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The skin serves as a physical barrier and an immunological interface that protects the body from the external environment 1 – 3 . Aberrant activation of immune cells can induce common skin autoimmune diseases such as vitiligo, which are often characterized by bilateral symmetric lesions in certain anatomic regions of the body 4 – 6 . Understanding what orchestrates the activities of cutaneous immune cells at an organ level is necessary for the treatment of autoimmune diseases. Here we identify subsets of dermal fibroblasts that are responsible for driving patterned autoimmune activity, by using a robust mouse model of vitiligo that is based on the activation of endogenous auto-reactive CD8 + T cells that target epidermal melanocytes. Using a combination of single-cell analysis of skin samples from patients with vitiligo, cell-type-specific genetic knockouts and engraftment experiments, we find that among multiple interferon-γ (IFNγ)-responsive cell types in vitiligo-affected skin, dermal fibroblasts are uniquely required to recruit and activate CD8 + cytotoxic T cells through secreted chemokines. Anatomically distinct human dermal fibroblasts exhibit intrinsic differences in the expression of chemokines in response to IFNγ. In mouse models of vitiligo, regional IFNγ-resistant fibroblasts determine the autoimmune pattern of depigmentation in the skin. Our study identifies anatomically distinct fibroblasts with permissive or repressive IFNγ responses as the key determinant of body-level patterns of lesions in vitiligo, and highlights mesenchymal subpopulations as therapeutic targets for treating autoimmune diseases. Single-cell analyses of skin samples from patients with vitiligo and functional genetic experiments in vitiligo mouse models show that distinct fibroblast subsets drive the organ level lesion patterns in this autoimmune disease.

Bullous pemphigoid (BP) is the most common autoimmune subepidermal bullous disease of the skin. Novel biologic agents represent a potential therapeutic option. We explore the use of dupilumab in the treatment of BP. Relevant studies published up to Oct. 20th, 2025 were systematically searched using PubMed, Web of Science, Embase, and Cochrane Library. Proportion rates of complete response and disease control were analyzed to determine treatment effects. Data were quantitatively synthesized using a random-effects meta-analysis. Meanwhile, we also conducted statistics on adverse events. A total of 587 patients from 24 studies were included. Pooled analysis revealed a complete response rate of 68% (95% CI 60%∼78%) and disease control rate of 95% (95%CI 92%~98%) in BP treated with dupilumab with/without other systemic therapy. Notably, complete response rate achieved 63% (95% CI 49%∼81%) in patients with dupilumab without other systemic therapy. A total of 112 adverse events were reported in 97 patients. Most adverse events were mild and did not lead to treatment discontinuation. This meta-analysis highlights the efficacy and safety of dupilumab in patients with BP, offering valuable evidence to guide future clinical practice. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251048550.

Autoimmune diseases, a disease characterized by immune imbalance caused by the human immune system mistakenly attacking its own components, include vitiligo, psoriasis and atopic dermatitis (AD). Previous studies on autoimmune diseases have focused mainly on immune cells, keratinocytes and endothelial cells. Fibroblasts, the main cells that secrete the extracellular matrix (ECM) in the dermis, have been studied thoroughly in terms of fibrosis and wound healing. However, an increasing number of studies have shown that fibroblasts play an important role in nonfibrotic autoimmune skin diseases. In this article, the previously reported role of fibroblasts in nonfibrous autoimmune skin diseases such as psoriasis, vitiligo and AD is summarized to provide new ideas for the treatment of this disease.

Vitiligo, a chronic autoimmune skin disorder characterized by refractory depigmentation, has inconsistent associations with various biomarkers and diseases due to confounding factors. Here, we conduct a comprehensive umbrella review and comparative analysis to evaluate the validity and strength of evidence from observational studies on vitiligo. 103 meta-analyses and 150 Mendelian randomization (MR) analyses are included, spanning categories including cardiometabolism, cancer, autoimmune, dermatosis, psychiatry/neurology/senses, and biomarkers/lifestyle. Evidence grading reveals seven convincing meta-analysis findings: five factors (fasting blood glucose, Graves’ disease, thyroid antibodies, cataracts, and glaucoma) are associated with an increased risk of vitiligo, while vitiligo is related to two conditions (a decreased risk of overall cancer and an increased risk of inflammatory bowel disease). Future similar research is unlikely to alter these findings according to fail-safe number. Among them, the protective effect of vitiligo on overall cancer risk is also supported by causal associations from MR evidence, indicating a reassuring cancer risk in vitiligo. This study establishes an evidence hierarchy for vitiligo, which may inform multidisciplinary management strategies. Vitiligo, a chronic autoimmune skin disorder, has inconsistent associations with various biomarkers and diseases due to confounding factors. Here, the authors conduct an umbrella review and comparative analysis of meta-analyses and Mendelian randomization studies to evaluate the strength and validity of evidence on multisystemic associations with vitiligo.

In order to clarify the effects of crude bio-oil for phenol-formaldehyde resin, the phenol-formaldehyde resin with bio-oil model compounds (BMPF) were prepared by model compound method. The bonding strength and aging resistance of BMPF were determined, and their microstructure and chemical bonds were also analyzed by scanning electron microscope, Fourier transform infrared spectroscopy, and nuclear magnetic resonance analysis, respectively. The results showed that the components of crude bio-oil had various degrees of effects on the BMPF performance, and the most obvious one is the phenols. The phenols and the ketones of bio-oil had positive effects on the bonding strength. The ketones had the biggest effect on the surface smoothness of BMPF film. But all components of bio-oil could inordinately improve the aging resistance of BMPF. The structural analysis indicated that the effects of bio-oil components on the BMPF performance by changing the resin structure. The CH 2 peak in FT-IR and the methylene bridges intensity in NMR of phenol-free BMPF and ketone-free BMPF were smaller, while the results of aldehyde-free BMPF and acid-free BMPF were opposite. And the influence degree of BMPF structure was basically consistent with that of BMPF performance. These results could provide a basis for the modification of phenol-formaldehyde resin by crude bio-oil.

Background Vulvar lichen sclerosus (VLS) is one of the most common clinical manifestations of vulva. Thirteen percent of women have symptomatic vulvar diseases. The aim of this study is to investigate the expression profile of circular RNA (circRNAs) in vulvar lichen sclerosus, and to identify the underlying core genes of VLS. Methods We removed rRNA for sequencing, and screened the differentially expressed messenger RNA (mRNAs), long non-coding RNA (lncRNAs) and single-stranded circRNA in 20 groups of VLS tissues and 20 groups of healthy female vulvar skin tissues. Bioinformatics analysis was used to analyze its potential functions. Results A total of 2545 differentially expressed mRNAs were assessed in VLS patients, of which 1541 samples were up-regulated and 1004 samples were down-regulated. A total of 1453 differentially expressed lncRNAs were assessed, of which 812 samples were up-regulated and 641 samples were down-regulated. A total of 79 differentially expressed circRNAs were assessed, of which 54 were up-regulated and 25 were down-regulated. The differential expression of circRNAs was closely related to biological processes and molecular functions. The differences in circRNAs were mainly related to the “human T-cell leukemia virus 1 infection” signaling pathway and the “axon guidance” signaling pathway. Conclusion The profile of abnormal regulation of circRNA exists in VLS. According to biological informatics analysis, the dysregulation of circRNAs may be related to the pathogenesis and pathological process of VLS.

Acquired reactive perforating collagenosis (ARPC) is a rare and complex dermatological condition often associated with systemic diseases such as diabetes and chronic kidney disease. It is characterized by the transepidermal elimination of collagen fibers. ARPC presents with diverse clinical manifestations, leading to frequent misdiagnosis. This study provided a comprehensive overview of the clinical pathology and treatment outcomes in 12 confirmed cases of ARPC. The findings aimed to enhance clinicians' understanding of this condition and inform better diagnostic and therapeutic strategies. A retrospective analysis was carried out to summarizes the clinical pathology and treatment response of the ARPC. The patients had a mean age of 60.2 years, with a predominance of female cases. The primary clinical features included papules and nodules predominantly affecting the lower limbs, with central ulceration, necrosis, and severe pruritus. Histopathological examination showing cupped epidermal invagination containing crusts, inflammatory cells, and degenerated collagen; degenerated collagen fibers penetrating vertically through the epidermis. Treatment primarily involved topical therapies, while dupilumab demonstrated efficacy in some refractory cases. Early diagnosis and intervention of ARPC are crucial for improving patients' quality of life. Further research is needed to elucidate the pathological mechanisms and management strategies of ARPC. Exploring its pathogenesis and biological characteristics remains pivotal for advancing diagnostic and therapeutic approaches.

Extramammary Paget Disease (EMPD) is a rare intra-epithelial malignancy often misdiagnosed due to diverse clinical manifestations. This study retrospectively analyzed the clinicopathological features of 40 EMPD patients to provide references for clinical practice. Clinical data of 40 patients with pathologically confirmed EMPD were collected, including demographics, clinical features, histopathological and immunohistochemical findings, treatments, and follow-up outcomes. Of the 40 patients (27 males, 13 females; mean age 68.8 years), the most common onset location was the external genitalia (n = 33). Lesions primarily presented as erythema or red plaques (n = 38), with itching being the most common symptom (n = 26). Immunohistochemically, tumor cells were positive for CK7, CEA, and EMA, with positive rates of 70% for GCDFP-15 and 25% for CK20. Thirty-nine patients underwent surgical excision, and one received photodynamic therapy combined with radiotherapy. During follow-up after surgery, one patient with invasive features (tumor mass in the dermis) recurred but achieved remission after reoperation; the other 38 patients remained disease-free. Invasive EMPD was associated with a higher risk of recurrence. EMPD's varied presentations pose diagnostic challenges. Key diagnostic differentials include eczema, psoriasis, and melanoma, particularly for rare pigmented or depigmented variants. For clinicians, a high index of suspicion and prompt biopsy are crucial for early diagnosis. For pathologists, a comprehensive immunohistochemical panel is essential, while CK20's utility in distinguishing primary from secondary disease is limited and warrants further malignancy screening. Surgical excision remains the primary treatment, with alternative therapies effective for inoperable cases. Early diagnosis, appropriate treatment, and long-term follow-up are crucial for optimal prognosis.

The bio-oil phenol-formaldehyde (BPF) resin, prepared by using bio-oil as a substitute for phenol, has similar bonding strength but lower price to phenol-formaldehyde (PF) resin. As a common adhesive for outdoor wood, the aging performance of BPF resin is particularly important. The variations in mass, bonding strength, microstructure, atomic composition, and chemical structure of BPF resin under five aging conditions (heat treatment, water immersion, UV exposure, hydrothermal treatment, and weatherometer treatment) were characterized by scanning electron microscope, X-ray photoelectron spectroscopy, and Fourier transform infrared spectroscopy, respectively. Compared under five aging conditions, after aging 960 h, the mass loss of plywood and film was largest under hydrothermal treatment; the bonding strength of plywood, the surface roughness, and O/C ratio of the resin film changed most obviously under weatherometer treatment. FT-IR analysis showed that the decreased degree of peak intensity on CH2 and C–O–C characteristic peaks of BPF resin were weaker under water immersion, hydrothermal treatment, and weatherometer treatment than those of PF resin. The comparison of data between BPF and PF resins after aging 960 h showed that adding bio-oil could obviously weaken the aging effect of water but slightly enhance that of heat. The results could provide a basis for the aging resistance modification of BPF resin.