Wenbo Bu

Surgery combined with photodynamic therapy for the treatment of Hidradenitis Suppurativa: A report of 7 cases

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease in the area of the apocrine sweat glands. The treatment of HS is relatively difficult. Therefore, surgery combined with PDT was applied to treat 7 cases of patients in this study, and treatment efficacy was observed. Simple surgical incisions and drainage were performed for patients with Hurley grade I. Surgical incisions and drainage as well as the removal of necrotic tissues were performed for patients with grades II and III. Immediately after surgery, PDT was performed. Their average Dermatology Life Quality Index (DLQI) was 24.14±4.26 before the surgery and 4.86±2.79 5 months after treatment, respectively. Scale (VSS) scores for evaluating scar formation were low to moderate after surgery and PDT. The experience of treating these 7 patients suggests that surgery combined with PDT might have a more pronounced effect, with the possible advantages of faster healing and less scarring.

Superficial resection combined with photodynamic therapy for successful treatment of facial lupus vulgaris with squamous cell carcinoma

Skin squamous cell carcinoma is the second most common non-melanoma skin tumor worldwide. Most skin squamous cell carcinoma patients have underlying diseases. Here, we report a 56u202fyear-old patient diagnosed with skin squamous cell carcinoma and with a 30u202fyear course of neglected lupus vulgaris, which was very rare. In this case, we adopted a treatment strategy involving a small wound: superficial resection combined with photodynamic therapy with a satisfied result.

Ultraviolet B radiation down-regulates ULK1 and ATG7 expression and impairs the autophagy response in human keratinocytes

Autophagy is a self-digestive pathway that helps to maintain cellular homeostasis, and many autophagy-related gene (ATG)s involved the regulation of the autophagy process. Ultraviolet light is a common stressor of skin, but it is unclear how autophagy is regulated after ultraviolet exposure in epidermal keratinocytes. Here, we found that the mRNAs of some key ATG genes such as ULK1, ATG5 and ATG7 exhibited significantly lower levels in the skin tissues of the face and chest with solar ultraviolet exposure, compared with perineal skin. Interestingly, UVB radiation down-regulated the expression of ULK1, ATG3 and ATG7, and it inhibited the autophagy flux via a mechanistic target of rapamycin (MTOR)-independent pathway in human keratinocytes. The inhibition of autophagy in UVB-treated keratinocytes cannot be restored by treatment with the MTOR-dependent autophagy inducer rapamycin. Importantly, UVB treatment perturbs the conversion of microtubule-associated protein 1 light chain 3 (LC3)-I to LC3-II and LC3-II turnover in response to treatment with MTOR inhibitors (Torin 1 and pp242), as well as endoplasmic reticular stress (A23187 and tunicamycin), inositol pathway (L690,330) and autophagy inducers (resveratrol and STF62247). Our study demonstrates that UVB radiation down-regulates several key autophagy-related proteins and impairs the autophagy response in keratinocytes. This study demonstrates a linkage between autophagy and skin disorders associated with ultraviolet exposure.

Is Ras a potential target in treatment against cutaneous squamous cell carcinoma

Hyperactive retrovirus-associated DNA sequence (Ras) genes have been found in human cancers and are involved in cancer pathogenesis. Salirasib, one anti-Ras compound, was reported to exhibit antitumoral effects, but its role remains unclear in cutaneous squamous cell carcinoma (cSCC). In our study, salirasib treatment led to deregulation of c-Raf, ERK and Akt signaling, blockage of MTOR signaling, interruption on Beclin 1-related autophagy regulation, activation of apoptosis and down-regulation of some cell cycle regulatory proteins in primary human epidermal keratinocyte (HEK)s, but did not exhibit similar effects in the human cSCC cell line COLO-16. MEK inhibitor U0126 can lead to dephosphorylation of MTOR and Rictor in COLO-16 cells; however, c-Raf was not yet down-regulated after salirasib treatment in the presence of U0126. Furthermore, we verified that the Ras activity could be suppressed by salirasib, and there was no loss-of-function mutation in c-Raf in HEKs and COLO-16 cells. In summary, salirasib does not exhibit antitumoral effects in the cSCC cells in assays in vitro. We speculated that the disability of signaling transmission from Ras to c-Raf in COLO-16 cells might contribute to the ineffective performance of salirasib.

Reconstruction of a buttock defect after excision of inflammatory linear verrucous epidermal nevus

Dear Editor, Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare variant of epidermal nevus. It typically presents in early childhood. It is usually unilateral and most often located on the lower half of the body, with a linear distribution that follows the lines of Blaschko (Kosann, 2003). ILVEN is significantly refractory to treatment; however, some therapies, including topical or intralesional steroids, topical retinoids, 5-fluorouracil, and calcineurin inhibitors may result in temporary improvement. For some difficult cases, surgical intervention may be successful (Burnett & Kouba, 2012). A 23-year-old female patient presented to our clinic with a linear, pruritic, erythematous, scaly, and verrucous plaque lesions on her left buttock, perianal region, and labium majus, which first appeared at 5months of age and exhibited gradual flaring. Approximately 10 years ago, she initiated treatment with moisturizing agents, topical corticosteroids, tretinoin, and antipsoriatic therapy, which were all ineffective. There is no deformity of her body and no other similar patient in her family. Physical examination indicated the presence of a 10 cm315 cm sized erythematous, scaly, and verrucous plaque on her left buttocks; as well as the erythematous, linear, scaly, and verrucous papular in the perianal region and labium majus (Figure 1). Skin biopsy revealed thin orthohyperkeratosis and parakeratotic layers, irregular acanthosis, papillomatosis, hyperpigmentation of the basement layer, and mild perivascular lymphocytic dermal infiltration, which led to the diagnosis of ILVEN. Surgery was performed to resolve the lesion. During the operation, a 10 cm 3 15 cm surgical defect on left buttock was left. For the young woman in this case, clinicians needed to consider both cosmetic as well as functional outcomes since the buttocks provide cushioning for sitting and serve as a socialized object of beauty and sexual attraction (Cuenca-Guerra & Lugo-Beltran, 2006). Full-thickness skin grafts and skin flaps can be taken into consideration for the reconstruction of the buttock defect. Full-thickness skin grafts are a well-established tool for the repair of skin defects. However, they are limited by the drawbacks associated with an additional surgical donor site, strict pressure dressing, and immobilization for at least 2 weeks. Furthermore, the function of the buttocks for cushioning and friction when sitting cannot be guaranteed. Additionally, contraction of the skin graft may result in asymmetry of both sides of the hips, which may result in destruction of the young lady’s hip contour. Pedicled myocutaneous flaps or local fasciocutaneous or perforator flaps or free flaps have been described for the surgical repair of large and deep gluteal defects, with large volume loss of both the skin and the fat, which occurs, most commonly, after trauma and pressure ulcer (Aggarwal & Pennington, 2013; Windhofer, Michlits, Gruber, & Papp, 2010). In our case, the resection only included the removal of skin and superficial subdermal fat. Additionally, it did not result in large volume loss, so the methods of those flaps were not necessary. Here, we describe the closure of buttock defect using a local rotation flap, which was designed adjacent to the defect (Figure 2). For the shape of the lesion on buttock is similar to triangle, and the skin tissue close to the defect is large and elastic enough to repair the defect, we designed an incision line along the base of the triangle, which length is equal to the base. And the

A case of granuloma faciale successfully treated with oral prednisone, tranilast and thalidomide

Address for correspondence: Xu Chen, Heng Gu, Institute of Dermatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Chinese Academy of Medical Science and Peking Union Medical College, 12 Jiangwangmiao St, 210042 Nanjing, China, phone: +86 25 8547 8919, fax: +86 25 85414477, e-mail: doctor_chx@hotmail.com, doctor_guheng@hotmail.com Received: 10.10.2016, accepted: 3.01.2017. A case of granuloma faciale successfully treated with oral prednisone, tranilast and thalidomide

Preliminary results of comparative study for subsequent photodynamic therapy versus secondary excision after primary excision for treating basal cell carcinoma

Some basal cell carcinomas (BCCs) are indistinguishable from nevi based on clinical manifestations. Therefore, it is often difficult for the excision margins of the initial surgical treatment to achieve radical removal of the malignancy. This study was a comparative analysis of the clinical results of aminolevulinic acid (ALA)-photodynamic therapy (PDT) or secondary surgery after the primary excision. In total, 20 patients with preoperative clinical diagnoses of nevi underwent in situ resection. The postoperative pathological diagnoses confirmed all cases were BCC. Ten patients received PDT twice after the primary excision, and 10 cases received extended resection after the primary excision. Patients were followed up for 8 months at least, and the 2 groups did not show statistically significant differences in the recurrence rate, while the PDT group had better results in terms of economic burden, healing period, and cosmetic satisfaction than the group with secondary surgery. Our study demonstrates that ALA-PDT can sever as a considerable remedial treatment for the BCC patients who have not accepted radical resection due to primary clinical misdiagnosis.

Long non-coding RNA expression profiling in the lesional tissue and derived fibroblasts of keloid

Introduction Long non-coding RNA (lncRNA) plays a key role in various disorders. However, its role in keloid is still unclear. Aim We explored differentially expressed (DE) lncRNAs and mRNAs between keloid tissue (KT)s and normal tissue (NT)s, as well as keloid fibroblast (KFB)s and normal fibroblast (NFB)s, respectively. Material and methods We use KTs and NTs from the chest of 5 patients, and 3 pairs of KFBs and NFBs, to perform microarray respectively. Gene ontology and pathway analyses were conducted by online software DAVID (Database for Annotation, Visualization and Integrated Discovery). The validation of targeted lncRNAs were conducted by qRT-PCR in enlarged samples (79 KTs and 21 NTs). Results We identified 3680 DE-lncRNAs in tissue essay, and 1231 DE-lncRNAs in cell essay. Furthermore, we found that many lncRNAs and their relative mRNAs were regulated simultaneously in keloid. We identified that ENST00000439703 and uc003jox.1 were up-regulated in both of the above essays through comparing the results of lncRNA screening between tissue essay and cell essay; the results were confirmed through qRT-PCR in enlarged samples. Conclusions Our study demonstrates that numerous lncRNAs are involved in the pathogenesis and development of the keloid.