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The primary objective of this study was to estimate the costs and healthcare resource utilization (HCRU) associated with atopic dermatitis (AD) in Chinese pediatric patients and to investigate the factors contributing to the costs of AD. This cross-sectional study employed a convenience sampling approach, with patient-level data obtained from a nationwide survey conducted across 31 provinces in China between February and March of 2022, utilizing an internet-based questionnaire. Caregivers of children under 18 years old with a physician-confirmed diagnosis of atopic dermatitis were recruited, and sociodemographic information, clinical characteristics, HCRU data, time spent on caregiving, and disease-related costs were collected from all eligible participants. A total of 599 eligible families were included in the study. Among them, 82.5% of families reported that their child had at least one outpatient or emergency room visit, while 5.8% of families reported that their child had been hospitalized in the past 12 months. The average annual cost across all cost categories amounted to 28 591.92 yuan per patient per year (PPPY), with 92.8% attributed to direct costs. Out-of-pocket expenses accounted for 90.7% of the cost of outpatient or emergency room visits and 43.4% of the cost of hospitalization. Factors associated with higher annual total costs included moderate (coefficient ± SE: 0.22 ± 0.09, P = 0.012) and severe AD patient groups (coefficient ± SE: 0.58 ± 0.15, P < 0.001), onset of AD on the head, neck, or hands (coefficient ± SE: 0.57 ± 0.14, P < 0.001), use of biological agents (coefficient ± SE: 0.64 ± 0.11, P < 0.001), and use of traditional Chinese medicine (TCM) (coefficient ± SE: 0.26 ± 0.09, P = 0.003), compared with their respective reference groups. This study highlighted a considerable economic burden of AD among pediatric patients in China across different disease severity groups, with significantly higher costs observed in patients with more severe disease. Additionally, factors such as disease severity, clinical characteristics, and treatment modalities might contribute to the higher costs encountered by pediatric patients with AD. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic immuno-inflammatory skin disease. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor approved for the treatment of mild to moderate AD. This post hoc analysis assesses the efficacy and safety of crisaborole in Chinese patients aged ≥ 2 years with mild to moderate AD. Methods: We evaluated the efficacy and safety of crisaborole in Chinese patients from the vehicle-controlled, phase 3 CrisADe CLEAR study. Patients were randomly assigned 2:1 to receive crisaborole or vehicle twice daily, respectively, for 28 days. The primary endpoint was percent change from baseline in Eczema Area and Severity Index (EASI) total score at day 29. Key secondary endpoints were improvement in Investigator's Static Global Assessment (ISGA), ISGA success, and change from baseline in weekly average Peak Pruritus Numerical Rating Scale (PP-NRS) score. Adverse events were documented. Results: Of 391 patients in the overall study, 237 were from China, 157 assigned to crisaborole and 80 assigned to vehicle. A greater reduction in percent change from baseline in EASI total score at day 29 was shown in the crisaborole vs. vehicle group (least squares mean [LSM]: −66.34 [95% (confidence interval) CI −71.55 to −61.12] vs. −50.18 [95% CI −58.02 to −42.34]). Response rates for achievement of ISGA improvement (43.2% [95% CI 35.4–51.1] vs. 33.4% [95% CI 22.5–44.2]) and ISGA success (31.7% [95% CI 24.3–39.0] vs. 21.5% [95% CI 12.1–30.9]) at day 29 were higher in the crisaborole vs. vehicle group. A greater reduction in change from baseline in weekly average PP-NRS score at week 4 was observed in the crisaborole vs. vehicle group (LSM: −1.98 [95% CI −2.34 to −1.62] vs. −1.08 [95% CI −1.63 to −0.53]). No new safety signals were observed. Conclusion: Crisaborole was effective and well tolerated in Chinese patients aged ≥ 2 years with mild to moderate AD. Trial Registration: ClinicalTrials.gov, NCT04360187. [ABSTRACT FROM AUTHOR]

This article presents a study conducted in China that examined the effectiveness and safety of dupilumab, a medication used to treat atopic dermatitis, in children aged 2-12 years. The study compared the data of children aged 2-6 years with those aged 6-12 years and found that dupilumab effectively improved disease severity scores in both age groups. The study also noted a higher response rate in children aged 2 to <6 years in the first 4 weeks of treatment. No adverse events were observed in the younger age group, but two patients in the older age group developed conjunctivitis. The study suggests that dupilumab is a viable treatment option for children with uncontrolled moderate-to-severe atopic dermatitis, but further research is needed. [Extracted from the article]

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder. Bristol Stool Form Scale (BSFS) is a widely used stool scoring method that could indirectly reflect intestinal function. Objectives: To evaluate the associations of AD with BSFS. Methods: This was a population-based cross-sectional study of freshmen in five universities of China. AD diagnosis was performed by dermatologists according to the guideline from the American Academy of Dermatology. BSFS and covariates were collected through an online questionnaire survey. Chronic itch scores were assessed by the numeric rating scales and grouped into quartiles (Q). Mixed logistic regression models were used. Subgroup analysis was conducted by covariates. P value < 0.05 was considered statistically significant. Results: The prevalence of hard stools and loose stools were 8.9% and 7.6%, respectively (20,049 participants). After adjusting covariates, AD was significantly associated with hard stools (OR = 1.38, P < 0.001) and loose stools (OR = 1.24, P = 0.037). In subgroup analysis of hard stool, a stronger effect was observed in intake of milk (> 3 days/week), yogurt (> 3 days/week), pork (< 1 day/week), and higher itch scores (Q4). Conclusion: This study found the relationship between AD and abnormal stool forms, and the association with hard stools might be modified by dietary factor. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is now a global health problem and has been attracting extensive attention from both academic and public society in China. This review aimed to present the current status of the prevalence, disease burden, clinical features, diagnosis, and management of AD in China. The prevalence of AD has been increasing rapidly in China during the past decades, partially due to the increased recognition of the disease; there are still substantial amounts of over-diagnosed eczema and under-diagnosed AD. Chinese dermatologists see many AD patients with atypical manifestation, which poses a challenge to the diagnosis. The Chinese diagnostic criteria for adults and pediatric patients with AD have been proposed respectively and validated with high sensitivity and specificity. International and Chinese guidelines for management of AD have been popularized; however, there are still many practices that need verification through randomized case-control study. Dupilumab and JAK inhibitors have demonstrated favorable efficacy for AD patients in China, and a multidimensional approach is needed for selection of the patients and evaluation of the efficacy and safety. Patient education and long-term management for AD are just beginning in China, and need to be strengthened in the future. [ABSTRACT FROM AUTHOR]

Background: Eczema is the most common form of dermatitis and also the starting point of atopic march. Although many eczema‐associated allergic and immunologic disorders have been studied, there remains a gap in the systematic quantitative knowledge regarding the relationships between all childhood disorders and eczema. This study aimed to systematically explore eczema‐associated childhood diseases using a real‐world, long‐term clinical dataset generated from millions of children in China. Methods: Data were collected at 8,907,735 outpatient healthcare visits from 2,592,147 children between January 1, 2013, and August 15, 2019, at the largest comprehensive pediatric medical center in Zhejiang Province of China. The period prevalence differences in various pediatric diseases between children with and without eczema were used to test the independence of various pediatric disorders and eczema using Fisher's exact test. Bonferroni correction was used to adjust the p value in multiple testing. Odds ratio >2 with 95% confidence interval not including 1 and adjusted p < 0.05 was used to identify eczema‐associated diseases. Results: Overall, 234 pediatric disorders were identified from more than 6000 different pediatric disorders. An interactive eczema‐associated disease map that has related quantitative epidemiological features called ADmap was published at http://pedmap.nbscn.org/admap. Thirty‐six of these disease associations have not been reported in previous studies. Conclusion: This systematic exploratory study confirmed the associations of many well‐known diseases with eczema in Chinese children and also identified some novel and interesting associations. These results are valuable for the development of a comprehensive approach to the management of eczema in childhood. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is a highly heterogeneous disease clinically and biologically. Serum biomarkers have been utilized for endotype identification and have the potential to be predictors for treatment. Objectives To explore the serum biomarker-based endotypes of Chinese patients with AD and to identify biomarkers for prediction of the efficacy of dupilumab. Methods Sera from 125 patients with moderate-to-severe AD and 60 normal controls (NC) were analysed for 24 cytokines/chemokines using the magnetic Luminex assay. After the patients received 16 weeks of dupilumab treatment, the efficacy was evaluated, and blood eosinophils, serum immunoglobulin (Ig) E and biomarkers were measured. Results Chinese patients with moderate-to-severe AD were characterized by T-helper (Th)2-dominant serum biomarkers that were mixed with differentially increased Th1-, Th17- and Th22-type cytokines/chemokines, and it was mainly Th2-type serum biomarkers that were positively correlated with disease severity and eosinophil counts. Adult (but not adolescent or elderly) patients with AD showed a consistent and more significant increase of biomarkers across different types of inflammation. The patients were grouped into two clusters by unsupervised k-means analysis, which were differentially associated with inflammation. Treatment with dupilumab decreased the levels of most cytokines/chemokines analysed. While there was no difference between the two clusters in the efficacy of dupilumab, baseline levels of CD25/soluble interleukin (sIL)-2Rα, IL-31 and IL-36β were identified as predictive factors associated with the efficacy. Conclusions Our study revealed two inflammation-related endotypes of Chinese patients with AD based on serum biomarkers. High levels of CD25/sIL-2Rα, IL-31 and IL-36β might predict good efficacy of dupilumab treatment. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) exhibits difference in immune polarization between Caucasians and Asian races due to which an evaluation of the efficacy and safety of Pimecrolimus (PIM) in Asian population is called for. The current study addresses the need via a sub-group analysis of the PETITE study (NCT00120523) to evaluate the safety and efficacy of PIM in Chinese infants. Patients with AD (≥3 months–<12 months of age) were randomized in a 1:1 ratio to either PIM 1% cream or topical corticosteroids (TCS). The primary endpoint was safety. The secondary endpoint was efficacy. 120 patients were randomized to either PIM 1% or TCS (n = 61 for PIM, n = 59 for TCS). The most often reported adverse events were reported by similar proportions of patients treated with PIM or TCS. There was a progressive increase in overall IGA treatment success in infants treated with PIM (82.9%, p <.05, 95% CI: 70.4, 95.3) after 26 weeks which was comparable to the TCS group (88.5%, p <.05, 95% CI: 79.8, 97.1). PIM showed an early and sustained efficacy in the Chinese sub-population with a substantial corticosteroid-sparing effect in patients with AD. [ABSTRACT FROM AUTHOR]

Introduction: Numerous guidelines have been published for atopic dermatitis management in children in recent years. To date, the quality of the newest guidelines has not been appraised. This study aimed to identify and evaluate guidelines for the management of atopic dermatitis in children. Methods: We reviewed the literature retrieved from PubMed, Web of Science, Ovid, ScienceDirect, Embase, China National Knowledge Infrastructure, WanFang Data, and guidelines websites. Search period from January 1, 2016, to December 31, 2021. The following keywords were used for searching: "atopic dermatitis," "atopic eczema," "eczema," "guideline," and "consensus." The quality of the guidelines was assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument independently, and domain scores >60% were considered to have sufficient quality. The guideline recommendations were reviewed. Results: Nineteen guidelines were included in the study. Three guidelines had a graded A level, which was recommended for use in practice. Eleven guidelines had a graded B level, which was recommended for use in revision. The remaining five guidelines were rated with C level, which was not recommended. The average score of six domains of AGREE II was 64.76%, 48.53%, 42.35%, 73.83%, 32.23%, and 70.17%, respectively. A consistency test showed an intraclass correlation coefficient range of 0.497 (95% CI: 0.105, 0.705) to 0.970 (95% CI: 0.93, 0.987) based on the two assessors' test results for the guidelines. Conclusions: Most guidelines were recommended for use with revision. No significant changes were observed in the primary management of atopic dermatitis in children compared to previous evidence. New biological agents and complementary alternative medicine are increasingly available, but the evidence for the treatment of atopic dermatitis in children is still limited. [ABSTRACT FROM AUTHOR]

Several studies have focused on treating atopic dermatitis (AD) using topical antifungal drugs. However, their findings are inconsistent. This meta‐analysis of randomized controlled trials (RCTs) aimed to evaluate the safety and efficacy of topical antifungal drugs for the treatment of AD. We searched prominent databases such as EMBASE, PubMed, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Database to retrieve all RCTs on the use of topical antifungal drugs for the treatment of AD. The two authors independently performed screening, extraction, and quality evaluation of data based on inclusion and exclusion criteria. In addition, quantitative synthesis and qualitative description of the results were performed using Review Manager 5.3. Nine studies with a total of 785 subjects were included in the meta‐analysis. Based on intervention measures, data were divided into three groups: topical antifungal drugs versus placebo, topical antifungal drugs versus topical glucocorticoids, and topical antifungal drugs plus topical glucocorticoids versus topical glucocorticoids. Risk‐of‐bias assessments revealed that the random distribution methods and allocation concealment were not ideal; further, some studies had incomplete data and reported selective results. Quantitative analysis revealed that in terms of effective rate, topical antifungal drugs are superior to topical glucocorticoids (p = 0.003), and topical antifungal drugs plus topical glucocorticoids are superior to topical glucocorticoids (p = 0.001). However, no significant differences in adverse reactions were observed between the three groups (p > 0.05). The safety and efficacy of topical antifungal drugs for treating AD cannot be accurately evaluated with existing data. Therefore, additional high‐quality and large‐sample prospective RCTs are required for further validation to determine the appropriateness of topical antifungal drug use for the treatment of AD in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Glycyrrhiza is one of the most widely used traditional Chinese medicines in China. Its main bioactive ingredient glycyrrhizic acid (GA) has the potential to be used as a treatment for atopic dermatitis (AD) because it has similar actions to steroids, but with relatively few side effects. Aims: The objective of this study was to explore the potential mechanisms of GA on AD mice model. Methods: Calcipotriol, a vitamin D3 analogue (MC903) was applied topically to establish AD mouse model. Mice were intraperitoneally administrated with 2 mg/kg dexamethasone (DEX), 25 or 50 mg/kg GA for 15 days. After mice were executed, skin tissues were collected and detected the expression levels of IL‐4, IFN‐γ, TNF‐α and thymic stromal lymphopoietin (TSLP). The percentages of Th1, Th2, Th17, langerhans cells (LCs) in draining lymph nodes (dLNs) were measured by flow cytometry. Results: Our data demonstrated that GA improved the symptoms of AD by exerting anti‐inflammatory and anti‐allergic functions in vivo. We found that GA treatment decreased the level of total IgE in serum, suppressed ear swelling, reduced the infiltration of mast cells in skin lesions and decreased expressions of IL‐4, IFN‐γ, TNF‐α and TSLP in skin lesions. Furthermore, our experimental results demonstrated that GA suppressed the Th1/Th2/Th17‐immune responses in the dLNs, inhibited the migration of LCs in dLNs. Conclusions: In conclusion, our findings suggested potential therapeutic effects of GA against MC903‐induced AD‐like skin lesions in mice. [ABSTRACT FROM AUTHOR]

Introduction/Background TQH2722 is a humanized monoclonal antibody targeting interleukin 4 receptor alpha (IL4Ra) which leads to the dual-blockade of interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling, inhibiting the T-helper cell type 2 immune pathway. Th2 inflammation is implicated in the pathobiology of diseases such as asthma and atopic dermatitis. We describe the safety and pharmacokinetic results from a first-in-human study in healthy subjects. Objectives: To evaluate the safety, tolerability, pharmacokinetic characteristics, and immunogenicity of TQH2722 injection in healthy adult subjects. Methods: This randomized, double-blind, placebo-controlled, ascending-dose phase I study (NCT05409326) was conducted in China. Each adult subject received a single subcutaneous (sc.) TQH2722 dose or placebo in single ascending-dose (SAD) cohorts, and 4 doses of TQH2722 or placebo administrated Q2W in multiple ascending-dose (MAD) cohorts. Pharmacokinetic samples were collected prior to first dose administration through 56 days after initial dosing in SAD cohorts. In the MAD cohorts, samples were collected before every administration until 56 days after last dosing. Results: As of 28 September 2023, all subjects had completed the study, with the database locked while remaining unblinded. Sixty-six (66) healthy subjects were enrolled in this study. The SAD cohorts consisted of single doses of TQH2722 of 50 mg (n-4), 150 mg (n=10 active, 2 placebo), 300, 600, and 1200 mg cohorts, each receiving TQH2722 (n=8) or placebo (n=2). Ten subjects were enrolled in each of the 150 and 600 mg MAD cohorts receiving TQH2722 (n=8) or placebo (n=2). No dose-limiting toxicities or SAEs were observed and only 3 subjects experienced a grade 3 AE including 1 subject of increased triglycerides, 1 subject with increased creatine kinase and 1 subject with decreased blood potassium). All other AEs were of grade 1 or 2. The incidence and severity of AEs were not dose dependent. No SAEs or AEs led to treatment discontinuation. The pharmacokinetics of TQH2722 were indicative of an anti-receptor mAb in that TQH2722 exhibited nonlinear target-mediated clearance. Maximum serum concentration was reached after 2.78-6.75 days with the half-life of a single sc. administration of TQH2722 increasing by dose level, ranging between 4 and 18 days. Conclusions: TQH2722 was safe and well tolerated in healthy volunteers. Injection site reactions and laboratory abnormalities were the most reported AEs, with grade 1-2 as the major severity. Most AEs resolved on their own. Single dosing showed non-linear increases of the drug exposure as the dosage increased. These data support further clinical development of TQH2722 as a therapeutic treatment for patients with Atopic Dermatitis and other related diseases mediated by Th2 inflammation. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) has a reported prevalence of 3% in adolescents aged 13-14 years in China. However, studies evaluating the efficacy and safety of Janus kinase 1-selective inhibitors in AD in patients from China are limited. Abrocitinib is an oral, once-daily, Janus kinase 1-selective inhibitor approved for the treatment of moderate-to-severe AD in adults and adolescents in the United States and in adults in China. The efficacy of abrocitinib as monotherapy or in combination with medicated topical therapy has been demonstrated in multiple phase 3 clinical trials in adolescent and adult patients with moderate-to-severe AD. In a separate phase 3 trial of adolescent patients (JADE TEEN [NCT03796676]), abrocitinib administered in combination with medicated topical therapy was effective in improving the signs and symptoms of moderate-to-severe AD, with an acceptable safety profile. JADE TEEN was conducted in several countries, including China. Objective To assess the efficacy and safety of abrocitinib in combination with topical therapy in Chinese adolescents with moderate-to-severe AD enrolled in JADE TEEN. Methods: In JADE TEEN, adolescent patients (aged 12 to 17 years) were randomly assigned (1:1:1) to receive abrocitinib 200 mg, abrocitinib 100 mg, or placebo for 12 weeks in combination with medicated topical therapy. This post hoc analysis included data from patients enrolled in JADE TEEN from mainland China. Assessments included the proportion of patients at week 12 who achieved an Investigator's Global Assessment (IGA) score of 0 (clear) or 1 (almost clear) with a =2-grade improvement from baseline, =75% improvement from baseline in Eczema Area and Severity Index (EASI-75), and =4 point improvement from baseline in Peak Pruritus Numerical Rating Scale (PP-NRS4; used with permission from Regeneron Pharmaceuticals, Inc., and Sanofi). Change from baseline in Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) total score at week 12 was also assessed. Safety was assessed by treatment emergent adverse event (TEAE) monitoring. Results: Of 285 patients enrolled in JADE TEEN, 52 (18.2%) were enrolled from mainland China and consisted of 14, 18, and 20 patients who were randomly assigned to receive abrocitinib 200 mg, abrocitinib 100 mg, and placebo, respectively. Median age at baseline was 15.0 years (interquartile range [IQR], 14.0-17.0 years), and median duration since onset of AD was 9.8 (IQR, 4.4-13.7) years. At week 12, a higher proportion of patients treated with abrocitinib at either dose compared with placebo achieved efficacy responses of IGA 0/1 (abrocitinib 200 mg, 46.2%; abrocitinib 100 mg, 46.7%; placebo, 22.2%), EASI-75 (69.2%; 73.3%; 27.8%), and PP-NRS4 (63.6%; 50.0%; 20.0%). Decreases from baseline in PSAAD total score were greater in patients treated with abrocitinib at either dose compared to placebo at week 12 (abrocitinib 200 mg, -3.4; abrocitinib 100 mg, -3.2; placebo, -1.8). Response rates were largely comparable between patients from China and the overall JADE TEEN study population, although CIs were wider in the China subgroup because of the small sample size. In the China subgroup, TEAEs were experienced by 13 (92.9%), 16 (88.9%), and 15 (75.0%) patients in the abrocitinib 200 mg, abrocitinib 100 mg, and placebo groups, respectively. Compared to the overall population, there were no new safety signals identified in patients from China. Conclusions: Abrocitinib administered in combination with medicated topical therapy was effective and well tolerated in adolescent patients from China with moderate-to-severe AD. Efficacy and safety findings were consistent with the overall JADE TEEN population. [ABSTRACT FROM AUTHOR]

Little real‐work data regarding the efficacy and safety of dupilumab in the treatment of atopic dermatitis (AD) is available at present. To assess the efficacy and safety of dupilumab at 12 weeks in the treatment of AD in clinical routine clinical practice. A retrospective, single‐centre study of adult patients with moderate to severe AD treated with dupilumab for 12 weeks in China. In total, 60 patients (48 male, 12 female; mean age: 53.2 ± 15.6) were enrolled in this retrospective study. These patients exhibited a mean AD disease course of 10.6 years (6.0), 30% exhibited a family history of allergies, and 31 (51.7%) had one or more allergic comorbidities. Following dupilumab treatment for 12 weeks, 83.3% and 42% of patients had achieved EASI‐50 and EASI‐75, respectively. Overall, adverse events (AEs) were reported by 15% of patients, with the most common being conjunctivitis, injection site reactions, and herpes simplex virus infections. Laboratory testing after 12 weeks revealed pronounced decreases in both circulating eosinophil counts (from 0.6 (0.1–2.8) to 0.3 (0.1–9.7) 109/L) and total IgE concentrations (from 327 (2.46–2500) to 230 (47.6–2200) U/ml) in these patients. These real‐world data reaffirm the safety and efficacy of dupilumab as a treatment for moderate‐to‐severe AD among Chinese patients in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The prevalence of anxiety and depression symptoms among caretakers of children with atopic dermatitis (AD) and associated factors is unclear. The study was designed to explore anxiety and depression symptoms among caretakers of AD, and screen factors associated with anxiety and depression symptoms. Methods: A total of 901 children with AD and their caretakers were continuously enrolled and interviewed at dermatology department of Capital Institute of Pediatrics, Beijing, China. Children's medication was administered by their caretakers. Caretakers' anxiety and depression symptoms were evaluated by Hamilton Depression Rating Scale-17 and Hamilton Depression Rating Scale, while medication compliance was evaluated and divided into poor (< 6 points), moderate (6–7 points), and good (> 7 points) by Morisky Medication Adherence Scale. Multilevel ordered logistic regression was used to screen factors associated with caretakers' anxiety and depression. Results: Among caretakers, 41.5% had anxiety symptoms, 39.6% had depression symptoms, 51.4% have any of the two and 29.7% had both of the two. Factors associated with caretakers' anxiety symptoms included longer duration of the illness (OR, 0.99, 95% CI 0.98–0.99) and taking care of children with severe AD (OR, 2.55, 95% CI 1.43–4.55). Factors associated with caretakers' depression symptoms included higher educational level (OR, 0.56, 95% CI 0.39–0.80), taking care of children with moderate (OR, 2.01, 95% CI 1.15–3.50) and severe AD (OR, 3.99, 95% CI 2.10–7.59) and poor medication compliance (OR, 3.45, 95% CI 1.13–10.56). Conclusions: Prevalence of anxiety and depression symptoms among caretakers of AD were high. Attention should be paid to caretakers of AD at higher risk for those psychological problems. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease with rising prevalence. Topical corticosteroids (TCS) are recommended as first-line therapy for patients with AD in China; however, corticophobia is a widespread concern, which can manifest as noncompliance: in a previous Chinese study, almost all parents whose children had AD were very concerned about the side effects of TCS and, as a result, nearly half did not use it in the event of recurrence. We propose a TCS-sparing treatment algorithm for the management of infants, children, adolescents, and adults with mild-to-moderate AD, to guide clinical practice in China. Methods: A panel of eight experts in AD from China and one expert from Germany formed to develop a practical algorithm for the management of mild-to-moderate AD, focusing on pimecrolimus. Results: Irrespective of body location, all patients with mild AD (including acute flares) and infants with moderate AD should apply the topical calcineurin inhibitor (TCI) pimecrolimus twice daily to the affected area until symptoms disappear. For children, adolescents, and adults with moderate AD, pimecrolimus should be applied twice daily to sensitive skin areas, and a TCI (either pimecrolimus or tacrolimus) should be applied twice daily to other body locations. Short-term administration of TCS, followed by TCI twice daily, is recommended for most patients with moderate AD experiencing acute flares, regardless of lesion site. Emollients should be used regularly. Conclusions: The algorithm presented intends to simplify treatment of AD in China and guide clinical decision-making. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic, recurrent pruritic, inflammatory skin disease associated with genetic allergies. Crisaborole is a phosphodiesterase 4 (PDE4) inhibitor approved by the US Food and Drug Administration for the treatment of patients over 2 years of age with mild to moderate AD. Previous studies have focused on the efficacy of crisaborole in the treatment of AD, and its influence on AD recurrence is not clear. Objective: To explore the efficacy and safety of sequential topical 0.1% mometasone furoate cream (Elosone) and crisaborole in the treatment of mild to moderate AD in children, and to investigate the effect of crisaborole on the recurrence of AD. Methods: • Patients Patients aged 2-17 years (ChiCTR2100054340) with mild to moderate AD treated with Elosone once daily for 2-4 weeks and then entered a maintenance treatment period when IGA = 1. During this treatment period, patients were randomised to crisaborole twice daily in combination with emollient or emollient alone for 16 weeks. In case of relapse (IGA>1) children in both groups received Elosone once daily for 1 week. • Endpoints The primary outcome was relapse rate at 16 weeks and secondary outcomes included proportion of people without recurrence, number of patients prescribed Elosone, change from baseline in EASI, IGA, NRS and POEM, and safety assessment. Results: • Patients 153 patients were screened for inclusion and after 2-4 weeks of treatment with Elosone once daily, 142 patients were randomised, of whom 73 received crisaborole and emollients twice daily and 69 received emollients twice daily. • Relapse At 16 weeks, the recurrence rate of crisaborole plus emollient group was 43.84%, which was significantly lower than that in the emollients alone group (71.01%, P=0.001). The Kaplan-Meier curve showed a significant increase in the proportion of children with no recurrence in the crisaborole plus emollient group compared with the emollient alone group over time (P=0.0016). • Mometasone furoate prescription After entering the maintenance period, the number of Elosone prescriptions in the crisaborole combined emollients group was significantly lower than in the emollients alone group. • Efficacy At 12 weeks, the increase in IGA, EASI, NRS and POEM from baseline were significantly reduced in crisaborole plus emollient treatment compared to the emollient treatment alone (P < 0.05). • Safety 12.33% and 21.4% of the experimental and control groups respectively experienced adverse reactions, which were not statistically different between the two groups (χ2=2.237, P=0.135) and did not correlate with the drugs. Conclusion: Treatment of mild to moderate AD in children over 2 years of age with sequential topical 0.1% mometasone furoate and crisaborole significantly reduced relapses and the amount of mometasone furoate prescribed and was safe and well tolerated by patients. [ABSTRACT FROM AUTHOR]

Background. Immunoglobulin E (IgE) is the most important promoter of allergic inflammation. However, there are few systematic studies on IgE in age range, genders, disease spectrum, and time regularity. Aim. To screen the common allergens, allergen spectrum, and IgE difference between type 2 inflammatory allergic diseases and other allergic diseases in Weifang, China. Methods. A retrospective study was performed by estimating patients' clinical data suffering from allergic diseases (urticaria, pollinosis, allergic rhinitis, atopic dermatitis, and bronchial asthma) between May 2019 and April 2020 using an allergen detection kit of Macro-Union Pharmaceutical. Results. 732 of the 1367 patients showed different antigen positive, and the positive rate was 53.5%. The most common allergens were dust mites, mixed fungi, Artemisia pollen, cat/dog dander, and cockroaches. There were 27.0% (369/1367) of the patients with single positive allergen-specific IgE (sIgE), 26.5% (363/1367) with multiple-positive IgE. The total immunoglobulin E (tIgE) levels varied with gender, age, and type of disease. There was a difference in the distribution of allergens between children and adults. A positive correlation between the serum-specific IgE and the corresponding local inhaled allergen density was observed. Conclusions. In this study, we found that type 2 inflammatory allergic diseases have higher serum IgE and a higher probability of inhaled sIgE positive. According to age, gender, and condition, serological IgE detection of allergens provides new insight into the early diagnosis and prevention of allergic diseases. [ABSTRACT FROM AUTHOR]

Background: There has been research about the prevalence and risk factors of eczema, hay fever, and asthma in children, but little is known about these conditions in adults in China. Objectives: To explore the prevalence of adult eczema/atopic dermatitis (AD) and its risk factors in northern China. Methods: A cluster sampling randomized population-based survey was conducted using a face-to-face questionnaire combined with skin prick tests of ten common aeroallergens including nine pollen allergens and Dermatophagoides pteronyssinu (Dp) allergen. The questionnaire was designed by specialists and included questions on the prevalence of eczema, hay fever, and asthma, socioeconomic risk factors, family history of atopy and environmental exposures. The prevalence of eczema with asthma and/or hay fever (EAH) was applied as a proxy of AD in this study. Results: Overall, 2096 subjects were enrolled and completed the study. The prevalence of eczema was 15.7% (95% CI 14.3–17.4), while the prevalence of hay fever and asthma were 20.6% (95% CI 18.9–22.4) and 6.5% (95% CI 5.5–7.6), respectively. In particular, the prevalence of EAH was 5.1% (95% CI 4.4–7.0). The prevalence of eczema and EAH was significantly associated with younger age, atopy family history, high education level, urbanization, and antibiotic overuse (P < 0.05, logistic regression). The sensitization rate was higher in EAH compared with eczema (48.2% vs 41.0%, P = 0.018), with weed pollen sensitization being the most common. Subjects with two or more concomitant allergic diseases had increased risk of eczema and EAH (P < 0.001). Allergen sensitization increased the risk of eczema and EAH (P < 0.001, both). Conclusions: Adult eczema and EAH are prevalent in northern China under high pollen exposure. Socioeconomic and environmental factors affected the prevalence of adult AD in China. Dp had a particular impact on the prevalence of eczema/AD in the grassland region. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a complex, common inflammatory skin disease. The Chinese herbal formula Huoxiang Zhengqi (HXZQ) has been a common dermatosis treatment in China for many years, but there is no high-level evidence for its effect on AD/eczema. The aim of this trial is to examine the efficacy and safety of HXZQ treating AD/eczema patients.Methods: This is a double-blind, multi-center, randomized controlled trial comparing HXZQ to a placebo. It will consist of 4 weeks' treatment and 4 weeks of follow-up. A total of 218 participants will be randomly allocated into two groups-an HXZQ group and a placebo group, from 7 hospitals in China. Patients diagnosed with AD will be enrolled if they are in accordance with CM dampness pattern, have body surface area (BSA) of 1-10%, have investigator's global assessment (IGA) of 1-3, have age between 18 and 70 years, and provide signed informed consent. The Eczema Area and Severity Index (EASI) is the primary outcome. The secondary outcomes are the numerical itch rating scale, IGA, BSA, Skindex-29, and EQ-5D-5L score, from baseline to the end of the treatment. Analysis will be on intention-to-treat and per-protocol subject analysis principles.Discussion: The goal of this trial is to evaluate the efficacy and availability of HXZQ oral liquid in treating AD/eczema in terms of symptoms and eczematous lesions. It will also address whether it has positive effect on QoL.Trial Registration: Chinese Clinical Trial Registry ( http://www.chictr.org.cn/index.aspx ): Chinese herbal formula Huoxiang Zhengqi for atopic dermatitis with dampness pattern (CHARM): a double-blinded randomized controlled trial, ChiCTR1900026700 . Registered on 19 October 2019. [ABSTRACT FROM AUTHOR]

Dermatological care has already been deeply impacted by the coronavirus disease-2019 (COVID-19) epidemic. The consequences may continue long after the epidemic resolves. In this study, we aimed to evaluate the change of dermatological practice since the COVID-19 outbreak is almost controlled in mainland China. Patients requesting a dermatology outpatient visit from January to May in 2019 and 2020 were retrospectively investigated. The number of patients decreased significantly shortly after the COVID-19 outbreak, and it started to increase after the spread of coronavirus was gradually controlled at the end of February in China. The three most common diseases were atopic dermatitis (11.0%), acne (10.2%), and warts (7.2%) in 2019, while acne (8.9%), warts (5.8%), and acute urticaria (5.6%) in 2020. The most statistically significant increased reasons for requesting an outpatient visit from March to May in 2020 was pet-related dermatophytoses, followed by cosmetic consultation and irritated contact dermatitis, an increase of 88.2%, 84.7%, and 58.8%, respectively, over the same period of 2019. Understanding the trends and impacts of dermatologic diseases on patients and health systems during this epidemic will allow for better preparation of dermatologists in the future. [ABSTRACT FROM AUTHOR]

The article presents a study which investigate the self-injurious skin picking behaviours of atopic dermatitis (AD and psoriasis patients using Skin Picking Scale (SPS). It mentions that the study also examined the overall association of degree of skin picking with itch and skin lesion intensity. It informs that skin picking is generated as a response to pruritus or other skin sensations, such as burning, tingling or pain.

Background: Elderly atopic dermatitis (AD) is a newly defined subtype of AD stratified by age‐related clinical pictures. Objectives: To analyse the clinical features and molecular profile of elderly AD patients in China, comparing with infantile, childhood and adolescent/adult AD. Methods: A total of 1312 patients diagnosed by Hanifin and Rajka diagnostic criteria of AD from Huashan Hospital, Shanghai, China, were divided into four groups by age (2–18, 19–40, 41–60 and >60 years), and clinical features were evaluated by questionnaire and physical examination. Serum total IgE, eosinophil counts and various cytokines were further analysed in some of the patients and healthy controls. Results: Elderly AD showed significantly higher male/female ratio and rural/urban ratio than other age groups, and more than half of elderly AD first appeared after 60 years old. Skin lesions of elderly AD were more often seen in the trunk and extensor sites of the extremities. Level of serum IgE and eosinophil counts were significantly lower in elderly AD than those in other age groups. Serum levels of IL‐4, TARC, IL‐17A, IL‐6, IL‐22, IL‐33 and TSLP were significantly higher in elderly AD patients than those of healthy controls, indicating a mixed Th2/Th17/Th22 inflammation. Conclusions: Elderly AD demonstrated unique clinical characteristics compared with other age groups and showed mixed Th2/Th17/Th22 skewing, indicating a unique pathogenesis for elderly AD. Linked Commentary: C. Vestergaard. J Eur Acad Dermatol Venereol 2020; 34: 2170. https://doi.org/10.1111/jdv.16910 [ABSTRACT FROM AUTHOR]

CBP-201 is a next-generation monoclonal antibody targeting the IL-4Rα subunit. Rapid efficacy with CBP-201 was demonstrated in global phase 2 (WW001) and China-only pivotal trials (CN002) in patients with moderate-to-severe atopic dermatitis (AD). Previous studies of AD therapy demonstrated similar efficacy between moderate and severe disease, with a trend toward greater improvement in moderate patients. It is unknown whether there are differences in clinical response to CBP-201 with moderate vs.severe AD. We report post hoc efficacy analyses at Week 16 with CBP-201 300 mg from WW001 in baseline severity subgroups, based on validated Investigator Global Assessment (vIGA™) scores of 3 (moderate) and 4 (severe). In WW001 (NCT04444752), adults with moderate-to-severe AD were enrolled in a RDBPC 16-week trial of subcutaneous CBP-201 or placebo. For post hoc analysis, data for 300 mg every 2- and 4-week dose regimens were pooled. Investigators assessed AD severity using Eczema Area and Severity Index (EASI), SCORing AD (SCORAD), percent Body Surface Area (BSA) of AD involvement and vIGA. Patient-reported outcomes were assessed with the Dermatology Life Quality Index (DLQI) and Patient Oriented Eczema Measure (POEM). Least squares mean (LSM) score changes were analysed using ANCOVA modeling (including treatment, baseline score and baseline vIGA), with missing data interpolated by last observation carried forward. Responder endpoints were analysed using Clopper–Pearson methodology and, for missing values, nonresponder imputation. P -values are for CBP-201 vs. placebo, per baseline severity subgroup, at Week 16. At baseline, 113 patients had moderate AD (n = 74 CBP-201, n = 39 placebo) and 56 patients had severe AD (n = 39 CBP-201, n = 17 placebo). Baseline EASI scores were lower in the moderate subgroup [mean (SD): CBP-201, 21.5 (7.0); placebo, 22.2 (6.3)] vs. the severe subgroup [CBP-201, 33.6 (11.9); placebo, 31.9 (10.8)]. In both the moderate and severe AD subgroups, significant improvements with CBP-201 vs. placebo were observed. Except for the proportion of patients achieving vIGA 0/1, numerically greater CBP-201 responses were observed in patients with severe vs. moderate AD at Week 16; placebo responses were comparable per subgroup. In the severe and moderate subgroups, LSM SCORAD scores decreased by −42.8% (severe) and −29.8% (moderate), and LSM percent BSA decreased by −29.8% and −17.3%, respectively. Clinically meaningful 2-point improvement in vIGA was reported for 48.7% and 27.0% of patients with severe and moderate AD, respectively. The proportions of patients achieving vIGA 0/1, with 2-point improvement, were 20.5% and 27.0% with severe and moderate AD, respectively. Numerically greater proportions of patients with severe vs. moderate AD experienced EASI responses with CBP-201: EASI-50, 66.7% vs. 54.1%; EASI-75, 53.8% vs. 39.2%; EASI-90, 28.2% vs. 23.0%. Patients with severe vs. moderate AD reported greater improvements in patient reported outcomes with CBP-201: DLQI, −8.7 vs. −7.0; POEM, −12.5 vs. −8.7. Clinically meaningful improvements were observed in patients with AD with either moderate or severe AD after 16 weeks of treatment with CBP-201 300 mg at either 2- or 4-week dosing. There were no differences noted between moderate and severe patients in the placebo treatment group. In most severity readouts, greater proportions of patients with AD with severe disease on study entry experienced clinically meaningful improvements with CBP-201. In future CBP-201 trials, a more severe AD population needs to be examined to determine if this same observation is also noted. Collectively, the WW001 findings support further investigation of CBP-201, at both the 2- and 4-week dosing schedules enrolling larger numbers of moderate and severe patients with AD and with prespecified analyses by baseline AD severity. [ABSTRACT FROM AUTHOR]

Background: In previous epidemiological study, the prevalence of atopic dermatitis (AD) was 12.94% among children aged 1–7 years by clinical diagnosis, whereas that was 4.76% and 3.51% using U.K., and Hanifin and Rajka diagnostic criteria. Objective: We aimed to propose new diagnostic criteria for children and evaluate its efficiency in different populations. Methods: We screened atopic features and analysed their correlation with AD using data from a previous study. A new set of diagnostic criteria for children in China was proposed and validated in 1031 children in outpatient clinics and 538 children in a birth cohort survey. Clinical diagnosis and atopic feature evaluation were performed face to face by dermatologists specialized in AD. Three criteria were compared for diagnostic efficiency using the clinical diagnosis as the reference. Results: The new diagnostic criteria for children were based on (i) pruritus; (ii) 'typical morphology and distribution' or 'atypical morphology and distribution with xerosis'; and (iii) a chronic or chronically relapsing course. Compared to classical diagnostic criteria, the sensitivity of the new diagnostic criteria was significantly higher in the epidemiological survey and the clinical setting, especially obvious among mild and moderate AD. In the birth cohort, the new criteria showed similar sensitivity and specificity. Conclusion: The new criteria for children yielded higher sensitivity for the diagnosis of AD in the epidemiological survey and clinical setting, particularly for mild and moderate AD. Among the birth cohort with a complete medical history, three criteria showed similar sensitivity and specificity. Linked Commentary: T. Bieber. J Eur Acad Dermatol Venereol 2020; 34: 438–439. https://doi.org/10.1111/jdv.16223. [ABSTRACT FROM AUTHOR]

Background: It acknowledged that skin care is an important part of atopic dermatitis therapy. However, clinical evidences are limited for the best bathing practices, especially the skin health performance of cleansing products on children's atopic dermatitis skin. Methods: A randomised controlled clinical study was conducted in China among 4‐ to 18‐year‐old children with mild‐to‐moderate atopic dermatitis to evaluate the skin health effect of three cleansing systems (a mild synthetic bar, an ultra‐mild body wash with lipids, and an ultra‐mild body wash with lipids and zinc pyrithione) by measuring SCORing of Atopic Dermatitis (SCORAD), consumption of topical corticosteroid and the characteristics of microbiome. Results: Increased Staphylococcus aureus abundance and decreased microbial diversity were observed in atopic dermatitis lesion sites compared with healthy control sites. After 4 weeks of treatment, all three treatments showed clinically important improvement from baseline in SCORAD. Four‐week corticosteroid consumption was significantly lower for the two body wash groups than the bar group. A significant decrease in S. aureus abundance and increase in microbial diversity were observed in the lesion sites for the two body wash formulas, while the microbial diversity was statistically insignificant for the mild cleansing bar group. However, there were no incremental benefits provided by the body wash formulas based on the assessment of SCORAD. Conclusions: These results demonstrated the safety and efficacy of using the investigational body wash formulas with lipids in reducing the needs for corticosteroid and improving the healthy composition of skin microbiome vs. the mild synthetic bar soap. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue. Objective: To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China. Methods: This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history‐taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy. Results: A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis. Conclusions: In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity. [ABSTRACT FROM AUTHOR]

In the multicenter induction, randomized withdrawal, and retreatment phase 3 JADE REGIMEN trial (NCT03627767), abrocitinib demonstrated efficacy and was well tolerated in patients with moderate-to-severe atopic dermatitis (AD). To analyze data from Chinese patients who were enrolled in the JADE REGIMEN trial with the aim of further characterizing the efficacy and safety of abrocitinib in Chinese patients with moderate-to-severe AD. In JADE REGIMEN, patients aged ≥12 years with moderate-to-severe AD who responded to abrocitinib 200 mg during open-label induction for 12 weeks (defined as achieving an Investigator Global Assessment score of 0 [clear] or 1 [almost clear] with a≥2-grade improvement from baseline [IGA 0/1] and a≥75% improvement from baseline on the Eczema Area and Severity Index [EASI-75]), were randomly assigned 1:1:1 to blinded abrocitinib 200 mg, abrocitinib 100 mg or placebo for 40 weeks (maintenance period). Patients who experienced a flare in the maintenance period (defined as a≥50% loss of initial EASI response at week 12 with a new IGA score ≥2) entered a 12-week open-label rescue period of abrocitinib 200 mg with medicated topical therapy. This analysis included data from Chinese patients enrolled in mainland China; evaluated endpoints were the probability of flare and median time to flare during the maintenance period and ≥75% improvement from rescue baseline on the EASI (recapture of EASI-75 response) at week 12 of the rescue period. Safety was assessed by adverse event monitoring. Of 1233 patients treated in the induction period, 118 were enrolled from China (median age [interquartile range, IQR], 24.0 [19.0–31.0] years; median duration since onset of AD [IQR], 8.0 [3.0–11.3] years). At week 12 of the induction period, 82 (69.5%), 83 (70.3%), 100 (84.7%) and 70 (67.3%) patients achieved IGA 0/1 and EASI-75; IGA 0/1; EASI-75; and a≥4-point improvement from baseline in Peak Pruritus Numerical Assessment Scale (PP-NRS4; used with permission from Regeneron Pharmaceuticals, Inc., and Sanofi), respectively, consistent with the overall JADE REGIMEN population. A total of 81 (68.6%) patients were randomly assigned to the maintenance period (median age [IQR], 22.0 [18.0–30.0] years). At week 52, the probability of experiencing a flare was 13.8% (95% CI, 5.4–32.7), 41.5% (25.4–62.4) and 76.0% (55.7–91.8) in the abrocitinib 200 mg, abrocitinib 100 mg and placebo arms, respectively. The median time to flare was 28.5 (95% CI, 22–119) days and 323 (154–323) days in the placebo and abrocitinib 100 mg treatment arms, respectively. It was not possible to estimate the median time to flare in the abrocitinib 200 mg treatment arm because too few flaring events (n=4) were reported in that group. At the end of the maintenance period, the proportions of Chinese patients in both abrocitinib treatment arms who maintained IGA 0/1, EASI-75 and PP-NRS4 responses achieved during induction were consistent with those observed in the overall population. After 12 weeks of rescue treatment, 75% of all Chinese patients who experienced a flare recaptured the EASI-75 response. In the maintenance period, 86.2% and 71.9% of Chinese patients experienced adverse events in the abrocitinib 200 and 100 mg arms, respectively. No new safety signals were identified in patients from China compared to the overall population; there were no adjudicated malignancy events and no deaths. The results of this post-hoc analysis of patients from China were consistent with the overall JADE REGIMEN study population. Induction with abrocitinib 200 mg and continuous or reduced-dose maintenance with abrocitinib 200 or 100 mg were effective in reducing the risk of flare and were well tolerated in Chinese patients. Rescue treatment effectively recaptured response in most patients who experienced a flare. [ABSTRACT FROM AUTHOR]

The association of atopic dermatitis and chronic spontaneous urticaria with socioeconomic status has been little studied. The aim of this study was to investigate the prevalence of skin diseases and their association with socioeconomic status in adolescents in China. A cross-sectional study was conducted at Central South University, Changsha, China. All newly enrolled students underwent dermatological examination and completed a survey. Socioeconomic status was measured in terms of parental education level and income. Two-level logistic regression models were used. A total of 8,226 students consented to participate. On dermatological examination, moderate to severe acne (10.2%) had the highest prevalence, followed by chronic spontaneous urticaria (2.7%), atopic dermatitis (2.5%), and tinea (1.7%). Socioeconomic status was positively associated with the prevalence of chronic spontaneous urticaria (ptrend = 0.001) and atopic dermatitis (ptrend = 0.0094). Tinea was inversely associated with socioeconomic status (ptrend = 0.025). Higher parental socioeconomic status was associated with higher risk of atopic dermatitis and chronic spontaneous urticaria, but lower risk of tinea. [ABSTRACT FROM AUTHOR]

First reported from Taiwan mistakenly as acral acanthosis nigricans in 1991, pigmented carpotarsal hyperkeratosis or hyperkeratosis nigricans carpi et tarsi displays a peculiar distribution of velvety brown‐grey hyperpigmented plaques symmetrically on the flexural side of the wrists and ankles and on the dorsal sides of the hands and feet. A marked epidermal hyperkeratosis with typically mild acanthosis and papillomatosis is observed in histology. Whitish maceration upon perspiration or water exposure, with exacerbation in summer but remission in winter, is common. The association with obesity, endocrine disorders, atopic dermatitis, ichthyosis or malignancy is unknown. Familial occurrence and hereditary patterns are ill‐defined. There is preliminary evidence indicating a pathogenic role of missense mutation in the transcription factor 4 gene. Treatment is empirical, with good outcome with topical retinoids and keratolytic agents. Recurrence is common, and long‐term prognosis is unclear. To be distinguished are acral acanthosis nigricans, palmoplantar keratoderma of the Nagashima type, palmoplantar keratoderma of the Bothnian type and aquagenic palmoplantar keratoderma. Most reported cases are from Southern China and are predominantly observed in men between the ages of 20 and 40 years. The currently used term 'symmetrical acral keratoderma' is non‐specific and misleading and may lead to global unawareness, underreporting or misdiagnosis of this phenomenon. Further genetic and molecular studies are required to clarify its pathogenesis and relation to palmoplantar keratoderma. [ABSTRACT FROM AUTHOR]

Asian Atopic dermatitis (AD) presents as a mixed phenotype between the European American (EA) AD and psoriasis phenotypes, with highly atypical features for AD, including clearer demarcation of lesions, with more prominent scaling, lichenification, parakeratosis, hyperplasia and a unique cytokine profile with coactivation of the TH2 and TH17 axes. The cutaneous immune dysregulation in Chinese patients with AD usually exhibit remarkable increase in epidermal hyperplasia and parakeratosis, frequently observed in areas such as the hands, feet, knees and elbows. Currently, the response of chronic hyperplastic lesions to various conventional treatment modalities, including topical corticosteroids and topical calcineurin inhibitors, is not optimistic and often accompanied by various complications. As a Phosphodiesterase 4 (PDE4) inhibitor, crisaborole broadly inhibits inflammatory signaling pathways, and has demonstrated definite efficacy in AD partly due to its smaller molecular weight and higher transdermal absorption efficiency. This study aims to find the clinical efficacy of 2% crisaborole ointment monotherapy for chronic hyperplastic lesions of AD in real-world research in China. We retrospectively enrolled 49 patients with AD aged 12 years or older with chronic hyperplastic lesions and an Investigator's Static Global Assessment (ISGA) score of mild or moderate. The patients were administered with 2% crisaborole ointment for twice-daily application until the complete clearance of lesion. The efficacy endpoints comprised the onset time of pruritus and lesion remission, and the time of complete lesion clearance. A 1-grade or more improvement of the VAS scores from baseline was defined as the pruritus remission. An improvement of 1 point or more of the ISGA scores was indicative of improved skin lesions. The ISGA score of 0 (clear) or 1 (almost clear) with a ≥2-grade improvement from baseline indicated complete remission of skin lesions. After subgrouping the patients by age and AD duration, we further compared differences in efficacy endpoints to explore potential influencing factors on the effectiveness of crisaborole. Two percent crisaborole ointment showed good efficacy for treating chronic hyperplasia lesions in Asian patients with AD, with minor irritation, early remission of pruritus [7.0 (3.0, 10.0) days] and lesions [7.0 (5.0, 10.0) days]. The median time for complete lesion clearance was 30 days. Two percent crisaborole ointment showed different efficacy in the different age. The onset of pruritus remission appeared to be more rapid in the elderly [2.0 (1.0, 10.0)] compared with the adolescents [4.0 (2.3, 6.5)] and the adults [7.0 (3.5, 10.0)], but with no statistically significant difference (P = 0.072). The adolescents had an earlier onset of lesion remission by approximately 3 days compared with the adults and the elderly (P = 0.044). Although the onset of pruritus remission for the adolescents and the adults was similar to their onset of lesion remission, the elderly seemed to experience significantly earlier pruritus remission compared with their lesion remission onset. There was no statistical difference in complete lesion clearance time among different age groups (P = 0.019). Commonly seen in Asian patients with AD, chronic hyperplasia lesions generally do not respond well to other topical medications. Two percent crisaborole ointment monotherapy is an effective treatment for chronic hyperplasia lesions in patients with AD of all age groups, and onset of pruritus and lesion remission is different in the different age group. [ABSTRACT FROM AUTHOR]

Based on the serum biomarkers, two endotypes of patients with AD were identified, which were associated with different levels of inflammation of the patients. The aim of this study was to explore the endotypes of Chinese patients with AD based on serum biomarker analysis, and to identify predictors for the effectiveness of dupilumab, a drug used to treat AD. [Extracted from the article]

Objective. To investigate the prevalence and features of ocular allergy (OA) and comorbidities among school children in Shanghai, China. Methods. This was a population-based cross-sectional study. Each participant completed an ISAAC-based questionnaire. The prevalence of OA symptoms, allergic rhinitis (AR) asthma, atopic dermatitis (AD), and sensitization to mites, pollen, and food was analyzed. Results. A total of 724 and 942 completed questionnaires from the 7–9-year-old (young group) and the 12–14-year-old (teen group) groups were analyzed, respectively. The overall prevalence of OA symptoms was 28%. However, more young students (10.6%) reported mild to severe daily life interference caused by OA than the teens (5.7%). The young group had higher prevalence of diagnosed allergic conjunctivitis (10.2%). The overall prevalence of AR symptom, diagnosed asthma, and diagnosed AD was 40.4%, 11.6%, and 16.7%, respectively. Young children had higher prevalence of diagnosed AR and AD than the teens. There were gender associated differences in the prevalence of AR and asthma among young children, but not among the teens. The comorbidities associated with OA was also analyzed. Sensitization to mites, food, and pollen was associated with higher prevalence of allergic conditions. Conclusions. OA together with other allergic conditions affected a significant number of children in Shanghai. [ABSTRACT FROM AUTHOR]

Background. The epidemiology of atopic dermatitis (AD) in Chinese outpatients is yet to be clarified. Objectives. To investigate population-based prevalence and clinical features of AD in Chinese outpatients. Methods. A multicenter cross-sectional study was conducted in outpatients with eczema or dermatitis from 39 tertiary hospitals in 15 provinces. Results. This study included 682 patients diagnosed with AD, with the mean age of 28.8±20.1 years and the median course of 5.3±6.9 years. AD patients had more severe itching (30.4% versus 13.8%, p<0.001) and clinically suspected bacterial infection (21.7% versus 16.1%, p<0.001) than those of other types of dermatitis. Older patients were more susceptible to have a history of flexion dermatitis (p<0.001), bacterial infection (p=0.005), and severe itching (p<0.001). Outpatients with clinically suspected bacterial infection had 3.53-fold increased risk of AD than those without it (p<0.001). The morbidity rate of AD in the (20–25°N) region is 2.86 times higher than that in the (40–45°N) region [OR (95% CI): 0.352 (0.241–0.514), p<0.001]. Conclusions. AD is characterized by unique clinical/demographic features. Bacterial infection and latitude region may have an impact on the incidence of AD in China. [ABSTRACT FROM AUTHOR]

[Display omitted] • Phellopterin improves MC903 induced AD-like symptoms including reduction of epidermal thickness, scales and serum IgE levels. • Phellopterin reduces infiltration of eosinophils and mast cells in the AD-like skin lesions, and represses expression of TSLP and IL-33 in the AD-like skin. • Phellopterin represses IL-4-induced overexpression of TSLP and IL-33 in human keratinocytes at both mRNA and protein levels. • Phellopterin represses IL-4-induced phosphorylation of STAT3 at Tyr705 in mouse epidermal keratinocytes and cultured human keratinocytes. • STAT3 is required for IL-4-induced overexpression of TSLP and IL-33 in keratinocytes. Anti-inflammation medication is one of the most important treatment for people with atopic dermatitis (AD) which presents persistent type 2 inflammation in skin lesions. Interaction between activated keratinocytes and immune cells in AD skin lesions amplifies inflammatory signaling by augmenting production of cytokines, such as keratinocyte-derived thymic stromal lymphopoietin (TSLP) and interleukin-33 (IL-33). Phellopterin is a bioactive compound isolated from ethanol extract of Angelica dahurica root which has been traditionally used for AD therapy in China. In the present study, we showed that Phellopterin possessed anti-type 2 inflammation activity and alleviated AD-like phenotypes including reduction in serum immunoglobulin E (IgE) levels and infiltration of eosinophils and mast cells in the AD-like skin lesions. Further molecular analysis found that Phellopterin suppressed phosphorylation of signal transducer and activator of transcription 3 (STAT3) at Tyr705, and the expression of TSLP and IL-33 in epidermal keratinocytes of AD-like lesions. In vitro studies in cultured human keratinocytes demonstrated that STAT3 was required for interleukin-4 (IL-4)-induced overexpression of TSLP and IL-33. Phellopterin inhibited IL-4-induced activation of STAT3, which leaded to suppress the STAT3-mediated transcription of TSLP and IL-33. Our study suggested that Phellopterin is an active compound with bioactivities of anti- type 2 inflammation and STAT3 inactivation, thus allowing to be a promising candidate for AD topical therapy. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors for atopic dermatitis (AD) and disclose the relationship between immune inflammatory factors (Immunoglobulin E (IgE), interleukin (IL)-4, IL-18) and the prevalence of AD in a Chinese population. Methods To evaluate the risk factors for infant AD, a total of 921 mother-newborn pairs were recruited through a questionnaire survey conducted during 2009–2011. Venous blood was collected from the mothers during birth hospitalization and umbilical cord blood was collected during delivery. Thirty-five infants with AD paired with their mothers served as the patient group. Thirty-five non-AD pairs were selected randomly and were used as the control group. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the levels of IgE, IL-4, and IL-18. The relationship between the prevalence of AD and the levels of IgE, IL-4, and IL-18 was analyzed. The risk factors for allergy were assessed in IgE positive cases. Results Family income, parental history of atopy, age of menarche, performing housing renovation before pregnancy, instance of a virus infection during pregnancy, and calcium supplementation during pregnancy were potential factors determining the incidence rate of infant AD. Compared with the control group, the AD patient group showed higher levels of IgE and IL-4 in both the maternal serum and umbilical cord blood ( P < 0.01). In the cases with AD, IL-8 was increased only in the maternal serum ( P < 0.01). In addition, the allergens dust mite, mugwort pollen, and mycete spores were risk factors for the incidence of IgE-positive AD. Conclusion IgE and IL-4 levels in the maternal serum and umbilical cord blood as well as IL-18 level in the maternal serum are related to the occurrence of childhood AD. Potential factors for infant AD include family income, parental history of atopy, age of menarche, housing renovation before pregnancy, virus infection, and calcium supplementation during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Atopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Current conventional medical treatment for moderate and severe atopic eczema is not satisfactory. There is promising evidence derived from randomised clinical trials to support the clinical use of Chinese herbal medicine in the management of atopic eczema. However, the available evidence is compromised by the high risk of bias associated with most of the included trials. Therefore, well-designed and adequately powered randomised clinical trials are needed. The primary aim of this trial is to evaluate the efficacy and safety of oral ingestion of an oral Chinese herbal formula (Pei Tu Qing Xin granules; PTQX) in children aged between 6 and 16 years with moderate to severe atopic eczema. Methods/Design: We have designed a randomised, double-blind, placebo-controlled, two-arm, parallel clinical trial with 12 weeks of treatment and a 4-week follow-up period. A pilot study with 30 participants will be conducted at the RMIT University in Australia to determine the feasibility of the full-scale randomised clinical trial (N = 124). Eczema Area and Severity Index score will be the primary outcome. Secondary outcome measures include change in symptoms using the Patient-Oriented Eczema Measure, the Children's Dermatology Life Quality Index and the use of concomitant medicines. Safety parameters include report of adverse events and pathology tests during the trial period. Discussion: Key elements for conducting a high-quality randomised clinical trial have been addressed in this protocol. Findings from the proposed trial will provide critical evidence regarding Chinese herbal medicine treatment for atopic eczema. [ABSTRACT FROM AUTHOR]

Background Previous cross-sectional studies have suggested a comorbid association between atopic dermatitis (AD) and depressive disorder as well as anxiety disorders, but the temporal relationship was not determined. Methods Using the Taiwan National Health Insurance Research Database, 8208 AD patients aged 12 and older without psychiatric history and age-/sex-matched (1:1) controls between 1998 and 2008 were enrolled in our study and followed to the end of 2011. Subjects who developed major depression, any depressive disorder, and anxiety disorders during the follow-up were identified. Results The Cox regression analysis after adjusting for demographic data and atopic comorbidities demonstrated that patients with AD had an elevated risk of developing major depression (hazard ratio [HR]: 6.56, 95% confidence interval [CI]: 3.64–11.84), any depressive disorder (HR: 5.44, 95% CI: 3.99–7.44), and anxiety disorders (HR: 3.57, 95% CI: 2.55–4.98). Stratified by age group, both adolescents and adults with AD were prone to developing major depression (HR: 4.26, 95% CI: 1.39–13.13; HR: 7.56, 95% CI: 3.75–15.23), any depressive disorder (HR: 4.38, 95% CI: 2.09–9.18; HR: 5.66, 95% CI: 4.01–7.99), and anxiety disorders (HR: 5.40, 95% CI: 2.02–14.39; HR: 3.36, 95% CI: 2.38–4.80). Conclusions AD in both adolescence and adulthood increased the risk of developing major depression, any depressive disorder, and anxiety disorders in later life. Further studies would be required to clarify the possible underlying mechanism between AD and depression as well as anxiety disorders. [ABSTRACT FROM AUTHOR]

• Single-dose dupilumab pharmacokinetics (PK) were studied in 30 Chinese subjects. • Repeated-dose PK were studied in 82 Chinese adults with atopic dermatitis. • PK were comparable to non-Asians after accounting for body weight. Dupilumab, a fully human monoclonal antibody targeting IL-4Rα, has demonstrated rapid and sustained improvements in clinical outcomes in patients with atopic dermatitis (AD), asthma, and chronic rhinosinusitis with nasal polyps. In a phase 1, double-blind, ascending-dose study, 30 healthy Chinese adults were randomized to single subcutaneous doses of dupilumab 200, 300, 600 mg, or placebo. In a phase 3, double-blind study, 165 Chinese adults with AD were randomized to dupilumab 300 mg or placebo every 2 weeks. Following single doses of dupilumab 200, 300, and 600 mg in the phase 1 study, mean serum maximum concentrations (C max) were 25.4 ± 4.0, 37.2 ± 14.5, and 77.3 ± 19.0 mg/L, respectively. For a 1.5-fold increase in dupilumab dose, 1.31-, 1.73-, and 1.66-fold increases in C max , area under the curve to real time (AUC last), and extrapolated to infinity (AUC) were observed, respectively, while a 2-fold dose increase resulted in 2.17-, 2.81-, and 2.80-fold increases, respectively. In the phase 3 study, mean dupilumab trough concentrations were 78.8 ± 32.0 and 86.4 ± 33.6 mg/L at weeks 12 and 16, respectively. C max increased approximately proportionally to dose, while AUC and AUC last increased greater than proportionally. Dupilumab pharmacokinetics were generally comparable between Chinese and non-Asian healthy subjects (single dose) and between Chinese and non-Asian AD patients (repeated doses), with differences accounted for by body weight. As differences in exposure by weight are unlikely to be clinically relevant based on late-stage study results, no dose adjustment by ethnic origin or weight is required. [ABSTRACT FROM AUTHOR]

Objectives To investigate the prevalence and the factors related to the sensitive skin in China. Methods A community-based study was undertaken in three major cities in China, Beijing, Shanghai and Guangzhou, from November 2009 to January 2010. The participants in the study were screened by cluster sampling, and were investigated by interview at their own homes. A questionnaire, including skin sensitivity, the occurrence of burning, prickling or irritating sensations correlated with the factors, history of skin diseases and skin types, was given to each participant aged over 15 years. Results Totally 9154 questionnaires were completed (3931 men and 5223 women). The mean prevalence of very sensitive and sensitive skin in three cities was 13% (17.12% in Beijing, 9.10% in Shanghai and 22.39% in Guangzhou.) The mean prevalence was 8.62% in men and 15.93% in women, with significant difference between men and women in three selected cities ( P < 0.001). The total prevalence of very sensitive and sensitive skin was 16.44% in <25 years group, 14.14% in 25-49 years group and 9.73% in ≥50 years group. Moreover, 18.54% of participants claimed with dry skin, 16.70% with greasy skin and 8.04% with normal skin claimed to have the symptoms of sensitive skin. Conclusions The prevalence of sensitive skin in the three cities of China is much lower than that in Europe and the United States. There was significant difference of the prevalence of sensitive skin among three cities located in different climatic and latitude regions and between men and women. The prevalence gradually decreased with the increasing age. The skin sensitivity was associated to the positive history of atopic dermatitis. [ABSTRACT FROM AUTHOR]

Background Recently, we have reported filaggrin mutations ( FLG) of atopic dermatitis in southern China. However, there have been few detailed reports of FLG mutations of patients with AD in northern China by now. Objectives The present aim was to establish the mutation spectrum of FLG gene in AD patients in northern China. Methods A total of 339 cases met Hanifin and Rajka diagnostic criteria of AD were recruited. A comprehensive sequencing of the entire FLG coding region in these patients was conducted. All detected FLG null mutations were screened in a cohort of 301 normal controls. Results Seven novel mutations (478insA, Q1070X, 4026delT, Q1712X, Q2397X, 7145del4 and 8001del4) and eleven reported mutations (3222del4, 3321delA, 4271delAA, S1515X, Q1790X, 5757del4, 6834del5, Q2417X, E2422X, 7945delA and K4671X) in AD were identified. Mutations 3321delA and K4671X were two of the most common mutations in AD. FLG null mutations were present in 26.0% of AD patients. FLG null alleles (compound genotypes) were significantly higher in AD ( P < 0.001) than in the controls. The compound genotypes for all FLG variants were significantly associated with IV ( P < 0.001) and palmar hyperlinearity ( P < 0.001). The common mutation, K4671X, was significantly associated with AD-coexistent allergic rhinitis ( P = 0.005). Conclusions Our study increases the total number of FLG mutations. We clearly demonstrated that FLG loss-of-function mutations were significantly associated with AD in northern China. The FLG null mutations in the Chinese population differed not only from that in the European population but also from that in sub-populations of Asians outside of the Chinese mainland. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a common inflammatory and chronically relapsing disorder with increasing prevalence. However, little is known about its prevalence in Shanghai, the top metropolitan of China. This study will estimate and compare the prevalence of AD in urban and rural areas in representative samples of 3 to 6-year-old children in Shanghai. Methodology/Principal Findings: A descriptive cross-sectional study was performed. Pre-school children were obtained by cluster sampling from 8 communities in different districts in Shanghai. The main instrument was the core questionnaire module for AD used in the U.K. Working Party's study. All the data were statistically analyzed by EpiData 3.1 and SPSS16.0. A total of 10436 children completed the study satisfactorily, with a response rate of 95.8%. The prevalence of AD in 3 to 6- year-old children was 8.3% (Male: 8.5%, Female: 8.2%). The prevalence in urban areas of Shanghai was gradiently and significantly higher than that in rural areas. The highest prevalence was in the core urban area (10.2% in Xuhui Tianping) vs. the lowest far from the urban areas (4.6% in Chongming Baozhen). Conclusions/Significance: The prevalence of AD was 8.3% (95%CI: 7.6%-9.1%) in children aged 3 to 6 in Shanghai. The prevalence of AD decreased from the center to the rural areas in Shanghai. [ABSTRACT FROM AUTHOR]

Background Defect in the SPINK5 gene is known to be implicated in Netherton syndrome (NS), and has been suggested to be a locus predisposing to atopy in general. Coding polymorphisms in SPINK5 exons 13, 14 and 26 have been reported to be associated with atopic dermatitis (AD), asthma and high level of IgE. Objectives To examine whether the SPINK5 gene polymorphisms are associated with AD in Northeast China, and to assess how variants influence selected phenotypic traits. Methods A case-control study was conducted on four non-synonymous polymorphisms in the coding region of SPINK5 in AD and controls. The SPINK5 gene polymorphisms were analyzed using the PCR and RFLP methods. Results For the four non-synonymous SNPs, A1103G(Asn368Ser), G1156A(Asp386Asn), G1258A(Glu420Lys), G2475T(Glu825Asp) in SPINK5, the allelic frequencies in the AD cohort were 0.55 for 1103G, 0.57 for 1156A, 0.54for 1258A, 0.62 for 2475T, consistent with those already published in the original British and Japanese cohorts. The T allele of SNP 2475G > T was found to be significantly associated with AD. There were significant differences in genotype frequencies for G1258A(Glu420Lys) and G2475T(Glu825Asp) but not for A1103G(Asn368Ser) and G1156A(Asp386Asn). Genotypes GA(420Glu/Lys), TT (2475Asp/Asp) and GT(2475Glu/Asp) were significantly more frequent in AD. However, the SPINK5 gene polymorphisms was found not to be associated with AD in regard to either serum IgE levels, concurrent allergic asthma or early onset of AD. Conclusions Our study confirms the association between SPINK5 and AD. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. There have been few detailed reports of the clinical evaluation of Chinese patients with AD. Objectives To give a profile of the clinical features of Chinese AD patients in a university hospital setting. Methods A total of 1008 cases met Hanifin and Rajka diagnostic criteria of AD were recruited at Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China. Results In our survey, 22.7% patients were mild, 66.6% were moderate and 10.7% were severe according to the SCORAD index. Both the frequency and severity of the male patients were slightly higher. The frequency of asthma among the AD patients was 16.7% and it was increased with the age ( χ2 = 205.20, P = 0.000). The frequencies of objective minor signs were demonstrated with age-related changes. Besides, three localized variants including eyelid eczema (49.8%), scalp dermatitis (49.7%), infra-auricular and retroauricular fissuring (44.8%) were commonly observed, especially in the infantile phase ( P < 0.01). It was showed significant differences in serum total immunoglobulin E (IgE) and eosinophil cationic protein (ECP) levels of different age groups. The positive rate of Phadiatop was raised after 3 years old and that of the common food allergens were decreased after 6 years old. Conclusions More males than females had ongoing AD in our survey. Most AD debuted in the first year of the cases. High incidence of the three clinical signs: eyelid eczema, scalp dermatitis and infra-auricular and retroauricular fissuring among the patients suggests it can be a potential valuable diagnostic clue to AD. [ABSTRACT FROM AUTHOR]

Background: Severe and widespread atopic dermatitis often fails to respond adequately to topical steroids and oral antihistamines and requires immunomodulatory drugs which, although effective, have undesirable toxic effects. Methods: In this prospective, randomized, double-blind, placebo-controlled trial, 71 patients with severe intractable atopic dermatitis were given an 8-week treatment with oral Xiao-Feng-San (XFS; 47 patients) or placebo (24 patients). Total lesion score, erythema score, surface damage score, pruritus score and sleep score were measured at 4-week intervals. Results: Fifty-six patients completed both the treatment and follow-up periods. The decrease in the total lesion score in the treatment group at 8 weeks was significantly greater than that of the placebo group (79.7 ± 5.8% vs. 13.5 ± 7.64%; p < 0.001). There was also a statistically significant difference between the treatment and placebo groups with regard to erythema, surface damage, pruritus and sleep scores. The difference between the 2 groups was still significant for all outcome measures except the erythema score at the 12-week follow-up, 4 weeks after the 8-week treatment had ended. Patients reported no side effects from treatment, although some commented on the unpalatability of the medication. Conclusion: Our study results suggest that the traditional Chinese herbal medicine XFS may be an alternative choice of therapy for severe, refractory, extensive and nonexudative atopic dermatitis. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Brain-derived neurotrophic factor (BDNF) plays an important role in the pathogenesis of atopic dermatitis (AD). Whether BDNF gene polymorphisms are associated with Chinese AD remains totally unknown. Objective The aim is to determine if BDNF gene C270T and G196A polymorphisms are associated with Chinese AD, and analyse the clinical relevance of BDNF gene polymorphisms and BDNF serum levels. Methods We conducted a case-control association analysis (160 patients and 169 controls) in Northern Chinese subjects. Genotyping was performed by restriction fragment length polymorphism, and serum levels of BDNF were measured using enzyme-linked immunosorbent assay. Results For C270T, there were significant differences in C/T genotype distribution ( P = 0.003) and T allele frequencies ( P = 0.004) between AD patients and controls in the whole dataset. Higher C/T genotype frequencies were found in male AD (10.6% vs. 1.1%, P = 0.018) and in intrinsic AD (IAD; 15.79% vs. 2.91%, P = 0.008). No association between G196A polymorphism and AD was observed in the whole cohort, while A allele was much more frequent in AD patients with atopy in first-degree relatives (65.8% vs. 34.2%, P = 0.038). Serum BDNF levels were correlated with IAD severity as measured by Scoring Atopic Dermatitis index ( r = 0.576, P < 0.001). Conclusion T allele in C270T may be a risk factor for AD, especially in IAD and male AD. A allele in G196A may be a risk factor in AD patients with atopy in first-degree relatives. Serum BDNF levels were correlated with the severity of IAD. [ABSTRACT FROM AUTHOR]

Artemisia anomala S. Moore is a perennial herbaceous plant classified as Asteraceae of the genus Artemisia. Many species of Artemisia have been used as medicinal materials. Artemisia anomala S. Moore has been widely used in China to treat inflammatory diseases. However, the mechanism of its action on the keratinocyte inflammatory response is poorly understood. Here, we investigated the anti-inflammatory reaction of Artemisia anomala S. Moore ethanol extract (EAA) using human keratinocyte (HaCaT) cells, which involved investigating the nuclear factor kappa B (NF-κB), signal transducer, and activator of transcription-1 (STAT-1), as well as mitogen-activated protein kinase (MAPK) signaling pathways and atopic dermatitis-like skin lesions in mice. We elucidated the anti-inflammatory effects of EAA on tumor necrosis factor-α/interferon-γ (TNF-α/IFN-γ)-treated human keratinocyte cells and 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD)-like mice. The levels of chemokines and cytokines (IL-8, IL-6, TARC, and RANTES) were determined by an enzyme-linked immunosorbent assay. The NF-κB, STAT-1, and MAPK signaling pathways in HaCaT cells were analyzed by western blotting. Thickening of the mice dorsal and ear skin was measured and inflammatory cell infiltration was observed by hematoxylin and eosin staining. Results showed that EAA suppressed IL-8, IL-6, TARC, and RANTES production. EAA inhibited nuclear translocation of NFκB and STAT-1, as well as reduced the levels of phosphorylated ERK MAPKs. EAA improved AD-like skin lesions in DNCB-treated mice. These findings suggest that EAA possesses stronger anti-inflammatory properties and can be useful as a functional food or candidate agent for AD. [ABSTRACT FROM AUTHOR]

Linked article: R. Cheng et al. J Eur Acad Dermatol Venereol 2020; 34: 542–548. https://doi.org/10.1111/jdv.15979. [ABSTRACT FROM AUTHOR]