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Hintergrund: Psoriasis ist eine immunvermittelte, langwierige Erkrankung, von der weltweit etwa 100 Millionen Menschen betroffen sind. Anti-Interleukin (IL)-23-Wirkstoffe haben einen besonderen Status in Bezug auf die Sicherheit und klinische Wirksamkeit. Anti-IL-23-Wirkstoffe haben in früheren weltweiten Forschungsarbeiten therapeutische Vorteile bei Psoriasis gezeigt. Allerdings war bei der Behandlung von Psoriasis eine Reihe von Nebenwirkungen mit den Anti-IL-23-Wirkstoffen assoziiert. Ziel dieser systematischen Übersichtsarbeit war es, die in Phase-III-Studien ermittelten Nebenwirkungen von Anti-IL-23-Wirkstoffen bei Patienten mit Psoriasis zu bewerten. Methodik: Für diese systematische Übersichtsarbeit wurden die PRISMA-Richtlinien herangezogen. Die Autorin durchsuchte systematisch die Datenbanken Google Scholar, PubMed, Scopus und Cochrane, um geeignete Artikel über Nebenwirkungen von Anti-IL-23-Wirkstoffen bei Patienten mit Psoriasis zu finden, einschließlich der entsprechenden Schlüsselbegriffe (Medical Subject Headings). Ergebnisse: Insgesamt 18 Studien, die die Auswahlkriterien erfüllten, wurden in diesen hochaktuellen systematischen Übersichtsartikel einbezogen. In diesem Review war die häufigste Nebenwirkung von Anti-IL-23-Wirkstoffen Nasopharyngitis, gefolgt von Kopfschmerzen, Infektionen der oberen Atemwege und Rückenschmerzen, die während der Behandlung mit Anti-IL-23-Wirkstoffen beobachtet werden. Die Anti-IL-23-Mittel Ustekinumab und Guselkumab waren signifikant an den Stufe-3-Nebenwirkungen bei der Behandlung von Psoriasis beteiligt, während die Anti-IL-23-Wirkstoffe Briakinumab, Tildrakizumab und Risankizumab signifikant an den Stufe-4-Nebenwirkungen beteiligt waren. Schlussfolgerung: Die zielgerichtete IL-23-Therapie hat einen raschen Aufschwung erlebt, da die Bedeutung der IL-23-Achse zunehmend erkannt wurde und einen neuen Maßstab für Behandlungsergebnisse bei Psoriasis gesetzt hat. In den letzten 3 Jahren sind nacheinander Ustekinumab, Guselkumab, Tildrakizumab und Risankizumab auf den Markt gekommen. Diese Medikamente verursachten jedoch mehrere immunologische und nicht immunologische Nebenwirkungen, sind aber in der Regel gut verträglich und haben ordnungsgemäße Sicherheitsvignetten.

Objective: Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. Methods: In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. Results: Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. Conclusion: In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.

Cutaneous squamous cell carcinoma (cSCC) is one of the most prevalent neoplasms worldwide. Important risk factors for cSCC include sun exposure, immunosuppression, pale skin, and aging. White people are more likely to develop cSCC, and men are more affected than women. In advanced cases, surgery and/or radiotherapy are no longer effective. Due to a historical lack of treatment options, some medications have been used in these patients without sufficient recommendation. There is an urgent need to identify patients at an increased risk of recurrence and spread early for timely diagnosis and treatment. Despite extensive data on the high-risk features and prognostication, considerable variation remains globally regarding high-risk cSCC and the delivery of oncology services. The current comprehensive review evaluated and summarized contemporary knowledge of various management options for cSCC to simplify the integrated treatment plans.

Acne vulgaris, or acne, is a prevailing cutaneous predicament that customarily crops up on the face, neck, and trunk in the forms of comedones, papules, pustules, and nodules. According to epidemiologic explorations, acne affects 9.4% of the global population, making it the eighth most common disease globally. Acne perturbs up to 85% of adolescents, while it is periodically misconceived as an ailment that affects teenagers only; nonetheless, it also affects myriad adults. Acne has well-documented psychosocial ramifications, including adverse effects on self-perception, mental health, and social functioning. Trifarotene is basically a novel fourth-generation locally applied retinoid approved for the first time in the regimens of both face and truncal acnes. The exclusive topical retinoid that adheres precisely to RAR-gamma, the epidermis' most frequent isoform, is trifarotene, approved in October 2019. The current review evaluates the role of trifarotene in treating acne.

Background Psoriasis is a T-cell mediated chronic inflammatory, a papulosquamous disease involving complex interactions between the innate and adaptive immune system and commonly manifested by skin lesions. It is characterized by hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. Chronic psoriasis can be a risk factor for developing comorbid diseases that share common immune pathophysiology and can be triggered by environmental factors in genetically susceptible individuals. Aim To study the clinico-demographic profile, determine the most common triggering factors and determine comorbidities' coexistence in patients with psoriasis at a tertiary care centre. Study Design A cross-sectional study. Methods A teaching hospital-based cross-sectional study including 231 psoriasis patients visiting skin outpatient department (OPD) was conducted by the dermatology departmentat Sri Krishna hospital, Karamsad, India following acceptance of the study proposal by the human research ethics committee. This study was outcome of the dissertation topic of the author during dermatology residency. Total 5 qualified dermatologists working in the dermatology department and 3 resident doctors took part in the study as evaluators. After taking informed consent, detailed history regarding aggravating factors, progress and morbidities was taken with clinical examinations, and the diagnosis was purely clinical. Data were analysed using statistical package for the social sciences (SPSS). Result Our study revealed a peak incidence of psoriasis in the fourth and fifth decade of life with male preponderance (1.9:1). The most commonly found psoriasis type was psoriasis vulgaris, and chronic plaque psoriasis and the most common site of involvement was extensors and trunk. Pruritis was the most disabling complaint (91.34%), and the disease course was progressive. Aggravating factors included stress, winter season, implant insertion, smoking, alcohol consumption, tobacco chewing and obesity. Koebner phenomenon was commonly found with implant insertion in psoriasis patients (76.2%). Family history was one of the well established risk factors for developing psoriasis (14.2%). Our study's most commonly found nail changes were pitting (35.49%) and dystrophic changes (18.61%). Palmoplantar keratoderma (4.76%) and vitiligo (4.76%) were the most commonly found dermatological condition with psoriasis and have been associated with various comorbidities such as cardiovascular disorder, metabolic syndrome, psoriatic arthritis and psychiatric disorders. As it was a cross-sectional study, no controls were used. Conclusion The study shows male preponderance and extensors, trunk as common sites of psoriatic lesion presentation. Aggravating factors included stress, winter season, implant insertion, smoking, alcohol consumption, tobacco chewing and obesity. Screening is encouraged for symptoms of psoriatic arthritis, cardiovascular diseases and metabolic syndromes in psoriasis patients due to its predilection with systemic comorbidities.

Melanoma, which is an aggressive skin cancer, is currently the fifth and seventh most common cancer in men and women, respectively. The American Cancer Society reported that approximately 106,110 new cases of melanoma were diagnosed in the United States in 2021, with 7,180 people dying from the disease. This information could facilitate the early detection of possible metastatic lesions and the development of novel therapeutic techniques for melanoma. Additionally, early detection of malignant melanoma remains an objective of melanoma research. Recently, melanoma treatment has substantially improved, given the availability of targeted treatments and immunotherapy. These developments have highlighted the significance of identifying biomarkers for prognosis and predicting therapy response. Biomarkers included tissue protein expression, circulating DNA detection, and genetic alterations in cancer cells. Improved diagnostic and prognostic biomarkers are becoming increasingly relevant in melanoma treatment, with the development of newer and more targeted treatments. Here, the author discusses the aspects of biomarkers in the real-time management of patients with melanoma.

Rosacea is a ubiquitous chronic inflammatory dermatosis that affects approximately 10% of the population worldwide. Skin manifestations can appear in diverse amalgamations and several degrees of intensity, with frequent spells of aggravation and regression. According to the National Rosacea Society (NRS), about 16 million Americans were affected by rosacea in 2021. Rosacea has been linked to immune system dysregulation and alterations in the neurological and vascular systems. The primary treatment paradigm for rosacea encompasses local and systemic therapies, as well as lasers. However, no exclusive treatment for rosacea is entirely remedial. Innumerable therapies have been considered till date, all of which provide wavering alleviation of the clinical condition. Recent advancements in combination treatments have resulted in therapeutics that has more robust inceptive outcomes and protracted sustenance than those previously available. Severity evaluation, exact subtype identification, and personalized therapy to meet the patient’s needs are the primary keys to successful rosacea treatment. In this review, compendious discussion is made on rosacea, and the currently available as well as emerging treatments for the management of rosacea.

Cutaneous melanoma remains a severe public health threat, with annual incidence increasing slowly but steadily over 4 decades. While early-stage melanomas can typically be treated with complete surgical excision with favorable results, the development of metastatic cancer, which is related to a lower survival rate, is linked to the primary tumor's rising stage and other high-risk features. Even though the first discoveries of an immunological anti-tumor response were published about a century ago, immunotherapy has only been a feasible therapeutic option for cutaneous melanoma in the last 30 years. Nonetheless, for the treatment of various cancers, including metastatic melanoma, the area of cancer immunotherapy has made significant progress in the last decade. As a result, melanoma continues to be the subject of several preclinical and clinical investigations to further understand cancer immunobiology and test different tumor immunotherapies. Immunotherapy's resistance to radiation and cytotoxic chemotherapy is one of its most distinguishing features. Furthermore, the discovery of biomarkers will aid in patient stratification and management during immunotherapy treatment. In this article, we discuss current knowledge and recent developments in immune-mediated therapy of melanoma.

The inhibition of enzyme subgroups of tyrosine kinases can block the ability of various cytokines at the same time. Tyrosine kinase inhibitors are a class of drugs that can be used either primarily as oral medicines or in dermatological definitions locally. In several skin problems, restraint of tyrosine kinases has been demonstrated to be advantageous. Aim of this article is to explore the role of tyrosine kinase inhibitors in various skin diseases. Tyrosine inhibitors have demonstrated a guaranteed response in psoriasis, alopecia areata, Vitiligo, while the variable response in other skin disorders, including atopic dermatitis, chronic actinic dermatitis, dermatomyositis, erythema multiforme, graft-versus-host disease, hypereosinophillic syndrome, STING vasculopathy, palmoplantar pustulosis and lupus. The approach of Tyrosine inhibitors in dermatology has been met with incredible interest. This class of prescriptions can generously propel the treatment of inflammatory and immune mediated dermatoses. It is still too early to make a strong inference regarding these medicines' place in dermatological treatment, even though the evidence provides promising results.

Background: The Atopic Dermatitis (AD) is a chronic, pruritus- inflammatory TH2dominant skin disorder characterized by a reaction with complex immunopathogenesis. Dupilumab’s effectiveness and safety profile by phenotypic variations of atopic dermatitis the treatment of atopic dermatitis has been investigated in a variety of large clinical trials in atopic dermatitis for more than 10 years. The goal of the current systematic review was to determine the effectiveness and protection of dupilumab through phenotypic differences in atopic dermatitis. Methods: We systematically searched PubMed, MEDLINE, EMBASE and Google scholar databases to find appropriate articles published between last ten years related to dupilumab efficacy and safety by phenotypic variations of atopic dermatitis with the appropriate key terms (MeSH) including “dupilumab”, “atopic dermatitis”, “eczema”, “phenotypic variations” “phenotypes” etc. Results: Seven studies were included in the current review, which met the inclusion & exclusion criteria of the current study. All the included studies in this review demonstrated that the dupilumab significantly treated the various phenotypes of AD, with the improvement of EASI and DLQI scores. The most commonly occurred side effect during the treatment of duplimab was allergic conjunctivitis followed by allergic rhinitis and asthma. Most of the included studies demonstrated that the dupilumab has been shown to rapidly improving signs and symptoms in the treatment of extreme AD. Conclusion: Dupilumab was first prescribed for adults with atopic dermatitis and has been generally approved since 2018 for adult patients with moderate to extreme atopic dermatitis. The IL-4 and IL-13 cytokines in atopic dermatitis modulate the epidermal barrier and inhibit the production of antimicrobial peptides. Dupilumab’s efficacy and safety profile in the treatment of atopic dermatitis has been investigated in a number of major clinical trials. This current systematic review provides an evidence-based report on dupilumab efficacy and safety by different phenotypic variations of atopic dermatitis, which will help to clinicians for better understanding of the mechanism of dupilumab against AD phenotypes.

Diabetic dermopathy is a cutaneous manifestation commonly seen in diabetes patients and was initially described by Melin in 1964. These lesions are well-demarcated, hyperpigmented macules or papules with atrophic depression and were commonly sighted on shins of the tibia with bilateral asymmetrical distribution and rarely seen on arms, thighs and abdomen. The incidence of DD ranges from 0.2 to 55%. It has been frequently associated with microangiopathic complications of diabetes such as nephropathy, retinopathy and polyneuropathy. Although the exact mechanism of occurrence is unknown, it may be related to impaired wound healing due to decreased blood flow, local thermal trauma or local subcutaneous nerve degeneration. Diagnosis is made by clinical examination and the differential diagnosis includes stasis dermatitis, early lesion of necrobiosis lipoidica and purpuric dermatitis. Prevention of dermopathy lesions includes optimized glucose control. No active treatment is recommended or proven effective and DD is known to resolve on its own as time passes. Modified collagen and high glycerine-based lotion have shown marked improvement in skin color changes due to diabetic dermopathy. Diabetic dermopathy is known to have a strong association with microangiopathic complications; the presence of such lesions must raise strong suspicion and prompt investigation for severe underlying pathology. Enhanced scrutinized glycemic control in diabetic dermatopathy patients can even lead to abatement in further progression to microvascular complications and improved long-term patient outcomes.

The previous ten years has been observer to another stimulus in surfactant self-get together articles as specialists for drug conveyance that are an option to micellar, lamellar (liposome, niosome and transfersome) or microemulsion-based vehicles. The audit focuses on the utilization of polymeric micelles as drug transporters. Micellization of naturally dynamic substances is an overall peculiarity that expands the bioavailability of lipophilic medications and supplements. At present utilized low-sub-atomic weight drug surfactants have low harmfulness and high solubilisation power towards inadequately solvent drugs.

Basal cell carcinoma (BCC) is the most common, accounting for 80-90% of skin cancers. It arises from the basal layer of the epidermis and its appendages. A complex interplay of environmental, phenotypic and genetic variables leads to the development of BCC. Literature has documented several clinical subtypes of BCC, the most common of which are nodular, superficial and morpheaform. Expeditious diagnosis and analysis are essential for improving the outcome of BCC. Preventive measures, particularly when implemented in childhood and adolescence, may play a critical role. Due to its low metastatic potential, treatment for BCC mostly focuses on local management. The standard treatment of basal cell carcinoma involved complete removal of the lesion by excision or Mohs surgery. In special circumstances, basal cell carcinoma can be treated with cryosurgery, electrodesiccation and curettage, topical medications and photodynamic therapy. This review aimed to evaluate the contemporary diagnosis and management of basal cell carcinoma.

Clear cell acanthoma, also known as Degos acanthoma, is a rare benign epithelial skin tumor. Generally, it appears as a solitary lesion on the lower legs, but in this case, it appeared on the right mammary area near the areola, which is an exceedingly rare and exciting finding. This lesion's clinical features revealed elevated dome-shaped plaque with surface lobulations and shiny pink color with a size of 9 mm. Dermoscopy was characteristic with blood vessels lined up in a strings pattern. Excision biopsy was done as a therapeutic measure. Histopathology showed a collection of glycogen-containing cells in the epidermis consistent with the diagnosis of clear cell acanthoma. Classical dermoscopy features and diagnostic histology were exemplary for a case report.

Background: Psoriasis is an immune-mediated protracted ailment that perturbs about 100 million people globally. Anti-interleukin (IL)-23 agents have a distinctive status of safety and clinical efficacy. Anti-IL-23 operatives have demonstrated therapeutic prominences in cases of psoriasis in preceding global research. However, arrays of adverse events have been associated with the anti-IL-23 agents in the remedies of psoriasis. This systematic review aimed to assess the adverse developments of anti-IL-23 operatives for patients with psoriasis determined in phase III trials. Methodology: The PRISMA guidelines were wielded for this systematic review. The author systematically searched Google Scholar, PubMed, Scopus, and Cochrane databases to diagnosticate appropriate articles on adverse effects of anti-IL-23 agents in patients with psoriasis including the appropriate key terms (Medical Subject Headings). Results: A total of 18 studies were encompassed in this cutting-edge systematic review that met the selection criteria. In this review, the most prevailing adverse effect caused by anti-IL-23 agents was nasopharyngitis followed by headache, upper respiratory tract infection, and back pain, which are observed during the treatment with anti-IL-23 agents. The anti-IL-23 operatives, including ustekinumab and guselkumab, were significantly involved in the grade 3 stage of adverse effects for the treatment of psoriasis, whereas the anti-IL-23 agents including briakinumab, tildrakizumab, and risankizumab were significantly involved in the grade 4 stage of adverse effects. Conclusion: Targeted IL-23 therapy has expeditiously upsurged to the forefront as the importance of the IL-23 axis has been progressively identified, setting a new benchmark for psoriasis outcomes. Over the last 3 years, ustekinumab, guselkumab, tildrakizumab, and risankizumab have successively come to the market. However, these drugs caused several immunological and nonimmunological side effects, but they are customarily well-tolerated and have orderly safety vignettes.

Cemiplimab, a high-affinity, highly potent human monoclonal antibody that binds to the programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) receptor, is the only drug to attain Food and Drug Administration (FDA) approval and marketing authorization from the European Commission for use in patients with metastatic and locally advanced cutaneous squamous cell carcinoma (CSCC) who are not candidates for curative surgery or curative radiation therapy as a first- or later-line treatment. In pivotal phase II clinical testing, cemiplimab showed rapid and substantial antitumor efficacy and acceptable safety. This systematic review was aimed at evaluating the efficacy and safety of cemiplimab in patients with advanced CSCC. To this end, I reviewed EMBASE, MEDLINE, PubMed, and clinical trial registries/databases by using the following keywords alone or in combination: "cemiplimab," "Libtayo," "cutaneous squamous cell carcinoma," "REGN2810," and "SER439684." Cemiplimab showed clinical efficacy and considerable safety and was associated with low rates of treatment discontinuation (7%) and death (3%). However, the current recommendation is primarily based on only phase II clinical testing due to the absence of an approved comparator agent.

Alopecia Areata is an inflammatory and T cell-mediated autoimmune reaction against unknown autoantigen of hair follicles characterized by patchy, non-scarring loss of hair follicles in the anagen phase. Although its etiology is minimally understood, genetic susceptibility, autoimmunity and stress are thought to be causative factors. It occurs in episodic and recurrent patterns with an incidence rate of 0.1-0.2% in the general population and 7-30 cases per 1000 dermatological patients with a lifetime risk of 1.7%. The lesions can be single and self-limiting or may be widespread. Autoimmune disorders such as Hashimoto's thyroiditis, Vitiligo, celiac disease, diabetes mellitus, psoriasis ad lupus erythematosus were observed as an associated comorbid disorder in AA patients, but hypothyroidism and Vitiligo have the strongest association. Its clinical course is unpredictable and shows no significant predilection to age, gender or race. AA is a heterogeneous variant of alopecia and has clinical types such as patchy alopecia, alopecia reticularis and alopecia totalis. Various epidemiological reports demonstrate an increased frequency of AA in thyroid disease patients. Contemporary research has shed spotlight on circulating auto-reactive cells in evolution of AA, which may play a role in ultimately linking these diseases. Comprehension of complex interplay between autoantigens and immune cells is still evolving. The present study will explore this association of Alopecia Areata in patients with thyroid dysfunction. This correlation was studied briefly with literature available in the medical database such as PubMed and Google Scholar.

Psoriasis is a chronic inflammatory dermatological disorder characterized by white scales and clearly demarcated erythematous plaques. The prevalence of psoriasis varies from country to country and can occur at any age, implying that ethnicity, environmental factors, and genetic background all play a role in its onset. According to the World Psoriasis Day Consortium, 125 million people globally and 2%–3% of the overall community have psoriasis. The introduction of biological treatments has revolutionized the treatment of moderate to severe psoriasis. These novel drugs, particularly those targeting interleukin (IL)-17 and IL-23p19, can help most patients with psoriasis achieve clear or virtually clear skin with satisfactory durability. Nevertheless, none of these modern treatments are not entirely remedial in their current form, and alarmingly, a limited but growing proportion of patients with severe psoriasis are not responding satisfactorily to currently available treatments. Stem cell therapy, including regulatory T-cells, hematopoietic stem cell transplantation, and mesenchymal stromal cells, has been used in patients with recalcitrant psoriasis. This review discusses the stem cell treatments available for psoriasis.

The prediction of forest biophysical parameters is an important task in remote sensing for understanding global carbon cycle. Spectral remote sensing data are available globally at a relatively economical cost making them a viable resource for forest remote sensing. However, the main drawbacks associated with such data is the uncertainty of predictions and cluttered process of selecting band combinations from hyperspectral/multispectral data to produce spectral features for modelling. In this paper, we present an approach that exploits the latest developments in generative variational autoencoders (VAE) that produce disentangled representation from input data to assess the capability of hyperspectral data to model forest aboveground biomass (AGB). The proposed VAE generates a special kind of deep spectral features that are proportional to AGB. A modelling accuracy of R2 = 0.57 (cross-validated) was obtained by the proposed approach, thus pointing out the potential of hyperspectral data to model AGB using disentangled deep spectral features. The proposed approach also enables in bypassing the unreliable process of selecting band combinations to produce spectral features and shows good prospects for mapping global level biomass.

Background: In the world scientific tradition, skin color is the primary physical characteristic used to divide humans into groups. Human skin has a wide range of tones and colors, which can be seen in a wide range of demographic populations. Many factors influence the color of people’s skin, but the pigment melanin is by far the most important. Melanin is produced by cells called melanocytes in the skin and is the primary determinant of skin color in people with darker skin. Indeed, >150 genes have now been identified as having a direct or indirect effect on skin color. Vitamin D has recently been discovered to regulate cellular proliferation and differentiation in a variety of tissues, including the skin. The mechanisms through which the active vitamin D metabolite 1,25 dihydroxyvitamin D3 (or calcitriol) affects keratinocyte development are numerous and overlap with the mechanisms by which calcium influences keratinocyte differentiation. Ultraviolet (UV) is the most major modifiable risk factor for skin cancer and many other environmental-influenced skin disorders when it is abundant in the environment. Although the UV component of sunlight is known to cause skin damage, few researches have looked at the impact of non-UV solar radiation on skin physiology in terms of inflammation, and there is less information on the role of visible light in pigmentation. Summary: The quantity and quality of melanin are regulating by the expression of genes. The enzyme tyrosinase is primarily responsible for the genetic mechanism that controls human skin color. Genetics determines constitutive skin color, which is reinforced by facultative melanogenesis and tanning reactions. High quantities of melanin and melanogenic substances are typically accepted in darker skin to protect against UV radiation-induced molecular damage. Previous research has proposed that skin color variation is caused by a dynamic genetic mechanism, contributing to our understanding of how population demographic history and natural selection shape human genetic and phenotypic diversity. However, the most significant ethnic skin color difference is determined by melanin content. This current review aimed to assess the influence of skin color variations in skin structure and functions as well as difference in dermatological disease patterns. Also, this article reviewed several cases of skin color adaptation in different populations. Key Messages: Skin color impacts the composition and activity. Therefore, the contrast of dermatological ailments between distinct race-related categories is remarkable. Skin color adaptation is a challenging procedure. Refinement of skin color is an age-old craving of humans with ever-evolving drifts.

Lentigo maligna (LM), also known as Hutchinson’s melanotic freckle, is a form of in situ melanoma characterized by the proliferation of atypical melanocytes along the basal epidermis in sun-damaged skin. If left untreated, LM will progress to lentigo maligna melanoma (LMM), a form of invasive melanoma with the same prognosis as other forms of invasive melanoma. LM is more common in the elderly, with a peak occurrence between the ages of 65 and 80 years. LM, however, is rarely present on the trunk and extremities. The diagnosis of LM, confirmed by histopathological and biopsy examination, is based on clinical and dermoscopic features. It typically begins as a tan-brown macule or patch, but it can progress to a variegated pigmentation with dark black color or even amelanotic characteristics. The risk factors involved in the LM development include a history of sunburns, lighter skin types, advanced age, history of nonmelanoma skin cancers, and tendency to form solar lentigines. This article explains the clinical presentation of LM, also reviews the available information on the diagnosis and management of LM, and discusses the potential of such information in facilitating the future prospective.

Objective During the coronavirus disease pandemic, enforced restrictions prevented face-to-face consultations for patients requiring non-emergency medical treatment. In response, there was a rise in telemedical practices, such as teledermatology. This study aimed at understanding the pan-world experiences of patients and healthcare staff who adapted to teledermatology in the coronavirus disease era. Methods This study made use of an online survey presented to dermatology professionals using social media and WhatsApp groups. Professionals who applied teledermatology between March and June 2020 were targeted. The survey was designed to identify respondent demographics and the preferred platforms for digital consultations. The most common diagnoses and rates of referral for further evaluation were recorded. Lastly, a platform was provided for practitioners to report their own and their patient's perspectives on the advantages and operational challenges of teledermatology. Data were collated and analyzed in Microsoft Excel. Results In total, 653 stakeholders participated, representing countries worldwide. Facebook and WhatsApp services were the most popular mediums of digital consultation. Diagnoses of ailments, such as acne and eczema, as well as skin-related infections, were most common. Of the cases referred for biopsy, 10 patients were subsequently diagnosed with cutaneous malignancies. Practitioners and patients not only reported personal benefit from adopting teledermatology, but also reported concerns regarding data privacy and the levels of technological literacy required. Conclusions Teledermatology proved an innovative clinical response to unprecedented challenges. However, further policy development and technological advancement aimed at increasing the diagnostic power of digital consultations are needed to support the continuation of teledermatology in the post-pandemic world.

The quality of training data in terms of precision is instrumental in delivering a good performance for a supervised or a semi-supervised machine learning algorithm. The role of training data becomes more crucial for applications based on remote sensing data due to its distinct characteristics and limited amount of training data. In this paper, we present an effective approach for collection of precise training data from remote sensing images applied for a soft machine learning (softML) algorithm. The objective function of a fuzzy c-means algorithm was used to implement a softML algorithm driven by different spectral similarity measures for image classification and identification of wheat crop from remote sensing images. The spectral similarity measures selected for driving the softML algorithm were stochastic, deterministic as well as hybrid in nature. The training data for the soft computing algorithm were collected using manual and the proposed automatic mode. The manual training data were obtained by field survey of the study area, and the automatic training data were derived using a stochastic region growing algorithm. The precision of the training data obtained from both the modes were assessed by computing the classification accuracy for multiple classes using a fuzzy error matrix and analysis of membership distribution plots of the target wheat crop. Results from the experiments suggest that the proposed approach for automatic training data collection from remote sensing images results in an increment of the overall accuracy of classification for the softML algorithm. Also, the analysis of membership frequency distribution plots of the target wheat crop suggests greater precision of the training data collected by the proposed automatic mode. The increment in the frequency of the greater membership values and reduction in lower values indicated more accurate identification of the wheat crop using automatic mode of training the softML algorithm.

Cold sores are nasolabial blisters caused by herpes simplex virus (HSV) infections. Novel therapies demonstrating simultaneously antiviral activity and improved wound healing are warranted. The aim of this study was to investigate the efficacy of medical-grade honey (MGH) for treating HSV-induced cold sores. A crossover trial was performed in patients with recurrent cold sores (n = 29). The majority (65.6%) of these patients experience four or more episodes per year, thus forming a valid self-control group. In this study, patients applied an MGH-based formulation (L-Mesitran Soft) on their cold sore at the onset of symptoms (62.1%) or appearing of blister (37.9%) and compared it to their conventional treatments. After complete healing, patients filled in a questionnaire evaluating healing, pain, and itching. The average absolute healing time was 72.4% slower with conventional treatment (10.0 days) compared to MGH (5.8 days). After MGH treatment, 86.2% of all patients experienced faster objective healing (6.9% similar and 6.9% slower) and the subjective healing score was higher in 79.3% of the patients (20.7% similar). If the patients normally experience pain and itching during their cold sores, these levels were lower with MGH therapy compared to conventional treatment in 72.7% and 71.4% of the patients, respectively. Moreover, 100% of the patients prefer MGH treatment over conventional treatment and will use it again on future cold sores. MGH is a promising alternative treatment for cold sores, likely by combining both increased antiviral and wound healing activities while alleviating pain and itching.

Atopic dermatitis (AD) is a prevalent condition impacting up to 25% of children and 8% of adults worldwide. An estimated 20% of those with AD comprise a subset of patients with treatment-resistant AD, for whom traditional therapeutics and management strategies are unsuccessful. Physical symptoms significantly impact quality of life for patients and caregivers. The condition is chronic and may persist throughout the lifespan with recurrent episodes. Novel AD therapeutics offer new opportunities to resolve symptoms of treatment-resistant more effectively AD. Recently developed pharmacological agents were developed with an appreciation of AD as a heterogeneous condition. New advances include topical, oral, and injectable therapeutics with novel mechanisms of action. In addition, advances in clinical practice, including the application of digital tools, can promote a personalized medicine approach. For example, teledermatology for chronic conditions such as AD have been embraced by clinicians and patients; communicating symptoms via photographs can augment patient symptom trackers and aid trigger identification. Digital tools can also be used to increase medication adherence and improve patient/caregiver engagement. Integrating the above is a personalized medicine approach. Advanced therapeutics with novel mechanisms of action, integrated with digital tools, and trends toward patient-centered medicine can assist this chronic, heterogeneous condition via precision medicine and better treat treatment-resistant AD.

Cutaneous melanoma (CM) is a malignant tumor formed from pigment-producing cells called melanocytes. It is one of the most aggressive and fatal forms of skin malignancy. In the last decades, CM's incidence has gradually risen, with 351,880 new cases in 2015. Since the 1960s, its incidence has increased steadily, in 2019, with approximately 96,000 new cases. A greater understanding of early diagnosis and management of CM is urgently needed because of the high mortality rates due to metastatic melanoma. Timely detection of melanoma is crucial for successful treatment, but diagnosis with histopathology may also pose a significant challenge to this objective. Early diagnosis and management are essential and contribute to better survival rates of the patient. To better control this malignancy, such information is expected to be particularly useful in the early detection of possible metastatic lesions and the development of new therapeutic approaches. This article reviews the available information on the early diagnosis and management of CM and discusses such information's potential in facilitating the future prospective.

Global mapping of forest aboveground biomass (AGB) is a challenging task and crucial for forest management and planning. Lidar data provides 3D information of forest stands and has been consistently identified as the state-of-the-art technology for monitoring forests. However, lidar data are expensive and their acquisition is spatially restricted to some forest areas. A reasonable solution for overcoming these restrictions is the use of spaceborne data. In recent years, the number of multispectral sensor based satellites have consistently increased, including open data sources like Sentinel-2 and small satellite sources like RapidEye and Dove constellations. In this work, we compared and evaluated different multispectral satellite data like Sentinel-2, RapidEye and Dove on the basis of different available spectral, spatial and temporal information for modelling AGB. We also used airborne lidar data as the state-of-the-art to compare results from multispectral data models. The experiments were performed under a common framework of variable elimination based on autocorrelation analysis and variable selection using stepAIC (Akaike Information Criterion) algorithm. A multiple linear regression with leave-one-out cross validation (LOOCV) was used to perform p-value quartiling for spectral information analysis, generate LOOCV metrics for temporal information analysis and modelling at spectral parity for spatial information analysis. Results demonstrate a clear and extensive influence of spectral information from specific channels like red-edge and SWIR for modelling AGB. Also, the addition of temporal information increases the precision and agreement of multispectral AGB models. Differently, the spatial information may not be relevant unless datasets are at spectral parity.

Bruton tyrosine kinase (BTK) is involved in a multifarious inflammatory and autoimmune process. As a result, BTK has emerged as a promising novel remedial target for amalgamated autoimmune diseases. Medicament corporations have recently devoted considerable attention to the evolution of BTK inhibitors. Pemphigus is an uncommon and often fatal autoimmune illness. Blisters and erosions on cutaneous surfaces and mucous membranes are crippling symptoms of pemphigus vulgaris, which are caused by immunoglobulin G autoantibodies binding to keratinocyte proteins, resulting in keratinocyte adhesion defects. Although systemic corticosteroids and adjuvant medications are used to treat pemphigus, some patients are resistant to these. BTK inhibitors inhibit B-cell signaling, which is clinically useful in treating pemphigus. Assorted clinical trials are underway to assess the safety, tolerability, and pharmacokinetics of distinct BTK inhibitors, including PRN473 and remibrutinib. The current review evaluates translational autoimmunity in pemphigus and discusses BTK inhibitors in the treatment of pemphigus.

Atopic dermatitis (AD) is a prevalent protracted inflammatory skin condition that affects approximately 12% of children globally. Topical remedies, such as pharmacologic and nonpharmacologic management, and off-label systemic medicines, have traditionally been used to treat pediatric AD patients. To minimize comorbidities, sleep disturbances, pruritus, and signs of inflammation and improve the patient's quality of life, it is vital to optimize severe AD management in pediatric patients. Treatment resistance can be caused by a variety of circumstances, including deficient obedience or inappropriate medicine usage, a shortage of adequate pharmaceuticals, hypersensitivity reciprocation to local application of therapeutics, cutaneous infections, and other infuriating ecological provoking factors. If these elements are eliminated, a skin biopsy is required to exclude other AD-like cutaneous disorders. New regimens that target peculiar avenues with improved proficiency and promise minimal adverse events have resulted from recent developments and understanding of the etiology of AD. Although the condition of most patients improves quickly with this treatment, some do not respond well. In this review, the author discusses the management of treatment-resistant atopic dermatitis, with an emphasis on the pediatric population.