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The Journal of Investigative Dermatology Nov 2023Skin injury and several diseases elicit fibrosis and induce hair follicle (HF) growth arrest and loss. The resulting alopecia and disfiguration represent a severe burden...
Skin injury and several diseases elicit fibrosis and induce hair follicle (HF) growth arrest and loss. The resulting alopecia and disfiguration represent a severe burden for patients, both physically and psychologically. Reduction of profibrotic factors such as dipeptidyl peptidase 4 (DPP4) might be a strategy to tackle this issue. We show DPP4 overrepresentation in settings with HF growth arrest (telogen), HF loss, and nonregenerative wound areas in mouse skin and human scalp. Topical DPP4 inhibition with Food and Drug Administration/European Medicines Agency-approved sitagliptin on preclinical models of murine HF activation/regeneration results in accelerated anagen progress, whereas treatment of wounds with sitagliptin results in reduced expression of fibrosis markers, increased induction of anagen around wounds, and HF regeneration in the wound center. These effects are associated with higher expression of Wnt target Lef1, known to be required for HF anagen/HF-activation and regeneration. Sitagliptin treatment decreases profibrotic signaling in the skin, induces a differentiation trajectory of HF cells, and activates Wnt targets related to HF activation/growth but not those supporting fibrosis. Taken together, our study shows a role for DPP4 in HF biology and shows how DPP4 inhibition, currently used as oral medication to treat diabetes, could be repurposed into a topical treatment agent to potentially reverse HF loss in alopecia and after injury.
PubMed: 37236597
DOI: 10.1016/j.jid.2023.04.027 -
BioMed Research International 2018This review examines the role of interventional radiotherapy (IRT otherwise known as brachytherapy) in cancer treatment for elderly patients. Despite their advanced age... (Review)
Review
This review examines the role of interventional radiotherapy (IRT otherwise known as brachytherapy) in cancer treatment for elderly patients. Despite their advanced age and associated comorbidities, elderly patients should receive definitive cancer therapies, including surgery and radiotherapy (RT). In fact, RT becomes first-line option for patients who are not eligible for surgery (due to comorbidities, anticoagulant drugs, and risk of disfigurement) or those who refuse it. It emerged from this review of the literature as effective, simple, safe, and comfortable and was associated with good local control, low toxicity rates, and excellent cosmesis and provided a cost benefit. IRT may be used as sole treatment for small cancers or as a useful adjunct to surgery or external beam radiotherapy (EBRT) in more advanced (or lymph node positive) cases, especially when the aim is local control with adequate preservation of normal tissue function. As palliative treatment, IRT preserves quality of life and/or improves survival. It is to be hoped that this review will serve as a helpful guide for members of multidisciplinary teams that are involved in treating elderly patients with cancer.
Topics: Age Factors; Aging; Brachytherapy; Humans; Neoplasms
PubMed: 29581964
DOI: 10.1155/2018/2178469 -
Current Drug Targets 2021Psoriasis is a challenging skin disorder due to its chronicity, high rate of prevalence, disability, comorbidity and disfiguration. It is a multi-system disorder that... (Review)
Review
BACKGROUND
Psoriasis is a challenging skin disorder due to its chronicity, high rate of prevalence, disability, comorbidity and disfiguration. It is a multi-system disorder that includes joints and metabolic syndromes. Psoriasis is a condition of pathologic interaction among immune cells, biological signaling molecules and skin cells. Several contributing factors are responsible for the exacerbation and onset of psoriasis, i.e. genetic factors and environmental factors such as medications, infectious diseases and lifestyle.
OBJECTIVES
To study the new insights in the treatment of psoriasis and future prospects.
METHODS
This review article gives an insight on the current concepts of psoriasis and deals with discussing the initiation and development of the diseases. We described the pathogenetic pathway for psoriasis. The article focuses on the treatment approaches for psoriasis that have arisen from the dissection of the inflammatory psoriatic pathways.
RESULTS
We aimed to highlight the novel therapies and drugs used in the treatment of psoriasis, including food and drug administration (FDA) approved drugs and drugs under clinical trials. The treatment can be initiated for mild to the moderate diseased condition employing vitamin D3 analogues, corticosteroids and a combination of products as first-line therapy.
CONCLUSION
Psoriasis can be managed by a proper understanding of the immune function. We have also discussed medicinal herbs used for psoriasis based on their ethnopharmacological knowledge and reported work of researchers.
Topics: Adrenal Cortex Hormones; Cholecalciferol; Humans; Plant Preparations; Plants, Medicinal; Psoriasis; Skin
PubMed: 33461464
DOI: 10.2174/1389450122666210118103455 -
Skin Appendage Disorders Jan 2022Hidradenitis suppurativa (HS) is a chronic, disfiguring, and debilitating inflammatory skin condition accompanied by pain, malodorous discharge, scarring, and a scarce...
INTRODUCTION
Hidradenitis suppurativa (HS) is a chronic, disfiguring, and debilitating inflammatory skin condition accompanied by pain, malodorous discharge, scarring, and a scarce quality of life. Skin folds are the most frequently affected areas, while the face is rarely involved.
CASE PRESENTATION
We herein report a case of a man in his 40s affected by a severe form of HS for 15 years. Physical examination showed massive, bridged scarring located on the cheeks, temporal area, chin, nuchae, and scalp.
DISCUSSION
Massive face scarring due to HS is an infrequent event and represents a further burden for patients affected by HS and a therapeutic challenge for clinicians due to the lack of codified guidelines. Novel therapies with lasers and combination therapies are emerging and may be beneficial for hypertrophic scarring in HS.
PubMed: 35118134
DOI: 10.1159/000518433 -
Psycho-oncology Sep 2018Our long-term goal is to develop a normative feedback intervention to support head and neck cancer patients in forming realistic expectations about how other people in...
OBJECTIVE
Our long-term goal is to develop a normative feedback intervention to support head and neck cancer patients in forming realistic expectations about how other people in non-social group settings will respond to their appearance. This study aimed to evaluate the relationship between observer ratings of facial disfigurement and observer ratings of emotional response when viewing photographs of faces of head and neck cancer patients.
METHODS
Seventy-five (75) observers rated their emotional response to each of 144 facial photographs of head and neck cancer patients using the Self-Assessment-Manikin and rated severity of facial disfigurement on a 9-point scale. Body image investment of the observers was measured using the Appearance Schemas Inventory-Revised. A standardized multiple regression model was used to assess the relationship between observer ratings of facial disfigurement and observer ratings of emotional response, taking into consideration the age and sex of the patient depicted in the stimulus photograph, as well as the age, sex, and body image investment of the observer.
RESULTS
Observers who had a strong emotional response to a patient's facial photograph tended to rate the patient's facial disfigurement as more severe (standardized regression coefficient β = 0.328, P < 0.001). Sex and age of the observer had more influence on the rating of facial disfigurement than did the patient's demographic characteristics. Observers more invested in their own body image tended to rate the facial disfigurement as more severe.
CONCLUSIONS
This study lays the groundwork for a normative database of emotional response to facial disfigurement.
Topics: Adult; Aged; Body Image; Face; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Observer Variation; Quality of Life; Social Perception
PubMed: 29846028
DOI: 10.1002/pon.4776 -
Body Image Dec 2022Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is... (Review)
Review
Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.
Topics: Humans; Social Stigma; Body Image; Adaptation, Psychological
PubMed: 36345083
DOI: 10.1016/j.bodyim.2022.10.011 -
Systemic Inflammation and Cardiovascular Comorbidity in Psoriasis Patients: Causes and Consequences.Frontiers in Immunology 2018Psoriasis is a common inflammatory skin disease characterized by the appearance of red scaly plaques that can affect any part of the body. High prevalence, chronicity,... (Review)
Review
Psoriasis is a common inflammatory skin disease characterized by the appearance of red scaly plaques that can affect any part of the body. High prevalence, chronicity, disfiguration, disability, and associated comorbidity make it a challenge for clinicians of multiple specialties. Likewise, its complex pathogenesis, comprising inflammation, hyperproliferation, and angioneogenesis, intrigues numerous scientific disciplines, namely, immunology. From a clinical perspective, the severity of psoriasis is highlighted by its increased mortality, with cardiovascular diseases contributing the highest excess risk. From a scientific point of view, psoriasis has to be considered a systemic inflammatory condition, as blood biomarkers of inflammation are elevated and imaging techniques document sites of inflammation beyond the skin. While the association of psoriasis with cardiovascular diseases is now widely accepted, causes and consequences of this association are controversially discussed. This review comments on epidemiologic, genetic, and mechanistic studies that analyzed the relation between psoriasis and cardiovascular comorbidity. The hypothesis of psoriasis potentially being an independent cardiovascular risk factor, driving atherosclerosis inflammation-induced endothelial dysfunction, will be discussed. Finally, consequences for the management of psoriasis with the objective to reduce the patients' excess cardiovascular risk will be pointed out.
Topics: Animals; Cardiovascular Diseases; Comorbidity; Disease Management; Disease Susceptibility; Humans; Inflammation; Prognosis; Psoriasis
PubMed: 29675020
DOI: 10.3389/fimmu.2018.00579 -
The Cleft Palate-craniofacial Journal :... Jul 2015To identify and critically appraise the literature on the psychosocial outcomes of orthognathic surgery, reflect on the clinical and theoretical implications, and... (Review)
Review
OBJECTIVE
To identify and critically appraise the literature on the psychosocial outcomes of orthognathic surgery, reflect on the clinical and theoretical implications, and suggest avenues for future research.
DESIGN
A search of the literature was completed using the databases Web of Science, MEDLINE, and PsycINFO to identify English-language articles published since January 2001 that have reported a measure of psychosocial functioning posttreatment.
RESULTS
A total of 38 articles were eligible for inclusion in the review. The studies reported improvements in areas such as satisfaction with facial appearance, self-confidence, self-esteem, anxiety, and social functioning. Small percentages of patients were left dissatisfied or had difficulty adjusting to appearance change despite the absence of treatment complications. Gains in psychosocial functioning were maintained over several years, and satisfaction increased over time.
CONCLUSIONS
There are consistent positive outcomes reported as a result of orthognathic surgery, but conclusions are limited by methodological issues in study design such as small sample sizes, limited use of control groups, and measures that fail to tap into relevant areas of psychosocial functioning. In addition, further exploration is required of processes such as adjustment to facial change and the role of psychological support during treatment.
Topics: Adaptation, Psychological; Anxiety; Humans; Orthognathic Surgical Procedures; Patient Satisfaction; Self Concept; Social Desirability
PubMed: 25191866
DOI: 10.1597/14-021 -
The Journal of Clinical and Aesthetic... May 2016Basal cell carcinoma is the most commonly occurring cancer in the world and overall incidence is still on the rise. While typically a slow-growing tumor for which... (Review)
Review
Basal cell carcinoma is the most commonly occurring cancer in the world and overall incidence is still on the rise. While typically a slow-growing tumor for which metastases is rare, basal cell carcinoma can be locally destructive and disfiguring. Given the vast prevalence of this disease, there is a significant overall burden on patient well-being and quality of life. The current mainstay of basal cell carcinoma treatment involves surgical modalities, such as electrodessication and curettage, excision, cryosurgery, and Mohs micrographic surgery. Such methods are typically reserved for localized basal cell carcinoma and offer high five-year cure rates, but come with the risk of functional impairment, disfigurement, and scarring. Here, the authors review the evidence and indications for nonsurgical treatment modalities in cases where surgery is impractical, contraindicated, or simply not desired by the patient.
PubMed: 27386043
DOI: No ID Found -
Indian Journal of Ophthalmology Jul 2023Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute...
Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Osteomyelitis is one of the rare sequelae of ROCM, frontal osteomyelitis being the rarest. We present four patients of coronavirus disease 2019 (COVID-19)-associated mucormycosis, who presented with frontal bone osteomyelitis after being treated for ROCM surgically and medically. This is the first case series highlighting this complication in post-COVID-19 mucormycosis patients and needs utmost attention as it can be life-threatening and can cause extreme facial disfiguration. All four patients are alive with salvage of the affected globe and vision being preserved in one patient. If identified early, disfiguration of face and intracranial extension can be avoided.
Topics: Humans; Mucormycosis; COVID-19; SARS-CoV-2; Disease Progression; Osteomyelitis; Orbital Diseases
PubMed: 37417145
DOI: 10.4103/IJO.IJO_3117_22