We report two cases of male monkeypox patients in a homosexual partnership, and both of them were infected with HIV. Both patients had typical skin lesions, high fever, a history of unprotected sex with men, and positivity of MPXV-qPCR.

Tranexamic acid has been increasingly used in dermatology in recent years. The drug is mainly administrated orally at low doses with good safety, and the most common adverse reactions are gastrointestinal discomfort and menstrual irregularity. However, long-term systemic application of tranexamic acid can lead to a variety of adverse reactions, such as thrombosis, hepatic and kidney impairment, visual defects, etc. Therefore, regularly monitoring blood coagulation function, D-dimer, hepatic and kidney function and other related indicators is necessary when taking tranexamic acid for a long time, so as to detect and manage adverse reactions timely and ensure drug safety.

We report a case of dupilumab-induced immune drifting from atopic dermatitis to polymyalgia rheumatica. A 66-year-old female presented with bilateral shoulder pain, widespread myalgia and morning stiffness for 4 weeks. She has had a history of moderate-to-severe atopic dermatitis and was treated with dupilumab over the past 48 weeks. Physical examination revealed limitation of active shoulder, hip and knee abduction but the muscle strength was normal. Laboratory findings showed elevated levels of erythrocyte sedimentation rate, C-reactive protein, while creatine kinase, rheumatoid factor and anti-cyclic peptide containing citrulline were of normal value. The patient was treated with low dose of prednisone, methotrexate, and other supportive treatment and the myalgias, rash and pruritus improved.

Treatment of hypereosinophilic syndrome with dupriulizumab has been reported abroad, but not in China. Herein, we report a case of dupriulizumab in the treatment of hypereosinophilic syndrome successfully. The patient received subcutaneous injection of dupilumab at an initial dose of 600 mg, 300 mg after 1 week, then once every 2 weeks with a dose of 300 mg. After 3 weeks of treatment, the pruritus was significantly relieved, and the skin lesions basically subsided after 7 weeks. Erysipelas appeared on the 3rd day after the first dose of treatment, which was improved by anti-infection.

Bullous pemphigoid (BP) is a common autoimmune bullous derma, which mainly occurs in the elderly patients, and such patients often have a history of multiple neurological diseases, thrombosis and embolism, so the application of glucocorticoids in the treatment of elderly BP patients is a great challenge. Herein, we report  a case of successful treatment of elderly BP patients complicated with multi-system chronic history with dupriuzumab alone.  A 91-year-old female presented with itching erythema, blister on the trunk and limbs for half a year. The patient had a history of hypertension for more than 2 years, myocardial infarction for 4 years and cerebral infarction for 2 years. The diagnosis of BP was diagnosed based on the results of biopsy immunohistochemistry and serum antibodies, and the baseline BPDAI score was 18. The patient was treated with dupriuzumab, and the initial dose was 600 mg ,then 300 mg was given after 2 weeks. The lesions subsided and  pigmentation remained 3 weeks after the second dose, and the BPDAI score decreased to 4. The patient did not relapse after 3 months of follow-up.

The traditional oral drugs of palmoplantar pustulosis includes acitretin, methotrexate, cyclosporine A, the use of which are often limited due to adverse reactions. Jak inhibitors such as tofacitinib could affect a series of cytokines by inhibiting the JAK-STAT pathway, and play an immunomodulatory role. The clinical efficacy of JAK inhibitors in psoriasis and atopic dermatitis has been confirmed. We reporte three cases of palmoplantar pustulosis successfully treated with tofacitinib and reviewed the relevant literature.

A 68-year-old male presented with papules, nodules and pruritus on his trunk and limbs for eight months. He developed these rashes three days after the first dose of inactivated COVID-19 vaccine injection, and symptoms worsened after the second injection. Combined with pathology and direct immunofluorescence, the diagnosis of pemphigoid nodularis was made. The patient was treated with tripterygium wilfordii polyglycosides, minocycline, azathioprine and topical corticosteroids for 3 months, and his condition gradually improved.

Alopecia areata (AA) is an autoimmune dermatological disease characterized by non-scarring hair loss, its etiology is still unknown, it could be related to environment, heredity and immunity. It is well accepted that the “loss of immune immunity” of hair follicles during the growth period plays an important role in the etiology of AA. In recent years,  the common immunological characteristics of AA and other autoimmune diseases have been discovered, and a variety of new biological agents have been gradually tried to apply to treat severe AA and those with poor efficacy of traditional therapies. The update of the immunologic mechanism of alopecia areata is reviewed in this paper.

Spitzoid melanoma (SM) is a specific subtype of malignant melanoma. The patient presented with pink nasal nodules, painless rapid growth for 3 months, but surface ulceration, which was early misdiagnosed as pyogenic granuloma. The diagnosis of Spitz nevus-like melanoma was made according to the features of pathology.

A 41-year-old male presented with erythematous, desquamative dermatitis  all over the body for 40 days. The clinical manifestation and biopsy features of the lesions were consistence with both pityriasis rubra pilaris and psoriasis, with negative family history. The age of first onset was 41 years old. Preliminary diagnosis was pityriasis rubra pilaris (Type I). Systemic acitretin shows significant improvement. Whole-exome and Sanger DNA sequencing were used to characterize the disease gene in the patient, and a novel heterozygous mutation c.1799 C>T(p.Pro600Leu) in the CARD14 gene was identified. The final diagnosis of CAPE (CARD14-associated papulosquamous eruption) was made according to the clinical and pathological features, as well as the genetic results.

Rosacea is a chronic recurrent inflammatory skin disease. With the development of the pathogenesis of rosacea, some new therapeutic methods have been used in treating clinic, including drug of antimicrobials, antimalarials, ROS inhibitors, JAK inhibitors, biologics, photoelectric therapy of radiofrequency therapy, 577nm near-yellow laser, ALA-PDT, ultrasound, injection therapy of botox and platelet, and dietary therapy. The new treatment methods in the past five years are reviwed in this paper.

Objective: To compare the efficacy and safety of secukinumab and adalimumab in the treatment of nail psoriasis. Methods: The patients with nail psoriasis and treated with secukinumab or adalimumab at the Department of Dermatology and Venereology of Tianjin Medical University General Hospital from January 2020 to March 2023 were retrospectively analyzed. The efficacy and safety of the two groups were evaluated after 0, 4, 12, 24 and 36 weeks of administration, respectively. The t test was used to compare the measurement data between the two groups, and the Fisher exact test was used to compare the count data between the two groups, to analyze the improvement of NAPSI before and after treatment in the two groups. Results: A total of 36 patients were collected, including 17 treated with secukinumab and 19 treated with adalimumab. The NAPSI score decreased by 7.60±4.34, 13.20±4.09, 17.60±3.79 and 21.20±4.87, and the decreasing rates of NAPSI score were (13.87±8.80)%, (24.13±9.44)%, (32.11±8.87)% and (38.41±9.64)% after 4, 12, 24 and 36 weeks in secukinumab treatment group. The NAPSI score decreased by 12.17±5.49, 25.67±9.69, 38.67±15.54, 34.67±18.49 and the decreasing rates of NAPSI score were (20.19±7.20)%, (45.34±11.96)%, (62.64±18.59)% and (71.83±19.64)% after 4, 12, 24 and 36 weeks in adalimumab treatment group. Conclusions: Secukinumab and adalimumab were equally effective in the treatment of nail psoriasis at week 4. At the 12th week of treatment, the efficacy of adalimumab began to be better than that of secukinumab. At the 24th week of treatment, adalimumab was significantly more advantageous.

Sweet syndrome (SS) is an inflammatory neutrophilic dermatosis of unknown etiology, which is associated with infections, drugs, tumors and autoimmune diseases. The pathogenesis involves neutrophil dysfunction, immune imbalance and genetic factors. Traditional first-line treatment is preferred to the systematic application of glucocorticoids. In recent years, as the research of SS has made some progress, biologics and small molecule targeted drugs have also been reported to treat SS successfully. The pathogenesis and therapeutic progress of SS are reviewed in this paper.

Melkersson-Rosenthal syndrome (MRS) is a rare syndrome involving nerve, skin, and mucosal, which characterized by a triad of recurrent oral facial swelling, recurrent peripheral facial paralysis, and cracked tongue. The classical manifestation is only found in 8%~25% of patients, so MRS is always misdiagnosed. Herein, we report three cases of classical MRS cases.

Objective: To access the clinical effect of combined therapy on androgenic alopecia. Methods: Sixty male patients with androgen alopecia were randomly divided into control group and treatment group. Patients in the control group were treated with finasteride tablets, 1 mg, methylprednisolone tablets 4 mg, doxycycline hydrochloride tablets 100 mg, twice daily, and minoxidil tincture twice daily, selenium disulfide lotion, twice a week. The patients in the treatment group were given additional intradermal injection of diprospan mixed with 2% lidocaine, once a month. 1 month was 1 course of treatment, and the patients were treated for a total of 3 courses. Results: The effective rate of the treatment group was 76.67% , which was higher than that of the control group (50.00%) . The scores of scalp itching, greasy, alopecia and scaly in the two groups were obviously decreased, and the treatment group was obviously better than the control group. No obvious adverse reaction was found in the two groups during the treatment. Conclusions: The multi-center study on comprehensive treatment of androgenic alopecia is effective.

Objective: To compare the efficacy and safety between ixekizumab and adalimumab in the treatment of moderate to severe plaque psoriasis. Methods: A retrospective study was conducted among patients with moderate-to-severe plaque psoriasis using ixekizumab or adalimumab from January 2020 to October 2022. Psoriasis lesion area and severity index (PASI), dermatologic quality of life index （DLQI） and adverse events were analyzed at baseline, 2, 4, 8, 12 and 24 week after administrating. Results: A total of 48 patients were analyzed in this study, including 31 patients in the ixekizumab treatment group and 17 patients in the adalimumab treatment group. Among the 48 patients, 37 were treated for 24 weeks, of which 25 were in the ixekizumab treatment group and 12 were in the adalimumab treatment group. PASI90 response rates in the ixekezumab group were 0%, 32.26%, 80.65% and 84.00% at 2, 4, 12 and 24 week after dosing, and PASI 100 response rates were 0%, 12.90%, 45.16% and 64.00%. The PASI 90 response rates were 0%, 5.88%, 47.06% and 66.67% and PASI 100 response rates were 0%, 5.88%, 23.53% and 25.00% in the adalimumab treatment group at 2, 4, 12 and 24 week. The median time to reach PASI 75 in the ixekizumab group was 4 weeks, that  of in the adalimumab group was 8 weeks.  No serious adverse reactions were observed in any of the patients. Conclusion: The short-term effect of ixekizumab were superior to adalimumab at improvement lesion severity as well as onset of action in the treatment of moderate to severe psoriasis vulgaris. The safety of the two drugs is comparable.

Drug induced hypersensitivity syndrome (DIHS) is a severe adverse drug reaction. Genetic susceptibility, drug-metabolizing enzymes deficiency, immune changes and virus reactivation may be involved in the etiology of DIHS. The traditional treatment includes glucocorticoids, immunosuppressant, intravenous immunoglobulin, plasmapheresis and so on. The research of DIHS has made certain progress and the application of targeted small-molecule inhibitors and biologic agents have been used successfully to treat DIHS in recent years. The pathogenesis and therapeutic advances of DIHS are reviewed in this paper.

We summarized 4 patients with severe bullous pemphigoid successfully treated by dupilumab combined with glucocorticoid, providing reference for the treatment of severe bullous pemphigoid. Of 4 patients, 3 had obvious itching accompanied by eosinophilia and the disease was controlled on day 2, 3, and 1st after treatment with glucocorticoid combined with dupriuzumab, respectively, the eosinophil count decreased to normal on day 6, 9, and 3rd, the dose of glucocorticoid began to be reduced on day 4, 10, and 4th. The other patient with concomitant tumors, had no obvious itching and normal eosinophil count, the condition was controlled after 10 days of medication, and the dose of glucocorticoid was reduced 14 days later.  Dupilumab combined with glucocorticoid is an effective method for the treatment of severe bullous pemphigoid patients.

We report a patient with refractory bullous pemphigoid was treated with glucocorticoid at first, but the effect was poor. Rituximab was used for treatment, and the rash recurred with severe pruritus. After oral administration of the JAK1 inhibitor abrocitinib, the pruritus was rapidly relieved, and there was no recurrence of the rash during follow-up.

Vitiligo is an autoimmune disease present with pigment cell damage related white patch for both skin and mucosa, which is easy to diagnose and difficult to treat. Current treatment options are mostly off-label and lack specific therapeutic drugs. In recent years, several studies have shown that systemic and topical targeted immunotherapy, including biological agents and small-molecule inhibitors, are effective in the treatment of vitiligo, shedding new light on the treatment of vitiligo. We review the clinical studies of systemic and topical targeted immunotherapy in recent years to add knowledge for the clinical treatment of vitiligo.

A 25-year-old male of Han nationality presented with gray plaques on the balanus for 9-days, sore throat and fever for 6 days and erythema, papulovesicles and vesicles scattered over the body for 2 days. The patient has a history of unprotected MSM 4 days before onset of illness. Physical examination revealed a congested posterior pharyngeal wall and three soy-sized enlarged lymph nodes with tenderness on both sides of the neck and on the right groin. Erythema scattered on his face, neck, trunk and upper limbs with rice-sized vesicles, papulovesicles and pustules. It was noted that multiple gray-white annular protuberant plaques located in the coronary sulcus with sticky secretions on the surface, leathery and tender. Histopathology of the plaque in coronary sulcus showed patchy necrosis surrounded by reticular degeneration in epidermis, with balloon-like cells, neutrophils and nuclear dust. There was also hemorrhage and necrosis vessels in superficial and middle dermis, as well as perivascular lymphocytic infiltration in superficial and deep dermis. qPCR results of monkeypox virus was positive in specimens such as blood, throat swabs, secretion of plaques on the coronal sulcus, swabs of vesicles on the face, upper limbs, and back. The diagnosis of monkeypox was confirmed based on the history of unprotected sex with men, clinical and histopathological manifestations, and positive qPCR results.

Monkeypox is a zoonotic disease caused by monkeypox virus. Monkeypox was predominantly prevalent in the Africa region, but the outbreaks continuously occurred in increasing number of traditionally non-endemic countries and regions since May 2022 indicating a human-to-human transmission. The epidemiological characteristics and its developing trend of these outbreaks were reviewed to provide the basis for formulating prevention and control strategies.

Mast cells are innate immune cells in human body and participate in diverse immune diseases. It has been proved that mast cell stabilizers that inhibit degranulation and the release of inflammatory mediators could be an effective treatment of rosacea. This review summarizes the research progress in the role of mast cells in the pathogenesis of rosacea and mast cell stabilizers in the treatment of rosacea, aiming to provide a basis for basic research and clinical treatment of rosacea.

It was previously reported that 82% of the patients with severe monkeypox were HIV infected, and there were also reports that immunocompromised HIV patients died after being infected with the monkeypox virus. This paper reported a case of monkeypox complicated with AIDS, syphilis and local bacterial infection. The patient had poor compliance with ART antiviral therapy, and high HIV viral load, and low immune function. After being infected with monkeypox virus, typical features such as rash, fever, and local lymphadenopathy appeared, and the hospital stay was longer than the average hospital stay of monkeypox in the region. Therefore, patients with low immune function had serious condition, and the hospital stay was longer, which should be paid enough attention to.

In recent years, more studies have shown that JAK-STAT signaling pathway plays an important role in the immune pathogenesis of vitiligo, and JAK inhibitors based on this pathway have shown a strong therapeutic prospect in the treatment of vitiligo. The update of the mechanism, clinical efficacy and safety of JAK inhibitors of vitiligo in recent years are reviewed in this paper.

The itching caused by primary cuticular amyloidosis (PCA) is unbearable, and the response to the treatment is currently poor, which greatly affected the patient's quality of life. In recent years, it has been found that the significant therapeutic effects by systemic use of system dupilumab, upadacitinib, baricitinib, and abrocitinib, as well as local use of tranexamic acid, gabapentin, dimethyl sulfoxide solution, fire needle therapy, and lattice carbon dioxide laser. The update of the treatment of PCA is reviewed in this paper to provide reference for clinical practice.

Immune checkpoint inhibitors (ICPIs) are a new type of anti-tumor immunotherapy drugs, which activate T cells to eliminate cancer cells by specifically binding to the inhibitory receptors on the surface of T cells, and obtain a good anti-tumor effect. However, a series of immune-mediated or immune-related adverse reactions may occur during the course of treatment, among which skin adverse reactions are the most common. In this paper, the literature of bullous pemphigoid caused by the immune checkpoint inhibitor programmed cell death 1(PD-1) and its ligand programmed cell death ligand 1 (PD-L1) were analyzed retrospectively. To review the prevalence rate, pathogenesis, clinical features, diagnosis and treatment methods.

DRG (Diagnosis Related Group, DRG) payment is a key way of medical insurance payment reform currently promoted by the state, which is to settle medical insurance expenses according to the weight of disease diagnosis grouping. The wide variety of dermatology diseases and the low weight of the overall disease group lead to low payment standards. How to better operate and develop and provide high-quality diagnosis and treatment services under the background of DRG payment reform is a challenge for dermatological hospitals and dermatology departments. Based on the data of our hospital , this paper analyzed the DRG management system of our hospital, including disease operation management, disease cost control, adjustment of income structure, standardization of path management, strengthening of department operation management, while improving the quality of the first page of medical records and the accuracy of coding, carrying out day ward and day surgery, strengthening communication with medical insurance agencies, optimizing information system construction, etc., to provide reference for the operation mode of DRG payment in dermatology.

Objective: To evaluate efficacy and safety of dupilumab in the treatment of bullous pemphigoid (BP). Methods: A retrospective study was conducted among 16 patients with BP treated by dupilumab from February, 2021 to February, 2023. The clinical, laboratory and COVID-19 infection date were analyzed. The severity of skin lesions and itching were evaluated by bullous pemphigoid disease area index (BPDAI) and numerical rating scale (NRS) respectively. Karnofsky score was used to evaluate the functional status of BP patients. Common Terminology Criteria for Adverse Events (CTCAE) was used for adverse events evaluation. Results: A total of 16 BP patients were included in this study. At week 16, 8 (50%) cases achieved disease control, 6 (37.5%) cases achieved complete remission, 2 (12.5%) cases were discontinued due to poor efficacy or adverse reactions. The average score of BPDAI and NRS decreased from 38.38±21.90 and 8.8±0.65 to 8.37±9.45 and 3.2±1.05, with significant differences (Ps＜0.05). Karnofsky score increased from 44.67±23.01 to 79.33±19.82 (P＜0.05). Among the 16 patients, 3 (18.7%) tested positive for COVID-19 and improved after symptomatic or topical treatment, while the rest remained stable. Respiratory failure and granulocytopenia occurred in 1 case (6.25%), systemic sweating in 1 case (6.25%), and local adverse reactions in 2 cases (12.5%). No other adverse events were found. Conclusion: The COVID-19 epidemic has no significant impact on the disease management of BP patients enrolled in this study. Dupilumab is an effective and safe treatment for bullous pemphigoid patients.

Objective: To evaluate the efficacy and safety of dupilumab in the treatment of adult prurigo nodularis (PN). Methods: The data of adult patients with PN who were treated with regular dupilumab for 16 weeks in our hospital from May 2021 to October 2021 were retrospectively anlyzed. The efficacy and safety were accessed using the Numerical rating scale(NRS), Dermatology Life Quality Index(DLQI), Investigator's Global Assessment (IGA),and Eczema area and severity index (EASI) at weeks 0,4,8,16. Results: A total of 28 patients were collected. After 16 weeks of treatment, the scores of NRS, DLQI, IGA and EASI of 28 patients all decreased significantly, which decreased from 8.96±0.88, 24.54±3.12, 4.00±0.67 and 39.64±10.89 at baseline to 0.96±0.88, 2.43±1.40, 0.86±0.53 and 7.10±3.68, respectively, with significant differences (Ps<0.05). Dry eye occurred in 1 patient, local injection reactions occurred in 4 patients, and no other serious adverse events occurred. Conclusion: Dupilumab can continuously improve the skin lesions and pruritus of nodular pruritus with high safety, which provide a new treatment option for PN.

Atopic dermatitis is a common chronic recurrent, itchy and inflammatory skin disease with high incidence rate and complex pathogenesis. TRPV1, as an important member of the transient receptor potential family, participates in the pathophysiology and pathogenesis of various skin diseases. Recent research evidence has also found a strong correlation between TRPV1 and the pathogenesis of atopic dermatitis. Currently, some drugs targeting TRPV1 have achieved good efficacy and safety in treating atopic dermatitis. The update of TRPV1 in the pathogenesis and treatment of atopic dermatitis is reviewed in this paper.

Objective: To identify the pathogen in a patient with long-term chronic facial infection and whether the patient has innate immunodeficiency. Methods: The lesions of the patients were collected, and biopsy, fungal culture, bacterial culture, strain sequencing were performed. The sequencing results were compared in Genebank and the Westerdijk Fungal Biodiversity Institute website to identify the strains. Whole exome sequencing was performed on the patient to screen for pathogenic mutations, and the found pathogenic mutations were further verified by Sanger sequencing. Results: The patient was infected with Fusarium verticillioides, which was diagnosed as localized skin Fusarium verticillioides infection, and the lesion recovered after oral administration of itraconazole. The sequencing results showed that the patient carried a homozygous frameshift mutation of CARD9 gene (c.820 _ 821insG, p.D274Gfs * 61). Conclusion: This is the first report of a case of localized skin Fusarium moniliforme infection with CARD9 deficiency, which enriches the phenotype spectrum of CARD9 deficiency diseases and suggests that patients with long-term chronic infection should consider the possibility of genetic defects.

Psoriasis is a chronic inflammatory skin disease induced by a combination of genetics and environment and mediated by immunity. Tyrosine kinase 2 (TYK2) and Signal Transducer and Activator of Transcription (STAT) protein are the main pathways of cytokine regulation and play critical roles in mediating inflammation and immune response. Deucravacitinib is the first innovative drug recently approved by the U.S. Food and Drug Administration (FDA) as the only TYK2 inhibitor for the treatment of moderate-to-severe psoriasis. It mediates the transcription of key inflammatory mediators through the TYK2/STAT pathway and in the pathogenesis of psoriasis. Compared with other Janus Kinase (JAK) inhibitors, deucravacitinib is more promising for its highly selective inhibition of inflammatory pathways through metabotropic inhibition. This paper summarizes the mechanism of action and research progress of deucravacitinib in the treatment of psoriasis.

Objective: To evaluate the cost-effectiveness of interleukin (IL)-17A antagonists, TNF-α antagonists, and IL-23 antagonists in the treatment of moderate-to-severe plaque psoriasis. Methods: A Markov model was constructed according the phase III clinical trial data to compare the medical costs and effectiveness of biological agents during treatment for psoriasis. The costs and utility parameters from published literature and various publicly available statistical information. Cumulative medical costs, Quality Adjusted Life Year (QALY), and Incremental Cost Effectiveness Ratio (ICER) were used as the outcome. One-way sensitivity analysis(DSA) and probability sensitivity analysis(PSA) was conducted to verify the robustness of the model results. Results: Over the course of a year, compared with secukinumab, the ixekizumab would produce an additional 0.04 QALYs, and the total costs were saved ￥21099.91. Compared with adalimumab, ixekizumab had an absolute cost-effectiveness advantage by adding 0.46 QALYs while reducing the medical cost of ￥18977.40. The incremental QALYs of guselkumab were 0.09 compared with ixekizumab and 0.59 compared with adalimumab, while with an incremental cost-effectiveness ratio (ICER) much greater than three times GDP per capita, guselkumab did not demonstrate a cost-effectiveness advantage over. ixekizumab and adalimumab. According to the analysis results of the model, the cost-effectiveness advantage relationship between various biologics was expressed as follows: IL-17A antagonists > TNF-α antagonists > IL-23 antagonists based on current health service costs in our country. Probabilistic sensitivity analyses confirmed the robustness of the results. Conclusion: IL-17A antagonists provide more cost-effective advantages than TNF-α antagonists and IL-23 antagonists in the treatment of moderate to severe plaque psoriasis.

Palmoplantar pustulosis (PPP) is a chronic recurrent disease confined to the palmoplantar region, and there is no uniform standard of treatment. Targeted drugs and emerging drugs have been carried out in several clinical trials and case series studies. This paper reviews the progress of clinical research on PPP-related biologics and small molecule targeted drugs to provide a reference for further clinical treatment and related drug development.

As a rare atypical mycobacterium, Mycobacterium cosmeticum can cause cutaneous granuloma. We report the first case in China of Mycobacterium cosmeticum infection. A 22-year-old female presented with erythema on the right arm for cat bite for 2 months and the past medical history was healthy. The histopathology was consistent with infectious granuloma and tended to atypical mycobacterium infection. The skin tissue was sequenced and the phylogenetic tree analysis was carried out. The final diagnosis was Mycobacterium cosmeticum infection. After the long-term treatments with adjusted medication, the lesion subsided by using condition by using ciprofloxacin, clarithromycin, and minocycline.

Researchers have been using platelet-rich plasma (PRP) as a treatment for alopecia areata since it was introduced as the first generation of autologous blood-derived growth factors. PRP has been found to be an effective adjunctive therapy for the treatment of alopecia areata. This paper reviews the mechanism of action and recent clinical applications of PRP in the treatment of alopecia areata.

There is no standard treatment scheme for lichen planus nail at present, and traditional treatment is limited due to severe pain and other side effects and poor efficacy. Tofacitinib is an oral, small-molecule JAK inhibitor that inhibits all JAKs, especially JAK1 and JAK3. We reported a case with lichen planus successfully treated by tofacitinib.

A 52-year-old female presented with rash on the trunk and limbs with fever and headache for 1 month. Dermatology showed multiple papules and nodes on the trunk and limbs with tenderness. Scab was seen in the center of some rashes.TPPA was positive and TRUST titer was 1∶64. The patient was treated with benzylpenicillin, but the decrease degree of TRUST titre and the skin lesions improved very slowly. After treated for 18 months, the lesions turned brown atrophic scars and TRUST titer decreased to 1∶2.