Background Plantar warts (verrucae plantaris), caused by human papillomavirus, are common and often resistant to standard therapies, which can be painful and damaging. Novel, noninvasive options are needed. Objective To evaluate the safety and preliminary efficacy of a topical nitric oxide–releasing solution (NORS) as a self-administered therapy for plantar warts. Methods In this Phase 2a, multicenter, randomized, double-blind, placebo-controlled trial, 20 participants with ≥3 plantar warts were randomized (1:1:1) to NORS 1X (41.1 PPM·min), NORS 3X (121.9 PPM·min), or placebo. Participants completed 15-minute footbaths three times weekly for 3 weeks, followed by 2 weeks of observation. The primary endpoint was complete wart clearance at Day 35; secondary endpoints included ≥70% wart area reduction, pain change, and Physician Wart Assessment (PWA) grading. Results NORS was well tolerated with no serious adverse events; mild, transient irritation occurred in 85% of participants. Complete clearance was achieved in 6% (NORS 1X), 8% (NORS 3X), and 0% (placebo). A ≥ 70% wart area reduction occurred in 21%, 16%, and 12%, respectively. Pain improvement and a 50% reduction in severe warts (PWA grade 3) were observed only with NORS 3X. Conclusion NORS demonstrated favorable safety and early clinical activity, warranting larger, longer-term efficacy trials. Trial Registration ClinicalTrials.gov Identifier NCT05877313.

Objectives Papuloerythroderma of Ofuji (PEO) is a rare disorder characterized by the ‘deck-chair sign’ and is diagnosed according to the criteria proposed by Torchia et al. in 2009. This study aims to summarize the clinical manifestations, emerging treatments, and prognosis of PEO, and to explore the efficacy and paradoxical flares associated with dupilumab treatment. Methods We report two cases associated with dupilumab treatment and conducted a search of PubMed, Embase, the China Knowledge Resource Integrated, and the Wanfang databases using the keywords ‘papuloerythroderma of Ofuji’ for the period from July 2009 to October 2024. Results A total of 52 patients were included, with onset most commonly occurring in their 70s. The systemic treatments included dupilumab (n = 7), cyclosporine (n = 6), oral glucocorticoids (n = 5), acitretin (n = 4), methotrexate (n = 3), and apremilast (n = 1). Dupilumab was administered to seven patients, and the skin lesions improved within a short period. No adverse effects were reported in three patients, although elevated eosinophil counts accompanied by worsening lesions were observed in one patient. Conclusions Our findings suggest that dupilumab is the most commonly utilized treatment for PEO; however, elevated eosinophil counts and potential exacerbation of clinical symptoms warrant attention. Additionally, Tripterygium glycosides may be an effective therapy to improve these conditions.

Objective The clinical effectiveness of 2% crisaborole cream and amorolfine hydrochloride cream on keratinized tinea pedis is the goal of this investigation. Methods Using random numbers, 100 patients with keratotic tinea pedis were split into two groups: the observation group received 2% crisaborole ointment and amorolfine hydrochloride cream once a night for four weeks, while the control group received white vaseline and amorolfine hydrochloride cream once a night. The two groups were compared in terms of clinical efficacy, adverse reaction incidence, and improvement in the dermatological quality of life index (DLQI) score. Results Following four weeks of treatment, the observation group’s overall effective rate was 98%, which was significantly higher than 82%, and the difference was statistically significant (p < 0.001). The pruritus scales were (6.12 ± 1.92) days, (12.01 ± 3.89) days, (3.92 ± 3.02) days, and (15.09 ± 3.98) days in the control group. The observation group was significantly lower than the control group at both the 2-week and 4-week treatment points (p < 0.001). The incidence of negative effects did not differ significantly between the two groups (p > 0.05). Conclusions For keratinized tinea foot, 2% crisaborole ointment can increase the effectiveness of amorolfine hydrochloride cream.

Background An increasing number of psoriatic patients are experiencing secondary failure with interleukin (IL)-17A inhibitors, highlighting the urgency to identify effective switching strategies. We evaluated the effectiveness and treatment patterns of intraclass versus interclass switching therapies in psoriasis patients experiencing secondary failure to IL-17A inhibitors over a 28-week period. Methods This single-center, retrospective analysis included psoriatic patients who experienced secondary failure to either ixekizumab or secukinumab and subsequently switched to another IL-17A inhibitor (ixekizumab or secukinumab; intraclass switching group) or to an IL-23 inhibitor (guselkumab; interclass switching group). Results 80 patients were enrolled, including 47 in the intraclass switching group and 33 in the interclass switching group. The mean psoriasis area and severity index and dermatology life quality index were lower in the intraclass switching group compared to the interclass switching group at each time point over 28 weeks (p < .05). The discontinuation rate was higher in the interclass switching group (24.1%) compared to the intraclass switching group (2.7%; p < .05). Previous exposure to ≥2 biologics working on different pathways was identified as a risk factor for treatment failure in the interclass switching group. Conclusion An intraclass switch following IL-17A inhibitors failure yielded better treatment outcomes than a switch to guselkumab.

Objective To compare the efficacy and safety of oral corticosteroids and JAK inhibitors as adjunctive treatments following non-cultured epidermal cell suspension (NCES) transplantation in patients with stable vitiligo. Methods Data were collected from 12 patients with stable vitiligo who underwent NCES transplantation at the Fourth Affiliated Hospital of Soochow University between June 2023 and December 2024. Postoperatively, 36 lesions (from 7 patients) were treated with oral corticosteroids, and 34 lesions (from 5 patients) with upadacitinib, totaling 70 vitiligo lesions evaluated. Clinical efficacy and safety were assessed over a 6-month follow-up period. Results Both treatment groups showed similar mean repigmentation rates at 6 months. However, the distribution of responses differed. Patients treated postoperatively with JAK inhibitors demonstrated a more polarized pattern, while those receiving corticosteroids showed a more uniform distribution. Anatomical analysis revealed significantly better responses in the face and trunk compared to acral areas in both groups. Notably, JAK inhibitors showed potential advantages in traditional treatment-resistant regions such as the limbs. No serious adverse events were observed in either group. Conclusion Both JAK inhibitors and corticosteroids appear to be safe and effective postoperative options following NCES. The choice of immunomodulatory strategy may influence repigmentation patterns, especially at different anatomical sites.

Background Solar lentigo (SL) is a skin disorder associated with photoaging. Studies suggest that high-intensity focused ultrasound can improve UV-induced hyperpigmentation and melasma. Objectives To evaluate the efficacy and safety of high-intensity macro-focused ultrasound (HI-MFU) for treating SL in Chinese. Methods This is a prospective, single-center study. Twenty-one patients with SL on both cheeks underwent HI-MFU treatment. Follow-ups at baseline and 2, 4, 6, and 8 weeks post-treatment were conducted to assess improvements using clinical imaging, noninvasive skin assessments, and the Global Esthetic Improvement Scale. Results The lesional and non-lesional areas showed an increase in L* values at all time points (p < 0.05). Transepidermal water loss values decreased on the left at 8 weeks (p < 0.001). Only two patients experienced transient mild pain and localized edema post-treatment. Two-photon microscopy revealed an uneven two-photon-excited fluorescence signal enhancement surrounding the nuclei of the stratum granulosum and stratum spinosum cells in the SL. At 8 weeks post-treatment, fluorescence signals in both areas were reduced compared to those at baseline. Conclusions HI-MFU effectively and safely treats SL and enhances skin tightness, lightness, and barrier function, suggesting its ultrasound-toning potential.

Background Bullous pemphigoid (BP) is a common autoimmune subepidermal bullous disease. Dupilumab, an IL-4/IL-13 inhibitor, represents a novel therapeutic approach for BP, but real-world long-term data in super-elderly patients are limited. Methods This retrospective, single-center observational study included super-elderly BP patients (≥80 years) receiving dupilumab monotherapy from September 2022 to September 2024. Disease severity was assessed using BPDAI and NRSP, and BP180 antibody, total IgE, and eosinophil count were monitored over 52 weeks. Results Thirteen patients with mild to moderate BP were enrolled. Ten (76.9%) achieved Complete remission (CR) within a mean of 7.4 weeks. BPDAI and NRSP significantly improved, with BPDAI scores decreased from 16.08 ± 9.00 at baseline to 1.23 ± 1.64 at week 16 and 0.23 ± 0.44 at week 52 (both p < 0.001). BP180 and total IgE also showed significant improvement. Two patients experienced relapse after discontinuing treatment. Comorbidities were generally well managed, though three patients passed away due to worsening comorbidities. One patient experienced mild drowsiness and erythema; no other dupilumab-related adverse events were observed. Conclusion Dupilumab demonstrates significant long-term efficacy and safety in super-elderly BP patients (≥80 years) with mild to moderate disease and multiple comorbidities, offering a promising alternative to traditional therapies.

Background Ivarmacitinib (SHR0302), a selective Janus kinase-1 inhibitor, is a novel treatment for moderate-to-severe atopic dermatitis (AD). Objectives This post hoc analysis evaluated the impact of early itch relief with ivarmacitinib on quality of life (QoL), working productivity, and sleep quality in affected patients. Methods Data from ivarmacitinib treatment groups in a phase III trial (NCT04875169) were analyzed. Patients were classified as early itch responders (EIR; ≥4-point reduction in Worst Itch Numeric Rating Scale at week 4) or non-early itch responders (non-EIR). Outcomes included the Dermatology Life Quality Index (DLQI) total score, DLQI 0/1 response rate, DLQI work/study item, and the Patient-Oriented Eczema Measure (POEM) sleep item. Results Of 225 patients, 90 were EIR and 135 were non-EIR. The EIR group showed significantly greater improvements in DLQI total score, DLQI 0/1 response rate, and work productivity from week 4 through week 52 compared to the non-EIR group. Sleep disturbance due to itch was also significantly improved in the EIR group from week 4 to week 40, though the difference at week 52 was not statistically significant. Conclusions Early itch relief with ivarmacitinib showed significant improvements in QoL, sleep, and work productivity in patients with moderate-to-severe AD.