Journal of Skin and Stem Cell
Volume:7 Issue: 3, Sep 2020

Context: 

Different factors such as the site of infection, the etiological agent, and the immune system can modify the antifungal response of the host. Differences in Sporothrix schenckii strains’ virulence and the host’s immune competency may be involved in the development of sporotrichosis. Nevertheless, the mechanisms related to the disease’s development and progression remain not fully elucidated. Nowadays, no model outweighs the usefulness of mice in biological studies. In these models, transient controlled immunity is created by depressed inflammatory cells during the acute phase of the disease. This is also related to nitric oxide-induced T-cell apoptosis and the lack of a mitogen response.

Evidence Acquisition: 

The recognition of the lipid components of S. schenckii can induce and prolong inflammation. This recognition occurs mainly through the Toll-like receptor (TLR)-4 or the inflammasome. At the same time, TLR-2-mediated identification of fungal exoantigen can serve as an immune evasion process, continuing and worsening the infection. Cell-mediated immune mechanisms have a predominant influence on modulating the clinical expression of sporotrichosis, which is mainly related to Th1/Th17 immunity.

 In this study, we aimed to explore the innate and acquired immune mechanisms involved in sporotrichosis, as well as the most commonly used animal models for experimental studies.

Context: 

As the COVID-19 was spreading to all countries, its manifestations were identifying gradually, which were related to several organs.

Evidence Acquisition: 

COVID-19 is associated with distinct hematological changes, increased serum inflammatory markers, and coagulopathy. Most of these changes are related to the patients’ prognosis and mortality, particularly in those with severe disease.

 Firstly, we discussed the associations between COVID-19 clinical features and complications, and secondly, its hematological findings and coagulopathy are investigated.

 Such associations not only may shed light on our prognostic view of patients with COVID-19 but also will entail significant therapeutic implications. One of its key implications is to utilize the mesenchymal stem cells (MSCs) to treat patients with COVID-19. Herein, this kind of novel therapy will be discussed, as well.

 Acne vulgaris is a multifactorial skin disease affecting many of the world’s population throughout their lives and can cause severe emotional distress and psychological disorders such as poor self-image, depression, and anxiety. Several underlying risk factors are known for acne development, and many, including different aspects of lifestyle, are yet to be studied.

 In this study, we aimed to determine the role of lifestyle factors including dietary habits, physical activity, and bathing frequency in the incidence of acne vulgaris.

 The study population included 425 subjects, of whom 171 were acne patients (the case group), and 254 were non-acne patients (the control group). All participants filled out a questionnaire addressing their demographic information and some lifestyle habits. The data were analyzed by SPSS.

 Fast food consumption was significantly higher in the case than in the control group (P = 0.008). Dairy intake and bathing frequency were significantly higher among non-acne patients than those with acne (P < 0.001 and P = 0.001, respectively). Vegetable consumption, water intake, and the number of episodes and minutes of physical activity per week were not significantly different between the two groups (P = 0.1, P = 0.4, P = 0.9, and P = 0.8, respectively). The mean weight of participants was significantly higher in the case than in the control group (P = 0.001).

 There was no significant difference in most of the studied factors between the two groups. Therefore, further studies are needed to assess the role of other underlying conditions such as genetic factors and hormonal changes in the development of acne vulgaris.

 Seborrheic keratosis (SK) is one of the most common non-cancerous lesions that appears on the sun-exposure areas of the body and highly prevalent among the middle-aged population. It is the result of the hyperproliferation of keratinocytes. The clinical changes in SK lesions such as sudden growth, color changes, and ulcerations are accompanied by malignancies.

 This study presents a rare case of giant SK on the flank part with rapid enlargement. The manifestations were in favor of malignancy and the patient underwent biopsy and total excision with a good outcome.

 Giant SK is a rare type of SK that has various similarities with malignant masses and requires further investigation.

 Nicolau syndrome is an iatrogenic dreaded adverse skin reaction leading to ischemic necrosis of skin and underlying tissue after parenteral drug injection. The etiopathogenesis is poorly understood. However, inflammation, reflex vasospasm, and thrombo-embolic occlusion of blood vessels, including arterioles and arteries, are suggested as the cause of ischemia.

 We report a 12-year-old girl who developed Nicolau syndrome after a simple office procedure of intralesional sclera therapy with sodium tetradecyl sulfate for a apyogenic granuloma on her right index finger. Three days later, she reported complaints of excruciatingly painful swelling with bluish discoloration of the right hand involving the palm, entire index, middle, and ring fingers, and distal part of the little finger. Nicolau syndrome was documented after intramuscular injections of drugs. Nevertheless, there are very few reports of Nicolau syndrome following post intralesional sclerotherapy.

 Sclerotherapy is a simple office procedure routinely performed by health care professionals (e.g., dermatologists and surgeons), and awareness about its dreaded entity is key. Stringent precautions and prompt management can prevent unfavorable complications. Additionally, prudent patient selection and detailed counseling with explicit informed consent regarding Nicolau syndrome are imperative while planning any parenteral drug injection or intralesional sclerotherapy to avoid litigation.