for jawline definition, with a predictable adverse event profile.
INTRODUCTION:Term and preterm newborns have differences in skin structure. Preterm newborns have skin structures that are more susceptible to various disorders. These differences are believed to impact skin pH regulation and bacterial colonization, particularly Staphylococcus spp. This study investigates the acidity difference and skin Staphylococcus spp. colonization in preterm and term newborns. METHODS:This is a descriptive observational study with a cross-sectional design. The study compared skin pH and Staphylococcus spp. colonization between term (37-41 weeks) and preterm (28-36 weeks) newborns. Skin pH was measured using a skin pH meter, and Staphylococcus spp. colonization was assessed through bacterial identification and colony-forming unit (CFU) testing. Assessments were conducted within the first 24 hours of life. RESULTS:There were 29 participants in this study: 16 preterm newborns and 13 term newborns. The preterm group was dominated by subjects with alkaline skin pH (80%), and the term group was dominated by subjects with acidic skin pH (71%). Positive Staphylococcus spp. colonization was more prevalent in the preterm group (62%) than in the term group (38%). CONCLUSIONS:Skin pH differed between preterm and term newborns, with relatively higher skin pH in the preterm group. Staphylococcus spp. was also more prevalent in the preterm group.
INTRODUCTION:The coexistence of skin diseases is common. Although molecular studies have made significant efforts to understand each disease entity, the shared molecular basis explaining their concurrence remains largely unknown. This study aims to identify common upregulated genes in skin diseases that may serve as potential biomarkers. METHODS:Gene expression datasets were retrieved from online databases and compared to healthy controls, focusing on genes common between concurrent diseases. The pathways these molecules are involved in were then analyzed, and their protein-protein interactions were illustrated. RESULTS:The analysis revealed that SLC44A5 is strongly upregulated in psoriasis and vitiligo; ARNTL2 is upregulated in lichen planus and vitiligo; HIST1H2BG is upregulated in lichen planus and psoriasis; S100A7A is upregulated in psoriasis and alopecia areata; CXCL9 is strongly upregulated in vitiligo and alopecia areata, as well as in lichen planus and alopecia areata, and cutaneous lupus erythematosus and lichen planus; and SERPINB4 is upregulated in acne and rosacea. CONCLUSIONS:This study enhances the understanding of skin disease concurrence and lays the groundwork for studying these diseases at a genomic level. It also helps identify common therapeutic targets that work for coexisting diseases.
Alopecia is a multifactorial disorder involving disruption of immune, oxidative, apoptotic, and regenerative pathways in the hair follicle microenvironment. Despite therapeutic advances, clinical responses remain inconsistent, partly due to the limited understanding of underlying molecular targets. Integrating biomarker data may help clarify disease mechanisms and guide more targeted interventions. This review synthesizes in vivo animal evidence on six key biomarkers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, malondialdehyde (MDA), caspase-3, vascular endothelial growth factor (VEGF), and β-catenin-and integrates their therapeutic implications into a biomarker-centered framework. A systematic search identified 15 animal studies (2014-2024) evaluating these biomarkers in alopecia models. TNF-α and IL-6 were generally elevated, indicating inflammation and immune-mediated follicular damage, whereas MDA reflected oxidative stress and caspase-3 activation marked apoptosis-driven regression. In contrast, VEGF and β-catenin were suppressed in alopecia but restored by effective interventions, supporting angiogenesis and Wnt-mediated regeneration. Various therapeutic approaches, including botanical extracts, bioactive compounds, sustained-release finasteride, microneedling, and nanoparticle-based delivery systems, were shown to reduce destructive biomarkers while enhancing regenerative pathways. Overall, alopecia can be conceptualized as an imbalance between degenerative and regenerative mechanisms, and a biomarker-guided therapeutic map may provide a useful translational framework for developing more precise and multitargeted treatment strategies.
Amyopathic dermatomyositis (AD) is an autoimmune connective tissue disease of uncertain etiology that comprises 20% to 30% of dermatomyositis patients. Multiple studies suggest an association between malignancies and AD; moreover, some also report fulminant lung disease in patients with AD. We present a 62-year-old female patient with severe clinical presentation of AD, characterized by diffuse severe alopecia and pronounced symmetrical livid edema of the upper and lower eyelid, and positive anti-melanoma differentiation-associated gene 5 (anti-MDA-5) antibodies, who was successfully treated with concurrent therapy with hydroxychloroquine, methylprednisolone, and methotrexate as well as topical corticosteroids. Underlying malignancies or lung disease were excluded. Furthermore, we recommend vigilance in the key differential diagnosis of cutaneous lupus erythematosus because they can both present with similar clinical and histopathological features. The remission correlated with the complete absence of anti-MDA-5 antibodies.
Generalized bullous fixed drug eruption (GBFDE) is a rare and severe adverse drug reaction characterized by widespread blisters and erosions involving at least 10% of the body surface. GBFDE can mimic Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), both clinically and histologically. We present the case of a 76-year-old woman with extensive painful blisters and erosions affecting approximately 70% of her skin, including the oral and genital mucosa, accompanied by an impaired general condition, strongly suggesting TEN. However, the absence of Nikolsky's sign, together with slate-gray hyperpigmentation, pointed toward GBFDE, later supported by histopathological analysis. Paracetamol was identified as the most likely causative agent. Following discontinuation of the culprit drug, the patient was treated with high-dose corticosteroids and antibiotics within a multidisciplinary care approach. After 3 weeks of hospitalization, the skin lesions healed with residual hyperpigmentation, and her condition stabilized. Our case highlights the challenge of differentiating between two uncommon severe disorders with overlapping clinical and histopathological features, including extensive epidermal necrosis and subepidermal blistering. Clinical and pathological correlation by experienced physicians is essential for distinguishing GBFDE from TEN because their management strategies differ, impacting both patient outcomes and healthcare costs.
Zosteriform reactions triggered by the recombinant shingles vaccine (Shingrix) have been described in only two patients although many more cases that might be dermatomal seem to have been reported to regulatory agencies. It appears that these reactions may be caused by two different pathomechanisms: paradoxical reactivation of varicella zoster virus (VZV) or immune-mediated reactivity to already deposited virus or its antigens boosted by the vaccine. Our patient's cutaneous reaction favors the latter explanation because she developed quite a disseminated reaction that did not respond to oral valacyclovir. Apart from the interesting immunological underpinnings of the reactions, these reports suggest that physicians should test such lesions for the presence of VZV DNA to guide management. If viral DNA is absent and/or antivirals fail, a short-term course of oral corticosteroids should be considered.
INTRODUCTION:Given the limited data on primary cicatricial alopecias (PCAs), which cause permanent hair loss, this study investigates the demographic and clinical characteristics, applied treatments, and disease course of PCA patients. METHODS:Medical records of 109 PCA patients that attended an outpatient clinic between 2010 and 2025 were retrospectively reviewed. Demographic and clinical characteristics, and treatment approaches were retrieved from patient files. RESULTS:Lymphocytic PCA (83.5%) was the most frequent type, followed by neutrophilic PCA (15.6%). Classic lichen planopilaris (LPP-C) was the leading lymphocytic subtype (39.4%), and folliculitis decalvans (12%) was the most common neutrophilic PCA. Lymphocytic PCAs showed female predominance, whereas male predominance was present in neutrophilic PCAs (p < 0.001). Disease onset occurred at an older age in lymphocytic PCAs compared to the neutrophilic group (42.0 ± 11.8 and 30.2 ± 11.4 years, p < 0.001). Pain and nodule/pustule formation were more frequent in neutrophilic PCAs (p < 0.001). Topical/intralesional corticosteroids and hydroxychloroquine were mainly used in lymphocytic PCAs, whereas oral antibiotics and isotretinoin were preferred in neutrophilic PCAs. CONCLUSIONS:PCA frequency may vary geographically. LPP-C was the most common subtype. Early diagnosis and timely treatment are essential to prevent irreversible hair loss and optimize cosmetic outcomes.
INTRODUCTION:Pyoderma gangrenosum (PG) is a rare destructive neutrophilic dermatosis of unknown etiology, associated with systemic diseases in approximately 50% to 75% of cases. METHODS:We conducted a search of the hospital database to retrieve medical records of patients diagnosed with PG at our facility between 1995 and 2019. The diagnosis was validated through clinical characteristics, histopathological examination, and necessary tests to rule out other dermatoses. Data on demographics, disease presentation, comorbidities, and treatment strategies were collected and evaluated. RESULTS:The analysis included 44 patients, 27 (61.4%) females and 17 (38.6%) males. The median age at presentation was 46.5 years (range 15-73). The most common location was the lower leg, in 32 (72.7%) patients. The ulcerative variant was found in 37 (84.1%) patients. In 11 patients (25%) an association with inflammatory bowel disease (IBD) was found. Hematological disorders occurred in five (11.4%) patients and rheumatoid arthritis in four (9.1%). Treatment was started with systemic corticosteroids (CS) in 36 (83.7%) patients, and pulse corticosteroid therapy was administered in five (11.4%) patients. The most frequently used steroid-sparing agent was dapsone, in 18 (40.9%) patients. CONCLUSION:PG often presents with associated systemic conditions, but it may also appear idiopathically. CS remain the mainstay of treatment, complemented by immunosuppressants and biologics such as infliximab for IBD-associated cases.
Intravenous administration of high-dose vitamins, minerals, amino acids, coenzyme Q10, α-lipoic acid, glutathione, and nicotinamide adenine dinucleotide has emerged as a popular longevity therapy, targeting key molecular processes, oxidative stress, mitochondrial decline, chronic inflammation, and genomic instability, which drive and accelerate aging. The rationale is that intravenous administration facilitates supraphysiological plasma concentrations, bypassing gastrointestinal absorption limitations to more effectively target these age-promoting mechanisms. Evidence from preclinical models and small clinical series reports transient reductions in oxidative biomarkers, modest improvements in fatigue syndromes, and anecdotal enhancements in skin elasticity. However, these findings are predominantly derived from disease-specific or aesthetic contexts rather than studies involving healthy aging populations. Crucially, few studies incorporate validated biomarkers of aging such as epigenetic age or telomere length, and placebo-controlled trials are scarce and underpowered or they yield conflicting results. Additional challenges include pharmacokinetic limitations, procedural risks, and substantial heterogeneity of infusion protocols, all of which hinder reliable interpretation. Until rigorously designed, adequately powered randomized controlled trials demonstrate reproducible long-term efficacy and safety, intravenous longevity therapy should be regarded as an experimental intervention rather than an evidence-based dermatological or anti-aging practice.
INTRODUCTION:There are still many gaps in the understanding of melanoma subtypes in Mexico. Currently, there is a growing search for prognostic markers and potential therapeutic targets for melanoma treatment. Nestin has been identified as a marker of angiogenesis, invasiveness, and shortened survival in various tumor types, and therefore we evaluated nestin expression in two types of melanoma tissue to investigate its possible clinical and pathological associations. METHODS:Immunohistochemistry using a polyclonal antibody was performed on selected paraffin blocks. Nestin expression was assessed by two independent dermatopathologists, yielding a kappa index of 0.83 (indicating almost perfect agreement). Nestin expression levels in these types of melanoma were evaluated in relation to Breslow index, Clark level, ulceration, and mitotic rate. Statistical analysis was performed using Pearson correlation, chi-square tests, and analysis of variance (ANOVA). RESULTS:Eighty-three melanoma cases were diagnosed based on clinical and histopathological criteria: 47 were nodular melanoma, and 36 were acral lentiginous melanoma. High nestin expression was mainly found in nodular melanoma (p = 0.0001). This subtype was also more frequently associated with a deeper Clark level of invasion and showed a 37.5-fold increased risk of histological ulceration. A lower but relevant level of nestin expression was observed in acral lentiginous melanoma, which has rarely been reported in the literature. CONCLUSIONS:Elevated nestin expression was statistically associated with nodular melanoma and a deeper Clark level of invasion. In addition, it was significantly linked to an increased risk of histological ulceration.
INTRODUCTION:Celebrity disclosures of health conditions can influence public awareness and searches for health information. On August 30th, 2025, Gordon Ramsay announced on Instagram (> 19 million followers) that he had undergone surgery for basal cell carcinoma (BCC). This study evaluates the impact of this announcement on online search behavior. METHODS:Google Trends data were analyzed for the terms "Gordon Ramsay," "basal cell carcinoma," "skin cancer," "photoprotection," and "sunscreen" worldwide and in the United Kingdom from August 2023 to September 2025. Wikimedia Pageviews Analysis was used to assess daily visits to the BCC article in multiple languages. RESULTS:Ramsay's announcement generated a marked but transient surge in searches for "basal cell carcinoma," with an associated 1,800% increase in combined queries and a 218% rise in daily Wikipedia pageviews. The effect was most prominent in English-speaking countries and briefly in the Czech Republic following local media coverage. No increase was observed for prevention-related terms. Comparisons with other celebrities show that Ramsay had the highest impact over the past 9 years. CONCLUSIONS:Celebrity health announcements can trigger immediate spikes in public information seeking, but the effect is brief and geographically limited. However, heightened awareness may not necessarily lead to sustained engagement or preventive behavior.
Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer. Although it has a good prognosis, cSCC of the ear is associated with a poorer outcome. Reconstruction following total ear amputation because of a cSCC of the ear can be challenging, especially in elderly patients. Currently, to the best of our knowledge, the number of published articles discussing reconstruction modalities following total ear amputation is relatively limited. A 95-year-old patient presented with an advanced form of cSCC of the left ear. Total ear amputation and defect reconstruction using a large preauricular transposition flap was performed. Because the patient was blind, there was no need to save the helix fold or tragus as an eyewear holder. Postoperative flap viability was good and, after complete site healing, the patient and his family were satisfied with its aesthetic appearance. Histopathological analysis showed poorly differentiated cSCC penetrating the surface of the auricular cartilage, with wide clear surgical margins. Total ear amputation in cases of advanced cutaneous carcinomas is very rare and lacks reconstructive modalities. In this patient, it provided him with tumor-free status as well as a satisfactory aesthetic appearance with good quality of life.
INTRODUCTION:Cutaneous melanoma (CM) is the most aggressive cutaneous malignancy. The aim of the study was to determine the predictive value of primary tumor histopathologic features and laboratory findings used in routine CM follow-up for sentinel lymph node biopsy (SLNB) results and progression-free survival (PFS). METHODS:This retrospective study included 157 patients. Planar images were acquired after an intradermal injection of 18 to 30 MBq of 99mTc-nanocolloid in 0.3 ml at two to eight sites 5 to 10 mm from the surgical scar. SLN excision was performed a day after lymphoscintigraphy. RESULTS:In a logistic regression analysis, Breslow thickness, ulceration status, and mitotic rate showed possible predictive significance for SLNB results, with serum lactate dehydrogenase (LDH) being the only independent predictor (p = 0.042). The difference in survival distributions reached statistical significance for Breslow thickness, mitotic rate, and LDH (p < 0.05, Kaplan-Meier, log-rank test). In a Cox regression analysis, Breslow thickness was a possible predictor of PFS and mitotic rate was an independent predictor (p = 0.025). CONCLUSIONS:LDH is an independent predictor of SLN histopathology findings, and mitotic rate is an independent predictor of PFS.
INTRODUCTION:Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) share transmission routes and cause significant morbidity and mortality worldwide. Three previous nationwide studies reported a low prevalence of HCV infection among Slovenian people living with HIV (PLWH). METHODS:Data were collected de novo from 526 PLWH newly diagnosed with HIV in Slovenia between January 1st, 2014, and December 31st, 2024, and combined with data from previous studies on this topic. RESULTS:Altogether 1,085 (93%) PLWH were tested for HCV at HIV diagnosis: 82 (7.6%) had anti-HCV antibodies (49 or 59.8% of them viremic), and three had HCV RNA only, resulting in an HCV prevalence of 7.8%. A significant increase in the prevalence of HCV infection has been observed over the last decade. HCV infection was significantly associated with female sex, foreign nationality, parenteral HIV transmission route, and non-B HIV subtype. The most frequent HCV genotypes were 1 (60%), 3 (22%), and 4 (16%), markedly different than previously found in the general population. CONCLUSIONS:The overall prevalence of HCV infection among PLWH in Slovenia remains low, but a significant increase has been observed in the last decade compared to the previous one. Such a situation requires further regular and tight monitoring to allow timely interventions if and when needed.
Giant cutaneous melanoma is a rare presentation characterized by significant morbidity and mortality. We report the case of a 45-year-old male presenting with an acute life-threatening hemorrhage from a giant melanoma on his right thigh. The tumor, measuring 90 × 50 × 85 mm, was immediately excised under local anesthesia to achieve hemostasis. The patient exhibited acute anemia and required postoperative blood transfusion. Histopathological analysis confirmed superficial spreading melanoma with a Breslow thickness of 85.0 mm and extensive ulceration. Genetic testing identified critical mutations, including BRAFV600D and alterations involving the ARID2, CDKN2A/B, AKT3, PTEN, and HRAS genes. Remarkably, no metastatic disease was detected upon thorough diagnostic evaluation. The patient received adjuvant immunotherapy with programmed cell death-1 inhibitors. Six months after the procedure, he remains free of metastasis. This case underscores the urgent need for timely recognition and intervention in giant melanoma with acute complications. It also highlights the effectiveness of modern adjuvant therapies in improving prognosis.
