Skin Biopsy Research Articles

Injection of hyaluronic acid versus platelet rich plasma for treatment of vulvovaginal atrophy in post-menopausal females.

Female sexual dysfunction is highly prevalent among postmenopausal females approaching 50%, with vulvovaginal atrophy (VVA) being a cardinal sign. For decades, hormone replacement therapy was the only solution to relieve symptoms associated with this atrophy. However, it was limited by its serious side effects, raising the need for new treatment strategies. This study aims to compare the efficacy and safety of injection of hyaluronic acid (HA) versus platelet rich plasma (PRP) in post-menopausal females presented with VVA to improve female sexual dysfunction. Twenty post-menopausal females presented with VVA were randomly divided into two groups, 10 patients in each group. Both groups received three sessions of injections into the vulva and vagina, one month apart. Group I was injected with non cross linked HA while Group II received PRP injection. Subjective assessment was carried out through female sexual function index questionnaire and global aesthetic improvement scale.While objective assessment was carried out by measuring the labia majora length and reviewing the histopathological changes occurring in the vulva through skin biopsies before and after treatment. The change in vaginal thickness was estimated by transvaginal ultrasound. Results showed that both HA as well as PRP were effective in the treatment of post-menopausal vulvovaginal atrophy. However, HA showed more significant improvement in female sexual dysfunction. There were also higher values in vaginal wall thickness as measured by transvaginal ultrasound in favor of HA injected group. Histopathological assessment showed more collagen deposition in papillary dermis in HA treated group. No complications were reported in both groups.

Successful use of avacopan in a case of ANCA-associated vasculitis with treatment-resistant medium-sized vessel involvement.

We report the case of a 75-year-old woman who presented with fever, right back pain, paresthesia in the right extremities, erythema, purpura, and nodules. She had previously initiated dialysis due to rapidly progressive glomerulonephritis and was transferred to our hospital. Imaging studies revealed multiple cerebral and splenic infarcts and hemorrhage encapsulating the right kidney, likely due to microaneurysms in multiple renal arteries. High MPO-ANCA titers were observed, and a skin biopsy revealed granulomatous inflammation affecting medium-sized vessels, leading to a diagnosis of granulomatosis with polyangiitis (GPA) and ANCA-associated vasculitis (AAV) involving medium-sized vessels. Treatment began with intravenous pulse steroid therapy (methylprednisolone 1000mg/day) and subsequent oral prednisolone (PSL) 40mg (about 0.8mg/kg) and intravenous cyclophosphamide (IVCY) at 250mg. While her symptoms improved, she developed severe infections, including candidemia and febrile neutropenia. Consequently, we combined PSL with the C5a receptor antagonist avacopan, which allowed for PSL tapering and stabilized her disease. This case is significant as no previous reports of avacopan's efficacy in AAV with medium-sized vessel involvement suggest its potential effectiveness in such cases.

Single-cell sequencing of human Langerhans cells identifies altered gene expression profiles in patients with atopic dermatitis.

Atopic dermatitis (AD) is characterized by dysregulated T cell immunity and skin microbiome dysbiosis with predominance of Staphylococcus aureus, which is associated with exacerbating AD skin inflammation. Specific glycosylation patterns of S. aureus cell wall structures amplify skin inflammation through interaction with Langerhans cells (LCs). Nevertheless, the role of LCs in AD remains poorly characterized. Here, we performed single cell RNA sequencing of primary epidermal LCs and dermal T cells, isolated from skin biopsies of AD patients and healthy control subjects, alongside specific glycoanalysis of S. aureus strains isolated from the AD lesions. Our findings revealed 4 LC subpopulations ie, 2 steady-state clusters [LC1 and LC1H] and 2 proinflammatory/matured subsets [LC2 and migratory LCs]. The latter 2 subsets were enriched in AD skin. AD LCs showed enhanced expression of C-type lectin receptors, the high-affinity IgE receptor, and activation of prostaglandin and leukotriene biosynthesis pathways, upregulated transcriptional signatures related to T cell activation pathways, and increased expression of CCL17 compared with healthy LCs. Correspondingly, T helper 2 and T regulatory cell populations were increased in AD lesions. Complementary, we performed bulk RNA sequencing of primary LCs stimulated with the S. aureus strains isolated from the AD lesions, which showed upregulation of T helper 2-related pathways. Our study provides proof-of-concept for a role of LCs in connecting the S. aureus-T cell axis in the AD inflammatory cycle.

The Cutaneous Pathology of Erythromelalgia and Its Role in Establishing Critical Clues Regarding Pathogenesis.

Erythromelalgia, a rare cutaneous pain syndrome, is characterized by acral burning pain and flushing, often alleviated by cold and rest. Primary erythromelalgia is caused by gain-of-function mutations of genes encoding for sodium channels, resulting in hyperexcitability of pain signaling neurons. Autoimmunity and hematologic dyscrasias such as thrombocythemia have been implicated in secondary erythromelalgia. The pathology of this rare disease remains poorly defined. The Weill Cornell dermatopathology database was analyzed for acral biopsies procured from patients here there was a clinical concern for erythromelalgia. We identified 9 patients with clinical diagnoses of erythromelalgia who had a skin biopsy from an affected area. The female-to-male ratio was 2:1. Three of 9 individuals had concurrent diagnoses of autoimmune disease including vitiligo, lupus erythematosus, and psoriatic arthritis. Biopsies showed superficial vascular ectasia in association with microvascular C5b-9 and variable upregulation of type I interferon expression in endothelial cells. CD56 stain revealed diminished autonomic innervation of the eccrine coil and arteries, mirroring similar autonomic denervation seen in small fiber neuropathy. This study suggests that erythromelalgia is a dysautonomia syndrome with reproducible findings on biopsy, hallmarked by vascular ectasia and denervation of the eccrine coil and arteries. In addition, there is a potential link to immune and nonimmune-based microvascular compromise.

Cutaneous Involvement of the Ear as the Sole Presenting Symptom in Recurrent Chronic Lymphocytic Leukemia: A Case Report.

Cutaneous involvement of chronic lymphocytic leukemia (CLL) is rare but has been previously documented to involve the head and neck region. Generally, involvement to the ears is limited to the ear lobule; however, this study presents a unique case of recurrent CLL with cutaneous involvement overlying the auricular ear. The presentation was initially concerning for possible perichondritis but remained unresponsive to antibiotics and steroids. Eventual punch biopsy confirmed the recurrent CLL, although the lesion also presented with unique pathology, notably associated granulomata. This case demonstrates auricular involvement of CLL with unique pathology and highlights the importance of a widened differential and early, definitive tissue biopsy when evaluating refractory inflammation of the external ear.

In-vitro and in-vivo studies of Tridax procumbens leaf extract incorporated bilayer polycaprolactone/polyvinyl alcohol-chitosan electrospun nanofiber for wound dressing application.

This study was an attempt to fabricate an antibacterial wound dressing, which was a bilayered polycaprolactone / polyvinyl alcohol-chitosan (PCL/PVA-CS) nanofibrous membrane. Entrapping ethanolic leaf extract of Tridax procumbens L. (PCL/PVA-CS/Tp). The membrane was prepared using the electrospinning technique to obtain beadless uniform nanofibers. The extract was then infused into the membrane by spraying and exposing to high temperature. in vitro antibacterial activity and cell viability of the membranes were performed. An optimized concentration of 800μg. mL-1 of Tp extract in PCL/PVA-CS/Tp evinced better antibacterial effect on E. coli than S. aureus and also showed rapid wound closure with a positive impact on the viability of L929 cell line. The tissue regeneration efficacy of PCL/PVA-CS/Tp was validated by the experiments on mice models with subcutaneous wounds created using biopsy punch and laser radiation causing burns. Furthermore, in vivo assessments illustrated that the biopsy punch wounds healed more rapidly than laser burn though healing was significant in both. The healing processes such as anti-inflammation and re-epithelialization were observed through histological study. The upregulation of proteins namely VEGF and CD31 along with a decrease in protein levels of Wnt and TGF-β indicated significant wound healing. In conclusion, the bilayered membrane infused with plant extract could be considered a potential material for wound dressing.

Factors Affecting Patient Outcomes of Abdominoplasty After Bariatric Surgery: A Retrospective Cohort Study.

Postoperative complications in body contouring surgery have been linked to several factors, including body mass index, diabetes, cardiovascular disease, and skin resection weight. Prior weight loss by surgical means is another predisposing factor for postoperative complications following body contouring. This study aims to examine these previously identified variables, and several others, in the context of a spectrum of abdominal body contouring techniques following bariatric surgery. Our goal is to highlight that current evidence supports the notion that the prior history of bariatric surgery does not significantly impact body contouring surgery's success and its associated complications. A retrospective cohort study including all consecutive patients (N = 198) who underwent abdominal body contouring between January 2011 and January 2022 following bariatric surgery was performed. Data collected included patient demographics, medical history, perioperative variables, and postoperative outcomes. Univariate and multivariate statistical analysis was performed. Sixty-four (32%) patients developed a postoperative complication. In the univariate analysis, patients who developed a postoperative complication were more likely to have a mental health disorder (63% vs 44%, P = 0.015) and to have undergone abdominal surgery other than panniculectomy (P = 0.002). They also had significantly longer median operative time (160 minutes, σ = 68.9, vs 140 minutes, σ = 72.3, P = 0.037) and longer follow-up time (99 days, σ = 471.1 vs 23 days, σ = 430.5, P < 0.001). In a multivariate logistic regression model including diabetes, hypertension, abdominoplasty type, operative time, skin excision weight, and concurrent body contouring procedure, the only significant factor in complication rate was the type of abdominal body contouring. Specifically, the traditional (odds ratio: 2.72, 95% confidence interval: 1.25-5.93) and vertical abdominoplasty (odds ratio: 5.50, 95% confidence interval: 1.17 to 25.87) techniques were more likely to lead to complications compared with panniculectomy abdominoplasty, respectively. Previously cited risk factors such as diabetes, body mass index, and skin resection weight did not increase the chance of complications. Panniculectomy appears to be a safer option for those with a history of bariatric surgery.

Selection of the biopsy procedure-critical for dermatopathological diagnostics

Skin biopsy is one of the most frequently performed diagnostic measures in dermatological practice. Depending on the diagnostic question, the selection of the type of biopsy procedure and the biopsy location can have aconsiderable influence on histological assessment. Depending on the disease, different aspects must be taken into account for aprecise diagnosis. This article summarizes these for exanthema, erythematosquamous dermatoses, blistering diseases, subcutaneous inflammatory processes, and alopecia with examples. Advantages and disadvantages of different biopsy types are also addressed for neoplastic diseases. The aim is to draw attention to difficulties in histopathologic differential diagnosis caused by the biopsy procedure and, thus, to improve the quality of biopsy and diagnosis.

Photobiomodulation therapy in diabetes: Benefits for pain relief, quality of life, and wound healing.

Globally, 537 million people suffer from diabetes mellitus (DM), a condition often associated with sensory disturbances, wound development, and chronic pain, which significantly affects the quality of life and imposes a substantial economic burden. This study evaluated the effects of photobiomodulation (PBM) therapy on nociceptive and sensory changes in diabetic patients to understand pain manifestations and explore PBM's molecular mechanisms on wound healing. Twenty patients with type 2 DM underwent clinical assessments, completed pain and quality of life questionnaires, and had their pain sensitivity evaluated using the quantitative sensory test (QST). A 5 mm skin biopsy was taken for fibroblast culture. PBM therapy, using 660 nm red light, was administered twice weekly for 7 weeks on lower limb wounds. Results indicated that DM patients faced significant sensory impairments, impacting their quality of life. PBM therapy improved pain scores, alleviated neuropathic pain, and enhanced sensory function, leading to better quality of life and reduced anxiety and depression. It also accelerated wound healing, enhancing mobility and autonomy. Invitro studies showed PBM therapy increased cell proliferation through the ERK signaling pathway and modulation of matrix metalloproteinases (MMP-1/8 and 2) and tissue inhibitors of metalloproteinases (TIMP).

Effects of Spinal Cord Stimulation in Patients with Small Fiber and Associated Comorbidities from Neuropathy After Multiple Etiologies.

Objectives: The aim of this study was to evaluate the effects of spinal cord stimulation (SCS) on pain, neuropathic symptoms, and other health-related metrics in patients with chronic painful peripheral neuropathy (PN) from multiple etiologies. Methods: A prospective single center observational longitudinal cohort study assessed SCS efficacy from April 2023 to May 2024, with follow-ups at 2, 4, 6, and 12 months in 19 patients suffering from the painful polyneuropathy of diverse etiologies: diabetic (DPN), idiopathic (CIAP), chemotherapy-induced (CIPN), and others. Patients were implanted with a neurostimulator (WaveWriter AlphaTM, Boston Scientific Corporation, Valencia, CA, USA) and percutaneous leads targeting the lower limbs (T10-T11) and, if necessary, the upper limbs (C4-C7). Stimulation programming was individualized based on patient preference and best response. Assessments were performed before and after implantation and included pain intensity (VAS and DN4), neuropathic pain symptoms (NPSI and SF-MPQ-2), autonomic symptoms (SFN-SIQ and SAS), sensory and small fiber nerve injury (UENS), functionality (GAF), sleep (CPSI), global impression of change (CGI and PGI), and quality of life (EQ-VAS and EQ-5D). Intra-epidermal nerve fiber density (IENFD) via skin biopsy was also performed at baseline (diagnostic) and after 12 months to assess potential small fiber re-growth. Statistical analyses were conducted to determine the evolution of treatment success. Results: To date, 19 patients have undergone implantation and completed follow-up. SCS produced a significant consistent and sustained improvement in pain intensity by 49% in DN4 and 76% in VAS, in neuropathic pain symptoms by 73%, in autonomic symptoms by 26-30%, in the sensorimotor physical exam by 8%, in functionality by 44%, in sleep by 74%, and in quality of life (69% for EQ-VAS and 134% EQ-5D). Both clinicians and patients had a meaningful global impression of change, at 1.1 and 1.3, respectively. Distal intra-epidermal nerve fiber density improved by 22% at 12 months while proximal intra-epidermal nerve fiber density decreased by 18%. Conclusions: SCS is an effective therapy for managing various types of PN.

Subcutaneous Infection With Snow Leopard Sign on 18F-FDG PET/CT Mimicking Subcutaneous Panniculitis-Like T-Cell Lymphoma.

A 37-year-old man presented with a 2-month history of fever of unknown origin and erythema rashes on the trunk and limbs. 18F-FDG PET/CT revealed increased 18F-FDG uptake in subcutaneous panniculitis, forming a snow leopard sign, along with enlarged lymph nodes, which suggested subcutaneous panniculitis-like T-cell lymphoma. However, skin biopsy indicated subcutaneous infection, and bone marrow biopsy revealed no abnormal lymphocytes. After anti-infection treatment, symptoms improved, leading to a final diagnosis of systemic infection. This case demonstrates how extensive subcutaneous infections on PET/CT could be misinterpreted as subcutaneous panniculitis-like T-cell lymphoma.

B-cell infiltration distinguishes mucosal from skin patterns of rejection in facial vascularized composite allografts.

Rejection monitoring in facial vascularized composite allotransplantation (fVCA) traditionally focuses on skin biopsies. However, mucosal rejection frequently presents with more pronounced signs of immune activity. To explore mechanistic differences between skin and mucosal rejection, rejection and non-rejection biopsies from allograft skin and oral mucosa of nine fVCA recipients were retrospectively analyzed using histology, multiplex immunostaining, and gene expression profiling, with peripheral blood mononuclear cells (PBMCs) quantified via mass cytometry (CyTOF). Both skin and mucosa exhibited similar patterns of granzyme B expressing (GZMB+) T-cells, indicating T-cell-mediated rejection in both tissues. However, mucosa demonstrated additional CD19+ B-cell infiltration and occasional plasma cells, which were absent in skin. These intramucosal B-cells expressed AHNAK and CD43, suggesting they may be innate-like B-cells (Bin cells). CD8+/GZMB+ cells and B-cell populations were enriched in PBMCs during combined skin and mucosal rejection but not isolated skin rejection. These findings suggest distinct rejection mechanisms in skin and mucosa, with mucosa uniquely involving B-cells. Current skin-focused rejection monitoring may overlook important mucosal rejection events, emphasizing the need to monitor both tissues concurrently. Mucosal biopsies could improve the accuracy in detecting acute rejection.

Acute therapeutic effects and pathophysiology of eosinophilic granulomatosis with polyangiitis neuropathy

ObjectiveThis study investigated the effects of early treatment and pathophysiology on eosinophilic granulomatosis with polyangiitis neuropathy (EGPA-N).MethodsTwenty-six consecutive patients with EGPA-N were diagnosed and treated within a day of admission...

Identification of Key Predictors of Cryoglobulinemia Severity at Diagnosis: Threshold, Type, and Severity Score at Diagnosis.

Background: Cryoglobulinemia (CG) syndrome is a heterogeneous condition characterized by the presence of cryoglobulins in serum, often leading to vasculitis with protean clinical manifestations. Understanding the presentation of cryoglobulinemia-related symptoms based on cryoprecipitate levels, GC type, and severity at diagnosis is essential for effective management. Hence, this study aimed to provide a comprehensive analysis of patients with positive cryoglobulin detection to investigate these aspects. Methods: We conducted a retrospective review of clinical charts from patients with positive cryoglobulin detection at Colmar Hospital between May 2015 and April 2019. Results: Among 166 patients with positive cryoglobulins, the median cryoprecipitate value was 37 mg/L [IQR: 25-70], with 62% of patients below the 50 mg/L threshold. High cryoprecipitate levels were associated with C-virus hepatitis (p = 0.0007), increased fatigue (p = 0.001), fever (p = 0.0013), weight loss (p = 0.028), and musculoskeletal symptoms (p = 0.002). These patients also exhibited decreases in complement fractions (p-values 0.017 to 0.006). At the end of the one-year follow-up, they required frequent renal replacement therapy (p < 0.0001) and had a higher mortality rate (p = 0.02). Based on the CG type, patients with type I GC had splenomegaly (p = 0.039) and hemopathy (p = 0.001). According to severity at initial presentation, the severe patients had more purpura (p < 0.001), Raynaud's phenomenon (p = 0.039), and leukocytoclastic vasculitis on skin biopsy (p < 0.001), along with higher cryoprecipitate levels (p = 0.011). Multivariate analysis identified purpura (OR: 10.25), hematological malignancy (OR: 7.06), Raynaud's phenomenon (OR: 6.41), and cryoprecipitate levels (OR: 1.02) as significant markers of disease severity serving for the development of a severity score for clinical practice. Conclusions: This study identifies severity markers in patients with positive cryoprecipitate and proposes a score related to severity at diagnosis.

Pan-TRK positive uterine sarcoma in immunohistochemistry without neurotrophic tyrosine receptor kinase gene fusions: A case report.

The classification of uterine sarcomas is based on distinctive morphological and immunophenotypic characteristics, increasingly supported by molecular genetic diagnostics. Data on neurotrophic tyrosine receptor kinase (NTRK) gene fusion-positive uterine sarcoma, potentially aggressive and morphologically similar to fibrosarcoma, are limited due to its recent recognition. Pan-TRK immunohistochemistry (IHC) analysis serves as an effective screening tool with high sensitivity and specificity for NTRK-fusion malignancies. We report a case of a malignant mesenchymal tumor originating from the uterine cervix, which was pan-TRK IHC-positive but lacked NTRK gene fusions, accompanied by a brief literature review. A 55-year-old woman presented to the emergency department with abdominal pain and distension, exhibiting significant ascites and multiple solid pelvic masses. Pelvic examination revealed a tumor encompassing the uterine cervix, extending to the vagina and uterine corpus. A punch biopsy of the cervix indicated NTRK sarcoma with positive immunochemical pan-TRK stain. However, subsequent next generation sequencing revealed no NTRK gene fusion, leading to a diagnosis of poorly differentiated, advanced-stage sarcoma. The clinical significance of NTRK gene fusion lies in potential treatment with TRK inhibitors for positive sarcomas. Identifying such rare tumors is crucial due to the potential applicability of tropomyosin receptor kinase inhibitor treatment.

First report of a cat (Felis catus) infected by Leishmania (Viannia) guyanensis from Southeastern Brazil.

Feline leishmaniasis is increasingly recognized as a disease affecting cats worldwide, with notable prevalence in regions surrounding the Mediterranean Basin and in Brazil. An approximately one-year-old domestic shorthair cat was presented with small papules and nodules (2mm) on the nasal planum. Physical examination and routine blood analyses were normal. The cat tested negative for FIV and FeLV. Skin biopsies of the lesions were conducted, removing the nodules entirely due to their small size. The samples were submitted for histopathological and molecular analysis. Histopathology confirmed the presence of Leishmania amastigotes, while PCR-RFLP and Sanger sequencing of the hsp70 gene identified the infecting species as Leishmania guyanensis. The patient has since been under continuous clinical monitoring every six months, with no recurrence observed to date. This is the first documented case of L. guyanensis infection in a domestic cat, underscoring the need for improved diagnostic accuracy and a broader understanding of feline leishmaniasis.

Effects of adipose allograft matrix on viability of humeral head cartilage and rotator cuff tendon

BackgroundRotator cuff repairs may fail because of compromised blood supply, suture anchor pullout, or poor fixation to bone. To augment the repairs and promote healing of the tears, orthobiologics, such a platelet-rich plasma (PRP), and biologic scaffolds have been applied with mixed results. Adipose allograft matrix (AAM), which recruits native cells to damaged tissues, may also be a potential treatment for rotator cuff tears.MethodsTo assess the potential use of AAM on rotator cuff tears, humeral head cartilage and subscapularis tendon were collected from patients undergoing reverse shoulder arthroplasty (RSA). Punch biopsies of the tissues were used to create explants for tissue culture, and the remaining tissue was digested to isolate the chondrocytes and tenocytes for cell culture. Explants and cells were then cultured in media containing AAM. After 48 h, the tissues and cells were measured for cell viability, cell proliferation, extracellular matrix (ECM) and metalloproteinase (MMP) gene expression and for MMP, inflammatory cytokine, and growth factor concentrations.ResultsCell viability was increased in humeral head chondrocytes and rotator cuff tenocytes cultured with AAM. Gene expression of the matrix proteoglycan, aggrecan, and of the proteolytic enzyme MMP-13 were downregulated in humeral head chondrocytes. MMP-13 concentrations were increased in subscapularis tenocytes and in humeral head chondrocyte/subscapularis tenocyte co-cultures. The anti-inflammatory cytokine, IL-1ra was increased in cartilage/tendon explant co-cultures. TGF-β1 concentrations were increased in chondrocytes, but decreased in tenocytes.ConclusionsOverall, AAM had no significant negative effects on the cells or explants. The results of these experiments provide the basis for the future use of AAM as a scaffolding for tissue engineering, preclinical animal models of rotator cuff tear and glenohumeral osteoarthritis, and clinical models.Clinical trial numberNot applicable.

Case Report: Diagnosis and treatment of incontinentia pigmenti with central nervous system anomalies in one patient

IntroductionThis article reports a detailed case of a patient with incontinentia pigmenti who exhibited epileptic status and dermatologic symptoms.Case presentationA 5-month-old female patient was brought to our hospital due to status epilepticus, with erythematous vesicular skin lesions on her trunk and extremities. Routine magnetic resonance imaging revealed infarction, ischemia, and encephalomalacia. Skin biopsy pathology indicated pigmentation disorder. Molecular genetic testing was conducted to identify IKBKG mutations, and the case was finally diagnosed with incontinentia pigmenti complicated by central nervous system anomalies. She was treated with oral levetiracetam (10 mg/kg/day, administered every 12 h) to control her recurrent seizures, and prednisone (1 mg/kg/day, once a day) for anti-inflammatory effects.ConclusionAfter nine months, her skin lesions have resolved, with only a few newly developed erythematous papules and areas of hyperpigmentation being evident. There were no recurrent epilepsy symptoms, developmental impairments, or other associated symptoms.

Examination of Isotopic Signals to Determine Trophic Dynamics and Diet of Gulf of Maine Mysticetes Prior to an Oceanographic Regime Shift

Stable isotope analysis (SIA) is a useful tool to assess the health and foraging habits of large marine predators, metabolic stress, pregnancy, and migration patterns. This study provides baseline SIA data for four Gulf of Maine mysticete species and serves as a benchmark for future assessments. SIA was conducted on skin biopsies collected in two time periods: 1988 to 1992 (n = 15) and 1999 to 2005 (n = 187). Samples were collected from humpback whales (Megaptera novaeangliae; n = 116), fin whales (Balaenoptera physalus; n = 74), minke whales (Balaenoptera acutorostrata; n = 6), and North Atlantic right whales (Eubalaena glacialis; n = 6). There were statistically significant differences in isotopic value among species, years, and regions sampled. By species, North Atlantic right whale δ13C and δ15N levels were significantly different than the other species analyzed. Additionally, humpback whales had a δ15N value that was significantly higher than the value found in fin whales. By date, humpback whales showed significant difference in δ13C in 2002 from the two previous years. For fin whales, 2002 showed significant difference in δ13C for all other years’ samples (2000 to 2003). By region, two regions that were the greatest distance apart (Bay of Fundy and Great South Channel) showed significant differences in δ13C for humpback whales. Demographic analyses for humpback and fin whales found a significant difference between calves versus other age classes, presumably due to nursing. A decadal comparison of humpback whales at one site (Stellwagen Bank) found no significant difference between decades. This dataset provides a benchmark for stable isotope measurements in large baleen whales for this regional ecosystem.

Contribution of epidermal growth factor (EGF) in the treatment of cutaneous leishmaniasis caused by Leishmania major in BALB/c mice.

Cutaneous leishmaniasis (CL) is a tropical disease that can cause chronic lesions and leave life-long scars, leading to social stigmatization and psychological disorders. Using growth factors and immunomodulatory agents that could accelerate wound healing and reduce the scar is highly demanded. Epidermal growth factor (EGF) plays an essential role in wound healing. It stimulates the proliferation of keratocytes and fibroblasts, and promotes re-epithelialization. Here, the effect of EGF in combination with Glucantime and nano-liposomal Amphotericin B (SinaAmpholeish) on the healing process of CL in BALB/c mice was investigated. Seventy-two mice were infected with Leishmania major parasites and randomly divided into eight treatment groups after the appearance of the lesion. The treatment was continued for five weeks, and lesion sizes were measured weekly. Parasite load was determined in the skin biopsies using qPCR. We found that subcutaneous injection of EGF at 4.5 μg/kg, combined with each of the two antileishmanial drugs, significantly reduced the wound size and parasite load; however, EGF at 1.5 μg/kg failed to be effective. Besides, the wound size and parasite loads were significantly lower in the SinaAmfoleish groups compared to the Glucantime groups. Among the treatment groups, EGF 4.5 μg/kg combined with SinaAmpholeish exhibited the most significant reduction in wound size and parasitic load. Our results suggest that EGF can potentiate the wound healing effect of antileishmanial drugs. Further studies are warranted to explore the beneficial effects of combining EGF with antileishmanial drugs in patients with cutaneous leishmaniasis in order to accelerate wound healing and reduce the scar.