31 research outputs found
Mesenchymal stem cells and cell-free preparations for treating atopic dermatitis
Atopic dermatitis (AD) is a chronic cutaneous inflammatory disease caused by an interaction between genetic,
immune and epidermal barrier factors. Several treatments can be used to treat this disease but there are patients that do
not respond to actual drugs. So, there is a need to develop effective therapies for AD. Mesenchymal stem cells (MSCs) are
non-hematopoietic multipotent adult progenitor cells with immunomodulatory power and self-regenerating capacity to
repair tissue damage, so they could be a potential effective treatment for AD. MSCs-Conditioned Medium (CM) and
MSCs-exosomes are cell-free preparation with molecules secreted by stem cells that could be also beneficial for AD.
This viewpoint reviews the actual development of MSCs, MSCs-CM and MSCs-exosomes for treating patients with AD
A multicenter case-control study comparing sun exposure habits and use of photoprotection measures in patients diagnosed with different types of skin cancer
BackgroundWhile skin cancer awareness programs have significantly furthered public understanding about the harmful effects of the sun, there is a disparity between photoprotection knowledge and protection practices. ObjectiveTo compare sun exposure habits and photoprotection measures in patients diagnosed with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma versus controls. MethodsMulticentre case-control observational study carried out by 13 Spanish dermatologists between April 2020 and August 2022. Patients diagnosed with BCC, SCC, or melanoma were considered cases. The control group consisted of individuals with no history of skin cancer. ResultsOf the 254 cases (56.2% female; mean age, 62.67 +/- 15.65), 119 (31.2%) had BCC, 62 (16.27%) SCC, and 73 (19.1%) melanoma. The control group consisted of 127 (33.33%) individuals. Avoiding sun exposure between 12:00 and 16:00 was the most commonly used photoprotection measure (habitually/always: 63.1%), followed by the use of sunscreen (habitually/always: 58.9%). Patients with melanoma were less likely to use clothing and shade to avoid sun exposure (p = 21, and the majority SPF > 50. No differences were observed in photoprotection measures between people with and without a previous history of skin cancer. ConclusionsWe describe differences in photoprotection measures and sun exposure patterns among patients diagnosed with different skin tumor types. Whether these differences may influence the type of tumor each developed will require further investigation
The Effect of Sunscreens on the Skin Barrier
Transepidermal water-loss (TEWL), stratum-corneum hydration (SCH), erythema, elasticity, pH and melanin, are parameters of the epidermal barrier function and skin homeostasis that objectively indicate the integrity of the skin barrier. Sunscreens are necessary to protect people from skin cancer, but could modify the skin barrier function. Nevertheless, there are not many studies on their impact on skin homeostasis. The aim of this study is to evaluate the impact of sunscreens on the epidermal-barrier function and skin homeostasis of healthy individuals. A prospective observational study was designed. TEWL, SCH, erythema, elasticity, pH and melanin were measured on the cheek and volar region of the forearm, using non-invasive methods before and after applying sunscreen. Four different sunscreens were tested, one full-body sunscreen and three facial sunscreens. The study included 51 healthy volunteers, 72.5% (37/51) women, with a mean age of 41.63 years. After full-body sunscreen application, temperature increased by 0.68 degrees C (p < 0.001), pH by 0.16 units (p < 0.001), and elasticity by 0.22% (p = 0.039), while melanin decreased by 10.95 AU (p < 0.001), erythema by 28.79 AU (p < 0.001) and TEWL by 0.66 g center dot m(-2)center dot h(-1) (p = 0.019). On the cheek, facial sunscreen 1 increased temperature by 0.51 degrees C, TEWL 0.7 g center dot m(-2)center dot h(-1) (p < 0.05), pH by 0.12 units (p < 0.001) and elasticity by 0.059% (p < 0.001), but decreased erythema by 19.87 AU (p < 0.05) and SCH by 5.63 AU (p < 0.001). Facial sunscreen 2 increased temperature by 0.67 degrees C, TEWL by 1.93 g center dot m(-2)center dot h(-1) (p < 0.001), pH by 0.42 units (p < 0.001) and elasticity by 0.12% (p < 0.01), but decreased melanin by 15.2 AU (p = 0.000), erythema by 38.61 AU (p < 0.05) and SCH by 10.80 AU (p < 0.01). Facial sunscreen 3 increased temperature by 1.15 degrees C, TEWL by 2.29 g center dot m(-2)center dot h(-1) (p < 0.001), pH by 0.46 units (p < 0.001) and elasticity by 0.15% (p < 0.01), but decreased erythema by 35.7 (p < 0.05) and SCH by 10.80 AU (p < 0.01). In conclusion, sunscreen could slightly modify the skin-barrier function. All of them decreased erythema, likely in relation to anti-inflammatory power
Situación actual de la prevención del cáncer de piel: una revisión siste
Skin cancer deaths continue to rise despite the implementation of numerous preventive
campaigns and programs. The aim of this systematic review was to evaluate reviews
of primary and secondary skin cancer prevention strategies as reported over the past 10 years.
We analyzed 63 systematic reviews and meta-analyses: 30 (46.6%) addressing primary interventions
and 35 (55.6%) addressing secondary interventions. Two of the reviews covered both.
The most widely reported primary prevention approaches were education programs (63.3%),
followed by risk modeling to identify individuals at high risk for melanoma (17.6%), and the
promotion of sunscreen use (11.8%). The most widely reported secondary prevention measures
concerned imaging systems for early skin cancer detection (40%), smartphones and new technologies
(22.9%), and visual diagnosis in population-based screening (17.4%). The most effective
measures were primary prevention education programs to improve sun protection habits.La mortalidad por cáncer de piel continúa aumentando a pesar de las numerosas
intervenciones dedicadas a su prevención. El objetivo de esta revisión es estudiar la situación
de la prevención primaria y secundaria del cáncer de piel en los últimos 10 a˜nos. Se incluye
un total de 63 revisiones, 30 (46,6%) revisiones incluyeron estrategias de prevención primaria
y 35 (55,6%) de prevención secundaria, incorporando 2 de las revisiones información sobre ambos tipos de estrategias. Para la prevención primaria, las medidas más estudiadas fueron losprogramas educativos (63,3%), seguidos de la creación de modelos para identificar a personascon alto riesgo de desarrollar un melanoma (17,6%) y la promoción del uso de fotoprotectores(11,8%). Los sistemas de toma de imagen para el diagnóstico precoz del cáncer de piel (40%),seguidos por el empleo de smartphones y nuevas tecnologías (22,9%), así como el diagnósticovisual como cribado poblacional (17,4%), fueron las medidas de prevención secundaria másevaluadas. De todas las medidas revisadas, las estrategias de prevención primaria centradas enprogramas educativos para mejorar los hábitos de fotoprotección fueron las que resultaron másefectivas
Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners
Hidradenitis suppurativa (HS) is a chronic skin disease that profoundly affects patients’
quality of life (QoL) and sexuality. Few data are available on the impact of HS on patients’ partners.
We aimed to explore the QoL and sexual function of patients’ partners and the factors associated
with their impairment and to compare the QoL and sexual function of single patients and those in
a stable relationship. We conducted a cross-sectional study at Hospital Universitario Virgen de las
Nieves (Granada, Spain) and at theWroclaw Medical University (Wroclaw, Poland). Patients over the
age of 16 years attending their scheduled follow-up and their partners, if any, were included. The
Dermatology Life Quality Index (DLQI) and the Family Dermatology Life Quality Index (FDLQI) were
used to estimate the QoL of patients and partners, respectively. The FSFI-6 was used to determine
sexual dysfunction in women and the IIEF-5 for erectile dysfunction in men. Thirty-four single
patients and twenty-eight patients in a stable relationship and their partners were included. Patients
had a very large impact (DLQI 12.5 7.5) and their partners a moderate impact (FDLQI 10.3 7.1)
in their QoL due to HS. Women with HS had a high prevalence of sexual dysfunction (13/32, 40.6%)
and men of erectile dysfunction (19/30, 63.3%). Male partners also had a high prevalence of erectile
dysfunction (10/17, 58.8%), while only one female partner had sexual dysfunction (1/11, 9.1%).
Factors related to disease severity, intensity of symptoms and body mass index were associated
with poorer QoL in partners and time of disease evolution with greater erectile dysfunction in male
partners. In conclusion, HS not only profoundly affects the QoL and sexuality of patients but also of
their partners. Several risk factors have been identified, which should be taken into account in the
holistic approach of the disease
Knowledge, Behaviour and Attitudes Related to Sun Exposure in Sportspeople: A Systematic Review
People who practice outdoor sports have an increased risk of skin cancer as they are exposed
to high doses of ultraviolet (UV) radiation. Recent studies have shown that in many athletes, sun
protection behaviours are inadequate, with the risk that this entails. The aim of this review is to collect
the information published to date about the knowledge, attitudes and habits of athletes in relation to
sun exposure and its risks. A systematic review was conducted using PubMed and Embase with the
search algorithm “(skin cancer OR melanoma) AND (exercise OR sport OR athletes)”. All studies
analysing the knowledge, attitudes and habits of photoprotection in athletes were included. A total
of 2,365 publications were found, of which 23 were selected, including a total of 10,445 sportspeople.
The majority of participants declared their voluntary intention to tan and stated that the sun made
them feel better, although they also showed concern about possible damage associated with UV
radiation. In most studies, less than half of the participants made adequate use of photoprotective
measures. In general, most athletes had a high level of knowledge regarding the risk of skin cancer
associated with sun exposure. In conclusion, most athletes are aware of the risks associated with
UV radiation but do not make adequate use of photoprotective cream. New training programs on
photoprotection could help improve athletes’ photoprotective behaviour, reducing the incidence of
skin cancer and precancerous lesions in this population
Impact of Water Exposure and Temperature Changes on Skin Barrier Function
We would like to thank all the individuals who generously shared their time to
participate in this research and Charlotte Bower for the English correction of this manuscript.The frequency of hand hygiene has increased due to the COVID-19 pandemic, but there is little evidence regarding the impact of water exposure and temperature on skin. The aim of this study is to evaluate the effect of water exposure and temperature on skin barrier function in healthy individuals. A prospective observational study was conducted. Temperature, pH, transepidermal water loss (TEWL), erythema and stratum corneum hydration (SCH) were measured objectively before and after hot- and cold-water exposure and TempTest (R) (Microcaya TempTest, Bilbao, Spain) contact. Fifty healthy volunteers were enrolled. Hot-water exposure increased TEWL (25.75 vs. 58.58 g center dot h(-1)center dot m(-2)), pH (6.33 vs. 6.65) and erythema (249.45 vs. 286.34 AU). Cold-water immersion increased TEWL (25.75 vs. 34.96 g center dot h(-1)center dot m(-2)) and pH (6.33 vs. 6.62). TEWL (7.99 vs. 9.98 g center dot h(-1)center dot m(-2)) and erythema (209.07 vs. 227.79 AU) increased after being in contact with the hot region (44 degrees C) of the TempTest. No significant differences were found after contact with the cold region (4 degrees C) of the TempTest. In conclusion, long and continuous water exposure damages skin barrier function, with hot water being even more harmful. It would be advisable to use cold or lukewarm water for handwashing and avoid hot water. Knowing the proper temperature for hand washing might be an important measure to prevent flares in patients with previous inflammatory skin diseases on their hands
Frontal Fibrosing Alopecia and Sunscreen Use: A Cross-sectional Study of Actinic Damage
Patients with frontal fibrosing alopecia report higher
rates of sunscreen use than control subjects. However,
it is not known whether the higher use of sunscreens is
a cause or a consequence of the alopecia. A greater use
of sunscreens should be associated with a lower incidence
of signs of actinic damage. The aim of this study
is to assess the presence of actinic damage in patients
with frontal fibrosing alopecia. A cross-sectional study
was carried out on 101 patients with frontal fibrosing
alopecia and 40 control subjects. The presence of actinic
damage, in the form of solar lentigines, actinic
keratoses, and basal and squamous cell carcinomas,
was recorded in both groups, together with sunscreen
use. Trichoscopy and skin biopsy were performed on
patients. Actinic damage was present more frequently
in patients with frontal fibrosing alopecia (69.3%)
than in control subjects (50%) (p = 0.031). Patients
used sunscreens more frequently than did control subjects
(83.2% vs 62.5%, p = 0.008). However, the prevalence
of trichoscopic inflammatory signs, peripheral
alopecia, and inflammatory infiltrate and sebaceous
gland involvement in skin biopsy, were similar in patients
who used sunscreens and those who did not use
them. In conclusion, patients with frontal fibrosing
alopecia had greater actinic damage than did control
subjects, and this is hypothesized as a reason for the
higher use of sunscreens among patients. Thus, use of
sunscreens may not be the trigger for frontal fibrosing
alopecia that dermatologists have proposed
Frontal Fibrosing Alopecia: A Histopathological Comparison of the Frontal Hairline with Normal-Appearing Scalp
Frontal fibrosing alopecia is characterized by the presence of a lymphocytic inflammatory
infiltrate around the upper follicle and by perifollicular fibrosis, which results in the destruction of
the hair follicle. Recent reports have also found the presence of those findings in clinically unaffected
areas. The aim of this report is to perform a deeper analysis of the histopathological features of
this apparently unaffected scalp. A cross-sectional study including 52 women with frontal fibrosing
alopecia was performed. Two areas were biopsied: the frontal hairline and a normal-appearing scalp
area. Sebaceous glands were reduced/absent in 80.8% of the frontal hairline samples compared to
42.3% of the “healthy scalp” samples (p = 0.001). Inflammatory infiltrate was observed in 92.3% of
patients in the frontal hairline and in 86.5% of them in the “healthy scalp” area (p = 0.508), although
the severity was higher in the former (p = 0.013). Follicular epithelium changes were seen in 70.6% of
the frontal hairline biopsies compared to 48.1% of the “healthy scalp” biopsies (p = 0.012). Fibrous
tissular changes were noted in 80.8% and 53.8% of the frontal hairline and “healthy scalp” biopsies,
respectively (p = 0.003). In conclusion, the histopathological features of frontal fibrosing alopecia are
shared by both affected and clinically unaffected areas
Alopecia Areata and Dexamethasone Mini-Pulse Therapy, A Prospective Cohort: Real World Evidence and Factors Related to Successful Response
The mini-pulse oral corticosteroids treatment for alopecia areata (AA) is an accessible
treatment whose efficacy and adverse effects have not yet been properly described. The objective of
the study was to assess the effectiveness and safety of the mini-pulse oral corticosteroids treatment
in patients with AA, and to explore potential factors associated to the response in a real-world
setting. An observational study of a prospective cohort to assess the effectiveness and safety of
a mini-pulse dexamethasone treatment in patients with AA, who failed to improve with topical
therapies, was performed. A SALT II score and other clinical and safety variables were recorded
at baseline, 3, 6, 9, and 12 months. An overall significant and progressive decrease of the SALT
score was found during treatment: SALT-50 response was achieved after 9 months in 51.8% of
the patients. Hypothyroidism and early age of onset were predictors of the lack of response to
treatment. The treatment combination with oral minoxidil showed no effect on the SALT score
reduction. Dexamethasone daily and cumulative dose were associated with a higher percentage of
side effects. To conclude, the mini-pulse oral corticosteroids treatment is an effective treatment for
AA, although patients with an early onset of the disease and hypothyroidism may not benefit