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In this paper we discuss the published relevant mycology dermatological reports which appeared in 1997 and 1998. The aims of this review is to give an actual view on antifungal therapy with a critical discussion on the efficacy of antifungals.
Imiquimod: Warts and Beyond Imiquimod (Aldara, 3M Pharmaceuticals, St Paul, Minn), a novel immunomodulatory imidazoquinolin heterocyclic amine, has shown potent antiviral and antitumor action both experimentally and in recent clinical trials. In clinical practice, the drug was approved by the Food and Drug Administration for topical application as a treatment of anogenital condylomata acuminata, and can be easily applied to affected areas by the patient at home, with 5% imiquimod cream left on overnight (6-10 hours) and then washed off, used 3 days a week for 16 weeks or until all visible warts have disappeared. Imiquimod shows no intrinsic antiviral or antineoplastic effect, but it is thought to owe its activity to in vivo induction of interferon alfa (IFN-a) subtypes 1, 2, 5, 6, and 8, and tumor necrosis factora(TNF-a).Multiplecell types including human peripheral blood mononuclearcellsandneonatal foreskin keratinocytes have been shown to produce these cytokines in the presence of imiquimod. In a recent clinical trial, 50%ofpatients applying5%imiquimod cream(n = 109;3times/wkfor16weeks) compared with 21% of patients applying 1% imiquimod cream (n = 102) and 11% of patients in a placebo vehicle group (n = 100) achieved eradication of all treated baseline warts. These results, which were obtained in a randomized, double-blinded,placebo-controlledfashion,compare favorablywithmore laborintensive and potentially painful standard rapid therapies such as excision, cryosurgery,electrosurgicalablation,and laser vaporization. In the above study, application of 5% imiquimod cream was not associated with systemic adverse symptoms, but did cause local inflammatory reactions including erythema (67%) that was characterized as severe at some point in 6 patients (5.7%). Recurrence in areas treated with 5% imiquimod cream occurred in 6 (13%) of 45 patients compared with no recurrences (0/ 18) in patients using 1% cream and a 10% recurrence rate in the placebo group (1/10). These rates compare favorably with alternative therapies such as cryotherapy, laser vaporization, and podophyllin, although comparison trials would be useful. This is especially true for podophyllin, a commonly used topical wart therapy that is less expensive than imiquimod and can be similarly applied at home by the patient. A randomized controlled trial comparing respective clearance rates, recurrence rates, and adverse effect profiles for these 2 competing topical therapies would be clinically useful. Evidence suggests that imiquimod may work by inducing a cell-mediated immune response to clear wart-inducing human papillomavirus with reduction in human papillomavirus viral load during treatment correlating with increased local production of IFN-a, IFN-b, and IFN-g and TNF-a. Similar clearance results have been obtained with intralesional injection of IFN-a, which cannot be topically absorbed, is costly ($350/10-million U vial of IFN-a 2b), and requires multiple visits for painful injections, with the added risk of systemic adverse effects. Topically applied imiquimod cream also effectively treated the poxvirusinducedmolluscumcontagiosuminarecent,prospective,controlledclinicaltrial, and thus is a reasonable topical therapy alternative for refractory and extensive molluscumlesionsnotresponsivetocryotherapy or tape-stripping (a mechanical techniqueforsheeringoffsolitarylesions). Otherclinicalapplicationsforimiquimod may be around the corner. For instance, oral imiquimodhasshownantitumoreffects on several murine tumor cell lines, withantitumoreffectssignificantlydiminishedbyconcurrentadministrationofantiserumtomurineIFN-a.Thesedatamay yield future clinical applications, with clinical trials currently under way to evaluate the effect of topical imiquimod oncutaneousmalignancies suchasbasal cell carcinoma, squamous cell carcinoma,andhumanpapillomavirus–induced dysplastic lesions.
BACKGROUND: Vitamin C (also known as L-ascorbic acid) plays a critical role in reactive oxygen species (ROS) reduction and cell regeneration by protecting cell from oxidative stress. Although vitamin C is widely used in cosmetic and therapeutic markets, there is considerable evidence that vitamin C easily undergoes oxidation by air, pH, temperature, and UV light upon storage. This deficiency of vitamin C decreases its potency as an antioxidant and reduces the shelf-life of products containing vitamin C as its ingredient. To overcome the deficiency of vitamin C, we have developed Aptamin C, an innovative DNA aptamer maximizing the antioxidant efficacy of vitamin C by binding to the reduced form of vitamin C and delaying its oxidation. METHODS: Binding of Aptamin C with vitamin C was determined using ITC analysis. ITC experiment was performed 0.2 mmol/L vitamin C that was injected 25 times in 2 µL aliquots into the 1.8 mL sample cell containing the Aptamin C at a concentration of 0.02 mmol/L. The data were fitted to a one-site binding isotherm using with origin program for ITC v.5.0. RESULTS: To investigate the effect of Aptamin C and vitamin C complex in human skins, both in vitro and clinical tests were performed. We observed that the complex of Aptamin C and vitamin C was significantly effective in wrinkle improvement, whitening effect, and hydration increase. In the clinical test, subjects treated with the complex showed dramatic improvement in skin irritation and itching. No adverse reaction was presented by Aptamin C complex in the test. CONCLUSION: Taken together, these results showed that Aptamin C, an innovative novel compound, should potentially be served as a key cosmeceutical ingredient for a range of skin conditions.
Context Dendrobium officinale Kimura et Migo (Orchidaceae) is a naturally occurring precious traditional Chinese medicine (TCM) originally used in treating yin-deficiency diseases. The main active substances of Dendrobium officinale are polysaccharides (DOP). Recent findings highlighted the potential of DOP as a promising natural material for medical use with a diversity of pharmaceutical effects.Objective In this review, we provide a systematic discussion of the current development and potential pharmacological effects of Dendrobium officinale polysaccharides in dermatology.Methods English and Chinese literature from 1987 to 2019 indexed in databases including PubMed, PubMed Central, Web of Science, ISI, Scopus and CNKI (Chinese) was used. Dendrobium officinale, Dendrobium officinale polysaccharides, phytochemistry, chemical constituents, biological activities, and pharmacological activities were used as the key words.Results Dendrobium officinale polysaccharides have been found to possess hair growth promoting, skin moisturising and antioxidant effects, which are highly valued by doctors and cosmetic engineers. We highlighted advances in moisturising and antioxidant properties from in vivo and in vitro studies. Dendrobium officinale polysaccharides exhibited strong antioxidant effects by decreasing free radicals, enhancing antioxidant system, inhibiting nuclear factor-kappa B and down-regulating inflammatory response.Conclusions Our review is a foundation to inspire further research to facilitate the application of Dendrobium officinale polysaccharides in dermatology and promote active research of the use of TCM in dermatology.
Dendritic cells (DCs) have a critical role in antiviral responses, in autoimmune disease pathogenesis and in initiating and maintaining inflammatory skin disorders, and are candidates for cell-based immunotherapeutic approaches for tumours. Recent studies have shown the important role of type I interferons (IFNs) in DC differentiation and activation. In the presence of IFN-α and granulocyte/macrophage colony-stimulating factor monocytes differentiate into DCs referred to as IFN-DCs. In vitro generated IFN-DCs show a partially mature phenotype, are effective in taking up antigens, share features of myeloid DCs, plasmacytoid DCs and natural killer cells, exhibit an enhanced chemotactic response and are capable of migrating to the lymph nodes. IFN-DCs produce several chemokines and cytokines, including T-helper 1 (Th1) mediators belonging to the interleukin-12 family. IFN-DCs stimulate T- and B-cell responses and the production of IFN-γ in mixed lymphocyte reactions and have a capacity to produce IFN-γ themselves. IFN-DCs express several toll-like receptor (TLR) subtypes and TLR ligand stimulation improves their costimulatory molecule expression, increases their Th1 cytokine production and enhances their capacity to stimulate naive T-cell proliferation. Here we review the interaction of IFN-α and monocytes and the role of IFN-DCs in infections, in autoimmunity, in inflammation and in cancer immunotherapy focusing on dermatological conditions.
Optical coherence tomography (OCT) was introduced as an imaging system, but like ultrasonography, other measures, such as blood perfusion and polarization of light, have enabled the technology to approach clinical utility. This review aims at providing an overview of the advances in clinical research based on the improving technical aspects. OCT provides cross-sectional and en face images down to skin depths of 0.4 to 2.00 mm with optical resolution of 3 to 15 μm. Dynamic optical coherence tomography (D-OCT) enables the visualization of cutaneous microvasculature via detection of rapid changes in the interferometric signal of blood flow. Nonmelanoma skin cancer (NMSC) is the most comprehensively investigated topic, resulting in improved descriptions of morphological features and diagnostic criteria. A refined scoring system for diagnosing NMSC, taking findings from conventional and D-OCT into account, is warranted. OCT diagnosis of melanoma is hampered by the resolution and the optical properties of melanin. D-OCT may be of value in diseases characterized with dynamic changes in the vasculature of the skin and the addition of functional measures is strongly encouraged. In conclusion, OCT in dermatology is still an emerging technology that has great potential for improving further in the future.
This work makes an effort which is new in dermatology; that is to bring together and consider critically the recent essential additions to the knowledge of dermatology in what is the modern period of the various subjects which it takes up and then, as far as may be, to interpret in the light of this knowledge various diseases of the skin. For example, it considers the discoveries and advances in the field of allergy which have given the present conception of that reaction and then interprets various diseases in the light of the new knowledge of allergy. The knowledge of the subjects is not merely summarized, as in the usual textbooks and year-books, but the discussion covers what may be considered the evolution in the recent period in any field, whether five or twenty-five years. The first few chapters take up the important new additions to the general
The field of "modern" (or advanced) cryosurgery has progressed at an impressive rate during the past decade. Zacarian has participated in this growth in many ways. He not only made and reported many of the basic clinical observations, but, he did much of the animal and other research projects that provided this field with the background that it required for acceptance. He brings his unique knowledge of his subspecialty to this publication. Zacarian has produced three books on the subject since 1969. In this, his third volume, the word "advances" seems to be the keynote. It is an attempt to bring the reader up to date on the latest advances, but it also reemphasizes the advances of the past. This may make the book of greater interest to the physician already in the field than to the potential beginner. Yet, this is not said in criticism. It is a beautifully
Desmosomes and keratinosomes serve a specific role in the complex process of keratinization and the formation of the horny layer. Their role is additional to the function of the tonofilaments and keratohyaline granules. Desmosomes serve as points of anchorage for the tonofilaments and give them orientation in the epidermal cells during their passage from the basal up to the horny layer. It appears likely that such orientation is necessary for normal keratinization to take place. Keratinosomes are associated with the rate of epidermal cell turnover and appear to be related to the transformation of granular cells into horny cells. Genetic acantholysis and dyskeratosis in Hailey-Hailey's and Darier's disease are due to either disruption or faulty synthesis of the tonofilament-desmosome complex. Genetic hyperkeratosis in epidermolytic ichthyosis is due to an increased turnover of epidermal cells. Genetic hyperkeratosis in dyskeratosis congenita of the mouth appears to be due to decreased shedding of cells from the horny layer.
BACKGROUND: Tremendous advances have been made in the medical application of the laser in the past few decades. Many diseases in the dermatological field are now indications for laser treatment that qualify for reimbursement by many national health insurance systems. Among laser types, the carbon dioxide (CO2) laser remains an important system for the dermatologist. RATIONALE: The lasers used in photosurgery have wavelengths that differ according to their intended use and are of various types, but the CO2 laser is one of the most widely used lasers in the dermatology field. With its wavelength in the mid-infrared at 10,600 nm, CO2 laser energy is wellabsorbed in water. As skin contains a very high water percentage, this makes the CO2 laser ideal for precise, safe ablation with good hemostasis. In addition to its efficacy in ablating benign raised lesions, the CO2 laser has been reported to be effective in the field of esthetic dermatology in the revision of acne scars as well as in photorejuvenation. With the addition of fractionation of the beam of energy into myriad microbeams, the fractional CO2 laser has offered a bridge between the frankly full ablative indications and the nonablative skin rejuvenation systems of the 2000s in the rejuvenation of photoaged skin on and off the face. CONCLUSIONS: The CO2 laser remains an efficient, precise and safe system for the dermatologist. Technological advances in CO2 laser construction have meant smaller spot sizes and greater precision for laser surgery, and more flexibility in tip sizes and protocols for fractional CO2 laser treatment. The range of dermatological applications of the CO2 laser is expected to continue to increase in the future.
In the past, the skills required to make an accurate dermatological diagnosis have required exposure to thousands of patients over many years. However, in recent years, artificial intelligence (AI) has made enormous advances, particularly in the area of image classification. This has led computer scientists to apply these techniques to develop algorithms that are able to recognize skin lesions, particularly melanoma. Since 2017, there have been numerous studies assessing the accuracy of algorithms, with some reporting that the accuracy matches or surpasses that of a dermatologist. While the principles underlying these methods are relatively straightforward, it can be challenging for the practising dermatologist to make sense of a plethora of unfamiliar terms in this domain. Here we explain the concepts of AI, machine learning, neural networks and deep learning, and explore the principles of how these tasks are accomplished. We critically evaluate the studies that have assessed the efficacy of these methods and discuss limitations and potential ethical issues. The burden of skin cancer is growing within the Western world, with major implications for both population skin health and the provision of dermatology services. AI has the potential to assist in the diagnosis of skin lesions and may have particular value at the interface between primary and secondary care. The emerging technology represents an exciting opportunity for dermatologists, who are the individuals best informed to explore the utility of this powerful novel diagnostic tool, and facilitate its safe and ethical implementation within healthcare systems.
Hepatocellular carcinoma (HCC) is a prevalent disease with a progression that is modulated by the immune system. Systemic therapy is used in the advanced stage and until 2017 consisted only of antiangiogenic tyrosine kinase inhibitors (TKIs). Immunotherapy with checkpoint inhibitors has shown strong anti-tumour activity in a subset of patients and the combination of the anti-PDL1 antibody atezolizumab and the VEGF-neutralizing antibody bevacizumab has or will soon become the standard of care as a first-line therapy for HCC, whereas the anti-PD1 agents nivolumab and pembrolizumab are used after TKIs in several regions. Other immune strategies such as adoptive T-cell transfer, vaccination or virotherapy have not yet demonstrated consistent clinical activity. Major unmet challenges in HCC checkpoint immunotherapy are the discovery and validation of predictive biomarkers, advancing treatment to earlier stages of the disease, applying the treatment to patients with liver dysfunction and the discovery of more effective combinatorial or sequential approaches. Combinations with other systemic or local treatments are perceived as the most promising opportunities in HCC and some are already under evaluation in large-scale clinical trials. This Review provides up-to-date information on the best use of currently available immunotherapies in HCC and the therapeutic strategies under development. Immunotherapeutic interventions might be effective tools for the treatment of hepatocellular carcinoma. This Review provides up-to-date information on the clinical use of currently available immunotherapies in hepatocellular carcinoma, the mechanisms of response and resistance, and the therapeutic strategies under development.
Skin-on-a-chip (SoC) technologies are emerging as a paradigm shift in dermatology research by replicating human physiology in a dynamic manner not achievable by current animal models. Although animal models have contributed to successful clinical trials, their ability to predict human outcomes remains questionable, owing to inherent differences in skin anatomy and immune response. Covering areas including infectious diseases, autoimmune skin conditions, wound healing, drug toxicity, aging, and antiaging, SoC aims to circumvent the inherent disparities created by traditional models. In this paper, we review current SoC technologies, highlighting their potential as an alternative to animal models for a deeper understanding of complex skin conditions.
Advances in Dermatological Sciences collates major scientific research achievements over the last two years in a diverse range of dermatological research fields. Examples of key topics covered include experimental models, toxicology, regulatory, exposure assessment, therapeutics, cosmetics and decontamination. A unique feature of the book is the introductory chapter to each section that is written by an internationally-recognised expert summarising work to date, and explaining how new research contributes to our overall understanding of the skin and where the next major developments are likely to be focussed in the future. Each section contains several experimental research chapters that present contemporary research on 'hot topics' or major advances relevant to the dermatological sciences. The book incorporates a broad range of specialist topics rather than focussing on one single aspect so as to appeal to a broader audience. Thus, the proposed book will distil cutting-edge advances across all of the dermatological sciences into one major work and so provide a one-stop portal for accessing the current state of knowledge that will communicate both a readily accessible overview (in the form of introductory chapters) and also detailed, expert contributions. The text will be essential reading for interdisciplinary scientists working in dermal pharmacology, dermatological and dermatotoxicological sciences.
BACKGROUND: Compared with systemic administration methods like injection and oral administration, traditional transdermal drug delivery has the advantages of rapid onset of activity and low side effects. However, hydrophilic drugs and bioactive substances are often unsuitable for traditional transdermal drug delivery. METHODS: The application of microneedles made from gelatin methylacryloyl (GelMA) has greatly expanded thepossibilities for skin transdermal drug delivery. We have reviewed the latest literatures about the dermatological application of GelMA hydrogel microneedles in recent years using Google Scholar, PubMed and Springer. RESULTS: GelMA hydrogel microneedles exhibit huge potency in the diagnosis and treatment of skin diseases, and this technology also brings broad application prospects for subcutaneous micro-invasive transdermal targeted drug delivery, which mainly used in skin tissue fluid collection, local substance delivery and wound healing. CONCLUSION: With in-depth research on GelMA hydrogel, this technology will bring more breakthroughs and developments in the clinical diagnosis and treatment of skin diseases.
Imiquimod (IQ) is an immune-response modifying agent, first approved by FDA for the topical treatment of external genital and perianal warts in 1997. It induces, through stimulation of Toll-like receptors (TLRs) localized on the surface of antigen-presenting cells, synthesis and release of several endogenous pro-inflammatory cytokines such as interferon-alpha (IFN-alpha), tumor necrosis factor-alpha (TNF-alpha) and interleukins (IL) 6 and 12, which in turn stimulate both the innate and acquired immune pathways, resulting in upregulation of natural antiviral and antitumor activity. IQ 5% cream has been used for the treatment of a wide variety of dermatologic conditions in which the immune system is thought to play a role in regression of the disease. In some disorders, such as genital and perianal warts, actinic keratoses, basal cell carcinomas, Bowen's disease and molluscum contagiosum, relative safety and efficacy are supported by randomized controlled trials of IQ. However, it is common for patients to experience local skin reactions, which can range from mild to severe in intensity, but usually resolve 1-2 weeks after interrupting treatment. Additional randomized trials are encouraged to assess safety and efficacy of IQ in the treatment of an even wider range of cutaneous disorders.
Background: Endogenous gasotransmitters are small gaseous mediators that can be generated endogenously by mammalian organisms. The dysregulation of the gasotransmitter system is associated with numerous disorders ranging from inflammatory diseases to cancers. However, the relevance of these endogenous gasotransmitters, prodrug donors and inhibitors in inflammatory dermatological disorders has not yet been thoroughly reviewed and discussed. Aim of review: This review discusses the recent progress and will provide perspectives on endogenous gasotransmitters in the context of inflammatory dermatological disorders. Key scientific concepts of review: ) can also be generated endogenously and may take part in physiological and pathological processes. These signaling molecules regulate inflammation, vasodilation, and oxidative stress, offering therapeutic potential and attracting interest in the field of inflammatory dermatological disorders including psoriasis, atopic dermatitis, acne, rosacea, and chronic skin ulcers. The development of effective gas donors and inhibitors is a promising alternative to treat inflammatory dermatological disorders with controllable and precise delivery in the future.
Sleeping well during a heatwave starts with stopping the home from overheating。 Close blinds against strong sunlight, ventilate when the air outside becomes cooler, and avoid using heat-producing appliances during the hottest hours。 Moving to a cooler room, choosing light bedding and using fans or ice packs safely can also make hot nights more mana
The scientific community and general public have been exposed to a series of achievements attributed to a new area of knowledge: Nanotechnology. Both abroad and in Brazil, funding agencies have launched programs aimed at encouraging this type of research. Indeed, for many who come into contact with this subject it will be clear the key role that chemical knowledge will play in the evolution of this subject. And even more, will see that it is a science in which the basic structure is formed by distilling different areas of inter-and multidisciplinary knowledge along the lines of new paradigms. In this article, we attempt to clarify the foundations of nanotechnology, and demonstrate their contribution to new advances in dermatology as well as medicine in general. Nanotechnology is clearly the future.