Search Results (724)

Background: Portulaca oleracea L. (POL) has anti-inflammatory and immunomodulatory activities, but its mechanism against atopic dermatitis (AD) remains incompletely understood. Methods: 2,4-dinitrofluorobenzene (DNFB)-induced AD mice were treated orally with POL or dexamethasone for 14 days. We evaluated skin lesions, scratchizng, serum IgE, histopathology, inflammatory cytokines, skin-barrier genes, JAK/STAT phosphorylation, and fecal metabolites. Results: POL alleviated skin lesions and pruritus, reduced serum IgE concentrations, attenuated epidermal hyperplasia and inflammatory-cell and mast-cell infiltration, and restored keratinocyte architecture. It decreased IL-4, IL-13, and IL-31 expression, increased filaggrin and loricrin expression, and inhibited JAK1, STAT1, and STAT3 phosphorylation. Untargeted metabolomics showed that POL mainly regulated unsaturated fatty acid and steroid hormone biosynthesis and restored levels of anti-inflammatory and antiallergic metabolites, including (±)18-HEPE, docosahexaenoyl ethanolamide, and dehydroepiandrosterone. Conclusions: These findings indicate that POL ameliorates AD by suppressing Th2 inflammation through JAK1/STAT3 signaling, correcting lipid-metabolic disturbances, and restoring skin barrier integrity. Full article

Background/Objectives: Chronic pruritus of unknown origin (CPUO) is mechanistically poorly resolved, and its relationship to atopic dermatitis (AD) is unclear. We asked how much apparent separation survives removal of leakage. Methods: Public bulk skin data (GSE237920; four healthy, four AD, four CPUO) were analyzed by differential expression and an XOmiVAE-inspired latent model, with public single-cell and atlas resources for context. Every label-dependent step was then re-executed inside each cross-validation fold, with label permutation and 1000 bootstraps. A frozen composite niche score was applied unchanged to prurigo nodularis (GSE210854) and AD (GSE174582) cohorts. Results: Fully nested, the latent classifier separated CPUO from healthy skin (AUC 1.000; permutation p = 0.020) but not from AD (0.741; p = 0.140); randomized labels also reached 1.00. The composite score reached 0.919 against healthy skin but did not exceed its null (p = 0.086). Six genes recurred in ≥80% of bootstraps, five within the signature. Cell-type-restricted blood analysis recovered CPUO-associated monocyte CCL3 upregulation. In both validation cohorts, the frozen score was reduced, not elevated, in lesional skin. Conclusions: CPUO skin differs from healthy skin and occupies the low-inflammatory, epidermal-stress-dominated pole opposite lesional inflammatory skin, but cannot be robustly separated from AD at twelve samples. Full article

Background: Methotrexate (MTX) is a well-established therapeutic agent for psoriasis owing to its anti-inflammatory and immunomodulatory effects. However, its clinical use is limited by insufficient local accumulation in skin lesions and the potential risk of systemic exposure. Dunaliella salina-derived exosome (DsEXO) has favorable biocompatibility, low immunogenicity and potential skin delivery capacity, making it a promising natural nanocarrier for topical MTX delivery. This study aimed to construct Dunaliella salina-derived exosome loaded with methotrexate (DsEXO@MTX) and evaluate its therapeutic efficacy and potential mechanisms in psoriasis-like skin inflammation. Methods: DsEXO@MTX was prepared and characterized in terms of morphology, particle size, surface charge and drug-loading capacity. Cellular uptake, skin retention and tissue distribution were evaluated using fluorescence imaging and skin section analysis. Therapeutic efficacy was evaluated in an imiquimod-induced psoriasis-like mouse model by clinical scoring, histopathological examination, spleen index measurement and Ki-67 immunofluorescence staining. STAT3 phosphorylation and Th17/Treg differentiation were further examined to explore the potential immunomodulatory mechanism. Results: DsEXO@MTX exhibited a relatively uniform particle size distribution and drug-loading capacity. In vivo fluorescence imaging and skin section analysis showed that DsEXO@MTX enhanced local skin retention and promoted fluorescence distribution in epidermal and dermal regions. It significantly alleviated IMQ-induced erythema, scaling, epidermal thickening, inflammatory infiltration, splenomegaly and abnormal keratinocyte proliferation in psoriasis-like mice. Mechanistically, DsEXO@MTX reduced STAT3 phosphorylation and modulated Th17/Treg differentiation, suggesting restoration of immune balance in psoriatic inflammation. Conclusions: DsEXO@MTX represents a natural exosome-like nanovesicle-mediated topical MTX delivery system that improves local drug delivery and enhances therapeutic efficacy in IMQ-induced psoriasis-like skin inflammation, particularly when administered topically. These findings provide a potential strategy for safer and more efficient local treatment of psoriasis. Full article

Radiation-induced morphea (RIM) is a rare, immune-mediated late complication of breast radiotherapy that may clinically mimic radiation fibrosis, malignancy, or other inflammatory dermatoses. Diagnosis is particularly challenging in patients with pre-existing cutaneous T-cell lymphoma (CTCL), in whom new post-radiation skin lesions may raise concern for lymphoma involvement or progression. To the best of our knowledge, based on a non-systematic search of the available literature, this is the first reported case of radiation-induced morphea occurring in a patient with pre-existing mycosis fungoides (MF). A 55-year-old woman with a history of MF and right breast invasive lobular carcinoma underwent bilateral mastectomy followed by adjuvant chest wall radiotherapy. Approximately 6.5 years later, she developed a progressive erythematous, indurated plaque within the irradiated field. Given her history of MF, cutaneous lymphoma involvement and radiation-associated sarcoma were important diagnostic considerations. Punch biopsy demonstrated dermal collagen homogenization with a mixed inflammatory infiltrate, while immunohistochemistry showed preserved pan-T-cell antigen expression without an aberrant phenotype, supporting RIM rather than lymphoma. The patient was treated with topical corticosteroids followed by methotrexate, with mild-to-moderate improvement in erythema without complete resolution; subsequent reconstructive revision was followed by further improvement in erythema, breast softness, and cosmesis. This case highlights the diagnostic overlap between RIM and CTCL and underscores the importance of prompt biopsy and careful clinicopathological correlation in evaluating persistent or atypical post-radiation skin changes. Full article

Acne vulgaris is one of the most prevalent dermatological conditions, affecting up to 85% of individuals aged 11–30 years. Clascoterone cream is the first topical androgen receptor inhibitor approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne vulgaris in patients aged 12 years and older, and the first agent in this class approved for use in both male and female patients. The aim of this narrative review is to summarize the current evidence regarding the efficacy, safety profile, and potential future applications of clascoterone in the treatment of acne vulgaris. A comprehensive literature search was conducted in PubMed/MEDLINE and ClinicalTrials.gov databases up to April 2026. Search terms included “clascoterone,” “cortexolone 17α-propionate,” and “androgen receptor inhibitor acne.” Eligible publications included randomized controlled trials, meta-analyses, open-label extension studies, retrospective analyses, case reports, and relevant review articles published in English. Clinical trial registries and regulatory agency announcements were also searched for ongoing studies and recent approval decisions. Phase 3 trials and meta-analyses demonstrate that twice-daily application of clascoterone 1% cream significantly reduces inflammatory and non-inflammatory lesion counts compared to vehicle, with efficacy sustained up to 12 months of treatment. The safety profile is favorable, with adverse events limited predominantly to mild and transient local skin reactions. Subgroup analyses have shown no significant sex-related differences in efficacy or safety, and the safety profile appears comparable between adolescents and adults. In an exploratory pooled subgroup analysis, lesion-count reductions were greater in adults than in adolescents, whereas the adjusted between-group comparison of IGA success was not statistically significant. Because no formal treatment-by-age interaction test was reported, these findings should be considered hypothesis-generating. Emerging but still incomplete data suggest potential applications in androgenetic alopecia and mild hidradenitis suppurativa. Clascoterone represents a novel addition to the therapeutic armamentarium for acne vulgaris, offering a unique mechanism of action with a favorable safety profile. Further research is warranted to establish its role in combination therapies and in other androgen-dependent dermatoses. Full article

Background and Clinical Significance: Eczema herpeticum (EH), or Kaposi’s varicelliform eruption, is a dermatologic emergency characterized by the abrupt onset of painful monomorphic vesiculopustules with potential for rapid dissemination. Atopic dermatitis (AD) is the main predisposing condition due to skin barrier dysfunction and impaired antiviral immunity. Early recognition is essential because delayed treatment may result in avoidable complications, including ocular involvement and systemic disease. Current recommendations emphasize immediate systemic acyclovir based on clinical suspicion, without awaiting laboratory confirmation. Case Presentation: A 4-year-old boy with moderate AD presented with a 6-day history of fever, malaise, and a rapidly progressive vesiculopustular eruption involving both eczematous and previously unaffected skin. The patient had a recent AD flare, molluscum contagiosum, and had initially received oral amoxicillin-clavulanate for presumed bacterial superinfection without improvement. Physical examination revealed widespread painful monomorphic umbilicated vesiculopustules with hemorrhagic crusts and mild bilateral conjunctival injection. Oral acyclovir was initiated within one hour of evaluation. Laboratory investigations showed mild inflammatory abnormalities without renal or hepatic involvement. Because lesional PCR was unavailable, complementary blood-based investigations were performed; HSV-1 IgM serology and blood PCR provided additional retrospective findings compatible with HSV-1 infection, while Gram stain and bacterial cultures were negative. Fever resolved within 24 h, no new lesions developed after day 3, and complete re-epithelialization was achieved after a 10-day course of acyclovir. Conclusions: This case highlights the importance of bedside recognition of eczema herpeticum in children with atopic dermatitis, particularly when painful monomorphic vesiculopustules are accompanied by fever and rapid dissemination. Early initiation of systemic acyclovir based on clinical suspicion remains the cornerstone of management. While PCR from vesicular lesions is the preferred diagnostic test when available, laboratory confirmation should not delay treatment. This report also illustrates common real-world challenges, including initial misdiagnosis as bacterial infection and limited access to optimal virological testing. Full article

Acne vulgaris is a chronic inflammatory skin disease associated with a substantial psychological burden that may extend beyond visible lesions and objective disease severity. Psychological factors such as stress, coping strategies, quality-of-life impairment, self-esteem, psychiatric symptoms, and treatment adherence are associated with disease perception, self-reported exacerbation, and treatment-related outcomes. This narrative review examines psychological stress and proposed biological mechanisms, coping strategies, treatment adherence, quality of life, self-esteem, sleep disturbance, and psychiatric comorbidity in people with acne. Relevant literature was identified through MEDLINE/PubMed, Scopus, Web of Science, and PsycINFO; the final literature search was conducted on 29 May 2026. Acne-specific studies were prioritized, with broader psychodermatology evidence used where acne-specific data were limited. The psychosocial burden of acne is individualized and only partly aligned with clinician-rated severity, supporting person-centered assessment. For each domain, the review outlines brief, commonly used screening instruments that may be feasible in routine dermatology. Incorporating psychological assessment and targeted supportive strategies into acne care may contribute to quality of life, adherence to therapy, and patient-centered care. The evidence is predominantly cross-sectional and derives from heterogeneous populations, instruments, and study designs, limiting causal inference. Full article

Psoriasis is a chronic immune-mediated inflammatory disease in which cytokine-driven epidermal activation is accompanied by extensive remodeling of the extracellular matrix, basement membrane, and cutaneous microvasculature. Matrix metalloproteinase-9 (MMP-9; gelatinase B) may provide an important link between these structural alterations and several key features of psoriatic inflammation, including neutrophil activation, endothelial dysfunction, vascular hyperpermeability, and leukocyte recruitment. This review critically examines the biological and clinical relevance of MMP-9 across the spectrum of psoriatic disease. Particular focus is given to the cellular sources and regulation of MMP-9, its expression in lesional and non-lesional skin, and its interactions with the IL-23/Th17, IL-17, TNF-α, IL-36, MAPK, and NF-κB signaling pathways. Experimental studies support a functional neutrophil–MMP-9–endothelium axis in which MMP-9 can promote endothelial activation, vasodilation, vascular hyperpermeability, and leukocyte transmigration. However, this mechanistic evidence derives predominantly from experimental systems, whereas human studies mainly demonstrate associations between psoriasis and increased tissue or circulating MMP-9. The interpretation of circulating MMP-9 is further complicated by sample type, enzymatic activation state, assay heterogeneity, treatment exposure, and inflammatory and cardiometabolic confounders. Overall, MMP-9 represents a biologically possible contributor to psoriatic tissue remodeling and vascular inflammation, but its causal importance in human psoriasis remains insufficiently established. Future studies should determine whether MMP-9 can contribute to validated phenotype-specific multimarker models. At present, its clinical utility as either a biomarker or therapeutic target remains exploratory. Full article

Incontinentia pigmenti (IP) is a rare, X-linked dominant genodermatosis caused by mutations in the IKBKG gene and characterized by sequential cutaneous stages following the lines of Blaschko. The highly inflammatory initial vesiculobullous stage frequently mimics severe neonatal infections, such as herpes simplex or bullous impetigo, leading to potentially dangerous diagnostic delays and unnecessary antimicrobial therapies. The objective of this report is to highlight the utility of multimodal medical imaging and clinico-pathologic correlation in the rapid diagnosis of early-stage IP. We present the case of a full-term female neonate presenting on the third day of life with a rapidly disseminating blistering eruption, initially treated as a widespread infectious process. A multimodal diagnostic approach was applied, incorporating bedside clinico-dermoscopic evaluation of the infant and her mother (who reported a history of early miscarriages), followed by neonatal skin biopsy, immunohistochemistry (S-100, MART-1), and subsequent genetic testing. Dermoscopy of the neonate’s transitional lesions revealed early dermal melanophage accumulation, while maternal evaluation exposed pathognomonic residual Blaschko-linear dyspigmentation featuring a distinct “pepper-like” dermoscopic pattern. Histopathology demonstrated classic eosinophilic spongiosis, intraepidermal vesicles, and early pigment incontinence. Genetic testing confirmed recurrent IKBKG exon 4–10 deletion. Crucially, this rapid diagnosis facilitated immediate targeted ophthalmologic screening, detecting asymptomatic stage 2B retinal vasculopathy. Integrating noninvasive dermoscopy with precise histopathologic correlation offers a rapid, highly effective framework to distinguish early IP from neonatal blistering infections. Timely multimodal imaging is crucial for triggering immediate multidisciplinary screening, effectively preventing severe, irreversible vision-threatening complications. Full article

Cold atmospheric plasma (CAP) is a promising tool used in medicine due to its broad spectrum of biological activity and the possibility of safe application on living tissues without the risk of thermal damage. CAP is a partially ionised gas containing electrons, ions and reactive oxygen and nitrogen species (RONS); it also emits ultraviolet radiation and an electromagnetic field. The aim of this study is to discuss the mechanisms of action of cold atmospheric plasma and to assess its significance in supporting the skin healing process. Analysis of the available data indicates that CAP acts in multiple ways: it stimulates the proliferation and migration of keratinocytes and fibroblasts, modulates the inflammatory response, exhibits antimicrobial properties, and improves microcirculation and enhances angiogenesis. The results of studies to date suggest that cold atmospheric plasma may provide valuable support for therapies, particularly in the context of skin regeneration, wound healing and the treatment of inflammatory lesions. However, further research is needed on the standardisation of treatment parameters, long-term safety, and the precise definition of indications and contraindications depending on the type of device used. Full article

In traditional Chinese medicine, frankincense is widely recognized for its anti-inflammatory and immunomodulatory capacities and has been conventionally applied to manage multiple chronic inflammatory skin disorders. Nevertheless, its therapeutic potency and molecular mechanisms against atopic dermatitis (AD) remain poorly clarified. This study aimed to explore the protective efficacy of frankincense oil extract (FOE) and its active constituents in AD mouse models, thereby clarifying underlying regulatory mechanisms. Two classic AD models induced by 2,4-dinitrochlorobenzene (DNCB) and carvacrol were established to evaluate the therapeutic performance of FOE and its bioactive components. Hematoxylin–eosin and toluidine blue staining were applied to characterize lesional histopathological alterations, immunohistochemistry was used to detect expression profiles of TRPV3, β-catenin, and COX-2 in skin lesions, and calcium fluorescence imaging was applied to monitor TRPV3-mediated intracellular calcium dynamics. The results showed that FOE markedly alleviated typical AD-like manifestations, reducing inflammatory injury, ear edema and splenomegaly in DNCB- and carvacrol-challenged mice. Histological evaluation confirmed that FOE improved pathological lesions, mitigated epidermal hyperplasia, and reduced mast cell infiltration. Meanwhile, FOE remodeled the abnormal expression patterns of TRPV3, β-catenin, and COX-2 triggered by AD stimulation. Additionally, FOE effectively regulated carvacrol-evoked calcium influx mediated by TRPV3 activation. Collectively, FOE and its active components exert anti-inflammatory effects, restraining epidermal over-proliferation and ameliorating epidermal structural disorders, thereby supporting the restoration of epidermal tissue morphology. Such benefits are attributed to modulating TRPV3 activity and remodeling the cutaneous inflammatory microenvironment. This work highlights FOE as a promising novel candidate for atopic dermatitis intervention. Full article

Pilonidal sinus is a chronic inflammatory skin condition predominantly found in the sacrococcygeal region, characterized by recurrent infections and sinus tract formation. Occurrences outside this area, particularly on the anterior chest wall, are exceedingly rare and prone to misdiagnosis. We report a rare case of a 24-year-old Chinese man presenting with a 3-year history of a recurrent, draining lesion on the anterior chest wall. Initial treatment via simple incision and drainage for a presumed sebaceous cyst resulted in delayed wound healing and persistent purulent discharge. Subsequent magnetic resonance imaging (MRI) and computed tomography (CT) revealed a localized superficial lesion. Definitive surgical debridement uncovered a sinus tract containing embedded hair fragments. Histopathological examination confirmed a pilonidal sinus with a robust foreign body giant cell reaction and chronic inflammation. After complete resection, during the nearly two-year follow-up period, the healing has been smooth, and no recurrence has been observed. This case highlights the necessity of detailed clinical history-taking and the inclusion of ectopic pilonidal sinus in the differential diagnosis of refractory chest wall abscesses to prevent repeated, ineffective interventions. Full article

Background/Objectives: The skin microbiome maintains barrier integrity, immune homeostasis, and pathogen defense; dysbiosis contributes to acne vulgaris, dandruff, seborrheic dermatitis, atopic dermatitis, psoriasis, and alopecia. This scoping review critically appraised evidence on prebiotics, probiotics, synbiotics, postbiotics, and paraprobiotics in dermo-cosmetics for acne vulgaris and scalp disorders. Methods: A scoping search (2006–2026) covered SciELO, PubMed/PMC, Google Scholar, CAPES Portal, Scopus, Heliyon, Frontiers, Nature, Wiley, and MDPI, following PRISMA 2020 guidelines. Results: Of 1665 records, 66 were included. For acne, effective prebiotics included blackcurrant, grape seed, ginseng, trehalose, and glucomannan hydrolysate; effective probiotic strains included Streptococcus thermophilus, Bifidobacterium longum, Staphylococcus epidermidis, and Streptococcus salivarius. A synbiotic (B. breve BR03, Lacticaseibacillus casei LC03, Ligilactobacillus salivarius LS03) reduced inflammatory lesions by 56.67% in an 8-week RCT (n = 114). For scalp disorders, oral Lacticaseibacillus paracasei ST11 reduced dandruff by 70% vs. 23% (placebo); Lactiplantibacillus plantarum TCI999 increased hair root diameter (n = 50, 12 weeks); a Lacticaseibacillus rhamnosus plus Bifidobacterium longum mixture improved alopecia areata by 56% vs. 30% (n = 26, 24 weeks). Conclusions: Biotic dermo-cosmetics can modulate the cutaneous microbiome and attenuate inflammation in acne and scalp disorders, with strongest evidence for multi-strain/synbiotic formulations. Formulation stability, strain specificity, regulatory heterogeneity, and lack of standardized microbiological endpoints remain key challenges; larger standardized RCTs with active comparators are needed. Full article

Psoriasis is a chronic inflammatory autoimmune skin disease significantly impairing the patients’ quality of life. Keratin (K)14 and K17 are abnormally expressed in psoriasis patients and considered to be potential autoantigens triggering this disease. However, the animal model for psoriasis induced with a specific antigen is yet to be established. Here we show that vaccinating BALB/c and C57BL/6J mice with purified murine recombinant K14 or K17 antigen induced psoriasis-like clinical symptoms in 40 ± 30% of animals, such as erythema and scaling, accompanied by hallmark histopathological changes including significant epidermal hyperplasia and inflammatory cell infiltration in the lesions. Furthermore, the immunized mice produced high levels of specific antibodies against K14/K17 in the blood, along with antigen-specific T-cell responses. These data indicate that immunization of mice with K14 and K17 antigens could cause psoriasis-like symptoms with immunopathological features of psoriasis, providing a novel experimental animal model for investigating the pathogenesis of psoriasis and development of effective therapies. Full article

Rett syndrome (RTT, OMIM 312750) is a complex multisystem neurodevelopmental disorder. Evidence suggests that RTT may have an autoimmune component and inflammatory activation. However, the autoimmune manifestations remain poorly described. Pemphigus foliaceus is a debilitating autoimmune blistering condition caused by IgG autoantibodies that target desmoglein-1 (Dsg1), resulting in widespread skin blistering and lesions. We report a case of pemphigus foliaceus in a 20-year-old female with RTT and discuss its clinical implications. Clinical data obtained from electronic health records were extracted and reviewed. Genetic testing was performed to identify the specific methyl-CpG-binding protein 2 (MECP2) mutation and on an expanded panel of 55 genes associated with pemphigus foliaceus and related blistering disorders. The individual had pemphigus foliaceus, which required immunosuppression, intravenous immunoglobulin (IVIg) therapy, and Rituximab. The disease trajectory was complicated by infections, aspiration pneumonia, and hypoxic cardiac arrest. There was progressive functional decline, and disease control was difficult to achieve, with frequent flares. Genetic testing confirmed a heterozygous pathogenic MECP2 variant (NM_001110792.1:c.952C>T; p.(Arg318Cys)). HLA genotyping identified alleles consistent with the HLA-DRB1*04:02–HLA-DQA1*03:01–HLA-DQB1*03:02 (DR4/DQ8) haplotype. Furthermore, genetic analysis identified a heterozygous DSG1 variant rs12967407. This study reports the first case of pemphigus foliaceus in RTT, expanding the clinical spectrum of RTT beyond its neurodevelopmental phenotype. The DR4/DQ8 haplotype, previously associated with pemphigus susceptibility, supports a background of genetic susceptibility in this individual. No causal association between RTT and pemphigus foliaceus can be inferred from this single case. Rather, this case demonstrates that a rare autoimmune disorder such as pemphigus foliaceus can co-occur with a pathogenic MECP2 mutation. The coexistence of a genetic and autoimmune disease can result in a more complex clinical presentation and treatment course. The case further emphasises the need for increased vigilance in identifying new and emerging systemic pathology alongside RTT. Full article