Virtual reality (VR) and augmented reality (AR) are making headlines, pushing the boundaries of educational experiences and applicability in a variety of fields. Medicine has seen a rapid growth of ...utilization of these devices for various educational and practical purposes. With respect to the field of dermatology, very few uses are discussed in the literature. We briefly present the current status of VR/AR with regard to this specialty.
Up to 15 billion dollars of US health care expenditure each year is consumed by treatment of poorly healing wounds whose etiologies are often associated with aberrancies in tissue oxygenation. To ...address this issue, several modes of tissue oxygen delivery systems exist, including Hyperbaric Oxygen Therapy (HBOT) and Topical Oxygen Therapy (TOT), but their efficacies have yet to be fully substantiated. Micro/nanobubbles (MNBs), which range anywhere from 100 μm to <1 μm in diameter and are relatively stable for hours, offer a new mode of oxygen delivery to wounds. The aim of this article is to systematically review literature examining the use of TOT for wound healing and use of MNBs for tissue oxygenation using the MEDLINE database. The search yielded 87 articles (12 MNB articles and 75 TOT articles), of which 52 met the inclusion criteria for this literature review (12 MNB articles and 40 TOT articles). Additionally, we present an analysis on the efficacy of our MNB generating technology and propose its use as a wound healing agent.
Collective cell migration is a hallmark of wound repair, cancer invasion and metastasis, immune responses, angiogenesis, and embryonic morphogenesis. Wound healing is a complex cellular and ...biochemical process necessary to restore structurally damaged tissue. It involves dynamic interactions and crosstalk between various cell types, interaction with extracellular matrix molecules, and regulated production of soluble mediators and cytokines. In cutaneous wound healing, skin cells migrate from the wound edges into the wound to restore skin integrity. Analysis of cell migration in vitro is a useful assay to quantify alterations in cell migratory capacity in response to experimental manipulations. Although several methods exist to study cell migration (such as Boyden chamber assay, barrier assays, and microfluidics-based assays), in this short report we will explain the wound healing assay, also known as the “in vitro scratch assay” as a simple, versatile, and cost-effective method to study collective cell migration and wound healing.
Steven-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare immunologic hypersensitivity reaction to stimuli that presents as widespread eruption with mucocutaneous detachment and ...involvement of other organs. Multiple causes have been noted in literature, including numerous medications. In this report, we present a 52-year-old woman who arrived at the emergency department with a complaint of rash, malaise, and pruritus. She subsequently developed diffuse cutaneous and mucosal detachment. Work-up supported a diagnosis of SJS/TEN secondary to her thyroid replacement therapy, derived from desiccated pig thyroid glands. The patient's natural thyroid medication was discontinued and she responded well to appropriate treatment. This case is unique in that thyroid replacement therapy is not a commonly reported trigger of SJS/TEN. Providers should be aware of the potential for natural thyroid and other animal-derived natural medications to cause adverse reactions such as SJS/TEN.
We present a case of delayed-type hypersensitivity to hyaluronic acid (HA)-based filler on the face following the Pfizer booster in a Moderna-vaccinated individual. It is the first known case of ...treatment of the delayed-type hypersensitivity reaction with hyaluronidase following Covid vaccination. Hyaluronidase is a viable option to treat this reaction, particularly for patients who may not benefit from systemic treatment options. With an anticipated fourth round of vaccine boosters on the horizon, there may be an increased incidence of cutaneous adverse events, including the reaction discussed.
Tetracycline‐class antibiotics are frequently prescribed by dermatologists, commonly for acne vulgaris. Gastrointestinal absorption of first and second‐generation tetracycline‐class antibiotics, ...including doxycycline and minocycline, may be reduced by co‐administration with food, resulting in potentially lower clinical efficacy. Development of novel compounds and formulations that are not impacted by diet could improve compliance, absorption, and effectiveness among patients. The objective of this study is to investigate weight‐based dosing protocols and the impact of food intake, including high‐fat meals, on the absorption, and clinical efficacy of sarecycline, a novel oral narrow‐spectrum third‐generation tetracycline‐class antibiotic approved by the Food and Drug Administration for acne vulgaris treatment. Data from 12 clinical studies were analyzed using population pharmacokinetic modeling, exposure–response modeling and pharmacodynamics to evaluate sarecycline dosing recommendations. The extent of exposure is estimated to decrease by 21.7% following co‐administration of a sarecycline tablet with a high‐fat meal. Based on the PopPK‐PD model, this is equivalent to a decrease in efficacy of 0.9 inflammatory lesions, which is not clinically meaningful. Sarecycline can be administered using weight‐based dosing with or without food. Co‐administration with high‐fat food has a limited impact on clinical efficacy. The pharmacokinetics of oral sarecycline may provide added convenience and support ease of use and improved compliance for acne vulgaris patients.
Pemphigus is a group of chronic IgG-mediated autoimmune blistering diseases that involves both the skin and mucous membranes. It is caused by autoantibodies disrupting intercellular keratinocyte ...adhesion. Loss of epidermal integrity clinically manifests as flaccid thin-walled blisters, erosions, and crusts on the skin, and painful mucosal erosions. Pemphigus vulgaris and pemphigus foliaceus are the two most common types of pemphigus. Although rare, pemphigus can be life-threatening. Substantial morbidity and mortality can occur as a result of complications of these diseases and their treatments. In general, pemphigus often results in extensive skin loss, leading to scar formation and adherence of articular skin folds, limiting joint and limb movements. The primary goal of treatment is to induce durable remission, decrease blister formation, prevent infections and promote healing of blisters and erosions. The mainstay of treatment for pemphigus is systemic corticosteroids combined with an adjuvant immunosuppressant and wound care. We performed PubMed and Google Scholar searches of the English-language literature for pemphigus disease and wound management for blistering disease (1966–2019). In this review, we discuss wound care in patients with pemphigus disease.
Abstract
In developed countries, over 100 million people per year form scars, of which 30% become hypertrophic. These scars are defined histologically by the presence of persistently contractile ...myofibroblasts. Recent in vitro research suggests that certain bone morphogenic proteins (BMP) can induce scar myofibroblast dedifferentiation and reprogramming into adipocytes. Since platelets contain BMPs within their granules, it is possible that platelet-rich plasma (PRP) can act as a vehicle to deliver BMP to sites of scarring or potential scarring. Additionally, when PRP is mixed with fat graft tissue, synergistic adipogenic growth factors (including BMPs) are released which can help complete myofibroblast transformation and adipogenesis. The aim of this article is to corroborate these findings by systematically reviewing articles demonstrating the following concepts: (1) the effect of PRP on scar modulation; (2) the extraction of BMP from PRP; (3) BMP-induced myofibroblastic dedifferentiation; and (4) the effect of PRP on adipose-derived stem cells using the MEDLINE database. This search yielded 2830 articles, of which 38 met the inclusion criteria for this literature review.
Level of Evidence: 4
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