Clinical, Cosmetic and Investigational Dermatology最新文献

Background: Acne is a common inflammatory dermatosis. Although gender-related differences in prevalence and age of onset have been documented. Other gender-related characteristics of acne have not been well elucidated yet.

Objective: We compared characteristics of skin lesions, severity and risk factors of acne between males and females in Chinese.

Methods: Investigator-administered questionnaire was used to collect demographic data, clinical feature and risk factors of acne from May 2020 to August 2021. All participants were from outpatient clinics in seven cities, China.

Results: A total of 13085 participants, including 4746 males (36.27%) and 8339 females (63.73%), aged 8 to 35 years old, completed the questionnaire. The age of onset of acne was significantly younger in males than in females(p<0.001). More females than males had comedones(83.76% vs 75.22%, p<0.001). In contrast, more males than females had pustules, cyst/nodules, scars and severer lesions(p<0.001). Moreover, the major risk factors for acne were constipation, cosmetics, dairy and sweet foods for females, while the major risk factors for males were computer usage/playing electronic games, staying up late at night, intake of hot or spicy foods. More females than males experienced good response to photodynamic treatment(79.52% vs 52.86%, p<0.05).

Conclusion: Acne appears earlier in males than in females. Clinical features and risk factors for acne differ between males and females. More females than males experience good response to photodynamic therapy.

Limitation: This questionnaire survey was carried out in Chinese aged 8 to 35 years old. Gender-related characteristics in other ages and regions remain to be explored.

Background: Facial contouring procedures are increasingly sought to address aesthetic concerns such as submental fat accumulation and lack of jawline definition. Cryolipolysis and hyaluronic acid (HA) injection have emerged as promising modalities for lower face contouring, targeting fat reduction and jawline enhancement, respectively.

Objective: This study aims to assess the efficacy and safety of a combined treatment approach involving cryolipolysis followed by HA injection for addressing lower face contour concerns. Specifically, the study seeks to evaluate outcomes associated with this comprehensive treatment modality in the lower face region.

Methods: A retrospective analysis was conducted on four females and one male who underwent cryolipolysis treatment for double chin reduction, followed by HA injection for jawline contouring. Pre- and post-treatment assessments, including digital photographs and standardized measurements, were performed to evaluate changes in lower face contouring. Objective evaluation of treatment outcomes was facilitated using digital photographs and standardized measurements, including 3-D images captured using the VECTRA system. Post-treatment assessments were conducted at 4-week intervals to monitor progress, with participant satisfaction assessed using the Global Aesthetic Improvement Scale (GAIS) at the end of six months after filler treatment.

Results: Findings from this pilot study demonstrate significant improvement in lower face contouring resulting from the combined treatment of cryolipolysis and HA injection. Post-treatment improvements included reduced submental fullness, enhanced definition in the jawline and improved chin projection. The cervicomental angle, measured using VECTRA, demonstrated a reduction post-treatment in all subjects. After Cryolipolysis only, the mean change in cervicomental angle was -4.94°, with a p-value of 0.0635. After both cryolipolysis and fillers, the mean change in cervicomental angle was -9.34°, and the p-value was 0.0244, indicating a statistically significant reduction. Subjective reports from participants, using GAIS, indicated high satisfaction with treatment outcomes.

Conclusion: These results indicate that while cryolipolysis alone shows a trend toward improvement, the addition of hyaluronic acid fillers provides a statistically significant enhancement in cervicomental angle and overall lower face contouring. Hence, integrating cryolipolysis and HA injections offers a comprehensive solution for addressing lower face contour concerns, providing synergistic benefits for both modalities.

Purpose: The purpose of the study was to determine the efficacy of secondary intention healing of wounds after penile nevi surgical shave excision.

Patients and methods: A retrospective study in the Department of Dermatology, Peking University People's Hospital, between 2019 and 2023, on 8 patients with penile nevi was performed. Patients were treated by surgical shave excision and underwent secondary intention healing. For patients with relatively large nevi involving the glans penis, staged excisions were applied.

Results: In our case series, 7 patients achieved excellent wound esthetic outcomes and 1 patient achieved a good esthetic outcome, all with no loss of sensation. During the follow-up, 2 patients experienced the recurrence of pigmented macules in situ and received a second excision, achieving satisfactory outcomes as well.

Conclusion: Secondary intention healing of wounds after surgical shave excision of penile nevi has satisfactory outcomes and is a simple procedure for both doctors and patients.

Background: Sensitive skin causes discomfort from irritants, impacting quality of life. While hypoallergenic moisturizers help prevent moisture loss, some ingredients can still cause irritation. Treatments like steroids and calcineurin inhibitors have side effects, and chemical sunscreens can cause irritation in sensitive skin.

Objective: In this study, we performed a patch test by applying Bariderm Shield Cream MD in patients with facial dermatitis or sensitive skin with weakened skin barrier function and investigated whether it had an effect in relieving clinical symptoms and improving skin barrier function. We also want to find out the safety of whether new dermatitis will not occur.

Methods: 15 pruritus patients (average age 33.07 ± 11.57) applied this twice daily for 8 weeks. Effectiveness was evaluated using SS-10 (Sensitive scale-10), severity by area, TEWL (transepidermal water loss), and SCH (skin corneum hydration). We performed repeated measures ANOVA and post hoc analysis using Python statistics.

Results: Fifteen pruritus patients (average age 33.07 ± 11.57) applied this twice daily for 8 weeks. Effectiveness was evaluated using SS-10 (Sensitive scale-10), severity by area, TEWL (transepidermal water loss), and SCH (skin corneum hydration). SS-10 showed a significant difference at week 8. TEWL decreased after 8 weeks, while moisture increased after 4 weeks of application. Severity scores for erythema, scales, papules, and pustules on both cheeks notably decreased compared to baseline at week 4 and 8 after application.

Conclusion: This study shows that Barriederm Shield Cream MD® is safe for patients with sensitive skin. It suggests that it is suitable for sensitive skin, with the result of improving the skin barrier, and addresses safety and efficacy issues.

Low-grade chronic inflammation without obvious infection is defined as "inflammageing" and a key driver of skin ageing. Although the importance of modulating inflammageing for treating skin diseases and restoring cutaneous homeostasis is increasingly being recognized. However, the mechanisms underlying skin inflammageing, particularly those associated with natural treatments, have not been systematically elucidated. This review explores the signaling pathways associated with skin inflammageing, as well as the natural plants and compounds that directly or indirectly target these pathways. Nine signaling pathways and 60 plants/constituents related to skin anti-inflammageing are discussed, exploring plant mechanisms to mitigate skin inflammageing. Common natural plants with anti-inflammageing activity are detailed by active ingredients, mechanisms, therapeutic potential, and quantitative effects on skin inflammageing modulation. This review strengthens our understanding of these botanical ingredients as natural interventions against skin inflammageing and provides directions for future research.

Background: Vitiligo is a chronic autoimmune disease manifested by depigmented patches of skin devoid of melanocytes. Baricitinib, a JAK inhibitor selectively targeting JAK1/2, has shown preliminary efficacy for vitiligo. We aimed to assess the efficacy and tolerability of combination therapy with baricitinib and narrowband UV-B (NB-UVB) to treat active nonsegmental vitiligo (NSV).

Methods: We formed a combination group of 52 patients with NSV receiving baricitinib and NB-UVB irradiation, and a control group of 49 patients with NSV receiving oral mini-pulse (OMP) methylprednisolone and NB-UVB irradiation. Efficacy analysis was conducted for the 6-month period. Six months after the last treatment, the recurrence rates were investigated through follow-up.

Results: From the first month, the mean total vitiligo area scoring index (VASI) score was significantly reduced in the combination group when compared to that in the control group. Starting on the fourth month, the overall response rates (ORRs) were significantly higher in the combination group than in the control group (P=0.034). By the sixth month, the ORRs reached 86.5% in the combination group, whereas they reached 67.3% in the control group (P=0.022). The serum levels of IFN-γ and CXCL10 in the combination group decreased from 38.52±5.98 pg/mL and 976.67±150.57 pg/mL at baseline to 26.46±5.93 pg/mL and 704.14±103.38 pg/mL at the 6-month juncture, respectively (P<0.001). Moreover, we found that there was no significant difference in recurrence rates within 6 months after stopping treatment in both groups. Three patients (5.8%) in the combination group reported developing itchy skin during the first month of treatment period, and one patient (1.9%) developed erythema; no other serious adverse events occurred.

Conclusion: Our observations suggest that the combination therapy with baricitinib and NB-UVB is a promising strategy against NSV. Patients tolerated the treatment well without serious AEs, these results expand treatment options for vitiligo patients, warranting larger clinical trials.

Psoriasis is a chronic autoimmune skin disorder characterized by high morbidity and a tendency for recurrence. Although biologic therapy for lesion clearance can achieve PASI 90/100, refractory sites remain challenging to completely clear, particularly on the lower legs and elbows. To explore the efficacy of novel treatments for these resistant sites, we present a clinical observation on the safety and effectiveness of fractional carbon dioxide (CO2) laser therapy combined with secukinumab for four patients with moderate-to-severe plaque psoriasis. After receiving at least 3 months of maintenance treatment with secukinumab 300 mg, these patients received fractional CO₂ laser therapy aimed at refractory sites on the lower legs. Treatments were administered every four weeks for a maximum course of 16 weeks. All four patients demonstrated improvement in the treatment of psoriasis lesions at refractory sites following the combined treatment approach. However, the degree of improvement differed among individuals. Leg Psoriasis Area and Severity Index (Leg-PASI) scores were reduced by 50% to 88%, while leg Physician's Global Assessment (PGA) scores showed a reduction of 50% to 75%. And no adverse effects were observed.

Background: Due to limited treatment options, cutaneous warts caused by human papillomavirus (HPV) remain a significant clinical challenge. Furthermore, the genetic susceptibility and molecular basis of viral warts are not yet fully understood.

Methods: We utilized a multi-omics integration approach, encompassing genome-wide association study (GWAS) meta-analysis, summary data-based Mendelian randomization (SMR) analysis, and transcriptomic validation using the GSE136347 dataset. Differential gene expression (DEG) analysis was conducted to identify significant changes in gene expression between wart tissues and healthy skin.

Results: Our analyses revealed five genetic susceptibility genes associated with cutaneous warts, with RARA showing significant differential expression in wart tissues. Co-expression analysis indicated that RARA may regulate apoptosis through interactions with BAX, a pro-apoptotic gene. Additionally, functional annotation via Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses highlighted key biological processes and pathways involved in wart pathogenesis.

Conclusion: This study identifies RARA as a pivotal regulator in the molecular pathology of cutaneous warts and a promising therapeutic target. RA-based therapies could offer effective and less invasive alternatives for wart treatment. Future investigations should refine the molecular role of RARA to optimize clinical interventions.

Objective: Alopecia areata (AA) is an autoimmune skin disease. Observational studies have reported an association between AA and cancer. However, the causal relationship between AA and cancer has not been reported. We employed a two-sample Mendelian randomization (MR) study to assess the causality between AA and 17 subtypes of cancers.

Methods: We employed a two-sample Mendelian randomization (MR) study to assess the causality between AA and 17 subtypes of cancers. AA and cancers' association genome-wide association study (GWAS) data were collected. The inverse variance weighted (IVW) method was utilized as the principal method in our Mendelian randomization (MR) study, with additional use of the MR-Egger, weighted median, simple mode, and weighted mode methods. After that, we explored the underlying biological mechanisms by Bioinformatic Analysis.

Results: According to our MR analysis, AA has a causal relationship with hepatic bile duct cancer (HBDC, (odds ratio [OR] = 0.944, 95% confidence interval [CI] = 0.896-0.994, P-value = 0.030) and colorectal cancer (CRC, OR = 0.981, 95% CI = 0.963-0.999, P-value = 0.046). AA could decrease the risk of HBDC and CRC. No causal link between AA and other subtypes of cancers was observed. No heterogeneity or pleiotropy was observed. Furthermore, disease-related genes were obtained, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis results showed that the set of genes associated with immunity-inflammatory signaling pathway.

Conclusion: This study provided new evidence of the relationship between AA with HBDC and CRC. AA may play a protective role in both HBDC and CRC progression. This could provide newer avenues for research in search of treatment for HBDC and CRC.

Background: Tacrolimus, a topical calcineurin inhibitor (TCI) with immunomodulatory effects, is considered a viable treatment option for vitiligo. A consensus building exercise was undertaken to determine the role and clinical utility of topical tacrolimus in the management of vitiligo using input from experts in the field of dermatology.

Methods: Seventeen experts collaborated to create consensus statements using a modified Delphi methodology. A questionnaire on effectiveness, safety and utility of topical tacrolimus in different types of vitiligo, duration, frequency, monotherapy and combination and other aspects was shared, and a concordance rate of 75% was preset to have consensus. A physical meeting was conducted to discuss statements, which did not achieve consensus.

Results: Amongst 34 statements derived from round one, consensus was not achieved for 9 statements. In the second round, consensus was achieved for 2/9 statements, hence in the physical meeting, discussion was done to reframe the remaining seven statements. Apart from these 34 statements, questions pertaining to "Vitiligo: types and presentation in clinical practice", where consensus was not intended, are presented as descriptive statements.

Conclusion: Topical tacrolimus ointment has a favorable risk benefit profile to be used as one of the first-line agents for vitiligo. Combination of topical tacrolimus and narrow band Ultraviolet-B (NBUVB) was recommended as an effective treatment for non-segmental vitiligo. Recommended frequency of application was once or twice daily for optimal results. Apart from a transient burning sensation, topical tacrolimus has a favorable safety profile.