Clinical, Cosmetic and Investigational Dermatology最新文献

Purpose: The modified Ferriman-Gallwey score, currently used to clinically evaluate and quantify excessive hair growth in women with hirsutism, has limitations because of its subjective nature. Therefore, we aim to investigate whether we could quantify terminal hairs on the output of a digital microscope camera to improve the clinical evaluation of hirsutism.

Patients and methods: This feasibility cross-sectional study included 20 healthy men and 15 healthy women. Two independent researchers used a digital microscope camera to obtain photos of the upper lip and chin in all participants. The hair thickness (when ≥ 60 µm), number of terminal hairs and hair color were determined to indicate mean differences between men and women by an independent t-test. Additionally, intraclass correlation coefficients were determined to assess the inter-observer variability.

Results: The mean (standard deviation) number of terminal hairs on the upper lip was 27 (15) in men and 0 (1) in women. On the chin, men had a mean (standard deviation) of 29 (18) terminal hairs, compared to 0 (0) in women. This corresponds to mean differences of 27 hairs (range: 19-34) on the upper lip and 28 hairs (range: 19-39) on the chin between men and women. Minimal inter-observer variability was observed, particularly in visible light analyses (intraclass correlation coefficient: 0.998).

Conclusion: Digital microscopy with visible light may contribute to a more objective method for diagnosing hirsutism by the quantification of terminal hair. Future studies should focus on the applicability of this new method in women with hirsutism.

Background: Alopecia areata (AA) is an autoimmune-mediated, non-scarring hair loss disorder. With the advancement of alopecia treatment research, the efficacy of Janus kinase (JAK) inhibitors in the clinical management of AA has been increasingly evaluated.

Objective: This study reports the efficacy and safety of tofacitinib in the treatment of severe AA and presents a literature review on tofacitinib in AA.

Methods: Collect patient information on severe AA treated at a tertiary hospital from April 2023 to May 2024, and analyze their clinical treatment outcomes.

Results: All five collected patients met the criteria for refractory alopecia areata. Three of these patients achieved favorable therapeutic outcomes with mild adverse reactions, consistent with current research findings.

Conclusion: This study supports the efficacy and safety of tofacitinib in AA treatment, providing further clinical evidence for its application.

Psoriasis is a chronic, recurrent, inflammatory autoimmune skin disease. The advent of biologics, such as ixekizumab, has provided a breakthrough for patients with moderate-to-severe disease by specifically inhibiting the interleukin-17A (IL-17A) mediated inflammatory cascade. The human papillomavirus (HPV) vaccine is a cornerstone in the prevention of HPV-associated malignancies, with well-established safety and efficacy profiles. However, due to the unique immune status of patients with psoriasis, cutaneous adverse events following HPV vaccination during biologic therapy have rarely been reported. Seborrheic keratosis (SK) is a common benign epidermal tumour. Its eruptive variant, known as the Leser-Trélat sign, has traditionally been associated with internal malignancies; however, recent studies suggest potential links to inflammation, pharmacological agents, and immune alterations. We report the case of a 37-year-old female with psoriasis who, after achieving stable disease control on ixekizumab, developed widespread eruptive brown macules, patches, and papules within one month of receiving a quadrivalent HPV vaccine. Histopathological examination confirmed SK, and malignancy, as well as other associated disorders, were excluded. The lesions faded following oral acitretin therapy. This case highlights the possibility that ixekizumab in combination with HPV vaccination may synergistically alter immune homeostasis, thereby precipitating eruptive SK. We discuss potential mechanisms, propose clinical management considerations, and provide insights that may inform future research and clinical practice. The ultimate aim is to contribute to the refinement of guidelines on vaccination in patients receiving biologic therapy for psoriasis, ensuring both therapeutic efficacy and patient safety.

Background: IgG4-related disease (IgG4-RD) is a rare chronic fibroinflammatory disorder. Elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells into affected tissues are characteristic of it. It often involves multiple organs. However, initial presentations with cutaneous involvement are relatively rare. To better understand and treat the associated disease, we report this case.

Patients and methods: We report a 39-year-old man who presented with a 3-year history of pruritic papules and nodules on the face, neck, shoulders, back, and lower extremities, along with progressive bilateral proptosis over the past year. He had a known history of allergic rhinitis. Previously diagnosed with "atopic dermatitis" at another hospital, he was treated with antihistamines and topical glucocorticoids, which produced minimal improvement. At our hospital, he underwent serum IgG4 testing,imaging studies,pathological examination, and multidisciplinary consultations involving dermatology, ophthalmology, and hematology, leading to a definitive diagnosis of IgG4-RD.

Results: Systemic glucocorticoids and methotrexate, along with topical medications,therapy resulted in marked clinical improvement in both skin and ocular symptoms, along with gradual normalization of serum IgG4 levels.

Conclusion: IgG4-RD can mimic a variety of diseases, through this case we found that this disease in addition to the reported diseases, but also mimic atopic dermatitis manifestations with intense itching makes it very easy to misdiagnose, missed diagnosis, which not only presents a complete multidisciplinary collaboration in the diagnosis and treatment of atopic dermatitis-like clinical diagnostic ideas of IgG4-RD, but also for the first time systematically reported the skin lesions of dermatoscopy and CT imaging features of skin, for clinical.

Purpose: Facial aging, characterized by skin laxity and the formation of wrinkles, is primarily attributed to collagen degradation and dermal thinning. Although ablative laser therapies have demonstrated efficacy in addressing these concerns, their application is often limited by prolonged downtime and the risk of pigmentary alterations, particularly in individuals with darker skin types. Radiofrequency (RF) technology offers a non-invasive, chromophore-independent alternative for skin tightening and rejuvenation. This case series aims to assess the clinical efficacy, safety profile, and patient-reported satisfaction associated with the use of a novel dual-mode RF device in the management of facial skin laxity.

Patients and methods: Five adult patients with Fitzpatrick Skin Type IV and clinically evident signs of facial photoaging underwent a single treatment session using the DENSITY RF platform, which integrates monopolar and bipolar energy delivery through High F-tip. Each procedure involved 10 to 12 uniform passes over the entire face, utilizing continuous contact cooling. No topical or systemic anesthesia was administered.

Results: All patients demonstrated measurable improvements in skin firmness, textural smoothness, and facial contouring. Marked reductions in wrinkle surface area and pore visibility were observed. Aesthetic enhancement scores ranged from 3 to 5 (on a 5-point scale), with high levels of patient satisfaction and minimal procedural discomfort (VAS score: 2-3/10). Three patients reported visible brow-lifting effects. No adverse effects or pigmentary changes were reported.

Conclusion: The DENSITY dual-mode RF system is a safe, well-tolerated, and effective non-invasive option for treating facial skin laxity in individuals with darker skin tones. It offers a compelling alternative for single-session rejuvenation with minimal recovery time and high patient satisfaction.

Background: Stable vitiligo, characterized by irreversible melanocyte loss, often resists conventional therapies. Non-cultured epidermal cell suspension (NCES) transplantation are increasingly used, and adjunctive autologous serum may enhance efficacy via growth factor-mediated cell survival and proliferation. This study evaluates the clinical outcomes of combined autologous serum and NCES therapy for stable vitiligo.

Methods: This prospective case series enrolled 30 patients (61 sites) with stable vitiligo at the Guangzhou New Centre Institute of Vitiligo (2024-2025). Patients received autologous serum followed by NCES transplantation. Repigmentation was assessed using the Vitiligo Area Scoring Index (VASI) and color matching. Adverse events were monitored.

Results: After 3 to 6 months, excellent repigmentation (> 90%) was achieved in 83.6% of treated sites (51/61), with particularly high efficacy on facial (90% efficacy in 9/10 sites) and neck regions (92.3% efficacy in 12/13 sites). The trunk, upper limbs, and hands/fingers exhibited excellent repigmentation in 80.0%, 77.8%, and 78.6% of sites, respectively. Poor repigmentation (< 25%) was observed in only one trunk site (1/61). Excellent color matching was achieved in 82.0% of treated sites (50/61), and no treatment-related adverse effects were reported.

Conclusion: The combination of autologous serum and NCES transplantation is highly effective and safe for stable vitiligo. Autologous serum may synergize with NCES by supporting the microenvironment for melanocyte engraftment, offering a promising strategy for stable vitiligo.

Introduction and purpose: Biological differences between Asians and Caucasians contribute to variations in the prevalence of skin disorders such as melanocytoses and skin aging. The current regenerative medicine indications were primarily developed for Caucasians; adapting them to the specific needs of Asian individuals may be beneficial. Five distinguished Asian experts had this purpose in mind when they convened to develop evidence-based and experience-based recommendations on maximizing the benefits of natural-origin ingredient Polynucleotides High Purification Technology (PN HPT™) in individuals of Asian descent. They based their recommendations on available literature and the outcomes of a digital survey. PN HPT supports dermal fibroblasts in producing collagen, elastin, and matrix by replenishing the dermal pool of nucleotide precursors.

Patients and methods: One hundred and one East Asian specialists in aesthetic and regenerative medicine accepted an invitation from Mastelli S.r.l. Sanremo, Italy, and Ardence Aesthetic, Petaling Jaya, Selangor, Malaysia (corporate sponsors), to respond to a 50-item online survey questionnaire. A subsequent consensus-building board meeting elaborated on the survey outcomes with a simplified Delphi approach, providing recommendations for the safe and effective use of PN HPT in Asian individuals.

Results: The paper highlights in specific chapters the perceptions of the surveyed East Asian specialists regarding the PN HPT indications and procedures (choice of PN HPT formulations, injection technique, scheduling, and layer) in facial areas and the neck. Furthermore, the paper discusses the experts' views on combining PN HPT with other skin regenerative strategies, as well as the innovative concept of "PN HPT Priming".

Conclusion: Offering tailored PN HPT treatment algorithms that take into consideration the Asian biological and cultural specificities, although without stratification for age and skin quality determinants, the board's suggestions are of immediate clinical applicability and may support clinicians who use PN HPT devices in their daily regenerative medicine practice.

Background: Livedoid vasculopathy is a rare, chronic thrombo-occlusive disorder that primarily affects the lower extremities, causing painful ulcerative lesions. Despite its clinical significance, the prevalence and demographic characteristics of LV, particularly among patients with connective tissue diseases, remain underexplored. This study aims to investigate the prevalence of LV among patients diagnosed with CTDs, providing insight into potential epidemiological patterns.

Methods: The study was a retrospective cohort study conducted at Mass General Brigham (MGB), a healthcare system in Greater Boston, Massachusetts, from January 1, 2014, to June 1, 2021. Data extraction was facilitated through the Mass General Brigham Enterprise Data Warehouse utilizing the Research Patient Data Registry (RPDR) system. Data extraction includes age, gender, race and autoimmune diseases associated with LV. SPSS v 29 was used for data analysis.

Results: We reviewed 1730 charts; 108 patients met criteria for LV. Prevalence is reported within the screened cohort (108/1730 = 6.2%). For system context, we also report a hospital-system registered prevalence of 0.0018% (108/6,000,000) based on the RPDR population. The majority of patients were female (74.07%). The mean age of the patients with LV was 44.87 ± 8.24 years. The racial composition was white (84.25%). Among the 17 patients with autoimmune diseases, females were more represented (82.35%). Systemic lupus erythematosus was the predominant condition, affecting 58.82% of these patients. Positive results for phospholipid antibodies were found in 57.40% of patients, with a p-value of 0.065. For anticardiolipin antibodies, p-value 0.095. Hyperhomocystenemia, p-value of 0.952. Activated C resistance, p-value of 0.088.

Conclusion: In this cohort of patients with connective tissue diseases, livedoid vasculopathy was observed more often in women and in middle-aged adults, and it frequently co-occurred with autoimmune conditions, particularly systemic lupus erythematosus. However, none of the between-group comparisons or serological associations reached statistical significance. These results should be interpreted as non-confirmatory trends and require validation in larger, adequately powered studies.

Background: Psoriasis is a chronic inflammatory disease frequently associated with metabolic comorbidities, psychological distress, and reduced quality of life. Its multifactorial nature and frequent overlap with other conditions pose substantial challenges in clinical management.

Purpose: This narrative review emphasizes the importance of a multidisciplinary approach to psoriasis care, integrating dietary counseling, physical activity promotion, psychological support, and sleep interventions. While multidisciplinary care models such as integrated clinics and coordinated care pathways have been proposed, to our knowledge, this is the first review to comprehensively synthesize evidence across these interrelated domains.

Methodology: A comprehensive literature search was conducted using PubMed, Scopus, Cochrane, and Web of Science to identify studies addressing psoriasis in the context of lifestyle, nutrition, mental health, and interdisciplinary collaboration.

Results: Lifestyle modifications, including weight management, anti-inflammatory dietary patterns, stress reduction strategies, regular physical activity, and sleep optimization, may significantly reduce disease severity and improve patient-reported outcomes. Mental health disorders and sleep disturbances are common among individuals with psoriasis and are increasingly recognized as important determinants of disease progression and treatment response.

Conclusion: Psoriasis management should extend beyond pharmacotherapy to address modifiable lifestyle-related factors. Integrating care from dermatologists, dietitians, psychologists, and physiotherapists facilitates a more comprehensive and individualized approach. This model has the potential to improve not only clinical outcomes but also sleep quality, psychological well-being, and long-term self-management in patients with psoriasis.

Background: Androgenetic alopecia (AGA) is a chronic form of hair loss influenced by various factors, with increasing focus on the role of immune cell-driven follicular microinflammation. However, the precise immune phenotypes involved and their causal relationship with AGA remain poorly understood. This study aims to identify and validate the causal role of immunophenotypes in AGA using Mendelian randomization (MR) integrated with multi-omics data, and to explore the mediating role of plasma proteins in this relationship.

Materials and methods: We utilized publicly accessible Genome-Wide Association Studies (GWAS) summary statistics encompassing immune phenotypes, plasma proteins, and AGA. MR analyses using inverse variance weighted (IVW), MR-Egger regression, and weighted median methods were performed to examine the causal links between 731 immune phenotypes and AGA. Sensitivity analyses were conducted to ensure robustness and address heterogeneity and pleiotropy. Linkage disequilibrium score regression was employed to assess genetic correlations, while Steiger filtering confirmed the causal direction. A multivariable MR approach was used to estimate the direct effects of each exposure on AGA, accounting for confounding factors. Additionally, mediation analysis of 3622 plasma proteins identified potential mediators in the immune-AGA pathway.

Results: We identified elevated CD25 on secreting CD4 regulatory T cell (Treg) as an independent genetic risk factor for AGA. Mediation analysis revealed five plasma proteins, SDF-1, GPIbα, KIR3DS1, MVI, and WFDC5, as key mediators in the immune-AGA axis.

Conclusion: This study established that specific immune cell phenotypes, particularly CD25 on secreting CD4 Treg, were causally linked to AGA, with plasma proteins mediating this effect. These findings provide new insights into AGA's immunological mechanisms and suggest potential immune-targeted therapeutic strategies.