Sequelae After Involution of Superficial Infantile Hemangioma: Early Intervention with 595-nm Pulsed Laser Combined with 755-nm Long-Pulsed Alexandrite Laser versus Wait-and-See.

BACKGROUND AND OBJECTIVE: Infantile haemangioma (IH) is the most common benign tumor in children. At present, pulsed dye laser (PDL) has made great progress in the treatment of superficial IH, showing good safety and effectiveness. But some doctors think that superficial IH should choose to wait-and-see. However, studies have reported that most of the IH after resolution still has residual disease, and thickness seems to be an important factor. Therefore, the purpose of this study is to investigate the relationship between Sequelae and thickness after superficial IH involution. In addition, compare the Sequelae difference between 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser treatment and wait-and-see. MATERIALS AND METHODS: This retrospective observational study included patients with superficial IH evaluated in the past 6 years and divided them into a laser group and an observation group. RESULTS: The incidence of sequelae in the laser group was 44.6%, and the incidence of sequelae in the observation group was 69.5%. The incidence of Sequelae of superficial IH in the laser group was significantly lower than that in the observation group (χ 2-test, χ 2=10.790, P <0.001). In the observation group, the average A scores of the three thickness subgroups (<2mm, 2-5mm, and >5mm) were 4.38, 3.39, and 1.80, and there were significant differences in the A scores between the three groups (Kruskal-Wallis, p<0.05). There is a significant difference in the A score between the laser group and the observation group in the superficial IH with a thickness of 2-5 mm and>5mm (Wilcoxon rank sum test, P<0.05). CONCLUSION: This retrospective study showed that the degree of Sequelae of superficial IH after involution is related to its thickness. In addition, the early intervention of 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser can reduce the incidence and extent of sequelae.

Observation on the effects of 595- nm pulsed dye laser and 755- nm long-pulsed alexandrite laser on sequential therapy of infantile hemangioma.

BACKGROUND: Infantile hemangioma (IH) can lead to severe complications. The 595-nm pulsed dye laser is poorly effective on thick and deep IH. Long-pulsed alexandrite laser has the proper wavelength of 755 nm and a relatively deep penetration. Thus, this may be a safe and effective treatment method for relatively deep or thick IH. AIMS AND OBJECTIVES: This study aims to determine whether 595-nm pulsed dye laser and 755-nm long-pulsed alexandrite laser in sequential therapy are safer and more effective for relatively deep or thick hemangioma. MATERIALS AND METHODS: This was a prospective study. A total of 194 infantile IH patients (thickness greater than 2 mm and less than 8 mm) were randomly divided into two groups: control group (treated using 595-nm pulsed dye laser) and experimental group (treated by sequential therapy with 755-nm long-pulsed alexandrite laser and 595-nm dye laser). RESULTS: The control group had a total effective rate of 36.1%, while the experimental group had a total effective rate of 76.3%. Enumeration data were compared by X2 -test. The results were considered statistically significant at P < .05. CONCLUSION: Sequential therapy with 755-nm pulsed dye laser and 595-nm long-pulsed alexandrite laser is a safe and effective treatment approach for relatively deep or thick hemangioma.

A Time-Series Analysis of Severe Burned Injury of Skin Gene Expression Profiles.

BACKGROUND/AIMS: Major burn injury is one of the main severe forms of wound which lead to a mass of clinical debilitation, this study was to identify core biomarkers for the recovery of severe burned injury. METHODS: Gene expression profiles (GSE19743) from the Gene Expression Omnibus (GEO) was downloaded, followed by background correction, normalization of raw microarray dataset and identification of differential expression genes (DEGs) . Soft clustering of DEGs was used for the screening of gene clusters that with sustained increasing (SIG) and decreasing expression (SDG) profiles along with the recovery process of burned injury. The significantly enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of SIGs and SDGs were obtained through the Database for Annotation, Visualization, and Integrated Discovery (DAVID), based on which the miRNA-gene regulation network for SIGs and SDGs were constructed from the miRWalk database. RESULTS: Ten clusters were obtained through soft clustering. The SIGs and SDGs were found to be closely associated with the biological processes of immune system. The miRNA-gene regulation network analysis suggested different roles between SIGs and SDGs in the recovery of severe burned injury. Furthermore, a bunch of important biomarkers were identified, which would be helpful in the treatment of burned patients. CONCLUSION: Our current findings suggest an interesting molecular link between transcriptional regulation potentially involved in immunosuppressive state after major burn injury, which warrants further exploration for their utilization in the treatment of major burn injury.

Concurrence of Multiple Cutaneous Malignancies on Sun-exposed Vitiligo Skin of a Patient: A Case Report and Review of the Literature.

There are very few published studies in the literature examining the association between vitiligo and skin cancers and only some anecdotal reports about phototherapy-associated nonmelanoma skin carcinoma (NMSC) in patients with vitiligo. Herein, we report a case of an 84-year-old male with widespread vitiligo with concurrent onset of two primary cutaneous malignancies in sun-exposed vitiligo skin. The association between vitiligo and NMSC deserves further assessment. Chronic sun damage might be a possible causative factor for the development of NMSC in the vitiligo patient.

Ecthyma gangrenosum in a 3-month-old, previously healthy infant: A Case Report.

RATIONALE: Ecthyma gangrenosum (EG) is an aggressive cutaneous disease caused by local or systemic infection with Pseudomonas aeruginosa. EG is characterized by cutaneous manifestations ranging from nodule and papule, to necrotic ulceration with surrounding erythema, especially with black eschar or central crust. EG presents with characteristic skin lesions which is important to establish diagnosis of sepsis caused by P aeruginosa, a serious condition that can be treated efficiently if diagnosed early. PATIENT CONCERNS: A 3-month-old female infant was presented with characteristic skin lesions of EG and developed sepsis 3 days later. DIAGNOSES: Ecthyma gangrenosum and sepsis caused by Pseudomonas aeruginosa. INTERVENTIONS: Meropenem was used in combination with ceftazidime at first and excision of necrotic skin lesions was performed later. OUTCOMES: Cure. LESSONS: Early recognition of EG plays an important role in providing appropriate empiric antibiotic treatment at early stage of sepsis, and improves the prognosis. Surgical excision may be helpful if no improvement was achieved via antibiotic treatment.

Levels of TGF-ß(1) in serum and culture supernatants of CD4(+)CD25 (+) T cells from patients with non-segmental vitiligo.

Compelling evidences support an autoimmune basis of non-segmental vitiligo, and dysregulation of CD4(+)CD25(+) regulatory T cell (Treg) is assumed to contribute to the pathogenesis of vitiligo. Serum levels of transforming growth factor-ß (TGF-ß), an important immunoregulatory cytokine produced by Treg cells, has been reported significantly decreased in patients with vitiligo. However, relation between the decrease in TGF-ß and the dysfunction of Treg cells in pathogenesis of vitiligo was still undemonstrated. To further reveal the role of TGF-ß in vitiligo, 46 patients with non-segmental vitiligo and 25 age- and sex-matched healthy control subjects were enrolled in the study. CD4(+)CD25(+) T cells isolated from peripheral venous blood with a CD4(+)CD25(+) regulatory T cell isolation kit were cultured with or without anti-CD3 mAbs and anti-CD28 mAbs for 4 days. The TGF-ß1 levels in serum and culture supernatants were detected by enzyme-linked immunosorbent assay in both groups. We have found that the TGF-ß1 levels both in serum and culture supernatants in the presence of anti-CD3 mAbs and anti-CD28 mAbs were decreased in the active vitiligo group when compared with the control group or stable vitiligo group, and were negatively correlated with the percentage of involved body area. These results suggested that TGF-ß may play a role in the pathogenesis of non-segmental vitiligo related to the suppressive function of Tregs.