BACKGROUND:Primary cutaneous lymphomas (PCLs), comprising cutaneous T-cell lymphomas (CTCLs) and cutaneous B-cell lymphomas (CBCLs), are rare non-Hodgkin lymphomas with distinct epidemiological characteristics. How the incidence rates (IRs) of PCLs have changed over the past decade has not been well documented. OBJECTIVES:To assess changes in IRs in overall and subtype-specific PCLs in the USA by sex, age and ethnic group. METHODS:This study analysed 13 126 cases of PCL diagnosed between 2010 and 2021 using data from the Surveillance, Epidemiology and End Results programme. Age-adjusted IRs (aaIRs), 5-year relative survival and annual percentage change were calculated. RESULTS:The overall aaIR of PCLs was 11.9 per 1 000 000 person-years, with 8.8 for CTCLs and 3.1 for CBCLs. Among CTCL subtypes, mycosis fungoides had the highest aaIR of 5.2, whereas within CBCLs, primary cutaneous marginal zone lymphoma exhibited the highest aaIR of 1.4. Between 2014 and 2021, the aaIR of CBCLs declined annually by 4.9%. In males, aaIRs for CTCLs and CBCLs decreased by 3.5% and 4.8%, respectively, per year over the same period. Five-year relative survival was 89.3% for CTCLs and 91.5% for CBCLs. CONCLUSIONS:The incidence of PCLs has exhibited distinct patterns of decline among different population groups over the past decade. The continued disparities in both incidence and survival underscore the need for targeted research and interventions to mitigate demographic inequalities.

INTRODUCTION:We conducted a systematic review and meta-analysis to evaluate real-world safety outcomes associated with Janus kinase (JAK) inhibitors in patients with moderate-to-severe atopic dermatitis (AD). METHODS:PubMed, Embase, Cochrane Library, and CINAHL were searched through April 2025. Two independent reviewers screened studies and extracted data according to predefined criteria. Risk of bias was assessed using Agency for Healthcare Research and Quality tools. RESULTS:The pooled incidence rates of adverse events (AEs) and serious adverse events (SAEs) with JAK inhibitors were 0.42 (95% CI: 0.35-0.50) and 0.03 (95% CI: 0.01-0.05), respectively. The most common AEs included acne (effect size [ES] = 0.14, 95% CI: 0.12-0.16), skin and subcutaneous tissue infections (ES = 0.17, 95% CI: 0.09-0.26), and herpes virus infections (ES = 0.07, 95% CI: 0.06-0.09). Compared with anti - interleukin-4/interleukin-13 inhibitors, JAK inhibitors were associated with higher risks of acne, anemia, and creatine kinase elevations. CONCLUSIONS:AEs were common but predominantly mild to moderate. Infections, particularly skin and subcutaneous tissue and herpes virus infections, were among the most frequently reported events. The pooled incidence of SAEs, including cardiovascular events, was low within reported follow-up periods. However, heterogeneity and relatively short follow-up limit conclusions regarding long-term risk. PROTOCOL REGISTRATION:CRD42025634423.

OBJECTIVE:To investigate the efficacy and safety of 308-nm excimer laser therapy with or without fire needle therapy in patients with stable acral vitiligo. METHODS:A retrospective study was conducted to review patients with stable acral vitiligo treated between January 2020 and October 2024. In addition to topical halometasone cream, patients received either 308-nm excimer laser therapy alone (laser group) or a combination of 308-nm excimer laser and fire needle therapies (combination group) for three months. Vitiligo Area Scoring Index (VASI), physician global assessment (PGA), pain during treatment, and side effects were compared between the groups. RESULTS:A total of 62 patients (32 in the laser group and 30 in the combination group.) were included. The mean age was 34.2 ± 9.8 years, with 39 (62.9%) males. Baseline characteristics were comparable between the two groups. Patients in both groups experienced a reduction in VASI scores (0.06 ± 0.74 and 0.16 ± 0.14 in the laser and combination groups, respectively). Compared with the laser group, the combination group showed significant improvement in lesion appearance, but reported mild pain (p < 0.001). Both groups experienced mild skin reactions, which resolved quickly after treatment. CONCLUSIONS:Combination therapy with 308-nm excimer laser and fire needle is a safe and effective approach for stable acral vitiligo.

Atopic dermatitis (AD), a chronic inflammatory skin disorder, remains a major therapeutic challenge in clinical practice. Its pathogenesis is primarily driven by dysregulated T helper 2 (Th2) immune responses and pathological accumulation of reactive oxygen species (ROS). Here, we demonstrated that Portulaca oleracea L.-derived exosome-like nanoparticles (PELNs) exerted potent anti-inflammatory effects on skin-associated cells. However, PELNs have limited antioxidant activity and poor skin barrier penetration. To address these limitations, we developed a dissolvable microneedle (MN) patch incorporating 4-amino-2,2,6,6-tetramethylpiperidinyloxy (4-amino-TEMPO) conjugated with hyaluronic acid (HA-TEMPO) as both an ROS-scavenging agent and a needle-forming matrix, combined with PELN for synergistic therapy. In vivo studies showed that this MN system (designated HA-TEMPO@PELN-MN) effectively attenuated cutaneous oxidative stress and suppressed pathological skin crusting. Notably, the HA-TEMPO@PELN MN restored Th1/Th2 immune balance. Overall, the MN patch combines excellent biocompatibility, rapid drug release, and efficient delivery, offering a safe and controlled strategy for AD treatment.

ObjectivesAtopic dermatitis is a chronic, relapsing, inflammatory skin disease that impacts patients’ quality of life and imposes substantial economic burdens on their families. Acupuncture holds promise as a viable treatment option for atopic dermatitis. This review aimed to evaluate the effect of acupuncture on atopic dermatitis.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, CENTRAL, the China National Knowledge Infrastructure, WanFang and VIP databases were searched through 17 September 2023, together with an updated search on 15 October 2024.Eligibility criteria for selecting studiesWe included randomised controlled trials (RCTs) about acupuncture for atopic dermatitis. The primary outcome was the SCORing Atopic Dermatitis (SCORAD) score. The secondary outcomes were the eczema area and severity index (EASI) score, the visual analogue scale (VAS) score for pruritus, the dermatology life quality index (DLQI) score, serum IgE level and adverse events (AEs).Data extraction and synthesisTwo independent reviewers conducted separate searches of the databases, assessed eligible articles for inclusion and employed the Cochrane Collaboration’s tool for assessing the risk of bias. The analyses were performed using RevMan 5.3 and Stata 13.0 software. The mean difference (MD) with 95% CI was employed to analyse continuous outcomes.ResultsEight studies with 463 participants were included. The meta-analysis indicated significant differences in the SCORAD score (MD=−10.61, 95% CI −17.77 to −3.45, p=0.004), the VAS score for pruritus (MD=−14.71, 95% CI −18.20 to −11.22, p<0.00001) and the DLQI score (MD=−2.37, 95% CI −3.57 to −1.18, p<0.0001), but no significant differences in the EASI score (MD=−3.95, 95% CI −8.35 to 0.45, p=0.08) and the IgE level (MD=−160.22 U/mL, 95% CI −334.13 to 13.68, p=0.07) between treatment and control. The differences in the SCORAD score and the VAS score for pruritus reached minimal clinically important differences. No serious AEs were reported.ConclusionsAcupuncture might be an effective and safe treatment for atopic dermatitis. Due to the limited quantity and quality of the included studies, it is recommended to conduct multicentre, large-scale and high-quality RCTs to further confirm the findings.PROSPERO registration numberCRD42023470643.

OBJECTIVE:The expression of vascular endothelial growth factor-A (VEGF-A) in snakebite patients, its value in patient prognosis and the correlation of VEGF-A with renal function were analysed.METHODS:A total of 124 snakebite patients admitted from January 2019 to January 2021 were retrospectively analysed and included in the observation group, and 40 healthy individuals who underwent physical examination in the same hospital within the same period were included in the control group. The t-test was used in analysing differences between the serum VEGF-A levels of the observation and control groups and changes in VEGF-A and renal function indices before and after treatment in the observation group. The effects of treatment on each patient in the observation group were evaluated, and the patients were divided into improved and unimproved groups according to the post-treatment condition. The predictive value of VEGF-A and renal function indices in patients in the improved and unimproved groups and their efficacy for snakebite patients were analysed through receiver operating characteristic (ROC) analysis. Finally, correlation analysis was used in evaluating the correlation between VEGF-A and renal function indices.RESULTS:VEGF-A was significantly higher in patients in the observation group (339.66 ± 97.72 pg/mL) than in patients in the control group (52.41 ± 8.93 pg/mL; p < 0.001). VEGF-A and renal function indices in the serum of patients were significantly lower after treatment than those before treatment (p < 0.0001). According to efficacy, the patients were divided into improved group (n = 102) and unimproved group (n = 22). The pre-treatment VEGF-A levels were significantly lower in patients in the improved group (318.47 ± 90.80 pg/mL) than in patients in the unimproved group (437.88 ± 63.16 pg/mL; p < 0.001). ROC curve analysis revealed that the area under the curve for VEGF-A in predicting patient treatment efficacy was 0.886, and VEGF-A was positively correlated with blood urea nitrogen, creatinine and cystin C but negatively correlated with glomerular filtration rate (p < 0.001).CONCLUSIONS:VEGF-A was highly expressed in snakebite patients and can be used as an observational indicator for predicting the prognosis of snakebite patients.

To determine the clinical efficacy of Zuqing Xu 'Wuduling' powder for snake injury on the swelling of the affected limb bitten by Agkistrodon halys. Sixty-five patients with Agkistrodon halys bite were assigned to a treatment group (n = 35) or control group (n = 30). The treatment group was additionally given 'Wuduling' powder dressing locally based on the therapy to the control group with conventional Western medicine. Clinical efficacy and improvement of traditional Chinese medicine symptoms and signs in the two groups were evaluated. The treatment group showed a notably higher cure rate than the control group. After 3 days of therapy, the swelling and pain of the affected limb in the treatment group were greatly alleviated. Additionally, after 7 days of therapy, the swelling and pain of the affected limb in the treatment group were more greatly alleviated, and those in the control group were also alleviated. The comparison of the two groups during the same period showed more obvious alleviation of swelling and pain in the treatment group than that in the other. Moreover, the treatment group experienced notably shorter disappearing time of swelling and pain than the control group. After treatment, the levels of CRP, TBIL, Cr, ALT, AST, BUN, CK, LDH and CK-MB in both groups declined notably, with notably lower levels of them in the treatment group than those in the other. Zuqing Xu 'Wuduling' powder for snake injury can substantially alleviate the swelling and local pain of affected limbs bitten by Agkistrodon halys.

目的:观察复方生石膏煎液冷湿敷治疗颜面再发性皮炎的临床疗效.方法:通过临床回顾性观察,分析2019年1～12月颜面再发性皮炎女患者68例,随机分为观察组与对照组,门诊治疗期间均给予地氯雷他定分散片口服,对照组加用0.03％他克莫司软膏外用,观察组加用复方生石膏煎液冷湿敷,复方生石膏煎液为我院协定方,药物内含生石膏、马齿苋等中药成分,面部冷湿敷每日2次,每次15～20分钟.结果:相同治疗时间后,观察组患者的症状评分、愈显率与对照组相比,差异具有统计学意义(P<0.05).结论:在口服地氯雷他定分散片基础上联合复方生石膏煎液冷湿敷治疗颜面再发性皮炎,具有起效快、疗效显著、使用方便、价格便宜、无明显不良反应等优点,值得临床推广应用.

[目的]探讨现代中医疫疹的内涵.[方法]研读古今疫疹相关文献,参考新型冠状病毒肺炎(以下简称新冠)皮肤病变的国内外临床报道,分析传统疫疹在概念认识上存在的争议与不足,提出现代中医疫疹的新定义;通过对传统疫疹和新冠疫疹的表征、病性进行比较,分析疫疹的皮损表现和疾病属性.[结果]现代中医疫疹已突破传统疫疹的概念范畴,系由疫疠毒邪所致,具有皮肤、黏膜损害表现的一类疫病的总称.疫疹之"疹"不仅限于"斑"和"疹",应扩充包含疮、痘、痧、疱、疡、痂、浆、脓、溃烂等中医皮损,以及斑块、疱疹、结节、囊肿、鳞屑、色沉、苔藓样变等现代医学的皮损表现.新冠疫疹即包括假冻疮样、荨麻疹样、囊泡样、紫癜样皮损等复杂的皮肤病变,症状不拘于发热,印证了疫疹的病性并非绝对属热,尚有寒、湿、燥之性.[结论]疫疹的表征和病性在本质上是机体感受疠气的外象和表观反映.重新审视疫疹的内涵,借助多学科交叉融合研究,有助于建构富有中医特色的现代疫疹辨治体系,从而进一步指导临床和科研工作.

目的:观察镇肝熄风汤加减治疗肝阳上亢型青春期胆碱能性荨麻疹(ChU)的疗效及对血清胆碱酯酶(ChE)的影响.方法:60例青春期ChU患者依据就诊先后顺序用随机数表法随机分为两组,对照组予以西医常规抗组胺药物西替利嗪片口服,治疗组予镇肝熄风汤.对两组治疗前及治疗4周、8周后的症状积分、复发率进行统计,观察总体疗效;采用酶联速率法检测治疗前及治疗4、8周后血清ChE的水平.结果:镇肝熄风汤能明显改善青春期ChU的症状,治疗2个疗程结束后总有效率96.67％(29/30)显著高于对照组的73.33％(22/30)(P＜0.05);停药后2周后,治疗组复发率11.53％,明显低于对照组63.64％ (P＜0.05);治疗4周、8周后治疗组ChE的水平上升,治疗8周后与治疗前比有显著性差异(P＜0.05).结论:镇肝熄风汤治疗肝阳上亢型青春期ChU疗效优于西医常规治疗,且复发率更低,其作用机制可能是调节血清ChE水平.

目的 观察射频电针散刺治疗寻常疣的临床效果.方法 选取门诊接诊的寻常疣患者81例,分为对照组和观察组.对照组予液氮冷冻,每2周1次;观察组予射频电针散刺,每2周1次,连续治疗6周,治疗结束后6个月随访,并对比分析临床效果.结果 两组临床疗效差异有统计学意义(P＜0.05),但两组总有效率差异无统计学意义(P＞0.05),观察组随诊6个月后复发率显著低于对照组(P＜0.05).对照组的不良反应主要表现为治疗局部可耐受的红肿及疼痛,一般在数小时至24h内消失,治疗后局部疣体变黑.观察组的不良反应主要表现为局部疣体变黑,轻度红肿,麻醉药药效过后伤口疼痛,均可耐受,一般在24h内消退.结论 采取射频电针散刺治疗寻常疣安全有效,复发率低,愈后局部皮肤无疤痕及明显色素沉着.

目的:观察硒酵母片联合当归饮子对慢性荨麻疹的临床疗效及对血清丙二醛(MDA)的影响.方法:选取2014年10月至2016年10月本院就诊的168例慢性荨麻疹患者,随机分4组:对照组予西替利嗪片口服,治疗组在对照组基础上,分为硒酵母组、当归饮子组及硒酵母+当归饮子组.各组患者疗程均为2个月.记录分析治疗前后症状评分,检测治疗前后血清MDA的水平.结果:与对照组比较,各治疗组结束疗程后症状积分下降明显(P＜0.05);各治疗组的总有效率均显著高于对照组(P＜0.05);各治疗组患者治疗后血清MDA值较治疗前均显著降低(P＜0.01),且低于对照组同期(P＜0.01);随访1月,各治疗组复发率明显低于对照组(P＜0.01),其中,硒酵母+当归饮子组效果更佳.结论:硒酵母片加当归饮子结合西替利嗪治疗慢性荨麻疹可提高临床疗效,其作用机制可能与降低MDA含量有关.

泛发性神经性皮炎(generalized neurodermitis,GND)是以全身泛发苔藓样变及剧烈瘙痒为特征的一种顽固的慢性炎症性疾病,病多从瘀论治[1],近年来研究发现在其发生过程中存在着血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCA)的显著升高[2].为了探讨其相关作用机制,笔者观察桃红四物汤辅助治疗68例GND患者的治疗效果及对血清SCCA的影响,现报告如下.

目的:观察刺络拔罐联合卤米松包敷治疗局限性神经性皮炎的临床疗效.方法:按随机数字表法将72例患者分为两组,刺络拔罐联合卤米松包敷36例为治疗组,单用卤米松乳膏外擦36例为对照组,分别进行治疗.结果:治疗组愈显率为91.7％,总有效率为100％;对照组愈显率为38.9％,总有效率为83.3％.经统计学比较,两组愈显率及总有效率差异均具有统计学意义(P＜0.05).结论:刺络拔罐联合卤米松包敷治疗局限性神经性皮炎疗效确切,无毒副作用,操作简便易行,值得推广.