bluuebunny/crossref_metadata_2025 huggingface dataset:
Controllable assessment of quantum rods with polarized emission for display applications
Authors: Chen Lixuan , Zhao Jinyang , Shi Zhiqing , Zhou Miao , Zhang Shengdong , Sun Xiao Wei , Zhang Xin
Published: January 2023

Semiconductor quantum rods (QRs) emit polarized light, which shows great promise in the development of modern display devices with regard to energy efficiency and color enhancement. Here we demonstrate stretching of an aligned QR polarized film for brightness enhancement and optical efficiency improvement of current quantum-dot based displays. Study of the relationship between the QR material, stretching ratio and degree of alignment provides a guide for the fabrication of highly polarized QR film. A large-area film with a high degree of alignment of 0.635 and more than 1.6-fold enhancement of brightness and transmittance compared with the traditional structure was achieved, making the film a viable candidate for use in various energy-saving display devices.
Weight Multiplicities and Young Tableaux Through Affine Crystals
Authors: Kim Jang Soo , Lee Kyu-Hwan , Oh Se-jin
Published: January 2023

The weight multiplicities of finite dimensional simple Lie algebras can be computed individually using various methods. Still, it is hard to derive explicit closed formulas. Similarly, explicit closed formulas for the multiplicities of maximal weights of affine Kac–Moody algebras are not known in most cases. In this paper, we study weight multiplicities for both finite and affine cases of classical types for certain infinite families of highest weights modules. We introduce new classes of Young tableaux, called the((spin))rigid tableaux, and prove that they are equinumerous to the weight multiplicities of the highest weight modules under our consideration. These new classes of Young tableaux arise from crystal basis elements for dominant maximal weights of the integrable highest weight modules over affine Kac–Moody algebras. By applying combinatorics of tableaux such as the Robinson–Schensted algorithm and new insertion schemes, and using integrals over orthogonal groups, we reveal hidden structures in the sets of weight multiplicities and obtain explicit closed formulas for the weight multiplicities. In particular we show that some special families of weight multiplicities form the Pascal, Catalan, Motzkin, Riordan and Bessel triangles.
Gromov’s Theory of Multicomplexes with Applications to Bounded Cohomology and Simplicial Volume
Authors: Frigerio Roberto , Moraschini Marco
Published: January 2023

The simplicial volume is a homotopy invariant of manifolds introduced by Gromov in his pioneering paper Volume and bounded cohomology. In order to study the main properties of simplicial volume, Gromov himself initiated the dual theory of bounded cohomology, which then developed into a very active and independent research field. Gromov’s theory of bounded cohomology of topological spaces was based on the use of multicomplexes, which are simplicial structures that generalize simplicial complexes without allowing all the degeneracies appearing in simplicial sets.

The first aim of this paper is to lay the foundation of the theory of multicomplexes. After setting the main definitions, we construct the singular multicomplex

K

(
X
)

\mathcal {K}(X)

associated to a topological space

X
X

, and we prove that the geometric realization of

K

(
X
)

\mathcal {K}(X)

is homotopy equivalent to

X
X

for every CW complex

X
X

. Following Gromov, we introduce the notion of completeness, which, roughly speaking, translates into the context of multicomplexes the Kan condition for simplicial sets. We then develop the homotopy theory of complete multicomplexes, and we show that

K

(
X
)

\mathcal {K}(X)

is complete for every CW complex

X
X

.

In the second part of this work we apply the theory of multicomplexes to the study of the bounded cohomology of topological spaces. Our constructions and arguments culminate in the complete proofs of Gromov’s Mapping Theorem (which implies in particular that the bounded cohomology of a space only depends on its fundamental group) and of Gromov’s Vanishing Theorem, which ensures the vanishing of the simplicial volume of closed manifolds admitting an amenable cover of small multiplicity.

The third and last part of the paper is devoted to the study of locally finite chains on non-compact spaces, hence to the simplicial volume of open manifolds. We expand some ideas of Gromov to provide detailed proofs of a criterion for the vanishing and a criterion for the finiteness of the simplicial volume of open manifolds. As a by-product of these results, we prove a criterion for the

ℓ
1

\ell ^1

-invisibility of closed manifolds in terms of amenable covers. As an application, we give the first detailed proof of the vanishing of the simplicial volume of the product of three open manifolds.
Impact of the COVID-19 pandemic and corresponding control measures on long-term care facilities: a systematic review and meta-analysis
Authors: Zhang Jun , Yu Yushan , Petrovic Mirko , Pei Xiaomei , Tian Qing-Bao , Zhang Lei , Zhang Wei-Hong
Published: January 2023

Background

Long-term care facilities (LTCFs) were high-risk settings for COVID-19 outbreaks.

Objective

To assess the impacts of the COVID-19 pandemic on LTCFs, including rates of infection, hospitalisation, case fatality, and mortality, and to determine the association between control measures and SARS-CoV-2 infection rates in residents and staff.

Method

We conducted a systematic search of six databases for articles published between December 2019 and 5 November 2021, and performed meta-analyses and subgroup analyses to identify the impact of COVID-19 on LTCFs and the association between control measures and infection rate.

Results

We included 108 studies from 19 countries. These studies included 1,902,044 residents and 255,498 staff from 81,572 LTCFs, among whom 296,024 residents and 36,807 staff were confirmed SARS-CoV-2 positive. The pooled infection rate was 32.63% (95%CI: 30.29 ~ 34.96%) for residents, whereas it was 10.33% (95%CI: 9.46 ~ 11.21%) for staff. In LTCFs that cancelled visits, new patient admissions, communal dining and group activities, and vaccinations, infection rates in residents and staff were lower than the global rate. We reported the residents’ hospitalisation rate to be 29.09% (95%CI: 25.73 ~ 32.46%), with a case-fatality rate of 22.71% (95%CI: 21.31 ~ 24.11%) and mortality rate of 15.81% (95%CI: 14.32 ~ 17.30%). Significant publication biases were observed in the residents’ case-fatality rate and the staff infection rate, but not in the infection, hospitalisation, or mortality rate of residents.

Conclusion

SARS-CoV-2 infection rates would be very high among LTCF residents and staff without appropriate control measures. Cancelling visits, communal dining and group activities, restricting new admissions, and increasing vaccination would significantly reduce the infection rates.
Molecular Characterization of Malignant Renal Epithelioid Angiomyolipoma: A Review of Two Cases
Authors: Rammal Rayan , Korentzelos Dimitrios , Skaugen John M , Quiroga-Garza Gabriela M
Published: January 2023

Objectives

Epithelioid angiomyolipoma (EAML, perivascular epithelioid cell tumor) is an uncommon primary renal tumor that may recur or metastasize, although there remain limited data for prediction of these outcomes. Here, we report two cases of renal EAML with molecular testing, adding to the existing literature of potential alterations associated with malignant behavior.

Methods

Tumors diagnosed as malignant renal EAML were identified, and clinical data, radiology, histology, immunohistochemistry, and molecular testing results were reviewed.

Results

Two cases of malignant renal EAML were identified, both of which demonstrated TSC2 and TP53 mutations. In ATRX, one had a mutation and the other had a variant of uncertain significance. In addition, one patient had a synchronous classic angiomyolipoma that lacked TP53 and ATRX alterations.

Conclusions

These findings highlight the molecular landscape of malignant renal EAML and expand on the existing literature suggesting a role for TP53 and ATRX alterations in malignant progression of these tumors. The presence of synchronous benign and malignant tumors within the same patient offers a unique opportunity to directly compare the molecular alterations, further supporting the association with aggressive behavior.
The shifting hues of Betelgeuse
Authors: Neuhäuser Dagmar L , Neuhäuser Ralph
Published: January 2023

How can you track changes in the colours of stars across hundreds of years, through differences in technologies, concepts and even languages? Dagmar L Neuhäuser and Ralph Neuhäuser show how ancient observations can still inform astrophysics today.
Patient perspectives on the lived experience of granuloma annulare
Authors: Clark Abigale , Murphy Michael J , King Brett , Cohen Jeffrey M , Rosenbach Misha , Barbieri John , Damsky William
Published: January 2023

Granuloma annulare is a relatively common inflammatory skin disease, yet patient-centered impacts of GA have not been thoroughly investigated, including the potential psychosocial and symptomatic burden, patients’ motivation for treatment, and patients’ perception of usefulness of commonly used medications. We conducted a survey of greater than 900 patients with GA and found an unexpectedly significant impact of GA on the quality of life, a generally poor reported response to commonly used therapies, and that symptoms such as itch and discomfort are not uncommon and may be the primary motivator for seeking treatment. More effective therapies and an understanding of their effect on quality of life is needed.
Impact of response patterns for patients with advanced acral melanoma treated with anti-programmed death-1 monotherapy
Authors: Zhou Li , Shao Lizhi , Gao Shunyu , Cui Chuanliang , Chi Zhihong , Sheng Xinan , Tang Bixia , Mao Lili , Lian Bin , Yan Xieqiao , Wang Xuan , Bai Xue , Li Siming , Guo Jun , Si Lu
Published: January 2023

Background

Acral melanoma (AM) is less responsive to immunotherapy than nonacral cutaneous melanoma. Variable responses are seen during immunotherapy, including pseudoprogression, hyperprogressive disease (HPD) and heterogeneous responses. There are currently no studies on the response patterns of patients with AM treated with immunotherapy and the impact on the outcome.

Objectives

To evaluate the response patterns and prognosis of patients with AM treated with anti-programmed death (PD)-1 antibodies.

Methods

Patients with advanced AM treated prospectively in five clinical trials of anti-PD-1 monotherapy at Peking University Cancer Hospital were included. Responses of individual metastases and heterogeneous responses were evaluated during immunotherapy. Cox proportional hazards regression analysis was conducted to identify the possible predictive factors and generate a nomogram to predict the risk of 1-year and 2-year mortality.

Results

The overall response rate was 18·0%, the disease control rate was 36·1%, median progression-free survival was 3·5 months [95% confidence interval (CI) 1·7–5·3] and median overall survival was 17·5 months (95% CI 15·1–19·9) for anti-PD-1 monotherapy. Overall, 9·8% of patients met the criteria of HPD, and displayed a dramatically worse outcome than patients without HPD. In total, 369 metastatic lesions were assessed, with the highest response rate in lymph nodes (20·4%) and the lowest in the liver (5·6%). Homogeneous response, heterogeneous response and heterogeneous or homogeneous progression had different prognoses from the best to the worst. A predictive model was constructed and achieved good accuracy with a C-index of 0·73 (95% CI 0·63–0·84) in the training set and 0·74 (95% CI 0·61–0·86) in the validation set.

Conclusions

HPD during immunotherapy serves as an essential biomarker of poor prognosis in advanced AM. Metastases in different sites respond distinctively to immunotherapy. Clinically heterogeneous responses to immunotherapy affect the outcome of patients. A predictive model was built to distinguish the prognosis of acral melanoma under immunotherapy.
Improving migrant health in the USA: opportunities for dermatologists to participate in care delivery, asylum medicine and community partnership
Authors: Kim-Lim Penelope , Castillo Valladares Herbert , Knapp Alexia , Kivlahan Coleen , Chang Aileen Y
Published: January 2023

With an increase in migrant patients in the U.S. who are facing legal and health barriers, dermatologists can engage in opportunities to improve migrant health. These include: providing trauma-informed, culturally competent dermatologic care to migrants; partnering with human rights clinics to provide dermatologic consultations for asylum seekers with skin conditions or unique scars; and engaging with community organizations to collaborate and advocate for the health and well-being of migrants.
Birth incidence and outcome of harlequin ichthyosis and collodion membrane in the UK and Ireland: a national 2-year prospective surveillance study
Authors: Moss Celia , Roked Fozia , Davis Peter J , Khan Murtaza , Tyler Catherine , Ibbs Samantha , Ewer Andrew K
Published: January 2023

Collodion membrane covers a heterogeneous group of ichthyoses with disparate outcomes. In this large, prospective birth-cohort study we show that babies with non-syndromic collodion membrane are born in good condition and in 40% the ichthyosis resolves within a year. Our data challenges existing guidelines and supports expectant management.
Pigmented demodicosis presenting as lentigo maligna diagnosed by reflectance confocal microscopy
Authors: Bertold Clemence , Martel Philippe , Passeron Thierry , Bahadoran Philippe
Published: January 2023

The differential diagnosis between benign pigmented macules and lentigo maligna (LM) is clinically challenging. The presence of pigmented circles around hair follicles is an important dermoscopic clue for the diagnosis of LM. Here we report on a woman with a pigmented macule of the face with perifollicular circles for whom the diagnosis of LM was suspected. Instead, reflectance confocal microscopy diagnosed pigmented demodicosis, spared an unnecessary biopsy, and deciphered the mechanisms of hyperpigmentation.
B-cell-derived transforming growth factor-β may drive the activation of inflammatory macrophages and contribute to scarring in hidradenitis suppurativa
Authors: Smith Conor M , Hambly Roisin , Gatault Solene , Iglesias-Martinez Luis F , Kearns Sean , Rea Helen , Marasigan Vivien , Lynam-Loane Kate , Kirthi Shivashini , Hughes Rosalind , Fletcher Jean M , Kolch Walter , Kirby Brian
Published: January 2023

Lesional HS skin was analysed using RNA-sequencing to assess the predicted functional interplay between B cells and macrophages. Our findings support the idea that TGF-beta plays a key role in HS pathogenesis. It is likely that the development of tunnels and scarring in HS is closely related to a chronic activation of TGF-beta signalling.
Living with hidradenitis suppurativa: managing the pain
Authors: Cowdell Fiona
Published: January 2023

“extraordinarily debilitating. I can’t work, I can’t do school. I can’t function and....every day moving on with my life turns into the worst thing ever”. Only a hard-hearted clinician could read this quote from a woman living with Hidradenitis Suppurativa (HS) and not be moved. The qualitative study in this issue of pain experiences in HS reveals a disconnect between patients and practitioners and offers new insights that may help improve HS care.
Trajectories of comorbidities in patients with psoriasis: a question to be answered
Authors: Vegas Laura Pina , Claudepierre Pascal
Published: January 2023

Trajectories of comorbidities in psoriasis patients: a question to be answered
Parent and child experience of skin conditions: relevance for the provision of mindfulness-based interventions
Authors: Hughes Olivia , Shelton Katherine H , Penny Helen , Thompson Andrew R
Published: January 2023

Background

Managing a skin condition can be difficult, and there is a lack of psychological support for children and their families.

Objectives

To identify issues surrounding caring for a child with a skin condition, investigate experiences of current psychological support to gain a sense of what is needed, and determine the relevance of offering mindfulness-based interventions for children and families.

Materials and methods

This study employed a mixed inductive and deductive form of qualitative inquiry to understand the experiences and needs of children and families. Twenty-three participants (12 parents/carers: 11 females, 1 male; 11 children: 6 females, 5 males, aged 8–11 years) were recruited with an advert posted on social media. In-depth data were collected from semi-structured interviews. Interviews were recorded, transcribed and analysed with a descriptive form of thematic analysis.

Results

Systematic analysis of the data led to five themes being developed: (i) caregiver burden of childhood skin conditions; (ii) skin condition overshadowing childhood; (iii) battling for recognition and lack of support; (iv) naturalistic use and understanding of mindfulness in everyday coping: and (v) openness and relevance of offering mindfulness-based interventions.

Conclusions

Living with a skin condition was reported as being associated with mood disturbance, with impacts on schooling, sleep and daily life. Parents and children expressed a desire for short/accessible interventions that could fit with daily routines and might provide the opportunity to connect with other families. The findings indicate that mindfulness-based interventions may be likely to be accepted, as many participants had experience of using mindful techniques in school, and described that they were naturalistically using ‘mindfulness’ to manage itch and stress. However, the findings indicate that a number of misconceptions exist about the fundamental nature and aims of mindfulness. Addressing misconceptions related to mindfulness needs to be considered when planning both future studies and service delivery.
Are Janus kinase inhibitors an effective treatment for palmoplantar pustulosis? A critically appraised topic
Authors: Gleeson David , Barker Jonathan N W N , Capon Francesca , Pink Andrew E , Woolf Richard T , Smith Catherine H , Mahil Satveer K
Published: January 2023

We carried out a critical appraisal of the literature to assess whether Janus kinase inhibitors are an effective treatment for palmoplantar pustulosis, a rare and debilitating form of psoraisis. Our appraisal identified case reports and case series of 16 patients who have been treated to good effect with tofacitinib, indicating this may be a promising therapeutic option. However, routine use of janus kinase inhibitors cannot be recommended outside the context of a clinical trial given the current low-quality of evidence available and the uncertain safety profile of Janus kinase inhibitors.
Dermatology Quality of Life Index scores in Bangladeshi patients with atopic eczema and their families in East London
Authors: Tawfik Soha S , Thomas Bjorn R , Kelsell David P , Grigg Jonathan , O’Toole Edel A
Published: January 2023

Background

Atopic eczema (AE) is a chronic relapsing, pruritic disease that greatly affects the child and family’s quality of life (QoL). It is usually common and severe among children of Bangladeshi ethnicity.

Objectives

This is a cross-sectional quantitative study in patients with AE of Bangladeshi origin, which aims to analyse different components of the family, children and adult quality-of-life indices and their relationship to patient age, sex, eczema severity and distribution, other allergic associations, parental education and socioeconomic level.

Methods

Children and young adults of Bangladeshi origin aged 0–30 years, clinically diagnosed with AE were recruited as part of the Tower Hamlets Eczema Assessment project, a clinical phenotyping study of AE in the Bangladeshi population living in East London. Questionnaires completed by children/parents included the Family Dermatology Life Quality Index (FDLQI), Infant’s Dermatology Quality of Life (IDQOL) and the Children’s Dermatology Life Quality Index (CDLQI). Young adults completed the Dermatology Life Quality Index (DLQI). The disease severity was assessed objectively using the Eczema Area Severity Index (EASI). Patients and parents who did not read or speak English were aided by Bengali/Sylheti-speaking research assistants.

Results

Overall, 460 Bangladeshi children and 98 adults with AE were recruited. Burden of care, extra housework and emotional distress were the highest affected domains in parental QoL, while itching and sleep were the highest for children. Significant factors influencing FDLQI score were EASI [marginal effect (ME) 1.01, 95% confidence interval (CI) 1.00–1.03; P = 0.004], age (ME 0.98, 95% CI 0.97–0.99; P = 0.004), extensor eczema distribution (ME 1.25, 95% CI 1.03–1.52; P = 0.023), parental English fluency (ME 1.29, 95% CI 1.10–1.52; P = 0.002) and atopic comorbidities (ME 1.10, 95% CI 1.04–1.17; P = 0.001). Parental socioeconomic class was a nonsignificant factor. IDQOL/CDLQI was influenced significantly by the child’s age (ME 0.99, 95% CI 0.97–1.00, P = 0.023), ‘nonclear’ eczema distribution clusters especially the ‘severe extensive’ cluster (ME 1.46, 95% CI 1.15–1.84; P = 0.002) and nonsignificantly by EASI and parental English literacy and socioeconomic levels. DLQI was affected significantly by nonclear eczema distribution groups especially ‘severe extensive’ (ME 2.49, 95% 1.76–3.53; P < 0.001) and nonsignificantly by patient age, and female sex.

Conclusions

AE is a chronic disease where many external factors other than disease severity affect QoL of patients and their families, ­especially in under-represented minority groups who face different linguistic and cultural barriers.
Online behavioural interventions for children and young people with atopic eczema: refining the way forward
Authors: Magin Parker , Fisher Katie
Published: January 2023

The online behavioural interventions for children and young people with atopic eczema evaluated in the article reviewed in this commentary have previously been found to be efficacious. A process evaluation, reported in the article, explored how and why the interventions have worked.
A dance that paves the way for diagnosis
Authors: Sachan Sonal , Shukla Prakriti , Agrawal Tanvi , Kumar Surender , Malhotra Kiran P , Suvirya Swastika
Published: January 2023

Filariasis is a tropical disease that, despite innumerable geopolitical measures, continues to be rampant in India. Breast filariasis, although uncommon, is not unknown. It can masquerade as breast carcinoma or breast abscess, with consequent delay in diagnosis. Real-time ultrasonography is a noninvasive method that can help with the diagnosis, as the adult worm shows classical rigorous body movements known as the ‘filarial dance’.
Successful treatment with anakinra in generalized spiculated porokeratosis and severe hidradenitis suppurativa in a patient with MVK and MEFV mutations
Authors: Oktem Ayse , Rasulova Gunel , Cavdarli Busra , Bostanci Seher , Heper Aylin , Vural Secil
Published: January 2023

The synergistic effect of two mutations of the innate immune system may facilitate hyperactivation and dysregulation of the inflammasome in skin macrophages. This case connects two diseases, hidradenitis suppurativa and porokeratosis, by the central role of autoinflammation.
Papulonodular eruption in the inguinal area of an adolescent girl with Down syndrome
Authors: Nanda Arti , Al-Noon Rana , Al-Sabah Humoud , Al-Enezi Athary
Published: January 2023

We report a 16-year-old adolescent girl with Down syndrome who developed a slowly progressive papulonodular eruption in the inguinal area. Skin biopsy for histopathology showed foci of bony trabeculae with osteoblasts and calcium deposition in the deeper dermis. An association of such lesions with Down syndrome, and the site of involvement, has not been reported previously.
Sun-protection practices of men in the west of Ireland
Authors: Hynes Jason , Griffin Laoise , Laing Mary E
Published: January 2023

We examined the sun-protection practices of 61 men attending a dermatology department in the west of Ireland. Most worked outdoors, either currently or in the past. Although most wore hats as a sun-protection measure, the majority wore baseball caps, with smaller numbers wearing other types of hats that do not offer protection to the head and neck. Use of SPF products was widespread, but often not used habitually.
Paediatric-onset generalized pustular psoriasis secondary to myeloperoxidase mutations
Authors: Pérez-Feal Patricia , Moreiras-Arias Noelia , Vega Ana , Suárez-Peñaranda José Manuel , López-Franco María Monsterrat , Rodríguez-Blanco Isabel , Sánchez-Aguilar Dolores , Vázquez-Osorio Igor
Published: January 2023

We examined the sun-protection practices of 61 men attending a dermatology department in the west of Ireland. Most worked outdoors, either currently or in the past. Although most wore hats as a sun-protection measure, the majority wore baseball caps, with smaller numbers wearing other types of hats that do not offer protection to the head and neck. Use of SPF products was widespread, but often not used habitually.
A large case series on the use of diphencyprone immunotherapy in the clearance of palmoplantar warts
Authors: Chadha Mehak , Walsh Sarah , du Vivier Anthony
Published: January 2023

Background

Palmoplantar viral warts are common, often affecting the quality of life of patients and present a major therapeutic challenge. Immunotherapy using diphencyprone (DCP) can be beneficial especially if first-line treatments fail.

Aim

To determine the effectiveness of DCP in clearing viral warts, and to provide detail on the number of treatments required and any adverse effects (AEs).

Methods

This was a retrospective case series of 124 patients who had received DCP treatment in a UK private practice setting from 1991 to 2008, carried out by a dermatologist experienced in the procedure. All patients had been referred by other clinicians after failure of standard treatments. The study data were extracted from clinical records, with follow-up until wart clearance or treatment discontinuation.

Results

There was an equal distribution in sexes (63 females, 61 males), with 37% of patients having warts present for greater than 5 years. The majority (93%) of patients had already tried cryotherapy, which was unsuccessful in clearing warts completely in all cases. Following DCP treatment, 77% of patients achieved full eradication of their warts, including three patients who were immunosuppressed. The mean number of DCP treatments required to achieve full clearance was 4·7, and the mean concentration of DCP required was 4%. Only 12% of patients experienced AEs, which were mild, and included urticaria and blistering.

Conclusion

We suggest that DCP immunotherapy is a safe and effective treatment for eradicating viral warts, especially in recalcitrant cases.
Mondor disease: an uncommon complication in dermatological surgery
Authors: Keeling Elizabeth , Bosbait Heba , Hackett Caitriona , Salim Asad , Connolly Maureen , Tobin Anne-Marie , Molloy Kevin
Published: January 2023

We present an unusual case of Mondor disease (MD) occurring secondary to elliptical excision of a naevus on the chest wall. MD is a rare superficial thrombophlebitis classically occurring on the anterolateral thoracoabdominal wall. It can be idiopathic, can be due to trauma, breast malignancy, hypercoagulable states or can be iatrogenic, most commonly arising from breast surgery. The condition is generally self-resolving within weeks.
The dangers of social media: patients with atopic dermatitis ceasing their basic treatment
Authors: Wilson Anna , Cowan Timothy L , Rivero Alexis D Lara , Murrell Dedee F
Published: January 2023

We report a patient who stopped using treatment for his atopic dermatitis (AD) following social media influence.
Do we practice and do we preach? A survey of Irish interns regarding knowledge, attitudes, personal and professional practices of skin cancer detection
Authors: Shafik Lidia , Griffin Laoise , Leahy Marion , Laing Mary
Published: January 2023

We undertook a study of skin cancer (SC) recognition and health promotion among interns in an Irish hospital. While the knowledge on SC was good, the majority of the interns did not practice safe sun behaviours themselves, and the majority did not feel confident in diagnosing skin lesions or SC. Most had never performed a skin examination on patients, or discussed sun protection or skin self examination with their patients.
Ancillary techniques to improve dermoscopy specificity for skin cancer detection
Authors: Nazir Zaeem H , Hussain Khawar , Marghoob Ashfaq A , Patel Neil P
Published: January 2023

Although the use of dermoscopy has markedly improved both the sensitivity and specificity for skin cancer detection, there is still opportunity for improvement. Ancillary techniques provide additional ways to assess a lesion with the aim of improving our diagnostic ability with little extra cost. Usage of these techniques can strengthen diagnosis and help reduce unnecessary biopsies of benign lesions.
Development of desquamation with Staphylococcus aureus colonization in patients with atopic dermatitis under treatment with upadacitinib
Authors: Jang Yun Kyung , Kim Dong Hyun , Yoon Moon Soo , Shin Jung U , Lee Hee Jung
Published: January 2023

We report two patients with atopic dermatitis who were treated with upadacitinib, and later developed desquamation of the face with Staphylococcus aureus colonization. Treatment with ciclosporin and antibiotics was unsuccessful, but both patients improved when treatment was switched to dupilumab.
IgG4-related skin disease responsive to thalidomide
Authors: Smith Lucy , Yesudian Paul Devakar , Murugusundaram Sundaram , Krishnakumar Subramaniam , Yesudian Patrick
Published: January 2023

IgG4-related skin disease is a rare, immune-mediated disorder characterized by tissue infiltration with IgG4+ plasma cells, along with elevated serum IgG4. We describe a patient treated successfully with thalidomide.
A progressive pigmentary dermatosis
Authors: McFeely Orla , Victory Liana , Pender Emily , Higgins Eleanor , Storan Eoin
Published: January 2023

A 53-year-old Indian man presented with a striking reticulate hyperpigmentation on photoexposed sites with a sharp cutoff in a V distribution on his anterior chest. Histopathology showed prominent basal degenerative changes, focal lymphocyte exocytosis and an upper dermal lymphohistiocytic infiltrate.
High-risk mucosal human papillomavirus-associated squamous cell carcinoma of the fingers presents distinctive clinicopathological characteristics and outcomes: a bicentric retrospective study
Authors: Marti-Marti Ignasi , Bosch-Amate Xavier , Morgado-Carrasco Daniel , Albero-González Raquel , Santos-Briz Angel , Puebla-Tornero Laura , Revelles-Peñas Leonor , Cañueto Javier , Alòs Llúcia , Toll Agustí
Published: January 2023

Background

High-risk mucosal human papillomavirus (HR-HPV) seems to play a role in cutaneous squamous cell carcinoma (cSCC), particularly in nail tumours, where genitodigital transmission has been suggested. The role of HR-HPV in nonungual cSCC of the finger needs to be clarified.

Aim

To evaluate the prevalence, clinicopathological characteristics, surrogates and outcomes of HR-HPV in cSCC of the finger.

Methods

This was an observational bicentric study including patients with an excised in situ or invasive cSCC located on the finger. Differences in HR-HPV and non-HR-HPV tumours were evaluated.

Results

Forty-five patients (45 tumours) were included. HR-HPV was detected in 33% of cases (22% HPV type 16). The mean age was lower in patients with HR-HPV than in those with non-HR-HPV (62·4 vs. 81·1 years, P = 0·001). HR-HPV tumours were smaller (10 mm vs. 15 mm, P = 0·07) and more frequently intraepidermal (60% vs. 20%, P = 0·004). The absence of elastosis (P = 0·030) and inflammation (P = 0·026) and the presence of basaloid morphology (P = 0·003) were surrogates of HR-HPV detection. Mean p16 positivity was 61% in HR-HPV and 36% in non-HR-HPV tumours (P = 0·061). Recurrence after surgery was more common in HR-HPV tumours (58% vs. 34%), although this was not statistically significant. HR-HPV was detected in 27% of the nonungual tumours.

Conclusion

HR-HPV-associated cSCC of the finger appears in younger patients, is smaller and is less infiltrative than non-HR-HPV tumours. The presence of a basaloid morphology and the absence of elastosis and inflammation could be used as markers for HR-HPV detection. The high prevalence of HR-HPV in nonungual cSCC suggests its aetiopathogenic role in these tumours.
Isotretinoin is among the medications that could cause aquagenic wrinkling of the palms
Authors: Aktas Habibullah
Published: January 2023

Article summary

Isotretinoin may cause aquagenic wrinkling by increasing autonomic nervous system sympathetic activation, as well as by impairing skin barrier function and water absorption.
Lichen amyloidosis: towards pathogenesis-driven targeted treatment
Authors: Fakhraie Sheiva , Daftary Karishma , Venkatesh Samantha , Chovatiya Raj
Published: January 2023

Lichen amyloidosis (LA) is an uncommon, primary cutaneous amyloidosis associated with chronic, idiopathic pruritus. We report the case of a 66-year-old woman who presented to clinic with intense pruritus of the shins for 40 years. This patient showed a complete response to the Janus kinase (JAK) inhibitor upadacitinib and we therefore suggest JAK inhibition as a targeted treatment strategy for LA.
Rapid improvement of refractory generalized granuloma annulare with the Janus kinase inhibitor baricitinib in two patients
Authors: Kim Dongchan , Kang Hee Young
Published: January 2023

We report the results from baricitinib treatment in two patients with refractory generalized granuloma annulare. We highlight that baricitinib could be a plausible treatment option as a new molecular-targeted therapy for refractory generalized granuloma annulare.
Genetic findings in a patient with paradoxical pyoderma gangrenosum induced by brodalumab
Authors: Aromolo Italo Francesco , Maronese Carlo Alberto , Moltrasio Chiara , Boggio Francesca , Violetti Silvia Alberti , Avallone Gianluca , Morini Nicole , Carrera Carlo Giovanni , Genovese Giovanni , Marzano Angelo Valerio
Published: January 2023

We describe a patient with psoriasis who developed pyoderma gangrenosum while on treatment with brodalumab, an anti-interleukin (IL)-17 receptor monoclonal antibody. Genetic analyses revealed heterozygous polymorphisms within the promoter region of the IL-6 (promoter polymorphism –174 G/C) and IL-10 genes (promoter polymorphism –1082 A/G).
The dermatologist identity crisis: a phenomenological analysis of dermatology trainee professional identity during generalist redeployment
Authors: Guckian Jonathan , Lee Natasha , Sutton Jonathan E , Mayat Nabilah Y , Morrison Kirsty , Farquhar Katherine E L , Singh Minal
Published: January 2023

Background

Dermatology faces a workforce crisis against a backdrop of wider medical education shifts towards generalism. A pivot towards generalism may have an impact on dermatology trainee professional identity, which, to our knowledge, has not been investigated and is known to have an impact on competence and conceptualization of ethics among physicians. Disruption because of the COVID-19 pandemic led to dermatology trainee redeployment and therefore presents a unique opportunity to examine dermatology trainee professional identity during times of pressure.

Aim

To identify the impact of COVID-19 redeployment on dermatology trainee professional identity, the factors influencing identity and whether such factors affect trainees’ perceptions about their future careers.

Methods

Ten trainees were purposively recruited to the study. Data were collected through semistructured interviews and were analysed phenomenologically using the template analysis method. Central and integrative themes were identified.

Results

Three central themes were identified: trainee identity and values; redeployment transitions; and future clarity. Three integrative themes were found: tribes; sense of purpose; and uncertainty. Trainees see competence and community as central to the dermatologist identity. Most trainees experienced a reaffirmation of their prior values, psychologically retreating to close-knit communities. However, some underwent disorienting dilemmas, later reflecting on their futures as dermatologists.

Conclusion

Healthcare crises may have a significant impact on dermatology trainee professional identity and may lead to reaffirmation of prior tribal values or disorienting reflection upon future career trajectories. Improved support among diverse communities, minimization of uncertainty and fostering a sense of purpose among trainees may aid identity enrichment and safeguard the future dermatology consultant workforce.
Top–down approach for increasing skin of colour representation in dermatology: emphasizing greater representation of skin of colour in national board examinations. Comment on ‘Assessment of diversity in skin colour in dermatology medical education resources’
Authors: Joshi Tejas P , Lewis Daniel J
Published: January 2023

Despite calls to increase skin of colour (SoC) representation in dermatology, educational materials continue to depict cutaneous lesions in lighter skin. In this letter, we endorse a top–down approach (i.e. increasing frequency of SoC representation in board exams) to remedy the poor representation of SoC in dermatology.
Severe psychological distress among patients with skin cancer: a population-based study spanning two decades
Authors: Zheng David X , Cwalina Thomas B , Treichel Alison M , Erickson Kayley L , Workman Kaelynn R , Zhan Jesse J , Rothermel Luke D , Levoska Melissa A , Scott Jeffrey F
Published: January 2023

In this analysis of the National Health Interview Survey, Americans with lower socioeconomic status, who are unmarried and with comorbidities were found to be at higher odds of severe psychological distress. Our findings may inform targeted support-based psycho-oncological interventions, such as shared medical appointments with other at-risk patients who have skin cancer.
A review of topical probiotic therapy for atopic dermatitis
Authors: Herbert Samantha , Haughton Reneé , Nava Jordan , Ji-Xu Antonio , Le Stephanie T , Maverakis Emanual
Published: January 2023

Atopic dermatitis (AD) is a common, chronic skin disorder that is associated with dysbiosis of the skin microbiome along with an impaired skin barrier and abnormal immune signalling. Particularly, AD has been associated with increased abundance of Staphylococcus aureus and decreased overall bacterial diversity. Topical probiotic formulations are garnering further interest in the treatment of AD and may be derived from commensal bacteria found on healthy epithelium or from exogenous bacteria. Strains chosen for clinical trials have often demonstrated antimicrobial actions to S. aureus in vitro. Multiple randomized clinical trials with topical probiotics have resulted in significant improvements in clinical severity, decreased abundance of S. aureus in treated lesional skin and increased bacterial diversity. Side-effects from available studies have been minimal apart from one patient who developed a furuncle in the treatment area. Topical probiotics have been shown to be safe and potentially efficacious in AD; however, further research including larger, longer-term clinical trials need to be performed before topical probiotics should be recommended to patients.
Bedbugs: how to diagnose and manage cases of infestations
Authors: Shipman Kate E , Weaving Gary , Shipman Alexa R
Published: January 2023

Bedbugs are on the rise in urban populations across the world, perhaps reflecting the ban on the use of organophosphates in many countries worldwide. They are flat obligate haematophagous insects, preferring humans, and as a consequence the bedbug bites lack toxins and can often go unnoticed for some time. Bites can, however, cause weals, purpura, petechiae, vesicles, pustules, papular urticaria, localized infection and rarely anaphylaxis. Infestations have to be confirmed by finding the bugs, usually around the bed of the person being bitten. Eradication usually requires a combination of physical (for example high temperature, mattresses protectors, traps, cold) and chemical methods (for example chrysanthemic acid derivatives plus potentiators such as geraniol and piperonyl butoxide or acetylcholine esterase inhibitors).
Connectome-based predictive modeling predicts paranoid ideation in young men with paranoid personality disorder: a resting-state functional magnetic resonance imaging study
Authors: Zhang Die , Yu Lan , Chen Yingying , Shen Jing , Du Lina , Lin Lin , Wu Jianlin
Published: January 2023

Paranoid personality disorder (PPD), a mental disorder that affects interpersonal relationships and work, is frequently neglected during diagnosis and evaluation at the individual-level. This preliminary study aimed to investigate whether connectome-based predictive modeling (CPM) can predict paranoia scores of young men with PPD using whole-brain resting-state functional connectivity (rs-FC). College students with paranoid tendencies were screened using paranoia scores ≥60 derived from the Minnesota Multiphasic Personality Inventory; 18 participants were ultimately diagnosed with PPD according to the Diagnostic and Statistical Manual of Mental Disorders and subsequently underwent resting-state functional magnetic resonance imaging. Whole-brain rs-FC was constructed, and the ability of this rs-FC to predict paranoia scores was evaluated using CPM. The significance of the models was assessed using permutation tests. The model constructed based on the negative prediction network involving the limbic system-temporal lobe was observed to have significant predictive ability for paranoia scores, whereas the model constructed using the positive and combined prediction network had no significant predictive ability. In conclusion, using CPM, whole-brain rs-FC predicted the paranoia score of patients with PPD. The limbic system-temporal lobe FC pattern is expected to become an important neurological marker for evaluating paranoid ideation.
Long-Acting Cabotegravir and Rilpivirine Dosed Every 2 Months in Adults With Human Immunodeficiency Virus 1 Type 1 Infection: 152-Week Results From ATLAS-2M, a Randomized, Open-Label, Phase 3b, Noninferiority Study
Authors: Overton Edgar T , Richmond Gary , Rizzardini Giuliano , Thalme Anders , Girard Pierre-Marie , Wong Alexander , Porteiro Norma , Swindells Susan , Reynes Jacques , Noe Sebastian , Harrington Conn , Español Carlos Martín , Acuipil Carolina , Aksar Asma , Wang Yuanyuan , Ford Susan L , Crauwels Herta , van Eygen Veerle , Van Solingen-Ristea Rodica , Latham Christine L , Thiagarajah Shanker , D’Amico Ronald , Smith Kimberly Y , Vandermeulen Kati , Spreen William R
Published: January 2023

Background

Cabotegravir (CAB) + rilpivirine (RPV) dosed intramuscularly monthly or every 2 months is a complete, long-acting (LA) regimen for the maintenance of HIV-1 virologic suppression. Here, we report the antiretroviral therapy as long acting suppression (ATLAS)-2M study week 152 results.

Methods

ATLAS-2M is a phase 3b, randomized, multicenter study assessing the efficacy and safety of CAB+RPV LA every 8 weeks (Q8W) versus every 4 weeks (Q4W). Virologically suppressed (HIV-1 RNA <50 copies/mL) individuals were randomized to receive CAB+RPV LA Q8W or Q4W. Endpoints included the proportion of participants with plasma HIV-1 RNA ≥50 copies/mL and <50 copies/mL, incidence of confirmed virologic failure (CVF; 2 consecutive measurements ≥200 copies/mL), safety, and tolerability.

Results

A total of 1045 participants received CAB+RPV LA (Q8W, n = 522; Q4W, n = 523). CAB+RPV LA Q8W demonstrated noninferior efficacy versus Q4W dosing, with 2.7% (n = 14) and 1.0% (n = 5) of participants having HIV-1 RNA ≥50 copies/mL, respectively, with adjusted treatment difference being 1.7% (95% CI: 0.1–3.3%), meeting the 4% noninferiority threshold. At week 152, 87% of participants maintained HIV-1 RNA <50 copies/mL (Q8W, 87% [n = 456]; Q4W, 86% [n = 449]). Overall, 12 (2.3%) participants in the Q8W arm and 2 (0.4%) in the Q4W arm had CVF. Eight and 10 participants with CVF had treatment-emergent, resistance-associated mutations to RPV and integrase inhibitors, respectively. Safety profiles were comparable, with no new safety signals observed since week 48.

Conclusions

These data demonstrate virologic suppression durability with CAB+RPV LA Q8W or Q4W for ∼3 years and confirm long-term efficacy, safety, and tolerability of CAB+RPV LA as a complete regimen to maintain HIV-1 virologic suppression.
A Model-Based Tool for Guiding Infliximab Induction Dosing to Maximize Long-term Deep Remission in Children with Inflammatory Bowel Diseases
Authors: Kantasiripitak Wannee , Wicha Sebastian G , Thomas Debby , Hoffman Ilse , Ferrante Marc , Vermeire Séverine , van Hoeve Karen , Dreesen Erwin
Published: January 2023

Background and Aims

Adequate infliximab concentrations during induction treatment are predictive for deep remission [corticosteroid-free clinical and endoscopic remission] at 6 months in children with inflammatory bowel diseases [IBD]. Under standard infliximab induction dosing, children often have low infliximab trough concentrations. Model-informed precision dosing [MIPD; i.e. model-based therapeutic drug monitoring] is advocated as a promising infliximab dosing strategy. We aimed to develop and validate an MIPD framework for guiding paediatric infliximab induction treatment.

Methods

Data from 31 children with IBD [4–18 years] receiving standard infliximab induction dosing (5 mg/kg at week [w]0, w2 and w6) were repurposed. Eight paediatric population pharmacokinetic models were evaluated. Modelling and simulation were used to identify exposure targets, identify an optimal sampling strategy, and develop a multi-model prediction algorithm for implementation into an MIPD software tool. A role for infliximab clearance monitoring was evaluated.

Results

A 7.5 mg/L infliximab concentration target at w12 was associated with 64% probability of deep remission at 6 months. With standard dosing, less than 80% of simulated children <40 kg attained this target. The w12 target was most accurately and precisely achieved by implementing MIPD at w6 using the w6 infliximab concentration [rapid assay required]. The multi-model algorithm outperformed single models when optimizing the w6 dose based on both w2 and w4 concentrations. MIPD using only the w2 concentration resulted in biased and imprecise predictions. Infliximab clearances at w6 and w12 were predictive for deep remission.

Conclusions

A freely available, multi-model MIPD tool facilitates infliximab induction dosing and improves deep remission rates in children with IBD.