Where Microneedle Meets Biomarkers: Futuristic Application for Diagnosing and Monitoring Localized External Organ Diseases.

Extracellular tissue fluids are interesting biomatrices that have recently attracted scientists' interest. Many significant biomarkers for localized external organ diseases have been isolated from this biofluid. In the diagnostic and disease monitoring context, measuring biochemical entities from the fluids surrounding the diseased tissues may give more important clinical value than measuring them at a systemic level. Despite all these facts, pushing tissue fluid-based diagnosis and monitoring forward to clinical settings faces one major problem: its accessibility. Most extracellular tissue fluid, such as interstitial fluid (ISF), is abundant but hard to collect, and the currently available technologies are invasive and expensive. This is where novel microneedle technology can help tackle this significant obstacle. The ability of microneedle technology to minimally invasively access tissue fluid-containing biomarkers will enable ISF and other tissue fluid utilization in the clinical diagnosis and monitoring of localized diseases. This review attempts to present the current pursuit of the application of microneedle systems as a diagnostic and monitoring platform, along with the recent progress of biomarker detection in diagnosing and monitoring localized external organ diseases. Then, the potential use of various microneedles in future clinical diagnostics and monitoring of localized diseases is discussed by presenting the currently studied cases.

A diagnostic challenge in an atypical variant of microcystic adnexal carcinoma mimicking ulcerative basal cell carcinoma: a case report and brief literature review.

Microcystic adnexal carcinoma (MAC) is a rare adnexal tumor with eccrine and pillar differentiations with a localized and aggressive nature, often misdiagnosed as other dermatoses. The most common clinical manifestations of MAC are yellowish or skin-colored papules, nodules, and plaques. However, in some rare cases an atypical manifestation such as ulceration that resembles malignancies such as basal cell carcinoma (BCC) can also occur. Diagnosis of MAC mainly relies on the aid of histopathology. Due to potential infiltration to other structures such as in perineural invasion, wide surgical excision or Mohs micrographic surgery is the preferred surgical option. We report the case of a 75-year-old male patient with ulcerative lesion on the forehead that clinically resembled BCC in addition to typical dermoscopic findings of BCC. However, histopathology confirmed a diagnosis of MAC, prompting physicians to be more aware of this condition when encountering chronic ulcerative lesions. After wide excision and a 1-year follow-up, the patient exhibited no signs of recurrences and will continue long-term follow-up.

Successful basal cell carcinoma defect reconstruction using combination of rotation and advancement flap: Two case reports.

Defects resulting from surgical procedure may be challenging to reconstruct depending on the size and location. In case of large defects, primary closure is often not possible and thus requires skin flap or graft. In such cases, skin flap is advantageous as it produces a similar color and texture with the surrounding tissue. Skin flap techniques such as advancement flap, rotation flap dan transposition flap are useful in closing small defects. In moderate to large-sized defects, especially in areas with high tension, a combination of more than one type of flap might be necessary. This report describes two cases of large defects on the temple and cheek following basal cell carcinoma excisional surgery which were successfully closed using a combination of rotation and advancement flaps. Both patients showed excellent functional and cosmetic outcome.

Cutaneous lesions as the first manifestation of breast cancer: a rare case.

Cutaneous metastases due to internal malignancies are rare but, in some cases, may present as the first manifestation of an undiagnosed malignancy. A 62-year-old female presented with itchy reddish patch on the left neck which spread to the left shoulder, arm, breast, and back four weeks prior to admission. Ten days later, vesicles emerged, ruptured, and ulcerated. The patient denied any history of breast lump. Skin biopsy showed diffuse dermal nests of tumor cells infiltrating to the collagen bundles and fat tissue, which was consistent with cutaneous metastasis from the breast cancer. The patient refused further workup and treatment and eventually passed away. This case showed the importance of conducting a comprehensive evaluation in cutaneous lesions presenting with early or sudden onset, rapid evolution, tendency to bleed, that do not resolve with treatment.

Unusual clinical manifestation of seborrheic keratosis on the scalp successfully treated with topical trichloroacetic acid: an atypical case report.

Seborrheic keratoses (SKs) are benign tumor of the skin. They can occur anywhere, except the palms and soles. SKs commonly present as multiple, pigmented papules which is classically described as verrucous stuck-on papules or plaques. A case with multiple nodular appearance is a rare case and to our knowledge has never been reported. Here we report a rare case of multiple SKs on the scalp. On clinical evaluation, multiple, erythematous hyperkeratotic nodules were present. Dermoscopic and histopathological examination supported SKs. The patient was successfully treated with topical application of 80% TCA solution.

Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals.

To compare the effectiveness of tranexamic acid (TA) combination serum with hydroquinone, the gold standard in whitening agents for healthy populations. This was a three-arm randomized controlled trial. The subjects were divided into three groups: the first group received 3% TA combination serum (3% TA, 4% galactomyces ferment filtrate, 2% niacinamide, and 4% alpha arbutin), the second group received 2% TA combination serum, and the third group received 4% hydroquinone. One milliliter of each serum was applied on three holes: Hole A, which was located 4 cm from the left cubital fossa, Hole B, which was located 4 cm from the first hole, and Hole C, which was located 4 cm from the right cubital fossa. The skin brightness and pigmentation intensity were evaluated each week for 4 weeks using a chromameter. A total of 44 subjects were recruited for this study. All groups showed a significant improvement in skin brightness and pigmentation intensity after 4 weeks (p < .001). There were no differences between the treatment groups and hydroquinone (p > .05). TA serum (2 and 3%) combined with 4% galactomyces ferment filtrate, niacinamide, and alpha arbutin is an effective depigmenting agent.