Major Skin Diseases Research Articles

FBP1 orchestrates keratinocyte proliferation/differentiation and suppresses psoriasis through metabolic control of histone acetylation

Keratinocyte proliferation and differentiation in epidermis are well-controlled and essential for reacting to stimuli such as ultraviolet light. Imbalance between proliferation and differentiation is a characteristic feature of major human skin diseases such as psoriasis and squamous cell carcinoma. However, the effect of keratinocyte metabolism on proliferation and differentiation remains largely elusive. We show here that the gluconeogenic enzyme fructose-1,6-bisphosphatase 1 (FBP1) promotes differentiation while inhibits proliferation of keratinocyte and suppresses psoriasis development. FBP1 is identified among the most upregulated genes induced by UVB using transcriptome sequencing and is elevated especially in upper epidermis. Fbp1 heterozygous mice exhibit aberrant epidermis phenotypes with local hyperplasia and dedifferentiation. Loss of FBP1 promotes proliferation and inhibits differentiation of keratinocytes in vitro. Mechanistically, FBP1 loss facilitates glycolysis-mediated acetyl-CoA production, which increases histone H3 acetylation at lysine 9, resulting in enhanced transcription of proliferation genes. We further find that the expression of FBP1 is dramatically reduced in human psoriatic lesions and in skin of mouse imiquimod psoriasis model. Fbp1 deficiency in mice facilitates psoriasis-like skin lesions development through glycolysis and acetyl-CoA production. Collectively, our findings reveal a previously unrecognized role of FBP1 in epidermal homeostasis and provide evidence for FBP1 as a metabolic psoriasis suppressor.

LncRNA microarray profiling identifies novel circulating lncRNAs in hidradenitis suppurativa.

Long noncoding RNAs (lncRNAs) have been demonstrated to be involved in biological processes, both physiological and pathological, including cancer, cardiovascular diseases, multiple sclerosis, autoimmune hepatitis and types I and II diabetes. LncRNAs are also known to have a critical role in the physiology of skin, and in the pathology of cutaneous diseases. LncRNAs are involved in a wide range of biological activities, including transcriptional post‑transcriptional processes, epigenetics, RNA splicing, gene activation and or silencing, modifications and/or editing; therefore, lncRNAs may be useful as potential targets for disease treatment. Hidradenitis suppurativa (HS), also termed acne inversa, is a major skin disease, being an inflammatory disorder that affects ~1% of global population in a chronic manner. Its pathogenesis, however, is only partly understood, although immune dysregulation is known to have an important role. To investigate the biological relevance of lncRNAs with HS, the most differentially expressed lncRNAs and mRNAs were first compared. Furthermore, the lncRNA‑microRNA regulatory network was also defined via reverse transcription‑quantitative PCR analysis, whereby a trio of lncRNA expression signatures, lncRNA‑TINCR, lncRNA‑RBM5‑ASI1 and lncRNA‑MRPL23‑AS1, were found to be significantly overexpressed in patients with HS compared with healthy controls. In conclusion, the three lncRNAs isolated in the present study may be useful for improving the prognostic prediction of HS, as well as contributing towards an improved understanding of the underlying pathogenic mechanisms, thereby potentially providing new therapeutic targets.

Herbal Bioactive Compounds for Skin Infections and Inflammatory Conditions

Skin microbiota is an integral part of the human immune system. Staphylococcus aureus is one of the essential components of the normal flora. Approximately 20–30% of healthy individuals are persistently colonized with S. aureus, whereas the remainders are considered low-level intermittent carriers. Despite these natural aspects of existence, S. aureus can be a major opportunistic human pathogen. This versatile microorganism can infect a variety of anatomical sites, causing a broad spectrum of pathologies ranging from superficial to invasive infections. It developed a variety of strategies to adopt to a changing microenvironment. This attributed to the emergence of resistance to antibiotics of different classes during the past six decades. Methicillin-resistant S. aureus (MRSA) was originally confined to health-care settings (health-care-associated MRSA). Later on, community-acquired MRSA was identified as another source of infections. Recent figures indicate that MRSA strains have been associated with approximately 75% of all S. aureus infections worldwide. Several guidelines have been published to establish an adequate treatment of skin and soft tissue infections (SSTIs) caused by MRSA strains. In the first part of this review, we focus on current treatment guidelines with a focus on medical drug therapy, but drug therapy has its own limitations. Recently, the interest in herbal remedies has greatly increased. There is growing evidence of antimicrobial activity of medicinal plants and their extracts. The second part of this review is dedicated to herbal compounds to circumvent antibiotic resistance. Herbal compounds may potentiate the action of antibiotics and restore the activities of antibacterial agents against which S. aureus has developed a drug resistance. Part 2 focuses on the role of S. aureus in pathology of the two major inflammatory skin diseases, i.e., atopic dermatitis (AD) and psoriasis. Finally, Part 3 provides an overview on natural compounds with antimicrobial activity against S. aureus and possible use in the treatment of SSTIs,

Ayurvedic Management of Visarpa w.s.r to Herpes Zoster

Visarpa is one of the major Skin disease which is widely explained in our Ayurvedic classics. The clinical features contemplates with Herpes Zoster which is an active transmitting Viral disease. This case reports shows the Successful treatment of Visarpa. Here presenting a case of 72 year, female with sudden onset of 2-3 Vesicles on an Erthyematous base over the chin and left half of the lower lip, along with dragging pain and burning sensation within 2 days. Gradually Vesicles started to appear over the left side of the face, left Ear, Tongue with increased number of Vesicles within 4-5days along with other symptoms persists. Clinically the patient was diagnosed as Visarpa (Herpes Zoster). As Pitta Dosha and Raktha Dhathu vitiation was noticed, managed by Siravyadha as Shodhananga chikitsa and the Dravyas with Tiktha Rasa, Sheetha veerya in nature. The patient showed improvement within 15days of Treatment. The detailed case is presented in the full paper.

A Study on Major Ectoparasites and Associated Skin Diseases of Ruminants in and Around Bishoftu Town, Central Ethiopia

A cross-sectional study was conducted from November 2018 to April 2019 to evaluate the occurrence of ectoparasites and associated skin diseases in ruminants in and around Bishoftu town, central Ethiopia. A total of 437 ruminants (216 cattle, 141 sheep, and 80 goats) brought to the open-air Veterinary Teaching Hospital (VTH) of the College of Veterinary Medicine, Addis Ababa University, were sampled using simple random sampling. Accordingly, the occurrence of ectoparasites and associated skin diseases was found to be 59% (258), and out of these animals, 195 (44.6%) were infected with ectoparasites, of which 111 (25.4%) were bovine, 27 (6.2%) were caprine, and 57 (13%) were ovine. The major ectoparasite species identified were Amblyomma variegatum (13%), A. gemma (0.7%), A. cohaerens (1.8%), A. nymph (3.2%), H. truncatum (2.7%), Boophilus decoloratus (6.2%), Rhipicephalus pulchellus (1.8%), R. eversi (0.7%), Damalinia ovis (3%), Linognatus vituli (5.5%), Psoroptes (0.7%), Demodex bovis (0.5%), Ctenocephalides canis (0.7%) and Ct. felis (5.03). On the other hand, the associated skin diseases infesting animals were: 63 (14.4%), lumpy skin disease (0.9%), sheep pox (5.5%), goat pox (5%), dermatophilosis (0.2%), contagious ecthyma in caprine (2.1%), and contagious ecthyma in ovine (0.7%). The findings of the present study suggest that ectoparasites and associated skin diseases in and around Bishoftu are still widespread and economically important constraints for the productivity and use of ruminants. Hence, stringent adherence to the control of ectoparasites and associated skin diseases is required as a responsibility of the concerned government body based on professional research results in the study area.

Type-I Photosensitizer-Triggered Controllable Carbon Monoxide Release for Effective Treatment of Staph Skin Infection.

Staphylococcus aureus (S. aureus) infection is a major infectious skin disease that is highly resistant to conventional antibiotic treatment and host immune defense, leading to recurrence and exacerbation of bacterial infection. Herein, we developed a photoresponsive carbon monoxide (CO)-releasing nanocomposite by integrating anion-π+ type-I photosensitizer (OMeTBP) and organometallic complex (FeCO) for the treatment of planktonic S. aureus and biofilm-associated infections. After optimizing the molar ratio of FeCO and OMeTBP, the prepared nanoparticles, OMeTBP@FeCONPs, not only ensured sufficient loading of CO donors and efficient CO generation but also showed negligible free ROS leakage under light irradiation, which helped to avoid tissue damage caused by excessive ROS. Both in vitro and in vivo results demonstrated that OMeTBP@FeCONPs could effectively inhibit S. aureus methicillin-resistant S. aureus (MRSA), and bacterial biofilm. Our design has the potential to overcome the resistance of conventional antibiotic treatment and provide a more effective option for bacterial infections.

Management of Herpes zoster in Ayurveda through Bloodletting therapy along with other Ayurveda treatment: A case study

Herpes zoster is a very painful disease. Generally, it is a unilateral and self-limiting condition. Inappropriate or delayed therapy might make the disease worse and increase the risk of complications such as post-herpetic neuralgia. Age-related immunosuppression and low immunity make people more susceptible to herpes infection and more likely to develop post-herpetic neuralgia (15%). According to Ayurveda, it correlates with visarpa. It is a raktapradoshaj vikara (disease caused by vitiated blood) and primarily a pitta-predominant disease manifesting twaka (skin) so visarpa is one of the major skin diseases. Here we present a case of a 66-year-old female patient with k/c/o HTN and hypothyroidism visited the OPD with symptoms of unilateral onset of blisters on the right side of the back region, the right axillary region, and the medial aspect of the right arm, within 48 hours; along with burning Pain, itching, and sleeplessness due to burning. According to Ayurveda, the patient was clinically diagnosed with pittaj visarpa. Considering pitta dosha and rakta dhatu dusti, raktmokshan was planned as the prime treatment. The patient showed improvement in burning pain after the first setting of raktamokshan. The numeric rating scale revealed that the patient experienced relief in the severity of burning pain (from 8 to 0) and itching (from 5 to 0). Other Ayurveda treatments like pittaghna chikitsa (pitta pacifying) and pradeha (local application) were used. Rapid blister formation stopped within three days of treatment, and after 28 days, all blisters crusted off and a normal skin complexion was achieved. Thus, Ayurvedic treatment was valuable and cost-effective for treating conditions like herpes. Ayurveda protects patient’s immune systems and reduces the chances of post herpetic neuralgia and reinfection.

Divergent in situ expression of IL-31 and IL-31RA between bullous pemphigoid and pemphigus vulgaris.

Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are two major autoimmune blistering skin diseases. Unlike PV, BP is accompanied by intense pruritus, suggesting possible involvement of the pruritogenic cytokine IL-31. However, the underlying mechanisms of the clinical difference between BP and PV in terms of pruritus are not fully understood. To compare the expression levels of IL-31 and its receptor IL-31RA in the lesional skin, including peripheral nerves in BP and PV patients, immunohistochemical staining for IL-31 and IL-31RA was performed in skin samples of BP and PV patients and healthy controls (HC). The IL-31RA-expressing area in epidermis and peripheral nerves was analysed using ImageJ and the percentage of positive cells for IL-31/IL-31RA in dermal infiltrating cells was manually quantified. Quantitative analyses revealed that IL-31/IL-31RA expressions in the epidermis and dermal infiltrate were significantly increased in BP compared to PV and HC. The difference between BP and PV became more obvious when advanced bullous lesions were compared. Peripheral nerves in BP lesions presented significantly higher IL-31RA expression compared to PV lesions. In conclusion, we found significantly augmented expressions of IL-31/IL-31RA in BP lesions, including peripheral nerves, in comparison to PV. These results suggest a possible contribution of IL-31/IL-31RA signalling to the difference between BP and PV in the facilitation of pruritus and local skin inflammation, raising the possibility of therapeutic targeting of the IL-31/IL-31RA pathway in BP patients.

Identification and characterization of bone/cartilage-associated signatures in common fibrotic skin diseases.

Background: Fibrotic skin diseases are characterized by excessive accumulation of the extracellular matrix (ECM) and activation of fibroblasts, leading to a global healthcare burden. However, effective treatments of fibrotic skin diseases remain limited, and their pathological mechanisms require further investigation. This study aims to investigate the common biomarkers and therapeutic targets in two major fibrotic skin diseases, namely, keloid and systemic sclerosis (SSc), by bioinformatics analysis. Methods: The keloid (GSE92566) and SSc (GSE95065) datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified, followed by functional enrichment analysis using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). We then constructed a protein-protein interaction (PPI) network for the identification of hub genes. We explored the possibility of further functional enrichment analysis of hub genes on the Metascape, GeneMANIA, and TissueNexus platforms. Transcription factor (TF)-hub gene and miRNA-hub gene networks were established using NetworkAnalyst. We fixed GSE90051 and GSE76855 as the external validation datasets. Student's t-test and receiver operating characteristic (ROC) curve were used for candidate hub gene validation. Hub gene expression was assessed in vitro by quantitative real-time PCR. Results: A total of 157 overlapping DEGs (ODEGs) were retrieved from the GSE92566 and GSE95065 datasets, and five hub genes (COL11A1, COL5A2, ASPN, COL10A1, and COMP) were identified and validated. Functional studies revealed that hub genes were predominantly enriched in bone/cartilage-related and collagen-related processes. FOXC1 and miR-335-5p were predicted to be master regulators at both transcriptional and post-transcriptional levels. Conclusion: COL11A1, COL5A2, ASPN, COL10A1, and COMP may help understand the pathological mechanism of the major fibrotic skin diseases; moreover, FOXC1 and miR-355-5p could build a regulatory network in keloid and SSc.

A Study on Major Ectoparasites and Associated Skin Diseases of Ruminants in and around Bishoftu Town, Central Ethiopia

A Study on Major Ectoparasites and Associated Skin Diseases of Ruminants in and around Bishoftu Town, Central Ethiopia

Comparative efficacy of ayurveda interventions Shwitrahara Lepa and Avalgujabeejadi Lepa in the Management of Shwitra (Vitiligo)

INTRODUCTION: Vitiligo is one of the major skin diseases affecting the normal pigmentation of the skin. It is an auto-immune disorder resulting in skin hypopigmentation due to reduced melanin production. In Ayurveda classical texts, the external application of Shwitrahara Lepa (SHL) and Avalgujabeejadi Lepa (AGL) is indicated for managing vitiligo. Hence, given literary indication, the present study was undertaken to evaluate the efficacy of SHL and AGL in managing vitiligo. MATERIALS AND METHODS: An open-label, parallel-group, randomized, controlled clinical study was conducted among 40 participants aged between 21 and 60 diagnosed with vitiligo. The participants were randomly assigned into two equal groups. Group A was treated by using an external application of SHL with water. Group B received AGL external application with cow urine. The external application of the interventions was done over the lesion once a day following early morning (7:00 a.m.) sunlight exposure for 15 min daily for 45 days. The effect of therapy was assessed through clinical parameters such as Vitiligo Area Scoring Index (VASI), pigmentation, margin, and the number of lesions along with classical symptoms of vitiligo, such as discoloration of the skin, reddish or coppery discoloration, skin dryness, burning sensation, itching, and thickening of the skin. RESULTS: The results of the study indicate that both SHL and AGL are significant in improving the score of VASI (P < 0.001) and pigmentation and reducing the margin of the lesions compared to baseline. Significant reduction in skin dryness and itching was noted in both SHL (P = 0.004, P = 0.023) and AGL (P = 0.034, P = 0.009) groups. SHL also significantly reduced whitish skin discoloration and burning sensation (P < 0.05). On comparing the effect of SHL and AGL, statistically nonsignificant results (P > 0.05) were obtained for all the assessment parameters, indicating that both interventions are equally effective. No adverse drug reactions were noted. CONCLUSION: Both the formulations are equally effective.

Inflammation Causes Exacerbation of COVID-19: How about Skin Inflammation?

COVID-19 is a recently emerged viral infection worldwide. SARS-CoV-2, the causative virus, is believed to have emerged from bat coronaviruses, probably through host conversion. The bat coronavirus which has the highest gene homology to SARS-CoV-2 specifically infects deep forest bats in China whose habitat extends through the Middle East to Southern Europe. Host conversion might have occurred due to the deforestation by humans exposing wild bats to the environment they had never encountered before. SARS-CoV-2 infects cells through two mechanisms: through its receptor ACE2 with the help of enzyme TMPRSS and through membrane fusion with the help of elastases in the inflammatory condition. Obesity, hypertension, diabetes mellitus, and pulmonary diseases cause poor prognosis of COVID-19. Aging is another factor promoting poor prognosis. These diseases and aging cause low-level and persistent inflammation in humans, which can promote poor prognosis of COVID-19. Psoriasis and atopic dermatitis are the major inflammatory skin diseases. These inflammatory skin conditions, however, do not seem to cause poor prognosis for COVID-19 based on the epidemiological data accumulated so far. These mechanisms need to be elucidated.

Evaluating the effect of tanning response to sun exposure on the risk of skin diseases through Mendelian randomization.

Background: Until now, the relevance of the tanning response to sun exposure and skin diseases has incomplete and inconsistent epidemiological observations. In this case, it is valuable to find out the causality of tanning response to sun exposure and skin diseases, and take a step further toward developing effective therapies as well as prevention methods. Methods: We investigated the causal effect of tanning response to sun exposure on 10 major skin diseases that have been studied in recent large-scale genome-wide association studies (GWASs). Significant independent genetic variants from large-scale GWAS on ease of skin tanning (N = 453,065) are selected as the effective instrumental variables (IVs). For each skin disease, we extracted the summary statistics of those IVs (or their proxies) from the corresponding skin disease-GWAS as the valid IVs. Mendelian randomization (MR) was further performed to evaluate the causal association of ease of skin tanning with each of the skin diseases using different statistical methods, including inverse-variance weighted (IVW), the weighted median, and MR-Egger. Sensitivity analysis was also conducted to evaluate the effect of horizontal pleiotropy and heterogeneity. Results: We observe significant associations between six skin diseases with tanning response to sun exposure with adjusted p-value derived by IVW less than 0.05 and with nominal p value less than 0.05 at the same time derived by either MR-Egger or weighted median. The six skin diseases include actinic keratosis (IVW FDR = 1.71E-40, MR Egger p-value = 3.46E-22), seborrhoeic keratosis (IVW FDR = 2.97E-4, MR Egger p-value = 1.06E-3), blepharochalasis (IVW FDR = 1.30E-3, MR Egger p-value = 2.91E-4), seborrhoeic dermatitis (IVW FDR = 1.29E-2, MR Egger p-value = 1.23E-2), malignant melanoma of skin (IVW FDR = 2.95E-2, MR Egger p-value = 1.91E-2), and freckles (IVW FDR = 2.95E-2, weighted median p-value = 1.02E-3). Interestingly, we find increased trends of developing all of the six skin diseases with increased tanning response to sun exposure (beta values are positive using IVW, MR-egger, and weighted median methods). We also replicate the association on three skin diseases using an independent outcome GWAS cohort, including malignant melanoma of the skin (replication IVW p-value = 2.13E-39), actinic keratosis (replication IVW p-value = 4.64E-32), and seborrhoeic keratosis (replication IVW p-value = 1.79E-3). Conclusion: Our observation shows that the tanning response to sun exposure is positively correlated with the development of skin diseases in people of European descent by Mendelian randomization studies. But randomized controlled trials are still needed to add proof to our observations.

Global Burden of Bacterial Skin Diseases: A Systematic Analysis Combined With Sociodemographic Index, 1990-2019.

BackgroundThe latest incidence and disability-adjusted life-years (DALYs) of major bacterial skin diseases (BSD) and their relationship with socioeconomic are not readily available.ObjectiveDescribe the global age-standardized incidence and DALYs rates of BSD and analyze their relationship with socioeconomic.MethodsAll data were obtained from Global Burden of Disease (GBD) 2019 database. The correlation between BSD and socioeconomic development status was analyzed.ResultsThe age-standardized incidence and age-standardized DALYs rate of BSD are: 169.72 million [165.28–175.44] and 0.41 million [0.33–0.48]. Of the two main BSD, pyoderma cause significantly much heavier burden than cellulitis. The change of age-standardized incidence (7.38% [7.06–7.67]) and DALYs (−10.27% [−25.65 to 25.45]) rate of BSD presented an upward or downward trend from 1990 to 2019. The highest burden was in the low-middle sociodemographic index (SDI) area while the area with the lowest burden was recorded in the high-middle SDI area in 2019.LimitationsGBD 2019 data of BSD are derived from estimation and mathematical modeling.ConclusionThe burden of BSD is related to socioeconomic development status. The results based on GBD2019 data may benefit policymakers in guiding priority-setting decisions for the global burden of BSD.

Etiopathgenesis of Dadru in Ayurveda: A Review

In recent years, Twak Vikar (Dermatological manifestations) are common and more so frequent in the elder age. There is a definite increase in its incidence especially, in the tropical region and developing countries like India due to various reasons like unhygienic environmental conditions, poverty, poor sanitation, illiteracy, malnutrition, improper skin care etc. The patients of skin disease are additionally prone to experience physical, emotional & socio-economic embarrassment in the society due to disfigured appearance. Dadru is one of the commonly occurring skin diseases which can be defined as an entity manifested by intractable itching, scaling, erythema with the lesions discoid in shape. Dadru, is a Kapha (Energy that forms the body’s structure) Pitta (Body’s metabolic system) Pradhan (prominent) Vyadhi (Disease). Acharya Charak has placed Dadru under Kshudra Kushth (Minor skin disease) but Acharya Sushrut and Acharya Vagbhata kept it under Mahakushth (Major skin disease). Acharyas did not explained separate Nidan (causative and diagnostic factor) for Dadru Kushth. The knowledge of Nidan is helpful for proper Diagnosis, prevention and treatment of disease.

Traditional Food for Dermal Health- A Review

Ayurveda, Indian system of medicine aims to revitalize and preserve the health of the healthy and alleviate the disease of the sick. Proper lifestyle and diet play a major role in the prevention and curative aspect of ailments. Diet in its simplest form can be described as the food consumed. A diet can be compatible or incompatible to the human body depending on the various factors such as time, weather, topography, domicile, digestive power of an individual. In ayurveda this compatible diet is termed as pathya ahara and incompatible diet is termed as apathya ahara. In the present scenario, current life style and food habits such as incompatible diet and irregular timings contribute to various ailments. Skin is the most exposed organ and thereby more prone to pathological changes. Present research works and published papers are observed to be focused on diseases and medications and their curative effects. There is lackadaisical approach on the part to control and alleviate diseased conditions through a strict pathya apathya (wholesome and unwholesome) rather than outright administration of medicine. The present review highlights the same. In Ayurveda, skin disease occurs mostly due to the kapha pitta (humors) and rasa- rakta dushti (vitiated rasa, rakta body constituents). This review enlists certain diets that cause rakta prasadana (nourishing rakta) and pacify kapha pitta dosha. Unlike other diseases, skin disease is anushangi (long term) and recidivistic in nature. Treatment along with life style modifications with pathya and apathya can only completely target the skin disease. Therefore, present review aims to focus on the importance of diet in dermal health. In this study, Ayurveda classics were reviewed in terms of various aspects of pathya and apathya in major skin diseases like kushta, visarpa shwitra etc. The electronic databases Google Scholar and PubMed were searched for relevant contemporary literature. In this article mostly mentioned food articles are richest source of vitamin C. Vitamin C is the most important vitamin for upkeep of a healthy skin, as it helps to prevent skin pigmentation and damage caused by UV light exposure, it also helps to reduce visible signs of aging such as wrinkling of skin. Also most compatible food mentioned in the article are sheeta veerya(cold in potency), which reduces deranged pitta and having madhura rasa (sweet )which can pacify pitta dosha. Some specific types of viruddha (incompatible) mentioned here plays an key role in imparting tissue level damage. Thus, this review covers various aspects of dermal health in terms of diet. In fact there are effective dietary modifications in Ayurveda through which fast recovery and prevention can be ensured in the spectrum of skin manifestations.

Effects of Ambient Exposure to Nitrogen Dioxide on Outpatient Visits for Psoriasis in Rapidly Urbanizing Areas

Rapid development and urbanization can increase ambient exposure to NO2 and its health risks in individuals. However, the association between NO2 exposure and outpatient visits of patients with psoriasis has rarely been reported, though psoriasis is a major skin disease in rapidly urbanizing areas with high population densities. This study applied a time-stratified case-crossover design to investigate the effect of short-term exposure to ambient NO2 on outpatient visits for psoriasis from 2014 to 2020 in Guangzhou, China (n = 62,305). A subgroup analysis was performed to evaluate NO2 impacts on vulnerable subpopulations. Our results showed that the NO2 concentration during the study period was lower than that of the level II threshold from China (PRC) but higher than that set by the WHO, indicating moderate air quality. However, a 10-µg m-3 increase in NO2 concentration could still be associated with 3.1% higher outpatient visits for psoriasis (adjusted RR of lag 0 d:1.031 [CI:1.025, 1.037]). NO2 exposure can also pose long-term risks. Additionally, NO2 impacts on psoriasis may be independent of other pollutants. Adjusting for PM2.5, SO2, O3, and meteorological factors, a 10-µg m-3 increase in NO2 was associated with RRs of 1.043 [CI:1.033, 1.053], 1.022 [CI:1.014, 1.031], and 1.022 [CI:1.014, 1.031] at lag 0, lag 1, and lag 2 days, respectively. NO2 risks were higher among older individuals (age ≥ 60 years) and those with medical insurance [adjusted RRs: 1.045 (CI:1.023, 1.066) and 1.047 (CI:1.036, 1.058)]. Being a major pollutant in rapidly urbanizing areas with high population densities, NO2 emission could be a crucial factor in psoriasis, although the daily pollution level was not above the air quality thresholds. Challenges associated with air quality control and health disparity create a necessity for the enhancement of health and environmental policies to reduce local and regional emissions (e.g., traffic-related pollution), and vulnerable subpopulations should be targeted.

Scabies Knowledge Among Undergraduate Nursing Students in China: A Questionnaire Survey.

PurposeScabies is a common, neglected, and a major health concern skin disease in the world. Improper care may produce a series of complications and even lead to the spread of diseases. Nursing students, as future health-care workers, are vital to the prevention and care of diseases. However, to date, few studies have focused on the basis of their disease cognition for scabies. This study aims to evaluate the level of undergraduate nursing students’ awareness of scabies disease.MethodsA questionnaire survey was conducted among all undergraduate nursing students in Xi’an FanYi University, Xian, Shaanxi Province, China.ResultsAll the 132 undergraduate nursing students completed the questionnaire. The true ignorance rate of scabies in this survey was 82.6%. However, among the 56 students (42.4% of total) who thought they knew about the disease. Only 23 students (17.4% of the samples) had 75% or more satisfactory knowledge. Fewer students claimed that they had read about the itchy-mite-disease in books (N = 20, 15.2%). Compared with college textbooks (P-value < 0.05) and medical books (P-value < 0.05), other books (medical journals) provide more information about scabies. Nearly half of the students did not know that the scabies can be contagious. All students expressed their willingness to learn about scabies knowledge and participate in the diagnosis and treatment of scabies (100%).ConclusionThis study shows that undergraduate nursing students have a poor level of knowledge about scabies. There is an urgent need to improve nursing students’ awareness of scabies and increase their knowledge base, so as to strengthen the standardized nursing of scabies and reduce the prevalence of scabies.

Management of Allergic Drug Reaction converted into Visarpa – A case study.

Physical appearance is something that is related to psychological stress. Skin is major organ which remains as a presentable material in front of the world which also defines any individuality. Around 20 – 30 % Population suffer from skin ailments. According to study the incidence rate of herpes zoster was highest i.e. 56% at 20 to 40 years of age and from lower socioeconomic strata. These problems vary from age, locality and season. Visarpa is one of the major skin disease which is explained in detail apart from Kusthavyadhi by every Acharya This imparts the severity and significance of disease. Visarpa is characterized by Aashu – anunnatashopha, Daha, Jwara, Vedana and nature of pidika is described as Agnidagdagdavat. Skin disorder vary greatly in symptoms and severity. so they can be temporary or permanent. they can be situational or genetic, minor or mortal. thus, visarpa is one which if mismanaged can lead to life threatening situation. Twak Roga are Chirkari and so recurrent relapse occurs easily. visarpa is bahudoshaj vyadhi.

Management of Kitibha Kushta (Plaque Psoriasis) with Combination of Ayurvedic Modality-A Case Study

Skin diseases are commonly observed due to altered lifestyle, lack of physical exercise, poor hygiene, mental stress and improper food habits. Kushta (Skin diseases) is divided into Maha Kushta (Major skin diseases) and Kshudra Kushta (Minor skin disease). Kitibha Kushta (Plaque Psoriasis) is included in Kshudra Kushta commonly found today, having sign and symptoms similar to Plaque psoriasis. Due to relapsing nature of Plaque psoriasis it needs long duration treatment. Ayurveda provides long lasting results by treating the disease and preventing reoccurrence. In this case study, a 43 years old male came to OPD of Kayachikitsa with chief complaint of Kandu (Itching), dry silvery white patches over left leg treated with Shodhana Chikitsa (Body purification treatment) using Vaman Karma (Therapeutic Emesis) and Shaman Chikitsa (Alleviating treatment) using internally Gandhaka Rasayana, Panchatikta Ghrita and S-kin powder, Shabsoria Oil for external application for 1 month. The PASI score was 14.4. Before treatment, after 15 days it was 7.4 and after 30 days it was reduced to 0. Patient got relief in the symptoms. Better result achieved in this case using Shodhana Chikitsa and Shaman Chikitsa along with Bahirparimarjan Chikitsa (External application).