This study aims to develop a five-dimensional skin color evaluation system and analyze the characteristics of Chinese women’s skin color across these dimensions, focusing on age and key change points. The findings will provide scientific evidence for personalized skin tone management for Chinese women.
Using noninvasive skin parameter measurements and image processing, 13 facial skin color parameters were collected from 300 Chinese women aged between 18 and 60. A correlation analysis was used to verify the construct validity of the system, exploring interrelationships within and between dimensions. Additionally, polynomial fitting was used to model the five-dimensional skin tone characteristics by age, and ANOVA was used to assess these characteristics across different age stages.
Skin pigmentation issues in the Chinese female population are categorized into five dimensions: T (skin tolerance), M (skin moisturizing), U (uniformity of skin color), O (skin optical transmittance), and B (skin brightness). T reflects the skin’s ability to respond to stimuli, while M indicates optimal skin hydration and sebum production. U assesses skin color uniformity, O measures light diffusion within the skin, and B indicates the light reflection intensity of the skin. Correlation analysis suggests that poor tolerance (T) may relate to inadequate moisturization (M), and that U, O, and B positively influence each other. The study identified four different stages of skin color changes in the female population aged between 18 and 60: latent stage (18–25), pigmentation appearance (26–30), accelerated pigmentation (31–43), and pigmentation explosion (44–60). ANOVA results show that Chinese women of varying ages exhibit divergent five-dimensional skin color characteristics, with a common issue of uneven skin tone observed in all participants.
The five-dimensional skin color evaluation system provides an objective method for assessing changes in Chinese women’s skin with age. Dimensions T and M reflect skin condition and underpin management practices, while U, O, and B represent skin tone. As women age, skin pigmentation problems become more noticeable, with an increase in pigmented spots, a decline in translucency, and increased skin unevenness. The most dramatic change occurs during the accelerated pigmentation period between the ages of 31 and 43.
Kaposi’s sarcoma (KS) is a rare neoplasm whose prevalence increased with the occurrence of the human immunodeficiency virus (HIV). We aimed to assess the demographic and clinical characteristics of patients with KS who had HIV.
This retrospective study was performed on 2750 patients in Nairobi, Kenya. The characteristics of the KS were assessed in patients.
From 2750 patients, 124 (4.50%) had KS, of which 68 (54.8%) were males and 56 (45.2%) were females. The mean age of patients was 34.63 ± 8.65 (range 17–62) years. The level of CD4 was less than 100 in 62/124 (50%). Of the patients, 87.9% had skin KS, 50% had mucous membranes, and 17.7% had reticuloendothelial KS. The locations of the lesions were mainly on the lower limbs (78, 62.9%), followed by the head and neck (53, 42.7%). Eye involvement was statistically more prevalent among females than males (p value = 0.029). Sixty-one patients (49.1%) had more than 10 KS lesions. Nodules (98, 79.0%) and edema (75, 60.4%) were the most common presentations of KS. Fifty-three patients (42.7%) had tuberculosis infection. There was a significant relationship between TB and CD4 levels (p value < 0.001). Patients with lower CD4 levels were more likely to have mucus membrane involvement (p value = 0.002) and ulceration (p value = 0.017).
Our study revealed the various clinical characteristics of KS, suggesting that patients in endemic regions require a thorough clinical examination to rule out this potentially malignant condition. This article will help physicians manage patients with KS more effectively.
Methotrexate is a well-known chemotherapeutic agent, widely used alone or in combination with other drugs in the treatment of cancer. Methotrexate applications in dermatology have significantly expanded over the years. Methotrexate is an established treatment modality for psoriasis; other indications include vitiligo, atopic dermatitis, immunobullous disorders, alopecia areata, neutrophilic dermatoses, and cutaneous T-cell lymphoma. To increase the efficacy and reduce the potential adverse effects, different methotrexate forms and modes of delivery have been investigated including intralesional and topical modalities. Herein, dermatologists are introduced to methotrexate different indications in clinical practice, its mechanism of action, and the in-depth knowledge needed to effectively and safely prescribe methotrexate to their patients with confidence. Mastery of prescribing methotrexate is an essential skill for dermatologists.
Tissue and blood survivin overexpression has been associated with psoriasis.
To evaluate the effect of brodalumab therapy on survivin expression in blood samples and tissue biopsies.
Peripheral blood samples and skin biopsies were obtained from 16 psoriatic patients and 16 healthy controls. Clinical scores (Psoriasis Area and Severity Index [PASI] and Dermatology Life Quality Index [DLQI]) were recorded at 0, 3, and 12 months. Serum and tissue survivin expression were examined using an enzyme-linked immunosorbent assay (ELISA) method.
Brodalumab produced a remarkable clinical response at 3 and 12 months compared to baseline (median PASI score change: −10.6 [Q1–Q3: −11.4, −8.1], p < 0.001 and −12.3 [Q1–Q3: −14.8, −11.0], p < 0.001, respectively, and mean DLQI score reduction: 13.1 ± 3.1, p < 0.001 and 15.1 ± 2.5, p < 0.001, respectively). A significant reduction in tissue survivin was found in psoriatic skin at 12 months (p = 0.046). The median difference in tissue survivin between the two groups at baseline was also statistically significant (p < 0.001), showing higher levels in the psoriasis group. Similarly, the mean difference between tissue survivin levels at baseline and 12 months was statistically significant (p < 0.001, 95% CI of 0.034 [0.022, 0.047]). At 12 months, serum survivin decreased significantly compared to baseline, in the psoriasis group (p = 0.004, 95% CI 11.2 [4.2, 18.1]). A moderate to strong negative correlation was found between the change in serum survivin levels and the change in DLQI at 3 months (p = 0.020).
Our study provides the first evidence that serum and tissue survivin may serve as a potential biomarker in patients treated with brodalumab treatment.
This study assesses the real-world effectiveness and safety of biologic switching in plaque psoriasis, addressing the complexity of biologic therapies and the variability in optimal switching strategies to inform clinical decision-making.
This single-center retrospective study included adult patients with plaque psoriasis (> 18 years old) who received treatment with tumor necrosis factor-α (TNF-α) inhibitors, interleukin (IL)-17 inhibitors, IL-23 inhibitors, or IL-12/23 inhibitors between January 2020 and November 2024. Baseline characteristics and data on treatment duration, treatment strategy, and severity of skin lesions were recorded. Patients were categorized into six groups based on their biologic switching strategies. Kaplan–Meier estimates and Cox regression analysis were employed to evaluate drug retention rates and associated factors.
This study included 1144 patients (mean age: 44.29 years, 69.41% male) with an average biologic treatment duration of 20.5 months. IL-17 inhibitors were the most commonly used (61.1%), followed by IL-12/23 inhibitors (7.2%) and TNF-α inhibitors (4.9%). Among 114 patients who switched biologics, 128 switches occurred, most frequently from IL-17 to IL-23 inhibitors (30.5%), followed by intraclass IL-17 switches (27.3%). Kaplan–Meier analysis showed higher early dropout rates for IL-17 to IL-12/23 switches, while TNF-α to IL-17 switches had a marked retention decline after 600 days. Cox regression identified age and BMI as significant factors, with older age and lower BMI linked to higher retention. Notably, switching from IL-17 to IL-12/23 inhibitors significantly improved retention rates.
Biologic switching is common in plaque psoriasis treatment, mainly due to inadequate initial efficacy. IL-17 inhibitors are favored for their rapid and potent effects, but switching to IL-12/23 or IL-23 inhibitors can restore clinical response when needed. Patient factors, including age and BMI, significantly influence switching outcomes. Larger multicenter studies are required to validate these findings and assess long-term impacts.
MMS is considered the gold standard for treating skin cancers at high risk of recurrence, particularly in functionally or cosmetically sensitive areas, due to its high cure rates and precision in margin control, while preserving healthy tissue. However, MMS has certain limitations, such as being a time-intensive procedure requiring the involvement of multiple professionals (physicians and technicians). In this regard, presurgical evaluation of tumor margins using noninvasive optical diagnostic methods such as RCM may aid in better margin assessment, potentially reducing the number of MMS stages and the overall duration of the procedure. This prospective observational study evaluated the use of RCM and VDS in defining preoperative surgical margins for high-risk NMSCs of the head and neck treated with MMS. The study was conducted at the Oncologic Dermatology Unit of IRCCS Azienda Ospedaliero Universitaria of Bologna from January 2018 to June 2024. Based on the treatment received, the patients were divided into 2 groups: patients treated with RCM-assisted MMS (36) and patients treated with VDS-assisted-MMS (302). Mean age at diagnosis was lower in Group 1 which also required fewer MMS stages to achieve clear margins (p < 0.001) compared to Group 2. The integration of RCM in preoperative margin assessment significantly reduces MMS stages, improves surgical efficiency, and enhances patient management, especially in high-risk, complex NMSC cases.
Alopecia areata (AA) is a cell-mediated, tissue-specific autoimmune disease. While AA primarily affects hair follicles, it has also been associated with various comorbidities due to immune dysregulation. Several studies have investigated cardiovascular risk in AA; however, no research has specifically assessed carotid intima-media thickness (CIMT) in AA patients. This study aims to evaluate the potential increase in atherosclerosis risk among AA patients by measuring CIMT and other associated risk factors.
A total of 61 patients with AA and 61 healthy controls were included. Anthropometric measurements including height, weight, body mass index, waist circumference, smoking history, and biochemical parameters, including total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and fasting blood glucose levels, were recorded. CIMT was measured bilaterally using ultrasound at three adjacent sites, 10 mm proximal to the carotid bifurcation, with 5 mm intervals. The average of three measurements was used for analysis.
CIMT measurements did not show a significant difference between the two groups. However, the smoking rate, fasting blood glucose levels, and diastolic blood pressure were significantly higher in the AA group compared to the healthy controls.
CIMT, an indicator of subclinical atherosclerosis, was not increased in AA patients. However, the higher diastolic blood pressure and fasting blood glucose levels in the AA group suggest a potential cardiovascular risk that warrants further investigation.
Obesity is a prevalent comorbidity in children with pediatric psoriasis and is known to influence treatment outcomes in adults. In China, secukinumab, an anti-IL-17A biologic, is available for treating pediatric psoriasis. However, the impact of obesity on the effectiveness of secukinumab in children remains unclear.
To evaluate the effect of obesity on the clinical response to secukinumab in pediatric patients with plaque psoriasis.
This retrospective cohort study included 70 children with plaque psoriasis treated with secukinumab for at least 52 weeks. Data on demographics, body mass index (BMI), disease duration, prior systemic therapy, and disease severity were collected. Patients were stratified by BMI into a nonobese group (normal: < 85th percentile; overweight: 85th–< 95th percentile) and an obese group (≥ 95th percentile) based on age- and sex-specific percentiles from national pediatric references. Treatment efficacy, measured by PASI100, PASI90, PASI75, and Investigator’s Global Assessment (IGA) 0/1 responses, was assessed at baseline and Weeks 4, 12, 36, and 52, when available. Mixed-effects models and generalized estimating equations were used to analyze the impact of BMI or BMI status on treatment efficacy.
Of the 70 children included, 70.5% and 80.3% achieved PASI100 and PASI90 at weeks 24, respectively, with efficacy sustained through 52 weeks. Nonobese children had significantly higher PASI100 responses compared to obese children at Weeks 12 (69.8% vs. 35.7%) and 24 (76.6% vs. 50.0%, both p < 0.05). After adjusting for confounders, obesity was associated with a reduced likelihood of achieving PASI100 (OR = 0.32, 95% CI 0.13–0.81) and PASI90 (OR = 0.23, 95% CI 0.06–0.83). Higher BMI independently reduced the odds of achieving PASI100 (OR = 0.90, 95% CI 0.81–1.00, p = 0.043).
Secukinumab is effective in treating children with plaque psoriasis; however, obesity and higher BMI negatively impact clinical outcomes.
Livedoid vasculopathy is a vascular obstructive disease commonly treated with anticoagulants, including low-molecular-weight heparin and rivaroxaban. However, the long-term use of subcutaneous nadroparin calcium injection can be inconvenient, and rivaroxaban may not rapidly relieve severe pain in some patients. In this study, we examined 19 patients with livedoid vasculopathy who received sequential low-molecular-weight heparin and rivaroxaban treatments. All patients received subcutaneous nadroparin calcium injections at the early stage, which were subsequently switched to oral rivaroxaban. The results showed that clinical symptoms improved in all patients after 12 weeks of treatment. Clinical scores decreased from 6.0 (IQR 4–8) to 5.0 (IQR 4–7) (p < 0.001) after 1 week of treatment and decreased to 0 (IQR 0–4) (p < 0.001) after 12 weeks. The pain visual score decreased from 5.0 (IQR 2–8) to 3.0 (IQR 1–5) (p < 0.001) after 1 week of treatment and decreased to 0 (IQR 0–2, mean 0.3 ± 0.6) (p < 0.001) after 12 weeks. Mild adverse effects, including slightly elevated liver enzyme levels, menorrhagia, and gingival bleeding, were observed in a few patients during treatment. Our study demonstrates that sequential treatment with low-molecular-weight heparin in combination with rivaroxaban is an effective, well-tolerated, and convenient method for treating livedoid vasculopathy.
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