Dermatological Disorders Research Articles

Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections.

Hepatitis B virus (HBV) infections affect approximately 296 million people around the world, and the prevalence of any past or present HBV infection during the years 2015-2018 was as high as 4.3%. Acute HBV infection often presents with nonspecific symptoms and is usually self-limited, but 5% of patients can have persistent infections leading to chronic HBV infection and the risk of turning into chronic HBV infection is significantly higher in babies with vertical transmission (95%). Patients with chronic HBV infection are usually asymptomatic, but 15 to 40% of chronic HBV carriers develop cirrhosis and/or hepatocellular carcinoma. In addition to liver-related disorders, HBV is also associated with several extrahepatic complications, including glomerulonephritis, cryoglobulinemia, neurologic disorders, psychological manifestations, polyarthritis, and dermatologic disorders. Making the diagnosis of HBV can be challenging since patients with chronic infections can remain symptom-free for decades before developing cirrhosis or hepatocellular carcinoma, and patients with acute HBV infection may have only mild, nonspecific symptoms. Therefore, understanding how this virus causes extrahepatic complications can help clinicians consider this possibility in patients with diverse symptom presentations. The pathophysiology of these extrahepatic disorders likely involves immune-related tissue injury following immune complex formation and inflammatory cascades. In some cases, direct viral infection of extrahepatic tissue may cause a clinical syndrome. Currently, the American Association for the Study of Liver Diseases recommends treatment of chronic HBV infections with interferon therapy and/or nucleos(t)ide analogs, and this treatment has been reported to improve some extrahepatic disorders in some patients with chronic HBV infection. These extrahepatic complications have a significant role in disease outcomes and increase medical costs, morbidity, and mortality. Therefore, understanding the frequency and pathogenesis of these extrahepatic complications provides important information for both specialists and nonspecialists and may help clinicians identify patients at an earlier stage of their infection.

Multiple Cutaneous Infections Secondary to Inadvertent Use of Systemic Steroids

Introduction: Steroids have a major role in the treatment of many dermatological disorders. This class of drugs is also one of the most frequently abused drugs, both by patients and doctors. Inadvertent use of steroids can cause a plethora of side effects. Methods: A 43-year-old male who presented to the dermatology outpatient department with complaints of generalized itching and hyperpigmented lesions on his glans was examined clinically. The patient was found to be a known case of pemphigus vulgaris who developed multiple cutaneous infections secondary to the inadvertent use of systemic steroids. Results: The case being presented shows multiple cutaneous infections, a side effect caused by systemic corticosteroids because of the immunosuppression they cause. Conclusion: The present case underscores the need to regulate the dispensing practices of not only corticosteroids but also all the drugs that are sold without the prescription of a registered medical practitioner.

Clinico-Histopathological Consistency in Dermatological Disorders in a Tertiary Care Hospital of Kathmandu

Introduction: A skin biopsy for histopathological examination is one of the most reliable investigations for confirming clinical diagnosis. When there is alignment of clinical and histopathological diagnosis, it demonstrates clinico-histopathological consistency. There is limited reported data on clinico-histopathological concordance in the context of Nepal. Objectives: To determine the consistency of clinical and histopathological diagnosis of dermatological disorders. Materials and Methods: A retrospective study was conducted on 551 patients who underwent skin biopsy at the Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital, for a period of 1 year. Both inpatients and outpatients who had undergone a skin biopsy were included in the study. Demographic data, clinical and histopathological diagnoses were noted on a proforma sheet. Histopathological diagnoses, both definitive and descriptive, were deemed consistent when they aligned with the clinical diagnoses. Conversely, if either definitive or descriptive histopathological diagnoses were not concordant with the clinical diagnoses, they were categorized as inconsistent. Results: The mean age of patients was 41.42 (±18.42) years. The male to female ratio was 1:1.5. Out of 551 cases who underwent skin biopsy, clinico-histopathological consistency was found in 64.43% of cases (355), whereas clinico-histopathological inconsistency was present in 35.57% (196). The maximum concordance was present in eczematous disorders (58.06%), followed by immunobullous disorders (47.22%), and vasculitis (45.45%). Conclusion: The overall clinico-histopathological consistency was 64.43%. Both experienced dermatologists and pathologists need to assist each other in providing a better understanding of the diagnostic process. This study emphasizes need for this cooperation and will aid in evaluating clinico-histopathological consistency.

Quality-of-Life Assessment in Singaporean Children with Alopecia Areata

Introduction: Alopecia areata (AA) is an autoimmune dermatological disorder characterized by nonscarring hair loss. Its chronic and visible nature can negatively impact the quality of life (QoL) of patients with the condition. There has been a lack of studies on the QoL of pediatric patients with AA, especially from Asian countries. Objectives: This study aims to evaluate the impact of AA on the QoL of pediatric patients in Singapore. Methods: Between 2016 and 2017, 25 patients with AA were recruited to complete three questionnaires: Children’s Dermatology Life Quality Index (CDLQI), Family Dermatology Life Quality Index (FDLQI), and Pediatric Alopecia Areata Quality of Life Index. The results of these questionnaires were subsequently analyzed. Results: All three questionnaires had a broad range of responses, but scores were generally low, suggesting AA does not have a large impact on the QoL of our participants and their families. Two factors were identified to have resulted in better outcomes: the presence of comorbidity (atopic dermatitis, nail disease, food allergy, and allergic rhinitis) on the CDLQI and the presence of allergic rhinitis on the FDLQI. On the other hand, a later age of onset resulted in higher FDLQI scores. Conclusions: Similar to findings of other studies, the QoL of pediatric patients with AA is generally good, and clinical severity does not equate to worse QoL. Further studies are useful to provide more holistic care for the patient and their caregivers, involving both medical and psychosocial interventions.

Management of Plaque Psoriasis through Agadatantra Principles – A Case Report

Psoriasis is a chronic, relapsing dermatological disorder characterized by the presence of pink to erythematous plaques with overlying silver hyperkeratotic plaques, distributed on the scalp, postauricular skin, elbows, gluteal cleft etc. Plaque psoriasis is one among the common variety of psoriasis. Though it is manageable with difficulty, its relapsing nature remains a threat to the present management strategies. On the contrary in Ayurveda, a thorough analysis of condition, purification, rasayana and samana medicines proves to be effective in such conditions. A single case report of 42 year old male consulted in the Vaidyaratnam Ayurveda College OPD with presenting complaints as dry itchy and scaly silvery white lesions on chest, lower back, scalp and beard upon reddish patches with duration of two years. He was allergic to dantappala (Wrightia tinctoria) also. On examination the case was having positive candle grease and Auspitz sign with PASI score as 20.8 and DLQI as 21. The case was doignosed as ekakushta associated with severe pitta dushti and poor satva bala. The Doosheevisha chikitsa along with snehapana, svedana, vamana, virechana, takradhara, Shashtika annalepa and rasayana was done with proper medicines. The condition of the patient improved considerably by reducing the symptoms like erythema, dryness, itching, scaling and pain. The PASI score reduced to 2.3 and DLQI reduced to almost zero at the time of discharge. The further follow up has not reported any recurrence of the disease since two years.The proper understanding of the pathology through dasa vidha pareeksha and tracing out the vishaja nidanas can lead to a proper treatment plan. This will give successful management of similar conditions along with the enhancement of immunity to prevent or reduce the recurrence of the disease through principles of Agadatantra.

Dermatological disorders with varioliform scars: A clinical approach.

Dermatological disorders with varioliform scars: A clinical approach.

Evaluation of the effectiveness of Berberis integerrima Bunge root extract combined with spearmint essential oil in the treatment of acne vulgaris: A randomized controlled clinical trial.

Acne vulgaris is one of the most common dermatological disorders. Berberis integerrima Bunge belongs to the Berberidaceae family. Several studies on different Berberis species in addition to B. integerrima have shown antimicrobial, antioxidant, and anti-inflammatory effects. Spearmint essential oil also has antioxidant, antibacterial, and anti-inflammatory activities. This study aimed to evaluate the clinical effectiveness of the topical combination of B. integerrima root extract and spearmint essential oil in the treatment of acne vulgaris. Patients with mild to moderate facial acne who met the inclusion criteria were randomly assigned to either drug (B. integerrima extract/spearmint essential oil topical solution) or control (clindamycin 1% topical solution) groups. Each group applied the solution twice a day for 4 weeks. Before and at the end of the intervention, the number of lesions and mGAGS (Modified Global Acne Grading Scale) score were recorded. Thirty patients in each group of drug and control completed the study. Topical B.integerrima root extract/spearmint essential oil significantly reduced the number of lesions (27.33 ± 26.17 vs. 21.58 ± 21.10; p < 0.001) and mGAGS (18.76 ± 8.61 vs. 13.87 ± 8.14; p < 0.001) at the end of the intervention. However, there was no significant difference between the two groups regarding the number of lesions (p = 0.906) and mGAGS (p = 0.882). B. integerrima root extract combined with spearmint essential oil has significant anti-acne effects, comparable to topical antibiotic clindamycin. It could be considered as a potential treatment for acne vulgaris. However, more studies with larger sample sizes and longer durations are required to confirm this effect.

Through Indian Eyes: A Case Series on Steroid-induced Secondary Cataract

Lichen planus, a chronic autoimmune dermatological disorder, often necessitates the use of topical corticosteroids for symptom management. However, this case series highlights the emergence of topical steroid-induced secondary cataracts in two patients, emphasizing a previously underrecognized complication. Both patients, females aged 36 and 43, presented with gradual vision loss in their left eyes, attributed to prolonged corticosteroid use for lichen planus and skin allergies, respectively. Ophthalmological examinations confirmed the diagnosis, leading to cataract surgeries. The pathogenesis involves complex cellular and molecular mechanisms, emphasizing the need for vigilant monitoring during corticosteroid therapy. Moreover, the lack of stringent reporting systems for adverse drug reactions in India underscores the necessity for comprehensive monitoring to mitigate economic and quality of life burdens. The study emphasizes the importance of judicious corticosteroid use, tapering regimens, and patient education to minimize complications while effectively managing dermatological conditions. This underscores the critical need for heightened awareness, surveillance, and patient-centred approaches to mitigate the risk of corticosteroid-induced secondary cataracts, ensuring optimal therapeutic outcomes and long-term ocular health.

Maintenance Acne Treatment With Topical Tazarotene after Oral Isotretinoin: Overview and Case Reports

Introduction: Acne vulgaris is a common dermatologic disorder that may require treatment over months or years. Acne negatively impacts quality of life, and acne of any severity increases the risk of long-term sequelae such as scarring. Common treatments for severe/nodulocystic acne include oral isotretinoin, an oral antibiotic combined with a topical (benzoyl peroxide or a retinoid), an oral combined contraceptive, or oral spironolactone (females). Though oral antibiotics and isotretinoin are not recommended for long-term use, there is scarce guidance or published research on maintenance therapy. Topical retinoids—a mainstay of initial acne treatment—may be prescribed for maintenance once initial oral treatments are complete. Additionally, some retinoids such as tretinoin and tazarotene are indicated for the treatment of fine wrinkles and certain pigmentation disorders, and some studies have shown that adapalene and tazarotene may also reduce acne-induced scarring. Tazarotene 0.045% polymeric emulsion lotion is a well-tolerated retinoid that has demonstrated efficacy in acne treatment and may reduce acne-induced post-inflammatory hyperpigmentation (PIH) and melasma. Further, tazarotene lotion provides rapid and sustained improvements in skin barrier function/moisturization. Herein is presented a report of patients with acne who received maintenance treatment with topical tazarotene 0.045% lotion after an initial course of oral isotretinoin.&#x0D; Methods: Patients with severe recalcitrant acne vulgaris were treated with once daily oral isotretinoin for at least 20 weeks until deemed clinically clear. All patients received 40 mg isotretinoin once daily for the first 30 days. The dosage was then increased to 1 mg/kg of bodyweight (treatment naïve) or 1.5 mg/kg (repeat treatment). After 20 weeks, patients who achieved clinically clear skin initiated once-daily topical tazarotene 0.045% lotion monotherapy on the day of their last isotretinoin dose. Follow up visits occurred at 6 months and 1-year post-isotretinoin treatment.&#x0D; Results: Patients (n=12) had a mean age of 17.8 years (standard deviation [SD]: 3.8) and the majority were female (58.3%) and White (66.7%). Oral isotretinoin was used for an average of 24.3 weeks (SD: 6.7), with a mean cumulative dose of 184.6 mg/kg. One patient required a repeat course of isotretinoin prior to tazarotene initiation. Post-isotretinoin, patients received tazarotene 0.045% lotion for an average of 13.0 months (SD: 6.7). No patients relapsed and all showed subjective visual improvements in acne-related scarring with tazarotene maintenance treatment. None discontinued tazarotene lotion due to adverse events. &#x0D; Conclusions: There is little guidance or research published on acne maintenance treatment after initial oral isotretinoin or other treatments are complete. Topical tazarotene 0.045% polymeric emulsion lotion has previously demonstrated good efficacy, safety, and tolerability with acne and PIH reductions in patients with moderate-to-severe acne, as well as dyspigmentation reductions in patients with melasma and/or PIH. The case reports presented here show that tazarotene 0.045% lotion may be an effective and safe treatment to prevent relapse after initial oral isotretinoin treatment for severe recalcitrant acne.&#x0D; Funding: Ortho Dermatologics

Dermatologists' and Rheumatologists' Adherence to the Latest Recommendations for Screening of Hydroxychloroquine Retinopathy in Saudi Arabia: A Cross-Sectional Study.

Hydroxychloroquine (HCQ) is used to manage the symptoms of inflammatory rheumatic and dermatologic disorders. However, HCQ retinopathy is aserious side effect becauseeven after the drug is discontinued, irreversible vision loss may occur and may continue to progress.According to the American Academy of Ophthalmology (AAO),the recent recommendation for HCQ dosing is ≤5 mg/kg of real body weight, with baseline ophthalmologic screening during the first year of HCQ treatment and yearly screening after five years of continuous use of HCQ medication, unless the patient is at high risk or symptoms have developed.Nonetheless, this study aims to assess dermatologists' and rheumatologists' adherence in Saudi Arabia to the 2016 AAO HCQ retinal toxicity guidelines. A questionnaire-based cross-sectional study was conducted on dermatologists and rheumatologists in Saudi Arabia. It was conducted between August and September 2022 and questionnaires were sent to dermatologists and rheumatologists via their professional emails or accounts. The collected sample consisted of 635 participants; males and females represented 54% and 46%, respectively; 47.6% were consultants; 50.1% were rheumatologists; and 49.9% were dermatologists. Approximately 28.2% of the participants reported treating one to three patients with HCQ in the previous year. Only 45.4% of the respondents stated that the ideal recommended HCQ dose for reducing the risk of retinopathy is "≤ 5 mg/kg of the real body weight." More than 50% of the respondents stated that systemic lupus erythematosus was the most common disease for which they used HCQ. Additionally, 36.5% of the physicians screened patients during the first year of HCQ treatment. We found significant associations between practice levels and specialty practice-related questions with a p-value of less than 0.05, except for the specialty practice-related question, "What is the most common disease for which you use HCQ?" with a p-value of 0.074. Also, we found significant associations between all demographic variables and screening-related variables with a p-value of less than 0.05, with two exceptions: no significant associations were found between specialty area and the screening-related question, "Do you recommend screening tests for all patients starting treatment with HCQ?" at p = 0.270, and gender and the screening-related question, "When would you recommend screening tests for a patient without risk?" at p = 0.142. Dermatologists and rheumatologists in Saudi Arabia have shown poor adherence to the most recent AAO recommendations. Educating physicians and patients about the AAO guidelines is needed for HCQ to be used in a way that is both effective and safe.

Medicinal plants used for dermatological disorders among the Nyamwezi community in Tabora region, Tanzania

Medicinal plants used for dermatological disorders among the Nyamwezi community in Tabora region, Tanzania

Synthesis of thiadiazole derivatives as competitive inhibitors of α-glucosidase and tyrosinase

A new series of thiadiazole derivatives (3a-3j) were designed and synthesized. Their structures were confirmed by spectral data and then subjected to in vitro assessment including α-glucosidase and tyrosinase inhibitory activities. The results of the inhibitory activity show that all the synthesized analogs effectively inhibit α-glucosidase and tyrosinase, with IC50 values ranging from 0.42± 0.011 to 1.83±0.076 µM for α-glucosidase and 0.97±0.025 to 3.87±0.141 µM for tyrosinase. There, compound 3e (IC50 = 0.42± 0.011 μM) exhibited the most effective anti-α-glucosidase activity, with a Ki value of 0.18 ± 0.006 μM. Furthermore, compound 3h (IC50 = 0.97±0.025 μM) showed the best tyrosinase inhibition activity with the value of Ki 0.41 ± 0.017 μM. Through the in silico molecular docking analysis, the ability of the synthesized analogs to inhibit α-glucosidase and tyrosinase was also examined. Molecular dynamics (MD) simulations and MM-GBSA calculations were performed for 3e and 3h to support our biological findings. The favorable binding affinities and interactions displayed by both compounds with the active sites of the target enzymes illuminate their potential as competitive inhibitors. The molecular dynamics results suggest insights into the system's dynamic behavior, including the ligand-receptor complex's stability and flexibility, conformational changes, and intermolecular interactions over time. As a result of this study, it was determined that the structure of the compounds is important in drug design for diabetes and dermatological disorders.

Regulating the Wnt/β-catenin Signaling Pathway Promotes Repigmentation in Vitiligo Using Fire Needle Therapy

Background. Vitiligo is a dermatological disorder characterized by the depletion of melanocytes. The key to its treatment lies in the promotion of melanin regeneration. The Wnt/β-catenin signalling pathway assumes a pivotal role in this regenerative process. Fire needle therapy (FNT), a traditional Chinese medical technique, has emerged as a promising intervention. Methods. We analyzed gene expression associated with the Wnt/β-catenin signalling pathway in both normal skin and the lesions of patients with vitiligo in the Gene Expression Omnibus database (GEO database). Furthermore, we evaluated the gene expression of this pathway and assessed the effects of FNT on pigmentation and its influence on the Wnt/β-catenin signalling pathway in a vitiligo mouse model. Results. Compared to that of the normal skin, the mRNA levels of WNT10A, WNT10B, WNT2, WNT2B, WNT3, WNT3A, WNT4, WNT5B, WNT7B, and LEF1 displayed significant decreases in the lesions of patients with vitiligo. Moreover, vitiligo mouse skin lesions improved following FNT, and the number of melanocytes and melanin levels increased. In addition, posttreatment, genes associated with the Wnt/β-catenin signalling pathway were revealed to be upregulated. Conclusion. FNT may play an important role in promoting pigmentation in vitiligo through modulation of the Wnt/β-catenin signalling pathway. This adds to the growing body of literature supporting the use of FNT to treat vitiligo. This, in turn, may inform clinical practice and improve patient outcomes.

The Application of Knowledge-Based Clinical Decision Support Systems to Detect Antibiotic Allergy.

Prevention of drug allergies is important for patient safety. The objective of this study was to evaluate the outcomes of antibiotic allergy-checking clinical decision support system (CDSS), K-CDSTM. A retrospective chart review study was performed in 29 hospitals and antibiotic allergy alerts data were collected from May to August 2022. A total of 15,535 allergy alert cases from 1586 patients were reviewed. The most frequently prescribed antibiotics were cephalosporins (48.5%), and there were more alerts of potential cross-reactivity between beta-lactam antibiotics than between antibiotics with the same ingredients or of the same class. Regarding allergy symptoms, dermatological disorders were the most common (38.8%), followed by gastrointestinal disorders (28.4%). The 714 cases (4.5%) of immune system disorders included 222 cases of anaphylaxis and 61 cases of severe cutaneous adverse reactions. Alerts for severe symptoms were reported in 6.4% of all cases. This study confirmed that K-CDS can effectively detect antibiotic allergies and prevent the prescription of potentially allergy-causing antibiotics among patients with a history of antibiotic allergies. If K-CDS is expanded to medical institutions nationwide in the future, it can prevent an increase in allergy recurrence related to drug prescriptions through cloud-based allergy detection CDSSs.

Communication between Mast Cells and Group 2 Innate Lymphoid Cells in the Skin.

The skin is a dynamic organ with a complex immune network critical for maintaining balance and defending against various pathogens. Different types of cells in the skin, such as mast cells (MCs) and group 2 innate lymphoid cells (ILC2s), contribute to immune regulation and play essential roles in the early immune response to various triggers, including allergens. It is beneficial to dissect cell-to-cell interactions in the skin to elucidate the mechanisms underlying skin immunity. The current manuscript concentrates explicitly on the communication pathways between MCs and ILC2s in the skin, highlighting their ability to regulate immune responses, inflammation, and tissue repair. Furthermore, it discusses how the interactions between MCs and ILC2s play a crucial role in various skin conditions, such as autoimmune diseases, dermatological disorders, and allergic reactions. Understanding the complex interactions between MCs and ILC2s in different skin conditions is crucial to developing targeted treatments for related disorders. The discovery of shared pathways could pave the way for novel therapeutic interventions to restore immunological balance in diseased skin tissues.

Advancing Treatment in Atopic Dermatitis: A Comprehensive Review of Clinical Efficacy, Safety, and Comparative Insights Into Corticosteroids, Calcineurin Inhibitors, and Phosphodiesterase-4 Inhibitors as Topical Therapies.

Atopic dermatitis (AD) is a pervasive and multifaceted dermatological disorder causing daily distress to afflicted individuals worldwide. This comprehensive review synthesizes the historical and contemporary advancements in therapeutic strategies, offering a critical analysis of their efficacy, safety profiles, and adaptability. The enduring role of topical corticosteroids in managing AD is examined, acknowledging their potent anti-inflammatory properties alongside their potential adverse side effects, particularly in extended usage. The article explores the utilization of topical calcineurin inhibitors like tacrolimus and pimecrolimus, highlighting their novel anti-inflammatory pathways while also scrutinizing concerns over potential malignancies that relegate them to second-line therapy. The present investigation features the emergence of crisaborole, a phosphodiesterase four inhibitor. Its innovative mode of action, benign safety profile, and applicability to mild and moderate AD are thoroughly evaluated. The review also includes challenges, particularly cost considerations, which constrain accessibility and necessitate nuanced implementation in therapeutic regimens. This study underscores the need for persistent investigation, teamwork, and innovations in managing AD. In this regard, AD requires a united approach between clinicians, researchers, affected individuals, and policymakers to refine patient-focused treatment and develop precise, economical strategies to address this chronic and frequently life-altering health condition.

A Critical Appraisal of Gluten in Skin Disorders, the Evidence So Far, and Updated Recommendations.

Gluten, a polypeptide hapten, found in many cereals such as barley, wheat, rye, oats, and others, has been recently implicated in a range of cutaneous disorders ranging from chronic plaque psoriasis through psoriatic arthritis, urticaria (chronic as well as paediatric onset), and angioedema to lichen planus, vitiligo, and rosacea. The evidence for them is still not well reviewed. To generate evidence for the causal role of gluten in various dermatological disorders. The Pubmed, MedLine, and EMBASE databases were searched using the keywords "Gluten" and one of the dermatoses, namely, "Atopic Dermatitis", "Vasculitis", "Psoriasis", "Psoriatic Arthritis", "Acne", "Alopecia Areata", and "Immunobullous disorders". All articles published in English for which free full text was available were taken into consideration. The search strategy returned in a total of 1487 articles which were screened for relevance and elimination of duplicates. Ultimately, around 114 articles were deemed suitable. The data were extracted and presented in the narrative review format. A simple and cost-effective solution to many of these chronic and lifelong conditions is to restrict gluten in the diet. However, the dermatologist would do well to remember that in the vast majority of dermatological disorders including the ones listed here, gluten restriction is not warranted and can even lead to nutritional deficiencies. The evidence varied from Grade I for some disorders like psoriatic arthritis to Grade IV to most disorders like acne, vitiligo, vasculitis, and atopic dermatitis. Herein, we review the evidence for each of these conditions and make practical recommendations for gluten restriction in them.

Dietary Influences on Skin Health in Common Dermatological Disorders.

The role of diet in the development of skin disorders is well-established, with nutritional deficiency often identified as a risk factor for skin diseases. Imbalances in the skin can be caused by nutritional deficiencies, excessive intake, insufficient nutrients, and hazardous ingredients. Patients frequently inquire about the impact of dietary patterns on skin health when consulting dermatologists in clinical settings. Simultaneously, the popularity of using nutritional supplements containing vitamins, minerals, and nutraceutical blends has been on the rise. It is crucial for dermatologists, primary care physicians, and other healthcare providers to be acquainted with evidence-based dietary interventions, distinguishing them from those that are more market-driven than truly efficacious. This review explores the modification of diet, encompassing both dietary exclusion and supplementation, as a therapeutic approach for conditions such as psoriasis, atopic dermatitis, bullous disease, vitiligo, and alopecia areata. A comprehensive literature search, utilizing the PubMed/Medline, Google Scholar, and Medscape databases, was conducted to investigate the relationship between each nutrient and various inflammatory skin diseases. The findings emphasize the significance of a well-balanced and thoughtfully planned diet in supplying adequate amounts of proteins, vitamins, and minerals to support optimal skin health. Additionally, this comprehensive review navigates through various dietary recommendations, offering insights into their multifaceted impacts on the immune system, gut microbiome, and skin health. The goal is to pave the way for informed and targeted dietary interventions for individuals dealing with food allergies and associated skin conditions.

Bone and Skin/Subcutaneous Tissue Concentrations of Cefiderocol During Treatment of Extensively Drug-Resistant Pseudomonas aeruginosa.

Pyoderma gangrenosum is a rare dermatologic disorder that disrupts the skin barrier, requiring immunosuppressive therapy. We successfully used cefiderocol for the treatment of an extensively drug-resistant Pseudomonas aeruginosa bacteremia, and presumed osteomyelitis in a patient with severe pyoderma gangrenosum and associated immunosuppressive therapy while being medically optimized for skin grafting. We obtained bone and skin/subcutaneous tissue while the patient was on cefiderocol under an institutional review board-approved biologic waste recovery protocol. Cefiderocol concentrations in bone and skin/subcutaneous tissue were 13.9 and 35.9 mcg/g, respectively. The patient recovered from bacteremia and underwent autografting without further complications. Cefiderocol at approved dosing of 2 g IV (3-hour infusion) every 8 hours resulted in bone and skin/subcutaneous tissue concentrations adequate to treat extensively drug-resistant Gram-negative bacteria that remain susceptible to cefiderocol.

Prevention and cure of dermatology disorders using herbal medications: summary

The use of isolated plant components and herbal extracts in the treatment of wounds and skin conditions is growing. In recent years, numerous new herbal medications, pharmaceuticals, and cosmetics have been produced to address a variety of skin disorders. We concentrate on herbal medications that underwent testing in well-controlled clinical trials or reliable preclinical investigations in this systematic review. Herbal biomedicines are designed to treat a variety of conditions, including atopic dermatitis (using St. John's wort, licorice, tormentil, bitter substances, and evening primrose), psoriasis (using araroba tree, lace flower, barberry bark, indigo, turmeric, olibanum, and St. John's wort), actinic keratosis (using birch bark and petty spurge), herpes simplex (using lemon balm, sage, and rhubarb), rosacea (using green tea, licorice, tormentil, and acne vulgaris) and acne vulgaris (using tea tree oil, green tea, and hop), or to enhance photoprotection (using green tea, Dyer's weed, cocoa tree, carotinoids, and licorice), aesthetic dermatology (using licorice, pine bark, and gotu kola), and wound healing (using birch bark and onion).