Cutaneous manifestations of Zika virus
The Zika virus has been reported in Africa, Asia, the Pacific, and the Americas, including 52 travel-related cases in the United States.
The most common dermatologic finding is a nonspecific, diffuse eruption of macules and papules that usually resolves within 1 week.
Dermatologists should be aware that a maculopapular exanthem does not rule in or out Zika, but the eruption is present in 90% to 95% of cases.
The exanthem seen in Zika generally begins on the face and extends down the trunk and extremities while sparing the palms and soles.
Mild petechiae and bleeding gums may also be seen. Because of the nonspecific morbilliform morphology, travel history is important, and the
differential diagnosis should also include dengue and chikungunya virus.
Testing via ELISA and PCR can be done within the first 7 days, or testing based on Zika-specific IgM antibodies and plaque-reduction neutralization
tests can be done 4 or more days after disease onset.
J Am Acad Dermatol. 2016 Mar 23. pii: S0190-9622(16)01502
Exploring the Association Between Rosacea and neurodegenerative disorders
Rosacea is a common chronic inflammatory skin disorder where upregulation of matrix metalloproteinases (MMPs) and antimicrobial peptides (AMPs) is observed. Notably, inflammation, MMPs, and AMPs are also involved in the etiopathogenesis of neurodegenerative disorders.
Rosacea constitutes an independent risk factor for Parkinson disease. In a nationwide cohort study there was a 2-fold increased risk of Parkinson disease in patients classified as having ocular rosacea (adjusted IRR, 2.03 [95% CI, 1.67-2.48]). Rosacea is also significantly associated with dementia, particularly Alzheimer disease. The same cohort study also found that mild and moderate-to-severe rosacea increases the risk of both depression and anxiety disorders.
Increased focus on symptoms of cognitive dysfunction in older patients with rosacea may be relevant.
JAMA Neurol. 2016 May 1;73(5):529-34, Ann Neurol. 2016 Apr 28. doi: 10.1002/ana.24645, Dermatology. 2016;232(2):208-13. doi: 10.1159/000444082. Epub 2016 Mar 9.
Cutaneous findings and underlying endocrine disorders
Retrospective cross-sectional study of a racially diverse referred sample of women published in the April 2016 issue of JAMA dermatology concluded that Hirsutism and acanthosis nigricans (AN) are the most reliable cutaneous markers of polycystic ovary syndrome (PCOS) and require a comprehensive skin examination to diagnose. Women who met the PCOS criteria demonstrated more severe truncal hirsutism and higher rates of axillary AN. Acne and androgenic alopecia are prevalent but unreliable markers of biochemical hyperandrogenism among this population.
Another cross-sectional study from India, published in the same issue concluded that post adolescent male patients with acne more commonly have insulin resistance. This resistance may be a stage of prediabetes, and the patients may develop hyperinsulinemia or type 2 diabetes in the future.
JAMA Dermatol. 2016 Apr 1;152(4):391-8, JAMA Dermatol. 2016 Apr 1;152(4):399-404.
Measuring variation in scalp hair fiber shape and pigmentation
A study evaluated the use of quantitative methods of measuring variation in scalp hair fiber shape and pigmentation. Cross-sectional area and shape and average curvature of scalp hair fibers were quantified and pigmentation was analyzed using chemical methods.
African and African Diaspora scalp hair was significantly curled, (East) Asian hair was significantly thick, and European hair was significantly lighter in color. These results reinforced findings from earlier, traditional studies. However, pigmentation analyses revealed a high level of variability in the melanin content of non-European populations and analysis of curvature found a large range of variation in the average curvature of East African individuals.
Am J Phys Anthropol. 2016 Jun;160(2):341-52.
Protective effects of stem cells against skin pigmentation
Hyperpigmentation, mainly following UV-irradiation, can cause major cosmetic concerns. Human adipose tissue-derived stem cells (ASCs) have been reported to serve as whitening agents through a paracrine effect.
Results of an animal study suggest that ASCs injected subcutaneously can attenuate tanning following UVB-irradiation, through suppression of tyrosinase activity. In the study, skin pigmentation was suppressed and the change in skin thickness following UVB irradiation was reduced in the ASC-injected side. The tyrosinase activity and melanin content of the ASC-injected side were also significantly reduced.
J Plast Surg Hand Surg. 2016 May 4:1-7
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