Skin Diseases Research Articles

Haemorrhagic shock in a pregnant patient and the unsuspicious subclavian catheter

Introduction: Central venous catheterisation (CVC) is a commonly performed procedure in clinical practice. Although usually safe, complications can arise such inadvertent vascular lesion. This report is of a case of left brachiocephalic vascular lesion due to a subclavian catheter, thus raising awareness about this potential complication, which is not always immediately recognised. Case report: We report the case of a 31-year-old healthy woman, 42 weeks pregnant, who presented with complications during an elective caesarean section. The patient experienced haemorrhagic shock due to the incomplete rupture of the left ovarian pedicle, further complicated by the accidental lesion of the left brachiocephalic vein caused by the tip of a right subclavian catheter, aggravated by the late discovery only after extubation. This case highlights the importance of patient selection, proper technique and the careful monitoring pre- and post-procedure. Conclusion: Brachiocephalic vein lesions arising from CVC insertions are rare but significant complications that require timely recognition and intervention.

Investigation of paeonol in dermatological diseases: an animal study review

Cortex Moutan is the root bark of the buttercup plant Paeonia suffruticosa Andr, of Ranunculaceae family. It has been utilized in Chinese medicine for thousands of years to treat a multitude of diseases, and traditional Chinese documents allege that it has heat-clearing, antipyretic, anti-inflammatory and detoxicating properties. Paeonol is a bioactive substance extracted from Cortex Moutan, which is considered to be one of its most effective metabolites. Recent studies have illustrated that paeonol treatment can alleviate skin damage, relieve the inflammatory response in patients with numerous dermatological conditions, and inhibit anomalous proliferation of skin tissue. Accordingly, paeonol may serve as a potential therapeutic agent for a variety of skin conditions. This review summarizes the physicochemical properties and pharmacokinetics (PK) characteristics of paeonol, and mechanisms of operation in diverse skin diseases, including dermatitis, psoriasis, pruritus, photoaging, hyperpigmentation, and hyperplasticscar. Additionally, much of the evidence is based on animal experiments. Furthermore, it explores the prospects of enhancing paeonol’s efficacy through extraction, synthesis, and formulation innovations, as well as strategies to overcome its limitations in dermatological therapy. This review aims to provide a more reliable theoretical basis for the clinical application of paeonol.

Neutrophil and mononuclear leukocyte pathways and upstream regulators revealed by serum proteomics of adult and juvenile dermatomyositis

Abstract Objectives Serum protein abundance was assessed in adult and juvenile dermatomyositis (DM and JDM) patients to determine differentially regulated proteins, altered pathways, and candidate disease activity biomarkers. Methods Serum protein expression from 17 active adult DM and JDM patients each was compared to matched, healthy control subjects by a multiplex immunoassay. Pathway analysis and protein clustering of the differentially regulated proteins were examined to assess underlying mechanisms. Candidate disease activity biomarkers were identified by correlating protein expression with disease activity measures. Results Seventy-eight of 172 proteins were differentially expressed in the sera of DM and JDM patients compared to healthy controls. Forty-eight proteins were differentially expressed in DM, 32 proteins in JDM, and 14 proteins in both DM and JDM. Twelve additional differentially expressed proteins were identified after combining the DM and JDM cohorts. C-X-C motif chemokine ligand 10 (CXCL10) was the most strongly upregulated protein in both DM and JDM sera. Other highly upregulated proteins in DM included S100 calcium binding protein A12 (S100A12), CXCL9, and nicotinamide phosphoribosyltransferase (NAMPT), while highly upregulated proteins in JDM included matrix metallopeptidase 3 (MMP3), growth differentiation factor 15 (GDF15), and von Willebrand factor (vWF). Pathway analysis indicated that phosphoinositide 3-kinase (PI3K), p38 mitogen-activated protein kinase (MAPK), and toll-like receptor 7 (TLR7) signaling were activated in DM and JDM. Additional pathways specific to DM or JDM were identified. A protein cluster associated with neutrophils and mononuclear leukocytes and a cluster of interferon-associated proteins were observed in both DM and JDM. Twenty-two proteins in DM and 24 proteins in JDM sera correlated with global, muscle, and/or skin disease activity. Seven proteins correlated with disease activity measures in both DM and JDM sera. IL-1 receptor like 1 (IL1RL1) emerged as a candidate global disease activity biomarker in DM and JDM. Conclusion Coordinate analysis of protein expression in DM and JDM patient sera by a multiplex immunoassay validated previous gene expression studies and identified novel dysregulated proteins, altered signaling pathways, and candidate disease activity biomarkers. These findings may further inform the assessment of DM and JDM patients and aid in the identification of potential therapeutic targets.

Assessment of therapeutic response to photodynamic therapy with the Zn-Phthalocyanine RLP068/Cl versus topical Clindamycin in patients affected by Hidradenitis Suppurativa: a comparative clinical pilot study

AbstractHidradenitis suppurativa is a chronic skin disorder characterized by painful inflammatory nodules and abscesses, significantly impacting patients’ quality of life. Current treatment strategies, including topical antibiotics, often yield limited efficacy and pose risks of antibiotic resistance. Photodynamic therapy has emerged as a potential option, with RLP068/Cl (ELKOFAST®, non-sterile formulation) showing promising efficacy due to its broad-spectrum bactericidal activity. We conducted a pilot study assessing the therapeutic response to photodynamic therapy with RLP068/Cl versus topical clindamycin gel in patients affected by hidradenitis suppurativa of Hurley score I, II, and III. Results revealed higher efficacy of photodynamic therapy in combination with RLP068/Cl, particularly in mild cases. Its efficacy remains reliable even in more severe cases when combined with adalimumab. The observed faster lesion improvement and pain relief were ascribed to the bactericidal effects of RLP068/Cl against Gram+ and Gram− bacteria. Furthermore, photoactivated RLP068/Cl was well tolerated with no adverse events reported. Therefore, photodynamic therapy following RLP068/Cl application represents a novel therapeutic option for hidradenitis suppurativa with potential implications for antibiotic stewardship in dermatology. Graphical abstract

Characteristics of information on inflammatory skin diseases produced by four large language models

Characteristics of information on inflammatory skin diseases produced by four large language models

Effectiveness of different acne treatment methods: a comparison of pharmacological, procedural and natural therapies

Acne vulgaris is a chronic skin condition affecting millions of people, especially adolescents. This study analyzes the effectiveness of various acne treatment methods, including pharmacological, procedural, and natural therapies. It compares their mechanisms of action, therapeutic effects, and potential side effects. The aim of this study is to identify the most effective therapeutic strategies to improve patients’ quality of life and mental health. The analysis results suggest that a comprehensive approach to acne treatment, combining different methods, may yield the best outcomes.

Skin Disease Analysis and Prediction using Machine Learning

A number of patients all over the world suffer from skin diseases; detection in the early stages is very important for curing such disease. For diagnosing skin conditions however, several factors make this very difficult, these include the multitude of skin diseases, their similar symptoms and dependence on expert dermatological evaluation. In this case, adopting machine learning (ML) is quite a suitable approach as it can help improve the accuracy of diagnosis and its availability. Therefore, the focus of the project is on the developing of a machine learning based skin disease detection system.The problem in consideration is the high demand for efficient and effective mechanisms that can be used in skin disease identification/ detection, whereby such tools should also be able to be used in low income areas. To tackle this, we use a machine learning model which classifies different forms of skin diseases through the use of dermatoscopic images.

Evaluation of anti‐acne activity of human whole saliva against acne vulgaris: An in vitro study

AbstractBackgroundAcne vulgaris (AV) is a multifactorial inflammatory skin disorder, affecting 9.45% of the world's population. AV can be painful, discomforting, and disfiguring due to scarring, leading to physiological distress, and economic burden. AV pathogenies can be due to various factors, key ones include follicular plugging, colonization by the microorganism, endocrinological factors, and inflammation. Gram‐positive bacteria Cutibacterium acnes and Staphylococcus epidermidis are the most common pathogens isolated from patients with AV.AimThe present study aimed to investigate the anti‐acne activity of whole human saliva against bacteria that cause AV.Materials and MethodsThe saliva sample from four different individuals was collected at three different intervals. These samples were used to perform antimicrobial susceptibility test (AST) against the pathogens. Kirby–Bauer disk diffusion susceptibility test, and Broth dilution method using Resazurin were performed.ResultsThe human saliva was effective in inhibiting Cutibacterium acnes and Staphylococcus epidermidis those causing AV. The Minimum inhibitory activity and disc diffusion assay depicted potency of saliva. The pH of the saliva samples was found to be more acidic in the morning samples when compared with the evening samples. The afternoon sample was found to be more effective when compared with the other two intervals.ConclusionsSaliva shows effective anti‐acne activity by inhibiting the growth and proliferation of acne‐causing bacteria.

Equitable Skin Disease Prediction Using Transfer Learning and Domain Adaptation

In the realm of dermatology, the complexity of diagnosing skin conditions manually necessitates the expertise of dermatologists. Accurate identification of various skin ailments, ranging from cancer to inflammatory diseases, is paramount. However, existing artificial intelligence (AI) models in dermatology face challenges, particularly in accurately diagnosing diseases across diverse skin tones, with a notable performance gap in darker skin. Additionally, the scarcity of publicly available, unbiased datasets hampers the development of inclusive AI diagnostic tools. To tackle the challenges in accurately predicting skin conditions across diverse skin tones, we employ a transfer-learning approach that capitalizes on the rich, transferable knowledge from various image domains. Our method integrates multiple pre-trained models from a wide range of sources, including general and specific medical images, to improve the robustness and inclusiveness of the skin condition predictions. We rigorously evaluated the effectiveness of these models using the Diverse Dermatology Images (DDI) dataset, which uniquely encompasses both underrepresented and common skin tones, making it an ideal benchmark for assessing our approach. Among all methods, Med-ViT emerged as the top performer due to its comprehensive feature representation learned from diverse image sources. To further enhance performance, we conducted domain adaptation using additional skin image datasets such as HAM10000. This adaptation significantly improved model performance across all models.

What are Juvenile-onset systemic sclerosis providers thoughts, experiences, and reasons for autologous stem cell transplant? Result of a multinational survey

Objective: Juvenile-onset systemic sclerosis (jSSc) is a rare and life-threatening disease with no formal studies evaluating the indications for, access to, or benefits of autologous stem cell transplantation (ASCT). As a first step toward understanding pediatric jSSc specialist thoughts and experiences with ASCT, we conducted a multinational survey. Methods: An electronic survey was developed and distributed in November 2023 to members of the Pediatric Rheumatology European Society (PRES) and/or Childhood Arthritis and Rheumatology Research Alliance (CARRA) pediatric scleroderma workgroups. Results: Twenty-nine (69%) jSSc specialists completed the survey. All participants have considered or would consider ASCT referral for a jSSc patient. Nearly all respondents indicated disease-modifying anti-rheumatic drugs (DMARDs) should be trialed prior to ASCT referral, with most indicating two to four DMARDs. The most common reasons selected for referral were rapidly progressive disease (despite DMARD) (90%), followed by severe disease status (83%), and significant impact on quality of life (83%). All respondents selected pulmonary disease as an indication for referral, followed by cardiac (93%), gastrointestinal (72%), and skin disease (66%). While pulmonary and cardiac involvement were considered individually sufficient for referral for ASCT, only a minority considered musculoskeletal involvement (28%) sufficient on its own. Conclusion: This survey is the first explore thoughts and experience with ASCT for jSSc. Results indicate pediatric rheumatologists were aware of and would consider ASCT for their patients. Our results indicate there is likely some variability in clinical practice regarding who is referred for ASCT, and further research is needed to guide development of evidence-based clinical care guidelines.

Cataract Prevalence in Patients with Cutaneous Melanoma in Lithuanian Population

Background/Objectives: Sun exposure and ultraviolet (UV) radiation significantly affect human health, especially concerning skin and eye conditions. Sun exposure is a risk factor for both cutaneous melanoma (CM) and cataract. To investigate the association between CM, cataract and the number of common melanocytic nevi (CMNs) in the Lithuanian population. Methods: A case–control study with 180 primary diagnosed CM subjects and 182 healthy controls was conducted. Participants underwent ophthalmic and dermatological examination, where a counting of the common melanocytic nevi (CMNs) on the face, outer surfaces of the upper arms, lower arms and hands was performed. A detailed ophthalmic slit lamp examination was conducted; additionally, lens status and cataract formation were evaluated according to the Lens Opacities Classification System III (LOCS III). Results: Subjects with an LOCS III grade of nuclear opalescence (NO) ≥3 had a 1.82 times higher risk of CM, and patients with a nuclear color (NC) grade ≥3 had a 2.02 times higher risk of CM. LOCS III evaluations of cortical (C) and of posterior subcapsular (P) cataract showed a 5.24 and 6.34 times increased risk of CM, respectively. The CMN number on the face increased CM risk by 1.25 times; on the outer surface of the upper and lower arms, correspondingly 1.05 and 1.04 times; and on outer surface of hands—1.29 times. Conclusions: All types of cataracts were found more often in patients with CM than in healthy subjects. The number of CMNs on the face and outer surfaces of arms and hands could be an indicator of higher risk for CM.

Transcriptomic evidence for atopic dermatitis as a systemic disease in NC/Nga mice

BackgroundIn the current study, we evaluated whether atopic dermatitis (AD) affects the entire body rather than being limited to skin barrier damage and inflammation. We hypothesized that medium-term exposure of distant organs to systemic inflammatory cytokines in sub-chronic inflammatory skin diseases has detrimental effects on distant tissues.ResultsOur findings demonstrated the dysregulation of genes and pathways associated with inflammation and the skin barrier, as well as genes and pathways involved in muscle development that respond to chemicals or stress in muscle tissues, all of which were reversed by hydrocortisone (Hc) administration. The expression of Ces1d showed significant differences during disease onset and after treatment in both skin and skeletal muscle, suggesting that Ces1d is likely responsible for the alleviation of subchronic AD.ConclusionsUsing NC/Nga mice with AD-like symptoms, we compared the transcriptomes of the skeletal muscle (a tissue that is relatively distant from the skin) with those of the skin (the lesion induction site) before and after disease induction, after which Hc was administered. Although further study is needed to better understand the effects of Ces1d on AD, skeletal muscle was associated with AD pathogenesis, and AD-like symptoms appeared to affect the body in a systemic manner. Given the importance of evidence-based medicine and the development of precision medicine, our findings provide insights into the mechanisms of AD onset and progression.

Exploring mechanisms of skin aging: insights for clinical treatment

The skin is the largest organ in the human body and is made up of various cells and structures. Over time, the skin will age, which is not only influenced by internal factors, but also by external environmental factors, especially ultraviolet radiation. Aging causes immune system weakening in the elderly, which makes them more susceptible to dermatosis, such as type 2 inflammatory mediated pruritus. The immune response in this condition is marked by senescent cells consistently releasing low amounts of pro-inflammatory cytokines through a senescence-associated secretory phenotype (SASP). This continuous inflammation may accelerate immune system aging and establish a connection between immune aging and type 2 inflammatory skin diseases. In addition, two chronic pigmentation disorders, vitiligo and chloasma, are also associated with skin aging. Aged cells escape the immune system and accumulate in tissues, forming a microenvironment that promotes cancer. At the same time, “photoaging” caused by excessive exposure to ultraviolet radiation is also an important cause of skin cancer. This manuscript describes the possible links between skin aging and type 2 inflammation, chronic pigmentation disorders, and skin cancer and suggests some treatment options.

Barriers to diagnosing and treating vulval lichen sclerosus: a survey study

Background Vulval lichen sclerosus (VLS) is a chronic inflammatory condition that is frequently misdiagnosed and under-recognised. To date, qualitative research focuses on lived experience of VLS, with women attributing diagnostic delay to poor interactions with health care professionals (HCPs) often due to lack of knowledge. In the UK, women with VLS are most likely to present to primary care. Aim To establish HCPs perspectives on identification, management and education of vulval skin disease, with a focus on VLS. Design and Setting A survey was distributed to HCPs working in primary care. Method The survey was distributed via professional networks and at events. Analysis comprised of descriptive statistics, Spearman’s rank correlations, and thematic analysis. Results Of 122 respondents, 53 were General Practitioners (GPs) and 59 were GP trainees. 37.7% of respondents had never participated in teaching nor learning on vulval skin disease. Confidence in the identification of vulval skin disease positively correlated with experience, exposure and female gender. The top identified barriers to diagnosis and treatment included lack of knowledge, embarrassment, and absence of VLS diagnostic criteria. Almost all participants (97.5%) felt VLS diagnostic criteria would be helpful in clinical practice. Conclusion This study provides insight into the barriers to diagnosing and treating VLS in primary care. HCPs recognise deficiencies in training, referral pathways and lack of tools to support VLS diagnosis. Training should include skills to address stigma and embarrassment. This study highlights the importance of developing interventions to overcome barriers, expediting diagnosis and treatment, such as reproducible diagnostic criteria.

Role of SIRPG gene in type 1 diabetes and lichen planus

Type 1 diabetes (T1D) is a form of diabetes caused by pancreatic β-cell destruction and absolute insulin deficiency. Lichen planus (LP) is an idiopathic inflammatory skin disease of unclear etiology. The role of SIRPG gene dysregulation in T1D and LP remains unclear. Mendelian randomization (MR) using matched samples was employed to study causal relationship between T1D and increased risk of LP. T1D-related single nucleotide polymorphism identification was conducted. Datasets GSE156035 for T1D and GSE52130 for LP were obtained from gene expression omnibus. Differentially expressed genes were identified, analyses included weighted gene co-expression network analysis, functional enrichment, gene set enrichment analysis, and protein–protein interaction network construction and analysis. Heatmaps of gene expression levels were generated. Comparative toxicogenomics database was used to identify diseases most relevant to core genes. Inverse variance weighted, MR-Egger, weighted median methods estimated genetic predisposition between T1D and LP, showing consistent positive correlations using both weighted median and inverse variance weighted methods. Horizontal pleiotropy analysis with MR-Egger intercept indicated no evidence of significant directional pleiotropy (P = .70645) for LP. There was no evidence of directional pleiotropy effects between T1D and LP. One hundred eighteen differentially expressed genes were identified. In biological processes, they were mainly enriched in apoptosis, inflammatory response, insulin receptor signaling pathway, glucose metabolism. In cellular components, enrichment was observed in mediator complex and replication fork. In molecular function, they were concentrated in leukotriene receptor activity and helicase activity. Kyoto Encyclopedia of Genes and Genomes analysis revealed enrichment in metabolic pathways, PI3K-Akt signaling pathway, cell cycle, p53 signaling pathway, AGE-RAGE signaling pathway in diabetic complications. Weighted gene co-expression network analysis with a soft threshold power of 4. SIRPG showing high expression in both T1D and LP samples. There is a positive causal relationship between T1D and LP. Comparative toxicogenomics database analysis revealed associations of core genes with metabolic syndrome, lipid metabolism disorders, cardiovascular diseases, immune system diseases, peripheral neuropathic pain, and inflammation. SIRPG is highly expressed in both T1D and LP, providing a new insight into the pathogenesis of T1D and LP.

Efficacy and safety of oral tofacitinib in vitiligo and its variants: A retrospective case series

Background: Vitiligo is a chronic inflammatory skin disorder characterized by patchy depigmentation due to melanocyte loss, often leading to psychiatric morbidities. Emerging therapies like JAK inhibitors, like tofacitinib, target the autoimmune process underlying vitiligo by inhibiting the JAK-STAT pathway, potentially offering more effective and sustained repigmentation with fewer side effects. There is limited data on the dosing, efficacy, and safety of tofacitinib in treating vitiligo, particularly within the Indian population, beyond a few case reports and clinical trials. Aim: This study aims to retrospectively analyze the safety and efficacy of tofacitinib in vitiligo patients. Methods: This retrospective case series reviewed oral tofacitinib use in vitiligo patients from the Department of Dermatology, Cutis Hospital, Bengaluru, India, between January 2020 and August 2022. Data were collected on patient demographics, treatment history, clinical assessments, and laboratory investigations. Tofacitinib was administered at 5 mg twice daily, often combined with NB-UVB phototherapy. Results: The study included 20 patients (11 males and 9 females) aged 24–57 years. Disease duration varied from 1 to 20 years. Nine patients had more than 25% reduction in Vitiligo Area Severity Index when compared to baseline. No significant side effects were recorded, although some patients showed an increase in cholesterol and triglycerides. Conclusion: Tofacitinib shows promise as a targeted therapy for vitiligo with a favorable safety profile. Despite limited data, initial results indicate significant efficacy, particularly when combined with phototherapy. Further research is needed to validate these findings, especially in the Indian population, to establish comprehensive treatment guidelines for JAK inhibitors in vitiligo.

Evolving HIV service delivery: scalability of pharmacist-led care

Abstract Introduction With declining healthcare budgets and numbers of HIV medical trainees1, workforce innovation is crucial to sustain delivery of HIV care. Since local introduction of an advanced pharmacist practitioner (APP) role, we have demonstrated the ability of pharmacists to provide holistic care to people living with HIV, including those with complex medical needs. Scaling up pharmacist-led care may be a potential solution to sustain service delivery2 whilst addressing the needs of an ageing cohort3. Further APP clinics were introduced with consultant support and supervision. Aim We aim to evaluate the impact and outcomes of these APP clinics. Method Prospective data collection of consultations conducted by four pharmacist practitioners (PP) across four HIV clinics between January to December 2023. Surveys were distributed after the appointment to capture service users’ opinions on the pharmacists’ role and care provided. Ethical approval was not required as this does not constitute as research. This was registered as a service evaluation with the research and innovation team at Chelsea and Westminster NHS Foundation Trust. All patient information is anonymised. Results A total of 634 consultations (513 individuals) within 170 clinical sessions were conducted during the 12 month period: 585 (92%) in person; 176 (34%) female; median age 52 (IQR 43-58); 233 (45%) non-white ethnicity; mean number of co-morbidities 2 (0-8); 87 (17%) had more than 5 co-medications (0-21); 87% virologically suppressed [viral load (VL) <50cp/mL]. Of 55 individuals seen with detectable VL, 32 (58%) resuppressed within 6 months. PPs have made 522 interventions and investigations in total, for example 147 referrals to other specialities such as dietitians and mental health services, 112 imaging requested (e.g DEXA and liver ultrasounds) and 99 initiation or switching of antiretroviral therapy (ART). Following investigations, 44 new medical conditions were identified and managed by the PPs which included namely 18 cases of micronutrient deficiencies, 8 cases of skin conditions and 6 cases of metabolic disorders. From the survey, 55% (30/55) of service users were aware that pharmacists could review their overall health. All (100%) respondents felt that the quality of care received met or exceeded expectations and 54 (98%) would attend a pharmacist-led appointment in future. Discussion/Conclusion We have previously successfully demonstrated implementation of pharmacist practitioner clinics as a novel way of utilising and developing the pharmacist workforce. We demonstrate scalability of this service delivery model in our large, urban multi-site centre by successfully increasing the number of pharmacist practitioner clinics from three clinics to six clinics week. The positive feedback from service users indicates high acceptability of this model. HIV services may consider investment into mobilising senior pharmacists to facilitate expansion of this advanced practitioner role in order to address increasing levels of co-morbidities, polypharmacy and complex medical needs observed in our ageing population. The knowledge base of HIV pharmacists means they are ideally placed to facilitate communication across sectors, specialties and disciplines. Future development plans include expanding to other specialist areas such as HIV pre-exposure prophylaxis, contraception, gender health and research delivery and enhanced skills such as phlebotomy, injectable ART administration.

Psychocutaneous Medicine: Current Global Understanding and Imperatives for Continuing Medical Education and Training Opportunities: A Systematic Review

Abstract The intersection of dermatology and psychiatry has gained significant attention in recent years. Psychocutaneous disease affect patient population, who have undiagnosed and undertreated ailments related to the body and mind. These patients suffer a reduce quality of life due to knowledge gaps and reduce awareness about psycho dermatology. This review aims to assess the integration of psychopharmacology topics in continuing medical education programs (CME) and its relevance in clinical practice, it's impact on healthcare professionals’ quality of care, and existing knowledge gaps among trainees and young dermatologists. To identify data from inception up to December 2023, a systematic literature review and search was conducted following PRISMA guidelines. Pubmed, Cochrane, and Embase databases were searched using predefined terms including “continuing medical education”, “dermatology”, “psychology”, “psychodermatology”, “psychocutaneous”, “awareness” and “practice patterns”. Inclusion criteria comprised studies evaluating CME programs, clinical studies and reviews published in English language. Studies were excluded if they were single case reports. A total of 93 studies were identified and 12 were included in this review following screening, removal of duplicates, and application of inclusion criteria. Studies revealed lower level of confidence among professionals in handling psycho cutaneous conditions, limited awareness of available resources and high interest in CME programs. Initiatives like video mentoring and clinical skills lessons showed promise but are currently scarce. Examined data from selected studies demonstrate that current CME programs in psychodermatology lack depth, leaving practitioners feeling ill equipped and unaware of available resources. There is substantial global interest in enhancing these programs. Given the breadth of conditions covered, educating dermatologists is crucial for enhanced patient outcomes and satisfaction. Addressing resource scarcity and patient stigma is imperative to develop specialized programs. Improvement to education can drive stronger outcomes and holistic patient care. Future efforts should prioritize refining program strategies and conducting thorough assessments to maximize impact.

Epidemiology of Sexually Transmitted and Dermatological Diseases among Patients in 250 Bedded General Hospital, Jamalpur, Bangladesh

Background: Skin diseases are widespread in developing nations. It is commonly acknowledged that the occurrence and characteristics of skin and venereal diseases vary across countries and even within different regions of a single country. These variations are influenced by a complex interplay of social, economic, racial, and environmental factors. Objective: To assess the epidemiology of sexually transmitted infections and skin illnesses among patients visiting the outpatient department of a tertiary care hospital in Bangladesh. Methods: This study was conducted at the outpatient department of skin and venereal diseases at the 250-bedded General Hospital in Jamalpur. The study took place from January 2023 to June 2023 and used a descriptive cross-sectional design. A total of 150 patients, spanning all age groups and presenting with various skin and venereal diseases, were included as the study sample from the 250-bedded General Hospital in Jamalpur during the study period. Data collection was conducted using the purposive sampling method. Results: The study findings revealed that a significant proportion of the patients (28%) fell within the age range of 20-29 years, with 23.3% and 18.7% falling within the age ranges of 10-19 years and <10 years, respectively. A mere 7.3% of individuals were encompassed within the age bracket of 50 years and older. Out of the 150 patients, a majority (54.70%) were male. In the study it was discovered that a noteworthy 14% of the patients were affected by venereal diseases and 86% of the patients were affected by skin diseases. It was particularly noteworthy that the highest prevalence of these venereal diseases was concentrated within the 20-29 years age range, affecting approximately 14.29% of individuals within this group. Specifically, 19.51% of males in the study were found to have venereal diseases, in contrast to a lower prevalence of 7.35% among females. Non-Gonococcal Urethritis (NGU) was a notable condition observed ...

Hydrogel-Forming Microneedles in the Management of Dermal Disorders Through a Non-Invasive Process: A Review

Microneedle (MN) technology has emerged as a promising approach for delivering therapeutic agents to the skin, offering significant potential in treating various dermal conditions. Among these technologies, hydrogel-forming microneedles (HFMNs) represent a transformative advancement in the management of dermal diseases through non-invasive drug delivery. These innovative devices consist of micrometer-sized needles made of native or crosslinked hydrophilic polymers, capable of penetrating the stratum corneum without damaging underlying tissues. Upon insertion, HFMNs rapidly absorb interstitial fluid, swelling to form a hydrogel conduit that enables the efficient transport of therapeutic agents directly into the dermal microcirculation. The non-invasive nature of HFMNs enhances patient compliance by eliminating the pain and discomfort associated with traditional hypodermic needles. This technology allows for the delivery of a wide range of drugs, including macromolecules and biomacromolecules, which are often difficult to administer dermally due to their size and polarity. Moreover, HFMNs provide controlled and regulated release profiles, enabling sustained therapeutic effects while minimizing systemic side effects. Additionally, HFMNs can be used for both drug delivery and real-time interstitial fluid monitoring, offering valuable insights into disease states and treatment responses. This dual functionality positions HFMNs as a versatile dermatology tool capable of effectively addressing various dermal complications. This review explores the potential use of polymeric biomaterials in HFMN fabrication and their application in treating major dermal disorders, such as acne, psoriasis, and other skin conditions. Furthermore, the review highlights the non-invasive nature of MN-based treatments, underscoring their potential to reduce patient discomfort and improve treatment adherence, as supported by the recent literature.