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We thank the patient for providing informed consent for publication of their case details and images. Our patient also reported receiving an annual influenza vaccination, which contains a similar excipient (polysorbate), without any adverse reactions. No mucosal lesions were observed and the lesions were found in > 2 different sites of the body. gl A punch biopsy was taken, and histopathology findings were consistent with bullous fixed drug eruption (BFDE) (Fig. [Extracted from the article]

Background: Spironolactone (SPL) is an effective treatment for women acne, but other effects on skin biophysical properties remain to be investigated., Objectives: The aim of the current study was to explore the effects of oral SPL used to treat women acne on skin biophysical properties, including hydration, transepidermal water loss (TEWL), skin surface lipid (SSL) levels, mechanical properties, color, pH, and pore size., Materials and Methods: Twenty-five Thai women with acne treated with oral SPL were followed for 6 months. Skin hydration, TEWL, SSL levels, mechanical properties, color, pH, and pore size of the forehead, chest, and inner arm were evaluated at baseline and 2, 4, and 6 months after treatment with oral SPL. Facial and upper back pore size were also assessed. Clinical outcomes were changes in these skin biophysical properties at each visit compared with baseline., Results: Skin hydration, TEWL, SSL levels, color, pH, and pore size remained stable throughout the study. Facial skin parameters at 6 months demonstrated the following changes: hydration levels, 7.60 (95% confidence interval [CI], -59.74 to 74.94); TEWL, -2.36 (95% CI, -5.77 to 1.06); L* value, 0.51 (95% CI, -0.70 to 1.72); individual typology angle, 1.65 (95% CI -2.27 to 5.57); pH, 0.01 (95% CI -0.43 to 0.46); pore size, -0.24 (95% CI, -1.21 to 0.73); and SSL levels, 7.60 (95% CI -59.74 to 74.94). Improvement of facial mechanical properties was observed. R0 (indicating skin tightness) and R1 (indicating elasticity) showed significant decreases (-0.076 [95% CI, -0.141 to -0.010] and -0.016 [95% CI, -0.033 to -0.001]). R3 and R4 (representing tiring effects) were also improved (-0.091 [95% CI, -0.158 to -0.025] and -0.022 [95% CI, -0.044 to -0.001]). Parameters in the truncal and inner arm areas remained stable, except for skin elasticity and tiring effects, which exhibited a similar trend of improvement as the facial area. The changes were notable as early as 4 months., Conclusion: Oral SPL used for acne did not impair the skin barrier. Moreover, the skin mechanical properties were improved at 4 to 6 months., (© 2024 Japanese Dermatological Association.)

Background: Biologics has been known to be effective for patients with psoriasis. However, optimal treatment pathways and their cost-effectiveness are limited in a resource-limited country. This study assessed the cost-effectiveness of different sequential biologics for moderate-to-severe plaque psoriasis., Method: A hybrid model from a societal perspective was used. Model inputs were derived from network meta-analysis, clinical trials, and published literature. Three different sequential biologic treatments were assessed; Sequence 1; 1st Interleukin-17 (IL-17) inhibitor (secukinumab) followed by 2nd IL-17 inhibitors (ixekizumab or brodalumab), then 3rd IL-23 inhibitor (guselkumab), Sequence 2; ixekizumab followed by secukinumab or brodalumab, then guselkumab, and Sequence 3; brodalumab followed by ixekizumab or secukinumab, then guselkumab. Methotrexate or ciclosporin was used as standard of care (SoC)., Results: All three different sequential biologic therapies could gain total quality-adjusted life year (QALY), but they had higher cost than SoC. Sequence 1 had the lowest incremental cost-effectiveness ratio (ICER) compared to SoC at 621,373 THB/QALY (19,449 $/QALY). ICER for Sequence 2 was 957,258 THB/QALY (29,962 $/QALY), while that for Sequence 3 was 1,332,262 THB/QALY (41,700 $/QALY). Fully incremental analysis indicated that Sequence 3 was dominated by Sequence 1 and Sequence 2. ICER for Sequence 2 was 7,206,104 THB/QALY (225,551 $/QALY) when compared to Sequence 1., Conclusion: At the current willingness-to-pay of 160,000 THB/QALY, no sequential IL-17 inhibitor was cost-effective compared to SoC. Secukinumab followed by ixekizumab or brodalumab then guselkumab (Sequence 1) may be the most appropriate option compared with other treatments., Competing Interests: Piyameth Dilokthornsakul receives research grants from Novartis (Thailand) Limited, Pfizer (Thailand) Limited. He also receives honorariums from GSK (Thailand) Limited, and Boehringer Ingelheim (Thailand) Limited. Other authors declare no conflict of interest., (Copyright: © 2024 Dilokthornsakul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Thailand's hospitals face overcrowding, particularly with non-communicable disease (NCD) patients, due to a doctor shortage and an aging population. Most literature showed implementation merely on web or mobile application to teleconsult with physicians. Instead, in this work, we developed and implemented a telemedicine health kiosk system embedded with non-invasive biosensors and time-series predictors to improve NCD indicators over an eight-month period. Two cohorts were randomly selected: a control group with usual care and a telemedicine-using group. The telemedicine-using group showed significant improvements in average fasting blood glucose (148 to 130 mg/dL) and systolic blood pressure (152 to 138 mmHg). Data mining with the Apriori algorithm revealed correlations between diseases, occupations, and environmental factors, informing public health policies. Communication between kiosks and servers used LoRa, 5G, and IEEE802.11, which are selected based on the distance and signal availability. The results support telemedicine kiosks as effective for NCD management, significantly improving key NCD indicators, average blood glucose, and blood pressure.

Background: Acne vulgaris (AV) exacerbation after whey protein (WP) consumption remains inconclusive among experts., Objectives: To investigate the association between WP consumption and acne severity in men with acne., Methods: A noninferiority trial was conducted in men with mild to moderate facial and/or truncal acne. After randomization, participants in an intervention group took daily WP 30 g with a non-WP nutritional supplement 18 g (WP group, n = 25), while the control group took a non-WP nutritional supplement 46 g (non-WP group, n = 24). At each follow-up appointment, investigators evaluated acne count (total acne lesions, comedonal lesions, and inflammatory lesions) and severity., Results: Forty-nine participants had a mean age of 19.7 years (standard deviation [SD], 0.9) and 20.3 years (SD, 1.4) in the WP and non-WP groups, respectively. The mean differences in the facial and truncal total acne lesions for the WP and non-WP group were -5.99 (95% confidence interval [CI], -13.18 to 1.19, p = 0.09) and -2.18 (95% CI, -11.83 to 7.48, p = 0.65), respectively. For severity changes, only one (4.3%) participant in the non-WP group reported an increase in the Investigator Global Assessment scale of at least two levels., Conclusions: In this 6-month trial, men with acne who undertook WP supplementation showed a noninferior difference in the changes in total acne lesions and severity of facial and truncal acne compared with the non-WP group., (© 2024 Japanese Dermatological Association.)

Background: Drug stores is an option that people can receive health care services for their common illnesses. This is the first study aims to estimate cost savings for 16 common illness symptoms to the Thailand's health system., Method: This study gathered retrospective secondary data from several studies and surveyed the median cost of medicines. Cost savings of care provided by pharmacists at drug stores in comparison to out-patient department (OPD) services at hospitals were quantified using cost of illness approach., Results: The average number of hospital visits for treatment for 16 common illness symptoms was 2,356 visits per month. The estimation of the cost savings per visit from three perspectives, including government, patient, and societal, at tertiary care hospitals were 12.7-19.4, 12.7-25.6, and 18.9-25.6 USD, and at secondary care hospitals were 6.0-12.7, 6.0-18.9, and 12.2-18.9 USD. Every $1 reimbursed at drug stores will save additional costs in Thailand's health system, ranging from $0.04 to $0.24 and $0.02 to $0.16 at tertiary care hospitals and secondary hospitals, respectively., Conclusion: Pharmacy services for 16 common illness symptoms can clearly save costs., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Dietary supplements containing a functional feed additive have been shown to be beneficial to fish and shellfish aquaculture. However, the functional properties of aquafeed formulations have rarely been reported in fish. This study aimed to investigate the effects of natural free amino acid mix (FAAM) supplementation as a functional solution on the growth performance and nutrient utilization in a carnivorous fish, Asian seabass (Lates calcarifer). Five isonitrogenous and isolipidic diets were prepared with graded supplementation levels of FAAM at 0 % (control group), 0.25 %, 0.50 %, 0.75 %, and 1.0 %, denoted as FAAM0, FAAM0.25, FAAM0.5, FAAM0.75, and FAAM1.0, respectively. The experimental fish were fed different dietary FAAM supplementations to apparent satiation twice daily for eight weeks. Significant improvements were observed in the growth performance of fish among the five groups (P < 0.05). Fish fed with FAAM0.75 displayed significantly increased activities of lysozyme, myeloperoxidase, catalase, and glutathione peroxidase (P < 0.05). The activities of digestive enzymes, including amylase, protease, and lipase, were enhanced by the supplementation of FAAM in the feed (P < 0.05), especially for the groups that contained more than 0.5 % FAAM in the feed. Furthermore, the morphological profile of the intestinal tract, including the mucosal fold height, width, thickness, and goblet cell, increased in fish fed with FAAM at 1.0 % (P < 0.05). Moreover, FAAM supplementation in diets not only modulated the expression of immune-related genes (glutathione peroxidase (GPx), complement (C)3, C4, and C-reactive protein) in the liver but also positively impacted the growth-ralated genes, including growth hormone (GH), GH receptor (GHR), insulin-like growth factor I (IGF-I), and IGF-II. In addition, the amounts of monounsaturated fatty acids (mainly oleic acid (C18:1n9c)) and polyunsaturated fatty acids-especially γ-linolenic acid (C18:3 n6) and α-linolenic acid (C18:3n3)-increased in fish fed with diets containing FAAMs (P < 0.05). Interestingly, the diets supplemented with FAAMs also had a positive effect on the economic indices in terms of revenue-to-cost ratios. These findings provide a scientific basis for the application of FAAMs as a functional solution that can be used in feed formulations for Asian seabass., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Cutibacterium acnes is associated with the pathogenesis of acne vulgaris (AV). The relationship between antibiotic-resistant C. acnes and AV remains unclear. The authors aimed to determine the prevalence of antibiotic-resistant C. acnes and investigate the association of acne severity with topical and systemic treatments in patients with acne. Samples were collected of inflammatory and noninflammatory acne, including closed and open comedones and erythematous papules/pustules from the face of patients with mild to severe acne. The samples were cultured under anaerobic conditions for the isolation of C. acnes. Antibiotic susceptibility tests for erythromycin, tetracycline, doxycycline, clindamycin, and trimethoprim/sulfamethoxazole were performed using the agar dilution method. From 153 patients, 143 viable C. acnes samples were isolated (93.5%). They were found resistant to trimethoprim/sulfamethoxazole (143/143, 100%), clindamycin (108/143, 75.5%), erythromycin (105/143, 73.4%), tetracycline (74/143, 51.7%), and doxycycline (73/143, 51.1%). There was no significant correlation between the prevalence of antibiotic resistance and acne severity. High-level resistant C. acnes correlated with higher clinical severity of acne in patients taking doxycycline (τ b  = 0.3). The present prevalence of antibiotic-resistant C. acnes was high in Thailand. Antibiotic stewardship in AV treatment should be encouraged to prevent further antibiotic resistance crises., (© 2023 Japanese Dermatological Association.)

Post-acne erythema (PAE) is one of the most common sequelae of acne inflammation. Unfortunately, the treatment of PAE remains challenging due to limited effective topical treatments. The objectives of this study were to evaluate the efficacy and safety of topical oxymetazoline hydrochloride (OxH) 0.05% solution for PAE. This study was a split-face, participants-and investigators-blinded, randomized, placebo-controlled trial conducted between December 2021 and March 2022 in Bangkok, Thailand. Healthy adults aged from 18 to 45 years with mild to severe PAE, according to the Clinician's Erythema Assessment (CEA), on both sides of the face were eligible. After randomization, each participant applied the OxH to one side of their face and a placebo to the contralateral face twice daily for 12 weeks. The primary outcome was PAE lesion counts. The secondary outcomes were erythema index, clinical response rate at week 12 ("clear," "almost clear," or "at least two-grade improvement" by CEA), and patient satisfaction scores. A total of 30 participants were enrolled. The OxH-treated skin showed a significantly greater mean difference (MD) reduction in PAE lesion counts than the placebo after 8 weeks of treatment (4.30, 95% confidence interval [CI] 1.42-7.18). Similarly, the MD reduction of the erythema index was higher in the OxH-treated skin from the second week (11.82, 95% CI 8.48-15.15). Additionally, the OxH-treated side also achieved a higher clinical response rate after 8 weeks of treatment (40.00% vs. 6.67%; p = 0.002) and rated higher satisfaction than those using the placebo at the end of the study (mean [standard deviation] satisfaction score 8.30 [0.18] vs 7.40 [0.18], P < 0.001). There were no serious adverse events or flares of erythema during the study. In conclusion, our study demonstrated that the topical OxH 0.05% solution was effective, well-tolerated, and safe for reducing PAE without a rebound effect. It could be a choice of PAE management. Trial Registration: Thai Clinical Trials Registry No. TCTR20211207004., (© 2023 Japanese Dermatological Association.)

The effects of topical non-antibiotic acne treatment on skin microbiota have rarely been demonstrated. In the study, we randomized 45 mild acne vulgaris participants into three treatment groups, including a cream-gel dermocosmetic containing Aqua Posae Filiformis, lipohydroxy acid, salicylic acid, linoleic acid, niacinamide and piroctone olamine (DC), retinoic acid 0.025% cream (VAA) and benzoyl peroxide 2.5% gel (BP). At months 0, 1 and 3, skin specimens were swabbed from the cheek and forehead and sequenced by targeting V3-V4 regions of the 16 S rRNA gene. QIIME2 was used to characterize bacterial communities. Acne severity, sebum level and tolerability were assessed concomitantly in each visit. We found that both VAA and BP could significantly reduce the bacterial diversity at month 1 (p-value = 0.010 and 0.004 respectively), while no significant reduction was observed in DC group. The microbiota compositions also significantly altered for beta diversity in all treatments (all p-value = 0.001). An increased Cutibacterium with decreased Staphylococcus relative abundance was observed at months 1 and 3 in DC group, while an opposite trend was demonstrated in VAA and BP groups. These findings suggest a potential impact of DC, VAA and BP on the diversity and composition profiles of the skin microbiota in mild acne participants., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: A better understanding of skin lipidomics and its alteration under treatment administration might offer therapeutic solutions for seborrhea., Aims: To quantitatively and qualitatively explore the lipid-modifying effect of the moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid (LDCS) in seborrhea participants with and without acne vulgaris (AV)., Patients/methods: We conducted an open-label explorative study on 20 seborrhea participants (10 AV and 10 non-AV). All participants applied LDCS for 8 weeks with the addition of benzoyl peroxide 2.5% gel and adapalene 0.1%/benzoyl peroxide 2.5% gel in AV. Skin surface lipid (SSL) assessments were performed biweekly, using Sebumeter® and lipid-absorbent Sebutapes® to collect forehead SSL for profile analysis by gas chromatography-mass spectrometry (GC-MS)., Results: SSL amount significantly decreased since week 2 in AV (p-value = 0.0124) and week 6 in non-AV (p-value = 0.0098), respectively. Twenty-two important SSLs were annotated from GC-MS analysis, comprising 19 free fatty acids, cholesterol, squalene, and glycerol. There was a significant reduction in 5 and 13 lipid components in AV and non-AV groups, respectively., Conclusion: LDCS, either alone or with topical acne treatment, demonstrated substantial sebusuppressive and lipid-modifying effects among seborrhea participants., (© 2022 Wiley Periodicals LLC.)

Acne scars are classified into various types based on their appearances, ranging from hypertrophic to atrophic. Abnormal wound healing processes play an important role in the pathogenesis of scars; however, the exact mechanisms involved in various scar appearances have still not been elucidated. In this study, we used immunofluorescence and immunohistochemistry techniques to detect the presence of myofibroblasts, B cells, and mast cells in each type of acne scar persisting longer than 6 months. We found the highest density of myofibroblasts in hypertrophic acne scars, while in the other atrophic scars, we could not identify any myofibroblast-rich areas in our specimens. B-cell infiltration was mild and found in only 23% (4/17) of all acne scar specimens. Interestingly, mast cells were identified in all specimens, ranging from minimal to high density, and a high number of mast cells in acne scars were associated with obesity. In conclusion, myofibroblasts are abundant only in hypertrophic acne scars, and mast cells, but not B cells, might play an important role in the pathogenesis of long-standing acne scars., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 by S. Karger AG, Basel.)

Introduction: During the ongoing COVID-19 outbreak, face mask use has increased and became a part of our daily lives. While wearing, prolonged contact time and microenvironmental change profoundly lead to an acne flare-up, defined as "maskne.", Aims: We aimed to assess the efficacy and safety of snail secretion filtrate, Calendula officinalis, and Glycyrrhiza glaba root extract combination serum (SCGS) in treating the maskne., Methods: This was a randomized, double-blind, placebo-controlled trial study. This study enrolled 66 participants with mild-to-moderate maskne. The SCGS and placebo were randomly assigned for participants to use twice daily for 12 weeks. Percentage change of acne lesion count, acne severity by Investigator Global Evaluation Acne (IGEA), sebum levels, corneometry levels, transepidermal water loss (TEWL), erythema score by Visia®, and adverse events were evaluated 4-weekly at baseline to Week 12. At Week 12, all participants evaluated their satisfaction scores using a 10-point visual analog scale (VAS)., Results: In the mask-covered area, the percent reduction in inflammatory acne lesions from the treatment group was significantly greater than the placebo group at all time points (coefficient of percentage change of inflammatory lesions = -33.89 [95% CI -65.24, -2.53]; p = 0.03). Also, a subgroup analysis with participants using concurrent acne treatments revealed similar results (12 participants, coefficient = -50.30 [95% -88.65, -11.95]; p = 0.01). However, there were no significant differences in non-inflammatory lesions, all skin biophysics, and VAS between groups. Adverse events were mild and occurred in a few cases in both groups., Conclusions: The SCGS could significantly improve inflammatory acne lesions and had a favorable tolerability profile, suggesting its role as an adjunctive treatment in maskne., (© 2022 Wiley Periodicals LLC.)

Introduction: Prolonged mask-wearing could modulate the skin microenvironment resulting in several facial dermatoses. Microbial dysbiosis is proposed to be linked with these changes; however, data regarding the association is still limited. Accordingly, we aimed to explore the impact of face masks on the skin's bacterial microbiota., Methods: We classified participants into short (<4 h/day) and long (≥4 h/day) mask-wearing time (SMWT and LMWT) groups according to mask-wearing time per day in the previous 2 weeks. Specimens were swabbed from the cheek and forehead of 45 mild acne vulgaris patients, representing mask-covered area (MCA) and mask-uncovered area (MUA), respectively. The 16S rRNA gene sequencing and QIIME2 were used to characterize bacterial communities., Results: There were 12 (26.7%) and 33 (73.3%) participants in SMWT and LMWT, respectively. There were no significant differences in beta diversity across MCA/MUA or LMWT/SMWT groups. In alpha-diversity, the evenness on MCA was significantly lower in LMWT than in SMWT ( p value = 0.049). Among all groups, the relative abundance of bacterial taxa was similar, showing Actinobacteriota and Firmicutes, and Cutibacterium and Staphylococcus as the most predominant phyla and genera, respectively., Conclusion: Our results showed no significant impact of mask-wearing on the skin microbiota in mild acne vulgaris participants., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2022 by S. Karger AG, Basel.)

The objective of this study was to investigate the effects of sources and levels of selenium (Se) on juvenile Nile tilapia (Oreochromis niloticus). A completely randomized design involving a 2 × 3 factorial arrangement of treatments was used in this study. Organic Se (L-selenomethionine; SeMet) and inorganic Se (sodium selenite; Na 2 SeO 3 ) were each added to the basal diet at 1, 3 and 5 mg Se/kg. The basal diet, without Se supplementation, was used as a control. There was a total of 7 experimental diets, and each was fed in triplicate to groups of fish with an initial average body weight of 13.5 g for 8 weeks. The results showed that growth performance was significantly affected by dietary sources and levels of Se (P < 0.05). Fish fed diets supplemented with SeMet of 1.0 mg Se/kg resulted in higher growth performance compared to basal diet (P < 0.05), but Na 2 SeO 3 supplementation did not affect growth. The feed conversion ratio was significantly decreased as dietary sources of SeMet (P < 0.05). Interestingly, fish fed diets supplemented with both forms of Se had lower cholesterol levels than those fed the basal diet (P < 0.05). Moreover, dietary sources and levels of Se significantly increased (P < 0.05) the antioxidant enzyme activities such as lysozyme, catalase, myeloperoxidase, superoxide dismutase and glutathione peroxidase. Dietary sources and levels of Se significantly could enhance the Nile tilapia resistance against Streptococcusagalactiae infection (P < 0.05). Overall, it can be concluded that the inclusion level of 1.0 mg Se/kg of organic Se in the diet is suggested to be the optimal level for the growth performance and immune response of Nile tilapia. Therefore, dietary supplementation with Se is useful for improving growth, antioxidant status, immune response, and disease resistance., (Copyright © 2021. Published by Elsevier Ltd.)

The synthesis of ZnO comprising different ratios of zinc acetate (ZA) and zinc nitrate (ZN) from the respective zinc precursor solutions was successfully completed via a simple precipitation method. Zinc oxide powders with different mole ratios of ZA/ZN were produced-80/1, 40/1, and 20/1. The crystallinity, microstructure, and optical properties of all produced ZnO powders were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), and UV-Vis-NIR spectrophotometry. The average agglomerated particle sizes of ZnO-80/1, ZnO-40/1, and ZnO-20/1 were measured at 655, 640, and 620 nm, respectively, using dynamic light scattering (DLS). The optical properties of ZnO were significantly affected by the extreme ratio differences in the zinc precursors. ZnO-80/1 was found to have a unique coral-sheet structure morphology, which resulted in its superior ability to reflect near-infrared (NIR) radiation compared to ZnO-40/1 and ZnO-20/1. The NIR-shielding performances of ZnO were assessed using a thermal insulation test, where coating with ZnO-80/1 could lower the inner temperature by 5.2 °C compared with the neat glass substrate. Due to the synergistic effects on morphology, ZnO-80/1 exhibited the property of enhanced NIR shielding in curtailing the internal building temperature, which allows for its utilization as an NIR-reflective pigment coating in the construction of building envelopes.

Introduction: Seborrhea or oily skin has been one of the most common complaints affecting both men and women physically and psychologically. Chitosan is a biopolymer obtained from the alkaline deacetylation of chitin. Due to its positively charged nature, chitosan can effectively bind to lipids. Therefore, chitosan nanoparticle (CN) formulation may benefit in the reduction of skin sebum., Objective: The aim of this study was to evaluate the efficacy and safety of CN formulation in the reduction of skin sebum., Method: The study was a randomized, double-blinded, placebo-controlled trial in 24 participants aged 18-40 years with clinical seborrhea. Participants were randomly assigned to apply the CN and gum (CN-G) or placebo (gum alone) twice daily for 4 weeks. Sebum level, corneometry, transepidermal water loss (TEWL), and clinical seborrhea grading were evaluated at baseline and week 2 and 4., Results: In the T-zone, sebum levels in the CN-G group were significantly lower than the placebo group at week 4 (p = 0.043), while for the U-zone, sebum levels were not different between groups. There were no statistical differences in corneometry and TEWL at any visit. Although the clinical seborrhea grading in CN-G was lower, it was not significantly different from the placebo. A few cases reported mild and self-limiting scaling and acneiform eruption., Conclusion: The CN-G gel could significantly reduce sebum levels on seborrhea patients with acceptable safety profiles., (© 2021 S. Karger AG, Basel.)