The occurrence of Kaposi′s sarcoma (KS) is closely related to Kaposi′s sarcoma-associated herpesvirus (KSHV) infection of endothelial cells. KSHV infection can present as various types of KS, and clinical features, severity and prognosis differ among different types of KS. Classic KS is characterized by localized lesions and slow progression, AIDS-related KS and endemic KS are highly aggressive, and iatrogenic KS needs control of the primary disease during treatment. Therefore, individualized therapies should be developed according to the clinical classifications and characteristics of KS. This review summarizes treatment modalities of and research progress in KS.

Narrow-band ultraviolet B (NB-UVB) phototherapy has been regarded as the first-line treatment of generalized vitiligo. However, NB-UVB monotherapy exhibits limited efficacy with a long course of treatment. NB-UVB phototherapy combined with other therapies can shorten the course of treatment and improve the therapeutic effect, and has become a commonly used therapeutic regimen in clinical practice. This review summarizes research progress in the combined therapies of NB-UVB with other approaches for the treatment of vitiligo, such as glucocorticoids, afamelanotide, calcineurin inhibitors, Janus kinase inhibitors, platelet-rich plasma, fractional CO 2 laser and surgical treatment, in order to provide more options for clinical treatment of vitiligo.

Microneedling is a simple, safe, effective, minimally invasive, and economical treatment technique with a wide range of indications. Studies in China and other countries have showed that microneedling plays a role in the treatment of androgenetic alopecia. Compared with traditional therapies, combined microneedling has better therapeutic efficacy, shorter treatment course and a better safety profile. This review summarizes the therapeutic efficacy, mechanisms of action and safety of combined microneedling, and describes prospective trends in the treatment of androgenetic alopecia with combined microneedling based on recent relevant Chinese and international literature.

Objective:To investigate the clinical efficacy of bilateral V-Y advancement island flaps on buttocks in repairing postoperative defects in patients with perianal Paget′s disease.Methods:From January 2009 to January 2021, a retrospective analysis was performed on clinical data collected from 13 patients with perianal Paget′s disease, whose perianal defects resulting from the tumor resection were reconstructed with bilateral V-Y advancement island flaps on the buttocks in the Department of Dermatology, Hangzhou Third People′s Hospital. The postoperative recovery of the buttocks and the effects on the defecation function were evaluated.Results:The areas of perianal defects in 13 cases ranged from 4.8 cm × 5.6 cm to 12.2 cm × 6.4 cm. All defects were successfully repaired by using the bilateral V-Y advancement island flaps, and all surgical wounds healed primarily. One case first received temporary ileostomy, and then received ileostomy closure 3 months later, resulting in the recovery of defecation function; in another 1 case of perianal Paget′s disease comorbid with rectal cancer, the permanent sigmoid colostomy was performed to divert feces, and the defecation function was lost. After the follow-up for 1 - 6 years, the buttocks were symmetrical in shape in all the 13 patients, and 12 with preserved anus had normal defecation function. No tumor recurrence was observed in 12 patients without other malignant tumors after the operation, while 3 patients experienced mild anal stenosis without anal mucosa eversion or wound dehiscence; 1 patient with perianal Paget′s disease complicated by anal canal adenocarcinoma developed bilateral inguinal lymph node and internal iliac lymph node metastasis 1 year after the operation, and died 6 months later.Conclusion:The bilateral V-Y advancement island flaps on the buttocks have the advantages of reliable blood supply and sufficient advancement mobility, and can be used to repair large skin defects around the anus.

Vitiligo is an acquired depigmented disease, and neurological factors may play an important role in its pathogenesis. Neurogenic inflammatory factors released by sensory nerves that control the skin can directly or indirectly regulate functions of keratinocytes, melanocytes, Langerhans cells, dermal dendritic cells, mast cells, dermal microvascular endothelial cells and immune cells. This review summarizes roles of several relevant neurogenic inflammatory factors in the occurrence and development of vitiligo, including neuropeptide Y, calcitonin gene-related peptide, catecholamines and nerve growth factor, with a view to providing new ideas for clinical treatment of vitiligo.

Objective:To investigate the clinical efficacy of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers.Methods:Totally, 100 infants and preschoolers with pigmented facial lesions were enrolled from the Department of Dermatology, Hanzhong Central Hospital and the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2019, and their clinical data were analyzed retrospectively. Among these patients, there were 59 males and 41 females, and their age ranged from 3 months to 5 years, with an average age of 15 months. All patients underwent outpatient surgery under local anesthesia, and sedative drugs were used before operation. The skin lesions were excised once or in stages according to their areas, and incisions were closed by using a subcutaneous asymmetric suture-based tension reduction technique, followed by dermal buried angular mattress sutures. After surgery, medical silicone gels and tension reduction devices were used for 6 months to 1 year, and postoperative follow-up was performed.Results:All patients were followed up for more than 1 year after surgery. Four patients showed suture rejection reaction within two months after surgery, and the incisions completely healed after the suture knots were discharged; cat′s ear-shaped scars were formed at the upper and lower ends of the incisions in 3 cases when the sutures were removed 1 week after surgery, no treatment was given, and the cat′s ear-shaped scars gradually became flat after 1 year of follow-up; fat liquefaction occurred in 1 case 4 days after surgery, re-suturing of the incision was done 1 week after the removal of internal sutures and drainage, and the incision healed well; 1 case developed infection 3 days after surgery, and then received the removal of internal sutures, drainage, and anti-infection treatment, re-suturing was performed after complete regression of the incision swelling, and the incisions healed well; scar hyperplasia occurred in 4 cases 3 to 6 months after surgery, and the scars became flat after the local injection of triamcinolone acetonide. In the remaining children, fine white linear scars were formed after the healing of incisions, the depressions and ridges at both ends of the incisions became flat, and there was no obvious pulling sensation in facial organs or formation of cat′s ear-shaped scars.Conclusions:Subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture can effectively reduce tension twice during delicate facial surgery in infants and preschoolers, and help to avoid incision widening and scar hyperplasia. The follow-up showed favorable long-term efficacy and aesthetic effect.

Objective:To analyze the clinical efficacy of electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation in the treatment of vitiligo-associated leukotrichia.Methods:Clinical data were retrospectively collected from 25 patients with stable vitiligo-associated leukotrichia in the Department of Dermatologic Surgery, Hangzhou Third People′s Hospital from January 2019 to January 2021. All the patients received electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation. Outpatient follow-up visits were conducted in the first week, as well as the first, third and sixth months after surgery. The texture and growth status of transplanted hair were observed, and the survival rate of transplanted hair follicles and the proportion of newborn white hair in white hair in the original lesions were recorded.Results:Among the 25 patients with stable vitiligo, there were 14 males and 11 females, and their disease duration ranged from 2 to 15 years, with the average duration being 5.8 years. A total of 30 white patches accompanied by leukotrichia were included, including 9 on the scalp, 7 on the eyebrows and 14 on the eyelashes. One week after surgery, the transplanted hair survived well in all patients, without obvious shedding or local infection. Six months after surgery, repigmentation was observed in most hair in the original lesion area, and only a small amount of white hair grew out, without obvious scarring; the survival rate of transplanted hair follicles was 76.5% ± 10.0%, and the proportion of newborn white hair in white hair in the original lesions was 16.7% ± 7.8%.Conclusion:Electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation was effective in the treatment of vitiligo-associated leukotrichia, with a simple treatment process and few postoperative complications, which provided a reliable choice for the clinical treatment of vitiligo-associated leukotrichia.

Objective:To identify pathogenic genes in 3 cases of piebaldism, and to explore the genotype-phenotype relationships in piebaldism.Methods:Clinical data were collected from 3 patients with piebaldism and their parents at the Department of Dermatology, Henan Provincial People′s Hospital from January 2019 to December 2021. Peripheral blood samples were obtained from them and 100 unrelated healthy controls, and DNA was extracted. Whole-exome sequencing technology was used to screen genetic variation sites, and then Sanger sequencing was performed for verification. The deleteriousness of genetic variants was evaluated by using pathogenicity analysis software tools.Results:Case 1: a 23-year-old male patient presented with white patches on the forehead, chest, and abdomen for 23 years, and his parents had no similar symptoms; case 2: a 1-year- and 5-month-old male infant presented with white patches on the forehead and abdomen for 1 year, and his parents had no similar symptoms; case 3: a 6-year-old male child presented with white patches on the forehead and limbs for 6 years, and his parents had no similar clinical manifestations. Genetic testing showed that a missense mutation c.2033T>C (p.L678P) in exon 14 of the KIT gene, a splice site mutation c.2485-1G>C in exon 18 of the KIT gene, and a heterozygous missense mutation c.2346C>G (p.F782L) in exon 16 of the KIT gene were identified in the case 1, 2, 3 respectively, but no above mutations were identified in the patients′ parents or 100 unrelated healthy controls. The 3 genetic variants were all novel pathogenic mutations, and all were deleterious mutations.Conclusions:Three novel pathogenic mutations in the KIT gene were identified in the 3 cases of piebaldism, namely c.2033T>C (p.L678P), c.2485-1G>C, and c.2346C>G (p.F782L). It was further verified that the severity of piebaldism was closely related to the type and location of KIT gene mutations.

Based on the results of the latest basic research on vitiligo, this article elucidates the significance of reconfiguration of glucose metabolism, lipid metabolism, amino acid metabolism, and metabolism of gut microbiota in the pathogenesis of vitiligo, attempts to delineate a panoramic picture of metabolic reconfiguration in vitiligo, and discusses the importance of dialectically and uniformly grasping the crosstalk between multiple metabolic pathways, and of thinking about the mechanisms of action of multiple metabolic pathway reconfiguration in the occurrence of vitiligo in individuals from a holistic perspective in future basic studies, in order to promote the understanding of the vitiligo pathogenesis and explore potential treatment methods for vitiligo.

In recent years, great progress has been made in the research on the pathogenesis of vitiligo, and many new treatment methods and drugs have emerged. Interferon-γ-activated Janus kinase (JAK) signaling and melanocyte regeneration signaling pathways are the most concerned targets in the research on the treatment of vitiligo. This article summarizes the efficacy of current new drugs targeting these pathways and the experience in applying these drugs in the treatment of vitiligo. JAK inhibitors are currently the most promising new drugs for the treatment of vitiligo, and their efficacy can be improved in combination with phototherapy.