Journal of Dermatology最新文献

{"title":"The impact of antibiotic therapy in psoriasis patients with active streptococcal infection: A prospective study","authors":"D. Bonciani,&nbsp;C. Della Bella,&nbsp;A. Corrà,&nbsp;A. Galano,&nbsp;G. Vaggelli,&nbsp;S. Tapinassi,&nbsp;A. Grassi,&nbsp;E. Mantengoli,&nbsp;A. Coi,&nbsp;L. Quintarelli,&nbsp;E. B. Mariotti,&nbsp;C. Aimo,&nbsp;V. Ruffo di Calabria,&nbsp;E. Garufi,&nbsp;V. Volpi,&nbsp;A. Verdelli,&nbsp;G. M. Rossolini,&nbsp;A. Bartoloni,&nbsp;M. M. D'Elios,&nbsp;M. Caproni","doi":"10.1111/1346-8138.17645","DOIUrl":"10.1111/1346-8138.17645","url":null,"abstract":"<p>The association between psoriasis and streptococcal infection has been widely explored in both children and adults. However, the exact impact of Streptococcus pharyngeal infection on the course of psoriasis is not fully comprehended. This study explored the impact of Streptococcus pharyngeal infection on psoriasis and investigated the effectiveness of systemic antibiotic therapy in conjunction with standard topical treatment for psoriatic patients with concomitant streptococcal throat infection. The research involved 115 patients with mild-to-moderate psoriasis, clinically assessed using the Psoriasis Area and Severity Index (PASI). Patients with active streptococcal infection were administered adjunctive systemic antibiotic therapy along with standard local treatment for psoriasis, while psoriasis patients without evidence of infection received the local topical treatment only. Streptococcal infections were more common in psoriasis patients compared to healthy controls. A group of psoriasis patients with active streptococcal throat infections, treated with antibiotics in addition to standard topical psoriasis therapy, did not show any difference in PASI score reduction compared to those without evidence of active infection. While our study did not show a statistically significant reduction in PASI scores in psoriasis patients with streptococcal throat infections treated with antibiotics, it highlights the complex interaction between infection and psoriasis. Larger studies with longer follow-up may better clarify this relationship, contributing to stronger evidence for or against the use of antibiotics in managing psoriasis triggered by streptococcal infections.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 3","pages":"432-438"},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for the management of drug-induced hypersensitivity syndrome 2023","authors":"Yoshiko Mizukawa,&nbsp;Natsumi Hama,&nbsp;Hiroyuki Niihara,&nbsp;Fumi Miyagawa,&nbsp;Hideo Hashizume,&nbsp;Mikiko Tohyama,&nbsp;Hayato Takahashi,&nbsp;Hideaki Watanabe,&nbsp;Manabu Ohyama,&nbsp;Yukie Yamaguchi,&nbsp;Tatsuyoshi Kawamura,&nbsp;Takashi Nomura,&nbsp;Kenji Kabashima,&nbsp;Hirohiko Sueki,&nbsp;Eishin Morita,&nbsp;Riichiro Abe,&nbsp;Hideo Asada","doi":"10.1111/1346-8138.17609","DOIUrl":"10.1111/1346-8138.17609","url":null,"abstract":"<p>Drug-induced hypersensitivity syndrome (DIHS) is one of the severe drug eruptions accompanied by fever and multiple organ dysfunction, and it is induced by a relatively limited range of drugs, including anticonvulsants. A distinctive feature of this condition is its association with the reactivation of herpes viruses, particularly human herpesvirus 6. The pathogenesis involves two key factors: drug allergy and herpesvirus reactivation. DIHS is often challenging to diagnose in its early stages, and its clinical course varies widely, ranging from relatively mild to life-threatening cases. Additionally, unexpected complications, such as autoimmune diseases, may occur during the convalescent phase. As a result, diagnosing, treating, and predicting the prognosis of DIHS remain complex issues. In response to these challenges, the Ministry of Health, Labour and Welfare Study Group on Severe Erythema Multiforme has taken the lead in developing new guidelines for the management of DIHS. These guidelines aim to support clinical practice by providing up-to-date, evidence-based information on the diagnosis, treatment, and prognosis of DIHS.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 3","pages":"e189-e209"},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of warts in toe webs due to HPV type 7: Case report and literature review","authors":"Mei Tochigi,&nbsp;Yuko Takamiya,&nbsp;Sawako Ochiai,&nbsp;Kazushi Anzawa,&nbsp;Kiyohiro Tsutsui,&nbsp;Akira Shimizu","doi":"10.1111/1346-8138.17653","DOIUrl":"10.1111/1346-8138.17653","url":null,"abstract":"<p>“Butcher's warts” are skin lesions caused by human papillomavirus type 7 (HPV type 7). Another clinically distinctive lesion, “warts in toe webs” (WTW), localized between the toes, has also been reported but remains poorly understood. We report the case of an 84-year-old man with a refractory, cauliflower-like lesion between his toes which was unresponsive to yokuinin and liquid nitrogen cryotherapy. The patient had no history of meat of fish handling. Biopsy revealed papillary thickening of the stratum corneum and vacuolated cells. Polymerase chain reaction and immunohistochemistry analysis confirmed HPV type 7. Treatment modifications, including maintaining a dry interdigital environment, led to resolution within 2 months. Our review of 19 previously reported WTW cases indicates a distinct clinical profile: all cases involved males from Asia, with a prevalence of fungal coinfection. This case indicates the importance of HPV typing for diagnosis and maintaining a dry interdigital environment to enhance treatment outcomes.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 4","pages":"754-757"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world 52-week effectiveness of deucravacitinib in psoriasis: A stratified analysis by age and body mass index","authors":"Teppei Hagino,&nbsp;Marina Onda,&nbsp;Hidehisa Saeki,&nbsp;Eita Fujimoto,&nbsp;Naoko Kanda","doi":"10.1111/1346-8138.17617","DOIUrl":"10.1111/1346-8138.17617","url":null,"abstract":"<p>Deucravacitinib, an oral tyrosine kinase 2 inhibitor, is effective for psoriasis. However, long-term real-world effectiveness stratified by age and body mass index (BMI) has not been precisely examined. This study aimed to evaluate 52-week real-world effectiveness of deucravacitinib in psoriasis patients, stratified by age (≥65 years vs &lt;65 years) and BMI (≥25 vs &lt;25). A prospective study was conducted from December 2022 to August 2024, involving 107 Japanese patients aged ≥15 years with moderate to severe psoriasis. Patients received 6 mg of deucravacitinib daily for 52 weeks. Therapeutic effectiveness was evaluated by the achievement rates of Psoriasis Area and Severity Index (PASI) 75, PASI 90, PASI 100, and other key clinical indices. Data were stratified by age and BMI. Mean PASI scores decreased until week 52 similarly in all patients’ groups stratified by age or BMI. The achievement rates of PASI 75, PASI 90, and PASI 100 at week 52 were 86.36%, 59.09%, and 13.64% in patients aged ≥65 years, while they were 86.36%, 65.22%, and 39.13% in patients aged &lt;65 years, respectively, showing a slightly lower rate of PASI 100 in patients ≥65 years. The achievement rates of PASI 75, PASI 90, and PASI 100 at week 52 were 81.82%, 73.33%, and 18.18% in patients with BMI ≥25, while they were 88.24%, 82.86%, and 29.41% in patients with BMI &lt; 25, respectively, and these rates at weeks 4, 16, 24, and 40 were slightly lower in patients with BMI ≥25. Deucravacitinib improved clinical indices of psoriasis patients during a 52-week period in all patients' groups stratified by age or BMI. The present results indicate that deucravacitinib may be effective for elderly psoriasis patients as well as younger or middle-aged patients, while effectiveness in patients with BMI ≥25 may be slightly lower compared with those with BMI &lt; 25.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 4","pages":"663-671"},"PeriodicalIF":2.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers associated with progression of infantile hemangioma: Exploratory study","authors":"Ken Miyazaki,&nbsp;Kayo Kunimoto,&nbsp;Shiho Yasue,&nbsp;Saori Endo,&nbsp;Akifumi Nozawa,&nbsp;Michio Ozeki,&nbsp;Takuma Ishihara,&nbsp;Minako Tanaka,&nbsp;Nobuyuki Kakimoto,&nbsp;Tomohiro Suenaga,&nbsp;Daisuke Tokuhara,&nbsp;Hidenori Ohnishi,&nbsp;Yuri Inose,&nbsp;Masatoshi Jinnin","doi":"10.1111/1346-8138.17639","DOIUrl":"10.1111/1346-8138.17639","url":null,"abstract":"<p>To identify patients with infantile hemangioma (IH) in need of early-stage treatment in this multicenter, prospective, observational study, we investigated the potential of plasma cytokines as a clinically useful marker. Plasma samples were collected at three time points from 41 patients with infantile hemangioma: baseline (days 14–60 after delivery), visit 1 (days 61–150, the proliferative phase), and visit 2 (days 151–395, the involuting phase). With a twofold or more increase in tumor volume during the baseline–visit 1 period regarded as progression, progression was seen in 15 cases (36.6%). In the first step, cytokine arrays were performed using plasma samples in five progressive and five non-progressive cases. Plasma levels of six cytokines at baseline were selected for a prediction marker of change in tumor volume during baseline–visit 1. Validation enzyme-linked immunosorbent assay indicated that the baseline growth differentiation factor 1 (GDF1) concentration tended to correlate with the proliferation ratio of total lesions or target lesion during baseline–visit 1, although without statistical significance. However, the plasma GDF1 concentrations were significantly lower in patients with a fourfold or more increase in total volume (<i>p</i> = 0.013). Furthermore, changes in plasma interleukin (IL)-7Rα levels showed a statistically significant inverse correlation between volume change of the target lesion during baseline–visit 1 (<i>p</i> = 0.0069). Our results suggest that plasma GDF1 measurement after birth is a useful marker for progression of IH. Additionally, the downregulation of IL-7Rα that begins several months after birth may also contribute to tumor growth. (UMIN-CTR: UMIN000038574).</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 4","pages":"712-725"},"PeriodicalIF":2.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for treatment responses to baricitinib in severe alopecia areata: A retrospective, multivariate analysis of 70 cases from a single center","authors":"Moyuka Wada-Irimada,&nbsp;Takehiro Takahashi,&nbsp;Mana Sekine,&nbsp;Toshiki Okazaki,&nbsp;Takuya Takahashi,&nbsp;Tomoko Chiba,&nbsp;Emi Yamazaki,&nbsp;Kosuke Shido,&nbsp;Toshiya Takahashi,&nbsp;Masato Mizuashi,&nbsp;Yoshihide Asano","doi":"10.1111/1346-8138.17641","DOIUrl":"10.1111/1346-8138.17641","url":null,"abstract":"<p>Alopecia areata (AA) is a chronic, autoimmune skin disease characterized by non-scarring hair loss. Baricitinib, a Janus kinase inhibitor (JAKi), prevents hair loss and promotes hair regrowth by inhibiting the inflammatory Janus kinase-signal transducer and activator of transcription (JAK–STAT) signaling pathway involved in cytotoxic T cell responses targeting hair follicles. The introduction of JAKi has transformed treatment against severe AA. However, treatment responses to JAKi are highly variable among patients, and the predictors of responsiveness remain insufficiently elucidated. This study aimed to identify independent predictive factors for the efficacy of baricitinib in patients with severe AA using multivariate analyses. A retrospective study was conducted on 70 severe AA patients who started baricitinib treatment at Tohoku University Hospital between July 2022 and August 2023. The primary outcome was the percentage of patients achieving a Severity of Alopecia Tool (SALT) score of ≤20 after 9 months of baricitinib treatment. Multivariate analysis assessed potential predictors of baricitinib treatment responses, including AA type, sex, age, disease duration, history of atopic dermatitis, intravenous methylprednisolone pulse (IVMP) therapy, and Clinician-Reported Outcome (ClinRO) measures for eyebrows and eyelashes. Achievement of a SALT score of ≤20 and SALT score improvement rates were used as objective variables in the multivariate analyses. Among the 70 patients completing 9 months of baricitinib treatment, 41% achieved a SALT score of ≤20. Multivariate analyses identified several independent predictors for positive outcomes, including shorter disease duration (≤4 years), history of IVMP, therapy SALT score of ≤95 at baricitinib initiation, and female sex. Further, we found differential response patterns based on AA type and sex. Specifically, AA type significantly influenced treatment responses, with ophiasis alopecia (OA) associated with the poorest improvement rate. In summary, the response to baricitinib in AA is significantly influenced by sex, AA type, disease duration, history of IVMP, and pre-treatment SALT score.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 4","pages":"701-711"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repurposing diacerein for the treatment of chronic wounds in recessive-dystrophic epidermolysis bullosa patients by modulating matrix metalloproteinase-9 expression","authors":"Sonja Dorfer,&nbsp;Michael Ablinger,&nbsp;Monika Wimmer,&nbsp;Julia I. Hummel,&nbsp;Selma Ibrahimpašić,&nbsp;Anja Diem,&nbsp;Martin Laimer,&nbsp;Stefanie Gruner,&nbsp;Josefina Piñón Hofbauer,&nbsp;Christina Guttmann-Gruber,&nbsp;Ulrich Koller,&nbsp;Iris K. Gratz,&nbsp;Johann W. Bauer,&nbsp;Roland Zauner,&nbsp;Verena Wally","doi":"10.1111/1346-8138.17621","DOIUrl":"10.1111/1346-8138.17621","url":null,"abstract":"<p>Recessive dystrophic epidermolysis bullosa (RDEB) is caused by mutations in <i>COL7A1</i>, leading to loss or dysfunction of type-VII collagen (C7), a protein essential for skin stability. Clinically, patients suffer from severe skin blistering, chronic or recurrent wounds, and scarring, which predispose to early onset of aggressive squamous cell carcinoma. Previous studies showed that RDEB-keratinocytes (RDEB-KC) express high levels of matrix-metalloproteinase 9 (MMP-9), a molecule known to play a crucial role in wound chronification if dysregulated. We investigated the potential of diacerein, a small molecule that interferes with the MMP-9 regulatory pathway, to improve wound healing in a 5-year old RDEB patient presenting with chronic, generalized skin involvement unresponsive to previous treatment approaches. Upon 4 weeks of topical therapy applied to the patient's back, parents reported a nearly complete wound closure and a significant increase in quality of life. We also provide evidence that diacerein treatment of patient keratinocytes results in a downregulation of MMP-9 expression, accompanied by a reduction in their ability to degrade a fibrinogen matrix. These data characterize diacerein as a potential candidate for improving wound healing in RDEB through its impact on inflammatory as well as epithelial cells.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 3","pages":"423-431"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17621","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of key malodor components in onychomycosis: A pilot study","authors":"Keiko Sakamoto,&nbsp;Masako Katsuyama,&nbsp;Chieko Okamura,&nbsp;Tetsuya Honda","doi":"10.1111/1346-8138.17633","DOIUrl":"10.1111/1346-8138.17633","url":null,"abstract":"","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 3","pages":"559-561"},"PeriodicalIF":2.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphomatoid papulosis type E: An indolent diagnosis in disguise","authors":"William Tuckwell,&nbsp;Jenny Callander,&nbsp;Krishnakumar Subramanian,&nbsp;Patrick Yesudian,&nbsp;Paul D. Yesudian","doi":"10.1111/1346-8138.17642","DOIUrl":"10.1111/1346-8138.17642","url":null,"abstract":"<p>A 51-year-old Indian man presented with a 2-month history of foot ulcers causing pain on exertion. Examination revealed two shallow, oval ulcers on the right dorsal foot with central eschars (Figure 1a). Inspection of the surrounding skin showed atrophic scarring, suggesting previously healed lesions. The patient had no systemic symptoms and no palpable lymphadenopathy. A diagnosis of vasculitis was considered.</p><p>The patient presented 3 months later with four new ulcerated and crusted plaques on the right anterior shin (Figure 1b). The previously identified lesions on the right foot had resolved. A skin biopsy of one of the new lesions was performed.</p><p>Histology revealed widespread epidermal and dermal necrosis with central ulceration. In the dermis, histiocytes, eosinophils, and infiltrates of atypical lymphocytes were found in an angiocentric pattern (Figure 1c). Lymphocytes invading the vessel walls had led to angiodestruction. Immunohistochemical investigations showed that CD2, CD3, CD4, CD5 and CD7 were positive. Additionally, CD30 and CD8 were focally positive (Figure 1d).</p><p>These findings supported a diagnosis of lymphomatoid papulosis (LyP) type E and treatment was commenced with methotrexate. The ulcers resolved within 6 weeks. Treatment was continued for 12 months and no further lesions were observed.</p><p>Lymphomatoid papulosis is a rare lymphoproliferative disorder characterized by recurrent papulo-nodular lesions.<span>¹</span> Despite low disease-specific mortality rates, LyP carries a 20% risk of developing secondary lymphoid malignancy.<span>²</span></p><p>Lymphomatoid type E is an uncommon subtype, making up less than 5% of cases.<span>³</span> It is characterized clinically by lesions that rapidly break down to form large, eschar-like, necrotic ulcers; the other five subtypes differ as smaller superficial ulceration is seen. Ulceration typically resolves spontaneously within 3–6 weeks leaving atrophic varioliform scarring. Histopathological distinction is based on angiocentric CD30+ and CD8+ atypical infiltrates.<span>⁴</span> Contradictory to its aggressive presentation, LyP type E has an excellent prognosis; only 5% of patients develop a secondary malignant lymphoma.<span>¹</span></p><p>None declared.</p><p>Informed consent was provided by the patient for the use of clinical images.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 3","pages":"e210-e211"},"PeriodicalIF":2.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of bullous pemphigoid patients of different ages and the possible mechanism","authors":"Xinyi Chen,&nbsp;Bingjie Zhang,&nbsp;Xuming Mao,&nbsp;Yiman Wang,&nbsp;Yuyan Yang,&nbsp;Yangchun Liu,&nbsp;Fangyuan Chen,&nbsp;Li Li","doi":"10.1111/1346-8138.17616","DOIUrl":"10.1111/1346-8138.17616","url":null,"abstract":"<p>Bullous pemphigoid (BP) is an acquired autoimmune bullous disease that often occurs in elderly patients. Some BP patients with early age of disease onset were observed to have difficulty in receiving applicable disease control. It remains challenging for clinicians to choose the appropriate treatment for these patients. This study aimed to analyze the differences between patients of different ages at disease onset and further explore the possible mechanism of these differences between patients of different ages. A total of 215 BP patients seen at the dermatology department of Peking Union Medical College Hospital between January 2009 and September 2020 were included. The patients were allocated to five groups according to the age at disease onset. Clinical data were collected through medical records and telephone follow-up interviews. Analyses of anti-BP180 antibody subclasses, anti-BP230 antibodies, complement fixation, serum cytokine levels, and single nucleotide polymorphisms (SNPs) were conducted. Nearly 52% of patients under 60 were misdiagnosed on their first visit, often presenting with oral mucosal involvement. The anti-BP180 immunoglobulin (Ig) E titers and C3 deposition increased in patients under 60 (<i>p</i> = 0.044 and <i>p</i> = 0.014, respectively), while the anti-BP230 IgG titers decreased (<i>p</i> = 0.043). The hospitalization rate of patients under 50 was significantly higher than that of patients aged 80 and older (<i>p</i> &lt; 0.001). The patients under 60 had a significantly higher serum concentration of interleukin (IL)-13, tumor necrosis factor (TNF)-α, and interferon gamma (IFN-γ) (<i>p</i> &lt; 0.005, respectively). We observed significant differences in the distribution of genotypes or alleles of TNF-α rs1799964, TNF-α rs1800630, and IFN-γ rs2069705. Approximately one-third of the elderly patients suffered from neurological diseases. Elderly patients usually presented with peripheral eosinophilia (<i>p</i> = 0.013). No significant difference was identified in the recurrence rate and complement-activating capacity among the age groups. In conclusion, the early age of BP onset was associated with a more severe clinical presentation, higher titers of anti-BP180 IgE, lower titers of anti-BP230 IgG, and significantly higher serum concentrations of IL-13, TNF-α, and IFN-γ. It may also be associated with the presence of SNPs of cytokines, including TNF-α rs1799964, TNF-α rs1800630, and IFN-γ rs2069705 variants.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 4","pages":"672-681"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}