Common Skin Condition Research Articles

Project ECHO® dermatology in the deep south: a comprehensive SWOT assessment.

There are nearly 45,000 patients for each dermatologist in the rural State of Mississippi, causing many patients to wait months for an appointment in a city that may be hours away [1]. To address this critical gap, Project ECHO® (Extension for Community Healthcare Outcomes) was launched at the University of Mississippi Medical Center (UMMC) in 2020 to teach rural primary care providers (PCPs) to care for common skin conditions. PCPs present images of their patients in a once monthly video teleconference that provides immediate feedback. A SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) of the UMMC dermatology Project ECHO® was conducted to assess the efficacy of this approach. The greatest strength is the perception of value by attendees which is reflected by growing numbers of primary care physician participants. This engagement is tracked by the number of people who join the teleconference virtually. The greatest threat is the inability to motivate participants to complete post-teleconference surveys for program feedback. This limits the ability of the program to fully assess its efficacy and identify opportunities for improvement. Looking forward, UMMC plans to offer incentives for survey completion and expand Project ECHO's reach by collaborating with other institutions to permit harmonization of metrics and facilitate data analysis for publications and grant applications.

SEBORRHEIC DERMATITIS, SCOPING REVIEW

Introduction: Seborrheic dermatitis (SD) is a common skin disease, where its signs and symptoms may differ according to skin color, associated medical conditions, environmental factors, and vehicle preference. Seborrheic dermatitis is a common skin condition in infants, adolescents and adults, characterized by scaling, erythema and itching, especially on the scalp, face, chest, back, armpits and groin. Objective: to detail the current information related to seborrheic dermatitis, etiology, epidemiology, pathophysiology, histopathology, clinical presentation, evaluation, differential diagnosis, treatment and prognosis. Methodology: a total of 29 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 23 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: sebopsoriasis, seborrheic dermatitis, seborrheic eczema, dandruff and pityriasis capitis. Results: The most relevant results indicate that seborrheic dermatitis has a significant global prevalence, affecting up to 5% of the population, with a higher incidence in individuals with HIV-AIDS. Its pathogenesis has been identified as involving a combination of factors, including Malassezia spp. colonization of the skin, alteration of the cutaneous microbiota and a deregulated immune response. The most effective treatments are topical, particularly antifungal agents such as ketoconazole and low potency corticosteroids, although treatment should be tailored to the individual characteristics of each patient. Despite being a chronic disease in many cases, early diagnosis and proper management allow control of symptoms and improve the quality of life of patients. Conclusions: Seborrheic dermatitis is a common skin disease, with significant prevalence in various ages and groups, especially in people with HIV-AIDS. Its pathogenesis involves factors such as colonization by Malassezia spp, alterations in the cutaneous microbiota and immune dysregulation. Although it may be self-limiting in some cases, in others it presents a chronic course with relapses. The most effective treatment includes topical antifungal and anti-inflammatory agents, adapted to the severity and location of the lesions. Early diagnosis and appropriate treatment are key to control symptoms and improve the quality of life of patients. KEY WORDS: dermatitis, seborrheic, eczema, skin.

Ceramides and Skin Health: New Insights.

Ceramide has transitioned from an incidental discovery to a vital element in skincare, becoming a thoroughly studied compound in the quest to treat skin conditions. Creating a moisture barrier, preserving hydration, regulating pH, controlling inflammation, and enhancing skin functions and appearance are among its established benefits. It is often used medically to repair skin barrier defects, as observed in inflammatory skin conditions like atopic dermatitis (AD) and dry skin types. Furthermore, ceramide and its metabolites are commonly used as predictors before disease manifestation and for prognostication processes, thus can be used as biomarker for clinical diagnosis as well. In the last couple of decades, momentum was also seen in the pre-clinical studies involving anti-cancer and nanotechnology field, whereby ceramide was also used as a drug, a carrier, or even adjunct formulation to increase efficacy of treatment such as chemotherapy. Approaches to increase ceramide levels include directly replenishing lost ceramides with natural extracts, synthetic pseudo-ceramides, or ceramide-like analogues, as well as using supplements that stimulate the body's natural ceramide production. Although ceramide is a well-known treatment in skincare and for common skin conditions like AD and psoriasis, its development and related pharmacology for severe skin conditions, such as skin cancer, remain in pre-clinical stages. Hence, the purpose of this research is to explore the role of ceramide in skin health and its application in common skin diseases.

Emulgel Containing Metronidazole and Clindamycin for the Treatment of Rosacea

Rosacea is a common skin condition with quite a relevance. It currently affects at least 10% of the European population at some point after the age of 30. It is a chronic disorder that mainly affects the skin on the face and is characterized by outbreaks and remissions. Under normal circumstances, the skin face presents a wide range of commensal organisms, such as Staphylococcus epidermidis or Demodex folliculorum, but dysbiosis of the skin flora plays a relevant role in inflammatory processes and the development of the disease. Metronidazole (MD) is one of the main treatments indicated to reduce redness on the cheeks, nose, chin, or forehead and also to treat flushing, erythema, pimples, and other symptoms due in part to its anti-inflammatory action. On the other hand, clindamycin (CM) is another antibiotic used for rosacea, especially for its action against anaerobic and Gram-positive bacteria. Background/Objectives: This study aimed to develop an emulgel formulation that includes MD and CM, using excipients with non-comedogenic and non-irritating properties. Methods: The formulation was characterised physiochemically, rheological measurements were made, and short-term stability studies were carried out. In vitro release, permeation studies, toxicity an in vitro inflammation model were evaluated in a HaCaT cell model. To determine the interaction between the antibiotics, the minimum inhibitory concentration was determined separately and together using the broth microdilution method. To determine the formulation’s antimicrobial activity, an agar diffusion method was used. Results: The MD-CM-gel droplet size was measured by laser diffraction and the diameter obtained was less than 2.68 ± 0.18 µm in 50% of the particles. Suitable results was observed for the short-term stability. Release and permeation data revealed sustained drug release and adequate permeation through human skin. Non-toxicity was detected and the MD showed an anti-inflammatory effect with non-interference of CM. Also, there is no antagonism between the two antibiotics and the MD-CM-gel shows better results when compared to the formulations with the antibiotics separately and to commercial formulations. Conclusions: It is suggested that, following detailed preclinical and clinical studies, MD-CM-gel could be considered as an alternative for treating rosacea.

Update on Atopic Dermatitis.

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition. This review highlights most recent advances in understanding and treating this debilitating disease. We are summarizing new insights regarding molecular endotypes and clinical phenotypes that characterize AD, the role of the skin microbiome, and improvements in diagnostic tools. We also emphasize recent scientific advancements in understanding the mechanisms driving AD pathogenesis and discuss the identification and implementation of new targeted treatment approaches that have revolutionized therapeutic options for affected patients.

A Multicentre Evaluation of a Ceramide-Containing Hydrating Cream-to-Foam Cleanser and Facial Moisturizing Lotion for Improving Topical Treatment Tolerability in Facial Acne.

Acne vulgaris (AV) is a common skin condition that can cause substantial psychosocial impact. Treatments of AV target clearing and prevention of lesions and reducing scarring and dyspigmentation. Numerous medications are used to target one or more of the pathogenetic factors contributing to AV. The irritative potential of acne products and their tolerability are important aspects that may affect patient adherence to therapies. Adjunctive skincare products offer several benefits to acne-prone skin, by reducing redness, inflammation, and discomfort and improving skin texture. In addition, complementing AV prescription interventions reduces the time to healing of lesions, the extent of scarring, and the number and severity of breakouts. This multicentre, open-label, single-cohort study evaluated the use of ceramide-containing hydrating cream-to-foam cleanser and facial moisturizing lotion for improving topical treatment tolerability and adherence in facial acne. Combining a proper skincare regimen with acne treatments may help decrease their irritating potential and support the skin barrier, which can improve treatment adherence and ultimately, treatment outcomes.

Identification of Drug-Targetable Genes for Eczema and Dermatitis Using Integrated Genomic and Proteomic Approaches.

Background: Eczema and dermatitis are common inflammatory skin conditions with significant morbidity. Identifying drug-targetable genes can facilitate the development of effective treatments. Methods: This study analyzed data obtained by meta-analysis of 2 genome-wide association studies on eczema/dermatitis (57,311 cases and 896,779 controls, European ancestry). We identified drug-targetable genes from the Drug-Gene Interaction Database and Finan et al's findings. Cis-expression quantitative trait loci (eQTL) data from human blood and skin tissues were used for Mendelian randomization (MR) analysis. Bayesian colocalization, proteomic MR, and meta-analysis validated the causal relationships. Finally, protein-protein interactions (PPIs) and correlation analysis of potential drug targets and cytokines were performed. Results: We identified 2532 drug-targetable genes; 3378 Single Nucleotide Polymorphism (SNPs) were associated with 1531 genes in blood cis-eQTLs, 664 SNPs with 667 genes in sun-exposed skin eQTLs, and 572 SNPs with 574 genes in nonsun-exposed skin eQTLs. Five genes (SLC22A5, NOTCH4, AGER, HLA-DRB5, and EHMT2) showed causal relationships with eczema/dermatitis across multiple datasets. Single-variable and multi-variable Mendelian randomization (SMR) and multi-SNP SMR analysis identified 8 genes (PIK3R4, DHODH, CXCR2, Interleukin (IL)18, LGALS9, RPS6KB2, SLC22A5, and AGER) across all tissues. Functional Summary Information for Variants in the Online Network (FUSION) analysis confirmed associations for SLC22A5 and AGER. Bayesian colocalization indicated AGER (PPH4: 0.95) as a shared causal variant. Proteomic MR and meta-analysis showed that increased AGER protein levels were associated with a lower risk of eczema or dermatitis (odds ratio: 0.995, 95% confidence interval: 0.997-0.993, P = 0.0002). A PPI network revealed interactions of AGER with NOTCH4 and multiple cytokines, whereas SLC22A5 showed no cytokine interactions. Conclusions: This study identified potential drug-targetable genes, with AGER showing strong potential as a target for reducing eczema/dermatitis risk. These findings provide a basis for developing targeted therapies.

Utilization and prescription patterns of topical steroids: a study at dessie comprehensive specialized hospital, Ethiopia

BackgroundTopical steroids are widely used in dermatology for their anti-inflammatory and immunosuppressive effects, but misuse can cause skin thinning and systemic issues. In Ethiopia, where skin conditions are common, understanding how topical steroids are prescribed and used is essential for ensuring their safe and effective use.ObjectiveThe study aimed to assess topical steroids’ prescription and utilization pattern in Dessie Comprehensive Specialized Hospital (DCSH) from February 1 to May 30, 2024.MethodologyThe study used a descriptive, cross-sectional design with a quantitative approach, analyzing data from 175 patient records on prescription and utilization patterns of topical steroids at DCSH. Participants were selected using a random sampling technique. Data were categorized and analyzed using Microsoft Excel 2010, with findings presented through descriptive statistics, including tables and figures.ResultEczematous dermatitis (31.49%) was the most common skin disease observed, followed by dermatophytosis (12.15%). Out of 304 drugs prescribed, averaging 1.73 per prescription, clobetasol (44.4%) and betamethasone (25.0%) were the most common topical corticosteroids. These steroids were primarily prescribed for eczema, dermatitis, pigmentary disorders, psoriasis, urticaria, and lichen planus. The commonly prescribed drugs were topical steroids 108[35.53%]. Generic names were used for 54.63% of the 108 topical steroids prescribed.ConclusionThe study found that dermatitis and eczema are the most common skin conditions treated in dermatology clinics, with topical steroids being the main treatment. However, many prescriptions lacked details on the application site, treatment duration, and quantity. To improve safety and effectiveness, the study recommends community education, better dermatological services, and increased oversight in professional training.

Udder cleft dermatitis: a review

Udder cleft dermatitis (UCD) is a common skin condition of dairy cows characterised by ulceration, tissue necrosis and a purulent, foul-smelling discharge. The lesions can be severe, and the herd prevalence is usually underestimated by farmers as milder lesions are often not detected. The condition is thought to occur as a result of opportunistic bacterial infection following physical abrasion in an anaerobic environment. A weak fore udder attachment and deep udder are associated with an increased risk of UCD. Culling and selective breeding to improve udder conformation within the herd are important for prevention of the condition. Treatment of severe lesions is challenging and as such early identification is critical along with repeated treatment applications.

Correlation between dietary calcium intake and eczema in American adult population

Eczema is a common chronic skin condition. Previous studies indicated the dietary factors, such as calcium intake, might influence the onset and progression of eczema in the population of gravidas and infants. However, there was no studies on the correlation between dietary calcium and the adult population. In this study, we aim to investigate the correlation between dietary calcium intake and the prevalence of eczema in adults. The characteristics of adults (≥ 18 years) were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 database. Dietary calcium intake was assessed using the 24-hour dietary recall method. The prevalence of eczema was determined through an allergy questionnaire. Logistic regression modeling was applied to analyze the correlation between dietary calcium intake and eczema prevalence. Restricted cubic spline (RCS) was used to investigate the nonlinear relationship between calcium intake and eczema. A two-stage linear regression model was used to calculate the critical effect of calcium intake on the prevalence of eczema by smoothed curve fitting. Subgroup analyses were performed to explore the effect of different demographic characteristics on the relationship between dietary calcium intake and eczema. Results In this cross-sectional study, we collected 4086 adult samples. There were 1930 males (46.9%) and 2156 females (53.1%), at the average age of 46.7 years, and 266 participants (7.6%) were diagnosed with eczema. Logistic regression results showed there was a significant difference between the third quartile group and eczema compared to the 1st quartile group of dietary calcium (OR: 1.913, 95% CI: 1.024–3.576, P = 0.043). The RCS showed an inverted U-shaped correlation between dietary calcium intake and eczema prevalence (non-linear P-value < 0.05). An increase in calcium intake was associated with an increase in eczema prevalence when the logarithmic value of dietary calcium intake was below 7.089 (OR: 1.790, 95% CI: 1.006–3.183, P = 0.048). These data indicated there was an inverted U-shaped correlation between dietary calcium intake and the prevalence of eczema, which suggested moderate reduction of calcium intake might be beneficial in the incidence of eczema. Further prospective studies are needed to explore causal relationships and optimal calcium intake levels to prevent eczema.

Contact dermatitis in children

Contact dermatitis is a common skin condition in children caused by environmental exposure to irritants or allergens. Manifestation of common endogenous eczemas, e.g. atopic dermatitis, causes differential diagnostic challenges. The diagnostic workup includes symptoms, dermatitis patterns, and exposure history. Patch testing is the gold standard for diagnosing allergic contact dermatitis and distinguishing allergic from irritant contact dermatitis. This review aims to describe contact dermatitis in children, including diagnostic procedures, differential diagnoses, and management strategies.

Anti-acne preparations containing tetracycline, azelaic acid and azeloglycine: Optimization of stability and physicochemical properties.

Acne vulgaris is a common inflammatory skin condition affecting almost 85% of the adolescent and young adult population. The etiopathogenesis of this dermatosis involves an imbalance in the skin microbiome, leading to inflammation of both the skin and hair follicles. The aim of this study was to develop topical anti-acne formulations with increased therapeutic efficacy and reduced risk of developing antibiotic resistance. Six hydrogel formulations containing azelaic acid or its derivative, azeloglycine, in combination with tetracycline hydrochloride were prepared as part of the study. The investigated formulations were prepared using an Eprus U500 pharmaceutical mixer and the pH was determined using an ERH-11S electrode designed for dense substances and a CPC-505 Elmetron pH-meter. The formulations were analyzed for tetracycline stability in the presence of additional active ingredients and varying pH over a period of 35 days using high-performance liquid chromatography (HPLC). In addition, the effects of azeloglycine and azelaic acid on the viscosity of the prepared formulations were evaluated using a Brookfield DV2T rotational viscometer. Chromatographic analysis showed significant stability of tetracycline in most formulations, with azeloglycine-containing formulations showing less degradation of the antibiotic than azelaic acid-containing preparations. In addition, azeloglycine-containing gels exhibited more favorable rheological properties, which may facilitate better application and be more beneficial to patients. The results suggest that formulations containing azeloglycine and tetracycline may be a promising strategy for acne therapy, offering increased tetracycline stability and an optimal rheological profile, which may result in prolonged therapeutic effect and more effective drug delivery to the skin.

Speciation of Malassezia and determination of sebum and hydration levels in secondary school students in Nigeria.

Pityriasis versicolor (PV) is a common skin condition associated with Malassezia species. Factors influencing PV development, such as sebum and skin hydration levels, are not fully understood, especially among adolescents. This study aimed to determine Malassezia speciation and assess sebum and hydration levels in secondary school students with PV in Ibadan, Nigeria. A cross-sectional study was conducted among secondary school students with PV and a control group. Sebum and hydration levels were measured using a sebumeter and corneometer, respectively. Malassezia speciation was determined through KOH microscopy and PCR-RFLP. Sebum levels were significantly higher in PV patients compared to controls. Skin hydration was lower in PV patients. Malassezia globosa was the predominant species, followed by Malassezia restricta and Malassezia sympodialis. No significant correlations were found between Malassezia species and clinical features. Increased sebum levels and decreased skin hydration are associated with PV in adolescents. Malassezia globosa is the primary species involved. Further research is needed to elucidate the complex relationship between these factors and PV pathogenesis. Clinical trial number Not applicable.

Ayurvedic Management of Mukhadushika (Acne Vulgaris): A Case Report

Acne vulgaris, also known as Mukhadushika; described under Kshudraroga (minor diseases) in Ayurveda is a common skin condition that can have serious psychological and physical effects, especially among adolescents. The present study set out to evaluate the efficacy of Ayurvedic medicines for treating Mukhadushika (Acne vulgaris). A 24-year-old female patient presented with Acne (facial), papules with burning sensation and pain on both cheeks. Her symptoms significantly improved after receiving medicine for both internal and external application. The treatment approach, including the use of Herbo-mineral drugs like Ras manikya, Gandhaka rasayana, Kamdudha Ras, Khadiraristha and Varnya gana lepa. The papules resolved and the discharge, pain and burning sensation disappeared.

Hubungan Penggunaan Masker Terhadap Tingkat Kejadian Akne Vulgaris Pada Tenaga Kesehatan di RS Royal Prima Medan

Acne vulgaris is a common skin condition with a prevalence of around 85-100%, frequently encountered in Indonesia. Prolonged use of masks can lead to continuous friction on the facial skin, triggering irritation and inflammation. The aim of this study is to examine the relationship between mask usage and the incidence and severity of acne vulgaris among healthcare workers at RS Royal Prima Medan. This research is an analytical observational study employing a quantitative approach with a cross-sectional design. The study was conducted at RS Royal Prima Medan from January 2024 to June 2024. The population of this study consists of healthcare workers at RS Royal Prima Medan, with 69 individuals selected as the sample. The results indicate a relationship between the duration of mask use and the incidence of acne vulgaris; a relationship between the type of mask and the incidence of acne vulgaris; a relationship between daily facial wash use and the incidence of acne vulgaris; a relationship between the frequency of facial cleansing with facial wash and the incidence of acne vulgaris; a relationship between replacing masks and the incidence of acne vulgaris; and a relationship between the occurrence of acne vulgaris and mask use with the incidence of acne vulgaris.

Clinical and Dermoscopic Comparison of the Efficacy and Safety of 5% Fluorouracil Topical Cream and 1% Niacinamide Topical Gel in the Treatment of Actinic Keratosis: A Randomized Controlled Trial.

Actinic keratosis (AK) is a common skin condition treated by dermatologists; however, the effectiveness, superiority, and potential side effects of current treatment protocols are still debated. This study aimed to compare the effectiveness and safety of 5% fluorouracil topical cream and 1% niacinamide topical gel in patients with AK. In a randomized clinical trial, 26 patients with 95 AK lesions were assigned to receive either 5% fluorouracil topical cream twice daily for 4 weeks or 1% niacinamide topical gel twice daily for 3 months. Photography and dermoscopy before and after treatment were used to evaluate the outcomes. The study included 26 patients who underwent randomization and treatment. Analysis of the improvement response after treatment through photography and dermoscopy scores, as well as patients' perspectives, showed that the fluorouracil group had significantly better outcomes than the niacinamide group. However, treatment complications including burning, itching, and erythema were significantly more frequent in the fluorouracil group than in the niacinamide group. Although 5% fluorouracil cream is more effective than 1% niacinamide gel in treating AK lesions, it is also associated with more frequent side effects.

SIMPLE MICRONEEDLING VERSUS MICRONEEDLING WITH TOPICAL INSULIN IN THE TREATMENT OF POST ACNE ATROPHIC SCARS; A SPLIT FACE COMPARATIVE STUDY

Background: Acne vulgaris is a common skin condition, involving upto 90% of the teenage population, being more common in women than in men. Post acne scars are the sequelae, leading to low esteem and self confidence in the affected individuals. Methods: Thirty patients participated in the study. On each patient, over the left side of the face, microneedling was done using topical insulin as a medium, while on the right side of the face, simple microneedling was done. Four such sessions, a month apart, were done in all the patients. They were called for follow up and the response was based on the "Acne scar assessment scale", in which Grade-0 referred to no improvement, Grade-1 referred to an improvement of less than 25%, Grade-2 was an improvement between 25–50%, Grade-3 meant an improvement between 50–75%, and, Grade-4 referred to an improvement of greater than 75%. Results: After completion of the sessions, over the left side of the face, where microneedling was done with insulin 11 (36.7%) patients showed Grade-2 improvement, while 19 (63.3%) patients showed Grade-3 improvement. On the right side of the face where simple microneedling was done, 10 (33.3%) patients showed an improvement of Grade-0, and 20 (66.6%) patients showed an improvement of Grade-1. Conclusion: After this study, we conclude that microneedling combined with topical insulin, shows better results in patients with scarring. It can be a breakthrough in the treatment of post acne scars, due to easier availability and lesser cost of insulin.

Athlete's Foot: A Common Fungal Infection in Athletes and Beyond. The Use of Terbinafine in Treating Tinea Pedis and Onychomycosis

Introduction: Tinea pedis is one of the most common skin conditions that often affects athletes, which is referred to by another name for the condition - Athlete's foot. It is a fungal infection that manifests itself with symptoms such as itching, redness, exfoliating skin and cracking of the epidermis. The foot skin infection can spread to the nails, so in this review we will discuss both conditions. Terbinafine is an allylamine derivative with antifungal activity. It can be applied both superficially and orally. It is used to treat fungal infections, including tinea pedis and onychomycosis. Aim of the study: The aim of this publication is to review the available literature to answer the question of whether terbinafine is an effective treatment for athlete's foot and onychomycosis. Methods: Review of specialised literature in the field of dermatology and PubMed and Google Scholar databases by searching with keywords such as athlete’s foot, tinea pedis, onychomycosis, terbinafine. Conclusion: Tinea pedis and often associated onychomycosis are a medical problem affecting a wide social group. Topical or systemic drugs can be used to treat the aforementioned conditions. Terbinafine, which is a drug belonging to the allylamines, is effective in the treatment of tinea pedis and onychomycosis and has a high safety profile. There are terbinafine products on the market in various forms, e.g. emulsions, creams, film-forming solution, pills, so it is therefore easy to choose a suitable and convenient treatment. The use of lasers such as CO2 fractional laser or Nd:YAG laser seems to be beneficial in the complementary treatment of onychomycosis with terbinafine.

Association of immunoglobulins and complement levels with pemphigus in patients at the Khartoum Dermatology and Venereal Disease Hospital, Sudan

Pemphigus is a group of autoimmune intra-epidermal blistering diseases that affect both the skin and mucous membranes. Characteristic histological features of pemphigus include intra-epidermal blisters and acantholysis, which is the loss of connections between epidermal cells. A cross-sectional hospital-based study was conducted in the period between January 2016 and January 2019. A total of 549 cases were selected; 92 cases were clinically diagnosed as pemphigus, and direct immunofluorescence (DIF) was applied for immunoglobulin (Ig) A, IgG, IgM, and C3 to confirm clinical diagnosis. Bullous pemphigoid (BP) was the most common autoimmune skin condition, comprising 29.3% of cases, predominantly affecting females (19.6%). Pemphigus vulgaris (PV) followed with 32.6% of cases, evenly distributed between males and females. Lichen planus pemphigoid accounted for 17.4%, with a higher prevalence in females (13.0%). Other conditions, such as pemphigus gestationis and bullous lupus erythematosus, were rare, each affecting only one gender. Epidermolysis bullosa acquisita was seen only in males, while linear IgA bullous dermatosis was slightly more common in females. Pemphigus foliaceus (PF) and pemphigus vegetans were infrequent, with the first one more common in males and the second one more common in females. Paraneoplastic pemphigus (PNP) and IgA pemphigus had the lowest incidence, with PNP affecting one male and IgA pemphigus equally distributed between genders. The study found PV (32.6%) to be the most common autoimmune blistering disease, followed by BP (29.3%), with females more frequently affected. DIF was effective in confirming clinical diagnoses across various subtypes.

Antioxidative hydrogel based on hyaluronic acid/polyethylene glycol loaded with shikonin-coated flexible liposome and evaluation of its therapeutic effect on eczema

Eczema, a common skin condition, is gaining attention due to its increasing annual prevalence and severe influence on both bodily and mental health. Existing treatments for this disease often have significant side effects and safety concerns. Comfrey, a traditional Chinese herbal remedy, is commonly used to treat skin conditions. Shikonin, the primary active compound in comfrey, has demonstrated efficacy in treating eczema. Herein, a flexible liposome-containing SHI was dispersed in hydrogels based on hyaluronic acid (HA) and polyethylene glycol(PEG) for the treatment of eczema. The hydrogel performed well in delaying drug release. SHI-F-Gel demonstrated notable antioxidant properties, effectively eliminating over 80 % of free radicals. Compared to the SHI solution, SHI-F-Gel significantly increased drug skin retention by 312.9 %. In animal studies, SHI-F-Gel administration reduced epidermal thickness in the affected area by approximately 36.8 % and increased collagen deposition by 90.23 %. Additionally, SHI-F-Gel inhibited the expression of pro-inflammatory cytokines interleukin-4 (IL-4) and IL-17. This observed reduction in inflammation suggests that the treatment is effective. In conclusion, the flexible SHI-based liposome hydrogel demonstrates excellent adhesion and biocompatibility, making it a promising candidate for enhancing eczema treatment.