Hyperthermia represents a physiological state marked by an elevation in body temperature due to the malfunctioning of thermoregulatory mechanisms. It transpires when the body either generates or absorbs a greater amount of heat than it is capable of expelling. In clinical practice, hyperthermia has gained increasing recognition compared with traditional laser, freezing, and other treatment measures. However, the regulatory effects of hyperthermia on immune cells and the underlying mechanisms remain insufficiently investigated. In this review, we summarized the therapeutic methods of hyperthermia including thermal water hyperthermia, infrared radiation (IR) hyperthermia, photodynamic therapy, and targeted radiofrequency hyperthermia in dermatology, the clinical practical applications as well as the treatment mechanism based on immune cells. Further studies should be conducted to clarify the underlying mechanisms and promote the clinical applications of hyperthermia.
Janus kinase inhibitors (JAKis) have revolutionised the management of immune-mediated inflammatory diseases (IMIDs); however, their potential to increase the risk of herpes zoster (HZ) remains a major concern.
A literature search was performed through February 2024. Phase II, III and IV randomised controlled trials (RCTs) and long-term extension (LTE) studies comparing JAKis with placebo, methotrexate or tumour necrosis factor inhibitors (TNFis) in IMIDs were included. The primary outcome was the risk ratio (RR) for HZ with JAKis compared to placebo/methotrexate or TNFis. Secondary outcomes included incidence rate ratios (IRRs) for HZ comparing JAKis with active treatments during long-term follow-up.
A total of 94 RCTs and 30 LTE studies, representing 120,698.3 patient-years, were included. Pairwise meta-analysis demonstrated a significantly increased HZ risk with JAKis compared with placebo/methotrexate (RR 1.98, 95% CI 1.56–2.50) and TNFis (RR 2.31, 95% CI 1.73–3.07). Network meta-analysis identified that in rheumatoid arthritis and psoriatic arthritis, upadacitinib 30 mg significantly increased HZ risk compared with placebo (IRR 2.76, 95% CI 1.58–4.85; IRR 3.54, 95% CI 1.48–8.50) and TNFis (IRR 5.30, 95% CI 3.19–8.81; IRR 10.76, 95% CI 4.78–24.22). In atopic dermatitis, abrocitinib 200 mg was associated with a higher HZ risk compared to placebo (IRR 4.97, 95% CI 1.58–15.60) and dupilumab (IRR 4.85, 95% CI 1.55–15.22). Tofacitinib 10 mg exhibited a higher HZ risk in inflammatory bowel disease compared to placebo (IRR 8.93, 95% CI 1.16–68.53). Patients with atopic dermatitis demonstrated the highest incidence of HZ in both short- and long-term analyses. The risk of HZ was dose-dependent across all conditions.
JAKi use was significantly associated with an elevated HZ risk in IMIDs, demonstrating a consistent dose–response relationship. These findings emphasise the importance of HZ vaccination before initiating JAKi therapy, particularly for patients on higher doses or long-term treatment.
This study explores the impact of β-glucan on the skin microbiome using high-throughput sequencing, aiming to develop skincare products targeting beneficial microbes.
A 9-week protocol involved collecting skin microbiota samples at baseline and subsequent weeks. This was followed by a 3-week washout period, after which β-glucan was applied. Samples from three distinct skin regions were subjected to 16S rDNA sequencing. The data analysis encompassed operational taxonomic units (OTUs) clustering, α-diversity and β-diversity metrics, T tests, and linear discriminant analysis effect size (LEfSe) for the identification of biomarkers.
Skin microbiome analysis at four time points (T0, T3, T6, and T9) in 10 participants over 3 months yielded 13,258 OTUs from 600 samples (10 participants × 4 time points × 3 regions × 5 technical replicates). β-glucan enhanced microbial diversity, with increased unique OTUs at T9. Significant differences in α-diversity (Chao1, observed species, Shannon, Simpson indices) were observed between baseline and T9. PCoA and NMDS analyses revealed shifts in the microbial community structure. LEfSe identified Cutibacterium, Pseudomonas, and Ralstonia as significantly enriched in treatment groups.
β-glucan modulated skin microbiome composition, increasing diversity and stability. These findings suggest its potential role in promoting skin health, warranting further research on its long-term effects.
Chronic plaque psoriasis negatively impacts patients’ work productivity, with potential substantial financial implications. This post hoc analysis assessed associations between disease (itch, pain, dermatology life quality index [DLQI], and psoriasis area and severity index [PASI])- and work-related outcome measures (absenteeism, presenteeism, and activity and work impairment) in 116 patients with moderate-to-severe plaque psoriasis treated with tildrakizumab for 24 weeks. We extrapolated the potential economic value of reducing work productivity loss with tildrakizumab treatment in society, using Norway as a model. Elevated pain and DLQI scores significantly increased the degree of absenteeism, and pain, DLQI, and itch were significantly positively associated with presenteeism, activity impairment, and work impairment. The PASI did not associate with any work outcome measure. Economic impact due to work productivity loss was extrapolated at approximately EUR 12,700 per person annually. In conclusion, all disease outcome measures except the PASI were associated with a work-related outcome measure, indicating that more holistic measures for assessing psoriasis disease burden may be more beneficial from a patient perspective. Additionally, the economic value of reduced work productivity loss due to tildrakizumab treatment was extrapolated to be substantial in Norwegian society, suggesting that managing plaque psoriasis with this biologic could be clinically and economically beneficial.
Hailey–Hailey disease (familial benign chronic pemphigus) is a rare autosomal dominant genodermatosis caused by ATP2C1 gene mutations, leading to defective calcium-dependent ATPase. The function of this protein is to regulate calcium sequestration in the Golgi apparatus. While the mutation leads to impaired desmosome function, causing acantholysis of the suprabasal epidermis in the skin. Clinically, it presents with vesicles, erosions, fissures and weeping plaques, primarily in intertriginous areas. Symptoms worsen with heat, sweat, friction, and trauma, while treatment options remain limited.
The aim of this systematic review was to review the available literature to assess the efficacy and safety of botulinum toxin as a therapeutic option for the treatment of Hailey–Hailey disease.
A literature review was conducted in Embase and MEDLINE using keywords like “Hailey–Hailey disease,” “pemphigus,” and “botulin toxin.” The search followed PRISMA guidelines, incorporating EMTREE and MESH terms. Inclusion criteria covered original trials, case reports, and case series in English until July 2025. Of 28 identified studies, 21 were included after further manual review.
Twenty-one articles involving 68 patients described the use of botulinum toxin in HHD. Most patients achieved significant improvement and partial or complete remission of skin symptoms after injection or reinjection of botulinum toxin. Only one patient showed no improvement in target lesions. Combined botulinum toxin, photodynamic therapy, and dapsone yielded superior improvement with PDT + BoNT-A showing better outcomes than BoNT-A alone. No side effects were observed.
Botulinum toxin appears to be a promising therapeutic alternative in HHD with a very good tolerability, both as a complementary treatment and as an adjuvant to other forms of therapy, such as PDT. Larger studies are required to confirm its efficacy, long-term effects, and also to establish the optimal doses and number of botulinum toxin injections resulting in a standardized treatment regimen.
Partial unilateral lentiginosis (PUL) is a rare acquired hyperpigmented disorder presenting as clusters of small, brown macules on otherwise normal skin, limited to one side of the body, and typically emerging in childhood. Only a few cases of successful treatment have been documented, and a consistently effective therapy for achieving favorable cosmetic results has yet to be established.
This study was performed to investigate the effectiveness and safety of golden parameter therapy (GPT) employing a high-fluence 1064-nm Q-switched Nd:YAG laser (QSNL) for the treatment of PUL.
The study involved 87 Korean patients with PUL, where 79 patients received weekly treatments using a 1064-nm QSNL under GPT for a total of 30–50 sessions. Treatment parameters included a 7 mm spot size, a 2.2 J/cm2 fluence, and a 10 Hz pulse rate, with a single pass applied using a sliding-stacking technique over the PUL area. In contrast, a small alternative therapy group of eight patients underwent monthly treatment with a 532-nm picosecond laser for three sessions, using a 3 mm spot size, a 1 J/cm2 fluence, and a 2 Hz pulse rate.
Following 30–50 GPT sessions using 1064-nm QSNL, 48 of the 79 patients achieved complete clearance (confluent brown patches type and mixed type: 60.8%), whereas 31 of 79 patients attained excellent clearance (grouped independent lentigines type: 39.2%). No significant side effects, such as purpura, crusting, postinflammatory hyperpigmentation, mottled hypopigmentation, or scarring, were observed. Additionally, no recurrences occurred in any patients over the 6–24-month follow-up period. In contrast, the small alternative therapy group of eight patients treated with the 532-nm picosecond laser showed poor treatment outcomes (100%).
We propose that GPT with a high-fluence 1064-nm QSNL is a new, safe, and effective treatment for PUL, reducing side effects and preventing recurrences.
Intense pulsed light (IPL) therapy has demonstrated clinically satisfactory outcomes as a nonablative and noninvasive modality for skin tightening and rejuvenation. However, no self-controlled study to date has directly compared the efficacy of single-wavelength filter IPL versus multiwavelength filter IPL in the treatment of facial photoaging.
Twelve patients received three IPL treatment sessions at 4-week intervals. Each patient underwent split-face therapy: one facial side was treated with a single-wavelength filter, while the contralateral side received multiwavelength filter treatment. Photoaging severity was assessed 1 month posttreatment using a standardized grading scale, with objective quantitative measurements obtained via the VISIA-CR imaging system.
Significant improvements in photoaging indicators were observed bilaterally following three IPL sessions. The multiwavelength filter–treated side exhibited superior enhancement in pigmentation, skin texture, and facial laxity compared to the single-wavelength filter–treated side.
Both single- and multiwavelength filter IPL therapies effectively improve facial photoaging. The multiwavelength approach, however, appears to yield superior outcomes, likely due to more targeted photothermal effects on diverse cutaneous chromophores and tissue structures.
Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500112082
Localized scleroderma (LS) is a disfiguring chronic inflammatory disease characterized by fibrosis of the skin and subcutaneous tissue. As the available therapeutic options are limited, developing effective and safe treatment protocols is crucial.
This study included both animal experiments and a single-arm, open-label clinical trial.
In the animal experiments, ablative fractional carbon dioxide laser (CO2-AFL) treatment (reaching the deep dermis) improved skin fibrosis, reduced dermal thickness, and induced collagen restructuring, promoting hair follicle proliferation. MMP-1, Krt15, and PCNA clearly increased after treatment. The subsequent clinical trial demonstrated that CO2-AFL treatment significantly improved the appearance and key parameters of skin lesions in LS patients. The tested therapy was associated with reduced skin hardening, restoration of the adipose tissue structure, and increased hair follicle growth. Following laser treatment, VAS scores decreased from 5.61 (1.09) to 3.90 (1.03), clinical ratings from 5.06 (1.32) to 3.68 (1.49), and ultrasound-based lesion activity scores from 4.79 (1.34) to 2.67 (1.85), all with p < 0.001. No severe adverse effects were observed.
This study underscores CO2-AFL as a promising therapeutic option for LS patients, elucidating underlying mechanisms and establishing a foundation for advancing future therapeutic strategies.
Chinese Clinical Trial Register (ChiCTR2200065939).
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