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Striae gravidarum (SG) is a connective tissue disorder seen commonly in primigravidas. It is associated with impairment in the quality of life.To determine the efficacy of ablative fractional carbon dioxide (CORandomized, double-blinded, and placebo-controlled trial.The study was conducted in 16 patients with SG. The assigned treatment area (abdomen) was divided into two sides and was randomly assigned to the PRP side and the control side. All patients received ablative fractional COThe combination of ablative fractional COAblative fractional CO

BackgroundHidradenitis suppurativa were associated with comorbidities in various organ systems. Inflammatory dermatological diseases such as pyoderma gangrenosum were reported to be associated with hidradenitis suppurativa. Nevertheless, as for the association between hidradenitis suppurativa and psoriasis, evidences were insufficient. In many studies, the association between psoriasis and hidradenitis suppurativa has been reported. However, some evidence seems to be controversial. The purpose of the systematic review and meta-analysis was to assess whether there was significant association between HS and psoriasis.MethodsOn June 01, 2022, we appraised 2,795 articles from databases including PubMed, Web of Science and Embase. Search syntaxes were based on ‘hidradenitis suppurativa’ or ‘acne inversa’ with “psoriasis”, “comorbidities” or ‘epidemiology’. Synonyms were determined based on MeSH terms and Emtree. Observational results that evaluated the odds ratio for people with hidradenitis suppurativa who had psoriasis were extracted for qualitative synthesis.ResultsAfter the selection process of the initial 2,795 studies, ten observational studies, including 3 cohort studies, 1 case-control study, and 6 cross-sectional studies, were extracted for critical appraisal. Based on the integration of 7 studies (with more than 560,000 participants included), people with hidradenitis suppurativa had a higher risk of having psoriasis, with a 2.67-fold risk (95% CI, 1.84, 3.87). The association remained in the sensitivity analyses utilizing strict adjustment models. In the analysis that only included studies with a similar study design and adjustments in obesity-related factors, the risk of people with hidradenitis suppurativa having psoriasis was 3.24 (95% CI, 2.27, 4.62). In male patients with HS, the risk of having psoriasis was 4.30-fold higher than male patients without HS (95% CI, 2.37, 7.78). Likewise, in an analysis including 3 cross-sectional studies, the risk of female HS patients having psoriasis was 3.94-fold higher than female HS-free patients (95% CI, 2.34, 6.63).ConclusionsThe co-occurrence of hidradenitis suppurativa and psoriasis can greatly increase the burden of the disease. Psoriasis could be one of the critical comorbidities of hidradenitis suppurativa and should be recommended for future screening and follow up. The association between the two diseases should be kept in mind in managing hidradenitis suppurativa patients. More prospective studies are needed to establish the true magnitude of the association between psoriasis and hidradenitis suppurativa.

Adverse drug reactions (ADR) remain the major problems in healthcare. Most severe ADR are unpredictable, dose-independent and termed as type B idiosyncratic reactions. Recent pharmacogenomic studies have demonstrated the strong associations between severe ADR and genetic markers, including specific HLA alleles (e.g., HLA-B*15:02/HLA-B*57:01/HLA-A*31:01 for carbamazepine-induced severe cutaneous adverse drug reactions [SCAR], HLA-B*58:01 for allopurinol-SCAR, HLA-B*57:01 for abacavir-hypersensitivity, HLA-B*13:01 for dapsone/co-trimoxazole-induced SCAR, and HLA-A*33:01 for terbinafine-induced liver injury), drug metabolism enzymes (such as CYP2C9*3 for phenytoin-induced SCAR and missense variant of TPMT/NUDT15 for thiopurine-induced leukopenia), drug transporters (e.g., SLCO1B1 polymorphism for statin-induced myopathy), and T cell receptors (Sulfanilamide binding into the CDR3/Vα of the TCR 1.3). This mini review article aims to summarize the current knowledge of pharmacogenomics of severe ADR, and the potentially clinical use of these genetic markers for avoidance of ADR.

As the world deals with the COVID-19 pandemic, vaccination remains vital to successfully end this crisis. However, COVID-19-vaccine-induced immediate hypersensitivity reactions presenting with potentially life-threatening systemic anaphylactic reactions are one of the reasons for vaccine hesitancy. Recent studies have suggested that different mechanisms, including IgE-mediated and non-IgE-mediated mast cell activation, may be involved in immediate hypersensitivity. The main culprits triggering hypersensitivity reactions have been suggested to be the excipients of vaccines, including polyethylene glycol and polysorbate 80. Patients with a history of allergic reactions to drugs, foods, or other vaccines may have an increased risk of hypersensitivity reactions to COVID-19 vaccines. Various strategies have been suggested to prevent hypersensitivity reactions, including performing skin tests or in vitro tests before vaccination, administering different vaccines for the primary and following boosters, changing the fractionated doses, or pretreating the anti-IgE antibody. This review discusses the current trends, potential mechanisms, and prevention strategies for COVID-19-vaccine-induced immediate hypersensitivity reactions.

Background Heart failure phenotyping in single‐ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross‐sectional Study database. EF was considered abnormal if 90th percentile (≥0.26 mL ‐1 ). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO 2 . Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P 2 compared with controls (52% [20] versus 67% [23], P P Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.

Introduction: The cardiac mechanics that contribute to the development of heterogenous heart failure phenotypes in Fontan patients have not been investigated. The objective of this study was to investigate the differences in contractility, afterload, and ventriculo-arterial (VA) coupling between patients with heart failure and preserved ejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF). Methods: Core-lab echocardiograms were obtained from the publically-available Pediatric Heart Network Fontan Cross-sectional Study database. Ejection fraction was considered abnormal if < 50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e’/end-diastolic volume) was > 10 th percentile. Patients were divided into three groups: 1 = normal EF and normal diastolic function, 2 = decreased EF with normal diastolic function, 3 = normal EF with abnormal diastolic function. End-systolic elastance (Ees), a measure of contractility, and arterial elastance (Ea), a measure of afterload, were calculated. VA coupling was defined as Ea/Ees. Results: 238 patients (61% left, 39% right ventricular dominant) were included. Differences between groups are reported in the Table. Conclusion: Both Fontan patients with HFpEF and HFrEF display increased afterload compared to their non-heart failure counterparts. However, HFpEF patients displayed a hypercontractile state to maintain a VA coupling ratio comparable to the non-heart failure group. These measures of cardiac mechanics may be useful in identifying the mechanisms that drive Fontan patients toward HFpEF versus HFrEF phenotypes.

While the etiology of Kawasaki disease (KD) is unknown, a role for infectious agents, including common skin organisms, has been proposed. We report 2 cases of KD associated with burn injury. Case 1: A 2 year old boy was admitted with a first and second degree scald injury to more than 9% of his body. Initial leukocyte count (WBC) was elevated. He was discharged to home the next day, and on daily visits was noted to have decreased fluid intake with fever without an infectious source. A generalized macular rash developed and he was readmitted with persistent fever. He subsequently developed conjunctivitis, oral changes and unilateral cervical lymphadenopathy with erythema of his palms. He had elevated WBC, ESR and liver transaminases. Acute KD was diagnosed and he received a single dose of IVIG on day 8 of his illness, with good response. All culture results were negative. Initial and follow-up echocardiograms were normal. Case 2: A 2 year old boy was transferred to hospital with second degree scald injury to 20% of his body. Within 24 hours he developed fever and cough, which continued without an infectious source for the next 6 days. He developed conjunctivitis and oral changes, with normal WBC, elevated ESR and normal liver transaminases. A diagnosis of atypical KD was considered, and he subsequently developed a generalized rash and extremity changes. A single dose of IVIG was given on day 8 of his illness, with good response. Initial echocardiogram showed mild dilation of the left main coronary artery, which resolved by his 6 week assessment. All culture results were negative. We speculate that the association of KD with burn injury in these patients may relate to stress or injury-induced immunologic changes, skin or tissue antigen release, or weakened barrier for entry of skin and other organisms