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During the First World War, the territories that constituted the front line in North East Italy were the theaters of intense shelling. The military tactics of the time involved the use not only of conventional ammunition but also of special ammunition containing asphyxiating and blistering compounds. However, the technology of the time did not guarantee a high explosion rate, leaving a considerable quantity of unexploded material on the ground. Although more than 100 years have passed since the end of the Great War, it is still common to find unexploded ordnance in the areas that were the site of combat. The demining campaign is still underway by the bomb squad of the Italian army with the medical support of the Military Corps of the Italian Red Cross. This case report reports the case of a young patient who came into contact with a vesicant chemical bomb along the Piave River and was subsequently admitted to the Major Burns Center of the Padua Hospital, where he was treated until full recovery. Although it is a rather rare eventuality, experiences like this provide the opportunity for the admitting surgeon to promptly and competently manage patients exposed to chemical warfare [ABSTRACT FROM AUTHOR]

Introduction: Neonatal linear immunoglobulin A (IgA) bullous dermatosis (NLABD) is a rare, life-threatening, mucocutaneous bullous disorder. The pathogenesis and optimal treatment remain poorly defined and raise critical clinical challenges. Case Presentation: We present a case of a full-term female infant with severe cutaneous and respiratory symptoms due to NLABD. Diagnosis was confirmed by immunofluorescence on the infant’s skin biopsy, while IgAs directed against the basement membrane of the skin and mucosa were identified in the mother’s milk. The infant fully recovered after nearly 8 weeks of intensive multidisciplinary care, including non-invasive ventilation, nutritional support, wound care, systemic corticoid treatment, and breastfeeding discontinuation. Conclusion: This case underscores the importance of timely adequate diagnosis and management of this rare and serious condition. Moreover, it adds novel evidence documenting the presence of pathogenic IgAs in breastmilk. [ABSTRACT FROM AUTHOR]

Case Presentation: In this case presentation, an 84-year-old male with Fitzpatrick type IV skin tone experienced blistering due to bullous pemphigoid (BP), first on the distal upper left extremity and then on the distal lower extremities, chest, and back. These symptoms resulted in three visits to the emergency department within a month, as well as an episode of hospitalization. Despite treatment, the blistering did not resolve until future outpatient care with dermatology.Discussion: Bullous pemphigoid is a rare autoimmune disease where autoantibodies target hemidesmosomal proteins causing basement membrane destruction and tense subepithelial bullae with pruritus. While uncommon, the incidence of BP is increasing. Bullous pemphigoid tends to affect older adults, appearing as a rash prior to bullae formation on the abdomen, extremities, groin, axillae, or mucosa. Bullous pemphigoid may also be drug-related with atypical symptoms. Diagnosis of BP should be based on immunopathology, and initial treatment of BP is through corticosteroid or doxycycline.

OBJECTIVES: This study aims to analyze data on the epidemiology, treatment and course of bullous pemphigoid in 50 patients and compare findings to the data already available in the literature. METHODS: Data were collected retrospectively through medical records and analyzed statistically. A review of the literature was conducted using articles indexed in the MEDLINE (via PubMed) database. RESULTS: The mean age at diagnosis was 71.1 years. Comorbidities were observed in almost all cases, and the association between bullous pemphigoid and neurological diseases was present in 18% of patients, in agreement with recent data in the literature. CONCLUSION: Care of comorbidities, especially neurological diseases, which increase the mortality of patients with bullous pemphigoid, is thus essential.

Beryllium (Be) has been selected as the solid neutron multiplier material for a tritium breeding blanket module in ITER, which is also the primary option of the Chinese TBM program. But the irradiation swelling of beryllium is severe under high temperature, high irradiation damage and high doses of transmutation-induced helium. Advanced neutron multipliers with high stability at high temperature are desired for the demonstration power plant (DEMO) reactors and the China Fusion Engineering Test Reactor (CFETR). Beryllium alloys mainly composed of Be12M (M is W or Ti) phase were fabricated by HIP, which has a high melting point and high beryllium content. Beryllium and beryllide (Be12Ti and Be12W) samples were irradiated by helium ion with 30 keV and 1 × 1018 cm−2 at RT. The microstructures of Be, Be12Ti and Be12W samples were analyzed by SEM and TEM before and after ion irradiation. The average size of the first blistering on the surface of Be-W alloy is about 0.8 μm, and that of secondary blistering is about 79 nm. The surface blistering rates of the beryllium and beryllide samples were also compared. These results may provide a preliminary experimental basis for evaluating the irradiation swelling resistance of beryllium alloy. [ABSTRACT FROM AUTHOR]

Background: In this case report, the connection between autoimmune bullous dermatosis acting as a paraneoplastic syndrome and testicular cancer is highlighted. Clinical case: A 28-year-old man with no chronic-degenerative diseases or medication consumption presented with erythematous macules and blisters on the chest, spreading to the back and limbs. Physical examination revealed eyelid erythema, conjunctival injection, ulcers on the tongue and lips, and blisters that denuded 90% of the body surface. He was admitted to the intensive care unit, where he was diagnosed and treated as toxic epidermal necrolysis. He received immunosuppressive treatment, with symptomatic improvement and re-epithelialization of the skin lesions. In the internal medicine service, a malignant testicular tumor was identified, for which he underwent orchiectomy, with the histopathological result of seminoma. Conclusions: It is concluded that the dermatological manifestations were probably secondary to an autoimmune bullous dermatosis, given that the patient had no infectious processes or recent drug use, in addition to the recent diagnosis of germ cell tumor. Highlights of this clinical case include the simultaneous identification of bullous disease and neoplasia during the same hospitalization, supporting the correlation between both entities, as has been observed in previous cases. [ABSTRACT FROM AUTHOR]

This case report presents the clinical scenario of a 22 years old female patient with decade long history of seizure disorder and is on chronic anti-seizure management therapy. The patient's initial symptoms manifested as lesions over the oral cavity, over the period of time the lesions progressed to scalp, chest and buttocks. Pemphigus is a rare heterogeneous group of autoimmune disease that affects the skin and the mucous membrane. A combination of inappropriate activation of host B lymphocytes producing intracellular ImmunoglobulinG antibodies and biochemical interactions results in the drug-induced pemphigus. Acantholypsia is the term for the process by which these auto antibodies target the desmogleins and split the cells in the epidermis. This case emphasizes the requisite for further research on understanding the effect of anti-seizure therapy. [ABSTRACT FROM AUTHOR]

Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking. The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death. A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996–2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195). Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid. Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases. Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls. [ABSTRACT FROM AUTHOR]

Here, we introduce the full functional reconstitution of genetically validated core protein machinery (SNAREs, Munc13, Munc18, Synaptotagmin, and Complexin) for synaptic vesicle priming and release in a geometry that enables detailed characterization of the fate of docked vesicles both before and after release is triggered with Ca2+. Using this setup, we identify new roles for diacylglycerol (DAG) in regulating vesicle priming and Ca2+-triggered release involving the SNARE assembly chaperone Munc13. We find that low concentrations of DAG profoundly accelerate the rate of Ca2+-dependent release, and high concentrations reduce clamping and permit extensive spontaneous release. As expected, DAG also increases the number of docked, release-ready vesicles. Dynamic single-molecule imaging of Complexin binding to release-ready vesicles directly establishes that DAG accelerates the rate of SNAREpin assembly mediated by chaperones, Munc13 and Munc18. The selective effects of physiologically validated mutations confirmed that the Munc18-Syntaxin-VAMP2 template complex is a functional intermediate in the production of primed, release-ready vesicles, which requires the coordinated action of Munc13 and Munc18.

A quiz is presented about the case of a 30-year-old man with two days of persistent fever and generalized lesions and whose examination revealed worsening lesion in the atopic dermatitis (AD) areas.

Pemphigus foliaceus is a superficial blistering disorder characterized by erosions and scaling in a seborrheic distribution. The condition typically occurs in healthy individuals but issues arise from delayed diagnosis. Many cases remain undiagnosed or misdiagnosed due to the lack of awareness of the condition. With use of common diagnostic tools, pemphigus foliaceus can be easily identified and monitored. Histological analysis exhibits "chicken wire" patterning along keratinocytes in the upper epidermis, whereas immunofluorescence study displays subcorneal acantholysis. Pemphigus foliaceus is confirmed via ELISA studies revealing the presence of autoantibodies against desmoglein 1. Once correctly diagnosed, typically the condition is responsive to corticosteroid therapy. However in recalcitrant cases such as in ours, adjunctive immunosuppressive therapy with dapsone or rituximab may be indicated.

Introduction: Pemphigus are rare, but potentially serious, autoimmune blistering diseases that can be associated with catastrophic consequences if an appropriate diagnostic and therapeutic approach is not performed. The Dermatology Service of the University of Antioquia at its main headquarters, Hospital Alma Mater de Antioquia, and Hospital Universitario San Vicente Fundación, is a reference center for the study and management of these diseases. Methodology: review of the literature and socialization in the group of teachers and residents of the University of Antioquia to develop management guidelines. Results: Guidelines are described in the diagnosis and treatment of patients with pemphigus vulgaris and pemphigus foliaceus. Likewise, a narrative review of the scientific evidence that supports what is recommended in this article is carried out. [ABSTRACT FROM AUTHOR]

High strength press hardening steels have a broad perspective of application for automobile light-weight technique. However, they also face a huge challenge of hydrogen related mechanical degradation as atomic hydrogen intrudes into products during their production or in service. Two press hardening steels with different strengths were studied comparatively under the conditions of high hydrogen fugacity without external loading to evaluate their susceptibility to hydrogen embrittlement (HE). In combination with the microstructure characterization through TEM and EBSD, the results showed that these two steels display different surface hydrogen damage modes, e.g., hydrogen blistering for the steel with strength of 1000 MPa and hydrogen-assisted cracking for the steel with strength of 2000 MPa, although their damage sensitivity ratio largely obeys the tradeoff relation between the strength and HE susceptibility. Internal hydrogen pressure is a necessity for formation of hydrogen blisters because the pressure should provide a driving force for plastic deformation of blister surface, which indicates that the hydrogen blistering has some difference in HE mechanism compared to the hydrogen-assisted cracking. The main crack propagation mode is transgranular cracking for both steels, and the crack path concentrates on the {110} slip plane, especially along the block/lath boundaries, which is indicative of the inter-lath decohesion cracking. Therefore, it can be concluded that in the absence of applied loading the intra-variant boundaries have a higher HE susceptibility compared to the prior austenite grain boundaries. • Different surface damage modes (e.g., hydrogen blistering or cracking) occurred on their surface of two PHSs. • Inter-lath decohesion cracking along {110} slip plane is a common mode for crack propagation. • Plastic deformation of hydrogen blistering is controlled by internal hydrogen pressure. • Hydrogen cracking for the PHS2000 forms by a coupled mechanism of HESIV and HEDE. [ABSTRACT FROM AUTHOR]

Purpose: Digital closed-loop medication administration (CLMA) is a prime example of how digitalization in healthcare can reduce time and costs while simultaneously increasing patient safety. However, in contrast to its social and economic benefits, associated environmental impacts have never been investigated. Since the required amount of packaging material is seen as a major subject of criticism, we assess associated environmental burdens using life cycle assessment (LCA) methodology to identify hotspots and provide adaptation recommendations. Methods: Digital, as well as conventional paper-based medication management (PBMM), involve two types of packaging: pharmaceutical packaging (blisters or bottles), containing purchased medication, and clinical packaging (unit doses or medical dispensers) for medication dispensation. Therefore, a cradle-to-grave life cycle model was established comparing impacts at pharmaceutical packaging level, clinical packaging level, and a combined level. While PBMM requires small, blistered boxes, CLMA requires large, bottled packages. Therefore, the functional unit allows to compare different box sizes but inhibits comparing medication from different manufacturers. Primary data is obtained from University Medical Centre Hamburg-Eppendorf which practices state-of-the-art CLMA. PBMM data is obtained in three dispenser scenarios, varying the reusability of medical dispensers. The life cycle impact assessment was performed for five impact categories using CML 2001(2016) method. Results and discussion: All compared blistered pharmaceutical packaging options yield higher impacts than their bottled counterparts. Cardboard and package inserts result in up to 40 times higher impacts for blisters than for bottles, which, however, is attributed to the methodology of comparing different box sizes. Yet, this does not influence the required amount of blister laminate. All blister materials were found to result in higher environmental burdens, peaking in nearly 240 times higher ozone depletion impacts for polyvinylchloride/polychlorotrifluoroethylene blisters. In terms of clinical packaging, two of three dispenser scenarios result in higher environmental burdens than the respective unit dose scenario. Only if reused, 7.2 times this trend is reversed. When combining selected impacts from both pharmaceutical and clinical impacts, all three dispenser scenarios perform worse than the unit dose scenario. Conclusions: Packaging impacts are lowest if unit dose dispensation is combined with bottled pharmaceutical packaging. Given a specific pharmaceutical packaging, dispensation via medical dispensers may perform better, if they are comprehensively reused. With this study, the authors disproved that packaging impacts are generally higher for CLMA than for PBMM. However, both systems certainly comprise other processes and materials like consumed paper or energy to run required digital infrastructure, which should be subject to future studies. [ABSTRACT FROM AUTHOR]

Angina Bullosa Hemorrhagica is characterized with rapid appearance of soft, blood-filled blisters on the mucosa of oral cavity and oropharynx. It is a benign condition, and is not associated with any systemic hematological disorder. No etiological factors have been identified and there are no established guidelines for its management. The current case report describes the sudden appearance of large, bluish, soft lesion on the soft palate which was managed with incision and drainage, and healed completely over the next three weeks. [ABSTRACT FROM AUTHOR]

Type IV hydrogen storage cylinder is a rising high-pressure hydrogen storage equipment, which is composed of a polymer liner and a fully wrapped carbon fiber composite. It is found that local blisters occur on polymer liners after rapid depressurization tests during the research and development process. Some manufacturers choose to add adhesives at the liner-composite interface to avoid blisters. In order to study the effect of adhesives to the local blisters, two type IV cylinders have been manufactured and tested, in which one has adhesives at the interface and the other does not. The depressurization tests were conducted from around 70 MPa–2 MPa under various mass flow rates. Digital radiography (DR) and videoscope have been used to conduct post-test inspections. Finite element analysis (FEA) was performed to verify the effect of adhesives, as well as estimating the pressure differential at the interface based on test results. According to the results of the test and FEA results, the use of adhesives at the interface does not effectively prevent the occurrence of local blisters. However, it does serve to slow down the blister propagation though. The results also indicate that the mass flow rate plays a crucial role in affecting the size of the local blister. Furthermore, based on the test and FEA results, an estimation of the local pressure differential at the interface that causes local blister was made. During the post-test inspection, it was observed that the size of several blisters initially increased but eventually decreased over time. Additionally, adjacent blisters were observed to merge as a single larger blister after the hydrostatic test. These results provide valuable insights into the formation and behavior of local blisters, which can inform future research and practical applications in relevant fields. • Blister phenomena of type IV storage cylinders was studied under different mass flow rates and manufacturing techniques. • Digital radiography (DR) and videoscope were used to perform the inspection of the polymer liner. • The change of blisters was observed in a periodic post-test inspection, the blisters were observed to merge. • The local pressure differential that causes the blisters was estimated based on experimental and FEA results. [ABSTRACT FROM AUTHOR]

Purpose: In Europe, most medicines are taken orally and primarily packaged as single solid oral dosage forms (SODF) in blister chambers (alveoli) arranged on blister cards. Blister cards are constructed as multilayer laminates of aluminum (Al) foils and/or various plastic polymers bonded together, forming the alveoli, which are separated by more or less large gaps. We calculated the amount of packaging material (and thus waste) generated annually for the packaging of the most commonly prescribed SODF in Germany and estimated how much waste could be saved by rearranging the alveoli. Methods: For this purpose, we analysed the SODF of the 50 most frequently prescribed medicines that were packaged in alveoli (N = 45; 13 of aluminum-aluminum blisters, 32 of mixed materials), measured and weighed their packaging material and content, calculated the annual amount of waste produced from them, and estimated how much waste could be saved if the alveoli were optimally positioned on the blister cards. In addition, we examined the variability of the blister packaging of eight groups of commonly prescribed generics of the same strength. Results: Detailed analysis of the blister cards revealed that most of the material (69%) was used for the space between blisters and that aluminum-aluminum alveoli were more than four times larger than the packaged SODF. The (conservatively) estimated annual amount of composite waste generated for the primary packaging of these SODF was 3868 t (and extrapolated to the entire German pharmaceutical market 8533 t), of which an optimized arrangement of the blister chambers, i.e., a 2-mm sealing area around each alveolus and the arrangement of the SODF in 2 rows, would save approximately 37%. Conclusion: Considering that other ecological strategies are not yet mature, the optimal arrangement of blister chambers would be a captivatingly simple and, above all, immediately implementable strategy to avoid large amounts of avoidable waste. [ABSTRACT FROM AUTHOR]

Introduction. Epidermolysis Bullosa, also known as "Butterfly Skin", is a "rare and orphan" autoimmune disease that affects the genetic structure of the epidermis, causing the formation of blisters and skin retractions. People who suffer from it, most of the time, suffer from rejection and isolation. Objective. Design an information booklet on Epidermolysis Bullosa for the basic education educational community of the department of Boyacá. Materials and methods. Qualitative approach study, descriptive, interpretive and analytical in nature that followed the parameters of the PRISMA (2020) systematic reviews. It was developed in 3 stages. 1. Bibliographic search in open access databases such as Scielo, Scopus, Dialnet and Redalyc, among others, with search equations. 2. Systematization of more than 70 articles. 3. Selection of information to fulfill the objective. Results. Research seeks ways to relieve symptoms and prevent complications. For its treatment, a multidisciplinary approach is necessary that includes dermatologists, psychologists, physiotherapists and nutritionists, among other health professionals, as well as education, to address the physical and emotional challenges that patients face, especially in the early years. Conclusions. The challenges focus on early diagnosis, a fundamental aspect for the initiation of treatment; and health strategies aimed at the care and control of the disease. It is necessary for school communities to inform themselves, not to stigmatize and isolate those who suffer from it; From the psychological aspects, support for both those affected and their families is essential. [ABSTRACT FROM AUTHOR]

Background: Hailey-Hailey disease is a rare autosomal dominant genodermatosis whose cause is the ATP2C1 gene mutation. A prevalence of 1 in 50,000 cases is estimated and it manifests as grouped flaccid vesicles that break easily. The diagnosis is confirmed with the histopathological study creating an appearance called "dilapidated brick wall", identifying dyskeratosis in the form of round bodies and pimples. Treatment ranges from general measures to multiple pharmacological options, with topical corticosteroids being the most commonly used. Clinical case: Male patient diagnosed with Hailey-Hailey disease. On physical examination we observed a dermatosis disseminated to the neck, trunk, axillary and inguinal folds, and intergluteal region, unilateral, asymmetric with a polymorphous appearance, constitution due to exulceration, erythema, some pustules and flaccid vesicles that coalesced to form eczematous and hypertrophic plaques with the presence of fine scales on their surface, with a chronic evolution accompanied by pruritus. We also took the opportunity to review the most relevant information in the literature regarding Hailey-Hailey disease, especially focused on the therapeutic aspect. Conclusions: It is important to take into account that Hailey Hailey disease is a rare pathology, in order to make a differential diagnosis in daily clinical practice. [ABSTRACT FROM AUTHOR]

Senear-Usher syndrome is a localized variant of pemphigus foliaceus, rare, with a chronic course, manifested by well-defined erythematous squamous plaques, with a seborrheic appearance and distribution, which adopts a butterfly-wing pattern resembling cutaneous lupus erythematosus (characteristic in our case) and a positive Nikolsky's sign. With the presence of fragile and fleeting blisters, it does not affect the mucosa, it is a disease of low incidence and represents 0.5 to 3.2 cases per 100,000 inhabitants per year. In ages from 15 to 84 years, on average at 54 years, without predominance of race or sex. We present the case of a 31-year-old male patient, skin phototype V/VI according to Fitzpatrick, with no signifi- cant history, presenting bilateral and symmetrical generalized dermatosis beginning in the central facial region characterized by well-defined erythematous plaques with regular borders, with presence of thick oily yellow scales and bruises on the surface, which spread to other seborrheic areas of the chest, anterior and posterior, exulcerated areas, hyperpigmented macules of variable sizes, pruritic with a 1-year history. A skin biopsy was performed with findings consistent with this disease. Treatment with topical and systemic steroids and immunosuppressants was started with a good response. A case is reported because it is a rare variant of pemphigus foliaceus, so it is important to report this case in Venezuela. [ABSTRACT FROM AUTHOR]

Epidermolytic ichthyosis is characterized by erythema and blistering at birth. We present a neonate with epidermolytic ichthyosis who had a subtle change in clinical findings while hospitalized, including increased fussiness, erythema, and a change in her skin odor, which represented superimposed staphylococcal scalded skin syndrome. This case highlights the unique challenge of recognizing cutaneous infections in neonates with blistering skin disorders and emphasizes the importance of having a high suspicion for superinfection in this population.

Blister formation as a presentation of B-cell lymphoma is extremely rare; only one case has been previously reported in the literature to our knowledge. We report a patient known to have refractory systemic diffuse large B-cell lymphoma who presented with nodules with overlying vesicular lesions, which was consistent with secondary cutaneous spread of diffuse large B-cell lymphoma.

Beryllium (Be) has been selected as the solid neutron multiplier material for a tritium breeding blanket module in ITER, which is also the primary option of the Chinese TBM program. But the irradiation swelling of beryllium is severe under high temperature, high irradiation damage and high doses of transmutation-induced helium. Advanced neutron multipliers with high stability at high temperature are desired for the demonstration power plant (DEMO) reactors and the China Fusion Engineering Test Reactor (CFETR). Beryllium alloys mainly composed of Be12M (M is W or Ti) phase were fabricated by HIP, which has a high melting point and high beryllium content. Beryllium and beryllide (Be12Ti and Be12W) samples were irradiated by helium ion with 30 keV and 1 × 1018 cm−2 at RT. The microstructures of Be, Be12Ti and Be12W samples were analyzed by SEM and TEM before and after ion irradiation. The average size of the first blistering on the surface of Be-W alloy is about 0.8 μm, and that of secondary blistering is about 79 nm. The surface blistering rates of the beryllium and beryllide samples were also compared. These results may provide a preliminary experimental basis for evaluating the irradiation swelling resistance of beryllium alloy.

Abstract Background We present a case report on desquamative gingivitis diagnosed as linear IgA disease (LAD), which is a rare autoimmune bullous disease exclusively affecting the oral gingiva. The oral mucosa can be impacted by various autoimmune bullous diseases, and our report focuses on this particular manifestation of LAD. Case presentation This patient presented with atypical symptoms, as frequent blister formation on the gingiva was the primary clinical manifestation. A combination of systemic and local treatment was administered to the patient. Following the treatment, there was a significant improvement observed in both the erythema and the bullous lesions on the gingiva. Conclusions A more suitable local treatment strategy should be formulated for patients presenting with oral topical lesions, which clinicians can employ effectively.

Ping-Chen Hou,1,* Nathalie del Agua,2,3,* Su M Lwin,4 Chao-Kai Hsu,1– 3 John A McGrath1,3,4 1Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan; 4St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK*These authors contributed equally to this workCorrespondence: Chao-Kai Hsu, Department of Dermatology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan City, Taiwan, Tel +886-62353535 Ext.5415, Fax +886-62766180, Email kylehsu@mail.ncku.edu.tw John A McGrath, St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK, Tel +44-2071886409, Fax +44-2071888050, Email john.mcgrath@kcl.ac.ukAbstract: Dystrophic epidermolysis bullosa (DEB) is one of the major types of EB, a rare hereditary group of trauma-induced blistering skin disorders. DEB is caused by inherited pathogenic variants in the COL7A1 gene, which encodes type VII collagen, the major component of anchoring fibrils which maintain adhesion between the outer epidermis and underlying dermis. DEB can be subclassified into dominant (DDEB) and recessive (RDEB) forms. Generally, DDEB has a milder phenotype, while RDEB patients often have more extensive blistering, chronic inflammation, skin fibrosis, and a propensity for squamous cell carcinoma development, collectively impacting on daily activities and life expectancy. At present, best practice treatments are mostly supportive, and thus there is a considerable burden of disease with unmet therapeutic need. Over the last 20 years, considerable translational research efforts have focused on either trying to cure DEB by direct correction of the COL7A1 gene pathology, or by modifying secondary inflammation to lessen phenotypic severity and improve patient symptoms such as poor wound healing, itch, and pain. In this review, we provide an overview and update on various therapeutic innovations for DEB, including gene therapy, cell-based therapy, protein therapy, and disease-modifying and symptomatic control agents. We outline the progress and challenges for each treatment modality and identify likely prospects for future clinical impact.Keywords: skin, blister, gene therapy, cell therapy, inflammation, fibrosis

Chemical vapor deposition tungsten (CVD-W) is a promising material for plasma-facing materials. This work evaluated CVD-W samples with a large grain size (CVD-L) and a small grain size (CVD-S) together with rolled W (ND-W) and recrystallized (Rec-W) samples for their performance under deuterium (D) plasma exposure with a flux of 1021 D m−2 s−1 and fluences up to 2 × 1025 D m−2 at a surface temperature of 500 K. Both CVD-L and CVD-S samples featured a columnar grain structure with a preferred orientation close to 〈001〉 || Z, with a more preferred orientation in CVD-L samples. Both CVD-L and CVD-S samples show good resistance to blistering and only few micron-diameter blisters were observed at fluences. In ND-W and Rec-W samples, the number and size of blisters increased with fluence. The D desorption spectra show two desorption peaks in both CVD-W samples at 520 K and 570–604 K. Whereas in ND-W and Rec-W samples, two peaks were at 520 K and 607–700 K. The total D retention in both CVD-L and CVD-S samples was less than 30 % of that in ND-W and Rec-W samples. The low D retention in CVD-W samples was attributed to the low desorption intensities with the peak at 570–604 K. It is suggested that the microstructure of the columnar grain and the 〈001〉 texture in CVD-W samples helps suppressing plasma-induced blistering, therefore reducing D retention. In terms of the stability of the surface integrity and hydrogen isotopes retention, CVD-W demonstrates a significant potential as a wall material for future fusion reactors.

In the present study, numerical simulation method was used to analyze the conditions, resulting in the formation of blisters during solution heat treatment. Blister formation is considered to occur as the height of blister reaches 5 μm. The effects of process parameters on the magnitude of the forming temperatures of blister (Tb) were discussed. Two kinds of Al–Si alloys were used to analyze the effect of mechanical properties of the alloys on blister forming conditions. Simulation results show that decreasing the initial pressure in gas hole, the long-short axial ratio of gas hole and the size of gas hole, as well as increasing the depth of gas hole and the strength of alloy are helpful to increase the critical temperature of forming blister. These conclusions are helpful for casters to understand the conditions controlling blister formation during solution heat treatment and take actions to avoid the blister defects. [ABSTRACT FROM AUTHOR]

Angina bullosa hemorrhagica (ABH) is a relatively common lesion seen on oropharyngeal mucosa. Often asymptomatic and sometimes may cause discomfort when the bulla ruptures. It has been seen that they tend to rupture and heal on their own. However, if the bulla is present in the oropharynx or laryngeal mucosa may result in complications such as asphyxia. The diagnosis of this entity is clinical and laboratory investigations are helpful in deducting the possible differential diagnoses. A report of an asymptomatic ABH is presented, here, along with the recent updates on the current understanding of this entity. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation (HSCT) is an important method for the treatment of malignant and non-malignant refractory hematologic diseases. Graft-versus-host disease (GVHD) is one of the main complications, which seriously affects the prognosis of patients. By reviewing of related studies, this paper summarized pathogenesis, clinical classification, prevention and treatment and nursing measures of acute skin graft-versus-host disease(aGVHD) following allogeneic HSCT, and put forward relevant management advice, in order to provide reference for clinical nurses in the early period of prevention, early detection and timely intervention on aGVHD. (造血干细胞移植是目前治疗恶性及非恶性难治性血液病的重要方法, 移植物抗宿主病(GVHD)是其主要并发症之一, 严重影响患者预后。本研究通过查阅国内外相关文献, 综述异基因造血干细胞移植皮肤急性移植物抗宿主病(aGVHD)的发病机制、临床分级、预防、治疗和护理措施, 并提出相关管理建议, 以期协助临床医护人员针对皮肤aGVHD的前期预防、早期发现、及时干预提供参考。)

Abstract Background The main activity of the skin is to create a protective barrier against damage. Loss of the skin due to injury or disease and failure to regenerate the affected area may result in disability, infection, or even death. We conducted a clinical trial to evaluate the therapeutic effect of dressing containing silver in process of healing skin blisters caused by limb fractures. Method This is a pioneering randomized trial that compares the effectiveness of two dressings containing silver (Ag coat) and Gaz Vaseline among patients with skin blisters due to bone fractures who were randomly selected from patients referred to the Kashani Medical Training Center. There were two treatment groups containing 16 patients treated with Ag coat and 15 patients treated with Gaz Vaseline. Pictures were taken of blisters on days 0, 7, and 14 to evaluate the healing process. The amount of pain, duration of the visit (measured by minutes), and general condition of the wound were checked. The amount of pain, duration of visit (measured by minutes) and general condition of the wound was checked. All continuous and categorical data are presented as mean ± standard deviation (SD) and frequency (percentage), respectively. Paired sample T-test and repeated measure analysis of variance (ANOVA), Chi-squared test was used. All pictures were analyzed by Mosaic soft ward. Result During this study, there was no significant difference between the mean of age and BMI and frequency of gender in the two study groups (P > 0.05). There was a significant difference in mean between the duration of the visit, number of dressings, and net cost of dressing $$(p

Jie Yang,* Xiaohuan Hu,* Mu Niu, Xiaole Zheng Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mu Niu; Xiaole Zheng, Department of Dermatology, The Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou City, Hainan Province, 570206, People’s Republic of China, Email 382219948@qq.com; 23124552@qq.comPurpose: We aimed to report a case of prurigo pigmentosa (PP) with blisters.Patients and Methods: A 21-year-old male patient presented to our hospital with erythema, papules, and blisters all over the front chest and back. Densely distributed round and oval edematous erythema was noted on the neck, front chest, and back of the patient. Histopathologic examination of the skin lesions (blisters) on the chest revealed epidermal cell hyperkeratosis. He was diagnosed with PP and was treated with oral minocycline.Results: After 1-week minocycline administration, the patient’s itching was relieved, and the blisters dried up. His skin lesions recurred following self-withdrawal from the medication; subsequently, the patient was administered oral minocycline treatment again. After 1-month continuous oral treatment, the drug was discontinued. No recurrence of symptoms was noted.Conclusion: Oral minocycline is effective for the treatment of PP.Keywords: prurigo pigmentosa, blister, minocycline, case report

Primary lung neoplasms are represented by solid, solitary or multiple formations. Blisters are pulmonary emphysemas larger than 1cm, present complete destruction of lung tissue, resulting from dilation, destruction and coalescence of adjacent alveoli, filled with air, located in the subpleural space, surrounded by connective tissue septa, between the lung and the layer of the visceral pleura. Bullaes occupy more than 30% and surgical removal is recommended. The present clinical case reports a 14-year-old female dog, of mixed breed, with an increase in the coughs frequency, fatigue and exercise intolerance. A chest X-ray was taken, a large emphysematous cystic area was found, with thickened and irregular walls located in the left caudal pulmonary lobe, which measured 8cm x 7.5cm x 3cm, and rejected the bronchial branch corresponding to the left caudal pulmonary lobe, in addition to thickening of the bronchial walls, compatible with bronchopathy. The tomographic examination of the cavity showed an air content structure, oval to round in shape, with irregular thick hyperattenuating walls measuring approximately 0.4 cm in thickness, occupying more than 30% of the left hemithorax, and pulmonary lobectomy was chosen. Histopathology confirmed the diagnosis of bronchoalveolar adenocarcinoma, with the presence of sparse areas of necrosis and dystrophic calcification. Concluding that the tomographic exam is of great importance, because only through it, it is possible to evaluate if there is lymph node or pleural involvement or the presence of small metastasis foci. There is indication for surgery and histopathological examination of the piece for a definitive diagnosis. [Open Vet J 2023; 13(2.000): 241-246]