Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Background/Objectives: Alopecia is a common and distressing hair loss condition that poses a major diagnostic challenge. While histopathology is the gold standard, its invasive nature limits its routine use. Trichoscopy, a non-invasive imaging technique, has shown promises in diagnosing and differentiating the various alopecia subtypes. However, existing diagnostic algorithms primarily rely on dermoscopic findings. To address this, we developed a novel, three-step algorithm that integrates clinical and trichoscopic features and employs pattern analysis as a diagnostic tool. Methods: A comprehensive literature review was conducted to identify key trichoscopic features associated with different alopecia types. The gathered data were used as a base for the description of trichoscopic features and patterns for each subtype of alopecia, either scarring or non-scarring. Results: The proposed algorithm is analyzed into three steps. In the first step, alopecia is categorized by distribution into: patchy, patterned, or diffuse. In the second step, it distinguishes between scarring and non-scarring alopecia based on the absence or presence of follicular ostia, respectively. Lastly, in the third step, alopecias are distinguished based on specific trichoscopic clues, allowing for the identification of distinct trichoscopic patterns. Conclusions: The three-step diagnostic algorithm for alopecia, utilizing clinical and dermoscopic findings, performs a pattern analysis in trichoscopy, leading to a dermoscopic diagnosis with great confidence, and minimizing the need for invasive diagnostic procedures....
Background: Hyperhidrosis (HH) is characterized by excessive sweating, which affects quality of life. The Hyperhidrosis Disease Severity Scale (HDSS) is a four-point scale used to evaluate HH severity by measuring how much excessive sweating disrupts daily activities. This study aimed to translate, validate, and adapt the HDSS tool into Arabic. Methods: A quantitative, analytical, cross-sectional study was carried out from May to June 2024 on patients clinically diagnosed with HH. The process of translating the HDSS into Arabic involved three independent forward translations, followed by a preliminary version created by a reviewer. Three additional independent translators conducted backward translations. All of the versions were then revised and merged to produce the final version. Reliability was evaluated through a test–retest reliability approach to ensure the reproducibility of the results. For validity, we used construct validity to compare the HDSS with the HidroQoL index. Results: A total of 167 patients were included, with a mean age of 29 ± 9.02 years, and over half of the patients were male (61%). The interrater agreement between the HDSS test and the retest results was substantial, with a kappa coefficient of 0.732. Significant positive correlations were observed between the HDSS score and daily life (r = 0.413, p < 0.001), the psychological domain (r = 0.374, p < 0.001), and HidroQOL (r = 0.425, p < 0.001). Conclusions: Our findings demonstrate that the Arabic HDSS has excellent psychometric properties, including construct validity and reproducibility. Proper use of the Arabic HDSS will allow the effective assessment of HH severity....
Our group has previously demonstrated that tissue-engineered dermis containing cultured fibroblasts or adipose-derived stromal vascular fraction cells is superior to artificial dermis in terms of scar quality for covering facial defects. However, using these cells for clinical applications requires Food and Drug Administration approval and involves complex procedures for cell culture or isolation. This retrospective study aimed to compare effects of tissue-engineered dermis containing micronized adipose tissue (MAT) and artificial dermis for facial reconstruction. Tissue-engineered dermis consisting of MAT seeded on artificial dermis was applied in 30 cases, while artificial dermis without MAT was grafted in 35 cases. Healing time and severities of scar contraction, color mismatch, and landmark distortion at one year after healing were evaluated. Wounds in the tissue-engineered dermis group re-epithelialized in 30.0 ± 4.3 days compared to 34.3 ± 5.4 days in the artificial dermis group (p < 0.05). The average dE2000 score in color mismatch analysis was 4.9 ± 1.7 in the tissue-engineered dermis group and 5.1 ± 1.7 in the artificial dermis group (p = 0.57). The extent of scar contraction was 16.2 ± 12.3% in the tissue-engineered dermis group and 23.2 ± 12.8% in the artificial dermis group (p < 0.05). The average severity grade of landmark distortion was 0.20 ± 0.50 in the tissue-engineered dermis group and 0.50 ± 0.71 in the artificial dermis group (p < 0.05). These findings indicate that tissue-engineered dermis grafts containing MAT are superior to artificial dermis grafts for facial reconstruction in terms of healing time, scar contraction, and landmark distortion severity. However, there was no significant difference in color mismatch between the two groups....
Background: Within the past few years, many new therapies have emerged for psoriasis and psoriatic arthritis (PsA). Current topical therapies—including corticosteroids, vitamin D analogs, tapinarof, and roflumilast—remain the mainstay for mild disease, while oral systemic and biologic options are for moderate to severe cases. Biologics—such as Tumor necrosis factor-alpha (TNF-alpha), Interleukin 12/23 (IL-12/23), Interleukin-17 (IL-17), and Interleukin-23 (IL-23)—have revolutionized care by providing highly effective and safer alternatives. Oral small molecules, including Janus kinase (JAK) and tyrosine kinase 2 (TYK2) inhibitors, further expand the therapeutic options. Objectives: The goal for this review article was to examine current and latest treatments for psoriasis and PsA and discuss whether these emerging therapeutic options address the unmet needs of current treatments. Methods: The search for this review article included PubMed, Google Scholar, and ClinicalTrials.gov for relevant articles and current clinical trials using keywords. Results: A wide range of novel psoriatic and PsA therapies are currently undergoing clinical trials. These include selective JAK inhibitors, TYK2 inhibitors, retinoic acid-related orphan receptor (RORγT) inhibitors, oral IL-23 receptor inhibitors, oral IL- 17A inhibitors, nanobody products, sphingosine-1-phosphate (S1P1R) antagonists, A3 adenosine receptor (A3AR) agonists, heat shock protein (HSP) 90 inhibitors, and rhoassociated protein kinases (ROCK-2) inhibitors. Conclusions: These different mechanisms of action not only expand treatment options but may offer potential solutions for patients who do not achieve adequate response with existing therapies. However, the safety and contraindications of these newer agents remain an important consideration to ensure appropriate patient selection and minimize potential risks. Certain mechanisms may pose increased risks for infection, cardiovascular manifestations, malignancy, or other immunerelated adverse events, necessitating careful monitoring and individualized treatment decisions. Ongoing clinical research aims to address unmet needs for patients who do not respond to previous agents to achieve sustained remission, monitor long-term safety outcomes, and assess patient preferences for delivery, including a preference for oral delivery. Oral IL-23 inhibitors hold potential due to their robust safety profiles. In contrast, oral IL-17 inhibitors and TYK-2 inhibitors are effective but may present side effects that could impact their acceptability. It is essential to balance efficacy, safety, and patient preferences to guide the selection of appropriate therapies....
An estimated 60,000 people die annually from skin cancer, predominantly melanoma. The diagnosis of skin lesions primarily relies on visual inspection, but around half of lesions pose diagnostic challenges, often necessitating a biopsy. Non-invasive detection methods like Computer-Aided Diagnosis (CAD) using Deep Learning (DL) are becoming more prominent. This study focuses on the use of multispectral (MS) imaging to improve skin lesion classification of DL models. We trained two convolutional neural networks (CNNs)—a simple CNN with six two-dimensional (2D) convolutional layers and a custom VGG-16 model with three-dimensional (3D) convolutional layers—using a dataset of MS images. The dataset included spectral cubes from 327 nevi, 112 melanomas, and 70 basal cell carcinomas (BCCs). We compared the performance of the CNNs trained with full spectral cubes versus using only three spectral bands closest to RGB wavelengths. The custom VGG-16 model achieved a classification accuracy of 71% with full spectral cubes and 45% with RGB-simulated images. The simple CNN achieved an accuracy of 83% with full spectral cubes and 36% with RGB-simulated images, demonstrating the added value of spectral information. These results confirm that MS imaging provides complementary information beyond traditional RGB images, contributing to improved classification performance. Although the dataset size remains a limitation, the findings indicate that MS imaging has significant potential for enhancing skin lesion diagnosis, paving the way for further advancements as larger datasets become available....
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