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Abstract Background Little is known about sun‐exposure and sun‐protection behaviors among tattooed individuals. Objectives This study sought to investigate the sun‐exposure and sun‐protective habits among tattooed individuals. Methods Population‐based study using a representative sample of the general population aged ≥18 years from four countries (Brazil, China, Russia and United‐States). All participants were asked to fill in a digital structured questionnaire. We inquired about socio‐demographics, self‐evaluation of their skin phototype (from I to VI), tattoo(s) and sun‐exposure and sun‐protection habits. Results A total of 9031 adult participants responded to the questionnaire of whom 1682 (18.6%) had ≥ 1 tattoo(s). The prevalence of tattoos was significantly higher among individuals with lighter skin tone (phototype I to III, 20.2%) compared to those with darker one (phototype IV to VI, 13.9%, p

Abstract Dermatophytids are defined as the acute occurrence of noninfectious secondary lesions at distance from a primary dermatophytic infection. They are well‐known after intertrigo of the toes. We report an 8‐year‐old boy, who developed generalised pustular lesions during the treatment of tinea capitis caused by Trichophyton violaceum. He had a rapid response to local corticosteroid ointment, while oral terbinafine was efficient on the scalp condition. Dermatophytids are the result of a type IV delayed hypersensitivity reaction to dermatophytic antigens. They may occur after initiation of an antifungal treatment. Generalised exanthematous pustular dermatophytids is a clinical variant of dermatophytids. They present as nonfollicular, nonconfluent pustules with an erythematous base, of abrupt onset. Main differential diagnoses are acute generalised exanthematous pustulosis and pustular psoriasis. Medical history, clinical presentation, laboratory findings and, if necessary, biopsy will help to distinguish between those conditions. Evolution is rapidly favourable under local or oral corticotherapy and antifungal treatments should not be withdrawn. Dermatophytids are a differential diagnostic of acute generalised pustulosis during tinea capitis.

Abstract Dermatomyositis (DM) is a rare idiopathic inflammatory disorder characterized by the association of typical skin and myositis. It may be associated with interstitial lung disease and/or malignancy. Diagnosis is usually easy in patients with fair skin due to very peculiar clinical features, but, among persons of colour (PoC), diagnosis can become challenging for an unexperienced eye, especially in case of lack of clinical myositis. We present the case of a young man with amyopathic DM that has evolved for 4 years before the proper diagnosis has been made. Our case highlights the pitfalls related to the clinical presentation of DM in PoC.

Skin reactions are well described complications of tattooing, usually provoked by red inks. Chemical characterizations of these inks are usually based on limited subjects and techniques. This study aimed to determine the organic and inorganic composition of inks using X-ray fluorescence spectroscopy (XRF), X-ray absorption spectroscopy (XANES) and Raman spectroscopy, in a cohort of patients with cutaneous hypersensitivity reactions to tattoo. A retrospective multicenter study was performed, including 15 patients diagnosed with skin reactions to tattoos. Almost half of these patients developed skin reactions on black inks. XRF identified known allergenic metals – titanium, chromium, manganese, nickel and copper – in almost all cases. XANES spectroscopy distinguished zinc and iron present in ink from these elements in endogenous biomolecules. Raman spectroscopy showed the presence of both reported (azo pigments, quinacridone) and unreported (carbon black, phtalocyanine) putative organic sensitizer compounds, and also defined the phase in which Ti was engaged. To the best of the authors' knowledge, this paper reports the largest cohort of skin hypersensitivity reactions analyzed by multiple complementary techniques. With almost half the patients presenting skin reaction on black tattoo, the study suggests that black modern inks should also be considered to provoke skin reactions, probably because of the common association of carbon black with potential allergenic metals within these inks. Analysis of more skin reactions to tattoos is needed to identify the relevant chemical compounds and help render tattoo ink composition safer.

In cinema, many visual characteristics of the characters serve as "unspoken" elements that allow the audience to attribute (rightly or wrongly) these characteristics without the need to use superfluous verbal information: clothes, hairstyles, scars, prostheses, physical defects, etc. Tattoos are obviously part of this visual panel. Tattoos may be the central theme of the movie, allow to give one or more attribute to the character, have a real function in the movie or simply has an aesthetic role of beautification. The prevalence of actors and actress with tattoos is unknown. However, some actors may display their tattoos for the purpose of the movie.

Melanoma is a highly metastatic tumour originating from neural crest-derived melanocytes. The aim of this study was to analyse the expression of neuron navigator 3 (NAV3) in relation to membrane type-1 matrix metalloproteinase MMP14, a major regulator of invasion, in 40 primary melanomas, 15 benign naevi and 2 melanoma cell lines. NAV3 copy number changes were found in 18/27 (67%) primary melanomas, so that deletions dominated (16/27 of samples, 59%). NAV3 protein was found to be localized at the leading edge of migrating melanoma cells in vitro. Silencing of NAV3 reduced both melanoma cell migration in 2-dimensional conditions, as well as sprouting in 3-dimensional collagen I. NAV3 protein expression correlated with MMP14 in 26/37 (70%) primary melanomas. NAV3 and MMP14 were co-expressed in all tumours with Breslow thickness 5 mm) melanomas. Altogether, NAV3 number changes are frequent in melanomas, and NAV3 and MMP14, while expressed in all thin melanomas, are often downregulated in thicker tumours, suggesting that the lack of both NAV3 and MMP14 favours melanoma progression.

Annular dermatoses are a heterogeneous and extremely diverse group of skin diseases, which share in common annular, ring-like patterns with centrifugal spreading. Numerous skin diseases can sometimes display annular lesions, but some specific skin conditions are originally annular. We take the opportunity to review here mainly the causes of primary annular erythemas and their differential diagnoses, but also the rare causes of annular purpuras.

Abstract Background and Aims Tattoo prevalence has significantly increased over the last decades. Proper tattoo aftercare, such as cleansing, moisturizing, and protection against sunlight, is essential to prevent complications and to keep the beauty of the tattoo. The tolerability, performance, and cosmetic acceptability of two dexpanthenol‐containing dermo‐cosmetic products, a wash and a sun‐care, were investigated on tattooed skin in two separate trials. Methods Two single‐center, exploratory, open‐label cosmetic studies were conducted between August and November 2020 to evaluate the dexpanthenol‐containing dermo‐cosmetic products. In the first study, healthy adults applied the 2.5% dexpanthenol‐containing wash right after their tattoo session daily for 14 consecutive days. In the second study, healthy adults applied the 2.5% dexpanthenol‐containing sun‐care sun protection factor 50+ cream on existing tattoos that were daily exposed to sunlight for 28 consecutive days. Clinical examination by a dermatologist and self‐assessment through subject questionnaires were used to assess the tolerability, acceptance, ease of use, and cosmetic outcomes of both products. Additionally, transepidermal water loss and moisturization assessments were performed to evaluate skin hydration after use of the sun‐care product. Results Both study products were well tolerated, and no product related adverse events were reported during the studies. At least 90% of the study participants appreciated the performance of the dexpanthenol‐containing wash and sun‐care product, including moisturizing properties, relief of unpleasant sensations, and preservation of the cosmetic appearance of the tattoo. For the sun‐care, it was shown that its application supported maintaining the skin barrier of tattooed skin, while keeping it hydrated. Conclusion The 2.5% dexpanthenol‐containing wash and sun‐care products are well tolerated and appreciated by tattooed subjects. Hence, they represent valid options for tattoo aftercare in line with current recommendations and practice.

Objective: Intestinal autoimmunity with gastrointestinal (GI) dysfunction has been shown in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). Patients lack entero-endocrine (EE) cells and have circulating autoantibodies (Aabs) against critical enzymes in serotonin (5-HT) biosynthesis. Design: We sought to determine the serum levels of 5-HT, tryptophan (Trp) metabolites and L-DOPA in 37 Finnish APECED patients and to correlate their abundance with the presence of TPH and AADC Aabs, GI dysfunction and depressive symptoms. We also performed an exploratory analysis of the gut microbiome. Methods: Serum 5-HT, L-DOPA and Trp metabolite levels were determined by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). TPH and AADC Aabs were measured by ELISA. Depression was assessed with a structured RBDI questionnaire. The V3–V4 regions of the bacterial 16S rRNA gene were sequenced for gut microbiome exploration. Results: Serum 5-HT levels were significantly decreased (130 ± 131 nmol/L vs 686 ± 233 nmol/L, P < 0.0001) in APECED patients with TPH-1 (±AADC) Aabs compared to controls and patients with only AADC Aabs. Reduced 5-HT levels correlated with constipation. The genus Escherichia/Shigella was overrepresented in the intestinal microbiome. No correlation between serum Trp, 5-HT or l-DOPA levels and the RBDI total score, fatigue or sleep disorders was found. Conclusions: This exploratory study found low serum levels of 5-HT to be associated with constipation and the presence of TPH-1 and AADC Aabs, but not with symptoms of depression. Hence, serum 5-HT, TPH1 and AADC Aabs should be determined in APECED patients presenting with GI symptoms.

Abstract is missing (Short communication)

Objectives: The data regarding the health of professional tattooists is inexistent. Tattooists are usually heavily tattooed and exposed daily to body fluids and skin-to-skin contacts with customers, tattoo inks, solvents, allergens, irritants, and work for hours often in inadequate positions using vibrating tattoo machines. We analyzed the health status of active French professional tattooists. Material and Methods: An observational self-reported Internet survey was performed among 448 tattooists who were members of the French Tattoo Union in November 2013. Results: The main physical complaints were musculoskeletal: back pain (65%), finger pain (41.5%) and muscular pain (28.8%). Finger pain, back pain, muscular pain and carpal tunnel symptoms/tingling sensations on the fingers occurred among 88%, 61.5%, 68% and 84% of the cases after having started their activity (p < 0.001). Other chronic diseases, autoimmune diseases and cancers remained at a low level here. Conclusions: Professional tattooists have a high prevalence of musculoskeletal complaints about back pain due to repetitive movements, awkward postures and use of a vibrating tattoo machine. Tattooists have a unique environment that imply developing intervention and preventive strategies for them. Int J Occup Med Environ Health 2017;30(1):111–120

High titer autoantibodies produced by B lymphocytes are clinically important features of many common autoimmune diseases. APECED patients with deficient autoimmune regulator (AIRE) gene collectively display a broad repertoire of high titer autoantibodies, including some which are pathognomonic for major autoimmune diseases. AIRE deficiency severely reduces thymic expression of gene-products ordinarily restricted to discrete peripheral tissues, and developing T cells reactive to those gene-products are not inactivated during their development. However, the extent of the autoantibody repertoire in APECED and its relation to thymic expression of self-antigens are unclear. We here undertook a broad protein array approach to assess autoantibody repertoire in APECED patients. Our results show that in addition to shared autoantigen reactivities, APECED patients display high inter-individual variation in their autoantigen profiles, which collectively are enriched in evolutionarily conserved, cytosolic and nuclear phosphoproteins. The APECED autoantigens have two major origins; proteins expressed in thymic medullary epithelial cells and proteins expressed in lymphoid cells. These findings support the hypothesis that specific protein properties strongly contribute to the etiology of B cell autoimmunity.

To assess the usefulness of using cutaneous swabs to detect Merkel cell polyomavirus (MCPyV) DNA, we analyzed swabs from persons with Merkel cell carcinoma (MCC), others with skin diseases, and healthy volunteers. MCPyV was detected in at least 1 sample from virtually all participants. Viral loads were higher in samples from patients with MCC.

Hypertrophic scars and keloids result from abnormal wound healing in predisposed individuals. They occur within months of cutaneous trauma (surgical wounds, piercing, lacerations) or inflammation (acne, folliculitis, vaccination site). They have rarely been reported after chickenpox. Herein we report a dramatic case in a 4-year-old black girl and discuss the issues related to the management of hypertrophic scars and keloids in this peculiar situation.