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Cells Nov 2023An intact barrier function of the skin is important in maintaining skin health. The regulation of the skin barrier depends on a multitude of molecular and immunological... (Review)
Review
An intact barrier function of the skin is important in maintaining skin health. The regulation of the skin barrier depends on a multitude of molecular and immunological signaling pathways. By examining the regulation of a healthy skin barrier, including maintenance of the acid mantle and appropriate levels of ceramides, dermatologists can better formulate solutions to address issues that are related to a disrupted skin barrier. Conversely, by understanding specific skin barrier disruptions that are associated with specific conditions, such as atopic dermatitis or psoriasis, the development of new compounds could target signaling pathways to provide more effective relief for patients. We aim to review key factors mediating skin barrier regulation and inflammation, including skin acidity, interleukins, nuclear factor kappa B, and sirtuin 3. Furthermore, we will discuss current and emerging treatment options for skin barrier conditions.
Topics: Humans; Skin; Dermatitis, Atopic; Psoriasis; Skin Diseases; Ceramides
PubMed: 38067173
DOI: 10.3390/cells12232745 -
Clinical, Cosmetic and Investigational... 2023Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that can progress to significant tunnels and scars that affect quality of life, especially if... (Review)
Review
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that can progress to significant tunnels and scars that affect quality of life, especially if diagnosis and treatment are delayed. Average delay after initial presentation of HS symptoms can range from 3 to 10 years in adults and 1 to 2 years in children. Factors associated with diagnostic delay include female gender, non-white race, and greater disease severity at diagnosis. Contributing factors include misdiagnoses, difficulty accessing a dermatologist, hesitation in seeking care due to the stigmatizing nature of the disease, and lack of awareness among providers and patients. While efforts to increase awareness include academic talks at conferences and by foundations geared toward HS, social media offers the opportunity to reach young audiences. Many patients report dissatisfaction with their HS treatments. Better understanding of HS pathophysiology and implementation of clinically focused phenotypes and endotypes can lead to development of more targeted and efficacious therapies. FDA approval of medications for HS beyond adalimumab will increase access to a wider selection of therapies, and implementation of therapeutic drug monitoring may maximize the use of biologics for HS.
PubMed: 37483473
DOI: 10.2147/CCID.S301794 -
The Keio Journal of Medicine Aug 2023Gorlin syndrome and Cowden syndrome are hereditary diseases that are characterized by multiple malignancies, cutaneous symptoms, and various other abnormalities. Both...
Gorlin syndrome and Cowden syndrome are hereditary diseases that are characterized by multiple malignancies, cutaneous symptoms, and various other abnormalities. Both disorders are caused by a mutation of the gene that regulates cell proliferation and growth, resulting in tumorigenesis. Representative mutations are mutation in the patched 1 gene (PTCH1) in Gorlin syndrome and mutation in the phosphatase and tensin homolog deleted from chromosome 10 (PTEN) gene in Cowden syndrome. Making a diagnosis of these diseases in the early years of life is important because detection of malignancies at an early stage is linked to improved prognosis. Both Gorlin syndrome and Cowden syndrome have cutaneous findings in the early phase in childhood, and the role of dermatologists is therefore important. These diseases are generally diagnosed by clinical criteria, but some patients who do not meet the criteria need genetic examinations including a genetic diagnostic panel and next-generation sequencing. The most important treatment and management are detection and resection of malignancies in the early stage, and targeted therapies have recently been used for treatment of tumors and other symptoms in these diseases. Although evidence of the effectiveness of targeted therapies has been limited, they are promising therapeutic options and further clinical trials are needed in the future.
PubMed: 37558433
DOI: 10.2302/kjm.2023-0010-IR -
Clinical, Cosmetic and Investigational... 2023Acne vulgaris is one of the most widespread skin conditions and the main reason for visiting a dermatologist. Inflammatory response and abnormal infiltrations of immune... (Review)
Review
Acne vulgaris is one of the most widespread skin conditions and the main reason for visiting a dermatologist. Inflammatory response and abnormal infiltrations of immune cells are the main pathogenesis of acne. The increased lipid is the prerequisite for the acne, and the perturbation of lipid composition and content is consistent with the severity of acne. Furthermore, the increased lipid production not only contributes to the occurrence and development of acne, but also sensitizes the function of immune cells. The lipid metabolic dysfunction aggravates the severity of local tissue and provides pro-inflammatory-cytokine cues, which indicates the crucial roles of lipid metabolism on immune cells. Recent advances have demonstrated the lipid metabolism reprogramming of various immune cells in acne lesion. The abnormal lipid accumulation, lipolysis, and fatty acid oxidation lead to the activation and differentiation of immune cells, which promotes the pro-inflammatory cytokines production. Thus, this review discusses the emerging role of lipid metabolism reprogramming of immune cells in the progress of acne and aims to constitute food for others' projects involved in acne research.
PubMed: 37675181
DOI: 10.2147/CCID.S424478 -
Indian Journal of Dermatology 2024Psoriasis is a chronic inflammatory skin condition affecting millions of individuals worldwide. Over the years, various treatment modalities have been explored to...
Psoriasis is a chronic inflammatory skin condition affecting millions of individuals worldwide. Over the years, various treatment modalities have been explored to alleviate the symptoms and improve the quality of life for patients with psoriasis. Among these treatment options, lasers and lights have emerged as promising non-invasive approaches with significant efficacy. This review aims to provide an overview of the current understanding and clinical applications of lasers and lights in the management of psoriasis. We have discussed the mechanisms of action behind different laser and light therapies and their impact on psoriatic plaques. Additionally, we discuss the various types of lasers and lights utilized, including excimer lasers, pulsed dye lasers, and narrowband ultraviolet B (NB-UVB) phototherapy, highlighting their unique properties and clinical outcomes. Moreover, we have addressed important considerations related to patient selection, treatment protocols, and potential side effects associated with lasers and lights. We emphasize the need for proper evaluation, monitoring, and customization of treatment plans to ensure optimal outcomes and minimize adverse events.
PubMed: 38841222
DOI: 10.4103/ijd.ijd_423_23 -
Skin Research and Technology : Official... Feb 2024Facial acne scars are a prevalent concern, leading to the development of various treatment modalities. (Review)
Review
BACKGROUND
Facial acne scars are a prevalent concern, leading to the development of various treatment modalities.
OBJECTIVES
This review aims to explore the latest advancements in the treatment of facial acne scars, focusing on both surgical and non-surgical methods.
METHODS
The non-surgical treatments reviewed include topical medications (such as retinoids and alpha hydroxy acids) and non-invasive procedures (like microdermabrasion and chemical peels). Surgical options discussed are punch excision, subcision, and fractional laser treatments.
RESULTS
Combination therapy, integrating both surgical and non-surgical approaches, is frequently utilized to achieve optimal results in scar improvement.
CONCLUSION
Recent advancements in the treatment of facial acne scars provide promising options for individuals seeking improvement. However, these treatments have associated risks and potential adverse effects, highlighting the importance of consulting a dermatologist before beginning any treatment regimen.
Topics: Humans; Cicatrix; Acne Vulgaris; Chemexfoliation; Dermabrasion; Retinoids; Treatment Outcome
PubMed: 38303407
DOI: 10.1111/srt.13573 -
Archives of Dermatological Research Nov 2023The diagnosis and management of hidradenitis suppurativa (HS) varies greatly between providers, often resulting in gaps in care including diagnostic delays and poor...
The diagnosis and management of hidradenitis suppurativa (HS) varies greatly between providers, often resulting in gaps in care including diagnostic delays and poor outcomes. As dermatologists strive to improve HS management, understanding patient perspectives is key. This study aims to characterize existing gaps in HS care as understood through patients' experiences. This study recruited adult patients with a diagnosis of HS seen at dermatology practices affiliated with Northwestern University. Data were collected through participant surveys and three semi-structured focus groups. Focus group meetings were transcribed verbatim and data were abstracted into themes using conventional content analysis. Six final themes were abstracted after review of 20 pages of transcribed conversation. Four themes centered on improved medical management of HS (access to care, disease-modifying therapies, symptom treatment, prevention of treatment-related adverse events). Two themes centered on supportive care (mental health support, specialized daily wear products). Limitations of this study include single-center recruitment and recall bias introduced by the focus group format. This study identifies six unmet needs for patients with HS and highlights the efficacy of a virtual format for research, conversation, and possibly clinical engagement. Moreover, multiple themes underscore the need for further collaboration across specialties in managing HS.
Topics: Adult; Humans; Hidradenitis Suppurativa; Health Services Needs and Demand
PubMed: 37264285
DOI: 10.1007/s00403-023-02645-y -
Frontiers in Medicine 2023Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the... (Review)
Review
Cutaneous manifestations of hematologic malignancy represent both a clinical challenge for the treating physician and a pathophysiological model for advancing the knowledge on individual neoplasms. Indeed, a growing body of evidence supports the concept of recurrent molecular defects associating with specific clinical features, as best exemplified by VEXAS. Herein neutrophilic and eosinophilic dermatoses of potential interest for both hematologists and dermatologists will be reviewed, including subcorneal pustular dermatosis-type IgA pemphigus, neutrophilic eccrine hidradenitis, Sweet's syndrome as well as myelodysplasia cutis and VEXAS, pyoderma gangrenosum, eosinophilic annular erythema, eosinophilic dermatosis of hematological malignancy, Wells syndrome and cutaneous involvement in hypereosinophilic syndromes. Possible management approaches are discussed for each, emphasizing scenarios that require treatment of the underlying condition to achieve remission at the skin level.
PubMed: 38249974
DOI: 10.3389/fmed.2023.1324258 -
JMIR Dermatology Dec 2023Social media significantly affects how patients understand their health and choose their healthcare providers, yet Australian dermatologists have a limited online...
Social media significantly affects how patients understand their health and choose their healthcare providers, yet Australian dermatologists have a limited online presence compared to their global peers.
PubMed: 38051576
DOI: 10.2196/48975 -
American Journal of Clinical Dermatology Jul 2023The current 2022 mpox (monkeypox) outbreak has been officially recognized as a public health emergency. The mpox clinical symptoms include high fever, fatigue, chills,... (Review)
Review
The current 2022 mpox (monkeypox) outbreak has been officially recognized as a public health emergency. The mpox clinical symptoms include high fever, fatigue, chills, headache, swollen lymph nodes, muscle aches, and a disseminated painful rash. However, recent cases of mpox have shown a shift in clinical symptoms, with anogenital skin lesions emerging as the predominant feature. Due to the predominant skin manifestations of mpox, dermatologists could be crucial in detecting new mpox cases and educating frontline healthcare professionals about mpox. The mpox virus is continuously evolving and has several variants. Genome sequencing has revealed that the Clade IIb variant is responsible for the 2022 mpox outbreak. Mpox spread may occur through animal-to-human and human-to-human transmission; however, unlike coronavirus disease 2019 (COVID-19), long-range airborne transmission has not been reported. Healthcare professionals are at higher risk of becoming infected since they are usually in close contact with both the patients and potentially contaminated fomites (e.g., examination table, gowns, gloves). Both public and healthcare professionals should take preventive and avoidance measures to limit the spread. Mpox is usually self-limiting and may require only symptomatic treatment; however, it may cause severe complications in special populations such as immunocompromised individuals. For severe infection, clinicians may consider antiviral drugs (off-label), tecovirimat and brincidofovir, originally approved for smallpox treatment. Two smallpox vaccines, ACAM2000 and JYNNEOS, can be used as pre-exposure prophylaxis against mpox. JYNNEOS, which carries approval for mpox use, has less adverse effect potential than ACAM2000, and may also be used as post-exposure prophylaxis, preferably within 4 days of exposure.
Topics: Animals; Humans; Diagnosis, Differential; Mpox (monkeypox); COVID-19; Dermatologists; Smallpox; COVID-19 Testing
PubMed: 37106278
DOI: 10.1007/s40257-023-00778-4