Dermatologic Therapy最新文献

Background: Xanthelasma palpebrarum (XP) currently lacks a universally endorsed treatment approach. The utility of picosecond 1064 nm Nd:YAG lasers in XP management has not been explored.

Objective: This study aimed to assess the efficacy and safety of picosecond 1064 nm Nd:YAG laser therapy in the treatment of XP.

Methods: A total of 47 patients with clinically confirmed XP received treatment with picosecond 1064 nm Nd:YAG laser at standardized settings. Patients were photographed using standardized photographic documentation, and the degree of clearance was evaluated.

Results: Following the initial treatment session, 97.87% of patients exhibited a good response to the picosecond laser, with some degree of lesion clearance. By the third session, 78.80% of patients achieved > 50% lesion clearance. Adverse effects were mild and transient, with postinflammatory hyperpigmentation observed in 2 (4.25%) patients.

Conclusion: The picosecond 1064 nm Nd:YAG laser demonstrated promising efficacy in the treatment of XP, with a potentially enhanced safety profile.

Background: Bromhidrosis can significantly impact a patient’s quality of life. Despite the availability of various treatment options, radical surgery remains the gold standard for permanent resolution. However, complications such as hematoma and malposition healing can occur postoperatively, necessitating the exploration of effective techniques to mitigate these risks and improve patient outcomes.

Objective: This study explores the application effect of skin puncture and external fixation techniques in preventing hematoma and malposition healing after radical surgery for bromhidrosis.

Methods: A total of 300 patients who underwent radical surgery for bromhidrosis in our hospital from June 2023 to April 2024 were retrospectively selected from medical records. They were divided into two groups based on whether skin puncture and external fixation techniques were applied, with 150 patients in each group after propensity score matching. Both groups underwent subcutaneous sweat gland removal using a small incision with a rotary cutter. The study group utilized skin puncture and external fixation techniques. The adverse reaction rates after surgery, postoperative negative emotion scores, surgical satisfaction rates, and scar Vancouver Scar Scale (VSS) scores of the two groups of patients were compared statistically.

Results: The total incidence of postoperative adverse reactions in the study group was significantly lower than that in the control group. Postoperative negative emotions were less frequent, and the overall surgical satisfaction rate was significantly higher than that in the control group. There was no statistically significant difference in scar VSS scores of wound scars within 3 months after surgery between the two groups.

Conclusion: Skin puncture and external fixation techniques effectively prevent adverse reactions such as hematoma and malposition healing after radical surgery for bromhidrosis. Patients experience fewer postoperative negative emotions, higher overall surgical satisfaction rates, and less noticeable scar formation.

Background: Scalp seborrheic dermatitis (SSD) is a chronic inflammatory dermatosis characterized by sebum imbalance and proliferation of Malassezia species. While various antifungal shampoos are commonly used to manage SSD, there remains a substantial demand for alternative treatments that provide a more rapid onset of action. Glycyrrhetinic acid is recognized for its antioxidative, anti-inflammatory, antimicrobial, and antiallergic properties. This study aimed to evaluate the efficacy of a novel scalp gel containing 4% glycyrrhetinic acid complex as a short-contact therapy for SSD.

Methods: A total of 40 patients with SSD were enrolled in this study and treated with the 4% glycyrrhetinic acid complex gel using a short-contact therapy approach. Clinical efficacy was assessed by the Adherent Scalp Flaking Score (ASFS) and Dermatology Life Quality Index (DLQI) at baseline, Week 1, and Week 2, all evaluated by the same dermatologist. Treatment satisfaction was measured at Week 2 using the Treatment Satisfaction Questionnaire (TSQ).

Results: Significant improvements in ASFS and DLQI were observed at both Week 1 and Week 2 compared to baseline. Patient satisfaction, as measured by the TSQ, yielded a mean score of 4.2 ± 0.8 on a 5-point scale.

Conclusions: This study demonstrates the clinical efficacy of the novel 4% glycyrrhetinic acid complex scalp gel as a short-contact therapy for SSD. The rapid onset of action and significant improvement in symptoms suggest that this gel could serve as an effective alternative for managing SSD in the acute phase.

Purpose: While the 2021 Chinese rosacea guidelines recommend hydroxychloroquine (HCQ) and doxycycline as A-level treatments for erythema, monotherapy with these agents has shown suboptimal clinical efficacy against both erythema and flushing symptoms. This study aimed to evaluate whether combination therapy could enhance therapeutic outcomes without increasing adverse effects (AEs).

Methods: In this randomized, double-blind, placebo-controlled trial conducted at Guizhou Provincial People’s Hospital (January 2022–January 2024), 73 moderate-to-severe rosacea patients were randomized to receive either (1) HCQ 200 mg bid plus doxycycline 100 mg qd (intervention group, n = 36) or (2) placebo plus doxycycline 100 mg qd (control group, n = 37). Treatment duration was 8 weeks with follow-up assessments at Weeks 0, 4, 8, and 12.

Results: Among 58 completers (29 per group), the intervention group demonstrated significantly higher clinical efficacy at Week 8: erythema improvement rates (89.67% vs. 68.97%, p < 0.05), flushing reduction (68.97% vs. 44.83%, p < 0.05), and greater quality-of-life improvement (RosQoL score Δ23.66 vs. Δ17.00, p < 0.05). Investigator’s Global Assessment showed comparable results (72.22% vs. 65%, p > 0.05). Both regimens were well tolerated with no severe AEs reported.

Conclusion: The HCQ–doxycycline combination demonstrates superior efficacy over doxycycline monotherapy for improving erythema, flushing symptoms, and quality of life in moderate-to-severe rosacea patients, with comparable safety profiles.

Trial Registration: Chinese Clinical Trial Register: ChiCTR2400089784

Androgenetic alopecia (AGA) affects about half of men and many women worldwide, yet current treatments often fall short. This review summarizes key pathogenic mechanisms of AGA, centering on three interconnected processes: the dihydrotestosterone–prostaglandin D2 (DHT–PGD2) loop, oxidative stress and inflammation, and lipid metabolism dysregulation. These factors converge to suppress Wnt/β-catenin signaling, the core pathway for hair growth. DHT and PGD2 reinforce each other to drive follicular miniaturization via CXXC5 and GSK-3β activation. Oxidative stress and chronic inflammation—exacerbated by scalp microbiome imbalance, notably excess Cutibacterium acnes and Malassezia—further damage the follicular environment. Suppressed PPARγ signaling disrupts adipocyte-follicle crosstalk, reducing growth factor support. These insights reveal emerging therapeutic targets, including DP2 antagonists, CXXC5/GSK-3β inhibitors, antioxidants, microbiome modulators, and PPARγ agonists. By integrating molecular, microbial, and metabolic perspectives, this review outlines a framework for multitarget strategies to address the limitations of existing AGA treatments.

Background and Purpose: Many people with atopic dermatitis seek treatment with Chinese herbal medicine (CHM). However, the evidence that informed clinical guideline recommendations is outdated. This research updates the evidence on the efficacy and safety of CHM for atopic dermatitis and supports clinical decision-making.

Methods: Randomised controlled trials (RCTs) were identified from the World Health Organization’s International Clinical Trials Registry Platform. RCTs that compared CHM with a placebo, waitlist control or conventional medicine were eligible if they reported patient-reported outcomes, clinician-reported symptoms, long-term control, health-related quality of life or safety. Characteristics and results were extracted, risk of bias assessed and the certainty of evidence determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Meta-analysis was conducted where possible.

Results: Seven RCTs (862 participants) were included. Topical CHM was not statistically different to placebo in reducing visual analogue scale itch score (MD −2.15 [−5.64, 1.34], I² = 95%; evidence not graded) but was more effective than placebo in reducing Eczema Area and Severity Index scores (MD −2.75 [−4.07, −1.44], I² = 0%; low certainty evidence). CHM was not statistically different to placebo in improving health-related quality of life (MD −2.20 [−5.27, 0.88], I² = 0%; moderate certainty evidence). More adverse events were reported in the CHM groups than in the comparator groups.

Conclusion: There is limited evidence to support a change in clinical practice using CHM for atopic dermatitis. Future research should focus on patient-reported symptoms and clinician-reported signs and should carefully assess adverse events.