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The Journal of Dermatological Treatment Dec 2024This study aimed to evaluate the efficacy of tranexamic acid (TXA) in treating melasma through a meta-analysis and systematic review of randomized controlled trials... (Meta-Analysis)
Meta-Analysis Review
This study aimed to evaluate the efficacy of tranexamic acid (TXA) in treating melasma through a meta-analysis and systematic review of randomized controlled trials (RCTs). The study focused on identifying associated adverse effects and comparing TXA's effectiveness with other melasma treatments. Following PROSPERO and PRISMA guidelines, an extensive electronic search was conducted across four databases for RCTs on TXA use in melasma. Inclusion criteria encompassed full-text English articles with specific outcome measures, while studies with high bias risk or non-English publications were excluded. Data were extracted from 22 relevant studies and analyzed using the RevMan software, with heterogeneity identified using I² statistics and forest plots. A total of 22 studies with 1280 patients were included. TXA was administered orally, topically, or via injection, with treatment durations ranging from 8 weeks to nearly 2 years. TXA significantly reduced melasma severity, evidenced by reductions in MASI, mMASI, MI, and hemi-MASI scores. Oral TXA showed the most substantial decrease in MASI scores, followed by injections and topical applications. However, studies exhibited high heterogeneity, particularly in combined treatments. Adverse effects included gastrointestinal discomfort, skin irritation, and menstrual irregularities. TXA is effective in treating melasma, either alone or combined with other treatments. Despite significant reductions in melasma severity, further research is necessary to standardize TXA administration methods and address long-term effects. The high heterogeneity observed suggests a need for more consistent treatment protocols.
Topics: Melanosis; Humans; Tranexamic Acid; Randomized Controlled Trials as Topic; Treatment Outcome; Administration, Oral; Antifibrinolytic Agents; Severity of Illness Index; Administration, Cutaneous
PubMed: 38843906
DOI: 10.1080/09546634.2024.2361106 -
Skin Research and Technology : Official... Mar 2023Cutaneous malignant melanoma (MM) is potentially aggressive, and numerous clinically suspicious pigmented skin lesions are excised, causing unnecessary mutilation for... (Review)
Review
BACKGROUND
Cutaneous malignant melanoma (MM) is potentially aggressive, and numerous clinically suspicious pigmented skin lesions are excised, causing unnecessary mutilation for patients at high healthcare costs, but without histopathological evidence of MM. The high number of excisions may be lowered by using more accurate diagnostics. Tape stripping (TS) of clinically suspicious lesions is a non-invasive diagnostic test of MM that can potentially lower the number needed to biopsy/excise.
MATERIALS AND METHODS
The aim is to determine the diagnostic accuracy of TS in detecting MM in clinically suspicious pigmented skin lesions. This systematic review following PRISMA guidelines searched PubMed, Web of Science, and Embase (September 2022) using melanoma combined with tape stripping, adhesive patch(es), pigmented lesion assay, or epidermal genetic information retrieval.
RESULTS
Ten studies were included. Sensitivity ranged from 68.8% (95% confidence interval [CI] 51.5, 82.1) to 100% (95% CI 91.0, 100). Specificity ranged from 69.1% (95% CI 63.8, 74.0) to 100% (95% CI 78.5, 100). A pooled analysis of five studies testing the RNA markers LINC00518 and PRAME found a sensitivity of 86.9% (95% CI 81.7, 90.8) and a specificity of 82.4% (95% CI 80.8, 83.9).
CONCLUSION
Overall quality of studies was low, and the reliability of sensitivity and specificity is questionable. However, TS may supplement well-established diagnostic methods as pooled analysis of five studies indicates a moderate sensitivity. Future studies are needed to obtain more reliable data as independent studies with no conflict of interest.
Topics: Humans; Antigens, Neoplasm; Biopsy; Melanoma; Pigmentation Disorders; Reproducibility of Results; Sensitivity and Specificity; Skin Neoplasms; Surgical Tape; Melanoma, Cutaneous Malignant
PubMed: 36973976
DOI: 10.1111/srt.13286 -
Acta Dermato-venereologica Mar 2020
Meta-Analysis
Topics: Humans; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Genetic; Risk Factors; Vitiligo
PubMed: 32162672
DOI: 10.2340/00015555-3448 -
PloS One 2022According to the literature, pigmentary disorders have a significantly negative impact on a person's health-related quality of life. Moreover, among pigmentary... (Meta-Analysis)
Meta-Analysis
BACKGROUND
According to the literature, pigmentary disorders have a significantly negative impact on a person's health-related quality of life. Moreover, among pigmentary disorders, incidence of melasma ranks high. The Melasma Area and Severity Index (MASI) is the scale that is generally used to evaluate a melasma-affected area and its severity. However, the relationship between the MASI and Melasma Quality of Life (MELASQoL) scores, as well as the impact of melasma on patients' quality of life, remain unclear.
OBJECTIVES
To explore the influence of melasma on patients' lives, analyze the relationship between the MASI and MELASQoL scores, and identify the factors that may be influencing the quality of life of patients with melasma.
METHODS
Two reviewers independently searched four databases (PubMed, Embase, the Cochrane Library, and Web of Science) for literature on quality of life of patients with melasma. In addition to an epidemiological study, a cross-sectional study, and validation studies, gray literature was also included. StataSE version 16 software was used for the meta-analysis. The score of each item on the MELASQoL scale was determined using a random-effects model.
RESULTS
Fourteen studies with a total of 1398 melasma patients were included in the systematic review, four of which were eligible for meta-analysis. The relationship between the MELASQoL and MASI scores was found to be mixed. Five studies concluded that the MASI and MELASQoL scores were statistically correlated, while seven studies found no statistical correlation between the two. It is obvious that melasma causes emotional distress and has a negative impact on patients' social lives. Patients were most bothered by the appearance of their skin condition. However, the MELASQoL score had no definite correlation with patient characteristics such as age, education levels, and history.
CONCLUSION
Melasma has a significant negative impact on patients' quality of life. Thus, evaluating the quality of life of patients with melasma should not be ignored. Additionally, utilization of the MELASQoL scale should be considered in the care plan. Further studies with larger sample sizes are needed to confirm the relationship between melasma and quality of life.
Topics: Humans; Melanosis; Quality of Life; Stress, Psychological
PubMed: 35085327
DOI: 10.1371/journal.pone.0262833 -
Scientific Reports Oct 2020Polyautoimmunity implicates that some autoimmune diseases share common etiopathogenesis. Some studies have reported an association between multiple sclerosis (MS) and... (Meta-Analysis)
Meta-Analysis
Polyautoimmunity implicates that some autoimmune diseases share common etiopathogenesis. Some studies have reported an association between multiple sclerosis (MS) and vitiligo; meanwhile, other studies have failed to confirm this association. We performed a systemic review and meta-analysis to examine the association of MS with vitiligo. We searched the MEDLINE and Embase databases on March 8, 2020 for relevant case-control, cross-sectional, and cohort studies. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of the included studies. Where applicable, we performed a meta-analysis to calculate the pooled odds ratio (OR) for case-control/cross-sectional studies and risk ratio for cohort studies with 95% confidence interval (CI). Our search identified 285 citations after removing duplicates. Six case-control studies with 12,930 study subjects met our inclusion criteria. Our meta-analysis found no significant association of MS with prevalent vitiligo (pooled OR 1.33; 95% CI 0.80‒2.22). Analysis of the pooled data failed to display any increase of prevalent vitiligo in MS patients compared with controls. Ethnic and genetic factors may play an important role for sporadically observed associations between MS and vitiligo. Future studies of this association should therefore consider stratification by ethnic or genetic factors.
Topics: Bias; Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Gene-Environment Interaction; Humans; Multiple Sclerosis; Odds Ratio; Risk; Vitiligo
PubMed: 33082449
DOI: 10.1038/s41598-020-74298-0 -
International Wound Journal Jun 2021Presently, there is an explosion in various uses of platelet-rich plasma (PRP). Several trials comparing combination therapy with PRP vs monotherapy for vitiligo have... (Meta-Analysis)
Meta-Analysis
Presently, there is an explosion in various uses of platelet-rich plasma (PRP). Several trials comparing combination therapy with PRP vs monotherapy for vitiligo have been published. However, evidence-based information is not enough for making well-informed decisions. This study aimed to evaluate several combination therapy strategies for vitiligo. EMBASE, PubMed, Web of Science, Cochrane Library and Google Scholar databases were searched to identify randomised controlled trials comparing combination therapy with PRP vs monotherapy for vitiligo. Eleven studies with 670 cases were included. Compared with monotherapy, clinical improvement of repigmentation was significantly higher in 308-nm excimer laser combined with PRP (odds rate for response rate of 50%-100% repigmentation, 4.47; 95% CI, 2.47-8.10; P < .00001) and in fractional carbon dioxide laser combined with PRP (mean difference for mean improvement grades of repigmentation, 1.61; 95% CI, 0.24-2.99; P = .02), respectively. Compared to monotherapy, there is no higher clinical improvement in strategies of PRP combined with narrowband-ultraviolet B or non-cultured epidermal cell suspension. Trivial adverse events were reported. This meta-analysis summarises current evidence that PRP combined with 308-nm excimer laser or fractional carbon dioxide laser is effective and safe for vitiligo. This systematic review and meta-analysis aims to evaluate the effectiveness and safety of several combination therapy strategies with PRP in the treatment of vitiligo. The response rate of repigmentation and mean improvement grades of repigmentation were mainly used for qualitative assessment. PRP combined with 308-nm excimer laser or fractional carbon dioxide laser is effective and safe for vitiligo due to its healing and regenerative properties.
Topics: Combined Modality Therapy; Humans; Lasers, Excimer; Platelet-Rich Plasma; Treatment Outcome; Vitiligo
PubMed: 33245822
DOI: 10.1111/iwj.13524 -
International Journal of Molecular... Aug 2021In health, the non-recirculating nature and long-term persistence of tissue-resident memory T cells (TRMs) in tissues protects against invading pathogens. In disease,...
In health, the non-recirculating nature and long-term persistence of tissue-resident memory T cells (TRMs) in tissues protects against invading pathogens. In disease, pathogenic TRMs contribute to the recurring traits of many skin diseases. We aimed to conduct a systematic literature review on the current understanding of the role of TRMs in skin diseases and identify gaps as well as future research paths. EMBASE, PubMed, SCOPUS, Web of Science, Clinicaltrials.gov and WHO Trials Registry were searched systematically for relevant studies from their inception to October 2020. Included studies were reviewed independently by two authors. This study was conducted in accordance with the PRISMA-S guidelines. This protocol was registered with the PROSPERO database (ref: CRD42020206416). We identified 96 studies meeting the inclusion criteria. TRMs have mostly been investigated in murine skin and in relation to infectious skin diseases. Pathogenic TRMs have been characterized in various skin diseases including psoriasis, vitiligo and cutaneous T-cell lymphoma. Studies are needed to discover biomarkers that may delineate TRMs poised for pathogenic activity in skin diseases and establish to which extent TRMs are contingent on the local skin microenvironment. Additionally, future studies may investigate the effects of current treatments on the persistence of pathogenic TRMs in human skin.
Topics: CD8-Positive T-Lymphocytes; Humans; Immunologic Memory; Lymphoma, T-Cell, Cutaneous; Organ Specificity; Psoriasis; Skin; Skin Diseases; T-Lymphocytes; Vitiligo
PubMed: 34445713
DOI: 10.3390/ijms22169004 -
Skin Research and Technology : Official... May 2024Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation....
BACKGROUND
Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation. Given the lack of standardized treatment and the uncertain efficacy of available options, applying procedural methods is of growing interest in treating NP.
AIMS
We sought to comprehensively evaluate the role of procedural treatments for NP.
METHODS
We systematically searched PubMed/Medline, Ovid Embase, and Web of Science until November 14th, 2023. We also performed a citation search to detect all relevant studies. Original clinical studies published in the English language were included.
RESULTS
Out of 243 articles, sixteen studies have reported various procedural modalities, with or without pharmacological components, in treating NP. Pharmacological procedures, including injections of botulinum toxin, lidocaine, and corticosteroids, led to a level of improvement in case reports and case series. However, botulinum toxin did not show acceptable results in a clinical trial. Moreover, non-pharmacological procedures were as follows: physical therapy, exercise therapy, kinesiotherapy, acupuncture and dry needling, electrical muscle stimulation, surgical decompression, and phototherapy. These treatments result in significant symptom control in refractory cases. Physical therapy can be considered a first-line choice or an alternative in refractory cases.
CONCLUSION
Procedural modalities are critical in the multidisciplinary approach to NP, especially for patients who are refractory to topical and oral treatments. Procedural modalities include a spectrum of options that can be applied based on the disease's symptoms and severity.
Topics: Humans; Pruritus; Lidocaine; Paresthesia; Hyperpigmentation; Physical Therapy Modalities; Acupuncture Therapy; Botulinum Toxins; Anesthetics, Local; Exercise Therapy; Adrenal Cortex Hormones; Dry Needling
PubMed: 38696233
DOI: 10.1111/srt.13723 -
Does a high-fat diet affect the circadian clock, or is it the other way around? A systematic review.Nutrition Research (New York, N.Y.) Dec 2020This paper reviews studies that addressed the influence of diet on circadian rhythmicity in mice and, in turn, circadian clock chronodisruption and its role in the...
This paper reviews studies that addressed the influence of diet on circadian rhythmicity in mice and, in turn, circadian clock chronodisruption and its role in the development of metabolic disorders. Studies from the past 14 years were selected via a systematic search conducted using the PubMed electronic database. After applying the inclusion and exclusion criteria, 291 studies were selected, of which 13 were chosen using the following inclusion criteria: use of a high-fat diet for mice, evaluation of clock gene expression, and the association between chronodisruption and lipid metabolism disorders. These studies reported changes in animals' biological clock when they developed metabolic disorders by consuming a high-fat diet. It was also evident that some clock gene mutations or deletions triggered metabolic changes. Disturbances of clock gene machinery may play important roles in lipid metabolism and the development of atherosclerotic processes. However, many metabolic processes also affect the function of clock genes and circadian systems. In summary, this review's results may provide new insights into the reciprocal regulation of energy homeostasis and the biological clock.
Topics: Animals; CLOCK Proteins; Circadian Clocks; Circadian Rhythm; Diet, High-Fat; Dietary Fats; Female; Gene Expression; Lipid Metabolism; Lipid Metabolism Disorders; Male; Mice
PubMed: 33213889
DOI: 10.1016/j.nutres.2020.10.003 -
Current Oncology (Toronto, Ont.) Feb 2024The reference to vitiligo-like lesions (VLLs) induced by immune checkpoint inhibitors (ICIs) as a valuable predictive marker of treatment success of immunotherapy with... (Observational Study)
Observational Study
The reference to vitiligo-like lesions (VLLs) induced by immune checkpoint inhibitors (ICIs) as a valuable predictive marker of treatment success of immunotherapy with ICIs in melanoma has been mentioned in the literature. Its role in non-small cell lung cancer (NSCLC)-treated patients remains a poorly recognized phenomenon with uncertain significance regarding its predictive value. A retrospective, observational, single-center report was performed, with descriptive analysis of clinicopathological and treatment characteristics of patients with stage IV NSCLC who developed ICI-induced VLL between January 2018 and December 2022, contextualized in a comprehensive review of the literature and reported cases regarding this phenomenon. During the first 5 years' experience of ICI use in stage IV NSCLC treatment, three cases of ICI-induced VLLs were diagnosed. In line with the previous reports, two of the three presented cases exhibited treatment response and favorable prognosis. The recognition and understanding of the pathophysiological processes underlying ICI-induced VLLs may represent a promising opportunity to identify a predictive marker of tumor response to ICIs, with impact in treatment selection and patient management. It also may contribute to the recognition of new patterns of molecular expression that could lead to improvements in therapeutic development.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Immunotherapy; Lung Neoplasms; Retrospective Studies; Vitiligo
PubMed: 38392077
DOI: 10.3390/curroncol31020083