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Objective:. Psoriasis is an immune-mediated inflammatory, chronic, recurrent skin disease associated with a high risk of developing psychiatric disorders, especially depression and suicidal ideation, leading to functional disability and poor quality of life. This study was conducted to comprehensively review and assess the epidemiologic association between psoriasis and the risk ratios (RRs) of depression or suicidal ideation. Methods:. Five databases (PubMed, Wanfang Database, CNKI, The Cochrane Library, and EMBASE) were searched for prospective cohort studies on the prevalence of depression and/or suicidal ideation in patients with psoriasis updated to February 2, 2023. Two independent reviewers evaluated and extracted the data, which were then pooled into a summary RR with corresponding 95% confidence interval (CI) using random-effects models. Results:. Sixteen cohort studies comprising 1,166,840 patients with psoriasis and 3,294,205 controls were eligible for the final analysis. The pooled RR for depression was 1.43 (95% CI = 1.13–1.81) in patients with psoriasis and1.55 (95% CI = 1.40–1.71) in patients with psoriatic arthritis. In the subgroup analysis, Asian patients with psoriasis (RR = 1.38, 95% CI =1.17–1.63) had a lower pooled RR for depression than non-Asian patients (RR = 1.45, 95% CI = 1.07–1.97), and patients with moderate-to-severe psoriasis (RR = 1.69, 95% CI = 1.15–2.50) showed a higher RR for depression than patients with mild psoriasis (RR = 1.60, 95% CI = 1.06–2.42). We also found no increase in the RR for suicidal ideation among people with psoriasis (RR = 1.25, 95% CI = 0.95–1.65). Conclusion:. Patients with psoriasis are at an increased risk of depression. Among patients with psoriasis, those with psoriatic arthritis, those who are non-Asian, and those with moderate-to-severe psoriasis are at higher risk for depression. However, the available evidence does not support an association between psoriasis and suicidal ideation.

Introduction:. Basal cell carcinoma (BCC) is the most common skin cancer which mainly affects the population over 50 years of age. In addition to surgical treatment, nonsurgical treatment is also an attractive option for some patients. We herein report a case of an 82-year-old man with BCC successfully treated with acitretin. Case presentation:. An 82-year-old man presented with BCC on his left nose wing more than 2 years ago. Due to his unwillingness to accept treatment that may lead to pain, discomfort, or trauma, the patient was prescribed oral acitretin 25 mg twice daily [0.8 mg/(kg·d)] and was instructed to apply 2% fusidic acid cream topically once daily for trauma protection. The lesion progressively shrank in size after 4 weeks of treatment, and was almost completely resolved after 28 weeks of follow-up. The patient reported mild adverse effects, such as mild skin fragility and cheilitis, and apparent scaling skin, which caused minor discomfort but did not affect the continuation of treatment. Discussion:. The pathogenesis of BCC is still unclear, but it has been demonstrated to be linked to overactive hedgehog signaling and its crosstalk with other pathways such as phosphoinositide 3-kinase and mammalian target of rapamycin. Acitretin could obviously inhibit cell growth and proliferation and down-regulate AMP-dependent protein kinases that plays critical role in the blocking of malignant progression of several tumors including BCC. Conclusion:. We provide an effective alternative for the patients with BCC who are unwilling to receive surgical therapy.

Objective: To analyse antimicrobial resistance of Neisseria gonorrhoeae to 7 antimicrobial agents and the penicillinase-producing Neisseria gonorrhoeae (PPNG) and tetracycline resistant Neisseria gonorrhoeae (TRNG) in Guangzhou during 2019. Methods: 100 Neisseria gonorrhoeae strains were isolated and cultured from our clinical department. Minimum inhibitory concentration (MIC) of penicillin, tetracycline, ciprofloxacin, spectinomycin, azithromycin, ceftriaxone, cefixime was determined by agar dilution method. β-lactamase was measured by paper iodine quantitative method. Results: PPNG and TRNG accounted for 35% (35/100) and 32% (32/100) of the Neisseria gonorrhoeae isolates, respectively.The antibiotic resistant rate of ciprofloxacin, penicillin and azithromycin was 99%(99/100)、93% (93/100) and 10% (10/100). Both moderate sensitivity rate of ceftriaxone and cefixime were 22% (22/100) and 19%(19/100), both sensitivity rate accounted for 78%(78/100) and 81%(81/100). All isolates were susceptible to spectinomycin. Conclusion: The resistant strains to spectinomycin, ceftriaxone and cefixime were not found and these antibiotics can still be used as the first drug for the treatment of Neisseria gonorrhoeae in Guangzhou. However, the dynamic changes in moderate sensitivity rate of ceftriaxone and cefixime show that it is essential to continuously monitor antimicrobial resistance of Neisseria gonorrhoeae for providing theoretical guidance to clinical rational antibacterial treatment.

Objective: To assess the role of matrix metalloproteinase 8 in the inflammation of psoriasis vulgaris (PV). Methods: According to the psoriasis area and severity index (PASI), twenty PV patients were grouped into mild (n=6), moderate (n=6), and severe (n=8) groups. Serum levels of MMP-8, measured with ELISA, were compared among PV groups and the controls (n=12), while expression levels of MMP-8 mRNA were compared between lesional sites and their adjacent normal skin by qPCR. Localization of MMP-8 positive cells in the skin was determined by immunohistochemistry. Results: Serum MMP-8 concentration was significantly lower in the mild PV than in both the severe PV (t=2.69, P=0.020) and the controls (t=2.54, P=0.022). Expression levels of MMP-8 mRNA in the lesional sites were significantly higher than that in their adjacent normal skins (t=2.91, P=0.009). Moreover, expression levels of MMP-8 mRNA were significantly higher in the lesions of severe PV than that of mild (t=3.45, P=0.005) and moderate (t=2.74, P=0.018) PV. MMP-8 positive cells were mainly localized in the basal and spinous layers of the lesional skin, while in their adjacent normal skin, MMP-8 positive cells mainly located in the basal layer. In the dermis, high intensity of MMP-8 staining was observed in endothelial cells of papillary vessels. Conlusions: Increased expression of MMP-8 in inflammatory site of PV suggests the involvements of MMP-8 in immunoregulation and pro-angiogenesis.

Abstract. Biologic drugs have been increasingly used in the treatment of psoriasis and are especially favorable for severe, recalcitrant, and special-type cases. Therefore, appropriate, effective, and safe use of biologic drugs has drawn attention from dermatologists. For this purpose, Chinese experts majoring in psoriasis analyzed domestic and international research data, summarized current clinical experiences, investigated features of Chinese patients with psoriasis, and finally formulated the present consensus, which provides detailed guidances to clinicians in terms of the principles and methods of the application of biologics, the efficacy and safety profile, patient screening and monitoring, main adverse events and corresponding solutions, and precautions for special patient populations.

Abstract. Objectives:. The wide use of antibiotics for acne is the main cause of drug-resistant Cutibacterium acnes. However, the complete genetic sequence reference of C. acnes has not yet been reported. Herein, we report the complete genetic sequence of Cutibacterium acnes type strain ATCC6919. Methods:. Whole-genome sequencing of Cutibacterium acnes ATCC6919 was performed using both the Illumina Hiseq4000 and PacBio RSII single-molecule real-time sequencing platforms. The generated sequence reads were de novo assembled using the HGAP3 protocol of single-molecule real-time analysis v.2.3.0 software. The draft genome was annotated and further analyzed by various bioinformatics tools. Results:. The total genome length of Cutibacterium acnes ATCC6919 was 2,495,001 bp (60.02% G + C content), with 2,450 coding sequences including 2,358 proteins, 45 tRNAs, 9 rRNAs, and 1 sRNA. The Comprehensive Antibiotic Resistance Database showed that the gene (thy A) found in ATCC6919 was associated with resistance to aminosalicylic acid. Antimicrobial susceptibility testing showed that this isolate was not sensitive to metronidazole and sulfamethoxazole, but was sensitive to all other tested antimicrobials (erythromycin, azithromycin, clarithromycin, tetracycline, minocycline, trimethoprim, levofloxacin, ceftriaxone, and doxycycline). Conclusion:. This study reports the complete genome sequence of Cutibacterium acnes ATCC6919, which provides a valuable reference for comparative analysis based on the genomic characteristics and resistance gene diversity of Cutibacterium acnes.

Objective: To investigate the effect of all-trans retinoic acid (ATRA) on Cx43 protein expression and GJIC function in IL-22-treated HaCaT cells, and whether it is related to the JNK pathway to further elaborate molecular mechanism of ATRA on GJIC function. Methods: The optimal pretreated time affected by ATRA on HaCaT cells was screened in IL-22 treatment group.Scrape-loading dye-transfer assay was applied to observe the variation of GJIC function.The expression value of Cx43, p-JNK, JNK in ATRA and/or IL-22 treatment group were detected by immunofluorescence. Results: ATRA caused time-dependent increasing of GJIC function in HaCaT cells. After treatment of ATRA on IL-22 induced HaCaT cells, Cx43 protein expression level increased, GJIC function up-regulated, and p-JNK expression had not significant change. Conclusions: ATRA inhibited the decrease of Cx43 expression by IL-22-mediated and down-regulation of GJIC, and this process was not related to the JNK pathway.

Retinoids has been used widely in the topical and systemic treatments of various dermatoses: psoriasis, disorders of keratinization (DOK), keratotic genodermatosis, and severe acne. Moreover, it is also used in the treatment and/or chemoprevention of skin cancer and other neoplasms. Retinoids display key regulatory functions and most dermatologists are familiar with the FDA-approved indication of this medication. Retinoic acid is a potent signaling molecule that is essential for many biological processes, and its levels are tightly regulated by mechanisms that are only partially understood. This article will review these recent findings and attempt to synthesize their meaning to provide a view into the off-label uses of retinoids in dermatology with an emphasis on oral isotretinoin and acitrein.

Retinoids have been used for years as monotherapy and/or in combination for treatment and suppression of cutaneous malignancies in patients with basal cell nevus syndrome, xeroderma pigmentosum, or cutaneous T-cell lymphoma (CTCL) basal cell carcinoma (BCC). We report 4 cases with BCC confirmed by histopathology who were treated by short-term systemic acitretin combined with retinoic acid 0.1% cream. The 4 cases with BCC showed good response to the treatment without severe adverse effects during treatment and follow-up. The finding suggests that acitretin may be an appropriate treatment option for elderly patients who require less invasive treatment for BCC.

Proteus syndrome (PS) is a rare and sporadic disorder characterized by overgrowth of multiple tissues and a propensity to develop particular neoplasms. The clinical manifestations of PS include macrodactyly, vertebral abnormalities, asymmetric limb overgrowth and length discrepancy, hyperostosis, abnormal and asymmetric fat distribution, asymmetric muscle development, connective tissue nevi, and vascular malformations. We report a 16-year old female patient who manifested a number of these complications and review the Chinese literature about the diagnosis, natural history, and management of PS.

Byline: Zhang. Xi-Bao, Zhang. San-Quan, He. Yu-Qing, Luo. Yu-Wu, Luo. Quan, Li. Chang-Xing Background : Netherton syndrome (NS) is a severe autosomal recessive ichthyosis. It is characterized by congenital ichthyosiform [...]

Background: The recent emergence of azithromycin-resistant (AZM-R) N. gonorrhoeae isolates that have coevolved decreased susceptibility to extended-spectrum cephalosporins has caused great concern. Here we investigated the prevalence of decreased susceptibility to ceftriaxone (CRO(D)) in AZM-R isolates and genetically characterized AZM-R isolates in Guangzhou, China from 2009 to 2013.Methods: The minimum inhibitory concentration (MIC) of AZM and ceftriaxone was determined using an agar-dilution method. All AZM-R isolates were screened for mutations in 23S rRNA, mtrR and penA genes and genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST).Results: Of the 485 identified N. gonorrhoeae isolates, 445 (91.8%) were isolated from male urethritis subjects, and 77 (15.9%) were AZM-R (MIC ≥ 1 mg/L), including 33 (6.8%) with AZM low-level resistant (AZM-LLR, MIC = 1 mg/L) and 44 (9.1%) with AZM middle-level resistant (AZM-MLR, MIC ≥ 2 mg/L). Significantly more CRO(D) (MIC ≥ 0.125 mg/L) showed in AZM-MLR isolates (43.2%, 19/44) as compared with that in AZM-LLR isolates (18.2%, 6/33) (p < 0.05). For the 23S rRNA, mtrR, penA or combined 23S rRNA/MtrR/penA mutations, no significant difference was found between AZM-LLR isolates and AZM-MLR isolates (P > 0.05); similar results were detected between combined AZM-LLR/CRO(D) isolates and combined AZM-MLR/CRO(D) isolates (P > 0.05). No mutation A2059G or AZM high-level resistant (AZM-HLR, MIC ≥ 256 mg/L) isolate was detected. Among 77 AZM-R isolates, 67 sequence types (STs) were identified by NG-MAST, of which 30 were novel. Most STs were represented by a single isolate.Conclusions: The AZM-R together CRO(D) isolates are now present in Guangzhou, China, which deserve continuous surveillance and the mechanism of concurrent resistance needs further study. [ABSTRACT FROM AUTHOR]