Differential Diagnosis and Treatment of Itching in Children and Adolescents

Saccharomyces boulardii (CNCM I-745) ameliorates Ovalbumin-induced atopic dermatitis by modulating the NF-κB signaling in skin and colon

Atopic dermatitis (AD) is a long-lasting allergic disorder characterized by itching, redness, swelling, dry skin, scaling, inflammation, and tissue damage. The exact cause of AD is still unknown. Steroid medications are frequently utilized in treating AD, but their prolonged use can result in complications. Multiple studies suggest probiotics may regulate the immune system, boost immune functionality, or reduce overactive immune responses. The current study investigated the anti-inflammatory, antioxidant, and immunomodulatory role of Saccharomyces boulardii in Ovalbumin (OVA)-induced AD in a murine model. Balb/c mice were sensitized and challenged with OVA to induce AD-like lesions. S. boulardii 1 × 109 CFU/ml/day/mice was orally administrated either as a pretreatment (administered 7 days before OVA induction and continued till day 28) or concurrent treatment (administered from day 1 and continued till day 28). Dexamethasone (5 mg/kg/day) was used as a standard treatment. S. boulardii alleviated the macroscopic and behavioral changes. Blood inflammatory cells were significantly reduced. Serum IgE levels were decreased. Oxidative stress and histopathological changes (epidermal/dermal thickness, inflammatory cells, collagen deposition) in skin tissue were improved. Similarly, the colon's antioxidant capacity and histological architecture were also maintained. Expression of proinflammatory cytokines like TNF-⍺ and IL-1β were significantly reduced in skin and colon tissue. The probiotic S. boulardii under study reduced inflammation by downregulating NF-κB signaling in both skin and colon tissue. This study provides a basis for a possible gut-skin axis, which can be targeted to relieve AD symptoms.

Explicating the multifunctional roles of tocotrienol and squalene in promoting skin health

The skin is the largest organ in the integumentary system, protecting against various external threats, including ultraviolet exposure, heat, infections, dehydration and mechanical injuries. Skin disorders can arise from various causes, including allergic reactions or breaches in the skin barrier, which allow microorganisms or chemicals to penetrate the sweat ducts. These conditions encompass a wide range of issues, including acne, xerosis (dry skin), fungal infections, atopic dermatitis (eczema) and psoriasis. Collectively, these ailments affect a significant portion of the global population, impacting approximately one-third of people worldwide. Additionally, oxidative stress induced by ageing and prolonged exposure to ultraviolet rays can manifest in visible alterations such as pigmentation, wrinkling and dehydration. Recent investigations have underscored the potential of natural antioxidant compounds in safeguarding skin health and combating ageing-related changes. Tocotrienols, a subgroup of vitamin E, have garnered significant attention owing to their antioxidant and anti-inflammatory properties. Significant amounts of tocotrienols can be found in rice bran, olive, oats and hazelnuts. Similarly, squalene, predominantly sourced from fish liver oils such as those from sharks, has been used as an emollient in cosmetic formulations. This article offers a comprehensive review of existing literature elucidating the dermatological benefits associated with tocotrienols and squalene, emphasising their roles as antioxidants, anti-inflammatories, skin barrier protection and facilitators of wound healing. Moreover, it sheds light on contemporary research findings suggesting these compounds' therapeutic promise in managing and ameliorating various skin conditions.

Managing Dermatologic Effects of Gender-Affirming Therapy in Transgender Adolescents

Transgender adolescents seek gender-affirming medical care to address gender identity and incongruence. Improved understanding of the dermatologic impact of gender-affirming medical care such as pubertal suppression, hormone therapy, and surgeries can enhance patient outcome. Pubertal suppression treats dysphoria associated with development of secondary sex characteristics, including androgen-driven acne. Gender-affirming hormone therapy influences acne and hair development in transgender adolescents. Dermatologists can help manage skin effects associated with chest binding and gender-affirming hormone therapy and surgery. Provision of patient-centered gender-affirming care in dermatologic and multidisciplinary settings is essential to improve skin and overall outcomes of gender-affirming therapy.