Bowen’s disease on the palm: A case report

BACKGROUND Bowen’s disease (BD) is a persistent, progressive intraepidermal carcinoma. BD usually occurs in areas exposed to sunlight. Involvement of the dorsum of the hand is not rare, but that of the palmar aspect is very unusual. Only a few cases have been reported in the literature. CASE SUMMARY Here, we report the case of a 48-year-old male patient who presented with a history of persistent local erythema lasting for 2 years on the thenar eminence of the left palm. Initially diagnosed as hand eczema, the condition did not improve with intermittent treatment with anti-allergy medications or topical glucocorticoid ointments, among other approaches. Then, the area of erythema gradually enlarged and was accompanied by mild itching. For a definite diagnosis and treatment, the patient came to our hospital. Dermoscopic examination revealed BD, and histopathological examination confirmed the diagnosis. We performed partial resection of the skin lesion followed by photodynamic therapy. No recurrence was observed at the 6-mo follow-up. CONCLUSION For all atypical palmar lesions, early dermoscopy and/or skin biopsy are needed to avoid missed diagnosis or misdiagnosis.

Association between celiac disease and vitiligo:A review of the literature

Celiac disease(CD)is an autoimmune intestinal disease caused by the intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes.Vitiligo is a commonly acquired depigmentation of the skin;its clinical manifestation are skin patches caused by localized or generalized melanin deficiency.Both diseases have similar global incidence rates(approximately 1%)and are associated to similar diseases,including autoimmune bullous disease,inflammatory bowel disease,autoimmune thyroiditis,autoimmune gastritis,and type 1 diabetes.The relationship between CD and vitiligo has been reported in several studies,but their conclusions are inconsistent.Further,it has also been reported that a gluten-free diet(GFD)can improve the symptoms of immunerelated skin diseases such as vitiligo.In this mini-review,we summarize and review the literature on the relationship between CD and vitiligo,assess the therapeutic significance of GFD for patients with vitiligo,and explore their possible physiopathology.We are hopeful that the information summarized here will assist physicians who treat patients with CD or vitiligo,thereby improving the prognosis.

Analysis of Clinical Features of Patients With Psoriasis and Metabolic Syndrome in Xinjiang,China:A Cross-Sectional Study

Objective:Psoriasis is often closely related to metabolic syndrome (MS),herein we conducted this study to investigate the clinical characteristics of a large sample of psoriasis patients with MS in Xinjiang,China.Methods:The prevalence of MS,age,height,weight,body mass index (BMI),red blood cell count,white blood cell count,platelet count,aspartate aminotransferase level,alanine aminotransferase level,and other clinical data were analyzed in 2,492 patients with psoriasis.The patients were divided into 2 groups based on the presence of MS and their clinical features were compared.Studentt test was used for independent samples,and the chi-square test was used for count data.Results:Among the 2,492 patients,349 had MS and 1,269 were considered overweight/obese.There were significant differences in sex,age,disease course,age at onset,BMI,systolic blood pressure (SBP),and diastolic blood pressure (DBP) between the patients with MS and those without (allP < 0.05).The red blood cell count (P < 0.001),white blood cell count (P = 0.013),erythrocyte sedimentation rate (P < 0.001),blood urea nitrogen level (P < 0.001),triglyceride level (P < 0.001),total cholesterol level (P < 0.001),and low-density lipoprotein cholesterol level (P = 0.002) were significantly higher in the MS group than in the psoriasis-only group.The high-density lipoprotein cholesterol level was significantly lower in the MS group than in the psoriasis-only group (P < 0.001).The alanine aminotransferase (P = 0.145) and albumin levels (P = 0.192) were not significantly different between the 2 groups (P > 0.05).Binary logistic regression analysis showed that sex,age,BMI,SBP,DBP,and fasting plasma glucose were independent risk factors for MS in patients with psoriasis,and high-density lipoprotein cholesterol was considered a protective factor for these patients.Conclusion:The prevalence of MS in patients with psoriasis is high.Female sex,age,BMI,SBP,DBP,and fasting plasma glucose may be risk factors for psoriasis complicated by MS.

Risk factors for infantile hemangioma:a meta-analysis

Background Infantile hemangioma(IH)is one of the most common tumors in infants.Its pathogenesis is complex and poorly understood.The risk factors of IH have been extensively studied from clinical and epidemiological perspectives in recent years,but the conclusions in the literature reports are inconsistent.To provide a reference for the prevention of hemangioma,we conducted a meta-analysis of the published studies of potential risk factors for IH.Methods The Cochrane Library,Ovid,PubMed,and Web of Science databases were searched systematically.Log odds ratios(log ORs),logistic regression standard errors and 95%confidence intervals(CIs)were used to compare the correlation between IH and potential risk factors.Review Manager 5.3.3 was used for the statistical analysis.Results Six studies were included and 17 potential risk factors were eventually evaluated.P values<0.05 were found for female gender(P<0.01,OR 2.04,95%CI 1.65–2.51),low birth weight(P<0.01,OR 4.39,95%CI 3.05–6.31),multiple gestation(P=0.01,OR 2.39,95%CI 1.21–4.71),preterm birth(P=0.03,OR 2.37,95%CI 1.07–5.23),progesterone therapy(P<0.01,OR 2.73,95%CI 2.12–3.51),and family history(P=0.01,OR 1.98,95%CI 1.16–3.38).Conclusions This meta-analysis revealed that risk factors,including female gender,low birth weight,multiple gestation,preterm birth,progesterone therapy,and family history may affect the occurrence of IH.

Effectiveness and safety of different doses of pioglitazone in psoriasis:a meta-analysis of randomized controlled trials

Background:Pioglitazone may be beneficial in the treatment of psoriasis.However,based on the effectiveness and safety considerations,it has not been widely used.To fully evaluate the strength of evidence supporting psoriasis treatment with pioglitazone,we conducted a meta-analysis of existing published studies.Methods:PubMed,Ovid,Cochrane Library,Google Scholar,and Web of Science databases were systematically searched before February 2019.Randomized controlled trials(RCTs)of pioglitazone administration compared with placebo,administered to patients with psoriasis for at least 10 weeks,and published in English were included.Quality of the included RCTs was identified by the modified Jadad scale.The quality of evidence for each outcome was evaluated using the GRADEpro Guideline Development Tool online software.Primary outcomes were proportion of patients showing psoriasis area and severity index(PASI)score improvement(<75%)and the mean percent change in PASI score from baseline to the end of treatment.Dichotomous data were analyzed using odds ratios(ORs)corresponding to the 95%confidence interval(CI),whereas continuous variables,expressed as mean and standard deviation,were analyzed using the mean differences(MD)with the 95%CI.Results:Six RCTs were analyzed.Meta-analysis showed that pioglitazone reduced the PASI scores in patients with psoriasis compared with the control group when administered at 30 mg per day(P<0.001,MD=-3.82,95%CI=-5.70,-1.93)and at 15 mg per day(P=0.04,MD=-3.53,95%CI=-6.86,-0.20).The PASI-75 of the pioglitazone group was significantly higher than that of the control group at 30 mg per day(P<0.001,OR=8.30,95%CI=3.99,17.27)and at 15 mg per day(P=0.03,OR=2.96,95%CI=1.08,8.06).No statistically significant differences in total adverse events were observed between the groups.There were no significant differences in common adverse reactions such as weight gain and elevated liver enzymes between the two pioglitazone groups.Conclusions:Use of pioglitazone in the current treatment of psoriasis is beneficial.The therapeutic effect of the daily 30 mg dose may be greater than that of the 15 mg dose per day with no significant change in the frequency of adverse reactions.

Clinical characteristics and risk factors of infantile hemangioma: a case-control study in Northwest China

Objective To investigate the clinical characteristics and risk factors of infantile hemangioma in Xinjiang Uygur Autonomous Region,China.Methods A total of 941 infants with infantile hemangioma were identified as subjects and matched with 941 infants of the same age without infantile hemangioma.Trained investigators used a standardized questionnaire to collect data from both groups,including demographic,prenatal,and perinatal characteristics.Univariate and multiple logistic regression models were used to screen risk factors.Results This study revealed that female (P < 0.001,OR =3.08,95% CI =2.54-3.74),maternal tea drinking (P< 0.001,OR =1.86,95% CI=1.32-2.61),low birthweight (P< 0.001,OR =3.01,95% CI=2.10-4.30),preterm (P< 0.001,OR =4.07,95% CI=2.73-6.09),gestational diabetes (P < 0.001,OR =2.03,95% CI =1.41-2.94),maternal progesterone use (P <0.001,OR =2.44,95% CI =1.83-3.25) and a history of hemangiomas in first-degree relatives (P <0.001,OR =1.80,95% CI =1.33-2.43) influenced the occurrence of infantile hemangioma.Female (P < 0.001,OR =2.82,95% CI =2.30-3.45),maternal progesterone use (P < 0.001,OR =14.64,95%CI =3.52-60.88) and a history of hemangiomas in first-degree relatives (P< 0.001,OR =0.011,95%CI =0.002-0.065) were independent risk factors for infantile hemangioma.Conclusions Female,maternal tea drinking,low birthweight,preterm,gestational diabetes,maternal progesterone use,and a history of hemangiomas in first-degree relatives may interact with each other leading to the occurrence of infantile hemangioma.

Association between acne and smoking:systematic review and meta-analysis of observational studies

To the Editor:Acne is a chronic inflammatory disease commonly found in areas with abundant sebaceous glands.It is more likely to produce permanent atrophic or hypertrophic scars that can cause serious psychosocial consequences and reduce the quality of life of the patients.111 Acne fades in most people after puberty and can continue into middle age in a small percentage of people.The occurrence of acne is caused by endogenous and exogenous factors,and many environmental factors can induce acne,such as occupational exposures,birth control pills,diet,certain cosmetics,and the menstrual cycle of the women.

Clinical and Epidemiological Characteristics of Vitiligo at Different Ages: An Analysis of 571 Patients in Northwest China

Objective:This study was performed to elucidate the clinical end epidemiological characteristics of vitiligo patients of different ages in Northwest China.Methods:We retrospectively reviewed the case records and questionnaires of all patients diagnosed with vitiligo,who visited People's Hospital of Xinjieng Uygur Autonomous Region from May 2016 to December 2017.The clinical end epidemiological characteristics of these patients were enalyzed by Pearson's x2 test end Fishar's exact test.Results:In total,we collected data of 571 Vitiligo patients with age of 32.9 ± 16.4 years.The prevalence of segmental Vitiligo in children end adolescents < 19 years old (24/175[13.7%]) was higher than that in adults aged from 20-59 years (23/370[6.2%]) and advanced patients aged >60 years (1/26[3.8%]) (P=0.020).The prevalence of progressive vitiligo was higher in children end adolescents < 19 years (72/175[41.1%]) and adults from 20-59 years (141/370[38.1%) than in patients ≥60 years (5/26[19.2 %]) (P =0.063).Children and adolescents < 19 years with Vitiligo had a higher rate of a family history of vitiligo (20/175[11.4%]) then adults (20/370[5.4%]) and advanced age (1/26[3.8%]) (P=0.031).Conclusions:This study provides clinical evidence that vitiligo at different ages has different characteristics,mainly regarding en increased incidence of segmental vitiligo,a higher prevalence of atopic dermatitis end halo nevus,and a more common positive family history among children and adolescent patients.

Childhood bullous pemphigoid with progressive muscular dystrophy: a case report

Introduction Bullous pemphigoid (BP) is an acquired autoimmune disorder,which is clinically characterised by subepidermal blistering,eosinophilia,and severe itch,and it can be complicated by a variety of senile diseases,including neurological diseases.BP mostly attacks older people and is considered rare in children.BP patients were often comorbid with neurological diseases,including dementia,stroke,epilepsy,Parkinson's disease,and multiple sclerosis has been demonstrated.