Vitamin D and Pigmented Skin

The default supply of vitamin D3 to humans is its endogenous production in UV-B-exposed skin [...]

Investigating Turf Burn Videos on TikTok: Observational Study (Preprint)

BACKGROUND Due to the increased use of artificial turf, turf burn has become a common sports injury caused by exposed skin sliding on artificial turf. Health complications such as MRSA outbreaks, sepsis, and pneumonia have been linked to untreated turf burns, and many athletes have been turning to social media for advice and companionship regarding their sports injuries. OBJECTIVE The goal of the study is to categorize and quantitatively assess the percentage of turf burn posts on TikTok based on the creator, content, and the athlete’s experience. With this data, we not only investigate if there is room for health care professionals to assist in the distribution of evidence-based health education to athletes to counteract misinformation, but also investigate if there is a potential audience of athletes on TikTok who have the potential to develop problematic responses to their injuries. METHODS Using the Discover page on TikTok, we searched for the word “turf burn” on October 17, 2021. 100 videos were used. Videos were categorized and analyzed by the creator, content, and experience of the athlete. Likes and comments were recorded. RESULTS Most of the videos (98/100, 98.0%) were created by athletes while only a small fraction of videos (2/100, 2.0%) were created by health-care professionals. Content wise, most of the videos (67/100, 67.0%) displayed the turf burn. A small amount of videos (15/100, 15.0%) showed the incident when the turf burn was acquired while nearly a quarter of the videos (23/100, 23.0%) demonstrated treatment/prevention of turf burns. Out of 23 treatment/prevention videos, a minority of the videos (4/23, 17.4%) showed accurate treatment of turf burns while most of the videos (19/23, 82.6%) showed inaccurate treatment. The smallest amount of videos (2/100, 2.0%) were about education of turf burns. Most of the athlete videos (56/98, 57.1%) depicted negative experiences the patient had with turf burn. Some of the videos (37/98, 37.8%) depicted neutral experiences while the smallest amount (5/98, 5.1%) depicted positive experiences. CONCLUSIONS Our observational study suggests that there is a potential audience of athletes on TikTok who could develop problematic responses to their sports injuries such as turf burn, as most of the people who post videos are athletes and many of the posts demonstrate a negative experience associated with the turf burn. TikTok is a growing social media platform that should be studied to see if it can be used to create a social support group for injured athletes to prevent the progression of their negative emotional responses into problematic responses. Physicians should also have a role in establishing their social media presence on TikTok and offer evidence-based advice to athletes while disproving misinformation that is present on TikTok.

MELASMA: A HOSPITAL BASED RETROSPECTIVE STUDY ON CLINICOEPIDEMIOLOGICAL PROFILE

Background: Melasma is a common, therapeutically challenging, psychological distressing, pigmentary disorder of sun exposed skin. Aim Of The Study: To study the clinical and epidemiological prole of melasma patients. Materials And Methods: Tertiary care hospital retrospective study using data of melasma patients who attended the dermatology outpatient clinic between February 2012 to May 2021. Study included 296 patients above 18 years. Demographic details were obtained from the pigment clinic proforma. Results: Mean age of 296 patients was 35.4 years, with female predominance (86.1%). Mean age at onset of melasma was 31.9 years. Aggravation with sun exposure was noted in 64.2% cases. Family history was present in 15.2% cases while hypothyroidism in 3.4% cases. Malar involvement was commonest (68.6%). Under Wood's lamp, epidermal type was commonest (57.4%). Cosmetic usage was present in 6.4% cases. Pregnancy precipitation and pregnancy aggravation was noted in 16.5% and 9% females. 7.5% females reported OC pill usage. Conclusion:This study showcases the multifaceted prole of patients aficted with melasma in a tertiary care hospital.

Deferoxamine Treatment Improves Antioxidant Cosmeceutical Formulation Protection against Cutaneous Diesel Engine Exhaust Exposure

Skin is one of the main targets of the outdoor stressors. Considering that pollution levels are rising progressively, it is not surprising that several cutaneous conditions have been associated with its exposure. Among the pollutants, diesel engine exhaust (DEE) represents one of the most toxic, as it is composed of a mixture of many different noxious chemicals generated during the compression cycle, for ignition rather than an electrical spark as in gasoline engines. The toxic chemicals of most concern in DEE, besides the oxides of nitrogen, sulfur dioxide and various hydrocarbons, are metals that can induce oxidative stress and inflammation. The present study aimed to evaluate the effects of topical application, singularly or in combination, of the iron-chelator deferoxamine and a commercially available formulation, CE Ferulic, in up to 4-day DEE-exposed skin. DEE induced a significant increase in the oxidative marker 4-hydroxy-nonenal (4HNE) and matrix-metallopeptidase-9 (MMP-9), the loss of cutaneous-barrier-associated proteins (filaggrin and involucrin) and a decrease in collagen-1, while the formulations prevented the cutaneous damage in an additive manner. In conclusion, this study suggests that iron plays a key role in DEE-induced skin damage and its chelation could be an adjuvant strategy to reinforce antioxidant topical formulations.

Micronodular basal cell carcinoma of the scrotum: a case report and review of the literature

Introduction Basal cell carcinoma is the most common nonmelanotic skin cancer. It has variable clinical and histological subtypes that vary in their aggressiveness and liability to recurrence and metastasis. Chronic ultraviolet radiation exposure is considered to be the main risk factor for developing basal cell carcinoma; therefore, it typically arises on sun-exposed skin, mainly the head and neck. Case presentation We present the case of a 55-year-old Caucasian male who presented with a lesion on the scrotum for 2 years. The lesion was clinically presumed benign and initially treated with curettage. Microscopic examination revealed an incompletely resected micronodular basal cell carcinoma with sebaceous differentiation. Therefore, a second excisional biopsy was performed to completely excise the incidentally discovered malignant tumor. Conclusion We report the first case of micronodular basal cell carcinoma arising on the scrotum. The goal of our article is to draw clinicians’ attention to the possible involvement of unexposed skin with basal cell carcinoma, and we highlight the importance of accurate diagnosis and prompt treatment due to the aggressive nature of micronodular basal cell carcinoma.

High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients—A Cross-Sectional Study

Background: Exogenous factors (such as sun exposure, smoking habits, and diet) and endogenous (inflammatory status, general diseases) have a direct influence on skin and soft tissue characteristics. The study’s objective was to assess the impact of metabolic syndrome (MS) on characteristics of skin layers in sun-exposed and non-exposed maxillofacial tissues evaluated by high-frequency ultrasound (HFU), as a potential diagnosis and monitoring tool for the aging process. Material and methods: The present study included 102 subjects (24 with MS; 78 without MS). Anthropometric parameters and disease history were recorded, and blood samples were harvested in order to assess biochemical parameters of MS. Sun-exposed skin (zygomatic region) and non-exposed oral mucosa of the lower lip were assessed using HFU (DUB® cutis, Taberna Pro Medicum) with a 22 MHz probe. Results: Patients with cardiac disease had significantly lower values for epidermis density (p = 0.002). Gender was independently linked to the aged dermis depth (p < 0.001), aged dermis no. of px (pixels) (p < 0.001), dermis depth (p < 0.001), dermis no. of px (p < 0.001), and subcutaneous tissue density (p < 0.001). Patients with MS had thinner epidermis (p = 0.008) and thinner aged dermis (p = 0.037) when compared to non-MS subjects. Conclusion: Patients with MS had thinner epidermis and a lower epidermis number of pixels in sun-exposed skin. Women had lower epidermis density and thicker dermis in sun-exposed skin. Our study showed that HFU, as a non-invasive investigation approach, is useful to diagnose and monitor the aging process in skin and oral mucosa, correlated with skin phenotype pathological conditions.

Efficacy of oral tranexamic acid versus triple combination for the treatment of melasma: A prospective, double blinded randomised controlled trial

Melasma is a common acquired hypermelanosis characterized by irregular light to dark brown macules and patches seen mainly in women and over sun-exposed skin on the face. We have undertaken this RCT to compare the efficacy between oral Tranexamic acid and Topical Triple combination as Tranexamic acid is having good safety profile.To compare the therapeutic efficacy of oral Tranexamic acid versus Topical Triple combination for the treatment of Melasma using MASI score. To compare the adverse effects profile of each treatment modality. Total subjects (66 patients) were divided into 2 groups (A and B, each with 33 patients) by simple randomization method.Patients and analysers were blinded to treatments. Group-A received topical triple combination cream once daily (15-minutes) at night for 8 weeks followed by maintenance regimen of biweekly application of product for 4 weeks and oral placebo tablets (calcium gluconate 250mg) twice daily for 12 weeks. Group-B received oral Tranexamic acid tablets 250mg twice daily for 12 weeks with topical placebo cream (Moisturizer) once daily at night for 8 weeks followed by maintenance regimen of biweekly application of product for 4 weeks. MASI score was assessed at baseline and monthly follow-up visits along with simultaneous serial digital photographs, with the recording of side effects. Both groups showed significant decrease in MASI score in each followup visits without any statistically significant difference.In epidermal melasma topical triple combination is preferred over oral tranexamic acid. In dermal and mixed variety oral tranexamic acid is better.

Micronodular basal cell carcinoma of the scrotum- a case report and review of the literature

Introduction: Basal cell carcinoma (BCC) is the most common non-melanotic skin cancer. It has variable clinical and histological subtypes that vary in their aggressiveness and liability to recurrence and metastasis. Chronic ultraviolet radiation exposure is considered to be the main risk factor for developing BCC; therefore it typically arises on sun-exposed skin, mainly the head and neck. Case presentation: We present the case of a 55-year-old male who presented with a lesion on the scrotum for 2 years. The lesion was clinically presumed benign and initially treated with curettage. Microscopic examination revealed an incompletely resected micronodular BCC with sebaceous differentiation. Therefore, a second excisional biopsy was performed to completely excise the incidentally-discovered malignant tumor. Conclusion: We report the first case of micronodular BCC arising on the scrotum. The goal of our article is to draw clinicians’ attention to the possible involvement of unexposed skin with BCC and we highlight the importance of accurate diagnosis and prompt treatment due the aggressive nature of micronodular BCC.

Optimization of Production Parameters for Andrographolide-Loaded Nanoemulsion Preparation by Microfluidization and Evaluations of Its Bioactivities in Skin Cancer Cells and UVB Radiation-Exposed Skin

Andrographolide (AG) is an active compound isolated from Andrographis paniculata (Family Acanthaceae). Although it possesses beneficial bioactivities to the skin, there is insufficient information of its applications for treatment of skin disorders due to low water solubility leading to complications in product development. To overcome the problem, an AG-loaded nanoemulsion (AG-NE) was formulated and prepared using a microfluidization technique. This study aimed to investigate the effect of pressure and the number of homogenization cycles (factors) on droplet size, polydispersity index and zeta potential of AG-NE (responses) and to determine the effect of AG-NE on skin cancer cells and UVB irradiation-induced skin disorders in rats. Relationships between factors versus responses obtained from the face-centered central composite design were described by quadratic models. The optimum value of parameters for the production of optimized AG-NE (Op-AG-NE) were 20,000 psi of pressure and 5 homogenization cycles. Op-AG-NE showed promising cytotoxicity effects on the human malignant melanoma- (A375 cells) and non-melanoma cells (A-431 cells) via apoptosis induction with a high selectivity index and also inhibited intracellular tyrosinase activity in the A375 cells. Op-AG-NE could reduce melanin index and healed UVB irradiation exposed skin. Op-AG-NE thus had potential for treatment of skin cancers and skin disorders from exposure to UVB radiation.

How we do it: ‘tonsil swabs please’ – an alternative use in open neck surgery

Background Thyroid and parathyroid surgery often involves the use of heated instruments for dissection. Whilst these are beneficial, accidental thermal damage to the exposed skin edges can occur, resulting in an unsatisfactory cosmetic outcome. Tonsil swabs can be used in head and neck surgery intra-operatively to control bleeding. This paper describes an alternative use for them in protecting wound edges during the procedure. Method Damp tonsil swabs are sutured onto the wound edges after the initial skin incision. They remain present for the duration of the surgery and are removed at the time of skin closure. Results The tonsil swabs provide protection and help avoid accidental injury to the skin. No complications with this technique have been experienced. Conclusion This paper describes a simple, effective and practical technique for protecting the skin during neck procedures using resources readily available in a standard ENT operating theatre.