Dermatologic Therapy最新文献

Background

Psoriasis is a chronic inflammatory skin disorder that frequently precedes psoriatic arthritis onset. Given that biologics can treat both conditions, there is growing interest in whether early biologic intervention can prevent psoriatic arthritis.

Objectives

This systematic review examines observational studies to determine whether biologic treatment for psoriasis reduces psoriatic arthritis incidence.

Methods

Following the PRISMA guidelines, we searched PubMed in November 2025 for studies published between 2003 and 2025; 11 articles met eligibility.

Results

A total of 368,033 psoriasis patients were analyzed, including 27,195 patients receiving biologics. Five clinical studies demonstrated that biologics were associated with a lower risk of psoriatic arthritis. In contrast, 6 claim-based studies showed conflicting results, often indicating higher psoriatic arthritis incidence among biologic users.

Conclusions

Current evidence is mixed regarding the ability of biologics to delay psoriatic arthritis onset in psoriasis patients. Prospective studies and rigorously designed retrospective analyses that carefully adjust for biases are needed to determine whether biologic therapy can reduce psoriatic arthritis incidence.

Background

The nail matrix is a unique structure, and usually nail matrix defects over 2–3 mm are very difficult to repair. The aim of this article was to repair larger nail matrix defects by a modified A-T advancement flap to avoid nail deformity.

Method

Surgery was performed on 22 fingers with melanonychia and nail splitting. Nail matrix defects were repaired by a modified A-T advancement flap. The results of the procedure were evaluated by postoperative scarring, nail ridges, nail curvature and gloss, and satisfaction. Patients were followed for 4–48 months.

Results

The average score for nail appearance and morphology was 5.39 points (maximum six points). The average overall satisfaction score was 0.91 (maximum one point). The difference in preoperative and postoperative nail width was significantly less than the width of the excised nail matrix.

Conclusion

This procedure produced good results in terms of nail appearance and morphology for the nail matrix defect.

Background

Psoriasis is an immune-mediated skin disease, of which plaque psoriasis is the predominant form. This study aimed to understand the clinical characteristics of patients with moderate-to-severe plaque psoriasis who received systemic medications in a real-world setting in China.

Methods

In this retrospective observational study, patients with moderate-to-severe plaque psoriasis were identified in electronic medical record databases from two study centers in China between January 1, 2018, and December 31, 2021. Analyses were conducted on patients with a follow-up period of ≥ 6 months. Primary objectives were to describe demographics, clinical characteristics, treatment experiences, and patterns of systemic treatments among this population. Secondary objectives were to describe healthcare resource utilization.

Results

Among 1102 eligible patients included in the systemic treatment analysis set, the mean (standard deviation [SD]) age was 44.9 (14.6) years, and 77% of patients were male. The most common comorbidity was allergic disease and skin disease (11%). Most patients received conventional systemic medications (84%), while few received biologic treatments (16%); 88% of patients discontinued systemic treatments within 90 days of the last prescription, 6% switched to a new systemic medication. The mean (SD) number of visits per patient-year was 6.5 (5.2) for outpatient and 0.9 (not applicable [NA]) for inpatient. The mean (SD) duration of inpatient visits per patient-year was 9.3 (NA) days, with a mean (SD) monthly direct medical cost of CYN 371.09 (741.56).

Conclusions

These results provide valuable insights for guiding decision-making for patients with plaque psoriasis. The high treatment discontinuation rate reflects a challenge to disease management and suggests better treatment options are needed for this patient population in China.

Background and Objectives

Plantar warts, caused by the human papillomavirus (HPV), are common skin growths that predominantly affect children and adolescents. These warts can lead to discomfort and have a significant impact on quality of life. This study aims to assess the effectiveness and safety of microneedling with bleomycin for plantar warts. Our goal is to determine whether this innovative approach can provide better relief for patients suffering from these persistent lesions.

Patients and Methods

The assessment of treatment efficacy involved measuring the size of warts and conducting photographic comparisons to evaluate healing status. Secondary outcomes included the monitoring of recurrence rates and the treatment-related adverse effects.

Results

45 patients aged 10–24 years, with a total of 360 warts treated, primarily with bleomycin in Group A, where 80% of patients achieved a full response. Analysis showed that lesion diameter influenced treatment outcomes, with lesions measuring 1 cm or less showing significantly better responses (p = 0.04).

Conclusion

The combination of topical bleomycin and microneedling is a promising and safe treatment for plantar warts, although variability in study outcomes necessitates further research with larger samples and longer follow-up to assess long-term efficacy and safety.

Background

Melasma treatment remains challenging with variable response to conventional lightening agents. Polyamine inhibition via ornithine decarboxylase 1 (ODC1) may offer an alternative approach, with eflornithine hydrochloride being an established ODC1 inhibitor.

Objectives

To compare the efficacy and safety of eflornithine hydrochloride 13% cream versus standard hydroquinone 2% cream for melasma treatment.

Methods

A randomized, double-blinded, split-face–controlled pilot trial was conducted over 3 months with 20 patients (16 female, mean age 54). Efficacy was assessed via modified Melasma Area and Severity Index (mMASI), Mexameter measurements, physician assessments, and patient satisfaction scores.

Results

Both treatment groups showed improvements in mMASI scores and Mexameter measurements (erythema and melanin). No significant differences were found between treatment groups when comparing unit differences or fold changes. Only one patient reported mild irritation from eflornithine. Patient self-assessments trended higher for eflornithine without reaching statistical significance.

Conclusion

Eflornithine hydrochloride 13% cream demonstrates comparable efficacy to hydroquinone 2% cream with a favorable safety profile, presenting a promising alternative for melasma treatment.

Trial Registration:ClinicalTrials.gov identifier: NCT06957834

Background

Rosacea treatments often lead to recurrence after discontinuation, highlighting the need for effective maintenance therapies. The long-term efficacy of treatments in preventing relapse has not been systematically compared.

Objectives

To compare the risk of relapse upon treatment discontinuation after achieving clinical remission with both topical and systemic therapies.

Methods

Updated systematic review and network meta-analysis of randomized controlled studies following PRISMA guidelines. A thorough literature search across different databases to identify randomized controlled trials (RCTs) on treatment relapse rates in adult patients with moderate to severe papulopustular rosacea treated with systemic and topical treatments was conducted. Data were independently extracted, and the risk of bias was assessed using the Cochrane tool. Statistical analyses were performed using network meta-analysis with random effects models.

Results

A total of seven out of an initial 14,450 articles screened were retrieved, involving 632 patients with moderate to severe rosacea and 552 controls treated with metronidazole 0.75% gel, doxycycline 40 mg, ivermectin 1% cream, isotretinoin 0.25 mg/kg/day, hydroxychloroquine 200 mg, and aminolevulinic acid photodynamic therapy. Results showed that isotretinoin and metronidazole significantly prevented rosacea relapse compared to placebo, with isotretinoin ranked as the most effective treatment according to SUCRA rankings. The average time regarding relapse varied among studies, with metronidazole showing a shorter relapse period (12 weeks) than ivermectin (21 weeks). The risk of bias was low, with no significant publication bias detected. The limits of this review were the relatively small number of studies included and the high degree of indirectness that was noted across these studies, potentially affecting the reliability of some estimates.

Conclusion

Rosacea remission can be maintained for a certain period of time after the discontinuation of the treatment and also during the treatments. Isotretinoin might be effective in reducing the risk of relapse.

Background

In China, the common treatment for Bowen’s disease (BD) is surgical excision. Although 5-aminolevulinic acid–based photodynamic therapy (ALA-PDT) has proven effective for BD in Caucasian patients, there is limited research on its effectiveness in Asian patients. This trial aimed to investigate the efficacy and safety of ALA-PDT in treating BD patients in China, providing data to standardize its application in Chinese BD patients.

Methods

A multicenter, prospective clinical study was conducted in seven tertiary hospitals in China. Histopathologically confirmed BD patients received standard ALA-PDT. After pretreatment, a 20% ALA gel or solution was applied to the lesions and incubated for 3-4 h. The lesions were illuminated with 635-nm red LED light at a dose level of 80–120 J/cm². Additional treatments were scheduled every 7–14 days based on lesion regression.

Results

The study included 35 BD patients with 44 lesions. All patients received 3–6 sessions of ALA-PDT. Three months after the last treatment, the complete response rate was 97.1% (34/35) for patients and 97.7% (43/44) for lesions. Subgroup analysis indicated that sex (p = 0.3518), age (p = 0.6906), number of lesions (p = 0.7155), lesion location (p = 0.2241), and size (p = 0.2898) did not significantly affect effectiveness. During the 12-month follow-up, the recurrence rate was 3.0% (1/33). Physicians rated 93.1% (27/29) of cosmetic effects as excellent or good. Meanwhile, patient satisfaction reached 92.6% (25/27). The primary adverse event observed was mild to moderate pain. Photodynamic fluorescence diagnosis showed that 100% (35/35) of the BD lesions exhibited brick-red fluorescence.

Conclusions

A regimen of 3–6 sessions of topical ALA-PDT using 20% ALA, 3-4-h incubation, and a red light source leads to high complete response rates, excellent cosmetic effects, good patient tolerance, and minimal adverse reactions in Chinese BD patients. Importantly, the efficacy of ALA-PDT is not affected by lesion size, location, or number.

Trial Registration: Chinese Registry of Clinical Trials: ChiCTR1800019213

Background

Low-level laser therapy (LLLT) has emerged as a nonpharmacologic intervention for androgenetic alopecia (AGA), but evidence on its long-term efficacy remains limited.

Objective

To evaluate the 12-month effectiveness and safety of a home-use helmet-type LLLT device in individuals with AGA.

Materials and Methods

This prospective, open-label study enrolled 68 patients (51 men, 17 women) with mild to severe AGA. Participants used a helmet-type LLLT device emitting red light (646–675 nm) three times per week for 20 min over 48 weeks. Hair density and shaft thickness were assessed using phototrichogram at predefined intervals. Additional evaluations included blinded global photographic assessments and patient-reported outcomes.

Results

Hair density increased significantly from a baseline mean of 99.2 ± 27.7 to 124.2 ± 33.1 hairs/cm² at 48 weeks (mean change +25.0 ± 28.1, p < 0.0001). Mean hair shaft thickness rose from 65.1 ± 11.8 to 74.9 ± 12.6 μm (p < 0.0001), reflecting an approximate 15% improvement. Gains were consistent across sexes and AGA severity levels. By Week 48, 59% of participants were rated as improved based on global photographs, and over 85% expressed satisfaction with treatment. No adverse events related to the device were reported, and adherence was high throughout the study.

Conclusion

Twelve months of home-use LLLT resulted in sustained improvements in hair density and thickness with excellent tolerability. These findings support its role as a safe, effective, and user-friendly long-term therapeutic option for patients with AGA.