Dermatological Skin Research Articles

Discriminative deep learning based benignity/malignancy diagnosis of dermatologic ultrasound skin lesions with pretrained artificial intelligence architecture.

Deep-learning algorithms (DLAs) have been used in artificial intelligence aided ultrasonography diagnosis of thyroid and breast lesions. However, its use has not been described in the case of dermatologic ultrasound lesions. Our purpose was to train a DLA to discriminate benign form malignant lesions in dermatologic ultrasound images. We trained a prebuilt neural network architecture (EfficientNet B4) in a commercial artificial intelligence platform (Peltarion, Stockholm, Sweden) with 235 color Doppler images of both benign and malignant ultrasound images of 235 excised and histologically confirmed skin lesions (84.3% training, 15.7% validation). An additional 35 test images were used for testing the algorithm discrimination for correct benign/malignant diagnosis. One dermatologist with more than 5 years of experience in dermatologic ultrasound blindly evaluated the same 35 test images for malignancy or benignity. EfficientNet B4 trained dermatologic ultrasound algorithm sensitivity; specificity; predictive positive values, and predicted negative values for validation algorithm were 0.8, 0.86, 0.86, and 0.8, respectively for malignancy diagnosis. When tested with 35 previously unevaluated images sets, the algorithm´s accuracy for correct benign/malignant diagnosis was 77.1%, not statistically significantly different from the dermatologist's evaluation (74.1%). An adequately trained algorithm, even with a limited number of images, is at least as accurate as a dermatologic-ultrasound experienced dermatologist in the evaluation of benignity/malignancy of ultrasound skin tumor images devoid of clinical data.

Skin concerns in patients with trisomy 21 (Down syndrome): A Mayo Clinic 22-year retrospective review.

Trisomy 21 has known associated clinical phenotypes, including skin and soft tissue concerns. However, the overall prevalence and types of findings are largely unclear. A retrospective review of children with trisomy 21 and one or more dermatologic diagnoses, seen from 1/1/1994 to 7/1/2016, was performed to record dermatologic diagnoses. If one or more diagnoses were confirmed, further data were collected, including demographics, medical specialty, referrals to dermatology, treatment, complications, and follow-up. One hundred and seventy-four patients with a diagnosis of trisomy 21 aged 18years or younger were confirmed to have one or more dermatologic diagnoses. In a total of 479 dermatologic diagnoses, superficial mycoses (12%), skin and soft tissue infections (10%), dermatitis (8%), and folliculitis (8%) were most common. Diagnoses were most commonly made as an outpatient (91%) and by general pediatrics (45%) or dermatology (25%). A significant difference (P<.05) in the frequency of various diagnoses made by different specialties was observed. A significant difference (P<.05) in the treatments recommended by different specialties was also observed. Referrals to dermatology were infrequent (6%). However, a frequent change in diagnosis (61%) or treatment (68%) for patients referred to dermatology was observed. Children with trisomy 21 are most commonly diagnosed with superficial mycoses, skin and soft tissue infections, dermatitis, and folliculitis. The majority of diagnoses were made by general pediatricians and although dermatology referral was rarely necessary, consultations often resulted in change of diagnosis and/or treatment, supporting consideration of early and frequent dermatology referral.

Универсальный инъекционный препарат для коррекции косметологических и дерматологических проблем кожи

Универсальный инъекционный препарат для коррекции косметологических и дерматологических проблем кожи

Application of epigenetics in dermatological research and skin management.

Epigenetics has recently evolved from a collection of diverse phenomena to a defined and far-reaching field of study. Epigenetic modifications of the genome, such as DNA methylation and histone modifications, have been reported to play a role in some skin diseases or cancer. The purpose of this article was to review the development of epigenetic in recent decades and their applications in dermatological research. An extensive literature search was conducted on epigenetic modifications since the first research on epigenetic. This article summarizes the concept and development of epigenetics, as well as the process and principle of epigenetic modifications such as DNA methylation, histone modification, and non-coding RNA. Their application in some skin diseases and cosmetic research and development is also summarized. This information will help to understand the mechanisms of epigenetics and some non-coding RNA, the discovery of the related drugs, and provide new insights for skin health management and cosmetic research and development.

A Call to Action by the Italian Mesotherapy Society on Scientific Research.

Mesotherapy (local intradermal therapy, LIT) is a technique used to slowly spread drugs in tissues underlying the site of injection to prolong the pharmacological effect with respect to intramuscular injection. Recommendations for proper medical use of this technique have been made for pain medicine and rehabilitation, chronic venous disease, sport medicine, musculoskeletal disorders, several dermatological conditions, skin ageing, and immune-prophylaxis. Although mesotherapy is considered a valid technique, unresolved questions remain, which should be answered to standardize methodology and dosing regimen as well as to define the right indications in clinical practice. New randomized controlled trials are needed to test single products (dose, frequency of administration, efficacy and safety). Even infiltration of substances for dermo-cosmetic purposes must be guided by safety and efficacy tests before being proposed by mesotherapy. In this article, we put forth a preclinical and clinical research plan and a health technology assessment as a call to action by doctors, researchers and scientific societies to aid national health authorities in considering mesotherapy for prevention, treatment and rehabilitation paths.

An Updated Review of What, When and How of Sertaconazole: A Potent Antifungal Agent

Sertaconazole is an imidazole/triazole type antifungal agent which selectively inhibit fungal cytochrome P450 sterol C-14 α-demethylase and act as potent antifungal agent. This enzyme is essential for fungal cell wall synthesis as it converts lanosterol to ergosterol. The antifungal spectrum of drug includes Candida, Malassezia, Cryptococcus, Aspergillus, Scopulariopsis and Scedosporium. In addition, sertaconazole has been reported to exhibit an antimicrobial activity against staphylococci, streptococci, and protozoa. The drug is practically insoluble in water and has an apparent half-life of approximately 60 hrs. It is prescribed for the treatment of interdigital tinea pedis (topical), mycoses of skin and mucosa in dermatology and gynaecology. Sertaconazole penetrates the horny layer of skin and the therapeutic concentrations may be found after a long period of time, avoiding the potential risk of systemic absorption. It is available in the market as cream, lotion and tablet formulations. This review summarises the physiochemical characterization of drug, involved pharmacokinetic, pharmacodynamics, safety profile along with the reported preclinical, clinical and formulation studies and patents thereof and the paradigm shift in the use of sertaconazole.

Practitioner assessment of mental health in dermatologic disease.

Patients with certain dermatologic skin diseases have been found to be at increased risk for depression and suicidal ideation. As there is not much information available on mental health interventions taken in dermatologic practices, we conducted a survey to assess the extent to which dermatologists monitor and follow up with the mental health of their patients. We discovered that dermatologists are aware of mental health issues associated with these dermatologic diseases but have no standard of care for their assessment. By obtaining this information, we can enable ourselves to fill in these deficiencies to help improve patient care.

Current updates on herbal oil vs synthetic antibiotics use for topical application

Topical skin infections represent some of the most common infectious sicknesses globally. Prevention and treatment of skin infections can involve utility of a topical antimicrobial, which may be an herbal oil and synthetic antibiotic drug. However, there's restricted evidence to aid the widespread rophylactic or healing use of topical agents. Challenges concerned inside the use of topical antimicrobials encompass growing costs of bacterial resistance, local allergy reactions. We evaluate the proof for the foremost scientific makes use of herbal oil and topical synthetic antibiotics. Herbal oils are traditional herbal treatments used to deal with several situations. 5% of plant oils used for dermatological usages, pores and skin moisturizing and skin care. The benefits of this sort of therapeutics encompass properly availability, local cultural elements and individual choices. the growing demand for herbal and organic merchandise, and the already established synergistic consequences of natural oil. Synthetic antibiotics are beneficial for topical administration to treating topical skin condition rather than the oral administration because of minimising the side effect of oral administration. Nowadays topical antibiotics is widely accepted effective and safe treatment for bacterial infection. In this review article comparison of the herbal oil Vs synthetic antibiotic drug for topical use.

Skin Preparation for Photodynamic Therapy, Chemexfoliation, and Ablative Laser Resurfacing: a Systematic Literature Review.

Photodynamic therapy, chemexfoliation, and ablative laser resurfacing are common practices for dermatologists, yet no formal protocols exist regarding preprocedural skin preparation. To review and summarize the skin preparation protocols for photodynamic therapy, chemexfoliation, and ablative laser resurfacing available in the literature. Data Sources A systematic review of English and non-English articles using the PubMed database was performed. A manual search of bibliographies from relevant articles was also performed to collect additional studies. Study Selection Only articles in the English language with full texts available that pertained to skin preparation for photodynamic therapy, chemexfoliation, and ablative laser resurfacing were included. Data Extraction Article selection was performed by one author, and relevant sources were verified by other authors using predefined inclusion and exclusion criteria. There is a paucity of scientific research regarding efficacy and safety of dermatologic preprocedural skin preparation agents. Only 2 studies have compared various cleansing agents for these measures. Yet, strong statements regarding the importance of degreasing are published without supportive data. Consensus guidelines for preprocedural protocols are lacking for photodynamic therapy, chemexfoliation, and ablative laser resurfacing. Further studies are warranted to explore the efficacy and safety of various preprocedural cleansing agents.

Comparing the delivery to the hair bulb of two fluorescent molecules of distinct hydrophilicities by different nanoparticles and a serum formulation

The follicular route is an important drug penetration pathway in any topical application, either concerning dermatological and cosmetic skin treatments or any transdermal administration regimen. Efficient transport into follicles will depend on drug inherent properties but also on the chosen vehicle. The main study goal was to compare several systems for the delivery to the hair bulb of two fluorescent molecules of different water affinities: the hydrophobic Nile Red and the quite similar but hydrophilic Nile Blue. Three common nanoparticle types were compared in terms of encapsulation efficiency and stability: liposomes, ethosomes and polymeric nanoparticles. A liquid serum-like formulation was also developed, adjusting the final ethanol amount to the type of dye to be solubilized. Then, this formulation and the nanoparticle systems that successfully passed characterization and stability stages were further studied on their ability to reach the bulb. The serum formulation was able to deliver, both drug models, to deeper follicular regions than nanoparticles. Attending to the envisioned zone target of the follicle, the simplest approach proved to be the best choice from all the systems tested in this work. Nonetheless, nanocarriers and the inherent complexity of their manufacturing processes may be justified under very specific requirements.

Antielastase Activity of Macassar Kernels (Rhus javanica) Stem Extract and Skin Elasticity Evaluation of Its Topical Gel Formulation.

Background Macassar kernels (Rhus javanica L.) has potential as an antiaging agent as it has antielastase activity, especially its stem extract which has best percent inhibition compared to its leaves and fruit extract. Moreover, the antiaging agent can be commonly used in the form of gel for topical applications. Hence, formulation of HEC-based topical gel from the stem extract of Macassar kernels was conducted. This study aims to determine the antielastase activity of the stem extract of Macassar kernels and evaluate the skin elasticity of its topical gel formulation by conducting dermatological safety and skin antiaging efficacy test. Methods The stem extract was in vitro tested for antielastase activity using a microplate reader. Then, a formulation of a topical gel containing Rhus javanica stem extract was made. Five stages of quality control, which consisted of an organoleptic test, homogeneity test, pH measurement, viscosity measurement, and physicochemical stability test, were conducted to ensure the quality of topical gel formulation. Last, clinical studies were conducted to evaluate the dermatological safety and antiaging efficacy of gel preparation containing stem extract of Rhus javanica. Results. The stem extract provided antielastase activity (IC50 = 245.68 μg/mL), and its polyphenol was valued at 23.28 ± 1.52 mg GAE/g). The gel containing 10% stem extract had better stability than the gel containing 5% stem extract. The dermatology safety test and efficacy test results indicated that the topical gel containing 10% Rhus javanica stem extract did not cause any skin irritation and significantly improved skin elasticity (p < 0.05). In the treatment group, the moisture parameter was significantly changed on day 14 (p < 0.0001), day 21 (p < 0.0001), and day 29 (p < 0.0001). The elasticity parameter was also changed significantly on day 14 (p=0.0485), day 21 (p=0.0537), and day 29 (p=0.0002). Conclusion The stem extract of Rhus javanica has potential antielastase activity. The topical gel containing Rhus javanica stem extract also has potential antielastase activity by increasing the skin moisture and enhancing skin elasticity.

Application of omics technologies in dermatological research and skin management.

"Omics" are usually based on the use of high-throughput analysis methods for global analysis of biological samples and the discovery of biomarkers, and may provide new insights into biological phenomena. Over the last few years, the development of omics technologies has considerably accelerated the pace of dermatological research. The purpose of this article was to review the development of omics in recent decades and their application in dermatological research. An extensive literature search was conducted on omics technologies since the first research on omics. This article summarizes the history and main research methods of the six omics technologies, including genomics, transcriptomics, proteomics, metabolomics, lipidomics, and microbiomics. Their application in certain skin diseases and cosmetics research and development are also summarized. This information will help to understand the mechanism of some skin diseases and the discovery of potential biomarkers, and provide new insights for skin health management and cosmetics research and development.

Intense pulsed light: Where we are now?

AbstractFrom the introduction of pulsed light broad‐spectrum energy in 1995, intense pulsed light (IPL) has evolved to become an extremely popular and well‐accepted technology for rejuvenation of photodamaged skin in dermatology and plastic surgery practices as well as medical spas. This paper details where IPL is now, 25 years later, and discusses the wide variety of valuable uses for IPL in medical practices as well as the reasons for IPL's growth in popularity and usefulness.

Addressing the challenges to skin health of refugees and migrants in the WHO European region.

The prevalence of dermatological disease and skin conditions is a significant issue facing refugees and migrants in the WHO European Region. Displaced populations in particular are vulnerable to dermatological diseases, due to the often poor conditions in which they live and transit through at different stages of their journey. Exposure to adverse weather conditions and heightened risk for injuries and violence are also potential causes for skin conditions and abnormalities. Through a review of published literature focusing on refugee and migrant health, this paper outlines the prevalence of skin conditions and dermatological diseases among these populations, and the impact of migration and displacement on susceptibility for them. It then discusses some of the challenges associated with managing skin conditions and highlights key opportunities to strengthen the integration of skin health within health care for migrants and refugees in the WHO European Region.

Wireless, soft electronics for rapid, multisensor measurements of hydration levels in healthy and diseased skin

Precise, quantitative measurements of the hydration status of skin can yield important insights into dermatological health and skin structure and function, with additional relevance to essential processes of thermoregulation and other features of basic physiology. Existing tools for determining skin water content exploit surrogate electrical assessments performed with bulky, rigid, and expensive instruments that are difficult to use in a repeatable manner. Recent alternatives exploit thermal measurements using soft wireless devices that adhere gently and noninvasively to the surface of the skin, but with limited operating range (∼1 cm) and high sensitivity to subtle environmental fluctuations. This paper introduces a set of ideas and technologies that overcome these drawbacks to enable high-speed, robust, long-range automated measurements of thermal transport properties via a miniaturized, multisensor module controlled by a long-range (∼10 m) Bluetooth Low Energy system on a chip, with a graphical user interface to standard smartphones. Soft contact to the surface of the skin, with almost zero user burden, yields recordings that can be quantitatively connected to hydration levels of both the epidermis and dermis, using computational modeling techniques, with high levels of repeatability and insensitivity to ambient fluctuations in temperature. Systematic studies of polymers in layered configurations similar to those of human skin, of porcine skin with known levels of hydration, and of human subjects with benchmarks against clinical devices validate the measurement approach and associated sensor hardware. The results support capabilities in characterizing skin barrier function, assessing severity of skin diseases, and evaluating cosmetic and medication efficacy, for use in the clinic or in the home.

Perspective approaches on melanogenesis inhibition

Melanogenesis is a melanin-forming process responsible for protecting the skin against ultraviolet radiation damage. An excess production of melanin, however, may result in hyperpigmentation (darkening of the skin) to adverse dermatological effects (freckles, solar lentigines, and melasma) and skin cancer. These hyperpigmentary skin disorders may also have a major effect on a person's appearance and could even result in emotional and mental distress, as well as a diminished quality of life. A large number of melanogenesis inhibitors have been discovered, but most of them appeared to have undesirable side effects. Therefore, in order to better understand the mechanisms of hyperpigmentary skin disorders and to establish effective and safe melanogenesis inhibitors, more fundamental research is needed. Apart from tyrosinase blockers, there are also alternative approaches that involve the manipulation of melanogenesis regulatory pathway such as α-melanocyte-stimulating hormone blockers, melanosome transferase inhibitors, and cytokines. This review abridges data on the different melanogenesis inhibitors and depigmentation agents from both natural and synthetic agents from the last few years.

Development of a Novel Minimally Invasive Sampling and Analysis Technique for Bioarchaeological Proteomics

Ancient proteomic analysis has been shown to have several advantages over ancient DNA studies, largely due to the ability of many proteins to survive over longer periods of time than their corresponding genes. High-resolution mass spectrometry allows for large scale data to be generated from small amounts of sample. Typically, sampling of bioarchaeological material for proteomics has involved the use of invasive tools such as drills and hammers, which presents an issue when working with museums and other heritage organisations. There exist a few studies in the published literature on the use of specifically manufactured sampling tapes for the minimally invasive analysis of paintings and frescoes, and recently an example of their application to mummified skin. Here we present the development of a novel minimally invasive sample preparation technique for application in the mass spectrometric analysis of bioarchaeological materials. The extraction protocol was developed by applying commercially available, dermatology grade skin sampling strips to modern skin surfaces as a surrogate, and then applied to cranial and bone fragments belonging to a 26th Dynasty Egyptian mummified individual from the coffin of a woman named Mer-Neith-it-es. Extracted proteins were subjected to electrophoretic separation and proteolytic digestion, resulting in peptides that were separated, fragmented and identified using nanoflow liquid chromatography - high resolution tandem mass spectrometry. We have identified a number of ancient brain and intracellular proteins on the surfaces of the various cranial and bone fragments, without causing any significant damage to these valuable remains.

Use of a Clinic-Based Skin Cancer Prevention Bundle to Promote Sun-Protective Behaviors in Patients at Moderate to High Risk for Skin Cancer

ABSTRACT Background Skin cancer is the most common type of cancer in the United States, and one in five Americans will develop a skin cancer at least once during their lifetime (U.S. Cancer Statistics Working Group, 2016). Analysis of current skin cancer prevention practices in a large academic university dermatology clinic revealed a lack of skin cancer risk stratification, targeted prevention messaging, and assessment of sun-protective behavior (SPB) use. An improvement project was initiated to evaluate the impact of a skin cancer prevention bundle (SCPB) on SPB use and sunburn frequency over a 2-month period. Methods Adult clinic patients 20–65 years old, at a moderate to high risk based on Brief Skin Cancer Risk Assessment Tool scores, received an SCPB consisting of personalized Brief Skin Cancer Risk Assessment Tool risk feedback, American Academy of Dermatology skin cancer prevention recommendations, and a brief American Academy of Dermatology skin cancer prevention video. A Sun Habits Survey and an assessment of perceived skin cancer risk were performed preintervention and postintervention. Results Thirty-eight participants (92.7%) completed the project. Outcome measures showing significant difference postintervention included Sun Protection Habits Index summary scores (p &lt; .0001), sunburn frequency (p &lt; .0001), and lifetime perceived risk of skin cancer (p = .007). Individual SPB habits of limiting midday ultraviolet exposure (p = .0004) and frequency of hat use (p = .01) also showed significant increases postintervention. Conclusions and Implications Use of the clinic-based SCPB improved SPB use and reduced sunburn frequency. The SCPB is being considered for clinic-wide implementation based on the findings. Further study with a larger number of participants and ongoing postclinic implementation evaluation is recommended to confirm results and fully assess the potential of the SCPB to improve patient outcomes and reduce skin cancer risk.

Educational brochure impact on postscreening practices of American Academy of Dermatology skin cancer screening participants

Educational brochure impact on postscreening practices of American Academy of Dermatology skin cancer screening participants

Natural History and Risk Factors of Infantile Atopic Dermatitis: A Case Report and Literature Review

Atopic dermatitis (AD) or atopic eczema is one of the most common forms of pediatric dermatological skin conditions, primarily beginning in childhood with a variable natural course characterized by intense pruritus and eczematous lesions. This condition requires multifactorial interplay and risk factors to explain the pathogenesis. We hereby report a case of a two-month-old male who presented with widespread erythematous lesions, excoriations, and dry skin since one day before admission. The antenatal history showed use of antibiotics during pregnancy, familial history of atopy, and non-exclusive breastfeeding which are all known risk factors. Dermatological examination revealed skin phototype III with diffuse erythematous patches scattered on the face, trunk, upper and lower limbs, and groin followed with excoriations and palmar hyperlinearity. Further laboratory and histopathological examinations were not conducted. The patient was treated with topical corticosteroid and emollients, resulting in a notable improvement without any further flares. A thorough history taking and physical examination must be conducted to establish the diagnosis based on the Hanifin and Rajka criteria and identify risk factors such as genetic factors, impaired skin barrier, and environmental factors and microbial exposure, which may play a protective or harmful role in AD development. Holistic treatments consist of pharmacological and non-pharmacological treatments, with significant emphasis on education to the patient and caregiver(s) to improve quality of life and prevent exacerbations and infectious complications while minimizing potential medication side effects.