Accurate assessment of crow's feet is limited by subjective scales and single-dimensional objective tools, impeding standardized evaluation. We recruited 350 healthy Chinese women and acquired macroscopic and microstructural parameters using VISIA-CR, DermaTOP[®], and two-photon microscopy. Following expert clinical grading, we developed a dual-track modeling strategy that combines interpretable Ridge Regression and TPOT-optimized Support Vector Regression (SVR) to translate macroscopic parameters into clinical scores. SVR model interpretability was evaluated by SHapley Additive exPlanations (SHAP) analysis. Crow's feet severity increased non-linearly with age. Two-photon microscopy qualitatively supported the hypothesis that grade 4 corresponds to a phase of notable epidermal barrier disruption and grade 5 to pronounced dermal matrix disorganization. The Ridge Regression model achieved a robust overall fit (R[2] = 0.519). Macroscopically, the Stacked SVR model achieved superior predictive precision in the Early Stage (Grades 0-2) by capturing subtle non-linear textural shifts, whereas the Ridge Regression model maintained robustness from the Transition Stage (Grades 3-4) onwards. SHAP analysis supported the physiological plausibility of the non-linear model. This study clarifies the micro‑physiological basis of crow's feet aging and establishes a stage-specific dual-track predictive framework, providing an objective, standardized approach for skin aging assessment.

Many Chinese wrinkle studies continue to use non-Chinese scales because few Chinese-based wrinkle scales have been developed. The study aims to develop a crow's feet grading scale for Chinese individuals. We enrolled 608 healthy Chinese subjects and measured data through the DermaTOP system. We chose exploratory factor analysis (EFA) to reduce the dimensions of the data. A three-factor structure was obtained by using EFA, and it explained a cumulative total of 89.551% of the variance. A computational formula was obtained by calculating the total factor tilt scores and taking the variance contribution rate of three factors as the weight. Based on the computational formula, a grading map was designed and tested. The model validation was conducted using both subjective assessments from the expert panel and objective results from the model calculations. The results showed that our grading scale model is stable. This study developed a Chinese crow's feet (CCF) grading scale, which included a parameter, a grading map, and literal descriptions. The CCF grading scale is a validated tool for evaluating the effects of cosmetics or specific therapies. More importantly, the CCF scale was developed based on objective data, which may inspire new ideas for wrinkle grading scale development in the future.

Annular lichen planus is a rare clinical variant of the lichen planus presenting with round-oval, red to brown macules and plaques with no central atrophy and slightly raised, nonscaly borders. Histopathological features are indistinguishable from typical lichen planus. Given that the accurate diagnosis relies on both the clinical presentation and typical histological features, it is important to be aware of the clinical spectrum of lichen planus. Click https://wileyhealthlearning.com/#/online-courses/6be3b20c-e9c3-40e9-8f36-bfcda6718a73 for the corresponding questions to this CME article.

Topical prednicarbate has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids may cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only the lower potency corticosteroids should be used on the nipple or areola where the infant could directly ingest the drugs from the skin. Only water-miscible cream products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1] Any topical corticosteroid should be wiped off thoroughly prior to nursing if it is being applied to the breast or nipple area.

Emission of compounds with biological activities from waste water treatment plant (WWTP) effluents into surface waters is a topic of concern for ecology and drinking water quality. We investigated the occurrence of hormone-like activities in waste water sample extracts from four Dutch WWTPs and pursued to identify compounds responsible for them. To this aim, in vitro reporter gene bioassays for androgenic, anti-androgenic, estrogenic, glucocorticoid and progestogenic activity and a UPLC-tQ-MS target analysis method for 25 steroid hormones used in high volumes in pharmacy were applied. Principal component analysis of the data was performed to further characterize the detected activities and compounds. All five types of activities tested were observed in the WWTP samples. Androgenic and estrogenic activities were almost completely removed during WW treatment, anti-androgenic activity was only found in treated WW. Glucocorticoid and progestogenic activities persisted throughout the treatment. The androgenic activity in both influent could predominantly be attributed to the presence of androstenedione and testosterone. Anti-androgenic activity was explained by the presence of cyproterone acetate. The glucocorticoid activity in influent was fully explained by prednicarbate, triamcinolone acetonide, dexamethasone and amcinonide. In effluent however, detected hormones could only explain 10-32% of the activity, indicating the presence of unknown glucocorticoids or their metabolites in effluent. Progesterone and levonorgestrel could explain the observed progestogenic activity. The principle component analysis confirmed the way in which hormones fit in the spectrum of other emerging contaminants concerning occurrence and fate in WWTPs.

This article presents the case of a patient with newly developed skin erosions and ulcerations following an exanthematous drug eruption due to sultamicillin therapy. The skin lesions were treated topically with clobetasol and prednicarbate and orally with methylprednisolone. A skin smear revealed massive growth of Escherichia coli bacteria. Blood cultures were negative. The cause for developing ecthyma gangrenosum in our patient were iatrogenic immunosuppression and transient bacteremia.