Objective:To evaluate the efficacy and safety of JAK1/2 inhibitors in the treatment of adult patients with dermatomyositis(DM).Methods:Patients with DM who visited the Department of Dermatology Dermatology Hospital of Southern Medical University Hospital of Dermatology from May 2020 to December 2022 were collected.The Disease Area and Severity Index(CDASI)score was assessed by dermatologist be-fore starting treatment.Meanwhile,skin rash photos were collected and blood routine,biochemical indexes,anti-nuclear antibody,anti-nuclear antibody spectrum,and myositis specific antibody were examined.After contraindications were excluded,oral baritinib 2 mg/d was administered for 12 weeks.At 4,8,and 12 weeks after treatment,CDASI scores were evaluated,relevant indicators were reviewed,and adverse events were re-corded.Results:Seven patients with DM were included,and six patients completed 12 weeks of drug treat-ment and follow-up observation.The CDASI scores of all the patients showed a continuous downward trend af-ter treatment,and the continuous improvement could be maintained until the 12th week.Some patients showed a decrease in muscle enzyme index,but it was not statistically significant.After 12 weeks of treatment,some patients with myalgia and/or muscle weakness improved their symptoms.The index of muscle enzyme de-creased in some patients,but there was no statistical significance.There were no serious adverse events in pa-tients during the follow-up period.Conclusion:JAK1/2 inhibitors may provide a safer and more effective op-tion for the adult DM patients with poor response to hormone or need to be treated with hormones or other sys-temic drugs.
Objective:To compare the efficacy and safety of secukinumab and adalimumab in the treatment of nail psoriasis.Methods:The patients with nail psoriasis and treated with secukinumab or adalimumab at the Department of Dermatology and Venereology of Tianjin Medical University General Hospital from January 2020 to March 2023 were retrospectively analyzed.The efficacy and safety of the two groups were evaluated af-ter 0,4,12,24 and 36 weeks of administration,respectively.The t test was used to compare the measure-ment data between the two groups,and the Fisher exact test was used to compare the count data between the two groups,to analyze the improvement of NAPSI before and after treatment in the two groups.Results:A to-tal of 36 patients were collected,including 17 treated with secukinumab and 19 treated with adalimumab.The NAPSI score decreased by 7.60±4.34,13.20±4.09,17.60±3.79 and 21.20±4.87,and the decreasing rates of NAPSI score were(13.87±8.80)%,(24.13±9.44)%,(32.11±8.87)%and(38.41±9.64)%after 4,12,24 and 36 weeks in secukinumab treatment group.The NAPSI score decreased by 12.17±5.49,25.67±9.69,38.67±15.54,34.67±18.49 and the decreasing rates of NAPSI score were(20.19±7.20)%,(45.34±11.96)%,(62.64±18.59)%and(71.83±19.64)%after 4,12,24 and 36 weeks in adalimumab treatment group.Conclusions:Secukinumab and adalimumab were equally effective in the treatment of nail psoriasis at week 4.At the 12th week of treatment,the efficacy of adalimumab began to be better than that of secukinum-ab.At the 24th week of treatment,adalimumab was significantly more advantageous.
A 6-month-old infant presented with multiple subcutaneous papules on the right lower limb for more than 1 year.Histopathology showed no abnormalities in the epidermis,and differentiated mature bone tis-sue and bone cells around the dermis and subcutaneous tissue.Children are low birth weight children with growth and development disorders and elevated PTH.The diagnosis of Albright hereditary osteodystrophy was made.
Objective:To analyze the diference of skin and intestinal microflora between psoriasis mice and control group based on 16S rRNA sequencing,and explore the key microflora of psoriasis.Methods:Twelve mice were randomly divided into experimental group and control group.Skin and fecal samples were collected and detected by 16S rRNA sequencing.Results:Compared with the control group,in the experimen-tal group,the relative abundance of bacteroidota,coriobacteriia,lachnospirales,rikenellaceae decreased in the skin flora.Nevertheless,the relative abundance of firmicutes,bacilli,staphylococcales increased in the skin flora.And the relative abundance of bacteroidota,alpha-proteobacteria,lactobacillales decreased in the intestinal flora.But the relative abundance of campilobacterota,clostridia,and lachnospirales increased in the intestinal flora.LefSe analysis showed that coriobacteriia,bacteroidia,lactobacillales,and staphylococcales played a major role in the skin microbiota of mice,and bacteroidia,clostridia,enterobacterales,and lachno-spirales played a major role in the gut microbiota of mice.The results of MetagenomeSeq analysis showed that the species composition and function of the skin and gut microbiota in the two groups were different at the phy-lum,class,order,family,genus,and species levels,with significant differences.Conclusion:The immune system of psoriatic mice is involved,the skin and intestinal barrier function is damaged,and the abundance of bacterial flora is changed,which further verifies the correlation of gut-immune-skin axis.
Transient receptor potential vanilloid 3(TRPV3)is a non-selective cation channel protein,which is most abundantly expressed in skin keratinocytes,and participates in physiological processes such as kerati-nocytes proliferation,skin barrier formation,sensory conduction,and hair growth,which plays an important role in maintaining skin homeostasis.Studies have found that TRPV3 plays an important role in the occurrence and development of skin diseases such as atopic dermatitis,Olmsted syndrome,and psoriasis.The role of TR-PV3 in the pathogenesis of these skin diseases and its future clinical application were reviewed in this paper.
A 76-year-old male presented with mass on the forehead for more than 1 month,and the mass gradually increased in size,followed by erosion and exudation with occasional pruritus.The patient underwent surgical resection,and the diagnosis of clear cell squamous cell carcinoma was made by pathological examina-tion.The patient was followed up and no recurrence was found.
There are a variety of biomarkers expressed on the membrane of malignant melanoma cells,which can be used as therapeutic targets to develop targeted chimeric antigen receptor T cells(CAR-T).CAR-T has shown good effects on GD2,HER2,CD70,Gp100,NYESO-1 and other targets in malignant melanoma.This paper aims to review the targets and clinical progress of CAR-T cells for malignant melanoma,and ana-lyze the challenges and countermeasures of engineered T cells,in order to apply CAR-T cells to the clinical practice of malignant melanoma.
We report a case of refractory SAPHO syndrome in which the disease could not be controlled by traditional drugs such as methotrexate and aveloxan capsules.After 6 weeks of maintenance treatment with adalimumab and echizumab,the disease remained uncontrolled.The rash completely disappeared,smooth new nail proximal to the toenail,no pressure pain in the sternoclavicular joint,after 75 days of treatment with the JAK inhibitor tofacitab.
Objective:To evaluate efficacy and safety of dupilumab in the treatment of bullous pemphigoid(BP).Methods:A retrospective study was conducted among 16 patients with BP treated by dupilumab from February,2021 to February,2023.The clinical,laboratory and COVID-19 infection date were analyzed.The severity of skin lesions and itching were evaluated by bullous pemphigoid disease area index(BPDAI)and nu-merical rating scale(NRS)respectively.Karnofsky score was used to evaluate the functional status of BP pa-tients.Common Terminology Criteria for Adverse Events(CTCAE)was used for adverse events evaluation.Results:A total of 16 BP patients were included in this study.At week 16,8(50%)cases achieved disease control,6(37.5%)cases achieved complete remission,2(12.5%)cases were discontinued due to poor effi-cacy or adverse reactions.The average score of BPDAI and NRS decreased from 38.38±21.90 and 8.8±0.65 to 8.37±9.45 and 3.2±1.05,with significant differences(Ps<0.05).Karnofsky score increased from 44.67±23.01 to 79.33±19.82(P<0.05).Among the 16 patients,3(18.7%)tested positive for COVID-19 and im-proved after symptomatic or topical treatment,while the rest remained stable.Respiratory failure and granulo-cytopenia occurred in 1 case(6.25%),systemic sweating in 1 case(6.25%),and local adverse reactions in 2 cases(12.5%).No other adverse events were found.Conclusion:The COVID-19 epidemic has no signifi-cant impact on the disease management of BP patients enrolled in this study.Dupilumab is an effective and safe treatment for bullous pemphigoid patients.
临床资料 患者,男,24 岁. 苗族,农民,云南省文山州文山市人. 患者既往体健,否认麻风家族史,但长期居住在疫区. 因躯干、四肢皮肤出现红斑 4 个月余就诊. 患者自诉 4 个月前无明显诱因先于右上臂皮肤出现一椭圆形红斑,无明显自觉症状,随后躯干、四肢、面部皮肤相继出现大小不等的类似皮疹,伴微痒. 病后曾到当地医院就诊,诊断为"玫瑰糠疹" ,予以药物(具体不详)治疗后,皮损颜色变淡. 为进一步诊治,到我所就诊. 患者自发病以来无头痛、发热、咳痰、鼻塞、流清涕、胸闷、呼吸困难、恶心、呕吐、腹痛、腹泻等症状,精神、饮食、睡眠可,二便正常,体重无明显变化.
Objective:To identify the latent class of family management characteristics in children with atopic dermatitis,and to compare the differences of different classes,so as to provide ideas for targeted inter-ventions.Methods:With the use of a convenience sampling method,164 children with atopic dermatitis were selected for this study.Latent profile analysis was used to analyze the latent class of family management,uni-variate logistics regression analysis and binary logistic regression analysis were used to compare the characteris-tics of each latent class.Results:The family management of children with atopic dermatitis could be divided into 2 classes,including low intimacy effective coping type(35.3%)and high intimacy ineffective coping type(64.7%).The results of logistic regression showed that father with a master or doctoral degree,average monthly household income above RMB 20000,living with grandparents,one-child family were more likely to be sorted into the low intimacy effective coping type.Mother as caregiver,higher itching score and higher pa-tient oriented eczema measure score were more likely to be classed into the high intimacy ineffective coping type.Conclusions:There is heterogeneity in the family management of children with atopic dermatitis.
A 5-year-old boy presented with diffuse dry,desquamation and pruritus after birth.The pa-tient was born with dry,flaky skin on the forehead,hands and lower legs,gradually spreading to the femur and abdomen.After the age of 2,the skin of the whole body began to be diffusely erubescent,exacerbated by scales and intense itching.The trunk and limbs were covered with large amounts of scales,with local infiltra-tion and hypertrophy,and the skin on the extensor sides of the joints was markedly mossy.Dermoscopic exami-nation showed bamboo hair.Blood eosinophils was 1.05×109/L.IgE>1130.00 IU/mL.The diagnosis of Neth-erton syndrome was made.At present,there are 15 literatures about the clinical effect of dupliuzumab in the treatment of NS.This patient was treated with dupilumab,itching improved significantly and the generalized scales was briefly relieved after 4 months.In this paper,the previous literature and the treatment of this pa-tient are reviewed.
We report a case of eczematous drug eruption after the treatment of psoriasis with secuchinumab.Cyclosporine and methotrexate were ineffective,and the skin lesions resolved after 2 weeks of the treatment with abxitinib.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae,which can lead to de-formities and disabilities without treatment in time.Leprosy has turned into low epidemic situation since 21st century.However,there are nearly thousand new cases every year with more than 20%grade 2 disabilities.In 2017,Shandong Dermatology Departments Alliance was established by Shandong Provincial Hospital for Skin Diseases.Based on the dual referral program,39 leprosy cases were diagnosed and the delay period of diagno-sis was decreased by 66.23 months.In this paper,three cases among the 39 leprosy cases of early diagnosis of leprosy were reported based on Shandong Dermatology Departments Alliance.
We report a patient with diffuse alopecia areata after COVID-19 vaccination who successfully treated with baratinib 4 mg daily.After 6 months of treatment,the drug was stopped,and the white hair turned to black hair 1 month after the drug was stopped.The patient was followed up for 10 months after drug with-drawal,and there was no recurrence.
Reticular hemangioendothelioma is a rare vascular tumor.We report a case of reticular heman-gioendothelioma with skin nodules on the back for 1 year.Combined with clinical and histopathological find-ings,the patient was diagnosed with reticular hemangioendothelioma and underwent surgical resection.
We report a 24-year-old male with atypical monkeypox,who appeared annular papules on the foreskin and glans 3 days ago,no systemic symptoms such as fever and sore throat,and there was unprotective MSM before the onset.Dermatological examination showed several ring-shaped papules with the size of mung beans and soybeans on the foreskin and glans penis,scabs in the central depression,and no obvious rashes on the trunk,limbs and head surface.Monkeypox virus was positive.The rashes gradually resolved after symp-tomatic treatment.This monkeypox patient only had genital lesions,which was different from routine monkey-pox and easy to be misdiagnosed in clinic.
In recent years,it has been reported that the incidence and prevalence of uveitis in psoriasis patients are higher than those in normal population,and the pathogenesis of the coexistence of the two is not clear.There is no standardized treatment for psoriasis complicated with uveitis.Glucocorticoids,immunosup-pressants and biologics can be used.Herein,we report a case of plaque psoriasis with uveitis treated with secuchiumab.After 12 weeks of treatment,most of the lesions and ocular symptoms basically resolved.
Soluble costimulatory molecules are soluble forms of costimulatory molecules,which participate in the transmission of costimulatory signals and play an important role in self-regulation.Their abnormal expres-sion will affect the body's immune response and the establishment of immune tolerance.It is closely related to the immune regulation,occurrence and development of autoimmune skin diseases.The update of soluble cos-timulatory molecules in autoimmune cutaneous disease was reviewed in this paper,in order to provide a refer-ence for clinicians and researchers to clarify the pathogenesis and effective treatment of this disease.
斑秃是一种以非瘢痕性脱发为特征的自身免疫性皮肤病,其具体病因未明,可能与环境、遗传、免疫等有关.目前普遍认为生长期毛囊"免疫豁免的丧失"在斑秃的发病中起关键作用.近年来斑秃与其他自身免疫病的共同免疫学特性相继被发现,多种新型生物制剂也逐渐被尝试应用于重度斑秃及传统方法疗效不佳者.本文对斑秃相关免疫机制的研究进展进行综述.
