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1.
Int J Mol Sci ; 22(18)2021 Sep 08.
Article in English | MEDLINE | ID: covidwho-1934105

ABSTRACT

Zinc pyrithione (ZnPT) is an anti-fungal drug delivered as a microparticle to skin epithelia. It is one of the most widely used ingredients worldwide in medicated shampoo for treating dandruff and seborrheic dermatitis (SD), a disorder with symptoms that include skin flaking, erythema and pruritus. SD is a multi-factorial disease driven by microbiol dysbiosis, primarily involving Malassezia yeast. Anti-fungal activity of ZnPT depends on the cutaneous availability of bioactive monomeric molecular species, occurring upon particle dissolution. The success of ZnPT as a topical therapeutic is underscored by the way it balances treatment efficacy with formulation safety. This review demonstrates how ZnPT achieves this balance, by integrating the current understanding of SD pathogenesis with an up-to-date analysis of ZnPT pharmacology, therapeutics and toxicology. ZnPT has anti-fungal activity with an average in vitro minimum inhibitory concentration of 10-15 ppm against the most abundant scalp skin Malassezia species (Malassezia globosa and Malassezia restrica). Efficacy is dependent on the targeted delivery of ZnPT to the skin sites where these yeasts reside, including the scalp surface and hair follicle infundibulum. Imaging and quantitative analysis tools have been fundamental for critically evaluating the therapeutic performance and safety of topical ZnPT formulations. Toxicologic investigations have focused on understanding the risk of local and systemic adverse effects following exposure from percutaneous penetration. Future research is expected to yield further advances in ZnPT formulations for SD and also include re-purposing towards a range of other dermatologic applications, which is likely to have significant clinical impact.


Subject(s)
Antifungal Agents/administration & dosage , Epithelium/drug effects , Organometallic Compounds/administration & dosage , Pyridines/administration & dosage , Skin/drug effects , Administration, Cutaneous , Animals , Antifungal Agents/chemistry , Dermatitis, Seborrheic/diagnosis , Dermatitis, Seborrheic/drug therapy , Dermatitis, Seborrheic/etiology , Dysbiosis , Epidermis/drug effects , Epithelium/microbiology , Humans , Microbial Sensitivity Tests , Optical Imaging/methods , Organometallic Compounds/chemistry , Pyridines/chemistry , Skin/microbiology , Skin Absorption , Spectrum Analysis
4.
AACN Adv Crit Care ; 33(2): 186-195, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1879536

ABSTRACT

SARS-CoV-2 infection can cause virus-mediated endothelial dysfunction, which in turn may lead to coagulopathy and ischemic microangiopathy. In the critical care population, cutaneous skin manifestations related to vascular compromise due to COVID-19 include livedo and purpura. These lesions can be difficult to differentiate from other dermatologic conditions seen in this population, including skin failure and deep-tissue pressure injuries. In addition, similarities in underlying pathophysiological mechanisms of these skin conditions can cause diagnostic overlap. Skin failure is known to occur in critical care patients owing to disease severity and shunting of blood to vital organs. COVID-19-related ischemic lesions can mimic the clinical course of deep-tissue pressure injury. The viral endothelial dysfunction present in patients with COVID-19 decreases tissue tolerance, which can result in an increased risk of hospital-acquired pressure injury. Extrinsic factors can also complicate diagnosis of cutaneous lesions in patients with COVID-19.


Subject(s)
COVID-19 , Skin Diseases , Critical Care , Humans , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/pathology
5.
Wound Repair Regen ; 30(2): 190-197, 2022 03.
Article in English | MEDLINE | ID: covidwho-1854206

ABSTRACT

Preventing recurrent pressure ulcers is an important challenge in healthcare. One of the reasons for the high rate of recurrent pressure ulcers is the lack of assessment methods for their early detection. Therefore, this study aimed to determine the thermographic characteristics of the healed area and to consider the predictive validity of thermographic images for recurrent pressure ulcers within a 2-week period. This observational study was conducted at a long-term care facility in Japan between July 2017 and February 2019 among patients whose pressure ulcers had healed. Thermographic images of the healed area were recorded once a week until recurrence or until the end of the study. We enrolled 30 participants, among whom 8 developed recurrent pressure ulcers. The generalised estimation equation revealed that the thermographic finding of increased temperature at the healed area compared to that of the surrounding skin was significantly associated with recurrent pressure ulcers (odds ratio: 101.13, 95% confidence interval: 3.60-2840.77, p = .007); the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio for recurrent pressure ulcers within 2 weeks were 0.80, 0.94, 0.62, 0.97, 12.9 and 0.2, respectively. Our thermographic findings revealed that the temperature of the healed area was higher than that of the surrounding skin; this could be a useful predictor of pressure ulcer recurrence within 2 weeks, even in the absence of macroscopic changes.


Subject(s)
Pressure Ulcer , Humans , Pressure Ulcer/diagnosis , Skin , Temperature , Thermography , Wound Healing
6.
Int J Mol Sci ; 23(9)2022 Apr 30.
Article in English | MEDLINE | ID: covidwho-1847342

ABSTRACT

Elucidating transcriptome in the peripheral edge of the lesional (PE) skin could provide a better understanding of the molecules or signalings that intensify inflammation in the PE skin. Full-thickness biopsies of PE skin and uninvolved (UN) skin were obtained from psoriasis patients for RNA-seq. Several potential differentially expressed genes (DEGs) in the PE skin compared to those in the UN skin were identified. These DEGs enhanced functions such as angiogenesis, growth of epithelial tissue, chemotaxis and homing of cells, growth of connective tissues, and degranulation of myeloid cells beneath the PE skin. Moreover, the canonical pathways of IL-17A, IL-6, and IL-22 signaling were enriched by the DEGs. Finally, we proposed that inflammation in the PE skin might be driven by the IL-36/TLR9 axis or IL-6/Th17 axis and potentiated by IL-36α, IL-36γ, IL-17C, IL-8, S100A7, S100A8, S100A9, S100A15, SERPINB4, and hBD-2. Along with IL-36α, IL-17C, and IκBζ, ROCK2 could be an equally important factor in the pathogenesis of psoriasis, which may involve self-sustaining circuits between innate and adaptive immune responses via regulation of IL-36α and IL-36γ expression. Our finding provides new insight into signaling pathways in PE skin, which could lead to the discovery of new psoriasis targets.


Subject(s)
Gene Expression Profiling , Psoriasis , Humans , Inflammation/pathology , Interleukin-17/metabolism , Interleukin-6/metabolism , Keratinocytes/metabolism , Psoriasis/genetics , Psoriasis/metabolism , Skin/metabolism , Transcriptome
7.
Clin Immunol ; 237: 108984, 2022 04.
Article in English | MEDLINE | ID: covidwho-1838656

ABSTRACT

The exact etiopathology of chilblains observed during the Coronavirus Disease 2019 (COVID-19) pandemic is still unclear. Initially, SARS-CoV-2 appeared as the obvious causing agent, but two years of various investigations have failed to convincingly support its direct implication. Most affected individuals have no detectable virus, no anti-SARS-CoV-2 antibodies and no symptoms of COVID-19. Analyses of skin biopsies similarly failed to unambiguously demonstrate presence of the virus or its genome. In a recent hypothesis, SARS-CoV-2 would cause the lesions before being promptly eliminated by unusually strong type I interferon responses. With others, we feel that environmental factors have not been sufficiently considered, in particular cold exposure related to unprecedented containment measures. The cause of pandemic chilblains remains a stimulating puzzle which warrants further investigation.


Subject(s)
COVID-19 , Chilblains , Chilblains/diagnosis , Chilblains/epidemiology , Chilblains/pathology , Humans , Pandemics , SARS-CoV-2 , Skin/pathology
9.
Intern Med ; 61(7): 1113-1114, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1834088
10.
Viruses ; 14(5)2022 04 21.
Article in English | MEDLINE | ID: covidwho-1822444

ABSTRACT

African pygmy hedgehogs (Atelerix albiventris) are popular exotic pets in Japan, and their breeding numbers have recently increased. Although various diseases have been reported in hedgehogs, including skin, respiratory, neurological, and neoplastic diseases, most of the causes remain unidentified. In this study, we investigated herpesvirus, adenovirus, and coronavirus infections among 150 African pygmy hedgehogs in Japan and evaluated the correlations between virus infection and diseases. A novel herpesvirus named Atelerix albiventris herpesvirus 1 (AAHeV), and African pygmy hedgehog adenovirus 1 (AhAdV-1) were detected in 14 and 3 oral swab samples, respectively. AAHeV infection may be related to neurological clinical signs. Interestingly, no hedgehog with a neoplastic disorder tested positive for AAHeV. Further research is required to determine the pathogenicity and prevalence of the detected viruses.


Subject(s)
Neoplasms , Virus Diseases , Animals , Hedgehogs , Humans , Japan/epidemiology , Skin
13.
Int J Dermatol ; 61(8): 923-929, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1784659

ABSTRACT

The Moderna COVID-19 vaccination was approved for use in the United States in December of 20201 and since that time massive public health efforts have been made to vaccinate patients against the COVID-19 infection. Adverse reactions from the vaccination are well-reported and include both local skin reactions, such as pain, swelling, and erythema at the injection site, as well as systemic reactions including fever, malaise, headache, muscle aches, drowsiness, nausea, and vomiting. While severe serious cutaneous adverse reactions, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), remain rare; two cases of SJS/TEN related to COVID-19 vaccination have been reported. We herein review the two previously reported cases of SJS/TEN and report the first case of SJS precipitated by the Moderna Inc., MRNA 1273 COVID-19 vaccination in the United States. Although we review potential adverse reactions to vaccination, the benefits of COVID-19 vaccination outweigh the risks based on current data. Cases should be reported to the Vaccine Adverse Event Reporting System (https://vaers.hhs.gov/) to help public health officials recognize and track these severe but rare adverse events.


Subject(s)
COVID-19 Vaccines , COVID-19 , Stevens-Johnson Syndrome , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Skin , Stevens-Johnson Syndrome/etiology , United States , Vaccination
15.
Dermatol Ther ; 35(6): e15461, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1752531

ABSTRACT

With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Mucous Membrane/pathology , Skin/pathology , Vaccination/adverse effects
16.
Contact Dermatitis ; 86(6): 507-513, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1745956

ABSTRACT

BACKGROUND: Studies investigating simultaneous influence of personal and work-related factors on skin health during the coronavirus disease 2019 (COVID-19) pandemic are missing. OBJECTIVES: To investigate the associations of skin hazards relevant for nursing apprentices with parameters of skin barrier function. METHODS: A total of 238 nursing apprentices attending the final year of education (median age 19 years) from vocational schools in Zagreb, Croatia, were enrolled in this study. We administered a questionnaire based on the Nordic Occupational Skin Questionnaire to the nursing apprentices, performed clinical examination of skin on the hands, and evaluated transepidermal water loss (TEWL) and stratum corneum (SC) pH on the dorsum of the hand. RESULTS: Around half of nursing apprentices had compromised hand skin barrier function, as indicated by TEWL values >25 g/m2 /h (48%) and SC pH >5.5 (57%). Skin barrier was compromised in around 40% of nursing apprentices without clinically observed skin symptoms. Elevated SC pH was independent of ambient conditions associated with skin symptoms and female sex. CONCLUSIONS: Measurement of SC pH was shown to be less sensitive to field conditions than TEWL, and should be employed more in the field studies. Strengthening of skin health promotion in healthcare workers and apprentices is needed in pandemic conditions.


Subject(s)
COVID-19 , Dermatitis, Allergic Contact , Adult , Dermatitis, Allergic Contact/diagnosis , Female , Humans , Pandemics , Skin , Surveys and Questionnaires , Water Loss, Insensible , Young Adult
17.
Hautarzt ; 73(4): 291-297, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1733959

ABSTRACT

BACKGROUND: The persistent global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can manifest on the skin in addition to the already known organ systems. Various clinical patterns of skin manifestations associated with coronavirus disease 2019 (COVID-19) have been described. In view of the associated morbidity and mortality, knowledge of cutaneous manifestations in the setting of COVID-19 may be helpful in early detection, risk stratification, diagnosis and treatment. Thus, we provide a summary of the various dermatologic findings associated with COVID-19, including clinical presentation, current pathophysiological concepts, and management, to support early diagnosis and treatment. GOAL: The current literature regarding skin lesions associated with COVID-19 and the most important aspects are analyzed. MATERIALS AND METHODS: A literature search was performed in PubMed and Medline databases until February 28, 2021. RESULTS AND CONCLUSION: The classification of skin manifestations in the context of SARS-CoV­2 infection according to clinical dermatological patterns can help to identify patients with increased risk at an early stage and to treat them adequately to counteract a possibly more severe course of the disease as it occurs, e.g., in livedo. Thus, knowledge of the pathophysiological mechanisms can improve management of the disease and support possible countermeasures in coping with the disease.


Subject(s)
COVID-19 , Skin Diseases , Humans , Pandemics , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/therapy
18.
Cleve Clin J Med ; 89(3): 161-167, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1726177

ABSTRACT

Cutaneous findings can be clues to diagnosis and infection severity in viral illnesses, including COVID-19. The authors provide an update on the diagnostic and prognostic value of the 5 most common cutaneous abnormalities associated with COVID-19 in adult patients: morbilliform rash, urticaria, vesicles, pseudo-chilblains, and vaso-occlusive lesions.


Subject(s)
COVID-19 , Exanthema , Skin Diseases , Adult , COVID-19/diagnosis , Exanthema/etiology , Exanthema/pathology , Humans , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/etiology
19.
J Cosmet Dermatol ; 21(5): 1822-1829, 2022 May.
Article in English | MEDLINE | ID: covidwho-1723294

ABSTRACT

COVID-19 is a systemic disease characterized by vascular damage, increased inflammation, and hypercoagulability. Acral ischemic lesions occur as a result of increased inflammation and cutaneous thrombosis. Skin lesions can sometimes be the only symptom of COVID-19. In this respect, recognizing acro-ischemic lesions, which are skin lesions, may help in the early diagnosis of the disease and in predicting the prognosis. In patients with skin lesions without typical symptoms, the diagnosis of COVID-19 should be kept in mind. Herein, we describe five patients affected by COVID-19 which developed acro-ischemic lesions.


Subject(s)
COVID-19 , Skin Diseases , COVID-19/complications , Humans , Inflammation/pathology , Ischemia/diagnosis , Ischemia/etiology , Skin/pathology , Skin Diseases/pathology
20.
Dermatol Ther ; 35(5): e15416, 2022 05.
Article in English | MEDLINE | ID: covidwho-1723136

ABSTRACT

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), is a type of delayed hypersensitivity reaction that requires urgent medical intervention. In the COVID-19 era, COVID-19 vaccines are currently being widely administered and mucocutaneous adverse reactions following vaccination have been reported; however, severe cutaneous adverse reactions associated with COVID-19 vaccines including SJS/TEN, are extremely rare. Herein, we describe a case of COVID-19 vaccination induced TEN which developed 1 day after receiving the first dose of Sinopharm COVID-19 vaccine with favorable clinical outcome.


Subject(s)
COVID-19 , Stevens-Johnson Syndrome , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Skin , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/etiology , Vaccination
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