Background: Viral skin diseases, particularly those caused by human papillomavirus (HPV), represent a major component of the global burden of infectious dermatoses. However, long-term global trends and socioeconomic inequalities remain insufficiently characterized.Methods: Data were obtained from the Global Burden of Disease Study 2021, covering approximately 7.97 billion individuals. Incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs) were analyzed. Age-standardized rates were calculated, and temporal trends were assessed using Joinpoint regression to estimate average annual percentage changes (AAPCs). Socioeconomic inequality was evaluated using the Slope Index of Inequality (SII) and Concentration Index (CI). Analyses were stratified by age, sex, country, region, and Socio-Demographic Index (SDI).Results: Between 1990 and 2021, the global incidence, prevalence, and DALYs of viral skin diseases increased by 32.27%, 36.29%, and 35.81%, respectively. The age-standardized incidence rate declined slightly from 1134.3 to 1126.3 per 100,000. Increased age-specific incidence was observed among children < 15 years and adults aged 50–65 years and 85–95 years, with consistently higher rates in males. Geographically, incidence and prevalence were highest in Germany and lowest in Israel. Burden indicators were generally greater in high-SDI regions, whereas lower-middle SDI regions showed continued growth. Projections indicate stable age-standardized incidence through 2046, with case numbers rising until around 2030 before plateauing.Discussion: The increasing absolute burden despite stable standardized rates reflects population growth and aging. Disparities across SDI regions highlight the roles of socioeconomic factors and healthcare access. Although vaccination and antiviral advances have improved viral disease control in high-SDI regions, limited resources and healthcare disruptions constrain progress in low- and middle-SDI regions, underscoring the need for targeted, equitable interventions.Conclusions: Viral skin diseases remain a substantial and evolving global health burden. Persistent age-, sex-, and socioeconomic-related disparities highlight the need for targeted prevention strategies and strengthened public health policies.
Alopecia areata (AA) is an autoimmune, non-scarring hair loss disorder caused by collapse of hair follicle immune privilege and T cell-mediated inflammation. It affects individuals of all ages and carries substantial psychological and social burden. The condition shows marked heterogeneity in presentation and prognosis, influenced by genetic, immune, and environmental factors. The 2026 Chinese Guidelines for AA provide updated, evidence-based recommendations spanning diagnosis, severity assessment, and management. It endorses a multidimensional evaluation that integrates scalp involvement, extra-scalp features, treatment response, and psychosocial impact to guide individualized care. Therapeutic pathways cover topical, intralesional, and systemic options, including corticosteroids, Janus kinase (JAK) inhibitors, and selected biologics, with adjunctive modalities such as light-based therapies, microneedling, platelet-rich plasma, and oral minoxidil. For children, topical corticosteroids remain first-line; JAK inhibitors or biologics may be considered in carefully selected severe cases with appropriate monitoring. The guideline emphasizes long-term follow-up, screening and management of comorbidities, and shared decision-making to improve quality of life. It further highlights the need for research into biomarkers and novel therapeutic targets to fuel continued iterations on treatments for AA.
