erythromycin + tretinoin (Loderm retinoico)

A randomized, double-blind, placebo- and self-controlled pilot study on combined therapy with topical 0.1% tretinoin and narrow-band UVB for stable vitiligo.

Malalie, Sun Yan Y, Wu Yan Y, Zhang Yuqing Y et al.

The Safety of Melasma Treatment in Vitiligo Patients: An International E-Delphi Study.

Abdallah Marwa M, Ezzedine Khaled K, Passeron Thierry T, Eleftheriadou Viktoria V et al.

Vitiligo and melasma frequently coexist, creating a treatment dilemma, since agents effective for one condition can destabilize the other, and no consensus currently exists on safe management. We conducted a scoping literature review (through June 2023) on treatment of patients with concomitant vitiligo and melasma, followed by a two-round international e-Delphi survey (22 experts from 14 countries; consensus defined as ≥ 70% agreement) and a final online consensus meeting. Only one study supported the safe use of oral tranexamic acid for melasma in vitiligo patients. Expert consensus favored prioritizing vitiligo treatment, particularly when active, while incorporating patient's preferences. Targeted phototherapy is suitable for localized facial lesions of vitiligo, and non-facial vitiligo can be treated alongside melasma after covering the face. Topical calcineurin inhibitors, ruxolitinib, tretinoin, corticosteroids, and oral tranexamic acid can be used. Lasers and chemical peels were recommended only with caution by experienced pigment specialists. Until there is enough scientific evidence, hydroquinone would be replaced by other safer cosmetic lightening agents (e.g., niacinamide, ascorbic acid, thiamidol, melasyl), which show comparable efficacy with less theoretical risk. This first international consensus offers practical, patient-centered guidance for managing coexisting vitiligo and melasma, emphasizing individualized, disease-activity-based treatment sequencing. Trial Registration: PROSPERO reference number: RD42023395586 Significance. Depigmenting agents used for melasma inhibit melanogenesis, a mechanism that can further compromise the already-stressed melanocyte populations characteristic of vitiligo. This consensus gives clinicians an expert-informed pathway through a common but understudied comorbidity. It also identifies a clear research gap: controlled, mechanistic comparisons of hydroquinone against newer tyrosinase inhibitors specifically in vitiligo-prone skin are still lacking.

Host defense peptide hepcidin 1 and iron overload differentially modulate energy, lipid, and hepatic-biliary metabolic pathways in gilthead seabream (Sparus aurata) blood.

García-Navarro Laura L, Marín-Parra Claudia C, Serna Duque Jhon A JA, Esteban María Ángeles MÁ

Hepcidin 1 (a host defense peptide with antimicrobial and iron-regulating properties) and iron overload are relevant in fish physiology; however, the in vivo effects of their increase in healthy fish are poorly characterised. This study evaluated the effects of intraperitoneal injections of hepcidin 1, iron (iron-dextran), and sequential treatment (iron and hepcidin 1) on the blood metabolome of gilthead seabream (Sparus aurata) after 10 days. Multivariate analyses revealed weak metabolomic changes in all three conditions. In all treatments, 15 chemical superclasses were conserved, with the predominance of lipids, indicating quantitative reorganisation. Energy metabolism and immune response were activated, involving lipids, fatty acids, acyl-CoA/acylcarnitines, and one‑carbon metabolism (folate/serine/methionine) linked to NAD(H)/NADP(H) and redox balance, although several associations lost robustness (non-significant FDR), consistent with the return to the homeostasis. Hepcidin 1 was associated with increased abundance of adenosine, Lys-Glu-Leu tripeptide, dodecanoylcarnitine, and phosphoethanolamines/phosphocholines (LysoPE/PE/LysoPC), and decreased levels of exogenous compounds (e.g. erythromycin C, harzianopyridone), suggesting modulation of the gut-microbiota-barrier axis or hepatic-biliary clearance. Iron overload-induced reprogramming is compatible with reactive oxygen species management, lipid remodelling, and mitochondrial fatty acid mobilisation, without markers of peroxidation, liver damage, or inflammation; herbicides (bensulfuron/sulfometuron methyl) were reduced. In the iron-hepcidin 1 group, PCA separation was not significant (p = 0.247), suggesting an overlap or no unidirectional shift in the metabolome. In conclusion, hepcidin 1 and iron modulate energy and lipid metabolism in gilthead seabream blood, providing biomarkers for interpreting immunometabolic adaptations, although targeted validation of annotations and higher temporal resolution are required for this purpose.

Antimicrobial susceptibility profiles of Escherichia coli and Enterococcus spp. isolated from companion animals in Indonesia.

Sukmawinata E E, Pisestyani H H, Alfara A A, Tangkonda E E et al.

This study aimed to investigate the antimicrobial susceptibility profile in Escherichia coli and Enterococcus spp. isolated from healthy cats and dogs in Indonesia. A total of 186 rectal swab samples were individually collected from June to October 2025 at 13 animal clinics from three regions. Bacterial isolation was performed using selective agar media, and the species was confirmed by polymerase chain reaction. In this study, we obtained 71 of 164 (43.3%) antimicrobial-resistant (AMR) E. coli and 53 of 94 (56.4%) AMR enterococci by disc diffusion test. The highest resistance of E. coli was observed for ampicillin (36.6%), followed by streptomycin (21.3%), tetracycline (15.9%), cefazolin (13.4%), nalidixic acid (12.8%), cefotaxime (11.0%), gentamicin (11.0%), aztreonam (8.5%), doxycycline (8.5%), chloramphenicol (7.9%), sulfamethoxazole-trimethoprim (6.7%), amoxicillin-clavulanic acid (3.7%), ciprofloxacin (3.0%) and enrofloxacin (2.4%). On the other hand, the highest resistance of enterococci was identified for tetracycline (24.5%), followed by high-level streptomycin (21.3%), erythromycin (21.3%), ciprofloxacin (10.6%), enrofloxacin (9.6%), penicillin (7.4%), linezolid (6.4%), ampicillin (5.3%), fosfomycin (4.3%) and chloramphenicol (3.2%). Multidrug-resistant (MDR) E. coli was detected in 44 of 164 (26.8%) isolates, which were dominated by extraintestinal pathogenic strains (phylogroup B2 and D), while MDR enterococci were detected from 13 of 94 (13.8%) isolates. Our study offers valuable insights into the resistance profiles of Indonesian companion animals. A continuous monitoring strategy for AMR is needed to control the development of AMR bacteria in companion animals.