Search

High‐resolution ultrasound (HRUS), operating at frequencies of 20–25 MHz, is a non‐invasive imaging tool that offers dermatologists the ability to visualize structures beneath the skin surface. The objective of this review is to present a comprehensive overview of HRUS applications, emphasising its utility in diagnosing, characterising and managing various dermatological conditions. We undertook a comprehensive literature review on the dermatological application of HRUS across Medline, Embase and Cochrane Library databases, while also incorporating our own clinical experience of over 16 years with the tool. In normal skin, the epidermis and dermis are hyperechoic, and the subcutaneous layer is hypoechoic. Basal cell carcinomas appear hypoechoic with irregular margins, while the presence of hyperechoic inclusion bodies suggests aggressive pathology. Squamous cell carcinomas pose challenges due to acoustic shadow artefacts from the thickened stratum corneum. Melanomas are homogenous hypoechoic lesions, with HRUS used to accurately predict Breslow thickness. HRUS provides dermatologists with a valuable adjunct to traditional clinical examination. Future advancement in image resolution and the standardisation of diagnostic parameters may further expand its utility. [ABSTRACT FROM AUTHOR]

Background/Objectives: Actinic keratoses (AK) are premalignant skin lesions caused by chronic sun exposure, topically managed by 5-fluorouracil (5-FU), diclofenac 3% gel, and imiquimod. Despite their effectiveness, long treatment duration and severe adverse local skin reactions have limited patient concordance. Calcipotriol has recently been used as a combination agent for existing topical AK treatments. A systematic review was performed to determine the clinical efficacy of 5-FU and calcipotriol for the treatment of AK, Bowen's disease, and squamous cell carcinoma (SCC). Methods: A systematic literature search was conducted on Medline, Embase, and Cochrane Library. Among the 84 records screened, 12 were retrieved for full-text review and 8 were included in the final analysis. Results: Among the 8 studies, there were 214 control patients and 288 patients who received the intervention. The combination 5% 5-FU with calcipotriol resulted in a significant reduction in the number of AKs on the face, scalp, right upper extremity, and left upper extremity for all sites at 8 weeks (P <.0001). No significant difference in SCC incidence was observed at 1 or 2 years, but there was a significant reduction observed at 3 years for SCC on face and scalp. No study assessed the combination for Bowen's disease. Conclusions: Combination 5% 5-FU with calcipotriol is an effective treatment for Aks; however, future trials may consider longer treatment and follow-up periods for the treatment and prevention of AK, SCC in situ, and SCC. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess the degree of stigmatizing attitudes and psychological distress amongst Australian medical students in order to better understand factors that may impact help-seeking behaviours of students. We hypothesize that sociodemographic factors will not significantly predict stigmatizing attitudes, and increasing levels of psychological distress will be associated with increasing stigma. Methods: A cross-sectional online survey was distributed to medical students at Western Australian universities and members of the Australian Medical Students' Association. Stigma was scored using the Mental Illness Clinicians' Attitudes (MICA-2) scale. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS). Participants provided information about gender, age, spirituality, financial hardship, treatment for mental illness, and experience in psychiatry. Results: There were 598 responses. The mean (Standard Deviation) MICA-2 score was 36.8 (7.5) out of a maximum of 96, and the mean (SD) HADS depression score was 4.7 (3.7). The mean (SD) HADS anxiety score was 9.3 (4.4). Past or current treatment for a mental illness was associated with lower MICA-2 scores. There was no association between MICA-2 and HADS scores, or sociodemographic factors. Conclusions: Our results demonstrate relatively low MICA-2 scores and high HADS-A scores overall, with no association between HADS scores and stigma. [ABSTRACT FROM AUTHOR]

This document is a scientific study or review on the use of intravenous immunoglobulin (IVIg) as a treatment for refractory pyoderma gangrenosum (PG). The authors conducted a systematic review and meta-analysis of studies on patients with PG treated with IVIg. They found that IVIg was effective and safe, with over half of the patients experiencing complete or near-complete resolution of PG. However, the authors note that the data may be impacted by publication bias and that further research is needed. They also highlight the need for caution in interpreting the results, as most patients received concurrent steroid treatment. [Extracted from the article]

Cellulose, being as the most abundant nature polymer material and the most promising oil substitute, attracts more and more interests. A new cellulose dissolution system, phosphoric acid (PA)/polyphosphoric acid (PPA) solvent, was investigated in this study. It had been found that a larger cellulose solid content could be dissolved quickly in a hypothermic situation. By evaluating the stability of regenerated cellulose ~m and file formation of anisotropic solution, the dissolution behavior of cellulose was investigated. Wide-angle X-ray diffraction (WAXD) and Fourier transform infrared spectroscopy (FT-IR) were employed to characterize the crystalline structure and morphology of regenerated cellulose. The measurement results revealed a transition from cellulose- I of raw cellulose to cellulose-II of regenerated cellulose and a decrease of crystallinity of cellulose after dissolved. This was attributed to the interaction between cellulose and acid solvent, which leaded to the breakage of cellulose intra- and inter-molecule hydrogen bonds and the conformation change of cellulose C6-OH. Moreover, the formation process of cellulose liquid crystal solution was illustrated by polarized light microscope(PLM). That may be induced by the rearranging movement of the cellulose macromolecular chains. [ABSTRACT FROM AUTHOR]

Subcutaneous granuloma annulare (SGA) is a rare clinicopathologic subtype of granuloma annulare characterized by the presence of subcutaneous nodules. There are no present reviews synthesizing the clinical features and treatment modalities in SGA. We conducted a systematic review following PRISMA guidelines [CRD42022344672] on all peer‐reviewed English‐language studies that reported one or more cases of SGA. A total of 97 studies, comprising 26 case series and 71 case reports with 324 patients, were included for analysis. Most cases were predominantly pediatric, with 78.9% of the cases identified being age 16 or lower and a median age of diagnosis of 6. There was no overall gender predisposition. Although over two‐thirds of patients did not have any comorbidities, diabetes mellitus was the most common comorbidity present in 4% of cases. The most common feature of SGA was nodules, which were present in 99.6% of patients. Pain or tenderness was reported in 15.4%, and erythema of overlying skin in 11.0% of cases. Surgical excision was performed in 96/141 (68.1%) patients. Among the 27/141 (18.0%) patients who were conservatively managed, 87.0% spontaneously improved, including 60.0% who completely self‐resolved. Topical and intralesional steroids were used in 3.40% and 1.85% of patients, respectively, resulting in complete or partial resolution in 54.6% and 100%. Among patients who were followed up, 83/324 (25.6%) patients experienced recurrence after a median duration of 26 weeks. SGA is predominantly a pediatric disease that frequently occurs on the limbs and the head. Juxta‐articular lesions are more commonly observed in adults than in children. Surgical excision is common and effective in most patients. Spontaneous improvement occurs in most untreated cases, and intralesional steroids but not topical steroids may be beneficial for non‐resolving cases and to reduce time to resolution. [ABSTRACT FROM AUTHOR]

Aim: To investigate the mechanisms of how cyclooxygenase-2 (COX-2) regulates E-cadherin in gastric cancer cells., Methods: COX-2 expression in human gastric cancer cell lines SGC-7901, BGC-823, MGC-803 and AGS were measured at the mRNA and protein level. COX-2 rich cell line SGC-7901 was chosen for subsequent experiments. siRNA mediated gene knockdown was used to investigate the impact of COX-2 on nuclear factor-κB (NF-κB), Snail, and E-cadherin in gastric cancer cells. Gene expression was determined by Western blot and real-time polymerase chain reaction. To analyze whether NF-κB inhibition could interrupt the modulatory effect of COX-2 or prostaglandin E2 (PGE2) on E-cadherin, gastric cancer cells were treated with celecoxib or PGE2, in the presence of NF-κB specific siRNA., Results: Highest expression level of COX-2 was found in SGC-7901 cells, both at mRNA and protein levels. siRNA mediated down-regulation of COX-2 led to a reduced expression of NF-κB and Snail, but an increased expression of E-cadherin in SGC-7901 cells. siRNA mediated down-regulation of NF-κB also led to a reduced expression of E-cadherin and Snail in SGC-7901 cells. However, COX-2 expression did not alter after cells were treated with NF-κB specific siRNA in SGC-7901 cells. Treatment of SGC-7901 cells with celecoxib led to a reduced expression of Snail but an increased expression of E-cadherin. In contrast, treatment of SGC-7901 cells with PGE2 led to an increased Snail and a decreased E-cadherin. However, siRNA-mediated knockdown of NF-κB partially abolished the effect of celecoxib and PGE2 on the regulation of E-cadherin and Snail in SGC-7901 cells., Conclusion: COX-2 likely functions upstream of NF-κB and regulates the expression of E-cadherin via NF-κB/Snail signaling pathway in gastric cancer cells.