Search Results (179)

Background/Objectives: Hypopigmented mycosis fungoides (hMF) is a rare variant of mycosis fungoides (MF) often seen in younger patients and individuals with darker skin phototypes. The lesions develop as hypopigmented patches or plaques, and they are usually asymptomatic and respond well to topical treatment or phototherapy. Methods: We provide a systematic review on hMF with onset at or beyond 30 years of age, based on SCOPUS, PubMed, and Embase databases. A total of 13 original articles, totaling 34 patients, were included in this review. Evidence was limited to case reports and small series; PROSPERO registration is CRD420251181894. Results: The majority of cases did not progress beyond stage IB and commonly used treatment methods, including topical corticosteroids and phototherapy. In three patients, a progression of the disease occurred, and in two of them it was fetal. Among patients receiving phototherapy, PUVA therapy achieved complete remission more often than UVB (13 out of 17 cases vs. 8 out of 16 cases). Although recurrences occurred with both treatments, they were less frequent, and relapses took longer to develop in the PUVA group. Conclusions: In this cohort, PUVA appeared to be associated with higher complete response rates and longer remission duration than UVB. However, this advantage of PUVA is derived from low-level evidence and should be confirmed in prospective comparative studies. Full article

The increasing demand for advanced cosmetic formulations based on natural biopolymers has stimulated the design of multifunctional and sustainable skin care products. Hyaluronic acid (HA) and silk proteins are widely recognized for their hydrating, barrier-supportive, and biocompatible properties. This study aimed to develop a novel topical formulation, integrating low- and medium molecular weight hyaluronic acid (LMW-HA and MMW-HA), encapsulated sodium hyaluronate (NaHA), silk, and hydrolyzed silk as active components, aiming to enhance skin barrier function and biocompatibility. The formulation was subjected to comprehensive physicochemical characterization including evaluation of appearance, odor, color, pH, viscosity, and stability, all assessed over 30 days and microbiological stability testing under controlled storage conditions. Safety evaluation followed a dual-phase strategy: (i) in silico toxicological screening of individual ingredients, including sensitization, and mutagenicity predictions, and (ii) in vivo skin compatibility assessment in 25 human volunteers using a semi-occlusive patch test. The formulation demonstrated good physicochemical stability, as pH remained stable, and viscosity showed no significant changes, confirming structural integrity, indicating preserved structural and microbiological stability throughout the study period. The in silico assessment indicated no mutagenic and/or sensitizing alerts and favorable safety margins for all components, confirming the safety profile of each ingredient, supporting their suitability for dermocosmetic use, while in vivo evaluation revealed no significant adverse effects, with irritation scores indicating no skin reaction (erythema or edema) across the test population. These findings support the potential of this novel biopolymer-based formulation as a safe and well-tolerated dermocosmetic product, aligning with principles of sustainable development and biomimetic design. Full article

Deep neural networks have outperformed conventional methods in various fields such as image recognition, natural language processing, and speech recognition. In particular, vision models are widely applied to real-world domains including medical image analysis, autonomous driving, smart factories, and security surveillance. However, these models are vulnerable to adversarial attacks, which pose serious threats to safety and reliability. Among different attack types, this study focuses on evasion attacks that perturb the inputs of deployed models, with an emphasis on black-box settings. The zeroth order optimization (ZOO) attack can approximate gradients and execute attacks without access to internal model information, but it becomes inefficient and exhibits low success rates on high-resolution images due to its dependence on image resizing and its high memory complexity. To address these limitations, this study proposes a patch-based fast zeroth order optimization attack, FP-ZOO. FP-ZOO partitions images into patches and generates perturbations effectively by employing probability-based sampling and an $ϵ$-greedy scheduling strategy. We conducted a large-scale evaluation of the FP-ZOO attack on the CIFAR-10, CIFAR-100, and ImageNet datasets. In this evaluation, we adopted attack success rate, ${\mathcal{L}}_2$ distance, and adversarial example generation time as performance metrics. The evaluation results showed that the FP-ZOO attack not only achieved an attack success rate of 97–100% against ImageNet in untargeted attacks, but also demonstrated performance up to 10 s faster compared to the ZOO attack. However, in targeted attacks, it showed relatively lower performance compared to baseline attacks, leaving it as a future research topic. Full article

Background: While topical NSAID patches are effective in non-surgical knee conditions, their efficacy following total knee arthroplasty (TKA) remains understudied. The intention behind this study was the comparison of pain and functional score between esflurbiprofen and placebo patches for postoperative pain control after TKA. Methods: A triple-blinded randomized controlled trial was conducted among patients aged 55–80 years with primary knee osteoarthritis. Patients who had an allergy to study medications, had chronic kidney disease, had diabetes, used steroids, were unsuitable for spinal and subsartorial block, or were unwilling to participate were excluded. All eligible participants were randomized and assigned to either esflurbiprofen 40 mg transdermal patch or placebo patch starting from postoperative day 3 to 16 blindly and followed up for 3 months. Outcome assessment was a visual analog scale (VAS), morphine use, minimum daily VAS, time to minimum VAS, knee osteoarthritis outcome score, joint replacement (KOOS, JR), knee circumference, flexion angle, and adverse events. Results: Seventy patients underwent primary TKA (n = 35 each group). The average age and body mass index were 67.5 ± 13.7 years and 26.8 ± 4.5 kg/m². There was no statistically significant difference in baseline characteristics between the two groups. When compared with the placebo group, the esflurbiprofen group presented statistically significantly diminished VAS scores after day 7 and morphine use at day 3 (p < 0.001), as well as subsequently enhanced KOOS scores at 6 weeks and 3 months (p < 0.001). No statistically significant difference between groups was found in terms of knee circumference, flexion angle, or time to minimum VAS (p > 0.05 for all). One patient in the esflurbiprofen group (2.86%) reported a mild skin reaction. Conclusions: Esflurbiprofen patches significantly reduce postoperative pain and improve short-term function after TKA without major complications. Full article

Melatonin, traditionally recognized for its role in regulating circadian rhythms and sleep, has emerged as a multifunctional molecule with significant implications in dermatology. Melatonin is described here as a pleiotropic, context-dependent modulator with antioxidant-related and immunomodulatory actions that are supported by both direct chemical scavenging in cell-free systems and indirect, enzyme-mediated effects in cells and tissues; its antitumor activity in dermatology is primarily preclinical and remains to be confirmed in large clinical trials. Melatonin protects skin cells from oxidative stress, UV radiation, and environmental damage by directly scavenging free radicals and activating endogenous defense systems. It also modulates immune responses, making it relevant in inflammatory dermatoses such as atopic dermatitis, while promoting tissue repair in wound healing and reducing signs of skin aging. Particular attention is given to topical formulations, including gels, creams, and patches, which enable localized delivery, improved skin penetration, and reduced systemic side effects. The review also discusses ongoing clinical trials, delivery technologies, and the potential for combinatorial therapies with established dermatological agents. Full article

Cyanoacrylate-based adhesives are commonly used for wound closure due to their short synthesis time, aesthetic outcomes, and minimal discomfort. However, reported adverse effects include the release of cytotoxic metabolites, inflammation, and foreign body reactions. This study evaluated and compared the effectiveness of three cyanoacrylate-based adhesives for skin incision closure in Rattus norvegicus. The subjects were divided into three groups based on the type of monomer: G1 (n-2-ethyl-cyanoacrylate), G2 (n-2-butyl-cyanoacrylate), and G3 (n-2-octyl-cyanoacrylate). Each animal received two 2 cm paramedian incisions, which were closed using either a topical over dermal (OD) or a topical transdermal (TD) application, resulting in two subgroups per group. Wounds were evaluated on postoperative days 3, 7, 14, and 21 to compare the different monomers and application techniques. Assessment of the inflammatory infiltrate revealed differences in polynuclear cells between the TD and OD on days 3 and 7, while TD demonstrated improved results in mononuclear cells at all time points. Sustained inflammatory processes and foreign body reactions were observed. Quantification of tumor necrosis factor (TNF-α) and thiobarbituric acid reactive substances (TBARS) indicated that TD maintained stability throughout the assessment periods, though it exhibited higher values than OD from days 7 to 21. These higher values were associated with a foreign body reaction and increased oxidative stress. Regarding tissue formation, OD produced more aligned wound edges, supporting the production of types I and III collagen and improving scar resolution compared to TD. Our findings indicate that the patch application technique has a greater impact on healing than the size of the cyanoacrylate monomer. Full article

In the past 25 years, the Qinghai–Tibet Plateau has experienced a significant climate transition, which directly triggers vegetation degradation. Vegetation degradation also aggravated the water erosion process in the Qinghai–Tibet Plateau. The accelerated warming from 2011 led to the emergence of degraded patches in the central region. The spatial heterogeneity of erosion intensity in the degraded area of Northwest China is significantly enhanced by the extreme climate events after 2021. In recent years, under the influence of human activities, vegetation degradation has aggravated the water erosion phenomenon. Based on the above content, this study analyzes the literature on the impact of vegetation on water erosion in the Qinghai–Tibet Plateau under climate change from 2008 to 2025 from the perspective of bibliometrics. CiteSpace software v.6.3.R1 was used to visualize the knowledge map of the 206 selected articles, and the research hotspots, topics, and development process in this field were analyzed. The results show that the main research hotspots in this field are climate change, basin, CO₂ consumption, etc., which can be divided into eight main research topics; after three stages of development, the research relationship between climate–vegetation–water erosion has gradually become clear. By identifying research gaps, future research can consider three aspects: cross-scale multi-dimensional analysis, technical method innovation, and policy collaborative research to address the dual challenges of vegetation degradation and water erosion in the Qinghai–Tibet Plateau under the dual pressures of climate change and human activities. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Prunus leaf extracts are rich in phenolic and flavonoid compounds like rutin, and they are known for their antioxidant potential. This study compares the bioactivity and stability of leaf extracts from Prunus domestica L. (EL), Prunus salicina Lindl. (JL), and Prunus cerasifera Ehrh. (CL) and evaluates the dermal safety of a cream containing the extract with the most favorable in vitro properties for potential cosmetic use. Ethanolic extracts were assessed for total phenolic and condensed tannin contents, as well as antioxidants, using DPPH assay and lipid peroxidation inhibitory activities. The CL extract exhibited moderate total phenolic content, the highest condensed tannin content, and strong antioxidant (IC₅₀ = 22.1 ± 3.1 µg/mL) and anti-lipid peroxidation (62.3 ± 1.0%) activities. Based on these results, CL was incorporated into a cream formulation (CCL), which was then evaluated for physicochemical properties, antioxidant retention, and in vitro skin permeation using Franz diffusion cells. The formulation remained physically stable under ambient conditions and retained antioxidant activity above 74.5% under thermal cycling conditions. Rutin from the CCL formulation was retained within the Strat-M™ membrane (4.0 ± 1.1%), which was 5.7-fold higher than that of the control (0.7 ± 0.6%) over 8 h; however, it was not detected in the receptor chamber under these in vitro conditions. A semi-open patch test conducted on 26 healthy volunteers under double-blind conditions revealed no signs of irritation, confirming the formulation’s dermal safety. Overall, the findings support the feasibility of using P. cerasifera extract as a stable antioxidant component in topical skincare formulations. Full article

Vitiligo, an autoimmune disorder causing depigmented skin patches, includes two types, segmental (SV) and non-segmental (NSV). Previously, NSV was off-label treated using Calcineurine inhibitors (Tacrolimus and Pimecrolimus). In 2022, the FDA approved Ruxolitinib cream, targeting the JAK/STAT pathway for NSV treatment based on promising results. This research conducts a retrospective descriptive safety assessment of Tacrolimus, Pimecrolimus, and Ruxolitinib safety in vitiligo treatment, utilizing the FDA Adverse Event Reporting System (FAERS) database spanning the period from 2013 to 2023 and including patients aged 2 years and above, encompassing both brand and generic names. A total of 844 adverse event reports involving 388 patients were extracted and categorized into dermatological and systemic groups for analysis. Tacrolimus resulted in 12 hospitalizations, two life-threatening events, and four disabilities. Pimecrolimus exhibited urticaria and pigmentation disorders, with tooth fracture as the primary systemic event. Pericarditis was the predominant systemic side effect of Ruxolitinib, followed by anemia, headache, and urosepsis. Local dermatological side effects reported were generally mild, not warranting treatment cessation. In conclusion, vitiligo significantly impacts patients’ psychological well-being, necessitating continuous post-marketing safety monitoring for topical medications. Full article

Innovative functional materials integrating host–guest complexes in cryogels offer promising applications in topical drug delivery, enhancing drug solubility and stability. In this study, we designed and developed a cryogel-based patch for acne treatment by polymerizing an acrylate-functionalized γ-cyclodextrin (γ-CD) and trimethoprim (TMP) inclusion complex with [2-(acryloyloxy)ethyl]trimethylammonium chloride (AETMA) at low temperatures. A multistep workflow was applied to synthesize the inclusion complex via mortar-assisted kneading, followed by cryogel formulation through radical cryopolymerization. The resulting hybrid system leverages the cationic nature of AETMA to promote adhesion and electrostatic interactions with the skin surface. At the same time, γ-CD serves as a drug reservoir, facilitating sustained release of the drug. The system was characterized by FT-IR, TGA, and SEM analyses. In vitro release studies demonstrated a sustained TMP release profile, best described by the Korsmeyer–Peppas diffusion model. Antibacterial assays confirmed the system’s effectiveness against Staphylococcus aureus, supporting its potential for localized and prolonged acne treatment. Moreover, cytocompatibility tests demonstrated that the formulation is biocompatible, further validating its suitability for topical application. Full article

Centella asiatica (CICA)-derived exosomes have emerged as bioactive agents for skin rejuvenation due to their regenerative and anti-inflammatory properties. This study evaluated the safety and efficacy of a topical ampoule containing CICA-derived extracellular vesicles (EVs) in healthy Korean adults. This human application study was conducted over a 15-day period, during which the test formulation was topically applied to the skin following a controlled regimen. A 24-h patch test with 30 participants confirmed non-irritation (irritation index: 0.00). In a separate two-week trial (n = 20; mean age 50.7 years), 3D imaging and ultrasound assessed five-dimensional pore improvement (area, density, volume, filling, texture), wrinkle depth reduction in five facial regions, dermal hydration at 0.5, 1.5, and 2.5 mm depths, and skin density. Significant reductions were observed in mean pore area (−17.9%) and pore density (−26.9%), with a 9.0% decrease in surface roughness. Wrinkle depths decreased by 7.8–18.8% across the forehead, glabella, crow’s feet, nasolabial folds, and neck. Hydration increased by 7.9% at 0.5 mm, and dermal density improved by 12.7% (p < 0.05). These findings highlight the excellent skin compatibility and multifaceted cosmetic benefits of the formulation containing CICA-derived exosomes and other active ingredients, underscoring its potential as a safe, effective, and innovative anti-aging cosmetic agent. Full article

Background: Reports of primary cutaneous lymphomas (CLs) following COVID-19 vaccines are extremely rare. Nevertheless, clinicians should be aware of a potential association between these events. Here, we report a case of the development and rapid progression of mycosis fungoides (MF) with lymph node involvement after COVID-19 vaccination. Case presentation: A 75-year-old female developed disseminated plaques and patches shortly after receiving the first dose of the SARS-CoV-2 mRNA vaccine. Within one month following the second dose of the mRNA vaccine, she additionally experienced rapid progression, leading to the development of tumors and inguinal lymphadenopathy. Blood and visceral involvement were excluded. The clinicopathological findings were consistent with the diagnosis of MF, and systemic methotrexate with topical treatment was implemented, resulting in remission of the lesions. Conclusions: The presented case of the development and rapid progression of MF after the SARS-CoV-2 mRNA vaccine raises the question of the possible immunomodulatory or oncomodulatory effects of mRNA vaccines. It prompted us to conduct a review outlining the mechanisms potentially causing the mRNA vaccine-associated CLs. We have performed an extensive literature search to determine an explanation for the observed phenomenon. Accumulated evidence suggests a link between CL occurrence and immunization with an mRNA vaccine. The proposed hypothesis revolves around shared signaling pathways that are enhanced by SARS-CoV-2 mRNA vaccines, thus driving the pathogenesis of MF. We want to raise clinicians’ attention to the rare side effects of COVID-19 vaccines and emphasize the need for thorough monitoring of patients with altered immunity in the course of various lymphoproliferative disorders. Full article

Background: Dissolvable Microneedle Patches (DMP) have emerged as a promising approach for improved topical delivery of skincare agents with dermatological values (dermo-cosmetics), effectively addressing the various skin concerns. These patches enable minimally invasive penetration of the skin’s outer layer, facilitating efficient transdermal delivery of actives by overcoming skin barrier for successful outcomes. Objectives: The aim of this work was to assess the efficacy and safety of hyaluronic acid-based microneedle patches (HA-MNP) with agents for the managements of an inflammatory disorder of acne. A particular focus was on helping individuals with moderate inflammatory acne. Methods: A single-center clinical trial was conducted over a period of four weeks on acne patients. Measurable skin properties, including sebum content, redness, and severity of inflammation, were evaluated to gauge the overall usefulness of the MN patches. Results: The application of the patches resulted in a significant decrease in sebum content, with reductions of −4.9% and −36.8% observed after two and four weeks of use, respectively. The redness of localized acne lesions also showed a marked decline, with reductions of −47.2% and −65.5% observed after two and four weeks of use, respectively. Additionally, the severity of inflammatory signs in acne lesions showed significant improvements, with reductions of −68.8% and −83.3% observed for the application periods. The patches utilized in this investigation exhibited highly encouraging results, displaying a notable synergistic effect in the context of combating acne without adverse effects. Conclusions: The patches have the potential to be broadly applied as a modular and adaptable approach for therapeutic delivery of actives for various skin diseases and concerns. Full article

Background: Cutaneous toxicities associated with CDK4/6 inhibitors are uncommon but may affect treatment adherence. We present the case of a patient with advanced breast cancer who developed vitiligo-like lesions after initiating ribociclib, contributing to the growing evidence of this under-recognized adverse effect. Methods: We present the case of a 72-year-old woman diagnosed in 2007 with early-stage, luminal A, HER2-negative breast cancer, initially treated with surgery and tamoxifen. In 2022, she experienced locoregional recurrence with bone metastases. In January 2023, she began treatment with ribociclib plus letrozole. Two months later, she developed intense pruritus, xerosis, and paresthesia, followed by hypopigmented lesions on her face and upper extremities. Clinical evaluation, supported by photographs and a skin biopsy (led to a diagnosis of ribociclib-induced vitiligo. Management included dose adjustments to the ribociclib and dermatologic treatments, including topical corticosteroids, antihistamines, and short courses of oral prednisone. Results: By September 2024, her skin lesions had stabilized and her pruritus improved with a reduced dose of ribociclib (one tablet per day). However, the hypopigmented patches persisted, mainly on her face and extremities. Despite these cutaneous effects, she maintained an acceptable quality of life and continued effective oncologic treatment. Conclusions: This case highlights the importance of early recognition and management of ribociclib-related cutaneous toxicities. A multidisciplinary approach is essential to minimize adverse effects without compromising therapeutic efficacy. Further research into the dermatologic manifestations of targeted therapies is needed to optimize patient care. Full article