Prevalence and clinical characteristics of pruritus, and the factors significantly associated with high pruritic intensity in patients with psoriasis: a cross-sectional study.

Despite the significant prevalence of pruritus in psoriasis, its pathogenesis remains unknown, and research on pruritus in Thai psoriasis patients is limited. Objectives: The objective was to investigate the prevalence and clinical characteristics of pruritus, and the factors significantly associated with high pruritic intensity in Thai psoriasis patients. Material and methods: In a cross-sectional study design, pruritus data were collected from the medical records of patients who attended an outpatient psoriasis clinic in Thailand between 2020 and 2021. Results: The overall prevalence of pruritus was 81.2% among 314 psoriasis patients. Psoriasis patients with pruritus had higher Psoriasis Area Severity Index and Dermatology Life Quality Index scores than those without pruritus. The legs, back, arms, and scalp were the most common areas for pruritus. Pruritus was relieved with topical emollients, topical corticosteroids, and oral antihistamines in 66.3, 63.1, and 52.9% of patients, respectively. Female sex, psoriasis body surface area greater than or equal to 10%, and genital psoriasis were factors that independently predicted high pruritus intensity. Conclusion: Psoriasis patients should be screened and treated for pruritus to improve both psoriasis treatment outcomes and patient quality of life. Further studies are needed to clarify the most effective medications for pruritus in patients with severe psoriasis.

Fractional CO2 laser-assisted Botulinum toxin type A delivery for the treatment of primary palmar hyperhidrosis.

Intradermal injections of botulinum toxin type A (BTX-A) have been used successfully to treat patients with primary palmoplantar hyperhidrosis (PPH). However, problems with local injections of BTX-A for palmar hyperhidrosis include injection pain and reduced palmar muscle strength. This case series describes three patients with PPH. Patients were followed up for 3 months and assessed using the minor iodine starch test and the visual analog scale (VAS). Over two sessions within a 2-week interval, all patients received treatment on one palm, while the other palm served as the untreated control. Treated palms received fractional CO2 laser therapy and immediate post-operative topical application of BTX-A solution for a total of 50 units. Sweat production was assessed based on the size of the sweat-producing area (measured by the minor iodine starch test) and subjective assessment of sweat production using the visual analog scale (VAS) at baseline, 2 weeks after the first treatment, and 1, 2, and 3 months after the second treatment. In the BTX-A-treated palm, the decrease in the mean sweat production was 51.6% at 2 weeks after the first treatment, and 88.5%, 67.8%, and 52.9%, at 1, 2, and 3 months after the final treatment when compared to the baseline. In the untreated palms, the decrease in the mean sweat production was 2% on all follow-ups when compared to the baseline. No adverse effect was observed in any patient. Fractional CO2 laser is a safe technique for BTX-A delivery on the palm area and is demonstrated to be safe and effective in decreasing sweat secretion of hyperhidrosis palm.

A Prospective, Split-Face, Randomized Study Comparing Picosecond to Q-Switched Nd: YAG Laser for Treatment of Epidermal and Dermal Pigmented Lesions in Asians.

BACKGROUND: Whether picosecond lasers outperform Q-switched lasers in treating pigmented lesions has not been clearly evaluated. OBJECTIVE: To compare the efficacy and safety of picosecond and Q-switched lasers in treating epidermal and dermal pigmented lesions in Asians. METHODS: Eight subjects with lentigines and 6 subjects with acquired bilateral nevus of Ota-like macules were enrolled. Subjects was randomly treated with a picosecond laser on one side of the face and a Q-switched laser on the other side. Subjective assessments on pigment clearance, and adverse effect were obtained at Weeks 0, 4, 12, and 24 after the final treatment. RESULTS: Clinical improvement differed between the 2 laser systems at Week 4 (p = .034), Week 12 (p = .039), and Week 24 (p = .027), with 85.7% of picosecond and 57.2% of Q-switched laser sites showing >50% improvement at 6 months. There was no significant difference in the incidence of side effect and healing time, but picosecond laser was significantly associated with a lower treatment discomfort (p = .05). CONCLUSION: The picosecond laser seems to be more effective and better tolerated than Q-switched laser for the treatment of pigmented lesions in Asians.

Efficacy of olive leaf extract-containing cream for facial rejuvenation: A pilot study.

BACKGROUND: Olive leaf extract (OLE), a naturally extracted product from olive leaves, contains oleuropein and other bioactive phenolic compounds. Oleuropein was identified to have various medical properties. It was also found to inhibit the effects of both acute and chronic UVB-induced skin damage as well as accelerate wound healing activity. AIMS: To evaluate the efficacy of olive leaf extract-containing cream on facial rejuvenation. METHODS: This is a prospective pilot study with a total of 36 participants, who presented with photoaging skin. All participants applied the olive leaf extract-containing cream (SUPERHEAL™ O-Live Cream, PhytoCeuticals, Inc, USA) to their whole face twice daily for 2 months. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: melanin and erythema index, transepidermal water loss (TEWL), skin hydration, skin pH, sebum level, texture, and wrinkles. RESULTS: After 2 months, TEWL decreased significantly (P = .007) and maintained the results 1 month after discontinuation of the treatment (P = .007). Skin hydration also increased significantly after 2 months (P = .004). Wrinkles improved significantly on all follow-ups (P < .001, P = .001, P = .001, respectively). An image of the skin captured using Visioscan® showed improvement of the skin texture 2 months after treatment. Majority of the participants (64%) noted improvement in their skin texture. CONCLUSION: Olive leaf extract-containing cream provided benefits on skin rejuvenation in human skin.

Predictors of serological cure after treatment in patients with early syphilis: A retrospective observational study in Thailand.

BACKGROUND: Some patients with early syphilis who receive appropriate treatment do not reach a serological cure and have a persistent titer which does not meet the criteria for treatment failure (serofast state). AIMS: This retrospective study aimed to determine the prevalence of serological cure and the serofast state as well as the factors associated with serological cure after treatment of patients with early syphilis. METHODS: A serological cure was defined as occurring when there was a ≥4-fold decrease in nontreponemal titer, whereas patients with a ≥4-fold increase were considered as having either a treatment failure or reinfection. Nontreponemal titers that neither increased nor decreased ≥4-fold after treatment were considered to be in a serofast state. Seroreversion was defined as occurring when there was a negative test within 12 months of treatment. RESULTS: There were 179 patients with a mean age of 31.9 years; 174 (97.2%) were men, and 125 (70%) were HIV patients. Of the total, 174 (98%; 95% confidence interval 94.82-99.42%) patients achieved a serological cure, whereas five were in a serofast state 12 months after treatment. Those five serofast patients were all HIV-positive men, of which 4 (80%) had secondary-stage syphilis, a CD4 count ≤200 cells/µl and a titer <1:8. In a bivariate analysis, a serological cure was associated with a baseline Venereal Disease Research Laboratory >1:16 titers (P = 0.018), and a CD4 cell count >200 cells/µl in 6 months preceding treatment (P = 0.016). The median time to a serological cure was 96 days. Only 22 (12.3%) of the patients achieved seroreversion at 12 months after treatment. LIMITATIONS: A retrospective medical record review is likely to have a selection bias, and in our study, 196 (52%) patients were excluded due to missing information. CONCLUSIONS: Most patients with early syphilis who achieved a serological cure at 12 months after treatment had high baseline Venereal Disease Research Laboratory titers and CD4 cell counts. However, only 22 (12.3%) had a negative Venereal Disease Research Laboratory titer after 1 year of treatment.

Treatment outcome and persistence of repigmentation from narrow-band ultraviolet B phototherapy in vitiligo.

Background: Narrow-band ultraviolet B (NB-UVB) phototherapy is a mainstay treatment in vitiligo. However, data relative to repigmentation outcome, prognostic factors, and duration of repigmentation are limited. Objectives: To investigate the quantitative repigmentation outcome of NB-UVB phototherapy in vitiligo, the factors associated with favorable prognosis after NB-UVB, and the duration of repigmentation after NB-UVB discontinuation. Materials and methods: Medical records of vitiligo patients who underwent NB-UVB phototherapy at Department of Dermatology, Siriraj Hospital during 2012 to 2016 were retrospectively reviewed. Repigmentation was assessed using Vitiligo Area Scoring Index (VASI) score. Results: Fifty-eight patients were included. All patients received NB-UVB phototherapy twice to three times weekly for a median duration of 12 months. Forty-two patients had nonsegmental vitiligo (NSV), and 16 had segmental vitiligo (SV). NSV and SV demonstrated overall improvement in VASI score of -50.0%±31.0% and -40.0%±28.3%, respectively. Factors predictive of good outcome included type of vitiligo, lesion location, disease duration before NB-UVB, and duration and total number of NB-UVB treatments. Persistence of repigmentation was observed in approximately 80% of cases at one year after discontinuation of NB-UVB. Conclusion: NB-UVB phototherapy is an effective treatment for vitiligo, especially NSV. Repigmentation persisted in 80% of patients at 1 year after cessation of phototherapy.