Abstract:Objective To evaluate the clinical efficacy of topical Guilian Ointment as an adjunct to conventional therapy in patients with psoriasis vulgaris characterized by blood-stasis syndrome.Methods Sixty patients diagnosed with psoriasis vulgaris of blood-stasis syndrome at the Dermatology Department of Langfang TCM Hospital between January 2023 and December 2024 were randomized(random number table)into two equal groups(n=30 each).The control group received oral Yinxie Granules combined with topical Calcipotriol Ointment.The observation group received the same regimen plus topical Guilian Ointment.Treatments were administered continuously for four weeks.Primary and secondary outcomes included Psoriasis Area and Severity Index(PASI),traditional Chinese medicine(TCM)syndrome scores,36-item Short Form Health Survey(SF-36),and overall clinical response rate.Results Both groups experienced statistically significant improvements in PASI and TCM syndrome scores(including itch severity,lesion color,skin/nail changes,and lesion thickness)after treatment(P<0.05).Improvements were significantly greater in the observation group compared with the control group for PASI and each TCM symptom domain(P<0.05).SF36 scores increased in both groups,with the observation group showing significantly larger gains(P<0.05).The overall effective rate was 90.00%in the observation group versus 66.67%in the control group(P<0.05).Conclusion Topical Guilian Ointment added to standard therapy appears to accelerate lesion clearance,reduce pruritus and other symptomatic manifestations,and improve quality of life in patients with psoriasis vulgaris and blood-stasis syndrome.

Abstract:Objective This study aims to conduct an in-depth investigation and analysis of the concomitant diseases of vitiligo in children,thus providing a basis for comprehensive clinical treatments.Methods Clinical data of 508 children diagnosed with vitiligo in the Department of Dermatology,Children's Hospital Affiliated to Jiangnan University(Wuxi Children's Hospital)from April 2021 to April 2024 were retrospectively analyzed to explore the concomitant diseases of vitiligo in children.Results Among the 508 children with vitiligo,295 were boys and 213 were girls,with a mean age of onset of 6.35±3.32 years.Lesions involved the head,face,and neck in 51.18%(260/508)of cases.A positive family history was reported in 5.51%(28/508)of patients.Dietary bias and nutritional deficiency were the most common predisposing factor,accounting for 7.87%(40/508).Laboratory testing showed abnormal thyroid autoantibody in 2.26%(14/508)of cases.Among the concomitant diseases,halo nevus was the most prevalent(15.3%,78/508),followed by thyroid dysfunction(2.8%,14/508).Conclusion Vitiligo predominantly occurs in preschool-aged children,predominantly affecting the head,face,and neck.Most diseases associated with childhood vitiligo are related to autoimmune dysfunction.Thus,clinical treatment should emphasize screening for autoimmune factors.

Abstract:Objective To evaluate the clinical effectiveness and safety of dupilumab in the treatment of moderate-to-severe atopic dermatitis(AD)in infants and young children.Methods This single-center retrospective study included 71 infants and young children aged 6 months to 6 years with moderate-to-severe AD treated with dupilumab in the Dermatology Department of the Affiliated Xuzhou Children's Hospital of Xuzhou Medical University from June 2023 to June 2024.Clinical data were collected at baseline and at weeks 4,12,and 16 after treatment initiation.Outcomes included SCORing Atopic Dermatitis(SCORAD),Eczema Area and Severity Index(EASI),itch Numerical Rating Scale(NRS),and age-appropriate quality-of-life scores(Children's Dermatology Life Quality Index[CDLQI]or Infants'Dermatitis Quality of Life Index[IDQoL]).Serum total immunoglobulin E(IgE),peripheral blood eosinophil(EOS)count,and EOS percentage were measured at baseline and week 16.The proportions achieving≥50%,≥75%,and≥90%improvement from baseline in Eczema Area and Severity Index(EASI 50/75/90)at week 16 were calculated.Associations between demographics/clinical characteristics and time to EASI 90 were assessed(Spearman correlation),and factors influencing achievement of EASI 90 at week 16 were evaluated(logistic regression).Adverse events were documented.Results A total of 71 children with AD were included.Compared with baseline,SCORAD,EASI,itch NRS,and CDLQI/IDQoL scores decreased significantly at weeks 4,12,and 16,with marked reductions at week 16(all P<0.05).At week 16,serum total IgE,EOS count,and EOS percentage were also significantly lower than baseline(all P<0.05).The proportions achieving EASI 50,EASI 75,and EASI 90 at week 16 were 97.18%,85.92%,and 52.11%,respectively.Spearman correlation analysis revealed that the time to EASI 90 was positively correlated with baseline disease severity(P<0.05),indicating that more severe disease required longer time to achieve EASI 90.Logistic regression suggested that percentage body surface area(BSA)involvement and age were associated with achieving EASI 90 at week 16(both P<0.05).During treatment,4 children(5.63%)experienced mild adverse events:conjunctivitis(n=2),urticaria(n=1),and transient rash exacerbation(n=1).Conclusion Dupilumab demonstrated effective and safe control over the symptoms and signs of moderate-to-severe AD in infants and young children.Baseline disease severity may influence the time to response,and both BSA involvement and age may be factors influencing its efficacy.

Abstract:Objective To evaluate whether a nursing care bundle reduces the incidence and delays the onset of cutaneous fungal infection in intensive care unit(ICU)patients with carbapenem-resistant Enterobacterales(CRE)infection.Methods This randomized study enrolled 94 consecutive CRE-infected patients admitted to the ICU of Nanjing Hospital of C.M.between March 2023 and March 2025.Patients were randomly assigned(random number table)to receive either routine nursing care(control,n=47)or a structured nursing care bundle(intervention,n=47).Outcomes compared included incidence of cutaneous fungal infection,time to onset,ICU length of stay,duration of antibiotic therapy,and clinical course of fungal lesions.Results The care-bundle group had a significantly lower incidence and a later onset of fungal infection compared with controls(both P<0.05).A total of 18 patients developed cutaneous fungal infection.All affected patients received topical antifungal therapy(e.g.,ketoconazole cream)plus skin hygiene measures.After one week,lesions in all four affected patients in the care-bundle group had largely resolved and were judged clinically cured.In the control group,10 of 14 patients improved after one week(reduced lesions and pruritus),while 4 required extended treatment;their symptoms resolved by week two.Patients in the care-bundle group also had shorter ICU stays and shorter durations of antibiotic use than controls(P<0.05).Conclusion Implementation of a nursing care bundle in the ICU was associated with a lower incidence and delayed onset of cutaneous fungal infection among patients with CRE infection,along with shorter ICU stays and reduced antibiotic exposure.

Abstract:This study reported a case of mixed porokeratosis.A 67-year-old female patient presented with vulvar and perianal rash and itching for three months.The patient was treated with surgery,chemotherapy and immune therapy for colorectal cancer one year earlier.Dermatological examination revealed the presence of well-defined red plaques with yellowish-white keratinous material on the vulva and perianal region.Brown,circumscribed papules and macules measuring 0.5-2.0 cm were seen on the inner thighs and groin,accompanied by dike-like elevations at the periphery of some rashes and a light-colored,smooth central region.Histopathological examination confirmed the diagnosis of porokeratosis.The patient was administered oral acitretin at a dosage of 10 mg daily,and a topical combination of triamcinolone acetonide and econazole cream on the affected areas.Following one month of treatment,the majority of the rashes had subsided,and pruritic symptoms were completely resolved.

Abstract:Objective To evaluate the clinical effect of superthin anterolateral thigh perforator(ALTP)flap repair for large soft-tissue defects of the lower extremity.Methods From March 2020 to March 2022,96 patients with large soft-tissue defects of the lower extremity treated at the Banan Hospital of Chongqing Medical University were enrolled.Patients were randomized by a random number table into a control group(n=48)and an observation group(n=48).The control group underwent repair with a deep inferior epigastric artery perforator(DIEP)flap,while the observation group received superthin ALTP flap repair.Operative parameters,the flap repair''excellent''rate at 4 weeks,sensory function of the grafted flap area at 3 months,complication rates,and aesthetic satisfaction of the recipient site at 1 month were compared between groups.Results There were no statistically significant differences between the two groups in duration of antibiotic use,time to flap stabilization,length of hospital stay,or wound healing time(P>0.05).At 4 weeks postoperatively,the excellent repair rate was 93.75%in the observation group versus 91.67%in the control group(P>0.05).At 3 months,sensory function in the grafted flap area was significantly better in the observation group than in the control group(P<0.05).The overall complication rate was 8.33%in the observation group and 12.50%in the control group,with no significant difference(P>0.05).At 1 month,aesthetic satisfaction of the recipient site was higher in the observation group(95.83%)than in the control group(81.25%)(P<0.05).Conclusion Compared with DIEP flap repair,superthin ALTP flap repair more effectively facilitates sensory recovery and yields higher aesthetic satisfaction for patients with large soft-tissue defects of the lower extremity.

Abstract:A 57-year-old male patient presented psoriasiform eruption after 14 weeks of treatment with tislelizumab for brain metastasis of squamous cell carcinoma of the lung,which gradually aggravated.Clinical manifestations consisted of generalized extensive confluent erythematous plaques covered with scales,accompanied by swelling in both lower limbs.Histopathology of the lesion showed parakeratosis,spongiform pustules and acanthosis of the epidermis,and chronic inflammatory cell infiltration predominantly composed of lymphocytes in the superficial dermis.The diagnosis of psoriasiform eruption was made.After assessment by the oncology department and obtaining informed consent from the patient and his family members,treatment with secukinumab was initiated.The skin lesions receded rapidly,and secukinumab was discontinued after six months.At a follow-up of 65 weeks,no recurrence of skin lesions or progression of the tumor was observed.

Abstract:Objective To evaluate the efficacy and safety of roller microneedling combined with topical tranexamic acid for treating melasma.Methods From June to July 2024,60 female patients with stable melasma who presented at Henan Provincial People's Hospital were enrolled and randomized into a treatment group(n=30)and a control group(n=30).The control group applied topical tranexamic acid serum twice daily.The treatment group received the same topical regimen plus roller microneedling performed every 4 weeks for a total of 3 sessions;after each session,a tranexamic acid-containing revitalizing serum was applied within 24 hours.Outcomes compared between groups included Melasma Area and Severity Index(MASI),skin colorimetric parameters(L*,a*,b*),Dermatology Life Quality Index(DLQI),and patient satisfaction.Adverse events during treatment were recorded.Assessments were made at baseline and at 12 weeks(end of treatment).Results At 12 weeks,both groups showed significant reductions in MASI,a*,and b* values(P<0.05),and significant increases in L* values(P<0.05).The treatment group demonstrated significantly greater improvements than the control group in MASI,a*,b*,and L*(all P<0.05).DLQI scores decreased significantly in both groups(P<0.05),with a larger reduction in the treatment group(P<0.05).Patient satisfaction was higher in the treatment group(86.67%)than in the control group(63.33%)(P<0.05).Only one patient in the treatment group reported mild pain during treatment,which resolved with cold compress;no post-inflammatory hyperpigmentation or serious adverse events were observed.Conclusion Roller microneedling combined with topical tranexamic acid is effective and safe for melasma.

Abstract:Drug-associated nail toxicity refers to a spectrum of adverse effects on the nail unit caused directly or indirectly by a variety of medications.Clinical presentations are heterogeneous and include nail discoloration,dystrophic changes,nail-fold injury,and vascular compromise.Discoloration manifests as melanonychia(black/brown nails),xanthonychia(yellow nails),blue nails,or leukonychia(white nails),and is commonly linked to tetracyclines,retinoids,antimalarials,and cytotoxic chemotherapy.Nail dystrophy,which manifests as thinning,brittleness,Beau's lines,or onychomadesis,occurs most often with chemotherapeutic agents,retinoids,and anticoagulants.Paronychia and pyogenic granuloma are frequently reported with targeted therapies,while vascular nail injuries are associated with anticoagulants and vasoconstrictive agents.Antineoplastic drugs are the predominant culprits,though antifungals,immunosuppressants,and other drug classes have also been implicated.Management emphasizes early recognition and tailored intervention:Symptomatic care,strict skin and nail hygiene,photoprotection when relevant,topical/systemic antimicrobial therapy for secondary infection,cooling strategies,and consideration of dose modification or drug cessation when necessary.Prophylactic and intra-infusion measures,such as frozen gloves,hilotherapy,and ice-pack application,have been shown to reduce the incidence of taxane-related nail toxicity.Clinicians should integrate the offending drug class and the characteristic pattern of nail involvement to initiate prompt preventive and therapeutic measures,thereby alleviating symptoms and preserving patients'quality of life.

Abstract:Objective To observe the clinical application effect of a mechanic-based poly-L-lactic acid vector injection technique on improving facial relaxation.Methods Sixty patients with facial relaxation admitted to the Department of Cosmetic Dermatology,Nanjing Medical University Friendship Plastic Surgery Hospital were selected as research subjects.They were randomly divided into the observation group and control group,with 30 cases in each group.Patients in both groups were treated with poly-L-lactic acid injections to improve facial relaxation.Patients in the observation group received injections based on vector injection technology,while those in the control group received traditional injections.After 3 courses of treatment,treatment effects of the two groups were compared.Results The overall improvement rate of cosmetic effects was 100%in the observation group and 93.33%in the control group.There were no significant differences between the two groups in the overall improvement rate and incidence of adverse reactions(all P>0.05).The dosage of poly-L-lactic acid suspension in the observation group was significantly lower than that in the control group(4.2±0.5 mL vs 6.8±1.2 mL,P<0.05).The observation group performed better in the Wrinkle Severity Rating Scale(WSRS)scores,Global Aesthetic Improvement Scale(GAIS)scores,and multiple items in the Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire(FACE-Q)scores(P<0.05).There were no significant differences between the two groups in the impact on life,satisfaction with social function,and psychological impact(all P>0.05).Conclusion The mechanics-based poly-L-lactic acid vector injection technology can reduce drug dosage and more significantly improve scores related to facial relaxation,while ensuring therapeutic efficacy and safety,thus possessing good clinical application value.

Abstract:Objective To identify NF1 gene variants and evaluate their potential functional impact in children whose principal clinical feature is multiple café-au-lait macules.Methods We retrospectively reviewed 93 children seen at the Capital Center for Children's Health,Capital Medical University from January 2019 to October 2023 for multiple café-au-lait macules(>6 lesions,each>5 mm)and with a high clinical suspicion of neurofibromatosis type 1(NF1).Probands underwent next-generation sequencing;candidate variants were confirmed by Sanger sequencing in family members where available.To assess potential structural consequences of missense substitutions,we examined protein three-dimensional models from the RCSB Protein Data Bank.Results Pathogenic or likely pathogenic NF1 variants were detected in 43 of 93 families(detection rate 46.24%).Eight of the identified variant sites were novel and have not been previously reported.The variant spectrum was dominated by de novo truncating mutations(nonsense and frameshift),consistent with loss-of-function mechanisms.Conclusion Among children presenting mainly with multiple café-au-lait macules,NF1 mutations are frequently de novo and are predominantly truncating variants.The identification of eight novel NF1 mutation sites expands the mutational spectrum and will aid clinical diagnosis and genetic testing for NF1.

Abstract:One case of keratoacanthoma-like inverted follicular keratosis is reported.A 34-year-old man presented with a 1-month history of a gradually enlarging,asymptomatic,dark-brown nodule on the right back.Occasional surface scaling was noted.Dermatologic examination revealed a well-circumscribed,crateriform papulonodule with a slightly erythematous rim and a central keratin plug.The lesion was completely excised.Histopathology showed an exophytic and endophytic papillomatous squamous proliferation extending into the mid-dermis,focally connected to a follicular(infundibular)structure,with slight inward curving of the epithelial edges.The epidermis exhibited hyperkeratosis with areas of parakeratosis and focal surface defect;the granular layer was diminished or absent.Basaloid cells at the periphery displayed palisading.The center contained pale outer root sheath-like cells admixed with eosinophilic keratinocytes forming numerous squamous eddies,large keratin plugs,and horn cysts.Only scant granular cells were observed;cytologic atypia was minimal,and no atypical mitoses were identified.The surrounding dermis showed a mononuclear inflammatory infiltrate,dilated small vessels,and thickened collagen bundles.These features supported a diagnosis of keratoacanthoma-like inverted follicular keratosis.The postoperative course was uneventful,and no recurrence was observed during 12 months of follow-up.

Abstract:Patients with multiple traumatic injuries who are critically ill,for example,those with severe traumatic brain injury or high-level spinal cord injury,frequently have impaired consciousness,reduced mobility,and prolonged bed rest,placing them at high risk for incontinence-associated dermatitis(IAD).IAD increases the risk of secondary complications such as pressure injuries,impairs quality of life,and complicates nursing care.Early identification of high-risk patients using validated,evidence-based risk prediction tools enables timely,targeted skin-care interventions and is therefore clinically important.This review summarizes current IAD risk prediction tools developed for critically ill multiple-trauma populations,comparing their development methods,variable composition,performance characteristics,and reported clinical utility,and aims to provide a basis for healthcare personnel to identify IAD risk factors early and implement skin prevention and management strategies.In constructing and applying prediction tools,researchers and clinicians should ensure broad coverage of risk factors,prioritize model validation and usability,and emphasize translation into practice.

Abstract:Objective To evaluate the clinical efficacy and immunological effects of the Qingfeng Jiedu traditional Chinese medicine method combined with narrowband ultraviolet B(NB-UVB)therapy in patients with psoriasis vulgaris characterized by blood-heat syndrome.Methods We retrospectively reviewed 112 patients with psoriasis vulgaris of blood-heat syndrome treated at Shaanxi Provincial People's Hospital from December 2023 to November 2024.Based on received treatment,patients were assigned to an observation group(NB-UVB plus Qingfeng Jiedu method,n=57)or a control group(NB-UVB alone,n=55).Both regimens were administered for 8 consecutive weeks.Outcomes included overall clinical response and adverse events,traditional Chinese medicine(TCM)syndrome scores,disease severity measured by the Psoriasis Area and Severity Index(PASI),and immune-function(CD3+,CD4+/CD8+ratio,and natural killer[NK]cell levels)before and after treatment.Results Both groups showed significant post-treatment reductions in TCM syndrome scores and PASI(P<0.05);reductions were significantly greater in the observation group(P<0.05).CD3+counts and CD4+/CD8+ratios declined in both groups after therapy(P<0.05),with larger decreases observed in the observation group(P<0.05).NK cell levels increased significantly in both groups(P<0.05),with a greater rise in the observation group(P<0.05).The overall effective rate was higher in the observation group(96.49%)than in the control group(83.64%)(P<0.05).Adverse event rates were 12.28%in the observation group and 7.27%in the control group,with no statistically significant difference between groups(P>0.05).Conclusion The Qingfeng Jiedu method combined with NB-UVB is a safe and effective treatment for psoriasis vulgaris with blood-heat syndrome and may modulate immune function.

Abstract:Objective To evaluate the efficacy of secukinumab in moderate-to-severe plaque psoriasis patients with comorbid metabolic syndrome and to assess the treatment's impact on metabolic parameters.Methods This single-center cohort study enrolled 40 patients with moderate-to-severe plaque psoriasis who were treated at the Provincial Hospital Affiliated to Anhui Medical University from December 2023 to February 2025.Patients were classified as having metabolic syndrome(observation group,n=20)or not(control group,n=20)according to standard diagnostic criteria.All patients received secukinumab 300 mg subcutaneously at weeks 0,1,2,3,4,8,12,and 16.Follow-up visits occurred at weeks 0,4,8,12,and 16,with Psoriasis Area and Severity Index(PASI)scores recorded at each visit.Waist circumference,blood pressure,fasting glucose,triglycerides(TG),and high-density lipoprotein cholesterol(HDL-C)were measured at baseline and immediately prior to the week-16 injection.Outcomes compared between groups included serial PASI scores,achievement rates of PASI 75 and PASI 90,changes in metabolic indicators,and safety/tolerability.Results Both groups experienced significant reductions in PASI scores at weeks 4,8,12,and 16 compared with baseline(all P<0.001).However,at each post-baseline visit the metabolic syndrome group had higher(worse)PASI scores than the control group(P<0.05).The metabolic syndrome group reached PASI 90 later and had lower PASI 75 and PASI 90 response rates than the control group(P<0.05).The overall response rate was 70%in the metabolic syndrome group versus 100%in controls(P<0.05).Subgroup correlation analysis showed a negative association between treatment efficacy and metabolic syndrome presence:moderate psoriasis group r=-0.498(P<0.05)and severe psoriasis group r=-0.623(P<0.01).After 16 weeks,patients with metabolic syndrome showed no significant changes in waist circumference,blood pressure,or fasting glucose,but had a significant reduction in TG(from 2.75±0.83 to 1.75±0.64 mmol/L,P<0.001)and a significant increase in HDL-C(from 0.92±0.14 to 1.36±0.20 mmol/L,P<0.001).The control group showed no significant changes in these metabolic parameters.Safety data were collected throughout the study.Conclusion Secukinumab demonstrated clinical efficacy in moderate-to-severe plaque psoriasis patients both with and without metabolic syndrome;however,the presence of metabolic syndrome was associated with reduced treatment response,with a stronger negative correlation in severe disease.Notably,16 weeks of secukinumab therapy in patients with metabolic syndrome was associated with improved TG and HDL-C levels.

Abstract:One case of pseudoxanthoma elasticum(PXE)is reported.A 53-year-old man presented with a 4-year history of asymptomatic yellowish papules on the face and neck.Systemic examination revealed no significant abnormalities.Dermatologic evaluation showed bilateral accentuation of cutaneous folds on the cheeks,jawline,and upper neck,with densely distributed,sharply demarcated yellow papules of varying sizes aligned along skin folds;some papules had coalesced and enlarged.The lesions were soft and smooth,with a characteristic"plucked-chicken skin"appearance,without appreciable cutaneous laxity.Histopathologic examination(HE)of a biopsy from the right mandibular region demonstrated loosening of the superficial to mid dermis with coarse,curled eosinophilic fibers,accompanied by lymphocytic and histiocytic infiltrates.Weigert elastic fiber staining revealed swollen,fragmented elastic fibers with a"crushed wool"appearance in the superficial and mid dermis.These findings were consistent with a diagnosis of PXE.

Abstract:Objective To investigate the sedative effect and safety of chloral hydrate combined with local anesthesia via subcutaneous injection of lidocaine and restraint band fixation in infants undergoing skin mass excision.Methods Fifty-six infants and young children receiving chloral hydrate sedation combined with local anesthesia via subcutaneous injection of lidocaine and restraint band fixation for removing benign skin masses at the Second Department of Dermatology,Capital Center for Children's Health,Capital Medical University from May 2023 to April 2024 were included in the observation group.The other 24 infants with skin mass excision under local anesthesia via subcutaneous injection of lidocaine and restraint band fixation were included in the control group.Vital signs like heart rate and respiratory rate were monitored at 20-30 minutes after medication.Success sedation to fall asleep was observed.The duration from local anesthesia to fall asleep,and the operation status were recorded.Intraoperative blood loss and surgery time were recorded after surgery.Infection status,and wound healing time were recorded at 2 weeks postoperatively.Scar hyperplasia and aesthetic satisfaction of guardians were recorded at 3-6 months postoperatively.Results Among the 56 children in the observation group,the sedation success rate reached 94.64%(53/56),with an average time to fall asleep of 8.5 min.In this group,83.02%(44/53)of infants maintained sleep state throughout the surgery to ensure the smooth completion of the fine operation.Among the 24 children in the control group,only 2(8.33%,2/24)fell asleep throughout the whole process and met the fine operation requirements.Significantly shorter operation duration,less intraoperative blood loss,lower respiratory rate,shorter wound healing,lower incidence of scar hyperplasia,and higher aesthetic satisfaction were detected in the observation group than the control group(P<0.05).The incidence of postoperative infection was lower in the observation group than the control group,without a significant difference(P=0.309).Conclusion Chloral hydrate combined with local anesthesia via subcutaneous injection of lidocaine and restraint band fixation in infants can enable infants and young children with benign skin mass excision to fall asleep quickly and smoothly,and significantly improve the fineness and success rate of the surgery.It has a slight impact on the circulation and respiratory system,and can reduce the risk of postoperative infection,promote wound healing,and improve postoperative aesthetic effect.

Abstract:We present a case of apocrine cystadenoma of the face.The patient was a 51-year-old man who presented with a pigmented lesion on the left zygomatic area that had been present for several years and had enlarged with ulceration over the past three years.On examination,there was a well-circumscribed,firm,smooth,black cutaneous nodule measuring approximately 1.0×0.7×0.4 cm on the left zygoma.Hematoxylin and eosin(HE)revealed multiple intact cystic spaces in the dermis;portions of the cyst wall showed papillary projections into the lumen,and luminal contents exhibited characteristic apocrine decapitation secretion.Findings were consistent with apocrine differentiation.Immunohistochemical profiling showed focal positivity for cytokeratin 5/6(CK5/6),p63 positivity in basal cells,CK8/18 positivity,partial epithelial membrane antigen(EMA)expression,Ki-67 labeling of about 5%,wild-type p53 expression,and negative α-smooth muscle actin(α-SMA).Special stains were alcian blue-periodic acid schiff(AB-PAS)and diastase periodic acid-schiff(D-PAS)positive,supporting the presence of apocrine secretory material.A diagnosis of apocrine cystadenoma was made.The lesion was completely excised surgically,and the patient was followed up through February 2025 without evidence of recurrence.

Abstract:Objective To evaluate the effectiveness of a teaching model that integrates dermatopathology and dermoscopy into the clinical clerkship for undergraduate dermatology education.Methods From August 2023 to July 2024,60 fourth-year medical students completing clinical clerkship at the Third Affiliated Hospital of Nanjing Medical University were enrolled.Students were stratified by gender and randomly assigned to an intervention(observation)group(n=30)or a control group(n=30).The control group received standard clinical teaching,while the intervention group received practical,hands-on instruction combining dermatopathology and dermoscopy within the clerkship.At course completion,students completed a standardized teaching evaluation.We compared dermatology course scores and overall semester scores across compulsory course between groups.Results Students exposed to the integrated model rated the dermatopathology component higher for practical relevance,support of theoretical learning,and stimulation of continued interest;however,they reported lower self-assessed mastery of specific dermatopathology content and procedural skills.The dermoscopy component was evaluated as engaging,innovative,supportive of theory,stimulating of further study,and practical,but students reported challenges in mastering dermoscopic technique,imageinterpretation criteria,and specialized skin-imaging concepts.Compared with controls,a significantly greater proportion of students in the intervention group agreed that the teaching approach increased learning motivation,improved study efficiency,and fostered scientific thinking(P<0.05).The intervention group achieved higher dermatology course scores than the control group(P<0.05),while total semester scores across compulsory course did not differ significantly between groups(P>0.05).Conclusion The dermatopathology plus dermoscopy integrated clinical clerkship model achieved high satisfaction among undergraduates in the dermatology clerkship and helped stimulate interest in dermatology and the understanding of theoretical knowledge.

Abstract:This study reported a case of oral mucocele with the auxiliary diagnosis by dermoscopy.A 14-year-old boy presented with a one-year history of a mucosal lesion on the lower lip.Clinical examination revealed a hemispherical,well-circumscribed nodule(0.5 cm×0.6 cm)on the lower labial mucosa,showing a clear margin,smooth surface,and soft texture without signs of erosion or ulceration.Dermoscopy demonstrated a hemispherical elevation on a reddish background,structureless white area in the center surrounded by numerous branched vessels and a few hairpin-like vessels.Histopathological examination revealed an essentially normal epithelium.Within the dermis,a cystic cavity containing abundant mucin,mucinophilic cells,and neutrophils was identified.The cavity wall lacked an epithelial lining and it was composed of granulation tissue.He was finally diagnosed with oral mucocele.The lesion was surgically excised,and no recurrence was observed during a two-month follow-up.