Modulation of Melanocyte in Melasma Patients After Picosecond Laser Treatment.

BACKGROUND: Melasma is a therapeutically challenging hyperpigmented skin condition. Currently, there is a lack of in vivo observation regarding changes in melanin and dendritic melanocytes after laser treatment. OBJECTIVE: To investigate alterations in melanin and melanocytes in melasma before and after laser treatment using optical coherence tomography (OCT). METHODS: Eight female melasma patients were enrolled in Taiwan. Based on the baseline OCT scans, the patients were categorized into either epidermal-type or mixed-type melasma and were assigned different treatment protocols accordingly. Sequential OCT images were collected from melasma lesions and normal skin at baseline, Week 4 and Week 8. RESULTS: After 8 weeks of laser treatment, the mean Melasma Area Severity Index (MASI) score improved from 10.92 to 6.30. Results from OCT showed no significant changes in the normalized density, area, or intensity of melanin in both lesional and normal skin. At baseline, the mean length of dendritic melanocytes in the affected skin was 15% longer than those in normal skin; at Week 8, the mean length of lesional dendritic melanocytes became the same as those in normal skin. Additionally, the mean width of dendritic melanocytes decreased from being 4% wider to only 2% wider than those in normal skin. CONCLUSION: After 8 weeks of treatment, an improvement of MASI score was noted, mainly attributable to a reduction in lesional area. OCT showed no notable change regarding melanin, but a decrease in length and width of dendritic melanocytes was noted in the lesional skin of melasma patients.

Association between vitiligo and risk of retinal detachment: a population-based cohort study in Taiwan.

BACKGROUND: Vitiligo is reportedly associated with several ocular abnormalities. However, the relationship between vitiligo and retinal detachment (RD) remains unclear. OBJECTIVES: To examine the risk of RD in patients with vitiligo. METHODS: A nationwide population-based cohort study was conducted using data from the Taiwan National Health Insurance Database from 2007 to 2018. A total of 21 132 patients with vitiligo were matched in a 1 : 4 ratio with people without vitiligo by age, sex and comorbidity propensity score. Cumulative incidence and Cox proportional hazard models were used to investigate the risk of RD in patients with vitiligo. Subgroup analysis was performed. RESULTS: The cohort with vitiligo had a significantly higher rate of RD than the cohort without vitiligo [adjusted hazard ratio (aHR) 1.44, 95% confidence interval (CI) 1.20-1.72; P < 0.001]. Patients with vitiligo who required treatments such as phototherapy, systemic corticosteroids or immunosuppressants exhibited an even greater risk of RD (aHR 1.57, 95% CI 1.16-2.14; P = 0.004). CONCLUSIONS: Our study revealed a 1.44-fold increased risk of RD in patients with vitiligo, with an even higher risk in patients receiving phototherapy, systemic corticosteroids or immunosuppressants. The risk remained consistently higher over a 10-year follow-up period.

Corrigendum: Pregnancy-related stress among pregnant women receiving tocolytic and non-tocolytic treatments where both used complementary medicine.

[This corrects the article DOI: 10.3389/fphar.2022.870659.].

Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine.

Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women's health studies.

Association between bullous pemphigoid and risk of venous thromboembolism: A nationwide population-based cohort study.

Bullous pemphigoid (BP) has been reported to be associated with an increased risk of venous thromboembolism (VTE). However, the exact time course is unclear, and no previous studies have been reported in the Asian population. This nationwide population-based cohort study examined the risk of VTE among BP patients in Taiwan between 2007 and 2018. A total of 12 692 BP patients were 1:2 matched with non-BP patients by age, sex, and propensity score of comorbidities. Cumulative incidence and Cox proportional hazards models were used to investigate the risk of VTE. The BP cohort had a significantly higher VTE rate than the non-BP cohort (0.17% vs. 0.08%, p = 0.015) in 1 year; the finding was more prominent within the first 6 months after diagnosis. BP was a significant risk factor for VTE (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.01-4.06); the association mildly diminished but remained significant after extending the follow-up period to 2 years (HR, 1.73; 95% CI, 1.06-2.81). Other significant risk factors for VTE included cancer, chronic liver disease and cirrhosis, and female sex. In conclusion, this study revealed a 2.02-fold increased risk of VTE in patients with BP in Taiwan.

Mid-Term Outcome of Infected Abdominal Aortic Stent Graft Dismantlement with Reconstruction of Bilateral Axillofemoral Bypass.

Background: Abdominal aortic stent graft infection (AAGI) is a severe complication. The optimal management of AAGI remains unclear. This study provides updated results of bilateral axillofemoral bypasses (AFBs) for patients with AAGI. Patients and Methods: In total, 31 patients (25 men; mean age, 67.1 years) with AAGI treated using AFB between January 2006 and April 2020 were included. Overall, the mean follow-up duration was 24 months (range, 1-72). In the 23 patients who survived the post-operative period, the mean follow-up duration was 32 months (range, 12-72). Results: Thirty-day and in-hospital mortality rates was 16% and 26%, respectively. The 12-month primary and secondary patency rates for the AFB graft were both 91%. In total, seven (30%) patients received re-interventions such as thrombectomy and balloon angioplasty. No amputation was required during follow-up. Culture results were positive in 87% of pre-operative cultures and 84% of intra-operative cultures. Staphylococcus aureus was the most prevalent pathogen, with four cases of methicillin-resistant Staphylococcus aureus and one each of vancomycin-resistant enterococci, carbapenem-resistant Klebsiella pneumoniae, and carbapenem-resistant Enterobacteriaceae. In-hospital mortality rate was 57% in patients with drug-resistant pathogens. Conclusions: Reconstruction with bilateral AFB and stent graft removal in patients with AAGI is a feasible treatment modality and provided an acceptable patency rate and low amputation rate. Additional studies investigating long-term results and the optimal treatment of AAGI are required.