Clinical, Cosmetic and Investigational Dermatology最新文献

Introduction: Cutaneous lupus erythematosus (CLE) is an autoimmune skin disorder increasingly recognized to have systemic effects, including possible links to atherosclerotic cardiovascular disease (ASCVD). However, the strength and pattern of this association remain uncertain.

Objective: To evaluate and assess available evidence on ASCVD risk in CLE, identify patterns across study designs and populations, and highlight research gaps requiring further study.

Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted up to July 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251156382). Eligible studies included adult CLE populations reporting ASCVD outcomes. Data extraction and risk-of-bias assessment were independently performed using the Newcastle-Ottawa Scale and the AXIS tool.

Results: Six observational studies met the inclusion criteria, including population-based cohorts, hospital datasets, and case-control analyses. Across designs, CLE was consistently associated with elevated ASCVD risk, particularly stroke and thromboembolic events. Large registry-based studies showed significant associations even after adjustment for traditional risk factors, suggesting CLE-specific inflammatory mechanisms. Smaller cohorts highlighted high comorbidity burdens and subtype differences, particularly a stronger signal in discoid lupus.

Conclusion: Evidence indicates that CLE is linked to increased ASCVD risk, especially cerebrovascular and thromboembolic outcomes. Standardized definitions and longitudinal studies are needed to clarify subtype-specific risks and inform prevention strategies.

Post-procedural bruising is one of the most common complications of aesthetic injections. Liquid-form polycaprolactone (PCL) is generally considered safe, with only transient and self-limiting adverse events reported. While bruising after liquid-form PCL injections is typically short-lived and no cases of permanent bruising have been documented, some patients may experience bruising persisting for several months. To date, however, no published reports have described such long-term cases. Here, we present retrospective review on seven clinical cases of persistent bruising following liquid-form PCL injections to the infraorbital, puncture point, and upper arm regions, and summarize their clinical management. Therapeutic approaches included pigment fragmentation (PICO, Nd:YAG, IPL, PDL), thermal loosening of the scaffold-tissue complex (radiofrequency, high-intensity focused ultrasound, warm application), mechanical dispersion (microcurrent stimulation, ultrasound, normal saline washout, gentle massage), and enzymatic degradation (hyaluronidase, lipase). All patients ultimately achieved resolution, and no serious adverse events were observed. These findings suggest that long-term bruising, although rare, is clinically relevant and may be associated with dense liquid-form PCL scaffold entrapment of pigment molecules or a Tyndall effect. Importantly, this phenomenon is not permanent, as its resolution parallels scaffold degradation over time. Preventive strategies, combined with multimodal management tailored to the underlying mechanisms, may reduce patient discomfort and optimize aesthetic outcomes.

Purpose: Pemphigus encompasses a group of rare and potentially life-threatening autoimmune bullous diseases. Epidemiological research on pemphigus in China remains limited. This study aimed to analyze the clinical characteristics, diagnostic delay, and initial treatment patterns of patients with newly diagnosed pemphigus at a tertiary center in China.

Patients and methods: This retrospective study included patients newly diagnosed with pemphigus between January 2020 and December 2024 at the outpatient department of Peking Union Medical College Hospital. Demographic and clinical data were collected and analyzed.

Results: A total of 138 patients were included. Pemphigus vulgaris was the most prevalent subtype (68 cases, 49.3%), followed by pemphigus erythematosus (34 cases, 24.6%), pemphigus foliaceus (13 cases, 9.4%), and pemphigus herpetiformis (11 cases, 8.0%). Notably, the diagnostic delay was substantial, with a median of 5.0 (2.0-12.0) months, and 106 patients (76.8%) had been misdiagnosed before a definitive diagnosis was made. Regarding initial treatment, the most frequently used drugs were corticosteroids (104/132, 78.8%), followed by mycophenolate mofetil (33/132, 25.0%), Tripterygium wilfordii Hook F (29/132, 22.0%), minocycline (28/132, 21.2%), and rituximab (24/132, 18.2%). There was no significant difference among the subtypes in the proportion of patients receiving non-steroidal therapies.

Conclusion: These findings highlight a significant diagnostic delay and outline evolving treatment patterns for pemphigus in a contemporary Chinese cohort. This information may inform future research directions and health policy decisions for managing this rare disease.

Purpose: Psoriasis is a chronic inflammatory skin disease involving complex immune dysregulation, where NLRP3 inflammasome-mediated pyroptosis-a pro-inflammatory programmed cell death-has been identified as a key driver of disease pathogenesis. Qingshi anti-itch ointment (QS), a traditional Chinese medicine used for psoriasis, has demonstrated clinical efficacy; however, its specific impact on the NLRP3-pyroptosis pathway remains unclear. This study therefore aims to elucidate the role and underlying mechanisms of QS in regulating NLRP3 inflammasome activation in keratinocytes.

Methods: Psoriasis models were established using both in vivo and in vitro approaches: (1) a mouse model induced by topical application of Imiquimod (IMQ) cream, and (2) a cellular model of keratinocyte pyroptosis stimulated with Lipopolysaccharide (LPS) and Adenosine triphosphate (ATP) in vitro. Therapeutic effects were evaluated through Psoriasis area and severity index (PASI) scoring and Hematoxylin-Eosin staining method (HE). NLRP3 inflammasome-mediated pyroptosis was assessed by IHC, RT-qPCR, and Western blot. Levels of IL-18, IL-1β, IL-17, and IL-22 were measured. Transmission electron microscopy was employed to examine NHEK cellular ultrastructure and pyroptotic status. MCC950, a specific NLRP3 inhibitor, was used to determine whether QS modulates keratinocyte pyroptosis through NLRP3 inflammasome regulation.

Results: QS effectively ameliorated IMQ-induced psoriasiform lesions by suppressing keratinocyte pyroptosis and maintaining cellular integrity. Both in vivo and in vitro experiments demonstrated QS's ability to inhibit the NLRP3 signaling pathway and selectively regulate key pyroptotic molecules (Caspase-1/GSDMD), thereby reducing proinflammatory cytokine release. Notably, QS combined with MCC950 exhibited significant synergistic effects in suppressing NLRP3 inflammasome activation in both IMQ-induced and LPS/ATP-stimulated models.

Conclusion: QS primarily alleviates psoriasis by modulating keratinocyte pyroptosis through mitochondrial protection, inhibition of GSDMD-mediated membrane perforation, and downregulation of Caspase-1 activity, collectively attenuating inflammatory responses. These findings provide novel mechanistic insights into QS's anti-psoriatic effects and may facilitate the development of innovative therapeutic strategies for psoriasis.

Hyperhidrosis is a disorder characterized by excessive sweating beyond physiological requirements, which significantly interferes with daily functioning and quality of life. It affects approximately 4%-5% of the population worldwide, yet its underlying pathophysiology remains unclear, with proposed mechanisms involving autonomic nervous system dysregulation, metabolic imbalance, and psychological factors. Here, we describe a case of chronic hyperhidrosis in which spontaneous sweating and facial flushing improved markedly following administration of Samhwangsasim-tang as monotherapy. A 66-year-old man presented with chronic hyperhidrosis occurring without identifiable triggers. Even minimal physical activity caused profuse craniofacial sweating accompanied by facial flushing, which was exacerbated by heat exposure and conditions associated with increased core body temperature. Based on his symptom pattern, Samhwangsasim-tang extract granules were prescribed. No other treatments, including acupuncture, cupping therapy, or conventional medications, were administered during the treatment period. Symptom severity was evaluated using the Numeric Rating Scale (NRS) and the Hyperhidrosis Disease Severity Scale (HDSS). After approximately 42 days of treatment, spontaneous sweating resolved completely (NRS 10 → 0; HDSS 4 → 1), and facial flushing was reduced to 20%-30% of baseline severity (NRS 10 → 2-3). This case suggests that the heat-clearing, anti-inflammatory, and metabolic-regulating properties of Samhwangsasim-tang may contribute to the normalization of skin temperature, sweating regulation, and peripheral circulation. Further clinical and mechanistic studies are warranted to elucidate its therapeutic potential in hyperhidrosis.

Cutaneous Rosai-Dorfman disease (CRDD) is a rare form of non-Langerhans cell histiocytosis. Because the etiology and pathogenesis remain unclear and the cutaneous manifestations are highly variable, no definitive diagnostic criteria have been established. As a result, the risk of diagnostic errors and missed diagnoses is common in clinical practice. This report describes the case of a 64-year-old woman with facial CRDD that initially misdiagnosed as sporotrichosis. This case broadens the known clinical spectrum of CRDD and underscores the importance of careful differential diagnosis to avoid misdiagnosis and ensure appropriate treatment.

Purpose: Acne affects up to 9% of the global population, with rising prevalence among Chinese urban youth, leading to significant physical and psychological impacts.

Patients and methods: A cross-sectional study was conducted at the Dingxi People's Hospital. Data on the demographics and knowledge, attitudes, and practices (KAP) of patients with moderate to severe acne were collected through questionnaire distribution.

Results: A total of 561 patients were included in the study, of them 58.65% females, The majority of participants believed that they have sufficient knowledge of routine acne management and 72.72% reported that they are satisfied with the current effectiveness of medication treatment. However, predominant answer for all questions regarding the oral treatment of acne (40.29%-58.82%) or combination therapy (23.89%-41.53%) was "unsure". Knowledge score was positively correlated with attitude score (p < 0.001) and practice score (p < 0.001), and higher knowledge scale scores were associated with higher practice scores according to logistic regression analysis (p = 0.002). According to the Structural equation modelling knowledge influenced practice directly and indirectly.

Conclusion: This study found that patients with moderate to severe acne in China might overestimate their knowledge of oral medication therapy and ability to manage acne. Targeted healthcare education is needed to address the identified gaps, ultimately optimizing acne management strategies and enhancing patient outcomes.

Urticarial vasculitis (UV) is a clinicopathologic entity characterized by urticarial lesions disclosing histopatho logically leukocytoclastic vasculitis, mainly of postcapillary venules. A 61-year-old woman with a four-month history of widespread, pruritic urticarial lesions was diagnosed with urticarial vasculitis. The patient received a subcutaneous injection of Omalizumab (300 mg) every 28 days, combined with oral Cyclosporine (3 mg/kg/day). Significant clinical improvement was noted within five days post-treatment. This case highlights the difficulties in treating refractory urticarial vasculitis while demonstrating the successful use of Omalizumab plus Cyclosporine, providing a viable treatment option for similar patients.

Introduction: Androgenetic alopecia (AGA) is traditionally regarded as a noninflammatory, androgen-driven condition. Yet clinical and histologic evidence identifies a subset of patients with perifollicular infundibulo-isthmic lymphocytic infiltrates and fibrosis (PIILIF), a histopathologic pattern resembling early primary cicatricial alopecia (PCA). This study evaluates the clinical, histologic, and immunophenotypic features of PIILIF and their diagnostic and therapeutic implications.

Methods: This retrospective study of 129 AGA patients drawn from a referral center, obtained trichoscopy-guided biopsies from balding and clinically non-alopecic scalp (cNAS). Histopathologic and immunohistochemical findings were correlated with clinical features and treatment outcomes. Patients with PIILIF received multimodal therapy targeting androgenic and inflammatory pathways. The cohort, from a specialty clinic, included both typical and treatment-resistant AGA.

Results: PIILIF was identified in the cNAS of 81% of patients, particularly in those aged 44 or older, with Norwood stage ≥5, or with prior poor response to therapy. Histology showed CD117+ mast cells, perifollicular CD4-predominant lymphocytes and fibrosis in the infundibulo-isthmic unit. Combination therapy using dihydrotestosterone blockade plus anti-inflammatory agents modeled after PCA therapies, including tetracyclines, topical calcineurin inhibitors, and select phytoactive botanicals, yielded greater improvement than standard AGA treatment regimens alone. Overall, 67% improved, and 2% had suboptimal outcomes (p < 0.0001). These findings support an AGA-PIILIF continuum that may include fibrosing alopecia in a pattern distribution.

Conclusion: PIILIF represents an under‑recognized inflammatory endotype within AGA that may account for treatment resistance in some patients. Early biopsy can confirm the diagnosis, and therapy targeting hormonal and immune pathways may improve outcomes. Routine trichoscopy with a low threshold to biopsy perifollicularly abnormal units showing mild erythema, scale, or hyperpigmented collars can guide care, particularly in treatment resistant or equivocal cases. The broader systemic implications of this inflammatory signature merit further investigation.

Purpose: Intense pulsed light (IPL) treatment may cause transient erythema, dryness, and barrier dysfunction, highlighting the need for effective postprocedural care. This study aimed to assess the efficacy and safety of a fibronectin-containing skincare regimen in restoring skin barrier function and relieving these IPL-related manifestations.

Patients and methods: In this 28-day, split-face study, 32 healthy female participants undergoing IPL treatment applied a fibronectin-containing serum to one side of the face and a control serum to the opposite side. Skin hydration, transepidermal water loss (TEWL), erythema, and radiance were evaluated at baseline, immediately post-IPL, and on days 3, 7, and 28.

Results: Compared to the control, the fibronectin-treated side showed significantly greater improvements in skin hydration (P < 0.01) and significantly lower TEWL on days 3 (P < 0.05), 7 (P < 0.01), and 28 (P < 0.01). By days 7 and 28, skin radiance and erythema also improved more significantly (P < 0.01). Both dermatologist and participant assessments confirmed the superior efficacy of the fibronectin serum. No adverse events were rePorted.

Conclusion: Post-IPL aPPlication of a fibronectin-containing serum effectively imProves skin hydration, reduces barrier dysfunction and erythema, and enhances radiance with good tolerability. These findings suPPort its Potential utility in Post-IPL skincare regimens.