Objective: To observe the effect of niacinamide‐containing body emollients combined with a cleansing gel on the clinical symptoms of mild atopic dermatitis (AD) in adults.Methods: From July 2022 to January 2023, adults with mild AD were enrolled at Huashan Hospital Affiliated to Fudan University using single‐center, randomized and placebo‐controlled methods. They were divided into three groups: the control group, treatment group 1 (T1) receiving niacinamide‐containing body emollients alone, and treatment group 2 (T2) receiving emollients plus niacinamide‐containing cleansing gel. All patients were orally administered 10 mg of ebastine tablets daily. AD severity (SCORAD score), peak pruritus numeric rating scale (PP‐NRS), patient‐oriented measure of eczema (POEM), dermatological quality of life index (DLQI) score, transepidermal water loss (TEWL), and stratum corneum water content (SCWC) were measured by the same dermatologist at days 0, 7, 14, and 28.Results: A total of 122 patients were enrolled, including 38 in the control group, 42 in the T1 group and 42 in the T2 group. There were no obvious adverse reactions at the end of the study and the clinical scores and stratum corneum barrier of all the groups improved significantly relative to baseline. The SCORAD, PP‐NRS, DLQI, TEWL and SCWC scores in T1 group (12.43 ± 3, 3.3 ± 0.9, 7.1 ± 2.33, 17.1 ± 9.12, 67.2 ± 21.46, seperately) and T2 group (11.17 ± 3.26, 3 ± 1.3, 6.5 ± 2.11, 16.3 ± 9.12, 69.4 ± 24.52, seperately) were significantly improved than the control group(15.1 ± 3.64, 4.3 ± 1.7, 9.5 ± 2.46, 21.2 ± 9.47, 52.7 ± 22.43, seperately) at the endpoint of the study, while compared the POEM scores, only T2 group showed the difference with control group (5.2 ± 1.4 vs. 6 ± 1.6). The epidermal barrier parameters of TEWL and SCWC in the T2 group (17.57 ± 5.24, 66.46 ± 21.38, seperately) were significantly better than that of the T1 (19.96 ± 4.45, 56.45 ± 20.48, seperately) and control group(21.89 ± 7.03, 51.56 ± 16.58, seperately) on the 14th day of follow‐up.Conclusion: The use of niacinamide‐containing body emollients can significantly improve the clinical symptoms, quality of life, and skin barrier function in patients with mild AD. The addition of niacinamide‐containing cleansing gel can also affect the clinical efficacy at certain time points.

Atopic dermatitis (AD) is recognized as a common inflammatory skin disease and frequently occurred in Asian and Black individuals. Since the limitation of dataset associated with human severe AD, this study aimed to screen potential novel biomarkers involved in mild AD. Expression profile data (GSE75890) were obtained from the database of Gene Expression Omnibus. Using limma package, the differentially expressed genes (DEGs) between samples from AD and healthy control were selected. Furthermore, function analysis was conducted. Meanwhile, the protein-protein interaction (PPI) network and transcription factor (TF)-miRNA-target regulatory network were constructed. And quantitative real-time polymerase chain reaction (qRT-PCR) was used to validate the expressions patterns of key genes. In total, 285 DEGs including 214 upregulated and 71 downregulated genes were identified between samples from two groups. The upregulated DEGs were mainly involved in nine pathways, such as hematopoietic cell lineage, pertussis, p53 signaling pathway, staphylococcus aureus infection, and cell cycle, while tight junction was the only pathway enriched by the downregulated DEGs. Cyclin B (CCNB)1, CCNB2, cyclin A (CCNA)2, C-X-C motif chemokine ligand (CXCL)10, and CXCL9 were key nodes in PPI network. The TF-miRNA-target gene regulatory network focused on miRNAs such as miR-106b, miR-106a, and miR-17, TFs such as nuclear factor kappa B subunit 1, RELA proto-oncogene, Sp1 transcription factor, and genes such as matrix metallopeptidase 9, peroxisome proliferator activated receptor gamma , and serpin family E member 1. Moreover, the upregulation of these genes, including CCNB1, CCNB2, CCNA2, CXCL10, and CXCL9 were confirmed by qRT-PCR. CCNB1, CCNB2, CCNA2, and CXCL9 might be novel markers of mild AD. miR-106b and miR-17 may involve in regulation of immune response in AD patients.

Pityriasis rubra pilaris is an inflammatory dermatologic disorder of unknown cause. We report a 67-year-old man with Pityriasis rubra pilaris might induced by COVID-19 vaccination. The patient developed the lesions after the first dose of vaccine and significantly aggravated after the second dose. He had poor effect and liver function impairment developed after acitretin used, but achieved satisfactory efficacy after replacement to ixekizumab, an interleukin-17A inhibitor.

Our previous study demonstrated that azithromycin could promote alternatively activated (M2) macrophages under lupus conditions in vitro, which might be beneficial for lupus treatment. Thus, the aim of this study was to further confirm whether azithromycin can drive M2 polarisation in lupus and ultimately alleviate systemic lupus erythematosus (SLE) in vivo. Lymphocyte-derived DNA (ALD-DNA)-induced mice (induced lupus model) and MRL-Fas^lpr mice (spontaneous lupus model) were both used in the experiment. First, we observed symptoms of lupus by assessing the levels of serum anti-dsDNA antibodies and serum creatinine and renal pathology. We found that both murine models showed increased levels of serum anti-dsDNA antibodies and creatinine, enhanced glomerular fibrosis and cell infiltration, basement membrane thickening and elevated IgG deposition. After azithromycin treatment, all these medical indexes were alleviated, and kidney damage was effectively reversed. Next, macrophage polarisation was assessed in the spleen and kidneys. Macrophage infiltration in the spleen was notably decreased after azithromycin treatment in both murine models, with a remarkably elevated proportion of M2 macrophages. In addition, the expression of interleukin (IL)-1, IL-6, tumour necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), CD86, toll-like receptor (TLR)2 and TLR4 was extremely downregulated, while the expression of transforming growth factor (TGF)-β, arginase-1 (Arg-1), chitinase-like 3 (Ym-1), found in inflammatory zone (Fizz-1) and mannose receptor (CD206) was significantly upregulated in the kidneys after azithromycin treatment. Taken together, our results indicated for the first time that azithromycin could alleviate lupus by promoting M2 polarisation in vivo. These findings exploited the newly discovered potential of azithromycin, a conventional drug with verified safety, affordability and global availability, which could be a novel treat-to-target strategy for SLE via macrophage modulation.

Background: GR1802 is a newly developed, fully humanized monoclonal antibody targeting the interleukin‐4 receptor alpha (IL‐4Rα) subunit, which is a component common to both the IL‐4 and IL‐13 receptor complexes. Objectives: Our objective was to assess the efficacy of GR1802 in adult patients presenting with moderate‐to‐severe atopic dermatitis. Methods: In this clinical trial, patients with moderate‐to‐severe atopic dermatitis were randomly assigned to receive either 300 mg GR1802, 150 mg GR1802, or a placebo every 2 weeks for 16 weeks. Primary endpoints were the Eczema Area and Severity Index (EASI‐75) response rates at Week 16. Secondary efficacy outcomes included responders at various evaluation points from baseline to study end: IGA 0/1 with ≥ 2‐point improvement; EASI‐75, EASI‐90, and EASI‐50; and ≥ 3‐ or ≥ 4‐point improvements in weekly average daily PP‐NRS score. Safety was evaluated throughout the study. Results: From August 2022 to February 2023, 120 patients were randomized to receive either GR1802 150 mg ( n = 40), GR1802 300 mg ( n = 40), or placebo ( n = 40), with 107 completing the study. GR1802 demonstrated a higher proportion of patients achieving EASI‐75 at Week 16 compared with the placebo group, and the observed differences in EASI‐75 response rates were 39.1% (GR1802 300 mg vs. placebo, 95% CI 20.0–58.2, p = 0.0002) and 19.4% (GR1802 150 mg vs. placebo, 95% CI −0.8–39.7, p = 0.0740). The GR1802 300 mg group also showed greater efficacy on secondary endpoints compared to the GR1802 150 mg group. Serious adverse events occurred in 10% of placebo patients, 2.5% of the GR1802 150 mg group, and none in the GR1802 300 mg group. Treatment‐emergent AEs occurred in 75.0% of the GR1802 150 mg group, 82.5% of the GR1802 300 mg group, and 85.0% of the placebo group. Conclusions: GR1802 was well tolerated and effective in moderate‐to‐severe AD patients, showing a dose–response trend at 150–300 mg. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2100051917