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  • 1.

    【2hr】An unusual case of Lyme borreliosis: Can we miss it?

    包量

    机译 莱姆病的罕见案例：我们能错过吗？
    摘要：Lyme borreliosis is an infective disease that is usually transmitted to humans via biting by bacteria-infected Ixodes tick. The disease is multisystemic and the affected organs are the skin (Erythema migrans), nervous system, eyes, heart and joints. Borrelia burgdorferi is the bacterium that causes borreliosis and the hosts are rodents of the genus Apodemus. In the Balkan region, Ixodes ricinus is the most representative vector. A bite from an infected insect is the most common mode of transmitting Borrelia; however, transplacental transmission has also been documented. Pathogenesis of the disease consists of both direct and indirect mechanisms of immunological reactions which result in the production of IgM antibodies to Borrelia in the first 3-6 weeks, and production of IgG class after 6 weeks. Many skin diseases and skin symptoms mimicking Lyme borreliosis, such as dermatomycosis, erysipelas, and undefined hyperpigmentation must be elaborated and considered for borreliosis, as skin symptoms of borreliosis can imitate many of them.
  • 2.

    【2hr】Clinical picture, diagnosis and treatment of rosacea, complicated by Demodex mites

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    机译 酒渣鼻并发蠕形螨病的临床图片，诊断和治疗
    摘要：The article analyzes the clinical picture and course of rosacea in patients with Demodex mites. It presents the advantages of using the method of confocal laser scanning microscopy over the method of light microscopy of facial skin scrapes. The aimes were to study the influence of Demodex mites on the clinical picture and course of rosacea; to compare laboratory and instrumental diagnostic methods for detecting Demodex mites; to evaluate the effectiveness of external therapy aimed at eliminating Demodex mites. 212 people were examined. The study included healthy patients, patients with a diagnosis of rosacea with the presence and absence of Demodex. The presence of Demodex mites was confirmed by two methods of study (light microscopy of skin scrapes and confocal laser scanning in vivo microscopy). Demodex mites promote the development of acute-inflammatory morphological elements, increase the duration of the condition (more than 5 years, P<0.01) and the probability of recurrence (from 1 to 3 relapses in 39.5% of patients, P<0.05), resulting in a decrease in the quality of life of patients (dermatology life quality index is 12.5±4.5, P<0.05). Antiparasitic drug ivermectin, in the form of an external form, at a concentration of 1% has a high therapeutic efficacy (in 93.3% of cases). Demodex folliculorum shows signs of parasitism, while Demodex folliculorum brevis is a saprophyte. The severity of the condition does not depend on the quantitative load of the mites in the scrape. As an antiparasitic drug, it is recommended to use 1% ivertmectin.
  • 3.

    【2hr】Trps1-deficient transplanted skin gave rise to a substantial amount of hair: Trps1 is unnecessary for hair development

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    机译 缺乏Trps1的移植皮肤会产生大量的头发：Trps1对于头发发育是不必要的
    摘要：Trps1 is considered as an important gene involved in the interactions between the epithelial and mesenchymal cells during hair follicle morphogenesis. The number of hair follicles in Trps1 Knockout (KO) newborn mouse skin was significantly lower than that in wild-type (WT) newborn skin. To gain insight into the functional role of Trps1 in hair development, we transplanted Trps1 KO newborn mouse skin on the backs of nude mice and examined hair growth at day 42 after transplantation. Surprisingly, transplanted skin from Trps1 KO newborn mice gave rise to a substantial amount of hair, although the hair was softer than that of WT mice. Histological examination revealed that the diameter of both hair follicles and hair shafts were significantly lower, whereas the density of hair follicles showed no significant difference between the Trps1 KO and WT mice. We introduce mouse hair follicles as a fascinating model to study the functions of Trps1 in mouse hair growth and pathology. This model suggests that the function of Trps1 is unnecessary for the development of normal hair follicles and hair shafts, although the loss of Trps1 affects the diameters of hair follicles and hair shaft.
  • 4.

    【2hr】Dermoscopy is a new diagnostic tool in diagnosis of common hypopigmented macular disease: A descriptive study

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    机译 皮肤镜检查是一种诊断常见色素沉着黄斑疾病的新诊断工具：一项描述性研究
    摘要：One of the most frequent complaints in dermatology clinics is the eruption of hypopigmented patchy skin lesions. The aim of the study was to investigate the utility of dermoscopy in common hypopigmented macular diseases. Patients with the followings diseases were examined by dermoscopy: vitiligo, pityriasis alba, nevus depigmentosus, achromic pityriasis versicolor, idiopathic guttate hypomelanosis, and extragenital guttate lichen sclerosus.This study showed that these hypopigmented macular diseases might display specific dermoscopic features. In vitiligo, the mean dermoscopic features were the presence of a diffuse white glow with perifollicular pigment, perilesional hyperpigmentation, leukotrichia and the pigmentary network. In idiopathic guttate hypomelanosis, the characteristic features were the presence of multiple, shiny, scaly macules with welland ill-defined edges borders that coalesced into polycyclic macules. For nevus depigmentosus, the mean features were hypopigmented patches with irregular border with a faint reticular network. For pityriasis alba, the fairly ill-demarcated hypopigmented macules with fine scales were the mean feature. In lichen sclerosus, there were white structureless areas, perilesional erythematous halo, follicular plugging and white chrysalis like structures. Dermoscopy of achromic pityriasis versicolor showed a fairly demarcated white area with fine scales localized in the skin creases.
  • 5.

    【2hr】Evaluation of the glycemic effect of methotrexate in psoriatic arthritis patients with metabolic syndrome: A pilot study

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    机译 甲氨蝶呤在代谢综合征银屑病关节炎患者中的血糖作用评估：一项初步研究
    摘要：Methotrexate (MTX) is a systemic immunosuppressant drug used for the treatment of psoriasis and psoriatic arthritis. Previous studies demonstrated a potential association between psoriasis and diabetes mellitus, obesity, atherosclerosis, hypertension, eventuating into metabolic syndrome. This study aimed at exploring the glycemic effects of MTX in psoriatic arthritis (PsA) patients. In this prospective cross-sectional study, 27 patients with PsA were evaluated. The status of PsA and presence of accompanying metabolic syndrome was determined by standard criteria and indices. Blood indicators including HbA1c, erythrocyte sedimentation rate, fasting blood sugar, total cholesterol, high-density lipoprotein, triglycerides, and C-reactive protein were examined before and 12 weeks after MTX therapy. There were no significant changes between HbA1c levels before and after MTX therapy in both genders (men: P=0.131, women: P=0.803). In addition, HbA1c levels in PsA patients with metabolic syndrome were not different before and after treatment (P=0.250). Finally, HbA1c levels did not change in PsA patients without metabolic syndrome before and after therapy (P=0.506). MTX in PsA patients does not appear to have hyperglycaemic effects in the short-term and can be safely used in patients with metabolic syndrome and diabetes.
  • 6.

    【2hr】Seborrheic keratosis evolution into squamous cell carcinoma: A truly modified sun-related tumor? A case report and review of the literature

    包量

    机译 脂溢性角化病演变成鳞状细胞癌：一种真正改良的与阳光有关的肿瘤？病例报告及文献复习
    摘要：The incidence of seborrheic keratosis (SK) generally increases with age and are mostly localized on the trunk, face and neck, especially on sun-exposed areas. The association between SK and skin malignancies appears to be accidental, but in situ transformation occurs more frequently in sun-exposed areas. Histopathological examination of all SK cases should be considered, especially when SK lesions exhibit atypical clinical manifestations, such as ulceration and cresting, as they may herald malignant transformation. In addition, other features associated with malignant transformation include excoriations or hemorrhages identified on the lesion, modification and evolution of the macroscopic characteristics, and the presence of local erythema or pruritus. Immunocompromised patients exhibit an increased risk of malignant transformation, even when radiation is involved.
  • 7.

    【2hr】Skin tissue expression and serum level of thymic stromal lymphopoietin in patients with psoriasis vulgaris

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    机译 寻常型牛皮癣患者皮肤组织表达和胸腺基质淋巴细胞生成素的血清水平
    摘要：Thymic stromal lymphopoietin (TSLP) is known to be associated with allergic diseases. It is also suggested that TSLP has a role in autoimmune diseases such as psoriasis; however, the associated pathways remain unknown. There is currently little information on TSLP in psoriasis vulgaris. We investigated TSLP expressions on lesional and non-lesional skin of psoriasis vulgaris patients using reverse transcription- polymerase chain reaction. TSLP level was also investigated in serum from psoriasis vulgaris patients compared to healthy control using enzyme-linked immunosorbent assay. TSLP expression was higher in lesional skin (1.90) compared to non-lesional skin (1.76); however, the difference was not statistically significant (P>0.05). TSLP serum levels were significantly higher in psoriasis patients (287.40 pg/dL) as compared to controls (114.70 pg/dL) (P<0.05). This study concluded that TSLP levels in the serum of psoriasis vulgaris patients are higher than controls. TSLP was also found in keratinocyte of psoriasis patients, the expression was higher in the lesional compared to non-lesional skin; however, this difference is statistically insignificant. These findings suggest that TSLP may play a role in the pathogenesis of psoriasis vulgaris, but its exact role remains unclear.
  • 8.

    【2hr】Antioxidant properties of topical Caulerpa sp. extract on UVB-induced photoaging in mice

    包量

    机译 外用Caulerpa sp。的抗氧化特性。提取物对UVB诱导的小鼠光老化的作用
    摘要：Caulerpa sp., a genus of seaweed native to the Indo-Pacific region, has been known for its antioxidant properties and health benefits when consumed as food. Previous studies have reported Caulerpa sp.’s potential as a strong antioxidant, but its effects on the skin in a topical preparation, especially its role in ultraviolet (UV) protection, have not been studied extensively. Our study investigated the protective effects of 0.2% and 0.4% Caulerpa sp. extract gels on photoaging in the UVB-irradiated skin of Wistar mice. The subjects were divided into naive control, vehicle control, and 3 treatment groups (0.2% Caulerpa sp. extract gel, 0.4% Caulerpa sp. extract gel, and 0.02% astaxanthin gel as a standard antioxidant). The groups, except the naive control group, received a total of 840 mJ/cm2 of UVB irradiation in four weeks. Protective effects of the extract were measured through the evaluation of collagen expression, matrix metalloproteinase (MMP)-1 expression and levels, and 8-OhDG expression. Mice who received topical application of Caulerpa sp. extract gel had higher collagen expression, better-preserved collagen structure, lower levels of MMP-1, and less MMP-1 and 8-OHdG expressions compared to the vehicle control group. There was no difference between different concentrations of the extract. Our findings demonstrated that topical application of Caulerpa sp. extract gel significantly protected UVB-irradiated mice skin from photoaging.
  • 9.

    【2hr】Histopathological and patient-related characteristics of basal cell carcinomas of the head and neck influencing therapeutic management

    包量

    机译 头颈部基底细胞癌的组织病理学和患者相关特征影响治疗
    摘要：The authors hypothesize that histopathological characteristics of basal cell carcinomas of the head and neck (BCCHN) have changed over time and the correlation of BCCHN localization and histological tumour type can help improving the number and quality of necessary therapeutic interventions. Information of 222 patients with 344 BCCHN was gained. Descriptive measures were compared to prior studies to prove whether or not characteristics of basal cell carcinomas or patients have changed over time. Afterwards descriptive measures were correlated with number of conducted operations to evaluate if tumour localization, histological tumour type and number of operations depend on one another. Aggravating factors which lead to a higher number of operations were older age, greater size of BCCHN, adjacent elastosis, the localizations eye, ear and nose and histological tumour types morpheaform and nodularulcerated. In comparison to earlier studies characteristics of BCCHN and patients showed positive developments because of grown awareness of BCCHN. Furthermore, our correlations demonstrate that therapeutic results of BCCHN treatment are continuously improving. Nevertheless, treatment of aggressive morpheaform BCCHN in combination with distinctive patient characteristics still needs improvement.
  • 10.

    【2hr】Cephalexin-induced acute generalized exanthematous pustulosis

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    机译 头孢氨苄诱发的急性全身性皮疹性脓疱病
    摘要：Cephalexin is a cephalosporin antibiotic that is commonly used in the treatment of infectious diseases. We report a patient exhibiting a rare adverse effect of cephalexin: drug-induced Acute Generalized Exanthematous Pustulosis (AGEP). We present this case because of the scarcity of reports associating cephalexin with AGEP in hopes that clinicians will consider AGEP in their differential diagnosis in the appropriate clinical setting.
  • 11.

    【2hr】Lupus pernio (Besnier-Tenneson syndrome): A rare form of sarcoidosis

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    机译 狼疮（Besnier-Tenneson综合征）：结节病的罕见形式
    摘要：Lupus pernio (LP) is a chronic non-life threatining type of cutaneous sarcoidosis that can be related to chronic fibrotic sarcoidosis, hyperglobulinemia and hypercalcemia. The aim of this case report is to evaluate the clinical and demographic features of cutaneous sarcoidosis mainly presenting with a rare manifestation of LP. In this paper we report a case of systemic sarcoidosis presenting with LP and a review of the available literature. LP is a rare presentation with infiltrated erythematoviolaceous plaques affecting the nose. We address the main management approach, and possible association with an underlying systemic sarcoidosis. LP is a rare but chronic manifestation of systemic sarcoidosis that needs to be treated in order to prevent cosmetic defects and psychological effects. It is important to recognize such a condition early in order to avoid a delay in treatment and worsening of the condition, both physically and psychologically. Further research regarding the diagnostic approach and management is required to understand this condition thoroughly.
  • 12.

    【2hr】Efficacy of adalimumab in moderate to severe hidradenitis suppurativa: Real life data

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    机译 阿达木单抗在中度至重度化脓性汗腺炎中的功效：真实生活数据
    摘要：Hidradenitis suppurativa (HS) is a relapsing, inflammatory disease characterized by painful nodules, abscesses, sinuses track formation and scarring. HS has a great impact on patients’ quality of life and its treatment may be really challenging. Adalimumab provides a new therapeutic option for HS. Our aim was to assess the therapeutic potential of adalimumab on patients with HS based on the data from the daily clinical practice of an HS Outpatient Clinic. 19 patients with clinically evident moderate to severe HS, under adalimumab treatment for at least 24 week, participated in this observational, retrospective study. The Hidradenitis Suppurativa Physician’s Global Assessment scale, Modified Santorius scale and Dermatology Life Quality Index (DLQI) at baseline, week 4, week 12 and week 24 were retrieved from the records. Both Modified Santorius score and DLQI were significantly decreased during the weeks of evaluation (Friedman’s test; P < 0.001). The proportion of patients who achieved clinical response was 10.5% (n = 2) at week 4, 42.1% (n = 8) at week 12 and 63.2% (n = 12) at week 24. Treatment with adalimumab was linked with both clinical remission of HS and improvement of patients’ quality of life.
  • 13.

    【2hr】A case of chronic ulcer due to subcutaneous arteriolosclerosis in an obese patient mimicking pyoderma gangrenosum

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    机译 一名模仿坏疽性脓皮病的肥胖患者皮下动脉硬化引起的慢性溃疡
    摘要：The differential diagnosis of chronic ulcers covers a wide range of diseases and poses a diagnostic challenge. Subcutaneous ischemic arteriolosclerosis can lead to local ischaemia and ulceration as a result of arteriolar narrowing and reduction of tissue perfusion. This pathophysiological feature can be seen in eutrophication (nonuremic calciphylaxis) in morbid obesity, hypertensive ischemic leg ulcer (Martorell ulcer) and calciphylaxis in chronic renal insufficiency. All of the ulcers happened in this way can be wrongly diagnosed as pyoderma gangrenosum because of clinical similarity and inadequate biopsies. We report a case of chronic ulcer due to subcutaneous arteriolosclerosis in morbid obesity, wrongly diagnosed as pyoderma gangrenosum. It can be detrimental to misdiagnose the ulcers due to subcutaneous arteriolosclerosis as pyoderma gangrenosum since they need a diametrically different approach.
  • 14.

    【2hr】Early morphea simulating patch-stage mycosis fungoides in two cases

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    机译 早期吗啡模拟斑块期真菌病两例
    摘要：Morphea is a skin disorder characterized by thickening of dermis and subcutaneous tissues and loss of adnexal structures. In the early inflammatory stage of morphea, diagnostic histological findings are absent and this may lead to confusion with other inflammatory dermatoses such as mycosis fungoides (MF). We report two cases of early stage morphea mimicking patchstage of MF. Histopathologic examination of biopsies obtained early in the disease course revealed lymphocytic epidermotropism arranged in small pautrier-like collections as well as linear arrangements in dermal- epidermal junction. Additional biopsies were performed which revealed replacement of subcutaneous fat with closely packed thick collagen bundles under eccrine glands. This report points toward the fact that early stage morphea can simulate MF. Therefore additional evaluation is sometimes required for definite diagnosis.
  • 15.

    【2hr】A case of lipomembranous panniculitis with a dramatic response to the treatment of venous insufficiency

    包量

    机译 一例脂膜性脂膜炎对静脉功能不全的治疗有明显反应
    摘要：Lipomembranous panniculitis (LP) is a peculiar type of fat necrosis and is reported with various clinical conditions, mostly with peripheral vascular diseases. Here, a case of a 57-year-old woman with a painful erythematous swelling of the right leg in association with venous insufficiency has been reported. Although LP is frequently associated with venous insufficiency, to the best of our knowledge, this is the first report on the beneficial effect of venous insufficiency treatment in LP.
  • 16.

    【2hr】Hidradenitis suppurativa in a patient with hyperandrogenism, insulin-resistance and acanthosis nigricans (HAIR-AN syndrome)

    包量

    机译 高雄激素血症，胰岛素抵抗和黑棘皮病（HAIR-AN综合征）患者的化脓性汗腺炎
    摘要：The author reports a rare presentation of hidradenitis supprutiva (HS) in combination with hyperandrogenism, insulin-resistance and acanthosis nigricans (HAIR-AN syndrome) in a female patient. Recently many clues have improved the understanding of HS as a systemic disease rather as a disease only with dermatological manifestation. This report might give another hint emphasizing the endocrinological and hormonal role in HS.
  • 17.

    【2hr】Clinical evaluation of Morgellons disease in a cohort of North American patients

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    机译 北美患者队列中的Morgellons疾病的临床评估
    摘要：Morgellons disease (MD) is a dermatological condition characterized by aberrant production of keratin and collagen fibers in skin. Although infection with Borrelia burgdorferi, the causative agent of Lyme disease (LD), has been associated with MD, relatively few studies have hitherto provided epidemiological evidence regarding this association. A cohort of 1000 seropositive North American LD patients was evaluated for the presence of MD. Patients were diagnosed with MD based on detection of microscopic fibers in skin lesions or under unbroken skin. Demographic and clinical features of MD patients were analyzed, and laboratory testing for tickborne coinfections and other infectious agents, was performed. Subjective and objective features of MD were analyzed using statistical methods. Of 1000 seropositive LD patients, 60 (6%) were diagnosed with MD. Of these 60 patients, 75% were female and 78% presented in the late disseminated stage of MD. All 60 patients (100%) were seropositive for B. burgdorferi infection. Tickborne coinfections in these patients included Babesia spp (62%), Bartonella and Rickettsia (25% each), Ehrlichia (15%) and Anaplasma (10%). Helicobacter pylori was detected in 12% of MD patients. In all, 77% of MD patients had one or more coinfections. This study confirms recent findings that MD occurs in a limited subset of LD patients. The clinical and genetic determinants of MD in LD patients require further study.
  • 18.

    【2hr】Foscarnet-induced genital lesions: An overview with a case report

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    机译 膦甲酸酯诱导的生殖器病变：病例报告概述
    摘要：Foscarnet is an important antiviral medication used mainly in the treatment of complicated Herpes-simplex virus and cytomegalovirus (CMV) infections. Reported first in the 1990’s, genital ulcers are a potential side effect in about 10% of cases. We report the case of a 29 year old man with acute myelogenous leukemia who was on ganciclovir for CMV prophylaxis. Three weeks after being switched to foscarnet because of neutropenia, he developed two, painful symmetric ulcers on the inferior aspect of glans penis. Viral and bacterial cultures were negative. Two weeks after stopping the infusion of foscarnet, the ulcers subsided without any additional treatment. It is important that physicians be aware of this potentially disfiguring side effect of foscarnet so that methods of prevention can be implemented early in the treatment of these patients.
  • 19.

    【2hr】Lentiginous eruption in resolving psoriasis plaques during treatment with ixekizumab: a case report and review of the literature

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    机译 伊克珠单抗治疗期间牛皮癣菌斑的长期萌发：一例病例报告并文献复习
    摘要：We report the case of a 56-year old male with severe plaque psoriasis that was successfully treated with ixekizumab, a new anti interleukin (IL)-17 monoclonal antibody. During the first months of treatment he developed a lentiginous eruption in the sites of rapidly resolving plaques. Biopsy and immunohistochemistry reports showed elements of both lentigo and post-inflammatory hyper pigmentation. These findings, which have been increasingly described in anti-tumor necrosis factor alpha (TNFt) and anti IL-12/IL-23 therapy, may be explained by the down regulating effect of TNFTTand IL-17 on pigmentation genes, which is very rapidly suppressed by ixekizumab, resulting in hyper pigmentation, and by the alteration of mesenchymal-epidermal interaction via keratinocyte growth factor during the inflammatory period, which results in the development of histopathological elements of lentigo.
  • 20.

    【2hr】Combination of negative pressure wound therapy and systemic steroid therapy in postsurgical pyoderma gangrenosum after reduction mammoplasty; a case of proven efficacy and safety

    包量

    机译 负乳切口成形术后脓性坏疽性脓皮病的负压伤口治疗和全身类固醇治疗相结合；经过验证的疗效和安全性
    摘要：Pyoderma gangrenosum (PG) is a rare non-infective inflammatory disease of unknown etiology characterized by cutaneous papulo-pustoles that rapidly evolve into painful ulcerative lesions. Postoperative PG (PPG) is a clinical variant of PG in which pathergic response occurs at surgical sites. It is important to include PG in the differential diagnosis of breast ulceration. An incorrect diagnosis and treatment can potentially worsen the patient state, causing disfigurement with extensive scarring, an unpleasant aesthetic result and produce consequent psychological trauma.We report a case of PPG after bilateral breast reduction mammoplasty treated with negative pressure wound therapy (NPWT) as local treatment for wound dehiscence in combination with systemic steroid therapy. This synergism led to a good aesthetic result. NPWT improved wound perfusion, it decreased the exudate, and promoted adherence of the mammary gland to the pectoral muscle. After 31 days deep sutures were placed to directly close the wound and the patient was discharged.PPG is a rare, devastating occurrence after surgery. Surgeons must know that PPG is an evenience that can occur in otherwise healthy patients and must be considered in the differential diagnosis in case of necrotic ulcers and apparent infection status. NPWT resulted to have benefits in the treatment of PPG, with a role in limiting the size of the defect, avoiding pathergic self-reaction and allowing a faster recovery with higher chances of achieving a better result.
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