The crosstalk between PTEN-induced kinase 1-mediated mitophagy and the inflammasome in the pathogenesis of alopecia areata.

Alopecia areata (AA) is a T-cell-mediated autoimmune disease that causes chronic, relapsing hair loss; however, its precise pathogenesis remains to be elucidated. Recent studies have provided compelling evidence of crosstalk between inflammasomes and mitophagy-a process that contributes to the removal of damaged mitochondria. Our previous studies showed that the NLR family pyrin domain containing 3 (NLRP3) inflammasome is important for eliciting and progressing inflammation in AA. In this study, we detected mitochondrial DNA damage in AA-affected scalp tissues and IFNγ and poly(I:C) treated outer root sheath (ORS) cells. In addition, IFNγ and poly(I:C) treatment increased mitochondrial reactive oxygen species (ROS) levels in ORS cells. Moreover, we showed that mitophagy induction alleviates IFNγ and poly(I:C)-induced NLRP3 inflammasome activation in ORS cells. Lastly, PTEN-induced kinase 1 (PINK1) knockdown increased NLRP3 inflammasome activation, indicating that PINK1-mediated mitophagy plays a critical role in NLRP3 inflammasome activation in ORS cells. This study supports previous studies showing that oxidative stress disrupts immune privilege status and promotes autoimmunity in AA. The results emphasize the significance of crosstalk between mitophagy and inflammasomes in the pathogenesis of AA. Finally, mitophagy factors regulating mitochondrial dysfunction and inhibiting inflammasome activation could be novel therapeutic targets for AA.

Comprehensive transcriptome profiling between balding and non-balding scalp of female pattern hair loss in Asian.

While many gene expression studies have focused on male pattern baldness (MPB), few studies have investigated the genetic differences between bald and non-bald hair follicles in female pattern hair loss (FPHL). This study aimed to identify molecular biomarkers associated with FPHL through genetic analysis of paired bald and non-bald hair follicles from 18 FPHL patients, using next-generation sequencing (NGS) techniques. RNA transcriptome analysis was performed to identify differentially expressed genes (DEGs) between bald and non-bald hair follicles in FPHL. The DEGs were validated using real-time PCR, and protein expression was confirmed through immunohistochemistry and western blot analysis. Our findings suggest that HOXB13, SFRP2, PTGDS, CXCR3, SFRP4, SOD3, and DCN are significantly upregulated in bald hair follicles compared to non-bald hair follicles in FPHL. SFRP2 and PTGDS were found to be consistently highly expressed in bald hair follicles in all 18 samples. Additionally, elevated protein levels of SFRP2 and PTGDS were confirmed through western blot and immunohistochemical analysis. Our study identified SFRP2 and PTGDS as potential biomarkers for FPHL and suggests that they may play a role in inducing hair loss in this condition. These findings provide a foundation for further research on the pathogenesis of FPHL and potential therapeutic targets.

The efficacy and safety of the combination of photobiomodulation therapy and pulsed electromagnetic field therapy on androgenetic alopecia.

BACKGROUND: Photobiomodulation therapy (PBMT) appears to be safe and effective for hair loss. Pulsed electromagnetic field therapy (PEMF) also has a positive biological effect on hair re-growth. OBJECTIVES: We evaluated the efficacy and safety of both PBMT and PEMF for the treatment of androgenetic alopecia (AGA). MATERIALS AND METHODS: This study was a 24-week, randomized, double-blind, sham device-controlled trial. We recruited 80 subjects with androgenetic alopecia. The subjects got treatment every week for the 1st 12 weeks, every other week for the next 8 weeks. PBMT entails 15-min therapy, and PEMF was carried out for 10 min. RESULTS: The baseline hair density was 114.57 (±28.75)/cm2 and 113.31 (±30.07)/cm2 in both treatment and control groups. After 24 weeks of treatment, the mean hair density increased to 139.37 (±31.4)/cm2 in the treatment group but only to 119.78 (±31.92)/cm2 in the control group. The difference between two groups was statistically significant (p < 0.05). Based on the global assessment of independent experts, the score was 0.41 (±0.62) in the treatment group and 0.07 (±0.45) in the control group. Only very mild erythema or irritation was reported, and no serious adverse reactions were reported. CONCLUSIONS: A combination of PBMT and PEMF is a valid and safe treatment option for AGA.

The First Case of Cutaneous Acanthamoebiasis Caused by Acanthamoeba triangularis in Korea.

A 62-year-old man with multiple myeloma visited our clinic with multiple painful erythematous to purpuric nodules on his whole body. He received a skin biopsy which showed septal and lobular inflammation with vasculitis, and multiple amoebic organisms were found. Polymerase chain reaction and culture were performed and an Acanthamoeba triangularis infection was diagnosed. This is the first report on cutaneous acanthamoebiasis caused by A. triangularis, suggesting that A. triangularis should be regarded as a clinical pathogen that can cause ocular as well as disseminated infection.

Comparison of the Efficacy and Safety of Biologics (Secukinumab, Ustekinumab, and Guselkumab) for the Treatment of Moderate-to-Severe Psoriasis: Real-World Data from a Single Korean Center.

Biologics are important treatment options for psoriasis; however, direct comparison of their efficacy, safety, and drug survival is insufficient in clinical practice. This retrospective single-center study aimed to compare the efficacy, safety, and drug survival of three commonly used psoriasis biologics (secukinumab, ustekinumab, and guselkumab) and identify the factors affecting drug survival in actual clinics in Korea. We enrolled 111 patients with moderate to severe psoriasis and for at least 56 weeks of follow-up; among these, 27, 23, and 61 were administered secukinumab, ustekinumab, and guselkumab, respectively. All groups were comparable with respect to their baseline characteristics. Secukinumab showed a rapid response, and guselkumab was superior in terms of a long-term response and complete remission compared with other biologics, while ustekinumab showed a lower efficacy compared with other biologics. All three biologics had a favorable and similar safety profile; however, allergic reactions and latent tuberculosis were more common with secukinumab and ustekinumab, respectively. Guselkumab was the most sustained biologic, and the survival rates of secukinumab and ustekinumab were similar. Drug survival was remarkably shorter in female patients and those with hypertension. Introduction of new biologics emerged as a negative factor for drug survival in clinical settings.

The first broad replication study of SNPs and a pilot genome-wide association study for androgenetic alopecia in Asian populations.

BACKGROUND: Many candidate genes for androgenetic alopecia (AGA) have been identified in studies of the Caucasians and some Asian populations. AIMS: This study aimed to confirm the known susceptibility genes reported in previous studies and find additional candidate genes for high-risk individuals for AGA in Korean population. PATIENTS/METHODS: We recapitulated the previously reported SNPs and identified the novel Korean AGA risk genetic variants using a Korean hospital-based AGA case and control samples. The population was consisting of 494 individuals (275 AGA cases and 146 controls). Using the 800 K SNPs of precision medical research array (PMRA SNP microarray chip) and imputation-based SNPs, 12 previous GWAS reports for AGA and a total of 62 160 SNPs were examined in our study samples. Also, we conducted the genome-wide association study (GWAS) by the logistic regression analyses for AGA cases and controls with controlling the age as the covariates. RESULTS: Among the 62 160 SNPs, a total of 1143 SNPs in 76 gene regions showed weak replication tendency with the p-values <0.05 and same direction of effects. Additionally, the GWAS results showed 110 SNPs in 13 independent regions with the suggestive p-values <1.00 × 10-5 . The most significantly replicated SNP resided on chromosome 20, which were similar to other AGA replication studies including Chinese study. The GWAS identified two SNPs (rs11010734 and rs2420640) increasing the risk for AGA in our study population. CONCLUSIONS: Our study would be a reference of the non-European studies to better understand AGA in different populations and ancestral contexts.

A retrospective study to evaluate the efficacy and safety of staged purse-string sutures for the reconstruction of surgical defects on skin using computer image analysis program.

Background: Staged purse-string suturing has been recently introduced for the reconstruction of round or oval defects following tumor excision. Objective: The aim of this study was to evaluate the clinical advantage of staged purse-string suturing for the reconstruction of relatively large skin defects. Materials and Methods: Twenty-one patients who received staged purse-string sutures were included in the study. To evaluate the defects and scar sizes objectively, computer-based image analysis was used. A modified observer scar assessment scale (OSAS) was applied for evaluating the clinical efficacy. Results: The mean primary postsurgical defect size in the total 21 cases was 1446.2 ± 1187.2 mm2, and the mean final scar size was about 268.1 ± 252.3 mm2. The defect area decreased gradually as staged purse-string suturing was performed. The mean total modified OSAS was 7.96 ± 1.69. Conclusion: Staged purse-string sutures might be an alternative reconstructive method for relatively large round or oval skin defects.

Giant Plexiform Neurofibroma of the Perineum and Pelvic Cavity Manifesting as Segmental Neurofibromatosis.

Segmental neurofibromatosis (SN) is rare form of neurofibromatosis characterized that cutaneous or neural changes are limited to one region of the body. SN present neurofibroma and less frequently, café au lait macules (CALMs) on usually unilateral or rarely bilateral of the body region. SN seems to have fewer systemic complications than neurofibromatosis type I or II, except patients with plexiform neurofibromas (PNFs). PNFs are rare benign peripheral nerve sheath tumors which arise from single or multiple nerves. PNFs can easily become aggressive growth particularly during puberty or pregnancy and leading to disfigurement and functional impairment. Also, PNFs can transform to malignant peripheral nerve sheath tumor, higher rate than classic neurofibroma. So, it is important to decide appropriate treatment modalities and time to intervention.

A Case of Ostraceous Psoriasis with Psoriatic Arthritis in an AIDS Patient.

Human immunodeficiency virus (HIV) infection may present with severe and atypical cutaneous diseases. Psoriasis also can develop in HIV patients associated with immune dysfunction and be presented as more severe and atypical manifestation. Furthermore, treatment of psoriasis in HIV patients can be complex and challenging. Herein, we report the case of a 50-year-old male with a 9-year history of HIV infection who developed an uncommon clinical variant of psoriasis with psoriatic arthritis and we discuss a possible pathogenesis of this autoimmune disease and possible treatment.

Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study.

Picosecond lasers have emerged as the leading technology for tattoo removal due to their shorter pulse lengths. To clarify the features of picosecond lasers, we compared picosecond and nanosecond lasers in their ability to remove multi-colored tattoo in an animal model. We first compared a nanosecond quality-switched Nd:YAG laser with picosecond Alexandrite and quality-switched Nd:YAG lasers and then the picosecond quality-switched Nd:YAG laser with the picosecond Alexandrite laser, using a guinea pig model. The colors in the tattoos included red, orange, yellow, green, blue, and black. Guinea pigs were treated for one session with each type of laser. The clearance of pigmentation and local reactions were evaluated based on clinical photographic assessment, quantitative assessment using a colorimeter, histopathology, and electron microscopic examination before laser treatment, immediately after, and at 3 weeks after the treatment. Regardless of pulse duration, a 532-nm laser was the most effective in clearing red, orange, and yellow pigments, although the overall effect and safety was better with the picosecond 532 nm laser. A picosecond 755 nm laser demonstrated excellent efficacy in removing only green and blue pigments. a picosecond 1064 nm laser demonstrated some effects on non-black colored tattoos. In terms of safety, picosecond lasers produced less tissue injury than nanosecond lasers. Conclusively, picosecond lasers are more effective and safer than nanosecond lasers.

Multiple Skin Colored Nodules on both Legs in Patient with Positive QuantiFERON®-TB Gold Test.

Nodular tuberculid (NT) was originally described by Jordaan et al. in 2000 in 4 patients from South Africa. It appeared as nodules on the legs; the pathologic changes were situated in the deep dermis and adjacent subcutaneous fat. A 34-year-old woman visited our hospital with subcutaneous skin-colored or slightly erythematous round to oval nodules. Skin biopsies revealed granulomatous inflammation at the dermo-subcutaneous junction with vasculitis. Chest X-ray, tuberculosus (TB)-polymerase chain reaction and TB culture of the skin specimen were normal. A QuantiFERON®-TB Gold test (QUIAGEN, Germany) was positive, which suggested a diagnosis of latent TB infection. The patient was treated with anti-TB medication and her condition has not recurred. Herein, we report a case of a patient with latent TB diagnosed by a positive QuantiFERON®-TB Gold test whose skin lesions had the clinical and histopathologic features of NT.

Secondary Cutaneous Amyloidosis in a Patient with Mycosis Fungoides.

Secondary cutaneous amyloidosis refers to clinically unapparent amyloid deposits within the skin in association with a pre-existing skin condition or skin tumors, such as basal cell carcinoma, porokeratosis, solar elastosis, Bowen's disease, and mycosis fungoides. A 70-year-old woman presented with a 6-month history of asymptomatic multiple yellowish plaques on both legs. She had been diagnosed with mycosis fungoides 7 years ago and was treated with psoralen and ultraviolet A radiation (PUVA) therapy, narrow-band ultraviolet B (UVB) therapy, and acitretin for 5 years. Finally, she reached complete remission of mycosis fungoides. However, new yellowish lesions started to appear 1 year after discontinuing the phototherapy. A physical examination revealed multiple yellowish plaques on both extremities. The plaques were well circumscribed and slightly elevated. All laboratory tests were normal. A biopsy specimen showed multiple nodular deposits of eosinophilic amorphous material in papillary dermis and upper reticular dermis. The deposits represented apple green birefringence on Congo red stain viewed under polarized light. Acellular small nodules in the upper dermis consisted of randomly oriented, non-branching, 6.67~12.7 nm thick amyloid fibrils on electron microscopy. We report an interesting and rare case of secondary cutaneous amyloidosis after narrow-band UVB therapy and PUVA therapy in a patient with mycosis fungoides.