OBJECTIVE: To investigate effect of Yupingfeng granules, prepared with Chinese Medicines, on the wound healing and on the expression of aquaporin 3 (AQP3) and the skin barrier in the animal models of atopic dermatitis (AD). METHODS: Acute skin lesions of AD models were prepared using 2,4-dinitrochlorobenzo (DNCB) in mice and animals were treated with either Yupingfeng granules or placebo for two weeks. Skin wound healing outcome was assessed by measuring skin thickness, weight (quality) of the skin, and trans-epidermal water loss (TEWL). Expression of AQP3 mRNA and protein was assessed by reverse transcriotion polymerase chain reaction (RT-PCR) and immunoblotting, respectively. RESULTS: Yupingfeng granule treatment resulted in significant acceleration of wound healing with 63.64% efficiency, which was significantly higher than that of placebo granule treatment (31.82%, P < 0.01 by Wilcoxon Rank-sum test). Skin thickness, weight of the wounded skin, and TEWL were significantly higher in the AD models compared to that of normal animals. Treatment with Yupingfeng granules resulted in significant decrease in skin thickness [(937 ±31) vs (360 ±21) urn, P < 0.01], weight of the wounded skin [(42 ± 4) vs (24 ± 5) mg, P < 0.01], and TEWL [(30 ±4) vs (13 ± 4) g • h⁻¹ • m⁻², P < 0.01]. Yupingfeng granules also significantly down-regulated mRNA and protein expression of AQP3 in the animal models. CONCLUSION: Our findings suggested that Yupingfeng granules could be used in AD treatment.

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare autoinflammatory disease, is usually defined by musculoskeletal symptoms and cutaneous manifestations. Cutaneous manifestations include palmoplantar pustulosis or severe acne, which are generally accompanied by osteitis and hyperostosis, and are the hallmark of SAPHO syndrome. Genetic, immune, and microbial factors are involved in the pathophysiology of the SAPHO. Small-molecule targeted therapies and biologic agents have transformed the treatment of inflammatory disorders. Upadacitinib, with efficacy in cytokine-related disorders, represents a therapeutic candidate for SAPHO syndrome. Here we report a patient with a 20-year history of pustular palmoplantar psoriasis (PPP) who developed progressive inflammatory arthralgia over the past decade. Radiographic and scintigraphic evaluations showed distinct sternocostoclavicular hyperostosis and osteitis, confirming a diagnosis of SAPHO syndrome. Conventional therapies, including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and topical agents, failed to improve cutaneous or articular symptoms. After ineffective treatment with secukinumab (an IL-17A inhibitor), transitioning to upadacitinib (a selective JAK1 inhibitor) improved pustular lesions and reduced joint pain and inflammation, demonstrating clinical improvement. This case illustrates the effectiveness of upadacitinib, a selective JAK1 inhibitor, for the rapid resolution of cutaneous and articular symptoms of SAPHO syndrome following unsuccessful IL-17A inhibition, offering valuable insights for management of refractory SAPHO syndrome.

The traditional prescription of Liangxue-Qushi-Zhiyang decoction (LQZ) has been demonstrated to be efficacious in treating atopic dermatitis (AD), a chronic inflammatory skin disorder marked by intense itching, redness, rashes, and skin thickening. Nevertheless, there has been an inadequate systematic exploration of the potential targets, biological processes, and pathways for AD treatment through LQZ. The study objective was to evaluate the efficacy and possible mechanism of LQZ in AD mice. In our study, we identified the primary compounds of LQZ, analyzed hub targets, and constructed a network. Subsequently, the predicted mechanisms of LQZ in AD were experimentally studied and validated in vivo, as determined by network pharmacological analysis. A total of 80 serum components of LQZ were identified through ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/MS), among which 49 compounds were absorbed into the bloodstream. Our results indicated that LQZ targets six putative key factors in the MAPK signaling pathway, which play essential roles in AD, namely, EGFR, p-MAPK1/3, p-MAPK14, IL-1β, IL-6, and TNF-α. We observed spleen coefficient, dermatitis scores, and ear thickness were all downregulated in 2,4-dinitrochlorobenzene (DNCB)-induced mice after LQZ treatment. Histological analysis of the dorsal and ear skin further revealed that LQZ significantly decreased skin inflammation, epidermal thickness, and mast cell numbers compared to the DNCB group. Our study demonstrated the effectiveness of LQZ in reducing epidermal and dermal damage in a mouse model of AD. Furthermore, our findings suggest that downregulating the MAPK signaling pathway could be a potential therapeutic strategy for the treatment of AD.

Lamotrigine is a preferred antiepileptic drug for women with epilepsy planning or undergoing pregnancy, owing to its relatively low teratogenic risk. However, serious adverse reactions, including life-threatening conditions such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), can occur. We report the case of a 33-year-old woman of childbearing age with epilepsy who developed TEN following the initiation of lamotrigine as part of a preconception antiepileptic regimen. The patient presented with high fever, a rapidly spreading erythematous rash, bullae formation, and extensive epidermal detachment. Prompt and comprehensive multidisciplinary treatment led to significant clinical improvement and eventual full recovery. The therapeutic approach included intravenous dexamethasone sodium phosphate, fluid resuscitation, intravenous immunoglobulin (IVIG), oral antihistamines, traditional Chinese medicine (TCM), and meticulous care of the skin and mucosal surfaces. While antiepileptic drugs (AEDs) such as lamotrigine are crucial for managing epilepsy, they may induce severe skin toxicity, potentially leading to fatal outcomes. Healthcare providers must remain vigilant for early symptoms and intervene promptly to mitigate adverse effects. This case report, alongside a literature review, aims to underscore the importance of comprehensive care throughout the preconception, pregnancy, and postpartum phases for women with epilepsy.