Distinct skin microbiome modulation following different topical acne treatments in mild acne vulgaris patients: A randomized, investigator-blinded exploratory study.

The effects of topical non-antibiotic acne treatment on skin microbiota have rarely been demonstrated. In the study, we randomized 45 mild acne vulgaris participants into three treatment groups, including a cream-gel dermocosmetic containing Aqua Posae Filiformis, lipohydroxy acid, salicylic acid, linoleic acid, niacinamide and piroctone olamine (DC), retinoic acid 0.025% cream (VAA) and benzoyl peroxide 2.5% gel (BP). At months 0, 1 and 3, skin specimens were swabbed from the cheek and forehead and sequenced by targeting V3-V4 regions of the 16 S rRNA gene. QIIME2 was used to characterize bacterial communities. Acne severity, sebum level and tolerability were assessed concomitantly in each visit. We found that both VAA and BP could significantly reduce the bacterial diversity at month 1 (p-value = 0.010 and 0.004 respectively), while no significant reduction was observed in DC group. The microbiota compositions also significantly altered for beta diversity in all treatments (all p-value = 0.001). An increased Cutibacterium with decreased Staphylococcus relative abundance was observed at months 1 and 3 in DC group, while an opposite trend was demonstrated in VAA and BP groups. These findings suggest a potential impact of DC, VAA and BP on the diversity and composition profiles of the skin microbiota in mild acne participants.

Lupus band test for diagnostic evaluation in systemic lupus erythematosus.

BACKGROUND: The lupus band test (LBT) using a sample of clinically normal skin was proposed as a useful diagnostic test for systemic lupus erythematosus (SLE). It is mostly performed to help diagnosing SLE in patients with insufficient clinical and serological profiles. However, most published studies on its utility are outdated and the results remain controversial. OBJECTIVES: To determine the diagnostic performance of LBT on non-lesion sun-protected (NLSP) and sun-exposed (NLSE) skin for SLE. METHODS: Consecutively presenting patients with clinical and serological suspicion of SLE who had LBT performed on non-lesion skin during January 2012 to August 2021 were retrospectively studied. LBT performed on either NLSE or NLSP skin biopsies were all included. Laboratory characteristics, number, types and patterns of deposited immunoreactants and disease activity were also assessed. RESULTS: LBT was performed in 57 patients with suspected SLE. LBT was positive in 18/57, 9/28 and 6/21 patients in overall non-lesion, NLSE and NLSP, respectively. Of all patients, 23 patients were diagnosed with SLE and 34 patients with other diseases. Overall, the sensitivity and specificity of LBT on non-lesion skin was 56.5% and 88.2%, respectively. The ability of the test to discriminate between those with and without SLE, assessed by the area under the Receiver-Operating Characteristic curve, was 0.72 (0.61-0.84). The sensitivity and specificity of LBT on NLSE skin was 58.3% and 87.5% while those of NLSP skin, were 57.1% and 85.7%, respectively. We found no significant correlation between the positivity of LBT and overall disease activity. Types, number and pattern of deposited immunoreactants also showed no correlation with disease activity (all p > 0.05). CONCLUSIONS: Used as a diagnostic adjunct, non-lesion LBT is still of value for diagnosing SLE in inconclusive cases.

On and off-label uses of interleukin-17 inhibitors for patients with plaque-type psoriasis in Thailand: a real-world study.

BACKGROUND: Off-label uses of biologics in the treatment of psoriasis are usually implemented in limited-resource settings and studies regarding their response profiles are limited. METHOD: This was a retrospective study performed in moderate-to-severe plaque-type psoriasis patients who had been treated with either secukinumab, ixekizumab or brodalumab at a university hospital in Thailand between 1 January 2017 and 1 April 2021. RESULTS: A total of 142 patients were included in the data analysis consisting of three groups of 48 patients, 86 patients, and 8 patients treated by secukinumab, ixekizumab, and brodalumab, respectively. Patients were then classified into five groups according to the dosing pattern they received; on-label, off-label with induction, off-label with specific pattern, off-label with irregular dosing interval <8 weeks and >8 weeks. Considering both secukinumab and ixekizumab, the adjusted hazard ratios (95%CI) for complete skin clearance of the four off-label regimens were 2.2(0.9-5.2), 1.9 (0.9-3.9), 1.0 (0.4-2.2), and 1.6 (0.7-3.6), compared to on-label regimen, respectively. In each biologic drug, almost all off-label dosing regimens demonstrated higher adjusted hazard ratios compared to on-label regimen. CONCLUSION: Off-label, patient-oriented regimens could be a promising choice of IL-17 inhibitors for administration in special settings. Off-label regimens are not inferior in terms of skin clearance to an on-label regimen in the efficacy of psoriasis treatment of secukinumab and ixekizumab but do cause more flares. The decision to use off-label regimens must account for the benefits and associated risks.

New Normal Mask-Wearing and Its Impact on Underneath Skin Microbiome: A Cross-Sectional Study in Mild Acne Vulgaris Patients.

Introduction: Prolonged mask-wearing could modulate the skin microenvironment resulting in several facial dermatoses. Microbial dysbiosis is proposed to be linked with these changes; however, data regarding the association is still limited. Accordingly, we aimed to explore the impact of face masks on the skin's bacterial microbiota. Methods: We classified participants into short (<4 h/day) and long (≥4 h/day) mask-wearing time (SMWT and LMWT) groups according to mask-wearing time per day in the previous 2 weeks. Specimens were swabbed from the cheek and forehead of 45 mild acne vulgaris patients, representing mask-covered area (MCA) and mask-uncovered area (MUA), respectively. The 16S rRNA gene sequencing and QIIME2 were used to characterize bacterial communities. Results: There were 12 (26.7%) and 33 (73.3%) participants in SMWT and LMWT, respectively. There were no significant differences in beta diversity across MCA/MUA or LMWT/SMWT groups. In alpha-diversity, the evenness on MCA was significantly lower in LMWT than in SMWT (p value = 0.049). Among all groups, the relative abundance of bacterial taxa was similar, showing Actinobacteriota and Firmicutes, and Cutibacterium and Staphylococcus as the most predominant phyla and genera, respectively. Conclusion: Our results showed no significant impact of mask-wearing on the skin microbiota in mild acne vulgaris participants.

Influence of moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid on facial skin lipidome among seborrhea participants.

BACKGROUND: A better understanding of skin lipidomics and its alteration under treatment administration might offer therapeutic solutions for seborrhea. AIMS: To quantitatively and qualitatively explore the lipid-modifying effect of the moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid (LDCS) in seborrhea participants with and without acne vulgaris (AV). PATIENTS/METHODS: We conducted an open-label explorative study on 20 seborrhea participants (10 AV and 10 non-AV). All participants applied LDCS for 8 weeks with the addition of benzoyl peroxide 2.5% gel and adapalene 0.1%/benzoyl peroxide 2.5% gel in AV. Skin surface lipid (SSL) assessments were performed biweekly, using Sebumeter® and lipid-absorbent Sebutapes® to collect forehead SSL for profile analysis by gas chromatography-mass spectrometry (GC-MS). RESULTS: SSL amount significantly decreased since week 2 in AV (p-value = 0.0124) and week 6 in non-AV (p-value = 0.0098), respectively. Twenty-two important SSLs were annotated from GC-MS analysis, comprising 19 free fatty acids, cholesterol, squalene, and glycerol. There was a significant reduction in 5 and 13 lipid components in AV and non-AV groups, respectively. CONCLUSION: LDCS, either alone or with topical acne treatment, demonstrated substantial sebusuppressive and lipid-modifying effects among seborrhea participants.

A Rare Case of Checkerboard-Like Becker Nevi with a Unique Distribution of Abnormalities.

Becker nevus syndrome refers to a rare disorder comprising the typical pigmented lesion and its associated developmental abnormalities. Becker nevus itself is typically localized on the upper trunk, scapular or upper arm unilaterally; however, it can occasionally occur as multiple or bilateral lesions on any parts of the body. In this report, a rare case of multiple Becker nevi arranged in a unique checkerboard-like pattern is presented. More uniquely, the associated abnormalities found in this patient, breast hypoplasia and leg lipodystrophy, seem to be regionally correlated with the nevi. In closing, we would like to raise an easy-to-remember 6B's mnemonic, which stands for Becker, Breast, Bone, Bowen's disease, Basal cell carcinoma, and Beta-actin, for the cases of Becker nevus syndrome.