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O’Brien’s actinic granuloma is clinically characterized by grouped red papules that may coalesce into annular plaques on sun damaged skin such as the head and neck, chest, and arms. There is no gender predilection, and patients tend to be middle-aged or older giving the association with significant actinic damage. We presented a 50-year-old male with multiple annular lesions on the neck of four years duration, associated with prolonged sun exposure. A biopsy confirmed the clinical suspicion of O’Brien’s granuloma and excluded other possibilities.

Dupilumab is the first biologic agent approved for treatment of moderate to severe atopic dermatitis (AD). Phase 3 clinical trials have shown the efficacy and safety in AD children. However, real-world evidence is still scarce. Thirty-nine pediatric patients with uncontrolled AD who regularly received dupilumab were included in a single-center retrospective study. Eight patients (20.5%) were aged 2 to <6 years, fifteen (38.5%) were 6 to <12 years, and sixteen were 12 to <18 years. Changes in clinical AD scores (EASI, SCORAD, P-NRS, CDLQI, and POEM) at baseline, week 4 (W4), W10, and W16, as well as safety data were collected. At W16, the average EASI values dropped from 29.0 ± 16.2 to 5.1 ± 4.7, and 22 patients (73.3%) achieved 75% improvement in EASI. 16 patients (53.3%) achieved 75% improvement in SCORAD. Significant reduction was also observed in the changes of P-NRS, CDLQI, and POEM values. Notably, the change of clinical scores was similar among three age subgroups. At W16, the mean percent decreases in EASI for 2 to <6 years, 6 to <12 years, and 12 to <18 years, and subgroups were 67.3%, 78.5%, and 83.9%, respectively. A total of three cases of adverse effects were recorded, with conjunctivitis seen in two >6-year-old patients and the injection site reaction in one <6-year-old child. Dupilumab exhibited favorable efficacy and safety profile, including the 2 to <6 years old subgroup. [ABSTRACT FROM AUTHOR]

When the structure of the silo steel framework of concrete mixing station is designed, In most cases, the dimension parameters, shape parameters and position parameters of silo steel framework beams are changed as the productivity adjustment of the concrete mixing station, but the structure types of silo steel framework will remain the same. In order to acquire strength of silo steel framework rapidly and efficiently, it is need to provide specialized parametric strength computational software for engineering staff who does not understand the three-dimensional software such as PROE and finite element analysis software. By the finite element methods(FEM), the parametric stress calculation modal of the silo steel framework of concrete mixing station is established, which includes dimension parameters, shape parameters, position parameters and applied load parameters of each beams, and then the parametric calculation program is written with MATLAB. The stress equations reflect the internal relationship between the stress of the silo steel frames with the dimension parameters, shape parameters, position parameters and load parameters. Finally, an example is presented, the calculation results show the stress of all members and the size and location of the maximum stress, which agrees well with realistic cases.

Half-thickness inversion layer high-frequency ultrasonic transducers were fabricated using lithium niobate (LiNbO(sub 3)) single crystal plate and the transducers used a 36 degree Celsius rotated Y-cut LiNbO3 thin plate with an active element thickness of 115 mum. The measured resonant frequency was consistent with the modeled data.

Background: Melanoma is one of the most malignant and aggressive skin tumors, and its incidence is increasing worldwide. However, few studies have investigated the process of tumorigenesis from normal skin to melanoma. Methods: Several bioinformatics analyses, including GEO databases, Oncomine database, TCGA database, STRING, MCODE and cytoHubba plug-ins, GEPIA, TIMER and TRRUST and DGIdb, were performed to disclose the hub genes and immunology implicated in primary melanoma tumorigenesis. Finally, immunohistochemistry (IHC) and quantitative real-time PCR (qPCR) were used to validate the results of bioinformatics analysis in vitro. Results: A total of 295 overlapping DEGs (ODEGs) (157 upregulated and 138 downregulated) and 9 hub genes were identified between primary melanoma and normal skin tissues. Functional analysis of these 9 hub genes indicated that the genes were primarily enriched in cell chemotaxis, the chemokine-mediated signaling pathway, the extracellular region, the extracellular space, chemokine activity and CXCR3 chemokine receptor binding. KEGG pathway enrichment showed that these genes were primarily involved in the chemokine signaling pathway, cytokine–cytokine receptor interaction, the toll-like receptor signaling pathway, the cytosolic DNA-sensing pathway and the TNF signaling pathway. Upregulated CCL5, CCL4, CXCL9 and CXCL10 demonstrated good overall survival (OS), and most of them have a higher expression in stage 0 and 1 of melanoma. Moreover, immune infiltration analysis showed that the above hub genes showed a strong positive correlation between their expression and infiltration of the six immune cell subsets. Transcription factor regulation network suggested that RELA and NFKB1 are the transcription factors of CCL4, CCL5, CXCL10 and CXCL2, while IRF7, IRF3 and IRF1 are the transcription factors of CCL5 and CXCL10. Drug–gene interaction analysis identified 46 drug–gene interactions. In vitro data demonstrated that the level of CCL4, CCL5, CXCL9 and CXCL10 is higher in melanoma than that in normal skin tissues, either at tissue or cell lines level. Conclusion: In summary, we identified 4 key chemokine members related to tumorigenesis and progression in primary melanoma, and these results may help to elucidate melanoma tumorigenesis and facilitate its treatment. [ABSTRACT FROM AUTHOR]

Background and Objective: The involvement of eyelids occurs in only 5–6% of patients with discoid lupus erythematosus (DLE), commonly with mucocutaneous lesions elsewhere. DLE solely involving the eyelids is relatively rare. This study aimed to describe the clinical features and treatments of all the reported cases of DLE with eyelid involvement as the only symptom. Methods: A systematic review was done of all the related literature published both in English and Chinese from May 1, 1984, to March 1, 2020. Only those cases of DLE solely involving eyelids were selected and summarized in two tables. Results: (i) DLE solely involving the eyelids is five times more likely to affect females than males. (ii) The majority of cases were presenting with unilateral eyelid involvement. Lower lids, especially both lower lids, were the most commonly affected locations. (iii) An erythematous plaque with scales is the most frequent manifestation. (iv) Approximately 22.9% of the cases had a positive antinuclear antibody (ANA) titer, and the speckled pattern was the most seen. For direct immunofluorescence (DIF), 94.4% of the performed cases showed positive results. (v) More than 85% of these cases showed an excellent response to treatment with oral antimalarials. Conclusion: Awareness of this atypical presentation is important to avoid underdiagnosis of DLE solely involving the eyelids. A biopsy for both routine histology and DIF is critical for establishing the diagnosis. [ABSTRACT FROM AUTHOR]

Byline: Tutyana. Sanusi, Yanqiu. Li, Yue. Qian, Changzheng. Huang Sir, A 43-year-old Chinese female presented with a 3-year history of mildly pruritic bullous skin eruptions on the upper and right [...]

Byline: Ying. Xia, Zhen. Yang, Siyuan. Chen, Changzheng. Huang, Yating. Tu, Juan. Tao Extranodal natural killer/T-cell lymphoma (ENKTL) is an extremely rare and an aggressive lymphoma. We report an interesting [...]

Aims: Adenoid cystic carcinoma (ACC) is a distinctive tumour. Limited studies involving a large population have reported multicentre systematic analyses of the clinical, pathological and immunohistochemical (IHC) features of ACC as well as the potential role of IHC markers in the prognosis of ACC. Methods and Results: The clinical, histopathological and IHC data of 296 cases obtained from two tertiary hospitals were analysed. The age at onset ranged from 12 to 87 years with a median age of 52 years. The male‐to‐female ratio was 1:1.3. Patients with ACC arising from the lacrimal gland were younger than those with tumours arising from other sites. Patients with tumours in the extra auditory canal and nasopharynx were older than those with tumours in other locations. Histopathologically, solid type ACC was the most frequent in the nasal cavity and paranasal sinus (6/51) group. Tumours arising from the oral cavity most commonly showed perineural invasion (10/60) and margin positivity (11/60). IHC analyses showed that CK8/18, CK7, CK14, epithelial membrane antigen and CD117 were expressed in 35/35 (100%), 87/88 (98.8%), 26/27 (96.2%), 42/43 (97.6%) and 113/120 (94.1%) patients, respectively. CK5/6, P63, smooth muscle actin, calponin and S100 were positively expressed in 73/73 (100%), 111/124 (89.5%), 38/43 (88.3%), 41/50 (82.0%) and 61/92 (66.3%) cases, respectively. S100 proteins were expressed in 54 (54/77) primary cases and two (2/9) metastatic cases (p = 0.013). Conclusions: ACC is a distinctive tumour that mainly affects middle‐aged and elderly individuals, with a mild female predominance. Loss of expression of S100 proteins may be a poor prognostic factor associated with metastasis. [ABSTRACT FROM AUTHOR]

After 4 months of baricitinib treatment, patient 5, who was the youngest patient at 7 years old, saw a SALT decrease of 80 and an improvement in her nail symptoms. In the treatment of juvenile dermatomyositis, baricitinib is taken between 4 and 8 mg per day, based on the patient's weight.[3] In adult AA patients, 4 mg of baricitinib daily had higher clinical effectiveness than 2 mg.[4] Here, three patients weighing <50 kg received a daily dose of 2 mg baricitinib and two patients weighing more than 50 kg were given 4 mg baricitinib daily. Except for patient 3 who showed no improvement, the other four patients demonstrated a significant decrease in SALT (Table 1). [Extracted from the article]

Background: The available treatments for refractory hyperkeratotic eczema are inadequate with frustrating results. We, therefore, incorporated Calcipotriol and Betamethasone Dipropionate (Daivobet®), and Viaminate into the mainstay treatment to improve the clinical symptoms. The study aimed to evaluate the efficacy of Daivobet ® and Viaminate as a potential treatment alternative for refractory hyperkeratotic eczema. Patients and Methods: Between 2013 and 2015, 61 patients diagnosed with refractory hyperkeratotic eczema (RHE) who had shown inadequate response to conventional therapies were pooled from a single center. Besides, they were all treated with Daivobet ® , Viaminate, and an occlusive dressing mixture containing 5% salicylic acid ointment and 25% zinc oxide paste following inadequate response to conventional therapies (corticosteroids plus 25% zinc oxide paste and 5% salicylic acid ointment). Investigators Global Assessment (IGA) and Patient-Oriented Eczema Measure (POEM) assessed baseline and outcome measures for the degree of hyperkeratinization (0-clear; 3-moderate; 4-severe). Results: Of the 61 patients, 49 (80.3%) patients presented with moderate RHE and 12 (19.7%) with severe RHE. After 24 weeks of treatment, the period for loss of keratinization was significantly lower in patients with moderate RHE (3.9± 1.9 weeks) than those with severe RHE (10.8± 1.0 weeks) with a P-value < 0.01. Furthermore, they required a significantly shorter total treatment duration (10.6 ± 4.3 weeks) than those with severe RHE (20.3± 3.6 weeks) with a P-value of < 0.01. However, there were no significant differences in post hoc analysis at week 36 with P-values of 0.46 and 1.00 for IGA and POEM, respectively. Conclusion: Our results showed that the incorporation of Viaminate and Daivobet® into mainstay treatment was effective and safe for the long-term management of RHE. [ABSTRACT FROM AUTHOR]

A new model is presented for studying the effects of crack parameters on the dynamics of a cracked beam structure. The model is established by the finite element displacement method. In particular, the stiffness matrix of the cracked beam element is firstly derived by the displacement method, which does not need the flexibility matrix inversion calculation compared with the previous local flexibility approaches based on the force method. Starting with a finite element model of cracked beam element, the equation of strain energy of a cracked beam element is formed by the displacement method combined with the linear fracture mechanics. Then, based on the finite element method, the dynamic model of the cracked beam structure is obtained. The results show that the dynamic model discovers the internal relation between the dynamic characteristics of cracked beam structure and structural parameters, material parameters, and crack parameters. Finally, an example is presented to validate the proposed dynamic model. [ABSTRACT FROM AUTHOR]