Inflammation-associated skin lesions, including psoriasis (PsO) and diabetic foot ulcers (DFU), greatly impair patients' quality of life. Gentiopicroside (GPS), a key iridoid glycoside from Gentiana species, exhibits anti-inflammatory, antioxidant, and wound-healing properties, but its clinical application is limited by low oral bioavailability and poor skin permeability. Nanodelivery strategies have been actively explored to overcome these limitations. The objective of this review was to critically analyze recent breakthroughs in GPS-loaded nanodelivery approaches for the treatment of inflammation-associated skin lesions, especially PsO and DFU, including the impact of these approaches on GPS bioavailability, efficacy, and safety profile. Oral bioavailability of GPS can be improved by poly (lactic-co-glycolic acid) (PLGA) nanospheres and phospholipid-complex self-nanoemulsifying drug delivery systems (PC-SNEDDS), while skin-targeted delivery and sustained release can be enhanced by chitosan (CHI) nanoparticles, electrospun nanofibers, ZIF-8 metal-organic frameworks, and nanoscale hydrogels. These nanodelivery technologies improve the translational potential of GPS for chronic inflammatory skin diseases. Although GPS-loaded systems have not yet entered clinical trials, analogous nanotechnologies have demonstrated enhanced drug stability, bioavailability, safety, and patient tolerability in treatments of other skin diseases, highlighting their strong potential for clinical translation. Future efforts toward clinical translation may focus on establishing common evaluation criteria, conducting full-scale toxicological and biodistribution tests, and implementing Good Manufacturing Practice (GMP)-scale-up projects with multicenter preclinical trials.

Psoriasis is a chronic systemic inflammatory disease that is increasingly seen in older patients. As the immune system ages, the mechanisms that normally keep immune responses in balance become less precise. The adaptive immune system is reshaped both quantitatively and structurally, whereas innate immunity becomes less well regulated rather than simply less active. Age-related changes in the skin microenvironment may also help sustain local inflammatory signaling. In older patients with psoriasis, these age-related immune changes intersect with the pathways already known to drive disease. Th17 and cytotoxic CD8⁺ T (Tc17) responses remain prominent, control of antigen-presenting cells (APCs) is less tightly regulated, and natural killer (NK) cell function is also altered. These changes help sustain inflammation and further compromise the epidermal barrier. Treatment decisions are made more complex by common comorbidities, especially cardiovascular disease and metabolic syndrome. Biologic agents targeting TNF-α, IL-12/23, IL-23, IL-17, and IL-36 have markedly expanded the therapeutic options for psoriasis. Direct evidence in older patients with psoriasis remains limited, but the studies available so far suggest that treatment efficacy is broadly comparable to that seen in younger populations. Even so, immune aging may still affect both susceptibility to infection and the likelihood of remaining on treatment over time. TNF inhibitors remain particularly useful in patients with systemic inflammatory comorbidities, although infection risk requires close attention. IL-12/23 inhibitors offer the advantage of dual cytokine blockade. Selective IL-23 inhibitors allow more focused control of Th17-driven inflammation while leaving Th1 function relatively preserved. IL-17 inhibitors are often associated with rapid clinical improvement, whereas IL-36 inhibitors may be particularly promising in pustular disease. Clarifying how immunosenescence shapes disease behavior and treatment response in older patients should make it easier to individualize therapy.

BackgroundDermoscopy is a noninvasive technique that has attracted increasing attention in the field of inflammatory skin diseases (such as psoriasis) in recent years.ObjectiveThis study aimed to provide an up-to-date overview of the role of dermoscopy in the diagnosis and extra-diagnosis of psoriasis.MethodsThis study sought to review the published literature regarding use of dermoscopy in the evaluation of psoriasis.ResultsThe diagnostic value of dermoscopy in psoriasis vulgaris, nail psoriasis, and other types of psoriasis was summarized from the aspects of vascular pattern, scale pattern, and other features. Meanwhile, the application value of dermoscopy in the differential diagnosis, efficacy and severity assessment, prediction and monitoring of psoriasis was discussed.ConclusionDermoscopy has good clinical value in the diagnosis and differential diagnosis of psoriasis and shows great prospects for severity assessment and efficacy prediction monitoring.

Psoriasis is closely associated with cardiovascular diseases (CVD). This study aimed to investigate the relationship between Life's Essential 8 (LE8), a latest measure of cardiovascular health (CVH), and psoriasis.This population-based cross-sectional study utilized data from the 2009–2014 National Health and Nutrition Examination Survey, including a total of 7,072 participants.Multivariable logistic regression models and restricted cubic spline models were used to evaluate these correlations.Out of the 7072 participants, 204 had psoriasis.Psoriasis patients exhibited lower LE8 scores compared to non-psoriasis patients.Across all models,the high-score(80–100) group was significantly associated with a lower incidence of psoriasis compared to the low-score(0–49) group, showing a notable negative correlation between the two(OR [95% CI]: 0.437[0.225,0.810]; P<0.05).The restricted cubic spline model showed a linear association, with an LE8 value inflection point at 64.786.Negative associations were found between both health behavior and health factor scores and psoriasis. Specifically, the negative correlation was most pronounced for the nicotine exposure score.Consistent results were additionally observed in both subgroup and supplementary analyses.LE8 scores and its subscale scores were inversely related to psoriasis. Our study emphasizes that promoting optimal CVH levels may be beneficial in preventing and alleviating psoriasis.

目的 观察清热除湿汤治疗带状疱疹肝经郁热证的临床疗效与安全性.方法 选取带状疱疹肝经郁热证患者56例,随机分为治疗组29例和对照组27例.治疗组给予中药清热除湿汤口服,每日1剂;对照组予盐酸伐昔洛韦片(每次0.3g,每日2次)、甲钴胺片(每次0.5mg,每日3次)、维生素B1(每次10 mg,每日3次)口服,两组疗程均为7天.于治疗前、治疗后记录症状或体征积分,治疗后判定临床疗效;于治疗前、治疗后、30天随访时、90天随访时记录疼痛视觉模拟法(VAS)评分,并记录两组患者水疱停止出现时间、全部结痂时间、全部脱痂时间、疼痛减轻时间、疼痛消失时间;观察并记录试验过程的不良事件发生情况,并检测肝功能、肾功能、血常规、尿常规.结果 治疗组临床疗效总有效率(82.76％)高于对照组(54.17％),差异有统计学意义(P＜0.05).两组患者VAS评分治疗前后差值、30天随访时与治疗前差值、90天随访时与治疗前差值比较差异均有统计学意义(P＜0.05),治疗组优于对照组.30天随访时治疗组后遗神经痛发生率为0,对照组为20.83％(5/24,P＜0.05),90天随访时治疗组后遗神经痛发生率为0,与对照组的4.17％(1/24)比较差异无统计学意义(P＞0.05).两组患者水疱停止出现时间、全部结痂时间、全部脱痂时间比较差异无统计学意义(P＞0.05).两组患者疼痛减轻时间、疼痛消失时间比较,治疗组短于对照组(P＜0.05).治疗期间两组均未出现严重不良反应,肝功能、肾功能及血常规、尿常规均未见异常.结论 清热除湿汤口服治疗带状疱疹肝经郁热证可明显减轻疼痛、促进皮疹愈合、缩短病程、减少后遗神经痛的发生,且安全性良好.

皮肤瘙痒是困扰老年人的常见症状,由其造成的不适感,对老年人的身心有着严重的影响.燕京赵氏皮科流派创始人赵炳南教授,以"善治湿者当治皮肤病之半"为基础,从湿论治急性、慢性迁延性老年皮肤瘙痒症,在临床上有着良好的疗效.笔者传承燕京赵氏皮科流派,现将治疗老年皮肤瘙痒症经验阐述如下,并举病案一则,以飨同道.

红皮病型银屑病为皮肤科疑难重症,皮损泛发全身,累及表皮较大面积,燕京赵氏皮科流派创始人赵炳南教授认为本病病位在血,血分热邪、血分毒邪、血分阴虚为3大关键因素.本病主因血分蕴热化火,进而内生或外受毒邪引动血分火邪,火毒炽盛,郁于营血,外发肌肤而来,后期迁延则以血分阴伤为主,正虚邪恋;治疗上赵炳南教授从血分出发,总以"清热、解毒、养阴"为纲,随病情发展,分期治以清热凉血,泻火解毒、清营护心,养阴益气、清解余邪.

儿童银屑病由多种因素共同诱发,由于小儿脏腑娇嫩,与成人相比治疗方法较为局限.中医药疗法安全有效,在儿童银屑病治疗中发挥重要作用.燕京赵氏流派学术传承人孙丽蕴教授在传承运用燕京赵氏皮科流派银屑病"从血论治"辨证体系基础上,总结出儿童银屑病多为"脾胃失和,血热内郁"发于肌肤所致,以"清热凉血、理脾消导"为基本治则.对孙教授治疗儿童银屑病经验进行了阐述,并附病案一则,以飨同道.

Purpose: In this study, we aimed to report the biological characteristics of the first successful synthesis of gentiopicroside-loaded chitosan nanoparticles and to evaluate the therapeutic effects and preliminary mechanisms of gentiopicrin-loaded chitosan on psoriasislike cell and mouse models.Methods: Gentiopicroside-loaded chitosan nanoparticles (CHI-GEN) were prepared, and their biological characteristics were evaluated.HaCaT keratinocytes were stimulated with TNF-α to establish a psoriatic keratinocyte model.MTT assay and flow cytometry were used to measure cell viability and apoptosis, respectively.mRNA levels of K17, VEGF A, and IL-6 and IL-23A were detected using qRT-PCR.These tests were used to preliminarily assess the effects of CHI-GEN on keratinocyte proliferation and inflammation.Imiquimod was used to construct a psoriasis-like mice model.The severity of psoriasis was scored based on the psoriasis area severity index (PASI), H&E staining was used to observe the histological changes and the level of inflammation and cell proliferation of skin lesions was evaluated by measuring the mRNA levels of K17, IL-23A, and IL-17A using qRT-PCR.Results: The average particle size of CHI-GEN nanoparticles was approximately 100 nm, and the zeta potential was 2.69 ± 0.87 mV.The cumulative release was 67.2% in solutions of pH 5.5 at 24 h.GEN reduced TNF-α-induced excessive proliferation of HaCaT keratinocytes and downregulated mRNA levels of K17, VEGF A, and inflammatory cytokines IL-6 and IL-23A, which was more obvious in the CHI-GEN treatment group.Additionally, CHI-GEN significantly improved the severity of skin lesions in psoriasis-like mice and downregulated the mRNA expressions of IL-6, IL-23A, and IL-17A in mice skin lesions. Conclusion:In conclusion, we successfully prepared gentiopicrin-chitosan nanoparticles.Our results show that these nanoparticles have anti-psoriasis activity, inhibits keratinocyte proliferation and improves symptoms in psoriasis model mice and can be used to develop an effective strategy for the treatment of psoriasis.

狼疮性脂膜炎,中医称之为"红蝴蝶疮""阴阳毒",其发病与阴阳失调关系密切,主要证型包括毒热炽盛证、阴血虚亏证、毒邪攻心证、肾阴亏损证、邪热伤肝证.燕京赵氏学派创始人赵炳南教授以着"调和阴阳"为原则,通过自身临床经验将秦艽丸化裁为秦艽五味方,有调和阴阳,攻补兼施之效,根据相应证型进行加减配伍,在临床上获得较好的疗效.总结燕京赵氏皮科学派从阴阳调和论治狼疮性脂膜炎的经验.

Objective To evaluate the quality of psoriasis-related health information on Chinese Internet sites.Methods Relevant keywords such as "psoriasis", "psoriasis treatment" were typed into Baidu, Haosou, the most common search engines in China, and the websites that met the requirements were searched. The reliability and authenticity of the information content were evaluated by referring to the Guidelines for the Diagnosis and Treatment of Psoriasis in China（2018 Complete Version） and combined with health information evaluation tools. Results Of the 300 links visited, only 14 sites met the criteria for inclusion in the review.Website attribute evaluations are all general health websites. DISCERN evaluation showed that the average score of overall quality evaluation is only 2.34. Only one site involved 10 items of psoriasis content score, while the other 13 sites all had incomplete content. Pearson correlation analysis shows that the correlation between the two scores is not statistically significant（r=0.493,P=0.73）. Conclusion The quality of health information on psoriasis in Chinese websites is generally poor, and it is difficult for ordinary people to obtain relatively comprehensive health information on Internet. It is necessary for China to explore a new model of Internet + medical services, and perfect the management mechanism of health information.

血瘀证银屑病多病情反复,缠绵难愈,对患者生活质量影响较大.孙丽蕴教授在传承燕京赵氏学术流派治疗银屑病"从血论治"思想的基础上,认为血瘀证银屑病是阴阳失调所致的血热与燥、湿、瘀、毒、虚互结之证.复方秦艽丸及四藤饮是燕京赵氏学术流派赵炳南教授的经典方药,有祛风除湿、清热解毒、活血通络、养血滋阴、益气升阳、沟通阴阳之效.孙丽蕴教授在此基础上加减化裁治疗血瘀证银屑病,配合忍冬藤、络石藤、大血藤、青风藤等加强化瘀通络、调节气血阴阳之力;配合刘寄奴、徐长卿、威灵仙等加强除湿通络之效;配合白英、白芷、白花蛇舌草加强解毒之功;配合郁金、生牡蛎安神解郁;配合益母草、泽兰、丹参、元胡、牡丹皮、仙鹤草、秦皮、椿皮等调经理血.本文特举典型病案予以总结.

孙丽蕴教授认为结节囊肿型痤疮的病机关键是痰瘀互结,久病致使痰浊、瘀血形成,阻滞脉络,论治当以化痰与散瘀为基础,配合清热、理气、透脓、软坚等法随症加减,用方以内消连翘丸化裁,在临床实践中收获疗效.本文通过探讨痤疮的病因病机、中医治则及辨证论治,总结孙丽蕴教授应用内消连翘丸加减治疗痤疮的学术思想,从而丰富痤疮临床治疗思路.

Introduction: Psoriasis is a kind of chronic inflammatory skin disease characterized by erythema, skin hyperplasia, scales and keratinocyte hyperproliferation. Psoriasis Vulgaris, the most common kind of psoriasis, severely deteriorates the life quality of patients. Traditional Chinese Medicine (TCM) is a good choice for the treatment of psoriasis, which has been proved to be safe and effective, and may reduce the recurrence rate. In clinical practice, Liangxue Jiedu Runzhi (LJR) ointment can effectively treat mild and moderate psoriasis with blood-heat syndrome, but there is a lack of evidence-based medical evidence. This trial aims to evaluate the efficacy and safety of LJR ointment for the treatment of mild and moderate psoriasis with blood-heat syndrome. Methods: A multicenter, randomized, double-blind, placebo-controlled, and self-controlled clinical trial was carried out according to this paper. The symmetrical rashes of each subject were regarded as the target lesions and were randomly divided into a treatment group (LJR ointment group) and a control group (placebo group). The LJR ointment or placebo ointment were externally administered on bilateral symmetric rashes, twice a day for eight weeks. The follow-up examination was made for subjects every two weeks. The primary research finding was conveyed by Psoriasis Area and Severity Index (PASI) in 8 weeks. The secondary research finding includes adverse events. Results: 46 subjects undergo this research project. The difference between PASI scores of the target lesions in the treatment group and control group is statistically significant were in 8 weeks (P < .001). The percentage of PASI 75 in treatment group and control group were 48% and 15% in week 8, respectively (x(2)=11.33, P<.05). No severe adverse events were reported. Conclusions: LJR ointment was proved to have efficacy in the treatment of mild and moderate psoriasis with the blood-heat syndrome.

目的 分析银屑病患者外周血T淋巴细胞亚群分布与中医辨证分型的关系.方法 选定本院2019年12月至2020年12月住院治疗的76例银屑病患者作为观察组,以及同期门诊体检的76例健康人员作为对照组,均进行外周血T淋巴细胞检测,比较中医辨证分型组、对照组T淋巴细胞因子水平,比较不同临床分期组、对照组T淋巴细胞因子水平,比较不同病情严重程度组、对照组T淋巴细胞因子水平.结果 CD4+水平血燥证组比血瘀证组、血热证组、对照组高,P<0.05.CD8+水平血热证组比血瘀证组、血燥证组、对照组高,P<0.05.CD4+/CD8+水平血燥证组比血热证组、血瘀证组、对照组高,P<0.05,4组CD3+水平比较,P>0.05.进行期组CD4+、CD4+/CD8+水平均高于静止期组、恢复期组、对照组,P<0.05.进行期组CD8+水平低于静止期组、恢复期组、对照组,P<0.05.4组CD3+水平比较,P>0.05.CD4+水平、CD4+/CD8+水平轻度组、中度组、对照组均低于重度组,P<0.05.重度组CD8+水平低于轻度组、中度组、对照组,P<0.05.4组CD3+含量比较,P>0.05.结论 银屑病患者CD4+、CD8+、CD4+/CD8+水平与中医辨证分型有一定的联系,通过检查免疫细胞因子水平,对疾病的诊治具有重要作用.

头疮在古籍中的病名演化复杂,以头疮为关键词,从中医古代文献对其进行较为系统的梳理,从病名释义、病因病机、临床表现、鉴别诊断、治则治法、预防与转归等方面进行总结.本病一般可分为白秃疮和肥疮,是发生在头皮毛发的浅部真菌性皮肤病,好发于儿童,具有传染性.中医认为其病机多与经络和脏腑之湿热、外感风热及虫邪相关,治宜清热除湿、杀虫止痒,治疗尤以外治为特色,外用剂型种类丰富,患病后尤需防止传染,及早诊治.

Exposure of skin to ultraviolet B (UVB) irradiation induces oxidative damage, immune suppression, inflammation, and skin cancer. Recently, an increase in the use of traditional Chinese medicine decoction with antioxidant properties has emerged as protection for skin tissues against UVB-induced damage. The aim of this study was to investigate mechanisms of the protective effect of the Haoqin-Huaban formula (HQHB) on UVB-induced skin damage. First, cell survival, apoptosis, and oxidative stress were evaluated upon UVB irradiation in the presence of HQHB using HaCaT cells and mice as model systems. Subsequently, bioinformatic analyses, RNA pulldown assays, RNA immunoprecipitation, luciferase reporter assays, and chromatin immunoprecipitation were conducted to verify the regulation among HQHB, hypoxia-inducible factor 1α (HIF-1α), HOXA11-AS and enhancer of zeste homolog 2 (EZH2) in HaCaT cells. In this study, we found that administration of HQHB inhibited, in a dose-dependent manner, UVB-induced skin damage by eliminating oxidative stress. HQHB was found to upregulate HOXA11-AS expression by activating HIF-1α. Furthermore, HOXA11-AS stabilized the EZH2 protein by inhibiting its ubiquitination and proteasomal degradation. Consequently, rescue assays demonstrated that HOXA11-AS promoted proliferation and inhibited apoptosis in HaCaT cells by reducing oxidative stress. Taken together, our results help to elucidate the function and regulatory mechanism of HQHB in reducing UVB-induced skin damage.

Purpose: Psoriasis is an immune-mediated chronic inflammatory disease. Metabolic syndrome (MetS) is characterized by central obesity, hypertension, dyslipidemia, diabetes and insulin resistance (IR). Increasing evidence indicates that psoriasis is associated with MetS. This study aimed to explore some metabolite indexes which could evaluate the severity or predict the risk of psoriasis patients associated with MetS. Patients and methods: It was a case-control study conducted in Beijing Hospital of Traditional Chinese Medicine. Sixty healthy volunteers (HC), 100 patients with psoriasis (Ps), 100 patients with MetS (MetS) and 80 patients with both psoriasis and MetS (Ps +MetS) were entered between January 2016 and December 2018. Blood samples were taken after at least 12 hours fasting and the contents of trimethylamine N-oxide (TMAO), carnitine, choline and betaine in serum were measured by Liquid Chromatography Mass Spectrometry (LC-MS/MS). Besides, the serum levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol (CHO), triglyceride (TG), blood glucose (BG), creatinine (Cr), urea nitrogen (BUN), uric acid (UA) were determined. Results: The non-healthy groups had different degrees of dyslipidemia, Ps-MetS> Ps >MetS. Compared with HC, the Ps had a higher level of TG; The MetS had the lowest level of HDL; The Ps+Mets had the highest level of TG and CHO. The Ps and Ps+MetS both had high level of UA, but there was no difference between the two groups. As for intestinal metabolites, the Ps had significant differences in TMAO, carnitine, and betaine in comparison with HC. The MetS had the highest level of TMAO. There was positive correlation between PASI and TMAO and betaine. Conclusions: TMAO and betaine could serve as indexes reflecting the severity of psoriasis. TG, CHO, LDL and UA could serve as risk factors of MetS in psoriatic patients.

瘙痒是一种皮肤病的常见症状,目前其发病机制尚不十分明确,西医治疗虽有较快的疗效,但却伴随较多的不良反应,且易复发.中医学称之为"风瘙痒",古籍文献中存在着大量对"风瘙痒"的相关论述,燕京赵氏学派创始人赵炳南教授在研读大量古籍基础上,本着"扶正祛邪"的原则,通过自身临床经验创止痒合剂,其组成为:防风、首乌藤、白鲜皮、白蒺藜、当归、苦参,六药合用从祛风、除湿、清热、杀虫、养血不同方面入手,以达养血润燥、祛风止痒之功.在治疗瘙痒诸证及预防其复发方面有着较好的效果.本文旨在论述止痒合剂的组成及其在临床中治疗风盛证、热盛证、湿盛证、虫淫证、血虚证瘙痒的临证应用.