When time does not heal all wounds-the use of medical grade honey in wound healing: a case series.

OBJECTIVE: Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. METHODS: In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. RESULTS: Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. CONCLUSION: In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.

Translational autoimmunity in pemphigus and the role of novel Bruton tyrosine kinase inhibitors.

Bruton tyrosine kinase (BTK) is involved in a multifarious inflammatory and autoimmune process. As a result, BTK has emerged as a promising novel remedial target for amalgamated autoimmune diseases. Medicament corporations have recently devoted considerable attention to the evolution of BTK inhibitors. Pemphigus is an uncommon and often fatal autoimmune illness. Blisters and erosions on cutaneous surfaces and mucous membranes are crippling symptoms of pemphigus vulgaris, which are caused by immunoglobulin G autoantibodies binding to keratinocyte proteins, resulting in keratinocyte adhesion defects. Although systemic corticosteroids and adjuvant medications are used to treat pemphigus, some patients are resistant to these. BTK inhibitors inhibit B-cell signaling, which is clinically useful in treating pemphigus. Assorted clinical trials are underway to assess the safety, tolerability, and pharmacokinetics of distinct BTK inhibitors, including PRN473 and remibrutinib. The current review evaluates translational autoimmunity in pemphigus and discusses BTK inhibitors in the treatment of pemphigus.

Treatment-resistant atopic dermatitis: novel therapeutics, digital tools, and precision medicine.

Atopic dermatitis (AD) is a prevalent condition impacting up to 25% of children and 8% of adults worldwide. An estimated 20% of those with AD comprise a subset of patients with treatment-resistant AD, for whom traditional therapeutics and management strategies are unsuccessful. Physical symptoms significantly impact quality of life for patients and caregivers. The condition is chronic and may persist throughout the lifespan with recurrent episodes. Novel AD therapeutics offer new opportunities to resolve symptoms of treatment-resistant more effectively AD. Recently developed pharmacological agents were developed with an appreciation of AD as a heterogeneous condition. New advances include topical, oral, and injectable therapeutics with novel mechanisms of action. In addition, advances in clinical practice, including the application of digital tools, can promote a personalized medicine approach. For example, teledermatology for chronic conditions such as AD have been embraced by clinicians and patients; communicating symptoms via photographs can augment patient symptom trackers and aid trigger identification. Digital tools can also be used to increase medication adherence and improve patient/caregiver engagement. Integrating the above is a personalized medicine approach. Advanced therapeutics with novel mechanisms of action, integrated with digital tools, and trends toward patient-centered medicine can assist this chronic, heterogeneous condition via precision medicine and better treat treatment-resistant AD.

Getting to the Core of Contemporary Therapies for Post-Inflammatory Hyperpigmentation.

Post-inflammatory hyperpigmentation (PIH) is a typical complication of inflammatory dermatoses that more frequently and severely affects people with darker skin. External insults to the skin, such as burn injuries, dermatologic treatments, and intrinsic skin disorders (eg, eczema and acne), are common causes of PIH. Individuals with darker skin are prone to develop PIH, which can cause substantial psychological suffering. PIH can be prevented or alleviated. When this happens, it is essential to point out what is causing it and treat it as soon as possible to prevent inflammation and PIH from progressing. If the inflammatory symptoms go away or there is no evidence of inflammation at the time of diagnosis, PIH treatments should be evaluated. To hasten the resolution of PIH, treatment should begin as soon as possible. Treatment begins with the care of the initial inflammatory condition. Topical medications, chemical peels, laser and light-based treatment, phototherapy, and other therapeutic modalities are offered to treat PIH. Understanding the therapy options available helps the physician in choosing the best treatment for each patient. With these backgrounds, the current review aimed to discuss the epidemiology, pathogenesis, clinical presentation, and available treatment options for the PIH. J Drugs Dermatol. 2022;21(3):276-283. doi:10.36849/JDD.6485.