Clinical, Cosmetic And Investigational Dermatology[JOURNAL]
Sun
200 papers
Life Events Preceding Alopecia Areata Onset-a Descriptive Retrospective Cohort Study Focusing on Strain.
Fhager J, Örmon K, Svensson Å … +1 more , Sjöström KJM
Clin Cosmet Investig Dermatol · 2026 · PMID 41939263 · Full text
BACKGROUND: Patients often relate preceding life events to the onset of alopecia areata (AA). This cohort study systematically examined number and type of life events together with experienced strain during two years bef...
BACKGROUND: Patients often relate preceding life events to the onset of alopecia areata (AA). This cohort study systematically examined number and type of life events together with experienced strain during two years before AA onset. METHODS: The study involved 100 patients with AA who reported life events through the Social Readjustment Rating Scale (SRRS). Life event strain was examined using the Streiner model, a stress-based model in which strain is defined as undesirable, unanticipated and uncontrollable. SRRS readjustment rating and the rated strain for each life event were obtained. Percentages of strainful life events for each SRRS category were calculated. Associations between AA disease-variables, sociodemographic-variables, Beck Depression Inventory-scores and Beck Anxiety Inventory-scores were examined in relation to the number of SRRS events and the number of strainful events. RESULTS: Total life events reported were median (range) 7.0 (0-22), almost two times higher than lifetime population studies on life events. The most experienced life events were loss of health and separation. At least one strainful life event prior to the AA onset was reported by 82% of patients. The highest strainful ratings were found in the Family and Personal categories of SRRS, such as Major change in health of a family member and Major personal injury or illness. A comparison between SRRS life events and strain ratings showed that 60% of the life events were rated higher and 35% were rated lower than the standard SRRS readjustment weight order. CONCLUSION: This study provides support for an inquiry into any strainful life event preceding AA onset in newly diagnosed patients with AA. Categories of highly strainful events and the importance of subjective strain are identified in patients with AA. This implies the need to address strain, which seems to be important for strain reduction thereby decreasing the burden among patients with AA.
A Nomogram Predicting Decreased Quality of Life in Patients with Keloids.
Xu S, Huang Y, Zhang L … +5 more , Wu Y, Zhang H, Wu J, Gu Z, Dong C
Clin Cosmet Investig Dermatol · 2026 · PMID 41939262 · Full text
PURPOSE: Most keloid patients have a low quality of life (QoL), which affects their prognosis. Our aim was to identify risk factors for a decreased QoL in patients with keloids and to create a predictive nomogram for thi...
PURPOSE: Most keloid patients have a low quality of life (QoL), which affects their prognosis. Our aim was to identify risk factors for a decreased QoL in patients with keloids and to create a predictive nomogram for this condition. PATIENTS AND METHODS: The Dermatology Life Quality Index (DLQI) is used to assess patients' QoL, with a DLQI score >10 indicated a decreased QoL. We used multivariate logistic regression to assess QoL in patients with keloids for predictive modeling. We assessed the predictive and clinical value of the nomograms using the consistency index (C-index), area under the curve (AUC), and decision curve analysis (DCA). RESULTS: The risk factors that associated with a decreased QoL in patients with keloids are smoking (OR = 2.463, 95% CI = 1.031-5.880, = 0.042), pain with pruritus (OR = 2.647, 95% CI = 1.232-5.684, = 0.013), and anxiety (OR = 5.294, 95% CI = 2.158-12.987, 0.001). The C-index of the nomogram was 0.704 (95% CI = 0.675-0.733), with the AUC of 0.714 (95% CI = 0.634-0.792). The results of the DCA suggest that the model is clinically beneficial when the risk threshold is between 0% and 79%. Internal validation indicates that nomograms could be more effectively utilized in clinical practice. CONCLUSION: Our study found that people with keloids currently experience a poor QoL, and that nomograms can assist dermatologists in predicting which patients are at higher risk for a further decline in QoL.
Bridging Accessibility and Precision: Evaluating the Reliability and Validity of a Smartphone-Based Skin Colorimeter.
Ouyang H, Yang J, Ning X … +9 more , Xia Q, Zuo X, Xu J, Sheng Y, Song J, Ma Z, Wu L, Song X, Cui Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41939261 · Full text
BACKGROUND: Accurate quantification of skin color is essential for dermatologic research and clinical practice. Conventional methods rely on specialized equipment, trained operators, and high costs. Smartphone-based tech...
BACKGROUND: Accurate quantification of skin color is essential for dermatologic research and clinical practice. Conventional methods rely on specialized equipment, trained operators, and high costs. Smartphone-based technologies provide a promising alternative for accessible skin color assessment. OBJECTIVE: To evaluate the reliability and validity of the smartphone-based skin colorimeter application, You Look Good Today (YLGTD), for facial skin color assessment compared with two validated devices, VISIA and DermaLab Combo. METHODS: A total of 105 Chinese participants with healthy facial skin were enrolled. Cheek skin color measurements were obtained using YLGTD (user self-assessment and physician measurement modes), VISIA, and DermaLab Combo. Inter-rater reliability between YLGTD measurement modes was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Criterion validity was evaluated using Pearson's correlation coefficients between YLGTD measurements and the reference devices. RESULTS: YLGTD demonstrated excellent inter-rater reliability across all parameters (ICC: 0.85-0.95). Bland-Altman analysis showed small biases between the two measurement modes for the L, a, and b (-0.05, 0.18, and -0.99, respectively). For criterion validity, YLGTD in user mode showed strong correlations with DermaLab Combo for L* (r = 0.71), individual typology angle (ITA°, r = -0.81), and chroma (C*, r = 0.78), and moderate correlations for b* (r = 0.59) and hue (h°, r = 0.57). Correlations were consistently stronger in physician mode (L*: r = 0.77; b*: r = 0.75; C*: r = 0.84; ITA°: r = -0.87). VISIA showed a stronger correlation for a* (r = 0.55) but weaker correlations for L* (r = 0.56) and ITA° (r = -0.68) compared with YLGTD. CONCLUSION: The smartphone-based application YLGTD demonstrated excellent reliability and acceptable validity for facial skin color assessment, particularly for pigmentation-related parameters. Its standardized measurement workflow and integrated algorithms enable consistent skin color evaluation across devices and real-world conditions, providing a convenient and cost-effective approach for objective skin color assessment.
Coexistence of Multiple Cutaneous Leiomyomas and Psoriasis Vulgaris: A Case Report and Review of Pathogenetic Insights.
Yu M, Chen X, Meng F … +1 more , Tian S
Clin Cosmet Investig Dermatol · 2026 · PMID 41939260 · Full text
The co-occurrence of multiple cutaneous leiomyomas (MCL) and psoriasis vulgaris (PV) is exceptionally rare, with no established pathophysiological link between these two conditions. We present a case of a 56-year-old wom...
The co-occurrence of multiple cutaneous leiomyomas (MCL) and psoriasis vulgaris (PV) is exceptionally rare, with no established pathophysiological link between these two conditions. We present a case of a 56-year-old woman with a 10-year history of widespread psoriatic plaques who presented with the concurrent development of multiple, firm, dark red papules and nodules. Histopathological examination confirmed the diagnosis of MCL, revealing interlacing bundles of spindle-shaped smooth muscle cells in the dermis, which were immunoreactive for smooth muscle actin and desmin. A separate biopsy from a psoriatic plaque showed characteristic features of PV. The patient was treated with a combination of thalidomide and tofacitinib, resulting in significant symptomatic and clinical improvement. This unique case highlights a potential, yet unexplored, interplay between smooth muscle proliferation and chronic inflammation, suggesting that shared immunogenetic mechanisms warrant further investigation. Clinicians should be aware of such unusual comorbidities when managing complex dermatological cases.
Outcome of Surgical Intervention in Giant Neurofibromas in Two Sisters with Neurofibromatosis Type 1: A Case Series and Literature Review.
Zhang H, Su L, Li H … +1 more , Zhang H
Clin Cosmet Investig Dermatol · 2026 · PMID 41939259 · Full text
Neurofibromatosis type I (NF1) is an autosomal dominant disorder involving the skin and nervous system. We present the surgical resection experience of two siblings with neurofibromatosis type I (NF1) and giant neurofibr...
Neurofibromatosis type I (NF1) is an autosomal dominant disorder involving the skin and nervous system. We present the surgical resection experience of two siblings with neurofibromatosis type I (NF1) and giant neurofibromas. The sisters had multiple skin discolorations and swollen areas that gradually increased in size with age. The gradually growing tumors have an impact on their lives and their quality of life. In one case, staged resection was performed following preoperative arterial embolization of the tumor. Through surgery, a tumor weighing 16 kg was removed from one sister and another weighing 11 kg from the other sister. Following surgery, both sisters demonstrated significant improvement in appearance and resumed normal daily activities. Regular follow-up visits were scheduled to monitor for recurrence or new growth.
Expert Perspectives: Evidence-Based Applications of Polynucleotides (PNs) in Aesthetic Medicine and Dermatology.
Rho NK, Chilukuri S, Chan G … +3 more , Kim MJ, Shin J, Suwanchinda A
Clin Cosmet Investig Dermatol · 2026 · PMID 41939258 · Full text
Polynucleotides (PNs) are increasingly used in aesthetic dermatology, supported by emerging clinical evidence and growing interest in restorative approaches to skin treatment aiming to improve skin conditions. This exper...
Polynucleotides (PNs) are increasingly used in aesthetic dermatology, supported by emerging clinical evidence and growing interest in restorative approaches to skin treatment aiming to improve skin conditions. This expert opinion article brings perspectives from an international panel of dermatologists and aesthetic physicians on the use of PNs (Rejuran, PharmaResearch, South Korea) across dermatological indications. The proposed mechanism of action of PNs involves the formation of a hydrophilic, scaffold-like matrix that may support tissue remodeling and hydration. This article highlights the clinical applications of PNs across four indications: skin hydration and rejuvenation; structural support through deep-plane injections; barrier repair in rosacea and eczema; and scar remodeling. For each, the authors provide suggested treatment protocols based on real-world use, including guidance on injection techniques and anatomical targets. PNs have demonstrated a favorable safety profile, with no reported cases of granuloma or vascular occlusion in the literature to date. Their biocompatibility and tolerability make them a promising option, particularly for sensitive or barrier-compromised skin. However, the current evidence base remains limited, and further studies, including randomized trials and histological validation, are needed. This article provides practical clinical guidance while highlighting areas for future research and standardization in the aesthetic use of PNs.
The Exposome in Melasma: A Comprehensive Review of Etiology, Mechanisms, and Implications for Management.
Yang W, Meng X, Liu T … +3 more , Chen N, Li D, Xu Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41930363 · Full text
Melasma is a common pigmentary skin disorder characterised by symmetrical brownish patches on the face, which significantly impacts patients' quality of life. This article provides a comprehensive review of the latest re...
Melasma is a common pigmentary skin disorder characterised by symmetrical brownish patches on the face, which significantly impacts patients' quality of life. This article provides a comprehensive review of the latest research progress on melasma from the perspective of the exposome, a dynamic interactive model. The exposome encompasses all environmental exposures and their biological responses experienced by an individual throughout their lifespan. We systematically explore the synergistic pathogenic mechanisms of endogenous exposures (such as hormonal levels, oxidative stress, thyroid dysfunction, vitamin D metabolism and psychological stress) alongside specific exogenous exposures (such as ultraviolet, visible light radiation, air pollution, pharmacological agents, dietary habits and skincare practices) and general exogenous exposures (such as climate change) in the pathogenesis of melasma. This article reveals how multiple exposure factors converge on key pathways such as the MITF/AhR signaling axis, oxidative stress cycles, and the POMC neuroendocrine pathway, collectively driving the sustained activation of melanocytes and pigmentation. Traditional therapies primarily target already formed pigmentation, with limitations including high recurrence rates and addressing symptoms rather than root causes. Based on the exposome concept, future clinical management strategies need to shift towards proactive, comprehensive health management throughout the entire process. This includes thorough assessment of individual exposure risks, enhanced full-spectrum photoprotection, skin barrier repair, lifestyle adjustments (such as stress management, regular routines and antioxidant-rich diets), as well as combined reparative treatments. This review aims to integrate existing evidence to provide new perspectives on the aetiology of melasma and offer insights for developing personalised prevention and treatment strategies.
Exploring the Causal Relationship and Potential Mediating Mechanisms Between Obesity and Facial Aging: A Two-Sample, Multivariable and Mediation Mendelian Randomization Study.
Lian J, Zhang Z, Yang W … +3 more , Pan L, Pan X, Shao Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41926485 · Full text
PURPOSE: Obesity is well established as a key contributor to multiple age-related diseases; however, its impact on facial aging (FA) remains equivocal. We aimed to elucidate the causal effects of various obesity phenotyp...
PURPOSE: Obesity is well established as a key contributor to multiple age-related diseases; however, its impact on facial aging (FA) remains equivocal. We aimed to elucidate the causal effects of various obesity phenotypes on FA with gender- and age-specific attention, as well as determine the potential mediating mechanisms in these relationships. PATIENTS AND METHODS: A two-sample, multivariable, and mediation MR analysis was employed. BMI, representing general obesity, and BMI-adjusted WHR, representing central obesity, were derived from the most comprehensive meta-analysis GWAS conducted by the GIANT consortium. Additionally, we utilized sex- and/or age-stratified GWAS summary statistics for both BMI and BMI-adjusted WHR. We performed a two-step MR analysis incorporating 44 potential mediators to elucidate potential mediating pathways underlying this causal relationship. Sensitivity and reverse MR analyses were performed to assess the findings' robustness rigorously. RESULTS: MR analyses indicated that higher genetically predicted BMI was associated with accelerated FA, though this effect was not observed in women under 50. As for WHR not stratified by sex and age, no association between WHR and FA was found. However, in men over 50, higher genetically predicted WHR was significantly associated with an increased risk of FA. Furthermore, several factors, including myocardial infarction, smoking, and premature menarche, were identified as independent risk factors for FA, independent of high BMI. Myocardial infarction, daily smoking, circulating levels of RAGEs, ischemic stroke, and multiple sclerosis were also found to mediate the causal relationship between BMI and FA partially. CONCLUSION: Our study reveals distinct and significant variations in the effects of different obesity phenotypes on the acceleration of FA, with these effects exhibiting gender- and age-specific patterns. The findings underscore the critical importance of weight management as a potential intervention for mitigating FA. Furthermore, this research contributes to a deeper understanding of the etiology of FA.
Breastfeeding, Family Stress, and Climate as Key Determinants of Atopic Dermatitis Severity in Children: A Cross-Sectional Study.
Molla A, Althobaiti S
Clin Cosmet Investig Dermatol · 2026 · PMID 41924296 · Full text
BACKGROUND: Atopic dermatitis (AD) severity in children is influenced by biological, environmental, and psychosocial factors, yet severity-focused, multicenter evidence from Middle Eastern populations remains limited. OB...
BACKGROUND: Atopic dermatitis (AD) severity in children is influenced by biological, environmental, and psychosocial factors, yet severity-focused, multicenter evidence from Middle Eastern populations remains limited. OBJECTIVE: To identify early-life, familial, and climatic determinants of clinical severity in pediatric AD. METHODS: This multicenter cross-sectional study included 600 children diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Disease severity was measured using the SCORAD index and categorized as mild, moderate, or severe. Independent variables included breastfeeding history, parental marital status, residential climate, animal exposure, and family atopy. Ordinal logistic regression models were used to estimate adjusted odds ratios (aORs) controlling for age, sex, and nationality. RESULTS: Compared with bottle-feeding, breastfeeding <6 months (aOR = 0.02; 95% CI 0.007-0.079) and ≥6 months (aOR = 0.29; 95% CI 0.17-0.50) were strongly protective against greater AD severity. Children from separated/divorced or widowed households and those living in mountain regions had significantly higher severity than peers from married families and coastal areas. Cat exposure was an independent determinant of greater severity (aOR = 6.48; 95% CI 3.33-12.64) and higher SCORAD, whereas general animal exposure, consanguinity, sex, and family atopy were not significant. CONCLUSION: Breastfeeding, family structure, residential climate, and cat exposure are key, potentially modifiable determinants of pediatric AD severity and should inform risk-stratified, context-aware management.
Refractory Morpheaform Basal Cell Carcinoma Successfully Treated with Oral Sonidegib.
Zhang Y, Zheng J, Li X … +4 more , Wang Y, Fang F, Wang Z, Bu W
Clin Cosmet Investig Dermatol · 2026 · PMID 41924295 · Full text
Morpheaform basal cell carcinoma (BCC) is a high-risk histologic subtype accounting for approximately 5-10% of all basal cell carcinoma cases. We report a case of facial morpheaform BCC successfully treated with oral son...
Morpheaform basal cell carcinoma (BCC) is a high-risk histologic subtype accounting for approximately 5-10% of all basal cell carcinoma cases. We report a case of facial morpheaform BCC successfully treated with oral sonidegib in a patient for whom surgery was contraindicated because of severe thrombocytopenia. A 68-year-old woman presented with an indurated sclerotic plaque with papules and crusts on the left cheek. Histopathological examination confirmed the diagnosis of morpheaform BCC. Because of the high bleeding risk associated with thrombocytopenia, surgical treatment was not considered feasible. The patient was treated with oral sonidegib at a dose of 200 mg daily, resulting in progressive regression of the lesion. After approximately two years of therapy, near-complete clinical remission was achieved, and follow-up histopathological examination with five-point sampling showed no residual tumor. This case highlights the potential role of Hedgehog pathway inhibition as an effective tissue-sparing therapeutic option for patients with difficult-to-treat morpheaform BCC.
Combination Therapy with 308-nm Excimer Laser, Compound Glycyrrhizin, and Tacrolimus for Pediatric Facial and Cervical Vitiligo.
Qian Y, Wu Y, Li W … +3 more , Chen Q, Song S, Zhang T
Clin Cosmet Investig Dermatol · 2026 · PMID 41924294 · Full text
BACKGROUND: Vitiligo is a common acquired depigmenting disorder in pediatric dermatology. Facial and cervical involvement is particularly distressing due to cosmetic disfigurement, leading to psychosocial impairment in c...
BACKGROUND: Vitiligo is a common acquired depigmenting disorder in pediatric dermatology. Facial and cervical involvement is particularly distressing due to cosmetic disfigurement, leading to psychosocial impairment in children and significant psychological burden for parents. Safe and effective treatment strategies to halt disease progression and promote repigmentation are urgently needed. OBJECTIVE: To evaluate the clinical efficacy, onset of repigmentation, safety, and repigmentation patterns of 308-nm excimer laser combined with oral compound glycyrrhizin and topical 0.03% tacrolimus in children with facial and cervical vitiligo. METHODS: A total of 112 pediatric patients were randomized into two groups: treatment group (n=56, 86 lesions) received oral compound glycyrrhizin, topical 0.03% tacrolimus, plus 308-nm excimer laser twice weekly for 16 weeks; control group (n=56, 78 lesions) received compound glycyrrhizin and tacrolimus only. Clinical efficacy, time to initial repigmentation, adverse events, and repigmentation patterns (marginal, follicular, mixed) were assessed. RESULTS: The overall efficacy rate was significantly higher in the treatment group (89.53%) than in controls (70.51%) (p<0.05). Initial repigmentation occurred earlier in the treatment group (face: 3.12±0.45 weeks; neck: 3.74±0.44 weeks) compared with controls (face: 4.08±0.50 weeks; neck: 4.54±0.51 weeks, both p<0.05). Adverse events were rare (3.57%) and self-limited. Repigmentation patterns differed: treatment lesions showed predominantly mixed repigmentation (65.12%), whereas controls were mainly follicular (57.69%). CONCLUSION: Combination therapy with 308-nm excimer laser, compound glycyrrhizin, and 0.03% tacrolimus is safe and effective for pediatric facial and cervical vitiligo, providing faster repigmentation, higher efficacy, and distinct repigmentation patterns compared with medical therapy alone.
The IL-36 Cytokine Rheostat: Hierarchical Regulation of Epithelial-Immune Crosstalk and Precision Therapy in Psoriatic and Related Dermatoses.
Qiao ZY, Liu JH, Luo NN … +4 more , Tang L, Ma WY, Cheng ZL, Hao PS
Clin Cosmet Investig Dermatol · 2026 · PMID 41924293 · Full text
The interleukin-36 (IL-36) cytokine subfamily-comprising IL-36α, IL-36β, IL-36γ, and their natural antagonists IL-36Ra and IL-38-has emerged as a central regulator of epithelial-immune communication and systemic inflamma...
The interleukin-36 (IL-36) cytokine subfamily-comprising IL-36α, IL-36β, IL-36γ, and their natural antagonists IL-36Ra and IL-38-has emerged as a central regulator of epithelial-immune communication and systemic inflammation. Acting through the IL-36 receptor complex (IL-1Rrp2/IL-1RAcP), IL-36 can be conceptualized as integrating protease-dependent molecular activation, multicellular amplification loops, and disease-specific network crosstalk within a unified hierarchical framework. At the molecular level, neutrophil-derived proteases license IL-36 activation, establishing a threshold that converts barrier stress into inflammatory signaling. Within cellular networks, keratinocyte-derived IL-36γ amplifies dendritic cell-Th17 interactions and neutrophil recruitment, while the antagonists IL-36Ra and IL-38 provide feedback restraint. Across the psoriatic spectrum, IL-36 acts as a driver cytokine in generalized pustular psoriasis (GPP), an amplifier in plaque psoriasis (PV), and a sustainer in psoriatic arthritis (PsA)-defining a gradient of cytokine dependency that is conceptually consistent with differential therapeutic responsiveness. Beyond psoriasis, IL-36 participates in neutrophilic, fibrosing, and atopic dermatoses, serving as a convergent inflammatory axis that bridges epithelial stress with systemic immune propagation. The successful clinical translation of IL-36R blockade-exemplified by spesolimab and imsidolimab-validates IL-36 as a tractable therapeutic target and underscores its role within the IL-17A/TNF-α/IL-23 cytokine network. Collectively, these advances position IL-36 as a cytokine rheostat capable of scaling immune intensity according to molecular and spatial context. Emerging multi-omic and spatial transcriptomic analyses are now redefining IL-36-high endotypes across inflammatory diseases, suggesting that IL-36 may serve as a reference axis for precision immunotherapy and as a conceptual model for hierarchical immune calibration in chronic inflammation.
Evaluation of the Effect of Laterality and Age on Pain Perception in Monopolar Radiofrequency Facial Therapy.
Wang Y, Bai H, Shi C … +4 more , Wang M, Zhao S, Lai X, Yan Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41924292 · Full text
BACKGROUND: Monopolar radiofrequency (RF) is an established non-invasive modality for facial rejuvenation. Despite its proven efficacy, treatment-related pain remains a major barrier to patient compliance. Previous evide...
BACKGROUND: Monopolar radiofrequency (RF) is an established non-invasive modality for facial rejuvenation. Despite its proven efficacy, treatment-related pain remains a major barrier to patient compliance. Previous evidence suggests lateralized differences in pain perception, yet systematic evaluation in RF therapy is lacking. PURPOSE: To investigate laterality in pain perception during monopolar RF treatment and to explore the influence of age on pain sensitivity. PATIENTS AND METHODS: A prospective study enrolled 46 patients (45 females, 1 male; age 30-58 years) with facial laxity undergoing bilateral monopolar RF (Thermage FLX) treatment. Treatment order (left-first or right-first) was randomized, and all procedures were performed by the same right-handed physician. Pain intensity was assessed within 5 minutes post-treatment for each hemiface using a 0-10 Visual Analogue Scale (VAS, scored to one decimal place). RESULTS: The left hemiface exhibited significantly higher VAS scores than the right (7.12 ± 2.05 vs. 6.62 ± 1.90, < 0.001), irrespective of treatment order. Stratified analysis revealed that younger patients (≤42 years) reported higher VAS scores than older patients (>42 years) (left: 7.60 ± 1.46 vs. 6.64 ± 2.18; right: 7.07 ± 1.15 vs. 6.16 ± 2.17; both values of < 0.05). Correlation analysis showed age was negatively associated with VAS scores. CONCLUSION: Monopolar RF treatment demonstrates a consistent left-side dominance in pain perception, with younger patients exhibiting greater pain sensitivity and age negatively correlated with VAS scores.
CO Laser Resection of Giant Rhinophyma Under Local Anesthesia: A Case Report.
Zhao QK
Clin Cosmet Investig Dermatol · 2026 · PMID 41918801 · Full text
INTRODUCTION AND IMPORTANCE: Phymatous rosacea (PhR), also known as "rhinophyma", refers to a benign condition characterized by the excessive proliferation of sebaceous glands and fibrosis in the facial skin due to rosac...
INTRODUCTION AND IMPORTANCE: Phymatous rosacea (PhR), also known as "rhinophyma", refers to a benign condition characterized by the excessive proliferation of sebaceous glands and fibrosis in the facial skin due to rosacea, leading to thickening and hardening of the nasal skin, ultimately developing into rhinophyma. This disease's pathophysiology remains unclear but is seen as an advanced stage of rosacea. PRESENTATION OF CASE: The patient is a 67-year-old male and has hypertrophy of nasal tip and an enlarged nodule measuring approximately 7 cm × 6.1 cm × 4.5 cm in size of dark red color, uneven surface, clear dilation of follicular orifices, presence of white pustules and yellowish-white comedone-like secretions on light touch. Compression causes deformity of the nostrils that influences the quality of life and breathing. A total excision of the rhinophyma under local anesthesia by means of the CO laser surgery was agreed upon. The dressing changes were used to treat the wound after surgery and full healing took place after 30 days. The patient had satisfactory results, both in a functional and aesthetic sense, with the result having no recurrence in 1 year after surgery. CLINICAL DISCUSSION: The CO laser therapy with local anesthesia is an extension of traditional general anesthesia surgery when it comes to the removal of rhinophyma because it is easy to perform the surgery, with minimal trauma, bleeding, and no follow-up surgical operation, which leads to the development of a personal approach to the treatment. In our case, reconstructing the nasal area is complicated by the decision on anesthesia and management of nasal wound, which does not interfere with its functionality and beauty. CONCLUSION: In this report, we emphasize the surgical value of local anesthesia with CO laser for rhinophyma, reducing blood loss, operation time, and the need for secondary surgery. Follow-up for 1 year.
Causal Association Between Ankylosing Spondylitis and Hidradenitis Suppurativa: A Twosample Bidirectional Mendelian Randomization Study.
Chang G, Zhang J, Chen B … +4 more , Li X, Guo W, Wang H, Zhang L
Clin Cosmet Investig Dermatol · 2026 · PMID 41913815 · Full text
BACKGROUND: Ankylosing spondylitis (AS) and hidradenitis suppurativa (HS) represent two chronic inflammatory diseases that share similar underlying immunological characteristics. Observational studies suggest a potential...
BACKGROUND: Ankylosing spondylitis (AS) and hidradenitis suppurativa (HS) represent two chronic inflammatory diseases that share similar underlying immunological characteristics. Observational studies suggest a potential association, but the causal relationship remains underexplored. OBJECTIVE: To evaluate bidirectional causal links between AS and HS using Mendelian randomization (MR). METHODS: We implemented two-sample bidirectional MR analyses, utilizing summary statistics obtained from genome-wide association study (GWAS) datasets. Genetic instruments for AS (ncase=9069, ncontrol=1550) and HS (ncases=409, ncontrols=211,139) were selected under stringent criteria (p<5e-5 LD clumping: r<1e-2, clumping window=1e4 kb). Primary analyses used inverse-variance weighted (IVW) regression, supplemented by MR-Egger, weighted median, and sensitivity analyses. RESULTS: Genetically predicted AS significantly increased HS risk (IVW OR=3.49, 95% CI=1.43-8.52, P=0.006), with no evidence of reverse causation (HS→AS: OR=1.00, 95% CI=0.9998-1.00, P=0.816). To validate the stability of our estimates, sensitivity analyses were performed. The MR-Egger intercept and Cochran's Q test yielded nonsignificant P values (both P>0.05), supporting the robustness of our findings. CONCLUSION: This investigation provides genetic evidence indicating a causal relationship between ankylosing spondylitis and an increased risk of hidradenitis suppurativa, underscoring a shared etiological pathway, likely involving the IL-17/IL-23 axis. No significant causal effect was observed from HS to AS within the limitations of the current data.
Photodynamic Therapy Combined with Surgery: An Effective Treatment for Keloids via the YAP/Engrailed-1 Signaling Pathway.
Ren Y, Zhang J, Jiang H … +2 more , Wang Y, Lu Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41913814 · Full text
OBJECTIVE: Keloid, a unique human ailment, poses challenges in scar treatment due to variable efficacy and lengthy therapy and follow-up periods. Therefore, there is a need for a novel approach to address all forms of ab...
OBJECTIVE: Keloid, a unique human ailment, poses challenges in scar treatment due to variable efficacy and lengthy therapy and follow-up periods. Therefore, there is a need for a novel approach to address all forms of abnormal scarring. Photodynamic therapy (PDT), although slow-acting, shows promise, particularly when combined with surgery. This study aims to assess the efficacy and potential mechanism of PDT in conjunction with surgery for keloid treatment. METHODS: Keloid patients were identified through pathological examination, and the expression of YAP and Engrailed-1 in keloid tissue was determined via immunohistochemistry. Initially, all keloids underwent treatment with 20% ALA-PDT as the initial therapeutic step (the preoperative photodynamic therapy margin extends 0.5 cm beyond the visible lesion edge to ensure full target tissue coverage), using red LED light with specific parameters. Subsequently, keloids were surgically excised 24 hours post-PDT, followed by another PDT session. RESULTS: Immunohistochemistry assays revealed a significant reduction in YAP and Engrailed-1 levels in keloid tissues post-PDT. Over a minimum 6-month follow-up period, no infections, scar exacerbations, or recurrences were observed, except for postoperative hyperpigmentation. CONCLUSION: The combination of PDT and surgical therapy demonstrates promising results for keloid treatment. The suppression of YAP leading to reduced Engrailed-1 expression may represent a mechanism underlying the successful treatment of keloids with PDT.
Analysis and Comparison of the Trends in Burden of Acne Vulgaris in China and Worldwide from 1990 to 2021.
Shi H, Song L, Liu M … +3 more , Geng X, Ding Y, Zhang Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41909539 · Full text
BACKGROUND: Acne vulgaris is a common chronic inflammatory skin disease with substantial psychosocial consequences, primarily affecting adolescents. Despite its global prevalence and significant impact on quality of life...
BACKGROUND: Acne vulgaris is a common chronic inflammatory skin disease with substantial psychosocial consequences, primarily affecting adolescents. Despite its global prevalence and significant impact on quality of life, long-term and standardized comparisons of acne burden between China and the rest of the world remain limited. This study aimed to analyze and compare trends in the burden of acne vulgaris in China and worldwide from 1990 to 2021, with a particular focus on sex- and age-specific differences. METHODS: Data were extracted from the Global Burden of Disease 2021 study. Incidence, prevalence, and disability-adjusted life years were assessed. Age-standardized rates were calculated, and trends quantified using average annual percentage change and Joinpoint regression. RESULTS: Globally, acne burden increased, with age-standardized incidence rising from 1442.92 to 1645.24 per 100,000. In China, absolute cases declined, but standardized rates increased. Adolescents aged 10-19 years consistently showed the highest burden, with females more affected. China exhibited earlier and faster increases in standardized rates compared to global trends. CONCLUSION: The acne burden has increased over the past three decades, especially among adolescents and females, highlighting the need for targeted prevention and management strategies.
Microarray Data Analysis of Gene Crosstalk Between Psoriasis and Non-Alcoholic Fatty Liver Disease.
Tan Y, Xu C, Xiao Y … +5 more , Song W, Zhang Y, Yang Z, Chen A, Wu Q
Clin Cosmet Investig Dermatol · 2026 · PMID 41909538 · Full text
BACKGROUND: Numerous studies both domestically and internationally have indicated a potential close association between psoriasis and non-alcoholic fatty liver disease (NAFLD), yet the precise mechanism underlying this a...
BACKGROUND: Numerous studies both domestically and internationally have indicated a potential close association between psoriasis and non-alcoholic fatty liver disease (NAFLD), yet the precise mechanism underlying this association remains incompletely elucidated. METHODS: Microarray datasets were retrieved from the GEO database, and differentially expressed genes (DEGs) were identified using the GEO2R tool. Functional system analysis was conducted utilizing clusterProfiler, STRING, Cytoscape, and cytoHubba. RESULTS: This study identified a total of 49 commonly differentially expressed genes, including 10 upregulated genes and 39 downregulated genes. Protein-protein interaction(PPI) network analysis identified 15 hub genes, and GeneMANIA analysis showed that they were mainly enriched in co-expression (75.18%). CONCLUSION: The study reveals the comorbid molecular mechanism of psoriasis and NAFLD from the perspectives of gene expression, functional pathways, and transcriptional regulation, providing a new direction for the development of cross-disease therapeutic targets.
Treatment Challenges in Refractory Urticarial Vasculitis.
Sun L, Yu Q, Chen X
Clin Cosmet Investig Dermatol · 2026 · PMID 41909537 · Full text
Urticarial vasculitis, a rare autoimmune disease, is characterized by inflammation of the small blood vessels. It presents with skin lesions that resemble hives, but unlike ordinary hives, these lesions last longer than...
Urticarial vasculitis, a rare autoimmune disease, is characterized by inflammation of the small blood vessels. It presents with skin lesions that resemble hives, but unlike ordinary hives, these lesions last longer than 24 hours, may leave behind bruise-like discoloration or purpura, and can be associated with systemic symptoms. This case reports details a middle-aged female patient, who exhibited extensive urticarial lesions persisting for two weeks and severe reactions to initial treatments.
Global, Regional, and National Burden of Alopecia Areata in Children and Adolescents Aged 0-19 years from 1990 to 2021 and Projection to 2040.
Lu H, Li J, Ma K … +4 more , Li L, Wang S, Wang T, Zhang B
Clin Cosmet Investig Dermatol · 2026 · PMID 41909536 · Full text
BACKGROUND: Global epidemiological patterns of alopecia areata in pediatric populations remain inadequately characterized. We evaluated the disease burden and trends among children and adolescents aged 0-19 years across...
BACKGROUND: Global epidemiological patterns of alopecia areata in pediatric populations remain inadequately characterized. We evaluated the disease burden and trends among children and adolescents aged 0-19 years across 204 countries and territories from 1990 to 2021 and projected the disease development from 2022 to 2040. METHODS: Using Global Burden of Disease (GBD) 2021 data, we analyzed incidence, prevalence, and disability-adjusted life years (DALYs), stratified by sex, age, and Sociodemographic Index (SDI). Temporal trends were quantified via estimated annual percentage changes (EAPC) in age-standardized rates. The Bayesian age cohort model was used to predict prevalent cases trend from 2022 to 2040. RESULTS: In 2021, global prevalent cases increased by 15.79% (1990-2021), yet age-standardized incidence (ASIR), prevalence (ASPR), and DALY rates (ASDR) declined significantly (EAPC range: -0.092 to -0.099). Females consistently bore 75% higher burden than males. Disease metrics escalated with age, peaking in the 15-19 age subgroup. Low-SDI group exhibited rising ASIR/ASPR/ASDR (EAPC up to 0.050), contrasting declines in higher-SDI areas. High-income North America recorded the highest ASPR (145.84/100,000) but the most rapidly decline (EAPC=-0.251), while Central Sub-Saharan Africa showed the steepest increases. India reported the highest national prevalent cases (420,913) in 2021. The disease burden of alopecia areata among children and adolescents aged 0-19 years worldwide and in India will tend to be stable from 2022 to 2040, while the disease burden in China will rise, and in the United States of America, it will continue to decline. CONCLUSION: Despite a decrease in the relative burden, the absolute number of alopecia areata cases rose globally. Critical disparities persist among females, adolescents (15-19 years), and low-SDI populations-particularly in Central Sub-Saharan Africa. Targeted interventions for these vulnerable groups are urgently needed.
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