【Abstract】 Atopic dermatitis is a common disease characterized by recurrent chronic eczematous lesions, accompanied with dry skin and pruritus. With the changes of life style and living environment, the prevalence of atopic dermatitis in China has been increased during the past decade. AD affects all age groups. This guideline is the revision of guideline for diagnosis and treatment of atopic dermatitis in China （2014）, and is based on advances on atopic dermatitis in recent 5 years. This guideline updates and elaborates the definition, prevalence, pathogenesis, classification, diagnosis, prevention and treatment of atopic dermatitis, and provides a scientific and authoritative reference for diagnosis and management of atopic dermatitis.

【Abstract】 Urticaria is a common skin disease characterized by wheals and pruritus, and some refractory cases showed prolonged duration and poor response to treatment. This guideline is a refinement of the previous version of the guideline for diagnosis and treatment of urticaria in China （2018）, and is developed by dozens of experts from Centre for Urticaria Research, Chinese Society of Dermatology after joint discussions on the basis of recent clinical and investigational advances in urticaria in China and other countries. This guideline is suitable for both Chinese adults and children with urticaria. In addition to supplementing and updating the definition and pathogenesis of urticaria, the guideline also provides detailed explanations about key concerns in clinical practicethe, such as the classification, diagnosis and treatment of urticaria, in the form of questions and answers. The guideline may provide a more comprehensive, scientific and authoritative reference for diagnosis and management of urticaria.

【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】 Psoriasis is an immune-mediated chronic, recurrent, inflammatory, systemic disease induced by the combination of heredity and environment. Psoriasis is a non-communicable disease, its typical clinical manifestations are limited or widely distributed scaly erythema or plaques. Its treatment is difficult, and patients usually need lifelong treatment. The etiology of psoriasis involves heredity, immunity, environment and other factors, which may induce excessive proliferation of keratinocytes or inflammation of joint synovial cells and chondrocytes via the immune response mainly mediated by T lymphocytes and various immune cells. In the theory of traditional Chinese medicine （TCM）, it is believed that psoriasis is mostly caused by hot toxic blood, loss of nutritional ingredient in blood, blood perfusion stasis, dry wicked wind in the body and skin system imbalance. Psoriasis is an incurable disease, and many drugs and regimens are available for its treatment at present. Choosing appropriate drugs and regimens is very important for patients with psoriasis to control disease progression and maintain long-term efficacy. The purpose of guidelines is to gradually standardize treatment, improve treatment effectiveness, and to minimize adverse effects as far as possible. Treatment protocols of psoriasis should be determined based on patient′s symptoms. Patients with mild psoriasis can be mainly treated with externally applied agents, those with moderate to severe psoriasis can be treated with systemic medications, and targeted biological agents can be appropriately chosen for those resistant to traditional systemic treatment. The main aim of psoriasis treatment is to control symptoms and improve the quality of life. With continuing development of novel drugs and regimens for psoriasis, we update guidelines to timely introduce new international and national achievements to domestic physicians, so as to keep pace with global progress in this field. Compared with the previous two editions of guidelines for diagnosis and treatment of psoriasis in China, some contents are supplemented and revised in this edition, which will further facilitate standardization of diagnosis and treatment of psoriasis in China, increase the efficiency of diagnosis and treatment, and improve the quality of life of patients.

Syphilis, gonorrhea and genital Chlamydia trachomatis infection are main sexually transmitted diseases which need focused prevention and treatment in China. Clinical manifestations of syphilis are complicated. According to its duration of onset, clinical features, and transmission routes, syphilis can be classified as primary syphilis, secondary syphilis, tertiary syphilis, neurosyphilis, latent syphilis and congenital syphilis. Gonorrhea and genital Chlamydia trachomatis infection mainly affect genitourinary tract, and their clinical manifestations markedly vary from asymptomatic types to complicated types. Diagnosis of the 3 diseases should be based on their epidemiological history, clinical manifestations and laboratory examination results. Treatment should be started according to recommended regimens as early as possible. Appropriate follow-up should be performed after treatment. The antimicrobial resistance in gonorrhea has become a clinical concern.

【Abstract】 Rosacea, a chronic inflammatory skin disease primarily affecting central areas of the face, mainly manifests as recurrent flushing and erythema on the central face. In recent years, there has been progress in the understanding of its diagnosis and treatment. To this end, some experts were organized to establish this guideline on the basis of “diagnosis and treatment of rosacea in China: an expert consensus statement （2016）”. The new guideline proposes diagnostic criteria for rosacea at different sites, aiming to further standardize the diagnosis and treatment of rosacea in China.

【Abstract】 Biologic agents are increasingly used in the treatment of psoriasis, and have played an active role in addressing moderate to severe, refractory and special types of psoriasis. Biologic agents that have been approved for marketing and used in the treatment of psoriasis in China include 7 agents of 3 major categories, namely tumor necrosis factor-α inhibitors, interleukin 12/23 inhibitors and interleukin 17A inhibitors. How to use biologic agents in a rational, effective and safe way has become an issue of great concern in clinical practice. To this end, experts in the field of diagnosis and treatment of psoriasis and related fields in China developed this guideline based on Chinese and international research data, clinical experience, as well as characteristics of Chinese patients with psoriasis after in-depth discussions. This guideline provides specific guidance for clinicians in terms of application principles and methods of major biologic agents, efficacy and safety profiles, patient screening and monitoring, common problems and solutions, as well as considerations for their application in special populations.

【Abstract】 At present, exact pathogenesis of melasma remains unclear, genetics, sunlight exposure, sex hormones, etc., are considered as the main causative factors. Its pathogenesis involves excessive melanin synthesis, vascular hyperplasia in skin lesions, inflammation and skin barrier impairment. The diagnosis of melasma mainly relies on clinical manifestations and non-invasive detection techniques. Based on research progress in recent years, this consensus comprehensively elaborates the etiology, pathogenesis, clinical manifestations, staging and classification, diagnosis and treatment of melasma, aiming to improve the diagnosis and treatment of melasma by Chinese dermatologists.

【Abstract】 Herpes zoster is an infectious skin disease caused by the reactivation of varicella-zoster virus, and characterized by skin lesions and neuropathic pain. Based on the consensus of Chinese experts on herpes zoster （2018 version）, this consensus comprehensively evaluates and analyzes the existing problems in the diagnosis and treatment of herpes zoster in China, especially in the selection of therapeutic drugs, treatment for special populations and of special types of herpes zoster, management of herpes zoster complications such as postherpetic neuralgia, and herpes zoster vaccination, aimming to better guide the standardized diagnosis and treatment of herpes zoster in clinic practice.

Objective To detect the expression of CD70 in peripheral T lymphocytes of patients with systemic lupus erythematosus （SLE） and the effect of azacitidine, an inhibitor of DNA methylation, on it. Methods Blood samples were obtained from 10 patients with active SLE （SLEDAI score ≥5）, 10 patients with nonactive SLE （SLEDAI score < 5） and 10 normal human controls. Peripheral T lymphocytes were isolated and cultured for 72 hours. A part of the T lymphocytes from normal controls, which were cultured in the presence of azacitidine at 1 mol/L, served as the methylation-inhibited group. Semiquantitative reverse transcription PCR and flow cytometry were applied to detect the mRNA expression of CD70 and frequency of CD70+CD4+ cells in the cultured lymphocytes, respectively. Results The frequency of CD70+CD4+ lymphocytes was 14.55% ± 5.49% in normal control group, 85.25% ± 14.08% in active SLE group, 77.65% ± 18.77% in nonactive SLE group, and 81.54% ± 8.71% in methylation-inhibited group. Compared with the normal control group, a significant increase was observed in both the frequency of CD70+CD4+ lymphocytes （all P < 0.01） and the expression of CD70 expression （all P < 0.05） in other three groups. There was a positive correlation between the frequency of peripheral CD70+CD4+ lymphocytes and disease activity of SLE in patients （r = 0.72, P < 0.05）. Conclusions The elevated expression of CD70 appears to play a significant role in the immunologic disarrangement in SLE, and may act as a indicator of disease activity of this disease.

【Abstract】Objective: To investigate the clinical efficacy and adverse effect of orsalin ointment to treat chronic eczema and neurodermatitis. Methods: 152 patients with chronic eczema and neurodermatitis were randomly assigned to two groups: one was a treatment group including 76 patients being treated with orsalin ointment (45 cases with chronic eczema and 31 cases with neurodermatitis), another was a control group including 75 patients being treated with clobetasol propionate (43 cases with chronic eczema and 32 cases with neurodermatitis).The Therapeutic efficacy and adverse effect was evaluated after treating one week,two weeks and three weeks. Results :After one week’s treatment, the healing rate was 13.16 % in the treatment group and 6.67% in the control group, there was no significant difference between the two groups(P>0.05). After two and three weeks’ treatment, the healing rate was 53.95% and 63.16% in the treatment group respectively, while that of control group was 28.00% and 37.33 % respectively, there was a significant difference between the two groups(P<0.05).The clinical effective rate of treatment group was 43.42%, 84.21% and 92.11% respectively as compared with that of control group was 18.67%,60.00% and 69.33% respectively, there was a significant difference both in the two groups (both P<0.05) and no obvious side effect was found in the two groups. Conclusion: orsalin ointment is a more suitable dermatologic topical preparation in the treatment of chronic eczema and neurodermatitis.

【Abstract】 Chronic spontaneous urticaria （CSU） is characterized by recurrent wheals with severe itching, and greatly affects the life quality of patients. The European guideline on chronic urticaria recommends the anti-IgE monoclonal antibody omalizumab as the only third-line therapy for patients with CSU whose condition can not be controlled by high doses of antihistamines. Although a lot of researches have shown that omalizumab is effective and safe for the treatment of CSU, its therapeutic mechanisms have not yet been fully elucidated. This review summarizes therapeutic mechanisms of omalizumab in the treatment of CSU, and indices for predicting and monitoring its clinical efficacy.

【Abstract】 Vitiligo is a common depigmented skin disease， which seriously affects the physical and mental health of patients. According to clinical experience of experts as well as research progress in vitiligo in the past 3 years, the Pigmentary Disorder Group, Combination of Traditional and Western Medicine Dermatology revised the statement "Diagnosis and treatment of vitiligo: an expert consensus statement （2018）" in terms of maintenance treatment of vitiligo and application of glucocorticoids, discussed the prospect for Janus kinase （JAK） inhibitors, and finally established this consensus.

【Abstract】 Psoriasis is an immune-mediated chronic, recurrent, inflammatory, systemic disease induced by the combination of heredity and environment. Psoriasis is a non-communicable disease, its typical clinical manifestations are limited or widely distributed scaly erythema or plaques. Its treatment is very difficult, and patients need lifelong treatment. The etiology of psoriasis involves heredity, immunity, environment and other factors, and may be considered as excessive proliferation of keratinocytes or inflammation of joint synovial cells and chondrocytes caused by the immune response mainly mediated by T lymphocytes and various immune cells. In the theory of traditional Chinese medicine （TCM）, it is believed that psoriasis is mostly caused by hot toxic blood, loss of nutritional ingredient in blood, blood perfusion stasis, dry wicked wind in the body and skin system imbalance. Treatment protocols of psoriasis should be based on patient′s symptoms. Patients with mild psoriasis can be mainly treated with externally applied agents, those with moderate to severe psoriasis can be treated with systemic medications, and targeted biological agents can be appropriately chosen in those resistant to traditional systemic treatment. The main aim of psoriasis treatment is to control symptoms and improve the quality of life. Compared with the previous two editions of guidelines for diagnosis and treatment of psoriasis in China, some contents are supplemented and revised in this edition, which will further facilitate standardization of diagnosis and treatment of psoriasis in China, increase the efficiency of diagnosis and treatment, and improve the quality of life of patients.

【Abstract】 Urticaria is a disease characterized by wheals and pruritus, which is common in clinical practice. Some cases show poor responses to treatment, and recurrence often occurs. This guideline aims at further supplementing and perfecting the previous version （2014 version） of the guideline for diagnosis and treatment of urticaria in China based on recent research advances in urticaria in China and other countries. This guideline is suitable for both Chinese adults and children of Han nationality with urticaria. The guideline updates and elaborates the definition, pathogenesis, classification, diagnosis and treatment of urticaria, and may serve as a more scientific and authoritative reference for diagnosis and management of urticaria.

【Abstract】 Vitiligo is a common autoimmune skin disease, currently believed to be caused by autoreactive T cell-mediated destruction of melanocytes in the skin, mucous membranes, or hair follicles, which can significantly induce psychological distress in patients. The consensus on the diagnosis and treatment of vitiligo （2024 version） was formulated by the Pigmentary Disorder Group, Combination of Traditional and Western Medicine Dermatology, etc., based on the latest international research progress in the diagnosis and treatment of vitiligo and actual situation in China. This version of consensus highlights early intervention, integrative therapy, application of JAK inhibitors in vitiligo, and provides future research directions, aiming to guide the treatment of vitiligo.

【Abstract】 Objective To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria （CSU）. Methods Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days （UAS7） and chronic urticaria quality of life （CU-Q2oL） score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point （complete control） in 93.3% of the patients, 1 - 6 points （favorable control） in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients （65%） achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed. Conclusion Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.

【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.

Objective To evaluate the efficacy and safety of imiquimod 5% cream applied with different treatment courses for preventing the recurrence of condyloma acuminatum lesions.Methods A randomized,controlled clinical trial was conducted.Patients with condyloma acuminatum were divided into 3 groups (Group A,B and C).Group A was treated with CO₂ laser only.Group B was given topical imiquimod 5% cream three times a week over 4 weeks after laser treatment of visible warts.Group C was given topical imiquimod 5% cream three times a week over 8 weeks after laser treatment of visible warts.All patients were followed up for 6 months.Results A total of 90 patients with anogenital warts were enrolled in,and finished the study.The recurrence rates of the Group A,B,and C were 64.29%,50%,21.88%,respectively,in 6 months of follow-up.The recurrence rate was statistically lower in Group C than in Group A and B (P=0.0033),and in Group C than in Group B (P=0.0457).Adverse reactions occurred in 73.33% and 84.38% of patients in Group B and C,respectively,which included erythema,itching,pain, burning,erosion,ulceration and flu-like symptoms.There was no significant difference of the frequencies of adverse reactions between Group B and C (P>0.05).Conelusion The recurrence rate of anogenital warts declines significantly in patients treated with imiquimod 5% cream for 8 weeks,but not in the 4 weeks group,after laser therapy.The frequencies of adverse reactions are not significantly different in both groups.

Objective To investigate the efficacy and tolerability of a recombinant human tumor necrosis factor:Fc fusion protein (rhTNFR:Fc,with a trade name of Yisaipu) in the treatment of moderate to severe psoriasis vulgaris.Methods A multicentre,randomized,double blind,and parallel-controlled trial was performed.One hundred and forty-four patients with moderate to severe psoriasis vulgaris from four centres were randomly assigned and treated with either once-weekly subcutaneous injection of rhTNFR:Fc (50 mg) or oral methotrexate (MTX)(7.5 mg) for 12 weeks.Patients were followed up at 2,4,8,12 weeks after the treatment.Results One hundred and twenty-four patients finished the 12-week course of treatment.At 12 weeks after the treatment,a 50%,75%,90% improvement in psoriasis area and severity index (PASI) was achieved by 86.11%,76.39%,52.78% respectively of rhTNFR:Fc-treated patients,and by 63.89%,44.44%,22.22% respectively in MTX-treated patients,and all the three improvement rates were of significant difference between the two groups of patients (all P<0.01).Physician global assessment (PGA), dermatology life quality index (DLQI) and 10-cm visual analog scale (VAS) all reduced more significantly, and more patients were cured or approximately cured in rhTNFR:Fc-treated patients than in MTX-treated patients (all P<0.05).Adverse reactions,mainly including decrease of leucocytes or neutrophils,infection, dysfunction of liver,edema and pruritus at the injection site,etc,occurred in 26.39% of rhTNFR:Fc-treated patients and 29.17% of MTX-treated patients (P>0.05).Conclusion Compared with MTX,rhTNFR:Fc acts more quickly with a higher cure rate and less toxic reactions in the treatment of psoriasis vulgaris.

【Abstract】 The incidence of herpes zoster is high in the elderly. Senile herpes zoster has complex and serious clinical symptom, and often involves peripheral motor nerves, central nervous system, cranial nerves and internal organs, which may cause associated special symptoms. The elderly is liable to suffer from special types of herpes zoster. This consensus describes and analyzes special clinical types of herpes zoster in the elderly and postherpetic syndromes; after systematic evaluation and exclusion of contraindications, early start of highly effective antiviral therapy, anti-inflammatory therapy, analgesic treatment and other treatments are recommended. This consensus aims to increase the attention to senile herpes zoster and promote the standardization of its diagnosis and treatment.

【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】 Objective To investigate epidemiological trends and characteristics of syphilis in China from 2014 to 2019, and to provide evidence for developing prevention and control strategies. Methods A descriptive epidemiological study was conducted to analyze personal, spatial and temporal distribution of syphilis cases reported in China from 2014 to 2019. Results The reported incidence rate of syphilis in China increased from 30.93 per 100 000 in 2014 to 38.37 per 100 000 in 2019, with an average annual increase rate of 4.41%. From 2014 to 2019, the average annual rates of decrease in primary and secondary syphilis and congenital syphilis were 10.95% and 26.16% respectively, and the average annual rates of increase in tertiary syphilis and latent syphilis were 1.61% and 10.75% respectively. The reported incidence rate was high in Xinjiang, Qinghai, Zhejiang, Hainan and Fujian, etc. From 2014 to 2019, the reported annual incidence rate of syphilis was slightly lower in males than in females, and the male-to-female ratio ranged from 0.86∶1 to 0.96∶1. The population aged 15 - 19 years showed a rapid yearly increase in the reported incidence rate, with an average annual increase rate of 13.54%. The reported annual incidence rate of syphilis peaked in the population aged 25 - 34 years during 2014 - 2018, and in the population aged 20 - 24 years in 2019. Syphilis cases were reported in all occupational groups, the largest proportion of cases was found in farmers and migrant workers （41.19% - 46.80%）, and the highest average annual increase rate of 20.72% was observed in students. Among all stages of syphilis, the proportions of primary syphilis and secondary syphilis decreased yearly, while the proportion of latent syphilis increased year by year, and went up to 82.95% in 2019. Conclusion There was a yearly increase in the total reported incidence rate of syphilis in China from 2014 to 2019, but the reported incidence rates of primary syphilis and secondary syphilis decreased yearly; a rapid increase in the reported incidence rate of syphilis was observed among young people; farmers and migrant workers were the most affected populations; some regions in northwest China and southeastern coastal provinces showed relatively high reported incidence rates.

【Abstract】 Chemical peeling is widely used for the treatment of a variety of skin diseases and skin photoaging. Its rational, effective and safe application has become a matter of concern in clinical practice. To standardize the clinical application of chemical peeling, an expert group developed this consensus based on the latest research achievements and extensive discussions. This consensus provides specific guidance for clinicians from the aspects of definition and classification, mechanisms of action, indications and contraindications of, techniques for and adverse reactions due to chemical peeling, as well as considerations during its application.

【Abstract】 Stevens-Johnson syndrome （SJS）/toxic epidermal necrolysis （TEN） is a severe cutaneous-mucosal response that carries a high risk of death, mostly induced by drugs, characterized by blisters and generalized epidermolysis, accompanied by a series of systemic symptoms, including multiple organ dysfunction syndrome. Based on the latest domestic and international consensus, guidelines and medical evidence, and combined with the current status of the diagnosis and treatment of SJS/TEN in China, the Adverse Drug Reaction Research Center of Chinese Society of Dermatology organized relevant experts to develop this consensus on SJS/TEN in terms of the definition, etiology, pathogenesis, clinical characteristics, diagnosis, identification of culprit drugs, evaluation of disease progression, treatment, prevention and so on, aiming to provide a reference for clinicians in clinical practice.

Objective To investigate the prevalence of vitiligo in China through a multi-center and large-population epidemiological survey. Methods A community-based survey was conducted in 6 cities from 6 provinces. Cluster sampling method was used. Subjects were required to fulfill the self-report questionnaires and received physical examination by dermatologists. EpiData and SPSS11.5 were utilized for statistical analysis. Results Totally, 19 974 patients participated in this study, and 17 345 valid questionnaires were retrieved with a return rate of 86.84%. Of them, 122 were found to have vitiligo. The prevalence and standardized prevalence of vitiligo was 0.70% and 0.56% in all patients, 0.95% （75） and 0.69% in male patients and 0.50% （47） and 0.45% in female patients, respectively. A significant elevation was observed in the prevalence of vitiligo in males than in females （P < 0.01）. The prevalence of vitiligo was increased with age and peaked in patients aging from 60 to 69 years and those over 70 years. The age at onset of vitiligo varied from 0 to 19 years in 21.85% of these patients, from 20 to 49 years in 47.05%. The most common type was focal vitiligo, which accounted for 36.06%, while the rarest type was segmental type（2.46%）. The positivity rate of family history of vitiligo was 9.84% in patients and 1.31% in community population （P < 0.01）. About 31.97% of the patients complained of negative influence of vitiligo on quality of life. Conclusions The standardized prevalence of vitiligo is 0.56% in 6 provinces from China. Males seem to have a higher prevalence of vitiligo than females.

【Abstract】 Objective To evaluate the efficacy of acrivastine alone or in combination with loratadine in the treatment of chronic refractory urticaria. Methods From March 2017 to December 2018, a multicenter, randomized, controlled clinical study was conducted in 4 centers. Patients with chronic refractory urticaria were randomly divided into two groups, i.e., combined treatment group receiving oral acrivastine capsules 8 mg thrice a day plus oral loratadine tablets 10 mg once a day, and acrivastine alone group receiving oral acrivastine capsules 8 mg thrice a day plus a placebo 10 mg once a day. The course of treatment was 4 weeks. Visits were scheduled at baseline and after 1, 2 and 4 weeks of treatment. At the same time, clinical data were collected, and adverse events were recorded. Symptom scores were evaluated based on degree of itching, number and size of wheals, duration of each attack and number of attacks per week, and symptom score reduce index （SSRI） was used to evaluate the efficacy. Repeated measures analysis of variance and chi-square test were used to evaluate the efficacy and safety. Results Fifty-three patients in the combined treatment group and 59 in the acrivastine alone group were included in the efficacy analysis. Before treatment, there was no significant difference in symptom score or visual analogue score between the two groups. After 2 weeks of treatment, 19 patients were cured and 10 achieved marked improvement in the combined treatment group, with a response rate of 54.72%; 15 were cured and 6 achieved marked improvement in the acrivastine alone group, with a response rate of 35.59%. After 4 weeks of treatment, 23 patients were cured and 9 achieved marked improvement in the combined treatment group, with a response rate of 60.38%; 20 were cured and 2 achieved marked improvement in the acrivastine alone group, with a response rate of 37.29%. After 2 and 4 weeks of treatment, the response rates were significantly higher in the combined treatment group than in the acrivastine alone group （χ2 = 4.13, 5.96 respectively, both P < 0.05）. The SSRI significantly differed among different follow-up time points, as well as between the 2 groups （F = 8.62, 4.38 respectively, both P < 0.05）. Multivariate analysis of variance showed that SSRI was significantly higher in the combined treatment group （0.63 ± 0.05, 0.68 ± 0.05, respectively） than in the acrivastine alone group （0.47 ± 0.05, 0.51 ± 0.05, respectively） after 2 and 4 weeks of treatment （both P < 0.05）. Drug-related adverse reactions, including drowsiness, stomach upsets, headache and liver function abnormality, occurred in 7 patients in the combined treatment group, as well as in 3 in the acrivastine alone group. Conclusion Acrivastine is safe and effective for the treatment of chronic refractory urticaria, and acrivastine combined with loratadine can markedly improve the efficacy.

【Abstract】 Psoriasis arthopathica, also known as psoriatic arthritis, is a special subtype of psoriasis. It manifests as varying degrees of peripheral and axial joint involvement, which seriously affects the life quality of patients. In recent years, rapid progress has been achieved in its diagnosis and treatment, especially the emergence of biologics has significantly improved the treatment outcome. Based on the latest domestic and international guidelines, and combined with the availability of diagnostic and therapeutic methods in China, the consensus focuses on clinical manifestations, classification, imaging and laboratory tests, diagnostic criteria and treatment of psoriasis arthropathica, providing a reference for the diagnosis and treatment of psoriasis arthropathica in clinical practice.

The clinical course of mycosis fungoides is indolent except when large cell transformation occurs. Large cell transformation of MF is rare and easy to misdiagnose. A case of large cell transformation of mycosis fungoides is reported. A 40-year-old man presented with a 10-year history of pruritic erythema and papules in the trunk and extremities as well as a 5-month history of nodules on the nape of the neck. Histopathologically, the erythematous patch showed typical changes of mycosis fungoides, while the tumor cells were small and expressed CD3 and CD4, and only a small number of tumor cells expressed CD30. Pathological examination of nodular lesions revealed the infiltration of large pleomorphic lymphoid cells expressing CD3 and CD4 throughout the entire dermis. There was an epidermotropism of large cells, and about 40% of these cells expressed CD30. Based on the medical history and histological findings, the patient was diagnosed with large cell transformation of mycosis fungoides. The lesions improved markedly after 3-week treatment with oral acitretin （30 mg once daily）, subcutaneous interferon-alpha （2 × 106 IU thrice a week） and local superficial X-ray irradiation for nodular lesions. Up to the time of this writing, the patient had been followed.

Objective To estimate the prevalence of alopecia areata in mainland China by a survey of multi-regional populations. Methods A community-based survey was conducted in 6 cities from 6 provinces in mainland China. Cluster sampling method was used. Subjects were required to fulfill a self-reported questionnaire and to receive physical examination by dermatologists. EpiData and SPSS 10.0 analysis system were used for statistical analysis. Results Totally, 19 974 questionnaires were delivered, and 17 345 valid questionnaires were returned with the response rate being 86.84%. Alopecia areata was diagnosed in 47 subjects in total, yielding a prevalence of 0.27% and standardized prevalence of 0.24%. In males, the prevalence of alopecia areata was 0.38%, which was significantly higher than that in females （0.18%） （χ2 = 6.53, P < 0.05）. Of these 47 patients, 33 （70.21%） had less than 1/3 scalp involvement, 14 （29.79%） more than 1/3 scalp involvement, 1 （2.13%） alopecia totalis, and 1 （2.13%） alopecia universalis. Family history was found in 4 （8.51%） patients. The prevalence of alopecia areata was 0.45% （12/2680） in Taiyuan，0.33% （9/2756） in Xichang， 0.28% （10/3597） in Langfang，0.22% （6/2721） in Jiaozuo, 0.17% （5/3000） in Zibo and 0.19% （5/2591） in Hailaer. There was no statistical difference between these regions （P > 0.05）. Conclusion Based on this survey, the overall prevalence of alopecia areata is 0.27% in the 6 Chinese cities. Also, men have a higher prevalence of alopecia areata than women do.

Objective To investigate the in vitro effects of baicalin on the growth of human hair follicles and secretion of vascular endothelial growth factor(VEGF)by human dermal papilla cells (DPCs).Methods Human hair follicles at the anagen stage of hair cycle were obtained during operation from the occipitalia,cultured with baicalin of different concentrations(3.75,7.5,15,30,45,60μg/mL). Then,hair shaft elongation and morphological changes in hair bulbs were observed and documented after 1, 2,4,6 and 8 days of culture.DPCs were isolated from the human hair follicles,incubated with different concentrations(1,3.75,7.5,15,30,45,60,80,100,150μg/mL)ofbaicalin for 72 h.The rate of cell proliferation was measured by methyl thiazolyl tetrazolium(MTT)method.ELISA was used to detect the level of VEGF secreted by DPCs.Results Compared with the negative control,baicalin(7.5,15,30,45μg/mL) significantly promoted the hair shaft elongation of cultured human hair follicles(all P<0.05).Baicalin at concentrations of 3.75,7.5,15 and 30μg/mL had no significant effect on the proliferation of DPCs,but significantly elevated the secretion of VEGF by DPCs(all P<0.05).Conclusion Baicalin can promote the growth of cultured human hair follicles,likely by stimulating the secretion of VEGF by DPCs.

【Abstract】 The treatment of psoriasis has entered an era of targeted therapy, and the application of biologics and small-molecule drugs has markedly improved the quality of life of patients, especially in the treatment of moderate to severe, refractory, and special types of psoriasis. In China, biologics that have been approved for marketing and used in the treatment of psoriasis include 9 agents belonging to 5 major categories, namely tumor necrosis factor-α inhibitors, interleukin-12/23 inhibitors, interleukin-23 inhibitors, interleukin-17A inhibitors, and interleukin-36 inhibitors; small-molecule drugs include 4 drugs belonging to 2 categories that inhibit different steps in the inflammatory cytokine pathways, namely phosphodiesterase 4 and Janus kinases （including tyrosine kinase 2）. How to use biologics and small-molecule drugs in a rational, effective and safe way has become an issue of great concern in clinical practice. To this end, experts in the field of diagnosis and treatment of psoriasis and related fields in China developed this guideline based on Chinese and international research data, clinical experience, as well as characteristics of Chinese patients with psoriasis after in-depth discussions. This guideline provides specific guidance for clinicians in terms of application principles and methods of major biologics and small-molecule drugs, efficacy and safety profiles, patient screening and monitoring, common problems and solutions, as well as considerations for their application in special populations.

【Abstract】 Postinflammatory hyperpigmentation is a hyperpigmentation disorder following skin inflammation or damage caused by various endogenous and exogenous factors, which may result in emotional distress and social difficulties in patients. The Group on Medical Aesthetics and Cosmetology of Chinese Academy of Aesthetic Medicine organized experts in this field to develop this consensus in terms of the epidemiological characteristics, etiology and pathogenesis, clinical manifestations, prevention, and treatment of postinflammatory hyperpigmentation, aiming to provide guidance for its prevention and treatment.

Abstract Aim: To explore the possible roles of HLA-DQA1 and –DQB1 genes in the pathogenesis of psoriasis vulgaris in Zhuang people. Methods: Using polymerase chain reaction-sequence specific primer (PCR-SSP), HLA-DQA1 and –DQB1 loci were typed for 58 Zhuang patients with psoriasis vulgaris and 102 healthy Zhuang adults living in Guangxi. All allelic frequencies of HLA-DQA1 and -DQB1 were compared between the two groups. Results: Allele HLA-DQB1*0303 was found to be positively (OR=4.540，p=0.004), whereas HLA-DQA1*0501 and HLA-DQB1*0301 were negatively （OR=0.189，p=0.000；OR=0.367，p=0.018, respectively）related to psoriasis vulgaris in Zhuang population. Conclusions: These three HLA-DQ alleles are closely associated with the pathogenesis of psoriasis vulgaris in Zhuang ethnic group, where HLA-DQB1*0303 might work as a susceptible factor, while HLA-DQA1*0501 and HLA-DQB1*0301 might take a role of antigonist.