Journal of Skin and Stem Cell
Volume:9 Issue: 4, Dec 2022

The solute carrier family 45-member 2 (SLC45A2) gene, located on chromosome 5p13.2, is involved in melanin biosynthesis. Single-nucleotide variants (SNVs) in this gene are associated with skin, eye, and hair color variations in the population. SNVs p.L374F (C/T) and p.E272K (C/G) are additionally associated with protection against melanoma.

This study aimed to evaluate the association of SNVs p.L374F and p.E272K with the development of melanoma in a sample of individuals from Bogotá, Colombia.

In this case-control study, DNA samples were obtained from individuals after signing an informed consent form. Genotyping was performed by real-time polymerase chain reaction high-resolution melting (PCR-HRM).

Phototype II was found in 19% of the subjects, phototype III in 70%, and phototype IV in 11%. Eighty percent of the subjects had brown eyes and dark brown hair color. Both SNVs were in Hardy-Weinberg equilibrium. The p.Glu272Lys variant was found to be a protective factor for melanoma, while the p.Phe374Leu variant was found to be a risk factor. The study also found that a CG haplotype was a risk factor for melanoma [odds ratio (OR), 2.75; 95% CI, 1.22 - 6.22; P = 0.021]. The study also found a strong correlation between variants and phototypes, as well as the sex of the patients. The study also analyzed the impact of these variants on the protein structure and found that the p.Phe374Leu variant has a probable pathogenic effect on the function of the protein.

The frequencies found for the SLC45A2 gene variants are consistent with other studies conducted in the Latin American population, where the predominant phototypes are II and III. The CG haplotype is associated with a higher risk of melanoma.

Psoriasis is a chronic auto-inflammatory condition. Treatment modalities include methotrexate (MTX) and apremilast (APL). Although the efficacy of MTX and APL is well studied, evidence of their superiority of one over the other is lacking. Dermoscopy is helpful in diagnosis and treatment evaluation. Therefore, dermoscopy is utilized to assess the treatment response.

This study aimed to evaluate dermoscopic assessment in psoriatic lesions treated by MTX and APL and compare their efficacy by calculating the respective Psoriasis Area and Severity Index (PASI) scores and study the effect of MTX and APL on different dermoscopic patterns in psoriasis at different levels of treatment.

This randomized interventional comparative study was conducted in a tertiary care hospital. A total of 98 patients were randomly divided into two groups of 50 and 48 patients, given oral/intramuscular MTX 7.5 mg once weekly and APL 30 mg twice daily for 3 months, respectively. The patients were assessed clinically and dermoscopically using a videodermoscope, and comparisons were performed between the two groups. The PASI score was calculated and evaluated.

The PASI score was reduced by 83% and 65% from the baseline in MTX and APL groups, respectively. The patients with patchy (61.5%) and minimal (23%) patterns of vessels and red dots (92.3%) showed faster achievement of PASI-100. However, the patients with a regular distribution of vessels and globular vessels failed to obtain PASI-100, suggesting a poor response to treatment.

Vascular structures play a significant role in the diagnosis and prediction of the treatment response. Particular patterns and type vessels under dermoscopy can give a hint about choosing appropriate drugs for psoriasis.

Nano-scaffolds loaded with bioactive compounds such as ZnO nanoparticles (ZnO-NPs), as tissue-engineered artificial skin grafts, can be a suitable substitute for extracellular matrix and greatly contribute to accelerating chronic wound treatment by decreasing the chance of bacterial infection.

Silk fibroin nanofiber was fabricated by using electrospinning and three-dimensional porous hybrids (3DPH) nano-scaffold with composite of sodium alginate/ZnO-NPs solution and silk fibroin electrospun nanofibers by adopting freeze-drying method. Successful configuration of nanofibers and porous nano-scaffolds were confirmed using field emission scanning electron microscopy (FE-SEM). Antimicrobial activity, cell attachment, and cytotoxicity evaluation of scaffolds were performed by employing disk diffusion method, L929 cell culture, and MTT assay, respectively.

Antibacterial analysis of 3DPH nano-scaffolds revealed their appropriate antibacterial activity against the Staphylococcus aureus and the Escherichia coli bacteria. Furthermore, the results from cytotoxicity and cell adhesion analyses indicated the appropriate cell attachment, viability, and proliferation on the silk fibroin nanofibers and 3DPH nano-scaffold, which are fundamental for wound healing and skin dermo-epidermal grafts.

In sum, silk fibroin nanofiber as an epidermal graft and 3DPH nano-scaffold loaded with ZnO-NPs as a dermal graft were fabricated. Moreover, 1.5% (w/v) concentrations of ZnO-NPs were selected and incorporated into the 3DPH nano-scaffold. Considering the promising results of biological analyses, the nanofibrous and 3DPH nano-scaffolds composite may have been suitable for skin dermo-epidermal grafts and skin regeneration.

Methotrexate is an antifolate agent commonly used in various dermatological and rheumatological diseases such as psoriasis, systemic lupus erythematosus, and other connective tissue disorders. Acute toxicity manifesting as mucocutaneous ulcerations is a rare event in 3 - 10% of patients. Normal dosing commonly used for dermatologic and rheumatologic diseases is 15 - 25 mg/week. The main culprit leading to toxicity is the overdose of medication. Nausea, leukopenia, infections, gastrointestinal bleeding, renal impairment, etc. are the common manifestations of methotrexate toxicity. Mucocutaneous ulcerations, though infrequent, can appear as early as 3 - 7 days following methotrexate administration. Thus, it can be the imminent sign of methotrexate toxicity, providing a clue to its timely diagnosis. The crucial steps in the management of methotrexate toxicity are withdrawal of medication, immediate administration of leucovorin which is the biologically active form of folic acid, adequate hydration for increasing renal clearance, and urinary alkalinization with sodium bicarbonate, wherever necessary.

Here, we report an accidental methotrexate overdose in a patient with psoriasis, presenting with extensive mucocutaneous ulceration mimicking autoimmune vesiculobullous disorder and Stevens-Johnson syndrome- toxic epidermal necrolysis, leading to an extremely rare and challenging scenario.

This case report emphasizes that careful history and evaluation of medical records facilitate early diagnosis and prompt management, which is critical to improving outcomes and patient’s survival.

Pyoderma gangrenosum (PG) is a relatively uncommon disorder associated with autoimmune and inflammatory conditions, including inflammatory bowel disease (IBD). PG’s prevalence ranges from 0.4 - 2.6% in patients with IBD. We describe a 34-year-old man with ulcerative colitis (UC) who was referred to our center with some small follicular and pustular lesions rapidly progressing into a painful necrotic ulcer in the right axilla. The ulcer was not responsive to broad spectrum antibiotics and topical cytotoxic agents like tacrolimus. Finally, a dramatic response was observed after initiating anti-tumor necrosis factor (anti-TNF) treatment with infliximab (10 mg/kg) within a week. A significant reduction in size and necrotic tissue was achieved one month after the index date of the prescription of infliximab. A 2-month follow-up of the patient revealed complete healing of the lesion.