Background Pigmentation-related disorders mainly revolve around abnormal melanogenesis, but the regulatory mechanisms remain unclear. Recent reports have found that COMMD3 plays a role in promoting melanin synthesis. Objectives This study aims to investigate the molecular mechanisms and relation with copper homeostasis of a novel pigment-promoting gene, COMMD3, in skin pigmentation. Methods A UV-induced pigmentation murine model was created by UVB irradiation for examining the function of COMMD3 in acquired hyperpigmentation. Intracellular copper content was measured to determine the effect of COMMD3 on tyrosinase activity. After suppressing COMMD3 by gene knockdown (KD) in the B16F10 cell line and the UVB-induced pigmented murine model, RNA sequencing was conducted to identify potential signaling pathways underlying COMMD3 regulating melanogenesis. Results COMMD3 modulating melanogenesis was observed in UV-induced pigmented murine models and B16F10s. RNA sequencing and validation supported that suppressing COMMD3 leads to an increase in clusterin (CLU), decreasing PAX3 and its nuclear translocation, ultimately resulting in a reduction of melanogenesis. Concurrently, as a copper transporter, a decrease in COMMD3 expression caused intracellular copper accumulation, which lowered tyrosinase activity and reduced melanin production. After using the copper chelator ammonium tetrathiomolybdate to alleviate copper accumulation caused by COMMD3 deficiency, repress CLU expression, and restore PAX3, leading to increasing melanin content in melanogenesis. Conclusion Our findings demonstrate that COMMD3 plays an important role in regulating melanogenesis. COMMD3 regulates melanogenesis via CLU-PAX3 axis and adjusts tyrosinase activity through intracellular copper levels. The insights provide a mechanistic rationale and potential therapeutic strategy for mitigating acquired skin pigmentation disorders.

BackgroundFacial aging is caused by structural and functional degeneration and atrophy of multiple layers including skin, fat, muscle, and bone. Energy-based device (EBD) therapy has been primarily utilized for strengthening muscle, as well as ameliorating the sagging and laxity of skin in the entire body. Hence, the appropriate EBD-induced strength of facial muscles might help improve facial rejuvenation.ObjectivesTo evaluate the efficacy and safety of facial rejuvenation by EBD of radiofrequency (RF) with low frequency (LF).MethodsParticipants aged 36-70 years with any Fitzpatrick Wrinkle Scale (FWS) score of 2 or higher were invited to the study and received EBD treatment. The primary outcome was the decline of FWS score and machine learning model inferred apparent age (MAA). The differences across age stratifications and the differences across facial regions represented the second outcomes.ResultsA total of 30 participants were included. Firstly, using a contemporaneous retrospective untreated comparator, the overall variation (baseline-follow-up) in FWS was -0.03 (-0.119 to 0.050 to, ns) in the untreated cohort vs 0.17 (0.083-0.253, & lowast;& lowast;& lowast;) in the EBD cohort. For MAA, variations were -0.77 (-1.453 to -0.093, ns) vs 0.66 (-0.270 to 1.595, & lowast;), respectively. Thus, EBD showed greater improvement than the retrospective untreated comparator for both endpoints. Secondly, in age stratification and facial region analysis, there were significant statistical differences between the mild and severe laxity stratifications and between periocular and nasolabial regions. Furthermore, the EBD-induced mid-to-upper facial lifting showed differences between the severe laxity stratification and mild laxity stratification, whereas no obvious volume variance of facial soft tissue was observed after treatment. The average visual analog scale (VAS) score was 0.167 (indicating mild and acceptable pain), and patient satisfaction was 86.67%. Adverse events were mainly mild, including slight pain sensation around the dental nerve in four cases (13.33%), as well as transient rash on the cheeks in one case (3.33%).ConclusionsThe results show that EBD therapy might safely and effectively improve facial aging. This technique appears to offer better facial rejuvenation outcomes for older individuals or those with severe mid-to-upper facial aging. Larger randomized clinical trials are needed to confirm this finding. Trail Registration: China Clinical Trial Registration Center: ChiCTR2300077485ConclusionsThe results show that EBD therapy might safely and effectively improve facial aging. This technique appears to offer better facial rejuvenation outcomes for older individuals or those with severe mid-to-upper facial aging. Larger randomized clinical trials are needed to confirm this finding. Trail Registration: China Clinical Trial Registration Center: ChiCTR2300077485

Metal ion-based inhibition of urease activity is a promising strategy for treating Helicobacter pylori (H. pylori) infections. However, the challenges of safe delivery and reducing cytotoxicity persist. In this study, an innovative nanocarrier capable of acid-responsive release of Ag+ and antibiotics is developed, with complete degradation after treatment. Mesoporous organosilica nanoparticle (MON) is encapsulated with hyaluronic acid (HA) to prevent drug leakage and further coated with bacterial outer membrane vesicle (OMV) from Escherichia coli Nissle 1917, creating a nanocarrier with cell-protective capabilities. Ag+ and antibiotic clarithromycin (CLR) are incorporated into the nanocarrier to form CLR-Ag+@MON@HA@OMV (CAMO), designed for the targeted treatment of gastric H. pylori infection. The HA encapsulation ensures acid-responsive release of CLR and Ag+ in the stomach, preventing premature release at non-inflammatory sites. There is a potential for Ag+ in CAMO to replace Ni2+ at the active site of urease, enhancing the bactericidal effect of CLR through urease inhibition. Furthermore, the OMV provides additional cytoprotection, mitigating cell damage and inflammation response induced by the H. pylori infection. This study introduces a safe and effective nanocarrier that eradicates H. pylori and alleviates gastric inflammation.

OBJECTIVES:Postpartum abdominal skin laxity represents a common yet challenging condition, with increasing demand for effective and safe noninvasive or minimally invasive treatments, such as phototherapy, radiofrequency (RF), and ultrasound, due to their controlled penetration depth and lower risks. Conventional treatments are limited by reason of thermal injury risk and long recovery periods, necessitating safer and more effective interventions. METHODS:This open-label, single-arm study evaluated bipolar microneedle radiofrequency (MNRF) for treating abdominal skin laxity in 17 postpartum women. Participants received three treatments at 8-week intervals. Assessments included global aesthetic improvement, abdominal circumference (AC), biomechanical properties, and patient satisfaction. RESULTS:Significant improvements were observed in skin elasticity, viscoelasticity, and echo density; AC showed a non-significant reduction trend with notable aesthetic enhancement. Histological analysis in one subject showed increased collagen density and restoration of the dermal-epidermal junction. Eighty percent of the subjects expressed satisfaction during the treatment period, with a subjective comfort score of 2.93 ± 1.29 (0-10) and an overall satisfaction of 2.40 ± 0.88 (0-4), and no serious adverse events occurred. CONCLUSIONS:These results indicate that bipolar MNRF is an effective and safe minimally invasive option for improving postpartum abdominal laxity.

Objective:To compare the efficacy and safety of 2 940 nm fractional erbium laser combined with fractional micro-plasma radiofrequency (FMR) therapy and 2 940 nm fractional erbium laser in the treatment of atrophic acne scars.Methods:A prospective randomized controlled research was conducted. A total of 100 atrophic acne scar patients (38 males and 62 females, aged 18-37 years) who were treated in the Scar Laser Clinic of the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from March 2018 to March 2021 and conformed to the inclusion criteria were recruited. The patients were randomly divided into erbium laser+FMR group and erbium laser alone group, with 50 cases in each group. The facial acne scars of patients in erbium laser alone group were treated with 2 940 nm fractional erbium laser, while the facial acne scars of patients in erbium laser+FMR group were treated with erbium laser as above, besides, the scars of U and M types were treated with FMR, once every 3 months for a total of 3 times. Before the first treatment and 3 months after each treatment, the Echelle D'Assessment Clinique des Cicatrices D'Acne (ECCA) was used to score the scar. The occurrence of adverse reaction during the treatment process was observed and recorded, and the incidence was calculated. Three months after the last treatment, the 5-level classification method was used to evaluate the satisfaction of patients with the treatment effect, and the satisfaction rate was calculated. Data were statistically analyzed with independent sample t test and chi-square test. Results:A total of 89 patients completed the study, including 46 patients in erbium laser+FMR group (19 males and 27 females, aged (26±5) years) and 43 patients in erbium laser alone group (15 males and 28 females, aged (27±6) years). The ECCA scores before the first treatment and 3 months after the first treatment of patients were similar between the two groups ( P>0.05). The ECCA scores of patients in erbium laser+FMR group at 3 months after the second and third treatment were 72±23 and 61±18, respectively, which were significantly lower than 85±26 and 76±25 in erbium laser alone group (with t values of -2.45 and -3.26, respectively, P<0.05). During the treatment process, the incidence of adverse reaction of patients in erbium laser+FMR group and erbium laser alone group were 23.91% (11/46) and 16.28% (7/43), respectively, and there was no statistically significant difference between the two groups ( P>0.05). The satisfaction rate of patients in erbium laser+FMR group was 78.26% (36/46) at 3 months after the last treatment, which was significantly higher than 53.49% (23/43) in erbium laser alone group ( χ2=6.10, P<0.05). Conclusions:The 2 940 nm fractional erbium laser combined with FMR is superior to 2 940 nm fractional erbium laser alone in the treatment of facial atrophic acne scars, achieving significantly higher efficacy without significantly increasing the incidence of adverse reaction, and patients are more satisfied with the efficacy. It can be used as a recommended therapy in clinical practice.

Background . Tranexamic acid (TA) has emerged as a promising treatment for melasma without serious adverse effects. Ethosomes have been reported as the carriers for transdermal drug delivery systems to increase the amount of drug permeation through the skin. However, few studies of the local usage of TA-loaded ethosomes exist. Objectives . To evaluate the efficacy of a mask containing 0.5% TA-loaded ethosomes in the treatment of melasma in the Asian skin. Methods . In a double-blind, placebo-controlled, randomized, prospective study, 88 Asian participants with melasma were randomized 1 : 1 to two groups as follows: the TA or control. The TA group was treated with moisturizing masks with 0.5% TA-loaded ethosomes, and the control was treated with moisturizing masks only. Masks were applied once daily for the first two weeks and once every other day for the third and fourth weeks. The primary outcome was measured by the modified melasma area and severity index (mMASI) and a visual analog scale (VAS) for vessels. The secondary outcomes were VAS for skin texture and satisfaction. Results . The reduction of VAS vessel scores at the end of treatment in the TA group was significantly greater than that in the control group ( P < 0.001). The mMASI scores and skin texture scores decreased over time in both groups, but no significant differences were found between the two groups ( P > 0.05). The score of participant satisfaction in the TA group was significantly higher than that in the control group ( P < 0.01). Conclusions . Masks containing TA-loaded ethosomes appear to be an effective treatment for Asian melasma in terms of angiogenesis and skin texture. It improves the pigmentation to some extent but has no significance. This trial is registered with ChiCTR1900024257 .

Acne scars are caused by inflammatory reactions, infections, and improper handling of acne lesions. Such scars have a high incidence and are difficult to treat. There are many methods currently used to treat acne scars, including medications, photoelectric technology, surgery, filling, chemical peeling, traditional Chinese medicine, biotherapy, and microneedle therapy, and many new methods are constantly emerging. However, there are still many issues, such as the lack of high-quality clinical studies, non-uniform treatment methods, and unsatisfactory therapeutic effects. The selection of appropriate methods for the comprehensive treatment of different types of acne scars at different stages in clinical practice remains challenging and is a research topic of great interest. From the perspective of evidence-based medicine, this consensus aims to provide a reference for the treatment of acne scars in clinical practice.

Tuberous sclerosis complex is a type of genetic multisystem disease that causes hamartomas in various organs. Facial angiofibromas commonly occur in 80% of patients and are prominently distributed over the cheek, chin, and nasolabial folds with severe disfigurement and emotional distress. Recently, photoelectric devices have been identified for the treatment of angiofibromas with great efficacy and fewer side effects. We report a case of a 42-year-old man with facial angiofibromas, who was treated with a combination of high-frequency electrocauterization, Ultrapulse CO2 laser, and microneedle fractional radiofrequency with 7 sessions and a 6-month follow-up. The patient showed great improvement in relation to the elevated lesions and nodules. A low recurrence rate was observed. This is the first study to investigate the efficacy of high-frequency electrocauterization and microneedle fractional radiofrequency in angiofibromas. It may provide an optimal approach for clinicians wherein a combined treatment of various lasers and electric devices is effective for complicated, protuberant, and firm angiofibromas of specific patients.