Publications by authors named "Lloyd Steele"

Resident macrophages play integral roles in maintaining tissue homeostasis and function. In the skin, prenatally seeded, specialized macrophages patrol sensory nerves and contribute to their regeneration after injury. However, mechanisms underlying the long-lasting postnatal commitment of these nerve-associated macrophages remain largely elusive.

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Cutaneous T cell lymphoma (CTCL) is a potentially fatal clonal malignancy of T cells primarily affecting the skin. The most common form of CTCL, mycosis fungoides, can be difficult to diagnose, resulting in treatment delay. We performed single-cell and spatial transcriptomics analysis of skin from patients with mycosis fungoides-type CTCL and an integrated comparative analysis with human skin cell atlas datasets from healthy and inflamed skin.

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Article Synopsis
  • The study created a comprehensive reference atlas of human prenatal skin (7-17 weeks post-conception) using advanced techniques like single-cell and spatial transcriptomics to explore the roles of immune cells, specifically macrophages, in skin development.
  • It was found that interactions between immune and non-immune cells are essential for key processes in skin development, such as hair follicle formation, scarless wound healing, and blood vessel growth.
  • Additionally, while a skin organoid model mimicked certain features of prenatal skin, it lacked immune cells and showed limited blood vessel diversity, highlighting the important roles of macrophages and their derived factors in skin morphology and development.
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Article Synopsis
  • Eczema is a major global skin condition that is often treated with topical anti-inflammatory treatments, but there is uncertainty about their effectiveness and safety.* -
  • A network meta-analysis was conducted to compare various topical treatments based on data from 291 trials involving over 45,000 participants, primarily from high-income countries.* -
  • The analysis found that potent topical steroids and tacrolimus 0.1% were among the most effective treatments; however, many trials exhibited high risk of bias, particularly concerning selective reporting.*
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Article Synopsis
  • Eczema is a widespread skin condition with no current prevention or cure, and existing treatments aim to control symptoms without clear consensus on their effectiveness and safety.
  • This study aims to compare and rank different topical anti-inflammatory treatments for eczema through a network meta-analysis of randomized controlled trials (RCTs).
  • The analysis focuses on various outcomes, including symptom relief, safety, quality of life, and withdrawal rates, while excluding certain types of eczema and treatments not related to topical anti-inflammatories.
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Assessing the severity of eczema in clinical research requires face-to-face skin examination by trained staff. Such approaches are resource-intensive for participants and staff, challenging during pandemics, and prone to inter- and intra-observer variation. Computer vision algorithms have been proposed to automate the assessment of eczema severity using digital camera images.

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Machine learning (ML) models for skin cancer recognition may have variable performance across different skin phototypes and skin cancer types. Overall performance metrics alone are insufficient to detect poor subgroup performance. We aimed (1) to assess whether studies of ML models reported results separately for different skin phototypes and rarer skin cancers, and (2) to graphically represent the skin cancer training datasets used by current ML models.

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Assessing the severity of atopic dermatitis (AD, or eczema) traditionally relies on a face-to-face assessment by healthcare professionals and may suffer from inter- and intra-rater variability. With the expanding role of telemedicine, several machine learning algorithms have been proposed to automatically assess AD severity from digital images. Those algorithms usually detect and then delineate (segment) AD lesions before assessing lesional severity and are trained using the data of AD areas detected by healthcare professionals.

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Sarcoidosis occurs much more commonly in cohorts of connective tissue disease (1%) compared to the general population (0.01-0.04%).

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This survey study examines the prevalence and characteristics of itch in pachyonychia congenita.

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Multiple techniques for skin graft fixation have been proposed, but the evidence underlying these techniques is unclear. This study aimed to review the literature for full-thickness graft fixation techniques. PubMed was electronically searched to identify relevant studies.

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Mohamad et al. (2020) describe loss-of-function mutations in SERPINA12 as a cause of diffuse, transgradient palmoplantar keratoderma (PPK). This disorder shares similar clinical features with other PPKs caused by protease overactivity, including erythema, peeling, and exacerbation on water exposure.

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Background: Failing to recognise the signs and symptoms of subarachnoid haemorrhage (SAH) causes diagnostic delay and may result in poorer outcomes. We report a rare case of SAH secondary to a vertebral artery dissection (VAD) that initially presented with cauda equina-like features, followed by symptoms more typical of SAH.

Case Presentation: A 55-year-old man developed severe lower back pain after sudden movement.

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Sepsis-3, published in 2016, defined sepsis as 'life-threatening organ dysfunction caused by a dysregulated host response to infection'. Instead of systemic inflammatory response syndrome (SIRS), calculating the Sequential Organ Failure Assessment (SOFA) score was recommended. The complexity of SOFA also led to the introduction of quick SOFA (qSOFA) as a bedside tool.

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A 51-year-old man presented with a swollen left arm and unilateral pulsatile tinnitus 2 weeks after a left upper arm polytetrafluoroethylene graft was created for haemodialysis access. A fistulogram of the left upper arm showed a central venous stenosis and significant retrograde flow up the left internal jugular vein. Percutaneous transluminal angioplasty was attempted unsuccessfully and fistula ligation was subsequently performed.

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Background/objectives: The International Society for the Study of Vascular Anomalies (ISSVA) classification separates vascular anomalies into vascular malformations and vascular tumors. However, misdiagnoses and misperceptions still persist around the use of the term "hemangioma." We assessed whether the term "haemangioma" (British spelling) was used as part of ISSVA terminology in the literature.

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Background: Smoking is a well-documented risk for acute ST-segment elevation myocardial infarction (STEMI). The differential effect between sexes has yet to be quantified.

Objectives: The purpose of this study was to differentiate the effect of smoking on increased risk of STEMI between sexes.

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A 46-year-old man presented with a 4-week history of bruising with subcutaneous nodules and weight loss. He also had a 2-week history of progressive back and hip pain. He had been diagnosed with stage Ib cutaneous melanoma 30 months previously, which had been fully excised.

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