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Distressed personality (or Type D personality, TDp) is a personality trait that has been associated with poor quality of life in patients suffering from a variety of skin diseases such as psoriasis or urticaria. To date the potential association between Alopecia areata (AA) and TDp has not been studied. The aim of this study was to compare the prevalence of TDp between patients with AA and controls, and to analyse the impact of TDp on patients with AA regarding mood status disturbances, quality of life and sexuality.Cross-sectional study includes patients suffering from mild-to-severe AA and sex- and age-matched healthy controls. Socio-demographic and clinical variables, quality of life, sexual disfunction, anxiety, depression and TDp were collected using validated questionnaires.A total of 120 participants (60 patients and 60 controls) were included. Patients with AA showed higher prevalence of TDp than controls (35% vs. 15% p = 0.01), as well as higher rates of anxiety, depression and sexual dysfunction (p 0.05). TDp was found to be linked to disease severity (p = 0.04), anxiety and depression scores (p 0.001) and worse quality of life (p = 0.001). No relationship was found between TDp and sexual dysfunction.Type D personality prevalence is higher in patients with AA than in controls. It is associated with higher rates of anxiety, depression and worse quality of life. Screening for this type of personality could be useful to detect patients who could benefit from additional psychological support as a complement to their medical treatment.

Background: Pain is not a trivial issue for hidradenitis suppurativa (HS) patients and has been considered a domain in the Core Outcome Set. To date, there is no evidence about pain caused by the ultrasound examinations. Objective: The aim of the study was to assess the presence of pain generated by the ultrasound examinations of HS patients. Methods: A multicentric cross-sectional study for detecting pain during the ultrasound examinations of HS patients using a validated verbal questionnaire immediately after the imaging studies. Statistical analysis included demographic data and possible associations with sex, age, location, clinical (Hurley), and ultrasonographic scoring (SOS-HS). The statistical tests were two proportions Z test, χ2 test, Student’s t test, and ANOVA. A p < 0.05 was considered significant. Results: 317 patients met the criteria. 77.3% of them did not present pain. Of cases with pain, 59.8% were mild, 16.7% moderate, and 23.6% severe. No significant association was found with sex, age, staging, location, or the number of affected regions. Although nonsignificant, severe pain cases were more frequent in the clinical Hurley III and ultrasonographic SOS-HS III stages. Conclusion: Pain generated by the ultrasound examination of HS patients is infrequent.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle which presents with painful nodules, abscesses, and fistulae in apocrine gland-bearing areas of the skin. Approved treatments include antibiotics and biologic drugs such as adalimumab. Despite these treatments, HS management is challenging. Acitretin is an oral retinoid used for its management as 3rd or 4th line therapy. There is little evidence regarding the effectiveness and safety of acitretin treatment for HS, and no reports have previously explored the potential clinical predictors associated with the response to the treatment. Methods: Retrospective cohort study to assess the effectiveness and safety of acitretin treatment in HS patients who failed to respond to topical therapies. Results: Sixty-two patients with moderate to severe HS were included. A significant decrease in the International HS Severity Scoring System (IHS4) score was found over time. Higher basal IHS4 score, family history of HS, follicular phenotype, and history of follicular plugging conditions were potential predictors of response. Most patients did not suffer any adverse events, and no severe side effects were observed. The main cause of discontinuation was lack of efficacy. Conclusion: Acitretin can be considered as a therapeutic option for patients with HS. The presence of follicular phenotype or a history of components of follicular occlusion syndrome is associated with better outcomes.

Twenty-one years have elapsed of the 21st Century and within the framework of the celebration of the 100th volume of Botanical Sciences , it is relevant to assess the progress of the research on conservation and on the activities undertaken for protecting the plants of Mexico, including the complementary in situ and ex situ approaches. By means of a systematic search of scientific articles related to the conservation of the Mexican flora on the Web of Science database, for the 2000–2021 period, we identified different scientific inputs, all showing specific objectives for undertaking conservation activities. The publications that resulted from this search were classified into six categories: (a) Regions and Ecoregions; (b) Communities or Ecosystems; (c) Taxonomic Groups; (d) Species and Populations; (e) Botanical Gardens; and (f) Seed Banks. For these categories, the results are presented under the headings “ in situ conservation” and “ ex situ conservation.” Additionally, we assessed by a random examination, the bibliography used to support touristic development projects. The results show that, despite the wide temporal range considered in this review, and even though there is a vast number of publications related to the characterization of the Mexican biodiversity, the production of scientific work oriented to the development of plant conservation strategies and activities is still scarce. Also evident is the lack of connection and communication among researchers of different disciplines, highlighting the disciplinary or multidisciplinary activities that they undertake. Finally, ten conclusions are presented, and some future research activities are suggested for conserving the Mexican flora.

Background: Hybridization in nature occurs in numerous botanical families. In particular, the Cactaceae family contains lots of genera in which hybridization is reported. Questions: What are the patterns of reported natural hybridization in Cactaceae and their probable causes? Are there phylogenetic and evolutionary implications related to hybridization, particularly in Opuntioideae? Data description: A total of 62 articles about natural hybridization and classical Cactaceae literature were reviewed. Study site and dates: From 1900 to June 2021 Methods: A search for articles was performed in Web of Science and Google Scholar with the keywords "Cactaceae hybridization", for time span "1900 to 2021" and included information from classic family-specific monographs. Results: Natural hybrids in Cactaceae occur in subfamilies, Cactoideae and Opuntioideae. There is evidence of nonselective mechanisms of reproductive isolation, but only for few taxa. For Cactoideae members the main approach used was morphological description, and the tribe with the highest number of natural hybrids was Trichocereeae. In Opuntioideae, the reviewed articles performed mostly chromosome counts, morphometric and phylogenetic analyses, and showed the highest number of natural hybrids. Conclusions: It has been suggested that hybridization impacts the evolution of Cactoideae and Opuntioideae, but few studies have formally tested this hypothesis. In Cactoideae, we found only descriptive evidences of hybridization; therefore, previous statements suggesting an important role of hybridization in the evolution of Cactoideae should be supported by performing formal analyses. For the postulation that hybridization impacts the evolution of Opuntioideae, we found formal evidence supporting hybridization hypothesis unlike what we found in Cactoideae.

Background: Chronic spontaneous urticaria (CSU) has been associated with poor quality of life and mood disturbances. However, factor associated to these dimensions have not been properly assessed. Moreover, there is a lack of studies regarding sexual dysfunction (SD) and CSU. Therefore, the aims of this study are to assess quality of life associated factors and to evaluate the prevalence and potential impact of SD in patients with CSU. Method: Cross-sectional study of patients suffering from CSU. Socio-demographic and disease activity variables, quality of life, sleep, SD, anxiety and depression were collected using validated questionnaires. Results: Seventy-five patients were included, with a female to male ratio of 2.40. Female sex, worse disease control, and sexual dysfunction were associated with poor quality-of-life indexes (p

Pilosocereus is one of the Cactaceae family’s most relevant genera in terms of the number of species and its wide geographical range in the Americas. Within Pilosocereus, five informal taxonomic groups have been recognized, one of which is P. leucocephalus group s.s., whose phylogenetic relationships remain unresolved. Therefore, our objectives are to recognize the circumscriptions of the species in P. leucocephalus group s.s. and to corroborate the monophyly and phylogenetic relationships of this group through a set of morphological and molecular characters. This study is based on representative sampling along the broad distribution of this group in Mexico and Central America using multivariate and phylogenetic analyses. The morphological characters identified to contribute to species recognition and group formation are branch diameter, areole length, the areole length-width ratio, the distance between areoles, the length of the longest radial spine, and branch and spines colors. The chloroplast markers rpl16, trnL-trnF, and petL-psbE and the nuclear marker AT1G18270 support the monophyly of the P. leucocephalus group s.s., and two probable synapomorphies are suggested, including one transversion in rpl16 and another in petL-psbE. Together, our results demonstrate that sampled species of P. leucocephalus group s.s. encompass six species distributed in Mexico and Central America: P. alensis and P. purpusii in the western region, P. chrysacanthus and P. collinsii in the central region, and P. gaumeri and P. leucocephalus in the eastern region. A taxonomic key to recognized species is provided.

The genus Coryphantha includes plants with globose to cylindrical stems bearing furrowed tubercles, flowers arising at the apex, and seeds with flattened testa cells. Coryphantha is the second richest genus in the tribe Cacteae. Nevertheless, the genus lacks a phylogenetic framework. The limits of Coryphantha with its sister genus Escobaria and the infrageneric classification of Coryphantha have not been evaluated in a phylogenetic study. In this study we analyzed five chloroplast regions (matK, rbcL, psbA-trnH, rpl16, and trnL-F) using Bayesian phylogenetic analysis. We included 44 species of Coryphantha and 43 additional species of the tribe Cacteae. Our results support the monophyly of Coryphantha by excluding C. macromeris. Escobaria + Pelecyphora + C. macromeris are corroborated as the sister group of Coryphantha. Within Coryphantha our phylogenetic analyses recovered two main clades containing seven subclades, and we propose to recognize those as two subgenera and seven sections, respectively. Also, a new delimitation of Pelecyphora including C. macromeris and all species previously included in Escobaria is proposed. To accommodate this new delimitation 25 new combinations are proposed. The seven subclades recovered within Coryphantha are morphologically and geographically congruent, and partially agree with the traditional classification of this genus.

Background: Aporocactus is an epiphytic or saxicolous genus that is endemic to Mexico and has a distribution restricted to cloud forests and pine-oak forests. As with many cacti, Aporocactus presents taxonomic conflicts, especially regarding species delimitation, since five species in this genus have been described and accepted by some authors, while others accept only two species. Questions: How many species comprise Aporocactus? What are their relationships? Do these species show differences in their climatic preferences? Studied species: The five putative species in Aporocactus were investigated. Study site and dates: This study was conducted in 2015 and 2016. The collection sites were in Hidalgo, Puebla, Querétaro, Veracruz, and Oaxaca states, Mexico. Methods: In this study, phylogenetic analyses were performed using chloroplast DNA markers from different Aporocactus populations and related genera, and ecological niche modeling techniques were also employed. Results: The phylogenetic analyses indicated that Aporocactus is composed of only two species: A. flagelliformis and A. martianus . Additionally, the phylogenetic analyses corroborated that Aporocactus is an early diverging group related to Weberocereus and Selenicereus . Finally, niche modeling and niche identity testing indicated that the niches of the two species of Aporocactus are significantly differentiated and niches are more different than would be expected by chance. Conclusions: Despite being a genus with only two species, Aporocactus represents a useful model for investigating such topics as the ecology of pollination, genetic populations, and flower development to characterize the evolution of these specialized cacti.

Atopic dermatitis (AD) is a chronic cutaneous inflammatory disease caused by an interaction between genetic, immune and epidermal barrier factors. Several treatments can be used to treat this disease but there are patients that do not respond to actual drugs. So, there is a need to develop effective therapies for AD. Mesenchymal stem cells (MSCs) are non-hematopoietic multipotent adult progenitor cells with immunomodulatory power and self-regenerating capacity to repair tissue damage, so they could be a potential effective treatment for AD. MSCs-Conditioned Medium (CM) and MSCs-exosomes are cell-free preparation with molecules secreted by stem cells that could be also beneficial for AD. This viewpoint reviews the actual development of MSCs, MSCs-CM and MSCs-exosomes for treating patients with AD.

Phylogenetic and geographic distances were estimated to produce a combined Distancing Index as a measure of historical reproductive isolation in the genus Cephalocereus. Geographic and climatic barriers were inferred from potential and observed distributions. Distances were extracted from a Bayesian tree for seven chloroplast regions and 26 terminals, and from the geolocation dataset for the exact same sampling. Distance matrices were relativized, and a Mantel test was applied to identify deviations between phylogenetic and geographic distances. Heatmaps and scatterplots were implemented to visualize combined trends. Two basal clades show patterns of differentiation or complete isolation; the first includes C. scoparius, C. apicicephalium, C. nizandensis, and C. totolapensis, and the second includes C. parvispinus, C. polylophus, and C. euphorbioides. The species C. fulviceps, and C. sanchezmejoradae appear in a differentiated grade as sisters of a well-defined clade that includes C. mezcalaensis, C. macrocephalus, C. tetetzo, C. senilis, C. columna-trajani, C. multiareolatus, and C. nudus, where geographic or phylogenetic distances lie below the mean, indicating a diversification process in absence of hard barriers. At the generic level, separation is related to climatic factors as temperature and moisture, while factors as the altitude could be determinants of separation at the species level. The steady accumulation of variants may lead to opposed evolutionary outcomes: differentiation or diversification, in isolated and non-isolated lineages, respectively. More studies are needed on how genetic variation is transferred or interchanged between and among lineages, and how morphological differentiation of diverging lineages account for reproductive isolation.

Deamia funis sp. nov. (Cactaceae) from Nicaragua, in the Mesoamerican region, is described and illustrated based on morphological data. The new species is characterized by its often long, dangling (ropey), and relatively narrow, multiribbed stems with relatively small flowers like those of D. chontalensis, but with the stigma exerted among or slightly beyond the anthers as occurs in D. montalvoae and D. testudo.

Transepidermal water-loss (TEWL), stratum-corneum hydration (SCH), erythema, elasticity, pH and melanin, are parameters of the epidermal barrier function and skin homeostasis that objectively indicate the integrity of the skin barrier. Sunscreens are necessary to protect people from skin cancer, but could modify the skin barrier function. Nevertheless, there are not many studies on their impact on skin homeostasis. The aim of this study is to evaluate the impact of sunscreens on the epidermal-barrier function and skin homeostasis of healthy individuals. A prospective observational study was designed. TEWL, SCH, erythema, elasticity, pH and melanin were measured on the cheek and volar region of the forearm, using non-invasive methods before and after applying sunscreen. Four different sunscreens were tested, one full-body sunscreen and three facial sunscreens. The study included 51 healthy volunteers, 72.5% (37/51) women, with a mean age of 41.63 years. After full-body sunscreen application, temperature increased by 0.68 °C (p < 0.001), pH by 0.16 units (p < 0.001), and elasticity by 0.22% (p = 0.039), while melanin decreased by 10.95 AU (p < 0.001), erythema by 28.79 AU (p < 0.001) and TEWL by 0.66 g·m−2·h−1 (p = 0.019). On the cheek, facial sunscreen 1 increased temperature by 0.51 °C, TEWL 0.7 g·m−2·h−1 (p < 0.05), pH by 0.12 units (p < 0.001) and elasticity by 0.059% (p < 0.001), but decreased erythema by 19.87 AU (p < 0.05) and SCH by 5.63 AU (p < 0.001). Facial sunscreen 2 increased temperature by 0.67 °C, TEWL by 1.93 g·m−2·h−1 (p < 0.001), pH by 0.42 units (p < 0.001) and elasticity by 0.12% (p < 0.01), but decreased melanin by 15.2 AU (p = 0.000), erythema by 38.61 AU (p < 0.05) and SCH by 10.80 AU (p < 0.01). Facial sunscreen 3 increased temperature by 1.15 °C, TEWL by 2.29 g·m−2·h−1 (p < 0.001), pH by 0.46 units (p < 0.001) and elasticity by 0.15% (p < 0.01), but decreased erythema by 35.7 (p < 0.05) and SCH by 10.80 AU (p < 0.01). In conclusion, sunscreen could slightly modify the skin-barrier function. All of them decreased erythema, likely in relation to anti-inflammatory power.

Antecedentes y Objetivos: En Oaxaca, México, se reportan 26 especies del género Mammillaria; siete de ellas endémicas. Mammillaria deherdtiana subsp. dodsonii está catalogada como amenazada. Los objetivos del trabajo fueron describir las características demográficas, reproductivas y aspectos etnobotánicos de su uso, así como los aspectos florísticos y bioclimáticos de las localidades estudiadas. Métodos: En enero de 2015 se encontraron dos localidades de Mammillaria deherdtiana subsp. dodsonii en la Sierra Norte. Entre enero y marzo se ubicaron cinco transectos de 5 m2 en una de ellas, en los cuales se registró el número de individuos, se establecieron categorías de tamaño y se obtuvo la estructura poblacional. Para la marcha floral se eligieron diez flores y cada dos horas se registró el diámetro de la apertura del perianto. Se registraron las especies de plantas vasculares que crecían cerca de ella y se obtuvieron datos de las variables climáticas. Se entrevistó a los pobladores para documentar el conocimiento y uso que le dan a esta cactácea.Resultados clave: La estructura poblacional es multimodal. Los individuos juveniles conforman 65% y los adultos reproductivos 33% en la localidad estudiada. La antesis dura siete horas; se observó dicogamia y hercogamia, lo cual indica un sistema de cruza xenógamo. La subespecie es reconocida con nombres en español y zapoteco y es usada de manera ocasional como alimento, medicina y ornamento. Se registraron 15 especies pertenecientes al bosque de Pinus y Abies. Las preferencias ambientales de la subespecie son temperaturas de 9.6-12.7 °C y precipitación de 1009-1405 mm.Conclusiones: El sistema de cruza xenógamo resulta preocupante por la observación de un solo visitante floral. La presencia de cerdas y espinas radiales sugiere adaptaciones morfofisiológicas de esta subespecie al frío. Se sugiere profundizar en la presencia y efectividad de los polinizadores y en la dinámica de reclutamiento de la subespecie.

Mexico harbors ~45% of world’s cacti species richness. Their biogeography and phylogenomics were integrated to elucidate the evolutionary history of the genera Coryphantha, Escobaria, Mammillaria, Mammilloydia, Neolloydia, Ortegocactus, and Pelecyphora (Mammilloid Clade). We analyzed 52 orthologous loci from 142 complete genomes of chloroplast (103 taxa) to generate a cladogram and a chronogram; in the latter, the ancestral distribution was reconstructed with the Dispersal-Extinction-Cladogenesis model. The ancestor of these genera arose ~7 Mya on the Mexican Plateau, from which nine evolutionary lineages evolved. This region was the site of 52% of all the biogeographical processes. The lineages 2, 3 and 6 were responsible for the colonization of the arid southern territories. In the last 4 Mya, the Baja California Peninsula has been a region of prolific evolution, particularly for lineages 8 and 9. Dispersal was the most frequent process and vicariance had relevance in the isolation of cacti distributed in the south of Mexico. The 70 taxa sampled as Mammillaria were distributed in six distinct lineages; one of these presumably corresponded to this genus, which likely had its center of origin in the southern part of the Mexican Plateau. We recommend detailed studies to further determine the taxonomic circumscription of the seven genera.

BACKGROUND Some skin diseases may modify epidermal barrier function. Psoriasis is a chronic multi-systemic inflammatory disease that affects the epidermal barrier. Phototherapy is an option for treating psoriasis, but little is known about how epidermal barrier function is modified by phototherapy in psoriatic patients. OBJECTIVES (a) To compare skin homeostasis between involved and uninvolved skin in psoriatic patients with healthy controls (b) To evaluate changes in the epidermal barrier function in psoriatic patients treated with phototherapy. METHODS Sixty patients with plaque-type psoriasis and sixty gender and age-matched healthy controls were enrolled. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity, erythema and melanin index were measured using non-invasive tools in the healthy control and involved and uninvolved psoriatic skin before and after phototherapy. RESULTS Healthy controls had lower TEWL and erythema index and higher SCH than psoriatic patients, both at uninvolved psoriatic skin and psoriasis plaques. TEWL was higher at psoriasis plaques than at uninvolved skin (19.20 vs 11.57 g/h/m2 ; P

Background Coronavirus disease 2019 has rapidly spread all over the world. Personal protective equipment (PPE) including masks and gloves is needed to avoid transmission. Adverse skin reactions associated with PPE have been described, but there is no information regarding objective measures to assess skin impairment related to PPE. Objective The aim of the study was to evaluate the impact of using facial mask and nitrile gloves on epidermal barrier function and skin homeostasis. Methods A cross-sectional study was designed. Thirty-four health care workers wearing nitrile gloves and a mask for 2 hours were included. Transepidermal water loss, stratum corneum hydration, erythema, and temperature were measured. Results Transepidermal water loss (31.11 vs 14.24 g·m-2·h-1), temperature (33.29°C vs 32.57°C), and erythema were significantly greater at the area covered by gloves compared with the noncovered area. Transepidermal water loss (22.82 vs 13.69 g·m-2·h-1), temperature, and erythema (411.43 vs 335.52 arbitrary units) were significantly increased at the area covered by mask, whereas stratum corneum hydration was lower. Transepidermal water loss was greater at the area covered by a surgical mask than at a filtering respirator mask coded filtering facepiece 2 (27.09 vs 18.02 g·m-2·h-1, P = 0.034). Conclusions Skin homeostasis and epidermal barrier function may be impaired by gloves and mask use. High-quality PPE should be provided, and adequate skin prevention measures should be implemented to reduce epidermal barrier damage.

The new coronavirus, severe acute respiratory syndrome coronavirus 2, is associated with a wide variety of cutaneous manifestations. Although new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous adverse effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin with or without interferon, oseltamivir, remdesivir, favipiravir, and darunavir), and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management, and key points for differential diagnosis are presented.

Background: Surgery is an essential part of hidradenitis suppurativa (HS) treatment. Understanding and reducing surgical recurrence are crucial to obtaining the best results in patients’ treatment. Objective: The aim of the study was to characterize surgical recurrences in a cohort of patients with HS treated with wide excision and second-intention healing. Methods: A prospective nested case-control study was conducted. A cohort of patients with HS treated with wide excision and second-intention healing was monitored for 68 weeks. The surgical procedure was classified as case (recurrence) or control (no recurrence). The type of recurrence was classified according to the elementary lesion in tunnel or abscess and inflammatory nodule (AN) recurrence. Sociodemographic and clinical data likely related to recurrence and the type of recurrence were evaluated. Results: Sixty-three patients were included, receiving a total of 82 surgical procedures. The mean age of the patients was 36.18 years, and the surgical site presented a Hurley stage II severity in 79.26% (65/82) of the interventions. Tunnel recurrence was observed in 8.5% (7/82) and AN recurrence in 15.85% (13/82) of the interventions. Obesity was associated with a higher risk of recurrence, for both tunnel and AN recurrence. Hurley III at the surgical site, a history of pilonidal sinus, and higher International Hidradenitis Suppurativa Severity Score System (IHS4) after surgery and at week 68 increased the risk of tunnel recurrence. Conclusion: We propose classifying surgical recurrence based on the elemental type of lesion. Tunnel recurrence could originate in the depth of the surgical scar and could be associated with both surgical site factors and inflammatory load. AN recurrence could originate in the borders of the surgical scar and may particularly benefit from preoperative ultrasound.

Type D personality (TDp) is a stable personality type that has been associated with poor quality of life in the general population and in patients with a variety of diseases, such as cancer, cardiac diseases, and dermatological diseases (e.g. psoriasis). To date, the potential association between chronic spontaneous urticaria and TDp has not been studied. The aim of this study is to analyse the impact of TDp on patients with chronic spontaneous urticaria, regarding mood disturbances, quality of life, sexuality, and sleep disturbances. A cross-sectional study including 75 patients with chronic spontaneous urticaria was performed. Data on sociodemographic variables and disease activity, quality of life, sleep, sexual dysfunction, anxiety, depression and TDp were collected using validated questionnaires. TDp was present in 28% (21/75) of the patients. Although TDp was not related to worse disease control, the presence of anxiety and depression was higher in patients with TDp. Regarding quality of life, TDp was associated with poorer quality of life and higher frequency of sleep disturbances. Prevalence of TDp in patients with chronic spontaneous urticaria is similar to that in the general population. It is associated with mood status disturbances and worse quality of life regardless of disease severity, especially in the emotional and psychological domains. This group of patients could benefit from additional psychological support as a complement to their medical treatment.

Background There is not an ideal biomaterial for tissue-engineered skin substitutes (TESSs), and most of the studies or existing therapies use xenogeneic origin natural biomaterials or biosynthetic scaffolds. Objective To analyse clinical, histological integration and homeostasis parameters of a human TESS manufactured with fibrin-hyaluronic acid biomaterial (HA-Skin), grafted in immunodeficient mice for 8 weeks, and compared with the gold standard treatment (Autograft), a human TESS manufactured with fibrin-agarose biomaterial (AG-Skin) and secondary wound healing dressings. Methods Human TESSs and autografts were implanted into BALB/c mice after surgical excision. Secondary wound healing approach was achieved with biosynthetic collagen wound dressing (Biobrane® ) and fibrin-hyaluronic acid or fibrin-agarose biomaterial without cells (Total N = 44). Clinical integration and homeostasis parameters were evaluated every two weeks for two months. Histological and immunohistochemical analyses were performed four and eight weeks after grafting. Results HA-Skin, AG-Skin and Autograft groups showed a proper clinical integration and epithelization eight weeks later. Scar evaluation revealed better results for Autograft and HA-Skin. Homeostasis analysis indicated similar values of transepidermal water loss and elasticity between HA-Skin (6.42 ± 0.75 g/h/m2 , 0.42 ± 0.08 AU), Autograft (6.91 ± 1.28 g/h/m2 , 0.40 ± 0.08 AU) and healthy mouse skin (6.40 ± 0.43 g/h/m2 , 0.35 ± 0.03 AU). Histological results showed that human TESSs and autografts presented better skin structuration and higher expression of cytokeratins. Conclusions This study suggests that human TESS based on fibrin-hyaluronic acid biomaterial could be suitable for clinical application in the treatment of several dermatological pathologies (wound healing).

Background: Hidradenitis suppurativa (HS) is a chronic debilitating autoinflammatory skin disease. Adalimumab is the only biologic agent available to treat HS, but lack of response is observed in some patients. Ustekinumab may be useful to treat patients with HS who do not respond to adalimumab.Objective: The objectives of this study were: (1) to retrospectively evaluate the therapeutic outcomes of ustekinumab in a multicenter series of patients with HS and (2) to assess all published scientific evidence on its utilization in patients with HS.Methods: We evaluated the therapeutic outcomes of 10 patients with HS treated with ustekinumab and conducted a systematic review of published epidemiological studies on ustekinumab-treated patients with HS.Results: In the case series, an improvement in the Physician Global Assessment score was observed in 70% (7/10) patients and an improvement in the Numerical Pain Rating Scale in 80% (8/10). In the systematic review, clinical improvement in disease severity was reported in 76% (34/45) patients and symptomatic improvement in 84% (38/45). No severe ustekinumab-related adverse event was recorded.Conclusion: These findings suggest that ustekinumab may be an effective and safe option for patients with HS who fail to respond to first-line therapies.

Background. Snow reflectivity and altitude increase the exposure of ski resort workers to solar ultraviolet radiation. The aim was to assess the presence of skin cancer in ski resorts workers and compare it with other groups of outdoor workers reviewing published studies. Methods. An observational cross-sectional prospective study was conducted in the three largest ski resorts in Spain: Baqueira Beret, Lleida; Formigal, Huesca and Sierra Nevada, Granada. All outdoor workers including ski instructors were invited to participate in the study. The participants completed a validated questionnaire about sun exposure and underwent a skin examination. Results. 219 workers were included in the study (80% male; mean age 43.8 (SD 11.31) years). Actinic keratosis (AK) but no other skin cancers were detected in 32 participants (14.62%). Those with AK worked in the Southernmost ski resort, were more likely to have light colour hair, and were older and with higher photoaging grade than those without them. Conclusion. Compared to other studies, outdoor workers on ski resorts show a higher prevalence of AK than general population but a lower prevalence than other groups of outdoor workers. This work was supported by the B18_17D Dermatology and Photobiology research group, as recognized by the Government of Aragon (Spain) and by the Medical School of Granada University (Granada, Spain).

Background/Aims: TNF-α inhibitors represent the most advanced approved therapeutic option for moderate and severe forms of hidradenitis suppurativa (HS). However, in recent years, cases of paradoxical HS secondary to the use of these biological drugs have been described, with very few cases reported in the literature. The aims of this study are (1) to present 2 new cases of paradoxical HS and (2) to perform a systematic review of scientific evidence regarding paradoxical HS with TNF-α inhibitors. Material and Methods: This is a retrospective study in which we searched all the cases of paradoxical HS secondary to the use of TNF-α inhibitors published in the literature and included two additional cases observed in our clinical practice. Results: A total of 34 patients under TNF-α inhibitor treatment were included (adalimumab = 21; infliximab = 9; etanercept = 4). The median delay from exposure to TNF-α inhibitor and the development of paradoxical HS was 12 months (range 1–72). The majority of patients were Hurley stage II (58.8%). Clinical improvement and complete remission were more frequent when the TNF-α inhibitor was stopped or switched to another biological agent with a different therapeutic target rather than maintenance or change to another TNF-α inhibitor. Conclusions: Paradoxical HS is an unusual adverse effect of TNF-α inhibitors. When this adverse effect appears, interruption or substitution of treatment is associated with a better clinical outcome.

Adalimumab is currently the only biological medicine approved by the FDA for the treatment of hidradenitis suppurativa (HS). The breakout of biosimilar drugs made them more accessible due to their impact on pharmacoeconomics. However, packaging, formulation, or excipients are unique characteristics of each drug. In that way, switching from adalimumab originator to biosimilar and between biosimilars could have implications in the clinical practice. The objective of this study is to describe our clinical experience in switching from adalimumab originator to biosimilar and switching back again. A single-center retrospective cohort study was conducted that included seventeen patients with HS treated with adalimumab originator in the maintenance phase, and that achieved Hidradenitis Suppurativa Clinical Response (HiSCR), who were switched to adalimumab biosimilar for no medical reasons. The reason for the change was to improve pharmacoeconomic efficiency, following our hospital policies on biologics. Median duration with adalimumab originator treatment before switching was 48 weeks. After switching, 41.2% of patients maintained HiSCR response without additional issues, while 58.8% (10/17) reported problems after the change. Switching from adalimumab originator to biosimilar in well-controlled patients could imply problems in efficacy and adherence. Switching back to adalimumab originator appears to solve most of the problems, but some patients can lose confidence in the drug and discontinue it. It would be worthwhile to evaluate the benefit–risk ratio individually when switching an HS patient to adalimumab biosimilar.

Type D personality is characterized by social inhibition and negative affectivity. Poorer outcomes and worse quality of life have been linked to type D personality in patients with a variety of non-dermatological diseases. Despite increasing evidence of the importance of type D personality in skin diseases, there are no reviews on this subject. The aim of this review is to summarize the current evidence regarding type D personality and skin diseases. A systematic search was performed using Medline and Web of Science databases from inception to 11 October 2022. Studies addressing the presence of type D personality, its associated factors, its impact on the outcomes of the disease or the quality of life of the patients were included in the systematic review. A total of 20 studies, including 3,124 participants, met the eligibility criteria and were included in the review. Acne, hidradenitis suppurativa, psoriasis, melanoma, atopic dermatitis, chronic spontaneous urticaria and pruritic disorders were the main diseases assessed. Type D personality was more frequent among patients with skin diseases than among controls. Type D personality was found to be associated with poorer quality of life and higher rates of psychological comorbidities in patients with skin diseases. In conclusion, type D personality appears to be a marker of patients with increased risk of poorer quality of life and higher rates of psychological comorbidities. Screening for type D personality in specialized dermatology units might be beneficial to identify patients who are more psychologically vulnerable to the consequences of chronic skin diseases.

Resumen Antecedentes y objetivo Previamente se habia iniciado el proceso metodologico para la validacion transcultural al idioma espanol de la escala Hair Specific Skindex-29 (HSS-29), que mide el impacto de la alopecia androgenica femenina sobre la calidad de vida relacionada con la salud (CVRS). Para finalizar el proceso, el objetivo del estudio fue completar la validacion a traves de la determinacion de su sensibilidad al cambio y su correlacion con una escala generalista de CVRS (SF-12). Material y metodo Se establecieron dos visitas, una basal y otra tras 6 meses de tratamiento con suplemento alimenticio con actividad inhibidora de la enzima 5-alfa reductasa. En cada visita, investigadores y pacientes valoraron la gravedad de la alopecia mediante la escala Sinclair, el estado de la apariencia del cabello, y se administraron las escalas HSS-29 y SF-12. Resultados Participaron 983 mujeres con alopecia androgenica. La media de puntuacion en la escala HSS-29 cambio de 27,5 ± 18,7 en la visita basal a 19,3 ± 15,7 en la de seguimiento, y sus dimensiones funcional, emocional y sintomatica tambien cambiaron significativamente. Tanto las diferencias entre basal y seguimiento en el indice HSS-29 global como en cada una de sus dimensiones se correlacionaron significativamente con las diferencias encontradas en las dimensiones de SF-12. Los coeficientes de correlacion de Pearson oscilaron entre −0,1 y −0,4, y en todos los casos el grado de significacion fue p Conclusiones La version en espanol de la escala HSS-29 posee sensibilidad, es decir, detecta cambios relacionados con la calidad de vida cuando las condiciones objetivas varian. Igualmente, se observo una correlacion entre las escalas HSS-29 y SF-12.

Coronavirus disease 2019 (COVID-19) has increased the frequency of handwashing. There is scarce evidence regarding the impact of different hand hygiene procedures on skin barrier function in clinical practice.To compare the impact on skin barrier function of different hand hygiene measures in healthcare workers in daily practice.A randomized controlled clinical trial was conducted. Participants were randomized to sanitize their hands with water and soap, alcohol-based hand sanitizers (ABHSs), or disinfectant wipes during their 8-hour working shift. Epidermal barrier functional parameters, such as transepidermal water loss (TEWL), and the microbial load were assessed before and immediately after the working day. Tolerance and acceptability of each product were recorded after work.Sixty-two participants were included and 20, 21, and 21 were randomized to use water and soap, ABHS, and disinfectant wipes, respectively. After the 8-hour shift, TEWL increase was higher with disinfectant wipes than with soaps or ABHS (+5.45 vs +3.87 vs -1.46 g hDaily hand hygiene with ABHS showed the lowest rates of skin barrier disruption and the highest reduction of CFU.

Obtaining a well supported schema of phylogenetic relationships among the major groups of living organisms requires considering as much taxonomic diversity as possible, but the computational cost of calculating large phylogenies has so far been a major obstacle. We show here that the parsimony algorithms implemented in TNT can successfully process the largest phylogenetic data set ever analysed, consisting of molecular sequences and morphology for 73 060 eukaryotic taxa. The trees resulting from molecules alone display a high degree of congruence with the major taxonomic groups, with a small proportion of misplaced species; the combined data set retrieves these groups with even higher congruence. This shows that tree-calculation algorithms effectively retrieve phylogenetic history for very large data sets, and at the same time provides strong corroboration for the major eukaryotic lineages long recognized by taxonomists. Fil: Goloboff, Pablo Augusto. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina Fil: Catalano, Santiago Andres. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina Fil: Mirande, Juan Marcos. Fundación Miguel Lillo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina Fil: Szumik, Claudia Adriana. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina Fil: Arias, J. Salvador. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina Fil: Källersjö, Mari. Göteborgs Botaniska Trädgård; Suecia Fil: Farris, James S.. Molekylärsystematiska laboratoriet; Suecia

Exposome factors, such as sleep deprivation and diet, could affect skin barrier function. The objectives of this study are to compare skin barrier function between patients with Obstructive Sleep Apnea Syndrome (OSAS) and healthy individuals, and to evaluate the effect of other exposome factors on skin. A cross-sectional study was conducted. Patients with OSAS and healthy volunteers matched by age and sex were included. OSAS severity was assessed by the Apnea-Hypopnea Index (AHI). Validated questionnaires were used to assess diet, anxiety, depression, and psychological stress. Skin barrier function parameters including temperature, erythema, melanin, pH, transepidermal water loss (TEWL), and stratum corneum hydration (SCH) were measured on the volar forearm. A total of 86 participants were included, 56 patients with OSAS and 30 healthy volunteers. TEWL was higher in OSAS patients than in healthy individuals (8.01 vs. 8.68 g·m−2·h−1). Regarding disease severity, severe patients had higher TEWL values (9.31 vs. 8.46 vs. 7.08 g·m−2·h−1) compared to moderate and mild patients. Patients with OSAS had significantly lower sleep quality (11.89 vs. 6.47 Pittsburgh Sleep Quality Index score; p < 0.001), poor adherence to the Mediterranean Diet (8.46 vs. 9.77; p = 0.005), and significantly higher anxiety and depression levels than healthy individuals. In conclusion, patients with OSAS may have skin barrier impairment, reflected in higher TEWL values. These patients also have higher levels of anxiety, depression, stress, and a lower adherence to a Mediterranean Diet, all exposome factors that might impact on skin barrier function.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has been associated with a greater risk of metabolic and cardiovascular comorbidities. The aim of this study is to assess cardiovascular risk by means of intima-media thickness (IMT), metabolic syndrome, and other potential biomarkers in patients with severe hidradenitis suppurativa who are candidates for biologic therapy and to explore potentially associated factors. A cross-sectional study was performed. Body mass index (BMI), carotid intima-media thickness (IMT), and blood tests, including glycemic and lipid profile, insulin, vitamin D, and inflammation markers were performed. Fifty patients were included in the study, the male/female ratio was 3:2. The mean age was 38 years, and the mean disease duration was 21.8 years. The mean carotid IMT was 651.39 μm. A positive association of IMT with disease duration, tobacco consumption, and HbA1c levels was observed. HbA1c correlated with the age of onset, hypertension, metabolic syndrome, and glucose levels. Vitamin D levels inversely correlated with the number of areas affected. In conclusion, patients with severe HS present a higher cardiovascular risk, but it is not distributed equally within the patients: Tobacco consumption, inadequate glycemic control, and disease duration could be useful clinical and biochemical markers to identify patients at higher risk.