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Background. Granuloma annulare (GA) and sarcoidosis are granulomatous inflammatory diseases that share similarities. Objective. To identify the histological and immunohistochemical (IHC) features of GA and sarcoidosis. Methods. A retrospective review of 36 patients with GA and 26 with sarcoidosis was performed. Results from hematoxylin and eosin (H&E) staining and IHC staining of MMP-9 and pSTAT1 within the skin lesions of GA and sarcoidosis were analyzed, and random forest was applied for developing a predictive model. Results. Significantly greater expressions of MMP-9 (especially in elastic fibers, EFs, P < 0.0001) and pSTAT1 (P = 0.0003) were observed in lesion samples of GA versus sarcoidosis patients. In GA patients, MMP-9 was significantly upregulated in the interstitial type (P = 0.0222), while staining of pSTAT1 was positively correlated with the area of mucinous collagen in palisading GA (R = 0.5356 , P = 0.0484). In sarcoidosis patients, MMP-9 (R = − 0.7127 , P = 0.0009) and pSTAT1 (R = − 0.5604 , P = 0.0067) were found to show stronger expressions in lesions with less lymphocyte infiltration. The predictive model demonstrated an AUC of 0.9675. Conclusion. These results indicate that MMP-9 and pSTAT1 might exert roles in granulomatous inflammation in different modes, and the presence of more robust MMP-9 staining in EFs appears to be more suggestive of GA. [ABSTRACT FROM AUTHOR]

This study aimed to assess and compare the clinical efficacy and safety of a triple combination treatment using 2940 nm Er:YAG laser, triamcinolone acetonide solution combined with either 308 nm excimer laser or 0.1% tacrolimus for the treatment of stable segmental vitiligo. Patients with stable segmental vitiligo were randomly divided into two groups and received a 5‐month treatment with 2940 nm Er:YAG laser followed by triamcinolone acetonide and, either 308 nm excimer laser (Group A, N = 8) or 0.1% tacrolimus (Group B, N = 13). General information and imaging data were collected before and at 1 month after treatments. Marked repigmentation and overall repigmentation rates were analyzed and any adverse skin reactions were recorded. Both treatments significantly reduced the percent of skin lesions per total body surface area (p < 0.05) and no significant differences in repigmentation were observed between the two groups (p > 0.05). The marked repigmentation rate of Group A was 42.11% and overall repigmentation rate was 94.74%, while for Group B these rates were 51.16% and 100%, respectively. There were no significant differences in the number of fingertip units at each time point (p > 0.05). While there was a significant effect for time on the number of fingertip units without considering other factors (p < 0.05), the time x treatment interaction was not significant (p > 0.05). One Group A patient developed adverse reactions consisting of erythema, burning sensation and blisters and one Group B patient developed mild erythema and burning sensations. Both treatments demonstrated a high level of efficacy and safety in the treatment of stable segmental vitiligo. [ABSTRACT FROM AUTHOR]

Aim: Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidence‐based guidelines to guide clinical practice are urgently needed. Methods: We collaborated with multidisciplinary experts to formulate this guideline based on evidences of already published literature, focusing on 13 clinical questions elected by a panel of experts. We adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form classification of recommendations as well as the improved Delphi method to retain respective recommendations with a consensus degree of over 80%. Results: Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. Conclusions: It is a comprehensive and systematic evidence‐based guideline and we hope this guideline could systematically and effectively guide the clinical practice of cutaneous warts and improve the overall levels of medical services. [ABSTRACT FROM AUTHOR]

Macrophages, which serve as a bridge between innate and adaptive immunity, play an important role in sporotrichosis. Sporothrix schenckii infections can produce immune responses such as macrophage polarization and inflammatory factor secretion. In the early stages of inflammation, the expression of DAB2 in macrophages is increased, which controls the secretion of inflammatory factors and affects the polarization of macrophages. However, the expressions and mechanisms of DAB2 in sporotrichosis are not clear. In this study, we examined the expression of DAB2 and its regulation of inflammatory factors under conditions of Sporothrix schenckii infection. Our results indicated that the Sporothrix schenckii infection increased the expression of DAB2 and revealed a mixed M1/M2‐like type of gene expression in BMDMs with the inhibited Il‐6, Il1‐β and Arg‐1 and induced Tnf‐α, Il‐10 and Mgl‐1. The deficiency of Dab2 gene suspended the changes of cytokines. In addition, JNK activity in BMDMs was inhibited by Sporothrix schenckii infection, leading to an increase in c‐JUN. We also identified c‐JUN as a transcription factor for Dab2 through chromatin immunoprecipitation and luciferase reporter assays. In an in vivo mouse model, sporotrichosis‐induced skin lesions were accompanied with an upregulation of c‐JUN and inhibition of JNK activity, which were in accord with findings from in vitro experiments. Taken together, these findings indicate that in the early stages of Sporothrix schenckii infection there is a promotion of DAB2 expression through the JNK/c‐JUN pathway, effects that can then control the expression of inflammatory factors. [ABSTRACT FROM AUTHOR]

The distinction between Keratoacanthoma (KA) and Cutaneous Squamous Cell Carcinoma (cSCC) is critical yet usually challenging to discriminate clinically and histopathologically. One approach to differentiate KA from cSCC is through assessing the immunohistochemical staining patterns of the three indicators, β-catenin, C-Myc, and CyclinD1, which are critical molecules that play important roles in the Wnt/β-catenin signaling pathway. Ki-67, as a proliferation biomarker for human tumor cells, was also assessed as an additional potential marker for differentiating KA from cSCC. In this report, these four indicators were analyzed in 42 KA and 30 cSCC cases with the use of the computer automated image analysis system. Computer automated image analysis is a time-based and cost-effective method of determining IHC staining in KA and cSCC samples. We found that C-Myc staining was predominantly localized in the nuclei of basal cells within KA patients, whereas cSCC staining was predominantly localized in the nuclei of diffuse cells. This C-Myc staining pattern has a sensitivity of 78.6% and a specificity of 66.7% for identifying KA. Moreover, positive rates of distinct expression patterns of C-Myc and Ki-67 may also serve as a means to clinically distinguish KA from cSCC. Taken together, our results suggest that these markers, in particular C-Myc, may be useful in differentiating KA from cSCC. [ABSTRACT FROM AUTHOR]

Background: Actinic keratosis (AK) is a precancerous disease, caused by ultraviolet radiation (UV). Objective: To analyze the clinical and pathological characteristics of AK in four areas with different ultraviolet radiation intensities. Methods: 1188 diagnosed AK patients, from January 2000 to July 2015, in dermatology department of four hospitals were collected. The UV intensity of hospital located cities from high to low is Kunming, Yinchuan, Shenyang and Nanjing. The information comes from medical records, and the pathological types and Keratinocyte Intraepithelial Neoplasia (KIN) grades were checked by two experienced pathologists. All information was conducted a retrospective multicenter research. Results: The patients were mainly middle‐aged and elderly female, which was in direct contrast to the majority of men in European. The age of onset in Kunming group was lower than that in Yinchuan Group (p = 0.013) and Nanjing Group (p < 0.01). The course of disease in Kunming group was significantly shorter than that in Nanjing Group (p < 0.001). The lesions were almost located in the exposed area. The proportion of unexposed areas in Shenyang group was significantly higher than that in other groups (p < 0.001). There were statistical differences in pathological morphological classification among the four groups. These differences were not affected by age and gender. The number of KIN III grade patients in Shenyang group was significantly higher than that in other three groups (p < 0.05). Conclusion: The Asian patients were mainly female. The clinical characteristics of AK are closely related to UV intensity, and environmental pollution, lifestyle, religious beliefs and other factors are also related. [ABSTRACT FROM AUTHOR]

Most plane warts are recalcitrant to treatment. Both cryotherapy and local hyperthermia have been applied to treat plane warts. However, no direct comparative study on their respective efficacy and safety has ever been performed. To assess the efficacy and safety of local hyperthermia at 43 ± 1°C versus liquid nitrogen cryotherapy for plane warts. Sequential patients with plane warts entered the study, either receiving cryotherapy or local hyperthermia therapy at the discretion of the patients and the recommendations of consultants. Cryotherapy with liquid nitrogen was delivered in two sessions 2 weeks apart, while local hyperthermia was delivered on three consecutive days, plus two similar treatments 10 ± 3 days later. The temperature over the treated skin surface was set at 43 ± 1°C for 30 min in each session. The primary outcome was the clearance rates of the lesions 6 months after treatment. Among the 194 participants enrolled, 183 were included in the analysis at 6 months. Local hyperthermia and cryotherapy achieved clearance rates of 35.56% (48/135) and 31.25% (15/48), respectively (p = 0.724); recurrence rates of 16.67% (8/48) and 53.33% (8/15) (p = 0.01); and adverse events rates of 20.74% (28/135) and 83.33% (40/48), respectively (p < 0.001). Cryotherapy had a higher pain score (p < 0.001) and a longer healing time (p < 0.001). Local hyperthermia at 43°C and cryotherapy had similar efficacy for plane warts. Local hyperthermia had a safer profile than cryotherapy but it required more treatment visits during a treatment course. More patients preferred local hyperthermia due to its treatment friendly nature. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of resveratrol combined with ablative fractional CO2 laser system (AFL) treating skin photoaging. Methods: Thirty‐two subjects were assigned to the treatment group (TG) or the control group (CG), respectively, applied test product (resveratrol essence) or control product twice daily for 6 months. Each subject was given an AFL treatment or no laser treatment on left or right side of the face randomly. Subjective evaluations by investigators and subjects themselves were conducted after treatment. Melanin index, erythema index, and cuticle moisture content were conducted at baseline and after treatments. Adverse events (AEs) were evaluated during the study period. Results: All subjects in TG achieved improvements of their photoaging signs compared to pre‐treatment both the laser side and the non‐laser side at 6 months (p < 0.05). On the laser side, TG produced a better improvement than CG at 6 months (p < 0.05). On the laser side, the difference values of MI in TG at the 2 months after enrollment (M2), M3, and M4 were more obvious than those in CG (p < 0.05). On the non‐laser side, the difference values of MI in TG at M3, M4, M5, and M6 were more obvious than those of CG (p < 0.05). Subjects in TG were more likely to have tingling and had a faster subsidence of erythema mild edema, and pigmentation induced by AFL compared to CG. Conclusion: The resveratrol can improve photoaging alone and add an efficacy to the AFL treatment and subside the AEs induced by AFL. [ABSTRACT FROM AUTHOR]

Flat warts (FWs) usually result from human papillomavirus (HPV) types 3, 10, 28 or 41. Induction therapy was conducted on days 1, 2, 3, 11 and 12, followed by five consecutive weekly sections of maintenance therapy. Treatment of high risk human papillomavirus infection in low grade cervical squamous intraepithelial lesion with mild local thermotherapy: three case reports. [Extracted from the article]

GLO:K8E/01jul21:jocd13835-fig-0001.jpg PHOTO (COLOR): 1 (A-B) Clinical appearance of the skin lesions; A, left upper limb; B, right upper limb; (C-D) histopathological findings gl One of the lesions was selected for biopsy. Lymphoid cells, tissue-like cells, and fibroblast-like cells of various morphologies may all be present within the connective tissue. Polymorphonuclear giant cells, granulocytes, and plasma cells can also exist in some of the lesions. [Extracted from the article]

Genital warts acquired during pregnancy tend to grow fast, and management is challenging. We treated two cases of primipara with extensive genital warts by local hyperthermia at 44°C for 30 minutes a day for 3 consecutive days plus 2 additional days 1 week later, then once a week till there showed signs of clinical regression. The warty lesions in the patients resolved in 5 and 7 weeks, respectively. There was no sign of recurrence during a 6-month follow-up. This suggests that local hyperthermia seems to be a promising method for treating genital warts in pregnant women. [ABSTRACT FROM AUTHOR]

A female Cushing's syndrome patient had been suffering from extensive viral warts for months. She was diagnosed with flat warts, common warts and plantar warts. The plantar warts on her right foot were initially treated using local hyperthermia at 44°C for 30 min according to a defined protocol, followed by treatment targeting a common wart on her left thumb. In response to hyperthermia, the flat warts on her eyelid dissipated within 12 weeks, and when combined with a 1 week administration of imiquimod, the common warts and plantar warts completely disappeared within 8 weeks. There were no signs of recurrence and during this treatment her Cushing's syndrome was alleviated. This pioneer trial suggests that local hyperthermia may serve as an effective mean for treating multiple cutaneous warts under the conditions of a systemic immuno‐compromised disease. [ABSTRACT FROM AUTHOR]

A letter to the editor about a study which examined the role of MIF-173G/C polymorphism in Chinese with atopic dermatitis (AD) is presented.