Search Results (77)

Background: currently, there is a growing trend toward multifunctional cosmetics, which combine several active ingredients in a single product to enhance efficacy and user convenience. As ingredients may influence one another, it is important to study the behavior of mixing multiple compounds in complex formulations, especially regarding their interaction with the skin. Piceatannol, for instance, is a naturally occurring stilbene recognized for its in vitro potent antioxidant, anti-inflammatory, and anti-aging activities, making it a promising candidate for dermocosmetic use in suncare. But despite its beneficial biological activities, its cutaneous permeation remains poorly understood, particularly when delivered from complex formulations containing multiple ingredients. Objectives: in this sense, this study aimed to evaluate the in vitro skin diffusion profile of piceatannol from a passion fruit seed extract (P_ext) incorporated into a topical base (B_em) or an organic sunscreen emulsion (O_em), with or without a spilanthol-rich Acmella oleracea extract (J_ext) used as a natural permeation enhancer. Methods: due to ethical and variability issues with human and animal skins, the Strat-M™ synthetic membrane was chosen as a standardized model for the in vitro skin permeation assays. Piceatannol localization within membrane layers was examined by confocal Raman microscopy (CRM), while compound identification in donor and receptor compartments was performed via UHPLC-DAD. Results: piceatannol from B_em was detected up to 140 µm from the Strat-M™ surface and exceeded 180 µm in depth when J_ext and organic sunscreens were included in the formulation. Notably, formulations containing J_ext and those based on O_em promoted enhanced accumulation in both the stratum corneum and deeper skin layers, suggesting an improved delivery potential in lipid-rich vehicles. Conclusions: even though some instability issues were observed, piceatannol penetration into Strat-M™ from the proposed formulations was confirmed, and the results provide a foundation for further research on its topical delivery, supporting the rational development of formulations capable of harnessing its demonstrated biological properties. Full article

Cutaneous leiomyosarcoma is a rare, malignant tumor that arises from smooth muscle cells, accounting for less than 3% of all cutaneous sarcomas. Our case report details a 63-year-old male patient who presented with a rapidly growing, painful nodule in the popliteal region. The patient underwent initial surgical excision in September 2021, followed by three subsequent resections until March 2022 due to local recurrence. Histopathological analysis of all specimens revealed a dermal neoplasm composed of spindle cells arranged in intersecting fascicles with storiform patterns. The immunohistochemistry profile showed strong positivity for the markers SMA and desmin, confirming the diagnosis. Despite early interventions, the deep surgical margins were positive, and further surgeries were required until tumor-free margins were achieved. This case emphasizes the morphological characteristics, clinical behavior, and therapeutic challenges in managing cutaneous leiomyosarcoma. A favorable prognosis is achieved with long-term follow-up and a multidisciplinary approach. Full article

Background/Objectives: Epidermolysis bullosa (EB) is a rare genetic disease often requiring extensive dental interventions. Whole genome sequencing of the oral microbiome may provide essential information on the pathogenic shifts reported in the literature, resulting in significant plaque development. Methods: Three EB patients had a proprietary whole genome sequencing completed. The samples were deidentified and compared to a library of 30,000 bacterial genomes. Results: The oral microbiome of the three individuals was significantly different from normotypical samples. Although a commonality was presented between the three individuals, differences were also noted. Neisseria sicca is present across all samples with relatively high percentiles (>95th percentile in all 3). Streptococcus mitis is also present in all samples, with its percentile and abundance differing significantly. With one sample, BHU, Morococcus cerebrosus was the top species with 19.74% relative abundance (100th percentile), an outlier compared to the other samples, and present in the highest concentration yet noted in the database. All three samples had at least one Actinomyces species in the 70th percentile or greater. Conclusions: Within the limitations of this small sampling, the oral microbiome of patients with Epidermolysis bullosa may be unique and require further investigation with the study of preventatives capable of inhibiting inflammation and overgrowth of pathogens. Full article

Melasma is an acquired hyperpigmentation that is more common in women and mainly affects the face. It can significantly reduce quality of life due to its chronic nature and resistance to treatment. Objectives: This study aimed to compare the clinical efficacy of azelaic acid peeling and combined tranexamic acid microneedling in patients with melasma, evaluating the impact of these therapies on skin depigmentation. Methods: This was a prospective clinical trial with a split-face design, using a convenience sample. Patients were recruited and divided into two groups for comparative treatment. Microneedling with 4 mg/mL tranexamic acid was applied to the right hemiface and 30% azelaic acid peeling to the left hemiface. The protocol included five sessions with a 15-day interval. Photographic records were taken before treatment, in the fifth session, and 15 days after the last session. The Melasma Area and Severity Index (MASI) and non-parametric tests were used to analyze the results. Results: The study included 10 patients, of whom 9 completed the treatment. The average age was 42 years. The most common skin phototype was type III (50%) and the predominant locations were the central facial area, forehead, and cheeks (55.6%). The photographic evaluation and MASI showed a significant improvement on both sides of the face, with the final values better than the initial ones. It was possible to observe that the azelaic acid peeling showed a significant whitening after the fourth session when compared to the other method. Conclusions: The clinical study of hemifaces concluded that both the azelaic acid peeling and microneedling with tranexamic acid are effective in the treatment of melasma, with the azelaic acid peeling showing results after the fourth session. Further studies with larger, randomized samples are recommended. Full article

Background: Melanoma of unknown primary (MUP) is a rare and distinct clinical subtype of metastatic melanoma, in which no identifiable primary tumor is found. The prognosis of MUP compared to melanoma with known primary (MKP) remains unclear, especially in the era of novel therapies like immune checkpoint inhibitors (ICIs) and targeted therapies. This meta-analysis aims to compare the overall survival (OS) of MUP and MKP patients under these therapies. Methods: This systematic review was conducted in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). A systematic search of major databases was conducted, yielding six eligible studies (nine study arms) that assessed the survival outcomes of MUP and MKP patients treated with immunotherapies and targeted therapies. We pooled the hazard ratios (HRs) for OS using both fixed and random effects models. Heterogeneity was assessed with the I² statistic followed by a Baujat plot, and publication bias was evaluated using funnel plots and Egger’s test. Results: Our analysis revealed a borderline significant HR of 0.90 (95% CI: [0.81, 1.00], p = 0.04) under the fixed effect model, suggesting a potential survival benefit for MUP patients. However, the random effects model, accounting for study heterogeneity, showed no significant difference in OS between MUP and MKP (HR = 0.87, 95% CI: [0.73, 1.05], p = 0.15). Significant heterogeneity (I² = 66.9%, p = 0.0022) was observed across studies. No substantial publication bias was detected. Conclusion: While the trend observed in the fixed effect model suggests a potential benefit for MUP patients, the random effects analysis indicates no significant difference between MUP and MKP in terms of OS. These findings underscore the importance of accounting for study heterogeneity and highlight the need for further prospective studies to better understand the impact of novel therapies on MUP. Full article

Background: Merkel cell polyomavirus (MCPyV) has been established as an etiological agent in Merkel cell carcinoma (MCC), yet its role in other cutaneous neoplasms remains under investigation. The impact of the host’s immunogenetic characteristics on the persistence of Merkel cell polyomavirus (MCPyV) in non-melanoma skin cancer (NMSC) is not yet well understood. Objective: Our aim was to investigate the presence of MCPyV in various skin lesions, particularly NMSC, and its association with cytokine gene polymorphisms related to immune regulation. Methods: We analyzed 274 skin biopsies (lesional, perilesional, and healthy skin) from 84 patients undergoing dermatological evaluation. MCPyV DNA and polymorphisms in IL-6, IL-10, IFN-γ, and TNF-α genes were detected using PCR-based assays. Results: MCPyV was significantly more prevalent in NMSC and non-cancerous lesions than in surgical margins or healthy skin (p = 0.050 and 0.048, respectively). Concordance between lesion and margin samples was low (κ = 0.305), suggesting microenvironment-specific viral persistence. Notably, high-expression IL-10 genotypes (-1082 GG) and low-expression IL-6 genotypes (-174 AA) were significantly associated with MCPyV detection (p = 0.048 and p = 0.015, respectively). Conclusions: MCPyV preferentially localizes to NMSC lesions, particularly in individuals with immunogenetic profiles favoring viral persistence. Since the role of MCPyV in the pathogenesis of NMSC remains uncertain, our results highlight the need for further studies to clarify whether the lesion’s microenvironment supports viral persistence or indicates a more intricate interaction between the virus and the host, which could be significant for the development of skin cancer. Full article

Sleep is crucial to overall health and plays a significant role in skin function. While the circadian rhythm has been extensively researched for its impact on the body’s optimal functioning, the skin also possesses an independent circadian system that serves many important functions. Sleep disruptions or deprivation can significantly affect skin conditions, by compromising the skin barrier and impairing processes such as collagen production, cellular repair, and wound healing. Given the commonality of sleep disturbances, it is crucial to understand the connection between sleep, circadian regulation, and skin health. This is particularly important in understudied populations, such as those with occupational sleep disruption and individuals with hormone-related conditions like PCOS and menopause. Bidirectional relationships have been established between sleep and several inflammatory skin conditions, including atopic dermatitis, psoriasis, rosacea, and hidradenitis suppurativa. While acne is influenced by sleep, the reverse relationship, how acne affects sleep quality, has not been well established. Chronic sleep disruption can increase cortisol levels and oxidative stress, both of which contribute to skin aging and the progression of autoimmune skin conditions, including systemic lupus erythematosus. As sleep is a modifiable risk factor, it is crucial to consider therapeutic options and interventions to prevent or alleviate skin conditions. This review discusses various therapeutic approaches, including melatonin, L-Theanine, Magnesium-L-threonate, Inositol, Cinnamomi cortex, nervous system regulation, and proper sleep hygiene. These therapeutic options have been studied for their impact on sleep, and importantly, several have been evaluated for their utility as adjuncts for treating skin conditions. Overall, the relationship between sleep and skin health is clear, and incorporating sleep-focused therapeutic interventions offers potential to improve both sleep quality and skin health in individuals with a variety of skin conditions. Full article

Objective: To conduct a systematic review of the literature evaluating the efficacy of the 308 nm excimer lamp in comparison to narrowband ultraviolet B (NB-UVB) and the 308 nm excimer laser for inducing repigmentation in vitiligo. Methods: A comprehensive search was performed in PubMed, Embase, Cochrane Library, Scopus, Web of Science, and LILACS databases, as well as in gray literature sources including Google Scholar, OpenGrey, Livivo, and ProQuest. Risk of bias was assessed independently by two blinded reviewers using the Cochrane RoB 2 tool, with disagreements resolved by a third reviewer. The primary outcome was the degree of repigmentation. Results: Of 3825 records identified, four randomized controlled trials met the inclusion criteria. The findings suggest that the 308 nm excimer lamp provides superior repigmentation outcomes compared to NB-UVB and demonstrates comparable efficacy to the 308 nm excimer laser. Conclusions: Phototherapy using the 308 nm excimer lamp appears effective in promoting repigmentation in vitiligo patients and is associated with minimal adverse effects. Nevertheless, variations in treatment protocols and potential bias across studies warrant cautious interpretation of the results. Full article

The barrel jellyfish (Rhizostoma pulmo), like other cnidarians, shows cnidocytes containing cnidae, responsible for the jellyfish’s stinging properties. The sting of R. pulmo can cause contact dermatitis or urticaria and even systemic symptoms. Recent studies have identified stinging-cell structures in the mucous secretion released in the water column by Cassiopea xamachana, belonging to the same order as R. pulmo. The present paper verifies the release of stinging-cell structures in the water by R. pulmo and reports the case of two 17-year-old adolescents (one male and one female) who were affected by epidermal rashes consistent with the irritating sensations of stinging water. The reaction happened twice in the Ionian Sea; the patients were in proximity to R. pulmo but, on both occasions, there had been absolutely no direct contact with the jellyfish’s tentacles. To test the hypothesis of stinging water caused by R. pulmo, samples of sea water and mucous harvested in close proximity to a living jellyfish were taken and analyzed under a microscope at different magnifications. The microscopic analysis showed the presence of free and aggregated nematocysts in both the samples of water and mucous. It is likely that the free and aggregated nematocysts observed were discharged in the water by the jellyfish and were dispersed by water currents that led them to come into contact with the patients’ skin. At present, it is not known what predisposes humans to the perception of stinging water, and it is reasonable to affirm that caution should be advised for people with an allergic history when entering the water in the presence of jellyfish. Further investigations are required to better understand both the pathophysiological pathways underlying the stinging water phenomenon and the minimum concentration of urticating elements that is able to trigger the onset of stinging water. Full article

Acne vulgaris is a common skin condition often causing physical and emotional distress. We reported a case of 27-year-old female with rash and acne over the chest and upper back following continuous application of moisturizer. This case emphasizes the role of comedogenic moisturizers in acne development or worsening by disrupting the skin’s natural barrier, especially on oily areas including the chest and upper back. We aim to highlight an underrecognized but significant factor in developing acne vulgaris resulting in psychosocial impact and morbidity. Full article

Background: Artificial intelligence (AI) has emerged as a transformative tool in modern medicine, particularly in dermatology, where it supports the diagnosis and management of various skin diseases, including skin cancer. Through machine learning and deep learning techniques, AI enables accurate analysis of clinical and dermoscopic images, improving early detection and clinical outcomes. Objective: This systematic review aimed to evaluate the clinical applications of AI in dermatology, focusing on its impact on diagnostic accuracy, workflow efficiency, and access to specialized care. Methods: The review was conducted according to PRISMA guidelines. Peer-reviewed studies published between January 2020 and March 2025 in English or Spanish were included if they evaluated AI-based tools for dermatological diagnosis, classification, or treatment. Animal studies, editorials, non-peer-reviewed articles, and studies with an unclear methodology were excluded. A comprehensive search was performed in PubMed, Scopus, IEEE Xplore, and Google Scholar between December 2024 and March 2025. The risk of bias was assessed qualitatively, using a tailored framework based on study design, dataset transparency, and clinical applicability. Results: A total of 29 studies met the inclusion criteria. AI tools demonstrated high performance in melanoma detection, achieving up to 90% accuracy and 85% sensitivity. In clinical settings, AI support reduced mismanagement of malignant lesions from 58.8% to 4.1% and avoided 27% of unnecessary procedures in benign cases. Additional tools such as convolutional neural networks and imaging systems like FotoFinder also showed promising results. Limitations: Limitations of the evidence include the heterogeneity of AI models, lack of external validation, and a moderate-to-high risk of bias. Conclusions: AI has demonstrated robust clinical potential in dermatology, particularly in cancer detection and workflow optimization. However, further studies are required to address challenges such as algorithmic bias, data privacy, and regulatory oversight. Funding and registration: This review received no external funding and was not registered in a systematic review registry. Full article

Background/objectives: According to the Chapel Hill Consensus Conference nomenclature, single-organ cutaneous small vessel vasculitis (SOCV) is defined histopathologically by immune complex-mediated vasculitis of the dermal capillaries/venules without systemic involvement. There is a lack of investigations studying predictors of SOCV outcomes. This multicenter retrospective study aimed to assess whether baseline serum liver scores could predict SOCV recurrence. Methods: Data from 204 inpatients with histopathologically confirmed idiopathic SOCV treated between 2000 and 2022 were analyzed. All patients had baseline blood tests for platelets and liver parameters; those with systemic diseases were excluded. The study evaluated the AST to Platelet Ratio Index (APRI), Fibrosis-4 (FIB-4) index, and De Ritis ratio (DRR). Results: Recurrence was observed in 17.6% of patients. Univariable analysis identified hospital stay length, DRR, cutaneous extent, and cardiovascular comorbidities as predictors, but logistic regression confirmed only cutaneous extent and DRR as independent predictors of disease recurrence. Conclusions: A higher DRR (cut-off > 1.13) may indicate necrosis from reduced blood flow, making it a potential predictor of SOCV recurrence. Full article

Background/Objectives: Skin lesions, ranging from benign to malignant diseases, are a difficult dermatological condition due to their great diversity and variable severity. Their detection at an early stage and proper classification, particularly between benign Nevus (NV), precancerous Actinic Keratosis (AK), and Squamous Cell Carcinoma (SCC), are crucial for improving the effectiveness of treatment and patient prognosis. The goal of this study was to test deep learning (DL) models to determine the best architecture to use in classifying lesions and create a web-based platform for improved diagnostic and educational availability. Methods: Various DL models, like Xception, DenseNet169, ResNet152V2, InceptionV3, MobileNetV2, EfficientNetV2 Small, and NASNetMobile, were compared for classification accuracy. The top model was incorporated into a web application, allowing users to upload images for automatic classification, thereby offering confidence scores as a measure of the reliability of predictions. The tool also has enhanced visualization capabilities, which allow users to investigate feature maps derived from convolutional layers, enhancing interpretability. Web scraping and summarization techniques were also employed to offer concise, evidence-based dermatological information from established sources. Results: Of the models evaluated, DenseNet169 achieved the best classification accuracy of 85% and was, therefore, chosen as the base architecture for the web application. The application enhances diagnostic clarity by visualizing features and promotes access to trustworthy medical information on dermatological disorders. Conclusions: The developed web application serves as both a diagnostic support system for dermatologists and an educational system for the general public. By using DL-based classification, interpretability techniques, and automatic medical information extraction, it facilitates early intervention and increases awareness regarding skin health. Full article

Background/objectives: Stimulator of Interferon Genes (STING)-associated vasculopathy with onset in infancy (SAVI) is a rare autoinflammatory disorder caused by gain-of-function mutations in the TMEM173 gene. These mutations result in chronic activation of the STING pathway and excessive type I interferon production, leading to systemic inflammation, vascular abnormalities, interstitial lung disease, and skin ulcerations. Janus kinase (JAK) inhibitors, including baricitinib, have shown promise in mitigating systemic and organ-specific manifestations. However, these inhibitors broadly suppress immune pathways, potentially increasing vulnerability to infections. Case presentation: This case report describes a 21-year-old woman with SAVI (due to a heterozygous TMEM173 mutation) who developed disseminated molluscum contagiosum (MC) while receiving baricitinib therapy. Laboratory results revealed lymphopenia, low CD4/CD8 ratio, and impaired immune cell activity, suggesting compromised antiviral immunity. Discussion: Despite SAVI’s association with excessive type I interferon signaling, this chronic hyperactivation may cause immune dysregulation, exhausting T cells and natural killer cells vital for viral defense. Furthermore, baricitinib suppresses interferon signaling via the JAK-STAT pathway, reducing inflammatory damage in SAVI but also impairing antiviral responses. Moreover, MC viruses evade host immune defenses by antagonizing STING and TANK-binding kinase 1-mediated interferon activation, further contributing to infection risk. This report is the first to document MC in a SAVI patient and highlights the rare complication of disseminated MC due to impaired type I interferon signaling and immune suppression from baricitinib therapy. This case underscores the need for vigilance regarding viral infections in SAVI patients treated with JAK inhibitors. Full article

Background and Objective: Age-related skin changes affect the skin’s structural and functional integrity and reduce the ability of the skin to perform its key barrier functions. Skin breakdown associated with dryness and itch becomes very common and older individuals are at an increasing risk. We aimed to evaluate a daily cleansing–moisturizing routine and conduct a skin assessment for the presence of five underlying skin integrity parameters among aged-care residents. Methods: This small, 6-week evaluation study included four participants over 80 years of age, all of whom were residents at OLC Care, Rocky Point Residence, Beverley Park, NSW, Australia. Skin assessment for the presence of five underlying clinical parameters including itchy skin, dry skin, bruising, skin tears and pressure injuries was conducted for all four participants at baseline and during the evaluation period. Clinical notes were also taken at baseline, during the evaluation and at the post-evaluation. Furthermore, clinical photographs were taken at baseline and after 2–3 weeks of the cleansing–moisturizing routine. Results: Of the four aged-care residents who participated in this evaluation study, all four showed overall improvement in the appearance of the skin with a reduction in severity of the five underlying skin integrity parameters, including itchy skin, dry skin, bruising, skin tears and pressure injuries, where present. Discussion and Conclusions: This case study has produced basic evidence to support a daily cleansing–moisturizing routine (comprising QV cleansers and moisturizers, and/or a protective barrier cream) as it provides moisturizing and protective benefits to the delicate and fragile skin of aged-care residents, where the aim is to reduce skin integrity associated issues. Full article