Chronic urticaria (CU) is one of the most common diseases in dermatology clinics, mainly characterized by recurrent wheals and pruritus. CU often co-exists with various comorbidities, including autoimmune diseases, infectious diseases, allergic diseases, mental diseases, metabolic syndrome, malignant tumors and endocrine system-related diseases. Currently, Chinese and international guidelines have not provided specific recommendations for screening comorbidities in CU. This review summarizes common comorbidities associated with CU, aiming to provide a reference for clinical diagnosis and treatment.

Chronic urticaria (CU) is one of the most common diseases in dermatology clinics, mainly characterized by recurrent wheals and pruritus. CU often co-exists with various comorbidities, including autoimmune diseases, infectious diseases, allergic diseases, mental diseases, metabolic syndrome, malignant tumors and endocrine system-related diseases. Currently, Chinese and international guidelines have not provided specific recommendations for screening comorbidities in CU. This review summarizes common comorbidities associated with CU, aiming to provide a reference for clinical diagnosis and treatment.

Objective:To analyze the clinical features of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), and to evaluate the accuracy of the TEN-specific severity-of-illness score (SCORTEN) in predicting death.Methods:A retrospective analysis was conducted on 104 patients with SJS/TEN at the First Affiliated Hospital of Army Medical University between December 2003 and December 2023. Clinical data, such as sensitizing drugs, clinical manifestations, laboratory tests, SCORTEN scores, and treatment regimens, were collected and retrospectively analyzed. The efficacy of different treatment modalities for TEN was analyzed. The receiver operating characteristic (ROC) curve was used to assess the accuracy of SCORTEN in predicting death in TEN patients.Results:Among the 104 patients, 57 were males and 47 were females, with ages ranging from 12 to 93 years (45.45 ± 19.76 years). There were 52 cases of SJS and 52 cases of TEN (including 1 case of SJS-TEN overlap). The ages of SJS patients (40.42 ± 17.06 years) were significantly lower than those of TEN patients (50.48 ± 21.13 years; t = 2.67, P = 0.009) ; the total hospital stay was 14.47 ± 7.24 days, and the TEN patients had significantly longer hospital stays (16.65 ± 7.82 days) compared with the SJS patients (12.29 ± 5.92 days; t = 3.21, P = 0.002). Definite sensitizing drugs were identified in 82 patients; combined drugs were the most common sensitizing cause (26 cases, 25.00%), and 20 patients reported combination treatment with antibiotics; 56 patients (53.85%) were treated with single drugs, and the common sensitizing drugs included carbamazepine (16 cases, 15.38%), nonsteroidal anti-inflammatory drugs (13 cases, 12.50%), and allopurinol (9 cases, 8.65%). Laboratory test results showed that the proportions of patients with decreased lymphocyte counts, elevated alanine aminotransferase and/or aspartate aminotransferase levels, decreased albumin levels, and with increased creatinine levels were significantly higher in the TEN patients than in the SJS patients (all P < 0.05), while the proportion of patients with increased monocyte counts was significantly lower in the TEN patients than in the SJS patients ( P = 0.006). Among the 52 TEN patients, 33 had SCORTEN scores < 3 points and 19 had scores ≥ 3 points, with 12.32 expected deaths and 4 actual deaths; the ROC curve analysis indicated that the area under the curve for SCORTEN in predicting death in TEN patients was 0.784 (95% CI: 0.558 - 1.00). Of the 104 patients, 57 (54.81%) received a monotherapy regimen (glucocorticoids only), and 47 (45.19%) received combination therapies, including glucocorticoids combined with intravenous immunoglobulin (IVIG) in 42 cases. Among the TEN patients, 30 started combination therapy with IVIG within 7 days after glucocorticoid treatment (early combination therapy group), and 7 patients started IVIG after 7 days of glucocorticoid treatment (late combination therapy group). The early combination therapy group showed a shorter time to lesion stabilization (10.82 ± 3.35 days) compared with the late combination therapy group (15.50 ± 4.04 days; LSD- t = 2.87, P = 0.006) . Conclusions:The main sensitizing cause in SJS/TEN patients was the combination of antibiotics. Early combination of glucocorticoids and IVIG could shorten the disease course in TEN patients to some extent. SCORTEN still holds a certain clinical value in predicting the prognosis of TEN patients.

Objective:To analyze the clinical features of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), and to evaluate the accuracy of the TEN-specific severity-of-illness score (SCORTEN) in predicting death.Methods:A retrospective analysis was conducted on 104 patients with SJS/TEN at the First Affiliated Hospital of Army Medical University between December 2003 and December 2023. Clinical data, such as sensitizing drugs, clinical manifestations, laboratory tests, SCORTEN scores, and treatment regimens, were collected and retrospectively analyzed. The efficacy of different treatment modalities for TEN was analyzed. The receiver operating characteristic (ROC) curve was used to assess the accuracy of SCORTEN in predicting death in TEN patients.Results:Among the 104 patients, 57 were males and 47 were females, with ages ranging from 12 to 93 years (45.45 ± 19.76 years). There were 52 cases of SJS and 52 cases of TEN (including 1 case of SJS-TEN overlap). The ages of SJS patients (40.42 ± 17.06 years) were significantly lower than those of TEN patients (50.48 ± 21.13 years; t = 2.67, P = 0.009) ; the total hospital stay was 14.47 ± 7.24 days, and the TEN patients had significantly longer hospital stays (16.65 ± 7.82 days) compared with the SJS patients (12.29 ± 5.92 days; t = 3.21, P = 0.002). Definite sensitizing drugs were identified in 82 patients; combined drugs were the most common sensitizing cause (26 cases, 25.00%), and 20 patients reported combination treatment with antibiotics; 56 patients (53.85%) were treated with single drugs, and the common sensitizing drugs included carbamazepine (16 cases, 15.38%), nonsteroidal anti-inflammatory drugs (13 cases, 12.50%), and allopurinol (9 cases, 8.65%). Laboratory test results showed that the proportions of patients with decreased lymphocyte counts, elevated alanine aminotransferase and/or aspartate aminotransferase levels, decreased albumin levels, and with increased creatinine levels were significantly higher in the TEN patients than in the SJS patients (all P < 0.05), while the proportion of patients with increased monocyte counts was significantly lower in the TEN patients than in the SJS patients ( P = 0.006). Among the 52 TEN patients, 33 had SCORTEN scores < 3 points and 19 had scores ≥ 3 points, with 12.32 expected deaths and 4 actual deaths; the ROC curve analysis indicated that the area under the curve for SCORTEN in predicting death in TEN patients was 0.784 (95% CI: 0.558 - 1.00). Of the 104 patients, 57 (54.81%) received a monotherapy regimen (glucocorticoids only), and 47 (45.19%) received combination therapies, including glucocorticoids combined with intravenous immunoglobulin (IVIG) in 42 cases. Among the TEN patients, 30 started combination therapy with IVIG within 7 days after glucocorticoid treatment (early combination therapy group), and 7 patients started IVIG after 7 days of glucocorticoid treatment (late combination therapy group). The early combination therapy group showed a shorter time to lesion stabilization (10.82 ± 3.35 days) compared with the late combination therapy group (15.50 ± 4.04 days; LSD- t = 2.87, P = 0.006) . Conclusions:The main sensitizing cause in SJS/TEN patients was the combination of antibiotics. Early combination of glucocorticoids and IVIG could shorten the disease course in TEN patients to some extent. SCORTEN still holds a certain clinical value in predicting the prognosis of TEN patients.

Objective:To explore the efficacy and safety of microneedle radiofrequency combined with supramolecular salicylic acid in improving facial photoaging.Methods:Thirty patients treated for facial photoaging were randomly divided into the combined treatment group and the microneedle radiofrequency group. All patients were female, aged between 30 and 50 years, with an average age of (39.4±4.1) years. The combined treatment group was treated with microneedle radiofrequency combined with supramolecular salicylic acid, and the Microneedle radiofrequency group was treated with microneedle radiofrequency alone. The patients were followed up 3 days, 7 days, 14 days, 28 days and 3 months after treatment. The results of VISIA, skin physiology and patients' satisfaction were used to compare the two groups of patients after treatment.Results:After 3 months of treatment, the skin pores (11.98±2.14 vs. 15.54±1.52), brown spots (12.40±1.85 vs. 15.84±1.42), ultraviolet spots (6.74±0.87 vs. 11.20±1.70), skin physiological status (transepidermal water loss): 11.84±1.80 vs 13.09±1.96 g/(h·m) 2, stratum corneum water content: 84.91±2.86 % vs 80.29±3.58 %, melanin index: 110.07±15.02 vs. 122.30±9.97, erythema index: 220.43±19.69 vs. 236.30±16.55), elasticity (75.98±3.94 vs. 69.89±3.58), epidermal thickness (1401.33±178.43 vs. 1217.13±139.77), skin color improvement (effective rate 86.7% vs. 40.0%) and patients' satisfaction (total satisfaction was 93.3% vs 67.0%) in the combined treatment group were significantly superior than those in the microneedle radiofrequency group, and the differences were statistically significant ( P<0.05). The reaction of moderate and severe erythema (the incidence rate 40.0% vs. 86.7%) and edema (the incidence rate 26.7% vs. 80.0%) in the combined treatment group was also significantly lower than that in the microneedle radiofrequency group ( P<0.05). No adverse pigmentation was reported in both groups after treatment. Conclusions:The combination of microneedle radiofrequency and supramolecular salicylic acid in the treatment of facial photoaging has definite clinical effect and high safety, which is worthy of clinical application.

This review comprehensively summarizes clinical assessment tools which have been developed and validated for cholinergic urticaria (CholU) , involving diagnosis and severity assessment of CholU, assessment of patients′ quality of life, and assessment of disease control. The application methods and status of relevant tools in clinical practice are introduced in detail.

A large number of studies have shown that immunoglobulin E (IgE) not only participates in the occurrence and development of allergic reactions, but also induces and aggravates autoimmune reactions through various mechanisms. IgE autoantibodies have been confirmed to be present in a variety of autoimmune skin diseases, and may be involved in the occurrence and development of related diseases by affecting multiple immune cells such as dendritic cells, mast cells, and basophils via binding to autoantigens. This review summarizes the role and possible mechanism of action of IgE in the induction and exacerbation of autoimmune skin diseases such as systemic lupus erythematosus, bullous pemphigoid and chronic idiopathic urticaria, and provides a theoretical basis for clinical diagnosis and treatment.

Aim To study the inhibitory activities of potential new anti-influenza virus agents,3-O-β-chaco-triosyl pentacyclic triterpenoids against the entry of H5N1influenza viruses.Methods Three target com-pounds were designed and synthesized structurally re-lated to the lead compound 3-O-β-chacotriosyl dioscin derivative (1 )with inhibitory activities against H5N1 influenza viruses.The inhibitory activities of these tar-get compounds were tested at a cellular level pseudo vi-rus system targeting H5N1 influenza viruse entry.Re-sults All the compounds 1 a,1 b and 1 c showed po-tent inhibitory activities against the entry of A/Thai-land/Kan353/2004 pseudo virus into the target cells, of which compound 1 b showed the best inhibitory activ-ity with an IC50 value of (1.25 ±0.22)μmol·L-1. Conclusion The SARs analysis of these compounds indicated that replacement of the aglycone moiety of compound 1 with pentacyclic triterpenoids could in-crease antiviral activity.Different types of pentacyclic triterpen as aglycone residue had the significant influ-ence on the inhibitory activity (1 b >1 c >1 a),sug-gesting ursane type of triterpenes was superior to the two other kinds of triterpenes as aglycone residue.