【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】 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.

【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】 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】 Objective To evaluate clinical efficacy and safety of secukinumab in the treatment of erythrodermic psoriasis. Methods From July 2019 to August 2021, 7 patients with erythrodermic psoriasis, who received subcutaneous injection of secukinumab at a dose of 300 mg once a week from week 0 to 4 followed by every-4-week dosing in Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, were collected. At weeks 0, 4, 8 and 12, the psoriasis area and severity index （PASI） was recorded, and adverse drug reactions were observed. Results All 7 patients were treated for at least 12 weeks. After 4-week treatment, 4 patients achieved PASI50; after 12-week treatment, 5 achieved PASI75, and 2 achieved PASI90. No serious adverse drug reactions occurred. One patient developed fever during the treatment, but the body temperature returned to normal after management; another 1 developed cough and expectoration, and the symptoms were relieved after oral administration of a Chinese herbal preparation named pharyngitis mixture. Conclusion Secukinumab is effective in the treatment of erythrodermic psoriasis, with fewer adverse reactions, which provides a new option for the treatment of erythrodermic psoriasis.

【Abstract】 Atopic dermatitis is a chronic inflammatory skin disease, characterized by eczematous dermatitis and severe pruritus, and has severe impact on patients′ quality of life. Patients with moderate to severe atopic dermatitis often require systemic treatments, but traditional systemic treatments are ineffective or intolerable in some patients. In recent years, several biological agents have been applied to the treatment of atopic dermatitis in clinical practice, among which the interleukin-4 receptor antagonist dupilumab has been marketed in China. Some experts in related fields from Working Group for Atopic Dermatitis, Chinese Society of Dermatology and Working Group for Children′s Diseases, Chinese Society of Dermatology discussed the application of dupilumab in the treatment of moderate to severe atopic dermatitis, and developed a consensus, in the hope of providing a reference for the clinical application of dupilumab in the treatment of atopic dermatitis.

【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】 COVID-19 can be accompanied by a variety of cutaneous abnormalities, which mainly include vascular lesions （chilblain-like lesions, livedo reticularis, purpura, ecchymosis, acral cyanosis, gangrene） and inflammatory lesions （diffuse erythema, morbilliform exanthem, acute urticaria, varicella-like exanthem）. Some types of skin lesions may be the first symptom or the only clinical manifestation of COVID-19.

【Abstract】 Dermatomyositis, a type of idiopathic inflammatory myopathies, is characterized by characteristic skin manifestations, proximal muscle weakness, and multiple organ involvement, which can also be accompanied by malignancies. Based on Chinese and international literature and expert advice on the diagnosis and treatment of adult dermatomyositis, experts from the Dermatology Branch of China International Exchange and Promotive Association for Medical and Health Care and the National Clinical Research Center for Dermatologic and Immunologic Diseases developed this consensus on the diagnosis and treatment of adult dermatomyositis, which can provide a reference for dermatologists and clinicians from other relevant departments in clinical practice.

【Abstract】 Recent studies have shown that changes in the gut and skin microbiome can directly affect the occurrence of acne. Regulating the skin and gut microbiome has brought new directions for the treatment of acne, and the most direct way to achieve this goal is to restore the balance of the microbiome through the use of probiotics. This review summarizes the relationship between acne and microbiome, and research progress in probiotics for the treatment of acne.

【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 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】 Eczema and dermatitis are very common diseases in dermatology. It is believed that they are dominant diseases for integrated traditional Chinese and Western medicine treatment, and many Western medicines and traditional Chinese medicines have been widely used in the treatment of these diseases. In order to ensure the rational application of these medicines, relevant experts developed this consensus on integrated traditional Chinese and Western medicine for eczema and dermatitis based on recent Chinese and international guidelines, consensus, and reported clinical studies, as well as personal clinical experience, aiming to standardize their application, improve efficacy and safety, and provide guidance for dermatologists in clinical practice.

【Abstract】 Objective To evaluate clinical efficacy and safety of dupilumab in the treatment of moderate and severe atopic dermatitis （AD） in the elderly. Methods An observational study was conducted, and a total of 42 elderly patients with moderate to severe AD were collected from Department of Dermatology, the First Affiliated Hospital of Soochow University from September 2021 to June 2022. These patients all received subcutaneous injection of dupilumab at an initial dose of 600 mg, followed by every-2-week injections at a dose of 300 mg, and the total course of treatment was 16 weeks. Clinical indicators, including eczema area and severity index （EASI）, numerical rating scale （NRS）, dermatology life quality index （DLQI） and investigator′s global assessment （IGA）, were recorded at weeks 0, 4, 8, 12 and 16, and the proportion of patients achieving more than 50% （EASI-50） and 75% （EASI-75） improvement in EASI scores were calculated; related laboratory indicators, including total serum immunoglobulin E （IgE） levels and eosinophil counts, were recorded at weeks 0, 4 and 16. During the treatment, adverse events were recorded. Statistical analysis was carried out by using chi-square test, one-way analysis of variance and t test with SPSS27 and GraphPad Prism 9.0 software. Results Among the 42 patients, there were 25 males （59.5%） and 17 females （40.5%）, and their age was 71.82 ± 16.81 years. Among them, 17 patients （40.5%） presented with generalized eczema phenotype, 15 （35.7%） with flexor eczema phenotype, and 10 （23.8%） with prurigo nodularis phenotype. At weeks 4 and 16 after start of the treatment, the mean EASI score significantly decreased by 38.4% and 73.3% respectively, the mean NRS score significantly decreased by 53.0% and 77.4% respectively, and the mean DLQI score significantly decreased by 58.2% and 93.8% respectively compared with the corresponding scores before the treatment （P < 0.05 or 0.001）. At weeks 4 and 16, the proportions of patients achieving an IGA score of 0 or 1 were 11.9% and 61.9% respectively, the proportions of patients achieving EASI-50 were 11.9% and 76.2% respectively, and the proportions of patients achieving EASI-75 were 2.4% and 57.1% respectively. Compared with the baseline levels, the mean total serum IgE level decreased by 23.1% and 38.2% at weeks 4 and 16 respectively （P = 0.274, 0.395, respectively）, and the mean eosinophil count decreased by 24.4% and 37.5% at weeks 4 and 16 respectively （P = 0.059, 0.735, respectively）. During the treatment, mild adverse events occurred in 6 （14.3%） patients, including conjunctivitis （3 cases）, fungal infection of the head and face （2 cases）, and psoriasiform dermatitis （1 case）, which subsided after symptomatic treatment. Conclusion Dupilumab exhibited a rapid onset and marked efficacy in the treatment of moderate and severe AD in the elderly, with few and mild adverse events; however, some patients had not achieved EASI-50 or EASI-75 after 16-week treatment, and maintenance treatment was required.

【Abstract】 Atopic dermatitis （AD） is a common pruritic, chronic, inflammatory dermatosis. The prevalence of AD has increased rapidly during the past 20 years, and it places the heaviest disease burden among non-fatal skin diseases. Therefore, it is urgent to carry out effective whole-process management of atopic dermatitis in clinical practice. This consensus is a set of AD management plans following previous guidelines and clinical consensus, based on the characteristics of AD in terms of prevention, treatment, rehabilitation, care, etc., aiming to provide a scientific and authoritative reference for the whole-process management of AD in China.

【Abstract】 Objective To investigate clinical efficacy and safety of dupilumab in the treatment of atopic dermatitis （AD）. Methods An ambispective study was conducted on 123 AD patients treated with dupilumab in Department of Dermatology, the Second Xiangya Hospital of Central South University from July 2020 to March 2022, clinical data were collected, and efficacy and safety of dupilumab were evaluated. Primary outcomes included scores of eczema area and severity index （EASI）, patient-oriented eczema measure（POEM）, peak pruritus numerical rating scale （NRS） and dermatology life quality index （DLQI） before and after 4-, 8-, 12- and 16-week treatment, and adverse reactions and events were recorded. Comparison of scores before and after treatment was performed using paired t test or repeated measures analysis of variance, Mann-Whitney U test was used for the comparison of efficacy among patients with different types of skin lesions or different IgE levels, and multiple regression model based on robust standard errors was used to analyze factors influencing the efficacy. Results Among the 123 AD patients, 107 were enolled into the efficacy analysis, and 85 （79.44%） completed at least 4 weeks of treatment, including 6 （7.06%） achieving EASI75 and 23 （27.06%） achieving EASI50, and the EASI, NRS, POEM, DLQI scores （10.41 ± 6.72, 4.12 ± 1.74, 8.60 ± 4.29, 7.81 ± 4.38, respectively） significantly decreased compared with those before treatment （18.08 ± 10.69, 7.21 ± 2.01, 16.88 ± 5.74, 12.95 ± 5.95, respectively; all P < 0.001） in the 85 patients. Among the 107 patients, 47 （43.93%） completed at least 16 weeks of treatment. Among the 47 patients, 23 （82.14%） of 28 adults and 17 （89.47%） of 19 adolescents and children achieved 75% or greater improvement in EASI score; the EASI, NRS, POEM and DLQI scores before the treatment all significantly differred from those 4, 8, 12, 16 weeks after the treatment （all P < 0.001）, and all the scores were significantly lower at weeks 4, 8, 12 and 16 than at the previous adjacent time points （all P < 0.05）. At week 4 during the treatment, the EASI improvement rate was significantly lower in the AD patients with prurigo nodularis than in those without （U = 151.00, P = 0.006）, while there was no significant difference in the EASI improvement rate between the AD patients with xeroderma and those without （P > 0.05）; at week 16 during the treatment, there was no significant difference in the EASI improvement rate between patients with prurigo nodularis or xeroderma and those without（both P > 0.05）. Multiple regression analysis based on robust standard errors at week 16 showed that the improvement degree in the EASI score was not correlated with the type of skin lesions （β = 3.20, P = 0.075）, but correlated with age （β = -0.22, P = 0.030）, whether patients were in adulthood （β = 9.54, P = 0.049）, immediate family history （β = 7.46, P = 0.017）; the improvement degree in the NRS score was correlated with the type of skin lesions? （β = 0.55, P = 0.032）, age （β = -0.04, P = 0.033）, weight （β = -0.05, P = 0.020）, whether patients were in adulthood （β = 2.06, P = 0.003） and whether patients received combined treatment with antihistamines （β = -1.91, P = 0.001）. Adverse reactions: among the 123 patients, 6 （4.88%） developed conjunctivitis, and 2 （1.63%） developed facial erythema. Adverse events: vitiligo-like changes occurred on the right forehead of 1 patient, and 3 patients discontinued the treatment with dupilumab due to Henoch-Sch?nlein purpura, distal axonal damage in peripheral nerves in both upper limbs, and epilepsy, respectively. The causal relationship between these adverse events and dupilumab was unclear. Conclusion Dupilumab is effective in the treatment of AD with high overall safety, and can serve as a new treatment option for AD patients with an unsatisfactory response to traditional treatment.

【Abstract】 Psoriasis is a chronic, recurrent, inflammatory and systemic disease, which places a heavy burden on patients and affects their quality of life. As multiple biologics have been constantly approved for clinical use, there are more effective treatment options for psoriasis patients, but there has been no consensus on what are the comprehensive treatment goals to be reached in China. Treat-to-target approach requires considering treatment outcomes in multiple dimensions, establishing long-term management goals, and assessing treatment outcomes regularly. Based on the latest Chinese and international consensus and guidelines, studies and clinical experience, and combined with results of a questionnaire survey and expert group discussion, this consensus focuses on the short-term and long-term comprehensive management goals on biologics treatment of psoriasis in four dimensions, i.e., clearing psoriatic lesions, improving the quality of life, screening and managing psoriasis comorbidities, and ensuring medication safety, and describes implementation methods, timing of evaluation, treatment monitoring, and regimen adjustment, aiming to achieve the goal of comprehensive management of psoriasis to the greatest extent, and to provide a reference for clinicians.

【Abstract】 To report a case of Noonan-like syndrome with loss anagen hair, and to detect gene mutations in the family. A 3-year-old female patient presented with a special facial appearance, short stature, deep palmar and plantar creases, dark skin. The scalp hair was sparse and thin, dermoscopy showed black spot sign, single-hair follicular units, hair shafts varying in the diameter, upright hair and new vellus hair, and constriction of hair shafts and nodular hair were occasionally observed. Peripheral blood samples were collected from the proband and her parents, and the genomic DNA was extracted for whole-exome sequencing. A heterozygous missense mutation c.4A>G was identified in exon 2 of the SHOC2 gene in the proband, resulting in the substitution of serine by glycine at amino acid position 2 （p.S2G）. The mutation was not identified in either of her parents. Combined with the clinical phenotype and gene mutation, the diagnosis of Noonan-like syndrome with loose anagen hair was confirmed.

【Abstract】 To report a case of generalized lichen amyloidosis successfully treated with dupilumab in China. A 70-year-old male patient presented with extensive itchy papules on the trunk and extremities for 23 years. Skin examination revealed diffuse millet- to mung bean-sized hemispherical brown plaques on the trunk, right anterior shank, and extensor aspect of both upper arms, with a hard texture on palpation. No abnormalities were observed in the blood eosinophil count or serum IgE level. Histopathological examination of the skin lesion on the lower limb showed epidermal hyperkeratosis and homogeneous red-stained lumpy materials in the papillary dermis. Immunohistochemical study showed positive staining with Congo red. The pruritus numerical rating scale score was 10 points. The diagnosis of generalized lichen amyloidosis was confirmed. The patient received subcutaneous injection of dupilumab at an initial dose of 600 mg, followed by an every-2-week regimen at a dose of 300 mg. At week 2 after the start of treatment, pruritus was markedly relieved; at week 14, the skin lesions began to subside markedly; at week 18, the skin lesions on the chest and abdomen nearly completely subsided, and lesions on the lower back and limbs markedly regressed. No obvious adverse reactions were observed.

【Abstract】 With the rapid development of immunology and molecular biology in recent years, great progress has been made in the research on psoriatic pathogenesis, as well as in therapeutic strategies targeting key molecules in the pathogenesis. In addition to biologics, small-molecule targeted agents for psoriasis have also received increasing attention, especially agents targeting phosphodiesterase 4, Janus kinase, and tyrosine kinase 2, etc. An increasing number of small-molecule drug candidates have shown favorable efficacy in clinical studies, and some of them have been approved for clinical application and play a unique role in the treatment of psoriasis.

【Abstract】 Localized neurovascular dysregulation is an important factor for the occurrence of rosacea, and it has been confirmed that neurogenic inflammation is a key step in neurovascular dysregulation. Intradermal injection of botulinum toxin can relieve facial flushing and burning sensations, which may be attributed to the inhibition of neuropeptide release from nerve endings and degranulation of mast cells. This review summarizes the research progress in neurogenic inflammation in the pathogenesis of rosacea and botulinum toxin in the treatment of rosacea, aiming to provide a basis for nerve-related basic research and clinical treatment of rosacea.

【Abstract】 In order to achieve treatment goals of maintaining efficacy, reducing recurrence, and improving the life quality of patients, the overall health management targeting scalp diseases is particularly important. Based on Chinese and international guidelines and consensus, relevant literature, and current clinical experience, a group of experts in the field of dermatology and cosmetology developed a Chinese expert consensus on management of scalp health after in-depth discussions. This consensus mainly describes causes and manifestations of scalp diseases, and provides guidance on management measures for scalp health, in the hope of providing a reference for global clinical management of scalp diseases in China.

【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】 Objective To evaluate the efficacy and safety of dupilumab in the treatment of adult prurigo nodularis. Methods A prospective study was conducted on patients with prurigo nodularis who received the treatment with dupilumab in Peking University People′s Hospital from January 2021 to November 2021. Efficacy was assessed using the Investigator′s Global Assessment （IGA）, Numerical Rating Scale （NRS） and Dermatology Life Quality Index （DLQI） at weeks 0, 4 and 16. Wilcoxon signed-rank test and paired t test were used to analyze changes in the above parameters before and after treatment. Results A total of 17 patients were enrolled in this study, including 12 females and 5 males, aged 48.47 ± 16.26 years. After 16-week treatment with dupilumab, the pruritus NRS score decreased from 8.00 ± 1.50 at baseline to 1.29 ± 0.85 （t = 6.98, P < 0.001）, the sleeplessness NRS score decreased from 5.18 ± 2.98 at baseline to 0.12 ± 0.49 （t = 12.55，P < 0.001）, and the DLQI score declined from 13.29 ± 4.03 at baseline to 0.88 ± 0.70 （t = 16.39，P < 0.001）; at week 16, the IGA grade of all the 17 patients decreased from 3 - 4 at baseline to 0 - 2, 16 achieved IGA grades 0 - 1, and 12 achieved IGA grade 0. During the treatment, mild conjunctivitis occurred in 2 cases, local injection reaction occurred in 1, and both conditions were improved after short-term symptomatic treatment. Conclusion Dupilumab is markedly effective and safe in the treatment of adult prurigo nodularis.

【Abstract】 Traditional therapies for alopecia areata, especially moderate to severe alopecia areata and special types of alopecia areata, remain unsatisfactory. Compared with traditional therapies, small-molecule targeted drugs and biological agents have advantages of more rapid and marked efficacy, however, some patients may experience adverse reactions such as infections during treatment or relapses after drug withdrawal. Thus, their efficacy and safety still need to be further evaluated. This review summarizes research progress in small-molecule targeted drugs and biological agents in the treatment of alopecia areata.

【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】 Guselkumab is the first monoclonal antibody that selectively targets interleukin （IL）-23. Several randomized controlled clinical trials have demonstrated that it is highly effective and safe in the treatment of moderate to severe plaque psoriasis, and can significantly improve the quality of life of patients. This review summarizes the action mechanisms of IL-23 and guselkumab, as well as the application of guselkumab in the treatment of psoriasis.

【Abstract】 Some progress has been made in pharmacological treatments for acne in recent years. Several new medications have been proven effective and safe in latest clinical trials, including sarecycline （a novel tetracycline-class antibiotic）, trifarotene （a new fourth-generation retinoid）, clascoterone （the first topical androgen receptor antagonist）, 4% SB204（a nitric oxide-releasing gel）, 4% FMX101 （a topical minocycline foam）, etc. This review summarizes latest advances in drug therapy for acne.

【Abstract】 A 10-day-old male infant presented with skin erythema and blisters for 6 days. Skin examination showed scattered or confluent erythema all over the body, tense blisters of varying sizes on the normal skin or an erythematous base, and some blisters were ulcerated and erosive; bloody bullae and erythematous erosive patches could be seen on the oral mucosa. Histopathological examination revealed subepidermal blisters, and there were some neutrophils and a few eosinophils in the blisters. Direct immunofluorescence assay showed homogeneous linear IgA and granular C3 deposits along the basement membrane zone, without IgG deposits. The diagnosis of neonatal linear IgA bullous dermatosis was confirmed. After comprehensive treatments including nutritional support and anti-infection treatment, skin erythema and blisters subsided, and the mucosal damage was attenuated. The telephone follow-up 16 months after discharge showed that the infant was in good general condition with normal growth and development, and the oral mucosal lesions had subsided and healed, without new skin lesions.

【Abstract】 Objective To investigate clinical features, treatment and prognosis of herpes zoster during pregnancy or the perinatal period. Methods Clinical data were collected from female inpatients with herpes zoster during pregnancy or the perinatal period in the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2020, and clinical characteristics, treatment and prognosis were retrospectively analyzed. Results A total of 25 patients were included in the study, including 22 pregnant patients at 10 - 38 gestational weeks （1 in the first trimester, 13 in the second trimester, and 8 in the third trimester） and 3 patients during the first postpartum week; their age ranged from 22 to 37 years, and the disease course varied from 2 to 9 days. Skin lesions were located on the head and face in 8 cases, on the chest and back in 5, on the waist and abdomen in 7, on the upper limbs in 1, on the lower limbs in 3, as well as on the perineum in 1; 3 patients presented with disseminated herpes zoster. The patients all presented with erythema, papulovesicles and blisters, which were accompanied by bloody bullae in 4 patients, by bullae in 3, as well as by erosions and exudations in 6; 5 patients had fever, 7 had mild pain, 6 had moderate pain, and 11 had severe pain. Sixteen pregnant patients and 3 postpartum patients received antiviral therapy （oral or intravenous infusion of acyclovir, vidarabine monophosphate, foscarnet sodium-sodium chloride injection）, 24 patients were treated with neurotrophic drugs, 1 pregnant patient and 3 postpartum patients received analgesic treatment, and other treatments included anti-infective therapy, wet compress, infrared radiation, etc. Preterm delivery occurred in 1 pregnant patient, other pregnant patients had full-term deliveries, and no abnormalities were observed in neonates. Sequelae occurred in 3 pregnant patients, including pain in 1 and pruritus in 2. Conclusion Among the 25 patients, the treatment of herpes zoster during pregnancy or the perinatal period showed no obvious effect on their fetuses or newborns.

【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.