Clinical, Cosmetic And Investigational Dermatology[JOURNAL]
Sun
200 papers
Incomplete Ascher's Syndrome Misdiagnosed as Eczema: A Case Report.
Song B, Li Q, Guo S … +2 more , Li Z, Bi J
Clin Cosmet Investig Dermatol · 2026 · PMID 41869425 · Full text
Ascher syndrome is a rare disorder classically characterized by blepharochalasis, double lip, and non-toxic thyroid goiter. We report a case initially diagnosed as eczema in the dermatology department, who presented with...
Ascher syndrome is a rare disorder classically characterized by blepharochalasis, double lip, and non-toxic thyroid goiter. We report a case initially diagnosed as eczema in the dermatology department, who presented with acquired double lips and blepharochalasis of the upper eyelids, without thyroid enlargement. Magnetic resonance imaging revealed uniformly increased T2-weighted signals in both the upper and lower lips, leading to a diagnosis of incomplete Ascher's syndrome. The patient underwent oculoplastic surgery, which successfully restored the natural aesthetic contour, demonstrating the efficacy and necessity of surgical intervention. We summarize the differential diagnosis of conditions related to Ascher's syndrome and analyze histopathological changes in the excised eyelid tissue to elucidate microscopic alterations associated with the disease.
Association Between Cutaneous Lupus Erythematosus and Atherosclerotic Cardiovascular Disease: A Systematic Review.
Althobaiti RF, Almansour TA, Altowairqi RK … +5 more , Alzahrani NM, Samman LA, Almutairi NA, Aljoudi SB, Alharbi RH
Clin Cosmet Investig Dermatol · 2026 · PMID 41869424 · Full text
INTRODUCTION: Cutaneous lupus erythematosus (CLE) is an autoimmune skin disorder increasingly recognized to have systemic effects, including possible links to atherosclerotic cardiovascular disease (ASCVD). However, the...
INTRODUCTION: Cutaneous lupus erythematosus (CLE) is an autoimmune skin disorder increasingly recognized to have systemic effects, including possible links to atherosclerotic cardiovascular disease (ASCVD). However, the strength and pattern of this association remain uncertain. OBJECTIVE: To evaluate and assess available evidence on ASCVD risk in CLE, identify patterns across study designs and populations, and highlight research gaps requiring further study. METHODS: A systematic search of PubMed, Scopus, and Web of Science was conducted up to July 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251156382). Eligible studies included adult CLE populations reporting ASCVD outcomes. Data extraction and risk-of-bias assessment were independently performed using the Newcastle-Ottawa Scale and the AXIS tool. RESULTS: Six observational studies met the inclusion criteria, including population-based cohorts, hospital datasets, and case-control analyses. Across designs, CLE was consistently associated with elevated ASCVD risk, particularly stroke and thromboembolic events. Large registry-based studies showed significant associations even after adjustment for traditional risk factors, suggesting CLE-specific inflammatory mechanisms. Smaller cohorts highlighted high comorbidity burdens and subtype differences, particularly a stronger signal in discoid lupus. CONCLUSION: Evidence indicates that CLE is linked to increased ASCVD risk, especially cerebrovascular and thromboembolic outcomes. Standardized definitions and longitudinal studies are needed to clarify subtype-specific risks and inform prevention strategies.
Aesthetic Medicine and Perceptual Distortion: The Role of Professional Aesthetic Drift.
Armenti AF
Clin Cosmet Investig Dermatol · 2026 · PMID 41869423 · Full text
BACKGROUND: Aesthetic medicine has traditionally focused on patient-related psychological vulnerabilities, particularly Body Dysmorphic Disorder (BDD). However, significantly less attention has been given to perceptual a...
BACKGROUND: Aesthetic medicine has traditionally focused on patient-related psychological vulnerabilities, particularly Body Dysmorphic Disorder (BDD). However, significantly less attention has been given to perceptual and cognitive changes occurring in aesthetic practitioners themselves. PURPOSE: This article introduces and conceptualizes , defined as a progressive shift in clinicians' aesthetic perception, judgment, and treatment thresholds resulting from chronic exposure to altered beauty standards, procedural repetition, and algorithm-driven social media environments. METHODS: Drawing on evidence from visual neuroscience, psychology, and sociocultural research, this paper develops a theoretical framework explaining how prolonged exposure to modified facial morphologies may induce perceptual adaptation and internal recalibration of aesthetic norms. RESULTS: We argue that aesthetic practitioners, due to their professional environment, are not only healthcare providers but also cultural agents and generators of contemporary beauty standards. PAD is conceptualized not as a psychopathology, but as an occupational perceptual bias comparable to expertise-related adaptations observed in other high-exposure professions. CONCLUSION: Preventive strategies, clinical indicators and future research directions are proposed to investigate and mitigate this phenomenon. Recognizing PAD may promote more reflective, ethical, and perceptually balanced aesthetic practice.
Case Report: Vitiligo and Alopecia Universalis Following Rituximab Therapy in a Patient with Myasthenia Gravis.
Alzahrani D, Niaz G, Roblah TM … +2 more , Al-Osaimi AK, Alsulaimani H
Clin Cosmet Investig Dermatol · 2026 · PMID 41869422 · Full text
Rituximab, an anti-CD20 monoclonal antibody, is being used more frequently to treat refractory autoimmune disorders such as myasthenia gravis. While it is usually well tolerated, rare cases of paradoxical immune-mediated...
Rituximab, an anti-CD20 monoclonal antibody, is being used more frequently to treat refractory autoimmune disorders such as myasthenia gravis. While it is usually well tolerated, rare cases of paradoxical immune-mediated skin reactions have been rarely reported. However, the concurrent development of vitiligo and alopecia universalis following rituximab therapy has not been previously described. We report a rare case of simultaneous vitiligo and alopecia universalis developing during long-term treatment with rituximab in a patient with myasthenia gravis and discuss the clinical course and treatment response. This case report describes a 30-year-old woman with myasthenia gravis who developed vitiligo followed by alopecia universalis during a long term of Rituximab therapy. Cutaneous findings included well-demarcated depigmented patches on the trunks and bilateral arms and diffuse non-scarring alopecia affecting the scalp, eyebrows, eyelashes, and body hair, consistent with 100% score of Severity of Alopecia tool (SALT) indicating Alopecia universalis. Rituximab was discontinued due to a possible drug-reaction. Treatment with oral Baricitinib was initiated to target both vitiligo and alopecia universalis. Within three months, there was significant scalp hair regrowth and re-pigmentation of vitiligo patches with minimal adverse effects. This case highlights a unique temporal association of rituximab therapy and the simultaneous onset of vitiligo and alopecia universalis. Although the relationship between the drug and the onset of the skin diseases cannot be established, it is important to be aware of the possibility of immune-related skin adverse effects during rituximab therapy. Early intervention and the use of Janus kinase inhibitors, such as baricitinib, may lead to good clinical outcomes.
Causal Associations Between Chronic Inflammatory Skin Diseases and Alzheimer's Disease: A Bidirectional Two-Sample Mendelian Randomization Study.
Cai Y, Dai W, Liu F … +2 more , Li Z, Liu G
Clin Cosmet Investig Dermatol · 2026 · PMID 41869421 · Full text
BACKGROUND: Inflammatory skin diseases (ISDs) and Alzheimer's disease (AD) share chronic immune activation, but their causal link remains unclear. METHODS: We performed a bidirectional two-sample Mendelian randomization...
BACKGROUND: Inflammatory skin diseases (ISDs) and Alzheimer's disease (AD) share chronic immune activation, but their causal link remains unclear. METHODS: We performed a bidirectional two-sample Mendelian randomization using GWAS summary data from Europeans. Instrumental SNPs were analyzed with inverse-variance weighted (IVW), weighted median, and MR-Egger methods, with sensitivity tests for pleiotropy and heterogeneity. RESULTS: Forward MR revealed significant causal effects of ISDs on AD, including lichen planus (OR 1.318, p=0.005), psoriasis vulgaris (OR 1.126, p=0.004), psoriasis with arthropathy (OR 1.032, p=0.002), psoriatic arthritis (OR 1.053, p=0.016), psoriasis (OR 1.072, p=0.008), papulosquamous conditions (OR 1.046, p=0.007), and follicular cysts (OR 1.066, p=0.047). No heterogeneity or pleiotropy was detected. Reverse analysis showed no causal effect of AD on ISDs. CONCLUSION: These findings support a potential causal role of chronic skin inflammation in AD risk, though effect sizes were modest and clinical implications remain exploratory. This suggests that neuroimmune mechanisms may represent potential targets for further investigation.
A Case Series of Rare Long-Term Bruising Following Injection of Liquid-Form Polycaprolactone: Mechanisms and Therapeutic Insights.
Byeon H, Baek H, Vachiramon V … +10 more , Park Y, Bae K, Chymber K, Jung J, Li X, Lee S, Teh SJ, Shestakova O, Lee C, Sumaetheiwit R
Clin Cosmet Investig Dermatol · 2026 · PMID 41869420 · Full text
Post-procedural bruising is one of the most common complications of aesthetic injections. Liquid-form polycaprolactone (PCL) is generally considered safe, with only transient and self-limiting adverse events reported. Wh...
Post-procedural bruising is one of the most common complications of aesthetic injections. Liquid-form polycaprolactone (PCL) is generally considered safe, with only transient and self-limiting adverse events reported. While bruising after liquid-form PCL injections is typically short-lived and no cases of permanent bruising have been documented, some patients may experience bruising persisting for several months. To date, however, no published reports have described such long-term cases. Here, we present retrospective review on seven clinical cases of persistent bruising following liquid-form PCL injections to the infraorbital, puncture point, and upper arm regions, and summarize their clinical management. Therapeutic approaches included pigment fragmentation (PICO, Nd:YAG, IPL, PDL), thermal loosening of the scaffold-tissue complex (radiofrequency, high-intensity focused ultrasound, warm application), mechanical dispersion (microcurrent stimulation, ultrasound, normal saline washout, gentle massage), and enzymatic degradation (hyaluronidase, lipase). All patients ultimately achieved resolution, and no serious adverse events were observed. These findings suggest that long-term bruising, although rare, is clinically relevant and may be associated with dense liquid-form PCL scaffold entrapment of pigment molecules or a Tyndall effect. Importantly, this phenomenon is not permanent, as its resolution parallels scaffold degradation over time. Preventive strategies, combined with multimodal management tailored to the underlying mechanisms, may reduce patient discomfort and optimize aesthetic outcomes.
A Case of Nevus of Ota Associated with Agminated Blue Nevus.
Xie X, Chen J, Zhou X … +2 more , Zhu H, Ma S
Clin Cosmet Investig Dermatol · 2026 · PMID 41869419 · Full text
Dermal melanocytosis is characterized by the presence of spindle-shaped melanocytes in the dermis. Common forms include Mongolian spots, nevus of Ota, nevus of Ito, and blue nevus. Nevus of Ota typically presents as blui...
Dermal melanocytosis is characterized by the presence of spindle-shaped melanocytes in the dermis. Common forms include Mongolian spots, nevus of Ota, nevus of Ito, and blue nevus. Nevus of Ota typically presents as bluish-brown patches involving the sclera and the cutaneous regions innervated by the ophthalmic and maxillary branches of the trigeminal nerve unilaterally. Blue nevus usually manifests as a solitary lesion. Agminated blue nevus is a rare variant that often presents as grouped, linear, or blaschkoid-distributed deep blue macules or papules. Only a few cases have reported the co-occurrence of nevus of Ota and agminated blue nevus. We herein report a case of extensive nevus of Ota combined with agminated blue nevus involving all three branches of the trigeminal nerve.
Omalizumab Combined with Cyclosporine for the Treatment and Management of Refractory Urticarial Vasculitis.
Chen X, Yu Q, Chang D … +1 more , Sun L
Clin Cosmet Investig Dermatol · 2026 · PMID 41858605 · Full text
Urticarial vasculitis (UV) is a clinicopathologic entity characterized by urticarial lesions disclosing histopatho logically leukocytoclastic vasculitis, mainly of postcapillary venules. A 61-year-old woman with a four-m...
Urticarial vasculitis (UV) is a clinicopathologic entity characterized by urticarial lesions disclosing histopatho logically leukocytoclastic vasculitis, mainly of postcapillary venules. A 61-year-old woman with a four-month history of widespread, pruritic urticarial lesions was diagnosed with urticarial vasculitis. The patient received a subcutaneous injection of Omalizumab (300 mg) every 28 days, combined with oral Cyclosporine (3 mg/kg/day). Significant clinical improvement was noted within five days post-treatment. This case highlights the difficulties in treating refractory urticarial vasculitis while demonstrating the successful use of Omalizumab plus Cyclosporine, providing a viable treatment option for similar patients.
A Single-Center Profile of Pemphigus in China: Significant Diagnostic Delay and Evolving Treatment Patterns.
Zhang H, Li D, Zhang Y … +4 more , Lu X, Tang K, Zuo YG, Jin H
Clin Cosmet Investig Dermatol · 2026 · PMID 41858604 · Full text
PURPOSE: Pemphigus encompasses a group of rare and potentially life-threatening autoimmune bullous diseases. Epidemiological research on pemphigus in China remains limited. This study aimed to analyze the clinical charac...
PURPOSE: Pemphigus encompasses a group of rare and potentially life-threatening autoimmune bullous diseases. Epidemiological research on pemphigus in China remains limited. This study aimed to analyze the clinical characteristics, diagnostic delay, and initial treatment patterns of patients with newly diagnosed pemphigus at a tertiary center in China. PATIENTS AND METHODS: This retrospective study included patients newly diagnosed with pemphigus between January 2020 and December 2024 at the outpatient department of Peking Union Medical College Hospital. Demographic and clinical data were collected and analyzed. RESULTS: A total of 138 patients were included. Pemphigus vulgaris was the most prevalent subtype (68 cases, 49.3%), followed by pemphigus erythematosus (34 cases, 24.6%), pemphigus foliaceus (13 cases, 9.4%), and pemphigus herpetiformis (11 cases, 8.0%). Notably, the diagnostic delay was substantial, with a median of 5.0 (2.0-12.0) months, and 106 patients (76.8%) had been misdiagnosed before a definitive diagnosis was made. Regarding initial treatment, the most frequently used drugs were corticosteroids (104/132, 78.8%), followed by mycophenolate mofetil (33/132, 25.0%), Tripterygium wilfordii Hook F (29/132, 22.0%), minocycline (28/132, 21.2%), and rituximab (24/132, 18.2%). There was no significant difference among the subtypes in the proportion of patients receiving non-steroidal therapies. CONCLUSION: These findings highlight a significant diagnostic delay and outline evolving treatment patterns for pemphigus in a contemporary Chinese cohort. This information may inform future research directions and health policy decisions for managing this rare disease.
Dermatosis Neglecta Localized to the Periumbilical Region: A Case Report.
Huang Z, Zhang R
Clin Cosmet Investig Dermatol · 2026 · PMID 41858603 · Full text
Dermatosis neglecta (DN) is a rare psychocutaneous disorder. To the best of our knowledge, this is the first reported case of DN localized to the periumbilical region. We present a case of 19-year-old male patient who de...
Dermatosis neglecta (DN) is a rare psychocutaneous disorder. To the best of our knowledge, this is the first reported case of DN localized to the periumbilical region. We present a case of 19-year-old male patient who developed extensive, persistent, scaly plaques on his abdomen over two years, which were resistant to routine washing with soap and water. Dermoscopy revealed no hemorrhage or other significant abnormalities. Wood's lamp examination demonstrated white fluorescence, and direct mycological tests were negative. The diagnosis was confirmed by the complete resolution of the lesions after wiping with 70% isopropyl alcohol, which revealed normal underlying skin. Based on the clinical presentation and diagnostic evaluation, a diagnosis of DN was established.
Secukinumab-Induced Delayed Behçet-Like Reaction in a Patient with Plaque Psoriasis: A Case Report.
Wei Y, Zhang P, Chuan J … +2 more , Ye J, Liu T
Clin Cosmet Investig Dermatol · 2026 · PMID 41858602 · Full text
PURPOSE: This report presents a rare paradoxical reaction manifesting as Behçet's-like features, which developed three months following the initiation of secukinumab therapy for psoriasis. PATIENTS AND METHODS: A 38-year...
PURPOSE: This report presents a rare paradoxical reaction manifesting as Behçet's-like features, which developed three months following the initiation of secukinumab therapy for psoriasis. PATIENTS AND METHODS: A 38-year-old female with a 30-year history of plaque psoriasis achieved significant remission of psoriatic lesions following seven doses of secukinumab (cumulative dose: 2100 mg). However, she subsequently developed systemic adverse events, including pharyngodynia, painful tonsillar and genital ulcers, folliculitis-like papules on the trunk and extremities, and erythema nodosum-like lesions on the extensor surfaces of both lower limbs. Laboratory tests, including bacterial, viral, and fungal cultures, excluded infectious etiologies. Histopathological examination of a skin biopsy demonstrated superficial and deep perivascular and interstitial inflammation with dense infiltration of lymphocytes, neutrophils, and eosinophils. Consequently, a diagnosis of secukinumab-induced Behçet's-like syndrome was established, as the patient did not fully meet the International Criteria for Behçet's Disease (ICBD). Secukinumab was immediately discontinued, and the patient was initiated on thalidomide (50 mg, three times daily) and colchicine (0.5 mg, twice daily). RESULTS: Two weeks after treatment initiation, oral and genital ulcers resolved. Folliculitis-like papules and erythema nodosum-like lesions regressed significantly, leaving only residual post-inflammatory hyperpigmentation. The patient was subsequently switched to ustekinumab maintenance therapy at a standard dosage. Psoriasis remained well-controlled, with no recurrence of Behçet's-like manifestations during a 4-year follow-up period. CONCLUSION: This report underscores the critical need for vigilant patient monitoring during anti-IL-17 therapy to detect such uncommon yet clinically significant paradoxical reactions. Furthermore, precise characterization of the onset timing of such adverse events is crucial, as it enables clinicians to implement timely preventive measures, mitigate risks, and rapidly identify emerging adverse reactions.
Fibronectin-Based Skin Care Regimens for Skin Recovery After Intense Pulsed Light Therapy: A Split-Face Study.
Feng H, Ge L, Shi G … +12 more , Yu S, Wang X, Li X, Wen S, Wu L, Yi Z, Xian X, Fu X, Zhang B, Liang J, Zhu H, Ye L
Clin Cosmet Investig Dermatol · 2026 · PMID 41858601 · Full text
PURPOSE: Intense pulsed light (IPL) treatment may cause transient erythema, dryness, and barrier dysfunction, highlighting the need for effective postprocedural care. This study aimed to assess the efficacy and safety of...
PURPOSE: Intense pulsed light (IPL) treatment may cause transient erythema, dryness, and barrier dysfunction, highlighting the need for effective postprocedural care. This study aimed to assess the efficacy and safety of a fibronectin-containing skincare regimen in restoring skin barrier function and relieving these IPL-related manifestations. PATIENTS AND METHODS: In this 28-day, split-face study, 32 healthy female participants undergoing IPL treatment applied a fibronectin-containing serum to one side of the face and a control serum to the opposite side. Skin hydration, transepidermal water loss (TEWL), erythema, and radiance were evaluated at baseline, immediately post-IPL, and on days 3, 7, and 28. RESULTS: Compared to the control, the fibronectin-treated side showed significantly greater improvements in skin hydration (P < 0.01) and significantly lower TEWL on days 3 (P < 0.05), 7 (P < 0.01), and 28 (P < 0.01). By days 7 and 28, skin radiance and erythema also improved more significantly (P < 0.01). Both dermatologist and participant assessments confirmed the superior efficacy of the fibronectin serum. No adverse events were rePorted. CONCLUSION: Post-IPL aPPlication of a fibronectin-containing serum effectively imProves skin hydration, reduces barrier dysfunction and erythema, and enhances radiance with good tolerability. These findings suPPort its Potential utility in Post-IPL skincare regimens.
Acquired Reactive Perforating Collagenosis Treated with Upadacitinib: A Case Report and Literature Review.
Xie B, Zhang X, Lei X … +3 more , Zhang Y, Zhang Q, Ye Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41858600 · Full text
Acquired reactive perforating collagenosis (ARPC) is a rare perforating dermatosis linked to systemic diseases, with unclear pathogenesis and no standardized therapy. We report a 53-year-old male with ARPC who failed con...
Acquired reactive perforating collagenosis (ARPC) is a rare perforating dermatosis linked to systemic diseases, with unclear pathogenesis and no standardized therapy. We report a 53-year-old male with ARPC who failed conventional treatments but improved rapidly with upadacitinib 15 mg/day for one month, followed by 15 mg every other day. After three months, most lesions resolved, leaving hyperpigmentation and scars. Literature review shows conflicting reports: one case of ARPC improved with upadacitinib, another developed ARPC during upadacitinib treatment for atopic dermatitis. Our findings suggest upadacitinib may be effective for ARPC, especially in pruritic patients, regardless of diabetes status.
Facial Cutaneous Rosai-Dorfman Disease Misdiagnosed as Sporotrichosis: A Case Report and Literature Review.
Wang X, Li J, Li Z … +4 more , Chen Y, Li Y, Li X, Han Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41858599 · Full text
Cutaneous Rosai-Dorfman disease (CRDD) is a rare form of non-Langerhans cell histiocytosis. Because the etiology and pathogenesis remain unclear and the cutaneous manifestations are highly variable, no definitive diagnos...
Cutaneous Rosai-Dorfman disease (CRDD) is a rare form of non-Langerhans cell histiocytosis. Because the etiology and pathogenesis remain unclear and the cutaneous manifestations are highly variable, no definitive diagnostic criteria have been established. As a result, the risk of diagnostic errors and missed diagnoses is common in clinical practice. This report describes the case of a 64-year-old woman with facial CRDD that initially misdiagnosed as sporotrichosis. This case broadens the known clinical spectrum of CRDD and underscores the importance of careful differential diagnosis to avoid misdiagnosis and ensure appropriate treatment.
A Topical Chinese Herbal Alleviates Psoriasis by Regulating Keratinocytes Pyroptosis Through Inhibition of NLRP3 Inflammasome Activation.
Wang X, Deng Y, Ren X … +4 more , Li Y, Liu T, Hu B, Li Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41858598 · Full text
PURPOSE: Psoriasis is a chronic inflammatory skin disease involving complex immune dysregulation, where NLRP3 inflammasome-mediated pyroptosis-a pro-inflammatory programmed cell death-has been identified as a key driver...
PURPOSE: Psoriasis is a chronic inflammatory skin disease involving complex immune dysregulation, where NLRP3 inflammasome-mediated pyroptosis-a pro-inflammatory programmed cell death-has been identified as a key driver of disease pathogenesis. Qingshi anti-itch ointment (QS), a traditional Chinese medicine used for psoriasis, has demonstrated clinical efficacy; however, its specific impact on the NLRP3-pyroptosis pathway remains unclear. This study therefore aims to elucidate the role and underlying mechanisms of QS in regulating NLRP3 inflammasome activation in keratinocytes. METHODS: Psoriasis models were established using both in vivo and in vitro approaches: (1) a mouse model induced by topical application of Imiquimod (IMQ) cream, and (2) a cellular model of keratinocyte pyroptosis stimulated with Lipopolysaccharide (LPS) and Adenosine triphosphate (ATP) in vitro. Therapeutic effects were evaluated through Psoriasis area and severity index (PASI) scoring and Hematoxylin-Eosin staining method (HE). NLRP3 inflammasome-mediated pyroptosis was assessed by IHC, RT-qPCR, and Western blot. Levels of IL-18, IL-1β, IL-17, and IL-22 were measured. Transmission electron microscopy was employed to examine NHEK cellular ultrastructure and pyroptotic status. MCC950, a specific NLRP3 inhibitor, was used to determine whether QS modulates keratinocyte pyroptosis through NLRP3 inflammasome regulation. RESULTS: QS effectively ameliorated IMQ-induced psoriasiform lesions by suppressing keratinocyte pyroptosis and maintaining cellular integrity. Both in vivo and in vitro experiments demonstrated QS's ability to inhibit the NLRP3 signaling pathway and selectively regulate key pyroptotic molecules (Caspase-1/GSDMD), thereby reducing proinflammatory cytokine release. Notably, QS combined with MCC950 exhibited significant synergistic effects in suppressing NLRP3 inflammasome activation in both IMQ-induced and LPS/ATP-stimulated models. CONCLUSION: QS primarily alleviates psoriasis by modulating keratinocyte pyroptosis through mitochondrial protection, inhibition of GSDMD-mediated membrane perforation, and downregulation of Caspase-1 activity, collectively attenuating inflammatory responses. These findings provide novel mechanistic insights into QS's anti-psoriatic effects and may facilitate the development of innovative therapeutic strategies for psoriasis.
Knowledge, Attitudes, and Practices of Patients with Moderate to Severe Acne Regarding Oral Medication Therapy: A Structural Equation Modeling Analysis.
Wang J, Bai D, Yao X … +3 more , Song X, Yang X, Yuan Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41858597 · Full text
PURPOSE: Acne affects up to 9% of the global population, with rising prevalence among Chinese urban youth, leading to significant physical and psychological impacts. PATIENTS AND METHODS: A cross-sectional study was cond...
PURPOSE: Acne affects up to 9% of the global population, with rising prevalence among Chinese urban youth, leading to significant physical and psychological impacts. PATIENTS AND METHODS: A cross-sectional study was conducted at the Dingxi People's Hospital. Data on the demographics and knowledge, attitudes, and practices (KAP) of patients with moderate to severe acne were collected through questionnaire distribution. RESULTS: A total of 561 patients were included in the study, of them 58.65% females, The majority of participants believed that they have sufficient knowledge of routine acne management and 72.72% reported that they are satisfied with the current effectiveness of medication treatment. However, predominant answer for all questions regarding the oral treatment of acne (40.29%-58.82%) or combination therapy (23.89%-41.53%) was "unsure". Knowledge score was positively correlated with attitude score (p < 0.001) and practice score (p < 0.001), and higher knowledge scale scores were associated with higher practice scores according to logistic regression analysis (p = 0.002). According to the Structural equation modelling knowledge influenced practice directly and indirectly. CONCLUSION: This study found that patients with moderate to severe acne in China might overestimate their knowledge of oral medication therapy and ability to manage acne. Targeted healthcare education is needed to address the identified gaps, ultimately optimizing acne management strategies and enhancing patient outcomes.
Clinical Profile of Elderly Atopic Dermatitis in China.
Wu M, Li F, Xu G … +3 more , Chen X, Zhang Y, Yao X
Clin Cosmet Investig Dermatol · 2026 · PMID 41858596 · Full text
BACKGROUND: With global population aging, elderly atopic dermatitis (AD) is emerging as a distinct subtype. This study investigated the clinical and hematological phenotype of elderly AD patients in a Chinese cohort. MET...
BACKGROUND: With global population aging, elderly atopic dermatitis (AD) is emerging as a distinct subtype. This study investigated the clinical and hematological phenotype of elderly AD patients in a Chinese cohort. METHODS: 593 patients who fulfilled the Chinese Criteria for Atopic Dermatitis (CCAD) were stratified into three age groups: 2-17, 18-59, and ≥ 60 years. Clinical features and risk factors were assessed via a standardized questionnaire and physical examination. Serum total IgE and complete blood counts were measured in a subset of patients along with age-matched healthy controls. RESULTS: Approximately three-quarters of the elderly AD patients were late-onset (first presentation ≥ 60 years old), with male predominance (male-to-female ratio 2.03:1). Lesions displayed a "widespread" distribution pattern in elderly AD. Over 80% of elderly AD patients had moderate-to-severe disease (SCORAD ≥ 25), with greater pruritus, quality-of-life impairment, and worse management outcomes compared with younger groups. The endogenous subtype increased with age, accounting for 47% of elderly AD. The elderly AD had higher monocyte count and percentage but lower lymphocyte count than other age groups. The Eczema Area and Severity Index (EASI) positively correlated with eosinophil count, and negatively with lymphocyte count and percentage in elderly AD. CONCLUSION: Elderly AD exhibits a distinct clinical and hematological phenotype characterized by severe disease burden, widespread distribution, male predominance, and age-specific immune dysregulation. While the role of eosinophil is established, our findings underscore the need for age-tailored management strategies and highlight the monocyte-macrophage axis as a novel direction for future research.
Hyperhidrosis Improved by Samhwangsasim-Tang: A Case Report.
Lee JH, Lee JM, Park SM … +2 more , Lee CL, Lee YU
Clin Cosmet Investig Dermatol · 2026 · PMID 41858595 · Full text
Hyperhidrosis is a disorder characterized by excessive sweating beyond physiological requirements, which significantly interferes with daily functioning and quality of life. It affects approximately 4%-5% of the populati...
Hyperhidrosis is a disorder characterized by excessive sweating beyond physiological requirements, which significantly interferes with daily functioning and quality of life. It affects approximately 4%-5% of the population worldwide, yet its underlying pathophysiology remains unclear, with proposed mechanisms involving autonomic nervous system dysregulation, metabolic imbalance, and psychological factors. Here, we describe a case of chronic hyperhidrosis in which spontaneous sweating and facial flushing improved markedly following administration of Samhwangsasim-tang as monotherapy. A 66-year-old man presented with chronic hyperhidrosis occurring without identifiable triggers. Even minimal physical activity caused profuse craniofacial sweating accompanied by facial flushing, which was exacerbated by heat exposure and conditions associated with increased core body temperature. Based on his symptom pattern, Samhwangsasim-tang extract granules were prescribed. No other treatments, including acupuncture, cupping therapy, or conventional medications, were administered during the treatment period. Symptom severity was evaluated using the Numeric Rating Scale (NRS) and the Hyperhidrosis Disease Severity Scale (HDSS). After approximately 42 days of treatment, spontaneous sweating resolved completely (NRS 10 → 0; HDSS 4 → 1), and facial flushing was reduced to 20%-30% of baseline severity (NRS 10 → 2-3). This case suggests that the heat-clearing, anti-inflammatory, and metabolic-regulating properties of Samhwangsasim-tang may contribute to the normalization of skin temperature, sweating regulation, and peripheral circulation. Further clinical and mechanistic studies are warranted to elucidate its therapeutic potential in hyperhidrosis.
Perifollicular Inflammation and Fibrosis in Androgenetic Alopecia: Implications for Diagnosis and Treatment - A Comparative Histopathologic and Clinical Study with Normal-Appearing Scalp.
Umar S, Tan BH, Shitabata PK
Clin Cosmet Investig Dermatol · 2026 · PMID 41858594 · Full text
INTRODUCTION: Androgenetic alopecia (AGA) is traditionally regarded as a noninflammatory, androgen-driven condition. Yet clinical and histologic evidence identifies a subset of patients with perifollicular infundibulo-is...
INTRODUCTION: Androgenetic alopecia (AGA) is traditionally regarded as a noninflammatory, androgen-driven condition. Yet clinical and histologic evidence identifies a subset of patients with perifollicular infundibulo-isthmic lymphocytic infiltrates and fibrosis (PIILIF), a histopathologic pattern resembling early primary cicatricial alopecia (PCA). This study evaluates the clinical, histologic, and immunophenotypic features of PIILIF and their diagnostic and therapeutic implications. METHODS: This retrospective study of 129 AGA patients drawn from a referral center, obtained trichoscopy-guided biopsies from balding and clinically non-alopecic scalp (cNAS). Histopathologic and immunohistochemical findings were correlated with clinical features and treatment outcomes. Patients with PIILIF received multimodal therapy targeting androgenic and inflammatory pathways. The cohort, from a specialty clinic, included both typical and treatment-resistant AGA. RESULTS: PIILIF was identified in the cNAS of 81% of patients, particularly in those aged 44 or older, with Norwood stage ≥5, or with prior poor response to therapy. Histology showed CD117+ mast cells, perifollicular CD4-predominant lymphocytes and fibrosis in the infundibulo-isthmic unit. Combination therapy using dihydrotestosterone blockade plus anti-inflammatory agents modeled after PCA therapies, including tetracyclines, topical calcineurin inhibitors, and select phytoactive botanicals, yielded greater improvement than standard AGA treatment regimens alone. Overall, 67% improved, and 2% had suboptimal outcomes (p < 0.0001). These findings support an AGA-PIILIF continuum that may include fibrosing alopecia in a pattern distribution. CONCLUSION: PIILIF represents an under‑recognized inflammatory endotype within AGA that may account for treatment resistance in some patients. Early biopsy can confirm the diagnosis, and therapy targeting hormonal and immune pathways may improve outcomes. Routine trichoscopy with a low threshold to biopsy perifollicularly abnormal units showing mild erythema, scale, or hyperpigmented collars can guide care, particularly in treatment resistant or equivocal cases. The broader systemic implications of this inflammatory signature merit further investigation.
Recurrent Primary Cutaneous Mucinous Carcinoma of the Lower Eyelid: A Case Initially Misdiagnosed as Metastatic Carcinoma.
Xu W, Gao Q, Wang Y
Clin Cosmet Investig Dermatol · 2026 · PMID 41858593 · Full text
Primary cutaneous mucinous carcinoma (PCMC) is a rare, low-grade adnexal tumor with a propensity for local recurrence despite a low metastatic potential. It typically presents as an asymptomatic, solitary red-to-gray-blu...
Primary cutaneous mucinous carcinoma (PCMC) is a rare, low-grade adnexal tumor with a propensity for local recurrence despite a low metastatic potential. It typically presents as an asymptomatic, solitary red-to-gray-blue nodule on the head and neck. We report a case of recurrent PCMC on the lower eyelid that was initially misdiagnosed as metastatic carcinoma. The lesion was successfully and definitively managed with Mohs micrographic surgery (MMS) following multiple recurrences after standard excision.
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