Wenhui Wang

Diabetic wounds represent an escalating clinical challenge driven by the rising global prevalence of diabetes and the lack of effective treatments. Platele

SUMMARY: The skin microbiome, consisting of bacteria, fungi, viruses, and archaea, plays a crucial role in maintaining skin health by regulating immune responses, preserving barrier function, and influencing metabolic processes. Dysbiosis in the microbiome is linked to dermatological diseases such as atopic dermatitis (AD), psoriasis, and acne, with specific microbes, such as Staphylococcus aureus and Cutibacterium acnes , either promoting or protecting against disease. This review summarizes recent advances in understanding the composition and functions of the skin microbiome, its interaction with host immunity, and impact on skin health. We also discuss the implications of environmental and biological factors on microbiome stability and explore emerging therapeutic strategies targeting the skin microbiota. These insights highlight the potential of microbiome-based approaches for advancing dermatological treatment.

Psoriasis is a chronic inflammatory skin disease driven by oxidative stress, keratinocyte hyperproliferation, and immune dysregulation. Conventional single-target therapies frequently result in incomplete remission and disease relapse. Here, we designed amino-functionalized fullerene hydrogels (TAPC@CB/TPPC@CB) that coordinately restore oxidative and inflammatory homeostasis via a multitarget mechanism. These hydrogels normalize keratinocyte proliferation by upregulating the cell-cycle inhibitor Cdkn1b, induce G0/G1 arrest, and eliminate excessive reactive oxygen species (ROS). They also promote macrophage polarization toward the anti-inflammatory M2 phenotype and downregulate stress-related and proinflammatory proteins, thereby inhibiting the NF‑κB/IL‑23/Th17 axis and restoring the inflammatory microenvironment. In vivo, topical TAPC@CB significantly reduced macrophage and T‑cell infiltration, alleviated inflammation, and lowered recurrence risk. This study establishes amino‑fullerene-based hydrogels as a single-agent, multipathway nanotherapeutic strategy for effective psoriasis treatment and relapse prevention.

Drug‐induced liver injury (DILI) with severe DRESS carries high mortality, yet rescue therapies for corticosteroid‐refractory cases remain undefined. We hypothesized that JAK inhibition could reverse refractory liver injury by targeting the underlying cytokine storm. In this prospective proof‐of‐concept study, consecutive patients with severe DRESS‐associated DILI refractory to corticosteroids (persistent/worsening liver injury) received oral tofacitinib rescue. Key assessments were the normalisation of liver biochemistries. Despite initial corticosteroids, all four patients exhibited progressive severe injury (median peak ALT 1126 U/L). Tofacitinib rapidly reversed liver injury in all cases. Transaminases normalised or near‐normalised (median: 48 days), total bilirubin normalised, and cutaneous symptoms resolved completely. Notably, baseline positive autoantibodies seroconverted to negative. No severe adverse events occurred (median follow‐up: 274 days). Tofacitinib shows promise as a rescue strategy for corticosteroid‐refractory DILI with severe DRESS. The rapid recovery underscores the JAK–STAT pathway's pathogenic role in this setting.

In 2024, a 75‐year‐old Chinese man presented with a complex dermatological case involving features of both disseminated superficial porokeratosis (DSP) and bullous pemphigoid (BP). The patient exhibited a long‐standing history of pruritic annular brownish plaques with hyperkeratotic borders, alongside recent blistering eruptions on his hands, feet and trunk. Diagnostic investigations revealed distinct histopathological and immunological markers characteristic of both conditions. Treatment with intravenous methylprednisolone, topical corticosteroids and tretinoin cream led to rapid improvement of BP lesions but also DSP plaques, culminating in complete resolution without new eruptions during corticosteroid tapering. Dermoscopic examination unveiled unique features, including the ‘double‐track sign’, dilated capillaries and a central yellowish translucent area with haemorrhagic crusts, underscoring the diagnostic utility of dermoscopy in elucidating this rare co‐presentation. This case highlights the diagnostic challenges and therapeutic considerations in managing concurrent DSP and BP, shedding light on potential exacerbating factors and treatment outcomes deserving further exploration in dermatological research.

Background: Alopecia areata (AA) represents a significant autoimmune disorder affecting hair follicles, with sex differences that have yet to reach scientific consensus. The regional and temporal, age-related, and socioeconomic dimensions of sex-based lifetime risk disparities remain inadequately characterized and require further investigation. Methods: (1) We estimated AA lifetime risk using the adjusted for multiple primaries method. We evaluated regional and temporal features of sex disparities through Average Annual Percentage Change analysis, with future projections to 2050 via ARIMA modeling. (2) Age-stratified sex disparity features were analyzed. (3) We evaluated AA risk associations with Socio-Demographic Index (SDI) variations through Spearman correlation analysis and concentration indices to quantify female-to-male relative risk. Results: (1) Global lifetime risk increased from 29.89% (95% CI, 29.83%-29.94%) to 31.66% (31.61%-31.71%) in females, and from 15.91% (15.86%-15.95%) to 16.93% (16.88%-16.97%) in males between 1990 and 2021. The female-to-male lifetime risk ratio remained stable, measuring 1.88 (1.87–1.89) in 1990 and 1.87 (1.86–1.88) in 2021. Future projections through 2050 indicate increasing lifetime risks reaching 34.44% (32.99%-35.89%) for females and 19.06% (17.50%-20.63%) for males, despite comparatively faster growth rates observed in the male population (9.83% vs. 7.01% for females). Both sexes exhibited similar regional distribution features. (2) Sex differences in age-specific risk features were notable: females exhibited a high lifetime risk window between ages 20–50 years, while males demonstrated a narrower window primarily between ages 20–30 years. Female lifetime risk consistently peaked in the 30–39 age group regardless of SDI level, whereas males displayed significant SDI-dependent variations, with peak lifetime risks occurring at ages 20–29 in high-SDI regions versus ages 30–39 in the other areas. Females showed a slower decline in residual risk with increasing age compared to males, resulting in progressively higher female-to-male risk ratios that were particularly pronounced in high-SDI regions, reaching 4.51 (3.42–5.95) in the 70–79 age cohort. (3) With increasing SDI levels (reflecting socioeconomic development), females exhibited more pronounced risk elevation than males. Females exhibited consistently lower concentration indices relative to males, maintaining stable trends, while male concentration indices have shown a declining trend in recent years. The female-to-male ratio of concentration indices has shown a consistent upward trend since reaching its lowest point of 0.62 (0.51–0.76) in 1993, rising to 0.75 (0.60–0.95) by 2021. High SDI regions persistently demonstrate the lowest female-to-male concentration indices. Conclusions: Our analysis reveals pronounced sex disparities in global AA lifetime risk: consistently higher risk in females across regions and time periods, prolonged age-related risk window with slower decline in females, and greater risk elevation in females with increasing SDI levels.

To evaluate the therapeutic efficacy and safety of the Janus kinase (JAK) inhibitor tofacitinib in the management of refractory perianal pyoderma gangrenosum (PG) under conditions of baseline immunosuppression and bone marrow suppression. We present a 62-year-old male with a 4-month history of painful, progressive symmetrical perianal ulcerations diagnosed as PG, coexisting with condyloma acuminatum. The patient had a background of pure red cell aplasia and myasthenia gravis, and was undergoing chronic immunosuppressive therapy with prednisolone and tacrolimus. Previous interventions including topical agents, antibiotics, phototherapy, and surgical debridement were ineffective. Oral tofacitinib (5 mg/day) was introduced following multidisciplinary evaluation. Marked pain reduction was achieved by day two of tofacitinib therapy, with near-complete ulcer healing observed within two weeks. Hematologic parameters remained stable throughout the 4-month treatment course, which was well tolerated with no adverse effects. The patient remained relapse-free during a 1-year follow-up. Tofacitinib may offer a rapid, effective, and well-tolerated treatment alternative in cases of refractory PG, even when layered onto preexisting immunosuppressive regimens. This case highlights the potential of JAK inhibitors as targeted therapy in complex PG presentations and supports their further clinical evaluation.