[Paederus Dermatitis, a disease not to forget] / Dermatitis por Paederus, una enfermedad para no olvidar.

Paederus contact dermatitis is a skin disease caused by beetles of the genus Paederus and the release of a vesicant substance called paederin. It is worldwide distributed; However, it is more common in rainy seasons and hot climates. The clinical manifestations are vesicle-pustules that settle on erythematous skin. Treatment is based on washing with soap and water to neutralize the action of the toxin and the administration of topical steroids in short cycles. We report the case of a 28-year-old male patient who came to the dermatology clinic with a 48-hour history of two erythematous plaques with central blisters plus superficial ulceration located on the flexor aspect of the arm and right forearm, accompanied by a sensation of burning and itching at the site of the lesions, without other accompanying symptoms. As background, he states that he was on vacation in the coastal region of Ecuador when the lesions appeared. An incisional biopsy was performed and due to the clinical characteristics and the history of travel to a tropical region, it was diagnosed as Paederus dermatitis and treatment with antihistamines, topical steroids and cold compresses was indicated. After 8 days of treatment, the lesions subsided, leaving post-inflammatory hyperpigmentation.

La dermatitis de contacto por Paederus es una enfermedad cutánea causada por los coleópteros del género Paederus y la liberación de una sustancia vesicante llamada paederina. Es de distribución mundial; sin embargo, es más frecuente en temporadas de lluvia y en climas cálidos. Las manifestaciones clínicas son vesículo-pústulas que se asientan sobre piel eritematosa. El tratamiento se basa en el aseo con agua y jabón para neutralizar la acción de la toxina y la administración de esteroides tópicos en ciclos cortos. Se comunica el caso de un paciente masculino de 28 años, que acude a consulta de dermatología con cuadro de 48 horas de evolución de dos placas eritematosas con ampollas centrales más ulceración superficial localizadas en cara flexora de brazo y antebrazo derecho, acompañadas de una sensación de ardor y prurito en el lugar de las lesiones, sin síntomas acompañantes. Como antecedente refiere que se encontraba de vacaciones en la región costera de Ecuador al momento de aparecer las lesiones. Se realizó una biopsia incisional y por las características clínicas y el antecedente de viaje a una región tropical se diagnosticó como dermatitis por Paederus y se indicó tratamiento con antihistamínicos, esteroides tópicos y compresas frías. Después de 8 días de tratamiento, las lesiones remitieron dejando una hiperpigmentación postinflamatoria.

Proton pump inhibitor alters Th17/Treg balance and induces gut dysbiosis suppressing contact hypersensitivity reaction in mice.

Proton pump inhibitors (PPIs), such as omeprazole, are the most commonly prescribed drugs. Treatment with PPIs alters gut microbiota composition and reduces the production of reactive oxygen (ROS) and proinflammatory IL-1ß, IL-6, and TNF-α cytokines. Here, using the T cell-dependent contact hypersensitivity (CHS) response, an animal model of allergic contact dermatitis (ACD) that affects up to 30% of the population, we demonstrated that a two-week omeprazole treatment suppresses the development of CHS. Omeprazole treatment before CHS induction, reduced inflammatory response in ears measured by ear swelling, ear biopsy weight, MPO activity, and proinflammatory cytokine production. These changes were associated with reduced frequency of TCRαß+ CD4+ IL-17A+ and TCRαß+ CD8+ IL-17A+ T cells and increased frequency of TCRαß+ CD4+ CD25+ FoxP3+ Treg, and TCRαß+ CD4+ IL-10+ Tr1 cells in peripheral lymphoid organs. Omeprazole treatment decreased the production of ROS, TNF-α, and IL-6, which supported Th17 cell induction, and increased the frequency of Clostridium cluster XIVab and Lactobacillus, implicated in Treg cell induction. The fecal microbiota transplantation (FMT) experiment confirmed the role of omeprazole-induced changes in gut microbiota profile in CHS suppression. Our data suggests that omeprazole ameliorates inflammatory response mediated by T-cells.

Follicular mediated etodolac phosalosomal gel for contact dermatitis alleviation, insights from optimization to in-vivo appraisal.

Despite its long history as a preferential cyclooxygenase-2 inhibitor, the topical application of etodolac in inflammatory disorders does not achieve the desired clinical efficiency because of its poor water solubility and poor skin permeation. In the ongoing study, phosalosomes were designed to mitigate the etodolac drawbacks and to enhance its skin localization. Hyaluronic acid was utilized to prepare a dermal gel for the alleviation of skin inflammation. Etodolac loaded hyaluronic acid phosalosomal gel had a sustainable release profile and 10.59-fold enhanced skin retention compared to free etodolac, with boosted skin tolerability on histopathological examination after acute and chronic applications. Confocal laser microscopy imaging indicated that the etodolac amounts accumulated in the liver and kidney following dermal application were 29 and 5.7-fold lower than those following the systemic dose, respectively. For in vivo studies, etodolac loaded hyaluronic acid phosalosomal gel presented superior anti-oedemic and significant anti-nociception potential. The promising homogenous localization highlighted its potential for the delivery of lipophilic drugs for the targeted treatment of other localized skin disorders.

Unveiling the immune-modulating power of THz-FEL irradiation.

As terahertz (THz) technology advances, the interaction between THz radiation and the living body, particularly its effects on the immune system, has attracted extensive attention but remains poorly understood. This study firstly elucidated that exposure to 3 THz-FEL radiation markedly suppressed contact hypersensitivity reactions in mice induced by DNFB, as evidenced by a reduction in ear thickness and a discernible recovery in the Th1/Th2 cell balance. 3 THz irradiation led to cellular stress in the irradiated skin locale, increasing the levels of IL-4 and IL-10 and modulating the activity and migration of dendritic cells and mast cells. Furthermore, THz irradiation precipitated a rapid alteration in the skin lipidome, altering several categories of bioactive lipids. These findings offer new insights into the immunomodulatory effects of THz radiation on living organisms and the potential underlying mechanisms, with implications for the development of therapeutic approaches in managing skin allergic diseases.

Non-Target Screening of Chemicals in Selected Cotton Products by GC/MS and Their Safety Assessment.

Cotton is used for the production of textiles, hygiene and cosmetic materials. During cultivation and technological processes, various types of substances (surfactants, softeners, lubricants, etc.) penetrate cotton, which can have a harmful effect on both the human body and the environment. The aim of this study was to analyze selected cotton products in order to identify the substances contained and to describe the potential possibilities of inducing textile contact dermatitis (CD). The impact of the identified compounds on the aquatic environment was also taken into account. Nine samples of cotton clothing and seven samples of cotton pads from various manufacturers were tested. Samples after extraction using the FUSLE (Focused Ultrasonic Liquid Extraction) technique were analyzed with GC/MS. Qualitative analysis was based on comparing mass spectra with library spectra using the following mass spectra deconvolution programs: MassHunter (Agilent), AMDIS (NIST), and PARADISE (University of Copenhagen). The parameter confirming the identification of the substance was the retention index. Through the non-target screening process, a total of 36 substances were identified, with an average AMDIS match factor of approximately 900 ("excellent match"). Analyzing the properties of the identified compounds, it can be concluded that most of them have potential properties that can cause CD, also due to the relatively high content in samples. This applies primarily to long-chain alkanes (C25-C31), saturated fatty acids, fatty alcohols (e.g., oleyl alcohol), and fatty acid amides (e.g., oleamide). However, there are not many reports describing cases of cotton CD. Information on the identified groups of compounds may be helpful in the case of unexplained sources of sensitization when the skin comes into contact with cotton materials. Some of the identified compounds are also classified as dangerous for aquatic organisms, especially if they can be released during laundering.

Dermatological conditions in the intensive care unit at a tertiary care hospital in Riyadh, Saudi Arabia.

OBJECTIVES: To evaluate the various skin conditions diagnosed in intensive care unit (ICU) patients. METHODS: This is a descriptive retrospective study of all adults, pediatric, and neonatal patients who were admitted to the ICU and had a dermatological manifestation during hospital stay or patients who had dermatological condition that requires ICU admission. All skin conditions were categorized and analyzed. RESULTS: A total of 344 ICU patients with 365 different dermatological conditions were included in the study. The age of patients ranged from less than 1-96 years, with a mean age of 43.6±30.1 years. Of the patients, 189 (54.9%) were males. The top 3 general disease categories observed were skin infections, inflammatory and autoimmune diseases, and drug reactions. The most commonly reported dermatological disorders included morbilliform drug eruption (6.8%), contact dermatitis (6.3%), vasculitis (5.5%), herpes zoster (4.6%), purpura due to thrombocytopenia (3.8%), dermatitis/eczema (3.8%), candidiasis (3.8%), infantile hemangioma (2.7%), unclassified drug reaction (2.5%), intertrigo (2.5%), and herpes simplex virus (2.5%). CONCLUSION: Dermatological disorders can occur at various levels of severity in the ICU. Skin infections, inflammatory and autoimmune diseases, and drug reactions were found to be the most prevalent conditions.

Facemask acne attenuation through modulation of indirect microbiome interactions.

During the COVID-19 pandemic, facemasks played a pivotal role in preventing person-person droplet transmission of viral particles. However, prolonged facemask wearing causes skin irritations colloquially referred to as 'maskne' (mask + acne), which manifests as acne and contact dermatitis and is mostly caused by pathogenic skin microbes. Previous studies revealed that the putative causal microbes were anaerobic bacteria, but the pathogenesis of facemask-associated skin conditions remains poorly defined. We therefore characterized the role of the facemask-associated skin microbiota in the development of maskne using culture-dependent and -independent methodologies. Metagenomic analysis revealed that the majority of the facemask microbiota were anaerobic bacteria that originated from the skin rather than saliva. Previous work demonstrated direct interaction between pathogenic bacteria and antagonistic strains in the microbiome. We expanded this analysis to include indirect interaction between pathogenic bacteria and other indigenous bacteria classified as either 'pathogen helper (PH)' or 'pathogen inhibitor (PIn)' strains. In vitro screening of bacteria isolated from facemasks identified both strains that antagonized and promoted pathogen growth. These data were validated using a mouse skin infection model, where we observed attenuation of symptoms following pathogen infection. Moreover, the inhibitor of pathogen helper (IPH) strain, which did not directly attenuate pathogen growth in vitro and in vivo, functioned to suppress symptom development and pathogen growth indirectly through PH inhibitory antibacterial products such as phenyl lactic acid. Taken together, our study is the first to define a mechanism by which indirect microbiota interactions under facemasks can control symptoms of maskne by suppressing a skin pathogen.

Differential diagnosis of contact dermatitis: A practical-approach review by the EADV Task Force on contact dermatitis.

The diagnosis of eczema ('dermatitis') is mostly clinical and depends on the clinical history and exploratory objective findings (primary lesions, patterns). Contact dermatitis remains as an important condition in the group of eczematous disorders, with important socioeconomic and occupational relevance. Although irritant and allergic contact dermatitis have a different pathogenesis, both are characterized by a rather typical morphology, are triggered by external factors and tend to occur primarily in the area of contact with the exogenous agent. In addition, allergic and irritant dermatitis may also co-exist. The importance of diagnosing contact dermatitis, especially when allergic in nature, is both due to the possibility of avoiding the trigger, and due to its role in aggravating other skin conditions. Nevertheless, the heterogeneity of clinical presentations in daily practice may pose an important challenge for the suspicion and correct diagnosis of contact dermatitis. Furthermore, other conditions, with different pathogenesis and treatment, may clinically simulate contact dermatitis. The Task Force aims to conduct a review of the unifying clinical features of contact dermatitis and characterize its main clinical phenotypes, and its simulators, in order to contribute to an early suspicion or recognition of contact dermatitis and enable a correct differential diagnosis.

Is the varying management of incontinence-associated dermatitis due to a lack of understanding of etiology?

Incontinence-associated dermatitis, previously and sometimes still referred to as moisture lesions or moisture damage, is a commonly seen contact dermatitis that is a reactive response of the skin to chronic contact to urine and faecal matter. Understanding the etiology is fundamental to creating a skin care plan and successfully prevention. Systemic reviews and studies have shown that the continued variability in management results from a combination of knowledge base, observation, diagnosis, and product selection. This article aims to improve clinicians' understanding of incontinence-associated dermatitis and its management.