Objective To investigate the effects of Tripterygium wilfordii extract (TWE) on the epidermal permeability barrier in mice with skin inflammation. Methods A total of 20 C57BL/6J mice were randomly divided into four groups: normal control group, 12-O-tetradecanoylphorbol-13-acetate (TPA) group, TPA+vehicle group, and TPA+0.3% TWE group. Except for the normal control group, mice in the other groups were induced to develop irritant contact dermatitis using TPA. The treatment groups were topically administered with vehicle and 0.3% TWE, respectively. Another 20 C57BL/6J mice were randomly assigned to a normal control group, 1-fluoro-2,4-dinitrobenzene (DNFB) group, DNFB+vehicle group, and DNFB +0.3% TWE group. Mice in all groups except the normal control group were established with allergic contact dermatitis models via DNFB application. The treatment groups received topical vehicle and 0.3% TWE correspondingly. A skin physiological monitor was used to measure transepidermal water loss (TEWL), stratum corneum hydration and skin surface pH value before treatment, as well as on day 2, 4, 6, 8, 10, 12 and 14 after continuous topical administration. Fifteen C57BL/6J mice were randomly divided into a normal control group, vehicle group and 0.3% TWE group. Quantitative real-time polymerase chain reaction was applied to detect the mRNA expression level of filaggrin in the mouse epidermis of each group. Results In the irritant contact dermatitis model, topical TWE significantly improved stratum corneum hydration levels and reduced transepidermal water loss rates starting from day 4 (P<0.001), and reversed the TPA-induced elevation in skin surface pH from day 8 (P<0.001). In the allergic contact dermatitis model, topical TWE markedly increased stratum corneum hydration levels (P<0.001) and decreased transepidermal water loss rates (P<0.05) from day 4, while no significant alteration was observed in skin surface pH throughout the experiment. Compared with the normal control group, topical TWE significantly upregulated the mRNA expression of filaggrin in mouse epidermis (P<0.001). Conclusions Topical TWE helps repair the epidermal permeability barrier in dermatitis mice, and restore skin hydration levels and acidity. Its underlying mechanism may be related to the alleviation of inflammation-mediated inhibition of filaggrin gene transcription by TWE.

Objective To evaluate the efficacy and safety characteristics of spesolimab in real-world clinical practice among patients with generalized pustular psoriasis (GPP). Methods A combination of retrospective case series analysis and systematic literature review was employed. Clinical data of 5 GPP patients treated with spesolimab in our center were collected. All relevant published case reports from China were collected through a literature search. Observation indicators included time to complete pustule clearance, GPP Physician Global Assessment (GPPGA) score, GPP Area and Severity Index (GPPASI) score, and adverse events. Results A total of 31 patients were pooled for further analysis. The median time to complete pustule clearance was 2 days, with 45.16% (14/31) achieving clearance within 48 hours. All patients showed significant decreases in GPPGA and GPPASI scores on day 7 compared to the baseline. Five pregnant patients and several elderly patients with severe comorbidities had good outcomes after treatment. In real-world practice, 8 patients received an initial combination therapy of spesolimab and glucocorticoids. Regarding safety, the overall tolerability was good, but 32.26% (10/31) of patients experienced exacerbation of pre-existing psoriatic erythema or developed new erythema. Conclusions In real-world clinical practice, spesolimab demonstrates rapid and potent efficacy in inducing remission in 31 Chinese GPP patients, including those who are pregnant or have complex comorbidities. Combination with glucocorticoids is a common and effective strategy for managing severe cases. Close attention must be paid to its characteristic reaction of potentially exacerbating pre-existing psoriatic lesions, and a comprehensive treatment plan encompassing both acute rescue and long-term management should be formulated.

Objective This study aimed to evaluate the synergistic effect of berberine hydrochloride on the antibacterial activity of penicillin against Penicillinase-Producing Neisseria gonorrhoeae (PPNG), offering new insights for the prevention and treatment of highly drug-resistant PPNG. Methods The minimum inhibitory concentration (MIC) of berberine hydrochloride combined with penicillin against PPNG strains were determined using microbroth dilution and checkerboard assays, with fractional inhibitory concentration (FIC) indices calculated to assess antibacterial efficacy. TEM DNA mutations were detected via gene sequencing. TEM mRNA expression levels were measured by RT-qPCR. Penicillinase was extracted by ultrasonic disruption, and its activity was assessed using the dual-wavelength colorimetric Amplite assay kit. Results The MIC range of the berberine hydrochloride-only treatment against PPNG was 0.03~128 μg/mL. The MIC of penicillin decreased by ≥4-fold and the FIC index was ≤0.5 when berberine hydrochloride was combined with penicillin against PPNG, demonstrating the synergistic antibacterial effects of these two compounds. The combined antibacterial strategy did not induce mutations in TEM genes, but it decreased penicillinase activity (P<0.05) through downregulating the mRNA expression of TEM (2^-ΔΔCt<1). Conclusions Berberine hydrochloride not only directly inhibits PPNG growth but also restores penicillin sensitivity by down-regulating TEM gene expression and inhibiting penicillinase activity. These findings showed that berberine hydrochloride is an antibiotic adjuvant against PPNG.

Objective To investigate the effects of intense pulsed light (IPL) combined with chemical peeling on skin surface physiological parameters in patients with mild to moderate acne. Methods One hundred and twenty patients with mild to moderate acne who visited the Department of Dermatology at Emergency General Hospital from January 2024 to June 2025 were enrolled in this study. The cohort was randomly divided into three groups (40 patients per group): Group A received IPL only; Group B received chemical peeling only; and Group C received both IPL and chemical peeling. The treatment course lasted three months, with monthly intervals. The clinical efficacy, incidence of adverse reactions, and skin surface physiological parameters were compared among three groups. Results Group C achieved 100% effectiveness, while Group A and Group B were both 97.50%. However, there were no statistically significant differences in treatment effectiveness among the three groups (P=0.600). Before treatment, there were no significant differences in surface pigment area, pore count, porphyrin count, or skin smoothness among the three groups of patients (F=0.22, 0.05, 0.16, 0.17; P=0.804, 0.952, 0.856, 0.847, respectively). After treatment, there were significant differences in surface pigment area, pore count, porphyrin count, and skin smoothness among the three groups (F=8.92, 3.48, 25.44, 28.38, respectively; P<0.001, P=0.034, P<0.001, P<0.001, respectively). Further pairwise comparisons showed that the surface pigment area in Group C was lower than that in Group A and Group B (t=3.69, 3.62, respectively, both P<0.001), the pore count in Group C was lower than that in Group A and Group B (t=2.28, 2.29, respectively; P=0.025 and 0.024), the porphyrin count in Group C was lower than that in Group A and Group B (t=6.52 and 5.76, both P<0.001), and the skin smoothness in Group C was higher than that in Group A and Group B (t=-6.09, -6.89, respectively, both P<0.001). There was no significant difference in the incidence of adverse reactions among the three groups (P=0.857). Conclusions Intense pulsed light combined with chemical peeling can effectively improve the skin color of patients with mild to moderate acne, reduce the number of pores and porphyrin fluorescence intensity, and the effect is significant.

Objective To investigate the clinical features, diagnostic clues, and management of mycosis fungoides (MF) presenting with palmoplantar eczema-like lesions. Methods A retrospective analysis of the clinical data of a patient with MF initially misdiagnosed as palmoplantar eczema was conducted. Diagnosis was confirmed by histopathology from multiple sites, immunohistochemistry, and T-cell receptor (TCR) gene rearrangement analysis. Results The patient had a 4-year history of refractory palmoplantar lesions and had failed multiple systemic therapies. Repeated biopsies confirmed MF. Treatment with methotrexate, combined with local radiotherapy and phototherapy, resulted in marked improvement in erythema, infiltration, and scaling. Conclusions MF should be considered if a patient has chronic palmoplantar eczema-like lesions that are persistent or treatment-resistant. Immunophenotyping and TCR clonality analysis of the repeated biopsies are necessary for accurate diagnosis and timely treatment.

We report a case of primary cutaneous mucinous carcinoma. A 74-year-old male was diagnosed with a small lesion located on the lower eyelid of his right eye three years ago. The lesion had progressively enlarged over the past six months. Dermatological examination showed a purple lesion on the lower eyelid of the right eye, approximately 4 cm×3 cm, characterized by a clear boundary, a soft texture and dilated capillaries. Further ultrasonography suggested a potential malignant transformation with a cystic-solid lesion. Immunohistochemistry (IHC) confirmed the primary skin mucinous carcinoma with CK7(+),CK20(-),CDX2(-),TTF-1(-),MSH2(+),MSH6(+),MLH1(+),PMS2(+),HER2(0),GATA-3(+). Subsequently, the surgical intervention involved local enlarged excision of the lesion in the lower right eyelid with pedicle muscle flap transfer, as well as peripheral nerve entrapment release and repair of the facial defect under general anesthesia. IHC examinations confirmed that the primary skin mucinous carcinoma showed no capsule invasion, vascular, or neural infiltration. Immunohistochemistry demonstrated CK7 (+), ER (+, strong, positive rate 90%), PR (+, strong, positive rate 80%), AR (+, strong, positive rate 90%), Ki-67 (+, approximately 15%), P53 (weak+, approximately 40%), GCDFP15 (partially+), GATA-3(+),Villin(-),CK20(-). The patient is still under follow-up.

A case of Marshall-White syndrome is reported. A 27-year-old male presented with leukoplakia on the upper limbs that had increased progressively for over four years. Multiple scattered round or quasi-round white spots with a diameter of about 0.2-1.0 cm could be seen on the upper limbs. The lesion boundary was clear, and the surface was smooth and free of scales. The white spots could be seen to fade or even disappear after rubbing or raising the arms. The dermoscopic examination showed a white unstructured area with a light red background and multiple scattered punctate globular telangiectasia around the upper limbs. After the upper limbs were lifted or rubbed, the background skin color could be seen, the white unstructured area was obviously lighter than before, and the original dot globular telangiectasia around it was significantly reduced. The diagnosis was Marshall-White syndrome. No treatment was given.

Scars represent a common outcome of aberrant tissue remodeling following wound healing. The hypertrophic scars and keloids cause pain, pruritus, cosmetic disfigurement, and functional impairment, which carry significant psychological and social consequences for patients. Scar management has shifted from single-modality treatment to a multidisciplinary strategy incorporating risk stratification, early intervention, and multimodal therapy. We reviewed the recent progresses in scar management including clinical guidelines, randomized controlled trials, silicone-based prevention, pressure therapy, tension-reduction techniques, intralesional corticosteroids, 5-fluorouracil (5-FU), bleomycin, and botulinum toxin type A (BoNT-A), vascular and ablative laser therapy, laser-assisted drug delivery, surgery combined with adjuvant radiotherapy, and emerging approaches such as regenerative medicine, exosomes, tissue engineering, and nano-enabled delivery et al. Current studies have shown that silicone, tension reduction, and pressure therapy are suitable for early prevention; the intralesional and energy-based therapies are suitable for active lesions; and the excision is not the only strategy because of the high recurrence risk. Future investigations are required for precision treatment guided by the standardized outcomes, patient-reported measures, long-term follow-up and molecular profiling.

Facial aging is a degenerative process involving the skin, subcutaneous fat, and skeletal structures, which is characterized by skin laxity, volume loss, blurred contours, and the coexistence of dynamic and static wrinkles. Currently, single-modality treatments are insufficient to address increasingly complex aging concerns, whereas comprehensive anti-aging strategies have emerged as the primary clinical management approach for facial aging due to their synergistic effects, prolonged efficacy, and reduced side effects. This review summarized the multilayered physiological mechanisms underlying facial aging, including epidermal atrophy, dermal degradation of collagen and elastin, subcutaneous fat atrophy, ligamentous laxity, and muscular tension imbalance. We also reviewed the assessment methods of facial aging, including Glogau grading, Fitzpatrick skin typing, VISIA imaging, and 3D modeling. Furthermore, we proposed a personalized combination therapy principle based on aging stages, skin types, and individual needs, and detailed the synergistic mechanisms and representative protocols integrating injectables, energy-based devices, and regenerative therapies. Finally, this review emphasizes the treatment sequence, complication prevention, and long-term maintenance, aiming to provide a scientific and systematic framework for facial rejuvenation in the clinic.

Melanoma is a malignant skin tumor characterized by high invasiveness and metastasis. Genomic mutations drive dysregulation of the immune microenvironment and the intracellular signaling network in melanoma. These pathways can be functionally classified into three categories: key pathways governing tumor initiation and progression, such as MAPK and PI3K/AKT, which drive cell proliferation and metabolic reprogramming via BRAF; phenotypic and invasive pathways, including TGF-β/Smad, Wnt/β-catenin and Notch, which multidimensionally regulate epithelial-mesenchymal transition and malignant progression; microenvironmental and immune escape pathways, such as NF-κB, Hedgehog, PD-1/PD-L1 and cuproptosis, which reshape tumor phenotypes by coupling redox homeostasis with immune suppression. Here, we reviewed the signaling pathways associated with melanoma and summarized novel biotherapeutic strategies across four aspects: gene editing and transcriptional regulation, nucleic acid-targeted therapy, novel delivery carriers and biological agents, and natural active molecules and small-molecule targeted therapy, aiming to provide new insights for the precise intervention in melanoma.

Keloids have a high recurrence after surgical excision and are hard to completely cure. Postoperative radiotherapy has become a comprehensive treatment for keloid after surgical excision and is widely used in clinical practice. Postoperative radiotherapy significantly reduces recurrence rates and improves treatment efficacy by inhibiting abnormal fibroblast proliferation and excessive collagen deposition, while maintaining an overall acceptable safety profile with mild, preventable adverse reactions. The intervention timepoint and radiotherapy dose are key parameters influencing clinical outcomes. Early intervention within 2 hours post-surgery yields optimal efficacy, with single-dose 10 Gy electron-beam radiotherapy or 20 Gy fractionated into 5 low-dose sessions as preferred clinical regimens. A safe and effective treatment window is within 24 hours. Compared with radiotherapy alone, combined regimens such as postoperative radiotherapy combined with botulinum toxin type A injections or refined suturing techniques can further optimize scar repair and reduce the risk of recurrence. In addition, the efficacy of radiotherapy varies across populations and body sites. Specifically, the high-tension skin areas and younger patients are at a higher risk of recurrence, making them candidates for postoperative radiotherapy. In summary, postoperative radiotherapy is an efficient and safe adjuvant after surgical excision. Personalized radiotherapy dose, treatment timepoint, and combined regimens, patient education, and improved multidisciplinary collaboration enhance the efficacy and mitigate risks. In the future, we should extend to large-sample, high-quality studies to promote personalized medicine.