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Indo-Pacific humpback dolphins (Sousa chinensis) inhabiting the Chinese coastline of the northern South China Sea are subject to intense human activity. To investigate potential impacts to dolphins, photographs taken from 2010 to 2021 in five different locations were analyzed. Among individual dolphins (N = 1,159), 10.6% presented human-induced injuries. Adults were more frequently injured than young dolphins, and individuals from around Jiangmen, Hainan, and Sanniang Bay presented the highest injury prevalence. More research should be conducted in areas that have been subject to less research, such as Jiangmen and Hainan, and the dolphin watching activities occurring in Sanniang Bay should be monitored and regulated. Forty-seven percent of dolphins presented skin conditions, with orange patches being the most frequent (41.5%). Orange patches and hyper-pigmented pink spots were significantly less prevalent in summer and fall than in winter and spring. Orange patches were less frequent in females than in males, as well as with calves relative to older age classes. Seasonal patterns may be linked to water temperatures, while demographic patterns may be associated with immune defenses. These findings allow for a better understanding of the potential impact of human activities on Indo-Pacific humpback dolphins and should inform further conservation measures. [ABSTRACT FROM AUTHOR]

Surgical procedures performed during neonatal period or childhood that result in vertical midline, transverse left upper quadrant, or central upper abdominal scars create significant psychological concerns in adulthood. Various surgical techniques correct depressed scars, including scar revision, Z‐ or W‐plasty flaps, sub‐incision tunnelling, fat grafting, and autologous or alloplastic dermal grafting. This article describes a novel technique for repairing depressed abdominal scars using hybrid double‐dermal flaps. We included patients with psychosocial concerns who underwent abdominal scar revision because of wedding plans. Hybrid local de‐epithelised dermal flaps were used to correct the depression of the abdominal scar. Superior and inferior skin flaps, medial and lateral to the depressed scar, were de‐epithelised for 2 to 3 cm and sutured using the vest‐over‐pants technique with 2/0 nylon permanent sutures. Six female patients who want to marry were included in this study. Depressed abdominal scars were successfully fixed using hybrid double‐dermal flaps, either from the superior‐inferior aspect for transverse scars or from the medial‐lateral aspect for vertical scars. No postoperative complications were noted, and the patients were satisfied with the outcomes. De‐epithelialised double‐dermal flaps in the vest‐over‐pants technique are an effective and valuable surgical technique for correcting depressed scars. [ABSTRACT FROM AUTHOR]

Although the impact of age, gender, and obesity on the skin wound healing process has been extensively studied, the data related to gender differences in aspects of skin scarring are limited. The present study performed on abdominal human intact and scar skin focused on determining gender differences in extracellular matrix (ECM) composition, dermal white adipose tissue (dWAT) accumulation, and Foxn1 expression as a part of the skin response to injury. Scar skin of men showed highly increased levels of COLLAGEN 1A1, COLLAGEN 6A3, and ELASTIN mRNA expression, the accumulation of thick collagen I-positive fibers, and the accumulation of α-SMA-positive cells in comparison to the scar skin of women. However, post-injured skin of women displayed an increase (in comparison to post-injured men's skin) in collagen III accumulation in the scar area. On the contrary, women's skin samples showed a tendency towards higher levels of adipogenic-related genes (PPARγ, FABP4, LEPTIN) than men, regardless of intact or scar skin. Intact skin of women showed six times higher levels of LEPTIN mRNA expression in comparison to men intact (p < 0.05), men post-injured (p < 0.05), or women post-injured scar (p < 0.05) skin. Higher levels of FOXN1 mRNA and protein were also detected in women than in men's skin. In conclusion, the present data confirm and extend (dWAT layer) the data related to the presence of differences between men and women in the skin, particularly in scar tissues, which may contribute to the more effective and gender-tailored improvement of skin care interventions. [ABSTRACT FROM AUTHOR]

Background: The appearance of skin scars is known as one of the main side effects of skin burns. Stromal vascular fraction (SVF), as a rich source of cell populations with tissue regeneration properties, plays an important role in the healing of skin lesions. Fractional CO2 lasers have occupied a special place in treating skin lesions, particularly skin scars, since their introduction. Our study aimed to compare the combination of SVF and fractional CO2 laser with fractional CO2 laser alone in the treatment of burn scars. Method: This double-blind clinical trial study was conducted on ten patients with burn scars that were treated three times with a fractional CO2 laser at site of burn lesions, and one of the two areas studied was randomly injected with SVF. Two months after completion of the procedure, patients' scars were assessed using the Vancouver scar scale (VSS), biometric criteria, and physician and patient satisfaction ratings. Results: The results confirmed a significant improvement in VSS, cutometry, R7 criteria, complete density sonography, and skin density sonography in the fractional CO2 laser-treated group. The VSS criteria, epidermal thickness sonography, complete density sonography, and skin density sonography in the group treated with the combination of fractional CO2 laser and SVF also showed significant improvement. The VSS criteria and melanin index of Mexameter in the group treated with SVF in combination with fractional CO2 laser were significantly better than the group treated with fractional CO2 laser alone. Also, physician and patient satisfaction in the group treated with SVF injection in combination with fractional CO2 laser was significantly higher than the other group. Conclusion: The results confirm the efficacy of SVF injection in combination with fractional CO2 laser in the treatment of burn scars and can be considered as a treatment option for better management of these lesions. Trial registration: The study protocol was retrospectively registered at Iranian Registry of Clinical Trials with code: IRCT20210515051307N1, Registration date: 2021-11-14, URL: https://www.irct.ir/trial/56337. [ABSTRACT FROM AUTHOR]

Exaggerated healing and remodeling after skin injury may cause hypertrophic and keloidal scars, which are associated with functional and quality of life impairment. There is limited guidance available regarding the relative effectiveness of therapies for hypertrophic scars and keloids. In this review, we aim to compare the effectiveness of treatments for hypertrophic scars and keloids. MEDLINE, Embase, Scopus, and the Cochrane Collaboration database were searched from inception to March 2019 for randomized control trials of treatments for hypertrophic and keloid scars that included 20 or more patients. Outcomes evaluated included the standardized mean reduction in scarring and adverse events. The type of scar and the demographic features were analyzed for their effect on clinical outcome. Based on 25 included clinical trials, intralesional injection (64.1% [95% CI 60.8–67.5%]) may be more effective than physical (29.9% [95% CI 28.9–30.9%]) or topical treatments (34% [95% CI 31.8–36.8%]). Combination of 5-fluorouracil and triamcinolone (9:1 dilution) appeared superior among intralesional treatments for keloids. Ablative laser and pulsed-dye laser were the most useful laser treatments. Regression modeling showed laser treatment response was linked to Fitzpatrick skin type (p = 0.002). Adverse events were uncommon for all treatments and mostly transient. Intralesional treatments for keloid and hypertrophic scars may be the most reliable treatment option to improve pathologic scars, while laser treatment may have specific benefits for Fitzpatrick skin types I–III over types IV–VI. Management of pathological scars is an area of critical need, where appropriate treatment can have a significant impact on quality of life. [ABSTRACT FROM AUTHOR]

Common bean has become very popular and widespread among the population since its introduction to Azerbaijan in the second half of the 18th century. The paper represents for the first time the genetic diversity and anthracnose resistance of 37 common bean accessions cultivated in Azerbaijan. ISSR marker characterization in the present study revealed a total of 47 bands, with 33.6% of average polymorphism. The polymorphism information content (PIC) and genetic diversity index (GDI) for each primer were in the range of 0.25–0.48 (mean 0.35) and 0.45–0.73 (mean 0.59), respectively, indicating a moderate level of genetic diversity in the current collection. UNJ tree showed that the common bean accessions tended to cluster according to the local and introduced gene pools, indicating the same original sources of these accessions, which is also supported by PCo analysis. Screening with linked SCAR markers revealed the existence of common bean genotypes with single or multiple Co resistance alleles. Among studied genes Co-4 locus and its alleles were found in all samples, followed by Co-6 (40.5%) and Co-34 (16%). Three genotypes had all studies resistance loci, while 12 had Co-4 and Co-6, and 3 had Co-4 and Co-34 . The results could provide valuable information for future common bean breeding activities and conservation. The use of genotypes with two or more resistance genes as donor parents can accelerate the development of new common bean cultivars with durable resistance to anthracnose. [ABSTRACT FROM AUTHOR]

Scar assessment tools can be utilized during the post-operative period to monitor scar progress. The primary aim of this systematic review was to evaluate current subjective scar assessment scales utilized in orthopaedic surgery. The secondary aim was to identify determinants of patients' satisfaction with their scars and evaluate current measurement scales. The preferred reporting items for systematic reviews and meta-analyses checklist was followed. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. There were no constraints based on language or publication status. A narrative synthesis provided a description and evaluation of scales utilized in orthopaedic surgery. Determinants of patient satisfaction were identified along with the scales used to measure satisfaction. A total of 6059 records were screened in the initial search. Twenty-six articles satisfied the inclusion criteria, assessing 7130 patients. In the literature, six validated subjective scar scales were identified, including the Vancouver scar scale, patient and observer scar assessment scale, Manchester scar scale, Stony Brook scar evaluation scale, visual analogue scale, and Hollander wound evaluation scale. Studies utilizing these scales to evaluate scars following orthopaedic procedures did so successfully. These were total hip arthroplasty, total knee arthroplasty, and limb reconstruction. The scales demonstrated satisfactory validity. Functional outcomes such as restoration of movement ranked among patients' highest concerns. Scar cosmesis was found to be amongst patients' lowest priorities. Subjective scar assessment scales identified in the literature were not designed specifically for orthopaedic surgery. However, these were able to appropriately assess scars in the studies identified in this review. Current evidence suggests the effect of scar cosmesis on patient satisfaction with orthopaedic procedures is limited. [ABSTRACT FROM AUTHOR]

The CHN•WU wound suture technique uses barbed sutures. The needle is inserted from the basal part of the superficial fascia at the left edge of the wound and passed through half of the reticular dermis to reach a point (1A) approximately 0.5–2 cm away from the wound edge. Occlusion is achieved at 1A at the level of the reticular dermis, and if done correctly, a shallow concavity will appear at the occlusion point on the skin. The needle is then walked along the natural curvature until it reaches the center of the wound and then moved out from the junction between the dermis and subcutaneous tissue. On the other side of the incision, the needle is inserted into the contralateral position at the junction between the dermis and subcutaneous tissue and moved along its natural curvature to achieve occlusion at the mirror site of 1A in the reticular dermis. This process is repeated until the entire wound is closed. In the end, two stitches should be applied in the opposite direction. The left barbed suture is cut and thrown. This technique does not break through the epidermis, has high suture efficiency and satisfactory cosmetic appearance, disperses mechanical tension, and maintains wound tensile strength. This technique was especially effective in closing high-tension wounds in the chest and extremities where the blood supply to both sides of the wound was not affected after suturing, and wound closure could be performed quickly and efficiently in one stage. [ABSTRACT FROM AUTHOR]

To investigate the impact of ablative fractional carbon dioxide laser (AFCO 2 L) on patient-reported outcomes measures, subjective scar appearance, dermal architecture, and gene transcription in early burn scars. Fifteen adult patients with a burn-related scar were recruited. Inclusion criteria were two non-contiguous scar areas of 1% total body surface area, similar baseline Vancouver scar scale (VSS) score and 3 months since the time of injury. All participants acted as their own control. Scars were randomized to treatment or control. Treatment scars received three AFCO 2 L treatments at 6-week intervals. Outcome measures were recorded at baseline, 3, 6, and 1 2 -months post-treatment. Measures included blinded VSS, Patient Observer Scar Assessment Scale (POSAS), Brisbane Burn Scar Impact Profile (BBSIP), blinded scar photo assessment, histological tissue analysis, and RNA sequencing analysis. No significant difference was found in VSS, scar erythema, or pigmentation. Patient POSAS improved in scar thickness and texture following AFCO 2 L. All elements of BBSIP improved in control and laser groups. AFCO 2 L -treated scars were scored better than control scars by blinded raters. RNA sequencing illustrated that AFCO 2 L induced sustained changes in fibroblast gene expression. AFCO 2 L treated scars had significantly altered scar thickness and texture 6 months post-laser and were rated better than controls on blinded photo analysis after 3 treatments. RNASeq results suggest laser treatment alters the transcriptome of treated fibroblasts for at least 3 months after treatment. Expansion of this research to study in more depth fibroblast changes in response to laser, as well as assessing the impact on daily activity and quality of life, will be beneficial. [ABSTRACT FROM AUTHOR]

Aims The amount of fibrosis in the left atrium (LA) predicts atrial fibrillation (AF) recurrence after catheter ablation (CA). We aim to identify whether regional variations in LA fibrosis affect AF recurrence. Methods and results This post hoc analysis of the DECAAF II trial includes 734 patients with persistent AF undergoing first-time CA who underwent late gadolinium enhancement magnetic resonance imaging (LGE-MRI) within 1 month prior to ablation and were randomized to MRI-guided fibrosis ablation in addition to standard pulmonary vein isolation (PVI) or standard PVI only. The LA wall was divided into seven regions: anterior, posterior, septal, lateral, right pulmonary vein (PV) antrum, left PV antrum, and left atrial appendage (LAA) ostium. Regional fibrosis percentage was defined as a region's fibrosis prior to ablation divided by total LA fibrosis. Regional surface area percentage was defined as an area's surface area divided by the total LA wall surface area before ablation. Patients were followed up for a year with single-lead electrocardiogram (ECG) devices. The left PV had the highest regional fibrosis percentage (29.30 ± 14.04%), followed by the lateral wall (23.23 ± 13.56%), and the posterior wall (19.80 ± 10.85%). The regional fibrosis percentage of the LAA was a significant predictor of AF recurrence post-ablation (odds ratio = 1.017, P = 0.021), and this finding was only preserved in patients receiving MRI-guided fibrosis ablation. Regional surface area percentages did not significantly affect the primary outcome. Conclusion We have confirmed that atrial cardiomyopathy and remodelling are not a homogenous process, with variations in different regions of the LA. Atrial fibrosis does not uniformly affect the LA, and the left PV antral region has more fibrosis than the rest of the wall. Furthermore, we identified regional fibrosis of the LAA as a significant predictor of AF recurrence post-ablation in patients receiving MRI-guided fibrosis ablation in addition to standard PVI. [ABSTRACT FROM AUTHOR]

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Marjolin's ulcer (MU) with rapid progression and multiple distant metastases is rare. We report a case of an MU of the thigh developing in a postburn scar, which after successful R0 resection developed multiple bony and visceral metastasis to femur, vertebra, skull, lung, and liver within 3 months of excision. We highlight the "hurricane-like" recurrence in an MU, which is unusual for the metachronous disease. We stress that MUs, unlike conventional wisdom, need a thorough metastatic workup at presentation, and prognostication of a possible rapidly progressive course after surgery which may lead to grave prognosis and mortality. [ABSTRACT FROM AUTHOR]

Orofacial soft tissue wounds caused by surgery for congenital defects, trauma, or disease frequently occur leading to complications affecting patients' quality of life. Scarring and fibrosis prevent proper skin, mucosa and muscle regeneration during wound repair. This may hamper maxillofacial growth and speech development. To promote the regeneration of injured orofacial soft tissue and attenuate scarring and fibrosis, intraoral and extraoral stem cells have been studied for their properties of facilitating maintenance and repair processes. In addition, the administration of stem cell-derived extracellular vesicles (EVs) may prevent fibrosis and promote the regeneration of orofacial soft tissues. Applying stem cells and EVs to treat orofacial defects forms a challenging but promising strategy to optimize treatment. This review provides an overview of the putative pitfalls, promises and the future of stem cells and EV therapy, focused on orofacial soft tissue regeneration. [ABSTRACT FROM AUTHOR]

Objective To observe the effects of different timing treatments on postoperative scar morphology and patient satisfaction in children with congenital pigmented nevi of the extremities. Methods From March 2019 to March 2022, 326 children with congenital pigmented nevi of the extremities were treated. They were divided into an infant group (3-11 months old) and a young children group (1-3 years old) based on their age, with 163 cases per group. The differences between the two groups in terms of operation length, hospital stay, postoperative scars, complication incidence, and patient satisfaction were compared. Results Six months after surgery, scar score and patient satisfaction in the infant group were better than those in the young children group (P<0.05). In terms of hospital days, there was no statistical significance between the two groups (P>0.05), but the operation duration of the infant group was smaller than that of the young children group, and the difference was statistically significant (P<0.05). There were 4 cases of surgical complications in the infant group (2.45%) and 12 cases in the young children group (7.36%), and the difference between groups was statistically significant (P<0.05). Conclusion It is safe and feasible to perform surgery in infancy to treat children with congenital pigmented nevus of extremities, and the clinical effect and patient satisfaction are better than those in the young children group. [ABSTRACT FROM AUTHOR]

(1) Objective: Keloid and hypertrophic scars are a challenge in clinical management, causing functional and psychological discomfort. These pathological scars are caused by a proliferation of dermal tissue following skin injury. The TGF-β/Smad signal pathway in the fibroblasts and myofibroblasts is involved in the scarring process of skin fibrosis. Today, multiple therapeutic strategies that target the TGF-β/Smad signal pathway are evaluated to attenuate aberrant skin scars that are sometimes difficult to manage. We performed a head-to-head, randomized controlled trial evaluating the appearance of the post-surgical scars of 64 subjects after two times daily topical application to compare the effect of a class I pullulan-based medical device containing Allium cepa extract 5% and hyaluronic acid 5% gel versus a class I medical device silicone gel on new post-surgical wounds. (2) Methods: Objective scar assessment using the Vancouver Scar Scale (VSS), POSAS, and other scales were performed after 4, 8, and 12 weeks of treatment and statistical analyses were performed. The trial was registered in clinicalTrials.gov (NCT05412745). In parallel, molecular docking simulations have been performed to investigate the role of Allium cepa in TGF-β/Smad signal pathway. (3) Results: We showed that VSS, POSAS scale, itching, and redness reduced significantly at week 4 and 8 in the subjects using devices containing Allium cepa and HA. No statistically significant differences in evaluated scores were noted at 12 weeks of treatment. Safety was also evaluated by gathering adverse events related to the application of the gel. Subject compliance and safety with the assigned gel were similar between the two study groups. Molecular docking simulations have shown how Allium cepa could inhibit fibroblasts proliferation and contraction via TGF-β/Smad signal pathway. (4) Conclusions: The topical application of a pullulan-based medical device containing Allium cepa and HA showed a clear reduction in the local inflammation, which might lead to a reduced probability of developing hypertrophic scars or keloids. [ABSTRACT FROM AUTHOR]

Deep partial-thickness and full-thickness burn wounds often undergo tangential excision or escharectomy to expose healthy tissue, combined with skin grafting to promote wound healing. However, conventional tangential excision with the humby knife leads to inevitable damage to the dermis while excising burn tissue due to the lack of precision. Indeed, the preservation of dermal tissue is a key factor in determining wound healing and scar quality. The precision and tissue selectivity of the Versajet Hydrosurgical System has been established for excising burn tissue while preserving dermal tissue. In this study, we retrospectively compared the efficacy of "Hydrosurgical excision combined with skin grafting" and "Conventional tangential excision combined with skin grafting" in treating deep partial-thickness and full-thickness burn wounds to demonstrate that hydrosurgery improved the treatment of deep partial-thickness and full-thickness burns. A total of 86 patients with deep partial-thickness and/or full-thickness burns with a total burn surface area (TBSA) ≤ 25% from July 2018 to July 2020 were included in this study and were divided into experimental (hydrosurgical excision combined with skin grafting, n = 43) and control (conventional tangential excision combined with skin grafting, n = 43) groups. Parameters were analyzed, including the intraoperative blood loss volume per unit area of grafted skin, surgery duration, wound healing time, skin graft survival, and the treatment costs per unit of burned area. Scar assessment was performed at 1 year with the modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA). No significant difference was found in male to female ratio, age, weight, TBSA, burn depth, skin grafting area (SKA), skin grafting methods, cases treated with carbon dioxide fractional laser or incidence of inhalation injury, and the incidence of hypovolemic shock between two groups(p > 0.05). Compared with the control group, patients treated with hydrosurgical excision combined with skin grafting experienced less intraoperative blood loss volume per unit area of grafted skin (p < 0.05). The mVSS-TBSA of patients that underwent hydrosurgical excision combined with skin grafting was significantly improved in comparison to the control group (p < 0.01). No significant difference was found in surgery duration, wound healing time, skin graft survival and treatment costs per unit of burned area between the two groups (p > 0.05). Hydrosurgical excision combined with skin grafting reduced intraoperative blood loss volume per unit area of grafted skin, improved scarring 1-year after injury, and did not increase the treatment costs per unit of burned area. This technique provides a novel alternative for managing deep partial-thickness and full-thickness burn wounds. • Hydrosurgical excision is associated with more precision compared to conventional tangential excision. • The intraoperative blood loss volume per unit area of grafted skin caused by hydrosurgery is less than with the humby knife. • Better scarring is associated with hydrosurgical excision compared to conventional tangential excision. • Hydrosurgery does not increase the treatment costs per unit of burned area. [ABSTRACT FROM AUTHOR]

Pathological scarring is an abnormal outcome of wound healing, which often manifests as excessive proliferation and transdifferentiation of fibroblasts (FBs), and excessive deposition of the extracellular matrix. FBs are the most important effector cells involved in wound healing and scar formation. The factors that promote pathological scar formation often act on the proliferation and function of FB. In this study, we describe the factors that lead to abnormal FB formation in pathological scarring in terms of the microenvironment, signalling pathways, epigenetics, and autophagy. These findings suggest that understanding the causes of abnormal FB formation may aid in the development of precise and effective preventive and treatment strategies for pathological scarring that are associated with improved quality of life of patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been confirmed that the mixing of decellularized matrix and polymer electrospinning can not only improve the structural properties of fibers, but also preserve the biological decellularized of decellularized matrix. However, there is no relevant report on the preparation of skin tissue engineering scaffolds by electrospinning polyurethane and decellularized skin matrix. OBJECTIVE: To investigate the reparative effect of a decellularized skin matrix/polyurethane blended fibrous scaffold on rat skin defects. METHODS: Polyurethane electrospun fibrous scaffold and decellularized skin matrix/polyurethane blended fibrous scaffold were fabricated using the electrospinning technique. The fiber structure was observed under scanning electron microscope. Rat adipose mesenchymal stem cells were inoculated on two kinds of scaffolds respectively. The morphology of the scaffolds was observed under scanning electron microscope. Three full-thickness skin defects of 1 cm×1 cm were fabricated on the back of 10 SD rats. Polyurethane electrospun fibrous scaffolds (control group) and decellularized skin matrix/polyurethane blended fibrous scaffolds (experimental group) were implanted in two of the defects, and no material was implanted in the remaining defects (blank control group). The skin wound healing was observed at 1, 2, and 3 weeks after operation. At 3 weeks after implantation, the wound was stained with hematoxylin and eosin and the scar area was calculated. RESULTS AND CONCLUSION: (1) Under scanning electron microscope, the two kinds of electrospun fibers were reticulated, and the rat adipose mesenchymal stem cells attached to the fibers on the two kinds of scaffolds, and the adhesion was good. (2) With the extension of the postoperative time, the skin wounds of each group gradually healed. By week 3 after the operation, the skin wounds of the experimental group and the control group were basically healed, and small ulcers could be seen on the wounds of the blank control group. Hematoxylin-eosin staining of skin wounds showed that the epidermal coverage of the wound was basically complete in the control group and the experimental group, and fibroblast growth and inflammatory cell infiltration could be seen in the dermis. In addition, the collagen fibers of the wound in the experimental group were abundant and arranged in a regular order, basically parallel to the epidermal surface. The wound epidermis of blank control group was still defective. The scar area of the experimental group was smaller than that of the other two groups (P < 0.05, P < 0.01). (3) These results indicate that the decellularized skin matrix/polyurethane blended fibrous scaffold can effectively repair full-thickness skin defects and improve scar formation in rats [ABSTRACT FROM AUTHOR]

Intro: Treating complex paediatric wounds is a challenge for many clinicians. Biodegradable Temporising Matrix (BTM) is a completely synthetic product that has shown promise in adults with acute burns, complex wounds, and reconstructive procedures. Currently, there is little documentation regarding the use of BTM in the paediatric population. Method: A retrospective chart review was conducted of all children who required application of BTM for wound treatment. Children were grouped into categories according to the type of injury or condition including thermal, friction, and electrical injuries, scar reconstruction, and various wound defects. Outcomes of interest included infection rates, time to application of BTM and split-thickness skin graft (SSG), dressings used, and overall functional and cosmetic outcomes. Results: 63 children were identified. Thermal (19/63) and friction (10/63) injuries represented the largest groups. Males accounted for 68 % of total children with lower limbs and feet most often affected. The median time for application of BTM was 7.5 days and 27 days from time of application of BTM to SSG. BTM provided satisfactory options for early wound closure and the ability to convert complex wounds, however it still does not negate the need for scar management. Conclusion: From our review, BTM is a versatile product that has shown positive results for the treatment of complex wounds in the paediatric population. It represents the largest consecutive BTM case series in either adult or paediatric populations to date.

Abstract Objectives The aim of this literature review was to synthesise and report current practice in evaluation and reporting of scar outcomes in hand and wrist clinical research. Methods A systematic search from inception to 2022 was conducted using three electronic databases. English language randomized controlled trials and observational cohort studies reporting standardised scar outcome measures and/or scar symptoms, appearance, impairment, function, or mental health outcomes in patients with hand and wrist scars were included. Two independent reviewers determined study eligibility and performed data extraction of a priori identified scar outcome domains. Data analysis included descriptive statistics and identification of discordance in taxonomy. Results Fifty-nine studies were included. Elective surgery cohorts were the most frequently included clinical population (n = 28; 47%) followed by burns (n = 16; 27%). Six different standardised scar outcome measures were reported by 25% of studies however only 7% of studies utilised a patient-reported measure. Scar symptoms were the most frequently reported outcome domain (81%); but taxonomy was incongruous, constructs lacked working definitions required for generalisability and outcome measurement was variable and unreported. Nineteen different measures of scar appearance and structure were reported by 30 (51%) of studies however only nine (23%) were patient-reported. Seven different hand function PROMs were reported by 25 (43%) studies. Person-centred domains including scar acceptability (12%), mental health impact (5%), and social participation (4%) were rarely reported. Conclusions This review highlights that evaluation and reporting of hand and wrist scar outcomes is not standardised, assessment methods and measures are under-reported and there is discordance in taxonomy. Evaluation is not person-centred, rather it is dependent on clinician assessment. Domains including scar acceptability, mental health, and social participation are rarely addressed. A stakeholder consensus derived hand and wrist scar core outcome measurement set will promote standardisation and underpin improvements in clinical research quality, transparency, and rigour.

Abstract Objective The pursuit of an esthetically pleasing scar following open thyroid surgery has led to the development of endoscopic thyroidectomy through remote incisions placed in several locations outside the neck. The objective of this study is to review the recent literature and compare the incision site appearance and patient satisfaction with the cosmetic outcome after extracervical and conventional thyroidectomy. Methods The English literature published since 2010 was searched through the PubMed/Medline database for studies comparing the cosmetic outcomes between remote‐access endoscopic and conventional thyroidectomy using a form of scar assessment scale. Results A total of 9 relevant papers fulfilled the eligibility criteria including 1486 patients. Among them, 595 patients underwent endoscopic thyroidectomy through several remote‐access approaches and 891 patients were assigned to the conventional group. Only one randomized‐controlled trial was identified, whereas among the rest, four were prospective and four were retrospective nonrandomized cohorts. Regarding the extracervical modifications performed in the endoscopic groups, the axillary approach was performed in three studies and the breast approach in four studies, while the retroauricular facelift technique and the transoral vestibular method were applied in one study, respectively. Conclusions Evaluation of the wound appearance and patient satisfaction with the cosmetic outcome at various time points during the follow‐up highlighted the superiority of the extracervical approaches over the conventional cervicotomy. Considering these findings, remote‐access techniques could possibly be the ideal surgical method for patients with high esthetic requirements, providing an excellent appearance of the thoroughly exposed neck.

Abstract Background The role of cardiac magnetic resonance imaging in the early management of chronic cardiac inflammatory conditions is growing. Our case enlightens the benefit of quantitative mapping in the monitoring and treatment guidance in systemic sarcoidosis. Case presentation We report about a 29-year-old man with an ongoing dyspnea and bihilar lymphadenopathy, suggesting sarcoidosis. Cardiac magnetic resonance showed high mapping values, but no scarring. In follow-ups, cardiac remodeling was noted; cardioprotective treatment normalized cardiac function and mapping markers. Definitive diagnosis was achieved in extracardiac lymphatic tissue during a relapse. Conclusion This case shows the role that mapping markers can play in the detection and treatment at early stage of systemic sarcoidosis.

This study aims to develop a simple polymerase chain reaction (PCR) sequence-specific primer method, which will be used to genotype HLA-B*15:02, HLA-B*15:13, and HLA-B*15:21.

Succinate dehydrogenase inhibition with malonate during initial reperfusion reduces myocardial infarct size in both isolated mouse hearts subjected to global ischemia and in in situ pig hearts subjected to transient coronary ligature. However, the long-term effects of acute malonate treatment are unknown. Here, we investigated whether the protective effects of succinate dehydrogenase inhibition extend to a reduction in scar size and adverse left ventricular remodeling 28 days after myocardial infarction. Initially, ten wild-type mice were subjected to 45 min of left anterior descending coronary artery (LAD) occlusion, followed by 24 h of reperfusion, and were infused during the first 15 min of reperfusion with saline with or without disodium malonate (10 mg/kg/min, 120 μL/kg/min). Malonate-treated mice depicted a significant reduction in infarct size (15.47 ± 3.40% of area at risk vs. 29.34 ± 4.44% in control animals, p < 0.05), assessed using triphenyltetrazolium chloride. Additional animals were then subjected to a 45 min LAD ligature, followed by 28 days of reperfusion. Treatment with a single dose of malonate during the first 15 min of reperfusion induced a significant reduction in scar area, measured using Picrosirius Red staining (11.94 ± 1.70% of left ventricular area (n = 5) vs. 23.25 ± 2.67% (n = 9), p < 0.05), an effect associated with improved ejection fraction 28 days after infarction, as determined using echocardiography, and an attenuated enhancement in expression of the pro-inflammatory and fibrotic markers NF-κB and Smad2/3 in remote myocardium. In conclusion, a reversible inhibition of succinate dehydrogenase with a single dose of malonate at the onset of reperfusion has long-term protective effects in mice subjected to transient coronary occlusion.

In this study, molecular typing using Randomly Amplified Polymorphic DNA (RAPD-PCR) was conducted on 16 original isolates of Metarhizium acridum obtained from locusts (Schistocerca piceifrons ssp. piceifrons.) in Mexico (MX). The analysis included reference strains of the genus Metarhizium sourced from various geographical regions. The isolates were identified by phenotypic (macro and micromorphology) and genotypic methods (RAPD-PCR and Amplified Fragment Length Polymorphisms (AFLP), through a multidimensional analysis of principal coordinates (PCoA) and a minimum spanning network (MST). Subsequently, Sequences-Characterized Amplified Region (SCAR) markers were developed for the molecular detection of M. acridum, these markers were chosen from polymorphic patterns obtained with 14 primers via RAPD-PCR. Phenotypic and genotypic characterization identified the MX isolates as M. acridum. Of all the polymorphic patterns obtained, only OPA04 and OPA05 were chosen, which presented species-specific bands for M. acridum, and further utilized to create SCAR markers through cloning and sequencing of the specific bands. The specificity of these two markers was confirmed via Southern hybridization. The SCAR markers (Ma-160OPA-05 and Ma-151OPA-04) exhibit remarkable sensitivity, detecting down to less than 0.1 ng, as well as high specificity, as evidenced by their inability to cross-amplify or generate amplification with DNAs from other strains of Metarhizium (as Metarhizium anisopliae) or different genera of entomopathogenic fungi (Cordyceps fumosorosea and Akanthomyces lecanii). These SCAR markers yield readily detectable results, showcasing high reproducibility. They serve as a valuable tool, especially in field applications.

The ability to heal one’s wounds is perhaps one of the most fundamental and critical of physiologic processes. This coordinated and closely regulated sequential biological process involves a variety of migratory and resident cells. The activation, modulation, balance, and control of these functions depend upon soluble mediators that activate cells and modulate their diverse functions. Recent advances have identified mechanotransduction as functionally integral in many different cell types and physiologic processes. The mechanically sensitive ion channel Pieoz1 is expressed on platelets, neutrophils, macrophages, endothelial cells, keratinocytes, and fibroblasts, all of which are principally involved in wound healing. On a cellular level, there have been great advances in our understanding of the functional role of Piezo1 mechanotransduction in cutaneous wounding. The blocking of Piezo1 has recently been shown to reduce scarring in vivo and yet, thus far, a comprehensive understanding of the roles that Piezo1 plays in in vivo wound healing remains lacking. Recognizing the ever-present and critical importance of optimal and reparative wound healing, and with the availability of new physical mechanomodulating devices, the time is ripe for gaining deeper insights into optimizing wound healing. In this review, we describe the current knowledge of Piezo1 related to wound healing.

There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, hopefully, exert a greater effect when combined with rehabilitation. However, no review has specifically summarized the combinatorial effects of rehabilitation with various medical agents. In the current review, which included 43 articles, we summarized the combinatorial effects according to the properties of the medical agents, namely neuromodulation, neurotrophic factors, counteraction to inhibitory factors, and others. The recovery processes promoted by rehabilitation include the regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, microenvironmental change in the spinal cord, and enforcement of the musculoskeletal system, which are additive, complementary, or even synergistic with medication in many cases. However, there are some cases that lack interaction or even demonstrate competition between medication and rehabilitation. A large fraction of the combinatorial mechanisms remains to be elucidated, and very few studies have investigated complex combinations of these agents or targeted chronically injured spinal cords.

Background: Acne often worsens in transmasculine patients who are on prolonged testosterone therapy. Isotretinoin is an oral retinoid used in the treatment of severe or refractory cases of acne, but it has the potential to cause delayed wound healing. Transmasculine patients may potentially be prescribed treatment for acne with isotretinoin while also planning to undergo chest masculinization surgery. Objective: This scoping review aims to determine whether isotretinoin has a negative impact on postoperative healing in transmasculine patients undergoing chest masculinization surgery. Methods: A scoping review was performed using the PubMed and Ovid databases. A total of 16 publications were selected for inclusion. Results: Acne tends to peak in transmasculine patients six months after initiation of testosterone treatment. Severe cases can be treated with isotretinoin; however, acne may recur once treatment is discontinued, given ongoing hormone therapy. There is little-to-no evidence in the medical literature regarding perioperative use of isotretinoin specifically among transmasculine patients undergoing chest masculinization surgery. In general, however, recent studies have found no evidence of increased hypertrophic scars or keloids in patients taking isotretinoin. Conclusion: Further studies are required to strengthen the current evidence that suggests that isotretinoin does not need to be discontinued before or after incisional or excisional surgeries, including chest masculinization surgery in transmasculine patients. [ABSTRACT FROM AUTHOR]

This article discusses the challenges of effectively managing keloids, which are abnormal scars that result from excessive accumulation of tissue. The surgical treatment of keloids can often lead to a dysmorphic appearance, particularly in the case of ear keloids. To address this issue, the authors developed a technique called the "dermal hinge flap method," which involves selectively removing the superficial layer of keloid tissue while preserving the deeper layer for structural support. The technique was successfully used in a case study of a 19-year-old female patient with an ear keloid, resulting in satisfactory outcomes. The authors recommend further research and longer follow-up studies to establish guidelines for the appropriate use of corticosteroid injections in conjunction with surgical treatment for keloids. [Extracted from the article]

This article discusses a case of lipoatrophy, a condition characterized by the loss of fat tissue, following a corticosteroid injection for a hypertrophic scar. The patient, a 16-year-old male, initially received topical corticosteroids with no effect, and then underwent a single session of corticosteroid injection. However, 11 months later, the patient developed progressive skin changes, including atrophy and hypopigmentation, in the area surrounding the scar. The article reports that the lipoatrophy was successfully reversed with a single treatment of isotonic saline injection. The authors suggest that saline injections may be a safe and effective treatment option for corticosteroid-induced lipoatrophy. [Extracted from the article]

Spinal cord injury (SCI) is caused by disease or trauma and results in a partial or complete loss of motor or sensory function below the injury level. Most patients with SCI are young, and long-term disability imposes both psychological and financial burdens. Rice is the most abundant source of γ-oryzanol, which exhibits both antioxidant and anti-inflammatory properties. γ-Oryzanol has been shown to cross the blood–brain barrier in an intact form and have beneficial effects on brain function. To the best of our knowledge, this is the first study to report the effect of γ-oryzanol on motor function recovery in mice after SCI.

Chronic wounds and scar formation are widespread due to limited suitable remedies. The macrophage is a crucial regulator in wound healing, controlling the onset and termination of inflammation and regulating other processes related to wound healing. The current breakthroughs in developing new medications and drug delivery methods have enabled the accurate targeting of macrophages in oncology and rheumatic disease therapies through clinical trials. These successes have cleared the way to utilize drugs targeting macrophages in various disorders. This review thus summarizes macrophage involvement in normal and pathologic wound healing. It further details the targets available for macrophage intervention and therapeutic strategies for targeting the behavior of macrophages in tissue repair and regeneration.

Scars caused by skin injuries after burns, wounds, abrasions and operations have serious physical and psychological effects on patients. In recent years, the research of scar free wound repair has been greatly expanded. However, understanding the complex mechanisms of wound healing, in which various cells, cytokines and mechanical force interact, is critical to developing a treatment that can achieve scarless wound healing. Therefore, this paper reviews the types of wounds, the mechanism of scar formation in the healing process, and the current research progress on the dual consideration of wound healing and scar prevention, and some strategies for the treatment of scar free wound repair. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute spinal cord injury is a disease with high disability and mortality. An active and effective treatment in the acute phase is of great significance to prevent secondary injury. OBJECTIVE: To investigate the mechanism underlying Tongfu Zhuyu therapy in the treatment of acute spinal cord injury through observing the therapeutic effect of Jiajian Didang Tang on edema and recovery of limb function after acute spinal cord injury in rats. METHODS: A total of 60 Sprague-Dawley rats were randomly divided into sham group, model group, Didang Tang group, 2-(nicotinamide)-1,3,4-thiadiazole (TGN-020) group, and Didang Tang combined with TGN-020 group (combined group), with 12 rats in each group. Among them, the sham group only underwent laminectomy without spinal cord shock and the other groups used NYU percussion device to create an acute spinal cord injury model. After modeling, the sham and model groups did not take any treatment measures. The Didang Tang group was given 5.04 g/kg Didang Tang by intragastric administration, the TGN020 group was given 5 mg/kg TGN-020 by intraperitoneal injection, and the combined group was given TGN-020 by intraperitoneal injection combined with Didang Tang by intragastric administration, once a day for 7 days. Basso, Beattie and Bresnahan score and Reuter score were evaluated on 1, 3, 5 and 7 days after operation. Spinal cord tissue was taken for general observation and water content measurement at 7 days after operation. The degree of tissue damage was detected by hematoxylin-eosin staining. The number of aquaporin 4/glial fibrillary acidic protein-positive cells in the spinal cord tissue was detected by immunofluorescence assay. The protein expression levels of Aquaporin 4, glial fibrillary acidic protein, chondroitin sulfate proteoglycan, and proliferating cell nuclear antigen protein in spinal cord tissue were detected by western blot. RESULTS AND CONCLUSION: The behavioral scores showed that compared with the model group, the Basso, Beattie and Bresnahan scores were significantly increased in the three administration groups (P < 0.05), while the Reuter scores were significantly decreased (P < 0.05). Moreover, there was no significant difference among the three administration groups (P > 0.05). Compared with the model group, the water content of spinal cord tissue was significantly decreased in the three administration groups (P < 0.05), while there was no significant difference among the three administration groups (P > 0.05). Hematoxylin-eosin staining results showed that the structure of the model group was disorganized, with a lot of scar tissue and syringomyelia. Compared with the model group, the tissue structure was relatively complete in the three administration group, with a small amount of scar tissue hyperplasia and syringomyelia, and the tissue morphology was effectively improved. Immunofluorescence staining results showed that compared with the model group, the number of aquaporin 4/glial fibrillary acidic protein-positive cells was less in the three administration groups, with lower brightness and reduced degree of cell swelling (P < 0.05). However, there was no significant difference among the three administration groups (P > 0.05). Western blot results showed that compared with the model group, the expressions of aquaporin 4, glial fibrillary acidic protein, chondroitin sulfate proteoglycan, and proliferating cell nuclear antigen protein in the spinal cord tissue of the three administration groups were significantly decreased (P < 0.05). While, there was no significant difference among the three administration groups (P > 0.05). To conclude, Jiajian Didang Tang can promote the recovery of limb function in rats with acute spinal cord injury under the guidance of Tongfu Zhuyu therapy. Its mechanism may reduce edema at the injury site by inhibiting the expression of aquaporin 4, so as to effectively inhibit the activation and proliferation of reactive astrocytes and reduce the formation of glial scar. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical effect of modified incision and drainage in the treatment of infectious sebaceous cyst. Methods A total of 60 patients with infectious sebaceous cyst who visited the hospital from January to June 2021 were selected and randomly divided into the study group and the control group with 30 cases in each group. The study group used modified incision and drainage, while the control group used traditional incision and drainage. The incision healing time, recurrence rate at six months after surgery, and incision scar width were compared between the two groups. Results The incision healing time of the study group and the control group was 14.00 (12.00,18.50) and 15.00 (12.75,21.25) days, respectively, and there was no statistically significant difference between the two groups (P＞0.05). At two and six months after surgery, there was statistically significant difference in recurrence rate between the two groups (P＜0.05). There was no statistically significant difference in incision scar width between the two groups at six months after surgery (P＞0.05). Conclusion The treatment of infectious sebaceous cyst with modified incision and drainage has a good effect, which can effectively reduce the recurrence rate, avoid secondary surgery, and improve patient satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To compare the healing following various maxillofacial incisions using 2-octyl cyanoacrylate (2-OCA) and prolene (4-0) sutures. Objective: To evaluate the complications and aesthetic outcome of the incision wounds after closure using 2-OCA and prolene (4-0) sutures. Materials and Methods: The patient undergoing an extraoral incision was evaluated for pain, inflammation, infection, dehiscence, scar, and surface texture. In Group I, 15 patient incisions were closed with 2-OCA and in Group II, 15 patient incisions were closed with prolene (4-0) suture. Result: A few patients experienced pain with Group I and then Group II, but infection, inflammation, and dehiscence were more in Group I than in Group II. Conclusion: A cosmetic outcome was higher in the cyanoacrylate group, and the surface texture was satisfying in the same group. [ABSTRACT FROM AUTHOR]

Differentiated thyroid carcinoma (DTC) is the most frequent endocrine neoplasm. Its treatment is based on surgery with consequent impact on patients' quality of life (QoL) and aesthetic implication. The aim of the present study is to assess scar satisfaction in patients affected by DTC who underwent total or partial thyroidectomy. A comparison was also made between scar satisfaction with different subcuticular suture. Validated questionnaires have been employed during a 3-month follow-up: Patient and Observer Scar Assessment Scale (POSAS) and the Patient Scar Assessment Questionnaire (PSAQ). Eventually, the impact of thyroid cancer on QoL of patients was performed in the studied population employing the Thyroid-related patient-reported outcome questionnaire (ThyPRO) and European Organisation for Research Additionally, Treatment of Cancer—Quality of Life questionnaire-C30 (EORTC QLQ-C30). It was conducted in a single center observational study considering 74 patients respecting inclusion criteria. Overall scar satisfaction was found to improve during follow-up, reaching the best scores at 3 months from surgery. Subcuticular suture does not seem to influence the scar satisfaction. In our study male patients seem to be more satisfied, on the other hand age does not seem to influence satisfaction. Overall, the ThyPRO questionnaire and EORTC QLQ-C30 scores did not statistically differ between preoperative and postoperative suggesting a small impact of DTC in QoL. [ABSTRACT FROM AUTHOR]

Renin-angiotensin system (RAS) components such as angiotensin II, angiotensin receptors (AT1R and AT2R), and angiotensin-converting enzyme (ACE) are expressed in different cell types of the skin. Through AT1R, angiotensin II increases proinflammatory cytokines contributing to fibrosis, angiogenesis, proliferation, and migration of immune cells to the skin. In contrast, AT2R suppresses the effects mentioned above. Many studies show that angiotensin receptor blockers (ARBs) and angiotensin-converting enzymes (ACEi) reduce the proinflammatory cytokines and fibrogenic factors including transforming growth factor ß (TGF-ß), Connective tissue growth factor (CTGF), and IL-6. This review article provides a detailed research study on the implications of ARBs in wound healing, hypertrophic scar, and keloids. We further discuss the therapeutic potentials of ARBs in autoimmune and autoinflammatory skin diseases and cancer, given their anti-fibrotic and anti-inflammatory effects. [ABSTRACT FROM AUTHOR]

Platelet-rich fibrin (PRF), a second-generation platelet concentrate, was developed for the purpose of overcoming the limitations of Platelet-rich plasma (PRP). PRF can produce a higher cumulative release of growth factors than PRP. Also, this release is slow and prolonged, making it ideal for tissue regeneration and growth stimulation. This study was conducted to evaluate the efficacy of fluid PRF either alone or combined with needling versus PRP in the treatment of atrophic acne scars. A comparative study including 30 patients with atrophic acne scars who were divided into two equal groups. Group I included 15 patients in which the left side of the face was treated with intradermal injection of PRP while the right side was treated with combined needling with PRP. Group II included15 patients in which the left side of the face was treated with intradermal injection of fluid PRF while the right side was treated with combined needling with fluid PRF. All patients received four sessions with 3 weeks interval. The acne scars significantly improved in both sides of face in both groups. According to quartile grading scale and patient satisfaction; the therapeutic response was significantly higher in PRF group than PRP either alone or combined with needling. The combination with needling increases efficacy of PRF and PRP. Fluid PRF is highly effective, safe and simple procedure that can be used instead of PRP in the treatment of acne scars. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study explored the physical and psychological effects of scar massage on burn patients. Background: Hypertrophic scar development is highly prevalent following burn injuries. Scar massage may have physical and psychological effects, although evidence of its effectiveness for burn scar improvement remains inconsistent. Design: A systematic review and meta‐analysis of randomised controlled trials and quasi‐experimental trials. Methods: This study was conducted following the Centre of Reviews and Dissemination guidelines and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PubMed, EMBASE, and Chinese Electronic Periodical Services were searched for studies published between January 1990 and February 2022. Quality was assessed using the Joanna Briggs Institute (JBI) Appraisal Checklist. The final recommendation strength was assessed according to the JBI recommendation rating. A meta‐analysis was performed using Review Manager Version 5.4 software with a random‐effect model. Results: Seven studies (420 participants) investigating scar massage for burn patients were included. The scar massage sessions lasted 5–30 min and were delivered by massage therapists 1–3 times a week for 12 weeks. Overall, scar massage decreased pain levels (standardised mean difference [SMD]: −2.39; 95% confidence interval [CI]: −3.96 to −0.83), improved scar thickness (mean difference: ‐0.05; 95% CI: −0.1 to −0.0), reduced pruritus (SMD: ‐1.89; 95% CI: −2.95 to −0.82) and reduced anxiety (SMD: ‐1.52; 95% CI: −2.73 to −0.32), but no significant effect on depression(SMD: ‐0.92; 95% CI:‐2.28 to 0.44). Conclusions: The meta‐effects of scar massage among burn patients are significantly improved scar formation and reduced pruritus and anxiety. Providing scar massage is feasible and effective for burn patients. Future research should evaluate its long‐term effects. Relevance to clinical practice: Scar massage is relatively convenient and effective in preventing and alleviating hypertrophic burn scarring. Further research can provide detailed suggestions for effective scar massage implementation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pityriasis lichenoides is a rare, acquired skin disorder of unknown etiopathogenesis. Pityriasis lichenoides et varioliformis acuta is one of its forms of presentation and is clinically characterized by polymorphous lesions usually covered by hemorrhagic crusts with autolimited tendency, which may leave varioliform scars and residual hypo- or hyperpigmented macules. Diagnosis is clinical and is confirmed by histopathology, where confluent parakeratosis, necrotic keratinocytes and superficial and deep lymphohistiocytic inflammatory infiltrate can be observed. Regarding treatment there is no consensus, but tetracyclines, cyclosporine, methotrexate and phototherapy are described. CLINICAL CASE: A 15-year-old female patient with diagnosis of pityriasis lichenoides et varioliformis acuta, who presented relieve of the lesions after one month of management with doxycycline.CONCLUSIONS: Pityriasis lichenoides et varioliformis acuta is an uncommon dermatosis and few cases are reported in the literature. There is limited information on the theories of its etiopathogenesis and therapeutic options, which represents a challenge for the dermatologist. This case is striking given the significant improvement in a shorter time than established in the literature and with a tetracycline not frequently used in the reported cases. [ABSTRACT FROM AUTHOR]

Excessive scar formation caused by cutaneous injury leads to pruritus, pain, contracture, dyskinesia, and unpleasant appearance. Functional wound dressings are designed to accelerate wound healing and reduce scar formation. In this study, we fabricated aligned or random polycaprolactone/silk fibroin electrospun nanofiber membranes with or without lovastatin loading, and then evaluated their scar-inhibitory effects on wounds under a specific tension direction. The nanofiber membranes exhibited good controlled-release performance, mechanical properties, hydrophilicity, and biocompatibility. Furthermore, nanofibers' perpendicular placement to the tension direction of the wound most effectively reduced scar formation (the scar area decreased by 66.9%) and promoted skin regeneration in vivo. The mechanism was associated with aligned nanofibers regulated collagen organization in the early stage of wound healing. Moreover, lovastatin-loaded nanofibers inhibited myofibroblast differentiation and migration. Both tension direction-perpendicular topographical cues and lovastatin synergistically inhibited mechanical transduction and fibrosis progression, further reducing scar formation. In summary, our study may provide an effective scar prevention strategy in which individualized dressings can be designed according to the local mechanical force direction of patients' wounds, and the addition of lovastatin can further inhibit scar formation. In vivo, cells and collagen are always arranged parallel to the tension direction. However, the aligned topographic cues themselves promote myofibroblast differentiation and exacerbate scar formation. Electrospun nanofibers' perpendicular placement to the tension direction of the wound most effectively reduces scar formation and promotes skin regeneration in vivo. The mechanism is associated with tension direction-perpendicular nanofibers reregulate collagen organization in the early stage of wound healing. In addition, tension direction-perpendicular topographical cue and lovastatin could inhibit mechanical transduction and fibrosis progression synergistically, further reducing scar formation. This study proves that combining topographical cues of wound dressing and drugs would be a promising therapy for clinical scar management. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction. Glaucoma is the leading cause of irreversible blindness worldwide, and conjunctival bleb scarring remains the most frequent reason for the failure of glaucoma filtration surgery. Excessive proliferation of fibroblasts from Tenon's capsule and excessive deposition of collagen contribute to the scarification of the conjunctival bleb. Heat shock protein 47 (HSP47) is assumed to act as a collagen-specific molecular chaperone, and thereby involved in the pathogenesis of fibrotic diseases. Therefore, we investigated the effect of HSP47 knockout against collagen type I (COLI) production in rat Tenon's fibroblasts. Material and methods. Newborn rat Tenon's fibroblasts were cultured and verified by anti-vimentin antibody. Transfection efficiency of small interference RNA targeted against HSP47 was confirmed by quantitative real-time polymerase chain reaction (RT-qPCR) at 48 h after siRNA transfection and by western blot at 72 h after transfection. The mRNA and protein expression of HSP 47 and COLI were detected by RT-qPCR and western blot. The proliferation of cells was measured by cell counting kit-8 assay. Results. HSP47 siRNA down-regulated the mRNA and protein levels of HSP47 in rat Tenon's fibroblasts, and suppressed the mRNA and protein expression of COLI. Moreover, HSP47 siRNA had no significant effect on proliferation of rat Tenon's fibroblasts. Conclusions. HSP47 siRNA inhibits the production of COLI in rat Tenon's fibroblasts, and may be the potential therapeutic method in bleb scarring after glaucoma filtration surgery. (Folia Histochemica et Cytobiologica 2023, Vol. 61, No. 3, 153--159) [ABSTRACT FROM AUTHOR]

Purpose: To review two cohorts of children treated by two different protocols (repeated needle aspiration-lavage vs. arthrotomy) for surgical treatment of septic arthritis of the hip (SAH). Methods: In order to compare between the two methods, the following parameters were checked: (a) Scar cosmesis was assessed by the Patient and Observer Scar Assessment Scale (POSAS). We considered satisfactory results (no scar discomfort) when POSAS was within 10% of the ideal score; (b) 24-h post-operative pain was evaluated by visual analog scale (VAS); (c) Complication rates of incomplete drainage (re-arthrotomy/therapy modification from aspiration-lavage to arthrotomy). The results were evaluated by the Student t-test or by the chi-square test. Results: Seventy-nine children (aged 2–14 years) admitted during 2009–2018 and available for at least two years of follow-up were enrolled. The POSAS score (range 12–120 points) at the latest follow-up was higher in the arthrotomy group compared with the aspiration-lavage group (18.10 ± 6.22 versus 12.27 ± 1.40, p < 0.001); 77.4% of patients treated by arthrotomy had no scar discomfort. The 24-h post-intervention VAS (range 1–10) was 5.06 ± 1.29 after arthrotomy and 4.03 ± 1.13 after aspiration-lavage, p < 0.04. Complications were three times more frequent in the aspiration-lavage group (8.8% in the arthrotomy group and 26.7% in the aspiration-lavage group, p = 0.045). Conclusions: We conclude that the lower complication rate observed in the arthrotomy group outweighs by far scar cosmesis and post-operative pain advantages in the aspiration-lavage group. Arthrotomy as a drainage method is safer than aspiration-lavage. [ABSTRACT FROM AUTHOR]