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Background: Both Wood's lamp and reflective confidential laser scanning microcopy are helpful for the diagnosis and treatment of vitiligo. However, there is few research that contains large samples and consistent observations. Aims: To analyze the characteristics of Wood's lamp images and reflectance confocal microscopy (RCM) images of vitiligo lesions and to evaluate their significance in vitiligo staging. Methods: We analyzed the characteristics of RCM images, Wood's lamp images, the vitiligo disease activity (VIDA) score, and clinical features to guide vitiligo staging and treatment. Results: The expert consensus based on the clinical features, VIDA score, Wood's lamp findings, and isomorphic response was consistent with the Wood's lamp findings (χ2 = 3.63, p > 0.05) and RCM findings (χ2 = 3.60, p > 0.05) in diagnosing vitiligo and assessing the disease stage. There was a correlation between the three lesion grades based on the Wood's lamp findings and the stage of vitiligo (p < 0.01). Lesions that appeared porcelain white under the Wood's lamp were in the slowly progressive stage; lesions that appeared gray‐white or trichromatic under the Wood's lamp were in the rapidly progressive stage; lesions with clear borders under the Wood's lamp needed further analysis by RCM for the stage to be determined; lesions with blurred borders under the Wood's lamp were in the rapidly progressive stage; lesions that were visible under the naked eye and under the Wood's lamp were in the rapidly progressive stage. Conclusion: The study demonstrates a reliable correlation between the findings of RCM (a sophisticated expensive tool) and Wood's lamp examination (a simple, readily available, inexpensive tool) in the assessment of the disease activity of vitiligo lesions. [ABSTRACT FROM AUTHOR]

Nicotinamide adenine dinucleotide (NAD+) level has been associated with various age‐related diseases and its pharmacological modulation emerges as a potential approach for aging intervention. But human NAD+ landscape exhibits large heterogeneity. The lack of rapid, low‐cost assays limits the establishment of whole‐blood NAD+ baseline and the development of personalized therapies, especially for those with poor responses towards conventional NAD+ supplementations. Here, we developed an automated NAD+ analyzer for the rapid measurement of NAD+ with 5 μL of capillary blood using recombinant bioluminescent sensor protein and automated optical reader. The minimal invasiveness of the assay allowed a frequent and decentralized mapping of real‐world NAD+ dynamics. We showed that aerobic sport and NMN supplementation increased whole‐blood NAD+ and that male on average has higher NAD+ than female before the age of 50. We further revealed the long‐term stability of human NAD+ baseline over 100 days and identified major real‐world NAD+‐modulating behaviors. [ABSTRACT FROM AUTHOR]

Rituximab has proven effective for the treatment of steroid‐refractory bullous pemphigoid (BP), but there is controversy over the dosing protocol. We report three cases of refractory BP treated successfully with ultra‐low‐dose rituximab (100 mg weekly for 4 weeks). Our cases confirmed the efficacy and good follow‐up outcomes of this treatment strategy for refractory BP. The ultra‐low‐dose rituximab regimen (100 mg weekly for 4 weeks) may be a useful alternative therapy in patients with refractory BP. [ABSTRACT FROM AUTHOR]

Therefore, the mechanisms that promote interactions between metastatic tumour cells and activated tumour-associated lymphatic endothelium in primary tumours and draining lymph nodes should be investigated in more detail to prevent and treat EMPD. Extramammary Paget's disease (EMPD) is a rare tumour presenting with an erythematous spread in elderly patients, mainly in the genital region.[[1]] It is most common in Caucasian women, but in Asian populations, there is a male predominance.[[3]] Given the rarity of this disease, limited studies have reported the 5-year outcomes on the Chinese population; hence a comprehensive survival analysis on the Chinese mainland is still lacking. Additional prospective data are needed to clarify the characteristics of high-risk EMPD patients and to further identify better and more effective superior management approaches to recurrent and potential tumour metastasis. [Extracted from the article]

Reflectance confocal microscopy (RCM) enables good visualization of cutaneous structures, akin to an optical biopsy.[6] The examination takes a few minutes to be performed and is painless even when performed in sensitive areas such as the penis or vulva region. Vulvar lichen sclerosus (VLS) is not rare in paediatric dermatology.[1] Although histopathology is gold standard, the diagnosis of VLS is primarily based on clinical findings rather than histopathology,[2] which is may not always be practical or necessary in children.[3] There are no sufficient researches about using non-invasive tools in the diagnosis of VLS,[4] only few case report available on dermoscopy examination,[5] which might be less efficient as it studies only the surface. Notably, all VLS lesions were significantly characterized by the presence of unique highly reflective, quasi-circular large cells in the EDJ and superficial dermis at RCM. [Extracted from the article]

Dear Editor, The classical characterization of lichen sclerosus (LS) is pruritic, white, sclerotic, and atrophic plaques.1 However, clinical variants have been separately described as bullous, hemorrhagic, pigmented, and verrucous forms, which are rare.1 We present a patient with extragenital LS with bullous and verrucous forms; it was a challenging diagnosis. The differential diagnosis of hyperpigmented and verrucous eruption includes LS, pemphigus vegetans, chromoblastomycosis, tuberculosis verrucosa cutis, squamous cell carcinoma, mycosis fungoides, viral warts, and pyoderma gangrenosum. The first-line treatment for LS is topical corticosteroids.3 The patients, who have a contraindication for the use of corticosteroids or have failed therapy with ultrapotent corticosteroids, can choose the topical calcineurin inhibitors as an alternative treatment option.3 Patients with associated malignancy or scarring interfering with normal function should undergo surgery after the disease activity has ceased.2 Phototherapy and photodynamic therapy are the third-line therapies used in patients who are resistant to the aforementioned treatments.2 In general, extragenital LS is not as responsive as genital LS, so it may therefore present a therapeutic challenge.3 Footnotes 1 Conflict of interest: None. [Extracted from the article]

The reliable and automatic segmentation of pulmonary lobes in computed tomography scans is an important pre‐condition for the diagnosis, assessment, and treatment of lung diseases. However, due to the incomplete lobar structures and morphological changes caused by diseases, the lobe segmentation still encounters great challenges. Recently, convolution neural network has exerted a tremendous impact on medical image analysis. Nevertheless, the basic convolution operations mainly obtain local features that are insufficient for accurate lobe segmentation. The idea that the global features are equally crucial especially when lesions appear is considered. Here, a dual‐attention V‐network named DAV‐Net for pulmonary lobe segmentation is proposed. First, a novel dual‐attention module to capture global contextual information and model the semantic dependencies in spatial and channel dimensions is introduced. Second, a progressive output scheme is used to avoid the vanishing gradient phenomenon and obtain relatively effective features in hidden layers. Finally, an improved combo loss is devised to address input and output lobe imbalance problem during training and inference. In the evaluation using the LUNA16 dataset and our in‐house dataset, the proposed DAV‐Net obtains Dice similarity coefficients of 0.947 and 0.934, respectively; these values are superior to those obtained by existing methods. [ABSTRACT FROM AUTHOR]

Paraneoplastic pemphigus (PNP) is an unusual variant of pemphigus mediated by paraneoplastic autoimmunity. In addition to blisters, interface dermatitis can be observed in PNP.1, 7 For suspected PNP patients, RCM examination can be performed on the lichenoid lesions to observe the dermal-epidermal junction. The patients in this manuscript have given written informed consent to the publication of their case details. [Extracted from the article]

Background Benign lymphangioendothelioma represents a rare lymphatic vascular proliferation characterized by proliferation of irregular and thin-walled vessels dissecting amongst dermal collagen. Immunohistochemical analysis has been lacking in most previously reported cases. Methods Herein, we report the clinical and histopathologic characteristics of four cases of benign lymphangioendothelioma. Immunohistochemical study was completed for all lesions. Results All lesions presented as large, red to brown patches or plaques. Three lesions were located on the thigh and one lesion was located on the neck. Histopathologically, all lesions showed proliferation of anastomotic or retiform thin-walled vessels with a single layer of endothelial cells that dissect the dermis. D2-40 and Prox1 immunostains were positive and Wilms tumor 1 ( WT-1) immunostain was negative in all cases. Conclusion Benign lymphangioendothelioma represents a lymphatic vascular proliferation. A lack of expression of WT-1 suggests it represents a lymphatic vascular malformation. [ABSTRACT FROM AUTHOR]

Connective tissue nevi represents a kind of hamartoma, and coalescence of the lesions in a cerebriform mode in the lumbar region without Proteus syndrome is rarely seen. Here, we report a 26-year-old woman presenting with nodules and plaques in her left lumbar region of 26 years in duration. Histopathological examination and Masson-trichrome stain showed increased dermal collagen bundles in a haphazard array. The diagnosis of connective tissue nevi was made. This is the first case report on cerebriform connective tissue nevi without Proteus syndrome in the lumbar region. [ABSTRACT FROM AUTHOR]

Background: Lupus erythematosus (LE) is a spectrum of autoimmune diseases. Due to the complexity of cutaneous LE (CLE), clinical skin image-based artificial intelligence is still experiencing difficulties in distinguishing subtypes of LE., Objectives: We aim to develop a multimodal deep learning system (MMDLS) for human-AI collaboration in diagnosis of LE subtypes., Methods: This is a multi-centre study based on 25 institutions across China to assist in diagnosis of LE subtypes, other eight similar skin diseases and healthy subjects. In total, 446 cases with 800 clinical skin images, 3786 multicolor-immunohistochemistry (multi-IHC) images and clinical data were collected, and EfficientNet-B3 and ResNet-18 were utilized in this study., Results: In the multi-classification task, the overall performance of MMDLS on 13 skin conditions is much higher than single or dual modals (Sen = 0.8288, Spe = 0.9852, Pre = 0.8518, AUC = 0.9844). Further, the MMDLS-based diagnostic-support help improves the accuracy of dermatologists from 66.88% ± 6.94% to 81.25% ± 4.23% (p = 0.0004)., Conclusions: These results highlight the benefit of human-MMDLS collaborated framework in telemedicine by assisting dermatologists and rheumatologists in the differential diagnosis of LE subtypes and similar skin diseases., (© 2024 European Academy of Dermatology and Venereology.)

Nicotinamide adenine dinucleotide (NAD + ) level has been associated with various age-related diseases and its pharmacological modulation emerges as a potential approach for aging intervention. But human NAD + landscape exhibits large heterogeneity. The lack of rapid, low-cost assays limits the establishment of whole-blood NAD + baseline and the development of personalized therapies, especially for those with poor responses towards conventional NAD + supplementations. Here, we developed an automated NAD + analyzer for the rapid measurement of NAD + with 5 μL of capillary blood using recombinant bioluminescent sensor protein and automated optical reader. The minimal invasiveness of the assay allowed a frequent and decentralized mapping of real-world NAD + dynamics. We showed that aerobic sport and NMN supplementation increased whole-blood NAD + and that male on average has higher NAD + than female before the age of 50. We further revealed the long-term stability of human NAD + baseline over 100 days and identified major real-world NAD + -modulating behaviors., (© 2023 The Authors. Aging Cell published by Anatomical Society and John Wiley & Sons Ltd.)

We report a case of 39-year-old female patient with paraneoplastic pemphigus (PNP) associated with thymoma treated with rituximab plus corticosteroids and methotrexate. After rituximab therapy for 8 weeks, oral ulcerations had cured, lesions on the trunk and limbs improved. Rituximab may be useful for PNP therapy, but further studies are necessary to confirm this hypothesis., (© 2021 Wiley Periodicals LLC.)

Health professions preventing and controlling Coronavirus Disease 2019 are prone to skin and mucous membrane injury, which may cause acute and chronic dermatitis, secondary infection and aggravation of underlying skin diseases. This is a consensus of Chinese experts on protective measures and advice on hand-cleaning- and medical-glove-related hand protection, mask- and goggles-related face protection, UV-related protection, eye protection, nasal and oral mucosa protection, outer ear, and hair protection. It is necessary to strictly follow standards of wearing protective equipment and specification of sterilizing and cleaning. Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection., (© 2020 Wiley Periodicals, Inc.)

The mol-ecule of the title compound, C(18)H(17)N(3), with the exception of the -C(CH(3))(2) group, is nearly planar [maximum deviation: 0.208 (4), r.m.s. deviation 0.099 (6) Å] and the disubstituted C atom is displaced by 0.679 (2) Å from the mean plane through the remaining non-H atoms. In the crystal, the packing is stabilized by weak C-H⋯π inter-actions.