This narrative review focuses on psoriasis, a chronic recurrent inflammatory skin disease with multisystem comorbidities that significantly impairs patients' quality of life. The recurrent nature of the disease often imposes substantial psychological burden, accompanied by anxiety, depression, and social avoidance behaviors. Precise dynamic assessment throughout the entire diagnostic and therapeutic cycle is crucial for improving patient prognosis. Artificial intelligence technology, with its powerful image recognition and data analysis capabilities, provides a novel technical pathway for dynamic assessment of psoriasis. This review comprehensively summarizes research progress of AI technology in whole-process assessment of psoriasis before, during, and after treatment, analyzing application characteristics and performance advantages of different AI models in auxiliary disease diagnosis, severity scoring, treatment regimen optimization, relapse risk prediction, comorbidity screening, and psychological status assessment. Furthermore, we examine the core challenges currently faced, including lack of data standardization, insufficient diversity of population and subtype-specific data, unresolved ethical and privacy protection concerns, and barriers to interdisciplinary clinical integration. AI models such as convolutional neural networks and deep learning can effectively improve the accuracy of psoriasis diagnosis and the objectivity of severity assessment, and also exhibit promising application potential in treatment regimen screening, therapeutic effect simulation, prognostic monitoring, and psychological burden identification. Moreover, multimodal fusion and cross-technology integration have emerged as important development directions. To address the existing challenges, future research should focus on advancing the construction of standardized and diverse data systems, fostering interdisciplinary expertise, developing an integrated AI model covering diagnosis, assessment, treatment, prognosis, and psychological status monitoring, and strengthening multicenter clinical validation and the establishment of ethical norms. This review demonstrates that the deep integration of AI technology with dynamic assessment of psoriasis can provide strong support for precise and individualized long-term disease management, and holds important clinical value for optimizing psoriasis diagnosis and treatment regimens, reducing the disease burden, and improving patients' mental health.
Objective: Psoriasis is a chronic inflammatory skin disease driven by dysregulated immune responses and keratinocyte activation. How topical disulfiram (DSF) ameliorates imiquimod-induced psoriatic dermatitis beyond pyroptosis inhibition remains unclear. This study aims to elucidate its cellular and molecular mechanisms and assess its multi‑target therapeutic potential. Methods: A murine model was established with petroleum jelly, imiquimod, and DSF treatment groups. Single-cell RNA sequencing of dorsal skin was performed to construct a cellular atlas. Bioinformatic analyses were conducted to identify key DSF-responsive populations. Findings were validated by flow cytometry, histology, and enzyme-linked immunosorbent assay. The role of Ly6C hi monocytes was evaluated using a selective C-C chemokine receptor type 2 (CCR2) inhibitor. Network pharmacology and molecular docking analyses were conducted to predict multi-target mechanisms. Results: Keratinocytes and myeloid cells were identified as central targets. DSF suppressed the expansion of a pathogenic keratinocyte subtype (Epd_DF2) and inhibited psoriasis-associated proinflammatory and metabolic pathways. DSF altered the functional activation state of Ly6C hi monocytes without affecting their abundance. In T cells, DSF attenuated IL-23/IL-17 axis activation, as reflected by reduced Il17a and Il17f expression and increased inhibitory signatures. CCR2 inhibition attenuated disease severity, reduced serum IL-17A levels, and significantly decreased Ly6C hi monocyte proportions from 23.6% ± 1.8% in the IMQ group and 23.3% ± 2.2% in the IMQ+Vehicle group to 13.9% ± 1.8% in the IMQ+BMS group ( F = 8.18, P = 0.003), whereas the VAS group showed a baseline proportion of 15.1% ± 6.4%, without altering neutrophil abundance. Multi-target analysis predicted mTOR and NQO1 as potential targets. Conclusion: Topical DSF ameliorates psoriasiform inflammation through multi-target effects on keratinocyte differentiation and immune cell function, accompanied by modulation of the IL-17A axis and CCL2/CCR2-related signaling. These findings support the potential repurposing of DSF as a nonsteroidal topical therapy for psoriasis.
Vitiligo is a common acquired depigmenting skin disorder characterized by melanocyte dysfunction or loss. It affects 0.5%–2.0% of the global population and imposes a substantial psychological burden. The pathogenesis involves genetic predisposition, oxidative stress, and immune dysregulation; distinct mechanisms underlie its progressive and stable phases. This review provides a systematic overview of recent advances in vitiligo treatment, from pathogenesis to clinical management, and emphasizes the importance of stage-specific therapy. During the active phase, management focuses on suppression of immune-mediated inflammation to halt disease progression. Key therapies include topical corticosteroids, calcineurin inhibitors, and Janus kinase inhibitors, all of which have demonstrated increasing efficacy. In the stable phase, the therapeutic objective shifts to repigmentation. Narrowband ultraviolet B phototherapy remains the cornerstone of treatment and is often combined with adjunctive therapies to enhance outcomes. Emerging research targeting tissue-resident memory T cells and the interleukin-15 pathway, along with strategies to restore the cutaneous microenvironment, offers promising approaches to prevent disease relapse. This review aims to inform clinicians of recent therapeutic advances and support optimal disease management, ultimately improving quality of life for individuals with vitiligo.
Extracellular trap formation (ETosis) is considered a novel form of cell death. These structures, composed of DNA, histones, and granular proteins, serve as a crucial defense mechanism against pathogen invasion. However, excessive extracellular trap formation can contribute to the development and exacerbation of inflammatory diseases, particularly psoriasis. Psoriasis is a chronic, multifactorial, immune-mediated inflammatory skin disorder that affects approximately 2%–3% of the global population. Although the mechanisms underlying psoriasis remain unclear, increasing evidence indicates that extracellular traps released by neutrophils, mast cells, macrophages, and lymphocytes are involved in its pathogenesis. This review provides a comprehensive overview of mechanisms underlying ETosis in the context of psoriasis, with a focus on the characteristics of extracellular traps, the immune cells involved, and their network interactions. It also explores novel pharmacological approaches that target extracellular traps, then discusses their translational prospects and clinical implications.
Objective: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. Salt-inducible kinase 1 (SIK1) has been implicated in the regulation of inflammation; however, its role and underlying mechanisms in HS pathogenesis remain poorly defined. The present study aimed to address this gap. Methods: Immunohistochemistry was used to assess SIK1 expression in lesions from 3 patients with HS and in 3 murine HS models. An ex vivo skin explant Transwell culture system was established, and multiplex secretome analysis was performed to quantify inflammatory mediators of 10 patients with HS after treatment with a SIK1 inhibitor. The therapeutic effects of SIK1 inhibition were then evaluated in murine models. RNA sequencing was conducted to identify differentially expressed genes and associated signaling pathways in lesional skin of 5 patients with HS after SIK1 inhibition. Protein expression patterns of key pathway components were subsequently analyzed in 3 patients with HS. Results: SIK1 expression was increased in HS lesional skin and in murine models. Pharmacological inhibition of SIK1 reduced the secretion of interleukin (IL)-6, C-X-C motif chemokine ligand (CXCL) 8 ( P ＜0.01), and tumor necrosis factor-α ( P ＜0.01) in HS skin explants ( P ＜0.01) and alleviated pathological features in murine HS models Following SIK1 inhibitor treatment, the epidermal thickness (33.2 µm vs 62.4 µm, P ＜0.05) at the lesional sites in murine models was significantly reduced and the expression of CXCL1 and IL-6 was decreased. Transcriptomic analysis indicated suppression of the Janus kinase (JAK)–signal transducer and activator of transcription (STAT) signaling pathway, accompanied by reduced levels of phosphorylated STAT3. Conclusion: These findings provide preliminary evidence that SIK1 inhibition attenuates HS-associated inflammation by reducing proinflammatory cytokine production and downregulating the JAK–STAT pathway, highlighting SIK1 as a potential therapeutic target for HS.
Objective: Alopecia areata (AA) is a immune-mediated condition that affects patients’ quality of life, particularly among children and adolescents, and treatment options remain limited. This study aimed to explore the clinical effectiveness and safety of abrocitinib in seven adolescents with moderate-to-severe AA. Methods: This prospective observational study enrolled AA patients aged 12–17 years with a Severity of Alopecia Tool (SALT) score ≥ 25 who received abrocitinib treatment for at least 10 months between August 2023 and December 2024 at the Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College. The primary endpoint was measured by the proportional reduction in SALT score between baseline and the most recent evaluation. Secondary endpoints included the proportion of patients achieving a SALT score ≤20 (SALT 20), SALT50, SALT75, and SALT90 at weeks 12, 24, 36, and the final visit, and safety assessments. Results: Seven patients (one boy and six girls), aged 12 to 17 years, completed a minimum of 10 months of therapy. The median baseline SALT score was 95 (IQR, 50–100), and the mean disease duration was 35.1 months. At week 12, 57.1% achieved SALT ≤20, increasing to 85.7% by week 24 and 100% by week 36; at the final visit, 85.7% maintained this response. SALT50/75/90 response rates improved from 71.4%/42.9%/28.6% at week 12 to 100%/85.7%/85.7% at week 24, reaching 100% each by week 36. The median percentage reduction in SALT score was 100% (mean, 90.6%; IQR, 47.4%–100%). Initial hair regrowth occurred after a mean duration of 7.7 weeks. No serious safety concerns were identified; one patient experienced mild transient bilirubin elevation. Conclusion: Abrocitinib demonstrated favorable efficacy and tolerability in adolescents with AA. The long-term clinical outcomes and safety considerations of abrocitinib and other JAK inhibitors in this age group remain to be established through adequately powered prospective trials.
Malignant melanoma, a highly aggressive form of skin cancer, has its progression, metastasis, and treatment resistance closely linked to profound metabolic reprogramming. Emerging research highlights that the rewiring of glucose and amino acid metabolism plays a central role in oncology, offering promising new directions for the treatment of this malignancy. With a focus on malignant melanoma, this review discusses how glucose and amino acid metabolism become dysregulated and presents the mechanistic basis for this rewiring. Metabolic reprogramming is a key mechanism through which tumors condition their microenvironment to support expansion and avoid immune detection. By synthesizing current evidence, this article aims to pinpoint promising directions for future research and therapy in this challenging disease.
Acne sequelae primarily include post-acne erythema, post-acne hyperpigmentation, and post-acne scarring. These residual cutaneous lesions persist in a substantial proportion of patients following the resolution of active acne and arise from factors such as inflammatory responses and inappropriate manipulation of lesions. Acne sequelae are highly prevalent, impose a considerable disease burden, and exert a profound negative impact on patients’ physical appearance, psychological well-being, and quality of life. Although a wide range of therapeutic modalities is currently available and new treatment technologies continue to emerge, substantial variability exists in treatment efficacy, and clinical decision-making remains highly heterogeneous. To promote standardized and evidence-based approaches to the diagnosis, prevention, and management of acne sequelae, an expert panel developed this consensus through a comprehensive review of recently published domestic and international literature, integrated with current clinical practice in China. This consensus is intended to provide practical and authoritative guidance for clinicians in the diagnosis, prevention, and treatment of acne sequelae.
Photobiomodulation therapy (PBMT) is a safe and effective option for multiple skin diseases. To promote standardized clinical use, this expert consensus was developed by 35 dermatology experts through 2 rounds of Delphi surveys and addressed 19 clinical questions with a consensus degree of over 80.0%. This consensus summarizes current evidence on PBMT’s mechanisms of action, indications, contraindications, treatment parameters, and adverse event management. Although encouraging outcomes have been observed regarding acne vulgaris, photoaging, alopecia, and other dermatologic conditions, considerable variability in treatment protocols and the scarcity of high-quality, large-scale clinical trials continue to limit broader clinical adoption. This consensus provides evidence-based and practical guidance to support the safe and effective incorporation of PBMT into dermatologic practice in China.
Objective::Leprosy prevention and treatment is a significant global public health and social challenge. Southwest China remains a high-burden area for leprosy. Analyzing the epidemic characteristics of different regions is crucial for tailoring effective prevention and control measures. This study aimed to characterize the epidemiological profile of leprosy in China from 2022 to 2023, providing essential data to inform future prevention and control strategies.Methods::Data were extracted from the Leprosy Management Information System in China, encompassing 31 provinces, autonomous regions, and municipalities from 2022 to 2023, and data from the Hong Kong Special Administrative Region, the Macau Special Administrative Region, and the Taiwan region were not available in the system and thus were not included in this analysis. Descriptive statistical methods were used to analyze the demographic and clinical characteristics, including sex, age, geographic distribution, and disability grade.Results::In total, 617 new leprosy cases were identified nationwide in 2022 and 2023, corresponding to a detection rate of 0.22 per million population. Among these, 380 cases (61.6%) involved male individuals, 588 cases (95.3%) were classified as multibacillary, 136 cases (22.0%) affected individuals with grade 2 disability, 114 cases (18.5%) involved migrant individuals, and 5 cases (0.8%) occurred in children under 15 years of age. In both years, 57.7% of new detected cases (356/617) were concentrated in Southwest China. Across the 2-year period, 47 relapse cases were reported. The registered prevalence was 1.279 per million population at the end of 2022, based on 1,806 cases. By the end of 2023, this number declined to 1.201 per million, based on 1,693 cases.Conclusion::Although the overall prevalence of leprosy in China is low, the disease continues to be geographically widespread and unevenly distributed. Southwest China remains a key region for targeted control efforts.
Objective::Treatment non-adherence in chronic dermatological diseases is a persistent problem. Therefore, the use of a reliable and valid instrument to identify barriers to treatment adherence is essential. To date, no Arabic version of the Adherence Barriers Questionnaire (ABQ-A) has been available to identify barriers to treatment adherence among patients in Arab communities. Therefore, we conduct this study to validate an ABQ-A and then identify potential barriers to adherence in common chronic dermatological diseases.Methods::The cross-section study was prospectively conducted in the Dermatology Department at Assiut University Hospital between March 2022 and August 2023. In total, 400 Egyptian patients with common chronic dermatological diseases (vitiligo, acne vulgaris, psoriasis vulgaris, and atopic dermatitis) were randomly recruited. Patient adherence to treatment was assessed using the Arabic versions of the Morisky Medication Adherence Scale and the Adherence to Refills and Medications Scale (ARMS). Adherence barriers were examined using the newly developed ABQ-A. Reliability and internal consistency of the ABQ-A were examined via Cronbach’s alpha coefficient (Cronbach’s α). Construct validity was evaluated through exploratory factor analysis. External validity was tested by calculating Spearman’s rho correlations between ABQ-A scores and ARMS scores.Results::The mean age of the 400 patients was 32.6 years (standard deviation = 15.6), ranging from 18 to 69 years and 228 patients were females. Totally 293 patients (73.3%) exhibited low adherence. The mean ARMS score was 33.5 ± 4.6, and the mean ABQ-A score was 39.1 ± 3.9. The Cronbach’s α for the ABQ-A was 0.78, indicating acceptable internal consistency. Exploratory factor analysis revealed that the ABQ-A consisted of 3 factors (intentional, medication/healthcare system-related, and unintentional adherence barriers), supporting construct validity. Among the three factors, the medication/healthcare system-related barriers subscale had the highest mean ABQ-A score (15.2 ± 1.8), followed by the intentional (13.1 ± 1.8) and unintentional (10.8 ± 1.6) adherence barriers subscales. Items with mean ABQ-A scores exceeding 3 identified key barriers: financial burden (item 8), psychological distress (item 10), difficulty maintaining medication routines (item 11), perceived systemic obstacles to healthcare (item 12), and concerns about side effects, which prompted discussions with doctors (item 15a) or led to medication discontinuation (item 15b). External validity was confirmed by a significant positive correlation between ABQ-A and ARMS scores ( r = 0.84, P < 0.001). Conclusion::The ABQ-A is a reliable and valid instrument for identifying barriers to treatment adherence. Perceived high medications cost and psychological concerns about side effects were among the most commonly reported barriers identified by ABQ-A.
Allergen-specific immunotherapy (AIT) has shown therapeutic efficacy in clinical trials regarding atopic dermatitis (AD). As the only currently available treatment that may potentially cure allergic diseases, AIT holds significant clinical importance. However, there is still controversy regarding the application of AIT in AD. This study evaluated the efficacy and safety of subcutaneous immunotherapy (SCIT) with mite allergens as add-on therapy in patients with AD. Ninety patients treated with SCIT for more than 3 years were evaluated using the Scoring Atopic Dermatitis (SCORAD) index, Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and a visual analog scale for itch (VAS) in Hospital of Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College from 2018 to 2023. Serum levels of total immunoglobulin E (IgE), house dust mite (HDM)–specific IgE (sIgE)-blocking factor, and HDM-specific IgG4 (sIgG4) were assessed at baseline and after 3 years. Patients were categorized into subgroups according to age, initial AD severity, and mono- or multi-sensitization. Subgroup response rates were analyzed; baseline characteristics were compared between responders and non-responders. Between-group comparisons used Student’s t-test or Wilcoxon signed-rank test as needed. After 3 years of SCIT, improvement was observed in 58 patients (64.4%). Three patients (5.2%) achieved complete remission, 19 (32.8%) showed significant improvement, and 36 (62.1%) demonstrated moderate improvement. Significant reductions were observed in SCORAD, EASI, DLQI, and VAS scores. Serum levels of Dermatophagoides pteronyssinus ( Der p ) and Dermatophagoides farina ( Der f ) sIgE decreased ( P = 0.02 and P ＜0.001, respectively), whereas sIgG4 ( P < 0.001), Der p sIgE-blocking factor ( P < 0.001) and Der f sIgE-blocking factor significantly increased ( P = 0.003). Response rates were similar in patients younger than 18 years and adults (63.9% vs. 65.5%, χ2=0.02, P =0.880). Patients with moderate-to-severe AD were more likely to respond than those with mild disease (78.5% vs. 28%, χ2=20.06, P < 0.001). Multi-sensitized patients showed responses similar to those of HDM-sensitized patients (63.0% vs . 65.9%, χ2 = 0.08, P = 0.780). No significant differences were observed at baseline in sex, age, total IgE, EASI, or eosinophil count between responders and non-responders; responders had higher baseline SCORAD ( P ＜0.001), VAS ( P= 0.01), and DLQI scores ( P= 0.020) compared to no-responders. Injection-site reactions were the most common adverse events, and no serious systemic reactions occurred. In this real-world study, a 3-year course of subcutaneous allergen immunotherapy (SCIT) provided evidence supporting its clinical efficacy and favorable immunomodulatory effect as an add-on therapy for patients with moderate-to-severe atopic dermatitis (AD). Efficacy was consistent regardless of age or sensitization profile, and patients with more severe baseline disease were more likely to respond. SCIT exhibited a reassuring safety profile, with only minor injection-site reactions and no serious systemic events.
The diagnosis and treatment of cutaneous T-cell lymphoma (CTCL), a rare and serious skin malignancy, remain challenging due to limited understanding of its pathogenesis. Recently, increasing attention has been directed toward a possible link between CTCL development and the use of biologic therapies for inflammatory skin diseases, such as psoriasis and atopic dermatitis. These biologics include tumor necrosis factor-α inhibitors, interleukin (IL)-4/IL-13 inhibitors, IL-17 inhibitors, and IL-12/IL-23 inhibitors. The precise relationship between CTCL onset and biologic exposure remains unclear, highlighting an important and evolving clinical concern. This review examined potential associations between CTCL development and commonly used biologic therapies for inflammatory skin diseases, with a particular emphasis on underlying immunological and molecular mechanisms. This review was intended to offer insights that can guide future research regarding molecular pathways involved in CTCL pathogenesis after biologic treatment, thus refining therapeutic strategies and improving patient care.
Recent studies have highlighted the role of lipid metabolic reprogramming in the pathogenesis of vitiligo, a common autoimmune skin disease characterized by acquired depigmentation. Patients with vitiligo exhibit alterations in fatty acid metabolism, dysregulation of lipid metabolism–related proteins, and increased lipid oxidative stress. Abnormal lipid metabolism may also promote disease progression by modulating the immune microenvironment. Concurrently, immune cell dysfunction and aberrant cytokine secretion impair keratinocyte function, thereby exacerbating melanocyte destruction. This review systematically examines lipid metabolic reprogramming in vitiligo, its defining features, and its relevance to disease pathogenesis, offering a novel perspective on the underlying mechanisms. By analyzing key aspects of lipid metabolic reprogramming, this review highlights the pivotal role of lipid metabolism in vitiligo onset and progression; it provides a theoretical framework to guide future research.
Hidradenitis suppurativa (HS), also known as acne inversa (AI), is a chronic, recurrent inflammatory disease of the pilosebaceous unit that primarily affects intertriginous areas and is characterized by recurrent, painful, deep-seated inflammatory lesions. The pathogenesis of HS/AI is multifactorial, involving genetic susceptibility, immune dysregulation, microbial imbalance, and obesity. HS/AI remains difficult to manage, and current treatment aims to reduce the frequency and duration of flares, decrease disease severity, and improve quality of life. Treatment selection should be guided by disease severity and activity. Pharmacologic therapies include antibiotics, biologics, small-molecule agents, retinoids, and immunosuppressants, while adjunctive approaches include surgical interventions and energy-based therapies. This updated consensus aims to standardize the diagnosis and management of HS/AI in China and to improve clinical practice by providing a stepwise, multidisciplinary treatment framework in which interventions are stratified according to disease severity and recommendation strength. Recommendation strength was determined by expert voting: an agreement rate of ≥85% indicated “Should be recommended,” ≥75% to <85% indicated “Could be recommended,” ≥50% to <75% indicated “May be considered,” and <50% indicated “No consensus reached.” Key recommendations reaching the ≥85% agreement threshold included severity-based treatment selection, topical clindamycin for mild localized disease, systemic tetracyclines for mild-to-moderate HS/AI, and biologics, including adalimumab, secukinumab, and bimekizumab, for moderate-to-severe disease. The consensus has been registered on the International Practice Guidelines Registry Platform (No: PREPARE-2025CN1964).
Objective: Rosacea severity assessment lacks objective, quantitative tools. The Multispectral Facial Imaging System (MFIS) can quantify red region area and red pigment concentration, but its utility in rosacea remains unverified. This study examined correlations between MFIS-derived parameters and clinical assessment scores, and explored its potential as an objective adjunctive tool. Methods: This cross-sectional study included individuals with facial rosacea in the Affiliated Hospital of Inner Mongolia Medical University between June 15, 2022, and March 1, 2024. All participants underwent comprehensive facial imaging using the MFIS, followed by evaluation with five scales: Investigator’s Global Assessment (IGA), Clinician’s Erythema Assessment (CEA), Flushing Assessment Tool (FAST), Global Flushing Severity Scale (GFSS), and telangiectasia scoring. Correlation analyses were then conducted between physician-assessed values and system-derived values. Results: A total of 108 patients were included (mean age, 42.45 ± 9.97 years; 24 male). Subtypes included erythematotelangiectatic rosacea (ETR, 35/108[32.4%]), papulopustular rosacea (PPR, 46/108[42.6%]), phymatous rosacea (PhR, 5/108[4.6%]), and mixed features (22/108[20.4%]). In the cohort, red region area and red pigment concentration significantly correlated with IGA, CEA, GFSS, FAST, and telangiectasia score (ρ =0.881, 0.608, 0.565, 0.792, 0.438, and 0.586, 0.634,0.411, 0.473, 0.407, all P < 0.010). In ETR, both parameters significantly correlated with all five scales (ρ = 0.860, 0.571, 0.551, 0.648, 0.680, and 0.655, 0.735, 0.568, 0.586, 0.746; all P < 0.001). In PPR, red region area significantly correlated with IGA, CEA, GFSS, and FAST (ρ = 0.917, 0.619, 0.498, and 0.789, respectively; all P < 0.001), but not telangiectasia score (ρ = 0.270, P = 0.077). Red pigment concentration significantly correlated with IGA, CEA, GFSS, and FAST (ρ = 0.565, 0.600, 0.358, and 0.396, respectively; P < 0.001, P < 0.001, P = 0.018, and P = 0.009, respectively), but not telangiectasia score (ρ = 0.138, P = 0.360). In PhR, neither red region area nor red pigment concentration was significantly correlated with any clinical assessment scale (all P > 0.05). Conclusion: MFIS-derived parameters correlate significantly with clinical assessment scores in rosacea, particularly in ETR. MFIS may serve as a potential objective adjunctive tool, though these findings are correlational and require prospective validation.
