Chemotherapy resistance remains a significant challenge in colorectal cancer (CRC) treatment, with disrupted redox balance playing a central role. Here we identify CHTOP as a key regulator of oxidative stress and chemoresistance in CRC. Mechanistically, CHTOP promotes NRF2 transcriptional activity by recruiting the SENP3-containing 5FMC complex to deSUMOylate NRF2, thereby sustaining HO-1 expression and redox balance. Notably, CHTOP expression itself is tightly controlled by a feedback mechanism. The p52 isoform of PSIP1 inhibits CHTOP expression by interfering with HNRNPH1-mediated splicing, leading to CHTOP degradation via nonsense-mediated decay (NMD). Conversely, elevated oxidative stress stabilizes SENP3, which promotes deSUMOylation and degradation of p52, thereby relieving p52-mediated suppression of CHTOP expression. This establishes an oxidative stress-SENP3-p52-CHTOP feedback loop that fine-tunes CHTOP levels. In 5-FU-resistant CRC cells, CHTOP downregulation shifts cells into an elevated oxidative stress state, which correlates with reduced 5-FU sensitivity. Notably, either restoring CHTOP expression or further depleting CHTOP disrupts this redox balance and resensitizes resistant cells to 5-FU. These findings suggest that modulating CHTOP expression may offer a therapeutic strategy to overcome chemoresistance in CRC through redox regulation.

Neurofibromatosis type 1 (NF1) is a common autosomal dominant neurocutaneous syndrome that affects 1 in 2,500-3,000 births. The phenotypic hallmarks include Lisch nodules, optic nerve gliomas, café-au-lait spots, axillary freckling, and benign neurofibromas. NF1 patients carry an 8-13% lifetime risk of malignant peripheral nerve sheath tumors, the leading cause of NF1 mortality. Current genetic testing detects NF1 variants in 95-97% of cases. In this prospective cohort of 103 cases, we used targeted NF1 sequencing by next-generation sequencing, multiplex ligation-dependent probe amplification (MLPA), and whole-genome sequencing to identify causative variants. Pathogenic or likely pathogenic variants were identified by in-house targeted testing in 93% of cases; six cases had large deletions detected by MLPA, and two had variants identified by whole-genome sequencing. This is the largest genetically confirmed Indian NF1 cohort reported, expanding the known mutational spectrum and demonstrating the utility of whole-genome sequencing for unresolved cases (~2%), as well as highlighting the clinical and genetic heterogeneity of NF1.

Conventional wound dressings often fail to integrate rapid hemostasis, antibacterial protection, and a pro-regenerative microenvironment, leading to persistent infection and delayed healing in complex wounds. Herein, we report a multifunctional self-adhesive hydrogel for integrated hemostatic, antibacterial, and regenerative wound management with a synergistic dual-crosslinked network. The hydrogel is composed of methylacrylamide-modified type I collagen (ColMA), o-nitrobenzene-modified hyaluronic acid (HANB), and methylacrylamide-modified chitosan (CSMA), and can rapidly form in situ under UV irradiation through free-radical polymerization of methacrylamide groups and Schiff base reactions between HANB and amino groups on ColMA/CSMA. Once applied to infected wounds, the hydrogel rapidly seals the wound bed and adheres tightly to the tissue, where HANB contributes hemostatic and adhesive properties, CSMA provides intrinsic antibacterial activity to inhibit bacterial colonization, and ColMA offers extracellular matrix-mimicking cues to support cell adhesion and tissue regeneration. Through this coordinated mechanism, the hydrogel not only controls bleeding and reduces infection risk at the early stage but also promotes the growth of granulation tissue, re-epithelialization, and matrix reconstruction during the subsequent repair phase. This platform integrates wound closure, antibacterial defense, and tissue regeneration into a single dressing system, acting as a promising strategy for the treatment of infected wounds.

Nevus spilus (NS) is a melanocytic lesion characterized by multiple darker macules or papules within a lighter-brown background patch. It is generally considered benign, but rarely melanoma may arise within NS. This association is controversial and poorly quantified. We systematically reviewed the literature on melanoma arising in NS and describe two additional reports. Clinical, histopathologic, molecular, and outcome data were extracted from all eligible cases. The aim of our study was to analyze the clinicopathological patterns, risk factors, and management implications. A total of 39 cases met inclusion criteria, suggesting that melanoma arising in NS is rare but not anecdotal. Most cases occurred in large, congenital, zosteriform lesions; the predominant location was the trunk, followed by the lower and upper limbs; the most common histotype was superficial spreading melanoma (SSM). Favorable outcomes were associated with early detection and thinner lesions, whereas thicker or nodular melanomas and delayed diagnosis correlated with poorer prognosis. Molecular data were limited but suggested possible heterogeneity, with infrequent BRAF/NRAS mutations. The risk of melanoma arising in NS appears to be subtype-dependent rather than uniform. Routine prophylactic excision of NS lesions is not supported by current evidence. A structured clinical and dermoscopic follow-up - particularly for larger, congenital, and segmental lesions - may represent a balanced management strategy, facilitating earlier identification of malignant transformation and ultimately improving patient outcomes. Further molecular profiling studies are needed to clarify pathogenetic mechanisms and refine risk stratification.

Background Chronic neck pain (CNP) is a major contributor to disability worldwide and may also occur as part of widespread pain syndromes such as fibromyalgia. However, evidence regarding its impact on health-related quality of life (HRQoL) remains limited in low- and middle-income countries such as Bangladesh. This study aimed to assess the relationship between pain intensity and HRQoL among patients with CNP. Materials and methods A hospital-based cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University in Dhaka from April 2021 to January 2022. A total of 96 adult patients (aged 20-60 years) with clinically diagnosed CNP (pain duration ≥3 months) were recruited using consecutive sampling. Pain intensity was measured using the visual analog scale (VAS). HRQoL was assessed using the Bangla version of the SF-36 questionnaire, which covers eight domains, as well as physical and mental health summary scores (PHS and MHS). Data were collected through face-to-face interviews and analyzed using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). Pearson correlation coefficients were computed to evaluate associations between pain intensity and HRQoL domains. Results The mean age of the participants was 38.37 ± 10.28 years, and 71 (74.0%) were male in this hospital-based sample. The most impaired SF-36 domain was role limitation due to physical health (mean: 36.19 ± 22.02). Pain intensity showed a strong negative correlation with physical functioning (r = -0.713, p < 0.001) and moderate negative correlations with PHS (r = -0.420, p < 0.001), MHS (r = -0.527, p < 0.001), and total SF-36 score (r = -0.550, p < 0.001). No significant correlations were observed with social functioning (r = -0.131, p = 0.205) or mental health (r = -0.165, p = 0.109). Conclusions Higher pain intensity is significantly associated with poorer HRQoL, particularly affecting role limitation due to physical health and other physical and emotionally mediated domains in patients with CNP. Comprehensive rehabilitation strategies targeting pain reduction and functional restoration are urgently needed in Bangladesh.

Facial depigmentation may remain clinically unrecognized when obscured by persistent erythema associated with steroid-induced rosacea-like dermatitis (SIRD). We report a 42-year-old woman with Fitzpatrick skin phototype IV and a history of prolonged facial topical corticosteroid use who presented with persistent centrofacial erythema. Clinical examination was consistent with SIRD. Multimodal VISIA imaging revealed findings that were not appreciable under standard visible light: red-channel (RBX®) imaging demonstrated increased vascularity and telangiectasia, while ultraviolet imaging identified patchy depigmentation with a speckled pattern and perifollicular pigment preservation. Linear depigmentation corresponding to prior eyebrow tattooing suggested a Koebner phenomenon. Although advised to discontinue corticosteroids, the patient was lost to follow-up and returned three years later with persistent erythema and progression of depigmentation. Repeat ultraviolet imaging demonstrated an increased extent and partial coalescence of the depigmented areas. The longitudinal evolution, imaging features, perifollicular pigment preservation, and trauma-induced depigmentation were most consistent with evolving vitiligo coexisting with SIRD. Following corticosteroid withdrawal, topical tacrolimus 0.1% ointment was initiated. This case highlights how persistent facial erythema can mask progressive depigmentation and demonstrates the value of multimodal VISIA imaging, particularly red-channel and ultraviolet modalities, in detecting subclinical pigmentary changes, differentiating overlapping disease processes, and documenting disease progression.