Skin Cultures Research Articles

Hospital Dermatology: analysis of dermatological consultations in a tertiary teaching hospital

BackgroundIn hospital settings, dermatology can offer substantial clinical support for the diagnosis and management of skin conditions, reducing morbidity and mortality. Thus, the study aimed to analyze the profile of referrals and consultations performed by the Dermatology Service of the Santa Casa de Misericordia de Porto Alegre, from August 2018 to January 2020. MethodsThis study is descriptive, quantitative, and retrospective, conducted through data collection and review of medical records and referrals. The variables included were clinical data of referrals, in-patients profiles, dermatological diagnoses, complementary exams, therapeutic conduct, and recommended follow-ups. ResultsA total of 1020 referrals were analyzed, which resulted in 641 consultations (328 men, 313 women). The most prevalent skin disease groups were ‘Dermatitis and Eczema’ (33.1%) and ‘Other infectious skin diseases (21.8%), while the most frequent ICD-10 were ‘Drug eruptions – L27’ (9.9%) and ‘Other and unspecified dermatitis – L30’ (6.6%). Corticoids were the most recommended treatments (27.7%), followed by antifungals (13.1%). ‘Consultation Discharge’ (44%) and ‘Outpatient’ Dermatology follow-up (27%) were the most frequent causes for ending consultation. Study limitationsAmong the study limitations, the authors highlight its retrospective nature, with data analysis based on referrals and medical records, which may present inaccurate or incomplete information. In addition to this, the study may demonstrate a certain degree of subjectivity due to the review and interpretation process conducted by the researchers. However, the definition of objective criteria based on previous studies attenuates such possible bias. Furthermore, considering that the Dermatology teams are composed of a preceptor dermatologist and residents, the established diagnoses were not submitted to third-party verification, except in the cases of skin biopsies and cultures. Thus, the professional’s experience and skills may have influenced the dermatological diagnoses. ConclusionsThese findings underlie the importance of Dermatology in hospital assistance, contributing to the management of a wide range of skin conditions.

Drug-induced acute febrile neutrophilic dermatosis (Sweet syndrome): A case report presented at Delhi State Cancer Institute

ABSTRACT Sweet syndrome is a rare, etiologically unknown dermatosis that can be idiopathic or associated with certain clinical conditions. Among these conditions are infections, autoimmune diseases, inflammatory bowel diseases, vaccinations, the use of medications, and neoplasias. Hematological neoplasias, particularly acute myeloid leukemia, are the most commonly described; however, the condition may also be related to solid tumors, being those of the genitourinary tract the most associated with the syndrome. Drug-induced Sweet syndrome has also been reported; however, it is rarely seen. We report a case of 59 years old male patient with a diagnosis of carcinoma urinary bladder, who developed skin eruption after infusion of the first cycle of chemotherapy (gemcitabine and cisplatin) and resolved after treatment with steroids. The diagnosis of Sweet syndrome was confirmed only after skin biopsy, cultures and laboratory investigations. Malignancy as the cause of skin eruptions was eliminated by the fact that it occurred only after infusion of chemotherapy and the tumor was still there in the bladder, and skin eruptions did not occur after stopping steroids.

Skin biopsy in adult patients with meningococcal purpura fulminans: a multicenter retrospective cohort study

BackgroundNeisseria meningitidis is the leading responsible bacterium of Purpura Fulminans (PF) accounting for two thirds of PF. Skin biopsy is a simple and minimally invasive exam allowing to perform skin culture and polymerase chain reaction (PCR) to detect Neisseria meningitidis. We aimed to assess the sensitivity of skin biopsy in adult patients with meningococcal PF.MethodsA 17-year multicenter retrospective cohort study including adult patients admitted to the ICU for a meningococcal PF in whom a skin biopsy with conventional and/or meningococcal PCR was performed.ResultsAmong 306 patients admitted for PF, 195 had a meningococcal PF (64%) with a skin biopsy being performed in 68 (35%) of them. Skin biopsy was performed in median 1 day after the initiation of antibiotic therapy. Standard culture of skin biopsy was performed in 61/68 (90%) patients and grew Neisseria meningitidis in 28 (46%) of them. Neisseria meningitidis PCR on skin biopsy was performed in 51/68 (75%) patients and was positive in 50 (98%) of them. Among these 50 positive meningococcal PCR, five were performed 3 days or more after initiation of antibiotic therapy. Finally, skin biopsy was considered as contributive in 60/68 (88%) patients. Identification of the meningococcal serogroup was obtained with skin biopsy in 48/68 (71%) patients.ConclusionsSkin biopsy with conventional culture and meningococcal PCR has a global sensitivity of 88% and should be systematically considered in case of suspected meningococcal PF even after the initiation of antimicrobial treatment.

The Intangible Cultural Heritage of Chinese Ethnic Minorities: Taking the Fish Skin Culture of the Hezhen people as an Example

As a unique ethnic minority in Heilongjiang Province, the Hezhen people have developed a unique fish skin culture based on the unique natural geography of their settlement area. Fish skin culture as one of China’s “intangible cultural heritage”, has a very high cultural value, economic value and social value, the protection and inheritance of the endangered Hezhen fish skin culture task has become urgent.

The anti-melanogenic properties of Swietenia macrophylla king

Fair flawless skin is the goal for some cultures and the development of irregular skin pigmentation is considered an indication of premature skin aging. Hence, there is a rising demand for skin whitening cosmetics. Thus, this research will be focusing on discovering the anti-pigmentation properties of Swietenia macrophylla seeds. Firstly, the seeds were extracted with ethanol and further fractionate based on their polarity before testing them on zebrafish embryos. The ethanolic extract of the seed demonstrated significant inhibition of both tyrosinase activity and melanin production in the embryos. However, after fractionation, the anti-melanogenic ability was observed to have decreased, signifying that the phytocompounds may be synergistic in nature. Still in the proteomic studies the ethanolic extract and its hexane fraction both induced the downregulation of cathepsin LB and cytoskeletal proteins that have connections to the melanogenic pathway, confirming that S. macrophylla seeds do indeed have anti-pigmentation properties that can be exploited for cosmetic use. Next, limonoids (tetranortriterpenoids found in the seed) were tested for their inhibitory effect against human tyrosinase related protein 1 (TYRP-1) via molecular docking. It was found that limonoids have a stronger binding affinity to TYRP-1 than kojic acid, suggesting that these phytocompounds may have the potential in inhibiting pigmentation. However, this still needs further confirmation before these phytocompounds can be developed into a skin whitening agent. Other assays like ex-vivo or 3D human skin culture can also be used to better study the seeds anti-pigmentation effect on humans.

Disease-related biomarkers as experimental endpoints in 3D skin culture models.

The online version contains supplementary material available at 10.1007/s10616-023-00574-2.

Genomic and clinical case characterisation of Staphylococcus haemolyticus isolated from dogs and cats in the United States, including strains with high-level mupirocin tolerance.

Staphylococcus haemolyticus is a coagulase-negative commensal organism of both people and companion animals. It has pathogenic potential and when cultured is often meticillin- and multidrug-resistant. To characterise the clinical features of dogs and cats with clinical skin disease that had positive S.haemolyticus skin cultures, and to employ whole-genome sequencing (WGS) to identify resistance genes and characterise the genetic relatedness of strains. Isolates were identified by the institutional clinical microbiology laboratory by routine aerobic culture and susceptibility from seven veterinary hospitals across the United States. Then, WGS and analysis of each isolate were performed and clinical data collected via a retrospective clinician questionnaire. S. haemolyticus was identified from superficial (seven of 12) and deep (five of 12) cutaneous infections in our study. Most animals had received antimicrobials (10 of 12) and/or immunomodulatory drugs (nine of 12) within the six months before culture. WGS analysis revealed a variety of genetic lineages and a wide array of antimicrobial resistance genes. Meticillin resistance was identified in nine of 12 isolates and four of 12 isolates demonstrated mupirocin tolerance. Staphylococcus haemolyticus may be an under-recognised pathogen in companion animals, and its demonstrated potential for multidrug-resistance, meticillin-resistance, and high-level mupirocin tolerance may create a therapeutic challenge. Further studies should evaluate the prior antimicrobial use and immunocompromised status as risk factors for infection with S.haemolyticus.

Granulomatous panuveitis in disseminated sporotrichosis: case report and review of the literature

PurposeTo report a case of intraocular sporotrichosis presenting with bilateral granulomatous panuveitis.MethodsObservational case report and literature review.Case presentationA 62-year-old woman with a history of polycythemia vera presented with a non-healing ulcer at the left index finger, generalized erythematous papules, and bilateral granulomatous panuveitis. Cultures of skin and amputated finger identified Sporothrix schenckii. The diagnosis of intraocular sporotrichosis secondary to disseminated sporotrichosis was made. Intravenous liposomal Amphotericin B and intravitreal Amphotericin B were used to control systemic and ocular disease resulting in resolution of the skin lesions and intraocular inflammation.ConclusionsIntraocular sporotrichosis can manifest as bilateral granulomatous panuveitis in the setting of disseminated sporotrichosis. Treatment with intravenous and intravitreal antifungal therapy is useful for controlling intraocular infection.

Transfersome Encapsulated with the R-carvedilol Enantiomer for Skin Cancer Chemoprevention.

The R-carvedilol enantiomer, present in the racemic mixture of the chiral drug carvedilol, does not bind to the β-adrenergic receptors, but exhibits skin cancer preventive activity. For skin delivery, R-carvedilol-loaded transfersomes were prepared using various ratios of drug, lipids, and surfactants, and characterized for particle size, zeta potential, encapsulation efficiency, stability, and morphology. Transfersomes were compared for in vitro drug release and ex vivo skin penetration and retention. Skin irritation was evaluated by viability assay on murine epidermal cells and reconstructed human skin culture. Single-dose and repeated-dose dermal toxicity was determined in SKH-1 hairless mice. Efficacy was evaluated in SKH-1 mice exposed to single or multiple ultraviolet (UV) radiations. Transfersomes released the drug at a slower rate, but significantly increased skin drug permeation and retention compared with the free drug. The transfersome with a drug-lipid-surfactant ratio of 1:3:0.5 (T-RCAR-3) demonstrated the highest skin drug retention and was selected for further studies. T-RCAR-3 at 100 µM did not induce skin irritation in vitro and in vivo. Topical treatment with T-RCAR-3 at 10 µM effectively attenuated acute UV-induced skin inflammation and chronic UV-induced skin carcinogenesis. This study demonstrates feasibility of using R-carvedilol transfersome for preventing UV-induced skin inflammation and cancer.

Skin Immuno-CometChip in 3D vs. 2D Cultures to Screen Topical Toxins and Skin-Specific Cytochrome Inducers.

The targets of topical genotoxic agents are basal and stem cells of the skin. These cells may misrepair DNA lesions, resulting in deleterious mutations of tumor suppressors or oncogenes. However, the genotoxicity of many compounds has not as yet been determined and needs to be tested using a relevant skin model. To this end, we designed a new high-throughput assay for the detection of agents that create DNA damage in epidermal stem and basal cells and used it to test known DNA-damaging agents. We utilized either 2D epidermal cells or 3D skin equivalents and topically exposed them to different compounds. The Skin Immuno-CometChip assay uses arrays of microwells formed in a collagen/agarose mixture to capture single basal cells in each microwell by virtue of collagen binding to α2β1 integrin, which is present only on basal and stem cells. The presence of β1 integrin was verified by immunofluorescent labeling cells that were then subjected to an electrical field, allowing for the migration of nicked DNA out of the nucleoid in alkali, with the resulting DNA comets stained and imaged. Furthermore, using improved comet detection software allowed for the automated and rapid quantification of DNA damage. Our study indicates that we can accurately predict genotoxicity by using 3D skin cultures, as well as keratinocytes grown in 2D monolayers.

A Surveillance Study of the Serotypes of Streptococci in the Throat and Skin Lesions in Acute Rheumatic Fever and Rheumatic Heart Disease Patients and their Families

Abstract Objectives: The objectives of this study were to determine the colonization of the throat and skin among patients of rheumatic heart disease (RHD) or acute rheumatic fever (ARF) and to elucidate the different Lancefield serotypes of streptococci (Group A, Group C, and Group G) among them. Methods: The prospective observational surveillance study was conducted from November 2016 to March 2018 among 161 enrolled family members belonging to 30 families with one of their patients being diagnosed with RHD/ARF. The outcome measures were period prevalence of serotypes of streptococci, streptococcal colonization of throat and skin lesions, and association of age and antibody titers with RHD/ARF. Results: Out of 30 families enrolled in our study, positive throat (n = 18)/skin (n = 1) cultures were found in 7 families (n = 19). The cultures were positive only for Group A streptococci (GAS), while none of the samples showed positivity for Group C or G serotypes. Overall period prevalence for our study period was 3.2%. Among the 18 members positive for GAS throat culture, 13 (72.2%) belonged to the age group <15 years (P < 0.025). The positive cultures in the throat sample were more in the ARF families than RHD families (P < 0.001). There was no association of culture positivity with antibody titer (P > 0.05). Conclusion: In conclusion, we found only GAS colonization in significantly higher proportion among the family members of cases of ARF in comparison to RHD. Rather there was no case of Group C and G streptococci colonization in cases or family members of RHD/ARF.

Bloodstream Infection in Children With Epidermolysis Bullosa.

Epidermolysis bullosa (EB) is frequently complicated by skin infection, which can lead to bacteremia. However, bloodstream infections (BSI) in patients with EB have not been well described. Retrospective study of BSI in children 0-18 years with EB from a national reference unit in Spain, in 2015-2020. Among 126 children with EB, we identified 37 BSI episodes in 15 patients (14 recessive dystrophic EB, 1 junctional EB). The most frequent microorganisms were Pseudomonas aeruginosa (n = 12) and Staphylococcus aureus (n = 11). Five P. aeruginosa isolates were ceftazidime-resistant (42%), 4 of which were also resistant to meropenem and quinolones (33%). As for S. aureus , 4 (36%) were methicillin-resistant and 3 (27%) clindamycin-resistant. In 25 (68%) BSI episodes skin cultures had been performed in the previous 2 months. The most frequent isolates were also P. aeruginosa (n = 15) and S. aureus (n = 11). In 13 cases (52%), smear and blood cultures grew the same microorganism, with the same antimicrobial resistance pattern in 9 isolates. Twelve patients (10%) died during follow-up (9 RDEB and 3 JEB). BSI was the cause of death in 1 case. In patients with severe RDEB, a history of BSI was associated with higher mortality (OR 6.1, 95% CI: 1.33-27.83, P = 0.0197). BSI is an important cause of morbidity in children with severe forms of EB. The most frequent microorganisms are P. aeruginosa and S. aureus , with high rates of antimicrobial resistance. Skin cultures can help guide treatment decisions in patients with EB and sepsis.

THE ROLE OF ANTIBACTERIAL THERAPY IN THE TREATMENT OF ATOPIC DERMATITIS IN CHILDREN

Background. Atopic dermatitis is one of the most common chronic inflammatory skin diseases. In atopic dermatitis, the diversity of the normal microflora decreases, so that the number of S. aureus prevails and the number of bacteria with antistaphylococcal activity decreases. The aim of this study was to evaluate the effectiveness of mupirocin 2% cream in the treatment of atopic dermatitis in children as an additional therapy, and the effect of the rs4696480 polymorphism in the TLR2 gene on the effectiveness of the treatment.Materials and methods. The study included patients with atopic dermatitis (n = 37), aged 1-18 years (7.9±4.9) from the Department of Allergy at Kyiv City Children Clinical Hospital №2. All children included in the study with atopic dermatitis had a positive S. aureus culture. Patients were randomized into two groups: a group receiving mupirocin 2% cream on the affected skin areas 2 times a day 10 days (group A) and a control group (group B). Children of the control group received only symptomatic therapy. The SCORAD score and CDLQI (children's dermatology life quality index) questionnaire score was recorded before and after the treatment, side effects were recorded during the study. Skin swab cultures were taken before and after treatment. Genotyping for TLR2 rs4696480 was performed by using Real-time PCR.This study was approved by the ethical committee of the O.Bogomolets National Medical University; all patients/parents of the children gave an informed consent to participate. Statistical processing of the obtained data was carried out using the statistical package IBM SPSS Statistics Base (version 22) and the software EZR version 1.32 (graphical interface of the R environment (version 2.13.0). The difference in the effectiveness of therapy between the two subgroups and the influence of genotype on the effectiveness of therapy was determined using the Student criterion for parametric data (T) and Wilcoxon W-test for nonparametric data (W). The dynamics of indicators in each group before and after treatment were evaluated using the Wilcoxon T-test (T-W). Eeffectiveness of S. aureus eradication was estimated using the odds ratio (OR) with a 95% confidence interval (CI). Results were considered statistically significant at the level of p < 0.05.Results. In both groups of children, improvement was observed in 10 days after the treatment. In group A, the improvement in ΔSCORAD was found to be 13.8 (T-W=190.0, p<0.001). In group B, there was also an improvement: ΔSCORAD 8.5 (T-W=153.0, p<0.001). The difference in ΔSCORAD scores between groups A and B was statistically significant (T=2.70, p=0.011). The decrease in CDLQI score after treatment was 31.3% in group A (T-W=190.0, p<0.001), and 18.3% in group B (T-W=171.0, p<0.001). The difference between these two groups was not statistically significant (W=334.0, p=0.409).After the treatment, the skin culture showed that in group A, 57.9% of patients were S. aureus-negative, in group B, only 22.2% of children had a negative culture (OR= 5.50, CI 1.32-22.86).We compared ΔSCORAD depending on the genotype of the rs4696480 polymorphism in TLR2 gene and found no difference in the two subgroups: In the subgroup with the AA genotype, ΔSCORAD was found to be 12.6±3.7; in the subgroup with the TT genotype ‒ 14.4±5.1 (T=0.84, p=0.413).Conclusions. Our results demonstrate the effectiveness of the use of topical mupirocin in the treatment of atopic dermatitis as an additional therapy.

An Analysis of Two Aged Patients with Pulmonary Tuberculosis

What methods would you choose apart from purified protein derivative (PPD) skin test and culture for acid-fasting bacilli (AFB) to make a clinical diagnosis of pulmonary tuberculosis (TB) in an aged patient with possible TB? These are two cases of pulmonary TB, that occurred with persistent low-grade fever, fatigue and anorexia due to a mild toxemia of tuberculosis. A final diagnosis of pulmonary tuberculosis was established on the basis of mild toxemia(low-grade fever), debilitation and characteristic pulmonary CT imaging, free of PPD and interferon-gamma release assay (T-spot). The authors realized that the dosage of anti-tuberculosis drugs should be carefully controlled and the improvement of their overall nutritional status to gain better efficacy is much more needed.

Technological advances in three-dimensional skin tissue engineering

Abstract Tissue engineering is an enabling technology that can be used to repair, replace, and regenerate different types of biological tissues and holds great potential in various biomedical applications. As the first line of defense for the human body, the skin has a complex structure. When skin is injured by trauma or disease, the skin tissues may regenerate under natural conditions, though often resulting in irreversible and aesthetically unpleasant scarring. The development of skin tissue engineering strategies was reviewed. Although the traditional approaches to skin tissue engineering have made good progress, they are still unable to effectively deal with large-area injuries or produce full-thickness grafts. In vitro three-dimensional (3D) skin constructs are good skin equivalent substitutes and they have promoted many major innovative discoveries in biology and medicine. 3D skin manufacturing technology can be divided into two categories: scaffold-free and scaffold-based. The representatives of traditional scaffold-free approaches are transwell/Boyden chamber approach and organotypic 3D skin culture. Because of its low cost and high repeatability, the scaffold-free 3D skin model is currently commonly used for cytotoxicity analysis, cell biochemical analysis, and high-throughput cell function. At present, many drug experiments use artificial skin developed by traditional approaches to replace animal models. 3D bioprinting technology is a scaffold-based approach. As a novel tissue manufacturing technology, it can quickly design and build a multi-functional human skin model. This technology offers new opportunities to build tissues and organs layer by layer, and it is now used in regenerative medicine to meet the increasing need for tissues and organs suitable for transplantation. 3D bioprinting can generate skin substitutes with improved quality and high complexity for wound healing and in vitro disease modeling. In this review, we analyze different types of conventional techniques to engineer skin and compare them with 3D bioprinting. We also summarized different types of equipment, bioinks, and scaffolds used in 3D skin engineering. In these skin culture techniques, we focus on 3D skin bioprinting technology. While 3D bioprinting technology is still maturing and improvements to the techniques and protocols are required, this technology holds great promise in skin-related applications.

Staphylococcus aureus causes aberrant epidermal lipid composition and skin barrier dysfunction.

Staphylococcus (S) aureus colonization is known to cause skin barrier disruption in atopic dermatitis (AD) patients. However, it has not been studied how S. aureus induces aberrant epidermal lipid composition and skin barrier dysfunction. Skin tape strips (STS) and swabs were obtained from 24 children with AD (6.0 ± 4.4 years) and 16 healthy children (7.0 ± 4.5 years). Lipidomic analysis of STS samples was performed by mass spectrometry. Skin levels of methicillin-sensitive and methicillin-resistant S. aureus (MSSA and MRSA) were evaluated. The effects of MSSA and MRSA were evaluated in primary human keratinocytes (HEKs) and organotypic skin cultures. AD and organotypic skin colonized with MRSA significantly increased the proportion of lipid species with nonhydroxy fatty acid sphingosine ceramide with palmitic acid ([N-16:0 NS-CER], sphingomyelins [16:0-18:0 SM]), and lysophosphatidylcholines [16:0-18:0 LPC], but significantly reduced the proportion of corresponding very long-chain fatty acids (VLCFAs) species (C22-28) compared to the skin without S. aureus colonization. Significantly increased transepidermal water loss (TEWL) was found in MRSA-colonized AD skin. S. aureus indirectly through interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-6, and IL-33 inhibited expression of fatty acid elongase enzymes (ELOVL3 and ELOVL4) in HEKs. ELOVL inhibition was more pronounced by MRSA and resulted in TEWL increase in organotypic skin. Aberrant skin lipid profiles and barrier dysfunction are associated with S. aureus colonization in AD patients. These effects are attributed to the inhibition of ELOVLs by S. aureus-induced IL-1β, TNF-α, IL-6, and IL-33 seen in keratinocyte models and are more prominent in MRSA than MSSA.

Pellino-1 promotes intrinsic activation of skin-resident IL-17A–producing T cells in psoriasis

Psoriasis is a chronically relapsing inflammatory skin disease primarily perpetuated by skin-resident IL-17-producing T (T17) cells. Pellino-1 (Peli1) belongs to a member of E3 ubiquitin ligase mediating immune receptor signaling cascades, including nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB) pathway. We explored the potential role of Peli1 in psoriatic inflammation in the context of skin-resident T17 cells. We performed single-cell RNA sequencing of relapsing and resolved psoriatic lesions with analysis for validation data set of psoriasis. Mice with systemic and conditional depletion of Peli1 were generated to evaluate the role of Peli1 in imiquimod-induced psoriasiform dermatitis. Pharmacologic inhibition of Peli1 in human CD4+ T cells and exvivo human skin cultures was also examined to evaluate its potential therapeutic implications. Single-cell RNA sequencing analysis revealed distinct T-cell subsets in relapsing psoriasis exhibiting highly enriched gene signatures for (1) tissue-resident T cells, (2) T17 cells, and (3) NF-κB signaling pathway including PELI1. Peli1-deficient mice were profoundly protected from psoriasiform dermatitis, with reduced IL-17A production and NF-κB activation in γδ T17 cells. Mice with conditional depletion of Peli1 treated with FTY720 revealed that Peli1 was intrinsically required for the skin-resident T17 cell immune responses. Notably, pharmacologic inhibition of Peli1 significantly ameliorated murine psoriasiform dermatitis and IL-17A production from the stimulated human CD4+ T cells and exvivo skin explants modeling psoriasis. Targeting Peli1 would be a promising therapeutic strategy for psoriasis by limiting skin-resident T17 cell immune responses.

An improved human skin explant culture method for testing and assessing personal care products.

Cultured human skin models have been widely used in the evaluation of dermato-cosmetic products as alternatives to animal testing and expensive clinical testing. The most common in vitro skin culture approach is to maintain skin biopsies in an airlifted condition at the interface of the supporting culture medium and the air phase. This type of ex vivo skin explant culture is not, however, adequate for the testing of cleansing products, such as shampoos and body washes. One major deficiency is that cleansing products would not remain confined on top of the epidermis and have a high chance of running off toward the dermal side, thus compromising the experimental procedure and data interpretation. Here, we describe an improved ex vivo method for culturing full-thickness human skin for the effective testing and evaluation of skin care products by topical application. This newly developed ex vivo human skin culture method has the ability to maintain healthy skin tissues for up to 14 days in culture. Importantly, the model provides a quick and safe way to evaluate skin care products at different time points after single or repetitive topical applications using a combined regimen of leave-on and wash-off. We found that the results obtained using the new skin culture method are reproducible and consistent with the data collected from clinical testing. Our new ex vivo skin explant method offers a highly efficient and cost-effective system for the evaluation and testing of a variety of personal care products and new formulations.

Arctigenin-Enriched Burdock Seed Oil (ABSO): A New Skin Brightening Botanical Extract

The Arctium lappa L. plant, commonly known as burdock, has been used therapeutically for hundreds of years. Arctigenin (ATG) is an active ingredient in burdock, albeit at low quantities or mostly in the form of acrtiin (arctigenin-4-glucoside). ATG has been touted for its anti-inflammatory properties in many cell types and disease states; however, its role in skin and melanin production has not been extensively studied. Our aims for this study were to develop a burdock seed extract enriched for ATG that is amenable to quasi-drug development, determine in vitro brightening activity, and evaluate safety and skin brightening efficacy clinically in human subjects. Arctiin and ATG content were measured by high-performance liquid chromatography (HPLC). In vitro studies utilized EpiDermTM tissues for skin irritation test, and MelanoDermTM tissues for melanin reduction capacity. A 45 subject clinical study was performed in adult subjects ranging in age from 30 to 60 years old (mean = 41.9 ± 6.7) to test the safety and skin brightening potential of 1% ABSO lotion. We demonstrate by HPLC that ABSO is a natural extract that contains ~5-times more arctigenin than BSO. Furthermore, ABSO inhibits melanin production better than BSO and retains the same melanin-reducing capacity as synthetic ATG in vitro in MelanoDerm™ 3D skin cultures. ABSO also adheres to quasi-drug criteria according to the Japanese Standards of Quasi-Drug Ingredients as determined by infrared absorption spectrum method, unsaponifiable matter, heavy metal and arsenic content, and acid, saponification, and iodine value methods. Clinical assessment of 1% ABSO lotion shows it is well-tolerated in human skin and demonstrates improved brightness and skin tone evenness. ABSO is a natural arctigenin-enriched burdock seed extract that reduces melanin content in vitro and clinically improves skin brightness.

Staphylococcal Scalded Skin Syndrome Superinfection in a Child with COVID-19: A Brief Case Report

Background: While the exact prevalence of bacterial co-infection and superinfection in children with coronavirus disease 2019 (COVID-19) remains unclear, numerous scattered reports of it are on the rise. Case Presentation: Our case was a 14-month-old infant with fever, truncal erythema, and scalded skin in flexor folds and also in perianal and perioral regions. A positive Nikolsky’s sign was observed. The oropharyngeal mucosa was intact. The patient was diagnosed with staphylococcal scalded skin syndrome (SSSS) according to clinical features and a skin culture report. Due to the general impact of COVID-19 these days, the patient was evaluated for coronavirus via a polymerase chain reaction (PCR) test, and the result was positive. The patient successfully responded to the treatment which included hydration, wet compress, topical emollient, topical mupirocin for periorificial regions, and intravenous clindamycin. He was discharged after nine days without any complications. Conclusion: This case highlights a clear bacterial infection superimposed on COVID-19. Nevertheless, inconspicuous cases of co-infections remain obscure and require a more diagnostic suspicion.