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This article explores the potential causal relationship between obesity and rosacea, a chronic inflammatory skin disorder. Using Mendelian randomization analysis, the study found no association between genetic susceptibility to obesity and the risk of rosacea. The authors suggest that previous observational studies may have limitations in determining causality and associations due to measurement errors and population differences. Further research is needed to confirm these findings in other races and rosacea subtypes and regions. The study was supported by funding from the Hangzhou Biomedical and Health Industry Development Support Project and the Hangzhou Medical Key Discipline Construction Project, and the authors declare no conflicts of interest. [Extracted from the article]

This study aimed to investigate the protective effect of NAcM‐OPT, a small molecule inhibitor of defective in cullin neddylation 1 (DCN1), on H2O2‐induced oxidative damage in keratinocytes. Immortalized human keratinocytes (HaCaT cells) were treated with NAcM‐OPT and exposed to oxidative stress. CCK‐8 assays were used to measure cell viability. The mGFP‐RFP‐LC3 dual fluorescent autophagy indicator system was utilized to evaluate changes in autophagic flux. Western blotting was used to measure the expression of the autophagy‐related proteins LC3 and Beclin 1. Keratinocytes were treated with the autophagy activator rapamycin, and HaCaT cell supernatant was added to PIG1 cells (immortalized human melanocytes), followed by evaluation of tyrosinase (TYR) expression via qRT‐PCR. NAcM‐OPT increased cell viability and cell proliferation. Furthermore, this molecule promoted autophagic flux through increased expression of autophagy‐related proteins under H2O2‐induced oxidative stress. Additionally, rapamycin increased the mRNA levels of TYR in PIG1 cells. Moreover, NAcM‐OPT alleviated mitochondrial damage, restored mitochondrial function, and upregulated the expression of NFE2L2, HO1, NQO1, and GCLM. Importantly, NAcM‐OPT also increased epidermal thickness, follicle length, and melanin synthesis under oxidative stress in vivo. These findings suggest that NAcM‐OPT may be a promising small molecule antioxidant drug for the treatment of vitiligo. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease (COVID-19) may trigger the reactivation of the latent varicella-zoster virus and may be a risk factor for herpes zoster (HZ). However, the causal relationship between COVID-19 and varicella-zoster infections remains controversial. This study aimed to estimate the causal inferences between COVID-19 and HZ. Methods: This study used a two-sample Mendelian randomization (MR) design. The inverse variance-weighted method was used as the primary method and sensitivity analyses were conducted, including the MR-Egger regression, weighted median and weighted mode. We searched at https://gwas.mrcieu.ac.uk/ using the keywords "COVID-19" for exposure data and "zoster" for outcome datasets. Results: We got 26 COVID-19 datasets and five zoster datasets. We used 26 COVID-19 datasets as exposure data corresponding to each zoster dataset for the MR analysis. There were nine datasets of COVID-19 where the number of SNPs was fewer than three in the MR analysis of the risk of HZ, varicella zoster virus (VZV) glycoprotein E and I antibody levels, anti-VZV IgG seropositivity, and post-zoster neuralgia. In addition, there were 10 datasets of COVID-19 where the number of SNPs was less than three in the MR analysis of anti-VZV IgG levels. The results of the MR analysis showed that all p-values were greater than 0.05. Sensitivity analysis revealed no evidence of horizontal pleiotropy in most two sample MR analyses. Conclusion: Our results indicate that there is no causal relationship between COVID-19 and varicella-zoster infection, HZ progression, and postherpetic neuralgia. [ABSTRACT FROM AUTHOR]

Background: An increasing amount of research demonstrates that metabolic disorders are related to rosacea. However, the correlations and causal relationships among them remain unknown. Methods: We conducted not only forward 2‐sample MR (Mendelian randomization) analyses but also reverse MR analyses which showed positive results in the forward MR analysis. In the forward MR analyses, inverse‐variance weighted (IVW) and MR‐Egger were performed as MR analyses. Cochran's Q test and the MR‐Egger Intercept were used for sensitivity analyses. Concerning reverse MR analyses, IVW, MR‐Egger, weighted median, simple mode, and weighted mode were applied. Cochran's Q test, MR‐Egger Intercept, and MR pleiotropy residual sum and outlier (MR‐PRESSO) outlier test were applied as sensitivity analyses. Results: A total of 24 metabolites and 1 metabolite ratio were shown to have a causal effect on rosacea. N‐lactoyl phenylalanine (N‐Lac‐Phe) was estimated as statistically significant by Bonferroni correction. Interestingly, we found three metabolites that were negatively associated with rosacea, especially caffeine, which are in line with the results of a large cohort study of females. For reverse MR analysis, we revealed that rosacea could potentially decrease the generation of two metabolites: octadecenedioate (C18:1−DC) and methyl vanillate sulfate. Conclusion: This study identified blood metabolites that may be associated with the development of rosacea. However, the exact mechanism by which these positive metabolites influence rosacea remains uncertain due to the paucity of experimental investigations. The combination of genetics and metabolomics offers novel viewpoints on the research of underlying mechanisms of rosacea and has significant value in screening and prevention of rosacea. [ABSTRACT FROM AUTHOR]

Background: Ultraviolet (UV)‐induced fluorescence technology is widely used in dermatology to identify microbial infections. Our clinical observations under an ultraviolet‐induced fluorescent dermatoscope (UVFD) showed red fluorescence on the scalps of androgenetic alopecia (AGA) patients. In this study, based on the hypothesis that microbes are induced to emit red fluorescence under UV light, we aimed to explore the microbial disparities between the AGA fluorescent area (AF group) and AGA non‐fluorescent area (ANF group). Methods: Scalp swab samples were collected from 36 AGA patients, including both fluorescent and non‐fluorescent areas. The bacterial communities on the scalp were analyzed by 16S rRNA gene sequencing and bioinformatics analysis, as well as through microbial culture methods. Results: Significant variations were observed in microbial evenness, abundance composition, and functional predictions between fluorescent and non‐fluorescent areas. Sequencing results highlighted significant differences in Cutibacterium abundance between these areas (34.06% and 21.36%, respectively; p < 0.05). Furthermore, cultured red fluorescent colonies primarily consisted of Cutibacterium spp., Cutibacterium acnes, Staphylococcus epidermidis, and Micrococcus spp. Conclusions: This is the first study to investigate scalp red fluorescence, highlighting microbial composition variability across different scalp regions. These findings may provide novel insights into the microbiological mechanisms of AGA. [ABSTRACT FROM AUTHOR]

Background: Transient Receptor Potential Mucolipin 1 (TRPML1) serves as a pivotal reactive oxygen species (ROS) sensor in cells, which is implicated in the regulation of autophagy. However, its function in melanocyte autophagy under oxidative stress remains elusive. Methods: The expression and ion channel function of TRPML1 were investigated using immunofluorescence and calcium imaging in primary human melanocytes (MCs). After activating TRPML1 with MLSA1 (TRPML1 agonist), autophagy‐related molecules were investigated via western blot. ROS level, apoptosis‐ and autophagy‐related molecules were investigated after pretreatment with MLSA1. After interference with TRPML1 expression, mitochondrial structures were visualized by electron microscopy with hydrogen peroxide (H2O2）treatment. Results: TRPML1 was expressed and functionally active in primary human MCs, and its activation promotes elevated expression of LC3‐II and reduced apoptosis and ROS levels under oxidative stress. TRPML1 downregulation caused mitochondrial swelling and disruption of cristae structures under oxidative stress in primary human MCs. Conclusions: TRPML1 might mediate lysosomal autophagy in primary human MCs under oxidative stress, participating in mechanisms that maintain the oxidative and antioxidant systems in balance. [ABSTRACT FROM AUTHOR]

Background: Body dysmorphic disorder (BDD) is a psychiatric condition characterized by extreme preoccupation with non‐existent or minor defects in appearance, disrupting daily functioning. Melasma is a common concern among BDD patients with dermatological conditions. This study aimed to estimate the incidence and characteristics of BDD in patients with melasma, and compare the psychological condition of patients and age‐ and sex‐matched healthy controls. Methods: Patients with melasma and healthy controls were screened using the BDD Questionnaire (BDDQ), Self‐rating Anxiety Scale (SAS), and Self‐rating Depression Scale (SDS). A questionnaire was administered to collect demographic information and clinical characteristics. Standard statistical tests were conducted, such as descriptive analysis, chi‐square, and nonparametric tests. The level of statistical significance for all tests was set at a P < 0.05. Results: Among the 470 patients with melasma included in the study, 53 were positive for BDDQ in the preliminary screening and were associated with a history of treatment, higher Melasma Area and Severity Index (MASI), and Melasma Quality of Life (MELASQoL) scores, and higher SAS and SDS scores. The positive rate of BDDQ ranged from 0.4%, using the most stringent criteria to assess melasma severity, to 11.3%, without using objective criteria. Compared to healthy controls, patients with melasma had a higher positive rate of BDDQ and higher SAS and SDS scores. Conclusion: In patients with melasma who exaggerate the severity of the disease, psychiatric treatment and the patient‐physician relationship have a positive effect. This study assessed the positive rate of BDDQ in melasma and proposed the feasibility of psychiatric treatment for patients with melasma. [ABSTRACT FROM AUTHOR]

Alopecia areata refers to an autoimmune illness indicated by persistent inflammation. The key requirement for alopecia areata occurrence is the disruption of immune‐privileged regions within the hair follicles. Recent research has indicated that neuropeptides play a role in the damage to hair follicles by triggering neurogenic inflammation, stimulating mast cells ambient the follicles, and promoting apoptotic processes in keratinocytes. However, the exact pathogenesis of alopecia areata requires further investigation. Recently, there has been an increasing focus on understanding the mechanisms of immune diseases resulting from the interplay between the nervous and the immune system. Neurogenic inflammation due to neuroimmune disorders of the skin system may disrupt the inflammatory microenvironment of the hair follicle, which plays a crucial part in the progression of alopecia areata. [ABSTRACT FROM AUTHOR]

Autophagy is recognized as a crucial regulatory process, instrumental in the removal of senescent, dysfunctional, and damaged cells. Within the autophagic process, lysosomal digestion plays a critical role in the elimination of impaired organelles, thus preserving fundamental cellular metabolic functions and various biological processes. Mitophagy, a targeted autophagic process that specifically focuses on mitochondria, is essential for sustaining cellular health and energy balance. Therefore, a deep comprehension of the operational mechanisms and implications of autophagy and mitophagy is vital for disease prevention and treatment. In this context, we examine the role of autophagy and mitophagy during hair follicle cycles, closely scrutinizing their potential association with hair loss. We also conduct a thorough review of the regulatory mechanisms behind autophagy and mitophagy, highlighting their interaction with hair follicle stem cells and dermal papilla cells. In conclusion, we investigate the potential of manipulating autophagy and mitophagy pathways to develop innovative therapeutic strategies for hair loss. [ABSTRACT FROM AUTHOR]

Background: While observational studies have suggested a link between gut microbiota diversity and alopecia areata (AA), the causal relationship remains unclear. Methods: We leveraged data from the MiBioGen and FinnGen consortiums' Genome‐wide association studies (GWAS) encompassing gut microbiota (n = 13,266) and AA (n = 211,428) datasets. A comprehensive Mendelian randomization (MR) and reverse MR approach were employed, utilizing five statistical methods to evaluate causality. Sensitivity analyses were also conducted to corroborate the MR results. Results: Inverse variance weighted (IVW) analysis indicated a protective effect against AA from Butyricimonas (OR = 0.37, 95% CI: 0.18–0.77, P = 0.01), Enterorhabdus (OR = 0.40, 95% CI: 0.16–0.95, P = 0.04), Eubacterium (xylanophilum group) (OR = 0.36, 95% CI: 0.15–0.84, P = 0.02), and Phascolarctobacterium (OR = 0.37, 95% CI: 0.15–0.91, P = 0.03), while Ruminococcaceae UCG003 posed as a risk factor (OR = 2.79, 95% CI: 1.27–6.14, P = 0.01). Reverse MR showed no significant causal link between AA and gut microbiota, with no significant heterogeneity or horizontal pleiotropy. Conclusions: Our analysis suggests probable causality between certain gut microbiota and AA, shedding light on its pathogenesis and potential intervention strategies. [ABSTRACT FROM AUTHOR]

A study published in the journal "Skin Research & Technology" explores the relationship between androgenetic alopecia (AGA) and dyslipidemia. The researchers used Mendelian randomization (MR) to analyze genetic variations and identify causal links between circulating metabolites and AGA. The study found that certain lipoprotein subcomponents, including high-density lipoprotein (HDL) and very low-density lipoprotein (VLDL), were associated with the risk of AGA. However, the association between HDL and AGA disappeared when adjusted for confounding factors. The study suggests that VLDL may play a role in the development of AGA by affecting vasculature. It is important to note that the study was limited to patients of European origin and further research is needed to validate the findings in other populations. [Extracted from the article]

Background: Female pattern hair loss (FPHL) is the most prevalent type of alopecia among adult women. Presently, topical minoxidil stands as the sole treatment endorsed by the FDA. Addressing cases of FPHL in individuals who develop contact dermatitis in response to minoxidil can pose a challenge for dermatologists. Objective: To assess the efficacy and safety of subcutaneous injections of Botulinum Toxin Type A (BTA) in treating FPHL. Methods: Enrolled outpatients with FPHL who exhibited an allergic reaction to minoxidil solution. Diagnosis of FPHL was established through clinical examination and trichoscopy. Inclusion criteria involved patients with no prior treatment within the last year and without any comorbidities. BTA, specifically 100 units, was mixed with 2 mL of 0.9% normal saline. Twenty injection target sites, spaced 2–3 cm apart, were symmetrically marked on the hairless area of the scalp. A dosage of five units was intradermally injected at each target site. Representative photographs and dermoscopic images of the scalp were captured before and after 3 months of treatment. Results: A total of 10 FPHL, aged between 26 and 40 years, were included. The average age was 30.3 ± 4.64 years, and all patients had a positive family history of Androgenetic Alopecia. The average duration of the disease was 3.70 ± 1.42 years. According to patients' self‐assessment, after 1 month of treatment, 10 FPHL patients reported experiencing moderate to marked improvement in symptoms related to scalp oil secretion. Three months later, dermatological assessments showed that three had mild improvement, six had no change, and one had a worsening condition. No adverse effects were observed. Conclusions: Our study suggests that the effectiveness of BTA for FPHL is limited to 3 months. However, it can be considered for tentative use after effective communication with patients. The long‐term efficacy and safety of BTA in treating FPHL require further observation and study. [ABSTRACT FROM AUTHOR]

Background: Previous research has highlighted an association between alopecia areata (AA) and the collapse of hair follicle immune privilege, however, the causal linkage to specific immune cell traits remains to be elucidated. This study aimed to investigate the causal influence of immune cell traits on AA utilizing a two‐sample Mendelian randomization (MR) approach. Methods: Leveraging GWAS summary statistics of 731 immunological traits (n = 3757) and AA data (n = 211,428), MR analyses were conducted employing inverse‐variance weighted (IVW), weighted median, and MR‐Egger regression methodologies. Sensitivity analyses were undertaken using Cochran's Q test, MR‐Egger intercept test, and MR‐PRESSO analysis. A reverse MR analysis was performed for immune cell traits identified in the initial MR analysis. Results: Our study unveiled multiple immune traits associated with AA. Protective associations were observed for CD62L‐ CD86+ myeloid dendritic cells (DCs), TD CD4+%CD4+ T cells, and others, with ORs ranging from 0.63 to 0.78. Conversely, traits like CD62L on CD62L+ plasmacytoid DCs, HLA‐DR on CD14‐ CD16+ monocytes, HLA‐DR on monocytes, and others, were determined to augment the risk of AA, with ORs ranging from 1.13 to 1.46. Reverse MR analysis signified a reduction in BAFF‐R on IgD‐CD24‐B cells post‐AA onset (OR: 0.97, 95% CI: 0.95–1.00), with no identified heterogeneity or horizontal pleiotropy among the instrumental variables (IVs). Conclusions: Our findings suggests that CD62L on certain subpopulations of DCs and HLA‐DR on monocytes may epitomize risk factors for AA, offering potential therapeutic targets for alleviating AA. [ABSTRACT FROM AUTHOR]

Tranexamic acid (TXA) is a promising therapeutic agent in melasma that can act on multiple pathophysiologic mechanisms of melasma. However, it is unclear whether TXA affects melanin in keratinocytes. To explore the effect of TXA on melanocores in keratinocytes. The melanocore‐incorporated keratinocytes were constructed by co‐incubating normal human epidermal keratinocytes (NHEK) with melanocores. After being treated with TXA, autophagy‐ and melanin‐related protein expressions were detected. Then, transcriptome sequencing was used to compare the genetic changes in melanocore‐incorporated keratinocytes before and after TXA treatment and further verified the differentially expressed genes. At the same time, the distribution of melanocores in human keratinocytes was observed by transmission electron microscopy. We found that TXA does not promote melanin degradation in primary keratinocytes by inducing autophagy. Protein transport and intracellular protein transport‐related genes were enriched after TXA treatment, and Rab5b was significantly upregulated. Transmission electron microscopy showed that the percentage of melanocores distributed in clusters increased after treatment with TXA, which was reduced after Rab5b silencing. In addition, results suggested that melanocores could colocalize with Rab5b and lysosome‐associated membrane protein1 (LAMP1). Our study found that Rab5b may be involved in the melanocore distribution in keratinocytes. TXA may promote the clustering distribution of endocytic melanocores through upregulation of Rab5b, representing a potential mechanism of TXA treatment against melasma. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is characterized by limited non‐scarring patchy alopecia, which appears as round or oval patches and is prone to recurrence, causing severe psychological burdens to patients. No specific device has been approved by the FDA for the treatment of baldness, but new treatments are being investigated and treatments such as the excimer laser, He‐ Ne laser, and excimer lamp have been proposed. A growing number of studies have found that fractional lasers also have great potential in the treatment of AA. Methods: A literature search and meta‐analysis using Review Manager 5.4 software to investigate the efficacy of fractional laser treatment for AA. Results: Fractional laser combined with minoxidil (RR 1.32, 95% CI 1.17–1.49, p < 0.00001) or cortisol (RR 1.39, 95% CI 1.15–1.67, p = 0.00006) was more effective than either drug alone in the treatment of AA. Of course, the fractional laser alone was also effective in the treatment of AA (RR 10.33, 95% CI 2.07–51.36, p = 0.004) and more effective than cortisol alone (RR 1.86, 95% CI 1.36–2.52, p < 0.00001), and there was no effect on the occurrence of adverse effects (p = 0.49 > 0.05). When compared to other physical treatments of a comparable kind, fractional laser therapy's effectiveness was not significantly different (p = 0.15 > 0.05). Conclusion: Our results show that the use of fractional lasers can effectively treat alopecia areata. [ABSTRACT FROM AUTHOR]

CD8+ T cells in the lesioned site play a crucial role in the pathogenesis of vitiligo. The chemokine CXCL10 secreted by keratinocytes regulates the migration of CD8+ T cells into the skin. In our previous study, we found that DCUN1D1 expression in vitiligo lesions positively correlates with Cxcl10 expression. In this study, the regulatory effect of DCUN1D1 on CXCL10 and cell function was investigated. DCUN1D1 protein expression was significantly higher in the skin tissue from vitiligo lesions compared with samples from healthy controls. High expression of DCUN1D1 in keratinocytes caused local hair depigmentation in mice, reduced melanin content, high infiltration of CD8+ T cells and increased CXCL10 expression. This suggested that DCUN1D1 may regulate CD8+ T‐cell infiltration and depigmentation through CXCL10. Inhibition of DCUN1D1 expression in HaCaT cells abolished the IFN‐γ‐induced upregulation of p‐JAK1, p‐STAT1 and CXCL10, suppressed the H2O2‐induced ROS generation and apoptosis, and upregulated tyrosinase expression in melanocytes. Collectively, these results show that DCUN1D1 is an important regulator of CXCL10 and may be a new target for the treatment of vitiligo. [ABSTRACT FROM AUTHOR]

This article discusses the treatment of perioral vitiligo, a condition characterized by depigmented patches around the mouth, using a combination of upper hair follicle transplantation and the application of a 308 nm excimer laser. The case study describes a 17-year-old male patient who had previously undergone melanocyte transplantation with poor results. The patient then underwent upper hair follicle transplantation, where hair follicles containing inactive melanin precursor cells were transplanted into the affected areas. The recipient sites were then treated with a 308 nm excimer laser once a week for 6 months. Significant repigmentation was observed in the treated regions, without excessive hair growth. The study suggests that this combined treatment strategy may be effective for non-hairy vitiliginous lesions that are unresponsive to other treatments. [Extracted from the article]

This article, published in the journal Skin Research & Technology, presents the findings of a cross-sectional study on hair parameters in the occipital region of male pattern hair loss (MPHL). The study included 386 male patients diagnosed with MPHL and categorized them based on the severity of their condition. The researchers analyzed hair density, the number of vellus-like hairs, and the ratio of single to compound hairs in the occipital region. The study found that patients with mild MPHL were younger and had higher occipital hair density compared to those with moderate or severe MPHL. The authors recommend early hair transplants to maintain the quality of the donor zone. The study was supported by funding from Zhejiang Provincial Natural Science Foundation and Hangzhou bio-medicine and health industry development support science and technology project. The authors declare no conflicts of interest, and no new data were created or analyzed in this study. Informed patient consent was obtained for the publication of patient photographs and medical information. [Extracted from the article]

Alopecia areata (AA) is a non-scarring hair loss mediated by T lymphocytes. Recently, a growing number of studies have shown that Janus kinase inhibitors are effective in the treatment of AA in children. A systematic review and meta-analysis were performed according to the PRISMA guidelines. Good response was defined as more than 50% decrease in Severity of Alopecia Tool (SALT) score or complete regrowth or more than 50% regrowth. Partial response was defined as 5–50% decrease in SALT score. Any response to treatment was defined as more than 5% in SALT score decrease. There were 81.9% responders, 68.5% good responders, and 7.7% partial responders among the 10 included studies. The treatment duration was longer in good responders than in partial responders (p =.009). Oral route was linked to a better response to topical medication, with an odds ratio of 7.8 (95%CI 1.655–36.76). In terms of toxicity, reported adverse events included only mild symptoms. Liver transaminase elevation, upper respiratory tract infection, and eosinophilia were the most common adverse events. Janus kinase inhibitors demonstrated promise in the treatment of AA in children, with the most common side effects being minor and reversible. [ABSTRACT FROM AUTHOR]

Laser-assisted drug delivery (LADD) is a new treatment for delivering drugs within the skin. This meta-analysis investigates the effectiveness and safety of the laser-assisted delivery of tranexamic acid (TXA) to treat melasma. A literature review was conducted by searching publication platforms to search for randomized controlled trials (RCTs) that compared laser-assisted delivery of TXA with laser-alone or topical TXA-alone treatment. The Embase, Web of Science, PubMed, Google Scholar, and Cochrane Library databases were searched, and Melasma Area Severity Index (MASI)/modified MASI (mMASI) scores used as the clinical improvement outcomes. All statistical analyses were performed using the RevMan software (Review Manager, V.5.3). The standardized mean differences and 95% confidence intervals were used to assess the results. Five RCTs were included in this meta-analysis. These studies used ablative fractional photothermolysis and nonablative dermal remodeling laser modalities. The results showed that both laser modalities combined with TXA significantly decreased the MASI/mMASI scores (P =.0003). Furthermore, no serious adverse events were observed, except mild erythema and burning pain. The meta-analysis found that the laser-assisted delivery of TXA is a new effective and safe treatment option for melasma treatment. [ABSTRACT FROM AUTHOR]

Purpose: This article attempted to describe the efficacy and safety of 1064QNYL in combination with other treatments for refractory melasma. Methods: Two researchers independently retrieved randomized controlled trials (RCTs) according to inclusion and exclusion criteria. Primary outcome was evaluated with MASI and mMASI scores in control group and experiment group. The secondary outcome was evaluated with MI scores. We calculated 95% CI of standardized mean difference (SMD) and heterogeneity of the included literature by Higgins I2 test, and assessed publication bias by Funnel plots, Egger's, and Begg's tests. Results: A total of 12 articles including 322 subjects were analyzed. Experiment group was treated with 1064QNYL combined with single treatment (e.g., PDL, IPL, RF, and TA). Control group was treated with 1064QNYL alone. A greater reduction of Melasma Area and Severity Index (MASI)/modified Melasma Area and Severity Index (mMASI) scores were shown in experiment group than that in control group at the end of the treatment (SMD, −0.37; 95% CI −0.70 to −0.04, p = 0.03, I2 = 33%). The SMD of MI scores further supported this conclusion by −0.32 (95% CI −0.63 to −0.02, p = 0.04, I2 = 27%). As for adverse events (AEs), combined treatment gave rise to more mild burning, stinging, and erythema that resolved spontaneously. Several studies reported focal purpura, punctate leukoderma, hyperpigmentation, hypopigmentation, and so on. Conclusion: Combined 1064QNYL treatment was better than single laser treatment, with the highest short‐term benefit and long‐term follow‐up to maintain the effect in favor of combined treatment. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is an acquired skin depigmentation disease. It can be misdiagnosed at an early stage and tend to relapse. Serum markers are essential to monitoring the progression of vitiligo. Exosomal miRNAs act as the communication mediator between melanocytes and immune cells. Our study aimed to use serum exosomal miRNAs as a reference for evaluating vitiligo progression. Methods: The miRNAs were extracted from the serum exosomes of ten progressive vitiligo patients (before and after treatment) and ten healthy individuals. We profiled miRNAs expression by RNA sequencing and screened out potential miRNAs and plotted their receiver operating characteristic (ROC) curves to explore their sensitivity and specificity as prognostic biomarkers in vitiligo progression. We examined the correlation between miRNA expression and the lesion area. Different databases were used to predict gene targets of miRNAs, which were analyzed by gene ontology and Kyoto encyclopedia of genes and genomes (KEGG). Results: Our results showed that 141 miRNAs were differentially expressed in serum exosomes of progressive vitiligo patients, and 365 miRNAs were differentially expressed in these patients after treatment compared to healthy individuals. The expression of hsa-miR-487b-3p was significantly lower in these patients compared to healthy individuals. Still, there was no difference in its levels in patients after corticosteroid treatment compared to healthy controls. ROC curve analysis (area under curve = 0.840) indicated that hsa-miR-487b-3p could serve as a biomarker for the prognosis of vitiligo progression. Its expression positively correlated with the lesion area. A total of 41 target genes of hsa-miR-487b-3p were predicted via different databases. KEGG pathways were enriched in phenylalanine metabolism, glycan degradation, and protein export. Conclusion: Serum exosomal hsa-miR-487b-3p can be a biomarker to detect vitiligo progression. The predicted target genes of hsa-miR-487b-3p were enriched in catabolism. Thus, its in progressive vitiligo may accelerate catabolism in melanocytes and cause its impairment. [ABSTRACT FROM AUTHOR]