Purpose: Intense pulsed light (IPL) treatment may cause transient erythema, dryness, and barrier dysfunction, highlighting the need for effective postprocedural care. This study aimed to assess the efficacy and safety of a fibronectin-containing skincare regimen in restoring skin barrier function and relieving these IPL-related manifestations. Patients and Methods: In this 28-day, split-face study, 32 healthy female participants undergoing IPL treatment applied a fibronectin-containing serum to one side of the face and a control serum to the opposite side. Skin hydration, transepidermal water loss (TEWL), erythema, and radiance were evaluated at baseline, immediately post-IPL, and on days 3, 7, and 28. Results: Compared to the control, the fibronectin-treated side showed significantly greater improvements in skin hydration (P < 0.01) and significantly lower TEWL on days 3 (P < 0.05), 7 (P < 0.01), and 28 (P < 0.01). By days 7 and 28, skin radiance and erythema also improved more significantly (P < 0.01). Both dermatologist and participant assessments confirmed the superior efficacy of the fibronectin serum. No adverse events were rePorted. Conclusion: Post-IPL aPPlication of a fibronectin-containing serum effectively imProves skin hydration, reduces barrier dysfunction and erythema, and enhances radiance with good tolerability. These findings suPPort its Potential utility in Post-IPL skincare regimens.

Background: Acne vulgaris is a chronic inflammatory skin disease, and photo-based therapies have been adopted as noninvasive alternatives to pharmacological treatment.Objective: To systematically evaluate the therapeutic strategies and biological mechanisms of photo-based therapies in the management of acne vulgaris, focusing on sebum modulation, inflammation control, and the treatment of acne sequelae to inform phenotype-oriented clinical decision-making.Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed and Web of Science for studies published between 2005 and 2025. From an initial 2,218 records, 64 articles comprising 42 clinical trials and 22 experimental studies were selected for inclusion based on their focus on the efficacy, safety, and molecular mechanisms of light-emitting diodes (LED), intense pulsed light (IPL), laser systems, and photodynamic therapy (PDT).Results: Analysis revealed that photo-based modalities target acne through three primary pathways: 1. Sebum Modulation: Aminolevulinic acid (ALA)-PDT demonstrates superior, durable efficacy in moderate-to-severe acne by inducing sebocyte apoptosis and downregulating lipogenesis via the PI3K/Akt/mTOR and OLR1-Wnt/β-catenin pathways. 2. Inflammation Control: Blue and red light (LED) and IPL provide gradual anti-inflammatory effects suitable for mild-to-moderate acne by reducing C. acnes colonization and modulating cytokines such as TGF-β1, IL-10, and TNF-α. 3. Tissue Remodeling: For acne sequelae, fractional CO2 and picosecond lasers promote collagen remodeling to improve atrophic scars, while vascular-targeted lasers (PDL, Nd:YAG) and IPL effectively reduce post-inflammatory erythema (PAE) and hyperpigmentation (PIH).Conclusions: Photo-based therapies are phenotype-specific rather than interchangeable. Strategies targeting sebaceous activity and inflammation are central to treating active lesions, while tissue-remodeling interventions are most effective for managing sequelae. This review establishes a strategy-oriented framework that supports personalized, evidence-based treatment planning in routine clinical practice.

Purpose:Optoelectronic advances have boosted interest in noninvasive rosacea treatments. Among them, pulsed dye laser (PDL), intense pulsed light (IPL), and radiofrequency (RF) therapy have been used to treat erythematotelangiectatic rosacea (ETR), and some therapeutic effects have been reported, but comparative studies are lacking. This study aimed to compare the efficacy and safety of PDL, IPL, and RF therapy for the treatment of ETR. Patients and Methods:A retrospective evaluation was conducted of patients with ETR who completed phototherapy between June 2019 and June 2024. The treatment protocol included two sessions of 585 nm PDL therapy (6-week interval), three sessions of IPL (M22 590 filter) therapy (590-1200 nm, 4-week interval), or six sessions of multisource 3DEEP RF therapy (2-week interval), with a follow-up visit at 12 weeks post-final treatment. The clinical efficacy evaluation consisted of the Clinician Erythema Assessment (CEA) scale, patient self-assessment (PSA) scale, the overall efficacy rate, and the Rosacea-Specific Quality of Life instrument (RosaQoL). Safety was evaluated in terms of adverse reactions such as pain, purpura, erythematous edema, blistering, hyperpigmentation, and scarring. Results:This study included 120 patients with ETR treated with PDL, M22 590, or RF therapy. Intragroup analysis revealed significant decreases in the CEA scale, PSA scale, and RosaQoL scores after treatment (p<0.001). The efficacy rates were 57.50%, 45.00%, and 67.50% for PDL, M22 590, and RF therapy, respectively, and no statistically significant intergroup differences were observed. Safety analysis confirmed that all the treatments were well tolerated. Conclusion:PDL, IPL and RF therapy all produced short-term improvements in erythema and quality of life in patients with ETR. RF showed comparable efficacy with better tolerability, suggesting a comfortable, low downtime option, while PDL and IPL are vascular-targeted tools. These exploratory findings require confirmation in longer, dose-standardized prospective studies.

Atopic dermatitis (AD) is a prevalent chronic skin disease worldwide. Emerging evidence suggests that an elevated salt microenvironment is a unique characteristic of skin lesions in AD patients. Emerging data indicate that lesional skin in AD contains abnormally high salt, yet how this microenvironment affects keratinocytes is unknown. We interrogated the impact of elevated NaCl on barrier function and inflammation using HaCaT cells in vitro, and 2,4-dinitrofluorobenzene (DNFB) and ovalbumin (OVA) treatment induced an AD model of mice in vivo. The interaction between SGK-1, mTOR, STAT3, and NFκB was identified with their roles in AD, analyzed through loss-of-function assays and pharmacological inhibitions. Our results showed that the high-salt microenvironment impaired keratinocyte differentiation and promoted inflammatory cytokine production, thereby exacerbating the disease. Mechanistically, NaCl activated STAT3 via the SGK-1-mTOR signaling pathway in keratinocytes, leading to a decrease in the expression of epidermal barrier proteins. In addition, inflammatory cytokines were increased by NaCl-induced SGK-1-mTOR-NFκB activation. We identified the SGK-1 inhibitor GSK 650394, which could rescue the NaCl-induced blockade of keratinocyte differentiation and inflammatory cytokine production. Moreover, in combination with the JAK inhibitor delgocitinib, GSK 650394 exhibits a synergistic effect in ameliorating AD-like symptoms in vivo. Taken together, our findings demonstrate that the high-salt microenvironment promotes the development of AD by activating the SGK-1-mTOR pathway in keratinocytes, suggesting that an SGK-1 inhibitor could potentially serve as a drug to alleviate AD-like symptoms.

The skin is vulnerable to ultraviolet (UV) exposure, and as a repair mechanism, autophagy activation is essential to eliminate UV‐damaged skin cells to maintain tissue homeostasis. As a UV‐induced protein, heme oxygenase‐1 (HO‐1; 32 kDa) is implicated in protecting cells from oxidative stress and plays an important role in disease prevention. However, the mechanism of photoprotection in skin cells has yet to be fully understood. In the current study, we uncovered that UV radiation induces proteolytic cleavage of HO‐1 into a 26 kDa product that accumulates in the cell nucleus. Biochemical analyses show that caspase‐1 (CASP1) directly binds to HO‐1 and cleaves full‐length HO‐1 at the C terminus. It is further unveiled that the 26 kDa HO‐1 product is a stronger activator of autophagy than full‐length HO‐1, as demonstrated by the activation of autophagy‐related genes. Moreover, the 26 kDa HO‐1 cleavage product promotes translocation of the transcription factor basic helix–loop–helix ARNT‐like protein 1 (Bmal1) into the cell nucleus. This translocation appears to be required for the induction of autophagy, as knocking down Bmal1 fails to activate autophagy induced by the 26 kDa HO‐1 cleavage product. We conclude that a proteolytic cascade involving CASP1/HO‐1/Bmal1 acts to modulate autophagy in UV‐irradiated human skin keratinocytes, presumably as a mechanism to mediate UV photoprotection. Our study identified proteolysis as a regulatory event by generating a previously unknown 26 kDa form of HO‐1 to play a distinct role in the activation of autophagy in UV‐exposed epidermal cells.

Background This study aimed to investigate the knowledge, attitude and practice (KAP) of rosacea patients towards rosacea.Objective The objective was to assess the KAP levels among rosacea patients to inform potential educational interventions.Design A web-based cross-sectional study was conducted.Participants/setting The study was conducted from November 2022 to October 2023 among rosacea patients attending the Dermatology Department of Southwest Hospital, Chongqing, using a self-administered questionnaire.Intervention No specific intervention was applied; the focus was on understanding existing KAP.Main outcome measures The primary outcome measures included KAP scores regarding rosacea.Statistical analyses performed Multivariate logistic regression analysis and structural equation modelling were employed to analyse the associations between KAP scores and demographic factors.Results A total of 514 valid questionnaires were collected, with 458 (89.11%) respondents being women. The mean KAP scores were 7.14±2.98 (possible range: 0–12) for knowledge, 52.57±7.07 (possible range: 13–65) for attitude and 62.77±13.24 (possible range: 18–90) for practice. Multivariate analysis indicated that knowledge, attitude, being male, aged 25–30 years and having health insurance were independently associated with proactive practice. Additionally, structural equation modelling revealed that knowledge directly influenced both attitude and practice, while attitude also directly impacted practice (all p<0.001).Conclusions The study found that rosacea patients had inadequate knowledge, a positive attitude and suboptimal practices regarding their condition. It is recommended that comprehensive patient education and support programmes be developed to enhance knowledge, foster positive attitudes and improve practice behaviours among rosacea patients.

Chronic spontaneous urticaria (CSU), characterized by recurrent wheals and/or angioedema persisting for more than 6 weeks, represents a substantial clinical challenge. Although international guidelines endorse second-generation H1-antihistamines (sgAHs) as first-line therapy, up to 50% of patients remain refractory even at quadruple doses, significantly compromising quality of life and mental well-being. Notably, standardized guidelines for managing H1 antihistamine-resistant CSU are currently lacking. To address this gap, we aimed to develop an evidence-based clinical practice guideline for the diagnosis, assessment, and step-wise treatment of H1 antihistamine-resistant CSU. A multidisciplinary panel conducted a systematic literature review and through multiple rounds of group discussions, both offline and online, to draft recommendations. Evidence was graded using the Oxford CEBM 2011 system and recommendations assigned GRADE strengths. This guideline provides a standardized, personalized treatment algorithm for H1 antihistamine-resistant CSU, aiming to improve clinical efficacy, reduce socioeconomic burden, and direct future research toward validating novel agents such as JAK inhibitors and optimizing long-term outcomes.

This study investigated the causal association between rosacea and psychiatric disorders, including major depression disorder (MDD), anxiety disorder (AD), and panic disorder (PD). A bidirectional two-sample Mendelian randomization (MR) analysis was performed. The publicly released genome-wide association summary data (GWAS) of rosacea and psychiatric disorders was used in the MR analysis. The random-effects inverse variance weighted method (IVW) was applied as the primary method, and several other estimators were used as complementary methods. MR-Egger, MR-PRESSO, Cochran’s Q, and leave-one-out were performed to evaluate sensitivity and robustness. The forward MR results suggested that genetically determined rosacea did not have a causal association with the three psychiatric disorders. In the reverse analysis, the MR analyses consistently showed non-significant causal effects of these psychiatric disorders on rosacea. These findings were robust across different analytical methods. Sensitivity analyses confirmed the consistency of the results and provided no evidence of horizontal pleiotropy or outliers. A validation analysis using different datasets for the exposures and the outcomes, supporting the initial MR analysis results. Overall, the study found no evidence of a bidirectional causal relationship between genetically predicted rosacea and three psychiatric disorders despite observational studies reporting an association between rosacea and psychiatric disorders. The causal effects between these diseases need further exploration.

Background: Atopic dermatitis (AD) is a chronic, multifactorial skin condition with distinct subtypes, each exhibiting unique immune characteristics and treatment responses. Objective: Our study aimed to characterize biomarker profiles of AD subtypes and identify biomarkers that may predict the response to abrocitinib treatment. Methods: Serum and tape strips from lesional and nonlesional skin were collected from patients with AD (n = 50) pre- and post-4 weeks of abrocitinib treatment (n = 15) and 13 healthy controls. We compared serum and skin biomarker expression in 16 patients with extrinsic and 16 with intrinsic AD with matched disease severity. Results: Th1, Th2, Th17/22, general inflammation-related factors, and JAK-STAT signaling molecules were upregulated in the skin and serum of patients with AD. Compared with intrinsic AD, extrinsic AD showed higher FCER1A and chemokine (C-C motif) ligand 22 expression in the skin (P < 0.05), while intrinsic AD had higher Th17/Th22-related biomarker expression. Multivariate correlation models significantly improved the correlation between the biomarkers and the severity of AD, both before and after treatment. Conclusion: Extrinsic AD shares Th2-type inflammation with intrinsic AD, but intrinsic AD shows elevated Th17/Th22-type inflammation. Biomarker integration models can contribute to precise AD treatment.

To investigate the knowledge, attitude, and practice (KAP) of photoaging in the Chinese population. This web-based cross-sectional study was conducted between January 2023 and March 2023 among the Chinese population aged 18–80 years old. Participants’ knowledge, attitude, and practice toward photoaging were collected through a self-administered questionnaire. A total of 830 questionnaires were collected, with 826 valid questionnaires and an efficiency rate of 99.52%. There were 274 (33.17%) males and 532 (64.41%) aged 31–51 years old. The average knowledge, attitude, and practice scores were 7 (4, 9) (possible range 0–12), 31.5 (28, 34) (possible range 8–40), and 33 (24, 42) (possible range 11–55), respectively, indicating poor knowledge, good attitude, and moderate practice. Spearman correlation analysis showed that knowledge was negatively correlated with attitude (r = − 0.111, P < 0.05) and practice (r = − 0.113, P < 0.05), and attitude was positively correlated with practice (r = 0.992, P < 0.05). The multivariable linear regression model showed that for each point increase in attitude score, the practice score increased by 2.96 points (β = 2.96, 95% CI 2.91–3.01, P < 0.001). The Chinese population has poor knowledge, good attitude, and moderate practice toward photoaging. A good attitude toward photoaging would lead to good practice, and more outreach and education for the Chinese population might be needed.

Little is known about the association between coronavirus disease 2019 (COVID-19) and autoimmune diseases, especially in the case of systemic lupus erythematosus (SLE). SLE patients met with many questions during the pandemic in COVID-19, such as how to minimize risk of infection, the complex pathological features and cytokine profiles, diagnosis and treatment, rational choice of drugs and vaccine, good nursing, psychological supervision, and so on. In this study, we review and discuss the multifaceted effects of the COVID-19 pandemic on patients living with SLE using the available literature. Cross-talk in implicated inflammatory pathways/mechanisms exists between SLE and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and SARS-CoV-2 displays similar clinical characteristics and immuno-inflammatory responses to SLE. Current epidemiological data inadequately assess the risk and severity of COVID-19 infection in patients with SLE. More evidence has shown that hydroxychloroquine and chloroquine cannot prevent COVID-19. During the pandemic, patients with SLE had a higher rate of hospitalization. Vaccination helps to reduce the risk of infection. Several therapies for patients with SLE infected with COVID-19 are discussed. The cases in the study can provide meaningful information for clinical diagnosis and management. Our main aim is to help preventing infection and highlight treatment options for patients with SLE infected with COVID-19.

BackgroundCell energy metabolism controls the activation and function of dendritic cells (DCs). Inflammatory dendritic epidermal cells (IDECs) in skin lesions of atopic dermatitis (AD) express high-affinity IgE receptor (FcϵRI) and toll-like receptor 2 (TLR2), which mediate the generation and maintenance of inflammation. However, cellular energy metabolism and effector function of IDECs mediated by FcϵRI and TLR2 have not been fully elucidated.MethodsIDECs in vitro were treated with TLR2 agonist Pam3CSK4 and anti-IgE alone or in combination for 24 h. Further, we analyzed the expression of cell surface activation markers, production of inflammatory factors, and cellular energy metabolism profiles of IDECs by using flow cytometry, multiplex assay, RNA sequencing, targeted energy metabolism, and seahorse assays.ResultsCompared to the unstimulated or anti-IgE groups, Pam3CSK4 alone or combined with anti-IgE groups significantly increased the expression of CD80, CD83, and CD86 on IDECs, but did not affect the expression of the above markers in the anti-IgE group. The release of inflammatory cytokines increased in the Pam3CSK4 alone or combined with anti-IgE groups, while there was a weak increasing trend in the anti-IgE group. The glycolysis/gluconeogenesis pathway of carbon metabolism was affected in all treatment groups. Furthermore, compared to the control group, we found a decrease in pyruvic acid, upregulation of PFKM, downregulation of FBP1, and increase in extracellular lactate, glycolysis rate, and glycolysis capacity after all treatments, while there was no difference between each treatment group. However, there was no difference in glycolytic reserve and mitochondrial basic and maximum respiration among all groups.ConclusionOur results indicate that glycolysis of IDECs may be activated through FcϵRI and TLR2 to upregulate inflammatory factors, suggesting that danger signals from bacteria or allergens might evoke an inflammatory response from AD through the glycolysis pathway.

BackgroundThe combination of botulinum toxin type A (BoNT/A) and energy equipment have been widely used in the clinic. AimsTo determine whether the energy of microneedle fractional radiofrequency (MFR) affects the efficacy of BoNT/A and to provide an optimal strategy for the energy device in combination with BoNT/A in the clinic. MethodsFirst, a total of 45 females with moderate-to-severe periorbital crow's feet wrinkles were enrolled and divided into three groups according to different treatment methods and intervals, including BoNT/A injection alone, BoNT/A injected immediately after MFR treatment and BoNT/A injected 7 days after MFR treatment. The photographs were compared before treatment and 4 weeks after treatment. Then, the mouse models were established by combining MFR with BoNT/A at different intervals, to evaluate muscle strength, muscle mass, muscle nutritional markers, and important cytokines levels. ResultsAll patients in each group had high satisfaction. The MFR + BoNT/A (immediately) group could improve dynamic wrinkles, but the others had more significant efficacy (p < 0.05). The results of mouse models showed that all BoNT/A groups induced different degrees of muscle paralysis in vivo, but the paralytic effect induced by the BoNT/A group, MFR + BoNT/A (interval of 3-day) group, and MFR + BoNT/A (interval of 7-day) group were higher than others and the expression levels of muscle nutritional markers in NMJ tissues were significantly upregulated. ConclusionMFR has a certain reduction effect on the activity of BoNT/A, and this reduction effect would last for 3 days after MFR treatment.

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Rosai-Dorfman disease(RDD) is a rare benign histiocytic proliferative disorder. Cutaneous Rosai-Dorfman disease(CRDD)is a rare variant of RDD with lesions localized to the skin. We report a case of patients with CRDD who was refractory to methotrexate, thalidomide, cyclosporine, glucocorticoid for local injection and external use, but resolved with fractional laser combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). We believe that fractional laser technology combined with ALA-PDT for CRDD is a minimally invasive, effective and satisfactory treatment.

Objective:To explore the efficacy and safety of microneedle radiofrequency combined with supramolecular salicylic acid in improving facial photoaging.Methods:Thirty patients treated for facial photoaging were randomly divided into the combined treatment group and the microneedle radiofrequency group. All patients were female, aged between 30 and 50 years, with an average age of (39.4±4.1) years. The combined treatment group was treated with microneedle radiofrequency combined with supramolecular salicylic acid, and the Microneedle radiofrequency group was treated with microneedle radiofrequency alone. The patients were followed up 3 days, 7 days, 14 days, 28 days and 3 months after treatment. The results of VISIA, skin physiology and patients' satisfaction were used to compare the two groups of patients after treatment.Results:After 3 months of treatment, the skin pores (11.98±2.14 vs. 15.54±1.52), brown spots (12.40±1.85 vs. 15.84±1.42), ultraviolet spots (6.74±0.87 vs. 11.20±1.70), skin physiological status (transepidermal water loss): 11.84±1.80 vs 13.09±1.96 g/(h·m) 2, stratum corneum water content: 84.91±2.86 % vs 80.29±3.58 %, melanin index: 110.07±15.02 vs. 122.30±9.97, erythema index: 220.43±19.69 vs. 236.30±16.55), elasticity (75.98±3.94 vs. 69.89±3.58), epidermal thickness (1401.33±178.43 vs. 1217.13±139.77), skin color improvement (effective rate 86.7% vs. 40.0%) and patients' satisfaction (total satisfaction was 93.3% vs 67.0%) in the combined treatment group were significantly superior than those in the microneedle radiofrequency group, and the differences were statistically significant ( P<0.05). The reaction of moderate and severe erythema (the incidence rate 40.0% vs. 86.7%) and edema (the incidence rate 26.7% vs. 80.0%) in the combined treatment group was also significantly lower than that in the microneedle radiofrequency group ( P<0.05). No adverse pigmentation was reported in both groups after treatment. Conclusions:The combination of microneedle radiofrequency and supramolecular salicylic acid in the treatment of facial photoaging has definite clinical effect and high safety, which is worthy of clinical application.

特应性皮炎的发病机制复杂,主要与遗传背景、环境刺激、表皮屏障缺陷、免疫失调等因素有关.以Th2型炎症细胞因子以及JAK-STAT通路作为治疗靶点已成为特应性皮炎药物开发的热点.目前已有多个生物制剂和小分子药物成功用于特应性皮炎的治疗,标志其治疗已经迈入精准治疗和靶向治疗时代.

Introduction Rosacea is a common chronic inflammatory disease occurring on the face, whose diagnosis is mainly based on symptoms and physical signs. Due to some overlap in symptoms and signs with other inflammatory skin diseases, young and inexperienced doctors often make misdiagnoses and missed diagnoses in clinical practices. We analyze the results of skin physiology and dermatoscopy using machine learning method and identify the characteristics of acne rosacea, which differentiate it from other common facial inflammatory skin diseases so as to improve the accuracy of clinical and differential diagnosis of rosacea. Methods A total of 495 patients who were jointly diagnosed by two experienced doctors were included. Basic data, clinical symptoms, physiological skin detection, and dermatoscopy results were collected, and the clinical characteristics of rosacea and other common facial inflammatory diseases were summarized according to the descriptive analysis results. The model was established using a machine learning method and compared with the judgment results of young and inexperienced doctors to verify whether the model can improve the accuracy of clinical diagnosis and differential diagnosis of rosacea. Results The proportion of yellow and red halos, vascular polygons, as well as follicular pustules, showed by dermatoscopy, and the melanin index in physiological skin detection revealed statistical significance in differentiating rosacea and other common facial inflammatory diseases (all P < 0.01). After adopting the machine learning, we found that GBM (Gradient Boosting Machine) algorithm was the best, and the error rate of this model in the validation set was 5.48%. In the final man-machine comparison, the accuracy of the GBM algorithm model for the classification of skin disease was significantly higher than that of young and inexperienced doctors. Conclusion Dermatoscopy combined with machine learning can effectively improve the diagnosis and differential diagnosis accuracy of rosacea and other facial inflammatory skin diseases.