| 1. |
- Frohm Nilsson, M., et al.
(författare)
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Comparison of two dye lasers in the treatment of port-wine stains
- 2010
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Ingår i: Clincal and Experimental Dermatology. - : Blackwell Publishing. - 0307-6938 .- 1365-2230. ; 35:2, s. 126-130
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Port-wine stains (PWS) are congenital capillary malformations that persist throughout life. Laser therapy is a common treatment for PWS, and pulsed-dye laser is the current treatment of choice.AIM: To compare the clinical results on untreated PWS of two dye lasers with different wavelengths and pulse duration: a flashlamp-pumped dye laser (FPDL) and a long-pulse-duration dye laser (LPDL).METHODS: In total, 24 patients were treated on 4-6 test areas with both laser types using high-energy and low-energy fluences. An FPDL with 0.45 ms pulse duration tuned to 585 nm was compared with an LPDL with 1.5 or 3.0 ms pulse duration tuned to 595 nm. Twelve weeks later the degree of lightening was evaluated by a blinded assessor. Pain was assessed directly after treatment with both lasers, using a visual analogue scale.RESULT: There was no significant difference overall between the two systems in lightening of the lesion or in patient-reported pain.CONCLUSION: Both laser systems are equivalent in terms of efficacy and pain.
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| 2. |
- Hagforsen, Eva, et al.
(författare)
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Somatostatin receptors are strongly expresssed in palmoplantar sweat glands and ducts : studies of normal and palmoplantar pustulosis skin
- 2011
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Ingår i: Clincal and Experimental Dermatology. - : Oxford University Press (OUP). - 0307-6938 .- 1365-2230. ; 36:5, s. 521-527
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe acrosyringium is the target for inflammation in the chronic and intensely inflammatory skin disease palmoplantar pustulosis (PPP). The sweat-gland apparatus seems to be an immunocompetent structure that probably contributes to skin defence. Furthermore, the sweat gland and duct may be a hitherto unrecognized neuroendocrine organ.AimTo obtain further information about the neuroendocrine properties of the sweat-gland apparatus by examining expression of the somatostatin receptors (SSTRs) 1-5 in healthy palmar skin and in PPP skin.MethodsBiopsy specimens were taken from 25 patients with PPP and 25 healthy controls. Immunohistochemical analysis was used to investigate expression of SSTRs 1-5.ResultsSSTRs 1-5 were expressed in both epidermal and endothelial structures. The staining intensity of the sweat-gland apparatus was more pronounced than that of the epidermis. Expression differed significantly between lesional PPP and normal plantar skin, with increased expression of SSTRs 3 and 4 in ducts in epidermis, and decreased expression of SSTR 1 in ducts in both papillary and reticular dermis. In specimens with pronounced inflammation, numerous dendritic cells with strong expression of SSTRs 1.. 2 and 4 were seen, especially in the papillary dermis.ConclusionsThe presence of SSTRs in palmoplantar skin, and specifically at high density in the sweat glands and ducts, might be of particular importance in skin neuroimmunoendocrinology. Although the relevance of the changes in SSTR expression in PPP skin compared with normal skin is unclear, our hypothesis is that these differences might influence the function of both the neuroendocrine and neuroimmunological properties of palmoplantar skin, especially in the sweat-gland apparatus.
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| 3. |
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| 4. |
- Paoli, John, 1975, et al.
(författare)
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Nerve blocks provide effective pain relief during topical photodynamic therapy for extensive facial actinic keratoses
- 2008
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Ingår i: Clinical and Experimental Dermatology. - : Oxford University Press (OUP). - 1365-2230 .- 0307-6938. ; 33:5, s. 559-64
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Photodynamic therapy (PDT) is a first-line therapeutic option for skin areas with multiple actinic keratoses (AKs). Its main drawback is the pain perceived during the irradiative phase, especially when treating field cancerization in the facial area. Effective pain-relieving strategies are needed. AIM: To determine the effectiveness of peripheral nerve blocks in achieving pain relief during PDT for extensive facial AKs. METHODS: In total, 16 patients with symmetrically distributed facial AKs, mainly on the forehead, were enrolled in the study. Nerve blocks were applied unilaterally, and the nonanaesthetized side of the treatment area served as control. Maximum pain during PDT was evaluated using a visual analogue scale (VAS). Pain experienced after PDT was evaluated by telephone interview within 2 weeks of treatment. Cure rates were assessed at follow-up at least 4 weeks after treatment. RESULTS: Pain was significantly reduced on the anaesthetized side (P < 10(-8)). The mean +/- SEM VAS score on the blocked side of the face was 1.3 +/- 0.3 compared with 7.5 +/- 0.5 on the nonanaesthetized side. Pain relief persisted 1-2 h after PDT. The nerve block was generally not experienced as painful (14/16 patients). Almost all patients (15/16 patients) would like to receive nerve blocks bilaterally if future PDT were needed. Excellent clinical results were observed in all patients after 4-20 weeks. CONCLUSION: Nerve blocks provide efficient pain relief during PDT when treating patients with field cancerization of the forehead. Nerve blocks were not found to affect the clinical outcome of PDT, and were generally well tolerated by the patients.
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| 5. |
- Sonkoly, E, et al.
(författare)
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MicroRNAs : novel regulators in skin inflammation.
- 2008
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Ingår i: Clincal and Experimental Dermatology. - : Oxford University Press (OUP). - 0307-6938 .- 1365-2230. ; 33:3, s. 312-5
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Tidskriftsartikel (refereegranskat)abstract
- Compelling evidence indicates that microRNAs (miRNAs), short, non-protein coding RNAs, are critical for the development and survival of multicellular organisms. Recently, miRNAs were implicated in the pathogenesis of psoriasis and atopic eczema (AE), the two most common chronic inflammatory disorders in skin. In particular, miR-203, the first skin-specific miRNA, showing an intriguing expression profile being confined to skin epithelium, is specifically overexpressed in psoriasis. MiR-146a, another miRNA showing specific upregulation in psoriasis, is involved in the regulation of innate immune responses and the tumour necrosis factor (TNF)-alpha pathway. Interestingly, miR-125b, another miRNA involved in the TNF-alpha pathway, is also deregulated in psoriasis and AE. As skin inflammation may serve as a model for chronic inflammatory disorders, it is likely that miRNAs involved in skin inflammation will eventually emerge in other inflammatory or autoimmune disorders, and some of these may become disease markers and therapeutic targets. In this review we present an overview of what is currently known about the roles of miRNAs in chronic inflammatory skin disorders.
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| 6. |
- Egeberg, Alexander, et al.
(författare)
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Real-world dose adjustments of biologic treatments in psoriasis and their economic impact : a Swedish national population study
- 2022
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Ingår i: Clincal and Experimental Dermatology. - : Wiley. - 0307-6938 .- 1365-2230. ; 47:11, s. 1968-1975
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Tidskriftsartikel (refereegranskat)abstract
- Background To date, evidence on the dose adjustments of biologics in the real-world treatment of psoriasis is limited. However, dose adjustments may have important clinical and economic implications. Aims To study the dose adjustments of individual biologics over time in real-world practice in Sweden. Methods A retrospective observational study of adults with moderate to severe psoriasis was conducted based on Swedish national registry data from 2010 to 2018. Treatment episodes were identified for individual patients from the date of drug dispensation to the end of the supply of the drug. Dosing data were expressed as the proportion of treatment episodes with accumulated syringes/vials equal to, above or below the recommended guidelines. Real-world costs were calculated and compared with costs predicted from dosing guidelines. Results The mean dose was above recommended levels for all biologics investigated. Weighted mean dose adjustments for adalimumab, etanercept, secukinumab and ustekinumab were 13%, 23%, 8% and 3%, respectively, over the entire treatment period. Higher doses translate to higher costs, including notable increases over time vs. expected costs for secukinumab. Conclusions Dose adjustments of biologics are frequent in clinical practice but differ for the various biologics. The mean observed increases in dose above guideline recommendations might indicate perceptions of suboptimal efficacy for biologics, with implications for the cost and cost-effectiveness of these treatments. Further research is warranted to understand the reasons for dose adjustments in clinical practice.
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| 7. |
- Frewen, J., et al.
(författare)
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Shin-pad dermatitis in a young footballer
- 2021
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Ingår i: Clinical and experimental dermatology. - : Oxford University Press (OUP). - 0307-6938 .- 1365-2230. ; 46:7, s. 1379-1380
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Tidskriftsartikel (refereegranskat)
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| 8. |
- Grapengiesser, S., et al.
(författare)
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Pain caused by photodynamic therapy of skin cancer
- 2002
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Ingår i: Clincal and Experimental Dermatology. - 0307-6938 .- 1365-2230. ; 27:6
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Tidskriftsartikel (refereegranskat)abstract
- Pain resulting from photodynamic therapy (PDT) of skin cancer was investigated. The study included 69 lesions (60 patients) with different types of skin tumours or precursors. Protoporphyrin IX, which is produced by the topical application of delta-aminolevulinic acid, was used as a photosensitizing agent. Twenty-three of the lesions (19 patients) were examined with a fluorescence imaging system which demarcates the tumour area from the healthy skin and visualizes the contrast between the fluorescence from healthy skin and that from the tumour. EMLA is used on all patients as part of our routine PDT protocol but despite this the major side-effect of PDT is pain during treatment. There is a large variation in pain intensity experienced by the patients, as measured by a visual analogue scale (VAS). Patients with actinic keratoses experienced more pain than those with Bowen's disease or basal cell carcinoma. The mean VAS score was higher when treating lesions located on the head than when treating lesions on the torso or the extremities. Also, treatment of large skin areas resulted in more pain than treatment of small areas, and men experienced more pain than women. The pain experienced by the patients did not correlate with treatment dose, Fitzpatrick skin type, age or fluorescence intensity.
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| 9. |
- Prosén, Sara, 1980-, et al.
(författare)
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Increased expression of LAT1 in basal cell carcinoma : implications for tumour cell survival
- 2022
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Ingår i: Clincal and Experimental Dermatology. - : Wiley-Blackwell Publishing Inc.. - 0307-6938 .- 1365-2230. ; 47:5, s. 910-917
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Basal cell carcinoma (BCC) is the most common type of cancer in fair-skinned individuals worldwide. Altered metabolism is a hallmark of cancer, and a growing body of evidence has shown increased expression of the large neutral amino acid transporter (LAT) small subunit 1 in several types of cancers, including BCC. However, the mechanisms behind changed LAT1 expression in BCC are largely unknown.OBJECTIVES: To describe the protein expression of LAT1 and its co-localisation with LAT2, and to examine LAT1 in association with BCC tumour biology characteristics such as cell proliferation, apoptosis, and hypoxia.METHODS: Formalin-fixed and paraffin-embedded tissue samples (n=14) from excised BCCs were stained with immunofluorescence and examined regarding protein-staining patterns.RESULTS: There was no correlation between expression of LAT1 and LAT2, and the co-localisation was low. The proliferation markers topoisomerase IIα and Ki-67 both showed a significantly higher expression in the BCC tissue than in the normal epidermis (p=0.0063 and p=0.010, respectively). The fraction of LAT1-expressing cells in the BCC was inversely correlated to the fraction of proliferative active tumour cells (p=0.0013). Cleaved caspase-3 was significantly increased in tumour areas with high LAT1 expression (p=0.016).CONCLUSIONS: The findings of the present study show that LAT1 is not usually expressed by proliferating BCC cells. The morphological localisation suggests that tumour cells use LAT1 in adaption to environmental changes such as starvation and/or hypoxia. These findings could have implications for future development of LAT1-inhibitory BCC treatments.
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| 10. |
- Vahlquist, Anders, et al.
(författare)
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A Scandinavian case of skin fragility, alopecia and cardiomyopathy caused by DSP mutations
- 2014
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Ingår i: Clincal and Experimental Dermatology. - : Oxford University Press (OUP). - 0307-6938 .- 1365-2230. ; 39:1, s. 30-34
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Tidskriftsartikel (refereegranskat)abstract
- Congenital skin fragility is a heterogeneous disorder with epidermolysis bullosa and various skin infections as the leading causes. However, even rare diseases must be considered in the differential diagnosis of neonatal skin blistering, including some genetic syndromes with extracutaneous involvement. One such syndrome is ectodermal dysplasia due to deficiency of desmoplakin, a desmosomal protein essential for cellular cohesion in both epithelia and cardiac tissues. Desmoplakin is encoded by the DSP gene, which is localized on chromosome 6p24. Both dominant and recessive mutations in this gene have been reported to cause skin fragility and keratinization defects. We report a child born with a fragile epidermis, alopecia, thick nails, and focal hyperkeratoses on the digits and knees. She was found to have a deficiency of desmoplakin caused by compound heterozygous DSP mutations. She has gradually developed signs of a left ventricular cardiomyopathy.
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| 11. |
- Yu, H., et al.
(författare)
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Increased expression of Toll-like receptor 7 and 9 in vitiligo melanocytes: a pilot study
- 2021
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Ingår i: Clincal and Experimental Dermatology. - : WILEY. - 0307-6938 .- 1365-2230. ; 46:1, s. 89-95
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Tidskriftsartikel (refereegranskat)abstract
- Background Toll-like receptors (TLRs) are expressed on human melanocytes, and play an important role in innate and acquired immunity. The role of TLRs in the pathogenesis of vitiligo has not been fully described. Aim To investigate the expression of TLRs in melanocytes from patients with vitiligo and healthy controls (HCs). Methods Primary cultured vitiligo and control melanocytes were obtained from perilesional normal skin of patients with generalized vitiligo and HCs. TLRs mRNA expression in melanocytes were determined by real-time reverse transcription PCR and protein expression by western blotting. Apoptosis was analysed using an annexin V-fluorescein isothiocyanate apoptosis detection kit, and tyrosinase activity and melanin content were measured by a modified dopachrome and colorimetric method. Interleukin (IL)-6, IL-8 and soluble cell adhesion molecule (sICAM)-1 expression were measured by ELISA. Results In vitiligo melanocytes, compared with control melanocytes, apoptosis rate, expression of TLR7 and TLR9 mRNA and protein, and production of IL-8, IL-6 and sICAM-1 were significantly increased, whereas tyrosinase activity and melanin content were significantly decreased. Conclusions Our results suggest that the increased expression of TLR7 and TLR9 might correlate with melanocyte dysfunction in vitiligo.
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| 15. |
- Rea, S., et al.
(författare)
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A feasibility study for a triple-blind randomized controlled trial investigating the effects of oral isotretinoin on mood and quality of life in patients with acne vulgaris
- 2018
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Ingår i: Clinical and Experimental Dermatology. - : Oxford University Press (OUP). - 0307-6938. ; 43:1, s. 54-56
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Tidskriftsartikel (refereegranskat)abstract
- Isotretinoin is used in the treatment of severe acne vulgaris (AV), but has controversially been associated with depression and suicide. Large prospective studies have failed to translate this clinically. We undertook a feasibility study to investigate the parameters of a triple-blind, randomized controlled trial (RCT) assessing the effect of oral isotretinoin on quality of life (QoL) and mood in patients with AV. Patients meeting the inclusion criteria were randomized for 2weeks to isotretinoin or doxycycline. Participants completed verified depression and QoL screening questionnaires at baseline and week 2. In total, 194 patients with AV were screened, with 48 meeting the inclusion criteria and 13 of these being willing to participate. The follow-up rate was 92% and questionnaire response rate was 96%. To our knowledge, this is the first study to demonstrate a successful design for a triple-blind RCT investigating the effects of isotretinoin on mood in patients with AV.
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| 16. |
- Hagelin, Susanna, et al.
(författare)
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Wind speed vertical distribution at Mt Graham
- 2010
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 407:4, s. 2230-2240
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Tidskriftsartikel (refereegranskat)abstract
- The characterization of the vertical distribution of wind speed, V (h), is fundamental for anastronomical site for many different reasons: (i) the wind speed shear contributes to triggeroptical turbulence in the whole troposphere; (ii) a few of the astroclimatic parameters, suchas the wavefront coherence time (τ0), depend directly on V (h); (iii) the equivalent velocityV0, controlling the frequency at which the adaptive optics systems have to run in order towork properly, depends on the vertical distribution of the wind speed and optical turbulence.Also, too strong a wind speed near the ground can introduce vibrations in the telescopestructures. The wind speed at a precise pressure (200 hPa) has frequently been used to retrieveindications concerning τ0 and the frequency limits imposed on all instrumentation based onadaptive optics systems. However, more recently, it has been proved that V200 (the wind speedat 200 hPa) alone is not sufficient to provide exhaustive elements concerning this topic, andthus the vertical distribution of the wind speed is necessary. In this paper, we report on acomplete characterization of the vertical distribution of wind speed strength, which has beencarried out above Mt Graham (Arizona, USA), the site of the Large Binocular Telescope.We provide a climatological study extended over 10 yr using the operational analyses fromthe European Centre for Medium-Range Weather Forecasts (ECMWF). We prove that this isrepresentative of the vertical distribution of the wind speed at Mt Graham, with the exceptionof the boundary layer. We also prove that a mesoscale model can provide reliable nightlyestimates of V (h) above this astronomical site from the ground up to the top of the atmosphere(∼20 km).
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