Clinical and dermoscopic characteristics of onychophagia and onychotillomania: a retrospective study of 63 cases.

Onychophagia and onychotillomania are common forms of nail-biting and nail-picking disorders, but there is insufficient literature documenting their comparison and coexistence. In fact, overlapping features can be involved in different nail self-injuries, and significant variations also exist. We conducted a retrospective study aimed at identifying differences between onychophagia and onychotillomania, and providing more detailed findings of both conditions.

[The Evaluation of Calcium Alginate Dressing Helping Wound Healing of Nail Surgery].

OBJECTIVE: To determine the effect of calcium alginate dressing therapy on wound healing after nail surgery. METHODS: Patients with nail surgery on nail bed of great toe were divide into two groups (20 caces for each group) randomly based on random number table. Calcium alginate dressing were used in treatment group after nail surgery and the vaseline gauze were applied in control group after surgery. The number of wound remain bleeding and the rating of pain [visual analogue scale (VAS)] scores were observed for three times (24 h, 48 h and 72 h). Median time of pain bearing and time of wound healing were also observed. RESULTS: There were 16 males and 4 females in control group [mean age (37.45±3.30) yr.]. There were 12 males and 8 females in treatment group [mean age (33.40±3.13) yr.].There were no significant differences in sex ratio and age between the two groups (P>0.05). No infection was found in the treatment group, but 1 case in the control group. The number of bleeding cases in treatment group was less than that in control group (P<0.05), as well as the VAS scores 24 h after nail surgery (P<0.05). At 48 h, no bleeding occurred in the traetment group, while there were 2 cases of bleeding in the control group (P>0.05); the VAS score in treatment group was less than that in control group (P<0.05). At 72 h, no bleeding was observed in both groups, and the difference in VAS score between the two groups was not statistically significant (P>0.05). The median time of pain bearing was 24 h in treatment group while 72 h in control group. Wound healing time of treatment group (9.40 d) and control group (11.35 d) was statistically significant (P<0.05). CONCLUSION: Calcium alginate dressing therapy can promote postoperative wound recovery and block bleeding and pain after nail surgery.

miR-141-3p inhibits fibroblast proliferation and migration by targeting GAB1 in keloids.

Keloids are benign dermal fibroproliferative tumors that develop as a result of several dysregulated processes. Emerging evidence has revealed that miRNAs contribute to keloid formation. However, the molecular mechanisms of keloid pathogenesis remain unclear. In our study, we found that miR-141-3p in keloid tissues and keloid fibroblasts was significantly decreased compared with the levels in normal tissues and normal skin fibroblasts, respectively. miR-141-3p overexpression resulted in significantly decreased proliferation and migration and the promotion of apoptosis in keloid fibroblasts, whereas miR-141-3p knockdown in keloid fibroblasts yielded the opposite results. Growth factor receptor binding 2-associated binding protein 1 (GAB1) was identified and confirmed as a direct target of miR-141-3p. The expression of GAB1 was up-regulated in keloid tissues, and the restoration of GAB1 partially reversed the inhibitory effects of miR-141-3p on the proliferation and migration of keloid fibroblasts. All data suggested that miR-141-3p decreased the proliferation and migration of keloid fibroblasts by repressing GAB1 expression, providing a useful target for keloid management.

Systemic antifungal therapy for tinea capitis in children: An abridged Cochrane Review.

BACKGROUND: The comparative efficacy and safety profiles of systemic antifungal drugs for tinea capitis in children remain unclear. OBJECTIVE: We sought to assess the effects of systemic antifungal drugs for tinea capitis in children. METHODS: We used standard Cochrane methodological procedures. RESULTS: We included 25 randomized controlled trials with 4449 participants. Terbinafine and griseofulvin had similar effects for children with mixed Trichophyton and Microsporum infections (risk ratio 1.08, 95% confidence interval 0.94-1.24). Terbinafine was better than griseofulvin for complete cure of T tonsurans infections (risk ratio 1.47, 95% confidence interval 1.22-1.77); griseofulvin was better than terbinafine for complete cure of infections caused solely by Microsporum species (risk ratio 0.68, 95% confidence interval 0.53-0.86). Compared with griseofulvin or terbinafine, itraconazole and fluconazole had similar effects against Trichophyton infections. LIMITATIONS: All included studies were at unclear or high risk of bias. Lower quality evidence resulted in a lower confidence in the estimate of effect. Significant clinical heterogeneity existed across studies. CONCLUSIONS: Griseofulvin or terbinafine are both effective; terbinafine is more effective for T tonsurans and griseofulvin for M canis infections. Itraconazole and fluconazole are alternative but not optimal choices for Trichophyton infections. Optimal regimens of antifungal agents need further studies.

[The Comparison and Evaluation of Partial Nail Avulsion and Total Nail Avulsion with Plate Replacement with Traditional Total Nail Avulsion].

OBJECTIVES: To determine the different effects of partial nail avulsion and total nail avulsion with plate replacement with traditional total nail avulsion. METHODS: Patients were divided into three groups randomly ( n=20): total nail avulsion group (control group), partial nail avulsion group, and total nail avulsion with plate replacement group (nail replacement group). The rating of pain [visual analogue scale (VAS) score], the wound healing time, the nail growth time , and the score of satisfaction were analyzed. RESULTS: The baseline data of three groups had no significant difference. From 8 h, VAS score of partial nail avulsion group and nail plate replacement group was different with that in control group ( P<0.05) . 48 h after surgery, the pain disappeared totally in partial nail avulsion group, largely in nail replacement group [90% (18/20) ] , which were both significantly different with that of control group [45%(9/20)] ( P<0.05) . Healing time of three groups was listed as follow: control group>nail replacement group>partial nail avulsion group ( P<0.05) . Nail growth time was the longest in control group, the shortest in partial nail avulsion group ( P<0.05, vs. control group), and median in nail replacement group. The score of satisfaction in control group was lower than that in partial avulsion group and nail replacement group ( P<0.05) , of the later two there was no statistic difference. CONCLUSIONS: By decreasing the defect of nail plate and the injury of nail bed, and by smoothing the pain, partial nail avulsion benefits the wound-healing. Nail plate should be replace to get further benefits.

[Clinical MedicineThe Evaluation of He-Ne Laser Therapy Help Wound Healing of Nail Surgery].

OBJECTIVES: To investigate the effect of He-Ne laser therapy on wound healing after nail surgery. METHODS: Patients who needed nail surgery were divided into treatment group (n=20) and control group (n=20) randomly.The He-Ne laser was applied to the wound after nail surgery in treatment group. The wound healing time, the inflammation duration, the pain rating, and the nail plate full-grown time were compared with control group. RESULTS: No significant differences in baseline of two groups were observed. The wound healing time was (16.00±2.51) d in control group and (11.35±1.73 ) d in treatment group, the inflammation duration was (9.10±2.10) d in control group and (7.20±1.44) d in treatment group (P<0.05), both above differences were significant (P<0.05).The nail plate full-grown time was (21.00±2.13) weeks in treatment group, whereas (21.40±1.05) weeks in control group (P>0.05).The pain rating of the 2 groups was different from 25 h (after 3 times treatment)(P<0.05). Pain disappeared in 85.0% (17/20) patients of treatment group after 49 h (5 times treatment), and completely disappeared (20/20) after 54 h (6 times treatment), which were faster than those of control group at the same time points (pain disappeared only in 50.0% and 98.5% of patients respectively). CONCLUSIONS: He-Ne laser therapy can help wound healing after nail surgery.

Systemic antifungal therapy for tinea capitis in children.

BACKGROUND: Tinea capitis is a common contagious fungal infection of the scalp in children. Systemic therapy is required for treatment and to prevent spread. This is an update of the original Cochrane review. OBJECTIVES: To assess the effects of systemic antifungal drugs for tinea capitis in children. SEARCH METHODS: We updated our searches of the following databases to November 2015: the Cochrane Skin Group Specialised Register, CENTRAL (2015, Issue 10), MEDLINE (from 1946), EMBASE (from 1974), LILACS (from 1982), and CINAHL (from 1981). We searched five trial registers and checked the reference lists of studies for references to relevant randomised controlled trials (RCTs). We obtained unpublished, ongoing trials and grey literature via correspondence with experts in the field and from pharmaceutical companies. SELECTION CRITERIA: RCTs of systemic antifungal therapy in children with normal immunity under the age of 18 with tinea capitis confirmed by microscopy, growth of fungi (dermatophytes) in culture or both. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 25 studies (N = 4449); 4 studies (N = 2637) were new to this update.Terbinafine for four weeks and griseofulvin for eight weeks showed similar efficacy for the primary outcome of complete (i.e. clinical and mycological) cure in three studies involving 328 participants with Trichophyton species infections (84.2% versus 79.0%; risk ratio (RR) 1.06, 95% confidence interval (CI) 0.98 to 1.15; low quality evidence).Complete cure with itraconazole (two to six weeks) and griseofulvin (six weeks) was similar in two studies (83.6% versus 91.0%; RR 0.92, 95% CI 0.81 to 1.05; N = 134; very low quality evidence). In two studies, there was no difference between itraconazole and terbinafine for two to three weeks treatment (73.8% versus 78.8%; RR 0.93, 95% CI 0.72 to 1.19; N = 160; low quality evidence). In three studies, there was a similar proportion achieving complete cured with two to four weeks of fluconazole or six weeks of griseofulvin (41.4% versus 52.7%; RR 0.92, 95% CI 0.81 to 1.05; N = 615; moderate quality evidence). Current evidence for ketoconazole versus griseofulvin was limited. One study favoured griseofulvin (12 weeks) because ketoconazole (12 weeks) appeared less effective for complete cure (RR 0.76, 95% CI 0.62 to 0.94; low quality evidence). However, their effects appeared to be similar when the treatment lasted 26 weeks (RR 0.95, 95% CI 0.83 to 1.07; low quality evidence). Another study indicated that complete cure was similar for ketoconazole (12 weeks) and griseofulvin (12 weeks) (RR 0.89, 95% CI 0.57 to 1.39; low quality evidence). For one trial, there was no significant difference for complete cure between fluconazole (for two to three weeks) and terbinafine (for two to three weeks) (82.0% versus 94.0%; RR 0.87, 95% CI 0.75 to 1.01; N = 100; low quality evidence). For complete cure, we did not find a significant difference between fluconazole (for two to three weeks) and itraconazole (for two to three weeks) (82.0% versus 82.0%; RR 1.00, 95% CI 0.83 to 1.20; low quality evidence).This update provides new data: in children with Microsporum infections, a meta-analysis of two studies found that the complete cure was lower for terbinafine (6 weeks) than for griseofulvin (6-12 weeks) (34.7% versus 50.9%; RR 0.68, 95% CI 0.53 to 0.86; N = 334; moderate quality evidence). In the original review, there was no significant difference in complete cure between terbinafine (four weeks) and griseofulvin (eight weeks) in children with Microsporum infections in one small study (27.2% versus 60.0%; RR 0.45, 95% CI 0.15 to 1.35; N = 21; low quality evidence).One study provides new evidence that terbinafine and griseofulvin for six weeks show similar efficacy (49.5% versus 37.8%; RR 1.18, 95% CI 0.74 to 1.88; N = 1006; low quality evidence). However, in children infected with T. tonsurans, terbinafine was better than griseofulvin (52.1% versus 35.4%; RR 1.47, 95% CI 1.22 to 1.77; moderate quality evidence). For children infected with T. violaceum, these two regimens have similar effects (41.3% versus 45.1%; RR 0.91, 95% CI 0.68 to 1.24; low quality evidence). Additionally, three weeks of fluconazole was similar to six weeks of fluconazole in one study in 491 participants infected with T. tonsurans and M. canis (30.2% versus 34.1%; RR 0.88, 95% CI 0.68 to 1.14; low quality evidence).The frequency of adverse events attributed to the study drugs was similar for terbinafine and griseofulvin (9.2% versus 8.3%; RR 1.11, 95% CI 0.79 to 1.57; moderate quality evidence), and severe adverse events were rare (0.6% versus 0.6%; RR 0.97, 95% CI 0.24 to 3.88; moderate quality evidence). Adverse events for terbinafine, griseofulvin, itraconazole, ketoconazole, and fluconazole were all mild and reversible.All of the included studies were at either high or unclear risk of bias in at least one domain. Using GRADE to rate the overall quality of the evidence, lower quality evidence resulted in lower confidence in the estimate of effect. AUTHORS' CONCLUSIONS: Newer treatments including terbinafine, itraconazole and fluconazole are at least similar to griseofulvin in children with tinea capitis caused by Trichophyton species. Limited evidence suggests that terbinafine, itraconazole and fluconazole have similar effects, whereas ketoconazole may be less effective than griseofulvin in children infected with Trichophyton. With some interventions the proportion achieving complete clinical cure was in excess of 90% (e.g. one study of terbinafine or griseofulvin for Trichophyton infections), but in many of the comparisons tested, the proportion cured was much lower.New evidence from this update suggests that terbinafine is more effective than griseofulvin in children with T. tonsurans infection.However, in children with Microsporum infections, new evidence suggests that the effect of griseofulvin is better than terbinafine. We did not find any evidence to support a difference in terms of adherence between four weeks of terbinafine versus eight weeks of griseofulvin. Not all treatments for tinea capitis are available in paediatric formulations but all have reasonable safety profiles.

[Effects of Human Acellular Amniotic Membrane on Postsurgical Recovery of Nail Beds].

OBJECTIVES: To determine the effects of human acellular amniotic membrane(HAAM) on postsurgical recovery of nail beds. METHODS: Patients undergoing nail surgery were randomly divided into two groups: 19 in the experimental and 19 in the control groups. Patients in the experimental group were given HAAM before the wounds were covered with vaseline gauze the next day after surgery; whereas those in the control group received vaseline gauze dressing only. Ratings of pain were recorded when 1, 4, 8, 12, 24, 36, 48 and 72 h after the dressing was changed. The time when the wounds healed and the nail grew thoroughly were observed. RESULTS: The characteristics of patients in the two groups were similar. The patients in the experimental group reported significantly less pain at 4 h and 48 h than those in the control group ( P<0.05). After dress changing 24 h, pain disappear in the experimental group. The wounds of the patients in the experimental group also healed quicker [(12.37±2.48) d] than those in the control group [(17.68±2.86) d, P<0.05]. It took (13.95±1.72) weeks for the patients in the experimental group to have their nails grown completely, compared with (15.63±2.00) weeks for those in the control group ( P=0.016). The experimental group had a similar degree of satisfaction (7.61±1.38) towards the cosmetic appearance of their nails compare the control group (7.58±1.18, P=0.919). CONCLUSIONS: HAAM can promote healing of surgical wounds on nail beds.

[Effect of Dermal Multipotent Cells Transplantation on Skin Elasticity in Aged Murine].

OBJECTIVE: To investigate the elasticity changes in aged dermis after injection of dermal multipotent cells (DMCs). METHODS: Dermal multipotent cells were isolated and cultured from 3-day-old BALB/c mice and then transplanted into the dermis of aged (12-week-old) BALB/c mice. Adult fibroblasts (FBs) were employed as control. At 2 and 4 weeks after the transplantation, we examined dermal elasticity by MPA580 skin test machine. RESULTS: The skin elasticity were improve at 2 weeks after the transplantion in both DMCs group and FBs group (P=0. 000) but have no statistical difference between these two groups (P=0. 216). The different effect between these two groups appeared in 4 weeks after the transplantation (P=0. 031). CONCLUSION: Dermal multipotent cells appear more effective than fibroblasts in increasing skin elasticity.

Oral potassium iodide for the treatment of sporotrichosis.

BACKGROUND: Sporotrichosis is a subacute or chronic disease, usually affecting the skin caused by a dimorphic (existing in two forms), aerobic (oxygen requiring) fungus called Sporothrix schenckii. Oral potassium iodide is widely used for cutaneous sporotrichosis in clinical medicine with more and more reports published. However, the benefits and adverse reactions of these treatments have not yet been systematically reviewed. OBJECTIVES: To assess the effects of oral potassium iodide for the treatment of sporotrichosis. SEARCH STRATEGY: In July 2009 we searched the Cochrane Skin Group Specialised Skin Register, the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) in The Cochrane Library (Issue 3, 2009), MEDLINE and EMBASE, The Chinese Biomedical Database, CNKI, VIP, and ongoing trials registers. SELECTION CRITERIA: Randomised trials comparing orally administered iodide with placebo, or with another treatment. Studies about potassium iodide as an adjunct were excluded. DATA COLLECTION AND ANALYSIS: Two authors planned to independently assess trial quality and extract data. We also planned to collect adverse effects information from the trials where possible. MAIN RESULTS: In the absence of any suitable randomised placebo-controlled trials or comparisons with other treatments in this area, we were unable to assess the effects of oral potassium iodide. AUTHORS' CONCLUSIONS: The currently available evidence is insufficient to assess the potential for oral potassium iodide in the treatment of sporotrichosis.There is no high-quality evidence for or against oral potassium iodide as a treatment for sporotrichosis. Further randomised double-blind placebo-controlled trials are needed to define the efficacy and acceptability of these interventions.

Oral potassium iodide for the treatment of sporotrichosis.

Potassium Iodide is the antimycotic of choice for the treatment of cutaneous sporotrichosis, because of its efficacy, safety and low cost. We carried out a review of published studies on the benefits and adverse reactions of using SSKI (Saturated Solution Potassium Iodide) as treatment for sporotrichosis, but could not identify any well-designed clinical trails. There is an urgent need to conduct randomized double-blind placebo-controlled trials and critically assess usefulness of SSKI by using a standardize monitoring or an effective self-report system.

[The expressions of PPAR-gamma, COX-2 in the lesions of patients with condyloma acuminatum and bowenoid papulosis].

OBJECTIVE: To investigate the expression of PPAR-gamma, COX-2 in the skin lesion of condyloma acuminatum and bowenoid papulosis. METHODS: The expression levels of PPAR-gamma, COX-2 were measured by immunohistochemistry in 17 cases of condyloma acuminatum, 17 cases of bowenoid papulosis, as well as 17 cases of normal foreskin lesions. RESULTS: The immunohistochemical study showed that PPAR-gamma and COX-2 weakly expressed in normal foreskin, but overexepressed in the skin lesions of both condyloma acuminatum and bowenoid papulosis (P<0.01). There was straight linear correlation between the expressions of PPAR-gamma and COX-2 not only in condyloma acuminatum (r=0.505, P=0.038) but also in bowenoid papulosis (r=0.562, P=0.019). CONCLUSION: PPAR-gamma and COX-2 may have important roles in proliferative dermatosis associated with human papilloma virus.

Human acellular amniotic membrane implantation for lower third nasal reconstruction: a promising therapy to promote wound healing.

BACKGROUND: The lower third of the nose is one of the most important cosmetic units of the face, and its reconstructive techniques remain a big challenge. As an alternative approach to repair or regenerate the nasal tissue, the biomaterial-based strategy has been extensively investigated. The aim of this study is to determine the safety and efficacy of human acellular amniotic membrane (HAAM) to repair the full-thickness defects in the lower third of the nose in humans. METHODS: In this study, 180 patients who underwent excision of skin lesions of the lower third of the nose from 2012 to 2016 were included; of the patients, 92 received HAAM and Vaseline gauze treatments, and the other 88 patients received Vaseline gauze treatment only. The haemostasis time and the duration of operation were recorded during surgery; after surgery, the time to pain disappearance, scab formation and wound healing, and the wound healing rate were measured. RESULTS: Immediately after the HAAM implantation, a reduction of the haemostasis time and an accelerated disappearance of pain were observed. Compared with the control group, the formation and detachment of scab in patients who received the HAAM implantation were notably accelerated, postoperatively. When the diameter of the lesion exceeded 5 mm, the HAAM implantation was found to enhance the wound healing, although this enhancement was not seen when the diameter was less than 5 mm. Additionally, the HAAM implantation significantly reduced bleeding, wound infection and scar formation, postoperatively. CONCLUSIONS: HAAM-assisted healing is a promising therapy for lower third nasal reconstruction leading to rapid wound healing and fewer complications and thus has considerable potential for extensive clinical application in repairing skin wounds. TRIAL REGISTRATION: ChiCTR1800017618, retrospectively registered on July 08, 2018.

Expression of Jagged1/Notch3 Signaling Pathway and their Relationship with the Tumor Angiogenesis in TNBC.

BACKGROUND AND AIMS: Jagged1/Notch3 signaling pathway plays a key role in angiogenesis of breast cancer, but little is known in TNBC. This study was designed to investigate the expression of Jagged1/Notch3 mRNA and protein in TNBC, analyze their correlations with clinicopathological characteristics and prognosis. Moreover, the interrelationship among Jagged1/Notch3 and VEGF was initially evaluated. METHODS: Jagged1/Notch3 mRNA and protein expression levels were determined by Q-RT-PCR and Western blotting. Additionally, Immunohistochemistry for Jagged1/Notch3 was detected by Ventana platform, VEGF and CD34 was performed using the EnVision/HRP technique. RESULTS: mRNA transcriptionof Jagged1/Notch3 was in accord with protein expression. TNBC patients with positive Jagged1 expression had poorer DFS (p = 0.008) and OS (p = 0.004). Jagged1 expression was independent predictors of OS (p = 0.038). The expression of VEGF was positively correlative to MVD (p = 0.018), MVD was significantly associated with Jagged1 (p <0.0001) and Notch3 (p <0.0001). The expression of Jagged1/Notch3 has no correlation with VEGF, only in positive VEGF expression of TNBC patients Jagged1/Notch3 had influence on DFS and OS (p <0.05). CONCLUSION: Jagged1/Notch3 was -expressed at both the mRNA and protein levels, Jagged1 served as an independent predictor of poor prognosis. We speculate that there is a cross-talk between Jagged1/Notch3 and VEGF in TNBC angiogenesis. Jagged1/Notch3 is expected to be an important signaling pathway for TNBC progression and a potential target for TNBC neovascularization therapy.