European Journal of Dermatology最新文献

Mastocytosis encompasses a heterogeneous group of clonal mast cell disorders ranging from cutaneous forms in children to advanced systemic mastocytosis (AdvSM) with significant morbidity. This review covers epidemiology, pathogenesis, diagnosis, and management, integrating World Health Organization (WHO)/International Consensus Classification (ICC) 2022 classification updates, molecular insights, and therapeutic advances. Pediatric cutaneous mastocytosis (CM) usually has a favourable prognosis and often resolves spontaneously, whereas adult-onset disease frequently reflects systemic involvement and warrants bone marrow biopsy. KIT D816V and non-D816V variants serve as key diagnostic and prognostic markers, guiding targeted therapy. Midostaurin and avapritinib have reshaped the treatment of AdvSM, while next-generation tyrosine-kinase inhibitors (TKIs) are in clinical trials. Multidisciplinary care is critical, and knowledge gaps remain in paediatric risk stratification, optimal sequencing of therapies, and disease progression assessment. This review highlights recent advances and future priorities for personalized, evidence-based care.

Severe Demodex infestation causes demodicosis, but its impact on skin function remains unclear due to a lack of sensitive detection methods. To develop an accurate, user-friendly detection method and assess the effects of Demodex on skin function. A modified squeezing/scraping method (MSS) was developed, combining mud pretreatment cleaning with traditional squeezing and scraping. Skin function was then assessed using Antera3D and a lactic acid sting test. The proposed method not only led to more consistent results compared with the traditional squeezing/scraping method, but also showed a higher detection rate by increasing the positive infestation threshold from 5 to 13 mites. Based on a subsequent assessment for skin physiological parameters, we found that aging was a risk factor for Demodex mite infestation. In addition, Demodex mite infestation was associated with skin barrier damage, characterized as reduction in skin water content, elevated transepidermal water loss, stimulated sebum secretion, and increased skin roughness, which may eventually lead to sensitive skin. The MSS method improves Demodex detection. Infestation may contribute to sensitive skin and may be a therapeutic target.

Psoriasis is a chronic, inflammatory disorder with incidence increasing markedly with age. Frailty, a multidimensional syndrome characterized by diminished physiological resilience, has emerged as a critical concern in aging populations. Despite the clinical relevance of both conditions in aging populations, the potential association between frailty and psoriasis remains poorly understood. To investigate the association between frailty and the risk of psoriasis and evaluate potential causal relationships. Cross-sectional analyses were conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2009-2014. Psoriasis was defined based on self-reported physician diagnoses, while frailty was quantified using a validated 49-item frailty index. Multivariable logistic regression, subgroup analyses, and interaction tests were employed to examine associations between psoriasis and frailty. Mendelian randomization (MR) analyses were conducted utilizing genome-wide association study summary statistics. The inverse-variance weighted (IVW) method served as the primary method, supplemented by sensitivity analyses. Frailty was significantly associated with elevated psoriasis risk (OR=1.75; 95% CI: 1.31-2.33; p=0.0003). This association was amplified in adults aged ≥60 years (OR=2.17; 95% CI: 1.26-3.73) and females (OR=2.08; 95% CI: 1.48-2.91). Stratified analyses demonstrated consistency across racial/ethnic, educational, and smoking subgroups. MR analyses supported a causal effect of frailty on psoriasis (IVW-derived OR=1.13; 95% CI: 1.03-1.21; p=0.01), with sensitivity models confirming robustness. Frailty is positively associated with psoriasis risk in observational analyses, and MR analyses further support a causal relationship. These findings highlight frailty as a potential modifiable target for psoriasis prevention in aging populations.