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Abstract Behçet's disease is a chronic inflammatory condition that affects multiple organs and systems. It is characterized by recurrent oral and genital ulcers. A previous study reported that the IL-17A inhibitor secukinumab can improve the skin and mucosal manifestations in patients with refractory Behçet's disease. Additionally, secukinumab has been shown to effectively improve neurological symptoms when administered for Behçet's disease. However, we report a case where Behçet's disease occurred after the treatment of psoriasis with the IL-17A inhibitor ixekizumab. To summarize its clinical characteristics and treatment experience, we consulted relevant domestic and international literature and conducted a literature review. We concluded that anti-IL-17A treatment may lead to the development of Behçet's disease. The reported cases are more likely to occur in middle-aged men with varying onset times. The main manifestations include oral and vulvar mucosal ulcers. Furthermore, the gut microbiota may be involved in paradoxical Behçet's disease. Keywords: Behçet's disease, IL-17 inhibitor, paradoxical reactions, reviews, Author(s): Yue-Kang Ren [1]; Ling Ren [2]; Wen Sun [1]; Hong-Ye Liu [2]; Shu-Ping Guo (corresponding author) [2] Introduction Interleukin (IL)-17A is a key member of the IL-17 family. It [...]

Author(s): Suvesh Singh [1]; Debopriya Paul [1]; Aditi Snehal [1] Introduction Roflumilast is a potent and selective inhibitor of phosphodiesterase-4 inhibitor.[sup.[1]] It has already been in use for treating COPD [...]

Rosacea, a chronic skin condition affecting millions of people in the USA, leads to significant social and professional stigmatization. Effective management strategies are crucial to alleviate symptoms and improve patients quality of life. Encapsulated benzoyl peroxide 5% (E-BPO 5%) is a newly FDA-approved topical treatment for rosacea that shows promise in enhancing therapeutic response and minimizing skin irritation. This review aims to assess the role of recently FDA approved E-BPO 5% in the current treatment landscape for rosacea management, as it is not yet included in clinical guidelines that predominantly rely on older approved therapies. The review focuses on randomized controlled trials conducted in English-speaking adults. It evaluates the efficacy, safety, and tolerability of various US Food and Drug Administration (FDA)-approved agents used for rosacea treatment, including E-BPO cream, metronidazole gel, azelaic acid gel and foam, ivermectin cream, minocycline foam, oral doxycycline, brimonidine gel, and oxymetazoline HCl cream. Existing therapies have been effective in reducing papulopustular lesions and erythema associated with rosacea for many years. E-BPO 5% offers a promising addition to the treatment options due to its microencapsulation technology, which prolongs drug delivery time and aims to improve therapeutic response while minimizing skin irritation. Further research is necessary to determine the exact role of E-BPO 5% in the therapeutic landscape for rosacea. However, based on available evidence, E-BPO 5% shows potential as a valuable treatment option for managing inflammatory lesions of rosacea, and it may offer benefits to patients including: rapid onset of action, demonstrated efficacy by Week 2, excellent tolerability, and sustained long-term results for up to 52 weeks of treatment.

Our objective was to establish consensus on (1) which patients with plaque psoriasis and limited skin involvement (body surface area [BSA] <10%) are suitable for systemic treatment, and (2) a definition of 'topical therapy failure'. A steering committee refined 13 statements drawn from literature related to the study objectives. An independent panel of 45 clinical experts from Japan indicated their agreement to each statement using a 10‐point Likert scale (Round 1; strong consensus, ≥70% of responses = 7–10 and median value ≥8). The steering committee reviewed Round 1 results and refined the statements for Round 2, as necessary. In Round 2, the panel indicated their agreement to each statement using a 3‐point scale (strong consensus, ≥70% of responses and median value of 3) and were shown Round 1 responses before voting. Forty‐five clinicians participated in Round 1 and 41 of those (91%) participated in Round 2. Consensus was achieved on the criteria of eligibility for systemic treatment among patients with limited skin involvement as disease involvement at special or difficult to treat areas, psoriasis‐induced psychological distress, uncontrolled symptoms (e.g., scaling, bleeding, pruritus, insomnia) affecting their social life, psoriatic arthritis, or failure of topical therapy. Consensus on criteria for topical failure were persistent symptoms (e.g., itchiness, pain) and plaques, poor patient satisfaction with treatment, a need to increase medication quantity or application time after treatment with two topicals for 4 weeks; or if the Psoriasis Area Severity Index score of >3 or Physician Global Assessment Score of ≥2 after 8 weeks treatment. Our Delphi panel proposes criteria to help physicians identify patients with psoriasis and limited skin involvement who would benefit from systemic therapy and suggests a definition for topical therapy 'failure' which could indicate a move to systemic treatment is warranted. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by eczema lesions and dry, itchy skin. Recent guidelines for the management of AD emphasize the importance of using moisturizers in the management of AD. This study is a double‐blind clinical trial to determine the effectiveness of moisturizers containing anti‐inflammatory ingredients compared with moisturizers without anti‐inflammatory ingredients for skin hydration in mild to moderate adult AD patients for 14 days at the Dermatology and Venereology Outpatient Clinic at Dr. Soetomo General Academic Hospital. There was a significant difference (p < 0.05) at the baseline and day 14 skin hydration values in the experiment group with anti‐inflammatory ingredients (35.97 ± 6.04–66.06 ± 15.84) and the control group without anti‐inflammatory ingredients (40.74 ± 10.94–56.12 ± 8.34). After comparison, there was a significant difference (p < 0.05) in the skin hydration value between the experiment group and the control group on the 14th day. There was also a significant difference in the improvement of skin hydration outcomes between both groups (p < 0.05). The severity of the disease using Scoring Atopic Dermatitis (SCORAD) showed a significant difference (p < 0.05) between the experiment group and the control group after 2 weeks of intervention. The addition of anti‐inflammatory ingredients in the moisturizer, namely, shea butter, bacterial lysate, allantoin, bisabolol, Phragmites kharka extract, Poria cocos, and Mirabilis jalapa in a moisturizer containing occlusive (dimethicone), humectants (glycerin, saccharide, butylene glycol, and hyaluronic acid), and emollient (shea butter and squalane) was shown to be significantly better in improving skin hydration in patients with mild to moderate AD. [ABSTRACT FROM AUTHOR]

This study investigated the effects of halibut oil cream, containing omega-3 fatty acids, vitamins A and D, and hydroxyproline, on burn wound healing in rats. Acute dermal toxicity tests confirmed its nontoxicity. Wistar rats were divided into five groups: a control, a positive control treated with silver sulfadiazine 1% (SSD), and three groups treated with 3%, 9%, and 27% halibut oil cream Formulation (HBOF). The SSD and HBOF groups showed significant healing improvements compared to the control. Histopathological analysis indicated increased collagen production in the HBOF groups, suggesting halibut oil cream's potential as a topical treatment for burn wounds. [ABSTRACT FROM AUTHOR]

Background: Melaleuca species (family Myrtaceae) are characterized by their wide-ranging applications as antimicrobials and in skin-related conditions. Herein, we estimated the volatile profile and biological significance of M. rugulosa (Link) leaves for the first time supported by a dereplication protocol. Materials and methods: Volatile components were extracted using hydrodistillation (HD), supercritical fluid (SF), and headspace (HS) techniques and identified using GC/MS. The variations among the three extracts were assessed using principal component analysis and orthogonal partial least square discriminant analysis (OPLS-DA). The extracted volatiles were tested for radical scavenging activity, anti-aging, and anti-hyperpigmentation potential. Finally, disc diffusion and broth microdilution assays were implemented to explore the antibacterial capacity against Streptococcus pyogenes, Staphylococcus aureus, Clostridium perfringens, and Pseudomonas aeruginosa. Results: The yield of the SF technique (0.8%) was three times higher than HD. GC/MS analysis revealed that the oxygenated compounds are the most proponents in the three extracts being 95.93% (HD), 80.94% (HS), and 48.4% (SF). Moreover, eucalyptol (1,8-cineol) represents the major component in the HD-EO (89.60%) and HS (73.13%) volatiles, while dl-α-tocopherol (16.27%) and α-terpineol (11.89%) represent the highest percentage in SF extract. Regarding the bioactivity profile, the HD-EO and SF-extract showed antioxidant potential in terms of oxygen radical absorbance capacity, and β- carotene assays, while exerting weak activity towards DPPH. In addition, they displayed potent anti-elastase and moderate anti-collagenase activities. The HD-EO exhibited potent anti-tyrosinase activity, while the SF extract showed a moderate level compared to tested controls. OPLS-DA and dereplication studies predicted that the selective antibacterial activity of HD-EO to S. aureus was related to eucalyptol, while SF extract to C. perfringens was related to α-tocopherol. Conclusions: M. rugulosa leaves are considered a vital source of bioactive volatile components that are promoted for controlling skin aging and infection. However, further safety and clinical studies are recommended. [ABSTRACT FROM AUTHOR]

Acne fulminans (AF) is a severe form of inflammatory acne commonly associated with adolescents. It is characterized by an abrupt onset of painful nodules and plaques and can progress to suppurative, ulcerative, and hemorrhagic lesions. AF can be associated with systemic symptoms such as fever, arthralgia, and bone pain. The etiology of AF is unknown but it has been linked to the use of certain medications and has been rarely found in autoinflammatory syndromes. In previous years, there have been reports of <200 cases in the literature; however, AF may be more common in clinical practice than reported. The most common presentation of AF is seen in adolescents starting isotretinoin therapy. Diagnosis of AF is determined based on its clinical findings. The main purpose of this article is to provide clinicians with a practical approach to treating AF. Current evidence for its treatment is limited to case reports and case series. The mainstay treatment of AF is a combination of prednisone and isotretinoin. It is important to taper or discontinue any exacerbating or precipitating medications such as isotretinoin, antibiotics, or androgens when AF is identified. Along with treatment of AF, it is important to treat associated scarring. Early identification and treatment of AF in adolescents is crucial to minimize both acute symptoms and long-term scarring, and further research is needed to determine optimal management. [ABSTRACT FROM AUTHOR]

Patients with chronic prurigo (CPG) experience intense itching leading to constant scratching, resultant lesions and, often, poor sleep and life quality. First-line therapies include emollients, topical corticosteroids and calcineurin inhibitors and ultraviolet therapies, with systemic agents including immunomodulators and neurological agents also suggested. In randomized controlled trials, dupilumab and nemolizumab both improved CPG itch and lesions and have subsequently become the first treatments to receive approval for prurigo nodularis (the most common subtype of CPG). Other emerging treatments, including vixarelimab, and Janus kinase inhibitors (abrocitinib and povorcitinib), show early promise in CPG. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic and complex immune-mediated papulosquamous disease affecting almost 2 of the world population. The interaction between a genetically predisposed individual and environmental triggers leads to a vicious cycle involving autoreactive T cells, dendritic cells, keratinocytes and dermal cells. Up to 40 of the psoriasis cases develop disabling psoriatic arthritis and an equal number of patients also tend to develop metabolic syndrome as well as cardiovascular comorbidities; hence, this is no more considered to be a disease limited to skin only. Being a systemic disease, there is an urgent need to develop potential biomarkers for the assessment of disease severity, prediction of outcome of the therapeutic intervention and association with various systemic comorbidities. Diverse genetic markers not only function as predictors of diseases pathogenesis, but also help to predict development of psoriasis and psoriatic arthritis. Personalised medicine is customising the therapeutic needs of a psoriasis patient and improving the outcome as per the hints we receive from the various biomarkers. This review deals with the list of potential biomarkers proposed to be useful in psoriasis, though there is limited data validating their routine use in clinical practice and the progress so far made in the field of precision medicine for psoriasis. Keywords: Biomarkers, comorbidities, genetic markers, predictive factors, psoriasis, Author(s): Bikash R. Kar (corresponding author) [1]; Dharshini Sathishkumar [2]; Sushil Tahiliani [3]; Anchala Parthasarathi [4]; Shekhar Neema [5]; Satyaki Ganguly [6]; K. Venkatachalam [7]; Shrichand G. Parasramani [8]; Haritha [...]

In this study, a wound-healing membrane was fabricated based on carboxymethyl cellulose (CMC) and polyethylene glycol (PEG) containing curcumin (Cur) and bromelain (Br). Citric acid (CA) was used as a cross-linking agent. This membrane showed an ideal degree of swelling, which was significantly dependent on the concentration and duration of cross-linked CA. The chemical characterization showed the CA cross-linker mechanism was more associated with chemical reactions with CMC carboxyl groups, and PEG hydroxyl groups played an important role in forming a hybrid polymer network. It greatly enhanced mechanical and adhesive properties, so the stress strength was improved from 29.4 to 38.52 Mpa. The hydrophilicity of the membrane surface according to the water contact angle assay showed the membrane surface is suitable for adhesion, growth, migration, and proliferation of skin cells. The drug delivery assay demonstrated that the Br and Cur were released during 48 h, but the Br followed the burst release in comparison with Cur. Antibacterial properties showed that CMC/PEG-Cur/Br have ideal antibacterial properties for preventing the growth of bacteria. In summary, the engineered CMC/PEG containing Cur/Br films with desired cell viability properties and antibacterial activity can potentially improve and accelerate skin regeneration for chronic wound healing. Highlights * Hydrogel film was prepared based on carboxymethyl cellulose (CMC), polyethylene glycol (PEG), and citric acid as cross-linking agent. * CMC/PEG film were induced controlling curcumin (Cur) and bromelain (Br) release for wound healing process. * CMC/PEG film revealed a wide range of physiochemical, mechanical, adhesion, and biological properties behavior. * Incorporation of Cur and Br promoted in vitro biocompatibility, L-929 cells attachments, and cell migration. KEYWORDS antibacterial properties, bromelain, carboxymethyl cellulose, curcumin, drug delivery, polyethylene glycol, wound dressing, 1 | INTRODUCTION As the largest human tissue, the skin serves a crucial role as a barrier against infection. (1) Due to an incomplete physical barrier and exposed subcutaneous tissue, [...]

Advanced nurse practitioner Michelle McLean delves into the benefits of poly-L-lactic acid filler (PLLA) for skin rejuvenation and restoration as patients demand a 'less is more' approach to facial aesthetics. A recent surge in patients wanting to restore or preserve a youthful appearance has seen a surge in popularity for collagen stimulators due to their association with high levels of patient satisfaction, long-lasting efficiency, minor adverse events and sound safety profile (Christen, 2022). Patients are increasingly opting for a 'less is more' visual aesthetic, hoping to achieve subtle, natural-looking, undetectable results. To meet patient goals, clinicians are utilising combination approaches in facial aesthetics, utilising products with PLLA because of its desirable results. PLLA is a powerful, well-tolerated tool for clinicians to employ for the non-surgical augmentation of the ageing face. [ABSTRACT FROM AUTHOR]

AimsWerner Syndrome is a rare premature ageing autosomal recessive disorder caused by pathogenic variants in the WRN gene. People with Werner Syndrome may develop diabetes mellitus. Chronic foot ulceration is seen, with some characteristics overlapping with diabetic foot disease. However, the clinical course of the ulceration is atypical of diabetic foot disease. We present four siblings from an Irish Traveller family with Werner Syndrome to highlight the complexity of this condition. The Irish Traveller population are an indigenous, endogamous population in which consanguinity is common. As a result, rare autosomal recessive disorders are prevalent among this population:. Methods: We describe our experience managing the complex foot disease seen in all four siblings. Foot complications present in the siblings include painful peripheral neuropathy, chronic foor ulceration, underlying osteomyelitis and acral melanoma. Results: The cases are described individually, with a particular focus on the complex foot disease associated with the condition. Conclusions: Although the siblings attend a diabetic foot clinic, we suggest that the combination of clinical features seen in these cases is unique to Werner syndrome and warrants the title 'Werner Syndrome' (rather than 'Diabetic') foot. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To improve your knowledge of atopic eczema and its prescribed treatment regimens • To enhance your awareness of the challenges encountered in the self-management of atopic eczema • To read about strategies nurses can use to support families to self-manage atopic eczema successfully. Atopic eczema is common in childhood and can continue into adulthood. Adherence to treatment is a significant factor in its effective management, but the complexity of treatment regimens can make adherence challenging. Additionally, living with the condition can have adverse psychosocial consequences for young people in particular. This article discusses treatment regimens for moderate-to-severe atopic eczema and some of the challenges encountered by children, young people and families in self-managing the condition. The authors discuss strategies that can support families to achieve optimal self-management, namely online support tools, written action plans and nurse-led eczema clinics. [ABSTRACT FROM AUTHOR]

Post-kala-azar dermal leishmaniasis (PKDL) is a neglected skin disease that has tremendous epidemiological significance as a reservoir of Leishmania parasites. Relapse, drug resistance, non-compliance to prolonged treatment, poor health-seeking behaviour, along with limited therapeutic options pose a significant impact on the management of PKDL. In this study, we aimed to review the efficacy, safety and tolerability data of combination therapies for PKDL in the published literature. We have also described patients' compliance with treatment and associated co-infections in PKDL. A comprehensive literature search was conducted in PubMed, Scopus and Google Scholar to identify the relevant articles. A total of nine studies were eligible for inclusion in this review. Drug combinations used in India were miltefosine-liposomal amphotericin-B, miltefosine-paromomycin, miltefosine-amphotericin-B, sodium stibogluconate (SSG)-immunotherapy and SSG-rifampicin. However, in Sudan, except one, all studies have used SSG-based combinations viz. SSG-rifampicin, SSG-paromomycin and SSG-immunotherapy. The efficacy and safety of miltefosine in combination with liposomal amphotericin-B as well as conventional amphotericin-B were found to be excellent in a limited number of patients. These combinations are said to have better patient compliance and shorter treatment duration. Another combination of miltefosine and paromomycin was found to be satisfactory with a final cure rate of 83.3%. SSG in combination with paromomycin had a good clinical outcome among severe PKDL patients in Sudan, though pain at the injection site was experienced by all patients. There is a lack of data on combination therapies for PKDL through large-scale randomised controlled trials (RCTs). Therefore, multicentric randomized controlled trials with a sufficiently large sample size are urgently needed to verify the efficacy, safety, and other advantages of combination therapies for PKDL. With the availability of liposomal amphotericin-B, miltefosine and immunotherapy, clinical management of PKDL appears promising. [ABSTRACT FROM AUTHOR]

This case describes a 9-day-old female infant who presented with severe skin peeling and diffuse erythema. As the patient was refractory to standard treatment, a working differential diagnosis was built and included infectious, inflammatory, and inherited etiologies. The patient's workup pointed toward Netherton syndrome, a rare autosomal recessive condition that presents at birth or within the first few weeks of life and is characterized by widespread erythroderma with ichthyosis. [ABSTRACT FROM AUTHOR]

Objectives: Ixekizumab, an interleukin (IL)-17A inhibitor, exerts its therapeutic effects in psoriasis by inhibiting the interleukin (IL)-17 signaling pathway. Common adverse reactions to ixekizumab include injection site reactions and upper respiratory tract infections (URIs), while occurrences of inflammatory bowel disease (IBD) and multiple mucosal ulcers are infrequent. We present a case of a 51-year-old man who developed multiple mucosal ulcers after ixekizumab treatment. Methods: A 51-year-old man presented to our hospital with a 1-month history of pharyngalgia. The flexible laryngoscope displayed mild hyperemia in the pharyngeal mucosa and tonsils, redness and swelling of the epiglottis, as well as multiple ulcers in the oral cavity, uvula, and epiglottis. These ulcers did not improve with conventional treatment. Results: Upon evaluation, the ulcers were an immune-related adverse event induced by ixekizumab. Consequently, a decision was made to discontinue the drug and initiate a therapeutic regimen including corticosteroids and thalidomide. Eventually, the patient's symptoms abated. Conclusions: Biologics are now becoming increasingly popular in psoriasis. It is vital for clinicians to be aware of this potential adverse event and to identify and intervene early to alleviate patients' suffering. [ABSTRACT FROM AUTHOR]

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Background: The management of pediatric dermatological conditions such as alopecia areata (AA), psoriasis, atopic dermatitis (AD), and hidradenitis suppurativa (HS) has significantly evolved with the introduction of biologics and small molecule targeted therapies. The advancement in understanding the immunopathogenesis of these chronic skin conditions has led to the development and approval of novel biologics and small molecule therapies. Initially approved by the United States Food and Drug Administration (FDA) for adults, most of these therapies are now being evaluated in clinical trials for safety and efficacy in adolescents and children, expanding new treatment options for pediatric patients. The role of the FDA in drug approval is multifaceted from drug inception, ensuring that research, data, and evidence show that the proposed drug is effective and safe for the intended use. Objective: The goal of this review article is to provide an overview of the recently FDA-approved and potential biologic and oral small molecule therapies in clinical trials for AA, psoriasis, AD, and HS in pediatric patients. Methods: The search for this review included keywords in ClinicalTrials.gov, PubMed, and Google Scholar for the latest research and clinical trials relevant to these conditions and treatments without the PRISMA methodology. Results: For pediatric AA, ritlecitinib is FDA-approved, while baricitinib and updacitinib are in phase 3 clinical trials for pediatric approval. The FDA-approved drugs for pediatric psoriasis include secukinumab, ustekinumab, ixekizumab, etanercept, and apremilast. Other phase 3 clinical trials for pediatric psoriasis include risankizumab, guselkumab, tildrakizumab, brodalumab, and deucravacitinib. For pediatric AD, the FDA-approved drugs are dupilumab, tralokinumab, abrocitinib, and upadacitinib, with many other drugs in phase 3 trials. Adalimumab is an FDA-approved biologic for pediatric HS, with various clinical trials ongoing for adults. The approved biologics and small molecule therapies had higher efficacy and improved safety profiles compared to traditional medications. Conclusions: With numerous ongoing trials, the success of these clinical trials could lead to their inclusion in treatment guidelines for these chronic skin conditions. Biologics and small molecule therapies offer new avenues for effective disease management, enabling personalized therapeutic interventions and improving pediatric health outcomes. [ABSTRACT FROM AUTHOR]

Tamarind (Tamarindus indica L.) rind is one of the natural products which has been proven to have antioxidant and sunscreen activities. It has the potential to be developed into cosmetic product such as cream. This study aims to determine the correlation between the antioxidant activity and the Sun Protection Factor (SPF) of tamarind rind ethanol extract cream. Tamarind rind was macerated in ethanol (96%) for 5 days, the extract was concentrated over a water bath to obtain a dried tamarind rind ethanol extract. The tamarind rind ethanol extract was formulated into creams using three different concentrations of tamarind rind ethanol extract as the active ingredient; FI (5%), F2 (10%), and F3 (15%). The sunscreen protection activity of the creams was assessed by determining the sun protection factor (SPF) using the Mansur formula. The antioxidant activity of the creams was evaluated by the DPPH (2,2-Diphenyl-1-picrylhydrazyl) radical scavenging assay. The correlation between the IC50 value of the antioxidant activity and the SPF value was analyzed using the Spearman's rank correlation test. Results show that formulation F3 has the highest sunscreen activity with SPF value of 6.469, but all the formulation has very weak antioxidant activity (IC50 < 200 ppm). The Spearman's rank correlation analysis showed a significant relationship between the IC50 value and the SPF value of tamarind rind ethanol extract cream, which suggests that the higher the antioxidant activity, the higher the SPF value of the cream formulation. [ABSTRACT FROM AUTHOR]

The evidence on products for the prevention of radiodermatitis is limited. The primary objective was to analyse the effectiveness of the spray skin protectant 'non‐burning barrier film' in the prevention of radiodermatitis with moist desquamation in patients with the anal canal and rectal cancer followed in nursing consultations compared to a standardised moisturiser based on Calendula officinalis and Aloe barbadensis. Single‐blind randomised clinical trial. The study was performed in a hospital in Rio de Janeiro, Brazil, with 63 patients undergoing anal canal and rectal cancer treatment, randomised into one of the following two groups: an experimental group, which used a spray skin protectant and a control group, which used a moisturiser. Data were collected using an initial and subsequent evaluation form and were assessed using descriptive and inferential analyses. Participants who used the spray skin protectant had a lower chance of presenting radiodermatitis with moist desquamation and a longer time without this outcome when compared to the control group. The overall incidence of radiodermatitis was 100%, with 36.5% being severe. Furthermore, 17.5% of participants discontinued radiotherapy due to radiodermatitis. There were no differences between the groups regarding the severity of radiodermatitis and the number of patients who discontinued radiotherapy. The skin protectant was effective in preventing radiodermatitis with moist desquamation amongst patients with anal canal and rectal cancer. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin condition affecting millions of individuals worldwide. Over the years, various treatment modalities have been explored to alleviate the symptoms and improve the quality of life for patients with psoriasis. Among these treatment options, lasers and lights have emerged as promising non-invasive approaches with significant efficacy. This review aims to provide an overview of the current understanding and clinical applications of lasers and lights in the management of psoriasis. We have discussed the mechanisms of action behind different laser and light therapies and their impact on psoriatic plaques. Additionally, we discuss the various types of lasers and lights utilized, including excimer lasers, pulsed dye lasers, and narrowband ultraviolet B (NB-UVB) phototherapy, highlighting their unique properties and clinical outcomes. Moreover, we have addressed important considerations related to patient selection, treatment protocols, and potential side effects associated with lasers and lights. We emphasize the need for proper evaluation, monitoring, and customization of treatment plans to ensure optimal outcomes and minimize adverse events. Keywords: Lasers, light therapy, psoriasis, Author(s): Aarti Sarda [1]; Varsha Vaidyanathan [2]; Sudip Das [3]; Abhishek De (corresponding author) [3] Introduction Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative [...]

BackgroundDisabling pansclerotic morphea (DPM) is a rare systemic inflammatory disorder, characterized by poor wound healing, fibrosis, cytopenias, hypogammaglobulinemia, and squamous-cell carcinoma. The cause is unknown, and mortality is high.MethodsWe evaluated four patients from three unrelated families with an autosomal dominant pattern of inheritance of DPM. Genomic sequencing independently identified three heterozygous variants in a specific region of the gene that encodes signal transducer and activator of transcription 4 (STAT4). Primary skin fibroblast and cell-line assays were used to define the functional nature of the genetic defect. We also assayed gene expression using single-cell RNA sequencing of peripheral-blood mononuclear cells to identify inflammatory pathways that may be affected in DPM and that may respond to therapy.ResultsGenome sequencing revealed three novel heterozygous missense gain-of-function variants in STAT4. In vitro, primary skin fibroblasts showed enhanced interleukin-6 secretion, with impaired wound healing, contraction of the collagen matrix, and matrix secretion. Inhibition of Janus kinase (JAK)-STAT signaling with ruxolitinib led to improvement in the hyperinflammatory fibroblast phenotype in vitro and resolution of inflammatory markers and clinical symptoms in treated patients, without adverse effects. Single-cell RNA sequencing revealed expression patterns consistent with an immunodysregulatory phenotype that were appropriately modified through JAK inhibition.ConclusionsGain-of-function variants in STAT4 caused DPM in the families that we studied. The JAK inhibitor ruxolitinib attenuated the dermatologic and inflammatory phenotype in vitro and in the affected family members. (Funded by the American Academy of Allergy, Asthma, and Immunology Foundation and others.).

Background: Medication use around widowhood has been poorly described for most medication classes. Medication use patterns can reflect health consequences of spousal loss, as previously shown for psychotropic drugs. Methods: We used data from nationwide health registers (2008–2020) to describe the patterns of use of dispensed medications in all widowed Swedes aged ≥65 years followed between 2 years before and 2 years after spousal death. All prescription drugs used by at least 5% of the cohort were considered according to their therapeutic subgroups (Anatomical Therapeutic Chemical [ATC] classification system 2nd level). We used group‐based trajectory models to cluster widowed individuals into up to 4 distinct longitudinal patterns of monthly medication use. We ranked the therapeutic subgroups with similar patterns according to their plausibility to reflect potential health effects of spousal loss, compared to those of psycholeptics (mainly anxiolytics, hypnotics) and psychoanaleptics (mainly antidepressants) as the references. Results: From 212,111 widowed adults included (68% female and 70% aged ≥75 years), we observed a significant increasing trend in medication use, especially after spousal death, for 21 out of the 39 different therapeutic subgroups that were used by at least 5% (most represented pharmacological groups: cardiovascular system, nervous system, and alimentary tract and metabolism). This increasing trend often concerned only a small proportion of individuals, with varying magnitude and speed of change in medication use across therapeutic subgroups. The patterns of use of antiepileptics, laxatives, skin emollients/protectives, analgesics, and drugs for anemia, constipation, or peptic ulcers, were the closest to those of references, displaying the largest changes in use, and were therefore ranked as the most likely to reflect health effects of spousal loss. Conclusion: Our results confirmed the increase in psychotropic medications' use in widowed older adults and identified several potential physical health effects of spousal loss that warrant further research. [ABSTRACT FROM AUTHOR]

Rosacea is a chronic, inflammatory condition of facial skin. Treatment of rosacea should be based on its presenting features i.e. inflammatory lesions, erythema, phymas and/or telangiectasia. First-line treatment options for inflammatory lesions include metronidazole, azelaic acid, ivermectin and modified-release doxycycline, but topical formulations of minocycline foam and encapsulated benzoyl peroxide are also now available. Persistent erythema can be treated with topical α-adrenergic receptor agonists or light-based therapies. Approved pharmacological options for phymas and telangiectasia are limited; nonpharmacological procedures should be considered in some cases. [ABSTRACT FROM AUTHOR]

Challenges in the modern National Health Service cannot be underestimated. Workforce pressures alongside increasing demands for healthcare requires creative adaptation to services. This article describes the introduction of interim wound dressing kits into residential homes and the resulting positive improvements to patient care. It details how a clear baseline investigation of a clinical issue, the use of modern technology and adherence to a structured process can achieve project goals. The objective of maintaining patient safety in relation to interim wound care was met, resulting in a reduction of same-day and out-of-hours community nurse visits. [ABSTRACT FROM AUTHOR]