Background Mesotherapy, a widely utilized minimally invasive cosmetic procedure, carries potential risks of adverse reactions due to non-standardized protocols and overuse. Delayed granulomatous reactions represent a chronic complication, imposing significant physical and psychological burdens on patients. Objective This case series aims to evaluate the efficacy and safety of tofacitinib in managing non-infectious granulomatous reactions following mesotherapy. Methods This retrospective analysis included six patients diagnosed with non-infectious granulomatous reactions post-mesotherapy, treated at Peking Union Medical College Hospital between October 2021 and April 2025. All patients received oral tofacitinib. Clinical outcomes, treatment regimens, and safety profiles were assessed. Results All six patients demonstrated significant improvement in skin lesion severity, with no treatment-related adverse events observed during follow-up. Conclusion Oral tofacitinib exhibits promising clinical efficacy and a favorable safety profile for non-infectious granulomatous reactions induced by mesotherapy, positioning it as a viable therapeutic option during the inflammatory phase.

BACKGROUND:The efficacy and safety of botulinum toxin type A (BoNTA) treatment for primary axillary hyperhidrosis (PAH) have not been explored in the Chinese population. OBJECTIVES:The objective was to evaluate efficacy and safety of 1 intradermal BoNTA injection in Chinese PAH cases. METHODS:This was a Phase 3, multicenter, randomized, double-blind, placebo-controlled study. Patients were randomized to an experimental group or the control group at a ratio of 3:1 and received either BoNTA or a placebo once. The primary efficacy endpoint was the proportion of patients who experienced an over 50% reduction in axillary sweat weight at Week 4 posttreatment compared to baseline. The key secondary efficacy endpoints were the percentage changes in axillary sweat weight at Weeks 1, 4, 8, and 16 posttreatment. RESULTS:A total of 344 patients were randomized to the experimental group (n = 258) or the control group (n = 86). The proportions of patients who experienced an over 50% reduction in axillary sweat weight at Week 4 posttreatment were 83.72% (216/258) in the experimental group and 55.81% (48/86) in the control group, respectively. The between-group difference was 27.91% (P < .001). BoNTA treatment yielded a significant reduction in axillary sweat weight, hyperhidrotic area, hyperhidrosis disease severity scale (HDSS) scores, and grade of bromhidrosis. The patients in the experimental group reported significantly higher satisfaction scores than those in the control group. BoNTA treatment was well tolerated. Neither group experienced suspected unexpected serious adverse reactions, or adverse events or adverse drug reactions leading to withdrawal or death. CONCLUSIONS:One intradermal 50-U BoNTA treatment led to a significant reduction in axillary sweat weight, axillary hyperhidrotic area, HDSS scores, and axillary bromhidrosis grades in Chinese PAH patients. The therapeutic effect was maintained for 16 weeks posttreatment, with a favorable safety profile. LEVEL OF EVIDENCE: 1 (THERAPEUTIC):

Background:Sensitive skin (SS) is a prevalent condition characterized by cutaneous hyperreactivity and neurosensory inflammation, for which effective treatments remain limited. Placenta polypeptide injection (PPI), rich in anti-inflammatory cytokines and growth factors, presents a promising therapeutic candidate. This study aimed to rigorously evaluate the safety and efficacy of mesotherapy with PPI for treating moderate-to-severe SS. Methods:In this multicenter, open-label, randomized controlled trial, 156 adults with moderate-to-severe SS were randomized (PPI group: control group = 2:1) to receive three sessions of mesotherapy with PPI (4 mL per session at 30-day intervals) or no treatment (control group) over a 90-day period. The primary endpoint was the change in total facial skin hemoglobin content, a proxy measure of cutaneous inflammation, from baseline to Day 90, quantified by a 3D skin analysis system. Safety was monitored through adverse events (AEs) and laboratory assessments. Results:A total of 154 patients were included in the full analysis set (FAS; 103 PPI group, 51 control group). At Day 90, the PPI group demonstrated a significantly greater reduction in skin hemoglobin content compared to the control group (mean change, -1705.82 ± 1808.17 vs -756.65 ± 1493.17; P=0.001). Furthermore, a significantly higher proportion of patients in the PPI group reported aesthetic improvement on the GAIS (88.9% vs 5.9% rated as "improved" to "very much improved"; P < 0.001). The incidence of AEs was comparable between the PPI (5.8%) and control (9.6%) groups (P = 0.376), with no serious AEs reported. Conclusion:Mesotherapy with placenta polypeptide injection is an effective and safe treatment for moderate-to-severe sensitive skin, leading to significant reductions in cutaneous inflammation metrics and high rates of patient-reported aesthetic improvement. Trial Registration:This study was prospectively registered at Chinese Clinical Trial Registry (No. ChiCTR2400080988, Date: 20/02/2024).

Brain-derived neurotrophic factor(BDNF),a protein involved in the survival,growth and maintenance of neurons,plays an important role in pathophysiological processes in various neuropsychiatric diseases.In recent years,attention has been widely paid to the roles of BDNF in regulating immunity and participating in inflammatory reactions in non-nervous systems,and more and more studies have shown that BDNF plays an important role in various skin diseases,such as atopic dermatitis,connective tissue diseases and skin tumors.This review summarizes research advances in the role of BDNF in relevant skin diseases.

ImportanceInconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea.ObjectiveTo develop a rosacea core outcome set (COS) based on key domains that are globally relevant and applicable to all demographic groups to be used as a minimum list of outcomes for reporting by rosacea clinical trials, and when appropriate, in clinical practice.Evidence ReviewA systematic literature review of rosacea clinical trials was conducted. Discrete outcomes were extracted and augmented through discussions and focus groups with key stakeholders. The initial list of 192 outcomes was refined to identify 50 unique outcomes that were rated through the Delphi process Round 1 by 88 panelists (63 physicians from 17 countries and 25 patients with rosacea in the US) on 9-point Likert scale. Based on feedback, an additional 11 outcomes were added in Round 2. Outcomes deemed to be critical for inclusion (rated 7-9 by ≥70% of both groups) were discussed in consensus meetings. The outcomes deemed to be most important for inclusion by at least 85% of the participants were incorporated into the final core domain set.FindingsThe Delphi process and consensus-building meetings identified a final core set of 8 domains for rosacea clinical trials: ocular signs and symptoms; skin signs of disease; skin symptoms; overall severity; patient satisfaction; quality of life; degree of improvement; and presence and severity of treatment-related adverse events. Recommendations were also made for application in the clinical setting.Conclusions and RelevanceThis core domain set for rosacea research is now available; its adoption by researchers may improve the usefulness of future trials of rosacea therapies by enabling meta-analyses and other comparisons across studies. This core domain set may also be useful in clinical practice.

We are pleased to present the Dermatologic Surgery Special Issue, which is focused on the extracellular matrix (ECM) in skin regeneration and dermopathy treatment. Regenerative medicine based on ECM is one of the most promising tools for skin rejuvenation and soft tissue regeneration. In addition, the occurrence of dermopathy is highly related to the disturbance of the ECM. In this issue, we provide the most recent advances in determining the role of the ECM in research and clinical application. This issue presents several articles on the cutting edge of dermatologic surgery. Dermatofibrosarcoma protuberans (DFSP) was discovered to have fibroblastic activity, and a variety of neural features were discovered, which validated DFSP’s fibroblastic origin and tendency toward neural differentiation. The efficacy and safety of picosecond laser therapy (PLT) was proven in the treatment of melasma. In addition, the efficacy and safety assessment found that the ECM is a dressing that promotes wound healing after PLT, which can shorten the downtime by alleviating erythema and edema and proceeding with scab shedding related to PLT. The treatment of keloids, a disease caused by ECM disorder, is an urgent problem in clinical practice. In this special issue, different keloid treatments are presented, including punch excision combined with drug injection, autologous split-thickness skin graft and postoperative radiotherapy, surgical excision with electron beam radiotherapy, and reduced incision tension of keloid surgery by tightening the fascia layer. The illumination of these promising strategies will be conducive to the development of future targeted therapies. Finally, we are fortunate to have several peer-reviewed literatures on the applications of ECM in skin regeneration medicine. Pingping Lin et al elucidated the dynamic composition and potential roles of the extracellular matrix in normal skin, the wound healing process, and abnormal skin scarring. Yixin Wang et al provided an overview of the clinical research, limitations, and potential application of botulinum toxin type A in the prevention and treatment of traumatic or postoperative scars. Weiyuan Zhang et al investigated the mechanism of Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) in reducing inflammation, promoting angiogenesis, promoting the proliferation and migration of epithelial cells and fibroblasts, and ECM remodeling during wound healing.

BACKGROUNDExtracellular matrix (ECM), a material with tissue repair function, is applied to treat various wounds. However, the role of ECM in facilitating wound healing after facial laser treatment remains elusive.OBJECTIVETo assess the efficacy and safety of ECM in promoting wound healing after picosecond laser therapy (PLT).MATERIALS AND METHODSEighteen female subjects with benign pigmentation disorders were randomly assigned to the ECM (n = 9) and control groups (n = 9). After PLT, the ECM and control groups were treated with ECM and facial moisturizer in the first 7 days, respectively. The severity of erythema and edema was assessed using photographs. The duration of erythema, edema, scab shedding, postinflammatory hyperpigmentation incidence (PIH), and adverse events was documented in detail.RESULTSCompared with the control group, the ECM group had a shorter duration of erythema, edema, and scab shedding after PLT (p < .01). A significantly decreased severity of erythema (p < .05) and edema (p < .01) was found in the ECM group versus the control group, respectively. The PIH incidence in the ECM group was lower than in controls, albeit without statistical significance. No serious adverse events were observed during the follow-up.CONCLUSIONExtracellular matrix is an effective and safe dressing for promoting wound healing after PLT.

Introduction Atopic dermatitis (AD) exhibits difference in immune polarization between Caucasians and Asian races due to which an evaluation of the efficacy and safety of Pimecrolimus (PIM) in Asian population is called for. The current study addresses the need via a sub-group analysis of the PETITE study (NCT00120523) to evaluate the safety and efficacy of PIM in Chinese infants. Materials and methods Patients with AD (≥3 months–<12 months of age) were randomized in a 1:1 ratio to either PIM 1% cream or topical corticosteroids (TCS). The primary endpoint was safety. The secondary endpoint was efficacy. Results 120 patients were randomized to either PIM 1% or TCS (n = 61 for PIM, n = 59 for TCS). The most often reported adverse events were reported by similar proportions of patients treated with PIM or TCS. There was a progressive increase in overall IGA treatment success in infants treated with PIM (82.9%, p < .05, 95% CI: 70.4, 95.3) after 26 weeks which was comparable to the TCS group (88.5%, p < .05, 95% CI: 79.8, 97.1). Conclusion PIM showed an early and sustained efficacy in the Chinese sub-population with a substantial corticosteroid-sparing effect in patients with AD.

Nasolabial folds (NLFs) are the most pronounced sign of facial aging. This study explored the efficacy and safety of polycaprolactone gel in treating Chinese patients with moderate-to-severe NLFs. Patients with moderate-to-severe NLF who wished to be treated by dermal fillers were recruited from three centers between July 2017 and September 2019. The randomizing ratio was 1:1 in the polycaprolactone group (polycaprolactone injection) or control group (sodium hyaluronate gel injection). The primary endpoint was the effectiveness rate of Wrinkle Severity Rating Score (WSRS) scores at 12 months after injection. The full-analysis set (FAS) and safety sets had 80 patients in the polycaprolactone group and control group, respectively. In the FAS, the effectiveness rate at 12 months in the polycaprolactone group was 88.8% compared with 23.8% in controls ( P < 0.001). The improvement in WSRS sustained during 12 months in the polycaprolactone group, while gradually vanished in the control group since 3 months after surgery. The global aesthetic improvement scale (GAIS) by investigator assessments was improved, much improved, or very much improved in all patients during follow-up, while the proportion of patients with a "no change " assessment gradually increased during follow-up after 6 months in the control group. The rates of injection-related adverse event (AE) and serve injection-related AE were 8.8 versus 11.3% and 0 versus 1.3% in the polycaprolactone group and control groups, respectively. Polycaprolactone gel injection is effective and safe to treat moderate-to-severe NLFs in Chinese patients.

BACKGROUND:Rosacea is a chronic inflammatory disease mainly with skin or ocular manifestations. Topical calcineurin inhibitors, pimecrolimus and tacrolimus, can be used to treat rosacea. However, they can also induce rosacea-like eruptions.AIMS:This study systematically reviewed the double-edged sword effects of pimecrolimus and tacrolimus on rosacea.METHODS:Four databases were retrieved to search for articles on the effects of pimecrolimus and tacrolimus on rosacea, including Cochrane Library, Embase, PubMed, and Web of Science. Only English articles were included in the systematic review. Relevant data were collected, and the levels of evidence were evaluated.RESULTS:28 articles published between 2001 and 2016 were included. 11 articles were about pimecrolimus as the treatment of rosacea, 4 articles were about the pimecrolimus-induced rosacea, 9 articles were about tacrolimus as the treatment of rosacea, and 4 articles were about tacrolimus-induced rosacea. Participants for each study ranged from 1 to 200. Several types of outcome measurements were used for these publications.CONCLUSIONS:Both pimecrolimus and tacrolimus might have double-edged sword effects on rosacea. Pimecrolimus and tacrolimus could be effective for rosacea. However, both of them could also induce rosacea. Larger, randomized, controlled studies on pimecrolimus and tacrolimus as the treatment of rosacea and studies on the mechanisms of pimecrolimus and tacrolimus in treating or inducing rosacea are needed. This systematic review emphasized the double-edged sword role of topical calcineurin inhibitors in rosacea, which may pave the way for future research.

Objective: To systematically review the efficacy of photodynamic therapy (PDT) in the treatment of rosacea. Methods: PubMed, Embase, and Cochrane Library databases were searched for articles published by February 5, 2022, using "photodynamic therapy" and "rosacea" as the keywords. Results: Nine studies were included in the review. The number of patients varied from 1 to 30 in each study, with ages ranging from 18 to 76 years. Methyl aminolevulinate (MAL) and aminolevulinic acid (ALA) were used as the photosensitizer, and red light, blue light, intense pulsed light (IPL), long-pulsed dye laser (LPDL), pulsed dye laser (PDL), and tungsten lamp were used as the light or laser source. The follow-up time ranged from one month to 25 months. Most of the studies showed a satisfactory clinical response, and the side effects were tolerant and temporary. Conclusion: Current studies have provided preliminary evidence that PDT is an efficient and safe therapy in treating rosacea. However, rigorous randomized control trials (RCTs) with a larger sample size and longer followup time are warranted to verify the curative effects of PDT in treating rosacea and explore the most appropriate treatment schedule.

This case report describes a 23-year-old man with excessive sweating of the bilateral palms and 20 yellow nails.

We have no financial interest or conflict of interest in association with this work. This manuscript has not been published previously and is not being considered for publication by another journal. The data that support the findings of this study are available from the corresponding author upon reasonable request.

玫瑰痤疮是一种由多种机制介导的慢性炎症性疾病,目前针对其导致的顽固性潮红和红斑的治疗方法疗效有限.A型肉毒毒素(botulinum neurotoxin A,BTX-A)可通过抑制肥大细胞脱颗粒及阻断乙酰胆碱和神经肽的释放,下调炎症因子水平,改善血管的持续扩张,从而减轻面部潮红的症状,具有治疗玫瑰痤疮的潜能.目前已有相关研究初步证实,BTX-A治疗玫瑰痤疮的有效性和安全性,因此BTX-A可能成为一种治疗玫瑰痤疮的新型有效方法.本文就BTX-A治疗玫瑰痤疮的机制,及其在玫瑰痤疮中的应用进行阐述.

Citation: Li A, Fang R, Sun Q. Inflammatory vitiligo. Dermatol Pract Concept. 2022;12(3):e2022096. DOI: https://doi.org/10.5826/dpc.1203a96

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.

The current conservative and surgical treatments are not fully effective and have complications for Raynaud's phenomenon (RP) secondary to systemic sclerosis (SSc). Botulinum toxin A (BTX-A) can be used to manage RP, but the literature mostly includes case reports and case series. Thus, we performed a randomized controlled trial to explore the efficacy of BTX-A in the treatment of RP secondary to SSc. Sixteen patients with RP secondary to SSc were recruited. One hand was randomly included in the BTX-A group and the other as control. Both hands were tested before treatment and 4 weeks later using qualitative and quantitative dermatoscopic assessments and the cold water test. Reynolds score (from 6.7 ± 4.0 to 2.9 ± 3.7, p < 0.001), Tbase (from 25.8 ± 3.0°C to 27.9 ± 2.1°C, p = 0.031) and Tchange (from 2.1 ± 1.2°C to 4.5 ± 2.1°C, p < 0.001) in the experimental group were improved, while there were no improvements in Tbase and Tchange in the control group. In the experimental group, the sum of the six dermoscopic parameters was improved after treatment (from 4.00 (3.00, 5.75) to 3.00 (2.00, 5.00), p = 0.002); the nailfold capillary pattern staging was also improved (from 2.00 (2.00, 3.00) to 2.00 (1.00, 3.00), p = 0.004). There were no improvements in the dermoscopic assessment in the control group. None of the patients reported adverse reactions such as infection, hematoma, hand muscle weakness, allergic reaction and nerve injury. In conclusion, local injection BTX-A to treat RP secondary to SSc might be safe and effective.

The authors have no financial interest or conflict of interest in association with this work. This manuscript has not been published previously and is not being considered for publication by another journal. The data that support the findings of this study are available from the corresponding author upon reasonable request.