Introduction:Atopic dermatitis (AD) is a chronic inflammatory disease. Phosphodiesterase-4 (PDE4) inhibitors have emerged as a potential therapeutic strategy, but their efficacy and safety profile in adult patients requires comprehensive evaluation. Aim:To assess the efficacy and safety of PDE4 inhibitor monotherapy in adult AD patients. Methods:A systematic literature search was conducted for studies evaluating PDE4 inhibitor monotherapy in adult AD patients. Study quality was assessed using the Newcastle-Ottawa Scale, and statistical analyses were performed using Review Manager 5.3. Results:Five studies were included. Topical PDE4 inhibitors significantly reduced EASI scores within 4 weeks, with MD = -3.77 [-6.92, -0.62] (p < 0.05) and at week 12, with MD = -3.30 [-5.65, -0.95] (p < 0.05). Within 4 weeks, the severity of targeted lesions and percentage change of severity of targeted lesions decreased significantly, with MD = -2.14 [-2.75, -1.53] and MD = -33.71 [-48.08, -19.34] (p < 0.05). Lower risk of treatment-emergent adverse events was shown for topical PDE4 inhibitors with RR = 0.70 [0.51, 0.97] (p < 0.05). Oral PDE4 inhibitors significantly decreased EASI scores at week 4, 8, 12, and over 16 weeks, with MD = -6.29 [-12.47, -0.11]; -8.32 [-15.12, -1.52]; -9.36 [-15.62, -3.10] and -11.02 [-14.84, -7.21], respectively (p < 0.05). Higher systemic adverse events were shown for oral PDE4 inhibitors with RR = 1.41 [1.13, 1.76] (p < 0.05). Sensitivity analyses demonstrated robust results, and funnel plots indicated no significant publication bias. Conclusions:PDE4 inhibitor monotherapy provides clinically meaningful treatment for adult atopic dermatitis patients. Topical formulations demonstrate rapid symptomatic improvement and favourable tolerance. Oral administration exhibits cumulative efficacy for severe disease but requires careful risk-benefit assessment.

Background:Psoriasis is a chronic, immune-mediated skin disorder that causes physical, psychological, and social burdens. There is a growing need to better characterize the distinct clinical features and specific treatment needs of elderly patients with psoriasis, which remains an important area for further research to optimize care in this population. Objective:To investigate the clinical characteristics, comorbidities, and treatment preferences of elderly patients with psoriasis vulgaris. Methods:Patients with psoriasis vulgaris were included in this retrospective study. Data on demographics, disease characteristics, including age at diagnosis, body surface area (BSA), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), comorbidities, and treatment needs were collected. Patients at the visit over 60 years of age were defined as elderly patients. Patients who were diagnosed before 40 years of age were defined as early-onset psoriasis (EOP), and patients who were diagnosed over 40 years of age were defined as late-onset psoriasis (LOP). Continuous variables were compared using t-tests or Mann-Whitney U-tests, categorical variables using Chi-square or Fisher's exact tests. Spearman correlation was used for association analysis. Statistical significance was set at P<0.05. Results:A total of 375 patients were included, comprising 70 (18.67%) elderly and 305 (81.33%) non-elderly patients. The elderly group had a significantly higher proportion of LOP (87.14% vs 48.76%, P<0.05). A higher percentage of elderly patients had moderate-to-severe (27.14% vs 20.98%, P<0.05) and severe (1.43% vs 0.66%, P<0.05) disease. Comorbidities were more prevalent in the elderly, including cardiovascular disease (12.86% vs 3.93%, P<0.05) and diabetes (12.86% vs. 1.31%, P<0.05). Despite this, elderly patients reported lower DLQI scores (median 2.00 vs. 3.00, P<0.05). Regarding treatment needs, elderly patients were less likely to prioritize reducing treatment costs (10.00% vs 20.98%, P<0.05) and preventing disease recurrence (30.00% vs 44.26%, P<0.05) compared to non-elderly patients. Within the elderly cohort, EOP patients exhibited more severe disease (median BSA: 3.00 vs 2.00; median PASI: 3.30 vs 0.80, P<0.05), a higher rate of familial psoriasis (33.33% vs 4.92%, P<0.05), and a greater demand for reducing treatment costs (33.3% vs 6.56%, P<0.05) compared to LOP patients. Conclusion:Elderly patients with psoriasis present a distinct clinical profile characterized by a high prevalence of late-onset disease, a significant comorbidity burden, and differing treatment priorities focused less on cost and recurrence. Despite the increased clinical severity, their perceived quality-of-life impact is lower. Besides, they report higher dissatisfaction linked to unmet needs in itch relief, drug safety, and long-term control. Within the elderly cohort, early-onset patients had more severe disease, stronger familial predisposition, and greater cost-related concerns. The findings highlight the necessity for age-specific, multidimensional management strategies for this population.

Background: Omalizumab is a recombinant humanized monoclonal antibody, which inhibits the occurrence of type 2 inflammatory response by reducing the serum-free immunoglobulin E (IgE) levels. Atopic dermatitis (AD) is a type 2 inflammatory response. However, the efficacy of omalizumab in treating AD remains controversial. Objectives: We aimed to assess the efficacy of omalizumab in the treatment of AD and therefore conducted a meta-analysis to obtain a more objective result. Methods: Seven databases were searched to identify relevant studies, which were subsequently subjected to quality assessment. RevMan5.4 software was used for meta-analysis (PROSPERO registered number: CRD42023476559).Results: A total of 25 studies involving 234 patients were included. The SCORing of AD, Eczema Area and Severity Index, and (Children's) Dermatology Life Quality Index were all significantly decreased after omalizumab treatment, with mean difference = -23.27 (95% confidence interval [CI]: -30.96, -15.59) (P < 0.05); -7.83 (95% CI: -14.37, -1.3) (P < 0.05); -7.66 (95% CI: -9.65, -5.66) (P < 0.05), respectively. Furthermore, as baseline IgE levels increased, the proportion of patients achieving an excellent response exhibited a declining trend. Conclusion: Omalizumab shows promise as a safe and moderately effective treatment for AD, particularly in patients with low IgE levels, elevated eosinophil counts, or positive autologous serum test results. Its efficacy may be influenced by baseline IgE levels, suggesting a need for individualized dosing strategies. Further large-scale randomized control trials are warranted to clarify its optimal use and identify ideal target populations.

Melasma significantly impacts life quality, and while various laser therapies show promise, rigorous comparative studies, especially between the novel Picosecond Alexandrite Laser (PSAL) and the traditional combined modality of Q-switched and Long-pulse Nd: YAG Lasers (QLNYL), are notably lacking. This study aims to fill this gap by evaluating the efficacy and safety of these modalities, providing insights into their comparative advantages for clinical practice. In a prospective, evaluator-blinded study, 40 participants with Fitzpatrick Skin Types (FST) III and IV underwent three treatment sessions at four-week intervals with either PSAL or QLNYL. Efficacy was primarily assessed by changes in Melasma Area and Severity Index (MASI) scores at baseline, 4, 8, 12, and 24 weeks, along with patient satisfaction evaluations at the 12- and 24-week marks, and safety assessments conducted throughout the study. Both groups experienced significant reductions in MASI scores post-treatment. Overall, the improvement in MASI scores in the QLNYL group significantly surpassed that in the PSAL group (P = 0.010). Patient satisfaction was comparably high between groups, and no significant differences were noted in safety profiles. The PSAL group showed a slightly higher incidence of adverse reactions (not significant) and significantly higher pain scores (P = 0.018). Recurrence rates at the 24-week follow-up were 10.5% for PSAL and 0% for QLNYL, with no significant difference. Both PSAL and QLNYL proved effective in treating melasma, with the traditional combined modality of QLNYL demonstrating superior efficacy in FST III-IV. Safety profiles were similar comparable.

Objective:To assess the correlations between Immunoglobulin E (IgE) levels, pruritus, and lesion severity in patients with eczema, atopic dermatitis, or urticaria. Methods:A retrospective study was conducted and data of 814 patients who visited the dermatology or allergy clinics of multiple hospitals, from December 2019 to December 2021, were collected. Patients were divided into children group (<18 years, 325 cases), adult group (18-60 years, 435 cases), and older population group (>60 years, 54 cases) based on the age. Baseline information, pruritus severity, severity of skin lesions, total IgE level, and specific IgE level were recorded to analyze the complex relationship between them. Results:The prevalence of allergic conjunctivitis and allergic rhinitis in the children group was significantly higher than that in the adult and older population group (P < 0.01 or P < 0.05). The positive rate of specific IgE in children group was significantly higher than that in the adult and older population group (P < 0.01). The IgE levels in children with moderate pruritus were significantly lower than those of severe pruritus (63.39vs 114.42 IU/mL, P < 0.05). The IgE levels in children with mild and moderate skin lesions were significantly lower than those in children with severe skin lesions (58.95 vs 72.88 vs 169.15 IU/mL, P < 0.001 or P < 0.01, respectively). Conclusion:Relationships among age, severity of skin pruritus and lesions, and allergen-specific IgE response are complex and subtle, displaying dynamic patterns.

Objective To comprehensively evaluate the association between Thymic Stromal Lymphopoietin (TSLP) and atopic dermatitis (AD). Methods Six databases were searched for relevant studies. For studies on TSLP levels, the standardized mean difference (SMD) was used. For studies involving gene polymorphisms, evaluation was performed using odds ratios (ORs) and 95% confidence intervals (95% CIs). Based on the between-study heterogeneity, a fixed- or random-effects model was chosen. Analyses were performed using RevMan 5.3 software and R 4.3.0 software. Trial sequential analysis was conducted to evaluate whether the number of cases was sufficient. Results A significant relationship between TSLP rs1898671 polymorphism and AD was found under homozygous (DD vs dd), and dominant contrasts (DD + Dd vs dd), with OR = 0.47 (95% CI: 0.24, 0.92) and 0.46 (95% CI: 0.24, 0.88), respectively ( p < 0.05). Whereas under allele (D vs d), heterozygous (Dd vs dd) and recessive contrasts (DD vs Dd + dd), no significant relationship was found. No significant relationship was found for rs1837253 or rs11466749. Serum TSLP levels were significantly higher in patients with AD, with the SMD = 1.45 (95% CI: 0.65, 2.25) ( p < 0.05). Conclusions TSLP gene rs1898671 polymorphism was associated with AD, and TSLP levels were elevated in patients with AD.

AMA Zhou B, Liang S, Shang S, et al. Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2023;40(5):699-701. doi:10.5114/ada.2023.132244. APA Zhou, B., Liang, S., Shang, S., Xiang, L., Zhou, K., & Wu, S. et al. (2023). Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 40(5), 699-701. https://doi.org/10.5114/ada.2023.132244 Chicago Zhou, Boyang, Surong Liang, Shuai Shang, Lujing Xiang, Kefei Zhou, Suhua Wu, and Linfeng Li. 2023. "Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 40 (5): 699-701. doi:10.5114/ada.2023.132244. Harvard Zhou, B., Liang, S., Shang, S., Xiang, L., Zhou, K., Wu, S., and Li, L. (2023). Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 40(5), pp.699-701. https://doi.org/10.5114/ada.2023.132244 MLA Zhou, Boyang et al. "Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 40, no. 5, 2023, pp. 699-701. doi:10.5114/ada.2023.132244. Vancouver Zhou B, Liang S, Shang S, Xiang L, Zhou K, Wu S et al. Evaluation of bone fracture risks in patients with atopic dermatitis: meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2023;40(5):699-701. doi:10.5114/ada.2023.132244.

Objective: To evaluate the association between IL-25, IL-33 and AD more generally. Methods: Databases, including PubMed, Web of Science, EMBASE, Scopus, CNKI and Sinomed were searched. Based on the criteria, publications were collected. The evaluation of study quality was through Newcastle-Ottawa Scale (NOS). Fixed or random effect model was selected according to the between-study heterogeneity to evaluate the association. The analysis procedure and the construction plots were using Review Manager 5.3 software. Results: Six studies were included. A total of 282 subjects were included from four studies to analyze the association between IL-25 and AD. The level of IL-25 was significantly elevated in AD patients, comparing with the control subjects (SMD = 0.89, 95% CI: 0.64, 1.14, p < 0.05). For IL-33, a total of 247 subjects were included from two studies, and the level of IL-33 was also significantly elevated in AD patients comparing to the control subjects (SMD = 0.49, 95% CI: 0.19, 0.80, p < 0.05). Conclusions: The serum levels of IL-25, IL-33 are elevated in AD patients of this study. The IL-25 and IL-33 are significantly associated with the risk of AD. Further studies with larger samples, in multiple countries and focused on different age groups are need.

OBJECTIVE:The aim of this meta-analysis is to investigate the relationship between interleukin (IL)-10 levels and its polymorphism and Takayasu arteritis (TAK).METHODS:Five databases including PubMed, Web of Science, Ovid, Sinomed and China National Knowledge Infrastructure (CNKI) were gone through from inception to March 31, 2022. Studies were screened according to the inclusion and exclusion criteria. Newcastle-Ottawa Scale (NOS) was applied to assess study quality. Strengths of association were evaluated by odds ratio (OR) and 95% CI. The T v. t (allele contrast), TT v. tt (homozygous contrast), Tt vs tt (heterozygous contrast), TT + Tt vs tt (dominant contrast) and TT vs Tt + tt (recessive contrast) models were adopted.RESULTS:Seven studies were included. No significant relationship between IL-10 and TAK was detected in the included patients (P > 0.05). The levels of IL-10 were lower in the active group than those in the stable group, which was -0.47 (95% CI: -0.93, 0.00) (P = 0.05). No significant relationships between IL-10 and TAK were found under all contrasts for polymorphisms rs1800871, rs1800872 and rs1800896 (P > 0.05).CONCLUSIONS:There was no significant difference in IL-10 levels between TAK patients and control subjects. The levels of IL-10 were lower in TAK patients in the active stage. There was no significant association between IL-10 gene polymorphisms and TAK. Further well-designed studies with larger sample sizes in patients with different stages are needed.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease. The mechanism was complex. Genetic mutations of Toll-like receptor (TLR) may be associated with AD, yet still unclear. We aim to provide specific evidence of the association of TLR2, TLR9 gene polymorphisms with AD. Publications were selected according to the criteria. Newcastle-Ottawa Scale was applied to evaluate the quality. The value of ORs and 95%CIs were applied to measure the associations. According to the heterogeneity, the effects model of fixed or random was selected in data combination. For TLR2 gene rs5743708 polymorphism, under allele and recessive contrasts, the pooled data showed a significant correlation, which was A vs a, OR = 0.51 (95%CI: 0.30, 0.86); AA vs Aa + aa, OR = 0.54 (95%CI: 0.33, 0.88). For TLR2 gene rs4696480 polymorphism, under allele, homozygous, heterozygous, and dominant contrasts, the pooled data showed a significant correlation, which was A vs a, OR = 0.79 (95%CI: 0.64, 0.97), AA vs aa, OR = 0.65 (95%CI: 0.43, 0.97), Aa vs aa, OR = 0.68 (95%CI: 0.48, 0.97), AA + Aa vs aa, OR = 0.67 (95%CI: 0.49, 0.93). There are significant associations of TLR2 gene rs5743708, rs4696480 polymorphisms with atopic dermatitis, while no associations are found in TLR9 gene rs5743836, rs187084 polymorphisms.

BACKGROUND:The aim of this study was to investigate the serum level of uric acid (UA) in male patients with androgenetic alopecia (AGA) and to compare the level with that of men without AGA. In addition, the comparison of the serum level of uric acid (UA) before and after treatment with finasteride was performed. METHOD:A total of 120 male patients with AGA and 120 males without AGA were enrolled in this prospective study. Patients with AGA were randomized into two groups: 60 patients were given 1 mg finasteride orally every day for 6 months, and 60 patients were given placebo. Serum UA level was detected at the first visit and after the 6-month treatment by colorimetric analysis. RESULTS:Before treatment, the mean serum UA level in patients with AGA was higher than that in the control group (401.52±83.27 umol/L vs 362.67±60.88 umol/L, P<0.050), and a higher proportion of hyperuricemia was found in patients with AGA (2 9.17% vs 15.00%, P<0.050). After treatment, the mean serum UA level in the finasteride group decreased significantly, from 405.87±87.12 umol/L to 381.84±82.50 umol/L (P<0.050), and from 397.17±79.73 to 394.18±78.09 umol/L in the placebo group (P = 0.370). Patients with AGA with hyperuricemia had a higher BMI (25.38±3.43 kg/m2) when compared to the patients without hyperuricemia (23.88±2.64 kg/m2). For every unit of BMI increase in patients with AGA, the risk of hyperuricemia increased by 30.5% (P = 0.030). Furthermore, the levels of UA were different in the finasteride group before and after treatment (P = 0.049, 95%CI, 0.080, 47.970). CONCLUSIONS:We found that AGA has a relationship with hyperuricemia, and the level of serum UA can decrease with the treatment of finasteride.

AMA Zhou B, Shang S, Liang S, et al. No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2023;40(5):705-707. doi:10.5114/ada.2023.130543. APA Zhou, B., Shang, S., Liang, S., Xiang, L., Zhou, K., & Wu, S. et al. (2023). No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 40(5), 705-707. https://doi.org/10.5114/ada.2023.130543 Chicago Zhou, Boyang, Shuai Shang, Surong Liang, Lujing Xiang, Kefei Zhou, Suhua Wu, and Linfeng Li. 2023. "No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 40 (5): 705-707. doi:10.5114/ada.2023.130543. Harvard Zhou, B., Shang, S., Liang, S., Xiang, L., Zhou, K., Wu, S., and Li, L. (2023). No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 40(5), pp.705-707. https://doi.org/10.5114/ada.2023.130543 MLA Zhou, Boyang et al. "No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 40, no. 5, 2023, pp. 705-707. doi:10.5114/ada.2023.130543. Vancouver Zhou B, Shang S, Liang S, Xiang L, Zhou K, Wu S et al. No elevated risk of COVID-19 in atopic dermatitis patients: a meta-analysis and trial sequential analysis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2023;40(5):705-707. doi:10.5114/ada.2023.130543.

Objectives:Peripheral blood immune cell profiling of atopic dermatitis patients before and after treatment by single-cell RNA sequencing technique has not been reported. To study the immune Cell Profiling of Atopic Dermatitis Patients Before and After Treatment with Halometasone Cream Wet-Wrap Therapy. Methods:We used single cell sequencing to detect the proportion change and gene expression change of immune cells in 2 patients before and after treatment, and then used real-time PCR to confirm the mRNA level of differential genes. Results:In this study, scRNA-seq in two patients with severe AD before and after halometasone cream wet-wrap therapy showed that in the mild severity of AD after treatment, Th2 cells were significantly decreased (41.2% vs 13.4%), Th1 and Th17 cells were increased (23.3% vs 43.7%, 2.3% vs 4.8% respectively). The proportion of Th22 cells did not change much (1.3% vs 1.9%). Tregs were significantly increased also (1.5% vs 5.0%). In the regulatory T cells, the expression of IL-27, PD-1, CD103, CTLA-4, ZNF-66, IL-β, CD7 gene was specifically increased after treatment, and CD39, P21, TOX2, CD151, CD79A, S100A12, TRAP1 gene was specifically decreased after treatment. In the TH2 cells, the expression of CD27, CD68, EZH1, RAD1, EGFR, CCR10, BCL11A, KLF4 gene was specifically increased after treatment and CCL26, CD180, IL-31, CCL22, LEF1, OX40 gene was specifically decreased after treatment. Conclusions:These genes may be new target for further study.

Introduction: Dupilumab is approved for a variety of type 2 inflammatory diseases. Changes in chemokine levels during treatment require further analysis.Aim: We evaluated changes in eotaxin-3 and PARC levels after dupilumab treatment through a meta-analysis, aiming to provide more comprehensive results.Material and methods: Databases were searched to select eligible publications. The study quality was assessed after inclusion. The standardized mean difference (SMD) was used for evaluation.Results: Four studies were included. Eotaxin-3 levels were not seen significantly decreased at weeks 1 and 12, with SMD = -0.39 (95% CI: -1.78, 0.99) and -2.60 (95% CI: -5.77, 0.57), respectively (p > 0.05). Eotaxin-3 levels decreased significantly at weeks 2, 4, 8, 16, 24, 36, and 52, with SMD = -0.94 (95% CI: -1.61, -0.27); -1.17 (95% CI: -1.49, -0.84); -1.20 (95% CI: -1.52, -0.88); -1.31 (95% CI: -1.83, -0.79); -4.57 (95% CI: -6.90, -2.33); -5.28 (95% CI: -5.52, -5.04); and -4.03 (95% CI: -4.22, -3.85) (p < 0.05), respectively. PARC levels decreased significantly at weeks 4, 8, 12, and 16, with SMD = -1.08 (95% CI: -1.59, -0.58); -1.17 (95% CI: -1.68, -0.66); -1.11 (95% CI: -1.61, -0.60); and -1.15 (95% CI: -1.66, -0.64) (p < 0.05), respectively.Conclusions: Eotaxin-3 and PARC levels can be significantly reduced in patients treated with dupilumab.

Background:Increasing numbers of studies demonstrated that picosecond lasers (Picos) were effective and safe for melasma. However, A limited number of randomized controlled trials (RCTs) regarding Picos contribute to a modest level of evidence. Topical hydroquinone (HQ) remains to be the first-line therapy.Objective:To compare the efficacy and safety of non-fractional picosecond Nd:YAG laser (PSNYL), non-fractional picosecond alexandrite laser (PSAL), and 2% HQ cream in the treatment of melasma.Method:Sixty melasma patients with Fitzpatrick skin types (FST) III-IV were randomly assigned to the PSNY, PSAL, and HQ groups at a 1:1:1 ratio. Patients in PSNYL and PSAL groups received 3 laser sessions at 4-week intervals. The 2% HQ cream was applied twice daily for 12 weeks in patients of the HQ group. The primary outcome, the melasma area and severity index (MASI) score, was evaluated at weeks 0, 4, 8, 12, 16, 20, and 24. The patient assessment score by quartile rating scale was rated at weeks 12, 16, 20, and 24.Results:Fifty-nine (98.3%) subjects were included in the analysis. Each group showed significant change from baseline in MASI scores from week 4 to week 24. The MASI score in the PSNYL group showed the greatest reduction compared to the PSAL group (p = 0.016) and HQ group (p = 0.018). The PSAL group demonstrated comparable MASI improvement as the HQ group (p = 0.998). The PSNYL group had the highest patient assessment score, followed by the PSAL group and then the HQ group, although only the differences between PSNYL and HQ groups at weeks 12 and 16 were significant. Four patients (6.8%) experienced recurrence. Other unanticipated events were transient and subsided after 1 week to 6 months.Conclusion:The efficacy of non-fractional PSNYL was superior to that of non-fractional PSAL, which was not inferior to 2% HQ, thus non-fractional Picos providing an alternative for melasma patients with FSTs III-IV. The safety profiles of PSNYL, PSAL, and 2% HQ cream were similar.Clinical Trial Registration:https://www.chictr.org.cn/showprojen.aspx?proj=130994, ChiCTR2100050089.

The relation between vitamin D receptor (VDR) gene polymorphisms and ankylosing spondylitis (AS) remains unclear. A systematic review and meta-analysis were conducted using six databases, including PubMed, Web of Science, EMBASE, CNKI, Wanfang and Cochrane Library. The selection of each study was based on inclusion and exclusion criteria. The Newcastle–Ottawa Scale was applied to assess the quality of the included studies, while the strength was evaluated by odds ratios and 95

Objective To provide evidence of the association between CLTA-4 gene polymorphisms and alopecia areata (AA).Methods PubMed, EMBASE, Web of Science, Cochrane, Wanfang, and CNKI databases were searched until 30 April 2021. The selection was completed according to the inclusion and exclusion criteria. The study quality assessment was based on Newcastle-Ottawa Scale. The assessment of the association was measured by ORs and 95%CIs.Results Nine studies, containing 2858 AA cases and 5444 disease-free control subjects were included. For rs231775 polymorphism, no significant association with AA was found, which was A vs. a, OR = 1.02 [0.81, 1.30], p = 0.85; AA vs. aa, OR = 1.26 [0.81, 1.97], p = 0.31; Aa vs. aa, OR = 1.04 [0.54, 2.01], p = 0.91; AA + Aa vs. aa, OR = 1.04 [0.71, 1.53], p = 0.82; AA vs. Aa + aa, OR = 1.31 [0.97, 1.78], p = 0.08. For rs3087243 polymorphism, also no significant association was found, which was A vs. a, OR = 0.93 [0.78, 1.11]; p = 0.40, AA vs. aa, OR = 0.68 [0.44, 1.06]; p = 0.09; Aa vs. aa, OR = 0.87 [0.45, 1.68], p = 0.68; AA + Aa vs. aa, OR = 0.93 [0.68, 1.28], p = 0.66; AA vs. Aa + aa, OR = 0.78 [0.34, 1.81], p = 0.57. For rs231726 polymorphism, a significant correlation was found, which was A vs. a, OR = 0.76 [0.70, 0.82], p < 0.05.Conclusions A significant correlation between CTLA-4 rs231726 polymorphism and AA susceptibility was found, but no significant association of CTLA-4 gene rs231775 and rs3087243 polymorphisms and AA susceptibility was found.

目的 分析脊柱关节病型银屑病关节炎关节受累的影响因素,寻找早期发现该病的可能指标.方法 回顾性选取2016年9月至2022年2月就诊于首都医科大学附属北京友谊医院风湿内科及皮肤科的358例银屑病关节炎的患者作为研究对象,根据受累部位不同将患者分为脊柱关节病型银屑病关节炎组(n=117)和外周关节病银屑病关节炎组(n=241).根据强直性脊柱炎疾病活动(ASDAS)评分对脊柱关节病型银屑病关节炎患者进行疾病活动度分组,疾病轻度活动组(ASDAS<2.1,n=47),重度活动组(ASDAS≥2.1,n=70).分析影像学分级、银屑病面积与严重性指数(PASI)评分、格拉斯哥超声附着点评分系统(GUESS)评分、自身抗体、炎症指标等与脊柱关节病型银屑病关节炎疾病活动度之间的相关性.结果 脊柱关节病型银屑病关节炎组患者的眼部受累的比率、HLA-B27阳性率、红细胞沉降率(ESR)、GUESS评分分别为14.5％、20.1％、(21.8±16.6)mm/h、(23.0±12.1)分,高于外周关节病变型银屑病关节炎组[6.2％、10.4％、(34.6±21.3)mm/h、(9.5±10.3)分],差异均有统计学意义(P<0.05).在脊柱关节病型银屑病关节炎患者中,轻度活动组与重度活动组骶髂关节CT分级差异无统计学意义(P>0.05);重度活动组患者PASI评分、GUESS评分为(14.5±9.1)、(12.8±9.6)分,均高于轻度活动组[(10.6±6.1)、(2.2±3.4)分],差异均有统计学意义(P<0.05);轻度活动组与重度活动组组间HLA-B27阳性率、抗环瓜氨酸肽(CCP)抗体阳性率比较(14.7％vs.22.9％、8.8％vs.12.0％),差异无统计学意义(P>0.05);重度活动组患者的平均ESR和C反应蛋白(CRP)值为9.4 mm/h、4.8 mg/L,均显著高于轻度活动组(1.6 mm/h、1.0 mg/L),差异均有统计学意义(P<0.05).多因素Logistic回归发现PASI评分(OR=1.075,95％CI=0.930～1.243,P<0.05)与GUESS评分(OR=0.476,95％CI=1.057～2.453,P<0.05)是脊柱关节病型银屑病重度疾病活动度的独立影响因素.结论 临床医师在早期评估银屑病关节炎患者时,应将PASI评分及GUESS评分作为整体评估脊柱关节病型银屑病关节炎的重要手段.

Background Dupilumab is approved for multiple type 2 inflammatory diseases. In the treatment procedure, the changes of IgE levels need further analysis. We evaluated the changes of IgE levels through meta-analysis, aiming to provide a more comprehensive result. Research design and methods Databases were searched to select eligible publications. After being included, study quality was assessed. The standardized mean difference (SMD) was used as an evaluation. Results Seven studies were included. At week 4, the level of IgE did not decrease significantly, with SMD = -0.12 (95%CI: -0.31, 0.07) (P > 0.05). At week 8, 12, 16, 24, and 52, the level of IgE decreased significantly, which was SMD = -0.26 (95%CI: -0.48, -0.03); -0.25 (95%CI: -0.32, -0.18); -0.49 (95%CI: -0.65, -0.33); -0.30 (95%CI: -0.38, -0.22); -0.40 (95%CI: -0.48, -0.32) (P < 0.05). In AD studies, with the increase of IgE levels, due to the decrease in the total dose of dupilumab, the efficacy index showed a decreasing trend. Conclusions Levels of IgE can be significantly decreased in patients with dupilumab treatment. In AD patients, the efficacy was related to total dose; for patients with high IgE levels, efficacy may be better with the dose increased.