Real-Time Experience of Abrocitinib for the Treatment of Mucous Membrane Pemphigoid: A Case Report.

Background: Mucous membrane pemphigoid (MMP), a rare autoimmune vesiculous and erosive disorder, may affect multiple mucous membranes, with the oral cavity being the most commonly affected site. Its treatment depends on the site(s) of mucosal involvement and disease severity. Patients and Methods: A 62-year-old female patient with MMP that predominantly involved the oral cavity strongly rejected systemic corticosteroid or immunosuppressive agents and was successfully treated with abrocitinib, a highly selective JAK-1 inhibitor with a good safety profile. Results: The case demonstrated good efficacy and safety profile of abrocitinib for the treatment of MMP with predominant oral involvement. Conclusion: Abrocitinib is a promising agent for the treatment of MMP with oral involvement.

Comparative efficacy of 2% minoxidil alone against combination of 2% minoxidil and low-level laser therapy in female pattern hair loss-A randomized controlled trial in Chinese females.

OBJECTIVES: To investigate the effectiveness and safety of combination of 655 nm low level laser helmet device with topical 2 % minoxidil solution at FPHL in Chinese population. MATERIALS AND METHODS: Randomized, parallel, controlled, single-blind clinical trial was conducted. FPHL subjects were randomly allocated into 2 % minoxidil group and combination group. The 2 % minoxidil group received 1 ml topical 2 % minoxidil solution twice daily for 24 weeks. The combination group received 1 ml topical 2 % minoxidil solution twice daily together with 20 min 655 nm low-level laser helmet once every other day for 24 weeks. Hair parameters in two scalp areas including midscalp and vertex were evaluated at baseline, 12th week and 24th week. RESULTS: In midscalp area, the combination group showed a lower increase in intermediate hair percentage than 2 % minoxidil group, which was statistically significant. Besides, the combination group had statistically significant increase than 2 % minoxidil group in mean hair diameter. Reported relative adverse events included slightly hair loss (27.8 %), desquamation (19.0 %), pruritus (15.2 %), seborrhea (2.5 %) and hypertrichosis (2.5 %). CONCLUSION: In our trial, LLLT was demonstrated as a useful supplementary treatment for FPHL and the combination with 2 % minoxidil accomplished better improvement in intermediate hair enlargement and hair diameter of midscalp for FPHL.

Successful Treatment of Granulomatous Rosacea by JAK Inhibitor Abrocitinib: A Case Report.

Granulomatous rosacea (GR) is a rare inflammatory skin disease characterized by persistent, hard, yellow, brown, red, or flesh-colored papules, plaques, or nodules on the face. Limited data are available on patients treated for GR, with only case reports and case series published. Herein, we describe the case of a 53-year-old woman who presented to the hospital with persistent red to brown and pink patches on both cheeks accompanied by a burning sensation for one month. Histopathological examination of a cutaneous biopsy revealed granulomatous inflammation in focal areas. Both acid-fast and Periodic acid-Schiff staining were negative. The patient was diagnosed with GR based on her clinical presentation and laboratory test results. She was treated with abrocitinib, a JAK-1 inhibitor, for 20 weeks. This resulted in substantial improvement in her rash and the associated burning sensation. Subsequent follow-up visits indicated no adverse effects or relapses. Additionally, a literature review was conducted to compare with the current case, which concluded that abrocitinib is a viable treatment option for GR, exhibiting a relatively high safety profile with minimal side effects.

A Case of Perioral Dermatitis Successfully Treated with Abrocitinib.

Perioral dermatitis (POD) is a chronic inflammatory skin disease that primarily affects females between the ages of 16 and 45. Conventional therapies face the challenge of limited efficacy and a high recurrence rate. In this report, we present the case of a 26-year-old male patient with POD who was successfully treated using the Janus kinase (JAK) inhibitor, abrocitinib. This treatment exhibited both good efficacy and safety. Abrocitinib, as a JAK inhibitor, holds promise as a potential therapy for cases of POD that might be resistant to conventional therapies.

Current and Emerging Therapies for Atopic Dermatitis in the Elderly.

Atopic dermatitis (AD) in the elderly has recently emerged as a distinct subgroup of AD, garnering widespread concern due to its increasing global incidence rate. Epidermal barrier dysfunction, inflammatory response, and chronic pruritus interact with each other, contributing to the pathogenesis and pathophysiology of AD in the elderly. Although fundamental medications are essential for managing AD in the elderly, older adults often struggle with regular usage of moisturizing emollients, topical medications, and avoidance of environmental triggers, leading to recurrent or even exacerbated disease progression. Therefore, a systematic medication approach is necessary to control pruritus and skin lesions. Traditional systemic treatments may not adequately meet the treatment needs of moderate and severe AD in the elderly and may even pose certain safety risks. Biologics and Janus kinase (JAK) inhibitors, exhibiting excellent clinical efficacy, have made significant breakthroughs in AD treatment. Existing evidence suggests that dupilumab, a human monoclonal IgG4 antibody, has been confirmed as an effective and safe first-line systematic treatment for moderate to severe AD in the elderly, with no notable differences between adults and the elderly. However, the limited inclusion of elderly patients in related clinical studies hinders the generalizability of these findings. As older patients face a higher risk of adverse events with JAK inhibitors, JAK inhibitors are recommended when no other suitable treatment options are available. Obtaining population-specific data is crucial for making evidence-based treatment choices when managing AD in older adults with JAK inhibitors.

A Chronic Multiple Site of Scrofuloderma: Is It Reactivation or Treatment Failure of Tuberculosis?

We report a case of 32-year-old patient who presented with painless erythematous plaque gradually ulcerated for 9 years. He had a history of pulmonary tuberculosis 12 years ago and was cured by the treatment of 2HRZE/4HR. The laboratory examination of t-spot and PPD skin test was positive. Histopathology examinations of left cervical lymph node as well as skin revealed granulomatous inflammation with caseous necrosis. A diagnosis of scrofuloderma was made. Negative sputum culture and chest CT scan results excluded pulmonary tuberculosis. The patient was treated with a standard antituberculosis therapy and recovered well after 5 months' follow-up. Scrofuloderma is a rare manifestation of mycobacterial infection. Early diagnosis and treatment are very important.

The Emerging Roles of Pyroptosis, Necroptosis, and Ferroptosis in Non-Malignant Dermatoses: A Review.

Unlike apoptosis, pyroptosis, necroptosis, and ferroptosis are recently identified modes of programmed cell death (PCD) with unique molecular pathways. Increasing evidence has indicated that these PCD modes play a crucial role in the pathogenesis of various non-malignant dermatoses (a group of cutaneous disorders), including infective dermatoses, immune-related dermatoses, allergic dermatoses, benign proliferative dermatoses, etc. Moreover, their molecular mechanisms have been suggested as potential therapeutic targets for the prevention and treatment of these dermatoses. In this article, we aim to review and summarize the molecular mechanisms of pyroptosis, necroptosis, and ferroptosis and their roles in the pathogenesis of some non-malignant dermatoses.

The Predictive Value of Midscalp Hair Density and Terminal Hair Percentage in the Severity Evaluation of FPHL Assessed by Trichoscan in a Sample of Chinese Population.

Background: Female pattern hair loss (FPHL) is the most common hair loss disorder in women, which may impair patient's self-identity. It presents as a diffuse reduction in hair density at the mid and frontal regions of the scalp with preservation of the frontal hairline. TrichoScan can be used as a diagnostic tool and for monitoring patients in male pattern hair loss, but little is known in FPHL with Chinese population. Objective: To explore the predictive value of various TrichoScan characteristics at different areas of the scalp in the diagnosis and evaluation of FPHL. Materials and Methods: A total of 261 FPHL subjects were divided into three groups according to Ludwig classification. Together with 108 healthy controls, they were evaluated by computer-assisted TrichoScan. Various hair parameters were analyzed in the frontal, midscalp, vertex, parietal, and occipital areas of the scalp. Results: Declining hair densities, terminal hair percentage, hair follicular unit density, mean hair diameter, and average hair/unit combined with increased intermediate hair percentage, and vellus hair percentage were observed across all areas of the scalp for FPHL subjects. Hair density and terminal hair percentage in the midscalp area were the factors most affecting Ludwig classification. The two parameters combined achieved 85.12% correct classification rate and an area under the ROC curve of 0.88 in the diagnosis of FPHL. Additionally, we reported a unique type of FPHL which mostly affected the parietal area, occurring with or without traditional midline changes. Conclusion: FPHL in a Chinese population presented characteristics of reduced hair density and miniaturization of hair follicles in the midline scalp and to a lesser extent in the parietal area. Hair density and terminal hair percentage in the midscalp exhibited the greatest predictive value of Ludwig classification. Our results may further provide the basis for quantitative classification of FPHL.

Genome Wide Differential Expression Profiles in Nevus Sebaceous Uncovered Low Expression of CDKN2AIP and Construction of a ceRNA Network.

Background: Nevus sebaceous (NS) is a benign hamartoma of the skin, characterized by hyperplasia of the epidermis, in addition to immature hair follicles. The exact mechanisms of folliculo-sebaceous-apocrine defects and adnexal tumorigenesis are unknown in NS, but benign and malignant neoplasms are often due to a complex etiology in NS. Long noncoding RNAs (lncRNAs) have been implicated in various important biological processes and regulate inflammatory diseases and tumors. However, the role of lncRNAs in nevus sebaceous is unclear. Objective: To identify NS-associated mRNA and lncRNA profiles and predict their potential roles in the development of the folliculo-sebaceous-apocrine unit and adnexal tumorigenesis. Methods: RNA-seq was used to identify NS-associated genes and lncRNAs. Analysis software Illumina NovaSeq 6000 was used to analyze the sequences, and real-time PCR and Western blot were used to validate the differentially expressed genes. Competing endogenous RNAs (ceRNA) networks were constructed by prediction software TargetScan & miRanda. Results: Many mRNAs were significantly differentially expressed between nevus sebaceous and adjacent normal scalp tissues. Among them, 72 were upregulated and 18 were downregulated. KEGG pathway analysis further revealed that 32 functional pathways were associated with the upregulated mRNAs, while only 1 pathway was associated with the downregulated mRNAs. Verification by real-time PCR and Western blot indicated that CDKN2AIP gene was downregulated consistently in NS tissue compared to normal scalp skin. Additionally, 7 upregulated and 10 downregulated significantly differentially expressed lncRNAs were detected between NS and adjacent normal scalp tissues. Three downregulated lncRNAs including AL355607.2, RP5-1024G6.8 and AC007780.1 were predicted to consistently associate with CDKN2AIP expression by competing endogenous RNAs(ceRNA) construction. Conclusion: Both mRNA and lncRNA profiles were altered in NS scalp tissues. We identified a downregulated gene, CDKN2AIP, as a target of differentially expressed mRNA and predicted a ceRNA network of CDKN2AIP with differentially expressed lncRNA.

Deep Learning-based Trichoscopic Image Analysis and Quantitative Model for Predicting Basic and Specific Classification in Male Androgenetic Alopecia.

Since the results of basic and specific classification in male androgenetic alopecia are subjective, and trichoscopic data, such as hair density and diameter distribution, are potential quantitative indicators, the aim of this study was to develop a deep learning framework for automatic trichoscopic image analysis and a quantitative model for predicting basic and specific classification in male androgenetic alopecia. A total of 2,910 trichoscopic images were collected and a deep learning framework was created on convolutional neural networks. Based on the trichoscopic data provided by the framework, correlations with basic and specific classification were analysed and a quantitative model was developed for predicting basic and specific classification using multiple ordinal logistic regression. A deep learning framework that can accurately analyse hair density and diameter distribution on trichoscopic images and a quantitative model for predicting basic and specific classification in male androgenetic alopecia were established.

Ascorbic acid detector based on fluorescent molybdenum disulfide quantum dots.

A rapid and facile method is reported for the detection of ascorbic acid using molybdenum disulfide quantum dots (MoS2 QDs) as a fluorescence sensor. Water-soluble and biocompatible MoS2 QDs with the maximum fluorescence emission at 506 nm have been successfully synthesized by hydrothermal method and specific detection for ascorbic acid (AA) was constructed to utilize the modulation of metal ion on the fluorescence of MoS2 QDs and the affinity and specificity between the ligand and the metal ion. The fluorescence of MoS2 QDs was quenched by the irreversible static quenching of Fe3+ through the formation of a MoS2 QDs/Fe3+ complex, while the pre-existence of AA can retain the fluorescence of MoS2 QDs through the redox reaction between AA and Fe3+. Based on this principle, a good linear relationship was obtained in the AA concentration range 1 to 150 µM with a detection limit of 50 nM. The proposed fluorescent sensing strategy was proven to be highly selective, quite simple, and rapid with a requirement of only 5 min at room temperature (RT), which is particularly useful for rapid and easy analysis. Satisfactory results were obtained when applied to AA determination in fruits, beverages, and serum samples as well as AA imaging in living cells, suggesting its great potential in constructing other fluorescence detection and imaging platforms.

A simple colorimetric method for viable bacteria detection based on cell counting Kit-8.

In this study, Cell Counting Kit-8 (CCK-8) was introduced to detect the concentration of live bacteria for the first time depending on the redox reaction between CCK-8 solution and dehydrogenase. CCK-8 solution can be reduced to form water soluble orange-yellow formazan by the dehydrogenase present in bacterial cells, and the concentration of live bacteria is proportional to the absorbance value of formazan at 450 nm. Based on this principle, Staphylococcus aureus and Escherichia coli were chosen as the model bacteria. The optimal detection conditions were investigated and a good linear relationship was obtained in the concentration range from 2.600 × 102 to 1.160 × 109 CFU mL-1 with a linear equation of Y = 0.06305 log10 X-0.1153 (X in CFU mL-1, R2 = 0.9747) for S. aureus and 9.750 × 102 to 6.000 × 108 CFU mL-1 with a linear equation of Y = 0.06122 log10 X-0.1358 (X in CFU mL-1, R2 = 0.9958) for E. coli. The CCK-8 based viable bacteria detection method can be completed within 2 h with a wide bacterial detection concentration range. Satisfactory results were obtained when applied to an actual sample analysis and there is a good consistency between the proposed CCK-8 based method and the traditional plate counting method. More importantly, this method can realize the one-time detection of a large number of samples with high sensitivity, which suggests its great potential in high-throughput bacterial detection.

Lupeol inhibits growth and migration in two human colorectal cancer cell lines by suppression of Wnt-ß-catenin pathway.

BACKGROUND: Lupeol, a triterpene isolated from various herbal plants, possesses an anti-inflammatory function and has been proposed as a candidate for anticancer agents. The purpose of this research was to investigate the effect of lupeol on the viability, apoptosis, cell-cycle distribution, and migration of colorectal cancer cell lines and its molecular mechanism. METHODS: Lupeol was assessed for its anticancer effect using two human colorectal cancer cell lines: SW480 and HCT116. These cells were treated with lupeol, and their viability, apoptosis, migration, and cycle distribution were detected by CCK8, flow cytometry, and the transwell method. Quantitative PCR, Western blot, and immunofluorescence were applied to detect the expressions of CTNNB1, TCF4, cMYC, CCND1, CLDN1, and CCNA2. RESULTS: Lupeol suppressed cell viability and migration and induced cellular apoptosis of both cell lines, with increased p53 and decreased Bcl2 protein levels (P<0.05). Cell cycles of both lupeol-treated cell lines were arrested in the S phase (P<0.05). Quantitative PCR and Western blot analyses showed significantly reduced expressions of CTNNB1, TCF4, and downstream genes of the Wnt-ß-catenin pathway, including the cell-cycle-regulated genes of cMYC and CCND1 of both cell lines upon lupeol treatment (P<0.05). mRNA and protein levels of CLDN1 decreased in HCT116 cells, plus the expression of CCNA2 mRNA and protein decreased in SW480 cells (P<0.05). Immunofluorescence analysis confirmed decreased expression of Wnt-ß-catenin signaling. CONCLUSION: Our findings indicate that lupeol effectively inhibits proliferation and migration and induces apoptosis and cell-cycle arrest of two colorectal cell lines by inactivation of the Wnt-ß-catenin signaling pathway and downregulation of cMYC, CCND1, CCNA2, and CLDN1, thereby making it a promising anticancer candidate.

Two cases of neuroleptic malignant syndrome in elderly patients taking atypical antipsychotics.

SUMMARY: Neuroleptic malignant syndrome (NMS) is a rare, life-threatening adverse reaction to antipsychotic medication that typically includes high-fever, extrapyramidal symptoms, autonomic nervous system dysfunction and disturbances in consciousness. Though reported to be more common following use of the older, first generation antipsychotic medications, it can also occur in patients taking the newer, second generation antipsychotic medications. This report discusses the clinical presentation, possible etiology, pathogenesis and treatment of two cases of NMS that occurred in elderly patients after taking atypical antipsychotics. With the increasing use of atypical antipsychotic medication in elderly patients - who may be more susceptible to this adverse reaction - there is a need to increase clinical vigilance about this condition, particularly among internists and gerontologists who may be unfamiliar with this rare complication to antipsychotic medication.