Pale Patches Research Articles

Early Gastric Signet Ring Cell Adenocarcinoma as a Flat Pale Patch on an Esophagogastroduodenoscopy.

Early Gastric Signet Ring Cell Adenocarcinoma as a Flat Pale Patch on an Esophagogastroduodenoscopy.

Microwave-assisted extraction of Lawsonia inermis L. leaves: Method validation, optimization, and tyrosinase-stimulating activity

Vitiligo is a long-term skin condition characterized by the development of pale white patches due to a lack of melanin. Lawsonia inermis L. leaves, which contain lawsone, have been explored as a potential alternative treatment for vitiligo. This study aimed to optimize the microwave-assisted extraction of L. inermis leaves and evaluate its ability to stimulate tyrosinase activity, which is relevant to vitiligo treatment. The Box-Behnken design was employed, with three factors being varied: microwave power, time, and cycle. Two responses were monitored: extraction yield and lawsone content. To determine the lawsone content, validated high-performance liquid chromatography was utilized, which demonstrated good linearity, specificity, precision, and accuracy. The optimal conditions that provided the highest extraction yield and lawsone content were then used to evaluate the extract’s ability to stimulate tyrosinase activity. The results revealed that a microwave power of 300 W and a microwave time of 20 s for one cycle yielded an extraction yield of 12.99% ± 0.10% and a lawsone content of 94.85 ± 3.12 mg/g extract. The accuracy of the prediction, with a percent error of less than 10%, confirmed the reliability of the computer program used for data prediction. Furthermore, the extract exhibited significant stimulation of tyrosinase activity, indicating its potential usefulness in vitiligo treatment. The optimal microwave-assisted extraction method identified in this study holds promise for maximizing extraction yield and lawsone content in L. inermis leaves extract. This extract could serve as a basis for developing topical products for the treatment of vitiligo.

First records of leucism in two species of duiker (Cephalophinae) in Gabon

The present study aimed to describe partial leucism, which is a pigmentation disorder, in two duiker species: Philantomba monticola and Sylvicapra grimmia. Leucism is a condition characterized by partial loss of pigmentation, resulting in white or pale patches on the animal's body. This is the first report of leucism in the subfamily Cephalophinae, which includes duikers, and similar occurrences may exist in other duiker species across their sub-Saharan distribution range. This finding highlights the potential for further research on pigmentation disorders in duikers and their prevalence in different species within the subfamily.

First Report of Leaf Blight of Jasminum sambac Caused by Bipolaris australiensis in Pakistan

During disease surveys of plants in 2021, leaf blight was observed on Jasminum sambac plants in City Housing Society, Gujranwala, Punjab, Pakistan. Infection spots occurred on the margins of leaves in the form of large patches on both abaxial and adaxial surfaces of J. sambac. These spots began as small necrotic spots and developed into irregular pale brown patches with black powder covering the surfaces. The causative organism was consistently isolated from infected leaves on potato dextrose agar. Based on morphological analysis, the species isolated from Jasminum sambac during this research belongs to the genus Bipolaris and has been identified as Bipolaris australiensis. This fungal species has not previously been reported on this host plant worldwide, and this fungal taxon has been characterized for the first time in detail from Pakistan. To the best of our knowledge, J. sambac is a new host record for this fungal species in Pakistan and worldwide. A key to the identification of Pakistani species of the genus Bipolaris is presented in this paper

Hereditary diffuse gastric cancer in a Japanese family with CDH1 mutation three case reports

BackgroundGermline pathogenic variants in the E-cadherin gene CDH1 cause hereditary diffuse gastric cancer (HDGC), which is an autosomal dominant cancer syndrome, accounting for 1–3% of all gastric cancers. HDGC harboring a CDH 1 variant is extremely rare in Japan.MethodIn this study we report the clinical courses of three cases with HDGC from a single Japanese family.ResultsThe proband exhibited advanced and metastatic gastric cancer, and was found to have a previously reported heterozygous frameshift variant in CDH1 (NM_004360.3:c.1009_1010del:p.Ser337Phefs*12). Five at-risk relatives underwent presymptomatic molecular testing after careful genetic counseling, and three were molecularly diagnosed as positive for the variant. Esophagogastroduodenoscopy was performed in these relatives revealing abnormal small pale mucosal patches, small ulcerative lesion and no abnormal findings. Moreover, random and targeted biopsies were compatible with pathological diagnosis of HDGC in the three cases, all of which underwent total prophylactic gastrectomy.ConclusionIt is critical for the assessment and management of HDGC patients to be actively offered a multidisciplinary and familial-oriented approach. Notably, genetic screening in suspected individuals and familial members is a determining piece for a higher detection rate and the identification of clinical relevant mutations in both low and high-incidence gastric cancer countries.

The association of Interleukin-10 and Interleukin-13 polymorphisms with susceptibility to vitiligo: A study in Iranian patients

Vitiligo is an autoimmune disease with non-pigmented and pale white patches in skin. Different studies showed that cytokines play a role in the onset of vitiligo symptoms. The aim of the present study was to investigate the association of IL-10 and IL-13 polymorphisms with susceptibility to vitiligo. With this aim, DNA was extracted from peripheral blood of 90 patients with vitiligo and 90 healthy individuals. Then, the genotype of IL-10 (rs1800896 T > C and rs1800872 T > G) and IL-13 (rs2069756 T > C and rs1295685 G > A) polymorphisms was determined by PCR-RFLP. The results of statistical analysis indicated that the heterozygote genotype of rs1800872 as well as rs2069756 significantly decreased the susceptibility to vitiligo (p < 0.05). However, no association was observed between rs1800896 and rs1295685 polymorphisms and the risk of vitiligo (p > 0.05). Among the patients, the heterozygote genotype of rs1800872 polymorphism showed to be associated with increased risk of Acrofacial phenotype development (p < 0.05). The obtained results suggested that heterozygote genotype of rs1800872 and rs2069756 polymorphisms play a protective role against development of vitiligo (p < 0.05). However, the heterozygote genotype of rs1800872 could be stated as a susceptible factor for onset of Acrofacial phenotype in patients with vitiligo.

34630 The mental health and psychosocial burden among patients living with vitiligo in the United States: Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the impact and burden of vitiligo on patients’ quality of life (QoL) from the perspective of patients and physicians in 17 countries. Participants aged ≥18 years who self-reported a clinical vitiligo diagnosis were recruited via an online panel and were asked questions regarding their mental health, psychosocial burden, and behavior in professional and social situations.

34631 Do patients with vitiligo and health care professionals treating them recognize the burden in living with the disease in the United States? Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the impact and burden of vitiligo on quality of life (QoL) from the patient and physician perspective from around the world. The VALIANT study recruited adult participants (aged ≥18 years who self-reported a vitiligo diagnosis) via an online panel. Participants were asked questions regarding their mental health, psychosocial burden, and behavior in professional and social situations.

EE294 Burden of Behavioral Health Conditions Among Individuals with Vitiligo in an Insured US Population

Vitiligo is an inflammation-mediated chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. Individuals with vitiligo often experience substantial psychosocial burden. Here we describe behavioral health burden in individuals with vitiligo in the United States.

Guidelines on managing people with vitiligo

Abstract Linked Article: Eleftheriadou et al. Br J Dermatol 2022; 186:18–29. Vitiligo is a common, long-term skin condition. It affects approximatively 1% of the world’s population, regardless of age, sex or race. The type of vitiligo and its stability help indicate the chance of improvement (or chance of relapse). In people with vitiligo not enough melanin is produced in the body, which leads to pale, white or light pink patches on the skin. Sometimes, these patches can merge to form larger areas. In rare cases, over 80% of the body surface can be affected. However, vitiligo appears most commonly on the face, neck, hands, body openings (nostrils, mouth, genitals, navel and around the eyes) and skinfolds (the underarms and groin area). The British Association of Dermatologists (BAD) formed a group of experts made up dermatologists, clinical psychologists, patient representatives and a technical team. They reviewed relevant articles published up to May 2019 to produce evidence-based recommendations using the rigorous GRADE system (Grading of Recommendations Assessment, Development and Evaluation) for guideline development. The guideline has 28 management recommendations, nine future research recommendations and five recommended audit points (audit points are used by health professionals to assess, evaluate and improve the quality of care received by patients in a systematic way). The management approach is presented as a flow diagram, allowing clinicians to see at a glance the key recommended actions when treating people with vitiligo. Based on the experience of the group, people with vitiligo may experience high levels of social anxiety, stigma and discrimination. They recommended, alongside the recommended treatments, routine assessment of patients’ quality of life, and mental and social wellbeing. People with vitiligo should also be offered information on self-help, and where appropriate, referred for psychological therapy. The guideline was used to update the BAD’s Patient Information Leaflet (PIL) for vitiligo, which can be accessed on the BAD website (www.skinhealthinfo.org.uk/a-z-conditions-treatments/). Linked Article: Eleftheriadou et al. Br J Dermatol 2022; 186:18–29.

Multiple etiological factors led septicemic disease with mass mortality of fishes in freshwater reservoir of Odisha, India

A detailed investigation on mass mortality of fishes was conducted in a small tropical reservoir- Derjang (20o50’32.0”N, 85o01’14.8″E), Odisha, India. Mortality mostly occurred in Systomus sarana followed by Labeo rohita, Cirrhinus mrigala, Labeo catla, Ompok bimaculatus, Labeo calbasu and Mastacembelus armatus. During 20 days of disease occurrence in May–June 2019, a total of about 3000 kg of fish died. The clinical signs in Cyprinid group were haemorrhagic spots, ulcerative lesions, rotten and pale patches in gills due to septicemic disease whereas haemorrhagic spots were the only prominent symptoms observed in Silurid group. Bacteriological isolation and identification through conventional and molecular techniques revealed that Klebsiella pneumoniae was the most common pathogen recovered from S. sarana, C. mrigala and O. bimaculatus. Further Aeromonas hydrophila, Acinetobacter baumannii were isolated from L. rohita and L. catla respectively. The role of these pathogens for this disease outbreak in multiple fish species is discussed in perspective of environmental factors. Sudden environmental alternation by the supercyclone Fani (3rd May 2019) on the coastal part of Odisha might have played a key role to translate the aquatic bacteria into the virulent infective pathogens. In the experimental challenge study, isolated bacteria showed pathogenicity in respective hosts as that in the reservoir. Thus this further revealed both bacteria and fish specific virulency with a variation in LD50 values. All the gram negative bacterial isolates were found to resist ampicillin and amoxicillin-clavulanic acid and most of them were TEM gene positive. However, the bacteria were found to be susceptible to the rest of the nineteen antibiotics. These findings suggested that the sudden cyclone is an enormous threat to reservoir aquaculture, and should be taken into consideration before breeding, stocking and harvesting of fishes.

Vitiligo – Study In view of familial occurence

Vitiligo – Study In view of familial occurence

Human-specific desmoglein 2 mutations in mice models of arrythmogenic right ventricular cardiomyopathy reproduce patients" phenotype

Abstract Funding Acknowledgements Type of funding sources: None. Background Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease that inevitably leads to terminal heart failure and sudden cardiac death due to ventricular arrhythmias. Excessive exercise accelerates the progress of the disease. At present, there is no curative therapy for ARVC. The disease is mostly caused by mutations in genes encoding desmosomal proteins, and Japanese ARVC patients commonly possess missense mutations in DSG2. Although there are animal models with Dsg2-related cardiomyopathy, they do not reflect the precise human disease caused by missense mutations in DSG2. Purpose We aimed to generate knock-in mouse models of ARVC carrying Dsg2 mutations equivalent to those found in ARVC patients. Methods We introduced Dsg2 mutations (R297C, D499A), which were equivalent to most common mutations in Japanese ARVC patients, to mice by CRSPR/Cas9 genome editing system. Echocardiography and treadmill training were performed to evaluate the cardiac phenotype of the mouse models. Results There is phenotype inequality between the two lines of Dsg2 knock-in mice. In R297C mice, all the homozygotes died suddenly until the age of 20 weeks, and half of the heterozygotes until the age of 25 weeks. Heart examination of the deceased homozygous mice demonstrated enlarged cavities, predominantly in the right ventricles, and scattered pale patches suggesting fibrotic replacement of the myocardium. Echocardiography of four 9-week-old homozygous mice shows acoustically dense zones (white arrows in the left figure) and left ventricular dysfunction (ejection fraction (EF) &amp;lt; 35%). Exploration of the hearts of sacrificed mice confirmed echocardiographical findings (red arrow in the right figure) demonstrating scattered pale regions similar to those in suddenly died mice. In contrast, homozygous and heterozygous D499A mice survived without sudden death. Both mutant mice develop heart failure after the age of 30 weeks. To mimic the effect of exercise, we performed treadmill training for two months started from 11 weeks old in both types of D499A and heterozygous R297C mice. The training significantly accelerated cardiac dysfunction: all D499A mice (homo and hetero) and half of heterozygous R297C developed biventricular dysfunction at the age of 19 weeks though no change in WT. EF for R297C heterozygous mice, D499A heterozygous and D499A homozygous mice decreased from 64.4 ± 4.3%, 71.9 ± 1.7% and 73.9 ± 1.1 to 31.2 ± 5.7%, 16.6 ± 2.1% and 12.4%±1.9, respectively. Treadmill training did not alter significantly EF in WT mice: 71.8 ± 2.3% before and 67.5 ± 1.4 at the end of physical challenge. Conclusion We generated mouse model of ARVC mutations that mimic the exact gene defect found in the humans. Our experimental work confirms significant overlap to the human phenotype. Further investigation will clarify the underlying cellular mechanisms. Abstract Figure. A heart from homozygous R297C mouse

Two cases of a previously undocumented New World warbler hybrid (Setophaga magnolia × S. ruticilla) in eastern North America

This study confirms 2 independent accounts of previously undocumented hybridization between Magnolia Warbler (Setophaga magnolia) and American Redstart (S. ruticilla) through morphological and genetic analyses. Hybrids were discovered in 2 locations in eastern North America: Ottawa County, Ohio, USA, and Laval, Québec, Canada. The hybrids, one male and one female, showed plumage intermediate to both parental species. White eye arcs, yellow wash on the belly, narrow white wing bars, and black lores reflect the Magnolia Warbler parentage, while dark yellow-orange coloration on the sides of the breast and under the wing, yellow on the base of most of the secondaries, and pale yellow patches on the outer tail feathers reflect American Redstart. Sequences of the mitochondrial ND2 gene, the Z-linked muscle-specific kinase (MUSK) gene, and the myoglobin intron-2 (MYO2) confirmed maternal ancestry from Magnolia Warblers and paternal ancestry in American Redstarts for both hybrids. There is ample opportunity for this species pair to hybridize; they are congeners with broad range overlap, similar habitat preferences, song structure similarities, and plumage similarities in some age categories. Despite these conditions and the unusually high rate of hybridization within the Parulidae, this hybrid combination has never been documented before, and we suggest that this is a rare event that may be expected anywhere in their broad, overlapping ranges.

Role of Homoeopathic Medicine in the treatment of Pityriasis Alba: A case report

Hypo-pigmentation of skin, although is not a life threatening disease, but is considered to be a social stigma, so invariably associated with significant psychological trauma and social isolation [1]. Pityriasis Alba is one of the cause of secondary hypo-pigmentation. Others include Pityriasis Versicolour, Idiopathic Guttate Hypomelanosis, Phenylketonuria etc. It is a type of eczema presenting as de-pigmented areas on the face, particularly in children, with or without scale [2]. Even though it is commonly encountered in dermatological practice, there is paucity of Indian studies on the subject.3A case presented in this paper of 23 years old female suffering from Pityriasis Alba of 3 months duration. The lesion started with a reddish popular lesion on lateral aspect both the elbow joint. In 3-4 days, it started converting into pale patches. An individualized homoeopathic medicine, Ignatia Amara was prescribed followed by Bacillinum which showed complete resolution of the disease. This case report suggests homoeopathic treatment as a promising complementary or alternative therapy in such type of skin lesion. Hypo-pigmentation of skin, although is not a life threatening disease, but is considered to be a social stigma, so invariably associated with significant psychological trauma and social isolation [1]. Pityriasis Alba is one of the cause of secondary hypo-pigmentation. Others include Pityriasis Versicolour, Idiopathic Guttate Hypomelanosis, Phenylketonuria etc. It is a type of eczema presenting as de-pigmented areas on the face, particularly in children, with or without scale [2]. Even though it is commonly encountered in dermatological practice, there is paucity of Indian studies on the subject.3A case presented in this paper of 23 years old female suffering from Pityriasis Alba of 3 months duration. The lesion started with a reddish popular lesion on lateral aspect both the elbow joint. In 3-4 days, it started converting into pale patches. An individualized homoeopathic medicine, Ignatia Amara was prescribed followed by Bacillinum which showed complete resolution of the disease. This case report suggests homoeopathic treatment as a promising complementary or alternative therapy in such type of skin lesion.

Isoenzyme Investigation and Morphometrics Study of Neckera complanata and Neckera crispa

Bryophytes are small, non-vascular, and non-flowering plants. Neckera complanata (Hedw.) Huebener and Neckera crispa Hedew.are one of the most prominent species in the Hyrcanian wetland found in glossy pale or yellowish-green patches. There is no evidence for morphometry and isoenzymes biochemical markers (Peroxidase/Superoxide dismutase) works on this genus in Iran. The purpose of this study is to investigate the differences and similarities among Neckera complanata and Neckera crispa moss populations in the north of Iran using morphometry and isoenzymes biochemical markers (Peroxidase / Superoxide dismutase). For this purpose, 18 populations from three provinces including Golestan, Mazandaran, and Guilan were collected at the same altitudes in autumn 2017. The results of morphometry were shown leaf length and leaf apex width/length were the most effective traits for the separation of populations. The results of the morphometry method and the results of isozyme banding patterns were the same, although very minor differences were observed. The largest diversity of Shannon (H) belongs to the population of Neckera crispa from Hezarjarib while other populations have low genetic diversity. Because of the destruction of many habitats in the northern provinces of Iran and the increase in pollution in these areas, it can be said as a general result that perhaps the reason for low genetic diversity in Neckera complanata and Neckera crispa populations is the gradual extinction of these two species.

A new species of Rain Frog (Brevicipitidae, Breviceps) endemic to Angola.

Recent molecular phylogenetic work has found that Breviceps Merrem, 1820 comprises two major clades, one of which, the B. mossambicus group, is widely distributed across southern sub-Saharan Africa. This group is notable for harboring abundant cryptic diversity. Of the four most recently described Breviceps species, three are members of this group, and at least five additional lineages await formal description. Although Breviceps has long been known to occur in Angola, no contemporary material has been collected until recently. The three most widespread taxa, B. adspersus, B. mossambicus, and B. poweri, may all occur in Angola, but accurate species assignment remains challenging given the rampant morphological similarity between these taxa, and, until recently, the lack of genetic resources. Phylogenetic, morphological, and acoustic analyses of recently collected samples from disparate localities within Angola provide evidence for an undescribed species that is sister to B. poweri. The new species can be diagnosed from its sister taxon by lacking pale spots along the flanks, a pale patch above the vent, and a short, dark band below the nares (all present in B. poweri). Additionally, the male advertisement call differs from the three other Breviceps that might occur in Angola in having both a longer interval between consecutive calls and a higher average dominant frequency. We here describe this lineage as a distinct species, currently only known from Angola, and discuss the presence of other Breviceps taxa within Angola.

Role of jyotishamati taila abhyanga in the management of the shvitra W.S.R vitiligo: A clinical study

The word Shvitra means in Sanskrit is Shvitra, which is white patch, without Kandu and inflammation, it present on anywhere of body, In this disease white spots or white discoloration takes place on the skin so it is named as Shvitra. Vitiligo is a long-term condition where pale white patches develop on the skin. It's caused by the lack of melanin, a pigment in the skin. In modern Science PUVA therapy and corticosteroid are used for treatment of disease but they may cause very harmful effect like skin burn, nausea dermatoheliosis that is ultraviolet ageing of skin. There is need Safe easier less complicate cost effective Ayurvedic treatment. Abhyanga stimulates Bhrajjak pitta which is present in the skin and helps restoring color. Jyotishamati Taila has extra medicinal property so it treats disease more comfortably.

Complicated maternal death: puerperal sepsis in a patient with subclinical chronic disease

Maternal death is a preventable tragedy. However, in some instances, a combination of different entities might complicate the case and mislead the diagnosis. This is a case of puerperal sepsis during the early postpartum period in a previously healthy primipara due to a chronic disease that has exacerbated. The postmortem examination revealed mildly infected foci of uterine mucosa, massive hepatosplenomegaly and multiple yellow and pale patches in ventricles confirmed microscopically as myocardial infractions)with patent coronaries. Cause of death was determined as puerperal sepsis complicated with chronic anaemia. Culture-negative septicemia has been reported in chronic disease such as malignancies (eg. lymphoma, paraneoplastic syndrome) etc. Generalized sepsis may rapidly arise from miniature foci of sepsis with undiagnosed predisposing conditions. A higher degree of clinical vigilance combines with necessary investigations are essential to establish the proper diagnosis and prompt management. Thorough antenatal screening of pregnant mothers is vital irrespective of their clinical state to avoid preventable maternal deaths.

The prevalence of psychological comorbidity in people with vitiligo: a systematic review and meta-analysis

Summary Vitiligo is a long-term condition where pale white patches develop on the skin. It's caused by a lack of melanin, a pigment (colour) in the skin. People of any age, skin type and gender can develop vitiligo and it can affect any area of skin. It is estimated that about 1 in 100 people around the world has vitiligo. The researchers who conducted this study are based in Nigeria and the UK. Our study aimed to find out how commonly psychological symptoms such as depression and anxiety occur in people in vitiligo, by looking at all relevant published studies from around the world. After extracting data from 29 studies published in this area we found that people living with vitiligo experience a range of psychological symptoms or disorders. Approximately one in four people with vitiligo appear to have depression and at least one in seven have anxiety. However, they were significantly less likely to show symptoms of depression than people with psoriasis. We also found that there were many tools to measure psychological outcomes (the emotional impact) in skin diseases, and more work needs to be done to develop tools which can be used in people with vitiligo. Our conclusion is that assessment of psychological state during clinical evaluation of vitiligo patients, as suggested by the British Association of Dermatologists’ guidelines, is essential. The same can be said for clinical evaluation of people with other skin conditions.