A simple modification to prevent the cross-infection by dermoscopy.

Because sterilization of imaging probes is commonly impossible, the issue of probe contamination and cross-infection becomes an issue when using dermoscopy in the clinic. We describe a simple modification to reduce cross-infection during dermoscopy.

Use of a metallic ink marking pen to assist in localization on the skin of lesions detected by reflectance confocal microscopy.

We report the use of a marking pen with metallic ink to assist body surface location in reflectance confocal microscopy (RCM). Not only is the marker waterproof, but the metallic ink appears brighter under RCM, thus assisting in identifying location.

Dermoscopy, reflectance confocal microscopy, and fluorescence staining for the noninvasive diagnosis of crusted scabies.

A 91-year-old woman presented with a 3-month history of [extensive](javascript:;) cutaneous lesions with intense pruritus. She lived in a nursing home for a long time. Physical examination revealed a generalized erythematous and scaly rash with intense hyperkeratotic lesions on the neck, trunk, and limbs. Dermoscopy showed a sinuous burrow filled with white dot eggs and feces on the hand with a mite at the end of the burrow. Reflectance confocal microscopy (RCM) manifested a sinuous burrow and a mite. The presence of mites was confirmed with fluorescence staining. The patient was diagnosed with crusted scabies and started treatment with 10% sulfur ointment. Her lesions and pruritus were resolved after 2 weeks.

Erythema papulatum centrifugum and new diagnostic criteria.

Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans (EPSR), is distinct from eczema and other well-described figurate erythemas characterised by annular erythematous lesions. We report 7 cases of EPC and propose new diagnostic criteria including the following: (i) EPC is characterised by single or multiple recurrent expanding annular or semi annular erythema with central regression, surrounded by tiny red papules; (ii) the lesions regularly relapse and resolve; (iii) the histopathologic feature shows superficial perivascular inflammation with or without mild inflammation around sweat glands in the mid dermis and (iv) patients lack other associated cutaneous or internal abnormalities.

Increased serum soluble vascular endothelial cadherin levels in patients with chronic spontaneous urticaria.

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common skin disease characterized by recurrent itchy wheals with or without angioedema that lasts longer than 6 weeks. Vascular endothelial (VE)-cadherin is an endothelial cell-specific adhesion molecule that plays critical roles in angiogenesis and endothelial permeability. OBJECTIVE: To investigate serum levels of soluble VE (sVE)-cadherin in patients with CSU. METHODS: Serum levels of sVE-cadherin in patients with CSU, patients with atopic dermatitis, and healthy controls were determined by enzyme-linked immunosorbent assay. In addition, changes in sVE-cadherin serum levels were compared in patients with CSU before and after H1 antihistamine treatment. Furthermore, the effects of histamine on sVE-cadherin release by HMEC-1 cells were determined by enzyme-linked immunosorbent assay. The inhibition effects of H1 antihistamine and H2 antihistamine on sVE-cadherin release, VE-cadherin phosphorylation, and VE-cadherin disruption were evaluated in histamine-treated HMEC-1 cells by western blot and immunofluorescence. RESULTS: Serum levels of sVE-cadherin in patients with CSU were significantly higher than those in patients with atopic dermatitis and healthy controls. Serum sVE-cadherin levels in patients with CSU were correlated with the severity of CSU according to Urticaria Activity Scores. Furthermore, serum sVE-cadherin levels in patients with CSU at pretreatment decreased after H1 antihistamine treatment. In addition, histamine markedly induced sVE-cadherin release in HMEC-1 cells. Moreover, H1 antihistamine, but not H2 antihistamine, significantly inhibited sVE-cadherin release in histamine-treated HMEC-1 cells. Western blot data showed that histamine induced phosphorylation of VE-cadherin in HMEC-1 cells, which was blocked by H1 antihistamine. CONCLUSION: The present data showed serum levels of sVE-cadherin are increased in patients with CSU. Histamine-induced sVE-cadherin release from endothelial cells could play a role in the pathogenesis of CSU.

Paeoniflorin suppresses inflammatory response in imiquimod-induced psoriasis-like mice and peripheral blood mononuclear cells (PBMCs) from psoriasis patients.

Psoriasis is one of the most common immune-mediated chronic inflammatory skin disorders, characterized by hyperproliferation of keratinocytes, dilation and growth of dermal capillary vasculature, and cellular infiltration of T cells, dendritic cells (DCs), and neutrophils. Paeoniflorin (PF), the principal component of total glucosides of paeony (TGP), displays anti-inflammatory and antioxidant properties in several animal models. In this study, we investigated the anti-inflammatory effects and mechanisms of PF in imiquimod (IMQ)-induced psoriasis-like mouse model. The effects of PF on inflammatory cytokine expression in peripheral blood mononuclear cells (PBMCs) from patients with psoriasis vulgaris were also observed. Our results indicated that PF effectively attenuated the clinical and histopathologic changes in IMQ-induced psoriasis-like mouse model. Furthermore, PF reduced the infiltration of T cells, CD11c(+)DCs, and neutrophils in lesional skin. In addition, PF also significantly decreased the mRNA expression of inflammatory cytokines, such as IL-17, INF-γ, IL-6, and TNF-α, in IMQ-induced psoriasis-like mouse model and PBMCs from patients with psoriasis vulgaris. Hence, our data suggest that PF can inhibit leukocyte infiltration and decrease the expression of inflammatory cytokines such as IL-17, INF-γ, IL-6, and TNF-α. PF might be a candidate drug for the treatment of psoriasis.

Targetoid haemosiderotic nevus: four cases and a literature review.

BACKGROUND: Targetoid haemosiderotic nevus (THN), a distinct clinical form of melanocytic nevus, is characterized by the sudden development of a purpuric halo surrounding a pre-existing nevus, easily mistaken for melanoma. OBJECTIVES: To summarise the clinical, dermoscopic and histopathological findings of THN in order to better recognize and manage this condition. MATERIALS & METHODS: We describe four cases and provide a review of the literature based on a search in PubMed. Overall, the clinical, dermoscopic and pathological findings of 15 THN cases are summarised. RESULTS: THN was characterized by a sudden onset of a purpuric halo surrounding a pre-existing nevus without any apparent trigger which occurred mainly in young females. Dermoscopically, the central nevus showed a black-brown, globular or homogeneous pattern, possibly interspersed with reddish, purple, or black structureless areas and comma-shaped vessels. The peripheric purpuric halo had two patterns: one with homogeneous reddish or purplish red areas, and another with an inner pale and outer homogeneous reddish or purplish red zone. The pathological findings showed an intradermal or compound nevus, dilated vessels, and extravasated erythrocytes, possibly accompanied by perivascular inflammatory infiltration and fibrin and hemosiderin deposits. CONCLUSION: THN is a benign lesion that usually requires no intervention other than follow-up observation. Dermoscopy is a useful non-invasive diagnostic tool, and biopsy can be avoided. The purpuric halo resolves spontaneously within two to four weeks with rare recurrence.

[FU Li-xin's experience in treatment of vertigo with "regulating the middle jiao, opening gate and relaxing tendon" method of acupuncture].

The paper introduces professor FU Li-xin's theoretic ideas and experience in treatment of vertigo. Professor FU believes that this disease is closely related to the blockage of qi movement in the middle jiao, opening-closing disarrangement in the pivot, "gate" obstruction, malnutrition of brain orifice and decreased blood flow in the nape. Based on the holistic idea of qi movement in traditional Chinese medicine and the circulatory theory of western medicine, the characteristics of the specific acupuncture therapy for "regulating the middle jiao, opening gate and relaxing tendon" are summarized. Using the layered needling technique at Zhongwan (CV 12) and "gate points" in the neck region, the tendon-bone needling technique with modified "dark tortoise seeking hole" at local tendon blockage points, vertigo is cured through regulating qi in the middle jiao, opening gate and nourishing marrow, relaxing tendon and harmonizing the mind.

Interleukin-35 inhibited the production of histamine and pro-inflammatory cytokines through suppression MAPKs pathway in HMC-1 cells.

BACKGROUND: IL-35 is a newly anti-inflammatory cytokine that belongs to the IL-12 family. Mast cells, as one of the major effector cells in the immune response system, plays an important role in the pathogenesis of chronic spontaneous urticarial (CSU). Our study aims to explore the inhibited role of IL-35 in HMC-1. METHODS: The effects of IL-35 on cell proliferation, cytokine expression, and histamine release in a human mast cell line (HMC-1) were investigated by CCK8, ELISA, or RT-PCR. The phosphorylation levels of ERK1/2, p38, and JNK1/2, in PMA plus A23187 induced HMC-1 cells was detected by Western Blot. RESULTS: We found that IL-35 significantly inhibited the proliferation of HMC-1 cells stimulated by PMA and A23187. IL-35 also down-regulates the release of histamine and the mRNA expression of IL-6 and IL-17 in activated HMC-1. Furthermore, IL-35 markedly inhibited the phosphorylation levels of ERK1/2, p38, and JNK1/2, in PMA plus A23187 induced HMC-1 cells. CONCLUSIONS: This study provides the first observations on the inhibitory and anti-inflammatory effect of IL-35 in activated HMC-1 cells. We suggest that IL35 may play an inhibited role in the pathogenesis of CSU.

Enhanced serum interferon-lambda 1 interleukin-29 levels in patients with psoriasis vulgaris.

BACKGROUND: Interferon (IFN)-λ1, also named Interleukin (IL)-29, is a new member of the Type III IFN or IFN-λ family. IL-29 plays an important role in the pathogenesis of many types of autoimmune and inflammatory diseases. OBJECTIVE: To study the role of IL-29 in the pathogenesis of psoriasis vulgaris. METHODS: The authors detected the serum levels of IL-29 in forty-one patients with psoriasis vulgaris, twenty-three patients with atopic dermatitis and thirty-eight age and gender-matched controls by sandwich Enzyme-Linked Immunosorbent Assay (ELISA). The effects of IL-29 on the expression of cytokines, such as IL-6, IL-17, IL-8, IL-4, IL10, Interferon (IFN-γ) and Tumor Necrosis Factor-α (TNF-α), in PBMCs and HaCat cells were determined by real-time quantitative PCR. RESULTS: Our data indicated that serum IL-29 levels were significantly elevated in patients with psoriasis vulgaris when compared with atopic dermatitis patients and the control group. Moreover, Serum levels of IL-29 were closely associated with the severity of psoriasis vulgaris. Furthermore, IL-29 up-regulated the mRNA expression levels of IL-6, IL-17 and TNF-α in PBMCs from psoriasis vulgaris patients. In addition, IL-29 enhanced the IL-6 and IL-8 expression from the HaCat cells. CONCLUSION: This study provides the first observations on the association of IL-29 and psoriasis vulgaris and showed elevated IL-29 serum levels. The authors suggest that IL-29 may play a role in the pathogenesis of psoriasis vulgaris.