Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Standardized Clinical Photography for Improving Dermatological Treatment Adherence (Scoping Review): Evidence Landscape and Research Gaps.","authors":"Naisu Cao, Yi Hu, Xiaqing Wang, Siqi Wu, Mengjie Zhang","doi":"10.2147/CCID.S639866","DOIUrl":"https://doi.org/10.2147/CCID.S639866","url":null,"abstract":"<p><p>Treatment adherence remains suboptimal across chronic dermatological conditions, contributing to poor clinical outcomes and increased healthcare burden. Despite the established role of standardized clinical photography in clinical documentation, its specific application as an adherence-promoting intervention remains poorly characterized. This scoping review aimed to systematically map the literature on photographic feedback in dermatology, identify research gaps, and propose methodological recommendations for future randomized controlled trials (RCTs). We conducted a scoping review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Systematic searches of PubMed, Embase, Cochrane Library, and Web of Science, supplemented by Europe PMC, ClinicalTrials.gov, WHO ICTRP, and Google Scholar (first 200 records), were performed from database inception to December 31, 2025 (searches executed September 20-27, 2026). Of 1181 identified records, 18 studies met the eligibility criteria: five provided direct evidence, five indirect evidence, and eight methodological evidence. Direct evidence comprised three observational studies in hair loss disorders encompassing 3,218 patients (93% of participants derived from a single retrospective cohort), one virtual feasibility study in atopic dermatitis, and one remote photographic wound-monitoring study in keloids; the remaining five prespecified conditions (psoriasis, acne, vitiligo, rosacea, and melasma) yielded zero direct evidence, although vitiligo has an established methodological photography literature. Of the five direct-evidence studies, four measured motivation, satisfaction, task completion, or image-upload compliance rather than treatment adherence per se. Indirect evidence from smartphone applications exists for psoriasis and atopic dermatitis, but these bundle photography with other digital functions. We propose the \"early difference refutation\" design to address reverse causality in future RCTs. High-quality RCTs are urgently needed to determine whether photographic feedback alone can improve dermatological treatment adherence.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"639866"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Upadacitinib Combined with Phototherapy for Progressive Vitiligo in 7-Year-Old Children: A Two-Case Report.","authors":"Yu Jiang, Zhirong Shu, Shilin Deng, Tingnan Chen, Xiaohong Lin, Jingyao Liang, Yaping Tang","doi":"10.2147/CCID.S636036","DOIUrl":"10.2147/CCID.S636036","url":null,"abstract":"<p><p>We report two 7-year-old children with progressive vitiligo despite prior topical therapy and phototherapy; one patient had also received low-dose systemic corticosteroid therapy. Oral upadacitinib, a selective Janus kinase 1 (JAK1) inhibitor, was initiated at 15 mg once daily in both patients in combination with phototherapy. The boy underwent 308-nm excimer laser therapy every 3 days, whereas the girl received narrowband ultraviolet B phototherapy at the same interval. Before treatment, baseline screening was performed to exclude contraindications, and no clinically significant abnormalities were identified. After 4 weeks, both patients showed rapid repigmentation and a reduction in lesion extent. The boy with facial vitiligo achieved near-complete repigmentation (Vitiligo Area Scoring Index [VASI] reduced from 0.4 to nearly 0), while the girl with non-segmental vitiligo involving the trunk and extremities showed progressive repigmentation (VASI reduced from 2.7 to approximately 1.0 by week 8). Follow-up laboratory tests during upadacitinib treatment, including complete blood counts, liver and renal function tests, and lipid profiles, remained within normal limits, and no clinically significant adverse events were observed during 18-20 weeks of treatment. Oral upadacitinib combined with phototherapy was associated with rapid disease stabilization and repigmentation in these two children, although larger and longer-term studies remain necessary.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"636036"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Albumin and Inflammation-Nutrition Burden in Adult Hospitalized Atopic Dermatitis: A Case-Control Study with Complementary Genetic Evidence.","authors":"Canni Gao, Peijia Zhang, Yi Yang, Wentao Lv, Mei Luan, Kuanhou Mou, Pan Li, Ruimin Bai","doi":"10.2147/CCID.S644991","DOIUrl":"10.2147/CCID.S644991","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin disease that may involve systemic inflammation and metabolic disturbance. Serum albumin (Alb) is a routinely available negative acute-phase protein, but its association with hospitalized AD and sphingomyelin-related metabolic signals remains unclear.</p><p><strong>Methods: </strong>This single-center retrospective case-control study included 814 adults (381 hospitalized patients with AD and 433 lipoma surgical inpatient controls). Alb was evaluated continuously, per standard-deviation increment, and by quartiles using multivariable logistic regression, restricted cubic splines, sensitivity analyses, and propensity-score matching. Two-sample Mendelian randomization (MR) provided complementary genetic evidence, and exploratory two-step MR examined a prespecified sphingomyelin-related phenotype.</p><p><strong>Results: </strong>Alb was lower in patients with AD than in controls (38.9 ± 4.6 vs 41.2 ± 5.0 g/L; <i>P</i><0.001). In the fully adjusted model, each 1-g/L increase in Alb was associated with lower odds of hospitalized AD status (OR=0.92, 95% CI: 0.89-0.96; <i>P</i><0.001), with consistent findings across standardized, quartile, spline, sensitivity, and matched analyses. In the primary IVW analysis, genetically predicted higher Alb was associated with lower AD risk (OR=0.693, 95% CI: 0.519-0.926; <i>P</i>=0.013), whereas complementary MR estimates were not uniformly significant. Exploratory two-step MR showed associations of higher genetically predicted Alb with lower levels of the prespecified sphingomyelin-related phenotype and of higher sphingomyelin-related levels with greater AD risk.</p><p><strong>Conclusion: </strong>Lower serum Alb was consistently associated with hospitalized adult AD status and may provide adjunctive information on systemic inflammation-nutrition burden in this inpatient setting. MR findings were supportive but not uniformly consistent, and the sphingomyelin analysis was exploratory rather than evidence of mediation. Prospective longitudinal studies incorporating standardized AD severity scores and serial Alb measurements are warranted.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"644991"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Refractory Pemphigus Vulgaris with Ultra-Low-Dose Rituximab in a High-Risk Patient: A Case Report.","authors":"Hui Wang, Zhanglei Mu, Yu Zhong, Guangdong Wen, Yan Zhao, Kun Li","doi":"10.2147/CCID.S642757","DOIUrl":"10.2147/CCID.S642757","url":null,"abstract":"<p><p>Pemphigus vulgaris is a rare autoimmune blistering disease that causes painful erosions on the skin and mucous membranes. Standard treatments include corticosteroids, immunosuppressants, and rituximab. However, managing pemphigus vulgaris in elderly patients with comorbidities remains challenging. We report a 73‑year‑old male patient who had pemphigus vulgaris poorly controlled by glucocorticoids and a history of malignancy after surgical resection. He was then treated with add-on ultra‑low‑dose rituximab (100 mg) combined with methylprednisolone. The patient achieved complete clinical remission without significant adverse events. The response has been sustained during 6 months of follow‑up. Our case suggests that ultra‑low‑dose rituximab may be a safe and effective option for selected patients with refractory pemphigus vulgaris, particularly those with advanced age or cancer. Longer follow-up and further studies are needed to evaluate its long-term efficacy and safety.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"642757"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy-Based Devices for GLP-1 Receptor Agonist-Associated Facial Aging: A Tissue-Specific Safety Framework.","authors":"Chang-Hwan Cho, Soyoun Koo, Kyounghun Yoo","doi":"10.2147/CCID.S628537","DOIUrl":"10.2147/CCID.S628537","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonist (GLP-1RA)-associated rapid weight loss may be accompanied by facial changes resembling accelerated aging, colloquially termed \"Ozempic face\". In this review, this proposed phenotype is termed GLP-1RA-associated facial accelerated aging (GLP-1RA-FAA) and is characterized primarily by facial volume loss and skin laxity, with possible but incompletely characterized alterations in dermal-adipose support, adipose-derived stem-cell biology, fibroblast-extracellular-matrix homeostasis, and facial muscle. Demand for energy-based device (EBD) treatment in this population is increasing; however, whether conventional EBD parameters are effective or safe in medication-associated facial volume depletion is unknown. A narrative review was informed by structured searches of PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library from January 2000 through August 31, 2026. Evidence was selected for clinical directness and relevance to radiofrequency, high-intensity focused ultrasound, broadband light, microwave, extracorporeal shock wave therapy, diode laser, and synchronized radiofrequency with high-intensity facial electrical stimulation. Available modalities differ in their intended tissue depth and in the potential relevance of three conceptual targets: preservation of adipose tissue, dermal fibroblast-extracellular-matrix remodeling, and facial muscle-SMAS support. Preclinical body-contouring studies suggest that sustained subcutaneous heating in the approximate 43-45°C range can be associated with adipocyte injury or apoptosis; however, no facial thermal dose threshold has been established, particularly in GLP-1RA-treated patients. No individual EBD modality has demonstrated simultaneous restoration of adipose, dermal, and muscle-related targets in prospective GLP-1RA-specific studies. Conservative control of treatment depth, careful avoidance of unnecessary deep energy deposition in volume-depleted regions, investigation of low-intensity dermal remodeling strategies, and evaluation of muscle-targeting approaches are proposed as research considerations. These concepts are hypothesis generating and do not constitute clinical recommendations or standards of care. Prospective controlled studies in well-characterized GLP-1RA-treated populations are required before device-specific protocols can be adopted.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628537"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary Apocrine Duct Obstruction in the Context of Long-Term Antiperspirant Use: A Case Report.","authors":"Mei Xiong, Zhongqiu Huang","doi":"10.2147/CCID.S640319","DOIUrl":"10.2147/CCID.S640319","url":null,"abstract":"<p><p>Axillary osmidrosis (bromhidrosis) is a distressing condition primarily caused by bacterial degradation of apocrine gland secretions, with eccrine sweat creating a moist environment that promotes bacterial proliferation. Aluminium salt-containing antiperspirants are widely used to reduce sweating by transiently obstructing eccrine sweat ducts, thereby indirectly alleviating malodour. However, their long-term effects on apocrine glands remain poorly understood. We report the case of a 34-year-old woman with a 20-year history of axillary osmidrosis who had used an aluminium chloride-containing antiperspirant daily for many years. She had been instructed to discontinue all antiperspirants 72 hours before surgery but reapplied the product approximately 24 hours preoperatively. During planned minor-incision excision of the apocrine glands, multiple white, well-circumscribed spherical masses were unexpectedly identified within the superficial subcutaneous tissue of both axillae and were readily dissected from the surrounding connective tissue. Histopathological examination demonstrated apocrine gland hyperplasia with focal ductal ectasia and retained secretory material, suggestive of chronic ductal obstruction. The patient recovered uneventfully, with marked improvement in axillary malodour. To our knowledge, this is the first report to describe such intraoperative and histopathological findings in a long-term user of an aluminium-containing antiperspirant. However, aluminium-specific staining was not performed and the presence of aluminium in the excised tissue could therefore not be confirmed; the observed association with antiperspirant use remains temporal rather than causal. Clinicians should remain aware of potential structural alterations of the apocrine glands in long-term users and consider discontinuing antiperspirants before axillary surgery.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"640319"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age‑Related Remodeling of the Skin Microbiome in Healthy Women: Site‑Specific Patterns Between Sebaceous and Dry Skin Regions.","authors":"Jin Zhou, Annette Mehling, Yuhua Ye, Ying Guo, Xinyue Hu, Liya Song","doi":"10.2147/CCID.S626939","DOIUrl":"10.2147/CCID.S626939","url":null,"abstract":"<p><strong>Background: </strong>Skin microbial communities are closely related to skin physiological status and may change with both body site and age. However, age‑related variations in the healthy skin microbiome, particularly across skin sites with distinct physiological properties, remain inadequately characterized due to limited coverage of different skin sites and insufficient analyses combining age with site‑specific physiological characteristics.</p><p><strong>Objective: </strong>To characterize age-related and site-specific differences in the bacterial communities of healthy skin and to explore their associations with skin physiological parameters.</p><p><strong>Methods: </strong>The bacterial communities of the forehead (sebaceous site) and forearm (dry site) were analyzed in 98 healthy women aged 18-70 years using 16S rRNA gene sequencing. Skin hydration, transepidermal water loss, and sebum levels were measured, and differences among age groups and skin sites were compared.</p><p><strong>Results: </strong>Age-related variation was observed in the microbiota of both skin sites. Alpha diversity increased with age in both the forehead and forearm, and this increase was most pronounced in the elderly group. On the forehead, aging was characterized mainly by a decrease in <i>Cutibacterium</i> (-54.83%) and increases in <i>Corynebacterium</i> (460.00%), <i>Micrococcus</i> (367.08%), <i>Paracoccus</i> (450.63%), and <i>Kocuria</i> (239.24%). On the forearm, aging was characterized by decreases in <i>Staphylococcus</i> (-36.01%), <i>Streptococcus</i> (-42.92%), <i>Cutibacterium</i> (-82.33%), and <i>Lactobacillus</i> (-41.27%), together with increases in <i>Paracoccus</i> (605.02%) and <i>Chryseobacterium</i> (900.00%). Across skin sites, the forearm showed higher bacterial diversity, whereas the forehead was dominated by <i>Cutibacterium</i>, whose abundance was positively correlated with sebum levels (R = 0.51193, <i>P=</i>0.00001) and decreased with age. Network analysis showed denser inter-genus associations in the forehead microbiota than in the forearm microbiota.</p><p><strong>Conclusion: </strong>Both age and skin site were associated with variation in the bacterial diversity and composition of healthy skin. Within the same skin site, age-related microbial variation was more closely aligned with changes in sebum than with hydration-related parameters. These findings provide a basis for understanding microbiome changes during skin aging and may be relevant to site-specific skin care strategies. As a cross‑sectional study with a sample of healthy women from Beijing, our findings require further validation in broader populations before generalizing.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"626939"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Scedosporiosis with Generalized Tinea Corporis in a Patient with Chronic Heavy Alcohol Use: A Case Report.","authors":"Chengxiang Lian, Jiaguang Su","doi":"10.2147/CCID.S637741","DOIUrl":"https://doi.org/10.2147/CCID.S637741","url":null,"abstract":"<p><p>We report a case of <i>Scedosporium boydii</i> (<i>S. boydii</i>)-induced cutaneous infection combined with generalized tinea corporis in a male patient with a long history of heavy alcohol consumption. The clinical presentation, diagnostic findings, treatment course, and outcome are described, together with a review of the relevant literature. A 63-year-old man presented with a 3-week history of generalized erythematous papules, plaques, scaling, and pain. The diagnosis was established through skin biopsy and mycological examination. Following systemic azole therapy, topical antifungal treatment, and supportive care, the patient's skin lesions and associated symptoms improved substantially. Cutaneous <i>S. boydii</i> infection is rare and may be difficult to distinguish from other infectious or inflammatory skin disorders. Voriconazole is generally considered a preferred systemic treatment, although therapeutic decisions should be guided by species identification, susceptibility data when available, and the patient's clinical condition. Chronic heavy alcohol consumption may have contributed to increased susceptibility in this patient, but a causal relationship cannot be established from a single case. Early tissue sampling and mycological evaluation are important for timely diagnosis and appropriate treatment.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"637741"},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiologic Aspects of Dark Eye Circles and Impact on Associated Quality of Life in Participants with Various Fitzpatrick Skin Types.","authors":"Lisa T Goberdhan, Katie Schneider, Giovanni Pellacani, Brian Biesman, Tsing Cheng, Elizabeth Makino","doi":"10.2147/CCID.S605666","DOIUrl":"https://doi.org/10.2147/CCID.S605666","url":null,"abstract":"<p><strong>Purpose: </strong>Dark eye circles (DECs) are a prevalent cosmetic concern for understanding the pathophysiological properties and etiology of DECs is crucial for effective treatment. This study assessed baseline DEC characteristics and associated quality of life (QOL) impacts in participants with varying DEC severities and Fitzpatrick Skin types (FSTs).</p><p><strong>Participants and methods: </strong>Adult with DECs across FSTs were enrolled into this observational study. Assessments were grouped as follows: clinical (investigator grading of DEC severity, DEC type, and puffiness), biophysical (spectrophotometry, corneometry, tewametry, and BTC-2000 elasticity/laxity measurements), imaging (standardized photography, 3D imaging, and dynamic optical coherence tomography [D-OCT]), and patient-reported outcomes (FACE-Q and participant questionnaires). Results were summarized descriptively by DEC severity and FST; statistical testing was performed for D-OCT comparisons across FST groups.</p><p><strong>Results: </strong>All 42 participants who completed the study had at least mild DEC severity in both lower and upper eyelids, with severe DEC incidence similar on the upper and lower eyelid. Most exhibited multiple DEC types (ie, pigmented, vascular, shadow effect) and mild eye area puffiness. Participants with mild DECs had the highest mean eyelid skin elasticity. Participants with moderate DECs showed transepidermal water loss (TEWL) measurements suggestive of high hydration and barrier function in the lower eyelid skin. Participants of all DEC severities were bothered by their upper and lower eyelids. Those with severe DEC reported on the FACE-Q more negative perceptions of their facial skin age and eyelid appearance and were less confident or positive about their facial appearance. DEC severity was highest in participants with FST V-VI. Pigmented and shadow effect DECs were observed more in FST III-IV and V-VI, whereas vascular DECs appeared most in FST I-II. Spectrophotometer results showed that the difference between control and lower eyelid skin was broadly similar across FST groups. D-OCT revealed that the FST V-VI group had significantly thinner vascular networks, but significantly higher epidermal thickness (P < 0.05) than the other FST groups. Participants with FST V-VI felt more positive perceptions about their skin age; however, types III-IV and V-VI were more bothered by their lower eyelids than types I-II.</p><p><strong>Conclusion: </strong>DECs are present on the upper and lower eyelids and participants are bothered by both areas regardless of severity. DEC characteristics varied according to severity and FST and influenced participant-based perception of eyelid appearance, facial age, and confidence.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"605666"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory Identification of Multidimensional Treatment-Response Profiles in Androgenetic Alopecia Treated with Combined Scalp Microneedling and Topical Minoxidil Using Unsupervised Clustering.","authors":"Yibei Wu, Dihui Liu, Ying-Mei Lin, Hui Tang, Fujun Ouyang, Mingzhu Yao","doi":"10.2147/CCID.S636889","DOIUrl":"https://doi.org/10.2147/CCID.S636889","url":null,"abstract":"<p><strong>Background: </strong>Combination therapy with scalp microneedling and topical minoxidil is more effective than minoxidil alone in androgenetic alopecia (AGA), yet treatment responses vary considerably among patients and the multidimensional structure of this heterogeneity remains poorly characterized.</p><p><strong>Objective: </strong>To explore whether unsupervised clustering identifies distinct multidimensional treatment-response profiles during combination therapy and to describe their clinical and molecular characteristics as a hypothesis-generating basis for personalized management.</p><p><strong>Methods: </strong>In this prospective cohort study, 156 patients with AGA received standardized combination therapy (microneedling 1.0 mm depth, biweekly; 5% topical minoxidil, twice daily) for 24 weeks, with longitudinal trichoscopic, molecular and clinical assessments. K-means clustering was applied to ten standardized treatment-response (change-from-baseline) variables; the number of clusters was examined by silhouette, gap-statistic and bootstrap-stability analyses, and between-profile differences were tested with assumption-appropriate methods and reported with effect sizes.</p><p><strong>Results: </strong>Silhouette analysis indicated weak global cluster structure (k=2, 0.274; k=3, 0.168); a three-cluster solution was retained as an exploratory, clinically motivated grouping and labelled Robust (n=45, 28.8%), Moderate (n=56, 35.9%) and Limited (n=55, 35.3%) responders. Profiles differed across the response variables that defined them, including hair-density change (36.25±19.07 vs 17.76±10.93 hairs/cm² for Robust vs Limited; ε²=0.19) and Wnt10b transcript change (0.80±0.37 vs 0.27±0.19; ε²=0.34). Baseline clinical and molecular parameters, including LEF-1 and IGF-1, did not differ across profiles and did not predict profile membership.</p><p><strong>Conclusion: </strong>Unsupervised clustering identified three clinically interpretable treatment-response profiles accompanied by graded differences in Wnt/β-catenin-associated transcript changes. Because the profiles showed weak internal separation and could not be predicted from baseline characteristics, these hypothesis-generating findings suggest, rather than demonstrate, multidimensional structure in treatment response and require validation in independent, controlled cohorts before any clinical application.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"636889"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}