Onychomycosis, a prevalent fungal infection, and psoriasis, a chronic immune disorder affecting the nail plate, present therapeutic challenges due to the limited efficacy of current treatments, often leading to prolonged therapy and a high relapse rate. The highly cross-linked keratin network of the nail plate acts as a barrier, impeding effective drug delivery. This pioneering study explores a novel approach using a tattoo device to enhance drug penetration through the nail. Ciclopirox olamine and clobetasol lacquers were selected as the model formulations. Drug permeation tests conducted on non-treated, filed (mechanically abraded), and tattooed nails demonstrated significantly higher drug permeation in tattooed nails, suggesting the potential of this delivery method. Nail tattooing offers a simple method to enhance topical therapy, allowing treatment initiation in the clinic and continuation at home.
Aims Metabolic-associated steatotic liver disease (MASLD), which encompasses metabolic associated steatotic liver (MASL) and metabolic-associated steatohepatitis (MASH), is the most common chronic liver disorder worldwide. Fibrosis stage remains the most dependable histological predictor of prognosis; however, routine stains do not fully capture regenerative and injury-related processes. Keratin 7 (K7) immunohistochemistry highlights bile ducts (BDs), ductular reaction (DR), hepatic progenitor cells (PCs) and intermediate hepatocytes (IHs), all of which are involved in regeneration and fibrogenesis. This study aims to quantify K7-positive cell populations across histological stages of MASLD to enhance disease characterisation and evaluate the diagnostic value of K7 immunohistochemistry in this setting. Methods Archived liver biopsies from a clinically well-characterised cohort of 36 patients (17 MASH, 19 MASL) were stained for K7, digitised and analysed using QuPath with manual expert review. K7-positive structures were classified into BD, DR, PC or IH, with over 10 000 objects quantified. Profile densities and portal tract normalised ratios were calculated and correlated with clinical, biochemical and histological grading and staging by the Steatosis Activity and Fibrosis score. Results PC showed the strongest association with necro-inflammatory activity, peaking at grade 3. DR density increased significantly with fibrosis, supporting its role as an early marker of disease progression. IH was notably higher in MASH than in MASL, resulting in higher IH/DR ratios. Conclusion Specific quantitation of K7-positive cell populations can refine the diagnosis of MASLD and complement routine scoring in clinical trials to improve patient stratification. Data are available upon reasonable request.
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Rxiv cytoskeleton