BACKGROUND: Psoriasis is a multifactorial disease associated with an increased risk for metabolic syndrome and cardiovascular diseases. Elevated levels of homocysteine (Hcy) are a marker of cardiovascular risk. Several studies have evaluated the associations between psoriasis and Hcy levels; however, the results remain inconclusive. OBJECTIVE: We performed a systematic review of the literature and a meta-analysis to better understand the relationship between psoriasis and Hcy. METHODS: Five scientific databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) were searched to identify relevant studies. A review of 307 publications identified 16 studies that directly assessed plasma levels of Hcy in psoriasis patients. RESULTS: A total of 16 studies including 2,091 subjects were included in the meta-analysis. Hcy levels were significantly higher in psoriasis patients relative to healthy controls (weighted mean difference [WMD], 3.30; 95% confidence interval [CI], 1.58∼5.02; I²=82.1%). Subgroup analyses revealed that patients with higher mean psoriasis area severity index (PASI) scores (PASI>10) had significantly higher Hcy levels compared to healthy controls (WMD, 4.17; 95% CI, 1.18∼7.16; I²=88.3%), whereas patients with lower mean PASI scores (PASI ≤10) had not (WMD, 0.76; 95% CI, −1.84∼3.35; I²=72.2%). CONCLUSION: This meta-analysis found that psoriasis patients, in particular those with PASI >10, had significantly higher Hcy levels compared to healthy controls. Further research is needed to determine the association between Hcy levels and psoriasis severity.
Cardiovascular Diseases ; Homocysteine ; Humans ; Plasma ; Psoriasis

No abstract available.
Masseter Muscle*

BACKGROUND: Q-switched lasers have made it possible to remove tattoos without leaving unsightly scars. OBJECTIVE: Tobdetermine the optimal time for permanent makeup removal using Q-switched Nd:YAG and ruby lasers, we compared the degree of removal and associated histological changes following irradiation at different time points. METHODS: Using black ink and a permanent makeup machine, we performed 108 separate permanent makeup applications on rat skin. The 1,064-nm Q-switched Nd:YAG laser (QSNDL) and 694-nm Q-switched ruby laser (QSRL) were used to irradiate the permanent makeup on the day of its application and also 3, 5, 7, 14, and 21 days later. We assessed changes in pigmentation over time at each irradiated site using Mexameter® measurements and skin biopsies. RESULTS: The Mexameter® analysis demonstrated no significant differences in pigment removal among irradiations with QSNDL or QSRL on the day of permanent makeup application or at 3, 5, 7, 14, and 21 days later. Histological analysis demonstrated that permanent makeup pigment migrated from the epidermis to the superficial and mid dermis over time. QSNDL more effectively removed pigment throughout the epidermis and dermis compared to QSRL. CONCLUSION: For maximum pigment removal efficacy, the melanin index results suggest that laser treatment should be performed on the day permanent makeup is applied. However, from the histological perspective, permanent makeup should be removed approximately 1 week later, at which point the crusts have peeled off and the wound repair process is almost complete. In this study, histological analysis suggested the superiority of treatment with QSNDL to that with QSRL.
Animals ; Biopsy ; Cicatrix ; Dermis ; Epidermis ; Ink ; Lasers, Solid-State* ; Melanins ; Pigmentation ; Rats ; Skin* ; Wounds and Injuries

Mycosis fungoides (MF) represents the prototype of cutaneous T-cell lymphoma, which is defined as clonal expansion of skin-homing T lymphocytes. The natural history of MF is characterized by an indolent progression through patch, plaque, tumor, and visceral stages; however, this progression is not necessarily seen in all patients. Classically, the atypical lymphocytes in MF are CD3/CD4 positive with a loss of CD7. However, fewer than 5% of cases of MF present with a cytotoxic/suppressor CD8 positive phenotype, which presents with a variety of clinical features, including granulomatous, folliculotropic, poikilodermatous, hypopigmented, and hyperpigmented MF. Different immunophenotypic variants have been reported in MF but seem to lack any specific behavior and prognosis. Herein, we report a rare case of hyperpigmented MF with CD8 positive cells.
Humans ; Hyperpigmentation ; Lymphocytes ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; Natural History ; Phenotype ; Prognosis ; T-Lymphocytes

Papular elastorrhexis is a rare entity, possibly a form of connective tissue nevi, characterized by asymptomatic white papules on the trunk and extremities first appearing during childhood or adolescence. Histopathologically, the elastic fibers are decreased and may appear in thin and fragmented forms. This rare condition has clinical and histological findings that overlap with those of other connective tissue nevi, making diagnosis a challenge for dermatologists. Herein we report the case of a 27-year-old Korean female presenting with asymptomatic 2~5 mm sized whitish papules on both extremities and showing histopathologic findings of increased layers of collagen fibers and decreased and fragmented elastic fibers in the dermis.
Adolescent ; Adult ; Collagen ; Connective Tissue ; Dermis ; Diagnosis ; Diagnosis, Differential* ; Elastic Tissue ; Extremities ; Female ; Humans ; Nevus

No abstract available.
Pilomatrixoma*

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.
Adult ; Amputation ; Arteries ; Fingers ; Humans ; Male ; Metacarpophalangeal Joint* ; Replantation* ; Skin ; Surgeons ; Tendons ; Veins* ; Wounds and Injuries*

Chronic subdural hematoma (CSDH) is a collection of old blood and its breakdown products between the surface of the brain parenchyma and the outermost layer called the dura. The most common treatment option for primary CSDH is burr-hole trephination; however, the treatment method for recurrent CSDH is still widely debated. An arachnoid cyst (AC) is a sac filled with cerebrospinal fluid located between the brain or spinal cord and the arachnoid membrane, which is one of the three meninges covering the brain or spinal cord. Although it is rare, the cyst is associated with CSDH in juveniles, and the recurrence rate of CSDH increases in such cases. Much of the literature has supported the preventive role of middle meningeal artery (MMA) embolization in recurrent CSDH. We report a 13-year-old male patient with recurrent CSDH and AC where the early intervention of MMA embolization was proven effective in preventing the further recurrence of CSDH.
Adolescent ; Arachnoid Cysts ; Arachnoid* ; Brain ; Cerebrospinal Fluid ; Early Intervention (Education) ; Embolization, Therapeutic ; Hematoma, Subdural, Chronic* ; Humans ; Male ; Membranes ; Meningeal Arteries* ; Meninges ; Recurrence ; Spinal Cord ; Trephining