Sweet side of bladder cancer

The malignant transformation of cells is often accompanied by deranged expression of the sugar chains,i.e.,glycans,attached the cancer cell surfaces or attached to secreted proteins.The aberrant expression of specific glycans in bladder cancer has also been reported by several research groups.Similarly to other cancers,glycans such as the sialyl Tn antigens have been suggested as diagnostic and prognostic biomarkers of bladder cancer,and associated with disease progression and patient’s response to treatment.At present our understandings about the role of glycans in bladder cancer is still limited,but at the same time it is now assumed that this understanding urges and it will fuel the development of novel strategies of diagnostic and therapy.     

Impact of Adverse Events Associated With Acitretin Treatment of Moderate-to-Severe Plaque Psoriasis: Based on an Observational,Single-Center Study in Shanghai,China

Objective: Acitretin is a widely used systemic retinoid that is to treat psoriasis but has significant variations in efficacy and adverse events (AEs) among individuals. This study aimed to determine the impact of AEs associated with acitretin treatment of moderate-to-severe plaque psoriasis on the Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS) scores.Methods: This prospective, observational, single-center study was conducted from March 2021 to June 2022 a...     

Recalcitrant Cutaneous Mastocytosis Treated With Genetically Informed Targeted Therapy: A Case Report

Introduction: Mastocytosis, a clonal proliferation of mast cells commonly involving the skin and bone marrow, has a varied clinical presentation ranging from cutaneous lesions to systemic disease. Cutaneous mastocytosis is managed symptomatically, but systemic mastocytosis is treated with targeted therapy against the mutated receptor tyrosine kinase c-KIT, the pathogenic driver of mastocytosis. However, there are no guidelines for the treatment of cutaneous mastocytosis refractory to symptomatic...     

Epidemiology of Pemphigus: A Single Center Experience in Morocco

Objective: Pemphigus is a life threatening autoimmune bullous disease which involves the skin and mucous membranes of the stratified squamous epithelium. The global distribution of Pemphigus varies according to genetic, ethnic, socioeconomic, and cultural backgrounds. The purpose of our study is to evaluate the epidemiological features of pemphigus a single center in Morocco and compare our results with those reported elsewhere.Methods: A retrospective analysis was conducted of 302 pemphigus pat...     

Research Progress of Genomic Variation in Psoriasis

As a typical representative of global complex diseases, psoriasis has attracted widespread attention because of its high heritability, heterogeneity, and incidence. Environmentally induced activation of the inflammatory–immune axis in patients with psoriasis relies on genetic regulation of genomic variation. The heritability of psoriasis exceeds 80%, and research of genomic variation in psoriasis is of great significance to the interpretation of the biological pathogenesis of the disease. The de...     

Role of β2-microglobulin in uremic patients may be greater than originally suspected

The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined.     

Clinical Application of Platelet-Rich Fibrin in Dermatology

Platelet-rich fibrin (PRF) is a second-generation platelet concentrate obtained from autologous blood. PRF is composed of abundant platelets, leucocytes, and a high concentration of various growth factors and fibrinogen. The composition and three-dimensional structure of PRF enable it to effectively make cells migrate and proliferate, playing an important role in tissue repair. Furthermore, the easy preparation and low cost of PRF make it a good treatment option. Numerous articles have been publ...     

Cutaneous Manifestations and Treatment Advances of Adult T-Cell Leukemia/Lymphoma

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell lymphoma caused by the human T lymphotropic virus type-1. The skin is affected in approximately half of ATLL patients, and skin lesions may be the first manifestation of the disease. The skin lesions of ATLL are polymorphous, and depend on the type of skin eruption, which makes it possible for doctors to predict the prognosis of the disease based on the characteristics of skin lesions. In this review article, we describe th...     

Efficacy of 308-nm Monochromatic Excimer Lamp and Topical Tacrolimus Combination Therapy in Localized Vitiligo: A Study in Vietnam

Objective: Combination therapy of a 308-nm monochromatic excimer lamp and topical tacrolimus is widely used in the treatment of localized vitiligo; however, there are no published studies investigating this combination therapy in Vietnamese patients with vitiligo. This study was performed to evaluate the efficacy of combined excimer lamp and topical tacrolimus therapy for patients with localized vitiligo in Vietnam.Methods: We performed a pre-post clinical trial of 30 patients diagnosed with loc...     

An Analysis of HPV Infection and Distribution in Cervical and Genital Samples With Condyloma Acuminatum: A Retrospective Study

Objective: Human papillomavirus (HPV) causes condyloma acuminata, which is one of the most widespread sexually transmitted diseases. This study was aimed to evaluate the prevalence of HPV infection and HPV genotype distribution in patients with condyloma acuminatum in Urumqi, China.Methods: A total of 835 cervical and genital samples were collected from outpatients treated for condyloma acuminatum between December 2016 and December 2018. HPV genotyping was performed with the HPV Genotyping Real-...     

Benzodiazepine in spinally mediated analgesia

Since benzodiazepine/γ-amino butyric acid receptor was found in the spinal cord, there have been many studies to investigate analgesic effects of midazolam, a watersoluble benzodiazepine in the spinal cord. In animal experiments, intrathecal midazolam has analgesic effects on visceral pain, thermal pain, and inflammatory pain, and it has synergistic or additive effects with different kinds of analgesics acting on different receptors. In human study, intrathecal midazolam has analgesic effects on back pain, somatic pain, but not visceral pain. The analgesic effect lasts long and intrathecal midazolam induces sedation, which is the effect in the brain. Epidural midazolam is less studied than intrathecal midazolam. Epidural midazolam has segmental analgesia forpostoperative pain, and adding midazolam to bupivacaine increased duration of analgesia. It also induces sedation, which might be the effects of midazolam coming from cerebrospinal fluid to the brain. Some histopathological studies in animals showed neurotoxicity of midazolam, while there are no toxic side effects in many human studies of intrathecal and epidural midazolam. Therefore, we need clinically relevant animal studies for neurotoxicity and analysis of complications in patients already studied with intrathecal and epidural midazolam to give final conclusion.     

Is continuous bladder irrigation after prostate surgery still needed?

Continuous bladder irrigation(CBI)is commonly prescribed after certain prostate surgeries to help prevent the clot formation and retention that are frequently associated with these sometimes hemorrhagic surgeries.However,it remains unknown how effective CBI is in preventing clot formation/catheter blockage because these complications still frequently occur in the presence of CBI.On the other hand,the outcome of prostate surgeries has significantly improved over the years,and these surgeries have generally become much safer and,in many hands,less hemorrhagic.Newer surgical options such as holmium laser enucleation of the prostate with associated improved hemorrhagic control have also been introduced,further creating the opportunity to eliminate CBI.Furthermore,there is a lack of review articles on CBI.Hence,this article will review the evolution and contemporary role of CBI in prostate surgeries.To eliminate CBI after prostate surgeries,it is important to achieve good hemostasis during the surgeries.Having in place a policy of nonirrigation after prostate surgeries is also important if less CBI is to be the norm.A non-irrigation policy will hopefully help reduce those cases of CBI prescribed out of long-standing surgical tradition while allowing for cases prescribed out of compelling necessity.The author’s policy of a consistent non-CBI during prostate surgeries over the last 9 years will be highlighted.     

Laboratory Safety of Dupilumab,and Its Effect on Inflammatory Biomarkers,in Chinese Adults With Moderate-to-Severe Atopic Dermatitis: An Analysis of a Randomized,Double-Blind Phase III Study

Objective: Limited information is available on the use of dupilumab for the treatment of atopic dermatitis (AD) in the Chinese population.Methods: We analyzed laboratory data from a previously published randomized, double-blind phase III trial (NCT03912259) to provide further insight into the safety of dupilumab in Chinese adults with moderate to severe AD. The trial participants received either 300 mg of dupilumab or placebo every 2 weeks for 16 weeks. Hematology, blood chemistry, serum thymus ...     

The Role of Intestinal Microbiota in Atopic Dermatitis

The early intestinal microbiota plays an important role in immune regulation, and the unbalanced composition may increase the occurrence of allergic diseases, including atopic dermatitis. This review summarizes the latest studies in the occurrence and development of intestinal microflora and its relationship with atopic dermatitis. These results are conducive to understand the differences in the composition of intestinal microbiota between patients with atopic dermatitis and healthy people, and ...     

Time to re-evaluate effects of renin-angiotensin system inhibitors on renal and cardiovascular outcomes in diabetic nephropathy

The use of renin-angiotensin system(RAS) inhibitors, such angiotensin converting enzyme inhibitors/angiotensin-Ⅱreceptor blockers, to slow progression of chronic kidney disease(CKD) in a large group dominated by elderly people in the real world is not supported by available evidence. Large-scale clinical trials had many faults,among them a lack of focus on the elderly. However,it would be difficult to conduct clinical trials of a similar scale in elderly CKD patients. Besides, progression ofkidney disease is often slow in elderly persons, and the vast majority of older adults with CKD will die before reaching end stage renal disease. Moreover, since it is not clear that progression of kidney disease, and even of proteinuric diabetic nephropathy, is not inhibited through the use of RAS inhibitors, the most patientcentric goal of therapy for many elderly individuals should be individualized.     

Causal Variants of the GJB6 Gene are Associated with Hearing Loss and Skin Manifestations: A Case Report from Turkey

Introduction: The gap junction beta 6 (GJB6) gene encodes connexin 30. This protein plays critical role in tissues and is responsible for the formation of gap junctions, which have a wide variety of physiological functions. Disease-associated variants ofGJB6 cause non-syndromic hearing loss (HL) and skin lesions.Case presentation: The 1-year-old girl patient was diagnosed with bilateral HL when she was 1 month old. Apart from this, the patient’s motor/mental development and physical examination ...     

Anagen Effluvium due to Azathioprine in a Patient With Normal Thiopurine S-Methyltransferase Levels: A Case Report Using Videodermoscopic Analysis

Introduction: Anagen effluvium (AE) is caused by impaired mitotic activity of matrix cells in the hair follicles. It presents with sudden loss of hair and myelosuppression. The diagnosis is based on the clinical history, trichoscopy, and trichogram.Case presentation: A 20-year-old woman presented with sudden loss of hair following treatment with oral azathioprine. Evaluation of the TPMT were within normal limits both in genotype and phenotype levels. Hair pull test was positive. Trichoscopy reve...     

Concurrence of Merkel Cell Carcinoma and Squamous Cell Carcinoma in A Patient with Generalized Actinic Keratosis: A Case Report

Introduction: Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous malignancy, and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection. MCC in the Chinese population is uncommon.Case report: An 82-year-old woman presented with two rapidly enlarging and rupture lesions on the face for 1 year. Biopsy was suggestive of squamous cell carcinoma (SCC) on the forehead and MCC on the left cheek. The patient had a history of generalized AK for 3 years. The les...     

Psoriasis:Biologic treatment and liver disease

Patients with moderate or severe psoriasis have a high prevalence of chronic liver disease. Chronic liver disease in these patients is related to metabolic syndrome, alcohol abuse or viral infections. Therefore,treatment of these patients is challenging. Classic systemic treatments may be contraindicated because of their immunosuppressive and hepatotoxic potential.First-line therapy in this setting is generally ultraviolet B phototherapy combined with topical treatment, but its feasibility and efficacy are sometimes limited. The therapeutic options are further restricted by concomitant psoriatic arthritis. Biologic treatments have shown to be effective in psoriasis and psoriatic arthritis, and they are largely devoid of liver toxicity. Anti-tumor necrosis factor-alpha(TNF-α) treatments have proven to be effective and safe in patients with chronic hepatitis C virus(HCV) infections and other non-infectious chronic liver disorders, including alcoholic and non-alcoholic liver diseases. However, in chronic hepatitis B virus(HBV), anti-TNF-α treatments carry a high risk of HBV reactivation. Anti-interleukin-12/23 treatments are also effective in patients with psoriasis, but data regarding their safety in chronic hepatitis infections are still limited. Safety reports in patients with psoriasis and chronic HCV infection are contradictory, and in chronic HBVevidence indicate a potential risk of viral reactivation. Moreover, concerns remain about the long-term safety of both TNF-α antagonists and ustekinumab. Non-viral liver diseases such as alcoholic and non-alcoholic liver diseases are more prevalent in patients with psoriasis than in the general population. TNF-α antagonists have also been prescribed in these patients. Although data are still scarce in this setting, results suggest a favorable profile in patients with psoriasis and non-alcoholic liver diseases. We review the literature regarding all these aspects.     

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Objective: Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the...