搜索结果：Clinical, cosmetic and investigational dermatology

The application of plant-derived extracts in dermatological and cosmeceutical formulations is often limited by poor bioavailability, low skin permeability, and the instability of bioactive compounds. Fermentation has emerged as a promising biotechnological approach to enhance phytochemical composition and biological activity through microbial biotransformation. This review aims to critically evaluate the effects of fermentation on plant-derived phytoconstituents and their relevance in cosmeceutical dermatology. A structured literature search was conducted using Scopus and PubMed databases for studies published between 2015 and 2025. A total of 32 records were initially identified. After screening titles and abstracts, 19 articles were assessed for full-text eligibility. Following full-text evaluation, 5 studies met the inclusion criteria and were included in the qualitative synthesis. The findings indicate that fermentation modifies phytochemical profiles, by converting glycosides into more bioactive aglycones resulting in improved skin permeability and biological activity. Fermented extracts demonstrate enhanced antioxidant capacity, increased tyrosinase inhibition, and improved photoprotective effects compared to non-fermented counterparts. Mechanistically, these effects were associated with modulation of oxidative stress pathways and inflammatory mediators, including upregulation of SOD and CAT and suppression of IL-6 and TNF-α. However, the available evidence is predominantly limited to in vitro studies, with variability in fermentation conditions and microbial systems. This review provides an integrated and critical perspective linking biochemical transformation, skin permeability, and dermatological relevance. Future research should prioritize standardization and clinical validation to support translational application.

Accurate quantification of skin color is essential for dermatologic research and clinical practice. Conventional methods rely on specialized equipment, trained operators, and high costs. Smartphone-based technologies provide a promising alternative for accessible skin color assessment. To evaluate the reliability and validity of the smartphone-based skin colorimeter application, You Look Good Today (YLGTD), for facial skin color assessment compared with two validated devices, VISIA and DermaLab Combo. A total of 105 Chinese participants with healthy facial skin were enrolled. Cheek skin color measurements were obtained using YLGTD (user self-assessment and physician measurement modes), VISIA, and DermaLab Combo. Inter-rater reliability between YLGTD measurement modes was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Criterion validity was evaluated using Pearson's correlation coefficients between YLGTD measurements and the reference devices. YLGTD demonstrated excellent inter-rater reliability across all parameters (ICC: 0.85-0.95). Bland-Altman analysis showed small biases between the two measurement modes for the L, a, and b (-0.05, 0.18, and -0.99, respectively). For criterion validity, YLGTD in user mode showed strong correlations with DermaLab Combo for L* (r = 0.71), individual typology angle (ITA°, r = -0.81), and chroma (C*, r = 0.78), and moderate correlations for b* (r = 0.59) and hue (h°, r = 0.57). Correlations were consistently stronger in physician mode (L*: r = 0.77; b*: r = 0.75; C*: r = 0.84; ITA°: r = -0.87). VISIA showed a stronger correlation for a* (r = 0.55) but weaker correlations for L* (r = 0.56) and ITA° (r = -0.68) compared with YLGTD. The smartphone-based application YLGTD demonstrated excellent reliability and acceptable validity for facial skin color assessment, particularly for pigmentation-related parameters. Its standardized measurement workflow and integrated algorithms enable consistent skin color evaluation across devices and real-world conditions, providing a convenient and cost-effective approach for objective skin color assessment.

Polynucleotides (PNs) are increasingly used in aesthetic dermatology, supported by emerging clinical evidence and growing interest in restorative approaches to skin treatment aiming to improve skin conditions. This expert opinion article brings perspectives from an international panel of dermatologists and aesthetic physicians on the use of PNs (Rejuran®, PharmaResearch, South Korea) across dermatological indications. The proposed mechanism of action of PNs involves the formation of a hydrophilic, scaffold-like matrix that may support tissue remodeling and hydration. This article highlights the clinical applications of PNs across four indications: skin hydration and rejuvenation; structural support through deep-plane injections; barrier repair in rosacea and eczema; and scar remodeling. For each, the authors provide suggested treatment protocols based on real-world use, including guidance on injection techniques and anatomical targets. PNs have demonstrated a favorable safety profile, with no reported cases of granuloma or vascular occlusion in the literature to date. Their biocompatibility and tolerability make them a promising option, particularly for sensitive or barrier-compromised skin. However, the current evidence base remains limited, and further studies, including randomized trials and histological validation, are needed. This article provides practical clinical guidance while highlighting areas for future research and standardization in the aesthetic use of PNs.

Previous epidemiological investigations have reported associations between beer, cheese, and dried fruit intake and the incidence of psoriasis (PS). Nevertheless, the extent of shared genetic architecture underlying these associations remains insufficiently characterized. Therefore, it is essential to examine their molecular relationships from a genomics perspective. A stratified, stepwise analytical framework was applied, utilizing genome-wide association study data for PS and three dietary intake patterns (beer, cheese, and dried fruit intake). In the initial phase, linkage disequilibrium score regression, genetic covariance analysis, and high-definition likelihood approaches were employed to quantify genome-wide genetic correlations. Subsequently, local genetic overlap analyses were conducted to delineate chromosomal regions harboring relevant associations. Finally, the conditional/conjunctional false discovery rate (condFDR/conjFDR) methodology was implemented to identify potential shared genetic loci (genetic overlap) across the phenotypes. The analysis revealed consistent genome-wide genetic correlations between psoriasis (PS) and the three dietary intake traits across LDSC, GNOVA, and HDL. PS showed a significant positive genetic correlation with beer intake (Rg = 0.1082 [LDSC], 0.0796 [GNOVA], and 0.144 [HDL]), whereas negative genetic correlations were observed for cheese intake (Rg = -0.1523, -0.1089, and -0.1866) and dried fruit intake (Rg = -0.2187, -0.1639, and -0.2623). Local analyses further identified multiple chromosomal regions with shared genetic signals. Finally, condFDR/conjFDR analyses supported these overlaps and enabled the identification of several significant shared loci between PS and the dietary traits. This study systematically investigated the genetic associations between PS and three dietary intake patterns from a genomic perspective and characterized their genome-wide and local genetic overlap. The shared loci identified enhance the understanding of nutrition-disease molecular mechanisms and provide genetic evidence to inform future mechanistic research and risk-modification strategies.

Acne affects 9.4% of the global population, with the highest prevalence among adolescent males (12-25 years of age). More than 95% of patients develop persistent scarring, predominantly atrophic acne scars (AAS). These scars markedly impair facial aesthetics, psychological well-being, and quality of life, and increase the risk of depression and suicidal ideation. Conventional therapies (eg, Dermabrasion, Subcision and Traditional Ablative Lasers) show limited efficacy for shallow AAS and are associated with procedural pain, delayed onset of improvement, and a need for repeated sessions. Dermal fillers provide a promising alternative by delivering immediate volumetric correction and aesthetic enhancement while also stimulating long-term collagen production with minimal invasiveness and favorable safety profiles. They therefore represent a novel therapeutic approach for AAS. This review systematically evaluates the clinical utility of dermal fillers for treating AAS and explores future diagnostic and therapeutic approaches. We searched the PubMed and Web of Science databases for studies published in the past 10 years, categorizing and evaluating the efficacy and adverse effects of different dermal fillers for treating AAS. Twenty-four studies met inclusion criteria, involving collagen-based fillers, hyaluronic acid fillers, collagen stimulator fillers, autologous fat, and decellularized matrix fillers. All filler types demonstrated significant scar improvement. Effects ranged from 3-6 months to >24 months. CaHA, PCL, and autologous fat/SVF demonstrated ≥6-month durability. Transient erythema, edema, and ecchymosis were common. Infrequent events included nodules and hyperpigmentation. No severe complications were reported. Multiple studies indicate that dermal fillers offer advantages over conventional therapies for atrophic scars. They provide immediate volumetric correction and stimulate long-term collagen production, with less tissue trauma than traditional approaches. Specific formulations also enhance skin hydration and may slow aging processes. Collectively, these benefits demonstrate substantial clinical promise, particularly when incorporated into combination therapies.

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae that primarily affects the skin and peripheral nerves, whereas generalized pustular psoriasis (GPP) is a rare and severe form of psoriasis characterized by widespread sterile pustules and systemic symptoms. Their coexistence is extremely rare due to distinct genetic, immunologic, and epidemiologic profiles. We report a case of a 28-year-old female presenting with both mid-borderline (BB) leprosy and severe GPP. She initially developed numb, erythematous patches on her extremities, followed by pustular eruptions on her right arm that became generalized. Physical examination revealed lagophthalmos, right claw hand, and glove-and-stocking anesthesia without nerve enlargement. Skin lesions included anesthetic macules and plaques on extremities, punched-out lesions on the back, and pustules with crusting and scaling on the face and extremities. A slit-skin smear showed a bacterial index of 1+, and Gram staining of pustules revealed polymorphonuclear cells without bacteria. Histopathology from punched-out lesions revealed granulomas with epithelioid cells and Langhans giant cells. Biopsy of pustules showed features consistent with GPP, including psoriasiform hyperplasia, Munro's abscesses, and Kogoj's spongiform pustules. The patient was diagnosed with BB leprosy with severe reversal reaction coexisting with GPP. She was treated with WHO-recommended multidrug therapy for multibacillary leprosy and systemic corticosteroids, leading to marked clinical improvement within 47 days. This case highlights the importance of recognizing rare coexisting conditions of leprosy and autoimmune diseases, emphasizing the need for a comprehensive diagnostic approach and prompt management to achieve favourable outcomes.

Obesity is well established as a key contributor to multiple age-related diseases; however, its impact on facial aging (FA) remains equivocal. We aimed to elucidate the causal effects of various obesity phenotypes on FA with gender- and age-specific attention, as well as determine the potential mediating mechanisms in these relationships. A two-sample, multivariable, and mediation MR analysis was employed. BMI, representing general obesity, and BMI-adjusted WHR, representing central obesity, were derived from the most comprehensive meta-analysis GWAS conducted by the GIANT consortium. Additionally, we utilized sex- and/or age-stratified GWAS summary statistics for both BMI and BMI-adjusted WHR. We performed a two-step MR analysis incorporating 44 potential mediators to elucidate potential mediating pathways underlying this causal relationship. Sensitivity and reverse MR analyses were performed to assess the findings' robustness rigorously. MR analyses indicated that higher genetically predicted BMI was associated with accelerated FA, though this effect was not observed in women under 50. As for WHR not stratified by sex and age, no association between WHR and FA was found. However, in men over 50, higher genetically predicted WHR was significantly associated with an increased risk of FA. Furthermore, several factors, including myocardial infarction, smoking, and premature menarche, were identified as independent risk factors for FA, independent of high BMI. Myocardial infarction, daily smoking, circulating levels of RAGEs, ischemic stroke, and multiple sclerosis were also found to mediate the causal relationship between BMI and FA partially. Our study reveals distinct and significant variations in the effects of different obesity phenotypes on the acceleration of FA, with these effects exhibiting gender- and age-specific patterns. The findings underscore the critical importance of weight management as a potential intervention for mitigating FA. Furthermore, this research contributes to a deeper understanding of the etiology of FA. Established causal relationship between obesity and accelerated facial aging.Identified gender- and age-specific effects of BMI and WHR on facial aging risk.Uncovered potential mediators like RAGEs and smoking in BMI-FA link.

To evaluate the clinical efficacy and patient satisfaction of high-speed rotary cutter combined with endoscopy for the treatment of nuchal fat pads. A total of 68 adult patients with hypertrophic nuchal fat pads were included in this study. Under super-wet tumescent anesthesia, incisions were marked around the fat pads. A fork-shaped dissector was first used to sharply dissect the adipose tissue through multiplanar and multiangular separation. Subsequently, an endoscope-assisted high-speed rotary cutter was employed to completely resect and aspirate the isolated fat. Thin liposuction cannulas were then used to refine the contour of the transition zone between the residual fat pads and the normal adipose tissue to achieve a smooth, natural gradient. The incisions were closed using oil-coated sutures, followed by figure-of-8 compression bandaging. Patients were instructed to use a rice pillow postoperatively and were followed up for 3 to 6 months to monitor complications, assess cervical contour improvement, and evaluate patient satisfaction. The mean operative time was 65 minutes. All patients experienced varying degrees of pain and swelling within 1-2 months after surgery. Among them, 7 cases (10.29%) exhibited bruising or ecchymosis, 3 cases (4.41%) had palpable subcutaneous cords or induration, and 1 case (1.47%) developed a seroma within two weeks. Swelling began to subside from the third postoperative day. Complete resolution of swelling was achieved in 63 patients (92.65%) within one month, and in the remaining 5 patients (7.35%) within one and a half months. One case (1.47%) showed delayed wound healing, which improved after two weeks of active dressing care; the other 67 cases (98.53%) achieved primary healing. One patient (1.47%) presented with a slight "step-off" appearance at the transition zone upon one-month follow-up, while the other 67 cases (98.53%) achieved complete fat removal, resulting in a natural and smooth nuchal contour. Within 3-6 months postoperatively, all patients recovered normal skin sensation, elasticity, and color in the operative area. No serious complications such as skin necrosis, infection, neurovascular injury, or fat embolism occurred. The satisfaction survey showed that 58 patients were satisfied, 8 were somewhat satisfied, and 2 reported fair satisfaction, yielding an overall satisfaction rate of 97.06%. The combination of a high-speed rotary cutter and endoscopy for nuchal fat pad removal demonstrates a natural appearance, short operative time, low complication rate, and high patient satisfaction. This technique is effective and worthy of clinical promotion.

Vitiligo is a common acquired depigmenting disorder in pediatric dermatology. Facial and cervical involvement is particularly distressing due to cosmetic disfigurement, leading to psychosocial impairment in children and significant psychological burden for parents. Safe and effective treatment strategies to halt disease progression and promote repigmentation are urgently needed. To evaluate the clinical efficacy, onset of repigmentation, safety, and repigmentation patterns of 308-nm excimer laser combined with oral compound glycyrrhizin and topical 0.03% tacrolimus in children with facial and cervical vitiligo. A total of 112 pediatric patients were randomized into two groups: treatment group (n=56, 86 lesions) received oral compound glycyrrhizin, topical 0.03% tacrolimus, plus 308-nm excimer laser twice weekly for 16&#xa0;weeks; control group (n=56, 78 lesions) received compound glycyrrhizin and tacrolimus only. Clinical efficacy, time to initial repigmentation, adverse events, and repigmentation patterns (marginal, follicular, mixed) were assessed. The overall efficacy rate was significantly higher in the treatment group (89.53%) than in controls (70.51%) (p<0.05). Initial repigmentation occurred earlier in the treatment group (face: 3.12&#xb1;0.45&#xa0;weeks; neck: 3.74&#xb1;0.44&#xa0;weeks) compared with controls (face: 4.08&#xb1;0.50&#xa0;weeks; neck: 4.54&#xb1;0.51&#xa0;weeks, both p<0.05). Adverse events were rare (3.57%) and self-limited. Repigmentation patterns differed: treatment lesions showed predominantly mixed repigmentation (65.12%), whereas controls were mainly follicular (57.69%). Combination therapy with 308-nm excimer laser, compound glycyrrhizin, and 0.03% tacrolimus is safe and effective for pediatric facial and cervical vitiligo, providing faster repigmentation, higher efficacy, and distinct repigmentation patterns compared with medical therapy alone.

Psoriasis is a chronic, immune-mediated skin disorder that causes physical, psychological, and social burdens. There is a growing need to better characterize the distinct clinical features and specific treatment needs of elderly patients with psoriasis, which remains an important area for further research to optimize care in this population. To investigate the clinical characteristics, comorbidities, and treatment preferences of elderly patients with psoriasis vulgaris. Patients with psoriasis vulgaris were included in this retrospective study. Data on demographics, disease characteristics, including age at diagnosis, body surface area (BSA), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), comorbidities, and treatment needs were collected. Patients at the visit over 60 years of age were defined as elderly patients. Patients who were diagnosed before 40 years of age were defined as early-onset psoriasis (EOP), and patients who were diagnosed over 40 years of age were defined as late-onset psoriasis (LOP). Continuous variables were compared using t-tests or Mann-Whitney U-tests, categorical variables using Chi-square or Fisher's exact tests. Spearman correlation was used for association analysis. Statistical significance was set at P<0.05. A total of 375 patients were included, comprising 70 (18.67%) elderly and 305 (81.33%) non-elderly patients. The elderly group had a significantly higher proportion of LOP (87.14% vs 48.76%,&#x202f;P<0.05). A higher percentage of elderly patients had moderate-to-severe (27.14% vs 20.98%,&#x202f;P<0.05) and severe (1.43% vs 0.66%,&#x202f;P<0.05) disease. Comorbidities were more prevalent in the elderly, including cardiovascular disease (12.86% vs 3.93%,&#x202f;P<0.05) and diabetes (12.86% vs.&#x202f;1.31%,&#x202f;P<0.05). Despite this, elderly patients reported lower DLQI scores (median 2.00 vs.&#x202f;3.00, P<0.05). Regarding treatment needs, elderly patients were less likely to prioritize reducing treatment costs (10.00% vs 20.98%, P<0.05) and preventing disease recurrence (30.00% vs 44.26%,&#x202f;P<0.05) compared to non-elderly patients. Within the elderly cohort, EOP patients exhibited more severe disease (median BSA: 3.00 vs 2.00; median PASI: 3.30 vs&#x202f;0.80, P<0.05), a higher rate of familial psoriasis (33.33% vs&#x202f;4.92%,&#x202f;P<0.05), and a greater demand for reducing treatment costs (33.3% vs&#x202f;6.56%,&#x202f;P<0.05) compared to LOP patients. Elderly patients with psoriasis present a distinct clinical profile characterized by a high prevalence of late-onset disease, a significant comorbidity burden, and differing treatment priorities focused less on cost and recurrence. Despite the increased clinical severity, their perceived quality-of-life impact is lower. Besides, they report higher dissatisfaction linked to unmet needs in itch relief, drug safety, and long-term control. Within the elderly cohort, early-onset patients had more severe disease, stronger familial predisposition, and greater cost-related concerns. The findings highlight the necessity for age-specific, multidimensional management strategies for this population.

Condyloma acuminata (CA) is primarily caused by low-risk human papillomavirus (LR-HPV); however, high-risk HPV (HR-HPV) co-infection is increasingly reported and cannot be reliably distinguished based on clinical appearance alone. Histopathological assessment and selected immunohistochemical markers may help identify lesions with greater biological risk. To evaluate the association between histopathological features, p16 and p62 expression, and HR-HPV co-infection in anogenital CA. This cross-sectional study included 81&#xa0;histopathologically confirmed CA cases. Semi-quantitative scoring was applied to lesion morphology, keratinization patterns, koilocytosis, atypical mitoses, and lymphocytic infiltration. p16 and p62 expression were assessed immunohistochemically. HPV genotyping was performed using real-time PCR. Variables significant in bivariate analysis were entered into multivariate logistic regression. HR-HPV co-infection was detected in 59.3% of cases, with HPV-16 as the most frequent genotype. Hyperkeratosis (aOR = 4.29; p = 0.039) and atypical mitotic activity (aOR = 14.29; p < 0.001) were independently associated with HR-HPV co-infection. Parakeratosis and koilocytosis showed inverse associations. p16 and p62 were not independent predictors, although p16 block positivity correlated with high p62 expression (p < 0.001). Certain histopathological features, particularly atypical mitoses and hyperkeratosis, are associated with HR-HPV co-infection in anogenital CA. Routine histopathological evaluation may therefore provide practical clues to identify lesions that warrant closer clinical attention, while p16 and p62 offer complementary biological information. Condyloma acuminata, also known as genital warts, is usually caused by low-risk types of human papillomavirus (HPV). However, some genital warts also contain high-risk HPV types that are associated with a greater chance of developing serious disease. These high-risk infections cannot always be recognized by visual examination alone, especially in healthcare settings without access to specialized HPV tests. In this study, we examined genital wart tissue under a microscope for features that might indicate a high-risk HPV infection. We focused on visible changes in the skin cells, such as abnormal cell division and thickening of the outer skin layer. We also studied two laboratory markers, p16 and p62, which reflect how cells respond to HPV infection. We found that abnormal cell division and certain keratinization changes were more common in warts with high-risk HPV. In contrast, p16 and p62 alone could not reliably identify high-risk HPV. These results show that routine microscopic examination can still provide useful clues about which genital warts may require closer medical attention. This is particularly valuable in settings where advanced HPV testing is unavailable, helping doctors and pathologists determine which patients may benefit from closer monitoring.

Acne vulgaris is a common chronic inflammatory skin disease with substantial psychosocial consequences, primarily affecting adolescents. Despite its global prevalence and significant impact on quality of life, long-term and standardized comparisons of acne burden between China and the rest of the world remain limited. This study aimed to analyze and compare trends in the burden of acne vulgaris in China and worldwide from 1990 to 2021, with a particular focus on sex- and age-specific differences. Data were extracted from the Global Burden of Disease 2021 study. Incidence, prevalence, and disability-adjusted life years were assessed. Age-standardized rates were calculated, and trends quantified using average annual percentage change and Joinpoint regression. Globally, acne burden increased, with age-standardized incidence rising from 1442.92 to 1645.24 per 100,000. In China, absolute cases declined, but standardized rates increased. Adolescents aged 10-19 years consistently showed the highest burden, with females more affected. China exhibited earlier and faster increases in standardized rates compared to global trends. The acne burden has increased over the past three decades, especially among adolescents and females, highlighting the need for targeted prevention and management strategies.

Patients often relate preceding life events to the onset of alopecia areata (AA). This cohort study systematically examined number and type of life events together with experienced strain during two years before AA onset. The study involved 100 patients with AA who reported life events through the Social Readjustment Rating Scale (SRRS). Life event strain was examined using the Streiner model, a stress-based model in which strain is defined as undesirable, unanticipated and uncontrollable. SRRS readjustment rating and the rated strain for each life event were obtained. Percentages of strainful life events for each SRRS category were calculated. Associations between AA disease-variables, sociodemographic-variables, Beck Depression Inventory-scores and Beck Anxiety Inventory-scores were examined in relation to the number of SRRS events and the number of strainful events. Total life events reported were median (range) 7.0 (0-22), almost two times higher than lifetime population studies on life events. The most experienced life events were loss of health and separation. At least one strainful life event prior to the AA onset was reported by 82% of patients. The highest strainful ratings were found in the Family and Personal categories of SRRS, such as Major change in health of a family member and Major personal injury or illness. A comparison between SRRS life events and strain ratings showed that 60% of the life events were rated higher and 35% were rated lower than the standard SRRS readjustment weight order. This study provides support for an inquiry into any strainful life event preceding AA onset in newly diagnosed patients with AA. Categories of highly strainful events and the importance of subjective strain are identified in patients with AA. This implies the need to address strain, which seems to be important for strain reduction thereby decreasing the burden among patients with AA. Life Events and Strain before Alopecia Areata Onset Patients with the hair loss disease alopecia areata (AA), often associates its onset with the experience of life events, but scientific studies show conflicting results. We wanted to know more about life events for two years preceding AA onset, and to know more about how patients perceived different types of life events, both minor and major events such as changing to a new school, leaving home or the death or illness of a family member. With this purpose, we examined life events reported by 100 patients with AA two years before the AA onset and asked them about their perceived strain in terms of whether the event was desirable or not, expected or not, or controllable or not. We also asked them about their AA illness, their social life, and symptoms of depression and anxiety. Our results show that patients with AA experienced a high number of personal and familiar life events perceived as strainful before AA onset. Dermatologists and medical staff need to be observant of the strain these patients may have. Asking about previous life events when seeing these patients may reduce the strain and hence the burden of disease.

Androgenetic alopecia (AGA) is characterized by perifollicular micro-inflammation, although its precise trigger remains elusive. Given that the hair follicle harbors a distinct microbiota which may modulate local immune responses, this study aimed to comprehensively profile the bacterial and fungal microbiome within the deep hair follicles of AGA patients versus healthy controls, and to evaluate the influence of disease severity, age, sex, and geographical environment. We recruited 96 subjects (72 AGA patients and 24&#xa0;healthy controls), collecting a total of 192 plucked hair follicle samples from the vertex and occipital scalp. Bacterial 16S rRNA (V3-V4) and fungal ITS regions were sequenced using the Illumina HiSeq platform. Bioinformatics pipelines were employed to analyze &#x3b1;- and &#x3b2;-diversity, as well as taxonomic composition, across multiple stratifications: disease stage, scalp region, age, sex, and geographical location. Bacterial community structure showed relative stability between groups. In contrast, fungal communities were markedly dysbiotic in AGA. A key finding was the significant depletion of the commensal yeast Malassezia in AGA follicles compared to controls (p < 0.01). Conversely, opportunistic taxa such as Thermomyces and Bifidobacterium were enriched in advanced disease stages. Notably, microbial &#x3b1;-diversity increased with both disease severity and age, indicating a disruption of the follicular niche ("niche collapse"). Male AGA patients exhibited distinct fungal shifts compared to females, and geographical location significantly shaped the follicular microbiome in patients but not in healthy controls. Androgenetic alopecia involves fungal dysbiosis with loss of commensal Malassezia and gain of opportunistic microbes. Driven by host and environmental factors, this reframes AGA as an ecological imbalance, opening avenues for microbiome-targeted therapies.

Dietary fat quality and carbohydrate processing shape lipid and lipoprotein profiles involved in skin barrier integrity and cutaneous inflammation relevant to atopic dermatitis (AD). We assessed the causal relevance of dietary patterns and food items to AD and mapped lipid-lipoprotein mediators. We conducted a two-sample Mendelian randomization using genome-wide significant instruments for 83 UK Biobank diet traits and 241 serum lipid/lipoprotein measures, with AD cases from FinnGen R10 (European ancestry). Primary analyses used inverse-variance weighted MR with extensive sensitivity analyses, false discovery rate control, reverse MR, and multivariable MR. Mediation was assessed using the product-of-coefficients approach. Instrument strength was adequate (median F > 10). Using two-step Mendelian randomization, we identified specific dietary items with causal effects on AD risk. Notably, a dietary pattern characterized by higher unsaturated fats-exemplified by the protective effect of "other oil&#x2011;based spreads"-was associated with lower AD risk (OR = 0.56, 95% CI 0.34-0.93, P = 0.023). Conversely, a pattern reflecting refined-grain intake, represented by the risk-increasing effect of "brown bread", was associated with higher AD risk (OR = 1.78, 95% CI 1.10-2.89, P = 0.01). Mediation analyses mapped the underlying lipid pathways: sphingomyelin SM C20:2 mediated 15.9% of the protective effect of oil-based spreads (&#x3b2; mediation = -0.09, P = 0.003), and VLDL particle measures mediated 8.9% of the risk associated with brown bread (&#x3b2; mediation = 0.05, P = 0.003). A complex antagonistic mediation was observed for muesli via phosphatidylcholine PC aa C36:0 (proportion mediated: -13.6%, P < 0.001). Reverse MR analyses supported the proposed direction of causality (all P > 0.05), and findings were robust across sensitivity analyses. Dietary patterns high in unsaturated fats, particularly oil-based spreads, appear protective against AD, while refined-grain intake, especially brown bread and black bread, increases AD risk. These effects are mediated through lipid pathways involving sphingomyelins and VLDL metabolism, highlighting modifiable nutritional targets for AD prevention and adjunctive management.

This case describes a 29-year-old man with Morbihan disease, characterized by a 5-year history of recurrent facial erythema, papules, and pustules, followed by persistent right face edema. Initially misdiagnosed as lupus erythematosus, he received multiple treatments with only transient relief. Clinical manifestations combined with pathological findings confirmed a diagnosis of Morbihan disease associated with rosacea. Notably, the patient developed erythema and papules on the inner thighs, along with small papules on the trunk and upper limbs for 3 months. A biopsy revealed nonspecific inflammation. Since the morphology of these lesions differed from any known skin disease and no other cause could be identified, we believe this may be a manifestation of the disease. Extra-facial manifestation not previously reported. Various therapies were attempted: doxycycline and azelaic acid improved erythema; baricitinib was ineffective; while omalizumab and intense pulsed light (IPL) achieved partial improvement in erythema and edema. Long-term isotretinoin therapy provided sustained remission without relapse during tapering, confirming its efficacy and safety. This case expands the clinical spectrum of Morbihan disease by documenting extra-facial involvement and reported isotretinoin as an effective long-term therapy, with omalizumab and IPL as promising adjuncts. Furthermore, the literature review (2004-2025) summarizes the clinical features, pathology, and treatment responses of reported cases, showing a male-to-female ratio of 2.81:1. Lymphatic or vascular dilation was significantly correlated with a favorable outcome. Conversely, dermal edema and granuloma were inversely associated with treatment efficacy, indicating poorer prognosis. However, based on uncontrolled data, these findings are strictly hypothesis-generating and do not establish a definitive treatment hierarchy.

Neurofibromatosis type I (NF1) is an autosomal dominant disorder involving the skin and nervous system. We present the surgical resection experience of two siblings with neurofibromatosis type I (NF1) and giant neurofibromas. The sisters had multiple skin discolorations and swollen areas that gradually increased in size with age. The gradually growing tumors have an impact on their lives and their quality of life. In one case, staged resection was performed following preoperative arterial embolization of the tumor. Through surgery, a tumor weighing 16 kg was removed from one sister and another weighing 11 kg from the other sister. Following surgery, both sisters demonstrated significant improvement in appearance and resumed normal daily activities. Regular follow-up visits were scheduled to monitor for recurrence or new growth. Two sisters with a genetic condition called neurofibromatosis type 1 (NF1) had surgery to remove very large, non-cancerous tumors (called neurofibromas). These tumors had caused noticeable skin changes and swelling that got worse as they got older. While most of their tumors grew slowly, some specific ones grew much faster. The younger sister had rapid growth on her right side from her waist down her leg. The older sister had rapid growth on her left neck, shoulder, chest, back, and arm. Their family has a history of NF1, which was also found in their father and in the older sister&#x2019;s children and grandchild. Doctors performed surgery to remove these massive tumors. One sister had a tumor weighing 16 kg (about 35 pounds) removed, and the other had an 11 kg (about 24 pounds) tumor removed. After the surgeries, both women looked significantly better and were able to return to their normal daily lives. They will continue to have regular check-ups to watch for any return of the tumors or new growths.

Atopic dermatitis (AD) severity in children is influenced by biological, environmental, and psychosocial factors, yet severity-focused, multicenter evidence from Middle Eastern populations remains limited. To identify early-life, familial, and climatic determinants of clinical severity in pediatric AD. This multicenter cross-sectional study included 600 children diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Disease severity was measured using the SCORAD index and categorized as mild, moderate, or severe. Independent variables included breastfeeding history, parental marital status, residential climate, animal exposure, and family atopy. Ordinal logistic regression models were used to estimate adjusted odds ratios (aORs) controlling for age, sex, and nationality. Compared with bottle-feeding, breastfeeding <6 months (aOR = 0.02; 95% CI 0.007-0.079) and &#x2265;6 months (aOR = 0.29; 95% CI 0.17-0.50) were strongly protective against greater AD severity. Children from separated/divorced or widowed households and those living in mountain regions had significantly higher severity than peers from married families and coastal areas. Cat exposure was an independent determinant of greater severity (aOR = 6.48; 95% CI 3.33-12.64) and higher SCORAD, whereas general animal exposure, consanguinity, sex, and family atopy were not significant. Breastfeeding, family structure, residential climate, and cat exposure are key, potentially modifiable determinants of pediatric AD severity and should inform risk-stratified, context-aware management.

Hypertrophic scars (HS) and keloids are pathological outcomes of aberrant wound healing. Their association with systemic physiological factors remains unclear. Mendelian randomization (MR) uses genetic variants as instrumental variables (IVs) to infer causality, minimizing confounding factors. In this study, we aim to investigate the causal effects of blood-related phenotypes, including blood cell counts, blood pressure, lipids, and glucose, on the risk of HS and keloids using a two-sample MR method. Genetic instruments for exposures were obtained from publicly available GWAS summary statistics, while outcome data were sourced from the FinnGen database and GWAS Catalog. The IVs were selected based on genome-wide significance (P < 5 &#xd7; 10-8) and clumped for independence (r2 < 0.001, window = 10,000 kb), with F-statistic > 10 and minor allele frequency > 0.01 applied to minimize weak instrument bias. Causal estimates were primarily derived using the inverse variance weighted method, supplemented by comprehensive sensitivity analyses including heterogeneity, pleiotropy, and reverse causality. Genetically predicted higher leukocyte (OR: 1.175, 95% CI: 1.049-1.315, P = 0.005) and neutrophil counts (OR: 1.177, 95% CI: 1.040-1.332, P = 0.010) were causally associated with increased keloid risk. Conversely, lower systolic blood pressure (SBP) (OR: 0.709, 95% CI: 0.537-0.938, P = 0.016) and diastolic blood pressure (DBP) (OR: 0.732, 95% CI: 0.565-0.949, P = 0.018) were causally linked to higher HS risk, and lower SBP (OR: 0.760, 95% CI: 0.622-0.928, P = 0.007) was associated with increased keloid risk. No causal relationships were found for other blood cells, lipids, or glucose with either scar type. Sensitivity analyses did not indicate substantial heterogeneity or horizontal pleiotropy, supporting the robustness of the main findings. Our study suggests the causal effects of blood-related phenotypes in HS and keloids by using an MR method. Our results offer novel etiological insights and a potential perspective for scar-related intervention.