What Are Skin Disorders?
The skin is the body's largest organ and a complex immune interface. Dermatology encompasses the diagnosis and treatment of over 3,000 conditions affecting the skin, hair, nails, and mucous membranes — ranging from common inflammatory conditions to rare autoimmune blistering diseases and cutaneous malignancies. Many skin conditions are chronic, significantly impacting quality of life and requiring long-term specialist management. Ruijin Hospital's dermatology department, led by Professor Zheng Jie, is one of China's most respected, with particular expertise in psoriasis, autoimmune skin diseases, and cutaneous lymphoma.
Common Skin Conditions
- Psoriasis — chronic immune-mediated skin disease causing red, scaly plaques; affects approximately 2–3% of the global population; associated with psoriatic arthritis, cardiovascular disease, and metabolic syndrome
- Atopic dermatitis (eczema) — chronic inflammatory skin disease causing intense itching and skin barrier dysfunction; the most common inflammatory skin condition
- Vitiligo — autoimmune destruction of melanocytes causing depigmented patches; significant psychological impact
- Pemphigus vulgaris — rare but serious autoimmune blistering disease affecting skin and mucous membranes
- Bullous pemphigoid — autoimmune subepidermal blistering disease; most common in elderly patients
- Cutaneous lupus erythematosus — skin manifestations of lupus including discoid lupus and subacute cutaneous lupus
- Dermatomyositis — inflammatory myopathy with characteristic skin findings; associated with internal malignancy
- Cutaneous T-cell lymphoma (CTCL) — including mycosis fungoides and Sézary syndrome; primary skin lymphomas requiring specialized management
- Urticaria and angioedema — chronic spontaneous urticaria causing hives and swelling
- Alopecia areata — autoimmune hair loss affecting the scalp and body
- Acne vulgaris — common inflammatory follicular condition; severe forms require systemic treatment
- Rosacea — chronic facial inflammatory condition causing redness, flushing, and papulopustules
Symptoms
Symptoms vary by condition but commonly include:
- Skin rash, redness, or discoloration
- Itching (pruritus) — often severe and sleep-disrupting in atopic dermatitis and urticaria
- Scaling, flaking, or thickening of the skin (psoriasis)
- Blisters or erosions (pemphigus, bullous pemphigoid)
- Depigmented patches (vitiligo)
- Hair loss (alopecia areata, lupus)
- Nail changes — pitting, onycholysis, subungual hyperkeratosis (psoriasis)
- Skin pain or burning (dermatomyositis, cutaneous lupus)
- Nodules, plaques, or tumors (cutaneous lymphoma)
Causes & Risk Factors
- Immune dysregulation — the underlying mechanism for most inflammatory and autoimmune skin diseases
- Genetic predisposition — HLA associations for psoriasis, pemphigus, and vitiligo; filaggrin mutations in atopic dermatitis
- Environmental triggers — infections, stress, medications, UV exposure
- Skin barrier dysfunction — central to atopic dermatitis pathogenesis
- Microbiome dysbiosis — altered skin and gut microbiome in psoriasis and atopic dermatitis
- Comorbidities — psoriasis associated with metabolic syndrome, cardiovascular disease, and depression
- Age — bullous pemphigoid most common in elderly; atopic dermatitis often begins in childhood
Diagnosis
Ruijin Hospital's dermatology team uses comprehensive clinical and laboratory assessment:
- Clinical examination and dermoscopy — magnified skin surface imaging to differentiate inflammatory and neoplastic conditions
- Skin biopsy and histopathology — the gold standard for definitive diagnosis of inflammatory, autoimmune, and neoplastic skin conditions
- Direct and indirect immunofluorescence (DIF/IIF) — essential for autoimmune blistering disease diagnosis (pemphigus, pemphigoid)
- Patch testing — for allergic contact dermatitis identification
- Skin prick testing and specific IgE — for atopic disease and urticaria workup
- Autoantibody testing — anti-desmoglein (pemphigus), anti-BP180/BP230 (bullous pemphigoid), ANA panel (cutaneous lupus)
- T-cell receptor gene rearrangement — for cutaneous lymphoma diagnosis
- Reflectance confocal microscopy (RCM) — non-invasive in vivo skin imaging
- Wood's lamp examination — for vitiligo and fungal infection assessment
Treatment Options
Ruijin Hospital offers the full spectrum of dermatological treatments, including the latest biologic and targeted therapies:
- Topical therapies — corticosteroids, calcineurin inhibitors (Tacrolimus, Pimecrolimus), vitamin D analogues (Calcipotriol), retinoids for psoriasis and atopic dermatitis
- Phototherapy — narrowband UVB (NB-UVB) and PUVA for psoriasis, vitiligo, atopic dermatitis, and cutaneous lymphoma
- IL-17 inhibitors — Secukinumab (Cosentyx), Ixekizumab for moderate-to-severe psoriasis; highly effective with rapid skin clearance
- IL-23 inhibitors — Guselkumab, Risankizumab, Tildrakizumab for psoriasis; durable remission with infrequent dosing
- IL-12/23 inhibitor — Ustekinumab for psoriasis and psoriatic arthritis
- Anti-TNF biologics — Adalimumab, Etanercept for psoriasis and psoriatic arthritis
- Dupilumab — IL-4/IL-13 receptor antagonist; transformative treatment for moderate-to-severe atopic dermatitis and chronic urticaria
- JAK inhibitors — Abrocitinib, Upadacitinib for atopic dermatitis; Ruxolitinib cream for mild-to-moderate AD; Baricitinib for alopecia areata
- Omalizumab — anti-IgE therapy for chronic spontaneous urticaria
- Rituximab — B-cell depletion for pemphigus vulgaris and other autoimmune blistering diseases
- Systemic immunosuppressives — Methotrexate, Cyclosporine, Mycophenolate mofetil for severe inflammatory skin diseases
- Acitretin — oral retinoid for severe psoriasis and palmoplantar disease
- PUVA and extracorporeal photopheresis (ECP) — for cutaneous T-cell lymphoma
- Excimer laser — targeted UVB for localized psoriasis and vitiligo
Why Treat Skin Disease in Shanghai?
- Ruijin Hospital's dermatology department is one of China's most prestigious, with Professor Zheng Jie as a nationally recognized authority on psoriasis and autoimmune skin diseases
- Access to the full range of biologic therapies for psoriasis and atopic dermatitis at significantly lower cost than in Western countries — often 50–70% less expensive
- Expert autoimmune blistering disease program with immunofluorescence laboratory capabilities
- Dedicated cutaneous lymphoma program with multidisciplinary hematology-dermatology collaboration
- Comprehensive phototherapy facilities including NB-UVB, PUVA, and excimer laser
Our Specialist
Professor Zheng Jie (郑捷) — Chief of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Professor Zheng is one of China's foremost dermatologists, with particular expertise in psoriasis, autoimmune blistering diseases, and cutaneous lymphoma. He has led numerous national clinical trials and is a key contributor to Chinese dermatology clinical guidelines and international research collaborations.
How CMCS Can Help
China Medical Concierge Shanghai (CMCS) coordinates comprehensive dermatological care for international patients at Ruijin Hospital — from reviewing your clinical history and biopsy results, to arranging specialist consultations with Professor Zheng's team, facilitating skin biopsy and immunofluorescence testing, coordinating biologic therapy access, providing medical interpretation, and supporting long-term disease management and follow-up care in Shanghai.
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