Pigmented Areas Research Articles

The anesthetic implications of lumbar tattoos.

Lumbar and sacral tattoos are popular amongst all ages. Some physicians are concerned that passing a needle through a pigmented area during lumbar puncture may deposit toxic material into the central nervous system, resulting in late complications. In this review, we highlight the tattooing process with an emphasis on anatomy and physiology of the skin, and the pathophysiology and toxicology of tattoos. We conclude that there is perhaps no evidence yet to suggest that pigment can be transported into the central nervous system from a well healed tattoo. There is insufficient evidence to endorse placement of a needle through a tattoo into the neuraxis before it is completely healed. The Fermi paradox 'absence of evidence is not evidence of absence of effect' still holds in light of emerging evidence that tattoos may be linked to lymphoma.

Efficacy of a Combination Treatment of Ablative Fractional Carbon Dioxide Laser Therapy and Recombinant Human Epidermal Growth Factor for Atrophic Acne Scars.

Atrophic acne scars (AAS) are disfiguring and permanent changes caused by inflammatory acne. Fractional carbon dioxide is a common ablative device used to treat this condition. However, issues such as unclear effectiveness, frequent treatments, and potential side effects exist. In recent years, recombinant human epidermal growth factor (rhEGF) has also been frequently reported for its application in the treatment of acne scars. To explore the potential synergistic effect of fractional carbon dioxide laser combined with rhEGF in AAS treatment. We enrolled 15 patients with AAS. They received fractional carbon dioxide laser treatment and were then randomly assigned to receive either rhEGF or a placebo on one side of the face. The procedure was repeated three times, and the results were evaluated using the échelle d'évaluation clinique des cicatrices d'acné (ECCA) score and analyzed using the CBS camera system, 3D analysis (3DMD). Reflectance confocal microscopy (RCM) examination was also conducted. Both sides exhibited significant improvement in the appearance of the acne scars after treatment, as confirmed by the ECCA score, 3DMD data, and CBS texture score. On the rhEGF-treated side, the pore number and epidermal pigment area significantly improved as compared to the control side, whereas no significant differences were observed in the other data. Under RCM, a significant increase in epidermal thickness and appearance of reticular collagen fibers in the dermal layer after treatment was observed. Compared to the sole use of laser, the combination of fractional carbon dioxide laser and rhEGF does not significantly enhance scar therapeutic effects. However, it does shorten the recovery period after laser treatment and improves the pore appearance.

Seed color patterns in domesticated common bean are regulated by MYB-bHLH-WD40 transcription factors and temperature.

Seed colors and color patterns are critical for the survival of wild plants and the consumer appeal of crops. In common bean, a major global staple, these patterns are also essential in determining market classes, yet the genetic and environmental control of many pigmentation patterns remains unresolved. In this study, we genetically mapped variation for several important seed pattern loci, including T, Bip, phbw, and Z, which co-segregated with candidate genes PvTTG1, PvMYC1, PvTT8, and PvTT2, respectively. Proteins encoded by these genes are predicted to work together in MYB-bHLH-WD40 (MBW) complexes, propagating flavonoid biosynthesis across the seed coat as observed in Arabidopsis. Whole-genome sequencing of 37 accessions identified mutations, including seven unique parallel mutations in T (PvTTG1) and non-synonymous SNPs in highly conserved residues in bipana (PvMYC1) and z (PvTT2). A 612 bp intron deletion in phbw (PvTT8) eliminated motifs conserved since the Papilionoideae origin and corresponded to a 20-fold reduction in transcript abundance. In multi-location field trials of seven varieties with partial seed coat pigmentation patterning, the pigmented seed coat area correlated positively with ambient temperature, with up to 11-fold increases in the pigmented area from the coolest to the warmest environments. In controlled growth chamber conditions, an increase of 4°C was sufficient to cause pigmentation on an average additional 21% of the seed coat area. Our results shed light on key steps of flavonoid biosynthesis in common bean. They will inform breeding efforts for seed coat color/patterning to improve consumer appeal in this nutritious staple crop.

Enhancing Quality of Life in Venous Ulcer Patient with Irsal-e-Alaq (Hirudotherapy): A Case Report

Background: In general practice, venous ulcers (stasis ulcers) are the most common and recurrent leg ulcers. Ignorance of it can have a severe detrimental effect on one's quality of life, cause gangrene, and even the limb amputation. Venous ulcers are the most dangerous and disabling side effect of chronic venous insufficiency. Leech therapy seems to be effective for the treatment of varicose ulcers due to its salivary secretions which it injects during bloodsucking. The saliva of leeches contains certain biochemical with vaso-dilating, anticoagulant, anesthetic, thrombolytic, antibiotic, analgesic, and anti-inflammatory properties. As a result, Irsal-e-Alaq (Hirudotherapy), one of the Unani regimens, can effectively control it. Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) on venous ulcers. Intervention: A 60-year-old male has a complaint of ulceration in his left lower leg near the medial malleolus with swelling, pain, discharge, and darkening of the skin of the left lower limb. Four leeches were applied once every week for 2 months. Efficacy of leech therapy was assessed on every 15th day by pain /leg discomfort on 4 point scale ranging from 0-3, limb girth at calf, ankle & foot, pigmentation color on 4 point scale, pigmentation area, pain in ulcer on 4 point scale from 0-3, ulcer depth, PUSH Score. Hb% was assessed every 15th day to check anemia, colour flow Doppler was done to assess any change in vein anatomy. Result: In this case report, the ulcers were completely healed, and also showed remarkable improvement in other variables. Conclusion: Irsal-e-Alaq has been proven beneficial in treating venous ulcers and enhancing patient’s quality of life. Keywords: Venous ulcer, Hirudotherapy, Unani Medicine, Pain, Pigmentation.

Treatment-induced anogenital melanosis is a very frequent finding in patients with vulvar lichen sclerosus.

Pigmented lesions such as melanosis have rarely been reported in patients with vulvar lichen sclerosus (VLS) that is typically characterized by hypopigmented lesions. We aimed to analyze systematically anogenital melanosis in a large cohort of VLS patients. We analyzed the clinical data of 198 female patients with VLS. The anogenital lesions of all patients were professionally photographed in a standardized position and illumination. Severity classification of architectural findings followed an easy-to-use clinical score. A modified Melasma Area and Severity Index and an image analysis software were used to evaluate the area and intensity of pigmentation. According to the clinical score, 79 (198/39.9%) patients showed grade 1 disease, 78 (198/39.4%) grade 2, 37 (198/18.7%) grade 3, and 4 (198/2%) grade 4 disease. About 111 (56.1%) of the 198 patients had anogenital melanosis with a median modified Melasma Area and Severity Index of 3.6 (0.4-14). Univariate analysis revealed that anogenital melanosis was positively correlated with the use of topical estrogens (P = .0018) and negatively correlated with the use of pulsed high-dose corticosteroids plus low-dose methotrexate (PHDC-LDM, P = .021). On multivariable analysis, the use of topical hormone therapy turned out to be a strong independent predictor for the presence of anogenital melanosis (odds ratio: 4.57, 95% confidence interval: 1.66-12.57, P = .0033), whereas PHDC-LDM use was an independent predictor for the absence of anogenital melanosis (odds ratio: 0.35, 95% confidence interval: 0.15-0.84, P = .018). The study includes the retrospective monocentric design. Anogenital melanosis is a very frequent and so far, under-reported clinical finding in VLS patients. It is likely caused by the use of topical estrogens employed for VLS treatment. In contrast, patients with more severe disease and PHDC-LDM treatment appear to develop less likely anogenital melanosis.

A rare case report of the Cowden syndrome

Cowden syndrome (CS) is a rare autosomal dominant genodermatosis caused by a heterozygous germline mutation in the PTEN gene, found in nearly 80% of cases. It is characterized by multiple benign hamartomas which manifest across various organs. This condition is further distinguished by its association with macrocephaly, facial trichilemmomas, acral keratoses, papillomatous papules, and a heightened susceptibility to certain malignant neoplasms, particularly affecting the thyroid, endometrium, and the breast (OMIM no. 58350).In this report, we detail the case of an Indian patient presenting with macrocephaly and multiple blackish pigmented areas on the face, alongside several small papules on the dorsum of the hands, and the presence of gastric and duodenal polyps, among other symptoms. Genetic analysis through Sanger sequencing of the PTEN gene revealed a heterozygous nonsense pathogenic variant (ENST00000371953.8: c.388C > T, p.Arg130Ter), thereby confirming a CS diagnosis. The report encompasses a comprehensive review of the existing literature, emphasizing the significance of genetic evaluation and discussing the intricacies of managing patients diagnosed with CS.

Artificial intelligence and skin melanoma

Melanoma is the deadliest skin cancer, presenting typically with changing pigmented areas and usually treated with surgical removal. As benign cutaneous pigmented lesions are very common in all populations, it can be challenging to identify which areas should be cut out or left untreated. Delayed treatment in melanoma increases the risk of death, but it is not possible to remove all lesions. Dermatoscopy uses polarized light and can be used to help distinguish melanomas from benign lesions. Dermatoscopy images with a confirmed diagnosis can be used to develop artificial intelligence (AI) as a medical device (AIaMD) tool. This contribution discusses the utilization of AI in melanoma management and describes an AIaMD tool used in current UK clinical practice on more than 80,000 patients. This is a springboard for discussing the scope, risks, and mitigations for future AI use by all clinicians involved in managing people with melanoma.

Coexistence of nonfluorescent chromoproteins and fluorescent proteins in massive Porites spp. corals manifesting a pink pigmentation response.

Several fluorescent proteins (FPs) and chromoproteins (CPs) are present in anthozoans and play possible roles in photoprotection. Coral tissues in massive corals often display discoloration accompanied by inflammation. Incidences of the pink pigmentation response (PPR) in massive Porites, described as inflammatory pink lesions of different shapes and sizes, has recently increased worldwide. FPs are reported to be present in PPR lesions, wherein a red fluorescent protein (RFP) appears to play a role in reducing reactive oxygen species. However, to date, the biochemical characterization and possible roles of the pigments involved are poorly understood. The present study aimed to identify and characterize the proteins responsible for pink discoloration in massive Porites colonies displaying PPRs, as well as to assess the differential distribution of pigments and the antioxidant properties of pigmented areas. CPs were extracted from PPR lesions using gel-filtration chromatography and identified via genetic analysis using liquid chromatography-tandem mass spectrometry. The coexistence of CPs and RFP in coral tissues was assessed using microscopic observation. Photosynthetic antivity and hydrogen peroxide-scavenging activitiy were measured to assess coral stress conditions. The present study revealed that the same CP (plut2.m8.16902.m1) isolated from massive Porites was present in both the pink spot and patch morphologies of the PPR. CPs were also found to coexist with RFP in coral tissues that manifested a PPR, with a differential distribution (coenosarc or tip of polyps' tentacles). High hydrogen peroxide-scavenging rates were found in tissues affected by PPR. The coexistence of CPs and RFP suggests their possible differential role in coral immunity. CPs, which are specifically expressed in PPR lesions, may serve as an antioxidant in the affected coral tissue. Overall, this study provides new knowledge to our understanding of the role of CPs in coral immunity.

Exploring a hypothetical design of a nanoparticle-base cancer vaccine for the skin cancer melanoma

Melanoma is a skin cancer, in which cancer cells form in the melanocytes. It can occur anywhere on the skin but is hard to spot due to its only signs being a change in the way a specific mole or pigmented area looks. It is usually curable. Still, once it has bypassed stage IV, it can become fatal and deadly. The stages of melanoma depend on how thick the tumor is and whether it has broken through the skin. The most deadly is stage IV, in which the cancer has spread to numerous parts of the body, including but not limited to the lungs, liver, and brain. Studies have shown that the average 5-year survival rate for melanoma skin cancer is 94%; however, only 32% of people survive once the cancer has spread to distant parts of the body (The American Cancer Society et al., n.d.). Treatments for stage IV melanoma include surgery or radiation therapy. However, newer forms of immunotherapy and targeted drugs have shown to be more effective than chemotherapy. This paper will explore both the benefits and drawbacks of the immune checkpoint inhibitor atezolizumab and the BRAF inhibitor dabrafenib, both of which are FDA-approved. Furthermore, the paper will also explore the use of the PLGA nanoparticle in drug delivery as well as the possible future direction of this cancer treatment.

Monophyly or Homoplasy? The Relationships of a Rare New Species of Cambeva (Siluriformes: Trichomycteridae) from the Brazilian Atlantic Forest with a Bicolored Caudal Pattern

The Brazilian Atlantic Forest, one the five main biodiversity hotspots in the world, still houses many organisms that are rare and unknown to science, mostly concentrated in mountain ranges. Herein, we describe a rare new species of Cambeva from the Rio Tietê drainage at the Serra da Mantiqueira, exhibiting a caudal fin color pattern comprising a light-yellowish–white bar posteriorly edged by a black pigmented area. A similar color pattern was described for C. castroi, C. diabola, and C. melanoptera, also endemic to the Rio Paraná basin, and considered evidence of close relationships among these three species. However, other morphological characteristics highly suggest that the new species is not closely related to C. castroi, C. diabola, and C. melanoptera). Herein, we perform a molecular phylogenetic analysis using two mitochondrial genes and one nuclear gene, including all species with that bicolored caudal pattern. The analysis strongly supports the new species as a member of the alpha-clade, and therefore as distantly related to those three species belonging to the beta-clade, indicating that this color pattern has homoplastically arisen in Cambeva. The data reported here reinforce the urgent need for field studies to better understand the different evolutionary patterns found in the genus, since an intense process of environmental degradation is in course.

Combination of Fractional Carbon Di Oxide Laser with Narrow Band Ultravoilet B Therapy to induce repigmentation in stable resistant vitiligo- A split-lesional study

Context: Resistant vitiligo is challenging to treat and needs new therapeutic approaches such as combining fractional carbon dioxide (CO2) laser and narrow-band ultraviolet B (NB-UVB) therapy. Aims: The study aimed to determine the efficacy and safety of combining fractional CO2 laser and NB-UVB therapy to induce repigmentation in resistant localized vitiligo patches. Materials and Methods: In this open, prospective, split-lesional study, 40 stable resistant vitiligo patches in 30 patients were included and assessed. After an initial assessment, a few resistant patches of vitiligo were identified, and a symmetrical half of it was given two sessions of fractional CO2 laser 1 month apart, followed by NB-UVB sessions to both sides thrice weekly for 3 months. Photographs were taken at baseline and 12 weeks, and repigmentation responses were assessed by calculating the mean percentage of improvement and mean grade of pigmentation on the fractional CO2 laser with NB-UVB site (test) and the only NB-UVB site (control) and then compared using Wilcoxon signed-rank test, with significance determined by P value <0.05. Results: The mean grade of pigmentation (1.8±0.88) and mean surface area improvement (8.40 ± 6.82 cm2) on the fractional CO2 laser with NB-UVB site (test) were statistically better than the mean grade of pigmentation (1.27 ± 0.71) and mean surface area improvement (5.37 ± 6.76 cm2) on the NB-UVB site. A better grade of pigmentation was noted over sun-protected areas with fractional CO2 and NB-UVB therapy, while NB-UVB therapy fared better in sun-exposed areas. Conclusions: Fractional CO2 laser with NB-UVB therapy is an effective treatment in resistant vitiligo patches, especially for sun-protected areas.

Chronic Serous Chorioretinopathy: A Case Study

Introduction Chronic central serous chorioretinopathy (CSCR) is characterized by persistent subretinal fluid that disrupts the outer layers of the retina and may lead to complications such as: outer retinal atrophy, increased risk of choroidal neovascularization (CNVM) and the potential for permanent vision loss. This report describes the clinical features of chronic CSCR. Case Presentation A 73-year-old male with a history of systemic steroid and inhaler use presented for a routine eye exam without visual complaints. Examination findings included normal visual acuity in both eyes and multiple areas of retinal hyper and hypopigmentation along the arcades with no macular involvement in the right eye; the left eye was unremarkable. Fundus photography and optical coherence tomography showed localized areas of outer retinal disruption and thinning near the optic nerve head and along the corresponding retinal areas of irregular pigmentation in the right eye; the left eye was unremarkable. Discussion In chronic CSCR, structural changes in the retina can lead to retinal dysfunction and permanent vision loss. Treatment options for chronic CSCR include photodynamic therapy, intravitreal anti-vascular endothelial growth factor therapy, or systemic steroid receptor blockers. Visual prognosis varies depending on the severity of the disease, age of onset, risk of CNVM and the degree of outer retinal degeneration. Conclusion Patients with chronic CSCR are at risk for permanent vision loss. The structural changes in the outer retina also increase the risk for CNVM. Hence, it is important that patients with chronic CSR receive regular eye examinations and are educated on the role of regular Amsler grid testing.

Archipsocus michamwiensis n. sp. - a new species of Psocoptera (Insecta) from Zanzibar (Tanzania)

This paper describes Archipsocus michamwiensis n. sp., a new species from the family Archipsocidae collected in Zanzibar, Tanzania. The single female (holotype) is macropterous and exhibits distinct reddish-brown colouration, and equal-length tarsal segments. Morphological measurements highlight features such as short antennae and a V-shaped pigmented area on the subgenital plate.

Diffuse hyperpigmentation with guttate hypopigmentation: a new pigmentary disorder.

Diffuse hyperpigmentation with guttate hypopigmentation (DHGH) is a new acquired pigmentary disorder. Only a few cases have previously been reported in the Chinese population, in Chinese. To summarise the clinical, dermoscopic, and histopathological findings of DHGH in the English literature, to improve the recognition and management of this condition. This was a retrospective study to summarise the clinical, dermoscopic, and pathological findings of nine cases of DHGH. All nine patients with DHGH were female. The age at onset varied from 6 to 24 years (median 17 years). Patients were generally in good health without systemic disease. The lesions were often generalised to the trunk and extremities without any discomfort. Typical lesions were characterised by multiple uniform hypopigmented spots, 2-5mm in diameter, irregularly distributed over diffuse hyperpigmentation. Dermoscopy revealed multiple blurred patchy areas of brownish pigmentation, sparse linear and dotted vessels, and perifollicular pigmentation on a white to bright white background, surrounded by brown hyperpigmentation. Histopathological findings included mild abnormal pigment of the epidermis, focal vacuolar degeneration of the basal cells, mild pigment incontinence and perivascular lymphocytic infiltration in the dermis. DHGH is a new entity with distinctive clinical manifestations that differ from those of other known pigmentary disorders. So far, DHGH has only been reported in the Chinese population. It may not be uncommon and has not received much attention due to the few reports. The aetiology and pathogenesis of DHGH are still unknown and require further investigation.

Лечебно-профилактические мероприятия витреоретинальных кровоизлияний различной этиологии

Retinal hemorrhages, varying in area of damage and localization in the fundus, are the result of many diseases. Studying the etiology of retinal hemorrhages will allow developing more effective methods of prevention and treatment. Purpose. To study the prevalence of retinal hemorrhages in individuals with rhinological pathology. Material and methods. 1332 people were examined as part of the annual medical examination of civil servants. In addition to routine research ophthalmologist methods, a questionnaire was developed with questions regarding the presence of possible causes of retinal hemorrhages. Results. Traces of peripapillary hemorrhages were diagnosed in 128 eyes (9.5 %). Among them, in 24 people (18.4 %), traces of hemorrhages were in two eyes, while in one eye the size of changes in the peripapillary retina was larger. Hemorrhages were presented in the form of black blood clots or areas of intense black pigmentation in the peripapillary region around the optic disc. The prevalence of hemorrhages ranged from 1 hour to half the diameter of the optic disc and more. Vitreoretinal hemorrhages among all the examined individuals were found on the periphery of the fundus in 11 patients. These patients did not make any complaints, their visual acuity did not change. With the help of a specially designed questionnaire, the causes of hemorrhages were clarified. It was found that in 58,6 % of cases, rynologic pathology was a possible cause, including COVID-19, acute respiratory viral infections, vasomotor rhinitis, curvature of the nasal septum. Other causes include hypertension, prolonged use of anticoagulants, trips to other climatic regions, power sports, intestinal disorders, general anesthesia during surgery. Myopia of medium and high degree was diagnosed in 13.2 %. Conclusions. The point of view is expressed that successive links of pathogenesis in the form of phenomena Valsalva follow nasal breathing disorders is the most common cause of retinal hemorrhages. Keywords: peripapillary hemorrhage, COVID-19, nasal breathing disorder, phenomena Valsalva

An open-label, single-arm clinical study to evaluate efficacy and safety of Nyumi radiant skin gummies in healthy adult subjects with fine lines/wrinkles, hyperpigmentary spots, and under eyes dark circles

Objectives: Flawless skin is certainly the most desired feature that plays a vital cosmetic role in human being. Apart from protecting our body from environmental factors, it also protects the body from water loss and infection-causing microorganisms. However, the skin condition changes due to various ageing factors. The present study was conducted to assess the safety and efficacy of multivitamin and nutraceutical ingredients-based gummies in adult human participants. Material and Methods: An open-label, single-arm clinical study was conducted on 36 enrolled healthy males and females (in ratio of 1:2) between 20 and 65 years of age to evaluate the efficacy and safety of the study product in healthy adult subjects with fine lines/wrinkles, hyperpigmentary spots, and under eyes dark circles. All eligible subjects consumed the test product for 75 days. They underwent clinical evaluation by dermatologist, instruments evaluation, and subjective evaluation. Results: Thirty two (n = 32) subjects completed all study visits. The study product, when consumed for 75 days, was found to be efficacious in reducing fine lines/wrinkles, under-eye dark circles, and pigmentation and also improving the overall skin condition as evidenced by dermatological, instrumental, and subjective assessments on day 25, day 50, and day 75. Regular consumption of gummies significantly reduced the appearance and severity of coarse wrinkling/lines and fine lines/wrinkles, improved skin laxity, reduced skin dryness by moisturizing the skin, lighten the pigmented area and under-eye dark circles by reducing the melanin concentration, increased the radiance/glow of the skin, improved the texture and firmness of the skin, reduced skin roughness, and also improved skin tone evenness. Moreover, no adverse event was recorded during the study conduction. Conclusion: The results of this clinical study suggest that consumption of two gummies together once daily for 75 days significantly improved skin radiance/glow, skin laxity, skin hydration, skin texture and firmness, skin tone evenness and reduced skin roughness, hence improving the overall skin condition. It was found to be efficacious in reducing the appearance and severity of coarse wrinkling/lines, fine lines/wrinkles, hyperpigmentary spots, and under-eye dark circles by reducing the melanin concentration as assessed by dermatologist, various instruments, and subjective assessment. The test product also proved to be safe based on no apparent or experienced discomfort, reactions or any kind of intolerance or adverse skin reactions or events during the trial.

Unstable solar lentigo mimicking lentigo maligna melanoma: A case report

Solar lentigo (SL) is a hyperpigmented macule that develops due to chronic ultraviolet exposure. A 35-year-old housewife, presented with an asymptomatic pigmented patch on the right side of her nose for the last 10 years, with a rapid increase in size and variability in pigmentation over the last 3 years. She had no history of excessive sun exposure. Upon examination, there was a solitary, hyperpigmented, well to ill-defined patch of irregular shape and margin, measuring 3 cm * 2.5 cm, with variability in colour and areas of regression, almost covering Right side of nose. The patch appeared light brown with areas of dark brown and black. Differential diagnoses considered were Lentigo maligna melanoma (LMM), Solar Lentigo (SL), and flat seborrheic keratosis. Dermoscopy (Polarised illuco IDS-1100 dermoscope) revealed diffuse brown pigmentation with a faint pigmented network, along with dark brown to black globules and blotches. Due to the asymmetry of pigmentation, a punch biopsy was performed from the area of darkest pigmentation to rule out LMM. In Histology, the epidermis exhibited hyperkeratosis, follicular plugging, acanthosis, and downward elongation of the rete ridges. There was hyperpigmentation of the basal layer, an increased number of melanocytes, and the presence of melanophages in the papillary dermis. The biopsy report was consistent with Solar Lentigo (SL), and we concluded it as unstable solar lentigo (USL). This case is presented due to its clinical and dermoscopic resemblance to LMM and to increase awareness of USL and the importance of periodic surveillance.

Smith-Kingsmore syndrome with nystagmus as the initial symptom

BackgroundSmith-Kingsmore syndrome (SKS) is a rare autosomal dominant disorder caused by de novo mutations of gene MTOR in most cases and germline mosaicism in a few cases. The first case of SKS was reported in 2013. The incidence of SKS remains unknown. The clinical manifestations of SKS are diverse, and common features are macrocephaly, intellectual disability, and seizures. Some patients with SKS have special facial features.Case presentationThe case was a 5-month-old baby girl, who was admitted to the hospital for nystagmus, delayed development for 2 months, and intermittent convulsions for 2 days. The patient had a head circumference of 42 cm (+ 2SD), and showed facial deformity, low limb muscle tension, large areas of pigmentation, as well as mosaic patchy and strip-like pigment loss in her trunk and limbs. Meanwhile, her development was lagging behind peers. Physical examination did not reveal other abnormalities. She was diagnosed with SKS based on whole-exome sequencing combined with clinical symptoms and signs. She successively received treatment with adrenocorticotropic hormone, methylprednisolone sodium succinate, topiramate, levetiracetam, and zonisamide to reduce the number of convulsions in a short time, but drug resistance appeared thereafter. After combined treatment with multiple antiseizure medications, the patient still had seizures, but the amplitude of limb movement during the seizures was reduced compared to that before treatment.ConclusionsThis case expanded the phenotypic spectrum of SKS for diagnosis. We also review the related literature to promote the awareness, diagnosis, clinical management, and follow-up of SKS patients with MTOR mutations.

Skin carotenoid levels in lactating dairy cows as measured using multiple spatially resolved reflection spectroscopy.

This research communication describes a pilot study measuring skin carotenoid levels of lactating dairy cows. Carotenoids are natural antioxidants, involved in cell communication and immune function, protecting against oxidative stress. They are precursors of vitamin A, important for reproduction efficiency, growth and male fertility. Therefore, easy-to-use, inexpensive methods to measure carotenoids in cattle would provide interesting data for farmers to monitor the health and nutritional status of their herds. In this study, we used a commercially available sensor based on multiple spatially resolved reflection spectroscopy (MSRRS), intended for human use, to measure the carotenoid content in bovine skin in three research herds in France, Ireland and Scotland. Carotenoid levels were measured by applying the sensor to the teat barrel, avoiding pigmented areas of skin. Mean sensor values differed significantly between herds and between diets, with pasture-based animals showing significantly higher carotenoid levels. Our results suggest that MSRRS can be used to accurately to measure skin carotenoids in cows. However, further calibration in bovines is needed to improve of the accuracy of the MSRRS sensor in cattle.

A novel treatment for Riehl's melanosis targeting both dermal melanin and vessels.

Riehl's melanosis is a difficult-to-treat condition characterized by persisting dermal hyperpigmentation. This study aimed to evaluate the efficacy of a histology-specific targeted therapy for Riehl's melanosis. Skin biopsy samples of Riehl's melanosis were assessed to identify histology-specific targets for treatment. Subsequently, the efficacy of a combination involving a fractional picosecond laser and a pulsed dye laser (PDL) targeting the dermal melanin and vessels, respectively, was evaluated. Clinical improvement was assessed using the dermal pigmentation area and severity index (DPASI). The treatment outcomes were compared to those of a control, in this case a single laser treatment solely targeting pigmentation. Histological and immunohistochemical analyses identified dermal melanin pigment and dilated vessels as treatment targets for Riehl's melanosis. The combined treatment of the fractional picosecond laser and PDL showed a significant reduction of the DPASI scores, which was significantly better than the control group. Patients who underwent the combined laser treatment indicated high levels of satisfaction with no adverse events except of transient erythema and oedema. The combined treatment of a fractional picosecond laser and a PDL was more effective for Riehl's melanosis compared to single laser treatment. The treatment targets both dermal pigmentation and dilated vessels, offering promising results for those working to manage Riehl's melanosis.