Dermato, Volume 3, Issue 2 (June 2023) – 6 articles

Cutaneous squamous cell carcinoma (cSCC) arises from the abnormal proliferation of keratinocytes of the epidermis, most commonly due to UV-light-induced DNA damage. Although histopathological assessment is the gold standard for diagnosing cSCC, nascent optical imaging diagnostic modalities enable clinicians to perform “optical or virtual biopsy” in real-time. We aim to report advances in optical imaging diagnostics for cSCC, along with an updated review of the literature. A comprehensive literature review was performed using PubMed, Embase, and Cochrane databases for manuscripts published from 2008 to 2022. The search yielded a total of 9581 articles, out of which 136 relevant articles were included in the literature review after fulfilling screening and eligibility criteria. This review highlights the current optical imaging devices used for diagnosing cSCC and their diagnostic features. These devices include in vivo and ex vivo reflectance confocal microscopy, optical coherence tomography, line-field confocal optical coherence tomography, multiphoton tomography, and high-frequency ultrasonography. Although surgical excision or Mohs micrographic surgery is considered the gold standard, the latest developments in nonsurgical management of cSCC are discussed. Based on he review of the literature, we conclude that contemporary optical imaging devices such as confocal microscopy, optical coherence tomography, line-field confocal optical coherence tomography and multiphoton tomography have revolutionized real-time diagnostic imaging in dermatology, particularly within the realm of skin cancer. These devices enable rapid diagnoses and allow for a faster initiation of therapy. The application of newer imaging devices to cSCC management may benefit high-risk patients (e.g., chronic UV radiation exposure or organ transplant recipients) or patients with multifocal cSCC, for whom multiple biopsies would be impractical, thus avoiding unnecessary biopsies. Together with dermoscopy, optical imaging technologies can help to improve the efficiency of diagnosis by reducing the turnaround time and the need for extensive laboratory processing resources. Full article

Cosmetics and personal care products (PCPs) are a few of the most commonly used products across the globe with a whopping market share of approximately USD 500 billion. These products are used for cleansing purposes and for improving the quality and beauty of the face, hair, and skin. There are many chemical substances involved in the manufacturing of cosmetics and PCPs. These chemical substances incorporated in cosmetics or PCPs are crucial to develop high-quality products with superior appearance, applicability, and stability; however, excessive use of such chemicals in cosmetics and PCPs has become a safety concern as many of these are reported to cause severe health complications. Overuse of cosmetics and PCPs with hazardous material should be minimized, especially by pregnant women and children. Gynecologists advise pregnant women not to use cosmetics and PCPs with hazardous chemicals. The implementation of a lawful framework is crucial to establish the safety of cosmetics and PCPs. Cosmetic companies/industries must be strictly regulated and made compliant to the guidelines in order to protect human health and minimize safety concerns. In this review, hazardous chemicals incorporated in the personal care products/cosmetics and their related risk and health complications have been discussed in detail. Additionally, regulatory status and clinical trials of chemical substances that involve toxicity and causing severe complications have also been discussed. Full article

Split-thickness skin grafting is a well-known procedure for the treatment of small- and medium-sized burns. However, its effectiveness has been reported to be limited in the case of large and severe burns due to much lower real expansion offered by the grafts than the claimed expansion by graft mesh manufacturers. Recent computational studies have indicated that the collagen fiber orientation within the skin layers have a significant effect on the skin graft expansion. In this study, biofidelic anisotropic synthetic skin with one and two layers and all possible fiber orientations were developed, and incision patterns used in traditional graft meshing techniques were projected to fabricate novel synthetic skin grafts with a theoretical meshing ratio of 3:1. A biaxial tensile testing device was designed to simulate skin graft stretching in clinical settings, and a wide range of synthetic skin graft variants were mechanically tested. The measured quantities included induced nonlinear stress–strain, void area, and meshing ratio. In addition, the stress–strain responses were characterized using nonlinear hyperelastic models. The key observations include the generation of higher induced stresses in two-layer grafts. In the one-layer graft models, a 15° fiber orientation produced the highest expansion at a minimal stress value of 0.21 MPa. In the two-layer graft models, the 45°–15° fiber orientation generated the maximum expansion with minimum stress. A range of such findings were analyzed to determine the graft orientations that may allow enhanced expansion without generating much stress. This information would be indispensable not only for understanding the expansion potential of skin grafts, but also for further research and the development of skin grafts with enhanced expansion for severe burn injury treatment. Full article

Dermatofibrosarcoma protuberans (DFSP) is a rare mesenchymal tumor of intermediate malignant potential. The neoplasm is locally aggressive with a high rate of recurrence. It typically presents in adults. Atrophic congenital DFSP is extremely rare. The few reported cases have presented as a morphea-like plaque that persists for years, before progressing into a nodular form. To our knowledge, congenital atrophic DFSP has been only reported fourteen times, and of those, only nine were confirmed by molecular studies. Herein we report a congenital case of atrophic DFSP, which initially presented as a bruise-like atrophic plaque on the dorsal forearm, initially mistaken for child abuse. The clinical appearance, histopathology, and molecular features of this rare form of DFSP are reviewed. Our case highlights the importance of early detection and adequate sampling of congenital DFSP; early treatment allows for treating small lesions without large, disfiguring, and potentially disabling excisions. Full article