BACKGROUND:Intravenous immunoglobulin (IVIg) is used in refractory pemphigus, but data linking disease activity, corticosteroid reduction, remission, and post-remission durability are limited. OBJECTIVES:To evaluate early clinical response, corticosteroid exposure, post-IVIg complete remission on therapy (CRon), and relapse-free survival (RFS) in pemphigus treated with IVIg before rituximab. METHODS:In this single-center retrospective cohort study, patients with pemphigus vulgaris or foliaceus treated between 2010 and 2018 were screened. Outcomes were analyzed in those receiving IVIg before rituximab. Mucosal and cutaneous Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and prednisolone exposure, normalized to the initial maximum dose (100%), were assessed. CRon was counted only when first documented after IVIg initiation, and RFS was measured from the CRon date. Missing data were not imputed. RESULTS:Among 100 patients, 37 received IVIg and 36 entered the IVIg-before-rituximab cohort. Prednisolone exposure decreased from 65.59±34.65% at IVIg initiation to 27.55±27.32% at month 6. By month 3, mucosal ABSIS decreased from 17.22±9.17 to 5.96±8.60 and cutaneous ABSIS from 5.00±7.46 to 1.38±2.58 (all p < 0.001). Post-IVIg CRon was documented in 25/36 patients (69.4%). In the primary RFS set (n=21), 10 relapses occurred; RFS was 72.4% at 12 months and 60.8% at 24 months. CONCLUSION:IVIg use was associated with early disease improvement and reduced corticosteroid exposure. Post-remission control was durable among patients achieving post-IVIg CRon, but RFS estimates are conditional on remission. Because background therapy continued, the independent contribution of IVIg cannot be determined.
Glucocorticoid drugs (GCs) are widely used in dermatology due to their potent anti-inflammatory and immunosuppressive effects. While numerous studies have demonstrated that exposure to glucocorticoids-whether due to stress or exogenous administration-can lead to severe ovarian aging, direct evidence regarding whether topical glucocorticoid (GC) treatment for dermatologic conditions affects ovarian aging remains limited. In female C57BL/6 mice (n = 6 per group), we established an excessive topical GC exposure model using an intentionally supratherapeutic fluocinolone acetonide regimen, which caused marked epidermal/dermal atrophy and impaired skin barrier function. Skin injury was evaluated by histological and barrier-marker assessments, and ovarian aging was assessed by estrous cyclicity, follicle counts, ovarian fibrosis, and the expression of AMH, p16INK4a, and γH2AX. In the present study, exogenous GCs caused marked atrophy in both the epidermal and dermal layers of the skin, impairing skin barrier function. These findings suggest that the dosage administered exceeded the therapeutic range, resulting in severe skin aging. However, the estrous cycles of the mice remained normal, and there were no significant differences in ovarian follicle counts, tissue fibrosis, or the protein expression of AMH, p16INK4a, and γH2AX compared to the control group. Under the specific experimental conditions tested, no significant ovarian aging-related differences were detected. However, systemic glucocorticoid exposure was not measured, and the study was not powered to exclude small effects on ovarian function. Therefore, these findings do not establish ovarian safety, and larger and longer-duration studies are required.
BACKGROUND:Comparative real-world evidence on cryotherapy, low-dose oral isotretinoin, and their combination for digital verruca vulgaris remains limited. METHODS:We conducted a retrospective multicenter cohort study of 393 adults treated with cryotherapy (n = 136), isotretinoin (n = 130), or combination therapy (n = 127) from 2022 to 2025. Outcomes included complete clearance by 3, 6, and 12 months, patient-reported outcomes, 12-month follow-up visit completion, and safety. Analyses used multivariable logistic regression, generalized estimating equations, and overlap-weighted propensity score sensitivity analyses. RESULTS:Complete clearance differed across groups by 3 months (54.4% cryotherapy, 60.0% isotretinoin, 75.6% combination; p = 0.001), 6 months (64.7%, 70.8%, 85.0%; p < 0.001), and 12 months (67.6%, 75.4%, 88.2%; p < 0.001). Adjusted models favored combination therapy versus cryotherapy at all timepoints and versus isotretinoin by 6 and 12 months; overlap-weighted analyses were directionally consistent. TSQM effectiveness and global satisfaction were higher with combination therapy. Treatment-emergent adverse events were more frequent with isotretinoin-containing regimens, with no Grade 3 or higher AST/ALT elevations reported. CONCLUSION:Combination therapy was associated with higher observed clearance than either monotherapy in real-world practice. Given the non-randomized design and follow-up attrition, prospective randomized trials are needed to establish comparative effectiveness.
PURPOSE OF THE ARTICLE:This narrative review summarizes current practices and emerging technologies on psoriasis with an emphasis on key genetic and molecular mechanisms that contribute to disease pathogenesis and inform therapeutic development. In particular, genetic associations involving HLA-Cw6, IL-12B, and IL-23R are discussed in the context of immune dysregulation and keratinocyte hyperproliferation. The review aims to contextualize how these mechanistic insights have influenced existing treatments and continue to guide the development of therapeutic strategies. MATERIALS AND METHODS:This review is based on published experimental studies, clinical trials, and authoritative reviews addressing the genetic, molecular, and immunological aspects of psoriasis. The review discusses therapeutic approaches, including topical agents, phototherapy, and traditional regimens such as Goeckerman therapy, alongside systemic agents and biologics targeting TNF-α, IL-17, and IL-23 pathways. Emerging approaches, including molecular therapeutics and nanotechnology driven drug delivery systems are explored as evolving strategies currently under investigation rather than established standards of care. RESULTS AND CONCLUSIONS:The reviewed evidence indicates that advances in genetic and molecular understanding have clarified key mechanisms involved in psoriasis pathogenesis. Genetic markers such as HLA-Cw6, IL-12B, and IL-23R highlight the role of immune dysregulation and keratinocyte hyperproliferation, which has guided therapeutic development. Conventional treatments namely topical agents, phototherapy, and traditional regimens such as Goeckerman therapy, remain important, particularly for mild-to-moderate disease and selected patients. Building on these approaches, systemic agents and biologics targeting TNF-α, IL-17, and IL-23 pathways have significantly improved outcomes in moderate-to-severe psoriasis. Current research is now exploring molecular therapeutics and nanotechnology driven drug delivery systems as adjunct strategies to enhance efficacy and reduce systemic toxicity. However, these approaches are still evolving and are not yet established standards of care. Despite ongoing progress, challenges related to long-term safety, accessibility, and sustained disease control remain. Integrating mechanistic insights with evolving therapies and multidisciplinary care will be essential for advancing psoriasis management.
BACKGROUND:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening mucocutaneous reactions. Although SCORTEN remains the most widely used prognostic tool, its performance in real-world settings may vary according to patient population and clinical context. This study evaluated clinical variables associated with in-hospital mortality in SJS/TEN. MATERIALS AND METHODS:We conducted a single-center retrospective cohort study including 20 patients diagnosed with SJS, SJS/TEN overlap, or TEN between January 2010 and December 2024. Clinical and demographic data were extracted, including SCORTEN, mucosal involvement, etiology, comorbidities, treatment modalities, need for intensive care unit (ICU) admission, organ failure, ICU and ward length of stay. Due to the small sample size, statistical comparisons were exploratory and were performed using appropriate exact and non-parametric tests. RESULTS:The in-hospital mortality rate was 40.0% (8/20; exact 95% CI, 19.1%-63.9%). ICU admission occurred in 8/8 non-survivors and 4/12 survivors (absolute difference, 66.7 percentage points; 95% CI, 24.1 to 86.2; p = 0.005). Respiratory failure, dialysis-requiring renal failure, and malignancy each occurred in 4/8 non-survivors and 0/12 survivors (absolute difference for each, 50.0 percentage points; 95% CI, 12.6 to 78.5; p = 0.014 for each), although these outcomes partly overlapped. Among ICU-admitted patients, the median ICU length of stay was 8.5 days in both outcome groups (Hodges-Lehmann difference, 0 days; 95% CI, -9 to 11; p = 0.958). Neither SCORTEN nor TBSA category was significantly associated with mortality. CONCLUSIONS:In this retrospective single-center cohort, ICU requirement, acute organ failure, and underlying malignancy were more frequent among non-survivors with SJS/TEN. Given the limited sample size and absence of multivariable analysis, these findings should be interpreted cautiously. Larger multicenter studies are needed to clarify prognostic factors and real-world clinical course in SJS/TEN.
BACKGROUND:Radiation-induced skin injury significantly impairs wound healing through excessive oxidative stress, prolonged inflammation, and defective tissue remodeling. Natural bioactive compounds with antioxidant and immunomodulatory properties may offer promising therapeutic alternatives. OBJECTIVE:This study investigated the effect of topical Spirulina platensis on excisional wound healing in γ-irradiated male albino rats. METHODS:Ninety rats were divided into six groups (n = 15/group): control, wound + vehicle, wound + Spirulina, radiation-only, radiation + wound + vehicle, and radiation + wound + Spirulina. Five animals from each group were sacrificed at days 3, 7, and 14. Biochemical parameters included TNF-α, VEGF, EGF, PDGF, MDA, GSH, MPO, and hydroxyproline, alongside histopathological evaluation. RESULTS:Spirulina treatment significantly improved wound healing in irradiated animals, evidenced by reduced oxidative stress (MDA), enhanced antioxidant status (GSH), improved collagen deposition (hydroxyproline), and modulation of inflammatory mediators. Histological analysis confirmed accelerated re-epithelialization and improved dermal architecture. CONCLUSION:Topical Spirulina platensis demonstrates significant therapeutic potential in radiation-impaired wound healing through coordinated antioxidant, anti-inflammatory, and pro-regenerative mechanisms.
Aim Alopecia areata(AA) is a chronic, non-scarring inflammatory disorder that affects hair follicles on the scalp and body.It is increasingly recognized that AA is not merely a dermatological condition limited to localized hair loss but may also be associated with systemic inflammatory processes. Materials and methods This retrospective study included male and female patients older than 4 years of age who were treated with topical diphenylcyclopropenone(DPCP) for moderate-to-severe AA between August 2023 and August 2024.The study comprised 19 female and 19 male patients.Patients who received topical DPCP treatment for AA and underwent complete blood count(CBC) analysis both before and after treatment were included. Results Of the 38 AA cases included in the study, 19 were female(50.0%).The mean Severity of Alopecia Tool(SALT) score at baseline was 87.76 ± 21.80(range: 25-100), while the mean SALT score at Month 6 was 60.21±41.33(range: 0-100), indicating a significant reduction in disease severity(p < 0.01). Significant changes were observed in lymphocyte counts(p = 0.01) and the platelet-to-lymphocyte ratio(PLR, p = 0.02) following treatment.When evaluating which hematological and inflammatory parameters predicted the SALT score at Month 6, an exploratory regression analysis(Adjusted R2 = 0.101) showed that only the change in lymphocyte levels was associated with treatment response(β = 0.354, p = 0.029). Conclusion Our findings suggest that, based on sixmonth evaluation results,DPCP may be an effective treatment option for AA.While it modulates local inflammation, it appears to have a limited effect on systemic immunity; however, this does not result in any significant adverse alterations in hematological and inflammatory biomarkers.Current data suggest that topical DPCP treatment demonstrated a potentially acceptable hematological safety profile in the short-tomedium term.Furthermore, the change in lymphocyte levels may emerge as a potential biomarker for predicting treatment response.
PURPOSE:To quantify the prevalence of pre-visit AI consultation among dermatology outpatients and to assess associated attitudes, anxiety changes, and triage impacts, given that real-world data on generative artificial intelligence (AI) use in dermatology remain scarce. MATERIALS AND METHODS:A cross-sectional survey was conducted at a university dermatology clinic. Data on demographics, AI use characteristics, and attitudes (7-item Likert scale) were collected. Multivariable logistic regression identified predictors of AI use. RESULTS:Among 349 patients (median age 25 years), 61.1% (n = 212/347; 95% CI: 55.9-66.1%) had consulted AI before their visit, predominantly using ChatGPT (77.4%). Younger age (aOR = 0.93) and frequent internet health searching (aOR = 3.43) independently predicted AI use. AI consultation was not associated with a detectable change in self-reported anxiety (Wilcoxon p = 0.836; rank-biserial r = 0.03). For 73.6% of users, AI confirmed an existing decision to seek care, while 17.5% visited because AI indicated severity. Patients strongly rejected AI as a physician substitute (mean 1.66/5) but partially endorsed it for asking informed questions (mean 2.89/5). Patient-recalled symptom-diagnosis plausibility, evaluable in a 33.5% recall subset, was 83.8% (57/68). CONCLUSIONS:Generative AI use is highly prevalent among younger dermatology outpatients. Within the limits of a cross-sectional design, it appeared to function primarily as a confirmatory pre-visit resource and was not associated with increased health anxiety. Patients view AI as an empowerment resource rather than a diagnostic authority.
PURPOSE:Excessive melanin production that results in localized skin darkening is the hallmark of dermal hyperpigmentation, a frequent dermatological disorder. It is primarily induced by ultraviolet exposure, hormonal changes, and inflammatory processes. To develop targeted therapy, it is crucial to determine the exact role of biomarkers, encompassing pro-inflammatory cytokines, growth factors, enzymes, proteins, and genetic markers. With a focus on translational significance and dermal safety, this structured narrative review attempts to assess developments in etiology, biomarker identification, and treatment approaches for dermal hyperpigmentation. MATERIALS AND METHODS:A structured narrative review was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify English-language literature published primarily from January 2005 to March 2026. Evidence was selected based on relevance to dermal hyperpigmentation, with emphasis on studies addressing pathogenesis, biomarkers, and therapeutic strategies. Findings were synthesized qualitatively, with clinical evidence prioritized for therapeutic conclusions and preclinical studies used to describe mechanistic insights and emerging drug delivery approaches. RESULTS:Emerging evidence highlights the involvement of pro-inflammatory cytokines, tyrosinase-related enzymes, and signaling mediators in the pathogenesis of dermal hyperpigmentation. Biomarker-guided therapeutic strategies remain largely supported by mechanistic and early translational evidence, with limited clinical validation. Nanotechnology-enabled drug delivery systems, including liposomes, nano-emulsions, and polymeric nanoparticles, have demonstrated improved skin delivery and therapeutic potential primarily in preclinical studies, while robust evidence demonstrating superior dermal targeting and clinical efficacy in humans remains limited. Current clinical evidence supports only a small number of nano-enabled formulations, emphasizing the need for further well-designed human studies. CONCLUSIONS:Current evidence supports the mechanistic relevance of several biomarkers and highlights the promise of nanotechnology-enabled delivery systems for dermal hyperpigmentation. However, both biomarker-guided therapeutic strategies and advanced nanocarrier platforms remain supported predominantly by preclinical and early translational evidence, with insufficient high-quality clinical validation. Future studies should prioritize standardized biomarker validation, rigorous dermal safety assessment, and well-designed clinical trials to facilitate successful clinical translation.
OBJECTIVE:This study assesses the concentrations and evaluates the dermal exposure risk of heavy metal impurities-including lead (Pb), cadmium (Cd), arsenic (As), antimony (Sb), nickel (Ni), and mercury (Hg)-in 102 cosmetic products marketed in Seoul, Korea. METHODS:Using inductively coupled plasma-mass spectrometry (ICP-MS) and a Direct Mercury Analyzer, metal concentrations were quantified and evaluated against Korean regulatory limits. Health risk modeling was performed using Margin of Safety (MoS), Hazard Quotient (HQ), Hazard Index (HI), and Lifetime Cancer Risk (LCR) models. Dermal absorption (50%) and exposure assumptions were applied based on the SCCS (Scientific Committee on Consumer Safety) Notes of Guidance (12th Revision, 2023). To ensure a conservative risk evaluation, non-detectable concentrations of Cd and Sb were substituted with LOD/2. RESULTS:All detected metal levels were within permissible limits. The mean concentrations for Pb, As, and Ni were 0.058 μg/g, 0.008 μg/g, and 0.095 μg/g, respectively. One-way ANOVA revealed significant differences across cosmetic types for Pb (F[4.97] = 5.679, p < 0.001) and Ni (F[4.97] = 3.642, p < 0.01). Duncan' post-hoc test further indicated that color cosmetics exhibited significantly higher concentrations of Pb and Ni compared with all other cosmetic categories. Additionally, Hg concentrations varied significantly between domestic and imported cosmetic products (p < 0.05). Although Cd and Sb were below the limit of detection (LOD) in all samples, concentrations below the LOD were conservatively substituted with LOD/2 for risk assessment calculations. All MoS values exceeded 100 (6.90 × 103 to 3.17 × 1011), and HQ and HI values were below 1, indicating negligible non-carcinogenic risk under the exposure assumptions applied in this study. LCR values for Pb, As, Ni, and Cd ranged from 2.75 × 10-11 to 5.66 × 10-6. Several values indicated negligible carcinogenic risk (<1 × 10-6), whereas the remaining values were within the USEPA acceptable risk range (1 × 10-6-1 × 10-4). CONCLUSION:While current findings suggest that these products pose negligible health risk under the exposure assumptions applied in this study, continued monitoring and stricter impurity control remain important because real-life aggregate exposure from the concurrent use of multiple cosmetic products may exceed single-product exposure estimates.
BACKGROUND:Skin cancer is one of the most common malignancies worldwide, and early detection is essential for improving treatment outcomes and reducing mortality. Conventional diagnostic approaches rely on visual examination and dermoscopic analysis by dermatologists, which can be time-consuming and subject to inter-observer variability. Recent advances in artificial intelligence have enabled the development of computer-aided diagnostic systems to support clinical decision-making in dermatological oncology. OBJECTIVE:In this study, a deep learning-based framework is proposed for multi-class classification of cutaneous lesions using dermoscopic images. METHODS:The proposed model integrates a Vision Transformer (ViT) to capture global contextual features and a Squeeze-and-Excitation Residual Network (SE-ResNet) to extract channel-refined local features. These complementary representations are combined using an adaptive attention-based fusion mechanism to improve classification performance. In addition, an Improved Crocodile Optimization Algorithm (ICOA) is employed to optimize model hyperparameters and enhance convergence stability. RESULTS:The proposed method was evaluated using the HAM10000, ISIC 2019, and PH2 datasets, achieving classification accuracies of 99.05%, 98.31%, and 99.17%, respectively. CONCLUSION:The results demonstrate the robustness and generalizability of the proposed framework, highlighting its potential as a clinical decision-support tool for early detection and improved diagnosis of skin cancer.
PURPOSE:To investigate the cytological and inflammatory effects of topical antiglaucoma medications on the ocular surface by comparing treated and untreated eyes in unilateral glaucoma patients. METHODS:This observational, case-control study involved 69 patients with unilateral glaucoma, receiving monotherapy with prostaglandin analogues. The untreated fellow eyes served as controls. Tear break-up time (TBUT), Schirmer test, conjunctival impression cytology, and tear cytokine levels [interleukin (IL)-1β and IL-6] were assessed in both eyes. Comparisons between treated and untreated eyes, correlations among ocular surface parameters, and linear mixed-effects analyses according to treatment duration were performed. RESULTS:TBUT was significantly lower in treated eyes than in untreated eyes (p < 0.001), whereas Schirmer test results did not differ significantly (p = 0.318). Conjunctival impression cytology analysis showed that goblet cell count was significantly lower (p < 0.001) and Nelson grading was higher (p < 0.001) in the treated eyes. Inflammatory cytokine analysis revealed significantly elevated levels of IL-1β and IL-6 in the treated group (p < 0.001). Goblet cell count correlated positively with TBUT, whereas both cytokines correlated negatively with goblet cell count. Linear mixed-effects analyses showed that longer treatment duration was associated with greater treated-fellow eye divergence in TBUT and IL-6, but not in the other parameters. CONCLUSION:Long-term use of preservative-containing antiglaucoma medications is associated with goblet cell loss, conjunctival squamous metaplasia, increased ocular surface inflammation, and tear film instability, findings that are most consistent with an evaporative-type dry eye pattern. This interpretation is further supported by the concordant findings of conjunctival impression cytology and tear inflammatory cytokine analysis.
PURPOSE:To validate the short-term reliability of optical coherence tomography angiography (OCT-A) metrics obtained after intravenous sodium fluorescein administration, and to determine whether fluorescein interferes with quantitative chorioretinal and peripapillary microvascular measurements in patients with mild nonproliferative diabetic retinopathy (NPDR). METHODS:This cross-sectional study included 47 eyes of 47 patients with mild NPDR undergoing fundus fluorescein angiography (FFA). OCT-A imaging was performed immediately before and 15 minutes after intravenous injection of 5 mL of 10% sodium fluorescein. Quantitative OCT-A parameters included the foveal avascular zone (FAZ) area, superficial and deep capillary plexus vessel densities (SCP and DCP VDs), choriocapillaris blood flow area (CBFA), retinal nerve fiber layer (RNFL) thickness, and radial peripapillary capillary vessel density (RPCVD). Pre- and post-FFA measurements were compared using paired-sample t-tests. Intraclass correlation coefficient (ICC) and Bland-Altman analyses were additionally performed to evaluate agreement and repeatability between measurements. RESULTS:The study population consisted of 23 female and 24 male patients (mean age: 45.08 ± 15.10 years). No statistically significant differences were observed in FAZ area, SCP or DCP vessel densities, CBFA, RNFL thickness, or RPCVD following fluorescein administration (p > 0.05 for all parameters). ICC analyses demonstrated good-to-excellent repeatability across representative OCT-A parameters, while Bland-Altman analyses confirmed good agreement without evidence of systematic proportional bias between measurements obtained before and after FFA. CONCLUSION:OCT-A-derived retinal, choroidal, and peripapillary microvascular parameters remain stable following intravenous sodium fluorescein administration. These findings support the methodological robustness and reliability of OCT-A measurements obtained shortly after FFA, allowing OCT-A to be safely integrated into routine multimodal retinal imaging protocols without concern for fluorescein-related measurement interference.
AIM AND PURPOSE:Visual impairment is the most common complications of methanol poisoning. In this study, we investigated the frequency of vision loss following methanol poisoning in patients admitted to poisoning centers at provincial hospital in Urmia. MATERIAL AND METHODS:Patients diagnosed with methanol poisoning between 2018 and 2022 who were hospitalized in the poisoning centers at Urmia were evaluated. The data were then collected and analyzed using SPSS version 21 software. RESULTS:124 patients with an average age of 34.89 years, 93.5% of whom were male, were evaluated. Blurred vision with 42.7% and decreased level of consciousness with 33.1% were the most common complaints of patient, and ethanol therapy with 91.9% was the most common treatment approach. 60.5% of the patients had complete recovery, 6.5% had decreased visual acuity, 13.7% of the patients had developed blindness, and 19.4% of the patients died. The final outcome was not correlated to the amount of consumed alcoholic beverages (p = 0.21), CO2 level (p = 0.33) and gender (p = 0.35), but the pH and HCO3 of deceased people were significantly lower (p > 0.001) than survived patients. Patients who died or those who lost their vision were older (p = 0.004) and had referred to medical centers significantly later than others (p < 0.001). CONCLUSION:Early referral and controlling the blood pH play critical role in managing the patients with methanol poisoning.
BACKGROUND:Burns can result in damage to the skin and subcutaneous soft tissues, leading to temporary or permanent injuries. Resina Draconis (RD), extracted from the trunk of the dragon blood tree, possesses high medicinal value and exhibits properties that promote blood circulation, antioxidation, and anti-inflammation. However, the effects of RD on wound healing in laser burn remain unclear. METHODS:Rats were exposed to the fractional CO2 laser to generate a standardized second-degree laser burn, thereby establishing the acute skin barrier disruption model. Changes in tissue morphology were assessed through histological examination (HE) staining. The levels of TNF-α, IL-1β, and IL-6 were evaluated through enzyme-linked immunosorbent assay (ELISA). Vascular endothelial growth factor (VEGF) protein expression was confirmed through an immunohistochemistry (IHC) assay. Key protein expression levels were further analyzed by western blotting. RESULTS:The results demonstrated that RD significantly accelerated wound healing in rats with laser burn. Additionally, the enhanced inflammatory response induced by laser burn was markedly attenuated following RD treatment. Furthermore, RD promoted angiogenesis in rats with laser burn. Finally, RD was shown to increase the p-AKT/AKT and p-mTOR/mTOR protein levels, indicating that RD was associated with activation of the AKT/mTOR signaling pathway. CONCLUSION:RD extract effectively performed skin barrier repair, restored steady-state regulation and improved wound healing in rats with laser burn. This work is the small animal model and lack of dose response. These findings suggest that RD may serve as a potential therapeutic agent for promoting wound healing during laser burn recovery.
PURPOSE:Rosacea is a chronic dermatological condition frequently associated with ocular symptoms and neurological comorbidities such as migraine. This study aimed to compare inflammatory and hematological markers between rosacea patients and healthy controls, and to assess differences in these markers among rosacea patients based on the presence or absence of ocular symptoms and migraine. MATERIALS AND METHODS:A total of 150 rosacea patients and age- and gender-matched healthy controls were enrolled. Demographic data and routine hematological parameters were collected for all participants. Neurological evaluations were performed to assess the prevalence of headaches and migraines. Ophthalmological examinations were conducted in the rosacea group to determine ocular involvement. RESULTS:Compared with healthy controls, rosacea patients had higher white blood cell counts (7.22 ± 1.60 vs 6.83 ± 1.38, p = 0.03) and neutrophil counts (p = 0.02), and lower eosinophil counts (p = 0.036), mean corpuscular volume (p < 0.001), and red cell distribution width-standard deviation (p = 0.015). Mean corpuscular hemoglobin concentration was higher in rosacea patients (p = 0.001). Headaches and migraine were more prevalent in rosacea patients than in controls (p < 0.0001 and p = 0.0006, respectively). Ocular symptoms were present in 51.3% of patients and were more frequent in females (p = 0.03) and in those with migraine (p = 0.03). CONCLUSION:Rosacea was associated with changes in hematological and inflammatory markers, as well as a higher prevalence of migraine and ocular symptoms. These findings support the need for comprehensive evaluation of patients with rosacea.
BACKGROUND:The application of nanotechnology to cosmetic formulations has gained recognition due to enhanced stability, efficacy, and aesthetic appeal of products. These engineered nanomaterials are purposefully produced to possess nano-specific properties, whereas traditional microsized particles are manufactured primarily to improve formulation texture. However, their increasing use for beautification and medicinal purposes has raised serious concerns regarding nanocosmetic toxicity. This review highlights the distinct physical and chemical characteristics of nanocosmetics that influence skin penetration, cellular interactions, and potential systemic uptake following dermal application, emphasizing the need for comprehensive toxicity evaluation. METHODS:This review compiles appropriate peer-reviewed literature from various scientific databases along with regulatory documents from authoritative sources. The review focuses on toxicity assessment approaches for nanocosmetics, including in vitro, in vivo, and alternative methods. Special emphasis is placed on skin irritation and sensitization models, cytotoxicity assays, genotoxicity assessments, and embryonic toxicity tests for evaluating nanocosmetic-associated toxicity. RESULTS:The review summarizes current approaches for evaluating the skin and ocular safety of nanocosmetic ingredients and discusses the influence of nano-specific physicochemical properties on dermal penetration and biological interactions. It also identifies existing data gaps in current regulatory frameworks, particularly concerning nano-specific safety assessment, physicochemical characterization, and dermal exposure evaluation. These findings highlight the importance of adopting comprehensive and standardized toxicity testing strategies for nanocosmetics. CONCLUSIONS:The increasing application of nanotechnology in cosmetic formulations necessitates robust toxicity evaluation to ensure consumer safety. Strengthening regulatory frameworks by incorporating nano-specific safety assessment and exposure evaluation is essential to promote the safe use of nanomaterials in cosmetic products while supporting their continued development and commercialization.
BACKGROUND AND OBJECTIVE:Skin cancer is highly prevalent in older adults; however, data on real-world sun-protective behaviors in this population are limited. Although patients with skin cancer are routinely educated about sun protection, whether these recommendations are reflected in daily practice remains unclear. This study aimed to evaluate real-world sun-protective behaviors by comparing geriatric patients with and without a history of skin cancer. MATERIALS AND METHODS:Patients aged ≥65 years presenting to a tertiary-care dermatology outpatient clinic completed a structured questionnaire assessing sociodemographic factors and sun-protective behaviors. Histopathologically confirmed skin cancer type (basal cell carcinoma [BCC], squamous cell carcinoma [SCC], or malignant melanoma [MM]) was recorded. Sun-protective behaviors in the skin cancer group were assessed after diagnosis. RESULTS:A total of 903 patients were included (441 women, 462 men; mean age 73.58 ± 7.47 years), of whom 161 (17.8%) had skin cancer. Patients with skin cancer reported higher sunscreen use and lower outdoor exposure between 10:00 and 16:00 compared with those without skin cancer (both p < 0.001). Sunglasses use and spending less than two hours in direct sunlight were more common in the non-skin cancer group (p = 0.016 and p < 0.001). Among patients with MM, sunscreen use was highest and outdoor exposure was lowest compared to other skin cancer types (p = 0.016 and p = 0.022, respectively). CONCLUSIONS:Patients with skin cancer, particularly those with MM, reported greater use of sun-protective measures. However, these findings may reflect post-diagnosis behavioral changes and clinical counseling. Further research is needed to understand these behaviors and inform strategies for improving sun protection in older adults.
PURPOSE:To investigate the cytotoxic effects of airborne particulate matter smaller than 2.5 μm (PM2.5) on human conjunctival epithelial cells and to elucidate whether these effects are mediated through activation of the aryl hydrocarbon receptor (AhR) signaling pathway. METHODS:Human conjunctival epithelial cells were exposed to PM2.5 (0, 12.5, 25, and 50 μg/mL) for 24 hours. Cell viability was assessed using an MTT-based colorimetric assay by measuring absorbance at 450 nm, and intracellular reactive oxygen species (ROS) production was evaluated using DCFH-DA staining followed by quantification of DCF fluorescence intensity. AhR activation was evaluated by analyzing cytoplasmic and nuclear fractions of mRNA via Western blot. The mRNA expression of AhR, its downstream target genes (CYP1A1, CYP1B1, AhRR), and inflammatory cytokines (IL-1β, IL-6, TNF-α) was quantified by real-time PCR. AhR involvement was confirmed using siRNA-mediated AhR knockdown cells. RESULTS:PM2.5 induced dose-dependent reductions in cell viability and significant increases in intracellular ROS at 25 and 50 μg/mL. Western blot analysis showed decreased cytoplasmic AhR and increased nuclear AhR following PM2.5 exposure. PM2.5 significantly upregulated AhR, its target genes, and inflammatory cytokines. In AhR knockdown cells, PM2.5 failed to induce nuclear translocation of AhR, upregulation of target genes, ROS production, or inflammatory cytokine expression, indicating that PM2.5-induced oxidative and inflammatory responses are dependent on AhR signaling. CONCLUSION:PM2.5 induces cytotoxicity, oxidative stress, and inflammation in human conjunctival epithelial cells through AhR activation. These findings identify AhR as a key molecular mediator of PM2.5-induced ocular surface damage and suggest that targeting AhR pathways may provide a potential therapeutic strategy for preventing air pollution-related ocular surface disease.
PURPOSE:This study aimed to evaluate the effects of a topical zinc oxide-Momordica charantia oil formulation on wound healing in diabetic and non-diabetic rats. MATERIALS AND METHODS:Twenty-eight female Wistar rats were randomly allocated into four groups (n = 7 each): non-diabetic control (NDC), non-diabetic treated (NDT), diabetic control (DC), and diabetic treated (DT). Three standardized full-thickness excisional wounds were created on the dorsal region of each rat. Treated groups received zinc oxide-M. charantia cream (0.5 g) topically once daily for 21 days, whereas control groups underwent daily saline cleaning. Wound healing was assessed by wound area measurements on days 7, 14, and 21, together with hydroxyproline analysis and histopathological examination. RESULTS:Wound area decreased significantly over time in all groups (p < 0.001). On day 7, residual wound area percentages were significantly lower in DT(51.54 ± 5.23%) and NDT(53.77 ± 3.16%) than in DC(62.42 ± 6.42%) and NDC(63.15 ± 2.43%; p = 0.001). By days 14 and 21, wound areas were markedly reduced in all groups with no significant differences between groups. Hydroxyproline levels increased over time(p = 0.004) and were higher in treated groups, especially NDT on day 7. Histopathology also indicated less inflammation and more organized connective tissue formation in treated groups. CONCLUSION:Topical zinc oxide-M. charantia oil cream improved early wound closure and collagen-related findings, particularly on day 7. However, wound closure became similar among groups by days 14 and 21. Because a vehicle-matched control cream was not included, these findings should be interpreted as preliminary evidence for the complete formulation and require confirmation in vehicle-controlled and adequately powered studies.
