Xeroderma Research Articles

Dermatological manifestations and associated factors in patients with Graves\' disease in Dakar

: The dermatological manifestations of Graves' disease exhibit a polymorphic nature. Our objective was to delineate the diverse cutaneous, mucosal, and pharyngeal manifestations associated with Graves' disease and to assess the influence of the received treatments.: This cross-sectional study involved the prospective collection of data conducted between March 1st and August 31st, 2021. We enrolled patients aged 18 years or older diagnosed with Graves' disease and under follow-up care at two referral endocrinology units.: Out of the 288 enrolled patients, 210 (72.9%) presented dermatological manifestations. The average age was 38.27 years, and the sex ratio was 0.117. Notably, 44.7% (n=84) of patients reported a history of voluntary skin bleaching. The predominant dermatological manifestations included palmar and/or plantar hyperpigmentation (55.7%), dry and brittle hair (47.6%), non-scarring alopecia (45%), axillary depilation (36.2%), hand wetness (22.8%), skin xerosis (18.6%), pruritus (17%), eyebrow tail sign (16.2%), palmar and/or plantar keratoderma (14.3%), brittle nails (9%), pretibial myxedema (1.4%), and one case of lichenoid toxidermia related to thiamazole. Notably, pruritus showed a statistically significant correlation with the use of oral phytotherapy (p=0.04784). Among former patients, cutaneous hyperpigmentation was statistically associated with carbimazole (p=0.03721) and propranolol (p=0.009850).: The primary dermatological feature in Graves' disease is characterized by the prevalence of cutaneous hyperpigmentation. The persistence of these manifestations for some patients may be attributed to the treatments administered.

Thyroid antibodies in Hashimoto's thyroiditis patients are positively associated with inflammation and multiple symptoms.

Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody (TPO-Ab) and/or thyroglobulin antibody (TG-Ab). Patients have multiple symptoms despite adequate hormone substitution. In the present study, we aimed to quantify the relationship between thyroid antibodies and multiple symptoms, inflammation and health-related life quality. A total of 108 HT patients with clinical euthyroid status and 57 heathy controls were recruited. Clinical parameters were determined by laboratory examination, and the symptoms burden and life quality were obtained by a Hashimoto's Thyroiditis Symptom Questionnaire and a SF-36 Questionnaire, respectively. Compared with healthy controls, multiple extrathyroidal symptoms were significantly more serious in HT patients despite euthyroid status, mainly including that related to digestive system (abdominal distension, constipation and diarrhea), endocrine system (chilliness, gain weight and facial edema), neuropsychiatric system (forgetfulness, anxiety, depressed, fatigue, insomnia, irritability, and indifferent) and mucocutaneous system (dry skin, pruritus, and hair loss). Furthermore, serum TPO-Ab and TG-Ab were both inversely correlated with health-related life quality of general health and vitality parameters, and positively correlated with pro-inflammatory factors of TNF-α and IFN-γ, as well as severity of abdominal distension, diarrhea, chilliness, forgetfulness and fatigue. Moreover, TG-Ab level was positively associated with depressed, insomnia and indifferent. HT patients suffered from a variety of symptoms, and the elevated thyroid antibodies were inversely associated with health-related life quality and positively associated with inflammation and multiple extrathyroidal symptoms.

Formulation and Evaluation of Herbal Footcream

Skin diseases are numerous and a frequently occurring health problem affecting all ages from the neonates to the elderly and cause harm in number of ways. If the cracks in the heels are deep, they can be painful, hurting when a person stands up, and they may sometimes bleed. Some wild plants and their parts are frequently used to treat these diseases. Herbal crack cream contains the extracts of the plantconsists of five ingredients viz., extract of Daruharida (Berberisaristata DC.), Pashanbheda (Bergenialigulata (Wall.) Engl.), Jivanti (Leptadeniareticulata W. & A.), kampilak (Mallotusphilippensis Muell.-Arg.), Manjistha (Rubiacordifolia Linn.) were used to prepare Herbal crack cream. The main objective of the research work was to prepare and evaluate Herbal crack cream and the results showed that Herbal crack cream passeall Parameters related to cream and TLC of formulated cream and extract showed that the tannins, flavonoids and alkaloids were found to be present in mentioned medicinal plants. These days, skin conditions are a major cause of illness for people of all ages. If someone has a crack in their foot's heel, it hurts and is quite uncomfortable. Environmental factors contribute to the growth of germs and fungi on human skin. This factor is taken into account when creating HERBALFOOTCREAM. That cream's function is to hydrate the heel, and its emulsion is w/o type (cold cream). Cold cream works by producing an oily coating on the skin that aids in reducing water loss from the skin to the environment. Water serves to hydrate and refresh the skin while beeswax and cocoa butter work as emollients, which aid to soften and smooth the skin. The key ingredient in these formulations is argan oil, which has vitamin E and is healthy for the skin since it hydrates. Neem extract also has antibacterial and antifungal properties. Lemongrass essential oil is used in fragrances. This cream is homogeneous, spread sreadily, and is naturally fatty. This is W/O emulsion and with anacidic pH (within the range of skin pH). There was no phase separation in this cream. • The main aim of our research was to develop on anti-cracked heels cream formulation consisting of hedychium spicatum, aleo bar, badensis azodirachta indica for the treatment of cracked heels. Skin diseases are numerous and frequently occurring health problem affecting all age from neonate to the elderly and cause harm in number of ways. • The skin is external exposure of the body. The ageing is most visible on the skin. Nowadays, premature ageing is a big complication in the world because of the changes in an environment. Feet is important part of body; they suffer from many frictions. The lack of oil gland in the feet skin which results into very dry skin. External penetration of dirt, fungus, bacteria cause cuts and wounds. Bacterial decomposition is also occurred in foot give bad odour. For these purpose herbal foot cream is prepared. • This herbal foot cream is prepared from Argan oil (good for dry skin), Neem extract (antibacterial & antifungal effects), Aloe vera extract (for hydration) and lemongrass oil (fragrance). Other than synthetic compound, herbs have more effective, low cost, more availability, and less side effects. Here, ARGAN OIL have good property which give protection to the skin and lemongrass oil is having a good fragrance. Argan oil contains vitamin E which is known as anti-inflammatory agent in skin and several studies proves that vit E is good in seal up the cracks caused by dryness..

PATH-45. TREATMENT OF FGFR1 – ALTERED WHO GRADE 1 GLIONEURONAL TUMORS WITH FGFR INHIBITOR ERDAFITINIB

Abstract INTRODUCTION Low-grade mitogen-activated protein kinase (MAPK) pathway-altered glioneuronal tumors carry distinct molecular alterations, which may represent therapeutic opportunities to avoid or delay toxic treatments like radiation. Erdafitinib is a pan-FGFR tyrosine kinase inhibitor, regulatorily approved in recurrent urothelial carcinoma, and is under clinical investigation for recurrent FGFR-altered gliomas (NCT05859334). METHODS We report two patients with FGFR1-altered rosette-forming glioneuronal tumors (RGNT) treated with erdafitinib. RESULTS Patient 1 is a 32-year-old woman who presented with obstructive hydrocephalus and a non-enhancing pineal tumor. She underwent a subtotal resection, with histopathology initially consistent with a low grade dysembryoplastic neuroepithelial tumor. She was under observant management for 7 years, and developed worsening symptoms with slow non-enhancing growth, although stable per RANO low grade criteria. The initial tissue was sent for next-generation sequencing (NGS) and DNA methylation profiling, revealing an FGFR1 pathogenic variant with DNA methylation profiling matching with RGNT. Patient began Erdafitinib 8 mg daily, and had stable disease per RANO at 6 months. She developed CTCAE grade 1 toxicities of subretinal fluid, fatigue, dry skin, and paronychia. Patient 2 is a 34-year-old man diagnosed 1 year prior with a tectal tumor, who underwent biopsy due to non-measurable/ non-enhancing progression. Histopathology was consistent with RGNT. NGS revealed FGFR1 mutation, PIK3CA mutation, and NF1 pathogenic variant, described in the literature as characteristic of RGNT. There was insufficient tissue for DNA methylation profiling. Patient started erdafitinib 8 mg daily and remains clinically stable for 1 month. He developed asymptomatic hyperphosphatemia (CTCAE grade 1). Both patients have tolerated treatment without interruptions or dose reductions. CONCLUSION Erdafitinib is a well-tolerated and potentially efficacious treatment of FGFR1- altered RGNT, and may avoid the need for radiation. Diagnosis of MAPK- altered low-grade glioneuronal tumors, specifically RGNT, is increasingly reliant on molecular data, and can significantly impact treatment options.

CTNI-20. ADDRESSING SKIN ADVERSE EVENTS (AES) DURING MIRDAMETINIB TREATMENT IN PATIENTS WITH NEUROFIBROMATOSIS TYPE 1-ASSOCIATED PLEXIFORM NEUROFIBROMAS (NF1-PN): GUIDANCE FROM A MULTIDISCIPLINARY GROUP OF EXPERTS ON THE MANAGEMENT OF MEK INHIBITOR-ASSOCIATED SKIN AES

Abstract ReNeu (NCT03962543) is a trial of the investigational, oral, selective MEK1/2 inhibitor (MEKi) mirdametinib in adults (≥18 years) and children (2-17 years) with NF1-PN. Skin adverse events (AEs) were common in ReNeu, and some discontinuations were noted with low-grade AEs. A multidisciplinary team retrospectively reviewed skincare practices at one high-enrolling site (n=12) with no discontinuations due to skin AEs; these were incorporated into ReNeu trial recommendations and recently updated. The purpose was to prevent/manage skin AEs and maintain protocol treatment adherence. MEKi skin AEs vary by pubertal status, therefore recommendations also vary by pubertal status. All patients were counseled to adopt hygienic skincare practices, including bathing daily, and using mild cleansers and hypoallergenic skin moisturizers (cream or ointment-based emollient; minimum BID) to prevent dry skin. Prepubescent patients were advised to incorporate diluted bleach baths (3-4 times/week) when initiating mirdametinib or after rash development. Treatments recommended for mild-to-severe dermatitis were hydrocortisone cream (2.5% BID) on face/skinfold areas and triamcinolone ointment (0.1% BID) on trunk/extremities. Treatments for mild acneiform eruptions included topical clindamycin lotion (1.0% BID) until resolution, with optional hydrocortisone cream (2.5% BID). For moderate-to-severe acneiform eruptions, cephalexin (20 mg/kg/day divided BID, max 500 mg, ≤6 weeks), amoxicillin (25 mg/kg/day divided BID, max 875 mg, ≤6 weeks), or oral fluconazole (20 mg/kg/day, max 100 mg, 5 days then once weekly for 3 months) were suggested. Postpubescent patients were advised to initiate topical 1.0% clindamycin lotion and oral doxycycline or minocycline (50-mg daily, 3 months) with mirdametinib initiation. Patients with subsequent mild-to-severe acneiform eruptions were advised to apply hydrocortisone cream (2.5% BID) or triamcinolone ointment (0.1% BID). Referral to a dermatologist was suggested for all patients with uncontrolled dermatitis, worsening acneiform eruptions, or infection. Proactive skincare practices appeared effective at this site, but prospective validation is necessary before making clinical recommendations.

Molecular mechanisms of acquired idiopathic generalized anhidrosis: differential gene expression and potential therapeutic targets

Eccrine sweat glands are essential for thermoregulation. Acquired idiopathic generalized anhidrosis (AIGA) is a rare disorder characterized by the absence of sweating, leading to severe complications like heatstroke and skin dryness. The underlying etiology remains unknown, complicating diagnosis and treatment. This study aimed to elucidate the genetic mechanisms of AIGA by analysing the gene expression in eccrine sweat glands using the GSE193125 dataset from the NCBI Gene Expression Omnibus (GEO). This study identified differentially expressed genes (DEGs) (genes that show statistically significant differences in expression levels in AIGA), with JUN and CCN1 significantly downregulated in anhidrotic lesions of AIGA patients. Receiver operating characteristic (ROC) curve demonstrated the accuracy of these genes in classification (JUN = 0.88 and CCN1 = 0.77). Gene and protein interaction networks which are defined as networks of physical interactions between genes and proteins, constructed using GeneMANIA and STRING, revealed substantial physical interactions among them. Gene set enrichment analysis highlighted the neuroinflammatory and estrogen receptor signaling pathways are associated with this condition, suggesting hormonal regulation’s role in the anhidrosis mechanism. Key miRNAs, including hsa-let-7b-5p, hsa-miR-10b-5p, and hsa-miR-124-3p, are associated with the DEGs, underscoring the importance of post-transcriptional and transcriptional regulation. Through the Drug Gene Interaction Database (DGIdb), ciprofibrate is identified as a potential therapeutic agent targeting the JUN gene. Molecular docking confirmed a strong binding affinity between ciprofibrate and JUN, suggesting ciprofibrate could modulate JUN activity and regulate AIGA symptoms. ADMET analysis, which refers to the assessment of absorption, distribution, metabolism, excretion, and toxicity of a drug or compound, is crucial for evaluating its pharmacokinetic and safety profile. The analysis indicated that ciprofibrate has favourable pharmacokinetic properties and a relatively safe toxicity profile. This comprehensive bioinformatics approach, integrating gene expression analysis, miRNA identification, and drug interaction, provides valuable insights into anhidrosis molecular pathology and highlights ciprofibrate’s potential as a targeted therapeutic strategy. Despite limitations, including a small sample size and reliance on computational predictions, this study paves the way for further research and potential therapeutic interventions for AIGA.

Pediatric Topical Steroid Withdrawal Syndrome: What Is Known, What Is Unknown.

Topical steroid withdrawal syndrome (TSW) is a debated condition marked by burning erythema, severe itching, and dry skin following the discontinuation of topical corticosteroids (TCS). This study reviewed reported pediatric TSW cases. With a total of 21 cases reported (inconsistent data provided), 60% (6/10) used TCS on the face; 69% (9/13) were associated with an escalation in potency of TCS and 75% (3/4) were the erythematoedematous variant. Overall, data on TSW in children is lacking and standardized diagnostic criteria are needed.

Ayurvedic management of Vipadika - A Case Report

Vipadika, categorized as a type of Kshudra Kustha in Ayurveda, presents as a chronic dermatological condition primarily affecting the palms and soles, characterized by symptoms such as Pani-Pada Sphutana (fissures), Teevra Vedana (severe pain), Manda Kandu (itching), and Saraga Pidika (red patches). Vipadika can be correlated to Palmoplantar psoriasis, which is a prevalent chronic inflammatory skin disorder characterized by erythematous plaques affecting the palms and soles significantly impairing daily function and quality of life. Ayurvedic management of Vipadika emphasizes Shamana Oushadhis aimed at pacifying aggravated Doshas, alleviating manifestations of Vipadika. Integral to this approach are Nidana Parivarjana and Pathya Ahara-Vihara Sevana to prevent recurrence. In the present case, a male patient with complaints of dryness, itching, cracking, scaling, and hyperpigmentation of skin of bilateral feet and bleeding from cracks for the last 6 months came to Kayachikitsa OPD and was diagnosed and treated as Vipadika with the Shamana Oushadhis. The patient's condition demonstrated a substantial improvement, with a marked reduction in symptoms evident within 21 days, suggesting effective management of Vipadika through Ayurveda.

Efficacy of Pseudo-Ceramide Absorption Into the Stratum Corneum and Effects on Transepidermal Water Loss and the Ceramide Profile: A Randomized Controlled Trial.

Changes in the level or profile of ceramides are associated with decreased stratum corneum (SC) barrier function. Topical application of a pseudo-ceramide (pCer)-containing moisturizer can improve barrier function. Additionally, pCer that absorbs into the SC may improve ceramide profiles. We investigated the relationship between pCer absorption into the SC and SC properties and determined the efficacyof a pCer-containing spray compared with that of a commercial spray without pCer. Patients with self-perceived dry and sensitive skin and decreased barrier function (transepidermal water loss [TEWL] > 10 g/m2h) were randomized into two groups to topically apply a pCer-containing spray (test group; N = 33) or commercial spray without pCer (control group; N = 19) twice daily as a single-blind study. SC function and ceramide properties were investigated before and after 4 weeks of application. In the test group, the ceramide (NP)/(NS) ratio proportionally increased with the pCer application level after 4 weeks of pCer-containing spray application. In the control group, there were no changes in SC function after topical application of the commercially available spray without pCer; however, the SC water content, TEWL, SC cell area, and scaling score improved in the test group. Furthermore, the changes in TEWL in the test group were significantly negatively correlated with the pCer application level. The efficacy of pCer-containing sprays for those who have sensitive skin with impaired barrier function was demonstrated. Furthermore, the improvement in SC barrier function induced by pCer may contribute to normalizing the SC ceramide profile.

Inclusive Exploration of Harmonizing and Alternative Treatments for Hypothyroidism

: A clinical syndrome known as hypothyroidism occurs due to a shortage of thyroid hormone as a result of decreased production, abnormal distribution, or no action of thyroid hormones. The most typical clinical symptoms included are dry skin, hair loss, weight gain, painful-prolonged periods, infertility, balance problems, slow speech, bradycardia, hypothermia, fatigue, anxiety & depression, joint pain, and indigestion. Basically, age, gender, the severity of the ailment, and a few other factors affect the various signs and symptoms of hypothyroidism. The limitations of allopathic modalities necessitate the investigation of alternative treatment options. Future healthcare initiatives for the poor world will increasingly depend on CAM approaches to these concerns because lifestyle, diet, obesity, lack of exercise, and stress are significant contributing factors to the development of hypothyroidism. This review's objective is to provide information on herbs as well as complementary and alternative medications which are grouped into five major domains: Biologically Based therapies, Manipulative body-based therapies, Mind body-based therapies, and the whole Medical system. These have traditionally been used to treat thyroid dysfunction. The distribution of diseases in emerging nations is altering as a result of globalization. Hence the existing and potential roles of CAM techniques in the general practice of medicine are illustrated in these approaches. Scientists are being compelled to consider traditional herbal medical treatments and CAM therapy in order to combat adverse medication occurrences, high treatment costs, and compliance problems thus described in this review paper.

An Updated Review on the Role of Phytoconstituents in Modulating Signalling Pathways to Combat Skin Ageing: Nature’s Own Weapons and Approaches

Abstract: Various geographical areas exhibit varying degrees of prevalence and severity of dermatological issues. The most commonly observed skin issues among adolescents during their growth period on a global scale encompass dry skin, dyspigmentation, wrinkles, fungal infections, as well as benign and malignant tumors. These conditions arise as a consequence of diminished functional capacity and heightened skin susceptibility. The primary manifestation of the whole process of skin ageing is its visual presentation, which encompasses changes in both the structure and function of the skin. The look and function of human skin exhibit particular variations as individuals age, representing a time-dependent phenomenon. This review article primarily examines the discussion surrounding the diverse phytoconstituents and their impact on signalling pathways in cellular metabolism, as well as their interaction with environmental factors and xenobiotic agents that contribute to skin aging. Ultraviolet (UV) light induces the rapid formation and subsequent accumulation of reactive oxygen species (ROS) within skin cells, hence accelerating oxidative stress and the ageing process of the skin. One effective approach to addressing age-related skin disorders entails the utilization of exogenous supplementation through the consumption of dietary antioxidants, as well as the application of antioxidant-based lotions to the skin prior to sun exposure. Several plant species include phenolic components, including ascorbic acid, ellagitannins, and carotenoids, which have the ability to protect the skin from harmful UV radiation, reduce inflammation and oxidative stress, and influence several survival signalling pathways. This comprehensive study elucidated multiple processes by which phytoconstituents exert their effects for intervention purposes. Additionally, it highlighted the ability of these phytoconstituents to modulate the NF-κB signalling pathway, MAPK signalling, Nrf2 signalling, and other pathways, hence demonstrating their potential anti-aging properties.

Clinical Improvement of Patients With Complications of Exfoliativa Dermatitis: A Case Report

Exfoliative dermatitis or erythroderma is a severe skin inflammatory syndrome, characterized by erythema and desquamation more than 90% of the body surface area. Previous study shown erythroderma incidence was 83 people in 2011 to 2014. Incidence of erythroderma in Portugal 9.4 cases per year, with the predominance age of 41 to 61 years. The most common etiology of erythroderma is psoriasis and dermatitis. A woman Mrs. T, 55 years old, came to emergency room Rajawali Citra General Hospital Bantul on 5 September 2023 with complaints of abdominal pain, frequent vomit, cough and itchy and dry skin on the face, upper limbs and lower limbs. Patient has erythroderma medical history since a year ago. On dermatological examination, the facial showed patch erythema with scales on left suprasilia and nasales, the upper and lower limbs showed xerotic. This patient was diagnosed with erythroderma with improvements. Patient was treated with Loratadine 10 mg tablets once a day orally and Desoximethasone oint twice a day. Erythroderma treatment depends on its underlying disease. The main therapy is using petrolatum, emollient or low-potency topical steroid to maintaince skin barrier function and reduce inflammatory. Antihistamines can be used to relieve pruritus and as antianxiety agent. A well combination drugs therapy shows clinical improvement on erythroderma performance.

Genome-Wide Association Study of Sweet Potato Storage Root Traits Using GWASpoly, a Gene Dosage-Sensitive Model.

Sweet potato (Ipomoea batatas) is an important food crop that plays a pivotal role in preserving worldwide food security. Due to its polyploid genome, high heterogeneity, and phenotypic plasticity, sweet potato genetic characterization and breeding is challenging. Genome-wide association studies (GWASs) can provide important resources for breeders to improve breeding efficiency and effectiveness. GWASpoly was used to identify 28 single nucleotide polymorphisms (SNPs), comprising 21 unique genetic loci, associated with sweet potato storage root traits including dry matter (4 loci), subjective flesh color (5 loci), flesh hue angle (3 loci), and subjective skin color and skin hue angle (9 loci), in 384 accessions from the USDA sweet potato germplasm collection. The I. batatas 'Beauregard' and I. trifida reference genomes were utilized to identify candidate genes located within 100 kb from the SNPs that may affect the storage traits of dry matter, flesh color, and skin color. These candidate genes include transcription factors (especially Myb, bHLH, and WRKY family members), metabolite transporters, and metabolic enzymes and associated proteins involved in starch, carotenoid, and anthocyanin synthesis. A greater understanding of the genetic loci underlying sweet potato storage root traits will enable marker-assisted breeding of new varieties with desired traits. This study not only reinforces previous research findings on genes associated with dry matter and β-carotene content but also introduces novel genetic loci linked to these traits as well as other root characteristics.

Isotretinoin-associated chronic diarrhea as a complication of systemic isotretinoin therapy

Objective: Isotretinoin is a synthetic derivative of vitamin A that is highly effective in treating acne vulgaris. Although its common side effects include skin dryness, photosensitivity, epistaxis, and depressive disorders, gastrointestinal side effects should also be considered, though they are less frequently highlighted. Case: We aim to present a 28-year-old female patient who developed chronic diarrhea and associated hypokalemic paralysis during isotretinoin treatment, prescribed for acne management. This case underlines the importance of recognizing gastrointestinal side effects, alongside the more commonly known adverse effects of isotretinoin. Conclusion: Chronic diarrhea is a rare but significant side effect of isotretinoin that may lead to serious complications such as hypokalemic paralysis. In this case, we demonstrated how isotretinoin can cause metabolic imbalances, even in relatively healthy young adults, by inducing diarrhea. While the association between isotretinoin and inflammatory bowel disease remains inconclusive, clinicians should remain vigilant regarding the gastrointestinal side effects of isotretinoin. Early recognition and discontinuation of the drug, combined with appropriate supportive treatments, are essential in preventing further complications. Dermatologists and gastroenterologists should collaborate in identifying patients at higher risk, such as those with pre-existing gastrointestinal conditions, and closely monitor for any adverse effects during isotretinoin treatment. Future studies, particularly large-scale randomized controlled trials, are needed to better understand the relationship between isotretinoin and gastrointestinal side effects.

Use of Pentoxifylline in Lipoidoproteinosis or Urbach’s Disease: Case Report

Lipoidoproteinosis or Urbach’s disease, is a genodermatosis with an autosomal recessive transmission pattern, without sex predilection. Characterized by varying degrees of intercellular deposits of hyaline material in the skin, mucous membranes and internal organs, leading to infiltration and thickening of affected organs. The course is slow and benign. Two cases are reported: a 6-year-old schoolgirl who consulted for dry skin and hoarseness since she was 2 years old; and a 13-year-old adolescent with similar symptoms. The clinical and histopathological diagnosis is made. Treatment with oral pentoxifylline was started, and a significant improvement of the lesions was observed after six months.

Effects of Thioglycolate Compounds in an Emerging Technique in the World of Cosmetics-Brow Lamination.

The side effects of two related chemicals, ammonium thioglycolate (ATG) and thioglycolic acid (TGA) have been widely highlighted in the world of cosmetics. These thioglycolate compounds are considered essential ingredients in a new technique known as brow lamination. This technique is widely used nowadays, with the aim of changing the eyebrow shape. To our knowledge, this is the first study to address the possible side effects of brow lamination. The hydrophilic characteristic of ATG and TGA reflects their transdermal absorption through the intracellular and transappendageal pathways. These compounds can affect the skin through allergic contact dermatitis (ACD), characterized by skin irritation, dryness, and erythema. Moreover, these thioglycolates can alter several mechanical and chemical reactions in the eyebrows' hair, therefore affecting their shape, structure, and pigmentation. In addition, these chemicals contained in brow lamination can exert systemic manifestations, at the level of the reproductive, ocular, respiratory, and endocrine systems. More studies should be elaborated to shed light on the possible side effects of this trend. Additionally, further regulations should be taken into consideration to ensure the concentration and the measures applied are convenient to minimize these side effects.

A Comprehensive Guide to Whitening Ingredients for Women

Many people think that a fair and glowing complexion is a sign of beauty; however, with the large number of whitening products available in the market of varying quality, the question of how to choose the right whitening product is an important one. This article takes an in-depth look at the whitening ingredients available to users, which include vitamin C, arbutin, niacinamide, kojic acid, glutathione, alpha-hydroxy acids (AHAs), licorice extract, and ellagic acid. For each ingredient, the source, production method, function and details are provided. Results show that different skin types have specific needs. Dry skin requires moisturizing, oily skin benefits from sebum control and light textures, and sensitive skin needs mild ingredients. Each ingredient has its advantages and disadvantages, and potential drawbacks such as stability issues, allergic reactions, and skin irritation are discussed. This paper also emphasizes key points for choosing whitening products, including understanding skin type, considering the pros and cons of each ingredient, researching product source and quality, following correct usage methods, and combining with a comprehensive skincare routine and sun protection. This research is significant as it provides valuable guidance for women in making informed choices about whitening products, helping them achieve a healthy complexion through proper skin care and understanding of different ingredients.

Correlation Between Symptom Clusters and Self-Management Among Maintenance Haemodialysis Patients: A Cross-Sectional Study.

The purpose of this study was to explore the relationship between symptom clusters and self-management among maintenance haemodialysis (MHD) patients. MHD patients experience disease progression and multiple symptom burdens that severely impact quality of life, and self-management of symptoms may significantly improve patient-reported outcomes. A cross-sectional study. This cross-sectional descriptive study included 194 patients undergoing MHD. The patients were assessed using the Dialysis Symptom Index (DSI) and the Haemodialysis Self-Management Instrument (HD-SMI). We used descriptive analysis, exploratory factor analysis, Pearson's correlation analysis and linear regression analysis to examine (1) the level of individual self-management, (2) the presence of symptom clusters by symptom severity and (3) the correlation between symptom clusters and self-management behaviours. This study was conducted in accordance with the STROBE checklist. The top five most severe symptoms among the patients were itching, feeling tired or lack of energy, difficulty sleeping, dry mouth and dry skin. We identified five groups of symptoms: (1) poor sleep, (2) neuromuscular, (3) gastrointestinal, (4) skin irritation and (5) psychological. In the present study, MHD patients reported low to moderate levels of self-management behaviours (50.84 ± 10.56), and low self-management ability was correlated with greater severity of the five symptom clusters (p < 0.01). Linear regression analysis revealed that all five symptom clusters were included in the regression equation, explaining 30% of the total variance in self-management skills among MHD patients. Enhanced awareness of symptom clusters and comprehensive symptom management are necessary to improve patients' quality of life. Nursing practices should incorporate comprehensive symptom assessments to help patients develop effective self-management strategies to improve quality of life.

Epidermolytic Hyperkeratosis Type 1 with a New Heterozygous Mutation in KRT1 Gene: A Case Report

Background: Epidermolytic hyperkeratosis (EHK) formerly known as bullous ichthyosiform erythroderma, is a rare autosomal dominant inheritance condition with a prevalence ranging from 1:200,000 to 1:300,000. The underlying etiology of which is a mutation in the genes responsible for keratin proteins synthesis, primarily in KRT1 and KRT10 genes, cataloged under OMIM number 113800. Clinicopathological presentations include blistering in the neonatal period followed by ichthyotic hyperkeratosis in childhood and adolescence, characterized by the hallmark features of generalized dry skin, scaling, hyperkeratosis, and frequently associated with erythroderma. EHK may present with or without palmoplantar keratoderma involvement, depending on the keratin gene variant. Case report: A 24-year-old male of Arab descent was born with diffuse skin hyperkeratotic plates featuring erythematous fissures, covering his entire body, resembling a collodion baby. His birth was full-term via cesarean section without complications, although he later developed developmental dysplasia of the hip. By the time he started primary school, he began experiencing severe thickening of the skin around his joints, reducing flexibility and leading to contractures and significant disfigurement. He is undergoing treatment with acitretin. Genetic testing using Next-Generation Sequencing (NGS) was performed to identify the responsible gene, revealing a novel heterozygous variant in the KRT1 gene (OMIM 139350), while no variant was detected in the KRT10 gene. Conclusion: EHK type 1 manifests with a new heterozygous variant in the KRT1 gene. This rare disorder, associated with variant in genes related to keratin production such as KRT1 and KRT10, results in distinctive skin features present from birth, as well as joint problems and fungal foot infections. Genetic testing has confirmed the presence of a variant in the KRT1 gene.

Central Hypothyroidism Associated With Empty Sella: Literature Review and Case Report

Empty Sella Syndrome (ESS) is a rare case of sella turcica malformation, resulting in pituitary gland decrease. It may reveal itself through neurological symptoms, endocrine disorders, visual disturbances or incidental findings during imaging. The urgency of this problem has increased with the widespread use in the diagnosis of the non-invasive method of magnetic resonance imaging (MRI). It can be discovered as part of the investigation of the pituitary disorders, or as an incidental finding when imaging the brain. Practice shows that such patients rarely come with typical complaints thus an extended review of this case is needed to prompt suspicion and aid in the diagnosis of ESS. Few cases of empty sella associated with isolated thyroid-stimulating hormone (TSH) deficiency were published. We report a case of a 46 year-old woman with complaints: edema, dizziness, low blood pressure, hair loss, dry skin. Examinations were performed: ultrasound of the thyroid gland, TSH, FT4 (free thyroxine), FT3 (free triiodothyronine), anti TPO (Antibodies to thyroid peroxidase). Conclusion: patients with TSH, FT4, and FT3 deficiency, should undergo examinations to exclude empty sella as one of the reason of central hypothyroidism. According to the above mentioned the recommendation is to examine all the tropic hormones of the pituitary gland after diagnosing empty sella. Diagnosing central hypothyroidism associated with empty sella helps improving the knowledge and points to different clinical manifestation of empty sella syndrome.