Chinese Expert Proposal on the Diagnosis and Management of Pemphigus Vulgaris (2020)

Pemphigus vulgaris(PV)is a life-threatening autoimmune bullous disease that causes blisters and erosions on the skin and mucous membranes to standardize the diagnosis and treatment of PV,Chinese experts in this field were invited to make recommendations which are presented in this article.Pemphigus vulgaris can be divided into cutaneous mucous type,cutaneous type and mucous mucous dominant type according to the different clinical manifestations.The pathological manifestations of PV are acantholysis above the basal layer.The diagnosis of PV and the assessment of the severity of the disease are made in accordance with the clinical manifestations,histopathological features,immunofluorescence assay results,and detection of pathogenic serum antibodies.The first-line treatment of PV comprises systemic glucocorticoids.Early combination with immunosuppressive agents or rituximab is recommended for moderate and severe PV.Intravenous immunoglobulin administration is recommended for patients being treated with rituximab.Plasma exchange and stem cell transplantation can be performed if necessary.During the course of therapy,the disease activity should be closely monitored,and actions should be taken to prevent adverse reactions.

Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China(2020)#

Atopic dermatitis(AD)is a common disease clinically characterized by chronic recurrent eczematous lesions,dry skin,and pruritus.AD can negatively impact patients’quality of life.The prevalence of AD in China has been increasing during the past few decades.Based on the most recent advances in the treatment of AD,we updated the 2014 version of the Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China regarding the definition,epidemiology,pathogenesis,clinical classification,diagnosis,prevention,and treatment of AD.

Association between HLA-B*46:01 and cutaneous adverse drug reactions in Han Chinese

The majority of patients who experience cutaneous adverse drug reactions(cADRs)concurrently receive multiple medications,meaning that the causative drug remains unidentified.We explored the association between human leukocyte antigen(HLA)alleles and cADRs,regardless of the allergenic drug,to investigate whether different drug-induced cADRs were associated with the same or similar risk alleles in a Han Chinese population.We genotyped a sample of 146 cADR patients and 230 population controls from the same hospital and systematically analyzed the association between HLA Class I genes and cADRs.The carrier frequency of HLAB∗46:01 in cADR patients was found to be significantly higher than that in population controls(P=.0021,odds ratio[OR]=2.18,95%confidence interval[CI]:1.33-2.58).Subgroup analysis showed that HLA-B∗46:01 was significantly associated with urticaria and erythema multiforme(P=.0077,OR=2.53,95%CI:1.30-4.91;and P=.0049,OR=2.77,95%CI:1.39-5.50,respectively).Furthermore,a significant association was also detected between HLA-A∗02:01 and erythema multiforme(P=.0038,OR=2.65,95%CI:1.31-5.33).This study is the first to demonstrate that HLA-B∗46:01 is a risk allele for cADRs in a Han Chinese population,indicating that screening for HLA-B∗46:01 prior to the administration of medication may predict the risk of developing cADRs.