The Journal of dermatological treatment最新文献

The nosological distinction between acute generalized exanthematous pustulosis (AGEP) and generalized pustular psoriasis (GPP) has become increasingly unclear due to shared IL-36 pathway dysregulation. This case highlights an important clinical gap: the therapeutic response to IL-36 inhibition in AGEP with wild-type IL36RN.

A 15-year-old female with ERASPEN-confirmed GPP developed hydroxychloroquine-induced AGEP (EuroSCAR score = 7) despite wild-type IL36RN and CARD14. Ten days after hydroxychloroquine exposure, she presented with widespread erythema, pustules, targetoid lesions, and fever (39 °C). Histopathology revealed subcorneal pustules with eosinophilic infiltration.

Acitretin provided no benefit, and cyclosporine (150 mg/day) produced only transient improvement before relapse. A single intravenous dose of spesolimab (450 mg) led to complete pustular clearance within 18 days. Sustained remission (GPPGA = 0) was observed at 5-month follow-up.

Spesolimab produced rapid and durable control of IL-36-driven AGEP independent of IL36RN mutation status. These findings support IL-36 receptor blockade as a targeted therapeutic option for refractory AGEP and further position AGEP and GPP along a shared IL-36-mediated disease spectrum.

Objectives: This study systematically reviews relevant studies on the application of discrete choice experiment (DCE) in treatment preference selection for atopic dermatitis (AD), with the aim of providing reference for the future application of DCE in clinical practice.

Methods: Relevant studies were retrieved from PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Medline, WanFang Data and CNKI databases. The search time restricted to the establishment of the database to 22 October 2025. Two researchers independently conducted literature screening, after which they extracted data, and carried out quality evaluation using the PREFS scoring criteria.

Results: A total of 13 studies were included, mainly from European and American countries. According to the PREFS scale, 8 studies were rated 4 points and 5 studies 3 points in quality assessment. The main data analysis model was random parameter Logit.

Conclusions: The research on the application of DCE in assessing AD treatment preferences is still in the development stage, with room for further improvement regarding respondents. Future relevant studies should adhere to the experimental design principles of DCE, while attaching importance to result attributes, so as to provide more high-quality evidence for research on AD treatment preferences.

Purpose: This study aims to explore the effectiveness of low-dose oral minoxidil (LDOM) in treating short anagen hair syndrome (SAS), a rare congenital condition characterized by a shortened anagen phase. While SAS often resolves spontaneously with puberty, treatment remains controversial. Recent studies have demonstrated the efficacy of low-dose oral minoxidil (LDOM) in treating various hair loss conditions, including SAS.

Materials and methods: This report presents a case of a 24-year-old female with SAS who experienced significant improvement following LDOM treatment. The patient, who had persistent hair growth issues since childhood, had tried several therapies, including topical 5% minoxidil with limited success. The patient was started on LDOM at 1.25 mg and increased to 2.5 mg after one month.

Results: After starting LDOM, the patient reported reduced hair shedding, increased hair length, and improved hair density, which was also confirmed by Canfield's HairMetrix measurements. Despite experiencing mild facial hypertrichosis, the patient opted to continue the treatment.

Conclusion: This case adds to the growing body of evidence supporting LDOM as a viable treatment for adult SAS. The findings may also offer insights into the genetic basis of SAS and its overlap with other hair loss conditions, suggesting possible shared therapeutic approaches.

Purpose: Dupilumab is a widely recommended treatment for moderate-to-severe atopic dermatitis (AD), with known ocular side effects but less frequent cutaneous reactions.

Material and methods: This case report details a 52-year-old female patient with atopic dermatitis treated with dupilumab. After an initially successful treatment, the patient developed a rosacea-like dermatitis. At first, dupilumab was continued alongside doxycycline, metronidazole gel and ivermectin cream.

Results: Following a worsening of her skin condition, dupilumab was discontinued. Lebrikizumab was introduced, leading to significant regression of the lesions.

Conclusions: This case highlights a rare paradoxical skin reaction to dupilumab, potentially linked to the blockade of IL-4Rα, which may shift the immune response towards a Th1/Th17 phenotype. The findings suggest that alternative therapies, such as IL-13 inhibitors, should be considered when cutaneous side effects arise during dupilumab treatment.

Background: The comparative effects of phototherapy and topical therapy in patients with vitiligo remain unclear. A network meta-analysis (NMA) was conducted to assess which combination therapy was more beneficial for patients with vitiligo.

Methods: This study analyzed phototherapy, including narrowband ultraviolet B (NB-UVB) and 308-nm excimer laser/light (EL) combined with topical therapies. Randomized controlled trials were sourced from PubMed, Embase, and Cochrane Library. Data analysis was based on a random-effects model, and surface under the cumulative ranking (SUCRA) curves employed to assess the efficacy of the interventions.

Results: This NMA included 27 trials, with a total of 2417 lesions (patches). According to the results of the SUCRA, for achieving ≥50% repigmentation, the top three combination therapies were phototherapy combined with antioxidants (SUCRA 87.7), corticosteroids (SUCRA 69.6), and calcineurin inhibitors (SUCRA 52.5), while for ≥75% repigmentation, the leading therapies were phototherapy combined with antioxidants (SUCRA 89.0), calcineurin inhibitors (SUCRA 70.3), and fractional CO₂ laser (SUCRA 63.6).

Conclusions: This meta-analysis suggests that combining phototherapy with topical antioxidants, corticosteroids, or calcineurin inhibitors may offer superior outcomes for vitiligo patients. This study provides a reference for clinicians to develop personalized treatment plans for patients with vitiligo.

Cannabis use has increased significantly in the last decade. This article presents a case where a patient needed more local anesthetic (LA) than usual to induce effective anesthesia during hair transplant surgery. The reason cannabis users often need more LA is poorly understood. One possibility is that cannabis withdrawal effect makes patients more sensitive to pain and stress. Additionally, vasodilatory property of cannabis may speed up LA clearance from the application site. The interactions of two major cannabinoids, cannabidiol (CBD) and tetrahydrocannabinol (THC), with cannabinoid receptor type 1 (CB1), cannabinoid receptor type 2 (CB2), and transient receptor potential vanilloid 1 (TRPV1) receptors are also complex. Furthermore, CBD and THC function as cytochrome P450 enzyme inhibitors potentially impacting systemic metabolism. When planning to administer LA during hair restoration surgery in cannabis users, clinicians should obtain a detailed history of prior consumption (type of cannabis, frequency, dosage). Preoperative planning should consider the anticipated duration of surgery and calculate the maximum safe LA dose to avoid the risk of toxicity. Also, patients should be carefully monitored for vital signs during surgery. If a patient requires frequent re-injection to remain pain free, the surgeon may need to re-assess the surgical plan to avoid toxicity.

Purpose: Alopecia areata (AA), an autoimmune disorder characterized by non-scarring hair loss, is detrimental to the psychological health and quality of life of people living with AA. Clinically meaningful hair regrowth is possible, but the relationship with downstream patient-reported outcomes (PROs) is complex.

Materials and methods: This post hoc analysis of ALLEGRO-2b/3 (NCT03732807) longitudinal data from Weeks 24-48 compared improvements in PROs between patients who achieved (responders) or did not achieve (non-responders) clinically meaningful scalp hair regrowth. Responders were defined by a Week 24 Severity of Alopecia Tool (SALT) score ≤20 (SALT20) or ≤10 (SALT10). Across 6 PROs assessing multiple AA-related health domains, response proportions and mean changes from baseline were estimated for Weeks 24-48.

Results: Among 650 included participants, 114 (17.5%) were SALT20 responders, of which 76 (11.7%) were also SALT10 responders. Generally, more responders than non-responders reported improvements in AA and related symptoms or limitations and satisfaction with hair regrowth. Responders additionally reported greater improvement from baseline than non-responders for measures of AA-related emotional symptoms, mental health, and work or activity limitations.

Conclusions: These results support a positive relationship between scalp hair regrowth and downstream PROs-including satisfaction and psychosocial burden-demonstrating an association between clinically meaningful hair regrowth and patient-reported treatment benefits.

Objectives: With the development of biotechnology, double-layer artificial dermis repair material has been increasingly employed to repair deep skin and soft tissue defects. This study aims to investigate the effectiveness of double-layer artificial dermis repair material combined with autologous skin patch in repairing deep skin and soft tissue defects.

Methods: This study conducted a retrospective analysis of 18 patients with deep skin and soft tissue defects who were treated with a combination of double-layer artificial dermal repair materials and autologous skin grafting at our hospital between January 2022 and January 2024.

Results: A total of 18 patients were treated, including 7 males and 11 females, with an average age of 41.7 ± 19.12 years. All patients exhibited good vascularization of the double-layer artificial dermal material postoperatively. In one patient, only a small part of the autologous skin patch survived after the first grafting, and the skin healed well after the second grafting. The remaining patients healed well after the operation. Two months after the operation, the results showed that no obvious hyperplastic contracture scar was found in the wound grafts of 18 patients, and the total Vancouver Scar Scale (VSS) score was not significantly different between 1 month and 2 months after the operation (p > 0.05).

Conclusion: Double-layer artificial dermis repair material combined with autologous skin patch provides a reliable, less invasive and simple treatment for deep skin and soft tissue defects.

Purpose: Sarcoidosis is a chronic, multisystem granulomatous disorder characterized histologically by non-caseating granulomas. Despite the availability of various therapeutic options, long-term disease control remains a significant clinical challenge.

Materials and methods: We report the case of a 55-year-old female diagnosed with sarcoidosis. Skin and lymph node biopsies revealed non-caseating granulomatous inflammation, and chest CT indicated pulmonary involvement. Infectious causes of granulomatous disease, including Mycobacterium tuberculosis, non-tuberculous mycobacteria, and fungal infections, were excluded through com-prehensive testing. The patient initially received conventional systemic corticosteroid therapy but developed treatment-related complications. Due to the need for sustained disease control, an alternative regimen combining low-dose corticosteroids with the selective JAK1 inhibitor abrocitinib was initiated.

Results: The patient showed significant clinical improvement following the combination therapy, with no observed treatment-related adverse events.

Conclusions: This case suggests that low-dose corticosteroids combined with a JAK1 inhibitor such as abrocitinib may represent a treatment option for patients with sarcoidosis.