【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】 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】 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】 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】 Acne scars are caused by inflammatory reactions, infections, improper handling of acne lesions, etc, and occur at a high incidence rate. Their treatment is difficult. Currently, there are many methods to treat acne scars, including medicines, photoelectric technology, surgery, filling, chemical peeling, traditional Chinese medicine, biotherapy, microneedle therapy, etc., and many new methods are constantly emerging. However, there are still many difficulties, such as the lack of high-quality clinical studies, non-uniform treatment methods and unsatisfactory therapeutic effects. It remains a challenge and a research hotspot to choose appropriate methods for comprehensive treatment of different types of acne scars at different stages in clinical practice. From the perspective of evidence-based medicine, this consensus aims to provide a reference for the treatment of acne scars in clinical practice.

【Abstract】 Chronic urticaria is a common immune-related skin disorder with a persistent and recurrent course. Some patients poorly respond to antihistamines, whose quality of life may be severely impaired. Recently, various Chinese and international studies have shown that the anti-immunoglobulin E （IgE） therapy, which is primarily based on new biologic agents, is effective and well-tolerated in the treatment of chronic urticaria and other diseases. In order to standardize and promote the application and understanding of anti-IgE therapy by clinicians, the Centre for Urticaria Research of Chinese Society of Dermatology organized relevant experts to develop this consensus on the basis of international guidelines and relevant research reports in recent years. By taking omalizumab as an example, this consensus elaborates on specific mechanisms and treatment schemes of anti-IgE therapy in the treatment of chronic urticaria, as well as considerations during its use, with a view to providing a relevant theoretical basis and medication guidance for 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.

【Abstract】 Objective To evaluate clinical efficacy and safety of omalizumab in the treatment of symptomatic dermographism by analyzing real-world data. Methods Clinical data were collected from patients with symptomatic dermographism who completed 16-week treatment with omalizumab in Department of Dermatology, Peking University First Hospital from February 2018 to May 2021, and retrospectively analyzed. The analysis was done by comparing data obtained before and after the treatment, including critical friction thresholds（CFTs）, pruritus scores in a provocation test, as well as urticaria control test （UCT）, dermatology life quality index （DLQI） and chronic urticaria quality of life questionnaire（CU-Q2oL）scores. Adverse events reported by patients during the treatment were recorded. Wilcoxon signed-rank test was applied for the analysis of clinical data before and after the treatment. Results A total of 27 patients with symptomatic dermographism who completed 16 weeks of omalizumab treatment were included. At baseline, the CFTs of all the 27 patients were 4, and their UCT, DLQI and CU-Q2oL scores were 7.0 （5.0, 8.0）, 9.0 （6.0, 10.0）, 63.0 （50.0, 72.0） points respectively. At week 4, the CFTs decreased from 4 to 0 in 9 patients （33.3%）, the UCT scores increased to 14.0 （12.0, 16.0） points （Z = 4.548, P＜0.05）, and the DLQI and CU-Q2oL scores decreased to 2.0 （0.0, 2.0） and 32.0 （25.0, 41.0） points respectively in the 27 patients （Z = 4.513, 4.433, respectively, both P＜0.05）. At week 6, the UCT scores increased to 15.0 （14.0, 16.0） points, and the DLQI and CU-Q2oL scores decreased to 0.0 （0.0, 1.0） and 25.0 （23.0, 30.0） points respectively in the 27 patients. No drug-related serious adverse events were reported during the treatment. Conclusion Omalizumab can effectively improve the symptoms of symptomatic dermographism and patients′ quality of life with a good safety profile.

【Abstract】 Pustular psoriasis is a special type of psoriasis, characterized by aseptic pustules on an erythematous base. Its etiology involves multiple factors such as heredity, immunity and infection. Pustular psoriasis can be classified into 2 subtypes: localized and generalized pustular psoriasis. Localized pustular psoriasis is mainly managed with topical treatment, and patients with poor response to topical treatment can be treated with systemic therapy and phototherapy; generalized pustular psoriasis is usually treated with systemic therapy, which can be combined with topical treatment and phototherapy. Based on the latest Chinese and international guidelines and consensus, and combined with the current status of diagnosis and treatment of pustular psoriasis in China, the working group established this expert consensus, with an emphasis on clinical manifestations, classification, laboratory examinations, diagnostic criteria, and treatment of pustular psoriasis, so as to further develop a standardized model for diagnosis and treatment of pustular psoriasis.

【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】 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】 Both Chinese and international guidelines for atopic dermatitis recommend step therapy based on the severity of the disease, so assessing the disease severity is of great significance for rational treatment. There are many methods to evaluate the severity of atopic dermatitis. This article introduces the commonly used evaluation methods and explores their value for clinical application.

【Abstract】 Autoimmune subepidermal bullous diseases mainly include bullous pemphigoid, mucous membrane pemphigoid, cicatricial pemphigoid, pemphigoid gestationis, lichen planus pemphigoides, linear IgA bullous dermatosis, epidermolysis bullosa acquisita, anti-p200/anti-laminin γ1 pemphigoid and dermatitis herpetiformis. Target antigens and pathogenic autoantibodies vary substantially among the above disorders, and there were similarities and differences in their clinical manifestations. Diagnosis and differential diagnosis commonly rely on clinical manifestations, pathological, immunopathological examinations and serum antibody testing. In order to standardize the management of autoimmune subepidermal bullous diseases, Chinese Society of Dermatology and China Dermatologist Association organized experts in this field to develop this consensus based on recent Chinese and international clinical research data, guidelines and consensus.

【Abstract】 Objective To retrospectively evaluate efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria（CSU）, as well as recurrence after its withdrawal. Methods Clinical data on patients with CSU, who received omalizumab treatment in Peking University First Hospital from February 2018 to January 2021, were collected and analyzed retrospectively. Through outpatient follow-up, urticaria control test （UCT） and dermatology life quality index （DLQI） were recorded to assess disease severity, and adverse events and recurrence after omalizumab withdrawal were monitored. Comparisons of normally distributed measurement data between groups were carried out using t test or analysis of variance, comparisons of non-normally distributed measurement data between groups using Mann-Whitney U test, Wilcoxon signed-rank test or Kruskal-Wallis H test, and comparisons of enumeration data between groups using chi-square test or Fisher′s exact test. Results A total of 59 patients with CSU were included and treated with omalizumab for at least 3 months, of whom, 45 were treated for more than 6 months, and 15 for more than 12 months. After the start of omalizumab treatment, UCT scores increased from 3.0 （1.0, 6.0） points at baseline to 11.0 （3.0, 14.0） points at 1 month and 15.0 （12.0, 16.0） points at 3 months （both P < 0.05）; DLQI scores decreased from 16.0 （12.0, 20.0） points at baseline to 7.0 （1.0, 13.0） points at 1 month and 1.0 （0.0, 4.0） points at 3 months （both P < 0.05）. The proportion of patients achieving partial or complete disease control increased from 0 at baseline to 44.1% at 1 month, 78.0% at 3 months, and 88.9% at 6 months. The proportion of patients whose quality of life was severely or extremely severely affected by CSU decreased from 84.7% at baseline to 30.5% at 1 month, 15.3% at 3 months, and 4.4% at 6 months. The disease duration was significantly shorter in the complete response group and partial response group than in the non-response group （t = -2.894, -2.511, P = 0.011, 0.036, respectively）; the treatment duration was significantly longer in the complete response group than in the partial response group and non-response group （t = 2.479, 2.677, P = 0.039, 0.022, respectively）. Compared with the rapid response group, the slow response group showed higher DLQI scores （Z =－2.622, P = 0.009） and lower UCT scores （Z =－2.746, P = 0.006） at baseline. Nineteen patients withdrew omalizumab after complete control of CSU, of whom 13 （68.4%） experienced relapse 7.0 （5.0, 8.0） weeks after the withdrawal, and showed significantly higher UCT scores at relapse than at baseline （Z = 3.172, P = 0.001）. The disease duration was significantly longer in the recurrence group than in the non-recurrence group （Z =－2.635, P = 0.007）. After recurrence, 5 patients restarted omalizumab treatment, and all of them regained partial or complete disease control. The adverse events reported during the treatment were all mild to moderate. Conclusions Omalizumab can effectively and safely control symptoms of CSU and improve the quality of life of patients with CSU. However, recurrence frequently occurs after omalizumab withdrawal, and reinitiating omalizumab treatment after recurrence is still effective.

【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】 Herpes zoster-associated pain is common in departments of dermatology and pain medicine, which seriously affects the quality of life of patients. Currently, there are some controversies about the diagnosis and treatment of herpes zoster-associated pain in China. This consensus focuses on the standardization of diagnosis and treatment of herpes zoster-associated pain. To this end, Chinese experts in the fields of dermatology and pain medicine were organized for comprehensive analysis on the basis of important Chinese and international literature in recent years, and this consensus was finally established after repeated discussions and revisions. It is hoped that this consensus may serve as a guide to the standardized diagnosis and treatment of herpes zoster-associated pain in clinical practice, and help more patients with the whole-process management of herpes zoster-associated pain.

【Abstract】 Androgenetic alopecia is a distinctive condition associated with genetic factors and effect of androgens, usually adversely affects the appearance and mental health of patients. This review summarizes research progress in the pathogenesis, diagnosis, evaluation and clinical treatment of androgenetic alopecia in 2020.

【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】 Basal cell carcinoma （BCC） is the most common malignant skin tumor. It is slow-growing and less likely to metastasize, but the high-risk subtype can destroy tissues and organs, and even endanger patients′ lives. Based on the recent domestic and international literature and guidelines, and combining with the current status of diagnosis and treatment of BCC in China and multidisciplinary expert opinions, this article focuses on clinical manifestations, diagnosis, risk assessment and treatment of cutaneous BCC, aiming to form an expert consensus on the diagnosis and treatment of cutaneous BCC in China and provide a reference for standardized diagnosis and treatment in clinical practice.

【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】 In 2021, Chinese and international researchers have made a lot of new progress in pathogenesis, diagnosis and evaluation, and treatment of systemic lupus erythematosus. This review summarizes major representative advances.

【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】 Objective To evaluate the efficacy and safety of baricitinib in the treatment of moderate-to-severe atopic dermatitis （AD）. Methods From June 2020 to June 2021, patients with moderate-to-severe AD who were insensitive or intolerant to topical agents were enrolled from Department of Dermatology, Peking University First Hospital. Before treatment, the patients were evaluated by 4 scales, including the Investigator′s Global Assessment （IGA）, Eczema Area and Severity Index （EASI）, Itch Numeric Rating Scale （NRS）, and Dermatology Life Quality Index （DLQI）; meanwhile, photos of skin lesions were taken, routine blood test was performed, blood biochemical indices and total IgE levels were measured. After exclusion of contraindications, the patients were treated with oral baricitinib at a dose of 2 mg/d for 16 weeks. Regular follow-up was conducted at weeks 1, 2, 4, 8, 12, 16 and 20 after the start of treatment, clinical evaluation was carried out with the above 4 scales, and adverse events were recorded during the treatment. Results A total of 24 patients were enrolled in the study, and all completed 16-week oral treatment and 20-week follow-up. All the 4 scale scores showed a continuous downward trend within 20 weeks after the start of treatment. At week 20, the patients′ IGA, EASI, NRS, and DLQI scores significantly decreased from 4.13 ± 0.61, 37.59 ± 14.86, 6.83 ± 2.26 and 18.67 ± 8.64 points respectively at baseline to 1.12 ± 0.49, 4.53 ± 3.78, 0.72 ± 0.58 and 1.39 ± 0.85 points respectively （t = 22.70, 10.55, 10.69, 8.40, respectively, all P < 0.001）. During the follow-up period, no serious adverse reactions were observed; 3 patients experienced gastric discomfort at the start of oral treatment, but the symptoms disappeared after the treatment continued; 3 developed acute allergic manifestations （1 case of allergic conjunctivitis, 2 cases of acute urticaria）, which resolved rapidly after the use of antihistamines without recurrence. Conclusion Baricitinib can provide a safer and more effective treatment option for patients with moderate-to-severe AD, especially those who are insensitive or intolerant to topical agents and need systemic treatments.

【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】 Cutaneous squamous cell carcinoma （cSCC） is one of the most common non-melanoma skin cancers. In recent years, with the in-depth study of its pathogenesis, as well as the development of diagnostic technology, Mohs micrographic surgery, targeted therapy and immunotherapy, great progress has been made in the diagnosis and treatment of cSCC. Based on recent domestic and international relevant literature and guidelines, and combined with the availability of diagnostic and therapeutic methods in China, this consensus focuses on clinical manifestations, classification, biopsy pathology and report standards, risk factor assessment, grading, staging, and standardized treatment of cSCC, and aims to provide a reference for the diagnosis and treatment of cSCC in clinical practice.

【Abstract】 Topical agents are main treatments of atopic dermatitis, and there are still many insufficiencies in the application of topical agents and patient education in China. Based on recent Chinese and international relevant guidelines, consensuses and literature, and combined with clinical experience from experts, some experts from Environmental and Occupational Skin Disease Research Group of Committee on Dermatology of Chinese Association of Integrative Medicine, Group on Children of Chinese Society of Dermatology, Committee on Dermatology of Chinese Association of Geriatric Research developed this consensus on the application of topical agents and patient education for atopic dermatitis, aiming to standardize the application of topical agents for atopic dermatitis, improve efficacy and safety, and reduce disease recurrence.

【Abstract】 Childhood psoriasis is an immune-mediated chronic, recurrent, systemic skin disease induced by both genetic and environmental factors （e.g., infection, etc.） and occurring in children aged under 18 years. Its clinical manifestations are complex and vary widely between different types. Because of the special physiological condition of children, more attention should be paid to safety of treatment. Compared with adults, the treatment of psoriasis in children is more challenging due to limited options. For example, the ideal therapeutic dose of systemic drugs, adverse effects of long-term treatment, the choice of drug combination, and the conversion of drugs have not been clarified. Many drugs, including topical and systemic drugs, have not been approved for the treatment of childhood psoriasis. The purpose of this consensus is to standardize the diagnosis and treatment of childhood psoriasis more effectively and scientifically, to guide physicians to timely and effective control of occurrence and development of childhood psoriasis, to improve the quality of life of children and their families, and to help children develop and grow as healthily as possible.

【Abstract】    In view of the confusion about the concept, classification and diagnostic terminology of dermatitis and eczematous diseases, the Immunology Group of Chinese Society of Dermatology and the Guideline Formulation and Standardization Committee of China Dermatologist Association organized experts to discuss current status and existing problems of diagnosis of dermatitis and eczematous diseases according to the Delphi method. Seven suggestions on standardized diagnosis were put forward, mainly including: （1） "dermatitis" and "eczema" are the category names of diseases rather than specific diagnostic terms; （2） when eczematous skin lesions are encountered clinically, doctors should actively look for relevant clinical and/or laboratory characteristics, and classify and diagnose them according to the terms or categories atopic dermatitis, contact dermatitis and other dermatitis; （3） the term "eczema" is recommended to be retained at present, and can only serve as a temporary and descriptive diagnostic term for eczematous skin lesions which cannot be definitely diagnosed for the time being. This consensus aims to promote the standardization and homogenization of diagnostic terms for dermatitis and eczematous diseases, and lay a foundation for improving disease management, epidemiological research and individualized treatment and prevention.

【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】 Objective To investigate clinical manifestations and dermoscopic characteristics of lichen planus-like keratosis （LPLK）. Methods Clinical data were collected from 21 patients with LPLK who visited Shanghai Skin Disease Hospital and underwent both dermoscopic and histopathological examinations from January 2017 to September 2019, and clinical and dermoscopic features were retrospectively analyzed. Results These patients were aged 64.69 ± 13.29 years, and the ratio of males to females was 1∶2. Skin lesions were located on the face of 18 cases and legs of 3 cases, and were red/violaceous in color in 7 cases, reddish-brown in 5, brown/gray in 8, and brown/reddish in 1. There were 3 types of kin lesions, including plaque-like type in 10 cases, flat pigmented patch type in 6, and flat erythema-like type in 5. As dermoscopy showed, 12 cases were non-pigmented LPLK, and 9 were pigmented LPLK. Pigment granules were found in 13 lesions, and there was no significant difference in the incidence of pigment granules between pigmented and non-pigmented LPLK （P = 0.07）; pigment granules were often diffusely distributed （9/13）, and the diffuse distribution pattern was common paticularly in pigmented LPLK（8/9）; locally distributed pigment granules were found in 4 cases of non-pigmented LPLK. Coarse pigment granules were seen in 10 cases （10/13）, including 8 of pigmented LPLK and 2 of non-pigmented LPLK, and the incidence rate of coarse pigment granules significantly differed between the pigmented LPLK and non-pigmented LPLK groups （P = 0.002）. Moreover, special distribution patterns of pigment granules included the annular granular pattern （8/13） and peppered pattern （7/13）, and no significant difference was observed in the incidence of the 2 special distribution patterns between the pigmented LPLK and non-pigmented LPLK groups （both P > 0.05）. Scales were seen in 13 cases （13/21）, and vascular structures in 7 （7/21）, and there was no significant difference in the incidence of the 2 structures between the pigmented and non-pigmented LPLK groups （P = 0.67, 0.16, respectively）. Conclusion LPLK mostly occurs on the face, and manifests as solitary red, reddish-brown or brownish-gray plaques or patches, whose surfaces may be covered with scales. The characteristic dermoscopic feature of LPLK is the presence of pigment granules, which are coarse, often diffusely distributed, and commonly observed in pigmented LPLK.

【Abstract】 Tranexamic acid can treat melasma through multiple steps, such as inhibiting dermal angiogenesis, reducing the number of mast cells and inhibiting their activity, reducing damage to the basement membrane zone, inhibiting melanin synthesis and transport in the epidermis, and promoting the recovery of skin barrier function. This review summarizes the mechanism and efficacy of tranexamic acid in the treatment of melasma, providing more evidence for its clinical application.