Dermatological Disorders Research Articles

MiR•101 and miR•122 Targeting δ-Catenin to Regulate Keratinocyte Responsiveness to IL-17A in Psoriasis.

Psoriasis is an immune-mediated inflammatory dermatological disorder characterized by the interaction between immune cells and keratinocytes, which perpetuates cutaneous inflammation and cellular hyperproliferation. In this study, we identified a strong δ-catenin signature in psoriatic skin; however, the precise role of δ-catenin remains to be elucidated. Additionally, we observed that Interleukin (IL)-17A, a pivotal cytokine involved in the development of psoriatic lesions, induces δ-catenin expression in HEKn and HACAT cells. From a mechanistic perspective, δ-catenin initiated NF-κB signaling, subsequently leading to the activation of IL-6 and IL-8 production. Furthermore, silencing δ-catenin expression mitigated IL-17A-induced hyperproliferation of keratinocytes through the NF-κB pathway. Our study further identified miR-101 and miR-122 as upstream regulators of δ-catenin, exerting their effects by downregulating δ-catenin protein levels. We demonstrated that miR-101 and miR-122 can inhibit the hyperproliferation of keratinocytes induced by δ-catenin. These findings validate the role of δ-catenin in the pathogenesis of psoriasis, particularly in keratinocyte-mediated inflammatory responses and cellular hyperproliferation. Consequently, miR-101 and miR-122 hold potential as therapeutic agents in the treatment of psoriasis.

Patient Age and Antibiotic Formulation Administration in the Pediatric Emergency Department.

Oral antibiotics are the most prescribed medication in the United States. We sought to describe the distribution of oral antibiotic formulation administration among children in the emergency department (ED). We performed a retrospective single-center study of children presenting to a pediatric ED. We included encounters for children (<18 years) discharged from the ED between 2016 and 2022 and prescribed one of 7 common antibiotics in oral suspension or tablet/capsule forms, excluding children with an enteral feeding tube or complex neuromuscular conditions. We analyzed encounters for children administered an antibiotic in the ED and antibiotic prescriptions. We determined the age at which the proportion of children given a tablet or capsule equaled or exceeded the proportion of those given a suspension. We identified 12,900 eligible encounters (median age: 4.3 years, interquartile range: 1.7 to 8.1 years; 51.5% boys). The most common diagnoses were infectious ear disorders (22.6%), infectious mouth and throat disorders (9.1%), infectious skin, dermatologic and soft tissue disorders (6.6%), and infectious nose and sinus disorders (6.2%). For all antibiotics administered in the ED (n = 3809 encounters; 52.6% for amoxicillin), the age threshold at which more children were prescribed the tablet/capsule than the suspension formulation was 14 years. This threshold for each antibiotic was 16 years for amoxicillin, 13 years for amoxicillin-clavulanate, 11 years for azithromycin, 14 years for cefdinir, 12 years for cephalexin, 11 years for clindamycin, and 10 years for trimethoprim-sulfamethoxazole. Findings were similar for encounters discharged from the ED with an antibiotic prescription. We identified age-related differences in antibiotic formulations in a pediatric ED. These findings can inform prescribing practices to optimize medication adherence and treatment effectiveness through clinical decision support and shared decision-making and may be especially useful during periods of formulation shortages or when planning for clinical research.

Bavachinin causes cholestasis by down-regulating BAAT expression and disrupting glycocholic acid synthesis in human liver organoids.

Bavachinin causes cholestasis by down-regulating BAAT expression and disrupting glycocholic acid synthesis in human liver organoids.

Mental Health Disorders Among Hidradenitis Suppurativa Patients – A Review of Literature

Introduction and objective: Hidradenitis suppurativa (HS) is a chronic skin condition that primarily affects areas of the body with a high concentration of sweat glands, characterised by painful papules, abscesses and scarring. It occurs in approximately 1-4% of people and is frequently associated with other health problems such as obesity, smoking and metabolic problems. HS can cause both physical and psychological suffering beyond simple pain. This review aims to assess the mental health challenges of people living with HS. Review methods: All data were collected from publicly available sources. This article's databases were accessed via PubMed, Scopus, and Web of Science. A brief description of the state of knowledge: HS is more than a dermatological disorder; it’s intimately associated with multiple other conditions. Patients affected by HS have a greater prevalence of depression, anxiety, and other mental health disorders. The psychological toll of HS is significant, with research indicating elevated rates of conditions such as bipolar disorder, schizophrenia and substance abuse. The association between physical health and mental well-being is an important concern, as these mental health challenges can lead to the further decline in a patient’s quality of life and increase the risk of self-harm or suicide. Summary: Overall, although HS is primarily a physical health issue, its psychological implications must not be overlooked. People are increasingly prone to depression, anxiety and other mental health issues. These psychological issues can be a vicious cycle of suffering that impacts their general wellbeing. Treating both the somatic and mental implications of HS must be a priority for enhancing patient outcomes.

Risk of Serious Infections in Patients Treated With Biologic or Targeted-synthetic Disease Modifying Antirheumatic Drugs in Qatar.

Biologic and targeted-synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), are pivotal in the management of autoimmune-inflammatory disorders, acting by suppressing pathological immune activation. Because of associated immune dysfunction, opportunistic or serious infections (SIs), and latent disease reactivation is frequently reported. This study aimed to investigate the epidemiology, risk factors, and outcomes of SIs in patients treated with b/tsDMARDs in Qatar. A retrospective cohort study was conducted at Hamad Medical Corporation, including all the patients treated with one of 10 b/tsDMARDs, between January 2017 and July 2021. Besides descriptive statistics, the Chi-square test and Kaplan-Meyer survival analysis were used for statistical analysis. Out of 1092 patients, 86 (7.9%) had SIs, with an incidence rate of 39.4 per 1000 patient years. Mean duration of onset was 10.8 months post-initiation of therapy. Younger age groups (18-52 years) were predominantly affected. A significant association was observed between the primary diagnosis (rheumatological followed by gastrointestinal, neurological, and dermatological disorders) and the occurrence of SIs (χ² = 9.512, p < 0.050). Adalimumab and infliximab had a higher risk of SIs compared to other b/tsDMARDs. There was no significant difference between TNF-inhibitors and others. Ocrelizumab was significantly associated with incidence of COVID-19 SIs (χ² = 16.84, p = 0.0000408), and etanercept with Staphylococcus aureus SIs (χ² = 17.51, p = 0.0000285). Predominant infection sites were skin-soft tissue and respiratory tract. Most of the SIs were secondary to either bacteria (43%) or viruses (17.4%). The mean duration of hospitalization was 9 days, and 7% of patients required critical care, with no recorded 90-day mortality. Patients with inflammatory conditions managed with b/tsDMARDs are at significant risk of SIs, which necessitate appropriate patient selection weighing benefits and risks, as well as careful long-term management that include patient education and relevant preventive therapy.

Secondary Psychiatric Disorders in Patients with Skin Diseases

Secondary psychiatric disorders develop during the course of a chronic dermatological illness. These include depression, anxiety, psychosis, adjustment disorders, substance use disorders, and delirium. Due to stigma associated with psychiatric disorders among patients and the barriers to assessment in a dermatology clinic (time, knowledge, and skills), the psychiatric comorbidities are often not identified and rarely treated even though they cause significant morbidity. Patients with chronic skin diseases should be regularly screened for psychological distress and managed in liaison with mental health professionals. This narrative review summarizes the latest available literature and discusses the epidemiology, etiology, and management of secondary psychiatric disorders among patients with dermatological disorders. Early recognition and management of psychiatric disorders among patients with dermatological illness can improve their quality of life.

Appearance of Verruca Over Nevus Unius Lateris – A Rare Occurrence of Locus Minoris Resistentiae

Nevus unius lateris is an infrequent dermatological disorder which is characterized by verrucous epidermal nevus involving one half of the body. It is a variant of systematized epidermal nevus. It commonly displays an association with neurological, visual, auditory, and musculoskeletal involvement. Verruca are nonmalignant growths that manifest on the skin and mucous membranes. It is caused by the human papillomavirus. It characterized by warty growth over the skin. Here, we report a case of nevus unius lateris and appearance of verruca over nevus unius lateris in a 29-year-old male.

Global health implications of urticaria burden (1990–2021): a comprehensive analysis of trends across nations and regions

IntroductionUrticaria is a widespread dermatological disorder that substantially affects patients’ quality of life. Current data on its worldwide impact are crucial for healthcare planning and resource distribution. By analyzing the Global Burden of Disease (GBD) Study 2021, we evaluated the burden of urticaria across global, regional, and national levels.Material and methodsA comprehensive analysis was performed using data from the GBD 2021 study. Key metrics included prevalence, incidence, and age-standardized rates, all calculated per 100,000 people. The results were analyzed across demographic factors including age groups, gender, and geographical locations.ResultsFrom 1990 to 2021, global urticaria metrics demonstrated relative stability, with female patients consistently reporting higher rates. During this period, the number of prevalent cases increased from approximately 48 million to 66.5 million, with the age-standardized prevalence rate (ASPR) showing a slight rise from 866 to 868 per 100,000 population. The number of incident cases increased from about 85 million to 117 million, while the age-standardized incidence rate (ASIR) showed a marginal increase from 1,529 to 1,534 per 100,000. The global age-standardized DALY rate reached 52.1 per 100,000 in 2021, ranging from 27.7 in Portugal to 88.4 in Nepal. The disease burden was most pronounced in low-middle SDI regions and lowest in high SDI areas. At the country level, Nepal recorded the highest burden across all metrics, while Portugal showed the lowest.ConclusionsOur analysis spanning three decades revealed that while the overall global burden of urticaria has remained relatively stable, there has been a modest upward trend in both prevalence and incidence. Notable disparities have emerged, with disproportionate impacts observed across different populations: females experience higher rates of the condition, and low-middle SDI regions shoulder a greater disease burden. These patterns highlight the importance of developing focused healthcare strategies and optimizing resource distribution, particularly in heavily affected regions. Given the inherent limitations of GBD data, these findings should be interpreted with appropriate caution.

Pinpoint the Aliment of Skin Disease With AI

Abstract: Dermatology is the field of science responsible for diagnosis and management of skin disorders. The dermatological disorders are wide spread and vary geographically, and usually due to the change in temperature, humidity and other environmental factors. Human skin presents one of the most complex systems to mechanically image and analyze due to its unevenness, color, presence of hair and other soothing features. Although, numerous researches are being done to find out and prove human skin As exploited (Computer Vision techniques), very few concentrated around the medical paradigm of the issue. Owing to lack of medical facilities available in the remote regions, patients often ignore early warning signs which could later worsen the situation over time. Thus, there is always a growing demand for automatic skin disease detection system with high accuracy of diagnosis. Therefore, we propose a system for automatic detection and classification of skin diseases for building a multi-class deep learning model to tell the difference between Healthy Skin and skin suffering from a disease and categorization of skin diseases into the following groups: Melanocytic Nevi, Melanoma, Keratosis like lesions, Basal cell Carcinoma, Actinic Keratoses, Vascular tumor, and Dermatofibroma. We have used Profound Learning to prepare our show. Profound Learning could be a subset of Machine Learning which uses a much bigger dataset than the traditional approach, thus the number of classifiers is reduced significantly. The machine is capable of learning all by itself, it sorts the provided data into different levels of prediction and very quickly, gives the precise results, thus helping and fostering the development of Dermatology. The algorithm that we have used is Convolutional Neural Arrange (CNN) because it is one of the foremost preferred calculation for picture classification

Snakes and Skin: A Review of Aesthetic, Analgesic, and Anesthetic Snake Venom Applications.

Snake venoms contain a diverse array of organic compounds, including potent neurotoxins and cytotoxins known for inducing neurologic impairment and cellular damage. Despite these dangers, several medications derived from snake venom have gained Food and Drug Administration (FDA) approval, marking significant advancements in therapeutic applications. Notably, neurotoxins have garnered attention in pain research due to their demonstrated analgesic and anesthetic properties, offering potential benefits in dermatological disorders associated with pain symptoms. Recent murine studies of snake-derived neurotoxins such as mambalgin-1, mambalgin-2, crotamine, and cobrotoxin have shown efficacy in alleviating neuropathic and chronic pain, often outperforming traditional analgesics like morphine, with fewer adverse effects reported. Limited applications of these venom components in humans, including local injections for the treatment of neuropathic pain and inflammation, have yielded encouraging findings through observational studies. Beyond pain relief, snake venom's benefits also extend to anti-aging treatments through their paralytic effects, with synthetic neurotoxins now available in various cosmetic products. This review explores the advancements in snake venom-based therapies, focusing on their analgesic, anesthetic, and aesthetic properties in the treatment of dermatological conditions.

Influence of Climatic Conditions and Atmospheric Pollution on Admission to Emergency Room During Warm Season: The Case Study of Bari

The study of the effects of climate change and air pollution on human health is an interesting topic for wellbeing projects in urban areas. We present a method for highlighting how adverse weather and environmental conditions affect human health and influence emergency room admissions during the summer in an urban area. Daily apparent temperature, a biometeorological index, was used to characterize thermal discomfort while atmospheric concentrations of PM10 and NOX were used as indicators of unfavorable environmental conditions. We analyzed how the above parameters influence the emergency room access, considering all the different pathologies. Over the four years analyzed, we identified the periods during which environmental conditions (both thermal discomfort and pollutant concentrations) were unfavorable, the persistence of these conditions, and verified that during these days, the average daily number of emergency room visits increased. Visits for ENT and dermatological disorders also showed significant increases. Our analysis showed that emergency room access is useful in evaluating the impact of unfavorable climatic and environmental conditions on human health during the summer period; vice versa, our results could be used to optimize resource management in emergency rooms during this specific period of the year.

Tzanck Smear: Old Handy Tool in Modern Dermatology.

Tzanck smears, first introduced by Arnault Tzanck, are widely used in dermatology for the cytodiagnosis of cutaneous lesions. In the current era of evidence-based medicine with the availability of more confirmatory sophisticated tests, the use of this bedside tool is limited. In this article, the authors tried to assess the utility of Tzanck smear in various dermatological disorders. Findings in the Pemphigus group of disorders were studied in detail with complete and incomplete changes. Results were compared with histopathology, anti-desmoglein antibody status, and in combination. Further subtle features of the acantholytic cells were studied in detail. The sensitivity and specificity with histopathology and anti-desmoglein antibodies were 80.70%, 68.18% and 82.75%,100%. When patients were having either follow-up of histopathology or anti-desmoglein antibodies, each sensitivity was 81.01% and specificity was 87.50%. Complete acantholytic cells were predominant in 39.18%, and incomplete cells were predominant in 60.32% of cases. Rounding was the most consistent feature followed by nuclear enlargement. Streptocytes, dyskeratosis, and tadpole cells were also seen in a few cases. Other diagnoses of viral infections, like molluscum contagiosum (4 cases) and Herpes virus cytopathic effects (25 cases), were also observed in the study. Finally, Tzanck smear is still useful in dermatology, which can aid in rapid diagnosis and starting early treatment. Incomplete acantholytic cells, when seen in smear, help to pick up Pemphigus disorders even if all the classical features are not seen.

The Role of Keratinocytes in Skin Health and Disease

ABSTRACTAimThis study aims to provide a comprehensive analysis of keratinocytes, the predominant cell type in the epidermis, by examining their structural, functional, and regulatory roles in skin biology. The study explores the intricate processes of keratinocyte differentiation, proliferation, and immune interactions, emphasizing their essential contributions to skin homeostasis, wound healing, and barrier integrity. Additionally, it investigates the involvement of keratinocytes in dermatological disorders such as psoriasis, atopic dermatitis, and skin cancer, highlighting their pathological alterations and molecular mechanisms.MethodsThis review covers a broad range of studies, including in vitro and in vivo research on keratinocyte biology, their interactions with growth factors, and their contributions to inflammatory responses in the skin. It also discusses therapeutic advancements such as biologics and gene therapy that focus on restoring keratinocyte function in skin diseases.ResultsThe review highlights that keratinocytes play a pivotal role in skin inflammation and the regulation of growth factors that promote wound healing and skin regeneration. Dysregulation of keratinocyte function is linked to several skin diseases, emphasizing the need for targeted therapeutic approaches. Recent advancements in treatments, such as gene therapy and biologics, offer promising outcomes for managing conditions driven by keratinocyte dysfunction.ConclusionThe primary aim of this review is to provide an in‐depth overview of the functions of keratinocytes, particularly their roles in skin health, inflammation, and disease development. The review also aims to highlight the latest therapeutic strategies targeting keratinocytes for the treatment of skin diseases.

Expanding Therapeutic Applications of Tofacitinib in Immune-Mediated Skin Disorders: A Comprehensive Review

Tofacitinib, a Janus kinase (JAK) inhibitor targeting JAK1 and JAK3, has gained attention for its immunomodulatory effects, particularly in autoimmune and inflammatory conditions. While initially approved for rheumatoid arthritis, its off-label uses in dermatology are expanding, with promising results in conditions such as vitiligo, alopecia areata, atopic dermatitis, psoriasis, and plaque psoriasis. By inhibiting the JAK-STAT signaling pathway, tofacitinib reduces cytokine-mediated inflammation and immune cell activation, offering a novel therapeutic option for dermatological disorders where traditional treatments have failed. This review explores the pharmacology of tofacitinib, its current off-label dermatological uses, and future research opportunities. It also addresses challenges related to long-term safety, accessibility, and treatment resistance. Ongoing clinical trials and potential new indications, as well as combination therapies, are discussed, highlighting tofacitinib's evolving role in dermatology.

An Overview of Malaysian Rainforest Herbs with Potential Anti-acne Activity

Background: Acne vulgaris, a common dermatological disorder that affects around 85% of individuals and is characterized by inflammation and infection. Natural products and traditional medicines have been used as alternative treatments to chemical-based products due to negative side effects and drug resistance. Objective: This review aims to provide an overview of the anti-inflammatory, antioxidant, and antibacterial properties of Malaysian medicinal plants for use in acne. Methodology: The databases used were the National Center for Biotechnology (NCBI), PubMed, Google Scholar, Scopus, and Science Direct. At least one keyword or combination of the following terms: i) antibacterial, ii) anti-inflammatory, iii) antioxidant, iv) anti-acne, v) antimicrobial, vi) Malaysia, and vii) medicinal plants, were used for the search. Results: Eurycoma longifolia Jack, Quercus infectoria, Strobilanthes crispus, Aquilaria crassna, Ficus deltoidea Jack, Phyllanthus emblica, Barringtonia racemosa, Boesenbergia rotunda L, Rhinacanthus nasutus, Tacca integrifolia rhizome, Clinacanthus Nutans, Labisa pumila Benth. Morinda citrifolia with Psidium guajava L. leaves, Cinnamomum verum, Moringa oleifera, Salix alba, Gaultheria fragrantissima, Garcinia mangostana, Azadirachta indica, and Aloe barbadensis miller have been linked to the use as potential anti-acne agents. Conclusion: Malaysia's rainforest herbs have the potential to be used in formulations for adjunct treatment to currently available anti-acne agents due to their antiinflammatory and antibacterial bioactivities.

Osteopontin promotes keratinocyte proliferation by G0/G1 cell cycle arrest in psoriasis.

Psoriasis isa chronic inflammatory dermatological disorder that is featured by the abnormal activation of epidermal keratinocytes. Osteopontin (OPN) is a multifunctional phosphoprotein upregulated in psoriasis. OPN levels in the skin of psoriasis patients and healthy subjects were assessed by immunohistochemistry. To evaluate the potential role of OPN in keratinocyte proliferation, the knockdown model of OPN was constructed using OPN siRNA. The proliferative activity of HaCaT cells was assessed via the CCK-8 and EdU cell proliferation assays. The cell cycle and apoptosis were analyzed using flow cytometry. Western blot assay was conducted in order to investigate the expression levels of cyclins, CDKs, and apoptosis-associated proteins. OPN expression was increased in the epidermis of psoriasis lesions and OPN knockdown inhibited the proliferation of keratinocytes. OPN affected keratinocyte proliferation by G0/G1 cell cycle arrest and promoted their apoptosis, which involved the regulation of cyclins (Cyclin D1 and Cyclin A2), cyclin-dependent kinases (CDK2 and CDK4), and apoptosis proteins (Bim, Bcl-2, and Caspase-3) in keratinocytes. OPN expression was significantly higher in keratinocytes of psoriasis lesions. OPN knockdown inhibited the keratinocyte proliferation, arrested the G0/G1 cell cycle, and promoted apoptosis. This suggests that OPN may provide a new mechanism for the proliferation of keratinocytes in psoriasis.

Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression

Acquired epidermodysplasia verruciformis (EV) is a rare dermatologic disorder linked to increased susceptibility to specific HPV infections in immunosuppressed states. We report a 43-year-old renal transplant recipient on prolonged immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and corticosteroids who developed multiple asymptomatic wart-like papules and plaques on extremities, hypopigmented pityriasis versicolor-like macules on the trunk, and seborrheic keratosis-like lesions on the face. Histopathology confirmed EV, showing acanthosis, hyperkeratosis, and keratinocytes with pale blue cytoplasm, perinuclear halos, and mild nuclear dysplastic changes. Due to malignancy risk in sun-exposed areas, strict sun protection and follow-up were advised. With acitretin and imiquimod unavailable, lesions were managed with intralesional measles, mumps, rubella (MMR) vaccine, and topical keratolytic, resulting in partial regression. This case highlights the need for early recognition, vigilant monitoring, and tailored management of EV in immunosuppressed patients, emphasizing further research to refine therapeutic strategies in resource-limited settings.

Ultra-High Frequency Ultrasound (UHFUS) Features of Pyoderma Gangrenosum, Venous Leg Ulcers, and Acute Ulcerative Lesions.

Pyoderma gangrenosum (PG) is a neutrophilic dermatological disorder, marked by the dysregulation of both innate and adaptive immunity. Recently, non-invasive imaging techniques, including the use of Ultra-High Frequency Ultrasound (UHFUS), have been used to assess patients with PG. The primary objective of this study is to characterize the UHFUS differences among various cutaneous ulcerative diseases. We enrolled 45 patients: 15 patients suffered from PG (Group 1), distinguished in inflammatory phase (PG-i) and non-inflammatory phase (PG-ni); 15 patients had Venous Leg Ulcers (VLU) (Group 2); and 15 patients had Acute Injury (AI) (Group 3). For each lesion, UHFUS examination was performed with a 70 MHz linear probe to examine the angle of ulceration, epidermal and dermal morphological characteristics vascular morphology and the "scattering" signal. The study identified significant differences in the ulceration angle among various ulcerative pathologies: obtuse in Group 2, flat or straight in Group 3, predominantly acute or straight in Group 1. Moreover, PG-i phase exhibited significant fragmentation of the dermoepidermal junction (DEJ). The presence of a Subepidermal Low Echogenic Band (SLEB), hypoechogenicity of the dermis, and fluid collections were predominantly observed in the PG-i. The predominant vascular morphology in Groups 2 and 3 was regular, while in Groups 1 was irregular, presenting a high degree of "scattering" signals. The study highlights the usefulness of UHFUS as an imaging tool for assessing skin ulcers, especially those related to PG. This approach could be promising for improving diagnosis and treatment. However, further research is needed for standardization and clinical implementation.

Dermatitis Artefacta : A Rare Case of Psychodermatological Disorder

Background: Dermatitis Artefacta (DA) or Factitious Dermatitis (FD) is a self-inflicted dermatological condition. It is more common in female. It has an underlying motive to assume a sick role for a secondary benefit. This act of deliberate self harm is to reduce the hidden sufferings of emotional distress. Due to polymorphism of the lesions and strong denial of the self-infliction of the injury there is always a diagnostic dilemma. Here we report an interesting case of DA with a confusing presentations where diverse and innovative means for self-inflicting injuries were produced. But initially it is difficult to diagnose the skin lesions, if proper history is not taken providing enough time and lack of proper examination of the lesion further add the difficulties. Case Presentation: Miss Y, 15 years old female, hailing from a nearby Upzilla of Chattogram, got herself admitted 10th July 2023 at Chattagram Maa-O-Shishu Hospital with the complaints of multiple skin eruption with bleeding from the lesions in both arms and lower limbs for three months. The lesions were bizarre, with a tapering end at various stages of healing, and were not compatible with any known dermatological disorder. Her mini mental state examination was normal and she had no delusions or hallucinations. Conclusion: Lack of proper identification of the underlying psychiatric disturbances may be the major cause of treatment failure and loss of follow up. Key words: Dermatitis artefacta; Dermatologist; Factitious dermatitis; Polymorphism; Psychiatry. Chatt Maa Shi Hosp Med Coll J; Vol.23 (2); July 2024; Page 104-107

Hyaluronic acid modified liposomes with enhanced transdermal delivery of methotrexate for psoriasis treatment.

Hyaluronic acid modified liposomes with enhanced transdermal delivery of methotrexate for psoriasis treatment.