The effectiveness and safety of dupilumab in the management of refractory prurigo nodularis in 45 Chinese patients: A real-life observational study.

Prurigo nodularis (PN) is a chronic, pruritic inflammatory skin disease characterized by severe skin itching and hyperkeratotic nodules. The existing treatment options for PN are limited by severe adverse effects. Dupilumab is an approved biological agent for treating atopic dermatitis and other type 2 inflammatory diseases in adults, showing good efficacy and safety in clinical trials. Recently, dupilumab has shown remarkable effects in patients with PN, but the data on Chinese patients are limited. This study aimed to evaluate the safety and efficacy of dupilumab to treat atopic and nonatopic PN in 45 Chinese patients. To our knowledge, this is the largest cohort to date to evaluate the safety and efficacy of dupilumab to treat atopic and nonatopic PN. To achieve this, 45 patients with PN from the department of dermatology of several Grade A hospitals in Shenzhen, China, were treated with off-label prescription dupilumab. We followed-up the patients on weeks 8 and 16, and the pruritus symptoms, changes in lesion color and area, and the quality of sleep and life were evaluated before and after treatment using the Pruritus Peak Numeric Rating Scale (PP-NRS, 0-10), the Dermatology Life Quality Index/Children's Dermatology Life Quality Index (DLQI/CDLQI, 0-30), and the Investigator's Global Assessment Scales for Stage and Activity (IGA/IGAa, 0-4) at weeks 2, 4, 8, 12, and 16. Total serum immunoglobin E and eosinophilic granulocyte levels were the main laboratory indices for patient evaluation. During treatment, the skin lesions and itching symptoms of these 45 patients were relieved remarkably within 2 weeks. All the PP-NRS, DLQI/CDLQI, and IGA/IGAa scores significantly improved from the baseline to 16-week dupilumab treatment (P < 0.001 for all scores) and no adverse events were reported.

A Case of Giant Perianal Condylomata Acuminata with IgA Nephropathy Treated Successfully by a Topical Chinese Medicine Preparation Paiteling.

Giant condylomata acuminata (a sexually transmitted disease caused by HPV infection) currently is treated in many methods. Surgery, the mainstay treatment of giant condylomata acuminata, may cause a high cost or scar formation. It is important to explore effective and safe treatment options. Although the external treatment of traditional Chinese medicine treatment of condyloma acuminatum has not been widely used, in our case, the use of traditional Chinese medicine successfully treated a perianal giant condyloma acuminatum patient who also suffered from mixed hemorrhoid and IgA nephropathy meanwhile. The treatment process was simple and the effect obvious. There was no recurrence more than 10 months after treatment finished, and the patients felt safe, comfortable and highly coordinated. The outcome of this case suggests that the traditional Chinese medicine might be considered as a mild and effective option for the treatment of giant condyloma acuminatum.

Differential expression of Candida albicans secreted aspartyl proteinase in human vulvovaginal candidiasis.

The opportunistic pathogen Candida albicans secretes aspartic proteinases (Saps), which raises a particular interest because of their role as virulence factors. Candida albicans possesses at least 10 members of a SAP gene family, all of which have been sequenced. Although the expression of the SAP genes has been extensively characterised under laboratory growth conditions and Saps contribute to the virulence of C. albicans in animal models of infection, few studies have analysed the difference of the in vivo expression of these proteinases in recurrent vulvovaginal candidiasis (RVVC), vulvovaginal candidiasis (VVC) and asymptomatic Candida carriers. The RT-PCR protocol was used to determine which of the SAP 1 to SAP 7 genes are expressed by C. albicans during asymptomatic Candida carriage, VVC and RVVC infection in this study. We found SAP 2, the SAP 4-6 and SAP 7 were the predominant proteinase genes expressed in the sample of both Candida carriers and patients with VVC and RVVC. SAP 2 and SAP 4-6 mRNA were detected in all subjects. SAP 1 and SAP 3 transcripts were observed only in patients with VVC and RVVC. SAP 7 mRNA expressions were detected in several of the patients and carriers samples. All seven SAP genes were simultaneously expressed in some patients with VVC and RVVC. This study demonstrates the differential expression of the secreted aspartic proteinases (Saps) genes during colonisation and VVC and RVVC infection in humans and correlates the expression of specific Candida species virulence genes with active disease and anatomical location.