Clinical, Cosmetic and Investigational Dermatology最新文献

Objective: Psoriasis (PsO) is a chronic inflammatory dermatosis that affects a significant portion of the global population and is associated with various comorbidities, including psoriatic arthritis (PsA). PsA develops in 20-30% of psoriasis patients and significantly impacts patient quality of life. Currently, early detection of PsA remains challenging, with no reliable, non-invasive biomarker for risk assessment. This study aims to evaluate the utility of pan-immune-inflammation value (PIV), along with other inflammatory indices, in predicting the development of PsA in patients with PsO.

Methods: A retrospective analysis was conducted on 101 psoriasis patients (51 PsO, 50 PsA). Hematological parameters, including neutrophil, lymphocyte, monocyte, and platelet counts, were collected, and various inflammatory indices (PIV, SIRI, SII, NLR) were calculated. The diagnostic performance of these indices was assessed using Receiver Operating Characteristic (ROC) curve analysis. As a retrospective, double-center study with a limited sample size, the findings should be interpreted with caution and validated in larger, prospective cohorts.

Results: The study found significant differences between PsA and PsO patients in terms of inflammatory indices, with higher PIV, SII, SIRI, and NLR levels observed in PsA patients. The diagnostic performance of PIV (AUC 0.63), SII (AUC 0.70), SIRI (AUC 0.64), and NLR (AUC 0.71) indicated that elevated levels of these indices could serve as potential markers for PsA risk. Additionally, PIV was significantly correlated with SII, SIRI, and NLR levels.

Conclusion: PIV and other inflammatory indices, particularly NLR and SII, show promise as biomarkers for predicting the onset of PsA in patients with PsO. These findings may aid in early identification and timely intervention for PsA, improving patient outcomes and informing treatment strategies.

Introduction: Sitosterolemia is a rare autosomal recessive disorder characterized by disrupted lipid metabolism and elevated plasma plant sterol levels. Clinical manifestations often include cutaneous and tendon xanthomas and hypercholesterolemia; delayed diagnosis can lead to cardiovascular disease and hematological abnormalities. This case report describes an 11-month-old female infant with sitosterolemia who presented with xanthomas appearing around 6 months of age. Genetic sequencing identified a homozygous ABCG5 c.1166G>A (p.Arg389His) mutation. This report aims to discuss the clinical features and genetic diagnosis of sitosterolemia caused by ABCG5 mutations, highlighting the challenges and key characteristics for early diagnosis to improve clinical awareness.

Case and methods: Clinical data of a pediatric patient with sitosterolemia caused by a homozygous ABCG5 gene mutation were retrospectively analyzed.

Results: An 11-month-old female infant developed linear xanthomas in the skin folds of her ankles at approximately 6 months of age, which progressively worsened. Blood tests revealed significantly elevated total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels. Sequencing of coding regions for genes associated with familial hypercholesterolemia and sitosterolemia identified a homozygous ABCG5 mutation: c.1166G>A (p.Arg389His). Sanger sequencing confirmed that this variant was inherited from each parent in a heterozygous state. The diagnosis of sitosterolemia was confirmed based on genetic testing (ABCG5/ABCG8), lipid profile results, and clinical presentation.

Conclusion: Sitosterolemia should be suspected in patients presenting with cutaneous xanthomas, prompting thorough investigation including lipid profiling, genetic testing, and plasma plant sterol quantification to avoid misdiagnosis as familial hypercholesterolemia (FH).

Background: Atrophic acne scarring is a chronic dermatological condition with significant psychosocial impact, yet the psychological burden it imposes has been relatively underexplored in clinical practice.

Objective: To explore the psychological experiences of patients with Atrophic Acne Scarring during the disease progression, and analyze their emotional changes and coping strategies based on uncertainty in illness theory.

Methods: A qualitative descriptive design was employed for this study. Purposeful sampling was chosen from a tertiary hospital in Henan Province, China. Semi-structured in-depth interviews were conducted with 15 patients with Atrophic Acne Scarring. The interview data was analyzed using the Colaizzi's method and results were reported following the COREQ standards.

Results: A total of 4 themes and 12 sub-themes were extracted, including: 1) Confusion and Denial in the Initial Diagnosis Stage: Disease-related cognitive bias, information confusion and incorrect interventions, normalization tendency. 2) Anxiety and Shame in the Flareup Stage: Appearance monitoring behaviors, social evaluation pressure, impaired social functioning. 3) Coping Strategies in the Long-Term Adaptation Stage: Positive coping, negative coping, polarized adaptation patterns. 4) Psychological Adjustment in the Recovery Stage: Contradictory acceptance, post-traumatic growth, behavioral-psychological asynchronous improvement. Uncertainty in illness was present throughout the process, affecting patients' self-recognition, social behaviors, and treatment adherence.

Conclusion: This study demonstrates that patients with atrophic acne scarring experience a four-stage psychological journey (confusion/denial, anxiety/shame, coping adaptation, and recovery adjustment), with illness uncertainty persistently impacting their psychological and social functioning. Healthcare providers should offer personalized psychological support based on the framework of uncertainty in illness theory to enhance patients' quality of life.

Introduction: Aesthetic gynecology procedures have been gaining growing interest among patients seeking improvement in the appearance, elasticity, and hydration of the external genitalia. A rising number of individuals attending aesthetic dermatology clinics request minimally invasive treatment options to enhance the quality of genital skin. This study presents preliminary findings on a novel formulation for chemical biostimulation of labial skin, designed to improve tissue firmness and structural integrity.

Methods: A pilot study was conducted to assess the clinical outcomes of a chemical biostimulation protocol performed on the external genital area. The primary endpoints were improvement in skin tension and thickness. High-frequency ultrasound imaging was employed as a quantitative tool for evaluating tissue hydration.

Results: The treatment protocol led to a visible enhancement in tissue firmness and hydration. No significant effect was observed in relation to skin pigmentation. High-frequency ultrasound provided consistent and reliable measurements of tissue hydration, confirming its usefulness as an objective assessment method in aesthetic gynecology.

Discussion: The pilot data support the potential of chemical biostimulation as a minimally invasive option for improving genital skin quality. Furthermore, high-frequency ultrasound appears to be a valuable adjunct in the objective evaluation of treatment effects. These preliminary results warrant further investigation in larger clinical trials.

Purpose: This study aims to characterize the etiology, clinicopathological features, laboratory findings, management strategies, and clinical outcomes of patients diagnosed with lichenoid drug eruption (LDE).

Patients and methods: A retrospective review was conducted on all biopsy-confirmed LDE cases from January 2008 to October 2024. Data collection included clinical characteristics, causative medications, histopathological as well as laboratory findings, and therapeutic responses.

Results: Of the 34 patients, half were male, with a mean age of 65.1 years. LDE most commonly presented as erythematous to violaceous lesions, appearing as patches and plaques, predominantly on the extremities. Histopathology showed lichenoid infiltrates in all cases, with focal infiltration in 58.8%. Parakeratosis was present in 17.7%. Necrotic keratinocytes were found in the basal layer in 82.4% and in the spinous layer in 38.2% of cases. Eosinophilic infiltration was observed in approximately one-third of patients. The most common offending agents were calcium channel blockers (CCBs) (42.5%), followed by statins (25.8%). The median latency period from drug initiation to symptom onset was 10.1 months (interquartile range [IQR] 3.0-45.5). Discontinuation of the causative agent combined with topical corticosteroid therapy resulted in clinical improvement in 73.5% of patients, with a median resolution time of 56 days (IQR 28.0-77.0).

Conclusion: Antihypertensive drugs, especially CCBs, were the most frequently implicated triggers of LDE. In addition to lichenoid dermatitis, eosinophilic infiltration served as a key histopathological hallmark of this condition. Timely identification and withdrawal of the causative medication, combined with appropriate treatment, are essential for achieving favorable clinical outcomes.

Background: Skin repair and anti-aging have long been central themes in dermatological and cosmetic science. Rooted in thousands of years of empirical knowledge, Traditional Chinese Medicine (TCM) literature contains systematic records of medicinal plants, many of which have been historically applied to improve skin health.

Objective: Based on the theoretical framework of the Five Elements, this study formulated a specific combination consisting of five chromatically representative medicinal plants-mung bean (green), white truffle (white), black truffle (black), chrysanthemum (yellow), and Lycium barbarum (red)-to investigate their potential synergistic anti-aging and skin regenerative effects.

Methods: The five-colored plants combination was analyzed by network pharmacology, followed by a scratch test of human fibroblasts, β-galactosidase staining, and ex vivo skin model.

Results: The network pharmacological analysis identified 27 core components and 636 targets, including CBS, CDK5, and AKR1B10, which are involved in skin anti-aging and repair. In vitro experiments indicated that at 0.5% concentration, the five-colored plant combination achieved a fibroblast wound healing rate of 59.89% after 24 hours, compared to the negative control group, which was 22.83% higher than that of individual raw materials. In the β-galactosidase staining of human fibroblasts, the blue-stained area in the experimental group was 0.777%, representing a 76.32% reduction compared to the negative control. In the in vitro skin model, treatment with the five-colored plant combination significantly increased the thickness of the epidermal living cell layer, collagen fiber content, and type IV collagen content, with respective increases of 28.16%, 49.12%, and 100.00%. Histological analysis revealed a significant increase in epidermal thickness and a more pronounced the dermal-epidermal junction (DEJ) ridge structure.

Conclusion: This study showed that the five-colored plant combination consisting of mung bean, white truffle, black truffle, chrysanthemum, and Lycium barbarum can repair the skin and delay aging.

Background: Cafe-au-lait macules (CALMs) are one of the earliest and most common cutaneous manifestations of neurofibromatosis type 1 (NF1) and serve as critical diagnostic criteria. Over the past two decades, research related to CALMs and NF1 has expanded significantly, driven by advances in molecular genetics, precision medicine, and clinical dermatology. However, no bibliometric study has systematically analyzed the global research landscape and evolution in this area.

Methods: Publications related to CALMs were retrieved from the Web of Science Core Collection up to May 16, 2025. A total of 850 English-language articles and reviews were selected following the screening process. CiteSpace was used for bibliometric analysis. Research trends were assessed through co-authorship, co-citation, keyword co-occurrence, citation bursts, and journal impact evaluations.

Results: The field has experienced a transition from early phenotypic descriptions to mechanistic insights and translational research. The United States and China led global research output, while emerging countries, such as Turkey and Iran, showed increasing contributions. Key institutions included the University of Alabama at Birmingham and Shanghai Jiao Tong University. Influential authors such as Eric Legius and Ludwine Messiaen formed intergenerational academic networks. Leading journals including PNAS and Genetics in Medicine, played pivotal roles in disseminating high-impact findings. Five major thematic clusters were identified, encompassing genotype-phenotype correlations, signalling pathways, cancer susceptibility, endocrine dysregulation, and tumour mutation burden. The emergence of keywords such as "genetic testing" and "laser treatment" underscores the growing emphasis on clinical translation and precision medicine.

Conclusion: CALM-related research has undergone significant growth over the past two decades, forming a diversified and multilayered academic ecosystem. Future studies should strengthen interdisciplinary and cross-regional collaboration, focus on multi-omics integration, and bridge the gap between fundamental discoveries and clinical applications.

Introduction: The periorbital region is highly susceptible to aging, manifesting as wrinkles, skin laxity, and under-eye bags due to collagen loss and fat displacement. Vacuum-assisted multi-frequency bipolar radiofrequency (RF) offers precise energy delivery, effectively stimulating collagen remodeling while ensuring safety and patient comfort.

Objective: This study aimed to evaluate the efficacy and safety of a bipolar RF device with channeling optimized RF energy (CORE™) technology and vacuum assistance for periorbital rejuvenation.

Patients and methods: A prospective, single-center trial enrolled 28 participants (18-60 years), receiving four treatments at three-week intervals. Efficacy was assessed through Fitzpatrick Wrinkle Scale (FWS), Investigator Global Assessment (IGA) scores, and objective skin parameters (hydration, elasticity, gloss), alongside participant self-assessments. Safety was evaluated via adverse events (AEs) and pain scores (VAS).

Results: Among 22 participants who completed the study, 95.46% achieved ≥25% improvement in FWS scores (mean reduction: -1.55 ± 0.50), with significant wrinkle reduction from the second treatment (p < 0.001). IGA scores showed visible improvement in under-eye bags, while skin hydration and elasticity increased. About 90.91% of participants reported high satisfaction, and 91.3% rated pain ≤1, with no AEs reported. The total observation period was approximately 12 weeks, including four treatment sessions and a three-week follow-up after the final session.

Conclusion: Bipolar RF treatment with CORE technology and vacuum assistance is a safe and effective non-invasive modality for improving periorbital wrinkles and under-eye bags. By promoting collagen remodeling and skin tightening, this technology offers significant clinical and aesthetic benefits with minimal discomfort and no adverse events.

Background: Autosomal recessive woolly hair (ARWH) is a rare genetic disorder characterized by tightly curled, sparse hair with variable degrees of hypopigmentation and slow growth. Pathogenic variants in the LIPH gene are a major cause, but information on Chinese patients remains limited.

Methods: Six unrelated patients with congenital woolly hair were analyzed. Clinical features were assessed by examination, trichoscopy, and scalp biopsy. Whole-exome sequencing (WES) and Sanger confirmation were performed, and variants were classified according to ACMG guidelines.

Results: All patients presented with sparse, curly hair since early childhood. WES identified biallelic LIPH variants in all cases. Three patients were homozygous for c.742C>A (p.H248N), one was homozygous for c.454G>A (p.G152R), and two were compound heterozygotes. Patients carrying the c.454G>A (p.G152R) variant tended to show milder hair loss compared with those with c.742C>A (p.H248N), suggesting a potential genotype-phenotype relationship.

Conclusion: This study broadens the understanding of LIPH-related ARWH in the Chinese population. The c.454G>A (p.G152R) variant may represent a recurrent allele among Chinese patients with ARWH.

A 59-year-old male presented with a 10-day history of erythematous vesicular lesions on the left chest and shoulder, accompanied by pain in the back. Clinical examination revealed grouped vesicles with some ulceration and exudate, leading to a diagnosis of herpes zoster. After a clear diagnosis, antiviral treatment with valacyclovir and pain relief with pregabalin was administered. Apply povidone-iodine and normal saline (in a 1:10 ratio) externally, once a day, for 30 minutes each time. One week later, the lesions developed ulcers and crusts, with increased exudate; cultures yielded a significant growth of Methicillin-resistant Staphylococcus aureus(MRSA). Based on the drug sensitivity results, cefuroxime combined with levofloxacin was administered for anti-infection treatment. Following two weeks of treatment, the patient showed significant clinical improvement. The patient's rashes have significantly subsided, the ulcers have healed and scabbed over, and the exudation has noticeably decreased. Herpes zoster combined with MRSA infection makes the treatment more complicated. This case illustrates the complexities of managing herpes zoster with MRSA and highlights the importance of comprehensive diagnostic and treatment strategies.