Facial Skin Lesions Research Articles

Miliary Osteoma Cutis, Report of A Case After Plant Injury

Osteoma cutis (OC) is a rare condition characterized by the presence of bone particles within the skin. One subtype of osteoma cutis is miliary osteoma cutis (MOC), which primarily affects middle-aged women and commonly occurs on the face. Clinical features of MOC include papules and skin-colored hard nodules, similar to milia. In this case, we present a 60-year-old woman with facial skin lesions resulting from a plant injury. The diagnosis was miliary osteoma cutis, and successful surgical treatment was performed

Dermoscopic Features and Algorithm- A Guide to Detecting Pre-Malignant Facial Pigmented Skin Lesions in Ethnic Skin

Introduction: Detection of pre malignant facial pigmented lesions on a photo damaged ethnic skin has been crucial for dermatologists in preventing malignant transformation. Facial Pigmented Skin Lesions (FPSLs) that render a diagnostic challenge include, Pigmented Actinic Keratosis (PAK), early Seborrheic Keratosis (SK), Solar Lentigo (SL) and Lentigo Maligna (LM). Dermatoscopy or epiluminescence microscopy, is skin surface microscopy that has demonstrated to be a non-invasive, in vivo, high yield technique to evaluate a pigmented macule for an atypical evolution. Objective: To establish dermatoscopic findings of clinically challenging FPSLs conforming PAK, SK, SL and LM and derive an Algorithm with diagnostic features for detecting Premalignant Facial Pigmented Skin Lesions. Subjects and Methods: We here in conducted a largest case study a cross-sectional analysis of clinically challenging 182 flat FPSLs, evaluated dermoscopic images consistent to pigmented AK, early SK, SL and LM and subsequently biopsied for histopathological evidence. Four major dermoscopic features were appraised: pigment pattern, sharp demarcation, vascular criteria and follicular/epidermal pattern. Study Design: Cross sectional validation-study Setting: Department of Dermatology Unit II, King Edward Medical University, Mayo Hospital Lahore. Study was conducted for a period of six months. Result: We derived an “Algorithm” elucidating diagnostic findings of FPSLs. Pigmented AK on dermoscopy has strawberry pattern in 42% of lesions (pink to red pseudo-network with erythematous background, prominent follicular ostia fenced by a white targetoid halo), while Sharp demarcation (57.15%) and follicular/epidermal pattern (cerebriform pattern 100% of lesions, milia-like cysts, 50%, and comedo-like openings 38.57%) are distinctively observed SK. In SL, homogenous structureless pigmentation is significant entirely (100%). However, in LM predominates pseudonetwork (89.47%), homogenous structureless pigmentation (78%) and vascular patterns while strawberry pattern is observed in (26.31%) of lesions. Conclusion Our “Dermoscopic Algorithm” constitutes diagnostic characteristics of “Facial Pigmented Skin Lesions,” that would not only aid in early corrective detection of clinically similar lesions with different biologic behavior, but serve the the purpose to prevent vigorous malignant transformation in photo damaged ethnic skin, particularly Lentigo Maligna turning into a potential Melanoma, Hence, Sharp demarcation with cribriform pattern is specific of Sebhorric Keratosis (SK), while homogenous structureless pigmentation without prominent vascular pattern is distinctive of Solar Lentigo (SL). Pigmented Actinic Keratosis (AK) is described by prominent strawberry pattern. Nonetheless, homogenous structureless pigmentation and vascular pattern with pseudonetwork are featured in Lentigo Maligna (LM), lacking of prominent strawberry pattern. Conflict of Interest: The Authors have no conflict of interest to disclose.

The impact of using a protective mask on the occurrence of maskne (mask acne) during the Covid-19 pandemic

Introduction
 The COVID-19 pandemic has led to a increase in the use of personal protective equipment (PPE). The term "maskne" was coined to describe acne caused by long-term wearing of a mask. It is a type of mechanical acne caused by the pressure and friction of the mask material against the skin. Although it’s prevalance is not well known, the maskne problem is becoming more and more significant.
 Aim of study 
 The aim of the study is to assess the prevalence and factors affecting the occurrence of mask acne.
 Materials and methods
 This cross-sectional study was conducted after the end of the COVID-19 pandemic among 148 residents of Poland. The results were obtained thanks to a self-conducted questionnaire distributed in both electronic and traditional form.
 Results
 In total, 148 participants took part in the study. 106 (71.6%) were women and 42 (28.4%) were men, with the dominant age group being 26-40, 70 (47.3%). Most participants wore a mask seven days a week, 62 (41.9%), four to eight hours a day, 70 (47.3%). Surgical masks were the most frequently used masks – 60 (40.5%). Ninety (60.8%) participants had no prior facial skin disease. Only 58 (39.2%) of participants had prior facial skin lesions. Of these, acne vulgaris was the most common, 48 (82.8%), followed by rosacea, 6 (10.4%), and psoriasis, 4 (6.8%). Fifty-three people (35.8%) who had facial acne before the pandemic said their acne got worse.
 Conclusions
 This study showed a significant association between the worsening of existing acne and frequent and long-term use of face masks. Therefore, certain measures should be taken to prevent the formation of new acne or the aggravation of existing acne while maintaining protection with face masks, especially for those working in the healthcare sector.

Facial skin lesions and diarrhea in a kidney transplant recipient

Facial skin lesions and diarrhea in a kidney transplant recipient

Endolaser for treating rosacea: Case report

Introduction: Rosacea is a chronic inflammatory skin disease characterized by persistent facial redness, telangiectasias, papules/pustules and skin lesions. Endolaser technique (also known as Endolift) uses a laser beam with a wavelength of 980 or 1470nm emitted through an optical fiber inserted into the subcutaneous tissue in order to tone the skin through neocollagenesis and/or reduce subcutaneous fat. Objective: This study aimed to report three cases of rosacea treatment using the endolaser with a wavelength of 980 nm. Methodology: Three cases of rosacea affecting the face of women who used the endolaser as the main treatment resource were reported. The procedure consisted of the application of a laser emitted through a 600 micron fiber optic, directed subdermally to treat dilated blood vessels and reduce the inflammation associated with rosacea. Each patient received a single treatment session. Results: In the reported cases, patients initially reassessed 30 days after the procedure, it was found a satisfactory decrease in rosacea, and free of intercurrences or complications. In the final reassessment, 8 weeks after the procedure, it was confirmed that there was no recurrence of the condition in this period and the final result remained extremely satisfactory. Conclusion: Finally, it is possible to conclude that the endolaser technique is effective for treating rosacea, showing itself as an innovative procedure, once through its photothermal action it has a great power of anti-inflammatory action, strongly contributing to the remission of clinical condition, and can also be associated with other therapeutic resources when there is another joint condition.

Knowledge and attitude of oral care providers in the Netherlands on skin lesions

To gain insight into the current knowledge of oral care providers in the Netherlands on facial skin lesions, a survey was distributed to 7,670 oral care providers. Their knowledge was tested by means of 4 multiple-choice questions and on the basis of 5 cases. The survey was completed in full by 90 respondents. The median age was 50.3 years and 62.2% were female. During dental check-ups, 55.6% always examined the face and 41.1% sometimes did so. Compared to the group 41 years old and older, the group 21-40 years of age alerted their patients more often to skin lesions (p = 0.017), was more afraid a specialist would find the referral useless (p < 0.001) and was more in need of a guideline (p = 0.049). The respondents scored 1.90 out of 4 correct answers to the knowledge questions. On the case studies, they scored 1.46 out of 5 for the correct diagnosis, 3.48 out of 5 for the correct choice of policy and 1.01 out of 5 for the combination correct diagnosis and correct policy. The total score was 2.91 out of 9. The results indicate that knowledge on aspects of skin lesions is limited and additional training and the availability of a guideline are necessary.

Psoriasis with facial skin lesions that arose against background of withdrawal of ixekizumab (clinical case)

Facial skin lesions in psoriasis, one of the most common dermatoses, are traditionally considered a relatively rare manifestation of the disease, especially in adult patients, but according to modern data, it is observed in at least 40 % of patients. It is believed that facial skin lesions are more typical for young patients with severe widespread skin lesions, involvement of the nail plates and a protracted course. Localization of rashes on the skin of the face – in a cosmetically and socially significant area – is accompanied by significant impairments in the quality of life of patients. The treatment of facial psoriasis is difficult, and few algorithms have been developed for the management of patients with facial psoriatic lesions. We present a patient with psoriasis involving facial skin that first developed after discontinuation of systemic therapy with an IL-17A inhibitor (ixekizumab). During the follow-up of the patient, it became necessary to re-administer systemic biological therapy with the potential risk of an escape effect. In the article, we discuss the clinical manifestations of facial psoriasis and the impact on the quality of life of patients. A description of the observation of a patient with lesions of the facial skin in severe plaque psoriasis and the role of biological therapy in this direction is presented.

Super-High Magnification Dermoscopy Can Help for the Diagnosis of Lentigo Maligna: a Pilot Study on 61 Cases.

Facial lentigo maligna/lentigo maligna melanoma (LM/LMM) is a significant diagnostic clinical challenge and dermoscopy can help its diagnosis. The following study aimed to evaluate if super-high magnification dermoscopy at 400x can add further details for the diagnosis of the LM/LMM. This is a retrospective observational, multicentric study enrolling patients who received a 20x and 400x (D400) magnification dermoscopic examination of facial skin lesions in clinical differential diagnosis with LM/LMM. Dermoscopic images were retrospectively evaluated by four observers for the presence/absence of nine 20x and ten 400x dermoscopic features. Univariate and multivariate analyses were carried out to find predictors of LM/LMM. We enrolled 61 patients with a single atypical skin lesion of the face, including 23 LMs and 3 LMMs. The presence of roundish and/or dendritic melanocytes (P < 0.001), irregular arrangement of melanocytes (P <0.001), irregular in shape and size melanocytes (P = 0.002), and folliculotropism of melanocytes (P <0.001) at D400 were more frequent in LM/LMM than other facial lesions. According to the multivariate analysis, roundish melanocytes at 400x dermoscopy were more indicative of LM/ LMM (Odds Ratio-OR 49.25, 95% CI 8.75-513.2, P < 0.001), and sharply demarcated borders at 20x dermoscopy were more indicative of not-LM/LMM (OR 0.1, 95% CI 0.01-0.79, P = 0.038). D400 can identify atypical melanocyte proliferation and folliculotropism that can help to identify LM/LMM together with conventional dermoscopy data. Our preliminary observations should be confirmed by larger studies.

Analysis of clinical and imaging features of 6 cases of linear scleroderma en coup de sabre with central nervous system involvement in children

Objective: To summarize the clinical and imaging features of linear scleroderma en coup de saber (LSCS) with central nervous system involvement in children. Methods: The clinical data(clinical manifestations and imaging features) of 6 children diagnosed with LSCS with central nervous system involvement who were admitted to Beijing Children's Hospital Affiliated to Capital Medical University from May 2019 to November 2021 were retrospectively analyzed. Results: The 6 patients were all female, aged 6.8 (3.3, 11.0) years at the time of diagnosis, and aged 3.0 (1.7, 4.1) years at the time of discovery of facial skin lesions. Facial skin lesions appeared before neurological symptoms in 5 cases, and neurological symptoms appeared 2 months before skin lesions in 1 case. All the patients had "sword wound" skin lesions on the forehead with alopecia. Neurological manifestations included epileptic seizures in 6 cases, focal neurological defects in 5 cases, and headaches in 2 cases. The intracranial lesions were all ipsilateral to the skin lesions. The magnetic resonance imaging (MRI) of 6 cases showed abnormal signals mainly involving white matter in 1 hemisphere, and 3 cases showed local encephalomalacia. The scattered low signal was observed in 5 cases on susceptibility weighted imaging. Localized brain parenchyma or leptomeninges enhancement was seen on Gadolinium-enhanced sequences in 5 cases. Scattered foci of calcification on the affected side were seen on cranial CT in 4 cases. Skin biopsy was performed in 2 cases. Part of the lesion of the brain was removed in 1 case, and the pathological findings suggested small vasculitis, which was consistent with skin pathological changes. All patients received symptomatic treatment with antiepileptic drugs. Oral prednisone combined with methotrexate was given in 4 cases, and 1 case was given oral prednisone only. One case was presumed to be in the resting stage of the disease due to significant cerebral atrophy in half of the brain, and only antiepileptic drugs were added. The patients were followed up for 6-36 months. The skin lesions of scleroderma and alopecia did not progress in 5 cases, and hemifacial atrophy was developed in 1 case, which was considered to be combined with Parry-Romberg syndrome. The seizures were controlled in 4 cases. One case had reduced seizure frequency but left hemiplegia. One patient still had intractable epilepsy and paroxysmal headache. Conclusions: LSCS with central nervous system involvement is more common in girls, with seizures and neurological defects as the main manifestations. Intracranial lesions are mostly ipsilateral to the skin lesions. Cerebral microbleeds, calcification, and encephalomalacia foci are common, and the pathological changes in skin and intracranial lesions are consistent with small-vessel vasculitis. Prednisone combined with methotrexate treatment has shown some efficacy, but some children remain with refractory epilepsy and neurological deficit symptoms.

The Accuracy of Clinical Diagnosis in 2135 Lesions on the Face. A Retrospective Analysis of Histopathological Records.

Biopsy of facial skin lesions is an important supplement to dermatological diagnostics, especially in doubtful cases or suspected of being malignant. The aim of the retrospective study of 2135 histopathological records of lesions on the face was to: establish the most common indications for a skin biopsy in patients with facial lesions, establish the frequency of histopathological diagnoses, evaluate how often clinically suspected inflammatory lesions are identified as tumors in histopathology, evaluate the accuracy of clinical diagnoses of the most common skin tumors and dermatoses. It was a retrospective study. Histopathological records from the lesions on the face from years 2010-2017 were analyzed. The mean age of patients was 69.3 [7-98]. Fifty-eight percent of the patients were women. Among 2135 clinical diagnoses skin tumors were suspected in 1905 cases. Among 2169 obtained histopathological results (34 biopsies showed 2 diseases), we identified skin tumors in 1940 cases, with 1388 confirmed as malignant. The clinical diagnosis of a specific benign or malignant skin tumor was accurate in 1013/1634 subjects, in comparison to inflammatory lesions, which were correct in 67/148 cases, (P = 0.0001). Among all preliminary inflammatory diagnoses, 33/204 lesions were identified as skin tumors in histopathology. In conclusion in most cases of skin tumors the clinical diagnosis is confirmed by histopathological examination. In case of facial inflammatory lesions, the accuracy of clinical diagnosis is lower, with a significant number of facial lesions appearing inflammatory in clinical evaluation but being diagnosed as skin cancers in pathology.

Perceptive Hierarchy of Facial Skin Lesions: An Eye-tracking Study.

Equal importance is given to every skin lesion in treatment guidelines and severity grading systems for facial lesions. Face recognition studies suggest differentially perceived areas of the human face. The aims of this study were to quantify the visual attention given to facial skin lesions and to explore their hierarchy. Eye movements were tracked in 118 participants who viewed 135 faces with facial skin lesions. The main effect of the image was significant (F[9, 1053]=15.631, p < 0.001, η2=0.118), which implied a difference in the total visual attention between images depicting skin lesions in different aesthetic units. Lesions in the frontal area received the highest area- specific attention, while lesions in the right parotid area had the smallest effect. Using objective computational clustering, 2 very distinct zones of visual attention were identified: the ocular, nasal, perioral, and frontal areas attracted high visual scrutiny and the remaining areas attracted little attention. However, the presence of skin lesions in the high-attention region resulted in a decrease in total visual attention to the face. The main effect of the aesthetic unit was significant (F[15, 1755]=202.178, p < 0.001, η2=0.633). More than 63% of attention-drawing potential of facial skin lesions depends on their anatomical location, which should be considered in disease severity grading and treatment planning.

Inverse Gottron’s papules

A 40-year-old woman presented with facial edema and painful skin lesions involving the hands. On examination, heliotrope rash [Figure 1a], hyperkeratotic ulcerated papules on the knuckles [Figure 1b] and erythematous, flat-to-raised keratotic lesions involving the palmar aspect of the interphalangeal joints [Figure 1c] were noted. A diagnosis of dermatomyositis (DM) was made with clinical features and raised muscle enzymes.Figure 1: Clinical photograph showing heliotrope with periorbital edema (a) and Gottron’s sign over dorsal aspect of hand (b), flat-to-raised lesions involving palmar aspect of the fingers in a distribution “inverse” of the classic Gottron’s papules/sign (c, black arrow) and fingertip scars suggestive of healed ulcers (c, white arrow)Gottron’s papules are pathognomonic of DM. Inverse Gottron’s sign/papules [Figure 1c], due to vasculopathy are a rare but specific cutaneous finding in DM, usually associated with digital ulceration, interstitial lung disease, and anti-MDA5 autoantibodies.[1-3] Anti-MDA5-positive DM occurs in 7.2% of adults and 9.7% of children, respectively, in the Indian subcontinent. Cutaneous vasculopathic features such as cutaneous ulceration, and periorbital edema as seen in the index may indicate a worse poor prognosis in adults with anti-MDA-5 DM.[4] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

33521 Two cases of oral baricitinib associated papular eruption on face

Background: Janus kinase (JAK) inhibitors reduce inflammation by interrupting JAK-STAT pathway and are used for various disease. However, cutaneous adverse effects including reactivation of herpes simplex virus, herpes zoster, disseminated molluscum contagiosum, and acneiform eruptions were reported. In addition, few cases of granulomatous inflammation after JAK inhibitor use have been reported recently. Methods: Patient 1, a 40-year-old woman, presented with erythematous papules on periorbital and perioral area for 13 months. She had been taking prednisolone and hydroxychloroquine for rheumatoid arthritis (RA) for 1 year, but symptoms were not controlled. Thus, oral baricitinib was administered. After 2 months, facial lesions appeared. Patient 2, a 64-year-old woman, presented with erythematous papules on face developed 2 weeks ago. She has been taking baricitinib for RA because of inadequate response to methotrexate. Facial eruption occurred 4 months after initiation of baricitinib. Results: For patient 1, histopathologic examination showed dense dermal infiltration of lymphocytes, histiocyte and few plasma cells, which implicated granulomatous dermatitis. Doxycycline and topical gentamycin/prednicarbate were given and the lesions showed response. Patient 2 showed improvement after treatment with doxycycline, topical metronidazole, and topical ivermectin. However, lesions aggravated 7 months after doxycycline cessation with continuous baricitinib use. Conclusion: Although JAK inhibitors are known to be effective for the treatment of granulomatous diseases like sarcoidosis, granulomatous drug eruption has been reported. In our cases, facial skin lesions appeared 2 and 4 months after starting baricitinib, respectively. Our cases imply that dermatologists should be aware of the potential association between JAK inhibitors and cutaneous eruption.

33521 Two cases of oral baricitinib associated papular eruption on face

Background: Janus kinase (JAK) inhibitors reduce inflammation by interrupting JAK-STAT pathway and are used for various disease. However, cutaneous adverse effects including reactivation of herpes simplex virus, herpes zoster, disseminated molluscum contagiosum, and acneiform eruptions were reported. In addition, few cases of granulomatous inflammation after JAK inhibitor use have been reported recently. Methods: Patient 1, a 40-year-old woman, presented with erythematous papules on periorbital and perioral area for 13 months. She had been taking prednisolone and hydroxychloroquine for rheumatoid arthritis (RA) for 1 year, but symptoms were not controlled. Thus, oral baricitinib was administered. After 2 months, facial lesions appeared. Patient 2, a 64-year-old woman, presented with erythematous papules on face developed 2 weeks ago. She has been taking baricitinib for RA because of inadequate response to methotrexate. Facial eruption occurred 4 months after initiation of baricitinib. Results: For patient 1, histopathologic examination showed dense dermal infiltration of lymphocytes, histiocyte and few plasma cells, which implicated granulomatous dermatitis. Doxycycline and topical gentamycin/prednicarbate were given and the lesions showed response. Patient 2 showed improvement after treatment with doxycycline, topical metronidazole, and topical ivermectin. However, lesions aggravated 7 months after doxycycline cessation with continuous baricitinib use. Conclusion: Although JAK inhibitors are known to be effective for the treatment of granulomatous diseases like sarcoidosis, granulomatous drug eruption has been reported. In our cases, facial skin lesions appeared 2 and 4 months after starting baricitinib, respectively. Our cases imply that dermatologists should be aware of the potential association between JAK inhibitors and cutaneous eruption.

Maskne-Dermatosis of a Pandemic. A Survey on the Impact of PPE on Facial Skin Among HCW and N-HCW in Poland.

IntroductionDuring the SARS-CoV-2 pandemic, personal protective equipment (PPE) became the new social norm for preventing COVID-19, but with an impact on the skin barrier. This study aimed to analyze the factors influencing PPE wearing, following hygiene rules, and effect on facial skin, including onset or exacerbation of dermatoses among healthcare workers (HCW) and non-healthcare workers (N-HCW).MethodsIn 2020, an original survey was carried out among 300 N-HCW and 60 HCW with 60 questions about using PPE and skin lesions experienced before and during the pandemic. Cross-sectional statistical analysis was completed to assess the interplay between environmental factors and maskne occurrence.ResultsThe N-HCW group included 74% females and 26% males with an average age 24.67 ± 0.74. Among HCW respondents 91.7% were women and 8.3% were men, with an average age of 30.07 ± 0.36. All participants used PPE. Volunteers for N-HCW mainly chose a disposable (53.3%) and reusable masks (37.3%), while HCW preferred surgical (66.7%) and FFP2/FFP3/N95 masks (30%) and almost never used reusable masks (3.3%). HCW mainly spent 5–8 h with PPE, and N-HCW spent 1–4 h with PPE/day. Respondents with dermatological problems before the pandemic were more aware of the maskne and paid more attention to hygiene with PPE. Significantly, HCW experienced more severe facial skin lesions than N-HCW (p < 0.0001). There was statistical significance in following the basic hygienic rules of wearing PPE between both groups, where HCW practiced them more.ConclusionsMaskne is a current and urgent problem to be cured. HCW should receive help if they develop maskne, such as limited time spent in PPE and treatment of the results of wearing it, as it is the main trigger of developing maskne. In addition, education about the correct use and choice of PPE should be improved.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00796-w.

Cutaneous Lesions From Monkeypox Infection.

A 33-year-old man presented to a sexually transmitted disease clinic in Lisbon with a 1-week history of facial and gluteal skin lesions. He had a mild fever and malaise during the first 3 days. He was otherwise healthy, reported sexual intercourse exclusively with men, and had no previous illnesses of sexual transmission. Physical examination disclosed multiple papules with a central dark crust distributed in the inner aspect of the buttocks, as well as an erosion on the posterior portion of the right thigh (Fig. 1). Two similar papules were found on the perioral region and a painful anterior cervical lymphadenopathy was palpable.Figure 1: Multiple papules with a dark crust in the center. Note the erosion on the right posterior thigh, compatible with a more advanced lesion. Figure 1 can be viewed online in color at www.stdjournal.com.A swab performed at the base of the lesions was sent to the Portuguese National Health Institute, which revealed the presence of monkeypox virus, via real-time polymerase chain reaction (PCR) technique. Serologies were negative for HIV, hepatitis C and syphilis. The PCR tests were positive for Chlamydia trachomatis in the urine, and Neisseria gonorrhoeae was positive in anal and oral samples. The PCR for herpes simplex virus 1 and 2 was not detected in the lesions. Antibiotic treatment for concomitant sexually transmitted diseases was prescribed. Regarding monkeypox infection, a symptomatic treatment was given, and contact isolation was advised. The patient made a full recovery in 1 week. Monkeypox is a rare zoonosis that is causing a worldwide outbreak.1 Cutaneous lesions frequently evolve the anogenital area and are variable during time, evolving from whitish papules, which become umbilicated with central crust and detach spontaneously in 1 to 2 weeks.2 When all the crusts fall off, the patient is no longer considered contagious. With this case, we intend to disclose a clinical picture, from this outbreak, and alert our colleagues worldwide for the different appearance of monkeypox lesions over time.

Toe growth

A 33-year-old man presented to Dermatology with a 1-year history of a painless, soft, pink-to-purple papule on the proximal nail fold of his left third toe. On physical exam, there were no other significant facial or periungual papules or skin lesions of concern. The patient was otherwise healthy.What’s your diagnosis?

Development of a comprehensive method for the dermatoscopic images analysis of the facial skin with acne

Background: One of the most common inflammatory chronic and recurrent skin diseases is acne (“acne vulgaris”), which appears itself as open or closed comedones and inflammatory skin lesions in the form of papules, pustules, nodes, etc. It has been established that acne is one of the most common dermatoses, since, according to modern data, it affects about 9.4% of the population. During adolescence, up to 90% of people suffer, and in adulthood — about 20% with varying degrees of severity. Currently, there are many approaches to treating this disease through various cosmetic treatments such as phototherapy, ultrasonic skin cleansing, Mesotherapy, chemical peels, and medication. Therefore, the development of methods and means of differential diagnosis of acne is one of the urgent tasks in the field of biomedical engineering, dermatology, and clinical medicine, since this allows timely identification of the localization of the disease, its causes, and prescribing appropriate treatment. However, the solution to the problem of monitoring the dynamics of external manifestations of the disease is possible only with the use of combined mathematical methods for image analysis. Objectives: To develop a comprehensive method for analyzing dermatoscopic images for monitoring the external manifestations of acne disease during treatment and isolating the affected areas of the facial skin. Materials and Methods: Dermatological preclinical researches of the skin were conducted in the laboratory of 3D-biomedical technologies of the Department of Biomedical Engineering of the Kharkiv National University of Radio Electronics, using a digital videodermatoscope BIO Bm6+ in daylight and a portable skin analyzer Skin Scope F-102 in the ultraviolet range. Clinical researches were conducted based on the Department of Pediatric Propaedeutics #2 of the Kharkiv National Medical University. The development of a software tool for image analysis was conducted out in Python programming using the libraries OpenCV, Scikit-image, Numpy, PIL, Mathplotlib. Determination of the affected skin areas and calculation of the parameters of inflammation were carried out using multi-Otsu methods and morphological segmentation of digital dermatoscopic images. Results: During the research, automated software was developed that allows to analyze in dynamics the nature of inflammatory processes and the area of facial skin lesions, as well as to carry out a differential diagnosis of acne disease. The proposed method for the analysis of dermatoscopic images makes it possible to perform color segmentation and obtain a map of the gradations of skin inflammations to control the dynamics during the prescribed treatment. Conclusions: The comprehensive method of analysis of dermatoscopic images of the skin of the face makes it possible to effectively control the condition of the skin of the face from acne during treatment, while analyzing the degree of inflammatory processes and the area of lesions, where, using the developed software, in an automated mode, red gradations are calculated to detect the boundaries of inflammation, geometric parameters and percentage of lesions in relation to healthy facial skin.

Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Familial Tumor Syndromes.

The initiative of the 5th edition of the WHO classification of the Head and Neck Tumours establishing a new section dedicated to familial/heritable tumor syndromes with tumors and lesions in the head and neck region was much needed to better understand the tumours, diseases, and associated syndromes, as well as establish recommendations for monitoring and treating these patients. (WHO Classification of Tumours Editorial Board. Head and Neck tumours. Lyon (France): International Agency for Research on Cancer; 2022. https://publications.iarc.fr/ ). Within the newly established chapter on genetic tumor syndromes, we have described the main manifestations on the head and neck region in 15 syndromes. This review highlights the important findings within these syndromes, especially on the update on syndromes with tumors involving the head and neck region, as Gorlin syndrome/nevoid basal cell carcinoma syndrome associated with odontogenic keratocysts; Brooke-Spiegler syndrome/familial cylindromatosis and the associated membranous-type salivary gland basal cell adenoma, PTEN hamartoma tumor syndrome/Cowden syndrome with associated facial skin and mucosal lesions and characteristic multinodular thyroid lesions, Von Hippel Lindau syndrome and the associated middle ear endolymphatic sac tumor, as well as the fascinating genetic aspects of the diverse Head and Neck Paragangliomas. We will also discuss hyperparathyroidism-jaw tumor syndrome is characterized by parathyroid tumors in association with fibro-osseous jaw tumors, as well as head and neck desmoid tumors associated with familial adenomatous polyposis with Gardner syndrome variant familial, multicentric head and neck squamous cell carcinoma, tuberous sclerosis and neurofibromatosis type 1-associated head and neck lesions.

Skin Wound Tension Reduction Device Combined with Ablative Fractional Carbon Dioxide Laser to Reduce Scar Formation After Excision of Pediatric Facial Skin Lesions: A Prospective Cohort Study.

PurposeTo investigate the efficacy of skin wound tension reduction device (SWTRD) combined with ablative fractional carbon dioxide laser (CO2-AFL) for the prevention of scar formation following the excision of facial cutaneous lesions in children.MethodsPatients undergoing surgical excision of facial cutaneous lesions in our hospital between May 2019 and April 2021 were enrolled. After the excision of facial cutaneous lesions and based on the personal intents and conditions, patients were assigned to undergo SWTRD combined with CO2-AFL. Outcome evaluations were as follows: defect size, incision width, scar width, the Vancouver Scar Scale (VSS) and University of North Carolina 4P Scar Scale (UNC4P).ResultsA total of 25 pediatric patients (mean age, 9.88 years) were enrolled in the study. Following the treatment of SWTRD+CO2-AFL, scar widths were relatively narrow and the appearance of the incision scars was significantly improved. A significant reduction in the patient-reported UNC4P scores at 6 months (3, 1–4) was observed when compared with that at 2 months (0, 0–1) after surgery (p<0.001). A similar reduction in the VSS scar scale was also evident (6 months: 1, 0.75–2.5 vs 2 months: 6.5–8.5; p<0.001).ConclusionCombined SWTRD and CO2-AFL treatment effectively modulates the scar formation after the incision is healed and resulting in preventing scar widening, leading to the improvement of scar appearance, reduction in wound pain and pruritus and its overall prognosis.