Oral postbiotics derived from Lactobacillus sp. in treatment of atopic dermatitis: a meta-analysis.

INTRODUCTION: The use of postbiotics, which are defined as dead microorganisms and/or their components that provide health benefits to the target host, has been shown to reduce the severity of atopic dermatitis (AD) in several studies. METHODS: A systematic literature review was conducted in Pubmed, the Cochrane Library, Science Direct, Clinicaltrials.gov, and Google Scholar, covering the period from January 2012 to July 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. AD patients of all ages that received oral postbiotics or placebo as treatment were the focus of the study. The main study outcome was the scoring of atopic dermatitis (SCORAD) and other measures, such as extension area, disease intensity, and adverse events. The final data were pooled using a fixed-effect model. RESULTS: A meta-analysis of three studies found that, compared to placebo, SCORAD was lower in subjects that were given oral postbiotics from Lactobacillus sp. (mean difference: -2.90, 95% confidence interval [CI; -4.21, -1.59], p < 0.00001). From the comparison of two studies, the differences in disease extension (mean difference: -2.40, 95% CI [-7.67, 2.81], p = 0.37) and intensity (mean difference: -0.27, 95% CI [-0.84, 0.30], p = 0.36) were not significant. CONCLUSIONS: The administration of oral postbiotics from Lactobacillus sp. has the potential to alleviate the severity of AD as indicated by a reduction in SCORAD scores.

A single dose of benzathine penicillin G as an effective treatment for malignant syphilis in an HIV-positive patient: a case report.

Malignant syphilis (MS) is a rare, atypical manifestation of secondary syphilis. Ulcerative lesions should be suspected as MS when found with supporting microscopic morphology, a high syphilis serology titer test, a Jarisch-Herxheimer reaction (JHR), and rapid disease resolution. To date, there is no specific recommendation for treatment for MS. A 24-year-old HIV-positive MSM patient with a CD4 count of 470 cells/µl presented with a chief complaint of necrotic, ulcerative lesions and oyster shell-like surface plaques on his face, trunk, groin, and extremities. The patient also developed various typical presentations of secondary syphilis. Dark-field microscopy revealed spirochetes. Histopathological examination showed spongiotic dermatitis with many neutrophil cells in the dermis, together with endarteritis and fibrin micro-thrombus in the blood vessels. The patient had a high venereal disease research laboratory (VDRL) titer of 1:512. There was rapid disease resolution following a single injection of 2,400,000-unit benzathine penicillin G (BPG); together with anti-retroviral therapy, this was supportive treatment for MS. JHR was not observed in this study and many other reports. This case showed that ulcerative lesions with an oyster shell-like surface presenting in HIV-positive patients along with supporting microscopic morphology, high VDRL titer, and a dramatic improvement after antibiotic treatment is highly suggestive of MS. JHR may no longer be a characteristic of MS. A single dose of 2,400,000-unit BPG is sufficient for MS treatment.

Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study.

Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients' quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018-2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.