Pruritus is the most common symptom of skin diseases and frequently occurs in the elderly. It significantly affects patients’ quality of life and poses challenges for nursing care. There is an urgent need for high-quality standardized documents to provide guidance for clinical nursing practice. Dermatological nursing experts from the Guangdong Nursing Association develop the “Expert Consensus on the Nursing Care of Chronic Pruritus in the Elderly” based on evidence from evidence-based medicine. This consensus outlines the fundamental principles of care for elderly patients with chronic pruritus, including pruritus assessment, environmental management, lesion care, medication-related nursing, physical therapy care, traditional Chinese medicine external treatment care, and health guidance, in order to promote standardized and consistent nursing practices, improve the quality of pruritus care, and alleviate symptoms for elderly patients.
Objective To explore the risk factors for oral infections after dental implant restoration in patients with syphilis serofast reaction. Methods A total of 121 patients with syphilis serofast reaction (132 implant sites) who underwent dental implant restoration in the Department of Stomatology, Southern Theater Command General Hospital from March 2019 to December 2024 were enrolled in the study group. Another 121 non-serofast syphilis patients (138 implant sites) who received implant restoration during the same period served as the control group. Basic clinical data and oral infection rates were compared between these two groups. The study group was further divided into a non-infection subgroup (n=106) and an oral infection subgroup (n=15) based on the presence of oral infections. Differences in basic clinical data, characteristics of dentition defects, and implant restoration features were compared between the two subgroups. Changes in salivary inflammatory factor levels before implantation and 1 week after implantation were also analyzed. Univariate logistic regression analysis, collinearity test, and multivariate linear regression analysis were used to identify factors influencing post-implant oral infections in patients with syphilis serofast reaction. Results After implant restoration, the infection rate was significantly higher in the study group than in the controls [15/121 cases (12.4%) vs. 6/121 cases (5%),χ2=4.22,P<0.05]. A total of 22 pathogenic strains were detected in the 15 infected patients of the study group, including 14 anaerobic bacteria (63.6%), 3 Porphyromonas gingivalis (13.7%), and 5 oral streptococci (22.7%). Compared with the non-infection subgroup, the oral infection subgroup had higher proportion of patients with a history of smoking, diabetes mellitus, multiple tooth loss, previous periodontal disease, and implant restoration duration ≥1 hour (all P<0.05). One week after implantation, the levels of CRP, IL-6 and TNF-α in both the oral infection group and the non-infection group were significantly higher than before treatment. Moreover, the levels of CRP, IL-6, and TNF-α in the oral infection group were higher than those in the non-infection group (P<0.05). Univariate logistic regression, collinearity test, and multivariate linear regression analyses showed that a history of diabetes mellitus, and CRP and IL-6 levels one week after implantation were independent risk factors for post-implant oral infections in patients with syphilis serofast reaction (P<0.05). Conclusions In patients with syphilis serofast reaction undergoing dental implant restoration, postoperative oral infections are predominantly caused by anaerobic bacteria. A history of diabetes and elevated levels of inflammatory markers after surgery are independent risk factors for infections following dental implantation.
Objective To assess the efficacy and safety of high-dose fractionated radiotherapy for the postoperative treatment of keloids. Methods A retrospective analysis was performed on 32 patients (48 lesions) with keloids who received treatment at our institution from January 2020 to June 2023. All patients received radiotherapy using 6 MV energy within 24 h after surgical excision, with a source-to-skin distance of 100 cm. Based on different fractionation regimens, patients were divided into two groups: the high-dose group [16 patients with 24 lesions received a total dose of 20 Gy, delivered as 5 Gy per fraction over 4 fractions (20Gy/5Gy/4F)] and the conventional-dose group [16 patients with 24 lesions received a total dose of 20 Gy, delivered as 2 Gy per fraction over 10 fractions (20Gy/2Gy/10F)]. Treatment outcomes were evaluated using the Darzi keloid efficacy criteria and classified into effective and ineffective categories. The treatment efficacy, adverse reactions, and recurrence rates were compared between the two groups. Results All patients completed the treatment as planned. At the 12-month follow-up, the response rate of the high-dose group was significantly higher than that of the conventional-dose group (91.67% vs. 66.67%, χ2=4.55,P=0.033). In contrast, the recurrence rate was lower in the high-dose group than in the standard-dose group (8.33% vs. 33.33%, P=0.033). There was no significant difference between the two groups in the incidence of acute radiation reactions (P>0.05). Additionally, no late adverse effects such as skin atrophy or fibrosis were observed in either group during the follow-up period. Conclusions The high-dose fractionation regimen of 20Gy/5Gy/4 fractions offers superior local control compared to the conventional dose fractionation regimen of 20Gy/2Gy/10 fractions, without increasing the incidence of adverse reactions. Therefore, it may be considered a preferred treatment option in clinical practice.
Objective To observe the effect of recombinant collagen 17 spray on male androgenic alopecia. Methods From September 2024 to December 2024, 30 men with androgenic alopecia were treated with recombinant collagen 17 spray twice daily at the dermatology department of the First Affiliated Hospital of Henan University of Science and Technology. After 12 weeks of treatment, hair growth and adverse reactions were observed. Results After 12 weeks, the appearance of patients’ hair improved. The average hair density was increased from 33.26±4.25 hairs/0.46 cm2 to 42.27±4.93 hairs/0.46 cm2, and the average hair diameter was from 50.20±4.91 μm to 57.93±3.96 μm (t=5.53 and 4.78, respectively; P<0.05 for both). According to patients’ self-assessments, 73.33% reported moderate improvement in hair loss after treatment, 3.33% reported significant improvement, resulting in a total effective rate of 76.67%. No serious adverse reactions occurred in any patient. Conclusion Recombinant collagen 17 spray can improve androgenic alopecia and promote hair growth.
Objective To compare the differences in skin microbial composition and diversity between patients with atopic dermatitis and healthy individuals, to provide clues for understanding the microbe-related molecular mechanisms of AD. Methods Skin samples were collected from 81 patients with atopic dermatitis (AD group) and 63 healthy individuals (control group). DNA was extracted using the CTAB method, followed by 16S rDNA sequencing. Differences in skin microbiota were analyzed using alpha diversity, beta diversity, and principal coordinates analysis (PCoA). The composition of the skin microbiota was examined at the phylum and genus levels, and heatmaps were generated for the top 30 most abundant bacteria at both levels. Results There were differences in the microbiome between the control group and the AD group. Compared with the control group, the AD group showed increased relative abundance of Firmicutes and Staphylococcus, while Actinobacteria, Proteobacteria, Rhodococcus, and Lactobacillus showed decreased relative abundance. Conclusions There are significant differences in the skin microbiota between patients with AD and healthy individuals. Further research is needed to elucidate the mechanisms of microbial dysbiosis, paving the way for targeted therapeutic interventions for AD.
We report a case of neonatal incontinentia pigmenti (IP). Genetic testing of the IKBKG gene was performed using whole-exome sequencing (WES), multiplex ligation-dependent probe amplification (MLPA), and long-range PCR. A literature review was conducted to explore the genetic mechanisms, diagnostic strategies, and recent advances in the treatment of IP. A female neonate was admitted 50 minutes after birth due to generalized skin rashes. Widespread erythema, vesicles, and crusted lesions were observed after birth. Dermatological examination showed scattered erythema, vesicles, and pigmented macules on the extremities and trunk, distributed along the Blaschko’s lines. Laboratory tests indicated an elevated eosinophil ratio (13.4%). Genetic testing identified a heterozygous deletion of exons 4~10 in the IKBKG gene, confirming the diagnosis of neonatal IP. Neither parent carried deletions or duplications in the IKBKG gene, suggesting a sporadic case of IP. Following skin care and multidisciplinary management, the patient’s lesions improved and she was discharged. At 6-month follow-up, no skin rash or systemic complications were observed.
Dermatology and venereology education plays a pivotal role in the modern medical education system. In the process of exploring standardized residency training for dermatology, we face numerous challenges,such as the lack of independent dermatopathology labs in some training institutes, limited hands-on opportunities for trainees, and insufficient feedback during the learning process. To address these issues, this study proposes an innovative teaching model: multimodal image reading combined with the WeChat platform. This model integrates clinical skin lesion observation, dermoscopic image analysis, and dermatopathological interpretation to build a comprehensive multimodal reading system. At the same time, it leverages the convenience and efficiency of the WeChat platform to share educational resources and facilitate learning exchanges. By detailing the design and implementation process of this teaching model, the paper provides a practical framework and operational insights for peers, aiming to cultivate dermatology professionals with solid diagnostic skills and strong clinical reasoning.
A case of statin-induced immune necrotizing myopathy with negative autoantibodies is reported. A 67-year-old female presented with generalized weakness and limb muscle soreness for 3 months, with worsening symptoms over the past month. She had been taking statins orally for lipid-lowering therapy for 10 years. Skin examination revealed no skin lesions throughout the body. Patient had difficulty to squat and stand up, without muscle atrophy in the limbs. Muscle strength was grade Ⅳ, and there was mild tenderness upon palpation of the upper limbs and thigh muscles. Laboratory tests showed an ESR of 34 mm/h, AMA-M2 (WB) strongly positive (+++), CK level of 530 U/L, CK-MB level of 830 U/L, and negative for anti-signal recognition particle antibody, anti-3-hydroxy-3-methylglutaryl-CoA reductase antibody, and dermatomyositis-specific anti-MDA5. LDH was normal. Electromyography showed myogenic damage in the biceps brachii and anterior tibial muscles. Biopsy of the biceps brachii revealed mild muscle degeneration, with no inflammatory cell infiltration. Magnetic resonance imaging of the limbs showed no abnormalities. Clinical diagnosis was seronegative immune-mediated necrotizing myopathy. After systematic treatment with glucocorticoids and mycophenolate mofetil, muscle pain and weakness resolved, and the laboratory test indicators improved significantly. After one year of maintenance therapy, there has been no recurrence to date.
We report a case of pretibial myxedema.A 66-year-old man presented with skin induration on the anterior tibia of both lower limbs for 3 years. Dermatological examination showed non-pitting, edematous plaques on the anterior, middle and lower tibia of the lower leg and the dorsal feet. The skin was indurated, significantly thickened, and reduced elasticity. Histopathological examination of skin lesions revealed chronic inflammation with edema and abundant mucin deposition between collagen fibers in the dermis. AB-PAS staining was positive. The patient was diagnosed with pretibial myxedema. The patient was treated with intralesional injections of glucocorticoids. At the 3-month follow-up, the induration and edema of the anterior tibial skin on both lower limbs had significantly improved.
Chlamydia trachomatis infection has become a major global public health concern. Pgp3, a virulence protein encoded by a cryptic plasmid, features a highly conserved trimeric structure and plays a pivotal role in C. trachomatis pathogenesis by neutralizing the antimicrobial peptide LL-37 and activating the TNFR1 signaling pathway. As an immunodominant protein, Pgp3-based serological assays (ELISA/MBA/LISA) demonstrate significantly superior performance compared to traditional MOMP detection. Pgp3 antibodies persist for over 12 years, making them ideal markers for assessing past infections. Furthermore, Pgp3 seropositivity is significantly associated with tubal infertility (aOR=2.6) and pelvic inflammatory disease (PR=2.0), highlighting its potential for predicting deep-tissue infections. This review systematically analyzes the structure of the Pgp3 protein, its pathogenic mechanisms, and the application of its antibodies in evaluating past infections and predicting deep infections, thereby providing a theoretical foundation for prognostic evaluation of C. trachomatis infections.
Atopic dermatitis (AD), a chronic inflammatory skin disease, has been widely recognized to exhibit significant associations with various mental health disorders. Epidemiological evidence indicates that AD patients face substantially increased risks of psychiatric comorbidities such as anxiety, depression, suicidal tendencies, attention-deficit/hyperactivity disorder (ADHD), sleep disturbances, autism spectrum disorder, and cognitive impairment. These associations are influenced by multiple factors, including genetic predisposition, individual characteristics, AD severity, and adverse lifestyle habits. The underlying mechanisms primarily involve bidirectional interactions of the "brain-skin axis" (encompassing neuroendocrine regulation, hypothalamic-pituitary-adrenal axis, and sympathetic nervous system), neuroimmune inflammation, and genetic regulation. Medications that effectively control the symptoms of atopic dermatitis (such as biologics) often improve associated psychiatric comorbidities, while interventions targeting mental health symptoms can also alleviate AD symptoms. Therefore, clinicians should fully recognize and screen for psychiatric comorbidities in patients with AD, and adopt an integrated management strategy that combines dermatological treatment with psychological interventions. Future research should aim to further elucidate the underlying mechanisms to optimize therapeutic approaches. This article reviews the epidemiology, influencing factors, pathogenesis, and therapeutic progress related to the psychiatric comorbidities of atopic dermatitis.
As the most common malignant skin tumor, the incidence of basal cell carcinoma (BCC) is rising with population aging. Although most cases are localized, a small number may infiltrate or metastasize, making early diagnosis and treatment crucial. This article reviews recent advances in the treatment of cutaneous BCC, highlighting the characteristics and latest developments of various therapeutic approaches. These include Mohs micrographic surgery, photodynamic therapy, cryotherapy, topical medications such as imiquimod, 5-fluorouracil (5-FU), ingenol mebutate (IM), radiotherapy, laser therapy, targeted drug therapies such as Hedgehog pathway inhibitors (HPI), and programmed death receptor-1 (PD-1) inhibitors. Emerging treatments such as oncolytic peptides and small interfering RNA (siRNA) drugs are also discussed. The article emphasizes the importance of tailoring treatment strategies based on BCC risk levels and suggests that future therapies will focus more on technological innovation and multidisciplinary collaboration to improve patient outcomes and quality of life.
