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This paper systematically reviews the current articles regarding the use of dupilumab in the treatment of bullous pemphigoid (BP) to evaluate its safety and efficacy. PubMed, Embase, Cochrane Library, and Web of Science databases were searched for publications on dupilumab for BP from inception to 10 March, 2023. A total of 26 studies were included for systematic review. The primary outcome was clinical remission, and the secondary outcomes were recurrence and adverse events. Among 96 patients, 71.8% (n = 69/96) received systemic or topical steroids, immunosuppressants, immunomodulators, intravenous immunoglobulins, antihistamines, plasmapheresis, rituximab, and omalizumab, but none of them were successful. After dupilumab treatment, 66.7% (n = 64/96) of patients achieved complete remission, 25.0% (n = 24/96) had partial remission, 5.2% (n = 5/96) showed no remission, and no patients experienced deterioration. In addition, 1.0% (n = 1/96) and 2.0% (n = 2/96) patients stopped using dupilumab due to adverse reactions and cost, respectively. The average remission time was 4.5 months. 46.2% (n = 25/96) of the patients were followed up with a median follow-up of 8 months and only 2 patients relapsed at 8 and 7 months, respectively. Adverse event was 16.9% (n = 12/71), of which transient eosinophilia was the most common. This study indicates that the dupilumab is a promising treatment for BP with high clinical benefit associated with low recurrence rate, adverse event rate, and mortality. However, a large-scale randomized controlled trial is needed to further confirm the safety and efficacy of dupilumab in patients with BP treatment. [ABSTRACT FROM AUTHOR]

Background. Breaking the itch-scratch cycle and facilitating lesion healing are pivotal in managing prurigo nodularis (PN). This study seeks to assess the efficacy of baricitinib, an oral JAK1/2 inhibitor, for treating PN. Methods. In this prospective pilot study, 12 patients with moderate to severe PN were administered oral baricitinib at a dosage of 4 mg/day for 12 weeks. The primary objective was to assess the efficacy of baricitinib in PN patients using the numeric rating scale (NRS) for pruritus, NRS sleep score, a 5-point investigator's global assessment (IGA) scale, dermatology life quality index (DLQI), and nodular lesion count at weeks 0, 1, 2, 4, 8 and 12. In addition, the NRS pruritus and sleep scores were assessed via phone on days 2 and 4 after baricitinib treatment. Results. Baricitinib treatment led to a statistically significant improvement in the mean NRS pruritus and sleep scores, evident as early as day 2 (57.7% change from baseline; P < 0.001 , and 34.7% change from baseline, P = 0.029 , respectively) and consistently declining thereafter. Evaluation of nodular lesions revealed a significant reduction starting from week 2 (mean difference of 37.08 from baseline; P < 0.001). Analysis of other endpoints, including mean DLQI and IGA scores, also demonstrated substantial improvement at all time points (week 1, 2, 4, 8, and 12) compared to baseline. However, it is important to acknowledge the limitation of a small sample size. This constraint warrants consideration when interpreting the results and generalizing the findings. Conclusion. This preliminary study underscores baricitinib's potential for PN treatment by providing a rapid clinical response. The larger and longer randomized controlled trials are essential to determine the effectiveness, longevity, and safety of baricitinib in managing PN. This trial is registered with TCTR20230227002. [ABSTRACT FROM AUTHOR]

Background. Actinic keratosis (AK) is a common premalignant skin condition. Its diagnosis is based on a clinical and sometimes dermoscopic examination, but, in some situations, a skin biopsy may be necessary. Dynamic optical coherence tomography (D-OCT) can often bypass this need, by noninvasive evaluation of skin morphology. Early and effective treatment of AKs is important to prevent the progression to invasive squamous cell carcinoma (iSCC). Tirbanibulin 1% ointment, a new topical field therapy for AKs, has recently been introduced. Objectives. The aim of this study was to evaluate the efficacy and safety of tirbanibulin 1% ointment for the field treatment of nonhyperkeratotic, nonhypertrophic AKs (Olsen grade 1) on the face and/or scalp in adults, using D-OCT technology. Methods. Patients, presenting multiple, mild to moderate AKs on the face and scalp, in treatment with tirbanibulin 1% ointment for five consecutive days of an area measuring 25 cm2, were evaluated with videodermoscopy (V-track Vidix 4.0) and D-OCT (VivoSight Dx, Michelson Diagnostics Ltd., Kent, England, United Kingdom), as normal clinical practice. The lesions were staged according to the Olsen classification, excluding the most aggressive lesions. Results. We retrospectively evaluated 50 patients (27 males and 23 females, mean age 76 ± 7.9 years). At 57 days posttreatment, the complete clearance rate was 68% (n = 34) and partial clearance rate was 76% (n = 38). D-OCT showed markedly improved morphology, including a better recognizable dermal-epidermal junction (DEJ), associated with reduced inflammation. The most common adverse events reported were erythema and scaling, which were mostly mild and self-limiting. Conclusions. This study demonstrated that tirbanibulin may be considered an effective and well-tolerated treatment option for nonhyperkeratotic, nonhypertrophic AKs. It showed a favorable safety profile, with mostly mild adverse events. D-OCT can be considered a useful tool for personalizing AK treatment and monitoring. [ABSTRACT FROM AUTHOR]

Objective. To analyse the clinical and pathologic features, discuss therapeutic strategies, and possibly cause and identify prognostic factors of scrotal basal cell carcinoma (BCC) in Chinese patients. Materials and Methods. Between January 2012 and December 2022, 12 patients with scrotal BCC were diagnosed and treated at our institution. A review was conducted based on the clinical characteristics, pathology slides, and tissues of these patients. Results. The median patient age was 69.26 ± 11.23 years. The skin lesions presented as red papules, blue-grey polypoid nodules, erythematous patches, brownish plaques, and so on. All patients were treated using wide excision, but the margins varied from 0.5 cm to 2 cm. HPV infection was checked in all lesions, with 4 out of 12 testing positive for P16 and 1 for HPV16 DNA. We found mottled positive expression of P16 in the cytoplasm and membrane. One patient developed left inguinal lymph node metastasis and was successfully treated using bilateral inguinal lymphadenectomy. The rest recovered well without relapse. Conclusions. BCC of the scrotum is rare, but long-term surveillance is recommended for BCC patients, and whether genital HPV infection is a noteworthy feature for these patients remains under investigation. [ABSTRACT FROM AUTHOR]

Background. Amoxicillin was associated with acute generalized exanthematous pustulosis (AGEP), and the clinical characteristics were not clear. The purpose of this study was to explore the clinical characteristics of amoxicillin-induced AGEP and to provide a basis for prevention and treatment. Methods. Case reports and case series of amoxicillin-induced AGEP were collected for retrospective analysis by searching the Chinese and English databases from inception to January 31, 2023. Results. A total of 46 patients were included with a median age of 40 years (range 1.4, 87). The onset time of AGEP ranged from 6 hours to 28 days, with a median of 2.5 days. Fever occurred in 32 patients (69.6%), and pruritus occurred in 13 patients (28.3%). Ten patients (21.7%) had mucous membrane involvement and systemic involvement, respectively. Twenty-two patients had elevated neutrophils, with a median of 12850/mm3 (range 7880, 29140). Skin biopsy mainly showed subcorneal pustules (22 cases, 47.8%), spongy pustules (14 cases, 30.4%), and inflammatory cell infiltration (26 cases, 56.5%). Skin lesions disappeared in a median of 10 days (range 2, 42) after discontinuation of amoxicillin and administration of topical steroids (26 cases, 56.5%) as well as systemic corticosteroids (13 cases, 28.3%). Conclusions. AGEP is a rare complication of amoxicillin and is self-limiting. Clinicians should correctly identify AGEP and should avoid represcribing amoxicillin. Clinicians should correctly identify AGEP and avoid represcribing amoxicillin, which can prevent unnecessary treatment measures. [ABSTRACT FROM AUTHOR]

Background. Treatment resistance to biologic treatment at specific sites in the body is a challenging issue. However, there is insufficient evidence for factors affecting the resistance of these areas to biological therapies. Methods. In this study, patients with moderate-to-severetreatment-resistant psoriasis who were biologic naïve and referred to Razi hospital were included. The relationship between treatment resistance in different areas and demographic and clinical variables was investigated. Results. A total of 131 biologic-naïve patients with psoriasis treated with anti-TNF-α were included in this study. The most common resistant sites included the scalp, anterior lower legs, and elbows. Also, hand- and toe-nail involvements were considerable. BMI, gender, smoking, PASI score, the duration of the disease, the time distance between diagnosis and treatment, and treatment regiments were found to affect the incidence of resistance to treatment in multiple areas, while age, the incidence of recalcitrant disease and/or psoriatic arthritis, and the duration of current treatment did not have effects. Conclusion. The most common refractory sites were the scalp, anterior lower legs, and elbows. This study should be followed up with larger samples containing a variety of biological treatments in order to evaluate the results. [ABSTRACT FROM AUTHOR]

Psoriasis is an important disease in dermatological practice and, despite many studies, its pathogenesis is still not fully understood. Gasdermin C (GSDMC; melanoma-derived leucine zipper-containing extranuclear factor, MLZE) is a member of the gasdermin protein family. The study enrolled 60 patients with active plaque-type psoriasis and 30 volunteers without dermatoses. GSDMC concentration was assessed in serum and urine samples of all participants using ELISA. GSDMC tissue expression was assessed by immunohistochemistry. The GSDMC concentration was significantly higher in serum of patients than in controls (p < 0.001). A urinary GSDMC/creatinine ratio was significantly lower in patients than in controls (p < 0.05). Psoriatic lesions exhibited a significantly higher expression of GSDMC than nonlesional patients' skin or controls' skin (p < 0.001 , p < 0.01 , respectively). There was a positive correlation between the GSDMC serum concentration and the age of patients (R = 0.31, p = 0.015) and a negative correlation between GSDMC and RBC (R = −0.37; p = 0.0038), HGB (R = −0.26; p = 0.047), and urea concentration (R = −0.36; p = 0.04). Our study shows the potential involvement of GSDMC in psoriasis. An increased serum GSDMC and a decreased urinary GSDMC/creatinine ratio could be considered noninvasive psoriasis biomarkers, especially of local hypoxia or cell proliferation. [ABSTRACT FROM AUTHOR]

Purpose. Sensitive scalp (SScalp) is characterized by abnormal and nociceptive sensations, such as stinging and itching, that lead to scalp discomfort. This study assessed the benefit of a once-daily serum containing Adenosine, Magnesium Sulfate (MgSO4), Vitamin C Glucoside (CG), and pre- and probiotic fractions in subjects with SScalp. Methods. An open-label, single center study in adult subjects with a Global Scalp Discomfort (GSD) score of ≥8 (0–27), defined as the sum of individual symptom scores (0–9) for itching, stinging, and warming sensations. The frequency of scratching was self-declared. Evaluations were performed immediately after the 1st application (D0Timm) and at D21, during which the cosmetic acceptability was additionally assessed. Transepidermal water loss and skin hydration were assessed at baseline, D21, and D28. Squalene (SQ) and SQOOH were analyzed at D0T0, D21T0, and D28. Tolerance was assessed throughout the study. Results. 42 subjects (30 women and 12 men) participated in this study. The mean age was 44.0 ± 13.0 years. At baseline, the mean GSD was 13.9 ± 3.28. The GSD and symptoms significantly p < 0.0001 improved at D0Timm and lasted until the end of the study (D28), with insignificant worsening. There was a significant reduction of SQOOH at D21 and D28. Subject satisfaction was high, associated with a good tolerance. A similar and significant p < 0.0001 improvement was observed for subjects with more severe symptoms and a GSD score ≥14 at baseline. Conclusion. The topical serum significantly reduces SScalp, global discomfort, and oxidative stress and is beneficial in the management of sensitive scalp. This TRIAL is registered with NCT05630027. [ABSTRACT FROM AUTHOR]

Psoriasis is an inflammatory disease nowadays considered not only as a cutaneous but also as a systemic disease. Systemic therapy plays a crucial role in the management of psoriasis. Apremilast is an inhibitor of phosphodiesterase-4 (PDE4), indicated in the treatment of moderate-to-severe psoriasis. Here, we report a multicentric case series of patients treated with apremilast with resolution of skin manifestations and maintenance of clinical response for a minimum of 2 years. By inhibiting PDE4, apremilast acts as a ubiquitous intracellular enzyme, whose active form degrades adenosine cyclic intracellular monophosphate (cAMP) into AMP. The increase in cAMP determines a decrease in proinflammatory cytokines such as TNF-a, IL-17, IL-23, and upregulation of IL-10 with an anti-inflammatory action. Considering the growing incidence of comorbidities in the world population and in particular the strict correlation in patients with psoriasis, it is important to identify therapeutic options able to avoid a negative impact on patients with both conditions. The aim of this work is to highlight the utility of this molecule in the long-term management of these patients. Moreover, these case series further underline the high safety profile and manageability of this small molecule. [ABSTRACT FROM AUTHOR]

Background and Objective. Patients with psoriasis may exhibit abnormal changes in serum adipokine levels, which are often related to disease severity of the disease. Leucine-rich alpha-2-glycoprotein 1 (LRG1) is an acute-phase inflammatory protein that may be linked to adipokines in psoriasis. In this study, we evaluated the differences in the expression of adipokines and LRG1 between patients with psoriasis and healthy individuals, analyzed the correlation between the expression of LRG1 and adipokines, and explored their relationship with psoriatic lesions. Methods. In this cross-sectional study, patients with psoriasis (n = 54) and healthy controls (n = 26) were enrolled, and their clinical characteristics were recorded. Fasting venous blood samples were collected from each participant. The serum concentrations of leptin, resistin, adiponectin, and LRG1 in each sample were measured using the enzyme-linked immunosorbent assay. Results. The study included 54 patients with psoriasis vulgaris and 26 healthy controls. The serum levels of LRG1, leptin, and resistin were significantly higher in patients with psoriasis than in healthy controls. Conversely, adiponectin levels were significantly lower in patients with psoriasis. The study showed that LRG1 expression was positively correlated with leptin and resistin expression but negatively correlated with adiponectin expression. Interestingly, only leptin, resistin, and LRG1 expression showed a linear correlation with the Psoriasis Area and Severity Index (PASI). When we categorized patients with psoriasis based on their LRG1 levels, we observed that the group with high LRG1 levels showed a higher PASI. Conclusions. We observed a significant correlation between LRG1 and adipokine expression in patients with psoriasis. In addition, the expression levels of LRG1, leptin, and resistin were observed to be correlated with the severity of psoriasis. We believe that the occurrence and development of psoriasis are collectively influenced by LRG1 and leptin/resistin expression. [ABSTRACT FROM AUTHOR]

Introduction. Androgenetic alopecia (AGA), the most common form of hair loss in women, is characterized by progressive hair thinning and loss of terminal hairs over frontal and parietal regions of the scalp. This study aimed to evaluate the efficacy of the nutritional supplement Pilopeptan® WOMAN 5αR (PPT5α) composed of specific plant extracts, vitamins, and minerals in women with initial to moderate AGA. Methods. This was a prospective, randomized, double-blind, placebo-controlled clinical trial study. Forty-seven women (aged 25–59 years) with AGA grade I/II were randomized to daily receive PPT5α (n = 24) or placebo (n = 23), and the treatment safety, as well as the percentages of terminal hair in frontal and parietal areas from trichoscopic images, was assessed at 0, 3, and 6 months. Secondary outcomes included self-assessed hair parameters and overall treatment satisfaction. Results. A total of 44 women completed the study. At 6 months, patients who received the nutritional supplement showed high percentages of terminal hair both in the frontal (77.6% vs 69.8%, p = 0.02) and parietal (77% vs 64.3%, p = 0.02) areas compared to the placebo group. Self-assessed evaluation of hair parameters showed an improvement in the reduction of hair loss and hair thickness both at the 3-month (p = 0.004 and p = 0.012) and 6-month (p = 0.009 and p = 0.004) visits. At the 3 month visit, the intervention group also showed higher treatment satisfaction p = 0.01 . No significant adverse events were reported. Conclusion. These results evidence that the nutritional supplement PPT5α may be beneficial in preventing progression or even improving the condition of AGA in the early stages. [ABSTRACT FROM AUTHOR]

The primary aim of this retrospective study was to investigate the potential effectiveness of autologous platelet gel as a method for facial volume restoration and skin rejuvenation. High-frequency ultrasonography was utilized to assess the outcomes of the treatment. The study included a cohort of ten female patients aged between 40 and 50 who actively participated in the research. They reported moderate-to-severe static and dynamic wrinkles, volume loss, thinning, and roughness of the skin. Each patient received one session of autologous platelet gel injections. The gel was prepared accordingly with the manufacturer's (INNMEDIS, ATR™) instructions. Medium viscosity gel was injected into the superficial subdermal fat pads in the temples, as well as in the middle and lower face areas, to improve facial volume. A high-frequency ultrasound (US) device was employed to quantify skin density, skin thickness, and the depth of nasolabial folds. The US images were captured at three time points: before gel administration, one month after the procedure, and three months after the procedure. The imaging focused on the nasolabial folds area to monitor changes and assess the effectiveness of the treatment over time. Based on the analyses, the use of autologous platelet gel is beneficial towards improving skin density and decreasing nasolabial fold depth. However, further research should be conducted into the gel's effects on dermis thickness to achieve a stronger, more statistically significant conclusion. The level of satisfaction of the enrolled patients regarding their facial appearance was evaluated using the visual analogue scale (VAS). The VAS assessment revealed an average score of 4.1 before the commencement of the treatment, an average score of 7.9 one month after the treatment, and an average score of 7.5 three months following the treatment. The results indicate a significant increase in patient satisfaction following treatment completion. Autologous platelet gel appears to hold promise as a treatment option for volume replacement and skin rejuvenation, making it an attractive choice for individuals seeking natural skin treatments. Despite the encouraging findings from this observation, further validation is required through a larger controlled study to definitively confirm whether autologous platelet gel is indeed an effective method for volume replacement and skin rejuvenation. [ABSTRACT FROM AUTHOR]

Facial erythema is a representative symptom of rosacea patients that greatly impairs quality of life. Recently, the therapeutic effects of intradermal injection of botulinum toxin type-A on erythema have been investigated. Fractional microneedling radiofrequency has been reported to be effective in dermal remodeling and anti-inflammation. To obtain enhanced therapeutic effects with a less painful and easier approach, a treatment regimen using transdermal botulinum toxin delivery with fractional microneedling radiofrequency was developed. We aimed at investigating the efficacy and safety of transdermal botulinum toxin delivery with fractional microneedling radiofrequency in treating the erythema of rosacea. This was a retrospective review of 20 patients with facial erythema associated with rosacea. All patients underwent two sessions of treatment at 4-week intervals. Standardized photographs were taken, and the clinicians' erythema assessment (CEA), erythema index (EI) measured through a spectrophotometer, investigator's global assessment (IGA), and subjective satisfaction and side effects were evaluated at the baseline and 4, 8, and 12 weeks after the baseline. Compared to the baseline, CEA levels significantly decreased after 8 weeks (P = 0.018) and 12 weeks (P = 0.005). As an objective measure, EI was observed to decrease significantly at 4 weeks (P = 0.04) and 8 weeks after the baseline (P = 0.005) compared with the baseline. Ninety-five percent of patients were either very satisfied or satisfied with the treatment. None of the patients experienced remarkable side effects. A novel treatment regimen involving transdermal botulinum toxin delivery and fractional microneedling radiofrequency may be an effective and safe option for reducing the facial erythema of rosacea. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease affecting approximately 25% of all people worldwide at some point during their lifetime. Although total serum immunoglobulin E (IgE) and blood eosinophil levels are not elevated in all patients with AD, they have been shown associated with AD severity. This study aimed to investigate whether IgE and blood eosinophil levels correlate with the response to phototherapy treatment, which is a second-line treatment for moderate-to-severe AD, and therefore could be considered a readily available and reliable biomarker that could guide patient management. Eighty-two patients with AD who received phototherapy at the Sheba Medical Center were retrospectively evaluated for the following: demographic characteristics, serum IgE levels, blood eosinophils count, hospitalization duration, response to phototherapy, and requirement for systemic treatment. Response to phototherapy treatment was assessed by comparing the pre- and post-treatment Investigator's Global Assessment score for each patient in relation to the aforementioned factors. The total IgE and eosinophil levels were found to be significantly higher in patients who did not respond to phototherapy (p = 0.018 and p = 0.002 , accordingly). Serum values of 1780 IU/mL for IgE and 225.0 cells/μL for eosinophils showed maximum sensitivity and specificity as predictive values for treatment response. In conclusion, this study found that high total serum IgE levels and eosinophilia were correlated with a low response to phototherapy. These results suggest that escalating treatment is recommended for patients presenting these clinical features. [ABSTRACT FROM AUTHOR]

Melasma is a challenging pigmentation disorder to treat, and although low-fluence 1064 nm picosecond ND-YAG lasers have shown potential for treating benign pigmented disorders, data on the use of this laser for melasma treatment are currently insufficient. In this prospective split-face study, twenty-four patients with melasma on the face were enrolled and randomly assigned to receive treatment on one side of the face either with a low-fluence 1064 nm picosecond ND-YAG laser or with a low-fluence PTP mode 1064 nm Q-switched ND-YAG laser. Laser treatment was performed 5 times at intervals of 2 weeks, with evaluation conducted before each treatment and 2 months after the completion of 5 treatments. Clinical pictures using a standardized, digital photographic system and dermoscopy were taken on each day of the visit. The modified melasma area severity index (mMASI), melanin index (MI), dermoscopic scores of the pigmentary and vascular elements in melasma, pain during laser treatment, and patient satisfaction score were recorded. Twenty-one participants completed the study, and from week 2 in both groups, a significant decrease in mMASI and MI were confirmed. Although no statistically significant difference was observed, the decrease in mMASI and MI were greater in the 1064 nm picosecond ND-YAG laser group than in the 1064 nm Q-switched ND-YAG laser group. The 1064 nm picosecond ND-YAG laser group showed significant improvement in the pseudoreticular network and globular pattern of dermoscopic features between week 0 and week 16, while significant improvement in the globular pattern was shown in the 1064 nm Q-switched ND-YAG laser group. No significant difference was observed between the two groups in terms of the patient satisfaction score and pain during laser treatments. Notably, no adverse events were observed in either group. In conclusion, our study demonstrated that a low-fluence 1064 nm picosecond ND-YAG laser is as effective and safe in the treatment of melasma as a low-fluence PTP mode 1064 nm Q-switched ND-YAG laser. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) secreted from adipose-derived stem cells (ADSCs) are known to exhibit collagen synthesis and migration activity in fibroblasts. These EVs can be used as a regenerative medicine and for cosmetic medicinal materials. Royal jelly (RJ) is produced from the hypopharyngeal and mandibular glands of honeybees (nurse bee), which contains apicin and 10-hydroxy-2-decenoic acid, compounds that promote fibroblast proliferation and collagen and elastin synthesis. Here, we investigated whether RJ could further enhance the physiological function of ADSC-EVs on fibroblasts. The findings confirmed that lyophilized RJ and enzyme-treated RJ enhanced the secretion of EVs by ADSCs, increasing the proliferation, migration, and collagen synthesis of fibroblasts compared to those induced by conventional ADSC-EVs. Bioinformatics analysis was conducted using various software programs, based on the data obtained from comprehensive gene expression and small RNA profiling analyses through next-generation sequencing; the results suggested that the RJ treatment of ADSC-EVs significantly enhanced the expression of genes related to extracellular matrix composition. Our findings suggest that the ADSC-EVs qualitatively altered using RJ could offer a more effective therapeutic material for regenerative and cosmetic medicine than conventional ADSCs-EVs. [ABSTRACT FROM AUTHOR]

Background. Itch can be transmitted by two parallel pathways, histaminergic and nonhistaminergic. Histaminergic itch is transmitted by a subgroup of mechano-insensitive C-fibers, while nonhistaminergic itch by a subgroup of polymodal C-fibers. Experimental models are used to study pruritus: histamine for the histaminergic itch by antagonizing the histamine H1-receptors, and BAM8-22 and cowhage for the nonhistaminergic by activating Mas-related G protein-coupled receptors and protease-activated receptors, respectively. This study aims to evaluate the antipruritic effects of topical doxepin (H1-receptor antagonistic effect) on histaminergic and nonhistaminergic itch induced by histamine, BAM8-22, and cowhage. Methods. This study was conducted on 22 healthy subjects. Histamine, BAM8-22, cowhage, and vehicle were applied to 4 areas on the forearms. After 7 days, the same substances were applied after 11 / 2 hour-pretreatment with doxepin. After the application of pruritogens, itch and pain intensities were assessed for 9 minutes, followed by the measurement of superficial blood perfusion (SBP), mechanical and thermal sensitivities. Results. Application of histamine, BAM8-22, and cowhage all induced itch as compared to a vehicle. The pretreatment with doxepin almost abolished the histamine-induced itch and modestly reduced BAM8-22- and cowhage-induced itch. Histamine induced a higher SBP compared to the other conditions. Doxepin reduced SBP induced by each pruritogen, even though SBP of histamine remains the highest. Conclusion. Doxepin cream abolished histaminergic itch by antagonizing the peripheral H1-histamine receptors. Moreover, doxepin reduced nonhistaminergic itch and related neurogenic inflammation. Further studies are needed to elucidate the molecular mechanisms underlying this peripheral modulation of nonhistaminergic itch by a topically applied H1-antagonist. This trial is registered with NCT04588532. [ABSTRACT FROM AUTHOR]

Several studies have shown that magnesium can be a useful tool in preventing various skin disorders. However, the mechanism remains unclear. In this study, we analyzed the mechanism by which magnesium improves skin function, focusing on the water channel aquaporin-3 (AQP3), which is a cutaneous functional molecule. Magnesium compounds (magnesium acetate, magnesium chloride, magnesium sulfate, and magnesium lactate) were added to human epidermal keratinocyte HaCaT cells, and the mRNA and protein expression levels of AQP3 were analyzed. We also investigated the mechanism by which magnesium acetate regulates AQP3 expression. Several magnesium compounds were individually added to HaCaT cells, and 6 hours later, the AQP3 mRNA expression level in the treated cells was significantly increased compared to that in the control cells. Among the magnesium compounds, magnesium acetate had a strong effect and markedly increased the AQP3 mRNA expression level by approximately 3.5 times and the protein expression level by approximately 3 times. Magnesium acetate also enhanced the phosphorylation of cAMP response element-binding protein (CREB), which is involved in AQP3 transcription. Furthermore, the increase in AQP3 expression levels induced by magnesium acetate was suppressed by treatment with the protein kinase A (PKA) inhibitor H-89. Magnesium compounds increased the expression level of AQP3 in epidermal keratinocytes and may have a skin-moisturizing effect. The magnesium-induced phosphorylation of CREB may be associated with the activation of the cAMP/PKA pathway. Overall, magnesium compounds may be useful for the prevention and treatment of age-associated xeroderma. [ABSTRACT FROM AUTHOR]

The objective of this retrospective study was to verify with the use of high-frequency ultrasonography whether Platelet-Rich Fibrin (PRF) can increase skin density and become an effective method of skin revitalization as well as to determine an optimal procedure protocol for the use of Platelet-Rich Fibrin to revitalize skin of the periorbital region. Ten patients (women, age 32–45) were assigned for the observation. They reported thinning and wrinkles of the skin in the periorbital area. For each individual two vials (18 mL) of peripheral blood were collected and placed in preprogrammed centrifuge (60 g , 3 minutes). After centrifugation injectable-PRF (i-PRF, 2 mL) was collected and injected intradermally in the periorbital area, using the mesotherapy technique with 4 mm 30 G needles. The patients underwent four procedures in one month intervals. A high-frequency ultrasound device was used to measure skin density. Skin density analyses were performed before PRF administration, a month after the second and a month after the third procedure in the crow's feet area. The results demonstrated an increase in skin density in all patients after just one procedure: on average it was 1.66 times higher compared to the baseline after the second and 5.08 times higher after the third treatment which was visualized using the DUB SkinScanner imaging. The enrolled patients' satisfaction with their facial skin appearance was measured with the visual analogue scale (VAS). Digital photographs were taken before the first treatment and a month after the last treatment. The VAS assessment results were as follows: the average score before the treatment was 4 and the average score after the treatment was 8.5, indicating a significant increase in patient satisfaction. i‐PRF seems to be a promising treatment modality for skin rejuvenation in the periorbital area and might be a solution for those seeking natural methods. Although the results of this observation are very promising, there is need for larger controlled research to definitely confirm Platelet-Rich Fibrin efficacy in the skin revitalization processes. [ABSTRACT FROM AUTHOR]

Postinflammatory hyperpigmentation (PIH) is one of the most prevalent complications of laser treatment. However, comprehensive evidence is lacking to confirm the effect of tranexamic acid (TXA) for the prevention of postlaser PIH. We classified laser combined with TXA as the experimental group and laser alone as the control group from the selected studies in order to determine the efficacy of the extra use of TXA. We conducted a comprehensive literature review of randomized controlled trials (RCTs) that matched TXA coupled with laser vs. laser alone. The melanin index (MI) scores were employed as the clinically improved outcomes. Seven RCTs and a total of 222 individuals were evaluated in this meta-analysis. The findings revealed no statistically significant difference between the TXA and control groups in terms of decrease in mean MI scores at the end of the research (P = 0.45). The subgroup analysis showed that at month 1, extra use of TXA after laser treatment resulting in a statistically significant decrease in MI as opposed to laser alone (P = 0.04). However, at months 2 (P = 0.73), 3 (P = 0.85), and 6 (P = 0.64), the decrease in MI scores was not statistically significant. In addition, there was no statistically significant difference between topical, oral, and intradermal TXA on the reduction of MI scores after treatment (P = 0.61). Furthermore, nausea and menorrhagia occurred in the oral TXA group. The current meta-analysis found limited temporary efficacy of TXA in preventing postlaser PIH after 1 month. [ABSTRACT FROM AUTHOR]

Background. Ingrown nails are a type of nonspecific inflammation of nail folds. Intralesional injection is a rarely reported nonsurgical therapy for ingrown nails. Objective. To observe the efficacy of treating ingrown nails with intralesional injection, and to evaluate at which stage ingrown nails are applicable for this therapy. Methods. Ingrown nails were randomly divided into treatment (n = 87) and control (n = 37) groups. The treatment group received local injections combined with basic nursing, whereas the control group was only treated with basic nursing. Patients were followed up at 1 week, 1 month, 3 months, and 6 months after the first treatment. Results. A statistically significant difference of the efficacy rates was observed between the two groups (P < 0.05). The overall satisfaction rate was 83.91% in the treatment group and 64.86% in the control group (P = 0.019). Conclusion. Intralesional injection is an effective therapy for ingrown nails, especially in the short term. This therapy is more applicable for Martinez-Nova stage I and IIA ingrown nails and can be used as a symptomatic treatment to relieve the acute inflammation of ingrown nails at stages IIB, III, and IV. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most common metabolic diseases in which one of the most serious complications is the diabetic foot ulcer (DFU). The aim of the study was to compare the efficacy of two physical therapeutic methods: topical oxygen therapy and topical ozone therapy in the treatment of DFU with the calculation of the financial costs for both applied physical methods. The study included 85 patients, 47 male (55.2%) and 38 female (44.7%) in age range between 40 and 90 years (mean age: 67.82 ± 12.42 years) with hard to heal diabetic foot ulcers. The mean diabetic foot ulcer duration was 3.6 ± 1.23 years. Patients were randomized into two study groups not significantly different in terms of age, body mass index (BMI) value, and baseline ulcer surface area value, who underwent topical oxygen therapy (group I) and topical ozone therapy (group II), respectively. Both the groups underwent a total of 30 daily treatments lasting 30 minutes, in 2 sessions of 15 treatments with a 14-day break between sessions. Progress in wound healing was evaluated by computerized planimetry and the pain intensity was assessed with use of a VAS scale. After the treatment, the ulcer area in group I decreased by an average of 33.25 ± 10.97% and by an average of 28.67 ± 14.47% in group II p = 0.030 . On the other hand, the intensity of pain ailments after the treatment was statistically significantly decreased in group I by an average of 57.13 ± 16.24% while in group II by an average of 40.21 ± 14.53% (p < 0.001). After application of topical oxygen therapy and topical ozone therapy in the treatment of diabetic foot ulcers a statistically significant reduction in the surface area of treated ulcers in objective planimetric assessment was observed, with local oxygen therapy showing only a slight advantage in this regard. Both compared methods also caused a statistically significant reduction in the pain intensity, while local oxygen therapy shows statistically significantly better analgesic effectiveness. Due to the calculated moderate cost, both applied methods appeared to be cost-effective. [ABSTRACT FROM AUTHOR]