Clinical characteristics and outcomes of psoriasis patients with COVID-19: A retrospective, multicenter cohort study in China.

BACKGROUND: Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection. METHODS: A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with COVID-19-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2. RESULTS: Among the infected group, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685-11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068-2.343), traditional systemic (adjusted OR = 1.887, 95% CI = 1.263-2.818), and nonsystemic treatment (adjusted OR = 1.602, 95% CI = 1.117-2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680-1.274, compared to no treatment), according to multivariable logistic regression analysis. CONCLUSIONS: A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension. TRIAL REGISTRATION: ClinicalTrials.gov (No. NCT05961605).

Impact of Air Pollutants on Outpatient Visits for Pediatric Atopic Dermatitis in Lanzhou.

Objective To analyze the correlation between air pollutants and pediatric atopic dermatitis outpatient visits in Lanzhou,and provide scientific insights for the life guidance of the affected children and disease prevention by relevant departments. Methods A generalized additive model was employed to analyze the effects and lagged effects of air pollutants on pediatric atopic dermatitis outpatient visits in Lanzhou while controlling for confounding factors such as long-term trends,holiday effects,day of the week effects and meteorological factors. Results The effects of NO2,PM2.5,PM10,and SO2 on pediatric atopic dermatitis outpatient visits were most significant on the current day(Lag0),but were not statistically significant (all P>0.05);CO also had the most significant effect on Lag0,and for every 10 µg/m3 increase in its concentration,the excess risk (ER) for pediatric atopic dermatitis outpatient visits was 0.05% (95%CI=0-0.10%,P=0.049);and O3 exhibited the most significant effect on day 7 of the cumulative lag (Lag07),with a statistically significant increase in the ER for each 10 µg/m3 increase in its concentration of 7.40% (95%CI=5.31%-9.53%,P<0.001) for pediatric atopic dermatitis outpatient visits.Age stratification showed that children aged 0-3 years with atopic dermatitis were the most sensitive to CO,with an increased ER of 0.09% (95%CI=0.04%-0.15%,P<0.001) for every 10 µg/m3 increase in concentration,and children aged 7-14 years with atopic dermatitis were the most sensitive to O3,with an increased ER of 8.26% (95%CI=4.99%-11.64%,P<0.001) for every 10 µg/m3 increase in concentration.Seasonal stratification showed that CO exerted a stronger effect on pediatric atopic dermatitis outpatient visits in summer and fall,with ER values of 0.45% and 0.16% (both P<0.001),respectively,while O3 had a significant effect on outpatient visits in winter,with an ER value of 20.48% (P<0.001). Conclusion Elevated daily average concentrations of air pollutants CO and O3 in Lanzhou were positively correlated with the number of outpatient visits for atopic dermatitis in children,with significant seasonal effects and age-stratified sensitivities.

Association between diurnal temperature range and outpatient visits for urticaria disease in Lanzhou, China: a distributed lag nonlinear analysis.

BACKGROUND: A growing number of epidemiological studies have shown that daily temperatures are associated with urticaria. However, the relationship between daily changes in temperature and urticaria is unclear. OBJECTIVES: To assess the diurnal temperature difference (DTR) effects on urticaria outpatient visits in Lanzhou, China. METHODS: Urticaria outpatient visits data during 2011-2019 were collected from three major tertiary hospitals in Lanzhou. Daily temperature data from the official website of China Meteorological Administration. Assessment of the relationship between urticaria outpatient volume and DTR in Lanzhou City using a distributed lag nonlinear model. RESULTS: A total of 83,022 urticaria visits were enrolled. There was a nonlinear relationship between DTR and urticaria outpatient visits and a lagged effect of DTR impact. The effects of high DTR on urticaria visits were not seen in all populations but in the male population and in the 15-59 age group. High DTR (P95: 18.2 °C) was associated with a 27% (95% CI: 0.01, 60.53%) and 31% (95% CI: 1.60, 68.99%) increase in the number of urticaria visits in the 21-day lag effect for the male cohort and the 15-59 year old cohort, respectively, compared with 11.5 °C, respectively. CONCLUSIONS: Our study suggests that DTR is a potential risk factor for urticaria. The results of this study may provide a scientific basis for local governments to improve preventive measures in the health care system.

Short-term effects of meteorological factors on childhood atopic dermatitis in Lanzhou, China.

Atopic dermatitis (AD) is one of the leading burdens of skin disease in children globally. Meteorological factors are involved in the onset and development of AD. Several studies have examined the effects of meteorological factors on AD, but their results are inconsistent, and the understanding of the link between AD and meteorological factors remains inadequate. In this study, a total of 19,702 children aged 0 to 14 visited the outpatient clinic for AD from 2015 to 2019 in Lanzhou, China. A distributed lag nonlinear model (DLNM) applies to evaluate effects of meteorological factors on childhood AD in Lanzhou, China, and further explored age and gender differences. It was found that extremely high or low temperatures, extremely high diurnal temperature range (DTR), extremely low relative humidity (RH), and extremely high wind speed (WS) increased the risk of outpatient visits for childhood AD. Effects of extremely high DTR and extremely high WS were more intense, with maximum cumulative risks of 2.248 (95% CI 1.798, 2.811) and 3.834 (95% CI 3.086, 4.759) at lag 0-21, respectively. Furthermore, the combination of low temperature and low RH can also contribute to the higher risk of childhood AD. For extreme temperatures, children aged 7-14 years were more vulnerable. For extremely low RH, extremely high DTR and WS, boys and children aged 0-3 years were more vulnerable. Public health departments should strengthen publicity and education about how meteorological factors affect childhood AD and develop sex- and age-specific preventative measures.

Network Pharmacology-Based Investigation on the Mechanism of the JinGuanLan Formula in Treating Acne Vulgaris.

Background: JinGuanLan (JGL) formula is a traditional Chinese medicine (TCM) developed by the Department of Pharmacology at the First Hospital of Lanzhou University. The network pharmacology approach was applied to determine the potential active compounds, therapeutic targets, and main pathways of the JGL formula to evaluate its application value in acne vulgaris. Methods: Data on the active compounds and their related targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Acne vulgaris-related targets were searched from the Online Mendelian Inheritance in Man (OMIM) database, GeneCards Database, Comparative Toxicogenomics Database (CTD), Therapeutic Target Database (TTD), and DisGeNET Database. Targets intersecting between JGL- and acne vulgaris-related targets were chosen as potential therapeutic targets. The protein-protein interaction (PPI) network of potential therapeutic targets was visualized using Cytoscape software based on the PPI data collected from the STRING database. Three topological features, namely, "Degree," "MCC," and "EPC" of each node in the PPI network were calculated using the cytoHubba plugin of Cytoscape to excavate the core targets. R program was used for the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the potential therapeutic targets. Finally, the compound-target-pathway network was constructed. Result: Among the 148 active compounds that were identified, quercetin and kaempferol showed the highest degree of target interaction and thus may play essential roles in the pharmacological effect of the JGL formula for acne treatment. Among the 97 potential therapeutic targets that were screened out, the 6 core targets were TNF, JUN, IL6, STAT3, MAPK1, and MAPK3. A total of 2260 terms of GO enrichment analysis were obtained, including 2090 for biological processes (BP), 37 for cellular components (CC), and 133 for molecular function (MF). A total of 156 enriched KEGG pathways were identified, including TNF, IL-17, Th17 cell differentiation, MAPK, PI3K-Akt, T cell receptor, and Toll-like receptor signalling pathways. Conclusion: This work showed that the JGL formula might reverse the pathological changes associated with acne vulgaris through its antiinflammatory effect and regulate the excessive lipogenesis in sebaceous glands via different signalling pathways. This new drug has application value and is worthy of further research and development.

[Effects of Temperature on Outpatient Visits for Urticaria among Lanzhou Residents Based on Distributed Lag Non-linear Model].

Objective To evaluate the influence of temperature on the outpatient visits for urticaria in Lanzhou City and its hysteresis and to find out the sensitive populations by sex and age stratification.Methods We collected the urticaria outpatient data in three grade A class three hospitals as well as the meteorological data and air pollutant data in Lanzhou from January 2011 to December 2017.The distributed lag non-linear model(DLNM)was employed to analyze the influence of daily mean temperature on the outpatient visits for urticaria.Stratification analysis was performed for different age groups(0-14,15-59,≥60 years)and different sex populations.Results Temperature had a non-linear relationship with the outpatient visits for urticaria,and there existed hysteresis.During the research period,the average daily outpatient visits for urticaria at the three hospitals in Lanzhou was 25,ranging from 1 to 76.With the rise in the daily mean temperature within 0-10 ℃,the risk of outpatient visits for urticaria first increased and then decreased.When the daily mean temperature was 2 ℃,hysteresis occurred on the 18th day,and the relative risk(RR)reached the maximum(1.12,95% CI:1.04-1.20)at the lag of 21 days.The risk of urticaria increased with the rise in temperature at high temperature.In addition,the effect of high temperature on the outpatient visits for urticaria in Lanzhou presented hysteresis,and the hysteresis was more obvious at higher temperatures.At the lag of 21 days,when the temperatures were 19.9 ℃ and 25.5 ℃,the RR values were 1.20(95% CI:1.12-1.27)and 1.39(95% CI:1.31-1.48),respectively.The results of stratified analysis showed that the effect of high temperature was more sensitive for those of 0-14 years and 15-59 years as well as the female population,and the RR values at a lag of 21 days were 1.60(95% CI:1.45-1.71),1.34(95% CI:1.25-1.43),and 1.43(95% CI:1.33-1.53)for the population of 0-14 years,the population of 15-59 years,and female population,respectively.Low temperature mainly affected the people aged ≥60 years,with a maximum RR of 1.38(95% CI:1.03-1.85)when the daily mean temperature was -4.8 ℃ at a lag of 12 days.It did not affect other populations.Conclusions The daily mean temperature in Lanzhou share a close relationship with the outpatient visits for urticaria.High temperature will increase the risk of urticaria for people at the age of 0-14 years and 15-59 years,while low temperature will increase the risk of urticaria for people above 60 years.

[Effects of Air Pollutants on Outpatient Visits for Atopic Dermatitis in Lanzhou].

Objective To quantitatively evaluate the associations of PM2.5,PM10,NO2,and SO2 concentrations with the outpatient visits for atopic dermatitis in Lanzhou. Methods The data of outpatient visits,together with meteorological data and air pollutant data,from January 2013 to December 2017 were collected.The generalized additive model based on Poisson distribution was employed to study the lag effects of PM2.5,PM10,NO2,and SO2 concentrations on the visits of outpatients,with the seasonal and long-term trends and day-of-the-week effect controlled. Results The results of the single pollutant model showed that PM2.5 and PM10 had the most obvious while still insignificant impact on the outpatient visits for atopic dermatitis on the current day(lag0).NO2 also had the most obvious impact in the case of lag0 and showed a lag effect.For each 10 µg/m3 increase in NO2 concentration,the excess risk(ER)of outpatient visits for atopic dermatitis was 1.95%(95% CI=1.09%-2.82%,P=0.01).SO2 had the most significant effect on lag6,and the outpatient visits increased by 1.55%(95% CI=0.48%-2.54%)for every 10 µg/m3 rise in SO2 concentration(P=0.02).Females were more sensitive to PM10 and SO2 than males.For every 10 µg/m3 increase in PM10 and SO2,the female outpatient visits increased by 0.02% and 2.47%,respectively.Males were sensitive to PM2.5 and NO2,and the every 10 µg/m3 rise in PM2.5 and NO2 increased male outpatient visits by 0.47% and 1.78%,respectively.Gaseous pollutants(NO2 and SO2)had more significant effect on people ≤2 years old than on those of other ages.Every 10 µg/m3 rise in NO2 and SO2 would increase the ≤2-year-old outpatient visits by 2.35% and 1.57%,respectively(P=0.02).People of 13-59 years old were sensitive to NO2 concentration,and every 10 µg/m3 rise in NO2 concentration increased their visits by 1.39%.NO2 affected the outpatient visits during the cold and warm seasons,with the ER values of 2.35% and 1.89%,respectively(P=0.01).Particulate matter(PM2.5 and PM10)had the most obvious yet insignificant association with the outpatient visits in winter.The interactions between PM2.5 and NO2,between PM10 and NO2,and between SO2 and NO2 affected the total outpatient visits for atopic dermatitis.The results of double pollutant model showed that in the presence of PM2.5,PM10,or SO2,the effect of NO2 on the outpatient visits for atopic dermatitis enhanced compared with that predicted by single pollutant model(P=0.01). Conclusion The air pollutants(PM2.5,PM10,NO2,and SO2)in Lanzhou were closely related to the outpatient visits for atopic dermatitis,and the increased concentrations of NO2 and SO2 was more likely to increase the risk of atopic dermatitis.

Association between ambient temperature and atopic dermatitis in Lanzhou, China: a time series analysis.

Many studies have explored the association between temperature and atopic dermatitis (AD); however, the results are inconsistent. We used a quasi-Poisson function fitted to a distributed lag nonlinear model (DLNM) to evaluate the association between daily average temperature and AD outpatient visits from January 1, 2013, to December 31, 2019, in Lanzhou, China. We found that the exposure-response association curve was inversely "s-shaped," low-temperature effects occurred at a lag of 11 days and then lasted for 10 days, and high-temperature effects occurred on the current day and then significantly decreased. Both low and high ambient temperatures can increase the risk of outpatient visits. Compared with median temperature (12.89°C), the cumulative relative risk (RR) of extreme high temperature and moderate-high temperature were 1.847 (95% confidence interval [CI]: 1.613, 2.114) and 1.447 (95% CI: 1.298, 1.614), respectively, at lag0-7 days, and the cumulative RRs of extremely low temperature and moderate-low temperature were 1.004 (95% CI: 0.904, 1.115) and 1.056 (95% CI: 0.925, 1.205), respectively, at lag0-21 days. Females were more sensitive to high temperatures than males, and high or low temperatures had significant effects on children ≤14 years of age. Graphical abstract.