Psoriasis patients in China face severe barriers to disease knowledge acquisition and limited access to medical resources, creating an urgent demand for reliable, evidence-based patient education tools. This multicenter expert evaluation study aimed to systematically assess the quality and clinical applicability of mainstream Chinese large language models (LLMs) in answering psoriasis-related patient inquiries. A total of 40 clinically representative high-frequency questions covering 5 core domains (etiology, triggers, treatment, management, psychosocial impact) were curated from 365 Questions on Psoriasis (compiled by 109 Chinese psoriasis experts) by 9 board-certified dermatologists. Four mainstream Chinese LLMs (DeepSeek-R1, DeepSeek-V3, GLM-4, Qwen3-Plus) were evaluated via a double-blind expert scoring protocol. Responses were independently rated by 9 dermatologists using a 10-point Likert scale across 4 equal-weight dimensions: accuracy, completeness, clarity, and safety. The overall mean scores of the 4 LLMs ranged from 7.30 ± 0.47 to 8.84 ± 0.42, with single-question scores ranging from 4.88 to 9.20. Qwen3-Plus achieved the highest overall score (8.84 ± 0.42), significantly outperforming the other 3 models (all P < 0.001), followed by DeepSeek-V3 (8.36 ± 0.41), DeepSeek-R1 (8.19 ± 0.48), and GLM-4 (7.30 ± 0.47, the lowest, all P < 0.001 vs. other models). A statistically significant difference was also found between DeepSeek-R1 and DeepSeek-V3 (Bonferroni-adjusted P = 0.010). All models avoided life-threatening misleading content, and 87.5% of responses proactively emphasized the necessity of physician consultation. However, 12.5% of responses deviated from evidence-based guidelines, 80% of which were concentrated in complex biologics-related topics, including incorrect claims of psoriasis cure by biologics, inconsistent descriptions of marketed biologics in Chinese mainland, and non-standard recommendations for special populations (pregnancy/lactation). Chinese LLMs show preliminary potential as supplementary tools for standardized psoriasis patient education on basic disease topics, with generally safe information output and appropriate guidance to seek professional medical care in most responses. However, significant performance heterogeneity across models, non-negligible guideline deviations in specialized clinical topics (especially biologics-related content), and low absolute inter-rater agreement of the scoring system indicate that the clinical applicability and reliability of current LLMs in complex psoriasis management scenarios are still limited, and they cannot replace professional dermatological advice.

Background:Prurigo nodularis (PN) is a chronic inflammatory dermatosis that often coexists with atopic dermatitis (AD) but represents a distinct entity. Evidence directly comparing PN and AD in Chinese populations remains limited. Objectives:To characterize clinical distinctions between PN and AD in Chinese adults and to explore whether total serum immunoglobulin E (IgE) status delineates distinct clinical profiles within PN. Methods:This multicenter case-control study enrolled 2,621 adult patients (≥18 years) including 1,462 with PN and 1,159 with AD. Multivariable logistic regressions were used to evaluate independent associations differentiating PN from AD and to examine IgE-defined clinical heterogeneity within PN. Results:Compared with AD, PN was independently associated with middle age, rural residence, lower education, smoking, and an overall reduced atopic profile, and was more frequently accompanied by type 2 diabetes mellitus and psychiatric disorders. Within PN, the IgE-high subgroup displayed a pronounced type 2 immune response-associated inflammatory profile, including peripheral eosinophilia and allergen sensitization, whereas IgE-normal patients showed comparatively attenuated atopic markers. In contrast, sociodemographic correlates that distinguished PN from AD were not consistently different between IgE-defined PN subgroups. Conclusions:In Chinese adults, PN exhibits clinical heterogeneity with two distinct patterns: one characterized by variability in type 2 immunity-associated and atopic features, and the other by a substantial burden of specific sociodemographic and metabolic comorbidities. Serum IgE may serve as a practical marker for stratifying type 2 immunity and atopic variability in PN.

Psoriasis is an autoinflammatory skin disease characterized by the abnormal activation of epidermal keratinocytes. The Hippo-YAP pathway is an evolutionarily conserved pathway that plays important roles in organ size control and tumorigenesis. Recently, accumulating evidence demonstrated that YAP1, the core downstream component of Hippo-YAP pathway, was up-regulated in psoriasis patients, suggesting its possible role in psoriasis development. However, its precise function and mechanism in psoriasis pathogenesis are still not well-clarified. In the present study, we confirmed the up-regulation of YAP1 in psoriasis keratinocytes by measuring its expression in psoriatic patient skins, psoriatic-like cellular model, and IMQ-induced mouse model. Further functional studies showed that YAP1 promoted keratinocyte proliferation and inflammation in vitro. Meanwhile, VP, a selective YAP1 antagonist, inhibited keratinocyte proliferation and inflammatory factor production in a dose-dependent way. Moreover, intradermal injection of si-Yap1 or VP hindered psoriasis development by impeding epidermal hyperplasia and relieving systemic inflammatory response in the IMQ-induced mouse model. Therefore, our findings suggest that YAP1 plays a crucial role in psoriasis pathogenesis through modulating keratinocyte activation and may serve as a novel target for the treatment of psoriasis.

BACKGROUND:Psoriasis is a systemic disease that brings enormous mental pressure and economic burden to patients and has a significant impact on patients' quality of life (QoL). This study aimed to explore factors affecting the dermatology life quality index (DLQI) in patients with psoriasis. METHODS:This retrospective cross-sectional study used data sourced from the Psoriasis Diagnosis and Treatment Real-world Database, and 8839 patients with psoriasis (recruited between June 24, 2020 and September 2, 2021) were included. Demographic and clinical characteristics and DLQI scores were retrospectively analyzed, and correlations between DLQI score and age, disease course, psoriasis area and severity index (PASI) score were calculated. Regression analysis was conducted to explore the factors affecting the DLQI scores of patients with psoriasis. RESULTS:The average DLQI scores were significantly higher in young (8.58 ± 7.22) and middle-aged individuals (8.09 ± 6.61) than those in juveniles (6.00 ± 5.79) and older individuals (7.39 ± 6.29) ( P = 1.70E-15). The average DLQI scores gradually decreased among individuals whose work status were unemployment (10.4 ± 7.83), part-time (9.02 ± 6.83), full-time (8.43 ± 6.90), retired (7.93 ± 6.07), and students (7.10 ± 6.31) ( P = 9.82E-23). Except for those with disease course ≥20 years, DLQI scores increased gradually with prolongation of the disease course ( P = 4.72E-22). The higher the severity of psoriasis, the higher the average DLQI score ( P = 3.79E-113). The presence of psoriatic lesions at the exposed sites significantly affected DLQI scores ( P <0.001). The average DLQI scores were significantly higher among individuals with nail holes, joint pain, and comorbidities than among those without these conditions ( P <0.05). Correlation analysis indicated that the PASI scores were positively correlated with the DLQI scores ( r = 0.26, P = 4.19E-134). Multinomial logistic regression analysis showed significant influencing factors (excluding comorbidity) with different degrees of impact based on the DLQI score ( P <0.05). CONCLUSION:Physicians should focus on significant factors, such as sex, age, marital status, education, work status, sub-types, disease course, PASI score, joint pain, and nail holes, to improve the QoL of patients with psoriasis.

Compared with the wound in the flat part of human body, the repair of the wound in the joint, armpit and other frequently moving parts is still a complex problem. Although many flexible and adhesive hydrogel dressings for the repair of wounds at moving parts have been developed, in order to improve their flexibility and adhesion, most hydrogel dressings use synthetic polymers and natural polymers to form composite hydrogels, which greatly reduces their biocompatibility and bioactivity compared with a single natural polymer hydrogel. They can only passively provide a barrier to the wound and the process of wound repair is slow, which seriously hinders their further application. Inspired by commercial adhesive bandages, we have successfully constructed a flexible adhesive hydrogel dressing of embedded structure with pro-angiogenesis activity. The hydrogel was prepared by the adhesive and non-adhesive parts by topological adhesion and molecular entanglement. Due to the high-density hydrogen bonding, hydrogels possessed good adhesion and flexibility, which allowed them to repair wounds of moving parts successfully. In addition, the non-adhesive part loaded with exosomes was directly in contact with the wound, minimizing the stimulation of the wound tissue by cytotoxic materials, and continuously releasing active substances to promote vascular regeneration. This biocompatible flexible and adhesive hydrogel dressing with pro-angiogenesis activity shows strong potential in wound tissue remodeling, providing a new strategy for the treatment of moving parts or sensitive wound parts.

目的 检测一个寻常型鱼鳞病家系FLG基因的突变情况.方法 根据典型的临床表现,1例先证者诊断为寻常型鱼鳞病.提取患者及其家系外周血DNA,采用遗传性皮肤病多基因芯片对先证者进行高通量测序,确定突变位点,再采用Sanger测序法对先证者和家系的DNA进行双向验证.结果 先证者FLG基因发生c.3321delA及c.6950_6957delCATCCCAT复合杂合突变.家系中其余4人为其中1个突变的携带者.对这2个突变位点进行功能预测显示,c.3321delA及c.6950_6957delCATCCCAT复合杂合突变,导致编码氨基酸发生p.G1109Efs*13及p.S2317*改变,最终影响FLG基因编码的中间丝相关蛋白原的功能.结论 FLG基因复合杂合突变是先证者的致病突变.

Psoriasis is an immune-mediated chronic, relapsing, inflammatory, systemic disease induced by a combination of genetics and environment. Currently, there are limited reports on the epidemiological and clinical characteristics of geriatric psoriatic patients in mainland China. This study analyzed the epidemiological characteristics, clinical features, and comorbidity rates of geriatric patients with psoriasis and evaluated the influence of age of onset on disease characteristics. This retrospective study enrolled 1259 geriatric patients with psoriasis in hospitals affiliated with the National Standardized Psoriasis Diagnosis and Treatment Center in China from September 2011 to July 2020 to analyze the epidemiological characteristics, clinical features, and prevalence of comorbidity in geriatric psoriasis. The cases were classified according to the age of onset into two groups to compare differences: early-onset psoriasis (EOP) and late-onset psoriasis (LOP). The mean age of geriatric patients with psoriasis was 67, with a 1.8:1 male-to-female ratio and 10.7% positive family history. The clinical manifestations of plaque psoriasis accounted for a high proportion (82.0%) and 85.1% of patients had moderate to severe disease. Overweight (27.8%), hypertension (18.0%), joint involvement (15.8%), diabetes (13.7%), and coronary heart disease (4.0%) were the first five common comorbidities. The LOP group had significantly more patients (79.9%) than the EOP group (20.1%). Positive family history was significantly associated with the EOP group (21.7%) than the LOP group (7.9%). The scalp (60.2%) was the most affected area, followed by the nails (25.3%), palmoplantar region (25.0%), and genitals (12.7%). This study analyzed the epidemiological and clinical characteristics of geriatric psoriasis in China and found that age of onset had no effect on disease characteristics or other comorbidities, except for toenail involvement, diabetes, and joint damage.

Psoriasis is an immune-mediated chronic inflammatory skin disease caused by a combination of environmental incentives, polygenic genetic control, and immune regulation. The inflammation-related gene absent in melanoma 2 ( AIM2 ) was identified as a susceptibility gene for psoriasis. AIM2 inflammasome formed from the combination of AIM2, PYD-linked apoptosis-associated speck-like protein (ASC) and Caspase-1 promotes the maturation and release of inflammatory cytokines such as IL-1β and IL-18, and triggers an inflammatory response. Studies showed the genetic and epigenetic associations between AIM2 gene and psoriasis. AIM2 gene has an essential role in the occurrence and development of psoriasis, and the inhibitors of AIM2 inflammasome will be new therapeutic targets for psoriasis. In this review, we summarized the roles of the AIM2 gene and AIM2 inflammasome in pathogenesis and treatment of psoriasis, hopefully providing a better understanding and new insight into the roles of AIM2 gene and AIM2 inflammasome in psoriasis.

Background The incidence of infection with Mycobacterium abscessus (M. abscessus) has increased in recent years. This increase is partly associated with invasive cosmetic procedures. Case summary The purpose of this case summary is to increase clinicians' awareness of M. abscessus infection and reduce mycobacterial infection caused by cosmetic procedures. We report the case of a 45-year-old woman who received acetyl hexapeptide-8 (argireline) injections in the forehead and temples, and erythema, nodules, and abscesses appeared at the injection sites after one week. The pus specimens were examined by microbiological culture and confirmed to be positive for M. abscessus. Clarithromycin 500 mg twice daily and moxifloxacin 400 mg once daily were administered for 5 mo and the lesions gradually subsided. Conclusion We report here for the first time a case of infection with M. abscessus after argireline injection. This condition is easily misdiagnosed as a common bacterial infection. Microbiological examinations are helpful for diagnosis and standardized cosmetic procedures can prevent infection with M. abscessus.

Psoriasis is an auto-inflammatory skin disease characterized by abnormal activation of epidermal keratinocytes, aberrant neovascularization, and dysregulation of immune cells. MicroRNAs are small non-coding RNAs that mainly function in the post-transcriptional regulation of gene expression. Recently, accumulating evidence has demonstrated that expression of microRNAs is dysregulated in psoriasis patients and microRNAs play key roles in psoriasis pathogenesis. Downregulation of miR-193b-3p has been identified to be associated with psoriasis development. However, the precise functions and action mechanisms of miR-193b-3p in psoriasis pathogenesis remain unclear. In this study, we confirmed the downregulation of miR-193b-3p in psoriasis patients, psoriasis-like inflammatory cellular models, and an imiquimod (IMQ) -induced mouse model. A negative correlation was found between miR-193b-3p level and patient Psoriasis Area and Severity Index (PASI) score. Furthermore, miR-193b-3p suppressed proliferation, inflammatory-factor secretion, and the STAT3 and NF-κB signaling pathways in keratinocytes. Importantly, intradermal injection of agomiR-193b-3p blocked, whereas antagomiR-193b-3p augmented, the psoriasis-like inflammation in the IMQ-induced mouse model. Bioinformatics analysis and the dual-luciferase reporter assay showed that miR-193b-3p targets ERBB4 3ʹ untranslated region (UTR). In addition, ERBB4 induced proliferation, inflammatory-factor production, and the STAT3 and NF-κB pathways in keratinocytes. Most importantly, forced expression of ERBB4 could attenuate the effects of miR-193b-3p in keratinocytes, indicating that miR-193b-3p inhibits keratinocyte activation by directly targeting ERBB4 . In conclusion, our findings demonstrated that the miR-193b-3p–ERBB4 axis underlies the hyperproliferation and aberrant inflammatory-factor secretion of psoriatic keratinocytes, providing a novel, microRNA-related causal mechanism and a potential therapeutic target in psoriasis.

Background In recent years, the rate of immunosuppressed patients has increased rapidly. Invasive fungal infections usually occur in these patients, especially those who have had hematological malignances and received chemotherapy. Fusariosis is a rare pathogenic fungus, it can lead to severely invasive Fusarium infections. Along with the increased rate of immune compromised patients, the incidence of invasive Fusarium infections has also increased from the past few years. Early diagnosis and therapy are important to prevent further development to a more aggressive or disseminated infection. Case summary We report a case of a 19-year-old male acute B-lymphocytic leukemia patient with fungal infection in the skin, eyeball, and knee joint during the course of chemotherapy. We performed skin biopsy, microbial cultivation, and molecular biological identification, and the pathogenic fungus was finally confirmed to be Fusarium solani. The patient was treated with oral 200 mg voriconazole twice daily intravenous administration of 100 mg liposomal amphotericin B once daily, and surgical debridement. Granulocyte colony-stimulating factor was administered to expedite neutrophil recovery. The disseminated Fusarium solani infection eventually resolved, and there was no recurrence at the 3 mo follow-up. Conclusion Our case illustrates the early detection and successful intervention of a systemic invasive Fusarium infection. These are important to prevent progression to a more aggressive infection. Disseminate Fusarium infection requires the systemic use of antifungal agents and immunotherapy. Localized infection likely benefits from surgical debridement and the use of topical antifungal agents.

BACKGROUND:Facial cosmetic procedures become popular for people with a desire to have a younger appearance, and cosmetic technology has developed rapidly over the past several decades. However, increasing complications related to cosmetic injections have been reported, and infection is one of the most serious problems and can cause anxiety and facial injury. We here report a case of Majocchi's granuloma (MG) caused by Trichophyton rubrum after facial injection of hyaluronic acid.CASE SUMMARY:A 37-year-old woman presented to our hospital with a history of red papules, nodules, and abscesses on her left zygomatic arch for 2 mo. She had received a cosmetic injection of hyaluronic acid on the left side of her face prior to the appearance of the lesions. MG caused by Trichophyton rubrum after facial injection of hyaluronic acid was diagnosed based on morphology and molecular biological identification. In vitro antifungal susceptibility testing was conducted according to the Clinical and Laboratory Standards Institute M38-A2 method. Minimal inhibitory concentrations were used to evaluate the antifungal susceptibility. The antifungal agents and their minimal inhibitory concentrations for the strain were terbinafine (< 0.5 μg/mL), itraconazole (0.06 μg/mL), amphotericin B (0.25 μg/mL), fluconazole (32 μg/mL), voriconazole (0.125 μg/mL), posaconazole (0.125 μg/mL), and isavuconazole (0.06 μg/mL). We initially administered 250 mg/d oral terbinafine for 2 mo, but the patient still had painful papules, nodules and abscesses on her face. Then, we adjusted the treatment to itraconazole 400 mg/d for 8 wk based on the in vitro antifungal susceptibility testing results. The skin lesions improved significantly, and there was no recurrence during follow-up.CONCLUSION:This case revealed that facial injection of hyaluronic acid may cause serious MG. Antifungal susceptibility testing should be considered in the treatment of MG caused by Trichophyton rubrum.

Objective To establish a culture method for primary human nail matrix cells in serumfree media.Methods Nail matrix tissues were collected from 9 patients,who received nail or toe amputation and nail bed repair in Peking University Shenzhen Hospital between January 2016 and December 2016,and cultured in the serum-free DEME/F-12 media at a 37℃ incubator with an atmosphere of 5％ CO2 in air for 2-3 days.Then,primary human nail matrix cells were cultured in keratinocyte serumfree media (CnT-07),and the morphology of human nail matrix cells was observed by microscopy during the culture process.Immunofluorescence cytochemistry with anti-keratin 5 (K5) and K10 was performed to identify the acquired cells,and flow cytometry to analyze the cell purity.Results After 2 or 3 days of the culture,some cells began to crawl out from the tissue.On day 10,large cell masses were formed,some cells were morphologically similar to epithelioid cells arranged in a paving stone-like pattern,and some were flat giving a spindle-shaped or star-shaped appearance.Immunofluorescence cytochemistry showed that some cells could express both K5 and K10,which proved the existence of nail matrix cells,and 37.6％ of the cells expressed K10.Conclusion Human primary nail matrix cells could be successfully cultured by using the tissue culture method with serum-free culture media,and the nail matrix cells cultured in vitro can express both K5 and K10.

Objective: This study aimed to explore the effects of STAT3 targeting by let-7a on T-cell proliferation and IFN-γ secretion in psoriasis. Methods: From January 2013 to January 2015, 40 patients with psoriasis (psoriasis group) and 38 volunteers undergoing plastic surgery (control group) were enrolled in this study. Pearson correlation analysis was performed to evaluate the correlation between let-7a and STAT3 expression. T-cells were isolated and subjected to different transfection methods. A dual luciferase reporter assay was carried out to confirm STAT3 as a target gene of let-7a. Let-7a, STAT3 and IFN-γ mRNA expression was detected by quantitative real-time fluorescent polymerase chain reaction (qRT-PCR), and pSTAT3 protein levels were determined by Western blot. T-cell proliferation was evaluated with a cell counting kit-8 (CCK-8) assay. Results: The level of STAT3 mRNA and pSTAT3 was higher, but let-7a expression was lower in the psoriasis group than the control group. Pearson correlation analysis indicated that STAT3 expression was negatively correlated with let-7a expression. T-cells transfected with inhibitors exhibited greater IFN-γ mRNA expression and T-cell proliferation than transfected T-cells and T-cells transfected with a non-sense sequence, while T-cells transfected with let-7a mimics exhibited lower IFN-γ mRNA expression and T-cell proliferation than transfected T-cells and T-cells transfected with a non-sense sequence. This suggested that siRNA-STAT3 could reverse the increase in IFN-y mRNA expression and T-cell proliferation induced by let-7a inhibitors. Conclusion: Our results demonstrated that let-7a inhibits T-cell proliferation and IFN-γ secretion by down-regulating STAT3 in psoriasis.

目的 观察Dectin-1在真菌性足菌肿皮损中的表达,初步分析其在足菌肿发病中的作用.方法 实验分为3组,A组8例足菌肿病例,B组为10例着色芽生菌病病例,A组和B组统称为感染组,C组为18例正常皮肤组织.应用免疫组化法检测3组病例的组织蜡块中Dectin-1、IL-4,IL-10,IFN-γ,TNF-α的表达.结果 与正常组相比,感染组皮肤的Dectin-1、IL-4、IFN-γ、TNF-α、IL-10的积分光密度增高(P＜0.05).A组与B组相比,两组间Dectin-1、IL-4、IFN-γ,TNF-α的积分光密度值比较无差异(P＞0.05).结论 真菌感染皮损中Dectin-1的表达上调,可能说明Dectin-1在足菌肿发病中具有一定作用.

目的 了解近年本院头癣临床特征及病原菌分布情况.方法 对2013年1月～2014年12月间本院皮肤科确诊的头癣患者进行回顾性分析.结果 24例头癣患者中男10人,女14人,平均年龄是10岁.头癣类型中白癣占58.3％.犬小孢子菌占致病菌的29％.结论 24例头癣患者以4～9岁的儿童居多,白癣是主要临床类型,犬小孢子菌是主要致病菌.