This study analysed the incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers. This study systematically searched both Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, EMBASE and Web of Science, to identify cohort studies related to lower extremity amputation and associated risk factors in patients with diabetic foot ulcers up to October 2023. The patients were stratified based on whether they underwent lower extremity amputation, and relevant data, including basic information, patient characteristics, complications, comorbidities and pertinent laboratory test data, were extracted from the included studies. The literature quality assessment in this study utilized the Newcastle‐Ottawa Scale to screen for high‐quality literature, resulting in the inclusion of 16 cohort studies, all of which were of at least moderate quality. Meta‐analysis of outcome indicators was conducted using the Stata 14.0 software. The results indicate that the overall amputation rate of lower extremities in patients with diabetic foot ulcers is 31% (0.25, 0.38). Among the 16 variables evaluated, gender (male), smoking history, body mass index (BMI), hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels were found to be correlated with the occurrence of lower extremity amputation in patients with diabetic foot ulcers. However, no significant correlation was observed between age, diabetes type, duration of diabetes, stroke, glycosylated haemoglobin, creatinine and total cholesterol levels and lower extremity amputation in patients with diabetic foot ulcers. This meta‐analysis indicates that the overall amputation rate in patients with diabetic foot ulcers is 31%. Factors such as gender (male), smoking history, high BMI, hypertension, cardiovascular disease, kidney disease, white blood cell count, haemoglobin and albumin levels are identified as significant risk factors for lower extremity amputation in diabetic foot ulcer patients. These findings suggest that attention should be focused on these risk factors in patients with diabetic foot ulcers to reduce the risk of lower extremity amputation. Therefore, preventive and intervention measures targeting these risk factors are of significant importance in clinical practice. (Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024497538]).

Background: Keloid is a benign fibro-proliferative dermal tumor formed by an abnormal scarring response to injury and characterized by excessive collagen accumulation and invasive growth. The mechanism of keloid formation has not been fully elucidated, especially during abnormal scarring. Here, we investigated the regulatory genes, micro-RNAs (miRNAs) and transcription factors (TFs) that influence keloid development by comparing keloid and normal scar as well as keloid and normal skin. Methods: Gene expression profiles (GSE7890, GSE92566, GSE44270 and GSE3189) of 5 normal scar samples, 10 normal skin samples and 18 keloid samples from the Gene Expression Omnibus (GEO) database were interrogated. Differentially expressed genes (DEGs) were identified between keloid and normal skin samples as well as keloid and normal scar samples with R Project for Statistical Computing. Gene Ontology (GO) functional enrichment analysis was also performed with R software. DEG-associated protein–protein interaction (PPI) network was constructed by STRING, followed by module selection from the PPI network based on the MCODE analysis. Regulatory relationships between TF/miRNA and target genes were predicted with miRnet and cytoscape. Core regulatory genes were verified by RT-qPCR. Results: We identified 628 DEGs, of which 626 were up-regulated and 2 were down-regulated. Seven core genes [neuropeptide Y(NPY), 5-hydroxytryptamine receptor 1A(HTR1A), somatostatin (SST), adenylate cyclase 8 (ADCY8), neuromedin U receptor 1 (NMUR1), G protein subunit gamma 3 (GNG3), and G protein subunit gamma 13 (GNG13)] all belong to MCODE1 and were enriched in the “G protein coupled receptor signaling pathway” of the GO biological process category. Furthermore, nine core miRNAs (hsa-mir-124, hsa-let-7, hsa-mir-155, hsa-mir-26a, hsa-mir-941, hsa-mir-10b, hsa-mir-20, hsa-mir-31 and hsa-mir-372), and two core TFs (SP1 and TERT) were identified to play important roles in keloid formation. In the TF/miRNA-target gene network, both hsa-mir-372 and hsa-mir-20 had a regulatory effect on GNG13, ADCY8 was predicted to be target by hsa-mir-10b, and HTR1A and NPY were potentially by SP1. Furthermore, the expression of core regulatory genes (GNG13, ADCY8, HTR1A and NPY) was validated in clinical samples. Conclusions: GNG13, ADCY8, NPY and HTR1A may act as core genes in keloid formation and these core genes establish relationship with SP1 and miRNA (hsa-mir-372, hsa-mir-20, hsa-mir-10b), which may influence multiple signaling pathways in the pathogenesis of keloid.

Background: Scalp seborrheic dermatitis (SD) is a chronic, recurrent inflammatory skin condition associated with scalp sebum secretion and dysbiosis. Aims: The aim of this study is to evaluate the efficacy and safety of a topical salicylic acid/piroctone olamine/zinc salt of L‐pyrrolidone carboxylate (Zinc PCA) scalp pre‐application gel in combination with a salicylic acid/piroctone olamine/antimicrobial peptide cleansing lotion for the treatment of moderate to severe scalp SD. Patients/Methods: In this prospective cohort study, 20 patients with moderate to severe scalp SD were treated with a combination of the scalp pre‐application gel and cleansing lotion for 4 weeks (one tube of the pre‐application gel per week and the cleansing lotion used every 1–3 days depending on the frequency of hair washing). This was followed by maintenance treatment with the cleansing lotion for 12 weeks. Efficacy was assessed through clinical and trichoscopic examinations, measuring the severity of dandruff, itching, erythema, and greasiness using a 4‐point scale. Results: This cohort study included a total of 20 patients with moderate to severe scalp SD. By the 4th week, the average dandruff score had significantly decreased from a baseline of 2.45 to 1.10 ( p < 0.01). The average itchiness score reduced from 2.35 to 1.10 ( p < 0.01), the erythema score dropped from 1.55 to 1.10 ( p < 0.05), and the greasiness score decreased from 2.60 to 1.40 ( p < 0.01). After 16 weeks, 12 patients with severe SD improved to mild SD, and six patients with moderate SD also improved to mild. During the treatment, two patients experienced a recurrence of dandruff, which subsequently resolved. The overall clinical improvement was 80%. Conclusions: Our study results indicate that the combination treatment of the scalp pre‐application gel and cleansing lotion is highly effective and safe for treating SD. The subsequent use of the cleansing lotion effectively maintains the benefits of the combined treatment. Trichoscopic examination provides accurate and reliable quantifiable data, aiding in the monitoring of treatment progress.

Background: The skin, a complex organ vital for protecting the body against environmental challenges, undergoes a multifaceted wound healing process involving hemostasis, inflammation, proliferation, and remodeling. The transcription factor FOSL1 has been implicated in various cellular processes crucial for wound healing, including cell cycle regulation, differentiation, and apoptosis. We hypothesize that FOSL1 is a key regulator of wound healing processes. Objective: The objective of this study was to investigate the role of FOSL1 in cutaneous wound healing, identify the core signaling pathways involved, and assess FOSL1′s potential as a therapeutic target. Method: We utilized datasets from the Gene Expression Omnibus (GEO) and applied the ‘limma’ package to discern differentially expressed genes (DEGs). We intersected these DEGs with transcription factor-associated genes from the TRRUST database. Subsequently, we constructed Protein–Protein Interaction (PPI) networks via the STRING database. Machine learning algorithms were instrumental in identifying pivotal genes, a finding corroborated through animal modeling and Western blot analysis of tissue samples. To elucidate biological pathway activities from gene expression data, we deployed the ‘PROGENy’ package, complemented by machine learning for precise pathway identification. Furthermore, Gene Set Variation Analysis (GSVA) was executed across Hallmark, biological process (BP), molecular function (MF), and cellular component (CC) categories to deepen our understanding of the wound healing process. Results: Our analysis revealed that FOSL1 is significantly upregulated in wounded skin. The Mitogen-Activated Protein Kinase (MAPK) and Epidermal Growth Factor Receptor (EGFR) pathways were identified as significantly associated with FOSL1. GSVA identifies critical changes in wound healing processes like ‘apical junction’ and ‘epithelial–mesenchymal transition.’ The upregulation of ‘cytoplasm organization’ and ‘response to gravity’ suggests roles in cellular adaptation. Molecular function analysis indicates alterations in ‘cytokeratin filaments’ and ‘growth factor binding,’ which are key for tissue repair. Cellular component shifts in ‘postsynaptic cytosol’ and ‘endoplasmic reticulum’ suggest changes in communication and protein processing. Conclusions: Our study identifies FOSL1 as a potential regulator of cutaneous wound healing through its modulation of cellular signaling pathways, offering novel insights into the molecular control of tissue repair. These findings highlight FOSL1 as a promising therapeutic target to accelerate healing in chronic or impaired wounds.

Background: The therapeutic role of natural medicines in pathological scars has received widespread attention in recent years. However, there is no systematic bibliometric study to analyze the research hotspots and trends in this field. Purpose: This study aimed to provide researchers with a comprehensive summary of natural medicines in pathological scars; visualize the current research status, hotspot directions, and development trends; and offer references for subsequent research and clinical translation in this field. Methods: Publications related to the topic from 2008 to 2025 were retrieved from the WOSCC and PubMed databases. Bibliometric analyses were performed using VOSviewer, CiteSpace, Scimago Graphica, Microsoft Office Excel, and GraphPad Prism. Results: Global publications on natural medicines for pathological scar treatment have steadily increased. A total of 234 papers were retrieved, contributed by 1,395 authors from 396 institutions across 39 countries/regions. China far outnumbered other countries in publication output, with four of the top five authors residing in China. Shanghai Jiao Tong University ranked first among institutions by publication count. The most recent keywords—drug delivery, transdermal delivery, antioxidant, angiogenesis, and the transforming growth factor-β (TGF-β)/Smad—suggest emerging research frontiers. Conclusion: Research on natural medicines in pathological scars is still in a developmental stage. This is the first bibliometric analysis in this domain, highlighting the current hotspots and shedding light on future research directions.