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Guideline for the diagnosis and treatment of psoriasis in China (2023 edition)
Committee on Psoriasis, Chinese Society of Dermatology
Chinese Journal of Dermatology    2023, 56 (7): 573-625.   DOI: 10.35541/cjd.20220839
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【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.
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Comparison of the latest Chinese and international guidelines/consensus on diagnosis and treatment of alopecia areata
Wang Yuqian, Qiao Jianjun, Fang Hong
Chinese Journal of Dermatology    2023, 56 (9): 885-888.   DOI: 10.35541/cjd.20210184
Accepted: 01 August 2022

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【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.
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Expert consensus on treat-to-target in chronic spontaneous urticaria (2023)
Chinese Society of Dermatology, China Dermatologist Association
Chinese Journal of Dermatology    2023, 56 (6): 489-495.   DOI: 10.35541/cjd.20230004
Accepted: 30 March 2023

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【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.
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Expert consensus on diagnosis and treatment of chronic inducible urticaria in China (2023)
Immunology Group, Chinese Society of Dermatology
Chinese Journal of Dermatology    2023, 56 (6): 479-488.   DOI: 10.35541/cjd.20220819
Accepted: 16 March 2023

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【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.
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A case of recurrent childhood Langerhans cell histiocytosis following chemotherapy successfully treated with dabrafenib
Si He′nan, Li Shanshan, Li Yang, Yu Yan
Chinese Journal of Dermatology    2023, 56 (10): 959-960.   DOI: 10.35541/cjd.20210311
Accepted: 09 March 2022

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Two cases of childhood generalized pustular psoriasis treated with secukinumab
Chen Yunliu, Wang Zhaoyang, Xiang Xin, Wang Yachen, Liu Ying, Xu Jiaosheng, Xu Zigang
Chinese Journal of Dermatology    2023, 56 (9): 874-876.   DOI: 10.35541/cjd.20210214
Accepted: 09 February 2022

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Guidance on application of moisturizers and emollients: an expert consensus (2023)
China Dermatologist Association
Chinese Journal of Dermatology    2023, 56 (8): 711-717.   DOI: 10.35541/cjd.20230133
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【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.
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Diagnosis and classification of chronic prurigo
Cheng Bihong, Dou Xia
Chinese Journal of Dermatology    2023, 56 (11): 1070-1073.   DOI: 10.35541/cjd.20210130
Accepted: 09 February 2022

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【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.
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Metformin in the treatment of psoriasis
Chen Xiaomin, Zhang Jingzhan, Ding Yuan, Kang Xiaojing
Chinese Journal of Dermatology    2023, 56 (8): 799-802.   DOI: 10.35541/cjd.20201257
Accepted: 08 June 2022

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【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.
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Expert consensus on diagnosis and treatment of atopic dermatitis in the elderly (2023)
Immunology Group, Chinese Society of Dermatology
Chinese Journal of Dermatology    2023, 56 (11): 991-999.   DOI: 10.35541/cjd.20230427
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【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.
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Clinical pathway for the diagnosis and treatment of moderate to severe atopic dermatitis in China (2023): an expert consensus
Chinese Society of Dermatology, China Dermatologist Association
Chinese Journal of Dermatology    2023, 56 (11): 1000-1007.   DOI: 10.35541/cjd.20230247
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【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.
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Correlation between rosacea and neuropsychiatric diseases
Tao Meng, Li Min, Liu Yixuan, Liu Yunyi, Jiang Peiyu, Zhang Jiawen, Nan Yuqing, Xu Yang
Chinese Journal of Dermatology    2023, 56 (7): 693-697.   DOI: 10.35541/cjd.20201083
Accepted: 10 June 2021

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【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.
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Expert consensus on the application and management of therapeutic drugs for atopic dermatitis (2024)
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, National Clinical Research Center for Dermatologic and Immunologic Diseases
Chinese Journal of Dermatology    2024, 57 (2): 97-108.   DOI: 10.35541/cjd.20230358
Abstract624)      PDF(pc) (14900KB)(117)       Save
【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.
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Consensus on the management of cutaneous adverse reactions to anti-tumor drugs
Shanghai Society of Dermatology and Venereology, Shanghai Society of Target Molecular Oncology, Shanghai Medical Association
Chinese Journal of Dermatology    2023, 56 (10): 907-919.   DOI: 10.35541/cjd.20230084
Abstract622)      PDF(pc) (16319KB)(1323)       Save
【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.
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Application of biologic agents in the treatment of bullous pemphigoid
Zhou Tong, Geng Songmei
Chinese Journal of Dermatology    2023, 56 (8): 789-793.   DOI: 10.35541/cjd.20201200
Accepted: 11 April 2022

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【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.
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Guidelines for the management of chronic pruritus (2024)
China Dermatologist Association
Chinese Journal of Dermatology    2024, 57 (5): 387-399.   DOI: 10.35541/cjd.20230746
Abstract581)      PDF(pc) (16357KB)(1229)       Save
【Abstract】 Chronic pruritus is a common symptom of various diseases, causing severe negative impacts on patients′ quality of life. Due to its complex pathogenesis, etiological diagnosis and treatment are often challenging. To improve the understanding of chronic pruritus among Chinese clinicians and to standardize diagnosis and therapeutic practices, the China Dermatologist Association organized experts in China to update the classification, etiology, and pathogenesis of chronic pruritus based on the "Guidelines for the Management of Chronic Pruritus (2018 edition)" , current research status and progress in China and other countries, as well as extensive consultation with experts in China through the Delphi method, aiming to provide expert opinions and evidence-based medical guidance on the etiological diagnosis and treatment of chronic pruritus.
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Anlotinib for the treatment of a case of cutaneous angiosarcoma
Chen Huyan, Wang Lei, Liu Yiwen, Zhou Junhao, Cao Lei
Chinese Journal of Dermatology    2024, 57 (5): 462-463.   DOI: 10.35541/cjd.20210557
Accepted: 06 May 2022

Abstract514)      PDF(pc) (8646KB)(5)    PDF(mobile) (4807KB)(0)    Save
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Anti-androgen drugs in the treatment of skin diseases
Sun Xiaojie, Liu Yi
Chinese Journal of Dermatology    2023, 56 (9): 882-885.   DOI: 10.35541/cjd.20210024
Accepted: 08 June 2022

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【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.
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Gardner-Diamond syndrome
Tan Yan, Qian Yuetong, Ma Donglai
Chinese Journal of Dermatology    2023, 56 (8): 787-788.   DOI: 10.35541/cjd.20201176
Accepted: 30 December 2021

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【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.
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Treatment of Kaposi′s sarcoma
Gao Yan, Wang Peng, Kang Xiaojing
Chinese Journal of Dermatology    2024, 57 (1): 85-89.   DOI: 10.35541/cjd.20210303
Accepted: 24 August 2021

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【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.
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Tacrolimus 0.1% ointment for the treatment of a case of granuloma faciale
Zhao Mengjie, Jiang Si, Song Jiquan
Chinese Journal of Dermatology    2024, 57 (2): 168-169.   DOI: 10.35541/cjd.20210512
Accepted: 06 May 2022

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Frontal fibrosing alopecia
Li Yuqian, Zhu Qilin, Zhu Jing, Chen Qitao, Li Zhongming, Xu Wenrong, Du Xufeng, Fan Weixin
Chinese Journal of Dermatology    2023, 56 (10): 973-977.   DOI: 10.35541/cjd.20210043
Accepted: 07 February 2022

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【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.
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A case of giant vulvar Paget′s disease
Gao Min, Su Danni, Liu Keshuai, Zhang Xiaoyan
Chinese Journal of Dermatology    2023, 56 (7): 684-685.   DOI: 10.35541/cjd.20210093
Accepted: 30 March 2022

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Biological agents targeting interleukin-23/Th17 axis in inflammatory skin diseases: from basic research to clinical application
You Ruixuan, Zeng Zhuotong, Qiu Xiangning, Xiao Rong
Chinese Journal of Dermatology    2023, 56 (11): 1065-1069.   DOI: 10.35541/cjd.20210232
Accepted: 06 May 2022

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【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.
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Autoinflammatory dermatosis
Jia Tao, Song Xiangjin, Geng Songmei
Chinese Journal of Dermatology    2023, 56 (8): 794-799.   DOI: 10.35541/cjd.20201253
Accepted: 09 March 2022

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【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.
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Association of microbiota with hair and scalp diseases
Li Haiyang, Lin Jinran, Liu Qingmei, Ni Chunya, Wu Wenyu,
Chinese Journal of Dermatology    2023, 56 (7): 686-688.   DOI: 10.35541/cjd.20201196
Accepted: 09 March 2022

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【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.
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Clinical phenotypes and genotypes of hidradenitis suppurativa/acne inversa
Wang Wenzhu, Wang Baoxi, He Yanyan, Xu Haoxiang
Chinese Journal of Dermatology    2023, 56 (9): 892-895.   DOI: 10.35541/cjd.20210252
Accepted: 08 June 2022

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【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.
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Expert consensus on the diagnosis and treatment of chronic actinic dermatitis (2023)
Dermatology Professional Committee of Chinese Research Hospital Society, China Dermatologist Association
Chinese Journal of Dermatology    2023, 56 (12): 1096-1106.   DOI: 10.35541/cjd.20230433
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【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.
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Paradoxical psoriasis induced by tumor necrosis factor-α inhibitors and other biological agents
Lu Jiawei, Lu Yan
Chinese Journal of Dermatology    2024, 57 (5): 479-482.   DOI: 10.35541/cjd.20210420
Accepted: 09 February 2022

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【Abstract】 Tumor necrosis factor (TNF)-α inhibitors have become an important choice for patients with chronic inflammatory diseases who are intolerant or poorly responsive to conventional therapies. Studies have shown that psoriasis can develop or be exacerbated in 2% - 5% of patients treated with TNF-α inhibitors, and this phenomenon is called paradoxical psoriasis. Paradoxical psoriasis and classic psoriasis have similar clinical manifestations, but different immunological mechanisms. This review summarizes the pathogenesis, clinicopathological features and management of paradoxical psoriasis, and provides an overview of paradoxical psoriasis following the application of other common biological agents.
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Application of reflectance confocal microscopy in interface dermatitis
Wan Li, Chen Jinbo, Jiang Qian, Chen Hongying, Hu Bin, Chen Liuqing
Chinese Journal of Dermatology    2023, 56 (10): 982-985.   DOI: 10.35541/cjd.20210269
Accepted: 31 December 2021

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【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.
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Efficacy and safety of omalizumab in the treatment of chronic urticaria: a retrospective analysis
Yang Nali, Xu Qiuyang, Wu Hanwen, Ye Yahui, Zhu Jiling, Liu Jingjing, Li Zhiming
Chinese Journal of Dermatology    2023, 56 (6): 518-524.   DOI: 10.35541/cjd.20220287
Abstract399)      PDF(pc) (9080KB)(571)       Save
【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.
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Pathogenesis and targeted therapy of pemphigus
Yan Rufan, Liao Jieyue, Guo Ziyu, Yao Nan, Zhou Wenyu, Luo Shuaihantian, Zhang Guiying, Zhao Ming
Chinese Journal of Dermatology    2024, 57 (4): 374-378.   DOI: 10.35541/cjd.20210248
Accepted: 29 April 2022

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【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.
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Severity assessment criteria for acne inversa/hidradenitis suppurativa
Ma Xiao, Li Chengrang, Wang Baoxi, He Yanyan, Xu Haoxiang
Chinese Journal of Dermatology    2024, 57 (3): 283-286.   DOI: 10.35541/cjd.20210236
Accepted: 10 January 2022

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【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.
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Small-molecule/biological agents in the treatment of pruritus
Guo Lan, Jin Hongzhong
Chinese Journal of Dermatology    2024, 57 (5): 475-478.   DOI: 10.35541/cjd.20210582
Accepted: 05 December 2022

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【Abstract】 In recent years, great progress has been made in the research on the pathogenesis of pruritus, and many new targeted therapeutic drugs have been developed, mainly including small-molecule drugs or biological agents targeting signal transduction pathways involved in the pathogenesis of pruritus, such as neurokinin-1 receptor, tropomyosin-related kinase A, transient receptor potential vanilloid 1, transient receptor potential melastatin 8 channels, interleukin 31, etc. Some of these drugs have shown good efficacy and safety in the treatment of pruritus in a variety of skin diseases, providing more options for patients with pruritus, especially those who are resistant to traditional drug treatment. This review summarizes research progress in the above small-molecule drugs and biological agents targeting signaling pathways involved in pruritus, in order to provide more options for pruritus treatment.
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A case of fibroepithelioma of Pinkus along Blaschko′s lines
Han Bing, Wang Hong, Liu Hesong, Tian Yaping
Chinese Journal of Dermatology    2023, 56 (9): 870-871.   DOI: 10.35541/cjd.20210218
Accepted: 09 February 2022

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Dupilumab for the treatment of a case of prurigo nodularis
Zhang Fan, Liu Hong, Zhang Furen
Chinese Journal of Dermatology    2024, 57 (1): 69-70.   DOI: 10.35541/cjd.20210391
Accepted: 05 December 2022

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Omalizumab for the treatment of 74 patients with chronic spontaneous urticaria accompanied by other allergic diseases: a clinical analysis
Su Chang, Sui Xiuli, Liu Ruiling, Cao Yiqun, Jiang Hong, Yan Cairong, Wang Huiping, Qi Yuqing
Chinese Journal of Dermatology    2023, 56 (6): 512-517.   DOI: 10.35541/cjd.20220931
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【Abstract】 Objective To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases. Methods Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%), 61 with complicated allergic rhinitis (82.4%), 6 with complicated atopic dermatitis (8.1%), and 4 with food allergy (5.4%). Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001); after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001); among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment (t = 15.04, 10.01, respectively, both P < 0.001), and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.
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Epitope spreading in autoimmune bullous diseases
Shan Ying, Chang Xiaotong, Zuo Yagang
Chinese Journal of Dermatology    2023, 56 (7): 702-705.   DOI: 10.35541/cjd.20201019
Accepted: 10 June 2021

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【Abstract】 Epitope spreading often occurs in patients with autoimmune bullous diseases (ABDs), resulting in exposure of more antigenic epitopes, aggravation or transformation of pre-existing diseases, or concurrence of other diseases. With the increase in the immunological evidence for epitope spreading, more and more scholars have realized that epitope spreading plays an important role in the development of ABDs. This review introduces the phenomenon of epitope spreading in ABDs from 4 aspects, including the concurrence or transformation between different types of pemphigoid, different types of pemphigus, pemphigus and pemphigoid, as well as between ABDs and other skin diseases.
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Insights into the progress in targeted therapy of atopic dermatitis from the perspective of its pathogenesis
Song Zhiqiang, Chen Qiquan, Ge Lan
Chinese Journal of Dermatology    2023, 56 (8): 718-723.   DOI: 10.35541/cjd.20230054
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【Abstract】 The pathogenesis of atopic dermatitis is complex, and mainly related to genetic background, environmental stimuli, epidermal barrier defects, immune disorders, and other factors. Using Th2-type inflammatory cytokines and the JAK-STAT pathway as therapeutic targets has become a hotspot in drug development for atopic dermatitis. By now, multiple monoclonal antibodies and small-molecule drugs have been successfully used in the treatment of atopic dermatitis, marking that the treatment of atopic dermatitis has entered the era of precision therapy and targeted therapy.
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Protocols for guidelines on the diagnosis and treatment of atopic dermatitis (specialist version, general practitioner version and patient version)
Guo Hao, Liu Hui, Zhang Li, Zhu Guannan, Wang Ping, Yao Zhirong, Gao Xinghua, Chen Yaolong,
Chinese Journal of Dermatology    2023, 56 (9): 809-814.   DOI: 10.35541/cjd.20230248
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【Abstract】 In order to further standardize the diagnosis and treatment of atopic dermatitis by health-care professionals, as well as to enhance the awareness of atopic dermatitis among patients and promote doctor-patient communication, Chinese Society of Dermatology and China Dermatologist Association jointly initiated the development of guidelines on the diagnosis and treatment of atopic dermatitis (specialist version, general practitioner version and patient version). The development working group had planned the development process of the 3 versions of guidelines with reference to relevant development manuals and methodological articles. It is also intended to expound the details of registration, working group establishment, clinical question collection, evidence search and grading, recommendation formation and consensus through this protocol, aiming to enhance the transparency of guideline development.
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