Background: Chlamydia trachomatis(CT) infection is one of the most pervasive sexually transmitted infections and has high prevalence in urogenital and extra-urogenital sites among men who have sex with men (MSM). This study investigated anatomical site-specific prevalence and genotypes of CT among MSM recruited from three geographic areas in China.Methods: We collected urine specimens and anorectal, pharyngeal swab specimens from 379 MSM. CT infection was identified using polymerase chain reaction and CT genotyping was determined by sequences of the ompA gene.Results: The results indicated that the overall prevalence of CT infection was 18.2% (95% confidence intervals [CIs], 13.9–22.5%) and significantly different between the cities (p = 0.048). The infection was most common at the anorectal site (15.6, 95%CIs 11.6–19.5%) followed by urethral (3.2, 95%CIs 1.4–5.0%) and oropharyngeal sites (1.6, 95%CIs 0.3–2.9%). Genotypes D and G were the most common CT strains in this population but genotype D was significantly predominated in Nanjing while genotype G was in Wuhan. No genotype related to lymphogranuloma venereum was found. CT infection was significantly related to the infection ofNeisseria gonorrhoeae(adjusted odds ratio [aOR] 14.27, 95%CIs 6.02–33.83,p < 0.001) and age. Men older than 40 years old were less likely to have a CT infection as compared to men under 30 years old (aOR 0.37, 95% CIs 0.15–0.93,p = 0.03).Conclusion: The high CT infection prevalence, particularly in the anorectal site, among MSM suggests the necessity to development an integrated CT screening and treatment program specifically focusing on this high-risk population. Surveillance of CT infections should be improved by including both infection and genotype based surveys into the current surveillance programs in China.

Chlamydia trachomatis (CT) is one of the most prevalent bacterial sexually transmitted infections (STIs) globally but has been inadequately detected for intervention. Introduction of point-of-care tests (POCTs) for CT is critical for filling the intervention gaps. We conducted a systematical review and meta-analysis on diagnostic performance of POCTs for CT to assist in guiding the application of these assays in CT screening and detection. We searched PubMed/Medline and Embase databases, from January 2004 to May 2021, for studies reporting the performance of POCTs for identifying CT using specimens collected from urethral, vaginal, cervical, anorectal, or pharyngeal site or of urine. Two investigators independently screened and extracted data for controlling the quality of data extraction. Any discrepancies in study selection and data extraction were resolved through consensus. We only included studies with sufficient data to estimate sensitivity and specificity, and used laboratory-based nucleic acid amplification test (NAAT) as the reference standard. The main outcomes were pooled sensitivity, specificity, and diagnostic odds ratio (DOR) and their corresponding 95% confidence intervals (CIs). Summary estimates were calculated using a random-effects model and summary receiver operator curves (SROCs) were generated using the Moses-Littenberg method. STATA 14.0 and Meta-DiSc 1.4 were used for statistical analysis. The study protocol is registered with PROSPERO, number CRD42019140544. Of 3,038 records identified, 39 studies (42,336 specimens) were included in the study, including 14 studies on evaluation of antigen detection (AD)-based and 25 on NAAT-based POCTs. The overall pooled sensitivity, specificity and DOR were 56% (95% CI 45%–67%), 99% (95% CI 98%–99%) and 86 (95% CI 46–163), respectively, for AD-based POCTs and corresponding values for NAAT-based POCTs were 94% (95% CI 91%–96%), 99% (95% CI 99%–99%) and 1,933(95% CI 1,018–3,669), respectively. The pooled sensitivity of AD-based POCTs varied across the types of specimens, indicating 46% for cervical swabs (95% CI 37%–56%; range 22.7%–71.4%), 52% for vaginal swabs (95% CI 34%–70%; range 17.1%–86.8%) and 57% for male urine (95% CI 36%–75%; range 20.0%–82.6%). For NAAT-based POCTs, the pooled sensitivity was 94% (95% CI 90%–96%) for cervical swabs, 94% (95% CI 86%–98%) for vaginal swabs, 95% (95% CI 91%–97%) for urine specimens and 93% (95% CI 87%–96%) for anorectal swabs. NAAT-based POCTs for CT have a significantly better performance particularly in sensitivity for diagnosing the infection with CT than the AD-based POCTs. Screening strategy with AD-based POCTs may potentially result in a substantial under-detection of the infections.

Purpose: Ferroptosis, a form of iron-dependent lipid peroxidation cell death. However, the mechanism of ferroptosis in psoriasis remains to be further investigated. Therefore, our research focuses on uncovering the role of ferroptosis in the pathogenesis of psoriasis and providing accurate biomarkers as therapeutic targets. Patients and Methods: We merged differentially expressed genes (DEGs) from the gene expression omnibus (GEO) with ferroptosis-related genes from FerrDb database. Key genes were further identified using weighted gene co-expression network analysis (WGCNA) and machine learning. Additionally, we used non-negative matrix factorization (NMF) clustering to identify two ferroptosis molecular subgroups. Results: CHAC1, PARP9 and LCN2 are identified as key ferroptosis-related genes in psoriasis. The psoriatic skin samples were divided into cluster 1 and cluster 2, with cluster 1 being the more severe subtype of psoriatic lesions. The expression of CHAC1 had the highest correlation with activated CD4 T cells, neutrophil, regulatory T cell (Tregs) and type 2 T helper cell (Th2), which were significantly enriched in cluster1. Conclusion: In conclusion, the ferroptosis associated diagnostic gene CHAC1 exacerbates psoriasis by regulating activated CD4 T cells, neutrophil, Tregs and Th2, serving as a reliable biomarker to predict patient survival.

Biologics have revolutionized the treatment of moderate-to-severe atopic dermatitis (AD), with dupilumab, an anti-interleukin-4Rα monoclonal antibody, showing notable clinical efficacy. However, some patients achieve rapid and profound improvement-termed super responders (SRs), while others respond poorly. This study aimed to identify SRs to dupilumab in patients with AD and analyze their clinical characteristics to inform personalized treatment strategies. A retrospective analysis was conducted on patients with moderate-to-severe AD treated with dupilumab, sourced from the National Clinical Research Center for Skin and Immune Diseases in China. Clinical and follow-up data were reviewed. Categorical variables were compared using Chi-square or Fisher's exact tests, while continuous variables were compared via t-tests or Mann-Whitney U tests. Furthermore, a logistic regression model was employed to evaluate the predictive ability of clinical and demographic variables collected at baseline on the probability of becoming SRs. Among 1,034 patients with AD, 125 (12.09%) were identified as SRs, achieving significant clinical improvement within 16 weeks. Further univariate analysis indicated that factors closely associated with SRs included: older age, higher body mass index, later disease onset, higher baseline scores of pruritus intensity (Peak pruritus Numerical Rating Scale, PP-NRS)/disease severity (Eczema Area and Severity Index, EASI)/quality of life (Dermatology Life Quality Index, DLQI), prior systemic therapy use, no prior biologics, elevated eosinophil count, high-dose dupilumab, shorter dosing intervals of dupilumab, and absence of concomitant therapies. Logistic regression identified moderate baseline pruritus (PP-NRS) and higher baseline DLQI scores (moderate-to-severe impact) as strong predictors of SRs (moderate pruritus Adj odds ratio (OR): 8.38, 95% confidence interval (CI) 2.56-27.42; moderate DLQI Adj OR: 11.01, 95% CI 3.34-36.29; severe DLQI Adj OR: 14.52, 95% CI 4.70-44.91; all p < 0.001). Baseline pruritus and quality of life impairment are key predictors of super response to dupilumab in AD. Early identification may guide more tailored, effective treatment strategies.

This case report presents an instance of Tumor Necrosis Factor-α Inhibitor-induced psoriasis (TNFiIP), also known as paradoxical psoriasis, in a 30-year-old male with fistulizing Crohn’s disease. The patient developed extensive erythematous and scaly lesions on the palms, lower limbs, ankles, and soles after 4 months of adalimumab monotherapy. Histopathological analysis revealed a pattern of psoriasiform dermatitis with notable dermal neutrophil and eosinophil infiltration, distinguishing TNFiIP from idiopathic psoriasis. The patient’s condition significantly improved following the transition from adalimumab to ustekinumab, which highlights the importance of alternative therapeutic strategies for patients who exhibit paradoxical reactions to TNF-α inhibitors.

Multiple eruptive dermatofibromas (MEDFs) are characterized by the rapid development of multiple dermatofibromas within a short period, often associated with underlying immune dysregulation or immunosuppressive therapies. We report a rare case of MEDFs in a young male with refractory psoriasis, who developed multiple cutaneous tumors following sequential treatment with biologic agents: secukinumab, guselkumab, and adalimumab. Despite achieving partial control of psoriasis, the patient experienced the onset of widespread, asymptomatic dermatofibromas, leading to the cessation of biologic therapy. Clinical examination, dermoscopic evaluation, and histopathological analysis confirmed the diagnosis of MEDFs. The Naranjo algorithm and WHO-UMC scale suggested a probable adverse drug reaction as the causative factor. The pathogenesis may involve a Th2-polarizing immune shift and persistent activation of antigen-presenting cells, possibly triggered by the cumulative effects of the biologics used. However, as a single-case report, our findings require validation through larger cohort studies to establish causality and incidence. This case highlights the potential for MEDFs as a novel adverse effect of biologic therapies and underscores the need for awareness and monitoring of such reactions in clinical practice.