Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"High-Intensity Focused Ultrasound for the Treatment of Infraorbital Fat Protrusion: A Preliminary Case Series.","authors":"Hyoung Moon Kim, Seung Min Oh, Myungjune Oh, Tatsuro Kamakura, Jean D A Carruthers, Eunsoo Park","doi":"10.2147/CCID.S643854","DOIUrl":"https://doi.org/10.2147/CCID.S643854","url":null,"abstract":"<p><p>Infraorbital fat (IOF) protrusion is a common feature of periorbital aging and is commonly managed with lower blepharoplasty. Although surgical approaches can provide predictable aesthetic outcomes, there remains interest in minimally invasive treatment options for appropriately selected patients. This preliminary case series evaluated the feasibility, short-term tolerability, and clinical outcomes of high-intensity focused ultrasound (HIFU) for the treatment of IOF protrusion. Three Korean patients (two female and one male; mean age, 48 years) underwent HIFU treatment using LinearZ device at focal depths of 4.5 and 9.0 mm following pre-treatment ultrasonography. Each treatment session delivered 0.6 J per shot in DOT mode under local anesthesia. Clinical photographs, patient satisfaction, and Global Aesthetic Improvement Scale (GAIS) scores were assessed three months after the final treatment session. All three patients showed clinically observable improvement in infraorbital bulging and lid-cheek contour, with high patient satisfaction. GAIS scores were 4, 5, and 4, respectively. Treatment was well tolerated, with transient erythema and edema reported and no major adverse events observed during follow-up. Given the very small sample size, absence of a control group, subjective and non-blinded outcome assessment, lack of systematic post-treatment imaging or quantitative fat measurements, and short follow-up, these findings should be considered preliminary and hypothesis-generating. Larger controlled studies incorporating objective outcome measures are warranted to establish efficacy, durability, and optimal treatment parameters of HIFU for IOF protrusion.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"643854"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105088","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":"Elevated IgE Levels in Psoriasis: An Atypical Subtype with Th2 Dominance and Overlapping Features of Atopic Dermatitis.","authors":"Leyao Shi, Sitan Dong, Dongmei Li, Huabao Xiong, Dongmei Shi","doi":"10.2147/CCID.S586000","DOIUrl":"https://doi.org/10.2147/CCID.S586000","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the potential impact of elevated IgE levels in psoriasis patients by exploring the responses of T cell subsets and B cell subsets, along with their associated cytokines.</p><p><strong>Patients and methods: </strong>Cytokine levels were measured using ELISA, and total IgE levels were measured using ELISPOT assay, along with PBMCs were collected for flow cytometry analysis to assess CD4⁺ T cell subsets (Th1, Th2, Th17) using their signature cytokines (IFN-γ, IL-4, IL-17A, respectively). Additionally, the expression of CD23 and CD19 on peripheral blood lymphocytes was measured to evaluate B cell responses.</p><p><strong>Results: </strong>Despite similar psoriasis area severity index (PASI) scores between the high-IgE psoriasis (H-PSO) and psoriasis vulgaris (PSO) groups, patients in the H-PSO group exhibited significantly higher peak pruritus numerical rating scale (NRS) scores. The elevated peripheral blood IgE levels in H-PSO patients were positively correlated with PASI scores, but not necessarily with peak pruritus NRS scores. Consistent with the elevation in IgE levels, Th2 cells and IL-4 cytokine levels were increased, along with the CD19⁺CD23⁺ cell population in H-PSO patients. Conversely, Th17 cells and associated IL-17A cytokine levels were more pronounced in H-PSO Conversely, the percentage of Th17 cells was significantly higher in H-PSO patients than in those with atopic dermatitis (AD), whereas IL-17A levels showed a similar trend that did not reach statistical significance; no significant differences were observed between H-PSO and PSO patients. The levels of Th1 cells and associated IFN-γ cytokines remained comparable not only between the two types of psoriasis but also between each psoriasis group and the AD group.</p><p><strong>Conclusion: </strong>These findings suggest distinct immune profiles in psoriasis patients with elevated IgE levels, characterized by heightened Th2 responses and CD23⁺ B cell populations, as well as a prominent Th17 response, underscoring the complexity of immune dysregulation in psoriasis.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"586000"},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105080","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":"High-Frequency Ion-Mediated Honeycomb Interval Puncturing Combined with Saturated Saline Soaking for Multiple Plantar Warts: A Retrospective Comparative Study.","authors":"Qiang Wang, Wenjun Zhong","doi":"10.2147/CCID.S639513","DOIUrl":"https://doi.org/10.2147/CCID.S639513","url":null,"abstract":"<p><strong>Objective: </strong> This retrospective study evaluated the clinical efficacy, safety profile, and long-term recurrence rate of honeycomb interval puncturing using high-frequency ion therapy combined with saturated saline soaking for multiple plantar warts, compared with saturated saline monotherapy.</p><p><strong>Methods: </strong> A total of 74 patients with clinically diagnosed multiple plantar warts were enrolled between January and December 2024. The observation group (n=42) received standardized honeycomb micropuncturing (hole spacing: 1.5-2.0 mm; pore diameter: 0.3-0.5 mm; puncture depth limited to stratum corneum and superficial dermal papillary layer), followed by room-temperature saturated saline soaking (30 minutes daily for 6 weeks) beginning 24 hours post-procedure. The control group (n=32) received identical saline soaking alone. Wart clearance, Visual Analogue Scale (VAS) pain scores, adverse events, and 12-month recurrence rates were assessed. Statistical analyses employed Chi-square and independent t-tests.</p><p><strong>Results: </strong> Baseline characteristics were comparable between groups (all P>0.05). At week 6, the observation group demonstrated significantly superior outcomes: complete wart clearance (95.0% vs 77.0%), complete patient remission (88.1% vs 65.6%), and overall effective rate (95.2% vs 75.0%). Mean time to therapeutic response was significantly shorter in the observation group (2.1±0.7 vs 3.8±0.9 weeks; P<0.05). Postoperative VAS score for local distending pain was 2.3±0.6. Pinhole scabs developed in 21.4% of patients and resolved spontaneously within 7-10 days. No wound infections, scar formation, or severe adverse events occurred. The 12-month recurrence rate was 2.70% in the observation group versus 14.29% in the control group.</p><p><strong>Conclusion: </strong> High-frequency ion-mediated honeycomb interval puncturing effectively disrupts the hyperkeratotic barrier and relieves intralesional pressure, enhancing saturated saline penetration. This combined regimen achieves faster responses, superior clearance, minimal trauma, and lower recurrence compared with monotherapy, representing a safe, cost-effective, and outpatient-friendly treatment modality for multiple plantar warts.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"639513"},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105098","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":"Evaluation of VISIA-Derived Erythema Metrics Against Blinded Clinician Assessment After Intense Pulsed Light Therapy in Erythematotelangiectatic Rosacea: A Real-World Cohort Study.","authors":"Birao Fan, Xingye Meng, Ruixing Yu","doi":"10.2147/CCID.S649214","DOIUrl":"https://doi.org/10.2147/CCID.S649214","url":null,"abstract":"<p><strong>Background: </strong>Erythematotelangiectatic rosacea (ETR) is characterized by persistent facial erythema, but objective evaluation of treatment response remains challenging. This study aimed to evaluate VISIA-derived erythema metrics against blinded clinician assessment and identify imaging-based thresholds associated with clinical improvement after intense pulsed light (IPL) therapy.</p><p><strong>Methods: </strong>This retrospective single-center real-world cohort study included 227 patients with ETR who completed three regular IPL sessions with paired baseline and post-treatment VISIA images. Three dermatologists independently performed blinded Clinician Erythema Assessment (CEA), and consensus scores were used as the clinical reference. Inter-rater reliability was assessed using quadratic weighted κ, and receiver operating characteristic (ROC) analysis with bootstrap resampling was performed to identify candidate VISIA thresholds corresponding to a ≥2-grade CEA reduction.</p><p><strong>Results: </strong>Blinded CEA demonstrated good-to-excellent reliability, with mean pairwise quadratic weighted κ values of 0.795 at baseline and 0.863 after treatment. VISIA erythema area, erythema concentration, and consensus CEA scores significantly improved after IPL therapy (all p<0.001). Changes in erythema area correlated more strongly with ΔCEA than erythema concentration (<i>ρ</i>=0.476 vs 0.308, both p<0.001). Percentage reduction in erythema area showed the highest discrimination for ≥2-grade CEA improvement (AUC=0.851; 95% CI, 0.797-0.901), with an optimal cutoff of 18.76% (sensitivity, 0.72; specificity, 0.93).</p><p><strong>Conclusion: </strong>VISIA-derived erythema area reduction correlated with blinded clinician-assessed improvement and may serve as an objective adjunct for monitoring IPL response in ETR. The 18.76% threshold is exploratory and requires external validation. Patient-reported outcomes were unavailable and should be incorporated in future prospective studies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"649214"},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105022","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":"Ultraviolet Radiation and the Skin Microbiome: Dose-Dependent Effects and Consequences for Epidermal Barrier Integrity.","authors":"Mihaela Zamfirescu, Sergiu Ioachim Chirila, Leonard Gurgas, Emma Gheorghe, Tony Hangan","doi":"10.2147/CCID.S630891","DOIUrl":"https://doi.org/10.2147/CCID.S630891","url":null,"abstract":"<p><p>The skin microbiome is continuously exposed to solar ultraviolet radiation (UVR), but the magnitude, direction and clinical meaning of the associated microbial changes remain uncertain. This narrative review critically evaluates evidence from controlled human, environmental, phototherapy, animal and in vitro studies linking UVA/UVB exposure to changes in skin microbial composition or function and to epidermal barrier outcomes. The available evidence indicates that UVA and UVB can alter community composition within minutes to days. However, these effects vary according to dose, wavelength, body site, host and sampling time, and may partly recover. The evidence does not support a universal pattern of decreased <i>Cutibacterium acnes</i> and increased <i>Staphylococcus aureus</i>. Dose is central to this relationship: repeated very-low or suberythemal exposure can induce antimicrobial peptides and adaptive responses, whereas single high exposures are more likely to cause inflammation, barrier injury and immunosuppression. Microbiome-dependent mechanisms include changes in tryptophan metabolites and AhR signaling, short-chain fatty acids, extracellular DNA and modulation of cytokine responses. Evidence from phototherapy studies shows that microbial remodeling can accompany clinical improvement, while sunscreen studies suggest that some formulations preserve microbial features without measurably disrupting dominant resident taxa. Because the available studies differ substantially in exposure, site, platform and endpoint, quantitative pooling is not currently defensible. Numerical results are therefore summarized in a structured evidence table Broad-spectrum photoprotection remains foundational. Microbiome-compatible formulations and microbial or metabolite adjuncts are promising but still require randomized, dose-resolved, multi-omic clinical validation.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"630891"},"PeriodicalIF":2.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105137","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":"Efficacy and Safety of Microneedle Fractional Radiofrequency Combined with Botulinum Toxin Type A for Periorbital Aging: A Retrospective Cohort Study.","authors":"Yaoying Li, Xueqin Chen, Lan Ge","doi":"10.2147/CCID.S620438","DOIUrl":"https://doi.org/10.2147/CCID.S620438","url":null,"abstract":"<p><strong>Purpose: </strong>To compare botulinum toxin type A (BoNT/A) alone with a single session of microneedle fractional radiofrequency (MFRF) followed by BoNT/A for periorbital aging.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 35 patients treated between May 2022 and May 2025. Patients received BoNT/A alone (n=20) or one MFRF session followed by BoNT/A 1 week later (n=15). Dynamic crow's feet, static crow's feet, static infraorbital fine lines, the Global Aesthetic Improvement Scale (GAIS), skin biophysical parameters, and adverse events were evaluated through week 24; patient satisfaction was assessed at week 12.</p><p><strong>Results: </strong>Dynamic crow's feet improved from baseline through week 16 in the BoNT/A group and through week 24 in the MFRF + BoNT/A group. Static crow's feet improved through week 12 and week 24, respectively. No individual follow-up comparison for static infraorbital fine lines remained significant after exact Wilcoxon testing and Holm adjustment. No between-group difference in wrinkle scores remained significant after Holm adjustment. GAIS was higher with combination treatment at week 16 (adjusted p=0.004). Compared with BoNT/A alone, the combination group showed a greater change in hydration at week 24 (adjusted p=0.021), greater improvement in elasticity at weeks 12, 16, and 24 (adjusted p≤0.002), and a transient increase in transepidermal water loss at week 2 (adjusted p<0.001). Procedural adverse events were transient, and no serious adverse events were documented.</p><p><strong>Conclusion: </strong>Both regimens improved dynamic and static crow's feet during early and intermediate follow-up. In exact multiplicity-adjusted within-group analyses, late improvement was not consistently maintained in the BoNT/A-alone group, whereas the combination group remained improved through week 24; however, no between-group wrinkle-score difference was statistically significant. In this small, predominantly female cohort, the combination regimen was associated with greater improvement in selected skin-quality outcomes. Larger prospective studies using standardized multi-session MFRF protocols are needed.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"620438"},"PeriodicalIF":2.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105089","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 and Topical Spironolactone in Adult Female Acne: A Narrative Review Comparing Systemic and Local Approaches.","authors":"Magdalena Łyko, Aleksandra Złotowska, Alina Jankowska-Konsur","doi":"10.2147/CCID.S630692","DOIUrl":"https://doi.org/10.2147/CCID.S630692","url":null,"abstract":"<p><strong>Background: </strong>Adult female acne (AFA) affects 12-45% of women over 25 years of age and is frequently resistant to conventional therapies. The antiandrogenic properties of spironolactone have positioned it as a promising non-antibiotic alternative. While oral spironolactone has been increasingly studied, its topical formulation remains comparatively underexplored, and recent evidence syntheses have generally pooled both routes of administration rather than comparing them within a framework specific to AFA.</p><p><strong>Objective: </strong>This narrative review synthesizes and critically compares the available evidence on the efficacy, safety, and practical considerations of oral versus topical spironolactone in AFA.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed and Google Scholar on 1 September 2025, using search terms combining adult female acne with spironolactone. Original clinical studies-randomized controlled trials, observational studies, and case series-were included. Preclinical studies, non-English-language articles, and non-original data were excluded.</p><p><strong>Results: </strong>Oral spironolactone (50-200 mg/day) consistently demonstrates significant reductions in inflammatory and non-inflammatory lesion counts and improves acne-specific quality of life. Head-to-head trials indicate comparable or superior efficacy relative to doxycycline, with longer treatment persistence than oral antibiotics. Topical spironolactone (2-5%) reduces comedones, papules, and pustules with minimal systemic absorption, suggesting a potential option for patients who are not candidates for systemic therapy. However, the evidence base for topical formulations remains limited by small sample sizes and heterogeneous study designs, and is derived largely from small mixed-sex or non-AFA cohorts and from pharmacokinetic studies in healthy volunteers; its applicability to AFA is therefore currently indirect and extrapolated.</p><p><strong>Conclusion: </strong>Oral spironolactone is supported by robust evidence as an effective non-antibiotic option for AFA and is suitable for moderate-to-severe disease, whereas topical spironolactone appears promising but remains supported by limited and partly indirect evidence, derived largely from small and heterogeneous studies, and may be appropriate for mild-to-moderate acne or when systemic therapy is contraindicated. Because no head-to-head trial has compared the two routes, the comparison presented here is necessarily indirect. Future research should prioritize head-to-head comparisons of both routes and standardization of topical formulations.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"630692"},"PeriodicalIF":2.5,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105074","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":"Osimertinib, a Trigger of Subacute Cutaneous Lupus Erythematosus: Three-Patient Case Series and Literature Review.","authors":"Joanna Nowiszewska, Mateusz Polaczek, Carolyn Szwed, Leszek Blicharz, Aleksandra Piórek, Lidia Rudnicka, Joanna Czuwara","doi":"10.2147/CCID.S616408","DOIUrl":"10.2147/CCID.S616408","url":null,"abstract":"<p><strong>Background: </strong>Osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is the standard first-line therapy for EGFR-mutant non-small cell lung cancer (NSCLC). While acneiform rash, pruritus, xerosis and paronychia are well-recognized cutaneous adverse events of EGFR-TKIs, drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is an emerging and under-recognized complication that may be misdiagnosed as eczema, psoriasis or drug allergic reaction, potentially leading to inappropriate management and permanent discontinuation of life-prolonging targeted therapy.</p><p><strong>Case presentations: </strong>We report three female patients (aged 55-80 years) with EGFR-mutant NSCLC who developed DI-SCLE during osimertinib therapy, presenting with characteristic annular and polycyclic erythematous plaques in a photodistributed location 3-17 months after treatment initiation. Histopathological examination revealed irregularly thin epidermis with dyskeratotic keratinocytes, interface lymphocytic infiltrate and vacuolar degeneration of the basal layer in all cases corresponding to subacute cutaneous lupus erythematosus. Direct immunofluorescence demonstrated immunoglobulin and complement deposition along the dermoepidermal junction in two of three patients (positive lupus band test). All patients were managed with systemic corticosteroids and antimalarials (hydroxychloroquine or chloroquine) additionally used in two patients. This approach enabled continuation or resumption of osimertinib.</p><p><strong>Conclusion: </strong>These three cases establish osimertinib-induced SCLE as a recognizable clinical entity. Early dermatologic referral with skin biopsy and direct immunofluorescence is essential for accurate diagnosis, enabling appropriate immunosuppressive management while preserving access to life-prolonging targeted therapy. Early recognition therefore allows appropriate dermatologic management while maintaining effective oncologic treatment.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"616408"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080017","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":"Refractory Adult-Onset Localized Cutaneous Langerhans Cell Histiocytosis Successfully Treated with Surgical Intervention: Case Report.","authors":"Yaru Tan, Junyou Zheng, Yabo Yao, Beilei Xu, Hao Song, Yan Wang, Wenbo Bu, Zhiwen Wang","doi":"10.2147/CCID.S634614","DOIUrl":"https://doi.org/10.2147/CCID.S634614","url":null,"abstract":"<p><p>Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder that frequently mimics common inflammatory dermatoses, often resulting in delayed diagnosis. We report a highly deceptive clinical presentation. A 36-year-old man presented with a five-year history of painful, refractory ulcerated plaques on his bilateral groins. Previous empirical therapies failed completely. A targeted skin biopsy eventually revealed classic atypical Langerhans cells with reniform nuclei, demonstrating striking immunohistochemical positivity for CD1a and CD207. Comprehensive systemic investigations confirmed isolated cutaneous involvement. Although subsequent trials of systemic agents-including thalidomide, methotrexate, and upadacitinib-were poorly tolerated and offered limited benefit, surgical excision ultimately achieved complete resolution. The patient has not presented recurrence at 18-month follow-up. This case highlights the critical necessity of an early biopsy for chronic intertriginous ulcers. Furthermore, it demonstrates that surgical management serves as a safe and durable definitive strategy for recalcitrant, localized cutaneous LCH.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"634614"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105100","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":"Burden, Trends, Associated Diseases and Predictions of Alopecia Areata in China, Japan, South Korea, and Globally: A GBD 2023 Analysis.","authors":"Yue Pan, Xianghui Li, Gao Wei, Zhijian Yao, Zhuren Ruan","doi":"10.2147/CCID.S646030","DOIUrl":"10.2147/CCID.S646030","url":null,"abstract":"<p><strong>Background: </strong>Alopecia areata (AA) causes non-scarring hair loss and substantial psychosocial burden, yet its trends, comorbidities, and future burden in East Asia remain underexplored.</p><p><strong>Methods: </strong>Global Burden of Disease(GBD) Study 2023 data from 1990-2023 were analyzed for the world, China, Japan, and South Korea. Age-standardized incidence (ASIR), prevalence (ASPR), and disability-adjusted life-year (DALY) rates were assessed by region, sex, and age. Joinpoint regression quantified temporal trends. Ecological correlations with associated diseases and socio-demographic Index (SDI) were examined. Burden through 2046 was projected using United Nations population estimates.</p><p><strong>Results: </strong>In 2023, Japan and South Korea had higher ASIR and ASPR than China and global averages. Females bore greater burden; incidence peaked in young-to-middle-aged adults. Global age-standardized rates(ASRs) declined (1990-2023), while rates remained stable in China and persistently high in Japan and South Korea. AA correlated with atopic dermatitis, iron deficiency anemia, and thyroid disorders. Higher SDI was associated with lower incidence in Japan, South Korea, and globally, but not in China. Substantial cases are projected through 2046.</p><p><strong>Conclusion: </strong>AA burden varies by region, sex, and age, and will continue to be a major public health issue. Clinicians should be particularly attentive to women and East Asian patients. While the etiology appears multifactorial, causality remains to be confirmed at the individual level. Nevertheless, these findings support more vigilant screening and tailored prevention in high-risk East Asian populations.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"646030"},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073698","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}