BACKGROUND AND OBJECTIVE

Orthodontic brackets predispose dental biofilm accumulation causing caries and gingivitis. Chlorhexidine is an adjunct to mechanical plaque removal, but has side-effects (tooth staining, bacterial resistance) due to long term use. This study tested the efficacy of Photodynamic Therapy, which produces reactive oxygen species, to reduce Streptococcus mutans in dental biofilm on orthodontic brackets.

A 5-day S. mutans biofilm was grown on forty enamel-bracket specimens. Thirty-nine specimens were randomized to three treatment groups: A. Distilled Water; B. 0.12% Chlorhexidine (CHX); C. Photodynamic Therapy (PDT) using Toluidine Blue O (TBO) as a photosensitizer, activated by red LED (630nm). After treatment, one random specimen from each group was viewed under Environmental Scanning Electron Microscopy (ESEM); the other 12 specimens, biofilms were collected, weighed, and cultured onto BHI agar plates to determine the number of CFU/mg. For baseline evaluation, one clean and one untreated specimens were preserved for ESEM.

Based on Tukey HSD test, group A had the most S. mutans (37.0573 CFU/mg) and was significantly different (pCONCLUSION

Both Photodynamic Therapy and 0.12% Chlorhexidine showed a significant reduction of S. mutans in dental biofilm on orthodontic brackets. However, there is no significant difference between them in reducing S. mutans CFU/mg. Photodynamic therapy could be an alternative adjunctive tool to mechanical removal of plaque adhered to orthodontic brackets.

Background: Dermoscopy enhances detection of basal cell carcinoma (BCC), especially for the pigmented subtype common among Asians. However, there is limited data on dermoscopic features of BCC in Filipinos. Objectives: The objective of this study is to describe the clinicopathologic profile and dermoscopic features of BCC in Filipinos seen in a tertiary care clinic. Methods: A cross-sectional study was conducted in the Philippines from November 2019 to December 2021 in a tertiary care clinic. Fifty-three (53) lesions suspicious for BCC were analyzed using dermoscopy prior to histologic confirmation. Fifty (50) biopsy-proven BCC lesions were included in the analysis. Results: Lesions were more commonly seen in females (72.50%), and located on the head and neck (88%). The most common histopathologic subtype was nodular (74%). The most common dermoscopic features were large blue-gray ovoid nests (86%) and ulcerations (70%). Conclusion The most common BCC type among the study participants was nodular, with large blue-gray ovoid nests and ulceration seen on dermoscopy.
carcinoma, basal cell ; dermoscopy

Incontinentia Pigmenti (IP) is an X-linked dominant genodermatosis caused by a mutation of the NEMO or IKBKG gene. Cutaneous manifestations are common, however, involvement of the eyes, teeth, and central nervous system can also be seen. Genetic counseling plays a vital part in the management, as well as a multidisciplinary approach involving other specialties.

This is a case of a newborn female with unremarkable birth and maternal history who presented with erythematous papules, vesicles, and pustules on the trunk, upper extremities, and lower extremities upon birth. She was born term via normal spontaneous delivery to a 34-year-old G1P0 with no known personal and family history of dermatologic or other genetic conditions. On the 5th day of life, lesions started to form a whorl-like appearance, eventually turning hyperpigmented, with a blaschkoid distribution. Skin punch biopsy revealed several eosinophils on the dermis highly suggestive of IP. Dermoscopy showed polycyclic scaling with a yellowish center and erythematous halo. Genetic testing revealed a heterozygous pathogenic deletion encompassing exons 4-10 of the IKBKG gene, confirming the diagnosis of IP. Genetic counseling was done. The patient’s family was advised periodic monitoring and surveillance.

Dermoscopy in IP can provide an earlier diagnosis. Stage I shows a yellowish center and erythematous halo with yellowish serocrusts surrounded by polycyclic scaling. Only two cases of IP dermoscopy have been published so far. Dermoscopy complements histopathology in IP.

Leprosy presents diversely, making diagnosis challenging. Histoid leprosy is a rare variant with atypical features. We present a case of a 40-year-old Filipino male with multiple erythematous to flesh colored, well demarcated hypoesthetic nodules primarily on his back and abdomen. Dermoscopy revealed features of granulomatous disease. Fite-Faraco stain showed globi formation. Skin biopsy showed epidermal atrophy, dense histiocyte infiltrates and collagen trapping. While histoid leprosy is uncommon in patients without a prior history of leprosy and treatment, this case highlights the importance of maintaining a high index of suspicion, especially in endemic regions. Early diagnosis and prompt multidrug therapy are crucial for preventing transmission and improving patient outcomes.

Pyoderma gangrenosum causes the destruction of skin tissue and then ulceration. There are currently no international treatment guidelines. Abrocitinib, a JAK1 selective inhibitor, has been used as treatment in some case reports.

A 54-year-old female, diagnosed for 20 years with ulcerative colitis and mostly treated with Chinese herbal medicine, admitted for a solitary painful ulcer on the right lateral ankle, measuring 10x8 cm, with swelling of the right lower leg. Antibiotics were given and wound debridement, exploration, then vacuum-assisted closure dressing were done. She was then referred to dermatology service. Wound care was done by light cleansing of the wound with cold-pressed virgin coconut oil (CP-VCO) - soaked gauze, gentle removal of wound and edge scabs, application of 30% Trichloroacetic Acid on the rounded edges of the ulcer, and covered with a gauze saturated with CP-VCO dressing. Abrocitinib 200 mg/tablet was started once a day. After being discharged, abrocitinib and wound care, with an added pharmacist-compounding of 4% monolaurin, 1% monocaprin, and 10% tranexamic acid in a petrolatum base, was maintained with the same dosage and frequency. At the end of the fourth month, the ulcer completely healed into a solitary pinkish to skin-colored linear scar, measuring at 1.8x4 cm. Dermoscopy monitoring of the wound healing showed progressive lines of epithelialization advancing into the ulcer to a scar with a cribriform pattern of epithelialized red dots.

The excellent results from this pyoderma gangrenosum case report using a combination of these treatment modalities are an opportunity to consider in future clinical cases.

BACKGROUND

Accurate diagnosis of onychomycosis is important because its treatment is long-term, costly, and sometimes with complications. KOH test is quick and cheap but has low sensitivity. Hence, the need for additional tests such as culture and/or PAS. However, these two tests are not readily available and expensive. Dermoscopy is an emerging tool for the diagnosis of nail conditions.

This study aims to evaluate the accuracy of dermoscopy as a point-of-care tool in diagnosing distal subungual onychomycosis (DSO).

This is a prospective, cross-sectional study of 22 clinically diagnosed DSO patients selected via convenience sampling in a tertiary hospital from November 2019 to March 2021. Participants had gross nail examination, dermoscopy, KOH and PAS tests. Measures of diagnostic accuracy for the different dermoscopic patterns were obtained, with KOH and PAS results as reference standard.

Fifty-one nail samples were submitted for processing with only 49 nails accepted for analysis. The most common pattern was jagged edge with spikes (65.3%). Combining all 5 dermoscopic patterns increased the sensitivity to 91.2% (95% CI: 76.3, 98.1).

Dermoscopy may be used as a first-step, point-of-care tool in the diagnosis of DSO. Addition of mycological and histopathological tests is still warranted for confirmation.

BACKGROUND

Hansen’s Disease, a chronic infectious disease, presents with a variety of cutaneous lesions. Being the “great mimicker” that it is, patients may often be misdiagnosed initially, hence the delay in the initiation of the multidrug therapy. Dermoscopy offers an effective, efficient, operator-friendly and non-invasive adjunctive tool in the diagnosis of Hansen’s Disease.

The general objective of the study is to describe the common dermoscopic features according to clinical and histologic findings among all newly diagnosed Hansen’s Disease patients in a tertiary institution within the study period of 6 months.

Purposive sampling was applied to include all newly diagnosed and biopsy-proven Hansen’s Disease patients aged 18 years to 65 years. Participants were clinically examined and dermoscopy was performed on a representative lesion. Other data were collected from chart review, acid fast smear and histopathology reports.

The main dermoscopic feature of Hansen’s Disease is yellowish orange areas observed in all 23 cases studied regardless of the spectrum. This feature can be attributed well to the presence of granuloma formation and inflammation. Another common feature is the presence of white globules and dots which correlates to the presence of the grenz zone, while vascular structures correlate with dilated blood vessels on histopathology.

The major dermoscopic features seen in the study may add to the clinical clues to arrive at a diagnosis of Hansen’s Disease. Although dermoscopy alone is insufficient for the confirmation of Hansen’s Disease, combining it with physical findings would provide additional basis for its clinical diagnosis.

Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ²=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.
Male ; Humans ; Female ; Adult ; Middle Aged ; Nasopharyngeal Carcinoma ; China ; Microscopy ; Organoids ; Nasopharyngeal Neoplasms

Humans ; Microscopy ; Vocal Cords

OBJECTIVES: The current study aimed to investigate the bonding properties of a novel low-shrinkage resin adhesive containing expanding monomer and epoxy resin monomer after thermal cycling aging treatment. METHODS: Expanding monomer of 3,9-diethyl-3,9-dimethylol-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) as an anti-shrinkage additive and unsaturated epoxy monomer of diallyl bisphenol A diglycidyl ether (DBDE) as a coupling agent were synthesized. A blend of DDTU and DBDE at a mass ratio of 1∶1, referred to as "UE", was added into the resin matrix at the mass fraction of 20% to prepare a novel low-shrinkage resin adhesive.Then, the methacrylate resin adhesive without UE was used as the blank control group, and a commercial resin adhesive system was selected as the commercial control group. Moreover, the resin-dentin bonding and micro-leakage testing specimens were prepared for the thermal cycling aging treatment. The bonding strength was tested, the fracture modes were calculated, the bonding fracture surface was observed by scanning electron microscope (SEM), and the dye penetration was used to evaluate the tooth-restoration marginal interface micro-leakage. All the data were analyzed statistically. RESULTS: After aging, the dentin bonding strength of the experimental group was (19.20±1.03) MPa without a significant decrease (P>0.05), that of the blank control group was (11.22±1.48) MPa with a significant decrease (P<0.05) and that of the commercial control group was (19.16±1.68) MPa without a significant decrease (P>0.05). The interface fracture was observed as the main fracture mode in each group after thermal cycling by SEM. The fractured bonding surfaces of the experimental group often occurred on the top of the hybrid layer, whereas those of the blank and commercial control groups mostly occurred on the bottom of the hybrid layer. Micro-leakage rating counts of specimens before and after thermal cycling were as follows: the experimental group was primarily 0 grade, thereby indicating that a relatively ideal marginal sealing effect could be achieved (P>0.05); meanwhile, the blank control group was primarily 1 grade, and the penetration depth of dye significantly increased after thermal cycling (P<0.05); the commercial control group was primarily 0 grade without statistical difference before and after thermal cycling (P>0.05), while a significant difference was observed between the commercial control group and experimental group after thermal cycling (P<0.05). CONCLUSIONS The novel low-shrinkage resin adhesive containing 20%UE exhibited excellent bonding properties even after thermal cycling aging treatment, thereby showing a promising prospect for dental application.
Composite Resins ; Dental Bonding ; Dental Cements ; Surface Properties ; Resin Cements ; Dentin-Bonding Agents ; Dentin ; Materials Testing ; Microscopy, Electron, Scanning