1.Comparative analysis of clinical characteristics between psoriasis-atopic dermatitis overlap phenotype and psoriasis vulgaris: a single-center retrospective exploratory study
Yuanxiong HE ; Sisi DENG ; Zhiqiang SONG
Chinese Journal of Dermatology 2025;58(11):1027-1033
Objective:To analyze the clinical characteristics between patients with psoriasis-atopic dermatitis overlap (PAO) and those with psoriasis vulgaris (PSO), and to enhance the understanding of the diagnosis and treatment of this overlap phenotype.Methods:A retrospective exploratory study was conducted on clinical data from patients who were diagnosed with PAO or PSO at the Department of Dermatology, Southwest Hospital, Army Medical University between January 2018 and June 2025. Clinical characteristics, laboratory examination results, comorbidities, and treatment regimens were compared between the two groups. Categorical data were compared using the chi-square test or Fisher's exact test; for non-normally distributed measurement data, intergroup comparisons were conducted using the Mann-Whitney U test. Results:A total of 103 PSO patients and 13 PAO patients were included. Patients in the PAO group were older than those in the PSO group ( M [ Q1, Q3]:63.00 [54.00, 71.50] years vs. 50.00 [38.00, 61.00] years; Z = 2.75, P = 0.006]. No significant differences were found between the two groups in terms of gender distribution, body mass index, disease duration, personal or family history of atopic diseases (all P > 0.05). Skin lesions involved the whole body in both PAO and PSO groups, with the trunk and limbs being commonly affected sites, and no significant difference in the lesion distribution was observed ( P > 0.05). Compared with the PSO group, the PAO group had fewer plaque lesions (5/13 [38.5%] vs. 70/103 [68.0%]), but more eczematous changes such as erosions and exudation, as well as scratches and crusts due to pruritus (all P < 0.05). Laboratory tests revealed that the PAO group showed increased peripheral blood neutrophil counts, eosinophil counts, serum IgE levels, eosinophil-to-lymphocyte ratios (ELRs), and neutrophil-to-lymphocyte ratios (NLRs) compared with the PSO group (all P < 0.05) ; moreover, the proportions of patients with elevated eosinophil counts (5/13 [38.5%] vs. 8/103 [7.8%], P < 0.001) and those with elevated serum IgE levels (10/13 [76.9%] vs. 39/103 [37.9%], P = 0.014) were significantly higher in the PAO group than in the PSO group. Compared with the PSO group, the PAO group had a higher overall comorbidity rate (11/13 [84.6%] vs. 52/103 [50.5%], P = 0.035), including a higher prevalence of hypertension. Regarding topical treatments, no significant differences were found in the use frequency of topical glucocorticoids (96 [93.2%] vs. 11 [84.6%]) or vitamin D3 analogs between the two groups (both P > 0.05) ; for systemic treatments, immunosuppressants such as cyclosporine (4/13 [30.8%] vs. 2/103 [1.9%], P = 0.001) and Tripterygium wilfordii (4/13 [30.8%] vs. 7/103 [6.8%], P = 0.021) were more commonly used in the PAO group compared with the PSO group; for targeted therapies, the PSO group received interleukin (IL) -17A inhibitors (13 cases, 12.6%), IL-23 inhibitors (4 cases, 3.9%), or tumor necrosis factor-α inhibitors (5 cases, 4.9%), while the PAO group received Janus kinase inhibitors (2 cases, 15.4%) or an IL-23 inhibitor (1 case, 7.7%) . Conclusions:PAO exhibited characteristics of both PSO and atopic dermatitis, with distinct differences in skin manifestations, laboratory findings, and treatment approaches compared with PSO. Topical glucocorticoids were the primary topical treatment for PAO, while systemic treatment was centered on immunosuppressants, highlighting the need for personalized treatment strategies.
2.Comparative analysis of clinical characteristics between psoriasis-atopic dermatitis overlap phenotype and psoriasis vulgaris: a single-center retrospective exploratory study
Yuanxiong HE ; Sisi DENG ; Zhiqiang SONG
Chinese Journal of Dermatology 2025;58(11):1027-1033
Objective:To analyze the clinical characteristics between patients with psoriasis-atopic dermatitis overlap (PAO) and those with psoriasis vulgaris (PSO), and to enhance the understanding of the diagnosis and treatment of this overlap phenotype.Methods:A retrospective exploratory study was conducted on clinical data from patients who were diagnosed with PAO or PSO at the Department of Dermatology, Southwest Hospital, Army Medical University between January 2018 and June 2025. Clinical characteristics, laboratory examination results, comorbidities, and treatment regimens were compared between the two groups. Categorical data were compared using the chi-square test or Fisher's exact test; for non-normally distributed measurement data, intergroup comparisons were conducted using the Mann-Whitney U test. Results:A total of 103 PSO patients and 13 PAO patients were included. Patients in the PAO group were older than those in the PSO group ( M [ Q1, Q3]:63.00 [54.00, 71.50] years vs. 50.00 [38.00, 61.00] years; Z = 2.75, P = 0.006]. No significant differences were found between the two groups in terms of gender distribution, body mass index, disease duration, personal or family history of atopic diseases (all P > 0.05). Skin lesions involved the whole body in both PAO and PSO groups, with the trunk and limbs being commonly affected sites, and no significant difference in the lesion distribution was observed ( P > 0.05). Compared with the PSO group, the PAO group had fewer plaque lesions (5/13 [38.5%] vs. 70/103 [68.0%]), but more eczematous changes such as erosions and exudation, as well as scratches and crusts due to pruritus (all P < 0.05). Laboratory tests revealed that the PAO group showed increased peripheral blood neutrophil counts, eosinophil counts, serum IgE levels, eosinophil-to-lymphocyte ratios (ELRs), and neutrophil-to-lymphocyte ratios (NLRs) compared with the PSO group (all P < 0.05) ; moreover, the proportions of patients with elevated eosinophil counts (5/13 [38.5%] vs. 8/103 [7.8%], P < 0.001) and those with elevated serum IgE levels (10/13 [76.9%] vs. 39/103 [37.9%], P = 0.014) were significantly higher in the PAO group than in the PSO group. Compared with the PSO group, the PAO group had a higher overall comorbidity rate (11/13 [84.6%] vs. 52/103 [50.5%], P = 0.035), including a higher prevalence of hypertension. Regarding topical treatments, no significant differences were found in the use frequency of topical glucocorticoids (96 [93.2%] vs. 11 [84.6%]) or vitamin D3 analogs between the two groups (both P > 0.05) ; for systemic treatments, immunosuppressants such as cyclosporine (4/13 [30.8%] vs. 2/103 [1.9%], P = 0.001) and Tripterygium wilfordii (4/13 [30.8%] vs. 7/103 [6.8%], P = 0.021) were more commonly used in the PAO group compared with the PSO group; for targeted therapies, the PSO group received interleukin (IL) -17A inhibitors (13 cases, 12.6%), IL-23 inhibitors (4 cases, 3.9%), or tumor necrosis factor-α inhibitors (5 cases, 4.9%), while the PAO group received Janus kinase inhibitors (2 cases, 15.4%) or an IL-23 inhibitor (1 case, 7.7%) . Conclusions:PAO exhibited characteristics of both PSO and atopic dermatitis, with distinct differences in skin manifestations, laboratory findings, and treatment approaches compared with PSO. Topical glucocorticoids were the primary topical treatment for PAO, while systemic treatment was centered on immunosuppressants, highlighting the need for personalized treatment strategies.
3.Pharmacokinetic study on baicalin and wogonoside in diabetic rats in vivo after oral administrating Huanglian-Jiedu Decoction
Yuanxiong DENG ; Changhua YANG ; Lingli MOU
Chinese Traditional and Herbal Drugs 1994;0(02):-
Objective To investigate the pharmacokinetic profiles of baicalin and wogonoside in diabe-tic rats in vivo,which are two major constituents in Huanglian-Jiedu Decoction(HJD).Methods The diabetic rats were induced by ip administration of streptozotocin(STZ).After the establishment of the method and the set-up of diabetic rats,the pharmacokinetic profiles of baicalin and wogonoside were investigated.Diabetic and normal rats were ig HJD extract,and then the blood samples were collected at the given time points.Contents of baicalin and wogonoside in diabetic and normal rat plasma were assayed by HPLC-UV method.The pharmacokinetic parameters(except Cmax and tmax) were analyzed by noncompartmental method.The area under the serum concentration-time curve(AUC0-t) was calculated using trapezoidal rule to the last point.Moreover,the presystemic metabolism of baicalin was investigated and compared to explore the pharmacokinetic difference by fermentation of baicalin in feces suspensions of normal and diabetic rats,respectively.Results The pharmacokinetic parameters of baicalin in normal and diabe-tic rats were:(4.50?1.92) and(7.5?1.0) h for tmax 2;(2.83?0.25) and(9.54?2.87) ?g/mL for Cmax1,(2.56?0.63) and(6.58?1.15) ?g/mL for Cmax2;(37.58?7.57) and(92.75?24.62) ?g?h/mL for AUC(0~24),(6.6?2.4) and(12.64?3.35) h for t1/2,respectively.And the pharmacokinetic parameters of wogonoside in normal and diabetic rats were:(5.5?1.0) and(8.00?1.63) h for tmax 2;(1.36?0.17) and(6.16?1.40) ?g/mL for Cmax1;(1.58?0.17) and(4.11?0.76) ?g/mL for Cmax2;(27.02?3.72) and(58.16?16.43) ?g?h/mL for AUC(0~24);(9.72?2.24) and(7.89?1.63) h for t1/2,respectively.The results indicated that Cmax1,Cmax2,AUC(0~24) of baicalin and wogonoside were significantly enhanced and t1/2 of baicalin was remarkably extended when compared with the normal rats.And the results also revealed that baicalin contained in HJD hydrolyzed more rapidly when incubated in the feces suspension of diabetic rats than in that of normal rats.Conclusion The results indicate that the pharmacokinetic difference of baicalin between diabetic and normal rats may result from the presystemic metabolism of baicalin.

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