Medicine and Pharmacology

Abstract: Periorbital hyperpigmentation (POH), commonly known as dark circles, is a highly prevalent, benign cosmetic concern with a heterogeneous etiology spanning constitutional (pigmentary), vascular, post-inflammatory, and structural (shadow/volume-loss) subtypes, which frequently coexist in the same patient. This narrative review draws on a literature search (PubMed, Cochrane Central and Google Scholar, conducted in September 2026) identifying 102 relevant sources spanning 1995–2026, of which 66 are directly cited, summarizing the evidence for each major treatment category, topical/cosmeceutical agents, chemical peels, laser and light-based devices, micro-needling, platelet-rich plasma (PRP), platelet-rich fibrin, carboxytherapy, dermal fillers, and autologous fat/nanofat grafting, organized around the presumed etiological subtype being treated. This review is an etiology-based framework to critically synthesize the treatment literature and distinguish replicated comparative evidence from isolated comparisons. Although improvement has been reported with many modalities, certainty remains limited by small samples, heterogeneous outcomes, inconsistent etiological classification, and short follow-up. We highlight replication of comparative trials with standardized outcome measures as the field's most pressing need.

Abstract: Background and Clinical Significance: Herpes zoster (HZ) results from reactivation of latent varicella-zoster virus and disproportionately affects older adults. Antiviral therapy and systemic analgesia are well established, but local wound care of the eroded skin remains largely empirical: no dressing has been validated in controlled trials for this indication, and denuded HZ lesions are frequently mismanaged with dry gauze that adheres to the wound bed and aggravates pain. Case Presentation: An 85-year-old man with no known chronic disease presented with a one-week history of thoracic HZ unresponsive to outpatient antiviral therapy, requiring admission for uncontrolled pain (9/10 on the Numeric Rating Scale, NRS), vomiting, asthenia, and hyporexia. Examination revealed confluent, superficial-partial-thickness erosions across the T6–T8 dermatomes (12.5 × 24 cm). After a negative wound culture, a single polylactic-acid-based membrane (Suprathel®250) was applied over the entire denuded area. Pain fell from 9/10 to 2/10 on the NRS within seven days, the membrane fully resorbed with complete re-epithelialization by day 12, and the patient resumed independent daily activities by the third week without scarring. Conclusions: A polylactic acid membrane produced rapid pain relief and complete wound closure after a single application in an extensive HZ lesion, comparing favorably with published outcomes for hydrocolloid dressings and standard gauze-based care. Synthetic skin substitutes deserve controlled evaluation as a dedicated wound-care option for HZ, particularly for patients with extensive dermatomal involvement or poor tolerance of conventional dressings.

Abstract: Topical vitamin D analogs are well-established therapies for psoriasis, but their broader dermatologic potential increasingly depends not only on their biological activity but also on the ability of topical formulations to achieve effective and localized cutaneous delivery. This narrative review critically examines the emerging use of calcipotriol, tacalcitol, and calcitriol beyond psoriasis, with particular emphasis on formulation strategies, cutaneous drug delivery, and their relationship with clinical performance. Conventional topical dosage forms, including ointments, creams, and solutions, remain the principal delivery systems used in clinical studies. Their therapeutic performance is influenced by vehicle composition, skin-barrier integrity, local retention, application conditions, and the physi-cochemical properties of the vitamin D compound, which collectively determine cutaneous penetration, tolerability, and systemic exposure. Across the reviewed indications, formula-tions and treatment protocols vary considerably, contributing to heterogeneity in clinical outcomes. Vitiligo currently presents the strongest clinical evidence, particularly when topical vitamin D analogs are combined with narrowband ultraviolet B phototherapy, whereas encouraging results have been reported for morphea, acne vulgaris, and inherited ichthyoses. Evidence for atopic dermatitis, alopecia areata, and basal cell carcinoma re-mains limited or inconsistent. Beyond conventional vehicles, emerging delivery technolo-gies including liposomes, nanoemulsions, solid lipid nanoparticles, nanostructured lipid carriers, polymeric nanocarriers, hydrogels, and microneedle-assisted systems offer op-portunities to enhance skin targeting, improve local drug retention and reduce systemic exposure. However, evidence specifically evaluating these advanced systems for vitamin D analogs remains predominantly preclinical. Future research should integrate clinical evaluation with formulation optimization, cutaneous pharmacokinetics, and comparative delivery studies, as accumulating evidence suggests that formulation-dependent skin de-livery may be a critical determinant of therapeutic success beyond psoriasis.

Abstract: Background/Objectives: Cutaneous melanoma is predominantly sporadic, although a subset of patients presents clinical features suggestive of inherited susceptibility. We introduced the pragmatic concept of genetically enriched (GE) melanoma, defined by the presence of early-onset melanoma, familial melanoma, or multiple primary melanomas. Methods: Its clinicopathological characteristics and prognosis were compared with those of sporadic melanoma. Demographic, clinicopathological, and survival data were analyzed using descriptive statistics, survival analysis, and Cox regression models. Results: In this retrospective single-center study, 1,874 patients were classified as having GE (n = 796, 42.5%) or sporadic melanoma (n = 1,078, 57.5%). Patients with GE melanoma were significantly younger at diagnosis (median age, 37 years [IQR 32–43] vs 57 years [IQR 50–66], p < 0.001) and were more frequently females than those with sporadic melanoma (56.8% vs. 51.4%, p = 0.024). The GE cohort also showed a distinct clinicopathological profile, with a higher proportion of melanoma in situ (20.2% vs. 15.2%), lower proportions of acral lentiginous (3.5% vs. 1.1%) and lentigo maligna (5.2% vs. 1.4%) melanoma, and a lower prevalence of previous malignancies. After a median follow-up of 8 years, disease-free survival did not differ significantly between the two cohorts (log-rank p = 0.23). Within the GE cohort, older age and male sex were associated with a higher risk of recurrence. Conclusions: Overall, patients fulfilling clinical criteria suggestive of inherited melanoma susceptibility appear to represent a distinct clinicopathological subgroup without evidence of poorer prognosis. The concept of GE melanoma may offer a pragmatic framework for identifying patients who may benefit from genetic counseling and tailored surveillance strategies.

Abstract: Pigmented lesions arising at sites of remote trauma can create diagnostic uncertainty when their clinical appearance overlaps with melanocytic neoplasms. A 64-year-old man presented with an asymptomatic 6-mm blue dermal nodule on the left fifth digit at the site of a penetrating pencil injury sustained during childhood. After remaining unchanged for decades, the lesion gradually enlarged over three years and produced mild nail plate deformity without periungual or subungual pigmentation. Cellular blue nevus, nodular melanoma, and graphite foreign-body granuloma were considered. Shave biopsy revealed a well-demarcated intradermal lesion containing abundant dark amorphous pigment and sclerosis. Higher-power examination demonstrated coarse granular black pigment with multinucleated giant cells and surrounding fibrosis, without melanocytic proliferation. These findings established the diagnosis of graphite foreign-body granuloma. The prolonged latency and recent enlargement illustrate how retained graphite may become clinically concerning many years after implantation. Because clinical features may overlap with melanoma and other pigmented tumors, remote trauma history can refine the differential diagnosis but cannot replace tissue examination. Histopathologic evaluation remains essential for definitive distinction of exogenous pigment from melanocytic proliferation.

Abstract: Background/Objectives: Atopic dermatitis (AD) has been associated with osteoporosis and fractures, but the magnitude, mechanisms, therapeutic implications, and clinical relevance of this relationship remain uncertain. This review critically evaluates the epidemiological and osteoimmunological evidence linking AD to skeletal fragility and proposes a lifespan-based, risk-adapted screening framework. Methods: A structured search of PubMed/MEDLINE and supplementary sources identified peer-reviewed publications from January 2020 through July 2026. Seventy-five studies, reviews, meta-analyses, guidelines, and consensus documents addressing AD, bone mineral density (BMD), osteoporosis, fractures, immune–bone pathways, treatment exposure, and skeletal assessment were included in a critical narrative synthesis. Results: A recent cohort-based meta-analysis associated AD with osteoporosis (odds ratio [OR], 1.56) and any fracture (OR, 1.08), although heterogeneity was substantial. Risk appeared greater in severe or long-standing disease and reflected the interaction among inflammatory, therapeutic, nutritional, behavioral, and age-related determinants. Systemic glucocorticoids constituted the clearest modifiable treatment-related risk, but did not fully explain the association. The RANK–RANKL–osteoprotegerin system and IL-4, IL-13, IL-31, and IL-33 provide biological plausibility, although their skeletal effects are context-dependent and predominantly supported by indirect or preclinical evidence. Available data do not demonstrate that dupilumab causes osteoporosis; emerging pediatric findings suggest improvements in growth and bone-related biomarkers, but do not demonstrate fracture prevention. Conclusions: AD alone does not justify universal DXA screening. Assessment should be individualized according to age, fragility-fracture history, disease severity and duration, cumulative systemic glucocorticoid exposure, nutritional status, physical activity, muscle function, and falls. Prospective studies combining standardized AD phenotyping with longitudinal imaging, biomarkers, and adjudicated fractures are required.

Abstract: Background: Trans-resveratrol (3,5,4′-trihydroxystilbene) is a natural polyphenolic antioxidant widely used in anti-aging dermocosmetics for its strong radical-scavenging capacity and its activation of cell-protective pathways such as SIRT1. However, its poor aqueous solubility, photochemical lability, and low bioavailability limit its incorporation into topical formulations and its delivery into the skin. Objective: In this study, ethosomal nanocarriers were designed as a phospholipid–ethanol vesicular system to solubilize, stabilize, and control the release of trans-resveratrol for dermocosmetic applications. Microfluidization process is not a commonly used method, however under optimized pressure circulating the formulation through the interaction chamber can produce ethosomes with desirable colloidal stability as an easy method. Methods: Resveratrol-loaded ethosomes were prepared with synthetic phosphatidylcholine (Lipoid P75), ethanol, and vitamin E. Microfluidisation was used as an easy method which was optimized by varying the number of high-pressure homogenization cycles and the pressure applied. Vesicle size, size distribution and distribution uniformity, zeta potential, pH, conductivity, density, and long-term stability were monitored for up to 180 days; morphology was examined by cryo-SEM and molecular compatibility by FTIR. A trans-resveratrol HPLC assay was developed and validated according to ICH Q2guidelines for quantitative analysis. Encapsulation efficiency was determined by HPLC after ultracentrifugation, cytotoxicity was assessed in HaCaT keratinocytes, and in vitro release was evaluated using Franz diffusion cells with two different membranes. Results: All ethosome formulations yielded a nanoscale size distribution (median diameter around 190 nm) and good colloidal stability, with absolute zeta potentials above the 30 mV threshold at early time points and had skin-compatible pH (around 6.5). The optimized formulation (T16) achieved a high encapsulation efficiency (EE) of 95.5% on day 1, 84.2% EE was retained after 180 days, consistent with strong partitioning of the lipophilic active into the ethanol–phospholipid bilayer. FTIR confirmed preservation of the phospholipid bilayer and indicated non-covalent loading, with the resveratrol bands largely masked by the dominant lipid signals. Cryo-SEM confirmed near-spherical vesicles with narrow size distribution. In vitro release showed a sustained, controlled release profile relative to a 1.5% resveratrol solution. Slower diffusion across the skin-mimicking Strat-M membrane was observed compared to cellulose acetate membrane. Conclusions: Using Optimized trans-resveratrol-loaded ethosomes represent a stable, efficient ethosomes enabling formulation stability and controlled topical release. The antioxidant and photoprotective efficacy of the loaded system was not assessed in this study and is identified as a topic for future work.

Abstract: Sebaceous carcinoma is an uncommon but potentially aggressive adnexal malignancy whose molecular pathogenesis has been substantially clarified in recent years. Rather than representing a single molecular entity, sebaceous carcinoma is now understood as a biologically heterogeneous group of tumors arising through distinct yet sometimes overlapping oncogenic pathways. Recent genomic and multi-omics studies have identified several major molecular subsets, including mismatch repair-deficient/microsatellite instability-associated tumors, ultraviolet radiation-driven tumors, and pauci-mutational tumors characterized predominantly by alterations in cell-cycle and epithelial differentiation regulators such as TP53, RB1, and ZNF750. These findings have also reinforced biologically relevant differences between ocular and extraocular sebaceous carcinoma, with periocular tumors more often enriched for TP53/RB1/ZNF750-driven mechanisms and extraocular tumors more frequently showing UV-related and MMR-deficient signatures. In addition to these core pathways, recent evidence has highlighted the contribution of NOTCH signaling, PI3K/AKT/mTOR pathway alterations, copy-number changes including MYC amplification, rare HPV-associated cases, and emerging transcriptomic abnormalities involving cholesterol metabolism and sebaceous differentiation programs. These advances not only deepen current understanding of sebaceous carcinoma biology but also have important diagnostic, prognostic, and therapeutic implications, particularly in relation to Lynch/Muir–Torre syndrome screening, molecular subclassification, and the potential use of immune checkpoint inhibitors and other targeted strategies in selected patients. This review provides an updated overview of the molecular pathogenesis of sebaceous carcinoma, focusing on the main genomic, transcriptomic, and biologically actionable alterations described to date, and discusses their implications for tumor classification, pathogenesis, and future translational research.

Abstract: Introduction: Vitiligo is a common pigmentary disorder, which is characterized by discrete depigmented patches or macules of different shapes and sizes, caused by the destruction of melanocytes. Although pruritus has been reported in a selected number of patients with vitiligo, the condition is normally asymptomatic. Objectives: The study aimed to determining the frequency of pruritus in patients with vitiligo and to identify the factors related to manifestation of pruritus. Design and methods: A prospective cross-sectional observational design was used in this study. Presence of symptomatic itch and the intensity of this symptom were evaluated among 59 patients with vitiligo who presented in the study period at Khartoum Dermatology Teaching Hospital and Omdurman Military Hospital in Sudan. Results: The study population consisted of 59 vitiligo patients, among them 33 (55.9%) were male and 26 (44.1%) were female, with a mean age of 30.15 ± 16.67 years. Itch was reported by 21 patients (35.6%), and 38 (64.4%) had no history of pruritus associated with vitiligo. Pruritus was the initial manifestation of vitiliginous lesions in most patients (66.7%), but in 33.3% it occurred after the lesions appeared. The itch intensity was 4 on a 10-point Visual Analogue Scale (VAS), with mild, moderate, and severe itch being reported in 42.9, 38.1, and 19% of patients respectively. In the majority of cases itch was intermittent (52.3%), then daily (33.3%), persistent itch (9.6%), and nocturnal itch (4.8%). The most frequently reported aggravating factors were hot weather. Conclusion: Itch was present in vitiligo patients with different levels of severity. Hot weather is the major aggravating factor. It usually preceded the onset of vitiligo lesions, and it was reported to be more intense in males compared females.

Abstract: Background: Facial pigmentary unevenness is frequently perceived as distressing and is associated with lower ratings of attractiveness, health, and youthfulness. Microdermabrasion together with selected cosmeceuticals can improve superficial discoloration, however, evaluation methods for objective color comparison differ considerably. Methods: We conducted an uncontrolled prospective interventional study in adults (n=5; ≥35 years) with pronounced skin pigmentation (all skin types) during four standardized institutional sessions every 14 days including a microdermabrasion and cosmetic protocol. Standardized facial photographs were rated in randomized, time-resolved order by expert estheticians (experts n=7) and lay assessors (novice n=13) using 5-point Likert scale questionnaire. Instrumental Colorimetry (VisioFace RD) quantified distinctive spot area (dL, %) and complexion evenness (dE) at baseline and over the following 10 weeks. Results: Pigment spot appearance and overall skin tone evenness improved significantly over time. Experts and novice rated most attributes equally. Even though analysis using traditional CIEDE color distance equations did not fully reflect hu-man perception, the triangulated, time-resolved assessment captured changes more comprehensively than colorimetry alone. Conclusions: This combined regimen was associated with improved facial pigmentation and tone uniformity. Instrumental colorimetry using CIEDE2000 calculation is recommended for future work.

Abstract: Hidradenitis suppurativa (HS) is a systemic inflammatory skin disease associated with obesity, insulin resistance, and visceral adiposity. Chronic metainflammation may contribute to cutaneous disease activity, while metabolic dysregulation potentially occurs independently of body mass index (BMI). Additionally, emerging metabolic pharmacotherapies may provide weight-dependent and weight-independent immunomodulatory benefits in HS. This narrative review synthesizes clinical and mechanistic evidence for glucagon-like peptide-1 receptor agonists (GLP-1RAs), GLP-1RA multi-agonists, metformin, sodium–glucose cotransporter 2 inhibitors (SGLT-2is), and peroxisome proliferator-activated receptor-gamma (PPAR-γ) agonists, in HS management. A structured PubMed and Embase search (28 March 2026) identified key metabolic-inflammatory targets. Proposed mechanisms include adipokine axis modulation (increased adiponectin; reduced leptin, retinol-binding protein 4, and haptoglobin); inhibition of nuclear factor kappa B (NF-κB) and NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome signaling; restoration of cutaneous antimicrobial peptides; and improved gut barrier function. Early screening for metabolic syndrome (MetS) enables dermatologists to initiate targeted metabolic pharmacotherapy before irreversible cutaneous scarring occurs. Integrating metabolic therapies into HS treatment algorithms using metabolic and inflammatory biomarkers supports phenotype-driven care, offering a synergistic strategy to optimize cutaneous control, extend biologic drug survival, and improve cardiometabolic health in selected patients with HS.

Abstract: Background/Objectives: psoriasis is a chronic immune-mediated inflammatory dis-ease associated with a high systemic burden. Inhibition of the IL-23/IL-17 axis is the cornerstone of therapy; however, in the assessment of psoriatic disease-associated comorbidities, an equally crucial topic concerns the study of immune-nutritional sta-tus. The aim of the study was to document the efficacy, safety and systemic impact of Bimekizumab and Tildrakizumab in patients with chronic plaque psoriasis by analyz-ing clinimetric and indices, atherogenic risk, and innovatively the immune-nutritional markers. Methods: this is a real world clinical study, including 52 psoriasis patients, treated with Bimekizumab or Tildrakizumab, followed for 52 weeks. In particular, we analized clinimetric (evaluated by PASI and DLQI) and inflammatory (CRP, ESR, NLR, PLR, and LMR ratios, SII) indices, atherogenic risk (by evaluating lipid profile), and im-munonutritional markers (HALP score, and CONUT score). Assessments were per-formed at baseline and after 52 weeks. Results: both treatments resulted in a significant reduction in PASI at week 52. The systemic inflammatory marker CRP decreased in both groups. A trend of reduction from baseline to week 52 was reported for both the NLR, and the PLR. Conversely, a trend of increase were reported for the LMR. The HALP index was significant increase in Bimekizumab group compared to Tildrakizumab group while the CONUT score was significantly lower, suggesting an improvement in the immune-nutritional status. Conclusion: In conclusion, the integrated assessment of hematological ratios, inflam-matory indices and immune-nutritional markers provides clinically useful information for a more complete and personalized management of the psoriatic patients.

Abstract: Significance: Chronic wounds are a growing public-health and economic burden. In the United States, about one-sixth of Medicare beneficiaries (~10.5 million people) carry a chronic wound, with Medicare spending an estimated $22.5 billion annually and global wound-care expenditure reached $148.65 billion in 2022. This review, written for clinicians and biomedical engineers, is organized from basic to advanced.Recent Advances: It defines normal skin architecture and regional variation, classifies the full spectrum of skin injury, and describes the body’s coupled tissue repair and immune response. It quantifies the epidemiology, risk, and mortality of the principal chronic wounds: arterial/ischemic, venous leg, and diabetic foot ulcers, pressure injury, and non-healing surgical wounds, and summarizes the clinical evidence and biological mechanisms of current chronic wound management strategies including revascularization, pressure redistribution, hyperbaric oxygen, debridement, infection control, and moisture-balancing, negative-pressure, growth factor, and skin substitute treatments, and it points to the databases, guidelines, and registries that anchor evidence-based practice.Critical Issues: The normal acute trajectory, which recovers only to about 70-80% of tensile strength, is contrasted with chronic wounds that stall in a self-sustaining inflammatory state marked by sustained neutrophils, cytokines, and M1 macrophages, bacterial biofilm, elevated matrix metalloproteinases, fibroblast senescence, and stalled keratinocytes, that recur or resist standard care despite management.Future Directions: Urgent unmet needs, from durable infection control to true regeneration and personalized care, are increasingly addressed through medical devices and engineered biomaterials.

Abstract: While anti-PD-1 immunotherapy has led to significant improvements in the outcome of advanced cutaneous squamous cell carcinoma (cSCC), over half of patients fail to respond, and there remains no established second line therapy. Here we present a systematic review of the literature and ongoing clinical trials to evaluate current evidence on treatment strategies in this setting. Following a comprehensive search, we identified 22 studies that were included in the final review. Data from the reported studies were compiled into the largest analysis on this topic to date, comprising 130 patients. Overall response rate (ORR), complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) were compared using Fisher’s exact tests. Median progression free survival (PFS) and overall survival (OS) were pooled using a sample-size–weighted approach. Although the review is limited by small sample sizes and the frequent use of combination rather than monotherapy regimens, the evidence suggests that epidermal growth factor receptor (EGFR) inhibition represents the current best treatment strategy for advanced cSCC following anti-PD-1 failure, supported by favourable reported outcomes including ORR, PFS and OS. Other treatment strategies including ipilimumab and oncolytic therapy show clinical promise warranting further investigation.

Abstract: Background/Objectives: Systemic corticosteroids remain pivotal in the management of moderate-to-severe inflammatory and autoimmune dermatoses, yet contemporary Indian data linking prescribing behaviour with patient-reported outcomes, adverse drug reaction (ADR) profiling and guideline concordance are sparse. We evaluated prescription patterns, effectiveness, quality of life, ADRs, adherence and concordance with the Indian Council of Medical Research (ICMR) Standard Treatment Workflows (STW) 2022. Methods: In a six-month prospective observational study at a Western Indian tertiary-care teaching hospital, adult (≥18 years) dermatology outpatients started on any systemic corticosteroid were reviewed at baseline and day 30. Disease-specific severity indices (PDAI, BPDAI, CLASI, EASI, LPSI, SALT, SCORAD, VASI) and the Dermatology Life Quality Index (DLQI) captured effectiveness; ADRs were graded per episode using the WHO–UMC causality scale; adherence was measured with the 5-item Medication Adherence Report Scale (MARS-5). Results: Of 82 patients enrolled (mean age 42.4 ± 14.9 years; 58.54% female), 76 (92.68%) completed follow-up. Eczematous dermatitis (23.17%), immunobullous disorders (21.95%) and papulosquamous disorders (12.20%) predominated. Oral Prednisolone accounted for 63.41% of prescriptions, and 80.49% carried a documented taper. Improvement occurred in 56/76 (73.68%), and mean DLQI fell by 9.62 points (57.06%; p < 0.001), with disease-specific severity indices showing mean reductions ranging from 20.42% (VASI, vitiligo) to 59.08% (SCORAD, atopic dermatitis). ADRs affected 11/82 patients (13.41%) across 14 episodes, of which 71.43% were mild. High adherence (MARS-5 = 25) was reported by 76.32%. Overall ICMR STW 2022 concordance was 67.80% (40/59); recurring deviations were drug selection (8/59; discoid lupus erythematosus, moderate eczema, urticaria), missing baseline random blood glucose documentation (12/59, 20.34%), non-concordant tapering regimens (9/59, 15.25%) and dose non-concordance (8/59, 13.56%). Conclusions: Systemic corticosteroid prescribing was broadly consistent with ICMR STW 2022, with satisfactory tapering documentation, encouraging short-term efficacy, an acceptable ADR profile and high self-reported adherence. Deviations clustered in three actionable areas — drug selection in discoid lupus erythematosus, moderate eczema and urticaria; dose- and taper-regimen concordance; and pre-treatment metabolic screening (random blood glucose) — providing concrete targets for departmental educational intervention. Larger multicentre studies with longer follow-up are warranted.

Abstract: Skin biopsy is one of the most valuable diagnostic procedures in dermatology, particularly when clinical findings alone are insufficient to establish a diagnosis. However, obtaining an accurate histopathological diagnosis depends on multiple steps, and errors at any stage of the biopsy pathway may compromise the final result. This review synthesizes current evidence and available guidelines on best practices for skin biopsy, integrating the practical experience of four internationally recognized dermatopathologists to address areas where evidence is limited or poorly standardized. The review covers biopsy planning, selection of the optimal biopsy site and technique, specimen handling and fixation, grossing and laboratory processing, prevention of technical artifacts, the use of ancillary diagnostic techniques, and clinicopathological correlation, with particular attention to challenging anatomical sites and complex diseases. Diagnostic accuracy depends on obtaining a representative specimen, maintaining high technical standards throughout tissue processing, providing adequate clinical information, and ensuring close communication between the clinician and the dermatopathologist. In selected cases, multidisciplinary review is required to reach a definitive diagnosis. Adherence to these principles can optimize diagnostic yield, reduce avoidable errors, and ultimately improve patient care.

Abstract: Background: Hair loss is one of the most common reasons patients seek dermatologic evaluation. Although clinical examination and trichoscopy establish the diagnosis in most cases, scalp biopsy remains essential when findings are inconclusive, when cicatricial alopecia is suspected, or when histopathologic documentation is required before systemic therapy. Methods: This narrative review synthesizes evidence from PubMed/MEDLINE and Embase on the indications, biopsy site selection, sampling technique, specimen processing, and histopathologic interpretation of scalp biopsy in alopecia. Results: Diagnostic yield depends on appropriate patient selection, trichoscopy-guided site selection, meticulous sampling, and optimal processing. A 4-mm punch oriented parallel to the hair shafts and extending into the subcutaneous fat, combined with horizontal and vertical sectioning (HoVert or Tyler technique), allows the most comprehensive assessment of follicular architecture. Histopathology reliably separates scarring from nonscarring alopecia and, in cicatricial forms, classifies disease by the predominant inflammatory infiltrate following the NAHRS scheme. Ancillary studies, including direct immunofluorescence, periodic acid-Schiff staining, elastic fiber stains, and microbiologic cultures, are applied selectively when clinically indicated. Conclusions: Integrating clinical, trichoscopic, and histopathologic findings improves diagnostic accuracy and guides therapeutic decisions. Close collaboration between the dermatologist and dermatopathologist maximizes the diagnostic value of scalp biopsy.

Abstract: Background: With changes in lifestyle and increased psychological stress, the incidence of hair disorders has risen, creating an urgent clinical need for non-invasive and highly effective diagnostic and therapeutic methods. Ultrasound, with its advantages of being non-invasive, real-time, reproducible, and capable of deep imaging, has become a key technology for the auxiliary diagnosis and treatment of hair disorders. This article systematically reviews the basic principles of ultrasound diagnosis and treatment, summarizes the diagnostic value of high-frequency ultrasound in hair disorders, and elaborates on the principles underlying the application of focused ultrasound in the treatment of hair disorders. Methods: By searching databases such as PubMed, Web of Science, and OVID-MEDLINE, we included relevant original studies, reviews, and clinical guidelines on the application of ultrasound in hair disorders published over the past decade to conduct a narrative review. Results: High-frequency ultrasound can clearly display the structures of various scalp layers, hair follicle morphology, hair shaft echopatterning, and blood flow perfusion characteristics. It enables early assessment of hair follicle miniaturization, inflammatory infiltration, and lesion characteristics, thereby overcoming the limitations of dermatoscopy—which can only observe the surface—and invasive histopathology. Focused ultrasound not only precisely ablates pathological tissue but also synergizes with microbubble carriers to enhance the transdermal delivery efficiency of hair-growth agents such as minoxidil and gene therapies. Conclusion: Ultrasound shows significant potential in the non-invasive diagnosis, staging, efficacy monitoring, and targeted treatment of hair disorders; however, current challenges include high operator dependency, a lack of standardized parameters, and insufficient high-quality evidence-based research. Future large-sample, multicenter randomized controlled trials are needed to establish appropriate ultrasound frequencies, energy doses, and treatment protocols for different hair disorders, thereby promoting the standardized clinical translation and widespread application of ultrasound technology in hair medicine.

Abstract: Background/Objectives: Wound healing relies on oxygen availability and controlled reactive oxygen species (ROS) signaling. Excessive ROS hinder repair, whereas low, sustained levels promote angiogenesis, antimicrobial defense, and tissue regeneration. Oxygen-enriched oleic matrices (OEOMs), generated by ozonating vegetable oils, combine a moist lipidic environment with continuous ROS and pH modulation. This review summarizes their mechanisms and clinical applications. Methods: We analyzed preclinical and clinical studies addressing the chemistry, mode of action, and translational use of OEOMs. Evidence was appraised across burns, surgical wounds, oncologic settings, pediatrics, and chronic ulcers. Results: Ozonation stabilizes oleic acid into gel-like matrices that act as wound barriers while releasing hydrogen peroxide, oxygen, and fatty acids. These mechanisms reduce microbial growth, lower pH, and support keratinocyte and fibroblast activity. Clinically, OEOMs accelerate healing, reduce pain, and improve outcomes in burns, oral ulcers, and Stevens–Johnson syndrome. Postsurgical applications—including hidradenitis suppurativa and pilonidal sinus disease—show improved closure, scar quality, and lower recurrence. In oncologic and reconstructive surgery, OEOMs decrease pain, enhance satisfaction, and facilitate outpatient care. Chronic leg ulcers demonstrate granulation, re-epithelialization, pain reduction, and absence of infections. Most studies are case series or small cohorts, with consistent safety and tolerability. Conclusions: EOMs provide combined antimicrobial and pro-regenerative effects across diverse wound types. Current evidence supports their role as innovative wound dressings, though larger randomized trials are needed to validate efficacy and cost-effectiveness.

Abstract: Background/Objectives: Cutaneous T-cell lymphomas (CTCL), most commonly mycosis fungoides and Sézary syndrome, are rare non-Hodgkin lymphomas. Advanced disease responds poorly to current treatments, highlighting the need for new molecularly tar-geted therapies. WEE1 is a central regulator of the G2/M checkpoint and S-phase progression and has emerged as a therapeutic target in several malignancies, yet it has not been systematically explored in CTCL. Methods: We screened a library of more than 2,200 kinase inhibitors in CTCL cell lines and selected adavosertib for further study. Its effects were tested in four CTCL lines, in primary keratinocytes and fibroblasts, in patient-derived malignant CD4⁺ T cells and healthy donor CD4⁺ T cells, and in a MyLa xenograft model, using viability, apoptosis, cell-cycle, western blot, and phospho-protein array assays. Results: Adavosertib reduced viability at submicromolar IC₅₀ values (0.26–0.56 µM) across all four CTCL lines while largely sparing primary skin cells and was more active in malignant than in healthy donor CD4⁺ T cells. It induced apoptosis and cell-line-specific S-phase and/or G2/M accumulation, lowered WEE1 and phospho-CDK1 (Tyr15), and increased phospho-H2A.X. A phospho-protein array showed activation of checkpoint and stress signalling. In vivo, adavosertib slowed MyLa xenograft growth. Conclusions: These preclinical data identify WEE1 as a therapeutic target in CTCL and support further preclinical and early-phase clinical evaluation of adavosertib in this disease.