Basal cell carcinoma (BCC) accounts for the majority of non-melanoma skin cancers (NMSCs) and are more common than all other malignancies of human body. Elliptical surgical removal of tumor is the standard surgical excision for a single lesion, and the surgical defect is recommended to be immediately repaired by side-side closure. Excision of facial BCCs with stand-ard 4-mm margins is not often feasible for special sites of body because of cosmetic and functional concerns. Here, we share our experiences of surgical excision and defect repair of the BCCs on face and  genital and perianal area.

【Abstract】   Objective To study the temporal trends in gonorrhoea incidence in China between 1991 and 2016.  Methods We obtained gonorrhoea surveillance data from the National Center for STD Control and population data from the National Bureau of Statistics in China. Joinpoint regression was performed to assess temporal trends of gonorrhoea incidence stratified by age and gender. Results Male-to-female incidence ratios of gonoeehoea have been increasing during the study period, ranging from 1.60 to 5.08. After the earlier increases, gonorrhoea incidence rates were found to have declined from the early 2000s. However, stalls or reversals of declining trends were observed in sexually active age groups in recent years, particularly a sharp increase (18.5% per year) among males aged between 15 and 19 years. Conclusions Gonnorrhoea incidence increased sharply from 1991 to 1999 and then declined significantly until 2012. Further observations are needed for slight and nonsignificant increases of incidence in recent years, and more effective interventions targeting adolescents or other high risk populations are needed for disease control and prevention.

【Abstract】   Objective The aim of the present study was to assess clinical outcomes of patients with angiosarcoma of the scalp and face and factors associated with prognosis, as well as to investigate the deregulation of the mechanistic/mammalian target of rapamycin (mTOR) signaling pathway in the disease. Methods We retrospectively analyzed the clincial data of 23 patients with localized angiosar-coma of the scalp and face, who were diagnosed between 2010 and 2016 in the Peking Union Medical College Hospital. Surgically resected or biopsy samples were collected, and immunohistochemical analysis was performed to detect expression of the mTOR pathway-related proteins. Results Twenty-three patients were included in the study. The median overall survival (OS) was 26.0 months at a median follow-up of 13 months. One-year and 3-year OS were 73.5% and 21.8%, respectively. Univariate analysis showed that: 1) Age 70 years or older (vs. < 70 years) was associated with poor prognosis (8.0 months vs. 33.0 months, P = 0.001); 2) Tumors larger than 5 cm (vs. ≤ 5 cm) were associated with decreased OS (13.0 months vs. 33.0 months, P = 0.02). Overexpression of phosphorylated (p-) protein kinase B (AKT) at Ser473, p-AKT at Thr308, p-mTOR at Ser2448, and p-p70-S6K1 at Thr421/Ser424 were observed in 13.0%, 78.3%, 47.8%, and 21.7% of patients, respec-tively. Conclusions Angiosarcoma of the scalp and face is highly aggressive with limited treatment options and poor clinical outcomes. Younger age and more localized disease were associated with improved outcomes. Activation of the AKT/mTOR complex 1 pathway is common in the disease, while abnormal activation of p70S6K1 is not significant. Furthermore, overexpression of mTOR complex 2 is observed in part cases.

【Abstract】   Objective This study is aimed to investigate the differences in pharmaceutical quality and therapeutic efficacy of calcipotriol ointments between the original product and the generics. Methods  We evaluated the pharmaceutical quality of the original product and the generics including pH, content and related substance, and calcipotriol stability in the matrix. Intradermal retention of calcipotriol ointments in vitro was investigated using skin of Bama miniature pig. The pharmacodynamics study was performed in psoriasis guinea pig models. Results The matrix of original product is better than the generics, and influenced the drug diffusion, stability and in vitro retention, thus resulted in the difference in pharmacodynamics. The retention amount of calcipotriol in the original product was significantly higher than that of generic B, and approximately 4 folds higher than that of generic A. All of the three ointments improved pathological indexed in psoriasis guinea pigs, and there was a significant difference between the preparation group and the model group (P = 0.001).  Guinea pigs in the original group had the lowest interleukin -17 level (35.7 ± 1.13 μg/ml) and Baker Score (2.70 ± 0.97) compared with generic A (37.9 ± 3.3 μg/ml, 3.10 ± 0.22, respectively) and generic B (39 ± 4.6μg/ml, 3.80 ± 0.57, respectively), but no statistical difference was found among the three groups (all P > 0.05). Conclusions Difference occurs in the internal quality between the original product and the generics. The original preparation owns suitable balance between matrix stability and transdermal ability so that showes superiority in pharmaceutical properties, intradermal retention and therapeutic effect in vitro and in vivo, which suggests that more attention should be paid to the formulation and process during the research and development of the generics. The original product is recommended with priority for treatment especially at emergency.

[Abstract]   Objective The results of association studies between hidradenitis suppurativa and diabetes mellitus remain controversial. This study aimed to investigate the association between hidradenitis suppurativa and diabetes mellitus by reviewing all the available evidences comprehensively. Methods    We performed a meta-analysis on observational studies that reported the odds ratio (OR) comparing diabetes mellitus risk in patients with hidradenitis suppurativa versus participants without hidradenitis suppurativa. Pooled OR and 95% confidence intervals (95%CIs) were calculated using a random effect, generic inverse variance methods of DerSimonian and Laird. Results Four studies (two cross-sectional studies and two case-control studies) including 5,362 patients with hidradenitis suppurativa and 23,193 participants without hidradenitis suppurativa were identified and coved in the meta-analysis. The pooled OR of diabetes mellitus in patients with hidradenitis suppurativa was 1.95 (95%CI: 1.31 - 2.91). The statistical heterogeneity of this meta-analysis was I2 = 63%. Conclusions This meta-analysis shows a signi?cant risk increase of diabetes mellitus incidence among patients with hidradenitis suppurativa. Patients with hidradenitis suppurativa should be regularly screened for diabetes mellitus as complication.

Psoriasis is a chronic, recurrent skin disease featured by scaly papules or plaques. Although the vast majo-rity of patients have mild psoriasis, approxi-mately 20% - 30% of patients have moderate or severe pso-riasis, which is defined as body surface area (BSA) > 10, psoriasis area and severity index (PASI) > 10, and dermatology life quality index (DLQI) > 10. These patients have severe symptoms and worse quality of life, warranting consideration of systemic therapy[1]. Biologic treatments directly target specific steps in the pathogenesis of psoriasis, providing a revolution for treatment. Among these drugs, six have been approved by the US Food and Drug Administration (FDA) for the management of moderate to severe psoriasis. Adalimumab, etanercept, and infliximab are inhibitors of tumor necrosis factor-α (TNF-α). Alefacept targets T cells, ustekinumab targets the interleukin (IL)-12/23 pathway, and secu-kinumab targets the IL-17A pathway.

Psoriasis characterized by red scaly skin lesions clinically is a chronic inflammatory skin disease, and there are 0.53% - 11.43% of the adults around the world suffered[1]. The pathophysiological changes of psoriasis are characterized by proliferation accelerated in epidermal basal keratinocytes and infiltration of inflammatory cells from epidermis and dermis. Many studies have shown that the occurrence and develop-ment of psoriasis is closely related to genes, cell signaling pathways and proliferation. The relationships between peroxisome proliferator-activated receptor-γ (PPARγ) and TGF-β/Smad signaling pathway and psoriasis has been mostly studied in recent years[2].

[Abstract]   Three cases of lymphomatoid papulosis (LyP) type D were reported. It is a new reported morphological subtype of LyP recently. Type D LyP manifests marked epidermotropism and shows co-expression of CD8 and CD30. It is necessary to differentiate Type D LyP from other benign and malignant diseases which have similar clinical and histopathological features. Awareness of this entity can lead to correct diagnosis of this disease.

Tubular Apocrine Adenoma (TAA) is a rare benign adnexal neoplasm with apocrine differentiation, which is now considered as a part of the spectrum of tubular adenoma. Pateints with TAA usually presents as a asymptomatic, solitary, slow-growing cutaneous nodule or a pedunculated lesion. It has a predilection for the scalp, occasionally on the face, axilla, and anogenital area. Here, we reported a case of TAA appearing on the left upper eyelid of a 23-year-old Chinese man, and further analyzed retrospectively the features of facial TAA cases proviously reported  in the world.

Syphilis is a sexually transmitted disease caused by Treponema pallidum （T. pallidum）, and involves in almost all of the body. When the nervous and vision system[1] is involved, neurosyphilis occures. T. pallidum can invade any part of the neuraxis, and neurosyphilis can occur at any stage of syphilis.Neurosyphilis  has been divided into five major categories, including asymptomatic meningeal, meningovascular, paren-chymatous, and gummatous neurosyphilis[2]. These entities represent a continuum and frequent overlap[4].

Lichen planus (LP) is a kind of common chronic inflam-matory skin disease, which has a variety of clinical manifestations, and solitary lichen planus (SLP) is a rare subtype. Here, we presented a case of SLP manifesting as Bowen’s disease and summarized the 6 similar cases reported from 1966 to 2017 globally.

Tufted angioma (TA)  is an uncommon vascular tumor. It most presents variable clinical appearances during infancy and early childhood. TA usually presents clinically as a large, plaque-like, red or dusky blue-purple, infiltrated lesion, or an exophytic, firm, violaceous, cutaneous nodule. TA is commonly solitary, but multifocal cases have been reported[1]. Histo-logically, TA demonstrates vascular tufts of tightly packed capillaries, randomly dispersed throughout the dermis in a typical model of “cannonball distribution”with crescent spaces surrounding the vascular tufts and lymphatic-like spaces within the tumor stromal. Here, we report a case of TA localized on the face of a 7-year-old female patient. The lesions appeared four years after birth and were excised at local hospital without histopathological examination. But the lesions recurred, and have gradually enlarged over the past two years.

From the low-power biopsy specimen, we found hyperkeratosis and acanthosis with some lymphocytes which looks like Seborrheic Keratosis (SK) (Figure 1). At high-power, we observed well-circumscribed intra-epidermal nests of clear-looking basaloid cells within the confines of an acanthotic epidermis (Figure 2), and the tumor cells were small and relatively mono-morphic, cellular and nuclear atypia was not pro-minent (Figure 3). Finally, we made the diagnosis of hidroacanthoma simplex. Smith & Coburn first intro-duced the term hidroacanthoma simplex in 1956 to refer to an intraepidermal variant of poroma[1]. The histopathologic findings of hidroacanthoma simplex are cuboidal or ovoid deratinocytes with a vesicular nucleus within an acanthotic epidermis arranged in well-circumscribed intraepidermal nests, with or with-out presence of the ductal and cystic space.