A Retrospective Study of Chinese-Specific Glabellar Contraction Patterns.

BACKGROUND: Botulinum toxin has been widely accepted as safe and effective for the treatment of glabellar lines, and previous studies have classified glabellar contraction patterns into 5 categories. OBJECTIVE: To classify the glabellar contraction patterns among a large-scale Chinese population and provide a reference for injections in Chinese patients. METHODS: Four hundred eighty-nine Chinese subjects who received botulinum toxin for the treatment of glabellar lines were selected for a retrospective photographic analysis of their glabellar contraction patterns. Using 2 separate previously established classification systems, the patterns were analyzed and classified by a panel of certified Chinese dermatologists. RESULTS: Two separate classification systems showed different distributions of glabellar contraction patterns among Chinese compared with Caucasians and Koreans. The classifications allowed for identification of the most frequent patterns in Chinese, which were "converging arrows" and "11" pattern, and provided references for identifying the most important muscles. CONCLUSION: Both classification systems are applicable to the Chinese population with varying distributions. Because the classification system of de Almeida and colleagues focuses more on the muscles involved in the formation of glabellar lines, the authors' subjects classified according to this system displayed a more balanced distribution among the 5 patterns. This provides an easier reference for dermatologists in daily clinical practice and guiding treatment strategies.

Case report: Infantile generalized pustular psoriasis with IL36RN and CARD14 gene mutations.

Infantile pustular psoriasis (IPP) is an extremely rare skin disease associated with genetic factors. Gene mutations of IL36RN (interleukin-36 receptor antagonist), CARD14 (caspase recruitment family member 14), and AP1S1 (the σ1C subunit of the adaptor protein complex 1) had been identified to be involved in the pathogenesis of IPP. IPP usually develops with no preceding psoriasis vulgaris (PV) or familial history. Here, we report a case of a 6-month-old infant and make the diagnosis of IPP by a series of examinations; subsequently, by detecting coexistent mutations of IL36RN and CARD14, the diagnosis is intensified from a genetic point of view. We treated the child with traditional oral and topical drugs regardless of the commonly used acitretin considering its potential side effects, such as skeletal toxicity, and the lesions got conspicuous improvement with much reduction of inflammation. Owing to the genetic mutation of IL-36, there had been reported cases focusing on anti-IL36 biological agents in the treatment of IPP, and it could be a new weapon to treat and improve such IL-36RN-deficient skin diseases.