Efficacy and safety of oral isotretinoin in the treatment of moderate to severe seborrheic dermatitis: a retrospective study.

BACKGROUND AND OBJECTIVES: Seborrheic dermatitis is a common, chronic, and recurrent inflammatory skin disease. There are few studies on oral isotretinoin in the treatment of seborrheic dermatitis. The aim of this research was to analyze the efficacy and safety of oral isotretinoin in the treatment of patients with moderate to severe seborrheic dermatitis. METHODS: This was a retrospective study. All included patients were diagnosed as moderate to severe seborrheic dermatitis and treated with oral isotretinoin from January 2019 to December 2020. Symptom Scale of Seborrheic Dermatitis (SSSD) was used to evaluate the overall severity status of disease. RESULTS: A total of 48 patients with moderate to severe seborrheic dermatitis were enrolled, of which 26 patients were treated with oral isotretinoin at a dose of 20 mg/day, and 22 patients were treated with oral isotretinoin at a dose of 10 mg/day. The duration of treatment was 2.42 ± 0.98 months (range: 2-6 months). The absolute SSSD values were 10.63 ± 1.02 for all 48 patients, 10.95 ± 1.15 and 10.30 ± 1.11 for patients with a dose of 20 and 10 mg/day, respectively. At the endpoint, there were no significant difference in SSSD values between the two groups (2.21 ± 0.24 vs. 2.35 ± 0.46, P = 0.18). The patients were satisfied with the two treatment schemes, and the difference was not statistically significant (P = 0.78). The most common side effect was cheilitis; however, no serious adverse events occurred in either group. CONCLUSIONS: When considering efficacy and safety, oral isotretinoin can be used to treat patients with moderate to severe seborrheic dermatitis.

Expression of Trem-1 and its significance in psoriasis vulgaris / 西安交通大学学报(医学版)

Objective To study the expression of triggering receptor expressed on myeloid cells-1 (Trem-1)in psoriatic vulgaris and normal skin tissues and blood,and to explore the potential pathogenesis of psoriasis.Methods Immunohistochemistry and Real-time PCR were used to detect the expression of Trem-1 in the blood and tissues of normal skin and psoriasis.Results The positive expression rate of Trem-1 in psoriatic lesion was significantly higher than normal tissue.Trem-1 was expressed in the whole epidermis,with a significant difference (P<0.05). The mRNA expression of Trem-1 was significantly higher in psoriatic skin tissues and blood than in normal skin tissues and blood (P<0.05).Moreover,the mRNA expression of Trem-1 was positively correlated with PASI (P<0.05).Conclusion Abnormal expression of Trem-1 might be related to the pathogenesis of psoriasis.Trem-1 will cure psoriasis vulgaris as the potential therapeutic target.

Heat shock protein 70 upregulates interleukin-6 expression by fibroblasts from psoriasis vulgaris lesions / 中华皮肤科杂志

Objective To evaluate the in vitro effect of heat shock protein 70(HSP70)on interleukin-6 (IL-6)expression by cultured fibroblasts from psoriasis vulgaris lesions(PFbs).Methods Fibroblasts were isolated from the lesions of patients with psoriasis vulgaris and subjected to a primary culture.After 3 to 5 passages of culture,the fibroblasts were collected and used in the next experiment.Some PFbs were cultured with different concentrations(5,10,20,30 mg/L)of HSP70 for 48 hours,or with HSP70 of 30 mg/L for different durations(3,6,12,24,48,72 hours);some PFbs were incubated with HSP70 of 30 mg/L for 24 hours after pretreatment with pyrrolidine dithiocarbamate(PDTC,a specific inhibitor of nuclear factor-kappa B)for 30 minutes.PFbs receiving no treatment served as the control.Enzyme-linked immunosorbent assay(ELISA)and semi-quantitative reverse transcription PCR were performed to measure the IL-6 protein expression in culture supematant and IL-6 mRNA expression by PFbs,respectively.Differences in the expression of IL-6 protein and mRNA between PFbs receiving different treatment were analyzed by using t test and Dunnett's t test.Results HSP70 significantly increased both protein production and mRNA expression of IL-6 in a time(0-48 h)-and dose(5-30 mg/L)-dependent manner.The expression levels of supernatant IL-6 protein and IL-6 mRNA were significantly higher in the PFbs treated with HSP70 of 10 mg/L for 48 hours than untreated PFbs((75.2 ± 15.4)ng/L vs.(47.2 ± 10.6)ng/L,0.439 ± 0.093 vs.0.249 ± 0.069,both P ＜ 0.05).A significant increase was observed as early as 6 hours in the level of IL-6 mRNA after the treatment with HSP70 of 30 mg/L,and 12 hours in the level of supematant IL-6 protein.Decreased supernatant IL-6 protein and IL-6 mRNA were noted for PFbs treated with PDTC and HSP70 of 30 mg/L compared with untreated PFbs((42.23 ± 9.41)ng/L vs.(68.40 ± 14.43)ng/L,0.144 ± 0.048 vs.0.295 ± 0.081,both P ＜ 0.05).Conclusion HSP70 may increase the expression of IL-6 mRNA and protein by cultured PFbs via the nuclear factor-kappa B pathway.