Journal of Skin and Stem Cell
Volume:9 Issue: 2, Jun 2022

Palmoplantar keratodermas (PPK) constitute a clinically and genetically complex group of cornification disorders characterized by defective epidermal differentiation leading to marked palmoplantar hyperkeratosis. Classically, keratodermas have been categorised as hereditary and acquired forms.

A 12-year-old male patient presented to our dermatology outpatient department with diffuse thickening and yellowish discoloration of skin over palms and soles since early childhood. He gradually developed progressive thickening and contractures of the fingers of both hands with functional impairment. No such history could be elicited in the family members. Dermatological examination showed bilaterally symmetrical thick hyperkeratotic fissured scaly plaques involving surface of entire palmwith sharp demarcation at volar aspect of wrist. Similar plaques with yellowishhuewere present over the soles with superficial fissures. The histopathological examination of skin biopsy specimen from the palm showed focal parakeratosis alternating with orthokeratosis in both horizontal and vertical directions (checkerboard pattern) with broadened rete ridges. The findings were consistent with pityriasis rubra pilaris (PRP). The patient improved with systemic and topical retinoids.

This report focuses on the recognition of unusual presentations of PRP and emphasizes the importance of early diagnosis and timely treatment, which can avert the dreaded morbid and disabling complication of contractures.

Sunitinib is an inhibitor of tumor angiogenesis and has been used as the first-line drug in metastatic renal cell carcinoma (RCC). Sunitinib attracts attention due to its cutaneous toxicities, which are unusual but can range from benign self-resolving skin rash to severe systemic involvement. Herein, we report a 51-year-old male case with metastatic RCC, clear cell type.

Due to multifocal metastatic disease, the patient was started on tablet sunitinib 50 mg once daily (2 weeks on and 1 week off protocol) with palliative intent. On the 4th day of the second cycle, the case developed multiple reticulate palpable purpuric lesions over bilateral shins without any other constitutional or systemic symptoms, such as fever, joint pain, or abdominal pain. Skin histopathology was consistent with clinical suspicion of cutaneous small-vessel vasculitis. The potential involvement of other organs was ruled out. The lesions resolved completely within 2 weeks through symptomatic treatment with topical fluocinolone acetonide 0.01% cream and emollients.

Sunitinib was continued uninterrupted without other organ involvement or the reappearance of lesions. Therefore, oncology care providers should always be vigilant and thoroughly evaluate any cutaneous toxicities associated with sunitinib, although it is a rare manifestation.

Elastin peptides stimulate the development of mouse melanocytes in neural crest culture. Ferrous ferric chloride (FFC) promotes mammalian melanocyte growth in culture. However, it is unclear whether elastin peptides in the presence of FFC can stimulate human melanocyte growth in situ.

This study aimed to investigate the mechanism of human melanocyte growth for skin and stem cell science since melanocytes control human skin color.

In this clinical trial study, a lotion containing elastin peptides and/or FFC was applied to the normal skin of 6 volunteers twice a day for 1 to 3 months. Punch biopsies were taken from treated skin and surveyed by histochemical methods using the dopa reaction (detect melanocytes) and dopa-premelanin reaction (detect melanocytes and melanoblasts). Elastin fibers were detected by Victoria blue staining.

Only the combined treatment of elastin peptides and FFC increased melanocyte populations in addition to dopa reactivity, melanogenesis, dendritogenesis, and epidermal melanin pigmentation. Mitotic divisions of melanocytes were also observed. However, themelanoblast population failed to increase, and nomitoticmelanoblasts were observed. In the dermis, elastin fibers became thicker and denser after the treatment. The data of statistical analyses were performed by tabulation, mean, and SD on Microsoft Excel for Macintosh OS Catalina 10 system.

Our present study suggests that elastin peptides with FFC can promote melanocyte growth, melanin synthesis, skin pigmentation, and elastin fiber formation. Our study can be expected to contribute to advancing skin and stem cell science.

Hirsutism is defined as excess terminal hair growth over androgen-dependent areas in women. It may cause significant social and psychological stigma with a negative impact on the quality of life. However, there is a dearth of data regarding this important parameter from the Indian sub-continent.

A cross-sectional study was performed to elucidate the quality of life of women with hirsutism using the dermatology life quality index (DLQI).

The severity of hirsutism was graded by modified Ferriman-Gallwey Score (F-G score) and correlated with quality of life by employing self-administered questionnaires of DLQI.

Of 40 women with hirsutism (mean DLQI score 5.55±1.501), 3% demonstrated no effect, 52% small effect, and 45% moderate effect. Among domains, “symptoms and feelings” had the highest mean DLQI. Moreover, F-G score and DLQI had a weak positive but insignificant correlation. There was no significant correlation between DLQI and variables like age, marital status, occupation, and polycystic ovarian syndrome (PCOS).

Hirsutism had a small to moderate impact on the quality of life, with symptoms and feelings as the most affected domain

Platelet-rich plasma is an autologous blood product defined by a concentration of platelets higher than baseline. Enough evidence supports its application for the treatment of orthopedic disorders.

The aim of this study was to report the absence of infection and/or complication events related to platelet-rich plasma treatment in patients with musculoskeletal disorders of diverse etiologies.

This transversal and descriptive study included a total of 513 patients, presenting either common orthopedic disorders or hemophilic synovitis/arthropathy. Peripheral whole blood was collected in the presence of anticoagulant and centrifuged. Plateletrich fraction was separated under sterile conditions. Before injection, the affected area was sanitized and covered with sterile field drapes. Injections were performed in the procedure room under ultrasound image. No anesthesia or antibiotics were administered. Data were analyzed using Pearson’s chi-square test and Cramer’s V test.

Of the 923 procedures, 63.2% were intra-articular, and 36.8% were performed in soft tissues. Intra-articular injections were more common in patients with hemophilia, compared with patients without hemophilia (P < 0.001). The most commonly affected anatomical sites were: the knee, the ankle, the hip, and the elbow, with a higher prevalence of ankle and elbow disorders in patients with hemophilia, compared with patients without hemophilia (P < 0.001). Among patients with hemophilia, 13 presented HCV infection, one presented HIV infection, and three were coinfected with HCV and HIV. Twelve patients presented inhibitors. No complications were observed during blood extraction or after platelet-rich plasma injection. No infections occurred at the site of injection.

Our platelet-rich plasma preparation and administration protocol under sterile conditions considerably reduce the chances of contamination and further complications associated with it. The occurrence of infection after intra-articular or soft tissue injection was nil in this study, even in patients with hemophilia.

Diabetic foot ulcer (DFU) remains a devastating and prevalent complication of diabetes, which leads to significant morbidity, mortality, and economic implications. Outcomes of DFU management are still unsatisfactory, warranting innovations to improve them. One accessible and promising potential for treating DFU is autologous platelet-rich plasma (PRP), a blood product abundant in bioactive molecules. Platelet-rich plasma has been used in other fields of medicine to treat various conditions.

While there is substantial research studying the use of PRP for DFU, these studies are regarded as having flaws in methodology. Hence, this systematic review aims to bridge the knowledge gap by only including randomized controlled trials (RCT).

After sifting through various databases, six studies were included. This review focused on specific outcomes, namely percentage of patients with healed wounds, wound size, and time to closure.

The authors found that PRP has performed well with regards to healing DFU wounds with a high rate of healing, which leads to a shorter time to wound closure.