Abstract:The analogy method is a characteristic mindset of traditional Chinese medicine(TCM).It emphasizes the observation of the similarity between natural phenomena and human physiological and pathological phenomena to reveal the essence and law of the disease,showing unique characteristics and advantages in guiding the understanding and treatment of the disease.Based on Professor Guo Yufeng's clinical experience in the treatment of alopecia areata by the analogy method,the core pathogenesis of alopecia areata is systematically expounded as follows:deficiency leads to no support;heat leads to scorch and wilting;dampness leads to unfixed roots;and wind leads to hair breakage and loss.Based on this,this article proposed the acupuncture treatment idea of shallow needling with fine-fire needle to guide the situation and drive out the evil to protect the hair.Additionally,we should make the best use of the situation and expel the pathogenic factor to protect hair based on the Wang's old ten needles,the overall acupoints were taken to generate qi and blood,cut off water and dampness,and regulate Qi to nourish the hair.

Abstract:Objective To explore the clinical effect of microneedling combined with ectoin liquid dressing for M+V type melasma.Methods Twenty patients with M+V type melasma who visited the Medical Cosmetic Center of Xi'an International Medical Center Hospital from September 2022 to December 2023 were recruited in the self-controlled clinical trial.All patients were managed by 0.5mm microneedling combined with Ectoin liquid dressing for 3 months(qm).They were scored by melasma area and severity index(MASI)and physician's global assessment(PGA)with VISIA images at baseline,at the termination of treatment,and 3-months follow-up.The PIMIA software was used to analyze the percentage of pigmented area,macular pigment optical density(MPOD)values,and red zone a* value(reflecting the degree of erythema).Results All patients completed treatment.MASI scores at the termination of treatment and 3-months follow-up were significantly decreased compared with the pre-treatment(6.26±3.27,5.28±2.89 vs 9.56±5.98,all P<0.001).At the termination of treatment,there were 4 patients with a PGA score of 1(essentially eliminated,≥90%),7 patients with a score of 2(markedly improved,75%-89%),7 patients with a score of 3(moderately improved,50%-74%),and 2 patients with a score of 5(non improved,＜25%),giving an overall treatment efficiency of 90%.The percentage of pigmented area,MPOD values,and the red zone a* value were significantly lower at the termination of treatment and 3-months follow-up compared with at the baseline(all P<0.05).All patients had mild erythema and edema within 1-3 days after treatment,which resolved on their own without treatment.None of the patients had serious adverse reactions.Conclusion Microneedling combined with Ectoin liquid dressing can effectively improve the therapeutic efficacy of M+V type melasma with a high safety.

Abstract:Objective To investigate the multimodal skin imaging characteristics of lichen nitidus in children.Methods The multimodal skin imaging data of 56 children with lichen nitidus diagnosed in the Outpatient Department of Dermatology,Children's Hospital of Soochow University from January 2019 to June 2024 were retrospectively analyzed.All children underwent dermoscopy,and 11 children completed in vivo reflectance confocal microscopy(RCM).Results Dermoscopic images showed multiple circular white homogeneous areas scattered on the skin color background,with clear boundaries and non-fusions,and a small number of white scales on some lesions.The RCM images showed that thinner epidermis above the skin lesions,and significantly widened dermal papillary ring containing dense mixed inflammatory cells with mild or weak light refraction,and irregular morphological cells in clusters and long stripes with unequal high refraction.Conclusion Lichen nitidus has characteristic manifestations on dermoscopic and in vivo RCM images,providing strong objective basis for diagnosis.

Abstract:Objective To evaluate the effectiveness of a blended teaching model that integrates short-form videos with traditional teaching in the undergraduate clinical course Dermatology and Venereology,and to provide evidence for curricular reform.Methods A total of 213 clinical medicine undergraduates from Shenzhen University(class of 2022)enrolled in the Dermatology and Venereology course were randomized by simple randomization into an intervention group(n=109)and a control group(n=104).The control group received traditional lecture-based teaching.The intervention group received a blended"short videos+clinical practice"model comprising:(1)brief post-lecture"mini-classes"that used popular-science short videos produced by dermatology specialists(refined based on clinical feedback)to explain key and difficult concepts;and(2)organized clinical clinic visits during which students were guided to create their own short videos.Teaching effectiveness was evaluated through theoretical examinations and student questionnaires.Results The post-intervention scores in the study group increased by(4.93±5.54)points from baseline,which represented a greater improvement compared with that of the control group(2.04±4.87 points)(P<0.001).In the theoretical examination,the final scores of the study group(77.10±9.69)were significantly higher than those of the control group(73.47±11.60)(P<0.05).Satisfaction with the quality of short-video content was significantly higher in the study group than in the control group(P<0.05).However,there were no statistically significant differences between the two groups in satisfaction regarding the systematic organization of course content,teaching methods,effectiveness of clinical practice sessions,or student-teacher interaction(all P>0.05).Conclusion The blended model integrating short-form videos with traditional teaching significantly improved students'theoretical performance and applied knowledge by combining"video-based theoretical analysis"with"clinical-practice-based content creation".Leveraging new-media technology,this approach overcomes temporal and spatial constraints and strengthens the translation of clinical thinking.Its framework-precise content production,clinical-scenario application,and student participatory output,has strong potential for broader implementation and offers a practical example for the digital transformation of medical education.

Abstract:Scleroderma is a chronic autoimmune disease characterized by fibrosis of the skin and mucous membranes,accompanied by metabolic changes.Metabolomics,as a novel histologic technique following genomics,transcriptomics and proteomics,plays a great role in the field of medicine.In metabolomics studies,the metabolic profiles of scleroderma patients can be determined by targeted and untargeted metabolomics techniques.Differentially expressed metabolites can be used as biomarkers for diagnosis,prognosis,and risk prediction of scleroderma,thus improving the specificity and accuracy of diagnosis and prognosis prediction.In particular,metabolic changes in lipids,amino acids,and glucose levels may reflect the pathogenesis of scleroderma and organ fibrosis;metabolic changes associated with scleroderma therapy may improve the understanding of therapeutic drug mechanisms;and modulation of metabolic homeostasis may be a new therapeutic strategy for scleroderma.

Abstract:A 57-year-old male patient presented with a circular plaque on the lower lip persisting for one year,without itching,pain and other discomforts.Dermatological examination revealed a scattered distribution of dark brown,circular plaques of varying sizes on the lower lip,characterized by raised edges and a white reticulated surface.No significant abnormalities were observed in the perianal and genital mucosa,and no notable skin lesions were detected on other parts of the body.Laboratory testing showed a positive rapid plasma regain(RPR)at a titer of 1∶4;a positive Treponema pallidum particle agglutination assay(TPPA)at a titer of 1∶320;and a negative human immunodeficiency virus(HIV)testing.Biopsy specimens from lower lip lesions were subjected to histopathological examination using hematoxylin and eosin(H&E)staining and silver staining techniques.H&E staining revealed dense infiltration of plasma cells and lymphocytes surrounding the dermal blood vessels and appendages,while the silver staining demonstrated a significant presence of spirochetes.These findings led to a diagnosis of secondary syphilis.The patient was treated with intramuscular injections of 2.4 million unit of Benzathine penicillin G into the bilateral gluteal muscles,once weekly for a total of three doses.Following three weeks of treatment,the patient's lower lip lesions became flattened and covered with scales.However,the patient subsequently lost of follow-up.

Abstract:Vitiligo is a prevalent autoimmune skin disorder with a multifaceted pathogenesis involving genetic,immunological,and environmental factors.It manifests as progressive depigmentation of the skin,mucous membranes,and hair.Melanocytes,as pivotal cells in pigment production,play an essential role in the repigmentation of vitiligo lesions.Their survival,differentiation,and migration are intricately governed by various signal transduction pathways.The pathogenesis of vitiligo is closely associated with imbalances in melanocyte signaling regulation at multiple levels,including the Wnt/β-catenin,microphthalmia-associated transcription factor(MITF),sex determining region Y-box 10(Sox10),Notch,transforming growth factor-β(TGF-β),and stem cell factor(SCF)/c-Kit pathways.Dysregulation in these pathways not only directly impairs melanocyte function but also exacerbates the disease through immune system modulation.This article systematically summarized the mechanisms of multiple melanocyte signaling pathways in the onset of vitiligo,thus providing new ideas for the treatment of vitiligo.

Abstract:Objective To observe the clinical efficacy and safety of pregabalin combined with Longdan Quanxiong Decoction in treating postherpetic neuralgia(PHN).Methods From January 2023 to August 2024,a total of 42 patients with PHN were recruited from the Department of Traditional Chinese Medicine of PLA Naval Medical Center(15 cases)and the Department of Dermatology of Yancheng Yandu District Center for Disease Control and Prevention(27 cases).They were randomized 1:1 to receive pregabalin capsules(control group)and pregabalin combined with Longdan Quanxiong Decoction(treatment group)for 20 days.The visual analogue scale(VAS)score,serum interleukin-17(IL-17),prostaglandin E2(PGE2),C-reactive protein(CRP)levels,clinical efficacy,adverse reactions and onset time were compared between the two groups before and after treatment.Results After treatment,VAS scores,IL-17,CRP,and PGE2 levels were significantly decreased in both groups compared to pre-treatment(P<0.05),with a significantly reduction in the treatment group(P<0.05).The therapeutic efficacy of the treatment group was significantly higher than that of the control group(P<0.05),and the average onset time was significantly shorter than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of pregabalin and Longdan Quanxiong Decoction is safe and effective in the treatment of PHN.

Abstract:Objective To describe the distribution of disease severity and identify factors associated with more severe atopic dermatitis(AD)among patients living on the Xinjiang Plateau,providing evidence to inform prevention and treatment.Methods We enrolled individuals exposed to the unique high-altitude environment of the Xinjiang Plateau between October 2022 and September 2023—including long-term residents,engineering personnel—as the study population.We estimated the incidence of AD in this population and collected clinical data from AD cases.Factors associated with AD severity were examined using univariable analyses followed by a multivariable ordinal(proportional odds)logistic regression model.Results Of the 1 946 people included,379 were definitively diagnosed with AD,with a prevalence rate of 19.48%.Initial lesions most frequently occurred on the hands(63.85%[242/379]),followed by the neck(49.34%[187/379]).Lesions predominantly involved the hands(74.14%[281/379])and lower limbs(57.26%[217/379]).In univariate analyses,ultra-high altitude(≥5 000 m),xerosis,prurigo/prurigo-like eruptions,skin pigmentation changes,bathing intervals≥4 weeks,non-use of full-body moisturizer,weight loss≥10%,special exposure history,lack of protective measures during outdoor work,and mental health disorders were associated with greater AD severity(all P<0.05).In multivariable logistic regression,ultra-high altitude(≥5000 m),special exposure history,xerosis,prurigo/prurigo-like eruptions,bathing intervals≥4 weeks,and mental health disorders remained independently associated with greater severity(all P<0.05).Conclusion Among AD patients living on the Xinjiang Plateau,greater disease severity was independently associated with ultra-high altitude(≥5000 m),special exposure history,xerosis,prurigo/prurigo-like eruptions,prolonged bathing intervals(≥4 weeks),and mental health disorders.

Abstract:A 6-year-old female presented with the appearance of white papules and oedematous plaques on both hands after contact with water for 15 days.The patient had a longstanding history of a similar condition for years,and skin lesions could gradually be resolved upon discontinuation of water contact.Physical examinations showed thickened keratinisation of the skin on the dorsal surfaces of both hands and the lateral margins of both wrists.Following a 5-minute water exposure,white papules and edematous plaques developed on these areas,characterized by soft texture,absence of tenderness,and diminished sensation,which were remarkable compared with pre-contact of water source.Lesions resolved and normalized within 20 minutes post-water exposure cessation.The water immersion test was positive.Histopathological examination of the lesions showed hyperkeratosis of the epidermis,thickening of the stratum spinosum and dilatation of the ducts of the sweat glands.Finally,the patient was diagnosed with aquagenic syringeal acrokeratoderma.After a two-month course of topical treatment with Desonide Cream in conjunction with Boric Acid and Zinc Oxide Ointments,the patient's skin lesions showed significant improvement.

Abstract:Objective This study aims to analyze the current research status and development trends of the vitiligo pathogenesis,thus providing reference for future basic research and clinical treatment related to vitiligo.Methods We searched the Web of Science Core Collection(WOSCC)database for literature related to the vitiligo pathogenesis,covering the time period from January 1,2003 to December 31,2023.The CiteSpace,VOSviewer,and the bibliometrix package in R were employed,The research trends,authors,countries,research institutions,journals,keyword co-occurrence,keywords with citation bursts,and other results were included Bibliometrics and visual analysis.Results A total of 902 papers related to vitiligo pathogenesis were included in the analysis.The top three authors in rankings of the number of publications are Li Chunying Begum Rasheedunnsa,Gao Tianwen.Harris John E,ranked among the top 3 co cited authors Begum Rasheedunnsa,Dwivedi Mitesh.The top three publishing institutions are Egyptian Knowledge Bank(EKB),Cairo University,Air Force Medical University.The top three countries in the rankings are China,the United States,and India.The top three journals that have published papers related to vitiligo pathogenesis are Archives of Dermatological Research,Journal of Investigative Dermatology and Pigment Cell&Melanoma Research.The Journal of Investigative Dermatology has the highest number of citations.The paper"Vitiligo:Mechanisms of Pathogenesis and Treatment"has the highest citation intensity.The top three keywords with citation bursts are"human melanocytes","generalized vitiligo"and"autoimmune disease".The keywords with high citation intensity in the past 5 years include"unfolded protein response","expression","upregulation","proliferation","serum","peripheral blood","stress",and"interferon gamma".Conclusion The research on the pathogenesis of vitiligo by different countries,institutions,and authors has significant regional significance.In the past five years,research hotspots include unfolded protein response,interferon gamma,stress,etc.

Abstract:Objective To detect serum matrix metalloproteinase(MMP)levels in patients with bullous pemphigoid(BP)and their association with disease activity.Methods A total of 60 BP patients treated in Cangzhou People's Hospital from April 2021 to April 2022 were selected as the BP group,and 60 healthy subjects during the same period were recruited as the healthy group.Serum MMP-2,MMP-9,MMP-11 and MMP-13 levels were compared between the two groups.According to the disease activity of BP patients,they were divided into the non-bullous stage group(n=32)and bullous stage group(n=28).Serum MMP-2,MMP-9,MMP-11 and MMP-13 in BP patients with non-bullous stage and bullous stage were compared and analyzed,and their correlation with disease activity was also analyzed by Pearson correlation analysis.A diagnostic model was constructed.The diagnostic efficacy of MMP-2,MMP-9,MMP-11 and MMP-13 in non-bullous stage of BP was evaluated by the receiver operating characteristic(ROC)curves.Results Serum MMP-2,MMP-9,MMP-11 and MMP-13 levels in the BP group were significantly higher than those of the healthy group(P＜0.05),and they were significantly lower in the non-bullous stage group than the bullous stage group(P＜0.05).Pearson correlation analysis showed that serum MMP-2,MMP-9,MMP-11 and MMP-13 levels were positively correlated with the disease activity(P＜0.05).A logistic regression model for predicting the activity of BP was created as follows:Logit(P)=-20.973+0.341×MMP-2+0.260×MMP-9+0.267×MMP-11+0.206×MMP-13.ROC curve analysis results showed that the area under the curve(AUC)of the combination of serum MMP-2,MMP-9,MMP-11 and MMP-13 levels was 0.872,which was larger than the AUC of the single indicator with good sensitivity and specificity.Conclusion Serum MMP-2,MMP-9,MMP-11 and MMP-13 levels significantly increase in BP patients,and closely related to the disease activity,which has good diagnostic efficacy in non-bullous patients.

Abstract:A 66-years-old male presented with warty plaques on his left scalp for 66 years and itching for 2 years.Clinical manifestations showed irregular raised patches on the scalp(6.5 cm×4 cm),which were divided into upper and lower parts.A yellow-brown papillomatous structure with focal overly keratinous scales was seen in the upper part of the lesion,where a black,smooth,elliptical protrusion(1.5 cm×1 cm)situated on the margin inferior to it.Skin lesions in the lower parts were dark red,with black background,papillomatous changes,local erosion,blood scabs and keratinous scales.Dermoscopic examination revealed papillomatous hyperplasia,with local blue-gray nodules,erosion,and crusts.Arborizing vessels and blue-gray ovoid nests were visible at the top of warty plaques.Histopathology showed epidermal papillomatous hyperplasia and mature sebaceous lobules in the dermis.The tumor mass consists of basaloid cells with clear margins and palisaded cells around,exhibiting a distinct retraction gap.Immunohistochemistry results showed positivity for Ber-EP4,P63,and AE1/3,with Ki-67(+,＞50%).Finally,nevus sebaceous complicated with basal cell carcinoma was diagnosed by histopathological and immunohistochemistry examinations.The patient was treated with the expansion of surgical resection and abdominal skin grafting.The wound has healed well,and recurrence during the 18 months of follow-up was not reported.

Abstract:Objective To analyze factors associated with vascular crisis(VC)following free latissimus dorsi myocutaneous flap reconstruction for head and facial cutaneous malignant tumors.Methods This retrospective study included 116 patients who underwent free latissimus dorsi myocutaneous flap reconstruction for head and facial cutaneous malignancies at Changzhi People's Hospital between May 2022 and October 2023.Patients were grouped by postoperative occurrence of VC:VC group(n=43)and non-VC(N-VC)group(n=73).The timing of VC and salvage outcomes were recorded.The coagulation parameters,hemorheological parameters,and hemodynamic parameters,repair scores and repair efficacy were compared between groups.Independent risk factors for VC were identified using multivariable logistic regression to construct a prediction model.Discrimination and calibration were assessed using receiver operating characteristic(ROC)curve and calibration curve,with internal validation by enhanced bootstrap resampling.Variable importance within the model was ranked.The predictive efficacy of the model was appraised by employing calibration curves to examine its accuracy.The model underwent internal validation utilizing an enhanced bootstrap sampling method,and the importance of the predictor variables was ranked.Results Of the 43 patients who experienced VC,salvage was most successful when VC occurred within 24 hours after surgery(65.38%,17/26)and least successful when it occurred beyond 72 hours(0/3).Overall,the VC salvage success rate was 53.49%(23/43).Coagulation indices and hemodynamic parameters did not differ significantly between the VC and N-VC groups at any time point(all P>0.05).By postoperative day 3,high-and low-shear whole blood viscosity,plasma viscosity,and the erythrocyte aggregation index had significantly decreased relative to preoperative,intraoperative,and postoperative day 1 values in both groups(all P<0.05),and each measure was significantly lower in the N-VC group than in the VC group(all P<0.05).At 6 months after reconstruction,flap color,facial aesthetic appearance,and functional status scores improved significantly versus each group's pre-reconstruction baseline(all P<0.05),with greater improvements in the N-VC group than in the VC group(all P<0.05).The clinical effectiveness rate was significantly higher in the N-VC group than in the VC group(93.15%vs 74.42%;P<0.05).In multivariable logistic regression,smoking history,end-to-side venous anastomosis,excessive intraoperative blood loss,and prolonged operative time independently increased the risk of postoperative VC after free latissimus dorsi flap reconstruction(all P<0.05).Model diagnostics showed no meaningful multicollinearity and good performance in discrimination,predictive accuracy,and internal validation.Predictor importance(descending)was:end-to-side venous anastomosis(0.171),excessive intraoperative blood loss(0.158),smoking history(0.147),and operative time(0.133).Conclusion Venous endtoside anastomosis,excessive intraoperative blood loss,smoking history,and prolonged operative duration are independent risk factors for VC after free latissimus dorsi myocutaneous flap reconstruction for head and facial cutaneous malignancies.

Abstract:Objective To analyze the clinical characteristics of cutaneous mycobacterial infection cases and explore their epidemiological features,diagnosis,and treatment.Methods A retrospective clinical analysis was performed on 32 patients diagnosed with cutaneous mycobacterial infections in the Department of Dermatology,the First Affiliated Hospital of Soochow University,between January 2023 and January 2025.Clinical features,pathogen identification,treatment regimens,and outcomes were analyzed.Results Among the 32 confirmed patients,the male-to-female ratio was 15∶17,with the majority predominantly aged 60-75 years.A definite history of trauma was documented in 78.13%(25/32)of cases.Mycobacterial nucleic acid sequencing yielded positive results in 100%(32/32)of patients,while mycobacterial tissue culture was positive in 59.38%(19/32).Mycobacterium marinum(75.00%,24/32)was the most prevalent pathogen,followed by Mycobacterium chelonae(12.50%,4/32).All evaluable patients(11 were lost to follow-up)achieved successful treatment outcomes.Conclusion Cutaneous mycobacterial infections primarily affect middle-aged and elderly individuals,show no significant gender predilection,and are frequently associated with a history of trauma.Nucleic acid sequencing significantly enhances detection sensitivity.Mycobacterium marinum is currently the most common causative pathogen identified at our institution,and most infections are curable with standardized treatment regimens.

Abstract:Objective To explore the impact of diversified follow-up management model on the quality of life and self-management of psoriasis patients.Methods A total of 102 psoriasis patients hospitalized at the Dermatology and Venereology Medical Diagnosis and Treatment Center of the People's Hospital of Xinjiang Uygur Autonomous Region from January to December 2023 were selected via a convenient sampling method as the research subjects.They were randomly divided into the experimental group and the control group using a random number table method,with 51 patients per group.Patients in the control group were intervened with conventional follow-up management,while those in the experimental group were managed by a diversified follow-up management model.After 6 months of follow-up,the medication adherence,self-management ability,and quality of life levels of the two groups were compared.Results After follow-up for 6 months,the scores of the medication adherence and self-management were significantly higher,while the score of the quality of life was significantly lower in the experimental group than those of the control group(P<0.05).Conclusion The diversified follow-up management model helps to improve the medication adherence and self-management ability of psoriasis patients,and effectively enhances their quality of life,showing good clinical application value.

Abstract:Objective To observe the clinical effect of CO2 fractional laser combined with tranexamic acid in the treatment of patients with seborrheic keratosis(SK)in plateau areas.Methods A total of 152 SK patients in the plateau area admitted to the Department of Dermatology of People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture from October 2024 to January 2025 were randomly assigned into control group(n=76)and the observation group(n=76)by the random number table method.All patients were managed by CO2 fractional laser,and those in the observation group were additionally treated with tranexamic acid.Treated for two months,the aim was to compare the recovery conditions(time to scab shedding and to erythema regression),skin physiological indicators(trans epidermal water loss[TEWL]measurements,stratum corneum water content),and dermatology life quality index(DLQI)score.The clinical efficacy and the incidence of adverse reactions were assessed.Results The overall effective rate in the observation group was significantly higher than that in the control group(94.74%vs 69.74%,P<0.05).The time to scab shedding and to erythema regression in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,significantly decreased TEWL measurements,and increased stratum corneum water content were detected in the two groups(all P<0.05),which were significantly pronounced in the observation group(all P<0.05).After treatment,the total DLQI score in the both groups was significantly decreased compared with before treatment,which was significantly lower in the observation group than in the control group(P<0.05).None of the total incidence of adverse reactions differed significantly between observation group and control group(15.79%vs 14.47%,P>0.05).Conclusion In the plateau area,CO2 fractional laser combined with tranexamic acid can effectively increase the total clinical effective rate for SK patients,shorten the time for scab shedding and erythema regression,improve skin barrier function and quality of life,and without increased adverse reactions.

Abstract:Objective To evaluate the efficacy and safety of intralesional tranexamic acid injection combined with 1064 nm Nd:YAG picosecond laser in the treatment of melasma.Methods Between January and March 2025,92 patients with melasma at the Guangzhou Dermatology Hospital were randomized(random-number table)into two equal groups.The control group(n=46)received 1064 nm Nd:YAG picosecond laser treatment,while the combination group(n=46)received the same laser protocol plus intradermal tranexamic acid injections.Treatments were performed once every 4 weeks for four sessions.We compared the two groups on Melasma Area Severity Index(MASI)scores,absolute VISIA measurements for facial brown and ultraviolet(UV)spots,clinical effective rates,incidence of adverse events,and recurrence.Results Compared with baseline,the combination group showed significant reductions in MASI scores and absolute VISIA brown-spot and UV-spot values at weeks 4,8,12,and 16 after treatment(P<0.05).The control group showed significant reductions in these measures at weeks 8,12,and 16(P<0.05).Between-group comparisons demonstrated that at weeks 4,8,12,and 16,the combination group had lower MASI scores and lower absolute UVspot values than the control group(P<0.05).For brown-spot absolute values,the combination group was significantly lower than the control group at weeks 8,12,and 16(P<0.05).Clinical efficacy(total effective rate)in the combination group at weeks 4,8,12,and 16 was 43.48%,78.26%,93.48%,and 100.00%,respectively;the control group rates at the same time points were 10.87%,34.78%,73.91%,and 82.61%,respectively.The combination group's total effective rate was significantly higher than the control group's at each corresponding time point(P<0.05).During treatment,4 patients(8.70%)in the control group developed transient,mild hyperpigmentation;no cases of hyperpigmentation occurred in the combination group.At 3-month follow-up,3 patients(6.53%)in the control group experienced recurrence at the original sites,whereas no recurrences(0.00%)were observed in the combination group.Conclusion Intradermal tranexamic acid combined with 1064 nm Nd:YAG picosecond laser provides reliable and fast-acting therapeutic benefit for melasma,with a favorable safety profile and low recurrence.This combined approach is superior to treatment with 1064 nm Nd:YAG picosecond laser alone.

Abstract:This study reported a case of artificial dermatitis misdiagnosed as pemphigus.A 78-year-old male presented with erythema and erosion with itching on the trunk and limbs for 3 months.He was misdiagnosed with pemphigus,and poorly responded to oral glucocorticoids and topical antibiotics.Routine pathological examination of skin lesions at the edge of erythema on the chest revealed skin ulcer formation,scab formation on the surface,granulation tissue proliferation in the superficial dermis,and no obvious special features.Immunopathology showed no immune complex deposition.Autoimmune blister antibodies were negative.Combined with the patient's history of chronic renal insufficiency and solitary personality,he was finally diagnosed with artificial dermatitis.After treatment with Niaoduqing granules and Jinshuibao capsules for kidney protection,and gabapentin against nerve sensitization,the patient had relieved pruritus and stopped scratching.Erosion area of chest and back was reduced,and erythema color was relieved.At the 3 months of post-discharge follow-up,the erosions and ulcerations had primarily re-epithelialized,with residual hyperpigmentation observed.

Abstract:Objective To provide evidence-based medical evidence for the clinical efficacy and safety of acupoint injection combined with catgut embedding therapy in the treatment of melasma.Methods Sixty melasma patients who visited the Department of Dermatology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from February 2023 to April 2024 were randomly divided into the combination group(tranexamic acid injection combined with acupoint catgut embedding)and aqueous acupuncture group(tranexamic acid injection)using the envelope method,with 30 patients per group.Interventions were given once every 4 weeks for a total of 3 sessions,spanning a 12-week treatment period.Patients were followed up at week 16.The primary efficacy outcome was the Melasma Area and Severity Index(MASI)scores,and the secondary outcome was patient satisfaction.Results Post-treatment MASI scores significantly decreased in both groups than pre-treatment values(P＜0.05).The MASI scores were significantly lower after treatment and at the follow-up visit in the combination group than those of the aqueous acupuncture group(P＜0.05).Patient satisfaction was comparable between groups(P＞0.05).Conclusion Tranexamic acid acupoint injection combined with catgut embedding therapy for melasma demonstrates certain advantages over the monotherapy of medication,which effectively alleviate the severity of skin lesions.It provides a novel approach for the treatment of melasma.