Term and preterm newborns have differences in skin structure. Preterm newborns have skin structures that are more susceptible to various disorders. These differences are believed to impact skin pH regulation and bacterial colonization, particularly Staphylococcus spp. This study investigates the acidity difference and skin Staphylococcus spp. colonization in preterm and term newborns. This is a descriptive observational study with a cross-sectional design. The study compared skin pH and Staphylococcus spp. colonization between term (37-41 weeks) and preterm (28-36 weeks) newborns. Skin pH was measured using a skin pH meter, and Staphylococcus spp. colonization was assessed through bacterial identification and colony-forming unit (CFU) testing. Assessments were conducted within the first 24 hours of life. There were 29 participants in this study: 16 preterm newborns and 13 term newborns. The preterm group was dominated by subjects with alkaline skin pH (80%), and the term group was dominated by subjects with acidic skin pH (71%). Positive Staphylococcus spp. colonization was more prevalent in the preterm group (62%) than in the term group (38%). Skin pH differed between preterm and term newborns, with relatively higher skin pH in the preterm group. Staphylococcus spp. was also more prevalent in the preterm group.
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Scalp seborrheic dermatitis (SSD) is a prevalent and chronic dermatological condition. Although various mechanisms have been proposed, its precise etiology and exacerbating factors remain unclear. This study aimed to identify the factors influencing clinical severity in individuals with SSD; to assess the associations between severity and variables such as gender, age at disease onset, treatment history, and the presence of comorbid systemic or dermatological conditions; and to determine potential triggering factors. A total of 198 adult patients diagnosed with SSD were included in this retrospective study. Collected data included demographic characteristics, smoking and alcohol use, Fitzpatrick skin type, age at disease onset, duration of the most recent flare, frequency of hair washing, and the season during which the patient presented. Clinical severity of SSD was assessed by a dermatologist. In addition, the presence of systemic and dermatological comorbidities, as well as patient-reported triggering factors, was documented. A statistically significant difference in SSD severity was observed between sexes, with higher severity noted in male patients (p = 0.006). No significant associations were found between SSD severity and age, Fitzpatrick skin type, smoking or alcohol use, season of presentation/flare up, or the presence of systemic diseases. However, SSD severity differed significantly based on the presence of onychomycosis (p = 0.001). The significant association between the frequency of onychomycosis and the severity of SSD highlights a potential link involving shared immunologic, microbial, and skin barrier dysfunctions underlying both conditions.
Given the limited data on primary cicatricial alopecias (PCAs), which cause permanent hair loss, this study investigates the demographic and clinical characteristics, applied treatments, and disease course of PCA patients. Medical records of 109 PCA patients that attended an outpatient clinic between 2010 and 2025 were retrospectively reviewed. Demographic and clinical characteristics, and treatment approaches were retrieved from patient files. Lymphocytic PCA (83.5%) was the most frequent type, followed by neutrophilic PCA (15.6%). Classic lichen planopilaris (LPP-C) was the leading lymphocytic subtype (39.4%), and folliculitis decalvans (12%) was the most common neutrophilic PCA. Lymphocytic PCAs showed female predominance, whereas male predominance was present in neutrophilic PCAs (p < 0.001). Disease onset occurred at an older age in lymphocytic PCAs compared to the neutrophilic group (42.0 ± 11.8 and 30.2 ± 11.4 years, p < 0.001). Pain and nodule/pustule formation were more frequent in neutrophilic PCAs (p < 0.001). Topical/intralesional corticosteroids and hydroxychloroquine were mainly used in lymphocytic PCAs, whereas oral antibiotics and isotretinoin were preferred in neutrophilic PCAs. PCA frequency may vary geographically. LPP-C was the most common subtype. Early diagnosis and timely treatment are essential to prevent irreversible hair loss and optimize cosmetic outcomes.
Psoriasis is a chronic immune-mediated disorder with a genetic component that primarily affects the skin and has potential systemic involvement. Advances in understanding the interaction between the innate and adaptive immune systems have facilitated improved disease management. This study included 25 patients with psoriasis and 20 healthy controls of both sexes. All participants underwent detailed medical history-taking and dermatological examination, including assessment of the body surface area and the Psoriasis Area and Severity Index (PASI). Blood samples (3 ml) were collected from all subjects, and 4 mm lesional skin punch biopsies were obtained from psoriatic patients and healthy controls. Serum and tissue levels of interleukin 39 (IL-39) were significantly elevated in psoriatic patients compared to healthy individuals. Patients with a positive family history of psoriasis showed higher serum IL-39 levels than those without such a history. In addition, psoriatic individuals with diabetes mellitus or hypertension had higher serum IL-39 levels than those without these comorbidities. A statistically significant correlation was found between disease severity and serum IL-39 concentration. Elevated serum and tissue IL-39 levels in psoriatic patients suggest a potential role for IL-39 in the pathogenesis of psoriasis, highlighting its possible utility as a biomarker or therapeutic target.
A well-defined jawline is an important aspect of facial aesthetics, contributing to overall appearance. This feature is particularly sought after by individuals, especially older adults, who are interested in enhancing their facial contours. This systematic review and meta-analysis evaluates safety and effectiveness following use of VYC-25L, a hyaluronic acid-based injectable gel, for restoration of jawline definition. VYC-25L is a soft tissue filler designed to add volume, lift, and contour to the jawline area, providing a non-surgical solution for improving facial aesthetics. This meta-analysis included two randomized controlled trials and three cohort studies of international databases-PubMed, EMBASE, Web of Science, and Cochrane Library-from January 2015 to May 2025, using keywords aligned with the study objective. The VYC-25L group had significantly higher responder rates on the Allergan Loss of Jawline Definition Scale (ALJDS) compared to the control group (71%; p < 0.001; 95% confidence interval [CI] [48%, 94%]). The most common event was swelling (effect size [ES]: 81%; 95% CI [69%, 92%]), lumps/bumps (ES: 83%; 95% CI [66%, 99%]), pain after injection (ES: 79%; 95% CI [62%, 96%]), and tenderness to touch (ES: 76%; 95% CI [61%, 92%]). In summary, VYC-25L appears to be an effective treatment for jawline definition, with a predictable adverse event profile.
Androgenetic alopecia (AGA) is a common hair loss condition characterized by follicular miniaturization. Vascular endothelial growth factor (VEGF) plays a key role in promoting angiogenesis and supporting hair follicle growth. Oral minoxidil has been suggested to upregulate VEGF levels, enhancing hair regrowth. This prospective study included 50 participants divided into two groups: oral minoxidil (1 mg/day; n = 25) and control (n = 25). Serum VEGF levels were measured at baseline and after 12 weeks of treatment. Hair growth parameters, including hair count, diameter, shedding, and pull test results, were assessed systematically. Baseline VEGF levels were similar between groups (p = 0.1873). Post-treatment, VEGF levels increased significantly in the minoxidil group (217.88 ± 22.65 pg/ml vs. 142.81 ± 23.14 pg/ml in the control, p < 0.0001). Hair count and diameter improved significantly (p < 0.0001 and p = 0.0040, respectively), with reductions in shedding and pull test results (p < 0.0001). Positive correlations were observed between VEGF and hair count (r = 0.9965), whereas shedding showed negative correlations (r = -0.5374). Oral minoxidil significantly enhances VEGF levels, promoting hair growth and reducing shedding. VEGF serves as a promising biomarker for assessing treatment effectiveness and understanding the angiogenic mechanisms involved in AGA.
The conventional dependence on mammalian models in dermatological research is increasingly subject to ethical and sustainability-focused scrutiny, prompting a transition toward new approach methodologies (NAMs). Within this paradigm, zebrafish (Danio rerio) have surfaced as a persuasive alternative due to their genetic and physiological congruence with human skin, optical clarity during early developmental stages, accelerated life cycle, prolific reproductive capacity, and economically viable maintenance. This review describes recent research using zebrafish models in dermatology, including skin pigmentation disorders, barrier function, wound healing and regeneration, pharmacological discovery, genetic and inflammatory skin conditions, and melanoma. By examining the research, ethical, and logistical merits of zebrafish NAMs, this review emphasizes their contribution to fostering more humane and efficient research frameworks. Such integration also aligns with various United Nations Sustainable Development Goals (SDGs) 3, 9, 12, 13, 14, and 17, particularly regarding the accessible biomedical innovation in low- and middle-income countries (LMICs). The review also recognizes ongoing challenges, such as regulatory fragmentation and inconsistent validation of dermatological endpoints, which impede widespread translational acceptance. It concludes by presenting strategic recommendations for international collaboration, targeted financial support, cross-sector partnerships, and regulatory harmonization to realize the potential of zebrafish-based NAMs in dermatological research.
Acne vulgaris is a common inflammatory dermatosis with a multifactorial pathogenesis. Recent research suggests that alterations in the gut-skin axis and impaired intestinal barrier function may contribute to acne pathogenesis; however, direct evaluation of gut barrier integrity in acne patients remains limited. The objective of this study was to assess intestinal barrier integrity in patients with acne vulgaris by measuring serum intestinal fatty acid-binding protein (I-FABP) levels and to evaluate the association between I-FABP levels and acne severity. This single-center, prospective case-control study included 77 patients with acne vulgaris and 77 age- and sex-matched controls without acne. Acne severity was assessed using the Global Acne Grading System. Serum I-FABP levels were measured using an enzyme-linked immunosorbent assay. Median serum I-FABP levels were significantly higher in patients with acne vulgaris than in controls (32.03 [7-107] pg/ml vs. 22.81 [12-189] pg/ml, p = 0.002). I-FABP levels differed significantly across acne severity grades (p < 0.001), with progressively higher levels observed from mild to very severe acne. A strong positive correlation was identified between acne severity and serum I-FABP levels (Spearman r = 0.797, p < 0.001). No significant association was found between I-FABP levels and body mass index. Serum I-FABP levels are significantly elevated in patients with acne vulgaris and correlate strongly with disease severity. These findings support the hypothesis that impaired intestinal barrier function may contribute to both the development and progression of acne vulgaris, highlighting the potential role of the gut-skin axis in acne pathogenesis.
Biologic therapies have emerged as targeted treatments in psoriasis, offering personalized options for patients. However, when examining the cytokine network in psoriasis, this raises the question of whether biologics should be viewed as targeted therapies. This article reviews the literature focusing on the impact of tumor necrosis factor (TNF)-α antagonists on the cytokine profile and immunocytes in psoriasis. The literature suggests that the effects of TNF-α antagonists extend beyond TNF-α. These agents have a significant influence on various cytokines of the innate and adaptive immune system, including interferon-γ, interleukin (IL)-1, IL-4, IL-6, IL-8, IL-12, IL-17, IL-22, IL-23, and IL-24 in blood and skin. In addition, TNF-α antagonists also affect immunocyte counts, such as neutrophil elastase-positive cells. This demonstrates that, even though biologic treatments were initially designed to target specific molecules structurally, their function should not be narrowly considered targeted. This concept has important implications in clinical practice, including for the understanding and knowledgeable prediction of drug-related side effects, such as colitis, inflammatory bowel disease, myocarditis, and infections, as well as for taking necessary precautions before prescribing medications.
Severe anaphylaxis in patients with clonal mast cell disorders highlights the need for proper use of adrenaline autoinjectors. This study assessed knowledge retention and adherence to autoinjector use in c-KIT p.D816V-positive individuals with hymenoptera venom allergy undergoing venom immunotherapy (VIT) and prescribed two autoinjectors. Seventy-one VIT patients received personalized autoinjector education, with knowledge assessed at 3, 4 to 12, 12 to 24, and > 24 months. Fifteen patients 5 years post-VIT underwent video-based retraining and were assessed 1 month later. Knowledge retention was 82.3% at 3 months, dropping to 40.0% at 12 to 24 months (p = 0.0160) and 22.2% after 24 months (p = 0.0005), indicating a clear decline over time. Common errors included ignoring the safety cap (16.7%), insufficient injection force, finger injection risk, and upper arm activation (totaling 19.0%). In addition, 19.8% failed to hold the autoinjector in the muscle for 3 seconds, 26.9% did not know to lie supine during anaphylaxis, and 14.3% did not seek emergency help. In the video-retrained group, 80.0% lacked proficiency 1 month later, 73.3% were unaware of the second dose, and 66.7% did not carry their devices. Ongoing tailored education is essential to ensure effective autoinjector use, especially in c-KIT p.D816V-positive venom-allergic patients. Video instruction alone may be insufficient.
Intravenous administration of high-dose vitamins, minerals, amino acids, coenzyme Q10, α-lipoic acid, glutathione, and nicotinamide adenine dinucleotide has emerged as a popular longevity therapy, targeting key molecular processes, oxidative stress, mitochondrial decline, chronic inflammation, and genomic instability, which drive and accelerate aging. The rationale is that intravenous administration facilitates supraphysiological plasma concentrations, bypassing gastrointestinal absorption limitations to more effectively target these age-promoting mechanisms. Evidence from preclinical models and small clinical series reports transient reductions in oxidative biomarkers, modest improvements in fatigue syndromes, and anecdotal enhancements in skin elasticity. However, these findings are predominantly derived from disease-specific or aesthetic contexts rather than studies involving healthy aging populations. Crucially, few studies incorporate validated biomarkers of aging such as epigenetic age or telomere length, and placebo-controlled trials are scarce and underpowered or they yield conflicting results. Additional challenges include pharmacokinetic limitations, procedural risks, and substantial heterogeneity of infusion protocols, all of which hinder reliable interpretation. Until rigorously designed, adequately powered randomized controlled trials demonstrate reproducible long-term efficacy and safety, intravenous longevity therapy should be regarded as an experimental intervention rather than an evidence-based dermatological or anti-aging practice.
Pyoderma gangrenosum (PG) is a rare destructive neutrophilic dermatosis of unknown etiology, associated with systemic diseases in approximately 50% to 75% of cases. We conducted a search of the hospital database to retrieve medical records of patients diagnosed with PG at our facility between 1995 and 2019. The diagnosis was validated through clinical characteristics, histopathological examination, and necessary tests to rule out other dermatoses. Data on demographics, disease presentation, comorbidities, and treatment strategies were collected and evaluated. The analysis included 44 patients, 27 (61.4%) females and 17 (38.6%) males. The median age at presentation was 46.5 years (range 15-73). The most common location was the lower leg, in 32 (72.7%) patients. The ulcerative variant was found in 37 (84.1%) patients. In 11 patients (25%) an association with inflammatory bowel disease (IBD) was found. Hematological disorders occurred in five (11.4%) patients and rheumatoid arthritis in four (9.1%). Treatment was started with systemic corticosteroids (CS) in 36 (83.7%) patients, and pulse corticosteroid therapy was administered in five (11.4%) patients. The most frequently used steroid-sparing agent was dapsone, in 18 (40.9%) patients. PG often presents with associated systemic conditions, but it may also appear idiopathically. CS remain the mainstay of treatment, complemented by immunosuppressants and biologics such as infliximab for IBD-associated cases.
Dermatomyositis is an inflammatory disease that affects the skin and skeletal muscles, with variants including clinically amyopathic dermatomyositis and malignancy-associated dermatomyositis. This research analyzes the characteristics of dermatomyositis in women. A retrospective cross-sectional study evaluated clinical presentation, muscle involvement, immunological markers, association with malignancy, complications, and mortality in females during a 15-year follow-up at a tertiary dermatology center. Thirty women (mean age 63.6 ± 11.6 years) were analyzed. The most common skin manifestations were the V-sign (73.3%), followed by a heliotrope rash and Gottron's papules (70.0% each). Periungual erythema appeared in 50.0%, and the shawl sign in 46.7%. Receiver operating characteristic curve analysis linked the V-sign with age ≥ 62.5 years (area under the curve = 0.75) and periungual erythema with age ≤ 68.5 (area under the curve = 0.76). Muscle weakness was present in 63.3% of cases. Myositis-associated autoantibodies and myositis-specific autoantibodies were positive in 53.3%. Seven patients (23.3%) had malignancy-associated dermatomyositis, including ovarian, breast, endometrial, lung, gastric, and nasopharyngeal cancers. The V-sign, a heliotrope rash, and Gottron's papules were the most common skin findings. Muscle involvement affected nearly two-thirds of patients. Malignancy was detected in almost a quarter of patients, emphasizing the need for thorough evaluation and early diagnosis, especially in cancer-associated cases.
Neutrophilic dermatosis of the dorsal hands (NDDH), a term coined in 2000 by Galaria et al., is an entity clinically and histopathologically similar to Sweet’s syndrome (acute febrile neutrophilic dermatosis) (1, 2). The first authors to describe this condition were Strutton et al. (1995), who described six patients with an eruption limited almost entirely to the dorsal hands clinically and histologically resembling Sweet’s syndrome. Because of its rarity, its pathophysiology is poorly understood. Although it has many aspects in common with Sweet’s syndrome (namely, the fact that histologically there is a dense neutrophilic infiltration of the upper dermis in the lesions), some particular characteristics, especially its confined anatomical location, help differentiate NDDH from the classic form of acute febrile neutrophilic dermatosis (3). We report the case of a 73-year-old Caucasian man with a diagnosis of polycythemia vera 8 years earlier, initially treated with hydroxyurea, that had been stable for the past 6 years with phlebotomy treatment every 6 months. The diagnostic criteria for polycythemia vera adopted were those of the World Health Organization. Our patient had raised hemoglobin, splenomegaly, no secondary erythrocytosis, and no elevated erythropoietin (16.5 mIU/ml, normal range 3.7–31.5 mIU/ml). He presented with acute nonpruritic, non-scaling, erythematous tumid papules and plaques on the dorsal aspects of both hands (Figs. 1a, 1b). The patient had no systemic manifestation including fever, arthralgia, or general malaise. Blood analysis revealed an ESR of 71 mm / 1st hour (normal range < 30 mm), an erythrocyte count of 5.75 × 1012/L (normal range 4.5–5.9 x1012/L), hemoglobin 17.8 g/dL (normal range 13–17.5 g/dL), hematocrit 52% (normal range 40–50%), leukocyte count 12.1 × 109/L (normal range 4.0–11.0 × 109/L), neutrophil count 6.39 × 109/L (normal range 1.9–7.5 × 109/L), eosinophil count 0.28 × 109/L (normal range < 0.5 x109/L), and platelet count 194 × 109/L (normal range 150–450 × 109/L). Electrolytes, renal and liver function panel, and urinalysis were normal. A skin biopsy was done, and histopathological examination revealed dense neutrophilic infiltrate of the dermis, mostly perivascular, with some eosinophils and without signs of vasculitis (Figs. 2a, 2b). Based on the clinical, histopathological, and laboratory data, a diagnosis of NDDH was considered. The patient was treated with betamethasone dipropionate cream bid for 6 weeks with progressive resolution of the lesions. After 4 months of follow-up, the patient had no relapse of the skin lesions, presenting only slight residual post-inflammatory hyperpigmentation. The first reports of Sweet’s syndrome (1964) highlighted its association with upper respiratory tract infections. Subsequent data suggested a relationship between the syndrome and myeloproliferative disorders, myelocytic leukemia, visceral malignancies, inflammatory bowel disease, connective tissue diseases, pregnancy, drug reactions, and other disorders (3). Because reported cases of NDDH are infrequent (fewer than 80 cases had been published by 2012), associations between this clinical entity and other diseases is less clear. Even so, conditions described as possibly being associated with NDDH are acute myelogenous leukemia, ulcerative colitis, metastatic lung cancer, B cell lymphoma, influenza vaccine, glomerulonephritis dialysis, streptococcus tonsillitis, chemotherapy, hypopharyngeal carcinoma, IgA gammopathy, Crohn disease, seropositive arthritis, sarcoidosis, hepatitis C, urinary Acta Dermatovenerologica Alpina, Pannonica et Adriatica Acta Dermatovenerol APA
Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of unknown etiology. It is assumed that a genetic predisposition contributes to the development of the disease and influences the patient's response to various etiological factors such as autoimmune reactions to epithelial antigens, microorganisms, and stress. Immunopathogenesis is primarily driven by cell-mediated immune mechanisms, with T lymphocytes playing a central role. The clinical presentation of OLP is varied, and multiple clinical forms can occur in the same patient. OLP is categorized into six clinical types: reticular, papular, and plaque-like (hyperkeratotic variants), and atrophic, erosive, and bullous (erosive variants). The histopathological diagnosis of OLP is unique. Continuous follow-up of patients is crucial because OLP is considered an oral potentially malignant disorder (OPMD). Reported rates of malignant transformation vary, with a pooled estimate of 1.43% for OLP and 5.13% for OLP with dysplasia. Patient education plays a crucial role in treatment initiation and planning. A personalized treatment approach focuses on controlling inflammation and relieving symptoms such as pain and burning. Treatment should be individualized according to disease severity, subtype, and patient response, with constant monitoring for possible malignant transformation and comorbidities.
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) share transmission routes and cause significant morbidity and mortality worldwide. Three previous nationwide studies reported a low prevalence of HCV infection among Slovenian people living with HIV (PLWH). Data were collected de novo from 526 PLWH newly diagnosed with HIV in Slovenia between January 1st, 2014, and December 31st, 2024, and combined with data from previous studies on this topic. Altogether 1,085 (93%) PLWH were tested for HCV at HIV diagnosis: 82 (7.6%) had anti-HCV antibodies (49 or 59.8% of them viremic), and three had HCV RNA only, resulting in an HCV prevalence of 7.8%. A significant increase in the prevalence of HCV infection has been observed over the last decade. HCV infection was significantly associated with female sex, foreign nationality, parenteral HIV transmission route, and non-B HIV subtype. The most frequent HCV genotypes were 1 (60%), 3 (22%), and 4 (16%), markedly different than previously found in the general population. The overall prevalence of HCV infection among PLWH in Slovenia remains low, but a significant increase has been observed in the last decade compared to the previous one. Such a situation requires further regular and tight monitoring to allow timely interventions if and when needed.
Alopecia areata (AA) is an autoimmune condition characterized by non-scarring hair loss. The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway is believed to play a central role in the autoimmune inflammatory processes underlying AA. Baricitinib, an oral JAK inhibitor, has been approved by the Food and Drug Administration (FDA) for the treatment of severe AA. This study evaluates the efficacy and safety of baricitinib in the management of AA. A retrospective cohort study was conducted on patients with AA receiving baricitinib 4 mg daily and that had completed a 1-year follow-up. Disease severity was assessed at baseline and the end of follow-up using the Severity of Alopecia Tool (SALT) score. Adverse events were systematically recorded. Among 87 patients included in the analysis, the mean age was 29.84 years, and the mean baseline SALT score was 77.07%. After a mean of 52 weeks, 37.20% of patients achieved a SALT score ≤ 20. A significant reduction in SALT scores was observed at the end of follow-up (p < 0.001). In addition, 72.40% of patients experienced mild or no adverse events, and no serious adverse events were reported. In this 52-week real-world cohort, baricitinib demonstrated both effectiveness and good tolerability in the treatment of severe AA. These findings contribute to the understanding of long-term outcomes with baricitinib therapy.
Amyopathic dermatomyositis (AD) is an autoimmune connective tissue disease of uncertain etiology that comprises 20% to 30% of dermatomyositis patients. Multiple studies suggest an association between malignancies and AD; moreover, some also report fulminant lung disease in patients with AD. We present a 62-year-old female patient with severe clinical presentation of AD, characterized by diffuse severe alopecia and pronounced symmetrical livid edema of the upper and lower eyelid, and positive anti-melanoma differentiation-associated gene 5 (anti-MDA-5) antibodies, who was successfully treated with concurrent therapy with hydroxychloroquine, methylprednisolone, and methotrexate as well as topical corticosteroids. Underlying malignancies or lung disease were excluded. Furthermore, we recommend vigilance in the key differential diagnosis of cutaneous lupus erythematosus because they can both present with similar clinical and histopathological features. The remission correlated with the complete absence of anti-MDA-5 antibodies.