Objective To investigate the regulatory effects and molecular mechanisms of M1/M2 macrophage-derived exosomes in scar formation, providing a theoretical basis for the prevention and treatment of pathological scarring. Methods Human keloid fibroblasts were isolated and expanded in vitro. Peripheral blood monocytes were induced to differentiate into M1 and M2 macrophages. Exosomes were subsequently isolated and purified for miRNA sequencing analysis. Fibroblasts were divided into a blank control group (without exosome treatment), an M1 exosome-treated group, and an M2 exosome-treated group for co-culture experiments. Cell proliferation, migration, and collagen synthesis were evaluated using the CCK-8 assay, Transwell assay, and hydroxyproline assay, respectively. Expression levels of several key genes were analyzed by RT-qPCR. Results Compared with the blank control group, M1 exosomes significantly inhibited fibroblast proliferation, migration, and collagen secretion (P<0.01) and downregulated the expression of TGFβ1, Smad3, AKT, mTOR, COLⅠ, and COLⅢ. In contrast, M2 exosomes markedly enhanced fibroblast activity and collagen production (P<0.01) while upregulating the these genes. RNA sequencing revealed that M1 exosomes were enriched in miR-21, miR-23a, miR-155, and miR-125b, which suppressed TGFβ/Smad and AKT/mTOR signaling, whereas M2 exosomes contained miR-34a, miR-124, miR-126, and miR-181a, promoting activation of these pathways. Conclusions M1/M2 macrophage-derived exosomes exert opposing effects on fibroblast behavior and scar formation through distinct miRNA-mediated regulation of TGFβ/Smad and AKT/mTOR signaling pathways. These findings provide a theoretical basis for developing macrophage exosome-based interventions to modulate wound repair and achieve scarless healing.
Objective To investigate the positivity rates of thyroid autoantibodies in patients with vitiligo and its association with gender, age, and clinical subtypes. Methods Clinical data and serum levels of thyroid autoantibodies (including TPOAb, TGAb, and TRAb) were retrospectively collected from 344 patients with vitiligo. The positivity rates among different genders, clinical types, and disease stages were compared. Independent-samples t-tests were conducted to compare age differences between antibody-positive and antibody-negative groups, as well as between genders within the positive group. Results The overall positivity rate for thyroid autoantibodies was 23.26% (80/344). The positivity rate in females (30.32%, 57/188) was significantly higher than that in males (14.74%, 23/156) (2=11.59, P=0.001). The mean age of the antibody-positive group (40.23±15.69 years) was significantly higher than that of the negative group (32.88±17.61 years) (t=3.35, P=0.001). No significant difference in mean age was observed between female and male patients within the positive group (t=1.11, P=0.272). No significant difference in positivity rates was found among different clinical subtypes (segmental, non-segmental, mixed, and unclassified) (2=4.49, P=0.213). Similarly, no significant difference was noted among subtypes in the subgroup of patients in the progressive stage (χ2=4.10, P=0.251). Conclusions Patients with vitiligo are often comorbid with thyroid autoimmune abnormalities. This study demonstrates that antibody positivity is significantly correlated with female sex and advanced age, but not with clinical subtype. Routine screening for thyroid autoantibodies is recommended for vitiligo patients, particularly for females, middle-aged and elderly individuals, and those in the progressive stage.
Objective To investigate the clinical efficacy of fire needle therapy combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on lesion repair and scar prevention in patients with refractory acne. Methods A total of 60 patients with refractory acne were enrolled at our dermatology department from January 2023 to April 2025 and randomly divided into a control group (ALA-PDT alone) and an observation group (fire needle combined with ALA-PDT), with 30 cases per group. Both groups received continuous treatment for 4 weeks and were followed up for 8 weeks. Clinical efficacy after treatment, lesion scores, scar incidence and severity, adverse reactions, and recurrence rate at the 8-week follow-up were compared between the two groups. Results At the end of treatment, the total effective rate in the observation group was significantly higher than that in the control group (93.33% vs. 70.00%, χ2=5.46, P=0.020). After an 8-week follow-up, the total lesion score in the observation group was significantly lower than that in the control group (9.62±4.32 vs. 18.53±5.83, t=6.73, P<0.001). The scar incidence in the observation group was significantly lower than that in the control group (6.67% vs. 26.67%, χ2=4.32, P=0.038), and the scar severity score was significantly lower than that in the control group (108.67±47.69 vs. 136.83±55.14, t=2.12, P=0.039). There was no significant difference in the incidence of adverse reactions between the two groups (2=0.13,P=0.718), and all adverse reactions were manageable. After the 8-week follow-up, the recurrence rate in the observation group (10.00%) was lower than that in the control group (36.37%, χ2=5.96,P=0.015). Conclusions The combination of fire needle therapy and ALA-PDT exerts a synergistic effect in the treatment of refractory acne, effectively promoting lesion repair, significantly reducing scar incidence and acne recurrence rates, with a favorable safety profile. Therefore, it warrants clinical promotion and application.
Objective To investigate the effect of collagen scalp care essence on hair growth in mice with androgenetic alopecia (AGA). Methods Twenty male C57BL/6J mice were randomly divided into four groups: negative control group, model control group, positive control group, and test group, with five mice per group. Twenty-four hours before the experiment, hair on the back of the mice (approximately 2 cm×3 cm) was removed. Except for the negative control group, all other groups of mice were subcutaneously injected with 5 mg/kg of testosterone propionate at the neck to establish the AGA model. Mice in the negative control group were subcutaneously injected with the same volume of physiological saline. Afterward, the negative control group and model control group were topically treated with 0.2 mL/day of saline on the depilated area, while the positive control group was topically treated with 0.2 mL of 5% minoxidil. The test group was topically applied with 0.2 mL of collagen scalp care essence. All treatments were once daily for 28 days. The hair growth was monitored throughout the experiment. After 28 days, the length and weight of new hair were measured, and hair follicle density and thickness at the root were observed. Skin from the depilated area was collected for histological assessment of follicle morphology and follicle count. Results After 28 days of administration, the lengths of new hair in the negative control, model control, positive control, and test groups were (4.89±0.48) mm, (3.47±0.31) mm, (4.92±0.51) mm, and (4.30±0.51) mm, respectively; corresponding new hair weights were (0.07±0.01) g, (0.02±0.00) g, (0.07±0.01) g, and (0.06±0.01) g, respectively. Compared to the model control group, both the positive control group and the test group showed significantly greater new hair length and weight (P<0.05). Observation of hair roots indicated that hair in the model control group was sparse and fine, whereas the positive control group and test group had denser new hair with increased thickness compared to the model control group. Histological analysis showed abnormal follicle morphology and frequent follicular atrophy in the model control group, while follicles in the positive control and test groups appeared structurally intact and morphologically normal. The proportions of anagen follicles in the negative control, model control, positive control, and test group were (95.54±3.08)%, (10.21±8.37)%, (89.27±8.72)%, and (85.11±5.83)%, respectively. Compared with the model group, the proportions of anagen follicles were significantly increased in both the positive control and test groups (P<0.05). Conclusion Collagen scalp care essence exerts a promoting effect on hair growth in a mouse model of androgenetic alopecia.
Objective To investigate the clinical characteristics, treatment strategies, and outcomes of Methotrexate (MTX)-induced severe cutaneous adverse reactions (SCARs), thereby providing evidence-based guidance for medication safety. Methods We systematically searched PubMed, CNKI, Wanfang, and VIP databases for case reports of MTX-induced SCARs published from inception to July 2025. Demographic characteristics, medication history, SCAR subtypes, time-to-onset, clinical manifestations, treatments, and outcomes were extracted and analyzed using descriptive statistics. Results A total of 27 patients were included in the analyses, comprising 14 males (51.8%) and 13 females (48.2%), aged 2 to 78 years. Underlying diseases were primarily acute lymphoblastic leukemia, systemic lupus erythematosus, non-Hodgkin's lymphoma, and rheumatoid arthritis. SCAR phenotypes included toxic epidermal necrolysis (TEN) in 17 cases, Stevens-Johnson syndrome (SJS) in 7 cases, and SJS-TEN overlap syndrome in 3 cases. The time to SCAR onset was within one week after drug administration in 21 cases (77.8%). All patients immediately discontinued MTX and received corresponding treatment. Among them, 7 patients (25.9%) were treated with a combination of glucocorticoids and intravenous immunoglobulin, while 8 patients (29.6%) received glucocorticoids alone. Outcomes were recovery/improvement (15 cases, 55.6%), death (10 cases, 37.0%, primarily from organ failure/sepsis), and discharge AMA (2 cases, 7.4%). Conclusions MTX can induce SCARs, predominantly presenting as TEN and SJS, which typically arise early during treatment and are associated with high mortality. Close monitoring for early symptoms, such as rash and fever, is essential during MTX therapy. If SCARs are suspected, MTX must be discontinued immediately, and multidisciplinary collaborative intervention should be initiated.
Objective To investigate the prevalence trends and epidemiological features of syphilis among women of childbearing age in Baotou City, Inner Mongolia, from 2010 to 2024, aiming to provide evidence-based recommendations for effective syphilis prevention and control. Methods Data on women of childbearing age (aged 15-49 years) with a diagnosis of syphilis in Baotou, Inner Mongolia, from 2010 to 2024, were extracted from the National Health Security Information System. The data were stratified by year, syphilis stage, and age group. Subsequently, a Joinpoint regression model was employed to analyze the trends in the reported incidence of syphilis. Results From 2010 to 2024, the overall reported incidence of syphilis among women of childbearing age in Baotou City decreased slightly from 28.73 to 24.45 per 100,000 (AAPC=-2.81%, P=0.064). The incidence of primary syphilis declined from 7.01 to 0.59 per 100,000 (AAPC=-17.91%, P<0.001), and that of secondary syphilis decreased from 7.79 to 1.84 per 100,000 (AAPC=-13.81%, P<0.001). In contrast, the incidence of latent syphilis increased from 13.94 to 21.87 per 100,000 (AAPC=2.34%, P=0.084). The average annual incidence of tertiary syphilis was 0.06 per 100 000. A decreasing trend in incidence was observed only in the 25-29 age group (AAPC=4.23%, P<0.001). But no significant trends were found in other age groups (P>0.05 for all). Regarding case distribution, the 20~24, 25~29, and 30~34 age groups accounted for the highest proportion of reported cases, representing 53.95% of the total. The most affected occupational category was homemakers and unemployed individuals (4 296 cases), representing 65.20% of all reports. Conclusions From 2010 to 2024, the overall incidence of syphilis and the rate of latent syphilis among women of childbearing age in Baotou City show fluctuating trends, while the incidence of primary and secondary syphilis exhibit a decreasing trend, and tertiary syphilis remains at a low endemic level. Targeted interventions should focus on women aged 20-34 years, particularly those who are homemakers or unemployed, with strengthened health education to curb the spread of syphilis.
To explore the value of a dermatopathology interest group in improving pathology teaching for residents. The key elements of this teaching model included weekly online sessions that employ the “gross-pattern” and “diagnostic-clue” methods to dissect carefully selected cases accessioned within the previous seven days, with emphasis on clinicopathological correlation. Residents captured the digital images, faculty prepared short-answer quizzes that were distributed to participants in advance, and every session was video-recorded. To date, 109 teaching meetings had been held covering 1 166 cases across 128 disease entities, thereby spanning the entire residency curriculum. Through the interest group activities, faculty and residents jointly fostered a positive learning atmosphere and established a tailored platform for dermatopathology education. This initiative not only motivated more residents to actively engage in learning but also effectively compensated for the limitations of short rotation periods and the tendency for fragmented study. With the support of interest group, teachers can continuously explore various teaching methods and enhance their teaching skills. Both faculty and residents derive tangible educational benefit from the initiative.
We report two cases of chemotherapy-induced toxic erythema in cancer patients following chemotherapy. Case 1: A 61-year-old female with a 6-year history of diffuse large B-cell lymphoma developed generalized erythema accompanied by fever for 5 days after receiving chemotherapy preconditioning prior to bone marrow transplantation. Dermatological examination revealed symmetrically distributed violaceous to dusky red patches and ecchymoses on the hands and feet, some of which were non-blanching upon pressure. Erosions and exfoliation were observed on the tongue and lips, with uniformly distributed pale erythematous patches on the trunk and extremities. Laboratory tests showed white blood cell count of 0.43×109/L, red blood cell count of 2.53×1012/L, hemoglobin of 71 g/L, and platelet count of 2×109/L. Case 2: A 33-year old male, who had been receiving postoperative chemotherapy for osteosarcoma for 5 months, developed fever and skin eruption lasting 4 days. Dermatological examination showed densely distributed purple macules and patches on the face and lower legs, symmetrically distributed bright red patches and ecchymoses with swelling on the hands and feet, and diffusely distributed bright red patches on the lower abdomen and inguinal region. Laboratory tests indicated white blood cell count of 0.25×109/L, red blood cell count of 2.05×1012/L, hemoglobin of 71 g/L, and platelet count of 14×109/L. Both patients were diagnosed with chemotherapy-induced toxic erythema. Treatment with systemic corticosteroids led to rapid improvement, allowing tapering and discontinuation within one week. No recurrence was observed during one year of follow-up.
We report a case of generalized lichen planus associated with Tislelizumab. A 62-year-old male presented with a 3-month history of erythematous papules on the dorsal hands and back accompanied by pruritus, which exacerbated and generalized over the past month. Ten months ago, he had been receiving regular Tislelizumab immunotherapy at our hospital for “left lung squamous cell carcinoma”. Dermatological examination revealed multiple purple-red, polygonal, flat-topped papules scattered across the body, predominantly on the upper trunk, with positive Wickham striae. Histopathological findings of the skin lesion on the right forearm included epidermal hyperkeratosis, acanthosis, basal cell liquefaction degeneration, and a dense lymphocytic infiltrate with occasional eosinophils in the superficial dermis. The patient was diagnosed with generalized lichen planus. Tislelizumab was discontinued, and treatment with methylprednisolone sodium succinate (80 mg) was initiated. Following this regimen, both the skin lesions and pruritus improved significantly. The patient remains under follow-up.
Skin photoaging is an accelerated aging phenomenon of the skin caused by the accumulation of ultraviolet radiation. The molecular mechanisms of photoaging have mainly been attributed to oxidative stress, DNA damage, and chronic inflammatory responses. In recent years, with the in-depth study of epigenetics, our understanding of the mechanisms underlying photoaging has been further expanded. Epigenetic regulation,including DNA methylation, histone modification, non-coding RNA regulation, and chromatin remodeling, dynamically and reversibly regulates gene expression without altering the DNA sequence, thus serving as a key bridge between environmental exposure and cellular phenotypes. This review systematically elaborates on how ultraviolet radiation interferes with epigenetic processes to affect extracellular matrix metabolism, drive cellular senescence and apoptosis, and exacerbate oxidative stress and inflammatory responses. Additionally, the article explores the potential of epigenetic markers in the early diagnosis and risk prediction of photoaging, and looks forward to epigenetic-targeted prevention and treatment strategies. This review aims to deepen the understanding of the epigenetic basis of skin photoaging and provide a theoretical basis for the development of new prevention and treatment strategies.
Pathological scar hyperplasia remains a common yet therapeutically challenging complication of cutaneous wound healing, with its underlying mechanisms incompletely elucidated. Traditional studies focusing on single cell types or isolated pathways have proven inadequate to fully explain the persistent activation, enhanced heterogeneity, and high recurrence rate characteristic of scarring. Recent basic and translational research demonstrates that scar formation is driven by a dynamic, network-based regulatory process involving the coupling of multiple functional axes: immune-inflammatory responses, fibroblast ecological imbalance, mechanobiological signaling, metabolic reprogramming, neuro-immune crosstalk, and epigenetic regulation. In this network, mechanosensitive transcriptional co-activators YAP/TAZ, TGF-β, immune-derived cytokines, and metabolites collectively establish a “pathological memory” state in fibroblasts. Building on this framework, novel engineered interventions, such as mechanotransduction-targeted biomaterials, precision delivery systems, mesenchymal stem cell-derived exosomes, and multi-axis synergistic therapies, are overcoming the limitations of conventional treatments. This review systematically summarizes recent advances (2020—2025) in the molecular mechanisms of scar formation under the “multi-axis coupling and network regulation” paradigm and discusses their potential for precision intervention strategies and clinical translation, providing new theoretical foundations and research directions for scar prevention and management.
Lactylation is a protein post-translational modification that links cellular metabolism with epigenetic regulation. This modification exhibits a “double-edged sword” property, as it can both promote tissue homeostasis and drive disease progression. In the skin, a metabolically active organ, lactylation plays important roles in diseases such as psoriasis, melanoma, systemic lupus erythematosus, and skin fibrosis through metabolic-epigenetic crosstalk mechanisms. This review summarizes the molecular mechanisms, key metabolic targets, and therapeutic strategies of lactylation in skin diseases, while addressing clinical translation challenges. At the level of molecular mechanisms, histone lactylation influences gene transcription, while non-histone lactylation regulates the functions of signal transduction proteins, thereby participating in disease development. Regarding key metabolic targets, critical enzymes, such as lactate dehydrogenase A (LDHA), monocarboxylate transporters (MCTs), and delactylases, can serve as precise intervention targets. To target these nodes, therapeutic strategies, including small-molecule LDHA inhibitors and specific MCTs blockers, have been developed. These are integrated with advanced drug delivery systems, such as nanocarriers, engineered adeno-associated virus vectors, and 3D-printed formulations, to achieve precise skin-targeted therapy. However, clinical translation faces significant bottlenecks, including insufficient target selectivity, the spatiotemporal complexity of metabolic interventions, and the challenge of synergizing novel therapies with existing regimens. This review provides a theoretical framework and identifies future research directions for precision medicine in skin diseases based on metabolic-epigenetic crosstalk.
