-
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 -
Dermatology and Therapy May 2024Atopic dermatitis (AD) is characterized by intense itch and other symptoms that negatively impact quality of life (QoL). This study evaluates the effect of upadacitinib...
INTRODUCTION
Atopic dermatitis (AD) is characterized by intense itch and other symptoms that negatively impact quality of life (QoL). This study evaluates the effect of upadacitinib (an oral selective Janus kinase inhibitor) monotherapy on patient-reported outcomes (PROs) among adults and adolescents with moderate-to-severe AD over 16 weeks.
METHODS
This integrated analysis of the double-blind, placebo-controlled periods of phase 3 monotherapy clinical trials Measure Up 1 (NCT03569293) and Measure Up 2 (NCT03607422) assessed itch (Worst Pruritus Numerical Rating Scale [WP-NRS] and SCORing Atopic Dermatitis [SCORAD]), skin pain and symptom severity (AD Symptom Scale), symptom frequency (Patient-Oriented Eczema Measure), sleep (AD Impact Scale [ADerm-IS] and SCORAD), daily activities and emotional state (ADerm-IS), QoL (Dermatology Life Quality Index [DLQI] and Children's DLQI), mental health (Hospital Anxiety and Depression Scale), and patient impressions (Patient Global Impression of Severity, Patient Global Impression of Change, and Patient Global Impression of Treatment).
RESULTS
Data from 1683 patients (upadacitinib 15 mg, n = 557; upadacitinib 30 mg, n = 567; placebo, n = 559) were analyzed. A greater proportion of patients receiving upadacitinib versus placebo experienced improvements in itch (≥ 4-point improvement on WP-NRS) by week 1 (upadacitinib 15 mg, 11.2%; upadacitinib 30 mg, 17.7%; placebo, 0.5%; P < 0.001), with response rates sustained through week 16 (upadacitinib 15 mg, 47.1%; upadacitinib 30 mg, 59.8%; placebo, 10.4%; P < 0.001). Improvements were similar for PROs assessing skin pain/symptoms, sleep, daily activities, QoL, emotional state, mental health, and patient impressions of disease severity and treatment. Responses generally improved rapidly (within 1-2 weeks), increased through weeks 4-6, and were maintained through week 16.
CONCLUSIONS
Once-daily oral upadacitinib monotherapy improved response rates across PROs compared with placebo. Upadacitinib therapy resulted in rapid, sustained improvements in PROs measuring symptom burden and QoL in adults and adolescents with moderate-to-severe AD.
TRIAL REGISTRATION
ClinicalTrials.gov identifiers, NCT03569293 and NCT03607422.
PubMed: 38696027
DOI: 10.1007/s13555-024-01157-5 -
Molecular Medicine Reports Jul 2024Inherited ichthyosis comprises a series of heterogeneous dermal conditions; it mainly manifests as widespread hyperkeratosis, xerosis and scaling of the skin. At times,...
Inherited ichthyosis comprises a series of heterogeneous dermal conditions; it mainly manifests as widespread hyperkeratosis, xerosis and scaling of the skin. At times, overlapping symptoms require differential diagnosis between ichthyosis and several other similar disorders. The present study reports seven patients with confirmed or suspected to be associated with ichthyosis by conducting a thorough clinical and genetic investigation. Genetic testing was conducted using whole‑exome sequencing, with Sanger sequencing as the validation method. The MEGA7 program was used to analyze the conservation of amino acid residues affected by the detected missense variants. The enrolled patients exhibited ichthyosis‑like but distinct clinical manifestations. Genetic analysis identified diagnostic variations in the , , and genes and clarified the carrying status of each variant in the respective family members. The two residues affected by the detected missense variants remained conserved across multiple species. Of note, the two variants, namely : c.452C>T(p.P151L) and c.647_650del(p.L216fs) are novel. In conclusion, a clear genetic differential diagnosis was made for the enrolled ichthyosis‑associated patients; the study findings also extended the mutation spectrum of ichthyosis and provided solid evidence for the counseling of the affected families.
Topics: Humans; Female; Male; Keratoderma, Palmoplantar; Filaggrin Proteins; Exome Sequencing; Child; Ichthyosis; Pedigree; Adult; Genetic Testing; Serpins; Keratin-10; Adolescent; Child, Preschool; Mutation, Missense; Mutation; Young Adult; Genetic Predisposition to Disease; Steryl-Sulfatase
PubMed: 38695247
DOI: 10.3892/mmr.2024.13235 -
Cureus Apr 2024Background TikTok is among the most popular social media sites, and its utilization for health information is growing each day. The present study assesses the...
Background TikTok is among the most popular social media sites, and its utilization for health information is growing each day. The present study assesses the popularity and quality of the top 100 most-liked videos on TikTok tagged with "#ichthyosis." This study aims to do so by assessing contributions from physician, and nonphysician sources (such as from patients) to guide healthcare professionals interested in leveraging this platform for public health. Methodology A cross-sectional analysis of the top 100 most-liked videos tagged with "#ichythosis" on TikTok as of January 3, 2024, was conducted. The parameters assessed for this study include observable characteristics, content type, and whether the creator was a physician or nonphysician. The quality of the content was measured using the DISCERN scale. Results Based on these results, 14 of the top 100 videos were posted by physicians with 1,912,975 as the mean number of views. There were 86 videos posted by nonphysician creators averaging 2,675,341 views. Videos posted by nonphysician creators had a higher average number of views, number of likes, and number of comments but less average saves. Videos made by physicians and educational content had the highest average DISCERN scores, whereas nonphysician, awareness, and personal experience content had the lowest average DISCERN scores. Conclusions Physicians are deemed trustworthy, reliable sources of healthcare-related information on TikTok. This study emphasizes the importance of physicians continuing to provide reliable, evidence-based health information on social media platforms such as TikTok.
PubMed: 38694685
DOI: 10.7759/cureus.57401 -
Journal of Lipid Research Jun 2024Lipids in the stratum corneum play an important role in the formation of the skin permeability barrier. The causative gene for congenital ichthyosis, NIPAL4, encodes a...
Lipids in the stratum corneum play an important role in the formation of the skin permeability barrier. The causative gene for congenital ichthyosis, NIPAL4, encodes a Mg transporter and is involved in increases in intracellular Mg concentrations that depend on keratinocyte differentiation. However, the role of this increased Mg concentration in skin barrier formation and its effect on the lipid composition of the stratum corneum has remained largely unknown. Therefore, in the present study, we performed a detailed analysis of epidermal lipids in Nipal4 KO mice via TLC and MS. Compared with WT mice, the Nipal4 KO mice showed compositional changes in many ceramide classes (including decreases in ω-O-acylceramides and increases in ω-hydroxy ceramides), together with increases in ω-hydroxy glucosylceramides, triglycerides, and free fatty acids and decreases in ω-O-acyl hydroxy fatty acids containing a linoleic acid. We also found increases in unusual ω-O-acylceramides containing oleic acid or palmitic acid in the KO mice. However, there was little change in levels of cholesterol or protein-bound ceramides. The TLC analysis showed that some unidentified lipids were increased, and the MS analysis showed that these were special ceramides called 1-O-acylceramides. These results suggest that elevated Mg concentrations in differentiated keratinocytes affect the production of various lipids, resulting in the lipid composition necessary for skin barrier formation.
Topics: Animals; Mice; Mice, Knockout; Epidermis; Magnesium; Ceramides; Lipid Metabolism; Lipids; Cation Transport Proteins; Keratinocytes; Fatty Acid Transport Proteins
PubMed: 38692573
DOI: 10.1016/j.jlr.2024.100550 -
Cureus Mar 2024Lichen planus (LP) is a common T-cell-mediated autoimmune skin disease, and its exact etiology is unknown. Typically, it affects the trunk, flexural surfaces, and the...
Lichen planus (LP) is a common T-cell-mediated autoimmune skin disease, and its exact etiology is unknown. Typically, it affects the trunk, flexural surfaces, and the mucosa.We report a rare finding of LP involving both eyelids in a 67-year-old female. A 67-year-old Saudi female with a medical history of diabetes mellitus, hypothyroidism and rheumatoid arthritis presented with a three-month history of pruritic skin eruptions in both eyelids. She had no associated musculoskeletal symptoms or fatigue and no medical or family history of atopy. The patient had violaceous, thin, scaly plaques confined to both eyelids. Oral mucosa, genitalia, scalp, and nails were not affected. Histopathology from the right lower eyelid confirmed the diagnosis of LP. Hepatitis C virus serology was negative. Patient was examined by ophthalmology to rule out conjunctival involvement of LP. She had dry eyes only. She was initially managed by topical tacrolimus 0.1% ointment and didn't tolerate it due to severe reaction. She tolerated mometasone propionate 0.1% cream, which relieved the itch and partially improved the lesions. Although rare, LP of the eyelids must be considered among differential diagnoses of eyelid dermatitis. It can be confined, or it may concomitantly involve other parts of the body. LP of the eyelid may also extend to the conjunctiva, so it's important to screen patients by ophthalmology to rule out possible ocular involvement. This is the first case report of a Saudi patient with LP confined to the eyelid. The management of LP involving the eyelids is challenging. Treatment options include topical steroids, tacrolimus ointment, phototherapy and oral retinoids (etretinate).
PubMed: 38690479
DOI: 10.7759/cureus.57299 -
Journal of Cancer Research and... Apr 2024This study aims to observe the curative effect of radioactive 125I seed implantation in treating inoperable or refused operation head and neck cancer.
PURPOSE
This study aims to observe the curative effect of radioactive 125I seed implantation in treating inoperable or refused operation head and neck cancer.
METHODS
Data from 132 patients with head and neck malignant tumors underwent computed tomography-guided radioactive 125I seed implantation from April 2004 to August 2020 were analyzed retrospectively. The Kaplan-Meier method was used to calculate the local control and survival rates. The logarithmic rank test and the Cox proportional risk model were used for univariate and multivariate analysis, respectively.
RESULTS
A total of 132 patients were enrolled. All tumors were confirmed to be malignant through pathological analysis. Herein, we revealed that the seeds were implanted at the primary tumor site (23 cases, representing 17.4%), recurrent (9 cases, representing 6.8%), or metastatic lymph nodes (100 cases, representing 75.8%). Three months after the operation, 96 patients were evaluated as effective, whereas 36 patients were considered ineffective. The median local control time was 16 months; the local rates at 6, 12, 18, and 24 months were observed to be 75%, 47%, 35%, and 22%, respectively. The study reports a median survival period (OS) of 15 months. Additionally, the survival rates at 6, 12, 18, and 24 months were 61%, 42%, 31%, and 27%, respectively. Regarding side effects, skin or mucosal toxicity occurred in 14 patients. Grade I skin toxicity occurred in seven cases (5.3%), grade IV skin toxicity in one case (0.8%), grade I mucosal ulcer in four cases (3.0%), and grade I dry mouth in four cases (3.0%). The multivariate analysis showed that short-term efficacy and tumor site were independent prognostic factors (P < 0.001, 0.006, respectively). Additionally, the multivariate analysis showed that the independent OS influencing factors included D90, the longest tumor diameter, and short-term efficacy (P = 0.017, 0.001, <0.001).
CONCLUSION
Radioactive 125I seed implantation is a safe and effective salvage therapy for patients with inoperable or refused operation head and neck cancer.
Topics: Humans; Iodine Radioisotopes; Male; Female; Middle Aged; Head and Neck Neoplasms; Aged; Adult; Retrospective Studies; Brachytherapy; Survival Rate; Aged, 80 and over; Treatment Outcome; Follow-Up Studies; Tomography, X-Ray Computed; Neoplasm Recurrence, Local; Prognosis
PubMed: 38687935
DOI: 10.4103/jcrt.jcrt_1891_23 -
Alternative Therapies in Health and... Apr 2024Iatrogenic skin injury is a common neonatal skin problem that can have a severe impact on the health and life of newborns. The purpose of this study was to explore the...
OBJECTIVE
Iatrogenic skin injury is a common neonatal skin problem that can have a severe impact on the health and life of newborns. The purpose of this study was to explore the factors influencing iatrogenic skin injury in neonates, identify and correct nursing behaviors that may lead to skin damage, thereby reduce the occurrence of skin damage and protect the health of newborns.
METHODS
The clinical data of 87 neonates with iatrogenic skin injury admitted to the Department of Neonatology of Shangrao People's Hospital, China, between January and June 2022, were retrospectively collected as a research group. The causes of iatrogenic skin injury were statistically analyzed. 50 neonates without iatrogenic skin injury in the same department during the same period were selected as the control group. The general data of the two groups were contracted, and the independent risk factors affecting iatrogenic skin injury in neonates were explored using multivariate Logistic regression. The corresponding nursing strategies were analyzed.
RESULT
(1) Among the 87 neonates with iatrogenic skin injury, the causes included adhesive dressing stripping (41.38%, 36/87), skin scratch during blue light phototherapy (25.29%, 22/87), diaper dermatitis (20.69%, 18/87), and skin pressure redness related to ventilator and continuous positive airway pressure (CPAP) (12.64%, 11/87). (2) The gestational age, birth weight, length of stay, use of noninvasive mechanical ventilation, orotracheal intubation, gastric tube, PICC catheterization, and skin allergy history of the two groups had statistically significant differences (P < .05). (3) The results of multivariate Logistic regression analysis indicated that the length of stay (OR=2.994, 95% CI=1.341~6.686), orotracheal intubation use (OR=0.015, 95% CI=0.004~0.060), and gastric tube use (OR=17.132, 95% CI=5.231~56.108) were independent risk factors of iatrogenic skin injury in neonates (P < .05).
CONCLUSION
Length of stay, orotracheal intubation use, and gastric tube use are independent risk factors for iatrogenic skin injury in neonates. Hospital stays and unnecessary use of orotracheal intubation and gastric tube should be reduced in future clinical management. Attention should be paid to strengthening skin observation and care, keeping skin dry and clean, and preventing iatrogenic skin injury.
PubMed: 38687850
DOI: No ID Found -
Annals of Burns and Fire Disasters Sep 2023Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves...
Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform or Mepilex Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex Ag group and 11.4% in the Xeroform group (p<0.0001). Patients with Xeroform donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex Ag and Xeroform groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex Ag) should be the standard of care in STSG donor site wound care.
PubMed: 38680433
DOI: No ID Found -
Biosensors Apr 2024Carbon nanotube (CNT)-based nanocomposites have found applications in making sensors for various types of physiological sensing. However, the sensors' fabrication...
Carbon nanotube (CNT)-based nanocomposites have found applications in making sensors for various types of physiological sensing. However, the sensors' fabrication process is usually complex, multistep, and requires longtime mixing and hazardous solvents that can be harmful to the environment. Here, we report a flexible dry silver (Ag)/CNT/polydimethylsiloxane (PDMS) nanocomposite-based sensor made by a solvent-free, low-temperature, time-effective, and simple approach for electrophysiological recording. By mechanical compression and thermal treatment of Ag/CNT, a connected conductive network of the fillers was formed, after which the PDMS was added as a polymer matrix. The CNTs make a continuous network for electrons transport, endowing the nanocomposite with high electrical conductivity, mechanical strength, and durability. This process is solvent-free and does not require a high temperature or complex mixing procedure. The sensor shows high flexibility and good conductivity. High-quality electroencephalography (EEG) and electrooculography (EOG) were performed using fabricated dry sensors. Our results show that the Ag/CNT/PDMS sensor has comparable skin-sensor interface impedance with commercial Ag/AgCl-coated dry electrodes, better performance for noninvasive electrophysiological signal recording, and a higher signal-to-noise ratio (SNR) even after 8 months of storage. The SNR of electrophysiological signal recording was measured to be 26.83 dB for our developed sensors versus 25.23 dB for commercial Ag/AgCl-coated dry electrodes. Our process of compress-heating the functional fillers provides a universal approach to fabricate various types of nanocomposites with different nanofillers and desired electrical and mechanical properties.
Topics: Nanocomposites; Nanotubes, Carbon; Silver; Dimethylpolysiloxanes; Electroencephalography; Electric Conductivity; Biosensing Techniques; Humans; Electrooculography; Electrodes; Signal-To-Noise Ratio
PubMed: 38667181
DOI: 10.3390/bios14040188