Paring of Skin for Superficially Lodged Foreign Body Removal.

Small foreign bodies superficially embedded in the acral skin can be difficult to remove. Typical treatment includes using forceps and pressure to attempt removal, which is painful and not always successful. Here we present a patient with a prolonged presentation of a superficially embedded foreign body on his finger. The method for extracting the foreign body was successful and painless through the paring of the skin to gently remove the object. This method decreases pain and swelling, making it a more efficient way of extracting small foreign bodies that are lodged in the superficial skin layer. This case report focuses on more efficient and painless removal of superficially lodged foreign body removal in the clinical office setting.

Hyperhidrosis: A Review of Recent Advances in Treatment with Topical Anticholinergics.

BACKGROUND: Topical anticholinergics have been reported to be effective in managing hyperhidrosis (HH) given the recent approval of glycopyrronium tosylate. OBJECTIVE: This review aimed to examine the effectiveness of emerging topical anticholinergic treatments for HH and their associated adverse effects in comparison to current treatment options. METHODS: We conducted a search within the PubMed and Embase databases for current and emerging topical anticholinergic treatments for primary HH. RESULTS: The topical anticholinergics that have been recently investigated for use in HH include glycopyrrolate, oxybutynin, sofpironium bromide, and umeclidinium. The only agent currently FDA approved is glycopyrrolate. CONCLUSION: Knowledge of topical anticholinergic treatment options is important for patient care when managing HH. This review shows that while available safety data thus far are limited, emerging topical anticholinergics pose minimal known human risks.

Occupational Hazards of Dermatology: A Comprehensive Review.

Dermatology involves various occupational hazards that threaten the safety of practicing dermatologists and may often go unrecognized and ignored. These dangers may appear minor but with the daily volume of patients examined by dermatologists do pose significant health risks. A review of the occupational hazards and exposures frequently encountered in the field of dermatology would be beneficial for both dermatologists and patients. In this review, we conducted a comprehensive search of published studies from inception to May 30, 2021 using the terms "dermatology," "occupational exposure," and "biohazard" in PubMed-MEDLINE, Google Scholar, Embase, and Cochrane Central to summarize occupational hazards in dermatology. (SKINmed. 2022;20:177-184).

Collagen VII maintains proteostasis in dermal fibroblasts by scaffolding TANGO1 cargo.

Lack of type VII collagen (C7) disrupts cellular proteostasis yet the mechanism remains undescribed. By studying the relationship between C7 and the extracellular matrix (ECM)-associated proteins thrombospondin-1 (TSP1), type XII collagen (C12) and tissue transglutaminase (TGM2) in primary human dermal fibroblasts from multiple donors with or without the genetic disease recessive dystrophic epidermolysis bullosa (RDEB) (n=31), we demonstrate that secretion of each of these proteins is increased in the presence of C7. In dermal fibroblasts isolated from patients with RDEB, where C7 is absent or defective, association with the COPII outer coat protein SEC31 and ultimately secretion of each of these ECM-associated proteins is reduced and intracellular levels are increased. In RDEB fibroblasts, overall collagen secretion (as determined by the levels of hydroxyproline in the media) is unchanged while traffic from the ER to Golgi of TSP1, C12 and TGM2 occurs in a type I collagen (C1) dependent manner. In normal fibroblasts association of TSP1, C12 and TGM2 with the ER exit site transmembrane protein Transport ANd Golgi Organization-1 (TANGO1) as determined by proximity ligation assays, requires C7. In the absence of wild-type C7, or when ECM-associated proteins are overexpressed, C1 proximity and intracellular levels increase resulting in elevated cellular stress responses and elevated TGFß signaling. Collectively, these data demonstrate a role for C7 in loading COPII vesicle cargo and provides a mechanism for disrupted proteostasis, elevated cellular stress and increased TGFß signaling in patients with RDEB. Furthermore, our data point to a threshold of cargo loading that can be exceeded with increased protein levels leading to pathological outcomes in otherwise normal cells.

Medical Student Confidence in Diagnosis of Dermatologic Diseases in Skin of Color.

Purpose: To evaluate medical student confidence in diagnosing dermatologic diseases in skin of color. Methods: A voluntary supplemental module was implemented as part of the second-year dermatology curriculum at Wayne State University School of Medicine (WSU SOM) in Detroit, Michigan. The goal of the module was to ascertain whether it may increase confidence in students with their approach to diagnosing diseases in darker skin tones. Results: Seventy-seven of 295 students (26%) completed a "Skin of Color" optional module consisting of thirteen cases of common skin pathologies in African American patients. A pre- and post-survey performed to assess students' confidence using a five-point Likert scale. After completing the module, medical students demonstrated a statistically significant increase in confidence in diagnosing skin pathologies in skin of color. Conclusion: Dermatology pre-clinical course work should include supplementary materials to increase student confidence in diagnosing skin diseases in darker skin tones.

Oral nail growth supplements: a comprehensive review.

As the cosmeceutical market for nail products is growing, there is an emerging need for dermatologists to provide patients with evidence-based information regarding over-the-counter products and supplements for nail growth. By law, there is no required efficacy and safety assessment by the Food and Drug Administration prior to these products being made available to consumers. This carries financial and health consequences for patients seeking affordable and effective over-the-counter products to improve their nail conditions. In this comprehensive review, we discuss available oral nail growth products, their mechanisms of action, and side effects.

The status of treatment for plantar warts in 2021: No definitive advancements in decades for a common dermatology disease.

Plantar warts are among the most common skin conditions and are classically resistant to treatment. To perform an evidence-based evaluation of the efficacy and safety of available treatment options for plantar warts, we conducted a systematic review of PubMed and Cochrane databases to identify large interventional and observational studies involving more than 100 patients who were treated for plantar warts from inception to October 2020. We identified only nine contributions meeting our inclusion criteria (N ≥ 100), representing 1,657 adult and pediatric patients with plantar warts. Treatments included in this review were topical keratolytic agents, cryotherapy, laser therapies, and intralesional and systemic treatments. Our evidence-based review of the larger studies suggests keratolytic agents and destructive treatments, in particular salicylic acid and cryotherapy, remain the primary treatments for plantar warts. Treatment with pulsed dye laser had the lowest rate of recurrence. Newer treatments and intralesional treatments were not represented owing to lack of large studies involving these modalities.

Techniques to Relieve Pain Associated With Botulinum Injections for Palmar and Plantar Hyperhidrosis.

BACKGROUND: Palmar and plantar hyperhidrosis (HH) is a common condition characterized by excessive sweating of the palms and soles. Botulinum neurotoxin (BTX) is a very effective and safe treatment. However, the associated intense injection pain is a major limiting factor deterring patients from selecting this treatment. OBJECTIVE: The aim of this study was to review the numerous techniques used to minimize pain accompanying injections for palmoplantar HH. Additionally, the advantages and limitations of each modality will be discussed. MATERIALS AND METHODS: The authors performed a comprehensive literature search in PubMed/MEDLINE, Embase, Cochrane Central, and Google Scholar on randomized controlled trials, cohort studies, and case series on techniques to relieve pain of BTX injections for treatment of palmar and plantar HH. RESULTS: Current available techniques in reducing botulinum injection with merits and drawbacks are nerve blocks, Bier blocks, cryoanalgesia, needle-free anesthesia, topical anesthetics, and vibration anesthesia. CONCLUSION: Topical anesthesia, ice, and vibration are the safest and most convenient noninvasive available methods to relieve pain associated with botulinum injection. Nerve blocks, Bier block, and needle-free anesthesia provide better anesthesia but are limited by the need for training and equipment.

Comparison of SOX-10, HMB-45, and Melan-A in Benign Melanocytic Lesions.

PURPOSE: Different immunohistochemical stains are used in dermatopathology to stain melanocytes and diagnose benign and malignant melanocytic lesions. METHODS: SOX-10, HMB-45, and Melan-A immunohistochemical stains were used to assess 32 biopsy specimens with a histologic diagnosis of lentigo. The total number of melanocytes stained with each immunohistochemical stain was counted and an average count was obtained from two readings. RESULTS: Analysis of the data revealed a significant difference in staining melanocytes between these three immunostains (p=0.0010, ANOVA). SOX-10 stained 0.195 more melanocytes than HMB-45 (p=0.0026). Similarly, Melan-A stained 0.195 more melanocytes than HMB-45 (p=0.0011). However, the difference between SOX-10 and Melan-A was not statistically significant (p=0.9810). CONCLUSION: SOX-10 and Melan-A immunostaining stain more melanocytes than HMB-45. No significant difference was noted between Melan-A and SOX-10.