Acne vulgaris is a chronic inflammatory disease and is one of the leading causes of dermatological morbidities among young adults. Doxycycline is widely recommended as first-line therapy for moderate to severe acne; however, its use is limited. To systematically compare the efficacy and safety of oral azithromycin pulse therapy versus doxycycline in patients with moderate to severe acne vulgaris. This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive literature search on different databases was performed. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models based on heterogeneity. A total of 23 comparative studies comprising 2,769 patients were included. Pooled analysis demonstrated a statistically significant improvement in global acne severity favoring azithromycin (GAGS reduction: MD 1.81; 95% CI 1.28-2.34; I² = 0%). Azithromycin achieved a significantly greater reduction in non-inflammatory lesion counts (MD -7.56; 95% CI -14.33 to -0.79). No significant differences were observed in inflammatory lesion reduction (MD 1.08; 95% CI -0.03 to 2.18). Oral azithromycin pulse therapy appears to have similar efficacy, better tolerability, and fewer side effects as compared to doxycycline.

Guillain–Barré syndrome (GBS) is a severe immune-driven polyneuropathy marked by the acute onset of flaccid paralysis, areflexia, and in severe cases, life-threatening autonomic or respiratory failure. Although the clinical presentation and diagnostic criteria are widely established, the precise mechanisms underlying GBS are complex and poorly understood. This review summarizes current literature on the interplay of post-infectious triggers, molecular mimicry, and host susceptibility as influenced by genetic and epigenetic variables. Infectious pathogens such as Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and, more recently, Zika and SARS-CoV-2 operate as initiators via molecular mimicry, in which pathogen antigens imitate peripheral nerve components, triggering the formation of autoreactive antibody and T-cell responses. Acute inflammatory demyelinating polyneuropathy (AIDP) is characterized by demyelination and inflammatory cytokine responses, whereas acute motor axonal neuropathy (AMAN) is associated with ganglioside-targeting antibodies and axonal loss. Genetic polymorphisms, such as those in HLA, TLR4, MMP9, and CD1A, influence vulnerability to the disease and its progression. Given that many patients experience persistent sensory, motor, and autonomic dysfunction despite treatment, the identification of long-term complications highlights the necessity of customized rehabilitation and long-term follow-up. Traditional therapeutic techniques, such as plasma exchange and intravenous immunoglobulin, remain in use, but current trials on complement inhibitors, antibody-degrading enzymes, and mesenchymal stem cell therapies indicate a move toward mechanism-driven approaches. Despite these advances, significant knowledge gaps remain regarding predictors of poor outcomes and underlying causes of persistent disabilities and complications, highlighting the need for continued translational and clinical research.

Background: Scabies is an infectious parasitic integumentary pathology affecting both pediatric and adult participants globally, specifically in resource‐limited settings. Topical permethrin is commonly advised as the preferred regimen, whereas oral and topical ivermectin have emerged as alternative regimens. Objective: This study aims to assess the safety and efficacy of oral or topical ivermectin compared to topical permethrin alone for the treatment of scabies in both pediatric and adult patients. Methods: A systematic search of four databases (PubMed, Google Scholar, Scopus, and Embase) was conducted from inception to November 2025. Data were analyzed using a random‐effects model (REML estimator) to calculate risk ratios (RRs) and mean differences. To prevent unit‐of‐analysis errors, overarching estimates utilized deduplicated data. Advanced influence diagnostics (leave‐one‐out sensitivity, Baujat plots, and GOSH plots) were employed to rigorously evaluate data stability and outcome fragility. Results: In this meta‐analysis, 38 studies met the inclusion criteria, encompassing 5604 participants. Permethrin demonstrated a robust and highly significant early clinical cure advantage over ivermectin at Week 1 (RR 1.40; 95% CI 1.22–1.62; p < 0.0001; I ² = 81.1%). While permethrin maintained a marginal statistical superiority at Week 2 (RR 1.11; 95% CI 1.01–1.22), extensive sensitivity analyses revealed this finding to be highly fragile and dependent on outliers. By Weeks 3, 4, and ≥ 6 , comparative efficacy converged, demonstrating no significant difference between the two treatments (RR 1.02 at ≥ 6 weeks; I ² = 0%). Continuous meta‐regression indicated no significant temporal shift in comparative efficacy over the last 25 years. Conclusion: Low‐to‐moderate certainty evidence suggests that permethrin exhibits superior acute efficacy and faster initial clearance during the first week of treatment compared to ivermectin. However, long‐term efficacy is equivalent. Ivermectin remains a highly viable and equally effective alternative for the definitive management of scabies, particularly when topical application is infeasible or poorly tolerated.

Autoimmune cardiovascular disease (CVD) includes myocarditis, coronary microvascular dysfunction (CMD), and heart failure with preserved ejection fraction (HFpEF). Traditional risk scores often overlook these conditions despite their links to high morbidity. Recent research highlights the significance of immunophenotyping, such as clonal hematopoiesis of indeterminate potential (CHIP), type I interferon activity, Th17/Treg imbalance, and cardiac autoantibodies, to improve risk assessment and guide treatment. This review combines mechanistic and clinical data connecting these immune signatures to endothelial dysfunction, arrhythmias, and fibrotic remodeling. It underscores the atherogenic role of CHIP and its influence on HFpEF prognosis, the vasculopathy driven by type I interferon signaling in CMD, and autoimmunity in myocarditis mediated by Th17 dominance. Cardiac-specific autoantibodies, like anti-heart and v1-adrenergic receptor antibodies, serve as early prognostic markers. Moreover, integrating immune biomarkers with advanced imaging techniques, such as cardiac magnetic resonance and positron emission tomography, could enhance risk stratification and therapy monitoring. Current immunomodulating treatments, including TNF and IL-6 inhibitors, provide cardiovascular benefits, while glucocorticoids and JAK inhibitors carry dose-related risks. In the future, personalized algorithms that incorporate CHIP genotyping, interferon scoring, and continuous biomarker and imaging assessments may transform autoimmune CVD management. This review highlights these translational insights and research priorities to bridge the gap between immune dysregulation and cardiovascular outcomes.