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BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a common, yet underdiagnosed, gut condition caused by gut dysbiosis. A previous study has shown the potential of herbal therapy, providing equivalent results to rifaximin. OBJECTIVES: The objective of this study was to assess how the use of an oral botanical regimen may modulate the gut microbiome, facial erythema, and intestinal permeability in those with SIBO. METHODS: This was an open-label prospective study of adults that had lactulose breath test-confirmed SIBO. Participants received a 10-week oral supplementation of a Biocidin liquid tincture and GI Detox+. If participants were found to be non-responsive to treatment after 10 weeks with a persistently positive lactulose breath test, a third oral supplement, Olivirex, was administered for an additional 4 weeks. Lactulose breath tests were administered at baseline, weeks 6, 10, and 14 to assess for SIBO status. A high-resolution photographic analysis system was utilized to analyze changes in facial erythema. Stool sample collections and venipuncture were performed to analyze the gut microbiome and intestinal permeability. RESULTS: A total of 33 subjects were screened with breath testing, and 19 subjects were found to have SIBO. Three of the subjects withdrew during the screening period prior to baseline, and sixteen subjects enrolled. Four subjects dropped out after baseline. Hydrogen-dominant SIBO was the most common subtype of SIBO, followed by methane and hydrogen sulfide. The botanical regimen was most effective for hydrogen- and hydrogen sulfide-dominant SIBO, leading to negative breath test results at week 10 in 42.8% and 66.7% of participants, respectively. Compared to baseline, supplementation with the botanical regimen led to positive shifts in short-chain fatty acid-producing bacteria such as A. muciniphila, F. prausnitzii, C. eutectus, and R. faecis by 31.4%, 35.4%, 24.8%, and 48.7% percent at week 10, respectively. The mean abundance of Firmicutes decreased by 20.2%, Bacteroides increased by 30%, and the F/B ratio decreased by 25.4% at week 10 compared to baseline. At week 10, there was a trending 116% increase in plasma LPS/IgG (p = 0.08). There were no significant changes in plasma zonulin, DAO, histamine, DAO/histamine, LPS/IgG, LPS/IgA, or LPS/IgM. Facial erythema was not statistically different at week 6, but at week 10, there was a 20% decrease (p = 0.001) in redness intensity. Among the patients that extended to week 14, there was no statistical change in erythema. CONCLUSIONS: Supplementation with an antimicrobial botanical supplemental regimen may have therapeutic potential in hydrogen and hydrogen-sulfide subtypes of SIBO. Furthermore, the botanical supplemental regimen may reduce facial erythema, increase SCFA-producing bacteria, decrease the F/B ratio, and modulate markers of intestinal permeability.

Serpentine supravenous hyperpigmentation (SSH) describes increased skin pigmentation that develops in the area immediately overlying the vessels through which chemotherapeutic drugs are administered. While SSH can be cosmetically distressing and there are no definitive management options, the literature is severely limited and the variations in clinical presentation, risk factors, and histopathology of SSH across patients are not well understood. We aimed to systematically summarize characteristics from current available data, and thus improve SSH awareness and management. A literature search was conducted in PubMed using specific eligibility criteria through the end of December 2022. Included articles focused on patients who experienced SSH after chemotherapy infusion. Study quality was assessed using a modified Oxford Centre for Evidence-Based Medicine quality rating scheme. Of the 41 articles identified by literature search, 24 met eligibility criteria. Two additional articles were identified through the reference sections of retrieved articles, for 26 articles total. All articles were case reports, representing 28 patients total. Locations of SSH were mostly in the forearm near the site of injection (85%), and the most common associated symptom was erythema. Histopathologic analysis was available for half of cases, the majority of which were inflammatory in nature. The most common inflammatory pattern observed was a vacuolar/lichenoid interface dermatitis. Duration of SSH ranged from days to > 1 year after the chemotherapy was stopped. Six (21%) patients were managed with topical steroids and oral vasodilators, six (21%) patients switched to central venous infusion rather than peripheral infusion, five (18%) patients received only supportive care, three (11%) patients received venous washing with chemotherapy, three (11%) patients stopped chemotherapy, and one (4%) patient reduced the chemotherapy dosage. Ten (36%) patients attained complete resolution, seven (25%) had SSH that was near resolution/fading, and three (11%) had persistent hyperpigmentation. Although SSH often spontaneously resolves once the chemotherapeutic agent is stopped, it can persist in some patients and cause significant distress. As the literature is severely limited and there are no definitive treatments, additional research using more standardized definitions and methods of assessments is necessary to improve characterization of SSH and evaluate potential interventions.

Background: Facial erythema from acne, vascular rosacea, or photoaging is a common difficult–to‐treat dermatologic challenge. Objective: The objective of this study was to examine the role of lapachol in alleviating facial erythema associated with a variety of common dermatologic conditions. Methods: Twenty‐five healthy female and male subjects 35–65 years of age of Fitzpatrick skin types I–II with mild‐to‐moderate stable facial erythema from acne, rosacea or photoaging were enrolled in a single‐site monadic study. Subjects received the study cream for twice daily application and were assessed at baseline, Week 4, and Week 8. The dermatologist investigator and subjects assessed efficacy and tolerability and facial photographic images were taken of all subjects at each visit. Noninvasive erythema assessments of the face were conducted using a colorimeter at baseline, Week 4, and Week 8 to document improvement in facial erythema. Results: Twenty‐five out of 25 subjects successfully completed the study without tolerability issues including 12 subjects with rosacea, 6 subjects with photoaging and 7 subjects with acne. After 8 weeks of use, the investigator rated a 44% decrease in facial erythema while the subjects rated a 40% decrease. Facial erythema was also noninvasively assessed with a colorimeter and dermaspectrophotometer (DSP). There was a 26% decrease in skin redness at Week 4 and a 31% decrease in skin redness at Week 8 on the colorimeter L*a*b* scale. This finding was collaborated by the DSP which registered a 29% decrease on the erythema scale at Week 8. Conclusion: Lapachol in a moisturizer formulation was found to be effective in reducing facial erythema from acne, rosacea, and photoaging. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines for the prevention of catheter associated urinary tract infection (CAUTI) recommend urinary catheter securement in critical patients although there is scant research on its effectiveness. Aim: To analyse whether securement of an indwelling urinary catheter (IUC) reduces the risk of CAUTI and meatal pressure injury among intensive care unit (ICU) patients and assess medical adhesive‐related skin injury (MARSI) associated with the securement device. Study Design: Open randomized controlled trial involving patients admitted to two ICUs in Spain. In the intervention group (n = 169 patients), the IUC was secured to the thigh using an in‐house device piloted as part of this trial. Controls (n = 181) received standard care, including non‐securement of the IUC. Barrier film spray was applied to the securement site with the aim of preventing MARSI. The definitions of the main outcomes were: CAUTI was diagnosed according to the criteria of the European Centre for Disease Prevention and Control, meatal pressure injury was categorized into four grades and MARSI was classified as either erythema or skin tears. Bivariate analysis and multivariate logistic regression were performed. Log‐rank and Cox regressions were used to compare risk over time to CAUTI and meatal pressure injury in the two groups. Results: Data from 350 patients were analysed, 169 (48.29%) from IG and 181 (51.71%) from CG. In the multiple logistic regression analysis, IUC securement was an independent protective factor against both CAUTI (RR = 0.2, 95% CI [0.05, 0.67]) and meatal pressure injury (RR = 0.31, 95% CI [0.15, 0.58]). The incidence of MARSI was 7.1%. Conclusion: Effective IUC securement significantly reduces the risk of CAUTI and meatal pressure injury among ICU patients. The in‐house device piloted in the present trial is simple for nurses to use, and the incidence of MARSI was low. These results underline the benefits of IUC securement. Relevance to Clinical Practice: Indwelling urinary catheter (IUC) securement reduces the risk of urinary tract infection. IUC securement helps prevent meatal pressure injury. IUC securement with in‐house devices is safe and effective. [ABSTRACT FROM AUTHOR]

Lyme borreliosis (LB), the most common tick‐borne disease in Europe, is endemic to southern coastal Norway. LB commonly presents as erythema migrans, which can disseminate, resulting in more severe disease such as Lyme neuroborreliosis or arthritis. In Norway, public health LB surveillance is conducted via mandatory reporting of laboratory‐confirmed disseminated cases. From 2012 to 2022, Norway's surveillance‐reported incidence of laboratory‐confirmed disseminated LB increased by 78%. Although surveillance provides estimates of the incidence of disseminated LB, this study sought to estimate the incidence of symptomatic LB to better understand Norway's LB disease burden. Two studies were identified that, when combined, estimated an LB seroprevalence of 6.8% in the general adult population in southern Norway. Utilizing data from these seroprevalence studies, public health surveillance, and results from literature searches indicating that 37% of seroconverted LB cases are symptomatic and that the duration of LB antibody detection ranges from 10 to 20 years, we estimated that there were 315–630 symptomatic LB cases per 100,000 adult population in five southern coastal counties in Norway in 2022 and 24–48 cases of symptomatic LB for every public health surveillance‐reported LB case in adults in these five counties in Norway. [ABSTRACT FROM AUTHOR]

Guidance on maximal limits for ultraviolet (UV) exposure has been developed by national and international organizations to protect against adverse effects on human skin and eyes. These guidelines consider the risk of both acute effects (i.e., erythema and photokeratitis) and delayed effects (e.g., skin and ocular cancers) when determining exposure limits, and specify the dose a person can safely receive during an 8‐h period without harmful effects. The determination of these exposure limits relies on the action spectra of photobiological responses triggered by UV radiation that quantify the effectiveness of each wavelength at eliciting each of these effects. With growing interest in using far‐UVC (200–235 nm) radiation to control the spread of airborne pathogens, recent arguments have emerged about revisiting exposure limits for UV wavelengths. However, the standard erythema action spectrum, which provides some of the quantitative basis for these limits, has not been extended below 240 nm. This study assists to expand the erythema action spectrum to far‐UVC wavelengths using a hairless albino mice model. We estimate that inducing acute effects on mouse skin with 222 nm radiation requires a dose of 1162 mJ/cm2, well above the current ACGIH skin exposure limit of 480 mJ/cm2. [ABSTRACT FROM AUTHOR]

Mask-wearing behavior, common in the post-COVID-19 era, raises concerns for sensitive skin. This split-face study investigated mask-related changes in skin barrier function and microbiome composition among 30 female volunteers with sensitive skin and assessed the mitigating effects of a moisturizer containing biological lipids and probiotics. Skin physiological indicators (transepidermal water loss, erythema index, stratum corneum hydration, pH, temperature) of masked and unmasked areas were collected at baseline, after three hours of mask-wearing, post-tape stripping, and after 24 h, respectively. Microbiome samples collected from the masked areas before and after wearing a medical mask were analyzed with bioinformatics methods. Mask-wearing significantly weakened barrier function in both masked and adjacent unmasked areas, while reducing bacterial diversity. It was also associated with an increase in Cutibacterium (P = 0.110) and decreases in Streptococcus (P = 0.032) and Prevotella (P = 0.026) abundance. Moisturizer application prior to mask-wearing significantly reduced transepidermal water loss and erythema (both P < 0.001) and further improved erythema after 24 h (P = 0.048). These findings demonstrate that mask-wearing can disrupt the skin barrier and microbiome in individuals with sensitive skin and applying a moisturizer beforehand can mitigate mask-related discomforts by aiding barrier repair and reducing sensitivity. [ABSTRACT FROM AUTHOR]

Spectroradiometry, radiometry, and dosimetry are employed for the measurement of ultraviolet radiation (UVR) irradiance and non‐ionizing exposure. Different types of UVR dosimeter have been developed for measuring personal and environmental UVR exposures since film dosimetry was pioneered in the 1970s. An important type of dosimeter is the thin film variant, which contains materials that undergo changes in optical absorbance when exposed to UVR. These changes can be measured at a specific wavelength using a spectrophotometer. Thin film dosimeters allow UVR exposure measurements on humans at various body sites during daily activities, as well as on plants, animals, and any sites of interest when utilized in a field environment. This review examines the properties and applications of five types of thin film UVR dosimeter that have different dynamic exposure limits and spectral responses. Polysulphone, with a spectral response approximating the human erythema action spectrum, was one of the first materials employed in thin film form for the measurement of UVR exposures up to 1 day, and up to 6 days with an extended dynamic range filter. Polyphenylene oxide has been characterized and employed for personal UVR exposure measurements up to approximately four summer days and has also been used for long‐term underwater UVR exposures. Phenothiazine and 8‐methoxypsoralen have been reported as suitable for the measurement of longer wavelength UVA exposures. Finally, polyvinyl chloride with an extended dynamic exposure range of over 3 weeks has been shown to have predominantly a spectral response in the UVB and extending up to 340 nm. [ABSTRACT FROM AUTHOR]

The article focuses on a 5-month-old infant with a rapidly expanding rash and fever, initially misdiagnosed as cellulitis, but later identified as a potential spider bite. Topics include her clinical presentation and progression of symptoms, the initial treatment with antibiotics, and the findings of the blackish skin lesion with expanding erythema and subsequent evaluation in the emergency department.

Objective: Erythema, characterized by the redness of the skin, is a common skin reaction triggered by various endogenous and exogenous factors. This response is often a result of the activation of underlying inflammatory mechanisms within the skin. The objective of this study is to investigate the potential benefits of applying a combination of skincare ingredients, namely allantoin, bisabolol, D‐panthenol and dipotassium glycyrrhizinate (AB5D), in the modulation of inflammatory factors associated with erythema. Additionally, the study aims to elucidate the mechanisms by which these ingredients exert their combined actions to alleviate erythema‐associated inflammation. Methods: Human epidermal keratinocytes were exposed to UVB and subsequently treated with AB5D. Transcriptomics profiling was performed to analyse the dose–response effect of AB5D treatment on keratinocytes. The quantitation of inflammatory mediators, including PGE2, IL‐1α, IL‐6, IL‐8, IL‐1RA and TNFα, was performed on cultured media. Additionally, the oxygen radical absorbance capacity (ORAC) assay was carried out to evaluate the total antioxidant capacity of both individual ingredients and the AB5D combination. To assess the in‐vitro antioxidant effects of AB5D against UVB‐induced oxidative stress in hTERT keratinocytes, real‐time quantitation of mitochondrial superoxide was measured through live‐cell imaging. Results: The application of AB5D to UVB‐exposed keratinocytes downregulated gene sets associated with inflammatory responses, highlighting the anti‐inflammatory properties of AB5D. Specifically, AB5D effectively reduced the production of PGE2, leading to the downregulation of inflammatory cytokines. Moreover, our findings indicate that AB5D exhibits antioxidative capabilities, functioning as both an antioxidant agent and a regulator of antioxidant enzyme expression to counteract the detrimental effects of cellular oxidative stress. Conclusion: We demonstrated that AB5D can reduce UVB‐induced PGE2, IL‐1α, IL‐6, IL‐8, IL‐1RA and TNFα as well as mitochondrial superoxide. These findings suggest that AB5D may alleviate erythema by modulating inflammation via PGE2 and through antioxidation mechanisms. [ABSTRACT FROM AUTHOR]

Objective: Delayed or stalled healing in open wounds can result from persisting chronic inflammation related to infection and/or persistent bacterial colonisation and biofilm. Treatment of hard-to-heal wounds focuses on debridement and exudate management, but also on infection prevention and control. Silver dressings have been evaluated in randomised clinical trials (RCTs); this meta-analysis evaluated the efficacy and safety of a silver ion-releasing foam dressing (Biatain Ag; Coloplast A/S, Denmark) to treat hard-to-heal wounds. Method: Literature databases (PubMed and Cochrane Library) were searched for studies on silver ion-releasing foam dressings in the treatment of hard-to-heal wounds. Individual patient data from four RCTs were obtained and included in the meta-analysis. Results: Findings showed that treatment with the silver ion-releasing foam dressing was associated with a significantly higher relative reduction in wound area after four (least squares-mean difference (LS-MD): -12.55%, 95% confidence interval (CI): (-15.95, -9.16); p<0.01) and six weeks of treatment (LS-MD: -11.94%, 95%CI: (-17.21, -6.68); p<0.01) compared with controls. Significant benefits were also observed for time to disappearance of odour (hazard ratio: 1.61, 95%CI: (1.31, 1.98); p<0.01), relative reduction of exudate (LS-MD: -5.15, 95%CI: (-7.36, -2.94); p<0.01), proportion of patients with periwound erythema (relative risk (RR): 0.81, 95%CI: (0.69; 0.94); p<0.01), and less pain at dressing removal (LS-MD: -0.35, 95%CI: (-0.63, -0.06); p=0.02). No differences regarding safety outcomes were identified. Conclusion: This meta-analysis has demonstrated beneficial outcomes and a good tolerability profile for silver ion-releasing foam dressings in the treatment of moderate-to-highly exuding wounds with delayed healing compared with control dressings. [ABSTRACT FROM AUTHOR]

Background: Given the limited treatment options available for oral lichen planus (OLP), a study was undertaken to obtain preliminary information on the therapeutic efficacy of tinidazole mouth rinse in patients with OLP. Methods: A prospective, open-label pilot study was conducted to assess the efficacy of thrice-daily tinidazole mouth rinse for one week in OLP patients (n = 27). Reticulation/erythema/ulceration (REU) scores and visual analog scale (VAS) scores were used to measure lesions at baseline and after one week of treatment. Mucosal samples were collected, and the abundance of Fusobacterium nucleatum was quantified using RT-PCR. Statistical analysis using t-test, Wilcoxon signed rank test and Pearson correlation test. Results: After treatment, VAS scores significantly decreased in both reticular (P = 0.03) and erosive OLP patients (P = 0.003). However, REU scores significantly decreased only in erosive OLP patients (P = 0.002). The relative abundance of Fusobacterium nucleatum on the damaged mucosa surface significantly decreased in all OLP patients (P = 0.01). In erosive OLP patients, the triamcinolone group showed a significantly greater improvement in VAS scores compared to the tinidazole group (P = 0.01). However, there was no statistically significant correlation between the relative abundance of Fusobacterium nucleatum and REU scores in OLP patients (r = 0.0754, P = 0.61). Conclusion: Tinidazole mouth rinse showed potential in reducing disease severity in OLP patients and was well-tolerated, suggesting its viability as a local therapeutic option. However, randomized controlled studies are warranted to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions The SkinMedica Acne Treatment Platform (SM Regimen) was formulated to treat acne without overdrying the skin. We evaluated efficacy and tolerability of the SM Regimen (including a novel 1% salicylic acid Acne Clarifying Cleanser and 2% salicylic acid Acne Treatment Lotion) versus a prescription formulation (Rx Regimen; including adapalene 0.1%/benzoyl peroxide 2.5%) in a diverse population of adults with mild to moderate facial acne.This single‐center, double‐blind, randomized study enrolled adults (18–45 years) with Fitzpatrick skin types (FST) I–VI. SM Regimen or Rx Regimen was applied topically to the entire face for 12 weeks. Assessments were conducted at 24 and 48 h and 4, 8, and 12 weeks.Subjects (SM Regimen, n = 31; Rx Regimen, n = 23) were primarily female (90.7%) with mean age of 28.6 years; 53.8% had FST IV–VI. Efficacy was comparable between regimens. The SM regimen resulted in significant improvements versus baseline in mean Investigator's Global Assessment of acne severity from 48 h through week 12 (p ≤ 0.001), as well as significant and sustained improvements from baseline in total acne lesion count, global postinflammatory hyperpigmentation/postinflammatory erythema, and oiliness. The SM Regimen was well tolerated at all time points, with mean scores below mild for all parameters; the Rx Regimen caused significantly more tightness/dry feeling at week 4 versus SM Regimen (p = 0.008). Subjects (> 96%) reported high satisfaction with the SM Regimen at all time points.The SM Regimen reduced acne severity and skin oiliness, evening out skin tone without overdrying or irritating the skin. [ABSTRACT FROM AUTHOR]

This article explores the possible role of cis-8-octadecenoic acid, a component of sebum, in facial skin redness. The study found that the proportion of cis-8-octadecenoic acid in sebum positively correlated with cheek redness in healthy individuals. Additionally, the research showed that cis-8-octadecenoic acid induced interleukin-36γ expression, which is associated with skin redness, in cultured human normal keratinocytes. The findings suggest that cis-8-octadecenoic acid may play a role in facial skin redness, although further research is needed to fully understand its effects. [Extracted from the article]

ABSTRACT Objective Methods Results Conclusion The primary aim of this systematic review and meta‐analysis was to synthesize and compare the clinical efficacy of intense pulsed light (IPL) and pulsed‐dye laser (PDL) therapies for the management of rosacea.The literatures were searched in the Web of Science, PubMed, Embase, and Cochrane Library databases to identify relevant studies investigating the use of IPL and PDL for the treatment of rosacea. Screening of the retrieved articles and data extraction were performed as per the pre‐established inclusion and exclusion criteria. The primary outcome measures evaluated in this meta‐analysis included clearance rates, erythema scores, and pain scores.The meta‐analysis incorporated data from four studies involving a total of 141 participants. The meta‐analysis did not reveal a statistically significant difference between IPL and PDL in the rate of achieving greater than 50% clearance (RR = −0.07, 95% CI: −0.19, 0.05). However, the IPL group demonstrated a significantly higher rate of clearance exceeding 75% compared to the PDL group (RR = −0.13, 95% CI: −0.23, −0.04). The change in erythema index, a key measure of rosacea severity, was similar between the two treatment modalities (SMD = −0.15, 95% CI: −0.55, 0.26). Interestingly, the PDL group reported a notably lower VAS pain score than the IPL group (SMD = 1.54, 95% CI: 0.08, 3.00).Either PDL or IPL appears to be effective modalities for the management of rosacea. IPL exhibits a slight advantage in achieving a higher rate of substantial (>75%) clearance, while PDL may be preferable for patients with lower tolerance for post‐treatment discomfort. However, the existing literature directly comparing these two laser/light‐based therapies is limited, warranting further well‐designed, large‐scale studies to establish the optimal treatment algorithm for this chronic inflammatory skin condition. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions Rosacea is a chronic, relapsing inflammatory dermatosis predominantly affecting the central face and can result in significant psychosocial impacts. Isotretinoin has been studied for rosacea due to its anti‐inflammatory and sebum reduction properties, but its use remains limited likely due to its off‐label use and potential adverse events.This systematic review and meta‐analysis investigated the efficacy and safety of low‐dose isotretinoin (LDI; ≤0.5 mg/kg/day) for the four main types of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular rosacea.Randomized and non‐randomized studies evaluating LDI for rosacea were included. Incomplete studies, non‐English studies and case reports were excluded. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation scale.Of 435 studies, and 16 studies involving 1445 patients were included. LDI decreased lesion count (p = 0.03) and erythema (p = 0.01) with large effect [standardized mean difference (SMD) > 0.8]. Compared to topical retinoids and topical antimicrobials, isotretinoin had larger reductions in lesion count (p = 0.03) with moderate effect (SMD > 0.5). Mean lesion count and erythema remained reduced by 70% and 47%, respectively, at 16 weeks after LDI cessation. Relapse rate was 35% at 5.5 months post‐isotretinoin, and three patients (0.4%) experienced worsening of rosacea. Three patients (0.4%) experienced serious adverse events.Study design heterogeneity limited more comprehensive comparisons. Overall, low‐dose isotretinoin may serve as an effective treatment for rosacea with good tolerability and safety. [ABSTRACT FROM AUTHOR]

Wound temperature is one of the wound biomarkers representing the wound healing progress. The diabetic wound is associated with a prolonged inflammation phase marked by an increasing wound temperature and erythematous wound. Purple sweet potato extract (PSP), an anthocyanin-rich plant, improved wound healing in both diabetic and non-diabetic wounds in animal studies. This study aims to know the effect of purple sweet potato ethanol extract on wound temperature and erythema in streptozotocin-induced diabetic rats. Rats were divided into four groups: normal rats + gel placebo; diabetic rats + gel placebo; diabetic rats + PSP 10%; and diabetic rats + PSP 15%. Diabetes mellitus was induced by streptozotocin injection. After diabetic confirmation, the back of the rats was excised and the gel was administered daily for 14 days. The wound temperature was measured at the wound surface using infrared thermography on days 0, 3, 7, and 14. The wounds were photographed and erythema analysis was conducted using Corel Photo paint®. Diabetic wounds exhibited higher surface temperature compared with the normal wound (37.08°C ± 0.29 vs 35.13°C ± 0.46) on day 14 of examination and topical application the purple sweet potato ethanol extract gel 10% and 15% markedly decreased the wound temperature at day 7 and 14 compared with the diabetes wound (p<0.0001). Wound erythema was significantly reduced in the PSP 10% and 15% diabetic wound treatment groups on day 14 (p<0.05). Purple sweet potato extract gel treatment was found to have the potential to reduce inflammation in diabetic wounds. [ABSTRACT FROM AUTHOR]

Epidermal nevi are common benign cutaneous hamartomas that may rarely demonstrate histopathologic evidence of epidermolytic hyperkeratosis (EHK), representing cutaneous mosaicism for pathogenic keratin variants. Rarely, individuals with linear epidermal nevi transmit to their children the inherited form of EHK, also known as epidermolytic ichthyosis, characterized by generalized erythema, blistering, and scaling at birth evolving to widespread hyperkeratosis. We present an updated review of reported cases of linear epidermal nevi with EHK exhibiting transmission of epidermolytic ichthyosis to guide important considerations in the care of individuals with epidermal nevi. Clinical characteristics of linear epidermal nevi do not reliably predict the presence of EHK. All reported cases of transmission to offspring have occurred in individuals with linear epidermal nevi involving more than one anatomic area suggesting increased reproductive risk with involvement of two or more anatomic sites. Therefore, genetics consultation is recommended for these individuals with biopsy‐confirmed EHK. For individuals with smaller areas of epidermal nevus involvement, the implications are less well known, though genetics consultation may still be considered for those interested in further discussion of general reproductive risk. [ABSTRACT FROM AUTHOR]

Post-acne erythema (PAE) is a bothering skin condition that emerges from inflammatory acne and persists after its resolution. It is characterized by telangiectasia and erythematous macules. the role of 1064-nm Nd: YAG when combined with low-dose isotretinoin in the acne erythema treatment. forty-eight PAE patients were involved in the study. They were divided into two groups; group (A) patients administering a low dose of oral isotretinoin (10 mg/day) and underwent a total of six two-week interval sessions of 1064 ND-YAG laser treatment, group (B) patients administering a low dose of oral isotretinoin (10 mg/day) only. All adverse effects experienced during the course of therapy were documented, and photos were taken before the start of the treatment and following the end of the treatment duration. Following the completion of the therapeutic intervention, a significant improvement in clinical condition was observed in both groups, with more improvement in group (A) compared to group (B) as evidenced by a notable improvement in the score on the Clinician Erythema Assessment Scale (CEAS) and also a significant decrease in the mean value of optical density of the erythema. combined 1064-nm Nd: YAG with low-dose isotretinoin may be an efficient and secure line in the PAE treatment. Also, the combined therapy had superior results when compared to low-dose isotretinoin alone. [ABSTRACT FROM AUTHOR]

Red palms syndrome consists of an intense redness on the palms of the hands and, occasionally, the soles of the feet. This infrequent condition may be primary or secondary. The primary forms are either familial or sporadic. They are always benign and do not require treatment. The secondary forms may have a poor prognosis related to the underlying disease, for which early identification and treatment are imperative. Red fingers syndrome is also rare. It manifests as a persistent redness on the fingers or toes pulp. It is typically secondary either to infectious diseases like human immunodeficiency virus, hepatitis C virus and chronic hepatitis B or to Myeloproliferative Disorders, such as Thrombocythemia and Polycythemia vera. Manifestations spontaneously regress over months or years without trophic alterations. Treatment is limited to that of the underlying condition. Aspirin has been shown effective in Myeloproliferative Disorders. [ABSTRACT FROM AUTHOR]

Tranexamic acid (TXA), a synthetic lysine analog, is a commonly used antifibrinolytic and procoagulant agent. Based on its good hemostatic efficacy, it is mainly used clinically for bleeding in trauma, various types of surgical and dental procedures and prevention of bleeding in patients with hemophilia. In recent years, studies have shown that TXA has the effects of anti-melanogenesis, anti-inflammation, anti-angiogenesis and promotes the recovery of the skin barrier, so it has been tried to be used as a treatment for hyperpigmentation and telangiectatic diseases. Oral, topical, intradermal injections and microneedling are all commonly used modes of administration. TXA for melasma is the most studied and has achieved indications in some countries, whereas it is still an off-label drug for many other dyschromia. We review the clinical use of TXA in hyperpigmentation and telangiectatic disorders other than melasma, such as post-inflammatory hyperpigmentation, Riehl's melanosis, rosacea, and post-acne erythema, to provide more evidence for the use of TXA in these disorders, and to provide safer and more cost-effective alternatives for the treatment of these diseases. [ABSTRACT FROM AUTHOR]

Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans, is a rare dermatological condition characterized by single or multiple annular or semi-annular centrifugally growing lesions surrounded by tiny erythematous papules typically observed on the trunk. EPC is prevalent, particularly in Japan and China, although only a few cases have been reported outside Asia. Herein, we present the case of a 47-year-old female from Thailand who experienced a pruritic annular erythematous rash on her right arm for two months. The diagnosis of EPC was established based on clinical manifestations and confirmed by histopathological examination. The lesions resolved after one month of treatment with 0.1% betamethasone valerate cream and avoiding warm weather. This case report contributes to the understanding of EPC, which may be underrecognized in clinical practice due to its self-limiting nature and frequent misdiagnosis. Furthermore, this article provides a comprehensive review of 17 previously reported cases of EPC, focusing on their detailed descriptions. [ABSTRACT FROM AUTHOR]

Cardiac myxomas are the most common primary benign tumors of the heart. The occlusion of peripheral arteries and complete obstruction of the abdominal aorta by a tumor embolus presents with distinct clinical manifestations. Herein, we present the case of a 38-year-old male with acute paresthesia, muscle weakness, erythematous, and violaceous changes in skin color localized to the dorsum of the left forefoot initially treated as cutaneous vasculitis. Further studies revealed the total occlusion of the terminal abdominal aorta by a saddle embolus from a cardiac myxoma. A multidisciplinary team consisting of cardiothoracic and vascular surgeons were involved in treating the patient, which resulted in full resolution of the case. This paper details the progression of acute bilateral limb ischemia to chronic limb threatening ischemia resulting from the total occlusion of the terminal abdominal aorta by a saddle embolus. [ABSTRACT FROM AUTHOR]

Objective To explore the oral mucosal manifestations of Sweet’s syndrome and provide a reference for its early detection and correct diagnosis. Methods The oral mucosal manifestations of a 60-year-old female patient with Sweet’s syndrome are described in detail, followed by a discussion of the related literature. Results The patient had skin erythema of both lower extremities, which was accompanied by oral mucosal ulceration and pain for 3 days. The patient presented with mild cutaneous lesions and diffuse large-scale erosion in the oral mucosa with obvious pain. During the onset of the disease, the patient was accompanied by fever with a temperature of 38.5°C. After visiting the Department of Stomatology, laboratory tests showed an increase in C-reactive protein (35.2 mg/L) and an accelerated erythrocyte sedimentation rate (77.00 mm/h). Scattered red plaques and mild tenderness were observed in the knees and lower limbs. Histopathological examination of the skin lesions revealed scattered infiltration of immature neutrophils across the entire dermis. The patient responded well to glucocorticoid therapy. According to the clinical signs and laboratory examination, combined with the lesion histopathological results, a diagnosis of Sweet’s syndrome was given. The patient was administered 1 mL compound Betamethasone injection only once intramuscularly. In the meantime, the patient was asked to gargle with compound chlorhexidine solution and topically apply recombinant bovine basic fibroblast growth factor solution to the damaged mucosa three times a day for 1 week. After 4 days of medication, the patient’s body temperature had returned to normal and the oral lesions were significantly reduced. After 2 weeks, the erythema in the leg and knee had almost all subsided, and the oral mucosal lesions had disappeared. The patient was followed up 6 months after treatment, with no recurrence of skin lesions. After 2 years of follow-up, the disease was stable with no recurrence. A review of the relevant literature shows that Sweet’s syndrome is a rare inflammatory reactive dermatosis with unknown etiology, which can be divided into three clinical types: specific, tumor-related, and drug-induced. The male/female prevalence ratio is 1:4. The salient clinical manifestations are abrupt onset of painful erythematous plaques or nodules most commonly involving the extremities, often accompanied by pyrexia, elevated neutrophil count, elevation of the erythrocyte sedimentation rate, and positive C-reactive protein. The use of glucocorticoids is the most common treatment for this disease, and most patients see a rapid improvement in skin lesions; however, some may experience infection or recurrence after withdrawal. Some patients with Sweet’s syndrome are accompanied by oral lesions, but cases of oral mucosal damage have been rarely reported, and this condition is easily misdiagnosed. Conclusion Oral mucosal lesions may be extraterritorial manifestations of Sweet’s syndrome, and the patient’s systemic condition should be comprehensively considered. Skin biopsy should be completed as soon as possible to make a clear diagnosis, so as not to delay the disease.

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The study aimed to directly assess the ocular safety of 222‐nm far‐ultraviolet‐C (UVC) irradiation in humans, given the limited clinical trials in this area. This wavelength offers the potential for safe and effective microbial inactivation in occupied spaces, but its safety profile for human eyes requires thorough investigation. This prospective, interventional study involved five subjects aged 29–47 years, who were exposed to 222‐nm UVC at doses of 22, 50, and 75 mJ/cm2. The subjects were monitored using custom‐made glasses with a UV‐cut filter on one eye to serve as a control. UVC irradiation was conducted using a KrCl excimer lamp, and ocular examinations were performed prior to exposure, 24 h post‐exposure, and at 1, 3, and 6 months. Parameters assessed included visual acuity, refractive error, corneal endothelial density, corneal erosion scores, and conjunctival hyperemia scores. The study found no clinically significant photokeratitis or long‐term eye damage across the five subjects, even at the highest dose of 75 mJ/cm2. Temporary ocular discomfort, including sensations of dryness and epiphora, was reported, but these symptoms subsided within hours after irradiation. The findings indicate that 222‐nm far‐UVC irradiation up to 75 mJ/cm2 does not cause “clinically significant photokeratitis” or long‐term ocular damage, though it may induce temporary discomfort. This supports the safe use of 222‐nm UVC for germicidal applications in occupied environments, providing a basis for revised safety guidelines. [ABSTRACT FROM AUTHOR]

This article discusses psoriasis with a brief overview of the various types. It considers the symptoms, aetiology and treatment options and hopes to give nurses and non-medical prescribers more confidence in recognising and treating this disease. [ABSTRACT FROM AUTHOR]

Acute generalized exanthematous pustulosis (AGEP) is a sudden-onset, severe and rare adverse skin reaction characterized by nonfollicular sterile pustules tending to intertriginous localization. Lesions develop on erythematous and edematous skin. It is often triggered by drugs. This article presents a case diagnosed with AGEP due to etodolac. To the best of our knowledge, this is the second case of AGEP due to etodolac in the literature. A 47-year-old female patient presented with diffuse erythema on the extremities, a purple purpuric rash on the extensor face of both legs, and millimetric pustules on an erythematous base on the inner surface of the left arm. She stated that the reaction developed after taking 3 medications, including etodolac tablets, and gargling the throat with povidone-iodine. The patient was diagnosed with AGEP and her EuroSCAR AGEP Validation Score was calculated as 9 suggesting a definitive diagnosis of AGEP. All of the suspected drugs were discontinued. Methylprednisolone 16 mg/day, a local corticosteroid, and an oral antihistamine were started. Her symptoms resolved and laboratory abnormalities returned to normal within 2 weeks. Patch tests were performed 3 months after the reaction with the suspected drugs. The patch testing showed that only 10% etodolac at 48-, 72- and 96-hour readings were positive (++). The patient was diagnosed with AGEP due to etodolac. AGEP is often secondary reaction to drugs. The most frequent causative drugs are diltiazem, aminopenicillins, pristinamycin, terbinafine, sulphonamides, quinolones, and hydroxychloroquine. AGEP secondary to NSAIDs is very rare. Only one previous case of AGEP due to etodolac was reported in 2011. [ABSTRACT FROM AUTHOR]

Background Kimura's disease (KD) is a rare chronic inflammatory condition characterized by nodules and lymphadenopathy in the head and neck region, exhibiting type II inflammation. Dupilumab is commonly used against type II inflammation. Aim To evaluate the efficacy and safety of dupilumab in KD patients. Design The real-world study was conducted in a hospital in China. Methods Six male patients with a mean age of 24.50 ± 15.47 years were treated with dupilumab following the same protocol as that for atopic dermatitis (AD). Clinical and laboratory indicators, such as maximum nodule diameter, blood eosinophil count, eosinophil percentage, and total serum IgE levels were assessed at baseline, Week 12 and Week 24. Adverse events were documented. Paired t -tests and one-way ANOVA were used for statistical analysis. Results The results showed significant reductions in the longest nodule diameter at Week 12 (P  =   0.006) and Week 24 (P  =   0.017) compared to baseline. Blood eosinophil count decreased by 57.95% (P  =   0.024) at Week 12 and 90.59% (P  =   0.030) at Week 24. Eosinophil percentage decreased by 58.44% (P  =   0.026) at Week 12 and 89.37% (P  =   0.013) at Week 24. Total serum IgE levels decreased by 78.02% (P  =   0.040) at Week 12 and 89.55% (P  =   0.031) at Week 24. The presence of AD did not affect the results. One patient experienced temporary facial erythema after 32 weeks of treatment, which resolved with topical treatment. No other adverse events were reported. Conclusion Dupilumab demonstrated effectiveness in treating KD without severe adverse events. [ABSTRACT FROM AUTHOR]

BACKGROUND: A major industrial fire accident occurred in a tire manufacturing factory in Daejeon, Korea, on 12 March 2023 and lasted for 3 d, generating air pollutant emissions. Although evidence regarding the health effects of urban fires is limited, residents near tire factory may have experienced health hazards due to smoke exposure from fire plumes. OBJECTIVES: Capitalizing on the timing of this fire incident as a natural experiment, we estimated the attributable excess air pollution exposure and associated disease development among residents living near the tire factory. METHODS: We used the generalized synthetic control method to estimate air pollution exposure and health burden attributable to the accident among residents living in smoke-exposed districts. Based on satellite images and air pollution monitoring results, three administrative districts (within 1.2 km from the factory) were defined as smoke-exposed, and the other 79 districts of Daejeon were defined as controls. Among the 11 monitoring stations in Daejeon, the station located 500 m from the factory was used to estimate excess air pollution exposure (PM10, PM2.5, NO2, O3, SO2, and CO) for residents in the exposed districts. The number of daily district-level disease-specific incidence cases were acquired from the National Health Insurance Database and used to estimate excess health burden resulting from the fire. RESULTS: During the first week following the factory fire, residents of exposed districts had an estimated excess exposure to 125.2 [95% confidence interval (CI): 44.9, 156.7] μg/m³ of PM10, 50.4 (95% CI: 12.7, 99.8) ppb of NO2, and 32.0 (95% CI: 21.0, 35.9) ppb of SO2. We also found an average increase in the incidence cases of other diseases of upper respiratory tract [20.6 persons (95% CI: 6.2, 37.4)], lung disease due to external agents [2.5 persons (95% CI: 2.1, 3.3)], urticaria and erythema [5.9 persons (95% CI: -0:6, 11.2)], and episodic and paroxysmal disorders [8.5 persons (95% CI: 3.7, 13.4)] in exposed districts. DISCUSSION: Excessive air pollution exposure and disease incidence were identified among residents living close to the tire factory. Preventive measures, such as a warning system, to avoid health impacts to people breathing fire-related pollution may be beneficial for communities impacted by such events. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to map the adverse reactions in the oral mucosa and face caused by the use of natural products. Methodology: This review was performed according to the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with a protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/R57D8). The search was carried out systematically using PubMed, Scopus, Web of Science, Embase, LILACS, and LIVIVO databases, as well as gray literature through Google Scholar and OpenGrey. Reports of clinical cases on the adverse effects of natural products on the oral mucosa or perioral region of the face resulted from inappropriate use or self-medication were included. Data from the included studies were described in a narrative form. Results: Seven hundred and six studies were identified, and after removing duplicates and applying the eligibility criteria, 28 studies were included. The year of publication ranged from 1976 to 2022. The studies were conducted in 19 countries. Fifty patients were mentioned in the included studies and 34 were female (68%). The natural products most related to adverse reactions were propolis (n = 17), with manifestations such as perioral eczema, edema, erosions, erythema, allergic contact dermatitis, and garlic (n = 9), with manifestations such as chemical burn, burning sensation, vesicles and blisters, crusts, and ulcerations. Conclusion: Propolis and garlic were the natural products with the most reported adverse effects on the oral mucosa and perioral region. [ABSTRACT FROM AUTHOR]