We evaluated the epidemiological and molecular features of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and methicillin-sensitive S. aureus (MSSA) from children and adult patients with skin and soft-tissue infections (SSTIs) in China. Prospective community-acquired S. aureus SSTI surveillance was conducted in 23 hospitals over a 24-month period. Susceptibility to 16 antimicrobials was evaluated using the agar dilution method. StatApriori was used to determine statistically significant association trends. The genotypic characteristics of CA-MRSA isolates were tested by staphylococcal cassette chromosome mec (SCCmec) typing, staphylococcal protein A (spa) typing, and multilocus sequence typing. The presence of Panton–Valentine leukocidin (pvl) genes was determined. Overall, 71.6% (1946/2716) of cases were community-associated S. aureus. CA-MRSA accounted for 2.6% (51). Out of 1895 methicillin-sensitive S. aureus strains, 97.3% were resistant to erythromycin, 96.6% to penicillin and 89.1% to clindamycin. No S. aureus strains were resistant to vancomycin. Thirteen sequence types (STs) and 17 spa types were detected among the CA-MRSA strains. The most prevalent sequence type was ST121 (19/51, 37.3%), followed by ST59 (13/51, 25.5%). In addition, t437 was predominant, accounting for 43.1% (22/51). Only five (9.8%) of the CA-MRSA strains harbored pvl genes. There were no significant differences in antibiotic sensitivity profiles between ST121 and non-ST121 MRSA isolates. However, ST121 strains tended to be more resistant to cefazolin, whereas non-ST121 strains were more resistant to chloramphenicol. In conclusion, CA-MRSA infections are rare among Chinese SSTI patients. MRSA strains in China have diverse genetic backgrounds, with ST121 being the predominant clone. Fusidic acid and mupirocin remain effective for topical treatment.

Secondary neoplasms of epidermal adnexal origin have been reported to develop into nevus sebaceous (NS), mainly in adulthood but rarely in children. Four cases of secondary neoplasms were identified in 413 children of nevus sebaceous from 2015 to 2019 by our department, accounting for 1% of all cases. We here report the clinical, dermoscopical, and histopathological features of these tumors, including syringocystadenoma papilliferum (SCAP), pilomatricoma, trichilemmoma, and basal cell carcinoma (BCC). We recommend prophylactic excision of nevus sebaceous before puberty, not only because of the cosmetical disfigurement but also due to the risk of malignant transformation.

In all the target lesions, at baseline VDS showed a light red background with irregular or patchy dotted vessels and exudative area; yellow crusts were associated with less prominent, diffuse white scales. After 16 weeks of dupilumab treatment on average serocrusts, scales, and diffuse erythema improved considerably, along with a normalization of the vascular network [dotted vessels homogeneously distributed and a significative decrease in their calibre (Figure 1)]. In particular, erythema, scales and erosion values decreased, respectively, from 2.5 AE 0.51, 1.75 AE 0.81 and 1.9 AE 0.71 at T0 to 0.4 AE 0.5, 0.04 AE 0.21 and 0.25 AE 0.44 at T1 (P < 0.05). These data seemed to be changed in consensus to EASI, P-NRS and DLQI. Dermoscopy can be helpful in the diagnosis of inflammatory skin disease. 8,9 Recently, an expert consensus provides dermoscopic parameters for inflammatory, infiltrative and infectious dermatoses. This tool is likely to enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology. 10 Our study is the first to combine the use of dermoscopy along with clinical evaluation to monitor biologic treatment efficacy in AD lesions, showing that VDS can be able in following the clinical changes during AD treatment.