BACKGROUND:Hyaluronic acid-based dermal fillers are commonly used to correct prominent nasolabial folds (NLFs), a hallmark of aging. OBJECTIVES:This study aimed to verify the effectiveness and safety of STYLAGE L filler (Laboratoires VIVACY, Archamps, France) vs a well-established comparator, Restylane (Galderma, Uppsala, Sweden), for correcting moderate-to-severe NLFs in Chinese subjects. METHODS:A 12-month, randomized, subject- and evaluator-blinded, controlled, parallel-group, noninferiority study was conducted across 8 hospitals in China. The primary endpoint was the percentage of Wrinkle Severity Rating Scale (WSRS) responders 6 months after last treatment. Secondary endpoints included Global Aesthetic Improvement Scale (GAIS) responders, subject satisfaction, device performance, and tolerance. RESULTS:In total, 194 and 196 subjects were randomly allocated to the treatment (STYLAGE L) and control (Restylane) groups, respectively, and analyzed. In the primary endpoint analysis, noninferiority of STYLAGE L was demonstrated because the lower limit of the 95% CI was greater than -10% (difference in percentage of responders, 9.33%; 95% CI, 2.10%-16.56%). WSRS responder rates were statistically significantly higher in the treatment compared with the control group at 6 months (9.19%; 95% CI, 1.85%-16.54%; P = .0157), 9 months (19.75%; 95% CI, 10.97%-28.53%; P < .0001), and 12 months (11.36%; 95% CI, 2.64%-20.09%; P = .0116). GAIS responder rates were high in both groups throughout the study (>73%). Subject satisfaction was high. Both devices were well tolerated. Device performance scores were statistically significantly higher (ie, aspects were "harder") for STYLAGE L vs Restylane. CONCLUSIONS:The study demonstrated the noninferiority of STYLAGE L vs Restylane in correcting NLFs in Chinese subjects. Results up to 12 months suggest comparable safety and effectiveness profiles. LEVEL OF EVIDENCE: 1 (THERAPEUTIC):

BACKGROUND:Masseter muscle prominence (MMP) may be aesthetically bothersome to some individuals, leading them to seek treatment for a slimmer lower face. OBJECTIVES:The aim of this study was to evaluate the safety and efficacy of onabotulinumtoxinA for the treatment of MMP, including patient-reported outcomes (PROs). METHODS:This was a prospective, multicenter trial including a randomized, double-blind, placebo-controlled period (Days 1-180) in which adults rated Grade 4 or 5 (marked/very marked) on the investigator-assessed MMP Scale (MMPS) were randomized to onabotulinumtoxinA 72 U or placebo. Efficacy endpoints were assessed at Day 90. The primary endpoint was ≥2-grade improvement from baseline on the investigator-assessed MMPS. Secondary endpoints included achieving Grade ≤3 on the MMPS and participant-assessed MMPS-Participant (MMPS-P), ≥2-grade improvement on the participant-assessed MMPS-P, and change from baseline in lower-facial width. Outcomes were assessed using validated measures. Adverse events (AEs) were monitored. RESULTS:Of 376 enrolled participants (onabotulinumtoxinA, n = 283; placebo, n = 93), 310 (82.4%) completed the study. At Day 90, a greater proportion of onabotulinumtoxinA-treated participants vs placebo achieved MMPS ≥2-grade improvement (51.2% vs 2.2%, P < .0001), and more onabotulinumtoxinA-treated participants vs placebo achieved the secondary endpoints (all P < .0001), with a mean lower-facial width reduction of -5.24 mm for onabotulinumtoxinA vs -0.04 mm for placebo (P < .0001). Participants reported benefits for onabotulinumtoxinA vs placebo in self-perceived change in MMP, treatment satisfaction, and psychosocial impact. Improvements were sustained through Day 180. Most AEs were mild, nonserious, and resolved. CONCLUSIONS:OnabotulinumtoxinA effectively reduced the appearance of MMP and improved PROs, with effects lasting up to 6 months and a favorable safety profile. LEVEL OF EVIDENCE: 1 (THERAPEUTIC):

BACKGROUND:Infraorbital hollowing (IOH) is characterized by a sunken appearance of the lower eyelid. The soft tissue filler VYC-15L has been demonstrated to be effective in correcting IOH in US and European populations. OBJECTIVES:The aim was to assess the safety and effectiveness of VYC-15L treatment in Chinese adults with moderate to severe IOH. METHODS:In this randomized, multicenter, 12-month study, the primary endpoint was the proportion of ≥1-grade improvements on the Allergan Infraorbital Hollowing Scale (AIHS) according to the evaluating investigator (EI) at Month 3. Secondary endpoints included EI-based and participant-based assessments with the Global Aesthetic Improvement Scale (GAIS) and FACE-Q responses evaluated at Month 3. Safety was monitored throughout. RESULTS:The primary endpoint was met with a 94.6% AIHS responder rate in the VYC-15L group vs 0.0% in the delayed-treatment control (DTC) group (P < .0001). Significant GAIS improvements in VYC-15L vs DTC participants were seen in EI-assessed (99.1% vs 0.0%) and participant-assessed (95.6% vs 5.7%) responder rates at Month 3 (P < .0001). The mean change in FACE-Q scores was greater in the VYC-15L group than the DTC group at Month 3 (P < .0001). Improvements from VYC-15L treatment were seen across all effectiveness measures through Month 12. Mean pain scores were 2.9. Most injection site reactions were mild and resolved within 14 days. Forty-six participants (28.8%) experienced treatment-emergent adverse events (TEAEs), including treatment-related TEAEs (1.7%), which were blepharospasm (0.8%) and injection site bruising (0.8%). No serious TEAEs were reported. CONCLUSIONS:VYC-15L was effective and well tolerated for IOH correction in Chinese adults over up to 1 year. LEVEL OF EVIDENCE: 1 (THERAPEUTIC):

BACKGROUND:OnabotulinumtoxinA has been licensed for the treatment of upper facial lines for over 20 years. Patient benefits extend well beyond correction of the lines themselves-including positive effects on confidence, self-esteem, feelings of attractiveness, and age appearance. Regulatory bodies recommend that patient-reported outcomes (PROs) are routinely included in registrational studies to ensure the patient perspective is considered. Essential guidance is available from regulators and other expert groups to aid the development, validation, and use of appropriate PROs. AIMS:To reflect on the evolution of patient experience data collection in onabotulinumtoxinA aesthetic medicine development programs within the context of PRO usage across approved botulinum toxins. METHODS:Literature searches were performed to identify relevant publications. RESULTS:Several PRO instruments have been rigorously developed and validated following regulatory guidance and implemented in onabotulinumtoxinA clinical programs. These include the Facial Line Outcomes Questionnaire (FLO-11) and Facial Line Satisfaction Questionnaire (FLSQ). The data generated have supported the licensing process and enabled a deeper understanding of patient perspectives. Although these instruments were developed for clinical studies, the concepts obtained directly from patient interviews align with patient goals in clinical practice. Similarly, PROs such as FACE-Q are now employed more widely across approved botulinum toxins. CONCLUSIONS:A patient-centric approach, in lockstep with regulatory requirements, has been central to onabotulinumtoxinA development. Awareness of the comprehensive benefits of aesthetic treatments should continue to improve based on increasingly robust PROs.

Background:Current standard beauty practices in East Asia focus on enhancing and refining Asian features within cultural normalities. Methods:This pilot study presents injection techniques using hyaluronic acid filler (YVOIRE), focusing on East Asian facial balance factors (line, angle, and proportion of the face). The Balance-L injection technique is suggested to achieve single convexity of the outer contour. The Balance-A technique is suggested to modify the profile angles, and the Balance-P technique is suggested to modify facial proportions. Five East Asian female patients gave written informed consent for the procedures and use of their photographs. Physicians used the Balance injection technique as per the patients' concerns and desired outcomes. Results:Adapting the Balance-L technique, nasolabial fold and marionette lines were treated to achieve a natural look in patient 1. A harmonious profile was achieved in patient 2 by treating forehead, nose, and chin guided by the Balance-A technique. Patients 3-5 were treated using the Balance-P technique. Overall sagging was corrected by treating the anteromedial malar in patient 3. In patient 4, a dimensionally balanced face was achieved by treating the nose, chin, frontotemporal junction, anteromedian malar, and deep pyriform space. A younger and tighter appearing face was achieved in patient 5 by treating the nose, nasolabial folds, deep pyriform space, nasal dorsum and radix, and cheek. Conclusions:The Balance injection technique for hyaluronic acid filler administration may help the achievement of East Asian-specific beauty standards of contour, angle, and proportion. Further study is required to confirm the findings of this pilot study.

BACKGROUND AND OBJECTIVES:Dyslipidemia has been reported to contribute to the psoriasis pathogenesis. Thus, evinacumab, a novel lipid-lowering drug targeting angiopoietin-like 3, may have therapeutic potential to treat and/or manage psoriasis. METHODS AND STUDY DESIGN:Summary statistics were obtained from genome-wide association studies addressing psoriasis (FinnGen Consortium; n=216,752) and serum lipid concentrations (United Kingdom Biobank; n=403,943-440,546). Two-sample Mendelian randomization analyses were conducted to evaluate the associations of serum lipid concentrations and genetically mimicked effects of evinacumab, respectively, with the risks of psoriasis and its subtypes. RESULTS:Genetically determined per standard deviation increase in triglyceride concentrations was associated with increased risk of psoriasis (OR: 1.17, 95% CI: 1.03-1.32, p=0.018), whereas that in low-density lipoprotein-cholesterol (LDL-C) was associated with both psoriasis (OR: 1.22, 95% CI: 1.05-1.43, p=0.011) and its subtypes, including arthropathic psoriasis (OR: 1.30, 95% CI: 1.02-1.65, p=0.032), psoriasis vulgaris (OR: 1.87, 95% CI: 1.16-2.99, p=0.0095), and guttate psoriasis (OR: 2.19, 95% CI: 1.17-4.07, p=0.014). Moreover, genetically mimicked effects of evinacumab, via angiopoietin-like 3 inhibition, significantly reduced the risk of psoriasis (OR: 0.752 per standard deviation reduction in triglycerides, 95% CI: 0.577-0.982, p=0.036) and arthropathic psoriasis (OR: 0.266 per standard deviation reduction in LDL-C, 95% CI: 0.0886-0.799, p=0.018). CONCLUSIONS:The genetically mimicked effect of evinacumab has the potential to reduce the risk of psoriasis and arthropathic psoriasis by lowering circulating triglyceride and LDL-C concentrations, respectively. These findings suggest that evinacumab may help prevent psoriasis and psoriatic arthritis progression in clinical practice.

Introduction:The periorbital region is highly susceptible to aging, manifesting as wrinkles, skin laxity, and under-eye bags due to collagen loss and fat displacement. Vacuum-assisted multi-frequency bipolar radiofrequency (RF) offers precise energy delivery, effectively stimulating collagen remodeling while ensuring safety and patient comfort. Objective:This study aimed to evaluate the efficacy and safety of a bipolar RF device with channeling optimized RF energy (CORE™) technology and vacuum assistance for periorbital rejuvenation. Patients and Methods:A prospective, single-center trial enrolled 28 participants (18-60 years), receiving four treatments at three-week intervals. Efficacy was assessed through Fitzpatrick Wrinkle Scale (FWS), Investigator Global Assessment (IGA) scores, and objective skin parameters (hydration, elasticity, gloss), alongside participant self-assessments. Safety was evaluated via adverse events (AEs) and pain scores (VAS). Results:Among 22 participants who completed the study, 95.46% achieved ≥25% improvement in FWS scores (mean reduction: -1.55 ± 0.50), with significant wrinkle reduction from the second treatment (p < 0.001). IGA scores showed visible improvement in under-eye bags, while skin hydration and elasticity increased. About 90.91% of participants reported high satisfaction, and 91.3% rated pain ≤1, with no AEs reported. The total observation period was approximately 12 weeks, including four treatment sessions and a three-week follow-up after the final session. Conclusion:Bipolar RF treatment with CORE technology and vacuum assistance is a safe and effective non-invasive modality for improving periorbital wrinkles and under-eye bags. By promoting collagen remodeling and skin tightening, this technology offers significant clinical and aesthetic benefits with minimal discomfort and no adverse events.

BackgroundAcne vulgaris significantly affects young individuals globally, with its onset associated with an increased prevalence of C acnes, a naturally occurring skin bacterium. In light of the rising concerns regarding antibiotic resistance and the potential for adverse effects, pharmacological interventions may not consistently represent the most suitable option. Nonpharmacological approaches, such as microneedling, offer promising alternative treatment modalities. Furthermore, the integration of postbiotics in skincare formulations for acne management has gained traction recently. Nonetheless, there remains a lack of sufficient evidence to establish the efficacy and safety of postbiotics when combined with microneedling.ObjectiveTo assess the clinical effectiveness of a postbiotic formulation combined with microneedling in mild-to-moderate facial acne vulgaris.MethodsTwenty Chinese patients were enrolled, all received one treatment and were monitored 4 weeks posttreatment. The evaluation assessed symptom improvement, treatment safety, and patient satisfaction.ResultsThe global acne grading system (GAGS) score decreased more than half based on the baseline. Clinical photographs following treatment revealed improved the skin lesions and brightened skin tone. Statistics from VISIA showed excellent improvement in speckle, pore, red region, and porphyrin. No significant adverse reactions have been reported during the treatment period. Additionally, more than 85% were very satisfied or satisfied with the outcome.ConclusionOur results showed that the postbiotic formulation combined with microneedling may benefit the restoration of the skin barrier and the equilibrium of skin microbiota. This approach may help mitigate inflammation and address skin lesions, presenting a promising therapeutic avenue for the prevention and management of acne vulgaris.

Background: Since its discovery as a facial aesthetic treatment [ 30 years ago, onabotulinumtoxinA has received worldwide approval for dynamic upper facial line treatment. Objective: Meta-analysis examining the safety of onabotulinumtoxinA for treatment of glabellar lines (GL), crow's feet lines (CFL), and forehead lines (FHL). Methods: Participants (N N = 5298) with moderate to severe GL, CFL, or FHL at maximum contraction received onabotulinumtoxinA or placebo in 1 of 18 registration studies (14 double-blind, placebo- controlled [DBPC]; 1 double-blind; 3 open-label). Adverse events (AEs) were analyzed by descriptive statistics and fixed-effects meta-analysis. Results: In the overall double-blind placebo-controlled (DBPC) population, AEs were reported in 1443 (42.1%) and 486 (35.8%) participants in the onabotulinumtoxinA (n n = 3431) and placebo (n n = 1359) groups, respectively. Serious AEs were reported in 54 (1.6%) and 17 (1.3%) participants; 1 (spontaneous abortion) was considered possibly treatment related by the investigator. Using fixed-effects statistical meta-analysis, AEs of interest that were found to be statistically higher for onabotulinumtoxinA than placebo in the DBPC population were eyelid ptosis, eyelid sensory disorder, skin tightness, brow ptosis, eyelid edema, and facial pain (P P <= .05). Limitations: Retrospective, ad hoc analysis. Conclusion: This meta-analysis confirms the onabotulinumtoxinA safety profile for GL, CFL, and FHL treatment, with no new onabotulinumtoxinA-associated AEs. ( JAAD Int 2024;14:4-18.)

Various botulinumtoxinA formulations are approved for glabellar lines treatment worldwide, including abobotulinumtoxinA (Dysport®). Assess abobotulinumtoxinA superiority versus placebo and non-inferiority versus active comparator (onabotulinumtoxinA; Botox®), for the treatment of Chinese patients with moderate/severe glabellar lines. Phase 3, randomized study (NCT02450526) comprising a double-blind (cycle 1) phase and an open-label (cycles 2−5) phase. Patients received abobotulinumtoxinA 50 units or matching placebo (5:1), active comparator (onabotulinumtoxinA 20 units) or matching placebo (5:1). In cycles 2–5, eligible patients were retreated with abobotulinumtoxinA only. Responders had glabellar lines of none/mild severity. Primary endpoint: responder rates at cycle 1, day 29 at maximum frown with abobotulinumtoxinA versus placebo (for superiority; by investigator’s live assessment [ILA] and subject’s self-assessment [SSA]), and versus active comparator (for non-inferiority; by ILA). Treatment-emergent adverse events were recorded. Overall, 520 patients were randomized. Superiority and non-inferiority, respectively, were demonstrated for abobotulinumtoxinA versus placebo (ILA, SSA; both p < 0.0001) and abobotulinumtoxinA versus active comparator. AbobotulinumtoxinA efficacy was maintained over open-label cycles; median time to onset of efficacy was 2.0 days. After 6 months, 17 www.springer.com/00266 . Botulinum toxin injections can be used to smooth frown lines that appear between the eyebrows (known as glabellar lines) in patients who have moderate or severe frown lines. This study looked at how injections of a botulinum toxin (abobotulinumtoxinA [aboBoNT-A]) could help with smoothing frown lines in patients from China compared with an injection of another botulinum toxin called onabotulinumtoxinA (onaBoNT-A) or placebo (saltwater, no treatment). The study included 520 patients from China, 18–65 years old, who had moderate or severe frown lines. All patients received a first injection of either aboBoNT-A, onaBoNT-A, or saltwater, and were studied for 12 weeks. After the first injection, patients could receive up to four more injections of aboBoNT-A, given at 12-week intervals, if their frown lines became moderate or severe again. Most patients (92

该文内容涵盖痤疮临床发病机制到防治等6个部分共100个问题.第一部分主要包括了痤疮概述、痤疮病因及发生机制、痤疮临床表现与分级等共计35个问题,拟以通俗语言诠释痤疮临床诊治中的相关疑问,为广大基层皮肤科医师快速掌握痤疮诊治及规范化诊疗提供依据.

In Asian populations, an oval face shape with a slimmer lower face is considered favorable. Botulinum toxin type A (BoNT-A) treatment of the lower face for aesthetic purposes is widely performed in Asia, although it is not officially approved for this indication in any country. In this review, the authors highlight recent research describing injection techniques, mechanism of action, clinical efficacy, and key learning points to safely treat benign masseter muscle prominence (MMP) in Asian populations using BoNT-A. To support the existing literature, clinical examples are provided that demonstrate individualized treatment plans for patients with asymmetric vs symmetric MMP and an observed complication after treatment. This review provides insights for optimizing clinical outcomes and for designing future studies investigating the safety and efficacy of BoNT-A for treating MMP.

该文内容涵盖痤疮临床发病机制到防治等6个部分共100个问题.第一部分主要包括了痤疮概述、痤疮病因及发生机制、痤疮临床表现与分级等,共计35个问题;第二部分主要包括了痤疮临床的中西医治疗等相关内容,共计30个问题;第三部分主要包括了痤疮患者教育和科学护肤等内容,共计35个问题.拟以通俗语言诠释痤疮临床诊治中的相关疑问,为广大基层皮肤科医师快速掌握痤疮诊治及规范化诊疗提供依据.

Background:. This study evaluated the efficacy and safety of IncobotulinumtoxinA 20 U for treatment of glabellar frown lines in Chinese subjects. Methods:. This was a prospective, randomized, double-blind, active-controlled, phase-3 study conducted in China. Subjects with moderate to severe glabellar frown lines at maximum frown were randomized to receive IncobotulinumtoxinA (N = 336) or OnabotulinumtoxinA (N = 167). Results:. For the primary efficacy endpoint at day 30, response rates at maximum frown (score “none” or “mild”) on the Merz Aesthetic Scales Glabella Lines – Dynamic were comparable between IncobotulinumtoxinA (92.5%) and OnabotulinumtoxinA (95.1%) per investigator’s live rating. Noninferiority of IncobotulinumtoxinA versus OnabotulinumtoxinA was successfully demonstrated, as the two-sided 95% confidence interval of −0.97% to 0.43% for the difference in Merz Aesthetic Scales-based response rates (−0.27%) lay completely above the predefined noninferiority margin of −15%. For the secondary efficacy endpoints assessed at day 30, Merz Aesthetic Scales-based response rates (score “none” or “mild”) at maximum frown were similarly comparable between both groups per subject (>85%) and independent review panel (>96%) rating. Per Global Impression of Change Scales, greater than 80% of subjects and greater than 90% of investigators in both groups rated treatment results as at least “much improved” at day 30 compared with baseline. Safety profiles were consistent between groups; IncobotulinumtoxinA was well tolerated, and no new safety concerns were identified in Chinese subjects. Conclusion:. IncobotulinumtoxinA 20 U is safe and effective for treatment of moderate to severe glabellar frown lines at maximum frown in Chinese subjects and is noninferior to OnabotulinumtoxinA 20 U.

Dear Editor, Psoriasis and seborrheic dermatitis (SD) are common skin inflammatory diseases, which were difficult to discriminate due to similar clinical features, especially when the scalp is the only area involved. The pathogenesis also has some common immunological and biomolecular pathways as these two conditions are considered to be driven by the Th17 response and related to dysbiosis of the skin microbiome.1-3 In this study, we aim to characterize and compare the skin microbial communities of the two diseases. We recruited 45 patients with SD, 37 patients with psoriasis and 30 healthy controls. The study protocol was approved by the Institutional Review Board of Peking University First Hospital. All participants provided written informed consent prior to participation. Patients above 21 years and diagnosed with psoriasis or SD involving the scalp were eligible for this study. The diagnosis of psoriasis and SD was based on characteristic clinical and dermoscopic signs of the affected skin, and histopathological examination was performed if necessary. None of the participants had used topical or systemic antifungals or antibiotics in the past 3 months. Skin swabs were collected from the scalps at lesional and nonlesional sites. Amplicon sequencing and analyses were performed as previously described.4 No significant differences were detected in the age and sex ratio among groups (Table 1). Analysis on bacterial diversity showed the Shannon diversity was significantly increased in psoriasis lesions compared with SD lesions and controls. No significant differences in fungal diversity were observed among groups (Figure 1A,B). Principal coordinates analyses did not show clear separations among the disease groups; however, healthy bacterial communities appear to be more similar among samples in comparison with psoriasis and SD communities (Figure 1C,D). ANOSIM was calculated showing significantly higher dissimilarities between groups compared with dissimilarities within groups (R = 0.077, p < 0.001, Figure S1). The fungal taxonomic profiles revealed that Malassezia was the predominant fungal genus in all groups. The relative abundance of Malassezia was slightly higher in lesions of SD than psoriasis, though no statistical significance was detected. Increased relative abundances of Fusarium and Phoma and decreased relative abundance of Chaetomidium were observed in the lesions of psoriasis compared with SD (Figure 1H). Species level analysis showed an increasing trend in the relative abundance of unidentified Malassezia/M. globosa ratio in the lesions of both diseases compared with controls (Figure 1I). Candida tropicalis was significantly higher in psoriasis lesions than in SD lesions (Figure 1J). Analysis of the bacterial microbiome showed higher relative abundance of Staphylococcus and lower relative abundance Cutibacterium in the lesions of both diseases than controls and their nonlesional sites (Figure 1E–G). Compared with SD lesions, significantly higher relative abundances of Streptococcus, Corynebacterium and Psychrobacter were observed in psoriasis lesions. Next, we used receiver operating characteristic curve analysis to discriminate SD and psoriasis. Based on a random forest algorithm, we could accurately differentiate the two diseases using the top 10 most abundant bacterial and fungal genera (area under the curve: 0.98, sensitivity: 0.96, specificity: 0.72) or the most abundant fungal species (area under the curve: 0.97, sensitivity: 0.72, specificity: 1.0) (Figure 1K,L, Figure S2). The disease and healthy states could also be accurately discriminated using a random forest algorithm (Figure S3). In this cross-sectional study, we have shown that both SD and psoriasis are characterized by alterations in the bacterial and fungal community. Comparison of the skin microbiome between psoriasis and SD reveal distinct pattern of microbial community alterations, especially in the level of Streptococcus, Corynebacterium, Psychrobacter and Candida. Candida has been shown to be involved in the pathogenesis of psoriasis by promoting tissue inflammation in a Candida-specific Th7/Langerhans cell-dependent manner.5 Streptococcus and Corynebacterium, whose levels are found elevated in psoriatic lesions, have been demonstrated to be associated with the exacerbation of psoriasis by direct binding of their superantigens to human cells, or inducing higher intensities of IL-23, IL-1β and dermal gdT17 cells.6, 7 In contrast to psoriasis, SD is more likely to be associated with disequilibrium of Malassezia species, though controversy exists between studies.3 Overall, our study shows that lesions of SD have microbiome signatures distinct from those of psoriatic lesions. Corynebacterium, Streptococcus and Candida could be potential biomarkers for identifying the two diseases. However, whether microbial shifts are a cause or consequence of the pathogenic process is unknown. Future studies focusing on specific microorganisms and the inflammatory responses may provide new ideas for explaining the pathogenesis of the two diseases. R.T, R.W., R.L. and Y.W designed the research study. R.T. involved in writing—original draft preparation. R.W. involved in writing— review and editing. R.T and R.W. analysed the data and performed the research; Z.W contributed essential experimental tools; R.L. and Y.W involved in supervision. All authors have read and agreed to the published version of the manuscript. This work was supported by the National Natural Science Foundation of China (81903225). The authors Rong Tao, Ruoyu Li, Zhe Wan, Yan Wu and Ruojun Wang declare no conflicts of interest. Figure S1 ANOSIM (ANalysis of Similarities) showing dissimilarities between groups compared to dissimilarities within groups. Figure S2 (a) Receiver operating characteristic (ROC) curve using the top 10 abundant fungal species based on a machine learning random forest algorithm to discriminate seborrheic dermatitis and psoriasis. (b) Mean decrease accuracy of taxas showing the predictive features to classify psoriasis and SD. SD: seborrheic dermatitis. Figure S3 (a) Receiver operating characteristic (ROC) curve using the top 10 abundant bacterial and fungal genera based on a machine learning random forest algorithm to discriminate seborrheic dermatitis and healthy controls. (b) ROC curve to discriminate psoriasis and healthy controls. HC: healthy control; SD: seborrheic dermatitis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

目的:观察复方非交联透明质酸通过滚针后涂抹、真皮内注射、联合真皮内注射和滚针后涂抹等不同给药方式对小鼠皮肤生理指标和组织病理的改变,探究非交联透明质酸不同给药模式对皮肤的作用和可能的作用机制.方法:C57BL/6小鼠随机分为3组,每组小鼠两侧皮肤接受不同处理,共6个处理组:CNCLHA真皮注射组(真皮内注射复方非交联透明质酸),CNCLHA真皮注射联合滚针涂抹组(注射联合滚针涂抹复方非交联透明质酸),CNCLHA滚针涂抹组(滚针涂抹复方非交联透明质酸),0.9％生理盐水滚针涂抹组(滚针涂抹0.9％生理盐水),0.9％生理盐水注射组(注射0.9％生理盐水),空白对照组(不做任何处理).在给药前、第7、14天进行注射和滚针治疗,在给药前和第28天检测小鼠皮肤生理指标[角质层含水量、皮肤弹性、经皮水分丢失(Transepidermal water loss,TEWL)],第28天取小鼠皮肤进行组织病理,以及Western blot和RT-PCR研究,观察Ⅰ型胶原和α-平滑肌肌动蛋白(α-SMA)在蛋白和基因水平的变化.结果:与基线(空白对照组)相比,第28天CNCLHA真皮注射联合滚针涂抹组和CNCLHA滚针涂抹组角质层含水量、弹性升高,TEWL降低,CNCLHA真皮注射组仅弹性升高,TEWL降低,差异有统计学意义(P<0.05).组织病理及特染结果示滚针治疗组均有表皮增厚;CNCLHA真皮注射组、CNCLHA真皮注射联合滚针涂抹组、CNCLHA滚针涂抹组均有不同程度的真皮增厚,胶原纤维、弹力纤维增生;CNCLHA真皮注射组、CNCLHA真皮注射联合滚针涂抹组透明质酸增多,其中CNCLHA真皮注射联合滚针涂抹组在各方面改善均最明显.Western blot示与空白对照组相比,第28天CNCLHA真皮注射组、CNCLHA真皮注射联合滚针涂抹组、CNCLHA滚针涂抹组、0.9％生理盐水滚针涂抹组、0.9％生理盐水注射组Ⅰ型胶原蛋白增多,CNCLHA真皮注射组、CNCLHA真皮注射联合滚针涂抹组、CNCLHA滚针涂抹组、0.9％生理盐水滚针涂抹组α-SMA增多,差异有统计学意义(P<0.05).RT-PCR示CNCLHA真皮注射组、CNCLHA真皮注射联合滚针涂抹组、CNCLHA滚针涂抹组小鼠皮肤中α-SMA表达量较空白对照组上升,差异有统计学意义(P<0.05).结论:滚针后涂抹复方非交联透明质酸能刺激表皮增生,增加角质层含水量,在促进皮肤屏障的修复方面有效,可以部分上调Ⅰ型胶原蛋白、α-SMA的合成;真皮注射复方非交联透明质酸可以通过刺激Ⅰ型胶原蛋白、α-SMA表达,促进真皮胶原纤维、弹力纤维和基质再生,增加皮肤弹性;联合真皮内注射和滚针后涂抹复方非交联透明质酸对于表皮和真皮均有作用,且效果更佳.

目的:观察两种含有神经酰胺的保湿剂对于干性皮肤屏障功能的影响,以及保湿效果和安全性.方法:采用随机、双盲、自身左右、阳性对照试验.选取33名受试者,每日早晚于双侧小腿分别使用试验产品(含有混合神经酰胺保湿剂)及对照产品(含有单一神经酰胺保湿剂),连续使用14 d后停用3 d,以观察产品的长期效果.在基线(D0)、使用后第1天(D1)、第7天(D7)、第14天(D14)、第17天(D17)分别进行数码相机拍照、检测角质层含水量和经皮水分丢失率(TEWL),同时研究者和受试者主观评价,并记录不良反应.结果:在使用试验产品及对照产品后各时间点角质层含水量均高于基线水平、TEWL均低于基线水平.组间比较显示试验侧角质层含水量在第17天显著优于对照侧(试验侧和对照侧比基线分别升高8.58±0.77和6.11±0.45,差异有统计学意义(P<0.05).试验侧第7天和第17天TEWL相比基线降低的程度显著优于对照侧(第7天中位数分别为1.57和1.54,第17天分别为1.24和1.10),差异均有统计学意(P<0.05).研究者和受试者的主观评价显示两侧各时间点与基线相比,皮肤干燥、脱屑和瘙痒评分均有改善,有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05).所有受试者在使用过程中均未出现明显不良反应.结论:试验产品及对照产品对于改善轻中度干性皮肤的干燥症状和修复皮肤屏障功能安全有效,含有混合神经酰胺的试验产品保湿效果更持久.

Seborrhoeic dermatitis (SD) is a common chronic inflammatory dermatosis. Current theories on the pathogenesis of SD highlight the role of microbes on the skin surface. Ketoconazole is commonly used for the treatment of SD; however, there are limited data focusing on the effects of ketoconazole in shaping the skin microbiome in patients with SD.