Abstract in English:

Abstract Background: Chromoblastomycosis is a chronic granulomatous fungal infection of the skin and subcutaneous tissue caused by dematiaceous fungi of the family Herpotrichiellaceae. It is considered an occupational disease, predominantly affecting male agricultural workers, with a worldwide distribution, especially in tropical and subtropical regions. Fonsecaea pedrosoi accounts for approximately 90% of reported cases. Objective: To describe the etiological agents, clinical features, and major complications asso-ciated with chromoblastomycosis. Methods: A retrospective, descriptive, and observational study presenting a case series was conducted, focusing on the pathogenesis, clinical presentation, disease course, and reported complications of chromoblastomycosis. Results: A total of 131 cases of chromoblastomycosis were documented; 10 patients (7.65%) developed squamous cell carcinoma. The mean age was 65.8-years, and the mean disease duration prior to malignant transformation was 17.4-years. The most frequently affected site was the upper limb (70%), followed by the lower limb (20%) and the trunk (10%). Study limitations: The descriptive nature of this review limits causal inference and precise estimation of malignant transformation rates. Conclusion: Chromoblastomycosis is a chronic, polymorphic cutaneous infection often diag-nosed late, leading to long-standing disease and disabling sequelae. Malignant transformation to squamous cell carcinoma represents one of its most severe complications and may occur even in residual scars. Early diagnosis and prolonged follow-up are essential to reduce morbidity and prevent malignant progression.

Abstract in English:

Abstract Background: Bullous Pemphigoid (BP) and Atrial Fibrillation (AF) share common underlying mechanisms involving chronic inflammation, but their relationship was unclear. Objective: To assess the risk of incident AF in individuals with BP. Methods: This nationwide cohort study utilized Taiwan’s National Health Insurance Research Database from 2011 to 2019. Adults newly diagnosed with BP were identified and initially matched by age and sex to controls without BP. Stabilized inverse probability weighting was applied to balance baseline characteristics between cohorts. Cox proportional hazards models were used to estimate Hazard Ratios (HRs) and 95% Confidence Intervals (95% CIs) for incident AF. Subgroup analyses were performed by age and sex, along with several sensitivity analyses. Results: During the follow-up period, AF occurred in 510 of the 9,554 patients in the BP group and 1,902 of the 52,015 individuals in the non-BP group, corresponding to an incidence of 15.03 and 7.99 per 1,000 person-years, respectively. BP was associated with an increased risk of incident AF (HR 1.83; 95% CI 1.66-2.02). This association persisted across analyses stratified by age and sex. The findings were consistent across multiple sensitivity analyses. Study limitations: The unavailability of data on potential confounders such as lifestyle factors (smoking, alcohol, obesity) and disease severity. Conclusions: BP is linked to a heightened risk of AF. Prompt recognition of AF and timely cardiology referrals may be warranted in BP patients presenting with suggestive symptoms.

Abstract in English:

Abstract Background: Isotretinoin is an effective therapy for acne vulgaris, but its impact on thyroid function remains uncertain, with existing studies reporting inconsistent biochemical changes. Objective: To assess the effects of oral isotretinoin on serum thyroid function parameters and thyroid antibody levels in patients with acne vulgaris. Methods: A systematic review and meta-analysis of observational studies was conducted according to PRISMA guidelines and prospectively registered (INPLASY202560049). PubMed, Sco-pus, Embase, and Web of Science were searched from January 1980 to September 2025. Studies reporting serum thyroid parameters before and during isotretinoin therapy were included. Random-effects meta-analyses were performed for parameters reported in more than three studies. Heterogeneity was assessed using the I2 statistic, and risk of bias using NIH tools. Results: Fifteen studies were included. Meta-analysis showed a small statistically significant increase in thyroid-stimulating hormone after isotretinoin treatment (MD = 0.03, 95% CI 0.02-0.05, p < 0.001), with significant decreases in thyroxine (MD = -0.19, 95% CI -0.24 to -0.15, p < 0.001) and triiodothyronine (MD = -0.62, 95% CI-0.76 - -0.48, p < 0.001). Heterogeneity was substantial for thyroid-stimulating hormone (I2 = 85%) and triiodothyronine (I2 = 86%), and moderate for thyroxine (I2 = 60%). Evidence regarding thyroid antibodies was limited and inconsistent. Study limitations: Included studies were observational, predominantly single-centre, and het-erogeneous in dosing, duration, and laboratory assessments. Conclusions: Isotretinoin is associated with statistically significant alterations in serum thyroid function parameters, though the clinical significance of these changes remains uncertain.

Abstract in English:

Abstract Background: Androgenetic Alopecia (AGA) and Seborrheic Dermatitis (SD) are scalp conditions that may show histopathological features overlapping with Fibrosing Alopecia in a Pattern Dis-tribution (FAPD), potentially leading to diagnostic confusion between non-scarring and scarring alopecias. Objective: To identify histopathological features that distinguish AGA from SD and to evalu-ate findings overlapping with those described in FAPD, focusing on perifollicular fibrosis and inflammation. Methods: Transverse scalp biopsy sections from 56 Caucasian male patients (21 AGA, 35 SD) were blindly evaluated. Quantitative follicular parameters and qualitative epidermal, follicular, inflammatory, and adnexal features were assessed and statistically compared. Results: AGA showed higher vellus follicle counts (p = 0.029) and lower terminal follicle and anagen hair counts (p = 0.002; p = 0.045), confirming follicular miniaturization. Perifollicular fibrosis (infundibular and/or isthmic) was frequent in both conditions, limiting its specificity for scarring alopecias. Mild basal vacuolization (14.3%; p = 0.048) and eccrine duct dilatation (23.8%; p = 0.006) occurred exclusively in AGA, whereas polytrichia was observed only in SD (17.1%; p = 0.050). Perifollicular inflammation was common and non-specific in both groups, occasionally mimicking lichenoid patterns. Demodex spp. was more prevalent in AGA (p = 0.007). Necrotic keratinocytes were rare, with no significant differences. Study limitations: The study included only male patients and had a limited sample size, a cross-sectional design, and no FAPD comparison. Nonetheless, substantial histopathological overlap exists between AGA, SD, and features attributed to FAPD, particularly perifollicular fibrosis and inflammation. Careful clinicopathological correlation is essential to avoid misclassification, with prognostic and therapeutic implications.

Abstract in English:

Abstract Background: People with albinism, a genetic condition characterized by reduced melanin production, have an increased risk of developing skin cancer due to their diminished photopro-tection. The global prevalence of albinism is estimated at 1 in 17,000 individuals, but it varies significantly by region, being more common in certain parts of Africa. Despite this heightened vulnerability, data on the prevalence of skin cancer and its subtypes in this population remain limited. Objective: This study aimed to determine the prevalence of Skin Cancer (SC) and Actinic Keratosis (AK) among patients with albinism. Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane databases was conducted, only including cross-sectional and cohort studies. The review adhered to Pre-ferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Statistical analyses were performed using R software, and heterogeneity was assessed via the I2 statistic. Results: Among 1,747 individuals with albinism from 12 studies, the pooled prevalence of actinic keratosis (AK) was 38% (95% CI 17.7-60.3; I2 = 99%), and that of skin cancer (SC) was 19% (95% CI 13.5-24.4; I2 = 89%). Within the SC group, squamous cell carcinoma (SCC) accounted for 55.4% (95% CI 36.2-73.8; I2 = 94%), basal cell carcinoma (BCC) for 33.7% (95% CI 19.6-49.2; I2 = 91%), and malignant melanoma (MM) for 0% (95% CI 0.00-0.56; I2 = 0%). Study limitations: The results show persistent heterogeneity driven by differences in study design, diagnostic criteria, and the predominance of cross-sectional data. Future research should aim to address these gaps by employing longitudinal designs, standardizing diagnostic criteria, and including detailed patient-level data. Conclusion: This study demonstrates a high global prevalence of actinic keratosis (AC) and skin cancer (SC) among individuals with albinism, reinforcing the need for targeted surveillance, pre-ventive strategies, and treatments tailored to this high-risk population. Overall, heterogeneity remained high across outcomes despite the exclusion of individual studies.

Abstract in English:

Abstract Background: Human skin, the body’s largest organ, hosts a diverse ecosystem of bacteria, fungi, viruses, and mites collectively known as the skin microbiome. This microbiome supports cutaneous homeostasis through barrier defense, immune education, and metabolic functions. Objective: To narratively review the historical evolution of skin microbiome research, synthe-size current knowledge on its composition, biogeography, and functional roles in health and disease, and highlight emerging microbiome-based therapeutic strategies in dermatology. Methods: This review integrates seminal historical works with contemporary evidence from culture-independent sequencing and multi-omic investigations of the skin microbiome, identi-fied through a selective search of recent dermatology and microbiome literature. Results: Modern molecular and multi-omic approaches have revealed microbial diversity across sebaceous, moist, and dry skin niches and clarified key functions of the skin microbiome, includ-ing colonization resistance, immune modulation, metabolite production, and participation in the gut-skin axis. Dysbiosis of these communities is linked to inflammatory conditions such as atopic dermatitis, acne vulgaris, psoriasis, and chronic wounds. A growing body of work supports microbiome-targeted interventions, including probiotics, prebiotics, postbiotics, and microbiome engineering, as promising personalized strategies. Study limitations: As a narrative review, this work may be subject to selection bias and does not provide a quantitative synthesis of all available studies on the skin microbiome. Conclusions: By integrating historical context with mechanistic insights from modern micro-biome research, this review underscores the skin microbiome as a central ecological determinant of cutaneous health and disease and provides a framework for translating micro-biome science into clinical applications and precision dermatology.

Abstract in English:

Abstract Background: Androgenetic Alopecia (AGA) is the most prevalent hair disorder. Conventional topical minoxidil is limited by suboptimal follicular penetration, local adverse effects, and poor adherence; nanocarrier-based ‘‘nanominoxidil’’ systems may optimize delivery, but their clinical value remains uncertain. Objective: To synthesize experimental and clinical evidence on nanocarrier-based topical minoxidil for AGA. Methods: We systematically searched databases (2015-2024) for in vitro, ex-vivo, in vivo, and human studies evaluating nanocarriers < 1000 nm loaded with minoxidil versus conventional minoxidil, placebo, or no treatment. Primary outcomes were follicular and cutaneous penetra-tion or retention; secondary outcomes included hair length, density and/or coverage, biomarker modulation, adverse events, and formulation stability. Risk of bias was assessed with SYRCLE and OHAT. Results: Of 410 records, 20 studies met eligibility criteria, predominantly preclinical, and one evaluated cutaneous tolerability in healthy volunteers. Across platforms (lipid, polymeric, hybrid and deformable systems, nanoemulsions), nanominoxidil consistently increased follicu-lar deposition and cutaneous retention (≈2- to > 7-fold vs conventional solutions) and improved hair growth surrogates and angiogenic or stem-cell markers. Local tolerability was generally acceptable and systemic exposure was negligible when reported. Study limitations: Evidence is preclinical, with a single non-therapeutic human study; het-erogeneity across models, comparators, doses, follow-up, and outcomes, and frequent lack of randomization, blinding, and standardized safety reporting, precluded meta-analysis and limited internal validity and generalizability. Conclusions: Nanotechnology-based minoxidil formulations enhance follicular targeting and hair-growth surrogate outcomes in experimental models and appear locally safe, but random-ized trials in patients with AGA are required before nanominoxidil can be recommended for routine clinical use.