Skin Appendages Research Articles

THE OUTCOME OF MODIFIED‐SMILE REGIMEN AS THE FIRST‐LINE TREATMENT FOR NEWLY DIAGNOSED FRAIL ADVANCED HIGH‐RISK NK/T CELL LYMPHOMA: A RETROSPECTIVE OBSERVATION STUDY

Introduction: To explore an effective and well-tolerant treatment for newly diagnosed advanced high-risk extranodal natural killer/T cell lymphoma (NKTCL) patients with poor performance status. We analyzed the efficacy and toxicity of modified-SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, etoposide) regimen in untreated advanced high-risk NKTCL patients retrospectively. Methods: Ten newly diagnosed advanced high-risk extranodal natural killer/T cell lymphoma (NKTCL) patients with a performance status of 2 were included in Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from May 2017 to May 2019. At least two cycles of modified-SMILE chemotherapy were administered as the first-line treatment. The primary endpoint was overall survival (OS) and progression-free survival (PFS). The secondary endpoint was the adverse effects of the treatment. Results: A total of 10 patients with newly diagnosed advanced high-risk NKTCL were enrolled, with a median age of 31.5 years (18-57 years). The male: female ratio was 7:3. The performance status of all patients was 2. Seven patients had B symptoms at the initial diagnosis, all presenting as hyperpyrexia. Extranodal organs involvement at the initial diagnosis included nasal cavity (8/10), skin (5/10), bone (4/10), lung (3/10), breast (2/10), pancreas (2/10), liver (1/10), stomach (1/10), intestine (2/10), adrenal glands (1/10) and uterine adnexa (1/10). Bone marrow involvement was present in 3 patients, and the spleen was involved in 2 patients. The prognostic index of NKTCL with Epstein-Barr virus DNA (PINK-E) of all patients was higher than 3. The median OS and PFS were 9 months (2-53 months) and 3 months (1-53 months), respectively. The main adverse effects were hematological toxicities including neutropenia, thrombocytopenia, and decreased fibrinogen. The grade 3/4 neutropenia happened in 2 patients, and the grade 4 thrombocytopenia happened in 1 patient. All toxicities were tolerable. To Mar 2023, the median follow-up period was 9 months (2-53 months), and the median OS was 9 months (2-53 months). Nine patients died and 1 patient survived. Of the 9 patients who died, all patients were diagnosed with Lymphoma-associated haemophilic syndrome (LAHS). Conclusions: The prognosis of advanced high risk NKTCL is very poor because of the poor tolerance to the intensive chemotherapy and the high incidence of LAHS. The modified-SMILE regimen might be an effective and well-tolerance chemotherapy to this intractable condition. Keywords: Chemotherapy, Combination Therapies No conflicts of interests pertinent to the abstract.

Abstract 70: Prognostic Factors in the Overall Survival of Skin Appendage Carcinoma: An NCDB Analysis

Abstract Purpose: Skin appendage carcinoma (SAC) is a malignant neoplasm arising from hair follicles or sweat glands. The incidence rates of cutaneous-type appendageal carcinomas have been increasing in the United States. The epidemiology of SAC is poorly understood due to its rarity. The National Cancer Database (NCDB) was analyzed to determine the primary sites at which SAC presents and the prognostic factors relating to overall survival. Methods: A retrospective cohort analysis utilizing the NCDB from 2004 to 2019 included patients diagnosed with histologically confirmed SAC between 0-99 years (N=815). Demographic factors were analyzed using Pearson Chi-squared tests, and a multivariate analysis of factors in overall survival was performed via Cox Regression. Results: The number of cases diagnosed with SAC has steadily increased from 2004 to 2019 (43 and 67, respectively). The majority of the cases analyzed were White (89.8%), male (57.5%), non-Hispanic (91.0%), located in the Atlantic regions (39.9%), insured by Medicare (55.1%), and had a median household income in the top quartile (44.9%). The mean age at diagnosis was 69.1 years (std. deviation=13.1) with an average comorbidity Charlson-Deyo Score of 0.3 (std. deviation=0.7). The most common primary site for SAC was the skin of the face (23.9%), followed by the scalp and neck (22.2%), the trunk (18.7%), and the upper limb and shoulder (14.2%). Site-specific surgical procedure of the primary site was performed in 94.6% of cases. Prognostic factors leading to better overall survival include age at diagnosis younger than 65 years of age (p<0.001; 95% CI= [1.5-3.2]), lower Charlson-Deyo scores (p<0.001), private insurance status (p<0.001; 95% CI= [0.2-0.9]), and surgery of the primary site (p<0.001; 95% CI= [<0.1-5.7]). Conclusions: There has been an upward trend in the diagnosis of SAC since 2004, with a predilection for White, non-Hispanic, older men in the South and Middle Atlantic regions. Given the rarity of the disease, this study serves as a valuable tool for understanding the prognostic trend of SAC. Citation Format: Xinxin Wu, Michelle Swedek, Peter Silberstein, Victoria Vardell. Prognostic Factors in the Overall Survival of Skin Appendage Carcinoma: An NCDB Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 70.

Decay of Skin-Specific Gene Modules in Pangolins

The mammalian skin exhibits a rich spectrum of evolutionary adaptations. The pilosebaceous unit, composed of the hair shaft, follicle, and the sebaceous gland, is the most striking synapomorphy. The evolutionary diversification of mammals across different ecological niches was paralleled by the appearance of an ample variety of skin modifications. Pangolins, order Pholidota, exhibit keratin-derived scales, one of the most iconic skin appendages. This formidable armor is intended to serve as a deterrent against predators. Surprisingly, while pangolins have hair on their abdomens, the occurrence of sebaceous and sweat glands is contentious. Here, we explore various molecular modules of skin physiology in four pangolin genomes, including that of sebum production. We show that genes driving wax monoester formation, Awat1/2, show patterns of inactivation in the stem pangolin branch, while the triacylglycerol synthesis gene Dgat2l6 seems independently eroded in the African and Asian clades. In contrast, Elovl3 implicated in the formation of specific neutral lipids required for skin barrier function is intact and expressed in the pangolin skin. An extended comparative analysis shows that genes involved in skin pathogen defense and structural integrity of keratinocyte layers also show inactivating mutations: associated with both ancestral and independent pseudogenization events. Finally, we deduce that the suggested absence of sweat glands is not paralleled by the inactivation of the ATP-binding cassette transporter Abcc11, as previously described in Cetacea. Our findings reveal the sophisticated and complex history of gene retention and loss as key mechanisms in the evolution of the highly modified mammalian skin phenotypes.

Effect of Marine-Derived Saccharides on Human Skin Fibroblasts and Dermal Papilla Cells.

The skin is the largest organ of the human body, composed of a diverse range of cell types, non-cellular components, and an extracellular matrix. With aging, molecules that are part of the extracellular matrix undergo qualitative and quantitative changes and the effects, such as a loss of skin firmness or wrinkles, can be visible. The changes caused by the aging process do not only affect the surface of the skin, but also extend to skin appendages such as hair follicles. In the present study, the ability of marine-derived saccharides, L-fucose and chondroitin sulphate disaccharide, to support skin and hair health and minimize the effects of intrinsic and extrinsic aging was investigated. The potential of the tested samples to prevent adverse changes in the skin and hair through stimulation of natural processes, cellular proliferation, and production of extracellular matrix components collagen, elastin, or glycosaminoglycans was investigated. The tested compounds, L-fucose and chondroitin sulphate disaccharide, supported skin and hair health, especially in terms of anti-aging effects. The obtained results indicate that both ingredients support and promote the proliferation of dermal fibroblasts and dermal papilla cells, provide cells with a supply of sulphated disaccharide GAG building blocks, increase ECM molecule production (collagen and elastin) by HDFa, and support the growth phase of the hair cycle (anagen).

Aryl hydrocarbon receptor is regulated via multiple mechanisms in human keratinocytes

Aryl hydrocarbon receptor (AhR) is a basic helix-loop-helix transcription factor activated by polycyclic aromatic hydrocarbons of synthetic and natural origin. While a number of novel AhR ligands have been recently identified, little is known about their possible influence on AhR levels and stability. We used western blot, qRT-PCR and immunocytochemistry to determine the effects of AhR ligands on AhR expression in N-TERT (N-TERT1) immortalized human keratinocytes, and immunohistochemistry to assess patterns of AhR expression in human and mouse skin and skin appendages. While AhR was highly expressed in cultured keratinocytes and in the skin, it was found primarily in the cytoplasm, but not in the nucleus, suggesting its inactivity. At the same time, treatment of N-TERT cells with proteasomal inhibitor MG132 and eventual inhibition of AhR degradation resulted in nuclear AhR accumulation. Treatment of keratinocytes with AhR ligands such as TCDD, FICZ, caused near-complete disappearance of AhR, and treatment with I3C resulted in substantially diminished level of AhR possibly due to ligand-induced AhR degradation. The AhR decay was blocked by proteasome inhibition, indicating degradation-based mechanism of regulation. Additionally, AhR decay was blocked by ligand-selective AhR antagonist CH223191, implying substrate-induced mechanism of degradation. Furthermore, degradation of AhR was blocked in N-TERT cells with knockdown of AhR dimerization partner ARNT (HIF1β), suggesting that ARNT is required for AhR proteolysis. However, addition of hypoxia mimetics (HIF1 pathway activators) CoCl2 and DMOG had only minor effects on degradation of AhR. Additionally, inhibition of HDACs with Trichostatin A resulted in enhanced expression of AhR in both untreated and ligand-treated cells. These results demonstrate that in immortalized epidermal keratinocytes AhR is primarily regulated post-translationally via proteasome-mediated degradation, and suggest potential means to manipulate AhR levels and signaling in the skin. Overall, the AhR is regulated via multiple mechanisms, including proteasomal ligand- and ARNT-dependent degradation, and transcriptional regulation by HDACs, implying complex system of balancing its expression and protein stability.

Transient agonism of the sonic hedgehog pathway triggers a permanent transition of skin appendage fate in the chicken embryo.

Vertebrate skin appendage early development is mediated by conserved molecular signaling composing a dynamical reaction-diffusion-like system. Variations to such systems contribute to the remarkable diversity of skin appendage forms within and among species. Here, we demonstrate that stage-specific transient agonism of sonic hedgehog (Shh) pathway signaling in chicken triggers a complete and permanent transition from reticulate scales to feathers on the ventral surfaces of the foot and digits. Resulting ectopic feathers are developmentally comparable to feathers adorning the body, with down-type feathers transitioning into regenerative, bilaterally symmetric contour feathers in adult chickens. Crucially, this spectacular transition of skin appendage fate (from nodular reticulate scales to bona fide adult feathers) does not require sustained treatment. Our RNA sequencing analyses confirm that smoothened agonist treatment specifically promotes the expression of key Shh pathway-associated genes. These results indicate that variations in Shh pathway signaling likely contribute to the natural diversity and regionalization of avian integumentary appendages.

Giant Trichilemmal Cysts Mimicking an ox Horn associated with an Occipital Lipoma: An Observation at the Dermatology Hospital of Bamako

Summary: The pilar cyst or trichilemmal is a benign tumour of the skin appendages. This tumour develops on the isthmic part of the pilar follicle and is characterised histologically by trichilemmal keratinisation. We report a case of bilateral giant temporal trichilemmal cysts with a giant occipital lipoma. Observation: This is a 53-year-old patient who presented with multiple scalp lesions that had been present for three years. On clinical examination, there were two bilateral symmetrical temporal tumours with an occipital mass. Histology revealed a trichellemmal cyst for the temporal and a lipoma for the occipital.

The potential mechanisms of skin wound healing mediated by tetrapeptides from sea cucumber

Numerous food-derived natural bioactive peptides have excellent skin wound healing potential. Herein, we reported the capacity of sea cucumber derived tetrapeptides VTPY and VLLY to promote wound healing. Our study revealed that the two peptides significantly contribute to the healing of skin wounds by promoting re-epithelialization, collagen and lipid regeneration for skin appendage remodeling, and enhancing angiogenesis both in vitro and in vivo. VTPY and VLLY significantly accelerate the migration of keratinocytes to seal the wound surface, as well as facilitate collagen regeneration by promoting the phosphorylation of EKR and P-38. Meanwhile, VTPY and VLLY further enhance angiogenesis and lipid regeneration via upregulating expression of VEGF and eNOS, and triggering ERK/AKT signaling. VTPY works better than VLLY. These findings indicate that sea cucumber derived tetrapeptide VTPY and VLLY can serve as natural food source-derived candidate for promoting skin wound healing.

Histopathological Review of Skin Diseases: A Three Years Survey of 510 Skin Biopsies in Multan

Introduction: Skin ailments share a major disease burden worldwide (1, 2).They are considerably frequent in underdeveloped nations and encompass simple ailments like inflammation and pimples to certain grave diseases like skin melanomas (3). However, the type and prevalence of skin disorders differ from area to area on account of dissimilar habitat (4, 5). Skin disorders influence human lives in various ways and many a times the dermal epidermal conditions point some internal ongoing serious disease (6). A vast majority of skin diseases are treated on the basis of clinical diagnosis without confirmation through biopsy. Microscopic examination is mandatory for verification and precise diagnosis and to direct the clinician to opt suitable treatment (7). Considering their importance, the research work being done on the prevalence of specific disorders in particular regions in our country appears deficient especially considering the clinicopathological consonance. The current research was outlined to acumen the skin diseases related burden in our institute. Aim & Objective: The aim of this research is to evaluate the histopathological diversity of skin diseases and their prevalence in Multan region along with the clinic-pathological consonance. Study Design: Retrospective cross sectional study Place and Duration: Histopathology and dermatology departments of Bakhtawar Amin Medical & Dental College and Trust Hospital Multan, from January 2020 to December 2022. Material and Methods: Histopathological reports of all skin biopsies were sorted. The required data like age, gender, clinical presentation, site of the lesion, dermatologist’s findings, and their clinical provisional impression with differential diagnoses were documented along with the histopathological microscopic opinion. The particulars were gathered from clinical files, histopathological demand forms and documented reports. Results: A sum of 510 skin biopsies was received in histopathology section. Out of these, 280 (54.9%) were females and remaining 230 (45.1%) were males. The mean age was 34.70 years (ranging from 2 to 84 years). Most of them were between ages 16-30 years. Majority of the lesions were benign non cancerous and related to skin appendages. Epidermal inclusion cyst appeared to be the most prevalent. Out of 510 biopsies, 68 (13.3%) turned out to be malignant neoplasms. Conclusion: A vast majority of skin diseases are treated only on the basis of clinical diagnosis. The present study revealed that the histopathological opinion was consistent with the clinical judgment in 63 % of the cases, unveiling the significance of histopathological examination that is must for saving time and expenses of the patients. It also helps in reduction of the morbidity related to various skin disorders Keywords: Histopathology, dermatology, skin disorders, skin cancers, epidermal inclusion cyst

Double network hydrogel based on curdlan and flaxseed gum with photothermal antibacterial properties for accelerating infectious wound healing

The healing of infected wounds has always been a clinical challenge. With the increasing threat of drug resistance due to antibiotic overuse, it is imperative to improve antibacterial wound dressings. In this study, we designed a double network (DN) hydrogel via a “one pot method” with antibacterial activity, and natural polysaccharides with the potential to promote skin wound healing were used. That is, a DN hydrogel matrix was formed by the hydrogen bond crosslinking of curdlan and the covalent crosslinking of flaxseed gum under the action of borax. We added ε-polylysine (ε-PL) as a bactericide. Tannic acid/ferric ion (TA/Fe3+) complex was also introduced into the hydrogel network as a photothermal agent to induce photothermal antibacterial properties. The hydrogel had fast self-healing, tissue adhesion, mechanical stability, good cell compatibility and photothermal antibacterial activity. In vitro studies of hydrogel showed its ability to inhibit S. aureus and E. coli. In vivo experiments also demonstrated the significant healing effect of hydrogel when used to treat wounds infected by S. aureus by promoting collagen deposition and accelerating the formation of skin appendage. This work provides a new design for the preparation of safe antibacterial hydrogel wound dressings and demonstrates great potential for promoting wound healing of bacterial infections.

SB216763-loaded multifunctional copper-doped bioglass 3D printed scaffold promotes wound healing and functional skin regeneration

Complete skin reconstruction is a complex process which involves regeneration and reconstruction of the epidermis, dermis, vascular system, nerves, hair follicles, and sweat glands. Multiple wound dressings have been developed for skin regeneration. However, only a few studies have focused on the regeneration of hair and skin appendages, particularly blood vessels and hair follicles. In this study, 3D printed Cu-doped 1393-2B bioglass (Cu-BG) with chitosan (CS) and 1393-2B bioglass (BG) with chitosan wound dressing (Cu-BG/CS, BG/CS) were designed. The swelling rate and mechanical and antibacterial properties of BG/CS and Cu-BG/CS wound dressings in different composites were compared. Cu-BG/CS exhibited antibacterial properties and vascular growth. Additionally, SB216763 was loaded onto Cu-BG/CS dressings, and it was observed that Cu-BG/[email protected] exhibited better proliferation ability and certain.

Systemic Prenatal Stress Exposure through Corticosterone Application Adversely Affects Avian Embryonic Skin Development.

Prenatal stress exposure is considered a risk factor for developmental deficits and postnatal behavioral disorders. While the effect of glucocorticoid-associated prenatal stress exposure has been comprehensively studied in many organ systems, there is a lack of in-depth embryological investigations regarding the effects of stress on the integumentary system. To approach this, we employed the avian embryo as a model organism and investigated the effects of systemic pathologically-elevated glucocorticoid exposure on the development of the integumentary system. After standardized corticosterone injections on embryonic day 6, we compared the stress-exposed embryos with a control cohort, using histological and immunohistochemical analyses as well as in situ hybridization. The overarching developmental deficits observed in the stress-exposed embryos were reflected through downregulation of both vimentin as well as fibronectin. In addition, a deficient composition in the different skin layers became apparent, which could be linked to a reduced expression of Dermo-1 along with significantly reduced proliferation rates. An impairment of skin appendage formation could be demonstrated by diminished expression of Sonic hedgehog. These results contribute to a more profound understanding of prenatal stress causing severe deficits in the integumentary system of developing organisms.

1426 Deletion of hoxc13 in frogs reveals key steps in the molecular evolution of cornified skin appendages

1426 Deletion of hoxc13 in frogs reveals key steps in the molecular evolution of cornified skin appendages

CLINICAL CASE OF CUTIS VERTICIS GYRATA

Cutis verticis gyrata (CVG) is a descriptive term for a rare benign skin condition characterized by the formation of tortuous folds and deep furrows that mimic the gyri of the brain because of excessive skin growth. It is observed mainly in men. The first clinical case of the disease was described in 1837 by Alibert J.
 There are primary and secondary forms of CVG. Among the cases of primary CVG in 1984, Garden JM and Robinson JK further distinguished the essential and combined subtypes. The reason for the appearance of the essential form is not known. Primary combined CVG can accompany neuropsychiatric disorders, cerebral palsy, epilepsy, seizures, and ophthalmological abnormalities, most commonly cataracts. Secondary CVG occurs as a result of chronic inflammation, such as hysteria, lymphostasis, elephantiasis, eczema, psoriasis, folliculitis, atopic dermatitis, etc. In case of secondary CVG, the lower extremities are more often affected, the skin is congested-red, cyanotic, dense, swollen. Papillomatous growths, layering of crusts and scales are often visible against the background of changed skin.
 Given the rarity of this disease (it was diagnosed for the first time in our more than 50 years of dermatological practice), we report a clinical case of CVG.
 Case Presentation. Patient P., 27 years old, complained of wrinkles and increased mobility of the skin of the scalp. He noticed the first manifestations of the disease at the age of 17, but did not pay attention, believing that these were individual features of the skin structure. For the last 3-4 years in a row, he noticed a thickening and increase in the size of the folds of the skin on the scalp, growing mobility. The skin, according to the patient, had the appearance of ribs.
 During the dermatological examination, the skin is of normal color, turgor and elasticity are preserved, sweat and sebum secretion is moderate. Skin appendages are without pathological changes. The skin of the scalp is uniformly covered with thick hair, hyperelastic, pronounced transverse deep linear furrows resembling brain convolutions are visible.
 When using dermoscopy without a light-conducting liquid, the vascular pattern is hardly visible, on the surface there is small lamellar peeling. However, after its application, areas of clearly visible vessels of the superficial vascular plexus of the skin, which coincide with the location of the furrows, are determined.
 The patient was examined; no pathology was detected on the part of internal organs and heart. The results of ultrasound of the thyroid gland and organs of the abdominal cavity were without pathological changes. General analysis of blood, urine, blood sugar within the normal range. Biochemical indicators of liver and kidney function without deviations. The patient is recommended to have a periodic examination by a dermatologist. With increasing clinical manifestations - surgical removal of skin folds.
 Conclusions. The described clinical case of CVG is of considerable interest to dermatologists, pediatricians, and geneticists as a rare new developmental disease. In our report, the clinical picture of changes on the skin is illustrated, and differential diagnosis with dermatoses that are closest in clinical manifestations is briefly carried out.

The Significant Potential of Simonkolleite Powder for Deep Wound Healing under a Moist Environment: In Vivo Histological Evaluation Using a Rat Model.

In the present work, simonkolleite powder consisting of Zn5(OH)8Cl2·H2O composition was proposed as a new candidate material for the healing of deep wounds in a moist environment. The powder was synthesized using a solution process and evaluated for wound-healing effects in rats. The pH value of physiological saline at 37 °C using the simonkolleite powder was 7.27, which was the optimal pH value for keratinocyte and fibroblast proliferation (range: 7.2-8.3). The amount of Zn2+ ions sustainably released from simonkolleite powder into physiological saline was 404 mmol/L below cytotoxic ion concentrations (<500 mmol/L), and the rhombohedral simonkolleite was accordingly converted to monoclinic Zn5(OH)10·2H2O. To evaluate the wound-healing effect of simonkolleite powder, the powder was applied to a full-thickness surgical wound reaching the subcutaneous tissue in the rat's abdomen. The histological analysis of the skin tissues collected after 1, 2, and 4 weeks found that angiogenesis, collagen deposition, and maturation were notedly accelerated due to the Zn2+ ions released from simonkolleite powder. The simonkolleite regenerated collagen close to autologous skin tissue after 4 weeks. The hair follicles, one of the skin appendages, were observed on the regenerative skin in the simonkolleite group at 4 weeks but not in the control group. Therefore, simonkolleite was hypothesized to stimulate the early regeneration of skin tissue in a moist environment, compared with commercial wound dressing material. These results suggested that simonkolleite could offer great potential as new wound dressing material.

Primary cilia control cellular patterning of Meibomian glands during morphogenesis but not lipid composition

Meibomian glands (MGs) are modified sebaceous glands producing the tear film’s lipids. Despite their critical role in maintaining clear vision, the mechanisms underlying MG morphogenesis in development and disease remain obscure. Cilia-mediate signals are critical for the development of skin adnexa, including sebaceous glands. Thus, we investigated the role of cilia in MG morphogenesis during development. Most cells were ciliated during early MG development, followed by cilia disassembly during differentiation. In mature glands, ciliated cells were primarily restricted to the basal layer of the proximal gland central duct. Cilia ablation in keratine14-expressing tissue disrupted the accumulation of proliferative cells at the distal tip but did not affect the overall rate of proliferation or apoptosis. Moreover, impaired cellular patterning during elongation resulted in hypertrophy of mature MGs with increased meibum volume without altering its lipid composition. Thus, cilia signaling networks provide a new platform to design therapeutic treatments for MG dysfunction.

Efficient scarless skin regeneration enabled by loading micronized amnion in a bioinspired adhesive wound dressing

AbstractComplete skin reconstruction is a hierarchical, physiological assembly process involving healing of the epidermis, dermis, vasculature, nerves, and cutaneous appendages. To date, few works have reported complete skin regeneration, particularly lacking vascular structures and hair follicles after full skin defects. In this study, a hydrogel derived from the skin secretion of Andrias davidianus (SSAD) that features adhesiveness was used as a bioactive scaffold to load micronized amnion (MA). The SSAD hydrogel was found to promote the migration and proliferation of amnion stem cells and human keratinocytes, as well as inhibit their apoptosis in vitro. In a rat full‐skin defect model, the regeneration of skin appendages was observed at the wound area, achieving scarless healing. Transcriptome analyses further validated that SSAD could positively regulate cell migration, proliferation, and differentiation. These functions might be attributed to the abundant growth factors present in the SSAD. Synergized by the delivery of MA, SSAD loaded with the MA could achieve a significantly better skin regeneration effect than SSAD or MA used alone, providing a simple yet highly effective means to obtain complete, scarless skin regeneration, suggesting favorable potential for clinical translation.

Implantation Mycoses and Invasive Fungal Infections with Cutaneous Involvement in Tropical Taiwan: An 11-Year Retrospective Study of a Medical Center

The rising incidence of implantation mycoses and invasive fungal infections prompts the need for studies describing the latest trends of these diseases; however, the literature remains scarce from tropical Asia in recent years. We shared our 11-year clinical experience at a tertiary center in Southern Taiwan to improve physicians' understanding of the diseases, which could help them assume appropriate management strategies. Forty cases of pathology-proven cases of implantation mycoses and invasive fungal infections with cutaneous involvement were retrospectively reviewed. The epidemiology, patients' characteristics, initial clinical impressions, fungal species, management, and outcomes were compared and reported. Fonsecaea sp. was the most commonly (14%) involved species in implantation mycoses. The percentages of immunocompromised patients with implantation mycoses and invasive fungal infections were 26% and 60%, respectively. Additionally, 46% of patients with implantation mycoses had type 2 diabetes mellitus. The lesions were commonly mistaken for skin appendage tumors, skin cancers, and hyperkeratotic dermatoses. The prognosis was favorable for the implantation mycoses (83% showed clinical improvement) but bleak for the invasive fungal infections (100% mortality). Presentations of implantation mycoses and invasive fungal infections vary widely, and immunocompromised status and diabetes mellitus are important associated factors.

Subepidermal Low-Echogenic Band-Its Utility in Clinical Practice: A Systematic Review.

High-frequency ultrasonography (HF-USG) is a relatively new imaging method that allows the evaluation in a non-invasive manner of the skin layers and skin appendages. It is a diagnostic tool with increasing usefulness in numerous dermatological pathologies. High reproducibility, non-invasiveness and short diagnostic time make this method an increasingly used tool in dermatological practice. The subepidermal low-echogenic band is a relatively newly described parameter that seems to be a marker not only of intrinsic and extrinsic skin aging, but also of inflammatory processes taking place at the skin level. This systematic review aims to evaluate the role that SLEB has in the diagnosis and monitoring of the treatment of some inflammatory and non-inflammatory dermatological conditions, as well as its utility as a disease marker.

Isolated Lichen Planus of the Lower Lip: Report of a Rare Case with an Updated Literature Review.

Lichen planus (LP) is a chronic inflammatory, autoimmune entity typically affecting the skin, oral and genital mucosa, and skin appendages, with an underlying malignant potential. Oral lichen planus (OLP) represents the mucosal counterpart of the cutaneous LP and exhibits episodes of exacerbation and remissions. OLP typically manifests as bilateral symmetrical lesions on the buccal mucosa, followed by tongue, and gingiva. However, the occurrence of LP lesions solely on the lip is rarely reported in the literature. The altered clinical appearance of the lip lesions poses a diagnostic threat and raises the possibility of a misdiagnosis. Our aim was to report an unusual case of isolated lower lip LP, and also to carry out a literature review about isolated lip LP lesions, thus, emphasizing the demographic, clinicopathologic attributes, and therapeutic regimen. We report an uncommon occurrence of an isolated lichen planus on the lower lip in a 53-year-old male patient. Clinical evaluation revealed a diffuse erosive crusted lesion bordered by peripheral lacy radiating streaks on the lower lip. After a confirmed OLP histopathology, the patient was treated with low potency topical steroids and Vaseline therapy, with almost completely resolved lesions after 2 months of therapy. We report a rare case of isolated lip LP, and our detailed review revealed 44 reported cases of lip LP till date. The majority of the cases were seen on the lower lip and exhibited an age and gender affinity (mostly in middle-aged males). Significant healing was observed after topical steroid therapy.