Porokeratoses: an update on pathogenesis and treatment.

Porokeratoses (PK) are a group of uncommon dermatoses characterized by abnormal epidermal differentiation due to a disorder of the mevalonate metabolic pathway. Several clinical subtypes exist that can be associated with the same patient or affect different patients within a family and could, therefore, be different expressions of one disease. All PK subtypes share a common histopathologic finding, the cornoid lamella, a vertical stack of parakeratotic corneocytes embedded in an orthokeratotic horny layer. PK often affects immunosuppressed patients, in whom the course may parallel the level of immunosuppression. The pathogenesis of PK, which had long remained mysterious, has been recently unraveled after discovering pathogenic variants of genes involved in the mevalonate metabolic pathway. The disease is due to germline pathogenic variants of genes of this pathway but requires a second-hit event to manifest; therefore, PK is considered a dominantly inherited but recessively expressed condition. The prognosis of PK is usually favorable, even though the lesions progress to keratinocyte carcinomas in 7%-16% of patients. The treatment of PK was based on physical (ablative) procedures and various (topical or systemic) treatments, whose efficacy is nevertheless inconsistent and often temporary. The discovery of the metabolic pathway involved in the pathogenesis of PK paved the way for the elaboration of new topical treatments (combination of statins and cholesterol), which are more regularly efficacious compared with older treatments, even though the management of some patients with PK may still be challenging.

Presentations of Cutaneous Disease in Various Skin Pigmentations: Porokeratosis.

Description Porokeratosis was first described in 1893. It is a relatively rare disorder with over 9 subtypes. Lesions are clinically characterized as well-demarcated, erythematous papules (raised, <1 cm) or plaques (raised, >1 cm), with an atrophic center, and raised scaly border. Porokeratosis is an important diagnosis to identify because it may undergo malignant transformation and mimics many commonly encountered diagnoses. These commonly mimicked diagnoses include squamous cell carcinoma, tinea corporis, nummular dermatitis, and psoriasis vulgaris, to name a few. The clinical images in this review focus on identifying porokeratosis along the full spectrum of skin tones.

Improving Environmental Stress Cracking Resistance of High-Density Polyethylene Grades by Comonomer Addition and Nanocomposite Approach.

The aim is to determine the effect of polymer density, correlated to the comonomer content, and nanosilica addition on the mechanical and Environmental Stress Cracking Resistance (ESCR) characteristics of high-density polyethylene (HDPE). In this regard, five HDPE samples with similar Melt Flow Index (MFI) and molar mass but various densities were acquired from a petrochemical plant. Two polymerization reactors work in series and differ only in the amount of 1-buene comonomer fed to the second reactor. To ascertain the microstructure of the studied samples, GPC and SSA (successive self-nucleation and annealing) analyses were accomplished. All samples resulted having similar characteristics but slightly various SCB/1000C=7.26-9.74 (SCB=Short Chain Branching). Consequently, meanwhile studied HDPEs reveal similar notched impact and stress at yield values, the tensile modulus, stress-at-break, and elongation-at-break tend to demonstrate different results with the SCB content. More significantly, ESCR characteristic varied considerably with SCB/1000C extent, so that higher amount of SCB acknowledged advanced ESCR. Notably, blending HDPE sample containing higher amount of SCB/1000C, with 3 wt.% of chemically modified nanosilica enhanced ESCR characteristic by 40%. DFT (Density Functional Theory) calculations unveiled the role of the comonomer, quantitatively by binding energies and qualitatively by Non Covalent Interaction (NCI) plots.

Development of Polymer Complexed Lamella That Retains α-gel Structure When Dried.

This paper reports a novel α-gel formulation technology referred to as polymer complexed lamella (PCL) that uses hydroxypropyl methyl cellulose (HPMC) and glycerol. The PCL method suppressed lipid crystallization even after drying. This effect was maximized by the addition of HPMC and glycerol at high temperature. HPMC and lipids coexisted when mixed at high temperature, which decreased the mobility of HPMC, an effect that was enhanced by the strong interaction of glycerol with HPMC. These results indicate that mixing of HPMC with glycerol directly regulates the lipid structure and suppresses crystallization. PCL also maintained the effect of occlusion related to the moisturization of skin, even if the membrane was repeatedly bent such as in facial expressions.

Preparation and Application of Decanoic Acid/Arginine Hydrogels to a Transdermal Formulation.

We prepared a supramolecular hydrogel composed of decanoic acid and arginine (C10/Arg gel) and evaluated its application to a transdermal formulation. C10/Arg gel adjusted to pH 7 with 1 M NaOH aq or 1 M HCl aq provided a translucent hydrogel with a lamellar liquid crystal structure in the concentration region of decanoic acid ≥12% and arginine ≤9%. Rheological measurements showed that C10/Arg gel is a viscoelastic material with both solid and liquid properties, with elasticity being dominant over viscosity in the low shear stress region. The skin permeability of hydrocortisone (HC) and indomethacin (IM) from C10/Arg gels was investigated in vitro using hairless mouse skin and compared to control formulation drug suspensions (IM or HC) in water. The cumulative permeation amount of HC and IM from the C10/Arg gel at 10 h after application was approximately 16 and 11 times higher than that of the control, respectively. On the other hand, the flux of IM decreased with increasing arginine concentration, likely due to the acid-base interaction between Arg and IM in C10/Arg gel. Adequate drug skin permeation enhancement by C10/Arg gel requires optimizing the gel composition for each specific drug.

Challenges in the Diagnosis and Management of Giant Porokeratosis: A Case Report.

Porokeratosis encompasses a diverse group of dermatoses, both acquired and genetic, marked by a keratinization disorder. Porokeratosis of Mibelli (PKM) presents as solitary plaques or multiple papules/macules with central atrophy and raised hyperkeratotic borders. Here, we present a case of giant porokeratosis (GPK), a rare form often considered a morphological variant of PKM, with unique clinical and histopathological aspects. Our case involves a 29-year-old patient with a 15 × 10 cm irregular plaque on the dorsal aspect of the right hand. The patient was previously prescribed various topical treatments (retinoids, calcineurin inhibitors, and combinations of corticosteroids with vitamin D3 analogs) and systemic retinoids without improvement before presenting to our department. Due to the high risk of neoplastic transformation and the unavailability of imiquimod, the patient was recommended topical 5-fluorouracil treatment. The trajectory of the lesion under treatment revealed a favorable evolution, and the patient was subjected to regular monitoring every three months to assess the ongoing progress. Recognizing GPK as a high-risk variant is crucial for dermatologists, and it requires a personalized approach. Regular monitoring is advised to detect potential malignant transformations promptly. Future research holds promise for diagnostic advancements, refined treatment modalities, and a deeper understanding of the molecular mechanisms underlying malignancy in porokeratosis.

Bioengineering autologous cartilage grafts for functional posterior lamellar eyelid reconstruction: A preliminary study in rabbits.

The reconstruction of posterior lamellar eyelid defects remains a significant challenge in clinical practice due to anatomical complexity, specialized function, and aesthetic concerns. The ideal substitute for the posterior lamellar should replicate the native tarsoconjunctival tissue, providing both mechanical support for the eyelids and a smooth surface for the globe after implantation. In this study, we present an innovative approach utilizing tissue-engineered cartilage (TEC) grafts generated from rabbit auricular chondrocytes and a commercialized type I collagen sponge to reconstruct critical-sized posterior lamellar defects in rabbits. The TEC grafts demonstrated remarkable mechanical strength and maintained a stable cartilaginous phenotype both in vitro and at 6 months post-implantation in immunodeficient mice. When employed as autografts to reconstruct tarsal plate defects in rabbits' upper eyelids, these TEC grafts successfully restored normal eyelid morphology, facilitated smooth eyelid movement, and preserved the histological structure of the conjunctival epithelium. When applied in bilayered tarsoconjunctival defect reconstruction, these TEC grafts not only maintained the normal contour of the upper eyelid but also supported conjunctival epithelial cell migration and growth from the defect margin towards the centre. These findings highlight that auricular chondrocyte-based TEC grafts hold great promise as potential candidates for clinical posterior lamellar reconstruction. STATEMENT OF SIGNIFICANCE: The complex structure and function of the posterior lamellar eyelid continue to be significant challenges for clinical reconstructive surgeries. In this study, we utilized autologous auricular chondrocyte-based TEC grafts for posterior lamellar eyelid reconstruction in a preclinical rabbit model. The TEC grafts exhibited native cartilaginous histomorphology and comparable mechanical strength to those of the native human tarsal plate. In rabbit models with either tarsal plate defects alone or bilayered tarsoconjunctival defects, TEC grafts successfully restored the normal eyelid contour and movement, as well as supported preservation and growth of conjunctival epithelium. This is the first study to demonstrate autologous TEC grafts can be employed for repairing tarsal plate defects, thereby offering an alternative therapeutic approach for treating posterior lamellar defects in clinic settings.

Space invaders: Reassessing the histology of hyperostosis frontalis interna.

Hyperostosis frontalis interna (HFI) is a human skeletal lesion characterized by nodules of hyperplastic bone and thickening of the frontal bone's inner surface. Despite its prevalence in the general population and its long history of observation-it is one of the most frequently observed pathologies in gross anatomy laboratories-HFI's etiology and pathogenesis remain poorly understood. This is largely due to the lack of a thorough survey of its histology across the various stages of its development. Our study has three major aims: (1) assess HFI histology from incipient to advanced lesions; (2) elucidate lamellar and trabecular structure in HFI; and (3) clarify impacts/roles of the dura mater in HFI. Sections of nondecalcified bone provide evidence for two different categories of lesions: (1) stratum lesions, characterized by lamellar-based overall thickening of the internal table, and (2) eruptive lesions, characterized by nodular formations of initially lamellar bone that appear to form the bulk of bone mass in advanced stages. Sections of nondecalcified bone also suggest that for both lesion types, HFI growths begin as deposits of lamellar bone, which are later remodeled into woven bone deposits; our data do not support the hypothesis that lesions begin as a "diploization" of cortical bone as suggested by prior studies. Trichrome-stained sections provide evidence that growing lesions erode through and engulf the dura mater, effectively destroying this tissue layer as they grow laterally and inwardly. Our results indicate possible avenues of research to better understand the root causes of this disorder.

Image analyses of artificially damaged carbon/glass/ epoxy composites before and after impact load.

In recent years, there has been a widespread utilization of composite materials, particularly in critical sectors such as aircraft manufacturing, where errors can have significant consequences. This has generated a need for effective protection of composite materials both during and after production. Detecting internal damage in composite materials, which is often visually imperceptible, becomes crucial and can be assessed using non-destructive testing methods. In this study, glass and carbon woven fabric-reinforced epoxy composites intentionally embedded with artificial damages during manufacturing were subjected to impact tests. The composite materials were scanned using the ultrasonic method to detect damages before and after the impacts. Particularly in glass fiber-reinforced composites (GFRP), the damaged area in the artificially damaged glass lamella sample (G/AL) was calculated to be 4-5 times higher than in the undamaged sample (G/UD). Damaged area values in GFRP were calculated as 72.88 mm2 in the G/UD sample, 143.74 mm2 in the G/AC sample, and 315.93 mm2 in the G/AL sample. While the samples with artificial damage in carbon fiber-reinforced composites (C/AL, C/AC) were perforated during the impact tests, the undamaged samples (C/UD) were not. The images obtained were evaluated using image processing algorithms and were employed in damage analysis. In conclusion, the applied method and the developed image processing algorithm yielded successful results in analyzing barely visible damages and detecting damaged areas.

Novel Method for the Preparation of Lamellas From Porous and Brittle Materials for In Situ TEM Heating/Biasing.

A novel method for the preparation of lamellas made from porous and brittle compressed green powder using a focused ion beam (FIB) is described. One of the main purposes for the development of this methodology is to use this type of samples in micro-electromechanical systems (MEMS) chips for in situ transmission electron microscopy heating/biasing experiments, concomitant with maintaining the mechanical integrity and the absence of contamination of samples. This is accomplished through a modification of the standard FIB procedure for the preparation of lamellas, the adaptation of conventional chips, as well as the specific transfer of the lamella onto the chips. This method is versatile enough to be implemented in most commercially available FIB systems and MEMS chips.

Robust Preparation of Sub-20-nm-Thin Lamellae for Aberration-Corrected Electron Microscopy.

Aberration-corrected scanning transmission electron microscopy (STEM) has been advancing resolution, sensitivity, and microanalysis due to the intense demands of atomic-level microstructural investigations. Recent STEM technologies require preparing a thin lamella whose thickness is ideally below 20 nm. Although focused-ion-beam/scanning-electron-microscopy (FIB/SEM) is an established method to prepare a high-quality lamella, nanometer-level controllability of lamella thickness remains a fundamental problem. Here, the robust preparation of a sub-20-nm-thin lamella is demonstrated by FIB/SEM with real-time feedback from thickness quantification. The lamella thickness is quantified by back-scattered-electron SEM imaging in a thickness range between 0 and 100 nm without any reference to numerical simulation. Using real-time feedback from the thickness quantification, the FIB/SEM terminates thinning a lamella at a targeted thickness. The real-time feedback system eventually provides 1-nm-level controllability of the lamella thickness. As a proof-of-concept, a near-10-nm-thin lamella is prepared from a SrTiO3 crystal by our methodology. Moreover, the lamella thickness is controllable at a target heterointerface. Thus, a sub-20-nm-thin lamella is prepared from a LaAlO3 /SrTiO3 heterointerface. The methodology offers a robust and operator-independent platform to prepare a sub-20-nm-thin lamella from various materials. This platform will broadly impact aberration-corrected STEM studies in materials science and the semiconductor industry.

Exclusive and Solitary Facial Porokeratosis: Pathogenesis and Literature Reappraisal of a Rare Entity.

Porokeratosis is a group of well-known clinically distinct entities, characterised by different clinical aspects, but sharing a single common histological aspect, namely the cornoid lamella. Usually, porokeratosis occurs in the limbs and trunk, while it rarely involves the face, especially as an exclusive, single, and solitary lesion. We report the case of a 52-year-old Caucasian woman, with an 11-month history of a 2-cm slowly growing solitary, keratotic lesion on her left cheekbone. The patient did not present other cutaneous lesions on the face, as well as in other body sites. A cutaneous biopsy showed epidermal hyperplasia with multiple, sharply defined cornoid lamella, associated with an underlying attenuation of the granular layer and scattered dyskeratotic cells in the spinous layer. The superficial dermis underneath showed a mild lymphocytic infiltrate and fibrosis with remodelled collagen bundles. A final diagnosis of solitary facial porokeratosis was made.

New Insight into Nanoscale Identification of the Polar Axis Direction in Organic Ferroelectric Films.

Ferroelectric poly(vinylidene fluoride-co-trifluoroethylene) [P(VDF-co-TrFE)] thin films have been deposited by spin-coating onto the Bi0.5Na0.5TiO3(BNT)/LNO/SiO2/Si heterostructure. The copolymer microstructure investigated by using grazing-incidence wide-angle X-ray diffraction (GIWAXD) and deduced from the (200)/(110) reflections demonstrates that the b-axis in the P(VDF-co-TrFE) orthorhombic unit cell is either in the plane or out of the plane, depending on the face-on or on the two types of edge-on (called I and II) lamellar structures locally identified by atomic force microscopy (AFM). For edge-on I lamellae regions, the electroactivity (dzzeff ∼ -50.3 pm/V) is found to be twice as high as that measured for both edge-on II or face-on crystalline domains, as probed by piezoresponse force microscopy (PFM). This result is directly correlated to the direction of the ferroelectric polarization vector in the P(VDF-co-TrFE) orthorhombic cell: larger nanoscale piezoactivity is related to the b-axis which lies along the normal to the substrate plane in the case of the edge-on I domains. Here, the ability to thoroughly gain access to the as-grown polar axis direction within the edge-on crystal lamellae of the ferroelectric organic layers is evidenced by combining the nanometric resolution of the PFM technique with a statistical approach based on its spectroscopic tool. By the gathering of information at the nanoscale, two orientations for the polar b-axis are identified in edge-on lamellar structures. These findings contribute to a better understanding of the structure-property relationships in P(VDF-co-TrFE) films, which is a key issue for the design of future advanced organic electronic devices.

A New Approach to Estimating the Parameters of Structural Formations in HDPE Reactor Powder.

The morphology of virgin reactor powder (RP) of high-density polyethylene (HDPE) with MW = 160,000 g/mol was investigated using DSC, SEM, SAXS, and WAXS methods. The morphological SEM analysis showed that the main morphological units of RP are macro- and micro-shish-kebab structures with significantly different geometric dimensions, as well as individual lamellae of folded chain crystals. A quantitative analysis of an asymmetric SAXS reflection made it possible to reveal the presence of several periodic morphoses in the RP with long periods ranging from 20 nm to 60 nm, and to correlate them with the observed powder morphology. According to the DSC crystallinity data, the thickness of the lamellae in each long period was estimated. Their surface energy was calculated in the framework of the Gibbs-Thompson theory. The presence of regular and irregular folds on the surface of different shish-kebab lamellae was discussed. The percentage of identified morphoses in the RP was calculated. It has been suggested that the specific structure of HDPE RP is due to the peculiarity of polymer crystallization during suspension synthesis in a quasi-stationary regime, in which local overheating and inhomogeneous distribution of shear stresses in a chemical reactor are possible.

Biomaterials and tissue engineering strategies for posterior lamellar eyelid reconstruction: Replacement or regeneration?

Reconstruction of posterior lamellar eyelids remains challenging due to their delicate structure, highly specialized function, and cosmetic concerns. Current clinically available techniques for posterior lamellar reconstruction mainly focus on reconstructing the contour of the eyelids. However, the posterior lamella not only provides structural support for the eyelid but also offers a smooth mucosal surface to facilitate globe movement and secrete lipids to maintain ocular surface homeostasis. Bioengineered posterior lamellar substitutes developed via acellular or cellular approaches have shown promise as alternatives to current therapies and encouraging outcomes in animal studies and clinical conditions. Here, we provide a brief reference on the current application of autografts, biomaterials, and tissue-engineered substitutes for posterior lamellar eyelid reconstruction. We also shed light on future challenges and directions for eyelid regeneration strategies and offer perspectives on transitioning replacement strategies to regeneration strategies for eyelid reconstruction in the future.

Wood Lamella-Inspired Photothermal Stearic Acid-Eutectic Gallium-Indium-Based Phase Change Aerogel for Thermal Management and Infrared Stealth.

Eutectic Gallium-Indium (EGaIn) liquid metal is an emerging phase change metal material, but its low phase transition enthalpy and low light absorption limit its application in photothermal phase change energy storage materials (PCMs) field. Here, based on the dipole layer mechanism, stearic acid (STA)-EGaIn-based PCMs which exhibit extraordinary solar-thermal performance and phase change enthalpy are fabricated by ball milling method. The wood lamella-inspired cellulose-derived aerogel and molybdenum disulfide (MoS2 ) are used to support the PCMs by the capillary force and decrease the interfacial thermal resistance. The resulted PCMs achieved excellent photothermal conversion performance and leakage proof. They  have excellent thermal conductivity of 0.31 W m-1 K-1 (this is increased by 138% as compared with pure STA), and high phase change enthalpy of187.50 J g-1 , which is higher than the most of the reported PCMs. Additionally, the thermal management system and infrared stealth materials based on the PCMs are developed. This work provides a new way to fabricate smart EGaIn-based PCMs for energy storage device thermal management and infrared stealth.

Novel Focused Ion Beam Liftouts for Spatial Characterization of Spherical Biominerals With Transmission Electron Microscopy.

Focused ion beam (FIB) is frequently used to prepare electron- and X-ray-beam-transparent thin sections of samples, called lamellae. Typically, lamellae are prepared from only a subregion of a sample. In this paper, we present a novel approach for FIB lamella preparation of microscopic samples, wherein the entire cross-section of the whole sample can be investigated. The approach was demonstrated using spherical, porous, and often hollow microprecipitates of biologically precipitated calcium carbonate. The microprecipitate morphology made these biogenic samples more fragile and challenging than materials commonly investigated using FIB lamellae. Our method enables the appropriate orientation of the lamellae required for further electron/X-ray analyses after attachment to the transmission electron microscopy (TEM) grid post and facilitates more secure adhesion onto the grid post. We present evidence of autofluorescence in bacterially precipitated vaterite using this lamella preparation method coupled with TEM selected area diffraction. This innovative approach allows studying biomineralization at the micro to nano scales, which can provide novel insights into bacterial responses to microenvironmental conditions.

The new future perspective in corneal tissue utilisation - methods of preparation and preservation.

PURPOSE: The goal of our study is to find an optimal approach to the preparation and preservation of corneal stromal tissue. We want to compare different methods of corneal stromal tissue creation and storage to optimize the efficacy of this process under the conditions of an eye bank. After we find the most suitable method to create a safe high quality product, we want to prove the possibility of using a single donor cornea for more than one patient. We would also like to verify the feasibility of making more corneal lenticules after the removal of a corneal endothelium for DMEK transplantation. METHODS: We provided morphological (histology, scanning electron microscope) and microbiological analysis in order to compare different methods of corneal lenticule and corneal stromal lamellae preparation and preservation. We also tested the surgical handling of the tissue to secure a safe manipulation of the tissue for clinical use. We compared two methods of corneal lenticule preparation: microkeratome dissection and femtosecond laser. As methods of preservation, we tested hypothermia, cryopreservation at -80 degrees Celsius in DMSO (dimethyl sulfoxide) and storage at room temperature with glycerol. Some intrastromal lenticules and lamellae in each group were previously irradiated with gamma radiation of 25 kGy (KiloGray). RESULTS: Corneal stromal lamellae prepared with a microkeratome have a smoother cut - side surface compared to lamellae prepared with a femtosecond laser. Femtosecond laser preparation caused more irregularities on the surface and we detected more conglomerates of the fibrils, while lamellae made with microkeratome had more sparse network. Using femtosecond laser, we were able to make more than five lenticules from a single donor cornea. Gamma irradiation led to damage of collagen fibrils in corneal stroma and a loss of their regular arrangement. Corneal tissue stored in glycerol showed collagen fibril aggregates and empty spaces between fibrils caused by dehydration. Cryopreserved tissue without previous gamma irradiation showed the most regular structure of the fibrils comparable to storage in hypothermia. CONCLUSION: Our results suggest that formation of a corneal lenticule lamellae by microkeratome results in smoother corneal lenticules, while being much cheaper than formation by femtosecond laser. Gamma irradiation of 25 kGy caused damage of the collagen fibres as well as their network arrangement, which correlated with loss of transparency and stiffer structure. These changes impair possible surgical utilisation of gamma irradiated corneas. Storage in glycerol at room temperature and cryopreservation had similar outcomes and we believe that both methods are appropriate and safe for further clinical use .

Limited vertical tarsal resection in a case of basal cell carcinoma of the lower eyelid.

We present the clinical case of a 71-year-old woman with a history of multiple basal cell carcinomas (BCC) who presented a nodular lesion in practically the entire extension of the free edge of the lower eyelid. The lesion was approached by excision of the palpebral margin with limited vertical resection of the tarsus and Tripier flap with a correct aesthetic and functional result, free histological margins and no recurrence in a 12-month follow-up.

Cell corner middle lamella in hydroids of dendroid moss Hypnodendron menziesii gametophyte is prominently thickened: a proposed role in the mechanical support function.

MAIN CONCLUSION: Significantly thickened corner middle lamella of the hydroid cell wall in the stipe of dendroid moss Hypnodendron menziesii has a mechanical support function. The hydroid cell walls of the erect stipe of Hypnodendron menziesii were investigated using light microscopy (LM), transmission electron microscopy (TEM), and TEM-immunogold labeling in support of the proposed biomechanical function for the highly thickened cell corner middle lamellae. The statistical analyses of dimensions of hydroid cell and wall parameters revealed a strong positive correlation between the area of hydroid cell and (i) the hydroid cell walls adhering to thick corner middle lamella, (ii) the area of the thick cell wall at hydroid corners, and (iii) the maximum thickness of cell wall at hydroid corners. The total area of the thick cell wall at the hydroid corners concomitantly increased with the area of the hydroid cell wall adhering to the middle lamella, and with the increased number of hydroids surrounding a reference hydroid. The results suggest that markedly thickened middle lamellae of the hydroid cell wall in Hypnodendron likely function by preventing hydroid cells from collapsing under the tensile forces generated from the transpirational pull on the water column. The specific localization of (1→4)- ß-D-galactan and (1,5)-α-L-arabinan in the interface region of the hydroid cell wall and the thick middle lamella is consistent with these cell wall components being involved in the mechanical strengthening of the interface through firm adhesion as well as elasticity, ensuring the structural stability of this cell wall region, which may be prone to delamination/fracturing from the various internal and external pressures imposed. The copious presence of homogalacturonan in the thick middle lamella may further enhance the strength and flexibility of hydroid cell walls.