Variables that predict response of nevus of ota to lasers

Summary

Nevus of ota is a dermal melanocytosis common among Asian patients, mottled, blue‐gray macule that is usually located unilaterally within the distribution of the first and second branches of the trigeminal nerve and almost always responds well to treatment with Q‐switched lasers (eg, ruby, alexandrite, and Nd: YAG). In spite of the plethora of science behind laser‐tissue interactions, the objective evaluation of nevus of ota response to laser is not on firm footing and most studies report subjective percentile scoring improvement. A knowledge of the variations in morphology of nevus of ota can help predict an optimal dose response and help to counsel patients appropriately.

http://bit.ly/2DfEIYM

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology

AbstractBackground.Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such relationships result in physician practice changes are unknown.Materials and Methods.We evaluated physician use of orally administered cancer drugs for four cancers: prostate (abiraterone, enzalutamide), renal cell (axitinib, everolimus, pazopanib, sorafenib, sunitinib), lung (afatinib, erlotinib), and chronic myeloid leukemia (CML; dasatinib, imatinib, nilotinib). Separate physician cohorts were defined for each cancer type by prescribing history. The primary exposure was the number of calendar years during 2013–2015 in which a physician received payments from the manufacturer of one of the studied drugs; the outcome was relative prescribing of that drug in 2015, compared with the other drugs for that cancer. We evaluated whether practice setting at a National Cancer Institute (NCI)‐designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict‐of‐interest policies were associated with the strength of the payment‐prescribing association. We used modified Poisson regression to control confounding by other physician characteristics.Results.Physicians who received payments for a drug in all 3 years had increased prescribing of that drug (compared with 0 years), for renal cell (relative risk [RR] 1.81, 95% confidence interval [CI] 1.58–2.07), CML (RR 1.22, 95% CI 1.08–1.39), and lung (RR 1.69, 95% CI 1.58–1.82), but not prostate (RR 0.97, 95% CI 0.93–1.02). Physicians who received compensation payments or >$100 annually had increased prescribing compared with those who did not, but NCI setting and institutional conflict‐of‐interest policies were not consistently associated with the direction of prescribing change.Conclusion.The association between industry payments and cancer drug prescribing was greatest among physicians who received payments consistently (within each calendar year). Receipt of payments for compensation purposes, such as for consulting or travel, and higher dollar value of payments were also associated with increased prescribing.Implications for Practice.Financial payments from pharmaceutical companies are common among oncologists. It is known from prior work that oncologists tend to prescribe more of the drugs made by companies that have given them money. By combining records of industry gifts with prescribing records, this study identifies the consistency of payments over time, the dollar value of payments, and payments for compensation as factors that may strengthen the association between receiving payments and increased prescribing of that company's drug.

http://bit.ly/2DahkvU

Effects of cerium oxide nanoparticles on bacterial growth and behaviors: induction of biofilm formation and stress response

Abstract

In this paper, the effects of cerium oxide nanoparticles (CeO₂ NPs) on the group bacterial behaviors were elaborated. After 36-h cultivation, the biofilm biomass was enhanced by the sub-lethal concentrations of 0.5 and 2 mg/L CeO₂ NP exposure. Meanwhile, the promoted production of total amino acids in microbes further resulted in the increased surface hydrophobicity and percentage aggregation. To resist the CeO₂ NPs stress, the biofilm exhibited a double-layer microstructure, with the protein (PRO) and living cells occupying the bottom, the polysaccharide (PS), and dead cells dominating the top. The bacterial diversity was highly suppressed and Citrobacter and Pseudomonas from the phylum of γ-Proteobacteria strongly dominated the biofilm, indicating the selective and enriched effects of CeO₂ NPs on resistant bacteria. The stimulated inherent resistance of biofilm was reflected by the reduced adenosine triphosphate (ATP) content after 4 h exposure. The increased levels of reactive oxygen species (ROS) in the treatments of 8 h CeO₂ NP exposure led to the upregulated quorum sensing signals of acylated homoserine lactone (AHL) and autoinducer 2 (AI-2), beneficial to mitigating the environmental disturbance of CeO₂ NPs. These results provide evidences for the accelerating effects of CeO₂ NPs on biofilm formation through oxidative stress, which expand the understanding of the ecological effects of CeO₂ NPs.

http://bit.ly/2HThqNS

11C‐Metomidate PET/CT is a useful adjunct for lateralisation of primary aldosteronism in routine clinical practice

Abstract

Objective

To describe clinical practice experience of ¹¹C‐Metomidate PET/CT as an adjunct to adrenal vein sampling (AVS) in the lateralization of aldosterone producing adenomas (APA) in primary aldosteronism (PA).

Context

Accurate lateralisation of aldosterone producing adenomas in the setting of primary aldosteronism (PA) offers the potential for surgical cure and improved long‐term cardiovascular outcomes. Challenges associated with adrenal vein sampling, the current gold‐standard lateralization modality, mean that only a small proportion of potentially eligible patients currently make it through to surgery. This has prompted consideration of alternative strategies for lateralisation, including the application of novel molecular PET tracers such as ¹¹C‐Metomidate.

Design

Clinical Service Evaluation / Retrospective audit.

Patients

Fifteen individuals with a confirmed diagnosis of PA, undergoing lateralization with ¹¹C Metomidate PET/CT prior to final clinical decision on surgical versus medical management.

Measurements

All patients underwent screening aldosterone renin ratio (ARR), followed by confirmatory testing with the seated saline infusion test, according to Endocrine Society Clinical Practice Guidelines. Adrenal glands were imaged using dedicated adrenal CT. ¹¹C‐Metomidate PET/CT was undertaken due to equivocal or failed AVS. Management outcomes were assessed by longitudinal measurement of blood pressure, ARR, number of hypertensive medications following adrenalectomy or institution of medical therapy.

Results

We describe the individual lateralisation and clinical outcomes for 15 patients with PA.

Conclusion

¹¹C‐Metomidate PET/CT in conjunction with adrenal CT and AVS provided useful information which aided clinical decision making for PA within a multidisciplinary hypertension clinic.

This article is protected by copyright. All rights reserved.

http://bit.ly/2TwQcOv

Building a Renewed ImaGe After Head & Neck Cancer Treatment (BRIGHT) 2.0

Condition:   Head and Neck Cancer
Interventions:   Behavioral: BRIGHT;   Behavioral: Active Control
Sponsor:   Medical University of South Carolina
Not yet recruiting

http://bit.ly/2SxFpX2

Diagnostic Significance of FDG PET/CT Dynamic Imaging in Detecting Metastatic Lymph Nodes With Papillary Thyroid Cancer.

Conditions:   Positron-Emission Tomography;   Lymph Node Metastases;   Thyroid Cancer
Interventions:   Diagnostic Test: ^{18F-FDG PET/CT dynamic scan;   Diagnostic Test: B-ultrasonography
Sponsor:   Fifth Affiliated Hospital, Sun Yat-Sen University
Recruiting}

http://bit.ly/2Gr9wJl

Paclitaxel (Albumin Bound),Bleomycin And Cisplatin Or Carboplatin for Recurrent Or Metastatic Squamous Cell Carcinoma Of The Head And Neck

Condition:   Squamous Cell Carcinoma Of The Head And Neck
Intervention:   Drug: PaclitaxelPaclitaxel (Albumin Bound),Bleomycin combined with Cisplatin or Carboplatin
Sponsor:   Sun Yat-sen University
Not yet recruiting

http://bit.ly/2SuYMQH

Weekly Plasma EBV DNA for Non-metastatic Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Carcinoma
Intervention:  
Sponsor:   The University of Hong Kong
Recruiting

http://bit.ly/2Gr9fGj

A Study to Assess the Safety, Tolerability and Pharmacokinetics of AZD9977 in Japanese Healthy Participants With Single and Multiple Ascending Dose Administration

Condition:   Heart Failure
Interventions:   Drug: AZD9977;   Drug: Placebo
Sponsors:   AstraZeneca;   Parexel
Recruiting

http://bit.ly/2Sza1HE

Issue Information

http://bit.ly/2GaGdLY

Pembrolizumab for Unresectable or Metastatic Melanoma in Patients Older than 85 Years of Age

Background: Programmed cell death protein-1 (PD-1) inhibitors (pembrolizumab and nivolumab) have been approved for the treatment of advanced melanoma. Over the past decades, patients older than 85 years represent an expanding group of patients in developed countries. In France, 25% of melanomas are diagnosed in patients older than 75 years. Objective: To perform a monocentric retrospective study of patients older than 85 years and treated with pembrolizu­mab for unresectable or metastatic melanoma in order to evaluate tolerance and potential benefits of this immunotherapy. Methods: Medical records of patients treated with the PD-1 inhibitor pembrolizumab between January 2015 and January 2018 were reviewed. Results: Nine patients (6 women and 3 men) older than 85 years were included in the study. The mean age was 89.6 (85–97) years at inclusion. All patients were PS 0 or 1. The mean number of infusions was 4 (1–12). However, most patients were not able to tolerate the 4-infusion schedule. One patient refused the second infusion for personal reasons. Seven patients had grade 3 or 4 treatment-related adverse events. Conclusion: These results indicate that pembrolizumab treatment in patients older than 85 years may induce responses but is associated with a high risk of toxicity and impaired autonomy.
Dermatology

http://bit.ly/2GbJRoW

Removal efficiency of As(V) and Sb(III) in contaminated neutral drainage by Fe-loaded biochar

Abstract

Performance of raw and two Fe-loaded biochars, produced either by evaporation (E-product, 26.9% Fe) or precipitation (P-product, 12.6% Fe), was evaluated in batch and column testing for As(V) and Sb(III) removal from contaminated neutral drainage (CND). Batch testing results showed that sorption capacity of the E-product tripled for As(V) and quintupled for Sb(III), whereas for the P-product, it doubled for both contaminants, relative to the raw biochar. Moreover, As(V) removal by the E-product reached 90% in less than 8 h, for initial concentrations up to 50 mg/L. In column testing, the E-product efficiently treated the influent [pH 6; 1 mg/L As(V)] for more than 286 days. The pH of the final effluent was within the legally allowed limits (6–9.5) while less than 0.3 mg/L Fe leached out. Based on these findings, Fe-loaded biochar by evaporation (E-product) seems promising for As(V) treatment in CND.

http://bit.ly/2Gp0sEM

Association of Eu(III) and Cm(III) onto an extremely halophilic archaeon

Abstract

In addition to geological, geochemical, and geophysical aspects, also, microbial aspects have to be taken into account when considering the final storage of high-level radioactive waste in a deep geological repository. Rock salt is a potential host rock formation for such a repository. One indigenous microorganism, that is, common in rock salt, is the halophilic archaeon Halobacterium noricense DSM15987^T, which was used in our study to investigate its interactions with the trivalent actinide curium and its inactive analogue europium as a function of time and concentration. Time-resolved laser-induced fluorescence spectroscopy was applied to characterize formed species in the micromolar europium concentration range. An extended evaluation of the data with parallel factor analysis revealed the association of Eu(III) to a phosphate compound released by the cells (F₂/F₁ ratio, 2.50) and a solid phosphate species (F₂/F₁ ratio, 1.80). The association with an aqueous phosphate species and a solid phosphate species was proven with site-selective TRLFS. Experiments with Cm(III) in the nanomolar concentration range showed a time- and pC_H+-dependent species distribution. These species were characterized by red-shifted emission maxima, 600–602 nm, in comparison to the free Cm(III) aqueous ion, 593.8 nm. After 24 h, 40% of the luminescence intensity was measured on the cells corresponding to 0.18 μg Cm(III)/g_DBM. Our results demonstrate that Halobacterium noricense DSM15987^T interacts with Eu(III) by the formation of phosphate species, whereas for Cm(III), a complexation with carboxylic functional groups was also observed.

http://bit.ly/2SoZ4sn

In situ evaluation of the NO x removal efficiency of photocatalytic pavements: statistical analysis of the relevance of exposure time and environmental variables

Abstract

In the recent past, the NO_x removal efficiency of photocatalytic materials has been subject of many studies with promising results. However, many of these studies involve laboratory tests carried out under standardized climatic exposure conditions, often not representative of the real-world environment. With the aim to bridge this gap, selected photocatalytic materials have been applied to different substrates in outdoor demonstrator platforms at pilot scale as part of the project LIFE-PHOTOSCALING. The paper presents the results of in situ measurements of NO_x removal efficiency of the materials, performed during 17 months. Statistical models accounting for the influence of exposure time and relevant environmental variables are derived. They suggest that photocatalytic emulsions on the tested asphalt experience a significant loss of activity over time irrespective of climatic conditions. The efficiency of photocatalytic slurries on asphalt and of concrete tiles, with the photocatalyst applied on surface or in bulk, mainly depends on substrate humidity.

http://bit.ly/2Gp7PMH

Estimating CDKN2A mutation carrier probability among global familial melanoma cases using GenoMELPREDICT

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Nicholas J. Taylor, Nandita Mitra, Lu Qian, Marie-Françoise Avril, D. Timothy Bishop, Brigitte Bressac-de Paillerets, William Bruno, Donato Calista, Francisco Cuellar, Anne E. Cust, Florence Demenais, David E. Elder, Anne-Marie Gerdes, Paola Ghiorzo, Alisa M. Goldstein, Thais C. Grazziotin, Nelleke A. Gruis, Johan Hansson, Mark Harland, Nicholas K. Hayward

Abstract

Background

Although rare in the general population, highly penetrant germline mutations in CDKN2A are responsible for 5-40% of melanoma cases reported in melanoma-prone families. We sought to determine whether MELPREDICT was generalizable to a global series of melanoma families and whether performance improvements can be achieved.

Methods

2,116 familial melanoma cases were ascertained by the international GenoMEL Consortium. We recapitulated the MELPREDICT model within our data (GenoMELPREDICT) to assess performance improvements by adding phenotypic risk factors and history of pancreatic cancer. We report areas under the curve (AUC) with 95% confidence intervals (CI) along with net reclassification indices (NRI) as performance metrics.

Results

MELPREDICT performed well (AUC=0.752; 95%CI: 0.730, 0.775), and GenoMELPREDICT performance was similar (AUC=0.748; 95% CI: 0.726, 0.771). Adding a reported history of pancreatic cancer yielded discriminatory improvement (p<0.0001) in GenoMELPREDICT (AUC=0.772; 95%CI: 0.750, 0.793; NRI=0.40). Including phenotypic risk factors did not improve performance.

Conclusion

The MELPREDICT model functioned well in a global dataset of familial melanoma cases. Adding pancreatic cancer history improved model prediction. GenoMELPREDICT is a simple tool for predicting CDKN2A mutational status among melanoma patients from melanoma-prone families and can aid in counselling these patients towards genetic testing or cancer risk counselling.

http://bit.ly/2BmJbc3

Coffee, tea, caffeine, and risk of non-melanoma skin cancer in a Chinese population: The Singapore Chinese Health Study

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Choon Chiat Oh, Aizhen Jin, Jian-Min Yuan, Woon-Puay Koh

Abstract

Background

While epidemiological studies in populations of European-descent suggest possible chemo-protective effect of caffeine against non-melanoma skin cancer (NMSC), data in Asian populations are lacking.

Objectives

We examined the relations between coffee, tea and caffeine consumption, and NMSC risk among Chinese in Singapore.

Methods

We used data from the Singapore Chinese Health Study, a prospective cohort of 63,257 men and women aged 45–74 years at recruitment from 1993 to 1998. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazard models.

Results

Coffee drinking was associated with reduced NMSC risk in a dose-dependent manner (P trend<0.0001); compared with those who drank coffee less than weekly, in those who drank ≥3 cups/day, HRs (95% CIs) were 0.54 (0.31-0.93) for risk of basal cell carcinoma, and 0.33 (0.13-0.84) for risk of squamous cell carcinoma. Compared with non-drinkers, daily drinkers of black tea also had reduced NMSC risk (HR=0.70; 95% CI=0.52-0.94). Caffeine intake reduced NMSC risk in a stepwise manner (P trend=0.0025); subjects with caffeine intake ≥400 mg/day had the lowest risk (HR=0.59; 95% CI=0.34-1.04).

Conclusion

Consumption of caffeinated drinks such as coffee and black tea may reduce the risk of NMSC among Chinese.

http://bit.ly/2TwUPIB

Incidence and Risk of Photosensitivity with Targeted Anticancer Therapies

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): K.T. Ciccolini, J. Kim, S.P. Chaudhari, A.Skripnik Lucas, B. Benhuri, J. Duran, S. Wu, M. Lacouture

http://bit.ly/2Bjnolw

Determining patient preferences and willingness to pay related to scar length and appearance following skin cancer treatment on the face and trunk: A multi-center discrete choice experiment

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Nicholas Golda, William Black, Vishal Patel, Donald Neal, Jeremy Etzkorn

http://bit.ly/2TsINzW

The Hydroxychloroquine–Interferon Gamma Release Assay Question: TB or not TB?

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Warren R. Heymann

http://bit.ly/2BlnlFX

Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: a dermatologist and nail expert group consensus

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Dimitrios Rigopoulos, Robert Baran, Soumiya Chiheb, Carlton Ralph Daniel, Nilton Di Chiacchio, Stamatis Gregoriou, Chander Grover, Eckart Haneke, Matilde Iorizzo, Marcel Pasch, Bianca Maria Piraccini, Phoebe Rich, Bertrand Richert, Natalia Rompoti, Adam I. Rubin, Archana Singal, Michela Starace, Antonella Tosti, Ioanna Triantafyllopoulou, Martin Zaiac

Abstract

Nail involvement in psoriasis is common, and the severity of it does not always parallel the intensity of cutaneous disease.

We created a consensus group, of which the aim was to provide practical recommendations for the treatment of nail psoriasis in patients without skin psoriasis, or with mild skin lesions with no indication for a systemic treatment. This collaborative process was conducted by an international panel of dermatologists with special expertise in nail disorders, using a formal consensus methodology.

During this process, the panel strived to establish an agreement regarding the definition of nail psoriasis, the severity of nail psoriasis, and treatment response. Treatment recommendations are provided regarding nail psoriasis severity and matrix or bed involvement. "Few-nail" disease was considered as nail psoriasis affecting 3 or less nails. In the case of matrix involvement only, intralesional steroid injections were considered the treatment of choice. Topical steroids alone or in combination with topical vitamin D analogues were suggested for nail psoriasis limited to the nail bed. For the systemic treatment of nail psoriasis acitretin, methotrexate, cyclosporine, small molecules, and biologics can be employed.

http://bit.ly/2TsJkBW

Pigments in American Tattoo Inks and their Propensity to Elicit Allergic Contact Dermatitis

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Walter Liszewski, Erin M. Warshaw

Abstract

Background

Tattoos have become increasingly common in the United States. Historically, tattoo inks were comprised of metallic pigments which had the potential to cause allergic contact dermatitis. Data have been lacking on the current use of these pigments in tattoo ink.

Objective

Identify pigments currently used in tattoo inks manufactured in or sold by wholesalers in the United States and investigate cases of allergic contact dermatitis to these pigments.

Methods

Using specific keywords, an internet search was performed. Pigment information listed in tattoo product inserts was collated and evaluated.

Results

1,416 unique inks were surveyed. The average bottle of ink contained 3.0 pigments. A total of 44 distinct pigments were identified, of which 10 contained metallic pigments including iron, barium, zinc, copper, molybdenum, and titanium. The remaining 34 pigments contained carbon, azo, diketopyrrolopyrrole, quinacridone, anthraquinone, dioxazine, or quinophthalone dyes. A literature search revealed that 11 of the 44 (25%) pigments had been suspected to cause contact dermatitis. Five were confirmed by patch testing.

Conclusions

These findings highlight the diversity of pigments currently used in tattoos. Relatively few inks contained metallic pigments to which allergic contact dermatitis has historically been attributed. Patch test clinicians should be aware of these new pigments.

http://bit.ly/2BkRSDD

Early Detection of Acral Melanoma: A Review of Clinical, Dermoscopic, Histopathologic, and Molecular Characteristics

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Claudia C. Darmawan, Gwanghyun Jo, Sara E. Montenegro, Yoonjin Kwak, Lee Cheol, Kwang Hyun Cho, Je-Ho Mun

Abstract

Acral lentiginous melanoma is a distinct subtype of melanoma on acral skin. Patient presentation at later stages as well as delayed diagnosis by physicians contribute to a worse associated prognosis and survival rate. Despite our progress on understanding the key features of this disease, the diagnosis of early stage acral melanoma is still challenging. It is essential to integrate clinical, dermoscopic, and histological findings in the diagnosis of acral lentiginous melanoma. In addition, molecular studies can be helpful. In this review, we summarized our current understanding of this disease entity from articles that have been published between 1969 and 2018. We outline clinical and dermoscopic features as well as pathologic and molecular findings of acral melanoma and present an algorithm for diagnosis. Understanding and integrating these characteristics may assist clinicians in the early detection of acral melanomas.

http://bit.ly/2TsIAg8

Intralesional sodium stibogluconate under inhaled anesthesia for the treatment of cutaneous leishmaniasis in children: A retrospective cohort

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Yael Renert-Yuval, Claes D. Enk, Sari Murad, Valerie Yofe, David Gozal, Vered Molho-Pessach

http://bit.ly/2BmZe9R

Liposuction-like Sclerotherapy Technique: a Deep Approach to Superficial Lymphatic Malformation

Publication date: Available online 5 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Huaijie Wang, Xinkui Guo, Qiang Liu, Na Liu, Xin He, Yuping Peng, Hongfen Lv, Xiaoqian Zhou, Ya Gao

http://bit.ly/2TspeHQ

L-α-Phosphatidylcholine attenuates mercury-induced hepato-renal damage through suppressing oxidative stress and inflammation

Abstract

The potential ameliorative effects of L-α-phosphatidylcholine (PC) against mercuric chloride (HgCl₂)-induced hematological and hepato-renal damage were investigated. Rats were randomly allocated into four groups (n = 12): control, PC (100 mg/kg bwt, intragastrically every other day for 30 consecutive days), HgCl₂ (5 mg/kg bwt, intragastrically daily), and PC plus HgCl₂. Hematological and hepato-renal dysfunctions were evaluated biochemically and histopathologically. Hepatic and renal oxidative/antioxidative indices were evaluated. The expression of proinflammatory cytokines (tumor necrosis factor-α and interleukin-6) was also detected by ELISA. HgCl₂ significantly increased serum aminotransferases (ALT, AST), urea, and creatinine levels that are indicative of hepato-renal damage. HgCl₂ also induced a significant accumulation of malondialdehyde (+ 195%) with depletion of glutathione (− 43%) levels in the liver and renal tissues. The apparent hepato-renal oxidative damage was associated with obvious organ dysfunction that was confirmed by impairments in the liver and kidney histoarchitecture. Furthermore, HgCl₂ significantly attenuated the expression of proinflammatory cytokines named tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Conversely, PC treatment attenuated these effects, which improved the hematological and serum biochemical alternations, reduced the oxidative stress and proinflammatory cytokine levels, and ameliorated the intensity of the histopathological alterations in livers and kidneys of HgCl₂-treated rats. It could be concluded that PC displayed potential anti-inflammatory and antioxidant activities against HgCl₂-induced hepato-renal damage via suppression of proinflammatory cytokines and declining oxidative stress.

http://bit.ly/2Gtz1to

Electron microscopy and tomography reveal that sodium 2‐naphthalene sulfonate incorporated into perming solutions swells and tilts trichocyte intermediate filaments causing straightening of curly Japanese human hair

Abstract

Objective

A new hair‐care process has been specifically developed for the straightening of curved Japanese woman's hair [1]. The process included sodium 2‐naphthalene sulfonate (SNS) in the reduction and oxidation steps of a conventional perming process. Our objective was to develop an understanding of how this process caused hair straightening by measuring the changes to morphology and ultrastructure between, untreated, conventionally permed and SNS permed hair. Untreated and SNS permed Merino wool fibres were used to confirm structural changes.

Methods

Japanese hair samples were measured for single fibre curvature before and after perming treatments. A silver staining method was developed to stain hair fibres without changing fibre curvature so that transmission electron microscopy could be used to measure changes in the lateral dimensions of all structural components from the cellular to protein filament level. Electron tomography determined intermediate filament slopes and slope changes after SNS perming relative to the central longitudinal axis of the fibre.

Results

SNS perming was found to cause greater lateral swelling than conventional perming of: the paracortical cells of wool; the cuticle, the cuticular cell membrane complex and the macrofibrillar centre‐to‐centre distance of hair; and of the intermediate filaments in wool and hair. In curved hair, SNS perming caused the intermediate filaments of the helical macrofibrils to simultaneously swell and to tilt further, resulting in the slight longitudinal contraction of the macrofibrils. The overall swelling and tilting was greatest in the helical macrofibrils of Type B cortical cells predominately located in the convex fibre half. The presence of a higher percentage of helical macrofibrils in the convex fibre half than in the concave fibre half caused a contraction differential between the two halves leading to straighten of the curved fibre. A mechanical model was proposed to explain how SNS perming straightened curly hair.

Conclusion

The effects of conventional and SNS perming on the morphological and ultrastructural components of curved Japanese hair and high‐curl Merino wool fibres has given clear insights into understanding the mechanism of fibre curvature change.

This article is protected by copyright. All rights reserved.

http://bit.ly/2RCz5sN

Validation of a predictive method for sunscreen formula evaluation using gene expression analysis in a Chinese reconstructed full‐thickness skin model

Abstract

Objective

The present study aimed to establish a predictive in vitro method for assessing the photoprotective properties of sunscreens using a reconstructed full‐thickness skin model.

Materials And Methods

A full‐thickness skin model reconstructed with human fibroblasts and keratinocytes isolated from Chinese skin was exposed to daily UV radiation (DUVR). We examined the transcriptomic response, identifying genes for which expression was modulated by DUVR in a dose‐dependent manner. We then validated the methodology for efficacy evaluation of different sunscreens formulas.

Results

The reconstructed skin model was histologically consistent with human skin, and upon DUVR exposure, the constituent fibroblasts and keratinocytes exhibited transcriptomic alterations in pathways associated with oxidative stress, inflammation and extracellular matrix remodeling. When used to evaluate sunscreen protection on the model, the observed level of protection from UV‐induced gene expression was consistent with the corresponding protection factors determined clinically and allowed for statistical ranking of sunscreen efficacy.

Conclusions

Within the present study we show that quantification of gene modulation within the reconstructed skin model is a biologically‐relevant approach with sensitivity and predictability to evaluate photoprotection products.

This article is protected by copyright. All rights reserved.

http://bit.ly/2WJCUA8

Could Isotretinoin flare Hidradentis suppurativa? A Case Series

Summary

We report eight cases of patients with severe acne who were treated with Isotretinoin and developed painful nodules in their axillae and groin consistent with Hidradenitis Suppurativa (HS). The pathogenesis of HS is still not completely understood; recent research from a study in 2011 of biopsies from HS lesions showed a reduction or absence of sebaceous glands compared to normal skin in HS patients and the author suggested this contributes to the pathogenesis of the disease^. Interestingly the main effect of Isotretinoin is to decrease the size and action of sebaceous glands; so hypothetically, as Isotretinoin acts by reducing the sebaceous glands further it could potentially aggravate the condition. Our experience has instilled caution in our prescribing of Isotretinoin; patients are questioned about symptoms of HS prior to and during treatment, particularly patients with acne conglobata.

This article is protected by copyright. All rights reserved.

http://bit.ly/2UFJy8L

Activation of endoplasmic reticulum stress in rat brain following low-intensity microwave exposure

Abstract

The present study was designed to explore the effects of low-intensity microwave radiation on endoplasmic reticulum stress and unfolded protein response. Experiments were performed on male Wistar rats exposed to microwave radiation for 30 days at 900 MHz, 1800 MHz, and 2450 MHz frequencies on four groups of animal: sham-exposed group, 900 MHz exposed (SAR 5.84 × 10⁻⁴ W/kg), 1800 MHz exposed (SAR 5.94 × 10⁻⁴ W/kg), and 2450 MHz exposed (SAR 6.7 × 10⁻⁴ W/kg) groups. Expressions of mRNA were estimated at the end of exposure in rat brain by real-time quantitative PCR. Microwave exposure at 900, 1800, and 2450 MHz with respective SAR values as mentioned above significantly (< 0.05) altered mRNA expression of transcription factors ATF4, CHOP, and XBP1 in accordance with increasing microwave frequency. The result of the present study reveals that low-intensity microwave exposure at frequencies 900, 1800, and 2450 MHz induces endoplasmic reticulum stress and unfolded protein response.

http://bit.ly/2GozHAr

Drivers of carbon emissions in Turkey: considering asymmetric impacts

Abstract

This study investigates the impacts of income, (renewable and non-renewable) energy consumption, trade, and financial development on carbon dioxide emissions in Turkey for the 1965–2015 period by employing the non-linear autoregressive distributed lag method. Results show that non-renewable and renewable energy consumption, and trade openness have asymmetric impacts on pollution in long-run, while only renewable energy consumption has asymmetric impact on emissions in short-run. Results further reveal that the Environmental Kuznets Curve hypothesis is not valid in Turkey. Moreover, both financial development and trade positively affect emissions. Additionally, in long-run, positive shocks in renewable and non-renewable energy consumption increase emissions, but the impact of renewable energy consumption is infinitesimally small compared to the impact of non-renewable energy consumption. However, negative shocks in renewable energy consumption increase emissions, whereas negative developments in non-renewable energy consumption decrease emissions. Further, in short-run, positive developments in renewable energy consumption decrease emissions, and negative developments in non-renewable energy consumption have the same influence on emissions. In accordance with the findings, some policy suggestions are proposed.

http://bit.ly/2SwuFYU

Removal of phenanthrene and pyrene from contaminated sandy soil using hydrogen peroxide oxidation catalyzed by basic oxygen furnace slag

Abstract

Soil contamination with polycyclic aromatic hydrocarbons (PAHs) is a serious problem in Northeast China, especially in the steel industrial area. The objective of this study was to evaluate the feasibility of using basic oxygen furnace (BOF) slag to activate the Fenton-like remediation of PAH-contaminated soil to achieve the objectives of "waste control by waste" and "resource recycling" in Chinese steel industry. The effects of BOF slag dosages, H₂O₂ concentrations, and exothermicity-driven evaporation were evaluated with respect to the removal efficiencies of phenanthrene (Phe) and pyrene (Pyr). Results indicated that PAH oxidation was proportional to the BOF slag dosages and was increased exponentially with H₂O₂ concentrations. Evaporation due to increasing temperature caused by exothermic reaction played an important role in total soil PAH losses. The sequential Fenton-like oxidation with a 3-times application of 15% H₂O₂ and the same BOF slag repeatedly used were able to remove 65.87% of Phe and 58.33% of Pyr, respectively. Soluble iron oxides containing in BOF slag were reduced, while amorphous iron oxide concentration remained stable during the repeated Fenton-like process. Column study mimics real field applications showing high removal efficiencies of Phe (36.05–83.20%) and Pyr (21.79–68.06%) in 30-cm depth of soil profile. The tests on soluble heavy metal concentrations after the reactions with high slag dosage or high H₂O₂ concentration confirmed that BOF slag would not cause heavy metal contamination. Consequently, BOF slag may provide an efficient way for enhancing the Fenton-like based remediation of heavily PAH-polluted soil with little risk on collateral heavy metal contamination. However, an external gas collection and purification equipment would be essential to eliminate the evaporated PAHs.

http://bit.ly/2GncEG9

Seasonal variation in metal concentration in various tissues of the European chub ( Squalius cephalus L.)

Abstract

Due to the increasing industrialization, metals are discharged into all spheres of the environment, in particular, in river courses, which leads to the need for constant monitoring. Metals do not degrade into harmless end products; they are very persistent and have high potential for accumulation in biota. Metals in the fish body are accumulated in different amounts in the tissue specific matter. In relation to the biotic conditions and fish metabolism, the load of food, or the stage of the reproductive cycle, the seasonal variation of metal levels can be expected. Because of that, the objective of our present study was to analyze 15 metals and metalloids in liver, gills, muscle, and gonads of European chub (Squalius cephalus) throughout the 4 seasons, autumn, winter, spring, and summer. The specimens were collected from two rivers, Pestan and Beljanica at the Kolubara basin, and their concentrations were determined with inductively coupled plasma optical emission spectrometry (ICP-OES). Specimens from both rivers have shown similarities in metal accumulation like the highest accumulation of majority of elements in gills, lowest accumulation of majority of elements in muscle (except for Hg), and higher accumulation of some elements in summer (Cu, Fe, Zn). In addition, Cu and Fe showed affinity for liver, while Ba, Cr, Sr, and Zn were specific for gills. Also, Al, B, Fe, Ni, and Pb did not show significant differences in concentrations among different seasons in all investigated tissues.

http://bit.ly/2SsjujX

Farmers’ knowledge, attitudes, and perceptions of pesticide use in apple farms of northern Iran: impact on safety behavior

Abstract

Farmers' knowledge of pesticide use as well as their attitudes and perceptions concerning risks and safety play a crucial role in safe spraying operations in farms, but little is known for the inter-relationships among these variables and their impact on safety behavior. This study examined the levels of knowledge, attitudes, and perceptions of pesticide use among apple farmers (n = 200) of Meshkinshahr County, Iran. All farmers used fungicides in their farms. On a scale from 1 to 5, the mean scores of knowledge, attitudes, and perceptions were 3.66 ± 0.77, 3.36 ± 0.59, and 4.37 ± 0.42, respectively, implying a moderate level of knowledge of pesticide use and attitudes towards pesticides, but positive perceptions of pesticides among respondents. Contact with extension agents, education level, reading pesticide labels, and household literate members showed positive association (P < 0.01) with knowledge, attitudes, and perceptions of pesticide use, while contact with other farmers was negatively associated (P < 0.01) with these variables. Farming experience showed positive association (P < 0.01) with knowledge of pesticide use, while age showed negative association (P < 0.01) with attitudes towards pesticides. Poisoning experience was negatively associated with both attitudes and perceptions (P < 0.01), but not with knowledge. Farmers' knowledge of pesticide use (total effect 0.62) was the most important variable affecting pesticide use behavior of apple farmers followed by attitudes (total effect 0.50) and perceptions (total effect 0.42). Also, knowledge impacted attitudes towards pesticide use (accounting for 71% of the variability in farmers' attitudes), while attitudes in turn impacted perceptions (accounting for 69% of the variability in farmers' perceptions). Findings specify inter-relationships between farmers' knowledge, attitudes, and perceptions and the impact of those variables on safety behavior concerning pesticide use. Increasing farmers' knowledge of pesticide use and modifying attitudes and perceptions concerning pesticides are necessary for improving safety behavior of farmers in the use of pesticides.

http://bit.ly/2TynNYm

ESSIMAGE: a tool for the assessment of the agroecological performance of agricultural production systems

Abstract

Over the last few years, intensive agriculture has often been denounced as a source of negative effects, particularly at the environmental and health level (overexploitation of natural resources, degradation of their quality, appearance and development of several diseases, etc.). Reducing the excessive use of agricultural inputs for the protection of the environment and the preservation of human and animal health is a social requirement nowadays. Investing in more sustainable agricultural models which make it possible to reduce, or even eliminate the risks, has become urgent. A possible solution may be to resort to agroecological systems. In order to be sustainable, these new systems must be performant at the agronomic, economic, social, and environmental levels. There is a multitude of tools for assessing the sustainability of agricultural systems. These tools are inappropriate for organic and agroecological systems, and do not make it possible to measure the agroecological transition performance of farms (Trabelsi et al. Environ Sci Pollut Res 23:139–156, 2016; Trabelsi 2017). This research project aims to design a decision support tool in order to help farms throughout the agroecological transition process, to assess the performance of this transition, and to put forward improvement scenarios. Contrary to other assessment methods, ESSIMAGE (Evaluation and Simulation of Agroecological Systems) is based on both pressure and impact indicators, and takes the specificities of agricultural production systems into account. It is a dynamic tool which not only makes it possible to assess farm performance at the present moment but also to consider the future by putting forward possible alternative improvement scenarios and by simulating their consequences at a later stage. ESSIMAGE is based on the interaction of two elements: agro-environmental, social, and economic indicators, and the GIS (Geographic Information System) software. This tool has been tested as part of a CASDAR "Post-MAET Gimone" ( agriculture.gouv.fr/ministere/mobilisation-collective-pour-lagroecologie. ) project on the subject of "Collective mobilization for agroecology" by using farm data, most of the farms having been involved in an agro-environmental measure for the progressive reduction of phytosanitary treatments since 2008. It has made it possible to compare the agroecological performances of these farms with an optimal situation, as well as with each other. Considering the research objectives and the approaches discussed, this study is an original step in the development of agricultural management strategies in favor of agroecology.

http://bit.ly/2BilwJS

Effect of bifenthrin on oxidative stress parameters in the liver, kidneys, and lungs of rats

Abstract

Oxidative stress inducing potential of bifenthrin was evaluated in the liver, kidney, and lung of rats following its repeated oral administration for 20 and 30 days. Bifenthrin-treated rats showed a significant lipid peroxidation in all three tissues. By 20th day of treatment, there was a significant decrease in superoxide dismutase activity of the liver, catalase and glutathione peroxidase activity of the liver and lung, and glutathione S-transferase activity of the kidney and lung. By 30th day of exposure, the activities of these enzymes were significantly decreased in all three tissues. The highest oxidative stress, indicated by lipid peroxidation and alteration in antioxidant enzymes, is produced in the liver followed by the kidney and lung. In conclusion, bifenthrin has a potential to induce severe oxidative stress in the liver, kidney, and lung. The extent of oxidative stress is increased with the duration of exposure.

http://bit.ly/2TynD3c

Web-based Korean maximum residue limit evaluation tools: an applied example of maximum residue limit evaluation for trichlorfon in fishery products

Abstract

To ensure public safety against veterinary drug residues in food products from animal sources, maximum residue limits (MRLs) should be established by scientific evidence and a transparent estimation process. The Joint Food and Agriculture Organization (FAO)/World Health Organization (WHO) Expert Committee on Food Additives (JECFA) developed an Excel workbook-based tool for MRLs evaluation in 2003. In this study, we developed a web-based tool for MRL evaluation, called Korean MRL evaluation tools (KMET). While KMET used algorithms of JECFA workbook, it added some databases (e.g., Korean food consumption database) and provided additional functions (e.g., selection of target marker residue). Web-based KMET enabled regulatory policy makers to update the database. All input data and output results related to MRL evaluation based on residue depletion and food consumption datasets were archived and provided overall processes from the initial depletion data entry to MRL establishment with user-friendly interface. Our results demonstrated the stepwise processes whereby MRL for trichlorfon in the muscle of Paralichthys olivaceus was established with functional descriptions of KMET. MRL for trichlorfon derived from KMET was proposed and notified by the Ministry of Food and Drug Safety in 2018.

http://bit.ly/2Bmy4jw

Pyrolyzed municipal sewage sludge ensured safe grain production while reduced C emissions in a paddy soil under rice and wheat rotation

Abstract

Safe recycling of the growing amounts of municipal sewage sludge containing toxic metals had been critically challenged with the fast urbanization. In this study, we investigated soil amendment of municipal wastewater treatment (MSS) converted biochar for its recycling in agricultural soils. In a field experiment, unpyrolyzed (USS) and pyrolyzed municipal sewage sludge (PSS) was amended at 20 t ha⁻¹ on dry base to a rice paddy before rice plantation, with a control without amendment. Grain yield and emission of non-CO₂ potent greenhouse gases were examined as well as topsoil metal mobility and plant uptake determined throughout a rice-wheat rotation year. Compared to USS treatment, addition of PSS caused a significantly increased grain yield of rice by 35% but no change in grain yield of wheat following the rice season. No distinct difference was observed in grain concentration of major nutrients of N, P, and K between USS and PSS treatments. Compared to USS treatment, PSS treatment reduced CH₄ emissions by 91.6% from soil and by 78.5% from ecosystem during rice-growing season. Whereas, PSS treatment led to a reduction of ecosystem N₂O emissions by 70.8% relative to USS treatment during wheat-growing season. While both USS and PSS treatments slightly but insignificantly increased soil total content of heavy metals, PSS treatment reduced CaCl₂-extractable Cd pool by 33~40% over USS treatment. Grain contents of Cd and Pb and Cd/Zn were markedly reduced under PSS over USS, without exceeding the Chinese state guideline limit. Carbon emission intensity was considerably (by over 20%) reduced for soil and ecosystem but unchanged for wheat soil, under PSS over USS. Thus, soil amendment of pyrolyzed sewage sludge could be a measure for climate smart soil and for safe grain production in rice agriculture. It deserves further study if repeated amendment could exert sustainable impacts on soil health and food security in the paddy.

http://bit.ly/2Tyns82

T‐cell responses against 4‐tertiarybutylphenol‐exposed pigmented cells in a patient with occupational vitiligo

Abstract

Several case studies on contact/occupational vitiligo after skin contact with 4‐tertiairybutylphenol (4‐TBP) have been reported. Biochemical and cellular effects of 4‐TBP on melanocytes have been shown in vitro, but immunological analyses explaining the immunising ability of 4‐TBP leading to wide‐spread vitiligo lesions beyond areas of primary contact are still lacking. We report here the presence of a systemic T‐cell response to 4‐TBP‐exposed pigmented cells in a patient with chemically‐induced vitiligo.

This article is protected by copyright. All rights reserved.

http://bit.ly/2HRKqpf

Photobiomodulation can alter mRNA levels cell death-related

Abstract

Photobiomodulation (PBM) by low-level laser has demonstrated excellent results for inflammatory treatments, promoting repair of injured tissues. Knowledge regarding the molecular mechanisms involved in this process has been increasing, but its effect on cell death/survival-related gene expression after laser irradiation with different doses is not well understood. So, it is important to know these effects in order to guarantee the safety of therapeutic protocols based on PBM. This study aimed to investigate the mRNA levels of genes related to proteins involved in cell death/survival pathways of healthy tissues from talocrural joint of mice after PBM. Mice were divided into three groups: control, PBM at 3 J cm⁻², and PBM at 30 J cm⁻². Laser irradiation was performed on talocrural joint during four consecutive days. Morphological analyses, immunocytochemistry, FasL, Fas, Bax, Apaf1, Caspase9, Caspase3, Caspase6, Bcl2 mRNA levels, and DNA fragmentation were performed to verify cell death induction after laser irradiation. PBM can increase mRNA levels of almost genes pro-apoptotic. On the other hand, mRNA level of anti-apoptotic protein Bcl-2 gene was not significantly altered. Bcl-2/Bax ratio (indicator of protective molecular response) was decreased after PBM at 30 J cm⁻², trending to DNA fragmentation. Results obtained in this study indicate that PBM by low-level infrared laser alters mRNA relative levels of genes involved in cell death pathways. However, these molecular alterations were not able to cause DNA fragmentation in cells in talocrural joint tissues, indicating that infrared laser was not enough to cause cell death.

http://bit.ly/2WGGJGu

A cellular blue nevus with pigmented epithelioid melanocytoma‐like pattern on the ipsilateral upper arm associated with a congenital plaque‐type blue nevus on the hand

A 36‐year‐old man presented with a subcutaneous nodule on the right upper arm. A small nodule had developed 8 years earlier, and grew in size, accompanied by a tingling sensation and numbness. In addition, he had a bluish irregular patch on the right hand since birth, which crossed from the palm to the dorsal hand. Skin biopsies from the hand showed heavily pigmented melanocyte proliferation in the dermis with perieccrine, perivascular, and perineural involvement, and a diagnosis of congenital plaque‐type blue nevus was made. The tumor on the arm was located closely along the median nerve, and was observed as a large black pedunculated round tumor. Histopathologically, the tumor on the arm consisted of densely packed tissue with nevoid cells without atypia in the larger nodular part, and heavily pigmented spindle and epithelioid melanocytes in the slender stalk area, which was diagnosed as cellular blue nevus with pigmented epithelioid melanocytoma‐like pattern. Next‐generation sequencing revealed GNAQ mutations in the hand lesion, and in the lesions on the arm. This case suggests that the areas of skin following the same neural distribution of a congenital plaque‐type blue nevus on the extremities should be followed‐up for secondary changes.

This article is protected by copyright. All rights reserved.

http://bit.ly/2Slzvsf

Differential Distribution of the Epigenetic Marker 5‐hydroxymethylcytosine Occurs in Hair Follicle Stem Cells during Bulge Activation

Background

Hair follicle cycling is dependent upon activation and differentiation of an epithelial subpopulation of cells with stem‐like characteristics. These cells express cytokeratin 15 (CK15) and are sequestered within a specialized niche termed the follicular bulge. The pathways that mediate bulge activation are poorly understood, although growing evidence suggests a role for epigenetic events.

Methods

Here we investigated murine and human hair follicles to determine whether a recently described epigenetic hydroxymethylation marker, 5‐hmC, known to mediate cell growth and differentiation, may play a role in bulge activation.

Results

We found the bulge region of murine hair follicles to demonstrate variable 5‐hmC distribution within the nuclei of CK15‐positive stem cells during early anagen, a pattern that was not associated with resting stem cells of telogen follicles which did not express 5‐hmC. Moreover, during phases of early anagen that were induced in an organ culture model, spatial alterations in bulge stem cell 5‐hmC reactivity, as assessed by dual labeling, were noted.

Conclusions

These preliminary findings suggest that 5‐hmC may play a dynamic role in bulge activation during anagen growth, and provide a foundation for further experimental inquiry into epigenomic regulation of hair follicle stem cells.

This article is protected by copyright. All rights reserved.

http://bit.ly/2GoX78X

Improvement of atopic dermatitis with dupilumab occurs equally well across different anatomic regions: data from phase 3 clinical trials

Abstract

Moderate‐to‐severe atopic dermatitis (AD) can affect different parts of the body, and some adults have more localized AD, such as face and neck involvement. Compared with non‐exposed areas, such as the trunk, exposed areas such as the face, neck, and hands could be more vulnerable to environmental allergens and irritants and can be more refractory to topical therapies. Local adverse effects of topical therapies are more likely to occur on the face and neck. Additional pathologies, such as contact dermatitis, could complicate the clinical picture and response of exposed areas to treatment. Microbial factors (e.g. Malassezia) in specific regions may also influence AD severity on the face and neck.

This article is protected by copyright. All rights reserved.

http://bit.ly/2HU3144

Clearance of molluscum contagiosum virus infection in patients with atopic eczema treated with dupilumab

Abstract

Molluscum contagiosum virus (MCV) infection in the setting of atopic dermatitis (AD), also known as eczema molluscatum, can represent a significant treatment challenge to the dermatologist. We report four patients with severe AD and disseminated MCV infection who experienced clearance of their MCV infection following treatment with dupilumab, a fully human monoclonal antibody against interleukin(IL)‐4 receptor alpha licenced for the treatment of moderate to severe AD.

This article is protected by copyright. All rights reserved.

http://bit.ly/2t5MG1W

TREatment of ATopic eczema (TREAT) Registry Taskforce: consensus on how and when to measure the core dataset for atopic eczema treatment research registries

Summary

Background

Comparative, real‐life and long‐term evidence on the effectiveness and safety of photo‐ and systemic therapy in moderate‐to‐severe atopic eczema (AE) is limited. Such data must come from well‐designed prospective patient registries. Standardisation of data collection is needed for direct comparisons and data pooling.

Objectives

To reach consensus on how and when to measure the previously defined domain items of the TREatment of Atopic eczema (TREAT) Registry Taskforce core dataset for research registries for paediatric and adult AE patients.

Methods

Proposals for the measurement instruments were based on the recommendations of the Harmonising Outcome Measures for Eczema (HOME) initiative, the existing AE database of TREATgermany, expert opinions and systematic reviews of the literature. The proposals were discussed at multiple face‐to‐face consensus meetings, one teleconference and via email. The frequency of follow‐up visits was determined by an expert survey.

Results

A total of 16 experts from 7 countries participated in the 'how to measure' consensus process and 12 external experts were consulted. Consensus was reached for all domain items on how they should be measured by assigning measurement instruments. A minimum follow‐up frequency of initially 4 weeks after commencing treatment, then every 3 months while on treatment and every 6 months while off treatment was defined.

Conclusions

This core dataset for national AE research registries will aid the comparability and pooling of data across centres and country borders and enable international collaboration to assess the long‐term effectiveness and safety of photo‐ and systemic therapy used in patients with AE.

This article is protected by copyright. All rights reserved.

http://bit.ly/2HTws6u

Late ulceration of residual abortive infantile hemangioma: a rare complication

Abstract

Abortive and minimal growth infantile hemangiomas (IH) are present at birth and have a proliferative component of less than 25% of their total surface. Clinically, they appear most frequently as a telangiectatic patch with venules, surrounded by a halo of vasoconstriction. They may be large or small, segmental or focal. On immunohistochemistry, these lesions are Glut‐1 positive.² Ulcerations are the most frequent complication and occur mostly during the proliferative phase.^3‐5 To our knowledge, ulcerations on IH sequelae are not reported.

This article is protected by copyright. All rights reserved.

http://bit.ly/2t4VnJR

Nine percent of biopsy proven lentigo maligna are reclassified as lentigo maligna melanoma after surgery

Abstract

Lentigo maligna (LM) is a melanoma in situ and the incidence is still rising in The Netherlands. LM is mostly located in the face, therefore radical surgical removal, which is the first choice of treatment, can be challenging in this delicate anatomical region. Staged excision is considered a useful alternative. The initial diagnosis of clinically suspicious LM is usually based on just one or a few biopsies, which may lead to reclassification into lentigo maligna melanoma (LMM) based on histological evaluation of the excision specimen.

This article is protected by copyright. All rights reserved.

http://bit.ly/2HRDEzP

化脓性汗腺炎患者的疾病感受和健康结局

Summary

化脓性汗腺炎 (HS) 是一种慢性皮肤病,1% 到 2% 的欧洲人口受到累及。该病由毛囊和汗腺发炎所引起,可导致腋窝内、腹股沟、生殖器和乳房下方的皮肤下面发生有疼痛感并散发难闻气味的肿胀。HS 与抑郁、焦虑和生活质量 (QoL) 下降有关。此前几项研究已经将这些影响与经临床医生评估确定的疾病严重程度建立关联,但目前尚未研究过健康结局(抑郁、焦虑和 QoL)是否与患者对其病症的看法(疾病感受)相关。在由英国一家大型医院的 HS 专科进行的这项研究中,皮肤科医生与心理医生合作,首次确定了疾病感受与健康结局之间的关系。他们尤其想要研究健康结局是否与 HS 的严重程度或患者的疾病感受高度相关。他们使用的数据通过患者自我报告的旨在评估疾病感受 (BIPQ)、抑郁 (PHQ‐2)、焦虑 (GAD‐2) 和生活质量下降 (DLQI) 情况的问卷定期收集,这些问卷由一项名为 IMPARTS(整合身心保健:研究训练与服务)的倡议提出。IMPARTS 现已在一些伦敦医院的几个专科中引入常规临床实践,所收集的数据在获得适当批准和同意后可用于研究目的。本研究包括 211 名年龄 17 至 71 岁的轻度、中度和重度 HS 患者。自我报告显示,抑郁、焦虑和 QoL 下降的水平显著,与疾病严重程度相比,这与疾病感受的相关度更高。作者得出的结论是:常规评估患者对其疾病的感受并采取干预措施以消除负面和无助的看法及情感,可以改善 HS 患者的健康结局。

http://bit.ly/2t9XWu9

利用自噬作用消除转移性黑色素瘤中的丝裂原活化蛋白激酶抑制剂诱导的耐药性

Summary

恶性黑色素瘤细胞通常携带 BRAF 蛋白内发生的突变,这可激活另一种名为 MEK 的蛋白为肿瘤生长提供"燃料"。通过使用可阻断 BRAF 和 MEK 突变型的药物,我们能够特异性靶向并杀灭大多数这类肿瘤细胞,但通常会有一部分肿瘤细胞对 BRAF 和 MEK 抑制药物产生耐药性,并导致肿瘤重新生长。本研究旨在确定 CD271 蛋白如何发生改变,此前的研究表明,该蛋白质可提高肿瘤生长速度和侵袭性,促使 BRAF 变异的黑色素瘤细胞对 MEK 抑制药物"曲美替尼"产生耐药性。此外,我们之前的研究表明,在 BRAF 突变的黑色素瘤细胞中,肿瘤细胞内一种叫做自噬作用的细胞程序性死亡的发生率增加,所以我们也想确定自噬作用在导致 BRAF 突变的黑色素瘤细胞对曲美替尼产生耐药性方面有何作用。我们的研究表明,CD271 和自噬作用在晚期恶性黑色素瘤中的发生率高于正常痣,在实验室使用曲美替尼治疗黑色素瘤细胞时,可导致一部分黑色素瘤细胞表现出 CD271 和自噬现象增多。然而,特异性抑制 CD271 可减少曲美替尼治疗后形成耐药性黑色素瘤细胞的数量,而阻断或激活自噬作用可导致曲美替尼耐药性黑色素瘤细胞死亡。我们的研究也表明,在不超过 5 天龄的斑马鱼胚胎中,使用特异性阻断 MEK 和自噬作用的药物联合治疗可降低曲美替尼耐药性黑色素瘤细胞的侵袭程度。我们的研究结果显示,处在发育早期的斑马鱼胚胎可以替代小鼠作为伦理要求更高试验的备选动物模型,用来研究癌症转移(扩散)和药物应答,我们也着重介绍了一种通过阻断自噬作用而在黑色素瘤细胞携带 BRAF 变异的患者中预防耐药性形成的重要新方法。

http://bit.ly/2HNwJrs

Can clinical decision making be enhanced by artificial intelligence?

http://bit.ly/2t5vfyH

Assessment of topical bakuchiol and retinol for facial photoageing

Summary

Bakuchiol is found mainly in the seeds of the Indian plant Psoralea corylifolia (babchi) and has recently been shown to have a number of antioxidant and anti‐inflammatory properties. The goal of this study, by researchers from universities in California, Michigan, Florida and Pennsylvania in the US, was to compare the efficacy and side effects of bakuchiol with the commonly‐used anti‐ageing ingredient retinol. 44 volunteers were asked to apply either bakuchiol 0.5% cream twice daily, or retinol 0.5% cream daily, to facial skin for 12 weeks. Retinol 0.5% has previously been shown to be effective at preventing and addressing signs of skin ageing but can have side effects including stinging, scaling and redness. A facial photograph and analytical system was used to take and analyse high‐resolution photographs of patients at 0, 4, 8 and 12 weeks of the study. Patients also answered questions about side‐effects. During study visits, a dermatologist graded pigmentation (skin colouring) and redness. To avoid bias, this dermatologist was not made aware of which treatment each participant was using. The study found that bakuchiol and retinol both significantly decreased wrinkle surface area and hyperpigmentation, with no statistical difference between the two compounds. However, the retinol users reported more skin scaling and stinging. The results were most marked after the full 12 weeks, with a 20 percent reduction in wrinkle severity. 59 percent of the participants in the bakuchiol group showed improvement in their hyperpigmentation at week 12, compared to 44 percent of those in the retinol group. The improvements related both to the intensity of the colour and to the size of the area affected. The findings of this study are promising for bakuchiol as an effective anti‐ageing treatment with minimal side effects, however this would need to be confirmed in larger studies.

http://bit.ly/2HU3Aea

Glucose metabolism in patients with psoriasis

Summary

Large epidemiological (population‐based) studies conclude that psoriasis increases the risk of type 2 diabetes (T2D). Our primary objective was to find out whether data from clinical studies support the notion of shared disease mechanisms in psoriasis and T2D. For this purpose, we reviewed clinical studies investigating glucose metabolism in patients with psoriasis. We also present existing theories of how psoriasis might lead to type 2 diabetes. Twenty‐six clinical studies reporting on insulin resistance, glucose tolerance or insulin secretion were eligible for review. Less than half of the studies showed results that suggest a defective glucose metabolism in patients with psoriasis. Overall, the studies lacked information on how known risk‐factors for type 2 diabetes had been taken into account in the study. Furthermore, research methods varied and in all but one study, they might not have been appropriate to detect early and subtle defects in glucose metabolism. The results of clinical studies investigating glucose metabolism in patients with psoriasis are conflicting and presently it seems presumptuous to firmly conclude that patients with psoriasis share disease mechanisms with people with type 2 diabetes. However, seen in conjunction with the epidemiological literature and the proposed theories of shared disease mechanisms, there is ample basis for further research in this area. New studies using sound methods and elaborate research techniques are needed to learn more about glucose metabolism in patients with psoriasis.

http://bit.ly/2t5vdqz

英夫利昔单抗用于银屑病患者及其引起严重感染的 风险

Summary

这项英国研究使用的信息来自一个名为"英国皮肤科医师协会生物干预注册数据库"(British Association of Dermatologists Biologic Interventions Register,或称 BADBIR)的数据来源,建立该数据库是为了收集有关对比新型生物疗法与全身性非生物疗法用于皮肤病的效果和转归的信息。在本研究中,生物疗法"英夫利昔单抗"用于包括银屑病在内的多种皮肤病的情况与其他全身性疗法("全身性"是指作用于整个身体,与此相对的是有些药物仅涂抹在皮肤上)进行了比较。本项研究工作聚焦于患者在接受不同治疗时的严重感染发生率。这类严重感染是指导致患者长时间住院、接受抗生素静注治疗或者死亡的感染。调查感染原因时也考虑到其他病症可能带来的影响,两组也均有可能存在因为其他病症出现的严重感染。本研究得出的主要结论是,接受英夫利昔单抗的患者发生严重感染的可能性(风险)是接受其他全身性治疗患者的两倍。主要感染是肺部感染或者皮肤和软组织感染。这些感染多发生于患者开始使用英夫利昔单抗后的最初六个月。这是一项重要发现,因为向患者告知此类风险将成为该药物用药前所进行初步评估的一个关键组成部分。作者指出,尚未在其他用于皮肤病治疗的生物制剂中得出类似信息,那些药物也可能与感染风险增加有关,但对结核病等既存慢性感染进行筛查已成为使用生物制剂治疗候选患者前进行调查评估的一个重要组成部分。

http://bit.ly/2HRDDvL

母亲的社会经济地位与银屑病

Summary

银屑病是一种常见的皮肤病,其典型特征是皮肤上有界限清晰的红色或鳞状斑点。丹麦有大约 0.4% 的儿童患有此病,其他西方国家的发病率相近。发生于幼年期的银屑病可被称为儿童银屑病。在丹麦进行的这项研究中,作者旨在确定社会经济地位低的儿童(来自受教育程度低、收入少和就业差的家庭)与社会经济地位高的儿童相,比,是否更有可能患上儿童银屑病。在一项研究中,母亲从怀孕起、其子女从出生起开始参加研究,一直持续到子女年满 11 岁,本文作者采用了这项研究的数据。在对儿童进行的 11 年随访中,母亲被问及其子女是否患上银屑病。有关社会经济地位的信息使用包含母亲收入水平、受教育程度和工作状况的官方数据库中的数据进行了收集。作者调查研究了这些因素是否会影响其子女发生儿童银屑病,结果表明两者高度相关。受教育程度或收入水平低的母亲所生的孩子与受教育程度或收入水平高的母亲所生的孩子相比,前者更有可能患上儿童银屑病。出生时和童年期的社会经济状况似乎在儿童银屑病发病风险方面扮演某种角色。

http://bit.ly/2t3GJTg

News and Notices

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Image Gallery: Spoon‐shaped nails in an 11‐year‐old boy

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Deep learning surpasses dermatologists

Summary

Skin cancer is increasing worldwide. However, it is not always practical to send all patients with skin symptoms to dermatology clinics. Artificial intelligence holds great promise in helping the screening for and diagnosis of skin cancer. Although several computer‐aided classification systems have been introduced that achieve high sensitivity of melanoma detection, low specificity was a trade‐off for high sensitivity. Sensitivity measures the proportion of 'actual positives' that are correctly identified (e.g. the percentage of sick people who are correctly identified as having the condition). Specificity measures the proportion of 'actual negatives' that are correctly identified as such (e.g. the percentage of healthy people who are correctly identified as not having the condition). The application of a new machine learning method, called deep convolutional neural network (DCNN), to a skin cancer classifier can potentially improve skin cancer screening sensitivity and specificity. However, the number of training images required for such a system is thought to be extremely large and compiling a large data set for rare skin conditions is difficult. In this study, we trained DCNN using fewer than 5000 images, and developed a DCNN classifier that can classify 14 different skin tumors and related conditions. Its performance was tested against 13 board‐certified dermatologists. As a result, our system requires only a single image and comes with 96.3% sensitivity and 89.5% specificity in the detection of skin cancer. The accuracy of malignant or benign classification by the DCNN achieved statistically greater accuracy compared with board‐certified dermatologists, 85.3% and 92.4%, respectively. In conclusion, we used DCNN trained with a relatively small number of images to develop an efficient skin tumor classifier. The current system could be used in screening purposes in general medical practice but it needs to be thoroughly tested in clinical trials first.

http://bit.ly/2HUOQfb

Homocysteine, folate and vitamin B12 in psoriasis

Summary

Patients with psoriasis have an increased risk of coronary heart disease and stroke. It has been suggested that psoriasis causes raised blood levels of homocysteine. High levels of homocysteine are linked to atherosclerosis ("furring up" of the arteries). The breakdown of homocysteine is dependent on folic acid and vitamin B12. Low blood levels of folic acid have been reported in psoriasis, partly due to its consumption by increased cell turnover in the skin and partly due to reduced absorption in the gut. The authors, based in Taiwan, reviewed the published studies and confirmed that patients with psoriasis indeed had high levels of homocysteine and low levels of folic acid in their blood compared with controls (people without psoriasis). There was no difference in the blood levels of vitamin B12 between psoriasis patients and controls. The authors express a note of caution, since many other confounding factors may affect the results. However, they recommend testing homocysteine blood levels in psoriatic patients to identify those at risk of cardiovascular disease. Further studies are recommended, particularly to investigate whether giving folic acid or vitamin B12 reduces the risk of these complications.

http://bit.ly/2t3GIia

Allergic contact dermatitis in psoriasis

Summary

Recent research suggests that people with the skin disease psoriasis may be at less risk of developing contact dermatitis, which is an eczema‐like reaction in response to the skin coming into contact with an irritant (irritant contact dermatitis) or allergen (allergic contact dermatitis, or ACD). This study looked at the prevalence of ACD specifically, in 2387 people with psoriasis who had been patch tested, compared to 161 981 patch tested people without psoriasis. Patch testing is used to find out which potential allergens cause a skin reaction in a person. Overall, 25.2% of the people with psoriasis and 38.9% of people without psoriasis showed at least one reaction to the allergens used in patch testing. These findings revealed a significantly lower overall risk for ACD in individuals with psoriasis. Taken together, psoriasis and contact dermatitis both involve complex processes of the body's immune system that make it difficult to understand what happens when both occur together. This research helps further our understanding on the topic.

http://bit.ly/2HQJ1j2

银屑病患者的述情障碍逆转

Summary

述情障碍是指不能识别和表达情感。这种疾病在患有关节炎、炎症性肠病等慢性炎症性疾病的患者中更为常见。该国际工作组此前在"对近期确诊的银屑病患者进行的流行病学研究" (Epidemiological Study In Patients With Recently DiagnosEd PSOriasis, EPIDEPSO) 中得出的结果表明,述情障碍也会影响成年重度银屑病患者;受影响者更有可能出现焦虑和抑郁,酗酒和失业的风险也较高。一个重要的问题是,述情障碍是固定不变的人格特质,还是随着银屑病好转能够得到改善的疾病状态:也许有些银屑病患者会封闭对情感的识别,就像感觉受到污蔑时启动的防御机制。为了回答这个问题,本文作者对最初参加 EPIDEPSO 研究的患者中的 467 名患者进行了一年随访,随访始于这些患者开始接受全身性药物治疗(即药物作用于全身,而不是仅涂抹于皮肤)或紫外线治疗之时。述情障碍的发病率从 26.7% 显著降低至 18.8%,这种改善在年龄小于 40 岁、曾出现过焦虑和抑郁、近期在显眼部位发生过银屑病或者对治疗反应良好的患者中最为明显。随访期间银屑病完全或几乎完全消除的患者获得了最大程度的述情障碍改善。一年后,酗酒发生率几乎降至 1/3。虽然述情障碍的改善与银屑病的缓解相关,但作者承认,他们使用的评估工具不够完美,无法对此建立因果关系。尽管如此,作者仍得出以下结论:存在述情障碍和重度银屑病的患者需要接受心理辅导和积极的银屑病治疗。

http://bit.ly/2t4Vmph

Spitzoid melanoma with ALK copy number gain

Summary

Spitzoid melanoma is an uncommon melanoma (type of skin cancer) that can occur at any age, and can resemble a harmless mole called a 'Spitz nevus'. This similarity can make it difficult to diagnose. Spitzoid tumours (Spitz nevi) have recently begun to be categorized according to their genetic profile, meaning the genes found in them, and certain molecular alterations were found to link to changes to the structure of the nevus as could be seen when examined under a microscope. For example, Spitz tumours can have what is called an anaplastic lymphoma kinase (ALK) gene rearrangement. ALK is a gene that tells your body how to make proteins that help cells talk to each other. ALK rearrangement means that part of this gene is broken and attached to another gene. Spitz tumours with ALK rearrangement have been shown to have a distinctive "plexiform pattern". Humans have two copies of most genes, but occasionally alterations can lead to the gain or a loss of one copy. When it is a gain of one copy this is called copy gain. In this report, authors from the US discuss a case of an 87‐year‐old man with a 3cm tumour on his back, and conclude that ALK copy gain represents an additional mechanism of ALK activation among Spitzoid tumours and shows the same plexiform pattern seen among ALK‐rearranged Spitz tumours.

http://bit.ly/2HPyq7F

Brodalumab 用于对乌司奴单抗应答不足的患者

Summary

银屑病是一种慢性病,可导致皮肤表面出现红色、鳞状斑点。治疗方法包括局部用(涂抹于皮肤上)乳膏、口服药物和注射用药物。银屑病由一种自身免疫反应所引起,自身免疫反应是指身体自己的免疫系统攻击健康的细胞和组织。为了治疗中度至重度银屑病,医生有时会使用名为抗体的特异性药物,抗体药物可阻断导致银屑病的自身免疫反应作用于身体不同部位。虽然这类抗体治疗有可能非常有效,但并不能对所有患者都有作用。本研究回顾了两项针对中度至重度银屑病患者的临床研究得出的数据。在每项研究中,患者最初接受以下两种抗体治疗之一:乌司奴单抗或 Brodalumab。有些最初接受乌司奴单抗或 Brodalumab 治疗的患者在第 16 周时的皮肤病变清除率不达标;这些患者或者开始使用 Brodalumab(如果他们最初接受乌司奴单抗治疗),或者继续使用 Brodalumab(如果他们最初接受 Brodalumab 治疗),直至第 52 周。第 16 周后对初始治疗应答不足的患者继续接受初始治疗,直至第 52 周。第 52 周时,因对乌司奴单抗应答不足而改用 Brodalumab 的患者表现出皮肤病变清除率提高。对于第 16 周后出现应答不足并继续使用乌司奴单抗的患者,其皮肤病变清除的彻底性不如第 16 周时因应答不足而改用 Brodalumab 的患者。此外,改用 Brodalumab 的患者和继续使用乌司奴单抗的患者出现的副作用相似。本研究的结果表明,对于使用其他银屑病疗法达不到足够皮肤病变清除率的中度至重度银屑病患者,Brodalumab 可能会表现出良好的疗效。

http://bit.ly/2t4C978