In recent years, growing evidence has suggested a strong correlation between the development of melasma and abnormal endocrine hormone levels, particularly sex hormones. This review summarizes clinical data on sex hormone profiles in melasma patients from previous studies, analyzes the roles of various hormones in pigmentation and the pathogenesis of melasma, and investigates their clinical significance as well as directions for future research.

Melasma is an acquired pigmentation disorder with complex pathogenesis. In addition to the dysfunction of melanocytes, the imbalance of the microenvironment, particularly the multicellular interactions among keratinocytes, fibroblasts, vascular endothelial cells, mast cells, and sebocytes, also contributes to the progression of melasma. This review summarizes relevant research progress on melanocytes and their microenvironment in the pathogenesis of melasma, as well as advances in the treatment of melasma.

Acquired dermal macular hyperpigmentation (ADMH) is a group of diseases clinically characterized by grayish-black macules and patches, with pigment predominantly deposited in the dermis. ADMH includes Riehl's melanosis, lichen planus pigmentosus, and erythema dyschromicum perstans/ashy dermatosis. In light of the remarkable similarities in both morphological and histopathological characteristics among this group of diseases, the academic community has recently proposed the new nosological term "acquired dermal macular hyperpigmentation" to achieve integration and unified classification of these related disorders. This review comprehensively elaborates on advances in the diagnosis and treatment of ADMH, including clinical manifestations, dermoscopic findings, pathological characteristics, and treatment progress.

Melanocyte death is the most notable feature of vitiligo, and ferroptosis is a unique pattern of programmed cell death, characterized by the iron-dependent accumulation of lethal lipid reactive oxygen species. Recent studies have found that ferroptosis is involved in the damage to melanocytes in the development of vitiligo. This review summarizes the possible mechanisms of ferroptosis in vitiligo and related therapeutic agents, aiming to provide novel insights into the pathogenesis of vitiligo, potential therapeutic targets, and associated targeted therapies.

Since the global outbreak in 2022, the mpox epidemic has evolved from an African endemic to a public health emergency of international concern. The 2024 mpox outbreak in the Democratic Republic of the Congo caused by the Clade Ⅰb lineage is yet another wake-up call, with markedly higher prevalence and fatality rates observed among children under 15 years of age, thereby presenting new challenges for the children. Therefore, it is necessary to strengthen prevention and control, block mother-to-child transmission routes, and establish innovative models with active community participation to reduce the risk of mpox transmission. In the future, it is urgent to analyze molecular mechanisms underlying the mother-to-child transmission of the virus, develop targeted antiviral drugs, establish a pediatric critical disease scoring system, and incorporate mpox vaccines into the World Health Organization′s expanded programme on immunization.

This article summarizes the current status and research advances in the diagnosis and treatment of pediatric skin tumors and vascular malformations, with particular emphasis on the pathogenesis, clinical manifestations, diagnostic approaches, and therapeutic options for hemangiomas, vascular malformations, histiocytosis, mastocytosis, and mycosis fungoides. With the enhanced understanding of distinctive growth and regression patterns of pediatric skin tumors, therapeutic strategies have been progressively optimized. However, significant challenges persist in managing pediatric skin neoplasms. Future investigations should prioritize the establishment of pediatric-specific molecular diagnostic and therapeutic systems, and integrate precision medicine with individualized strategies, so as to improve clinical outcomes and quality of life in affected children.

Atopic dermatitis (AD) is a common chronic inflammatory skin disease in children, significantly impairing their quality of life. In recent years, advances in the understanding of AD pathogenesis have led to major breakthroughs in its pharmacological treatment. However, the diagnosis and management of AD remain challenging. This article systematically analyzes the current status and key challenges in the diagnosis and treatment of pediatric AD in China, including the complexity of diagnosis and differential diagnosis, insufficient physician/patient education, difficulties in pruritus management, underrecognized psychiatric comorbidities, delayed accessibility of targeted therapies, and infection risk management. Future directions should focus on accelerating the development of targeted therapies, promoting the implementation of precision medicine, and establishing comprehensive long-term management policies, with the goal of enhancing standardized diagnosis and treatment of pediatric AD in China and improving outcomes for affected children.

Objective:To evaluate the efficacy and safety of dupilumab in the treatment of moderate-to-severe atopic dermatitis (AD) in infants aged 6 months to 2 years.Methods:A prospective cohort study was conducted. Children aged 6 months to 2 years with moderate-to-severe AD were enrolled from the Department of Dermatology, Children′s Hospital of Chongqing Medical University between July 2022 and March 2023. Children weighing 5 to < 15 kg received subcutaneous injections of dupilumab at a dose of 200 mg every 4 weeks, while those weighing 15 to < 30 kg received subcutaneous injections of dupilumab at a dose of 300 mg every 4 weeks. Three age-matched healthy children were recruited as controls at the same time. Clinical assessments were performed at weeks 0, 2, 4, 8, 12, and 16 by using the parameters scoring AD (SCORAD), eczema area and severity index (EASI), investigator′s global assessment (IGA), body surface area (BSA) involvement, patient-oriented eczema measure (POEM), pruritus numerical rating scale (NRS), sleep NRS, and infants′ dermatitis quality of life (IDQoL) index. The primary efficacy endpoint was the proportion of patients achieving an IGA score of 0 or 1 (IGA0/1) at week 16, and the key secondary efficacy endpoint was the proportion of patients achieving at least 75% improvement from baseline in EASI (EASI75) at week 16. In addition, serum immunoglobulin (Ig) E, IgG, IgM, and IgA levels and peripheral blood eosinophil counts were measured at weeks 0, 4, and 16. Peripheral blood T helper (Th) cell subsets were analyzed in 10 AD patients and 3 healthy children at baseline by flow cytometry, and 6 AD patients underwent repeat testing at week 16. Adverse reactions were recorded throughout treatment. Changes in clinical scores over time after dupilumab treatment were analyzed using repeated-measures analysis of variance, and changes in serum total IgE levels were analyzed using generalized estimating equations.Results:A total of 12 children with AD were enrolled, including 8 males and 4 females, aged 1.5 ± 0.3 years, and the baseline SCORAD was 64.8 ± 9.9 points. Compared with baseline, SCORAD, EASI, IGA, BSA, POEM, pruritus/sleep NRS, and IDQoL scores were all significantly reduced at week 2 (all P < 0.05), and continued to decrease at weeks 4, 8, 12, and 16. At week 16, the IGA scores decreased from 3.9 ± 0.3 points at baseline to 1.7 ± 0.9 points, with 9 patients achieving IGA0/1; the EASI scores decreased from 28.1 ± 12.4 points at baseline to 4.9 ± 5.4 points, with 9 patients achieving EASI75. Compared with baseline, serum total IgE levels were significantly reduced at weeks 4 and 16 (Wald χ2 = 11.51, P = 0.003). At baseline, the proportion of Th2 cells among total CD3 +CD4 + T cells in patients was significantly higher than that in healthy controls (6.3% ± 1.3% vs. 4.3% ± 0.8%, t = 2.45, P = 0.032) ; at week 16, the proportion of Th2 cells in patients (5.3% ± 2.0%) was significantly lower than that at baseline ( t = 5.56, P = 0.003). The proportion of Th1/17 cells increased from 2.2% ± 1.5% at baseline to 3.9% ± 2.1% at week 16 ( t = 3.51, P = 0.007), whereas the proportions of Th1 and Th17 cell subsets showed no statistical significance compared with baseline (both P > 0.05). One patient experienced an injection-site reaction and another developed fever, but no treatment-related serious adverse reactions were observed. Conclusions:Dupilumab demonstrated favorable efficacy and safety in infants aged 6 months to 2 years with moderate-to-severe AD. In addition, dupilumab could decrease the proportion of Th2 cell subsets and serum levels of total IgE.

Objective:To investigate clinical characteristics, treatment approaches, and prognosis of drug-induced hypersensitivity syndrome (DIHS) in children.Methods:A retrospective analysis was performed on clinical data from pediatric inpatients with DIHS in Department of Dermatology, Beijing Children's Hospital from 2009 to 2023. The clinical data included demographic characteristics, clinical manifestations, laboratory findings, treatment regimens, and outcomes.Results:A total of 103 children with DIHS were included, comprising 54 males (52.4%) and 49 females (47.6%), with ages ( M [ Q1, Q3]) of 2.3 (1.2, 4.5) years. Primary causative drugs were antibiotics (52 cases, 45.2%), antiepileptic drugs (41 cases, 35.7%), and nonsteroidal anti-inflammatory drugs (19 cases, 16.5%), with a median latency period of 12 days. All patients presented with rashes, including 72 (69.9%) with maculopapular rashes, 69 (67.0%) with edema (including 46 with facial edema). Lip involvement occurred in 25 cases (24.3%), and mucosal involvement was noted in 11 cases (10.7%). Additionally, 102 (99.0%) patients had fever, and 79 (76.7%) presented with lymphadenectasis. Eosinophilia was present in 64 cases (62.1%). Among 84 patients tested for atypical lymphocytes, 51 (60.7%) showed elevated percentages of atypical lymphocytes. Liver involvement was noted in 94 cases (91.3%), followed by pulmonary involvement in 31 (30.1%), gastrointestinal symptoms in 25 (24.3%), cardiac involvement in 14 (13.6%), renal involvement in 10 (9.7%), and pancreatic involvement in 7 cases (6.8%). Among 82 patients tested for blood immunocytes, 49 (59.8%) showed decreased percentages of B lymphocytes, and 69 (84.1%) showed decreased percentages of natural killer cells. Of 88 patients tested for serum immunoglobulins, 40 (45.5%) showed decreased IgA levels. Among 20 patients tested for serum cytokines, 15 (75.0%), 15 (75.0%), 13 (65.0%), and 12 (60.0%) showed elevated levels of interleukin (IL) -5, IL-6, IL-10, and interferon-γ, respectively. All patients received systemic glucocorticoid therapy, among whom 86 additionally received intravenous immunoglobulin therapy, 4 received Janus kinase inhibitors, and 3 received dupilumab. Five patients died, 9 developed hemophagocytic lymphohistiocytosis, 6 developed bronchiolitis obliterans, and 5 experienced long-term immune-related sequelae. Conclusions:Among these children with DIHS, antibiotics were the most common causative drugs, and the latency period could be shorter than 2 weeks. In addition to the common involvement of the liver and lungs, gastrointestinal and cardiac impairments were relatively frequent, while renal involvement was rare. Immunological features included decreased percentages of B lymphocytes and natural killer cells, reduced IgA levels, and elevated levels of cytokines such as IL-5, IL-6, IL-10, and interferon-γ.

Psoriasis is an immune-mediated chronic, relapsing, inflammatory, systemic disease. With advances in the understanding of its mechanisms, treatment strategies have evolved from conventional anti-inflammatory and immunosuppressive approaches to precise targeted interventions against specific cytokines or inflammatory pathways, markedly improving therapeutic efficacy and safety. This article comprehensively reviews the current landscape of psoriasis management and discusses the advancements and emerging trends based on clinical evidence.