Cutaneous And Ocular Toxicology[JOURNAL]
Sun
200 papers
ChatGPT-4o as a diagnostic tool for skin cancer: Diagnostic accuracy in melanoma and non-melanoma detection.
Ünal E, Yücel MB, Gedikli SN … +1 more , Akay BN
Cutan Ocul Toxicol · 2026 Mar · PMID 41355746 · Publisher ↗
INTRODUCTION: The global incidence of skin cancer is rising, emphasizing the need for early detection tools. Artificial intelligence (AI) models, including multimodal systems like ChatGPT-4o, can analyze visual data to a...
INTRODUCTION: The global incidence of skin cancer is rising, emphasizing the need for early detection tools. Artificial intelligence (AI) models, including multimodal systems like ChatGPT-4o, can analyze visual data to assist clinicians in diagnosis. This study evaluated ChatGPT-4o's diagnostic accuracy in detecting melanoma and non-melanoma skin cancers from macroscopic and dermoscopic images. METHODS: Ninety patients with histopathologically confirmed lesions were included. For each patient, macroscopic images were first uploaded to ChatGPT-4o, followed by combined upload of macroscopic and dermoscopic images. ChatGPT-4o was instructed to provide a preliminary diagnosis and three differential diagnoses for each lesion. Accuracy was assessed at four levels: Level 1: preliminary diagnosis using macroscopic images; Level 2: preliminary diagnosis using macroscopic and dermoscopic images; Level 3: three differential diagnoses using macroscopic images; Level 4: three differential diagnoses using macroscopic and dermoscopic images. RESULTS: Overall Level 1 accuracy was 73.3%, with Level 2, Level 3, and Level 4 accuracies of 66.6%, 75%, and 76.6%, respectively. Dermoscopic images improved accuracy for squamous cell carcinoma (72.7% vs 81.8%, p = 1.00), reduced overall and basal cell carcinoma accuracy (73.3% vs 66.6%, p = 0.180 and 79.6% vs 67.8%, p = 0.065, respectively), and did not affect malignant melanoma (84.6% vs 84.6%) or lentigo maligna (0% vs 0%). Statistical analysis revealed that the addition of dermoscopic images did not significantly influence diagnostic accuracy, either overall or within individual diagnostic categories. The model recommended biopsy for all lesions, suggesting potential as a supportive diagnostic tool. CONCLUSION: ChatGPT-4o showed variable diagnostic accuracy for melanoma and non-melanoma skin cancers. Dermoscopic images reduced performance for certain diagnostic categories. These misclassifications highlight the potential for unnecessary interventions and patient anxiety underscoring that AI-based systems should serve as supportive aids rather than standalone diagnostic tools.
Analysis of clinical characteristics of tislelizumab-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in the Chinese population: a systematic review.
Wen X, Li W, Zhang Q
Cutan Ocul Toxicol · 2026 Mar · PMID 41269056 · Publisher ↗
OBJECTIVE: Tislelizumab frequently induces cutaneous immune-related adverse events (cirAEs), among which Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are rare but potentially life-threatening cutaneous...
OBJECTIVE: Tislelizumab frequently induces cutaneous immune-related adverse events (cirAEs), among which Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are rare but potentially life-threatening cutaneous reaction. The clinical characteristics of SJS/TEN induced by tislelizumab remain unclear. METHODS: This systematic review aims to clarify the clinical manifestations, therapeutic interventions, and outcomes of tislelizumab-related SJS/TEN in Chinese patients. Published case reports of SJS/TEN induced by tislelizumab were systematically collected (up to 10 May 2025). A total of 21 articles and 22 patients were included. RESULTS: A total of 22 patients were included, consisting of 14 males and 8 females, aged 42-81 years, with a median age of 71 years and a mean age of 68.59 ± 9.10 years. Lung cancer was the most common primary disease, affecting 12 patients (54.55%). 7 patients were treated with tislelizumab alone, while 15 underwent combination therapy (chemotherapy, radiotherapy, or targeted therapy). The time from treatment initiation to SJS/TEN onset ranged from 12 to 138 days. 20 patients experienced pain to varying degrees, with early symptoms primarily manifesting as erythema and rash. Mucocutaneous involvement was observed in 12 patients, and fever occurred in 11 patients. After drug discontinuation and symptomatic supportive care, the symptoms of 20 patients improved. Two patients died - one of septic shock and another of acute coronary syndrome. CONCLUSIONS: This indicates that tislelizumab-related SJS/TEN mostly occurs days to months after treatment. Clinical practice should strengthen the evaluation and monitoring of early cutaneous adverse reactions, with timely detection and intervention to ensure safe medication use for patients.
Anti-infection and healing promotion of skin ECM hydrogel.
Zhang J
Cutan Ocul Toxicol · 2025 Dec · PMID 41259238 · Publisher ↗
OBJECTIVE: Diabetic wounds are slow to heal, causing pain and increasing medical burden. This study aims to develop a skin extracellular matrix (ECM) hydrogel containing ciprofloxacin (CIP) and S-nitrosoglutathione (GSNO...
OBJECTIVE: Diabetic wounds are slow to heal, causing pain and increasing medical burden. This study aims to develop a skin extracellular matrix (ECM) hydrogel containing ciprofloxacin (CIP) and S-nitrosoglutathione (GSNO) to evaluate its antimicrobial and wound healing effects. METHODS: Porcine skin was used to extract ECM hydrogel via decellularization, followed by loading with CIP and GSNO. Scanning Electron Microscopy (SEM) was used for microstructure and drug distribution characterization. In vitro antibacterial tests, along with human umbilical vein endothelial cell (HUVEC) proliferation and migration assays, were conducted. Animal studies on diabetic mice and histological analysis were performed. RESULTS: The ECM hydrogel with CIP and GSNO demonstrated uniform drug distribution and significant antibacterial effects, with a 99.2% antibacterial rate against Staphylococcus aureus. In vitro, the hydrogel enhanced HUVEC cell proliferation by 35% and migration by 51%. In diabetic mice, wound healing was accelerated, with a 95.2% healing rate at 14 days, 56.1% higher than the control group. Additionally, bacterial load was reduced by 77.6%, and angiogenesis and collagen fiber formation were promoted. CONCLUSION: This study successfully developed a skin ECM hydrogel with dual antimicrobial and healing effects, offering a promising strategy for diabetic wound treatment.
Chemopreventive role of Blume ethanolic whole plant extract in DMBA/croton oil-induced skin tumorigenesis in mice.
Sethuraman SP, Ramachandran KP, Vellapandian C
Cutan Ocul Toxicol · 2026 Mar · PMID 41251023 · Publisher ↗
PURPOSE: This study aimed to investigate the chemopreventive potential of the ethanolic extract of Blume against skin cancer. METHODS: The ethanolic whole-plant extract of was tested for acute and sub-chronic dermal to...
PURPOSE: This study aimed to investigate the chemopreventive potential of the ethanolic extract of Blume against skin cancer. METHODS: The ethanolic whole-plant extract of was tested for acute and sub-chronic dermal toxicity according to the OECD guidelines 402 and 411. Its chemopreventive efficacy, along with the antioxidant and histopathological changes, was assessed using DMBA/Croton oil-induced skin cancer model in mice. RESULTS: The toxicity studies indicated that the extract was safe up to 2000 mg/kg body weight. The 90-day repeated application of the extract at 500, 1000, and 2000 mg/kg b.w. showed no mortality or toxicity observations. Topical application of the extract at 200 and 400 mg/kg b.w. applied 10 minutes before DMBA/Croton oil treatment delayed the tumor onset. Importantly, there was a significant decrease in tumor incidence, tumor burden, tumor yield, decreased lipid peroxidation and restored superoxide dismutase, catalase, and glutathione peroxidase levels in extract-treated mice compared with the control. The histopathological observations further substantiated the chemopreventive effect, revealing a marked reduction in neoplastic alterations. CONCLUSION: The ethanolic extract of was well tolerated up to 2000 mg/kg b.w. and, at 200 and 400 mg/kg b.w., reduced tumor incidence to 80% and 60%, while 5-fluorouracil showed the higher efficacy (50% tumor incidence). Our findings showed the significant chemopreventive activity by enhancing antioxidant defenses and suppressing skin tumorigenesis in mice, warranting further mechanistic and clinical investigations.
Identification of human papillomavirus, Epstein-Barr virus and cytomegalovirus in paraffin tissues by molecular methods in patients with anogenital warts.
Sorkulu Eroğlu K, Demir B, Cicek D … +4 more , Toraman ZA, Balta H, Çelik MS, Otlu B
Cutan Ocul Toxicol · 2025 Dec · PMID 41212867 · Publisher ↗
BACKGROUND: Anogenital warts (AGWs) are typically caused by low-risk HPV types. Coinfection with EBV and CMV may influence disease progression, especially under immunosuppression. This study aimed to detect HPV, EBV, and...
BACKGROUND: Anogenital warts (AGWs) are typically caused by low-risk HPV types. Coinfection with EBV and CMV may influence disease progression, especially under immunosuppression. This study aimed to detect HPV, EBV, and CMV in tissue samples from AGW patients. This descriptive, retrospective, single-center study aimed to detect HPV, EBV, and CMV DNA in paraffin-embedded tissue samples from patients with AGWs. MATERIAL AND METHODS: Paraffin-embedded tissues from 24 AGW patients were analyzed using real-time PCR and pyrosequencing for HPV, EBV, and CMV DNA. Demographic and viral data were statistically evaluated. Degraded or insufficient DNA samples were excluded following quality control assessment. Descriptive and comparative statistical analyses were performed using SPSS v22.0. RESULTS: HPV was detected in 62.5% of patients, most commonly type 6, followed by types 40, 87, and 16. EBV was found in 2 patients (8.3%), both with HPV coinfection. HPV. CMV was not detected in any samples. No statistically significant associations were found between demographic or clinical parameters and viral positivity. CONCLUSION: The study identified rare EBV and HPV coinfections in AGWs but no CMV positivity. These findings are descriptive, and the small sample size limits generalization. The presence of EBV in immunosuppressed individuals may suggest immunotoxic mechanisms affecting viral persistence in the skin. Further studies with larger cohorts are warranted.
Low-temperature extracted L. as a functional ingredient in facial masks for photorejuvenation of sensitive skin.
Cheng D, Yuan Y, Wang F
Cutan Ocul Toxicol · 2025 Dec · PMID 41182319 · Publisher ↗
OBJECTIVE: To prepare low-temperature extracted L. () and investigate the application of masks containing this extract in photorejuvenation for sensitive skin. METHODS: Eligible participants were randomly divided into t...
OBJECTIVE: To prepare low-temperature extracted L. () and investigate the application of masks containing this extract in photorejuvenation for sensitive skin. METHODS: Eligible participants were randomly divided into two groups. Experimental group used the mask for 14 days prior to photorejuvenation. Both groups used the mask for 7 days post-treatment. Changes in physiological parameters and Dermatology Life Quality Index (DLQI) were observed. RESULTS: Immediately after photorejuvenation, control group showed a significant increase in skin red area and red blood cell concentration, while experimental group did not. At 7 days post-treatment, skin hydration and transepidermal water loss (TEWL) improved significantly in both groups, with greater improvement in the experimental group. Both groups' DLQI decreased, with a significant reduction in the experimental group. CONCLUSION: Facial masks containing low-temperature extracted show promising potential in protecting sensitive skin from photothermal stimulation and improving skin barrier function during photorejuvenation therapy.
Effect of silver nitrate solution on corneal epithelial barrier function in rabbits.
Fukuda M, Kiyoi T, Takeda S … +6 more , Sasaki Y, Masuoka T, Mito T, Sasaki M, Kubo E, Sasaki H
Cutan Ocul Toxicol · 2025 Dec · PMID 41176732 · Publisher ↗
PURPOSE: Some preservatives in eye drops induce corneal epithelial damage. Diquafosol sodium, a dry eye treatment drug released in 2022, contains silver nitrate as a preservative. This study examined the effects of diqua...
PURPOSE: Some preservatives in eye drops induce corneal epithelial damage. Diquafosol sodium, a dry eye treatment drug released in 2022, contains silver nitrate as a preservative. This study examined the effects of diquafosol sodium ophthalmic solution and silver nitrate solution on the barrier function of corneal epithelial cells in rabbit eyes. PATIENTS AND METHODS: The 14 rabbits included in the study were divided into 7 eye drop treatment groups (4 eyes per group): (1) 3% diquafosol (Diquas) without silver nitrate; (2) 3% Diquas LX containing silver nitrate; (3) 3% Diquas LX without silver nitrate; (4) 0.01% silver nitrate; (5) 0.1% silver nitrate; (6) 1% silver nitrate; and (7) saline. Electrical corneal resistance (CR) was measured using a CR-measuring device (CRD) at 30, 60, and 120 minutes after the final instillation, and CR% was calculated. Corneal epithelial damage was evaluated using fluorescein staining 120 minutes after the final instillation.Corneal tissue obtained 120 minutes post-instillation was fixed in 4% paraformaldehyde, permeabilized, and blocked. Zonula occludens-1 protein, which constitutes tight junctions between epithelial cells, was visualized using whole-mount immunohistochemical staining. To examine the expression of ZO-1 in corneal epithelial cells, photographs of the outermost layer of the cornea were taken. RESULTS: CR in the Diquas LX group 1 (containing silver nitrate) reached its peak value (114.2 ± 7.1%) 60 minutes after the final instillation, which was comparable to that in the 0.1% silver nitrate group (117.2 ± 17.6%) and significantly higher than that in the Diquas group 3 (without silver nitrate) (98.8 ± 5.8%; < 0.05). Zonular occludens-1 protein was localized in a continuous linear pattern at the boundary between epithelial cells in all three Diquas groups. CONCLUSIONS: Diquas LX eye drops containing silver nitrate significantly increased CR compared to Diquas eye drops without silver nitrate and improved corneal barrier function. Silver nitrate as a preservative may have contributed to this effect.
Systemic oxidative stress imbalance in actinic keratosis: Insights from thiol-disulfide homeostasis and ischemia-modified albumin.
Metin MS, Demirbaş A, Diremsizoglu E … +7 more , Tehçi T, Kolukırık İ, Akoğul S, Metin Z, Özkoca D, Neşelioğlu S, Erel Ö
Cutan Ocul Toxicol · 2025 Dec · PMID 41157836 · Publisher ↗
BACKGROUND: Actinic keratosis (AK) is a common premalignant skin condition linked to chronic ultraviolet (UV) exposure and oxidative stress. Systemic biomarkers of redox imbalance in AK remain underexplored. AIMS: To ass...
BACKGROUND: Actinic keratosis (AK) is a common premalignant skin condition linked to chronic ultraviolet (UV) exposure and oxidative stress. Systemic biomarkers of redox imbalance in AK remain underexplored. AIMS: To assess systemic oxidative stress in AK using plasma thiol-disulfide homeostasis (TDH) and ischemia-modified albumin (IMA). METHODS: This cross-sectional study included 42 patients with clinically diagnosed AK and 42 age- and sex-matched healthy controls. Native thiol, total thiol, disulfide concentrations, and derived redox indices (Index-1, -2, -3) were measured using a spectrophotometric assay. IMA levels were assessed via the albumin-cobalt binding test. Statistical comparisons and correlation analyses were performed. RESULTS: Native thiol, total thiol, and disulfide levels were significantly lower in the AK group ( = 0.001), whereas disulfide-based indices showed no significant differences. IMA concentrations were significantly elevated in AK patients ( = 0.001). IMA levels were negatively correlated with native ( = -0.312, = 0.044) and total thiol ( = -0.309, = 0.046) values. Patients with Fitzpatrick Type IV skin exhibited significantly higher lesion counts than those with Types II and III ( < 0.05). CONCLUSION: AK patients show systemic oxidative imbalance, with reduced thiols and elevated IMA, reflecting persistent UV-induced redox stress and protein oxidation. TDH and IMA may have potential utility as systemic indicators of oxidative stress in AK. Limitations include cross-sectional design, modest sample size, and unmeasured confounders. Future longitudinal and interventional studies should assess causality and antioxidant-based therapies.
Clinical and pharmacovigilance safety evaluation of LUXTURNA (voretigene neparvovec-rzyl).
Simoens D, Shravah V, Jones WK … +1 more , Kaja S
Cutan Ocul Toxicol · 2025 Dec · PMID 41140124 · Full text
BACKGROUND: LUXTURNA (voretigene neparvovec-rzyl) is the first FDA-approved gene therapy for inherited retinal dystrophies caused by biallelic RPE65 mutations. While pivotal clinical trials established its safety and eff...
BACKGROUND: LUXTURNA (voretigene neparvovec-rzyl) is the first FDA-approved gene therapy for inherited retinal dystrophies caused by biallelic RPE65 mutations. While pivotal clinical trials established its safety and efficacy, there has been no formal analysis of real world data to date. METHODS: We reviewed published literature and regulatory safety databases, including the FDA Adverse Event Reporting System and EudraVigilance, to assess clinical outcomes and adverse event reporting associated with LUXTURNA. RESULTS: Clinical trials demonstrated durable functional vision improvements, with approximately 70% of patients maintaining gains up to four years post-treatment. Adverse events reported in trials were largely mild to moderate, such as conjunctival hyperemia, cataract, and transient intraocular pressure elevation. Post-marketing surveillance, however, revealed additional safety concerns, most notably chorioretinal atrophy (CRA), which has been reported in 13-50% of treated eyes, particularly in younger patients and often near the injection site. Disproportionality analyses confirmed CRA as the most prominent adverse event, alongside elevated risks for retinal tears or detachment, intraocular pressure changes, ocular hemorrhage, and inflammation. Despite these findings, central visual acuity was generally preserved, and no systemic toxicity was identified. CONCLUSIONS: LUXTURNA provides meaningful and durable visual benefits for patients with RPE65-related disease, but long-term monitoring is essential to address its emerging ocular safety profile. Our data represent the first comprehensive pharmacovigilance review of LUXTURNA, providing critical insights for clinical practice and post-marketing surveillance.
Effect of interleukin 23 inhibitors (risankizumab and guselkumab) on cardiovascular and cerebrovascular risk in psoriasis patients.
Yıldız S, Temiz SA, Dursun R … +3 more , Daye M, Özer İ, Kıran M
Cutan Ocul Toxicol · 2025 Dec · PMID 41131909 · Publisher ↗
BACKGROUND: Psoriasis is a chronic systemic inflammatory disease mediated by the immune system. Interleukin-23 (IL-23) plays a key role in its pathogenesis by amplifying inflammation, triggering atherogenic dyslipidemia...
BACKGROUND: Psoriasis is a chronic systemic inflammatory disease mediated by the immune system. Interleukin-23 (IL-23) plays a key role in its pathogenesis by amplifying inflammation, triggering atherogenic dyslipidemia and insulin resistance, and thereby increasing cardiovascular and cerebrovascular risk. This study aimed to evaluate the effect of the IL-23 inhibitors risankizumab and guselkumab, used in psoriasis treatment, on cardiovascular and cerebrovascular risk through the plasma atherogenic index (PAI) and triglyceride-glucose (TyG) index. METHODS: This retrospective study included 110 patients diagnosed with psoriasis and treated with risankizumab (n = 61) or guselkumab (n = 49). Psoriasis Area and Severity Index (PASI) scores, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C) levels and fasting blood glucose (FBG) values at baseline and at 6 months of treatment were obtained from patient records. The plasma atherogenic index (PAI) was calculated as log₁。(TG/HDL-C), and the triglyceride-glucose (TyG) index as log₁。(TG × FBG / 2). RESULTS: In both IL-23 inhibitor groups included in the study, PASI scores, PAI, and TyG index values showed a significant decrease from baseline at the 6th month of treatment (p < 0.05). However, there was no significant difference in the reduction of index levels between the groups (p > 0.05). CONCLUSION: IL-23 inhibitors can reduce atherogenic dyslipidemia and insulin resistance alongside dermatological improvement in the treatment of psoriasis. This suggests a potential role for these agents in reducing the risk of cardiovascular and cerebrovascular disease. However, large-scale, long-term studies are needed to confirm these beneficial effects.
A systematic review of ionizing radiation-induced glaucoma: clinical manifestations, pathogenesis, and current treatment approaches.
Wu A, Huai X, Zhou Q … +2 more , Li C, Zhou H
Cutan Ocul Toxicol · 2025 Dec · PMID 41091454 · Publisher ↗
PURPOSE: Ionizing radiation-induced glaucoma (IRG) is an uncommon yet vision-threatening complication that presents primarily as neovascular glaucoma (NVG) after high-dose exposure and normal-tension glaucoma (NTG) after...
PURPOSE: Ionizing radiation-induced glaucoma (IRG) is an uncommon yet vision-threatening complication that presents primarily as neovascular glaucoma (NVG) after high-dose exposure and normal-tension glaucoma (NTG) after low-dose exposure. Despite increasing recognition, its dose-response relationship, mechanisms, and optimal management remain poorly defined. This review evaluates the clinical spectrum, pathogenesis, and therapeutic approaches of IRG to inform future research and practice. METHODS: A systematic literature search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Database (1964-2024) was conducted following PRISMA guidelines. Among 7256 screened articles, 37 studies fulfilled the inclusion criteria. RESULTS: NVG typically develops following ocular radiotherapy exceeding 30 Gy, particularly in patients with uveal melanoma, and is characterized by retinal ischemia, neovascularization, and secondary intraocular pressure elevation. NTG arises from chronic low-dose exposure (< 1 Gy), producing optic nerve injury and visual field loss without elevated pressure. Anti-VEGF therapy can temporarily control NVG progression, whereas trabeculectomy, glaucoma drainage devices, and cyclodestructive procedures are variably employed but often limited by postoperative complications and inconsistent outcomes. The lack of consensus-driven protocols and heterogeneity across studies underscore ongoing clinical challenges. CONCLUSIONS: IRG represents a dose-dependent entity with distinct phenotypes and mechanisms. Current therapies provide partial benefit but remain unsatisfactory in terms of durability and standardization. Advancing the field will require mechanistic studies to clarify radiation-induced optic neuropathy and vascular injury, alongside well-designed trials to establish preventive strategies and evidence-based treatment algorithms.
Biological activity of pumpkin pulp extracts: cytoprotection, anti-inflammatory effects, and photoprotection in human skin cells.
Miljic M, Vlaisavljevic Krstic S, Nacka-Aleksic M … +7 more , Jovanovic A, Dekanski D, Stankovic JA, Bozic DD, Krivokuca MJ, Bojic-Trbojevic Z, Pirkovic A
Cutan Ocul Toxicol · 2025 Dec · PMID 41071954 · Publisher ↗
BACKGROUND: Pumpkin extracts are rich in vitamins and bioactive compounds, offering antioxidative, anti-inflammatory, and wound-healing properties, making them valuable in dermatology and cosmetics, however pumpkin pulp...
BACKGROUND: Pumpkin extracts are rich in vitamins and bioactive compounds, offering antioxidative, anti-inflammatory, and wound-healing properties, making them valuable in dermatology and cosmetics, however pumpkin pulp extracts have not been evaluated before for their cutaneous biological activities. METHODS AND RESULTS: This study evaluated the biological activity of methanolic pumpkin pulp extracts from six Serbian accessions of and on normal keratinocytes (HaCaT) and melanoma (FemX) cells. The extracts showed no cytotoxicity to normal cells up to 1000 μg/mL and exhibited concentration-dependent cytotoxicity to melanoma cells (determined by MTT assay). They also demonstrated antioxidative effects against HO-induced oxidative stress in HDCFDA assay, and reduced tumor necrosis factor -α/interferon-gamma-γ-induced expression of pro-inflammatory cytokine interleukine-1β in HaCaT cells, as shown in the cell-based ELISA assay. Sun protection factor (SPF) calculations for all six accessions confirmed the photoprotective potential of the extracts, with noticeable differences in SPF values between species and varieties. The highest SPF value was observed in the variety. CONCLUSION: Significant variations in biological activities among the examined accessions were noted, with extracts showing pronounced antioxidant and antiinflammatory properties while extract showed the highest SPF values. These findings represent the first report on the skin-beneficial effects of pumpkin pulp extracts, identifying them as sustainable sources of safe, bioactive compounds with antioxidant, anti-inflammatory, and photoprotective properties for dermatological or cosmetic applications.
Predictors of response to omalizumab in chronic spontaneous urticaria: a retrospective cohort study.
Zorlu Ö, Albayrak H, Aytekin S
Cutan Ocul Toxicol · 2025 Dec · PMID 41058188 · Publisher ↗
INTRODUCTION: Although omalizumab is a highly effective treatment against chronic spontaneous urticaria (CSU), the treatment duration for response varies among patients. Thus, determining easy-to-access predictive biomar...
INTRODUCTION: Although omalizumab is a highly effective treatment against chronic spontaneous urticaria (CSU), the treatment duration for response varies among patients. Thus, determining easy-to-access predictive biomarkers of omalizumab response is essential. OBJECTIVE: This study aimed to investigate the value of baseline hematological and inflammatory parameters and patient-specific features as predictive markers of response to standard-dose omalizumab. METHODS: This single-center retrospective cohort study was conducted on 242 patients with CSU treated with omalizumab 300 mg every 4 weeks for at least 6 months between 2014 and 2025. The demographics, clinical features, treatment responses, and baseline laboratory tests were assessed. Response to omalizumab was evaluated based on the weekly Urticaria Activity Score (UAS7). Patients were categorized as early responder (ER, within 3 months), late responder (LR, after 3 months), and nonresponder (NR). RESULTS: Of patients, 180 (74.4%) were classified as ER, 28 (11.6%) as LR, and 34 (14%) as NR. ERs had higher white blood cell (WBC) and lymphocyte counts ( = 0.047 and = 0.005, respectively) and lower mean platelet volume (MPV)/lymphocyte ratio (MPVLR) ( = 0.008). LRs had higher mean corpuscular hemoglobin concentration (MCHC) and platelet/lymphocyte ratio (PLR) ( = 0.023 and = 0.014, respectively) and lower MPV levels ( = 0.043). The platelet distribution width (PDW) was higher in the NRs ( = 0.011). Red cell distribution width-coefficient of variation (RDW-CV) [odds ratio (OR): 0.793, 95% confidence interval (CI): 0.641-0.980, = 0.032], WBC count (OR: 1.418, 95% CI: 1.093-1.840, = 0.009), and PDW (OR: 0.813, 95% CI: 0.693-0.954, = 0.011) were found to be the independent predictors of responders. The lymphocyte count (OR: 1.713, 95% CI: 1.122-2.613, = 0.013) and MPVLR (OR: 0.427, 95% CI: 0.218-0.837, = 0.013) were independent predictors of ER, whereas MCHC (OR: 2.368, 95% CI: 1.522-3.686, < 0.001) and PLR (OR: 1.010, 95% CI: 1.003-1.017, = 0.003) were independent predictors of LR. The receiver operating characteristic curve analysis results showed that the predictive strengths of RDW-CV, WBC count, PDW, lymphocyte count, MPVLR, MCHC, and PLR were low (the area under the curve values 0.634, 0.620, 0.672, 0.656, 0.621, 0.649, and 0.624, respectively; all < 0.05), suggesting the limited use of these parameters in clinical practice. STUDY LIMITATIONS: The limitations of this study included its single-center, retrospective design, lack of external validation, and reliance solely on UAS7 for assessing disease activity. CONCLUSIONS: WBC and lymphocyte counts, RDW-CV, PDW, MPVLR, MCHC, and PLR can be considered when appraising the omalizumab response. However, given their limited predictive strength, these parameters alone may not accurately predict the efficacy of omalizumab.
Relation between demographic status and clinical characteristics of Kaposi sarcoma: a single centre study.
Türkmen Dedeoğlu A, Gezmen S, Türsen Ü … +1 more , Karabulut YY
Cutan Ocul Toxicol · 2025 Dec · PMID 41043032 · Publisher ↗
Kaposi sarcoma (KS) is a vascular tumour with four main clinical types-classic, endemic, iatrogenic, and epidemic-all linked to infection by human herpesvirus 8 (HHV-8). This retrospective cohort study assessed the relat...
Kaposi sarcoma (KS) is a vascular tumour with four main clinical types-classic, endemic, iatrogenic, and epidemic-all linked to infection by human herpesvirus 8 (HHV-8). This retrospective cohort study assessed the relationship between demographic factors and clinical characteristics in 73 patients with biopsy-proven KS treated at a single dermatology centre between 2009 and 2023. Demographic and clinical data, including age, gender, birthplace, blood type, smoking, alcohol use, HIV status, tumour site, and disease stage, were collected and statistically analysed. Most patients were male (77%), with a mean age of 61 years, and the classic KS subtype predominated (86%). The majority (75%) had tumours localised to the extremities. HIV-positive status was diagnosed in 14% of cases and was strongly associated with non-extremity tumour location and increased visceral involvement. Notably, blood type showed a significant association with tumour localisation: 0Rh- and ARh- blood groups were less common in KS patients with extremity tumours. This is the first study to demonstrate a significant relationship between blood group and KS tumour site, introducing a novel epidemiological association. Smoking and alcohol consumption were each significantly linked to higher HIV positivity rates. Patients from the Mediterranean region had a higher frequency of HIV-positive KS, although birthplace did not correlate with disease stage. No associations were observed between gender and disease type. The study is limited by its retrospective design and missing data for certain variables, but it identifies potentially novel patterns-including a possible link between blood group and tumour location-and confirms known associations, such as HIV status with advanced disease. These findings underscore the complexity of KS presentation and suggest that demographic, clinical, and lifestyle factors may shape disease patterns. Prospective, multicentre studies are needed to validate these findings and guide personalised approaches to KS management.
Investigating the effective features of chitosan alginate hydrogel wound dressing containing plant extract.
Khajeh-Amiri A, Qasemi S
Cutan Ocul Toxicol · 2025 Dec · PMID 41004498 · Publisher ↗
OBJECTIVE: This study aimed to investigate the development of a chitosan-alginate hydrogel wound dressing enriched with extract due to its antioxidant and antimicrobial properties. Natural polymer-based hydrogels are id...
OBJECTIVE: This study aimed to investigate the development of a chitosan-alginate hydrogel wound dressing enriched with extract due to its antioxidant and antimicrobial properties. Natural polymer-based hydrogels are ideal for wound healing due to their biocompatibility and capacity for controlled drug delivery. METHODS: Methanolic, ethanolic, and aqueous extracts of were evaluated for antioxidant and phenolic content. Cytotoxicity was assessed using MTT assay, and antimicrobial activity was determined by MIC testing. Physicochemical properties, including swelling, drug release, porosity (SEM), and molecular interactions (FTIR), were analysed. RESULTS: The methanolic extract showed the highest antioxidant activity (95.41%) and phenolic content (118 mg GAE/g). It was non-toxic up to 1000 ppm (73.6% cell viability). When loaded into the hydrogel, MIC decreased from 6.25 mg to 0.781 mg. The hydrogel showed a swelling ratio of 4016.6%, 80% drug release in 48 hours, reduced porosity (32.26% to 11.59%), and confirmed chitosan-alginate interactions via FTIR. DISCUSSION: The hydrogel formulation demonstrates strong antimicrobial, antioxidant, and biocompatible properties, making it a promising wound dressing. To improve the manuscript, more detailed methodology, statistical support for cytotoxicity, enhanced FTIR visualisation, and inclusion of recent literature and mechanistic discussion are recommended.
A novel marker to monitor potential cardiac arrhythmic effects of isotretinoin therapy: Frontal QRS-T angle.
Zekey E
Cutan Ocul Toxicol · 2025 Dec · PMID 40983501 · Publisher ↗
BACKGROUND: . . . . Isotretinoin is widely used to treat acne vulgaris. Although primarily targeting the skin, it exerts systemic effects, including rare cardiac manifestations such as arrhythmia. Electrocardiography (EC...
BACKGROUND: . . . . Isotretinoin is widely used to treat acne vulgaris. Although primarily targeting the skin, it exerts systemic effects, including rare cardiac manifestations such as arrhythmia. Electrocardiography (ECG) is the standard tool for rhythm monitoring. The frontal QRS-T angle, a novel ECG-based parameter, reflects ventricular depolarisation-repolarisation heterogeneity and has been recognised as a predictor of arrhythmic events. This study aimed to evaluate electrophysiological and biochemical changes associated with isotretinoin, focusing on the frontal QRS-T angle, basic ECG parameters, hemograms, and lipid profiles. METHODS: Forty patients receiving oral isotretinoin (0.5-1 mg/kg/day) for acne vulgaris were prospectively followed. The frontal QRS-T angle, ECG parameters, hemograms, lipid values, heart rate, and blood pressure were recorded at baseline, 3 months, and 6 months. RESULTS: At 6 months, statistically significant increases were observed in the frontal QRS-T angle and QRS duration, though both remained within accepted reference ranges. P wave duration, PR interval, QTc interval, heart rate, and blood pressure showed no significant changes. Lipid alterations were notable: HDL decreased, while total cholesterol, LDL, and triglycerides increased significantly. Hematological analysis showed stable leukocyte counts, with platelets rising transiently at 3 months and declining at 6 months. DISCUSSION: .Isotretinoin therapy was associated with measurable changes in cardiac electrophysiology and lipid metabolism. The frontal QRS-T angle may provide an early ECG marker of arrhythmic risk, supporting its inclusion in dermatologic pharmacovigilance. Concurrent lipid alterations may enhance arrhythmic vulnerability, underscoring the importance of cardiac and metabolic monitoring during isotretinoin treatment.
Tobacco ethanol extract accelerates wound healing through anti-inflammation and promoting angiogenesis.
He F, Liu Y, Yu R … +7 more , Zhang T, Guo F, Wu X, Fan Y, Zhu X, Zhou Q, Shu D
Cutan Ocul Toxicol · 2025 Dec · PMID 40966382 · Publisher ↗
OBJECTIVE: Wound repair remains a significant challenge in the field of regenerative medicine. Notably, while numerous studies have investigated the effects of isolated nicotine or chlorogenic acid, the systematic evalua...
OBJECTIVE: Wound repair remains a significant challenge in the field of regenerative medicine. Notably, while numerous studies have investigated the effects of isolated nicotine or chlorogenic acid, the systematic evaluation of tobacco ethanol extract (TEE) on cutaneous wound healing has remained uncharted territory. Therefore, this study aims to systematically explore TEE's multifaceted effect on wound healing. METHODS: The hepatorenal toxicity of 5% TEE was evaluated in 6-7-week-old ICR mice. Subsequently, full-thickness 6 mm wounds were created, and images were captured on days 0, 3, 6, 9, and 12. Tissues were collected for H&E staining, Masson trichrome staining, and immunohistochemistry to assess wound healing. RESULTS: The TEE we prepared showed little hepatorenal toxicity ( > 0.05). By day 12, the wound closure rate in the TEE group reached 95.26%, significantly higher than that in the vehicle group (89.20%, < 0.05). Histopathological analysis demonstrated that TEE reduced neutrophil infiltration in the wound tissues, accelerated granulation tissue formation, and increased collagen content by 20.99% compared to the vehicle group ( < 0.05). Immunohistochemical staining revealed that on day 6, the positive areas of IL-6 and TNF-α in the TEE group were 5.91% and 4.87% lower than those in the vehicle group ( < 0.05), respectively. On day 9, CD31 expression in the TEE group (8.58%) was significantly higher than that in the vehicle group (5.54%) ( < 0.05). CONCLUSION: This study reveals that TEE accelerates wound healing, providing new insights into effective topical therapies for skin wounds while highlighting the potential for tobacco waste valorization.
Micronutrient levels and thyroid functions in scarring alopecias: Do they play a role in disease pathogenesis?
Gönülal Bak R, Çetin C, Kılınç F … +2 more , Akbaş A, Aksoy Saraç G
Cutan Ocul Toxicol · 2025 Dec · PMID 40957422 · Publisher ↗
OBJECTIVE: Scarring alopecias are chronic inflammatory disorders characterised by irreversible hair follicle destruction. In this study, we aimed to evaluate the potential roles of serum ferritin, folate, vitamin B12, vi...
OBJECTIVE: Scarring alopecias are chronic inflammatory disorders characterised by irreversible hair follicle destruction. In this study, we aimed to evaluate the potential roles of serum ferritin, folate, vitamin B12, vitamin D levels and thyroid function markers in the pathogenesis of scarring alopecias. ATERIALS AND METHODS: Between 2020 and 2025, a total of 68 patients over the age of 18 who were diagnosed with scarring alopecia based on clinical and/or histopathological findings and whose medical records were accessible retrospectively were included in the study, along with 68 healthy control subjects. Serum levels of ferritin, folate, vitamin B12, vitamin D, and thyroid function markers were recorded and statistically compared between groups. RESULTS: Among patients with scarring alopecia, 91.2% were female ( = 62), with a mean age of 47.25 ± 12.98 years. The average disease duration was 34.37 ± 24.22 months (min: 3, max: 144). The distribution of diagnoses among patients was as follows; lichen planopilaris in 45.6% ( = 21), frontal fibrosing alopecia in 29.4% ( = 20), pseudopelade in 16.2% ( = 11), discoid lupus erythematosus in 7.4% ( = 5), and folliculitis decalvans in 1.5% ( = 1). There were no statistically significant differences between patients with scarring alopecia and the control group regarding serum vitamin B12 (340.19 ± 107.950 vs. 357.04 ± 107.549 ng/L, = 0.373), folate (11.89 ± 6.11 vs. 12.23 ± 6.53 ng/mL, = 0.767), ferritin (34.75 ± 38.05 vs. 39.89 ± 66.74 µg/L, = 0.593), and vitamin D (54.3 ± 26.57 vs. 58.59 ± 37.38 nmol/L, = 0.434) levels. Thyroid function tests (TSH and free T4) were also similar between the two groups ( > 0.05). CONCLUSION: Our study demonstrated that serum ferritin, folate, vitamin B12, vitamin D levels and thyroid function in patients with scarring alopecia were similar to those in the healthy control group.
The efficacy of erythropoietin in methanol induced optic neuropathy: a systematic review.
Alsubhi AH, Mohammedsaleh A, Alorainy J … +1 more , Badeeb N
Cutan Ocul Toxicol · 2025 Dec · PMID 40955913 · Publisher ↗
PURPOSE: Methanol toxicity outbreaks have been a recurring problem around the world, and the recent pandemic has contributed to an increase in their incidence. The resulting toxic optic neuropathy may lead to complete pe...
PURPOSE: Methanol toxicity outbreaks have been a recurring problem around the world, and the recent pandemic has contributed to an increase in their incidence. The resulting toxic optic neuropathy may lead to complete permanent blindness. Erythropoietin (EPO) has demonstrated potential neuroprotective and neuroregenerative capabilities, which may improve the outcomes of patients with methanol-induced optic neuropathy (MTON). This work aimed to understand the efficacy and practical applications of EPO in cases of MTON. MATERIALS AND METHODS: We included all original studies if they had patients with MTON, treated with EPO, and reported the outcomes of interest for clinical questions, including the end visual outcome. MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched with no date restriction to obtain records. RESULTS: We included 9 articles in our review, with a total of 192 patients, all of whom had been diagnosed with MTON. Erythropoietin treatment started 2 to 29 days after the onset of visual symptoms. Most studies reported an improvement in visual acuity compared to baseline. However, compared to the standard corticosteroid treatment alone, the results of EPO were conflicting. No adverse events were reported. CONCLUSION: The result of adding EPO to corticosteroid treatment in the management of MTON had variable improvements in visual acuity. EPO has potential beneficial effects if used early on in the acute phase of exposure to methanol. The role of repeating or maintaining therapy for a longer duration to enhance the protective effects or prevent relapses remains unknown. Future clinical trials to investigate these options.
Teledermatology in cutaneous tumors: diagnostic accuracy, influencing factors, and the role of dermatoscopy.
Ünal E, Yücel MB, Gedikli SN … +6 more , Gündüz K, Çevirgen Cemil B, Su Küçük Ö, Ertaş R, Akay BN, Örnek Özdemir S
Cutan Ocul Toxicol · 2025 Dec · PMID 40944897 · Publisher ↗
INTRODUCTION: Teledermatology, which utilizes communication technologies to remotely assess skin lesions, has become a vital tool in healthcare. This study aimed to compare the diagnostic accuracy of teledermatology vers...
INTRODUCTION: Teledermatology, which utilizes communication technologies to remotely assess skin lesions, has become a vital tool in healthcare. This study aimed to compare the diagnostic accuracy of teledermatology versus face-to-face examination and explore factors influencing accuracy, such as teledermatoscopy use, dermatoscopy type, and clinical experience. METHODS: Fifty-seven cutaneous tumors were evaluated using handheld or digital dermatoscopy in face-to-face examinations, and preliminary diagnoses were recorded. A definitive diagnosis was established through histopathological examination, which served as the reference standard. Macro and dermatoscopic images were then sent to six teledermatologists for remote diagnosis, and findings were analyzed statistically. RESULTS: The preliminary diagnosis matched the histopathological diagnosis in 84.2% of face-to-face cases. Teledermatologists achieved 63.7% accuracy with macro images alone, increasing to 70.8% with dermatoscopic images. Teledermatology showed lower accuracy than face-to-face examination, regardless of whether teledermatoscopy was used (p < 0.05), but accuracy significantly improved with dermatoscopic images (p = 0.004). The teledermatology's accuracy for malignancy prediction was comparable to face-to-face examination (p > 0.05). Dermatoscopy type did not significantly impact accuracy (p > 0.05), while longer clinical experience correlated with higher accuracy (p < 0.05). Interrater reliability was poor for specific diagnoses but improved when categorizing lesions as malignant or benign (κ = 0.192, κ = 0.683). CONCLUSION: Although teledermatology performed below face-to-face examination in terms of specific diagnoses, it remained effective in distinguishing between benign and malignant cutaneous tumors. The inclusion of teledermatoscopy and longer clinical experience enhanced diagnostic accuracy.
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