【Abstract】 Psoriasis is an immune-mediated chronic, recurrent, inflammatory, systemic disease induced by the interaction between the individual and environment. Psoriasis is a non-communicable disease, its typical clinical manifestations are locally or widely distributed scaly erythema or plaques. The etiology of psoriasis involves heredity, immunity, environment, and other factors. Until now, psoriasis is still an incurable disease. Choosing appropriate drugs and regimens is very important for patients with psoriasis to control the condition, reduce comorbidities, maintain long-term efficacy, and comprehensively improve the quality of life. To standardize the diagnosis and treatment procedure of psoriasis, improve treatment effectiveness, and minimize adverse reactions, the Committee on Psoriasis of Chinese Society of Dermatology formulated this guideline based on the "Guideline for the diagnosis and treatment of psoriasis in China （2018 complete edition）" and according to the current situation in China, with some contents supplemented and revised in this guideline. Because latest research achievements in traditional Chinese medicine for the diagnosis and treatment of psoriasis were combined, this guideline was also an integrated Chinese and Western medicine guideline for the diagnosis and treatment of psoriasis. Considering the complexity of psoriasis, the treatment regimens should be decided according to patients′ individual situation. Topical treatment is commonly recommended for patients with mild psoriasis, systemic treatment can be chosen for those with moderate to severe psoriasis, and biological agents or small-molecule drugs can be selected for those with poor response to traditional systemic treatment.

【Abstract】 Nowadays, various countries have developed guidelines/consensus on the diagnosis and treatment of alopecia areata. Differences between these guidelines/consensus may reflect differences in backgrounds, research status, medical resources and clinical traditions among countries. This review compares Chinese and international guidelines/consensus on the diagnosis and treatment of alopecia areata in the past three years, and analyzes the epidemiology, etiology, diagnosis, severity assessment methods and treatment of alopecia areata, so as to provide a reference for standardized and individualized diagnosis and treatment of alopecia areata in China.

【Abstract】 Chronic inducible urticaria is a group of chronic urticaria induced by specific triggers, with wheal and/or angioedema as main clinical manifestations, which may be accompanied by itching, tingling, burning sensation, pain and other unpleasant symptoms. This group of diseases are characterized by highly heterogeneous clinical manifestations, long courses, and recurrent symptoms, which have a great impact on the quality of life of patients. Based on progress in Chinese and international clinical studies on the diagnosis and treatment of chronic inducible urticaria in recent years, the Immunology Group of Chinese Society of Dermatology extensively consulted experts through the Delphi method, and finally developed this consensus after several rounds of discussion among relevant experts, in order to improve clinicians' understanding of this group of diseases and standardize their diagnosis and treatment.

【Abstract】 Chronic spontaneous urticaria （CSU） is the most common phenotype of chronic urticaria. Liscenced-dosed, up-dosed, or combined second-generation H1-antihistamines are choices for the treatment of CSU. However, approximately 50% of patients with CSU are resistant to antihistamine therapies. The treat-to-target approach has been proven to improve the quality of chronic disease management, but has not been proposed in CSU in China so far. Based on the latest guidelines, consensus, clinical trials and real-world studies in China and other countries, and combined with experts′ clinical experience, 31 Chinese experts in the field of urticaria diagnosis and treatment and related fields developed this consensus on treat-to-target in CSU, aiming to provide detailed guidance to clinicians.

【Abstract】 Chronic prurigo is an independent chronic inflammatory skin disease, and complex underlying etiologies or comorbidities may exist in patients. Diagnosis of chronic prurigo requires a systematic process, including identifying core symptoms, taking a comprehensive medical history, performing physical examination, completing necessary laboratory or imaging tests, and assessing disease severity. Treatments of chronic prurigo include management of possible causes and comorbidities, and stepwise control of pruritus. This review mainly summarizes clinical diagnosis, classification and treatment of chronic prurigo.

【Abstract】 The application of moisturizers and emollients is an important method for protecting or repairing skin barriers, maintaining skin health, and coping with skin diseases. In order to standardize and rationalize the application of moisturizers and emollients, the China Dermatologist Association convened Chinese experts in this field to conduct sessions of in-depth discussions based on up-to-date Chinese and international research outcomes, and reached a consensus on the efficacy, composition selection, application indications, application methods and adverse reactions of moisturizers and emollients, as well as considerations during their use.

【Abstract】 The prevalence of psoriasis in China is witnessing an upward trend in recent years. Diet is one of the vital factors associated with patients′ quality of life, but there is still a lack of standardized instructions. Hence, it is of great importance to develop an evidence-based guideline for dietary management among Chinese patients with psoriasis. This guideline was jointly endorsed by the China Dermatologist Association and the Chinese Society of Dermatology. A working group composed of experts in the fields of dermatology, nutriology, and evidence-based methodology developed this guideline following the standardized process of formulating clinical evidence-based guidelines. This guideline provides 17 evidence-based recommendations on 12 clinical issues of great concern to dermatologists and patients, aiming to provide more scientific and reasonable dietary interventions for patients with psoriasis.

【Abstract】 Metformin, the first-line treatment of type 2 diabetes, has been also increasingly used in the treatment of some skin diseases, such as psoriasis. This review summarizes therapeutic mechanisms of and clinical research progress in metformin in the treatment of psoriasis, aiming to provide ideas and methods for the treatment of psoriasis, especially psoriasis complicated by metabolic diseases.

【Abstract】 Atopic dermatitis in the elderly （> 60 years old） differs from that in children and adults in terms of demographical characteristics, pathogenesis, clinical manifestations and complications, and special considerations are needed for its diagnosis and treatment. Thus, the Immunology Group of the Chinese Society of Dermatology developed an expert consensus on the diagnosis and treatment of atopic dermatitis in the elderly, aiming to standardize and guide the effective management of elderly patients with atopic dermatitis.

【Abstract】 In this review, guidelines and consensus for the diagnosis and treatment of vitiligo in Europe, the United States, Japan, South Korea, China and other countries and regions were compared in terms of clinical typing, staging, severity assessment, drug treatment and non?drug treatment of vitiligo, and similarities and differences in recommended treatments of vitiligo as well as emphasized concepts were summarized among different guidelines and consensus. It is hoped that this review will help clinicians provide more appropriate individualized treatment for patients with vitiligo.

【Abstract】 Mycosis fungoides, the most common type of cutaneous T-cell lymphoma, usually only involves the skin at the early stage, and progresses into tumors with involvement of lymph nodes, peripheral blood and the viscera at the advanced stage. A comprehensive stage evaluation should be performed before the initiation of the treatment, and treatment decisions are determined according to the disease stage. Based on the latest international guidelines and consensus, as well as a review of evidence-based treatment options, and combined with current treatment status in China, 12 Chinese experts in the field of diagnosis and treatment of mycosis fungoides established this consensus, with an emphasis on first-line and second-line treatment options and novel therapies for mycosis fungoides, so as to provide guidance for standardizing the treatment of mycosis fungoides.

【Abstract】 In order to promote the standardization of diagnosis and treatment of moderate to severe atopic dermatitis in China, Chinese Society of Dermatology and China Dermatologist Association organized Chinese experts to establish a clinical pathway for the diagnosis and treatment of moderate to severe atopic dermatitis, through a combined approach of literature analysis, thematic discussion, and expert consultation. Firstly, the diagnosis, assessment, screening, and examination items for atopic dermatitis, as well as entry criteria for clinical pathway were described; secondly, the treatment principles, regimens and drugs for moderate to severe atopic dermatitis were elaborated, so were the efficacy assessment, follow-up and evaluation indicators, patient education and guidance, standards for pathway completion, pathway variation and its cause analysis; it was suggested that the course of induction treatment should not be less than 3 months, and the plan of maintenance treatment should be set for at least 3 - 6 months after the efficacy of induction treatment was achieved; finally, the management process and the clinical pathway form for the diagnosis and treatment of moderate to severe atopic dermatitis were listed in the appendixes.

【Abstract】 Serofast state in syphilis refers to a special serological reaction in syphilis patients, whose clinical symptoms have disappeared after regular anti-syphilitic treatment, but the non-Treponema pallidum antigen-based serologic test remains positive. Accurate estimation of serofast state in syphilis is important for the avoidance of overtreatment and/or relative undertreatment in clinical practice. In order to further understand the serofast state in syphilis, establish and improve its clinical management strategies, solve clinicians′ doubts about serofast syphilis, and reduce the psychological burden and improve the quality of life of the population with serofast syphilis, the Committee on Sexually Transmitted Diseases, China Dermatologist Association organized relevant Chinese experts to discuss and reach a consensus on the definition, epidemiological features, possible relevant factors and standardized management of serofast state in syphilis.

【Abstract】 Rosacea is a chronic recurrent inflammatory skin disease that mainly occurs on the face. A large number of studies have confirmed that rosacea is related to a variety of systemic diseases, including neuropsychiatric diseases such as anxiety, depression, migraine, Alzheimer′s disease and Parkinson′s disease. This review summarizes research progress in the correlation between rosacea and neuropsychiatric diseases, as well as the underlying mechanisms.

【Abstract】 In recent years, new therapeutic targets for bullous pemphigoid (BP) have continued to emerge, and new biologic agents targeting pathogenic antibodies, complements, T helper type 2 (Th2) and Th17 cytokines in BP have also successively entered clinical trials, e.g., the CD20-targeting antibody rituximab and the IgE-targeting antibody omalizumab have been applied in clinical practice and have benefited some patients with refractory BP. This review summarizes the literature and clinical trials related to biologic agents as the treatment strategy for BP, analyzes and discusses clinical application of new biological agents in BP, in order to provide new ideas for the treatment of refractory BP.

【Abstract】 Clinical and histological features of Spitz nevi, atypical Spitz tumors and spitzoid melanoma overlap each other, making their identification challenging. Combined with clinical and histological features of spitzoid melanocytic tumors, this review summarizes research progress in their immunohistochemical features and application of fluorescence in situ hybridization in their identification.

【Abstract】 Cutaneous adverse reactions are common during anti-tumor therapy, which not only greatly affect patients′ quality of life, but may also cause discontinuation and dose reduction of anti-tumor therapy. With the increasing diversity of anti-tumor drugs, cutaneous adverse reactions have become more complex and challenging for clinicians. In view of this, the Shanghai Society of Dermatology and Venereology and Shanghai Society of Target Molecular Oncology, Shanghai Medical Association organized experts to discuss and sort out existing relevant clinical evidence to develop an expert consensus. This consensus summarizes cutaneous adverse reactions to anti-tumor drugs, such as cytotoxic chemotherapy drugs, molecular targeted drugs, and immune checkpoint inhibitors, and proposes prevention and management measures for common cutaneous adverse reactions, aiming to provide standardized guidance for clinicians and nurses in the fields of oncology and dermatology in clinical practice.

【Abstract】 Atopic dermatitis is a common chronic recurrent inflammatory skin disease. Previous therapeutic drugs include topical glucocorticoids, topical calcineurin inhibitors, oral antihistamines, systemic immunosuppressants and glucocorticoids, etc. In recent years, biologics and a variety of small-molecule drugs have been approved for the treatment of atopic dermatitis. Based on recent research progress, Chinese and international guidelines or consensus, and experts′ clinical experience, China Dermatologist Association, Chinese Society of Dermatology, Dermatology Branch of China International Exchange and Promotive Association for Medical and Health Care, State Key Laboratory of Complex Severe and Rare Diseases, and National Clinical Research Center for Dermatologic and Immunologic Diseases convened experts to develop this consensus on strategies for the clinical application of therapeutic drugs for atopic dermatitis, monitoring and management of adverse drug reactions, and drug management in special populations, aiming to provide a reference for the application and management of therapeutic drugs for atopic dermatitis.

【Abstract】 Rosacea is a chronic inflammatory dermatosis mostly occurring on the central face, and its pathogenesis is still unclear. Currently, drug treatment is the first-line therapy for rosacea. In recent years, photoelectric therapy has showed a favorable therapeutic effect on rosacea by selective photothermolysis. This review summarizes latest advances in photoelectric therapy for rosacea.

【Abstract】 Androgens are important sex hormones in the body, and are involved in the occurrence and development of various skin diseases, such as acne, androgenetic alopecia, hirsutism. Anti-androgen drugs can act on different sites in the androgen synthesis and functional pathways to antagonize the effects of androgens, and can be used in the alleviation and treatment of related diseases. In recent years, some research progress has been made in the treatment of skin diseases with anti-androgen drugs. For example, clascoterone is a first-in-class topical drug in the treatment of acne in the last 40 years, dutasteride can be applied in male patients aged over 20 years with androgenetic alopecia, and topical finasteride is markedly effective for the treatment of androgenetic alopecia, as well as idiopathic hirsutism in females. This review summarizes research progress in anti-androgen drugs in the treatment of skin diseases in recent years.

【Abstract】 The occurrence of Kaposi′s sarcoma （KS） is closely related to Kaposi′s sarcoma-associated herpesvirus （KSHV） infection of endothelial cells. KSHV infection can present as various types of KS, and clinical features, severity and prognosis differ among different types of KS. Classic KS is characterized by localized lesions and slow progression, AIDS-related KS and endemic KS are highly aggressive, and iatrogenic KS needs control of the primary disease during treatment. Therefore, individualized therapies should be developed according to the clinical classifications and characteristics of KS. This review summarizes treatment modalities of and research progress in KS.

【Abstract】 Gardner-Diamond syndrome is a rare skin disease characterized by recrudescent, spontaneous, tender ecchymoses, and mostly affects psychologically disturbed adult women. The positive autoerythrocyte sensitization test has noticeable diagnostic significance. Currently, there is no specific therapy for Gardner-Diamond syndrome. This review summarizes advances in the pathogenesis, clinical features, diagnosis and treatment of this disease.

【Abstract】 Frontal fibrosing alopecia is a primary lymphocytic cicatricial alopecia, and generally considered to be a subtype of lichen planopilaris due to similar histopathological changes. Its etiology is still unclear. With the deepening of research on this disease, more and more cases of frontal fibrosing alopecia have been reported in China and other countries. This review summarizes research progress in pathogenesis, clinical and pathological characteristics, and treatment of frontal fibrosing alopecia.

【Abstract】 Interleukin-17 （IL-17） has been proved to be closely associated with the pathogenesis of various inflammatory skin diseases. Its main source is Th17 cells, whose differentiation is evoked by interleukin-23 （IL-23）. Therefore, the IL-23/Th17 axis is an emerging target for the treatment of inflammatory skin diseases. IL-17 antagonists, IL-23 antagonists and IL-12/23 antagonists have shown satisfactory efficacy and safety in the treatment of psoriasis, atopic dermatitis, hidradenitis suppurativa, pityriasis rubra pilaris and SAPHO syndrome in latest clinical trials. Accordingly, this review mainly summarizes progress in molecular signaling pathways in and pathophysiological basis of the IL-23/Th17 axis in the occurrence of inflammatory skin diseases, as well as clinical application of different biological agents targeting this axis.

【Abstract】 Autoinflammatory diseases （AIDs） are a group of abnormal inflammatory diseases mediated by innate immune cells with a certain hereditary susceptibility, including monogenic AIDs and polygenic AIDs. AIDs are characterized by various clinical manifestations, periodic attacks and intermittent symptom relief, multiple systems are often involved, and skin is one of the predominantly involved organs. Due to genetic diversity and uncertainty in AIDs, gene-based classification is unhelpful in clinical recognitoin and selection of therapeutic strategies. With in-depth study of the pathogenesis of AIDs, researchers have found overlapping inflammatory pathways in AIDs sharing common skin lesions, which may be treated with similar strategies. This review describes classification of AIDs according to features of skin lesions, summarizes commonalities in their immune mechanisms and histopathological features, and discusses possible effective treatment regimens and interventions, in order to facilitate the clinical diagnosis and treatment.

【Abstract】 Skin microbiota is associated with various skin diseases. Scalp hair follicles penetrate deeply into the skin, and carry complex microbial communities distinct from those on the skin surface. Local imbalance of microbial communities may impair the skin barrier function, leading to a variety of hair and scalp diseases. This review discusses changes in microbial diversity and colonization by specific microorganisms in various hair diseases, dandruff, folliculitis decalvans, etc., and provides new ideas for exploring the pathogenesis of and therapeutic strategies for various hair and scalp diseases.

【Abstract】 Hidradenitis suppurativa（HS）/acne inversa（AI） is a chronic, recurrent and inflammatory skin disease caused by follicular atresia with varying clinical manifestations, and there is no unified classification criteria for it in China and other countries. Based on its clinical characteristics, gene mutations and their correlations, researchers have enriched the subtype classification of HS/AI. This review summarizes recent advances in clinical phenotypes and genotypes of HS/AI as well as their relationships, in order to help clinicians better understand the disease, and provide a theoretical basis for correct diagnosis and individualized treatment strategies.

【Abstract】 Interface dermatitis refers to a group of skin diseases in which inflammation mainly involves the dermo-epidermal junction, including lichen planus, lupus erythematosus, dermatomyositis, lichen sclerosus, lichen nitidus, lichen striatus, erythema multiforme, bullous pemphigoid, Riehl melanosis, poikiloderma, large-plaque parapsoriasis/mycosis fungoides, etc. Interface dermatitis shows characteristic reflectance confocal microscopic features. This review summarizes reflectance confocal microscopic characteristics of interface dermatitis and recent progress in the application of reflectance confocal microscopy in its auxiliary diagnosis.

【Abstract】 The degree of severity varies greatly among different patients with acne inversa（AI）/hidradenitis suppurativa（HS）, and disease severity usually determines treatment strategies. There have been a number of severity assessment criteria for AI/HS, such as the Hurley grading system, Sartorius score, HS severity index, etc., which have been widely used in clinical classification and research and have shown clinical guiding significance. However, limitations still exist in some criteria, such as low sensitivity for efficacy evaluation, limited application range, etc. This review introduces several severity assessment criteria for AI/HS that have been proposed in recent years, aiming to better evaluate the disease and carry out graded treatment.

【Abstract】 Chronic actinic dermatitis is a photosensitive dermatosis commonly occurring in middle-aged and elderly males, clinically characterized by eczematous lesions on the sun-exposed skin. The diagnosis mainly relies on clinical manifestations and photobiological tests. The key to treatment is avoidance of sunlight exposure and removal of photosensitizers, and other treatments include topical drugs, physical therapy, systemic drugs, etc. Based on recent research advances in chronic actinic dermatitis in China and other countries, the Dermatology Professional Committee of Chinese Research Hospital Society and the China Dermatologist Association organized experts in the field of photodermatology to discuss the causes, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment and prognosis of chronic actinic dermatitis in clinical practice, and to develop an expert consensus on the diagnosis and treatment of chronic actinic dermatitis （2023）, which provided a scientific and authoritative reference for the diagnosis and management of chronic actinic dermatitis.

【Abstract】 Objective To retrospectively analyze clinical efficacy and safety of omalizumab in the treatment of chronic urticaria （CU） in southern Zhejiang, China. Methods A retrospective observational study was conducted on CU patients who received omalizumab treatment at the First Affiliated Hospital of Wenzhou Medical University from January 1st, 2018 to August 1st, 2021. Through the outpatient follow-up visits, the disease activity, condition control, and quality of life were evaluated using the 7-day urticaria activity score （UAS7）, urticaria control test （UCT）, and dermatology life quality index （DLQI）. In addition, changes in disease condition, recurrence after withdrawal, and adverse events were assessed. Independent-sample t test was used for intergroup comparisons of normally distributed measurement data, Wilcoxon signed-rank sum test or Kruskal-Wallis H test was used for comparisons of non-normally distributed measurement data, and chi-square test or Fisher′s exact test was used for comparisons of enumeration data. Results A total of 252 CU patients with poor response to antihistamines were included, with a baseline UCT score of 5.0 ± 2.4 points, a UAS7 score of 25.6 ± 6.2 points, and a DLQI score of 17.5 ± 4.7 points; among them, 204 （81.0%） were treated with omalizumab at an initial dose of 300 mg, and 48 （19.0%） with omalizumab at an initial dose of 150 mg. At the end points （12.0 ± 1.4 months after the start of treatment）, an overall control rate of 90.3% （224/248） was achieved after the omalizumab treatment; concretely, 137 （55.2%） patients achieved complete control （UCT = 16 points）, 87 （35.1%） achieved partial control （12 points ≤ UCT < 16 points）, and 24 （9.7%） showed no response （UCT < 12 points）, while 10 with partial response shifted to complete control after dose increase. During the treatment period, recurrence occurred in 50 patients （36.5%）, of whom 32 patients opted for retreatment with omalizumab, and then 30 （93.8%） achieved partial or complete control. Adverse events were reported in 8 patients （3.2%）, and all were mild or moderate. Conclusion Omalizumab was effective in the real-world treatment of CU, and could improve patients′ quality of life, with a favorable safety profile.

【Abstract】 In recent years, with the in-depth study of pemphigus, new pathogenesis has been identified based on the desmoglein antibody-mediated immune response mechanism, and new progress has been made in targeted therapy. This review summarizes recent advances in the pathogenesis and targeted therapy of pemphigus.