毛囊闭锁性三联征二例

毛囊闭锁性三联征(Follicular occlusion triad,FOT)是化脓性汗腺炎(Hidradenitis suppurativa,HS),聚合性痤疮(Acne conglobata,AC)和脓肿性穿掘性头部毛囊周围炎(Perifolliculitis capitis abscedens et suffodiens,PCAS)3种疾病的总称,在多数情况下它们分别发生在不同的病人身上.     

综合疗法治疗头皮脓肿性穿掘性毛囊周围炎2例

头皮脓肿性穿掘性毛囊周围炎(PCAS)是一种原因未明的头部慢性化脓性疾病。主要特点是头皮波动性结节,结节间相互连接的窦道,瘢痕性脱发等。笔者从2003年6月—2004年12月采用维胺脂胶囊等综合疗法治疗2例PCAS患者取得了较好疗效,现报告如下。1临床资料2例患者均为男性,例1,22岁,     

雄激素性秃发的发病机制

【摘要】 雄激素性秃发（AGA）是最常见的一种非瘢痕性脱发类型。研究提示,AGA的发病机制涉及遗传背景、性激素代谢异常与毛囊微型化、毛囊微环境炎症反应以及环境因素等多个方面,其中遗传易感性是造成AGA个体发病差异最重要的因素,性激素代谢异常和/或毛囊微环境炎症反应诱发的毛囊微型化则是AGA发病的最后环节。     

维胺酯胶囊治疗头皮脓肿穿凿性毛囊周围炎2例

头皮脓肿穿凿性毛囊炎(PCAS)是一种原因不明的头部慢性化脓性疾病，主要特点是头皮波动性结节、结节间相互连接的窦道、瘢痕性脱发等^[1]。现有的治疗方法大多难以取得满意疗效，笔者应用维胺酯治疗2例PCAS患者均取得了较好的疗效，现报告如下。     

5-氨基酮戊酸光动力疗法治疗反常性痤疮1例

正反常性痤疮(acne inversa,AI)是近年来新提出的命名,是指聚合性痤疮、化脓性汗腺炎和头部脓肿性穿掘性毛囊周围炎存在于同一例患者身上,曾称之为毛囊闭锁三联征。本病与寻常痤疮发病过程相同,包括毛囊角化过度、毛囊漏斗部扩张导致破裂以及继发细菌感染,毛囊角化异常是上述疾病的共同特点,但是发病部位和临床特点与寻常痤疮不同,通常以腋窝、腹股沟、肛周和外阴等大汗腺分布丰富的部位为主,因此,称为反常性痤疮。其发病机制尚不十分清楚,目前认为是由毛囊闭锁、遗传因素、感染、激素水平变化及外因     

毛囊闭锁性三联征一例及家系分析

目的 探讨毛囊闭锁性三联征的临床和遗传学特点。方法 对1例毛囊闭锁性三联征继发鳞状细胞癌的特殊病例,在临床检查的基础上,进行了家系调查和系谱分析。结果 此家系共有13例,于20岁左右发病,先证者临床特点及实验室检查符合毛囊闭锁性三联征的诊断。结论 遗传因素是不可忽视的主要因素,本病可能为常染色体显性遗传病。     

秃发性毛发角化症

报告1例秃发性毛发角化症。患者女，22岁。因全身泛发毛囊性红色丘疹8年，头皮瘢痕性秃发伴瘙痒4年就诊。临床表现为头部毛发稀疏，部分秃发区可见毛囊萎缩。面颊部毛细血管扩张，密集毛囊性粉刺样丘疹，四肢、躯干泛发粟米大毛囊性丘疹。枕部头皮组织病理检查：表皮角化过度，表皮突局灶性延长，毛囊口有角质栓，毛囊内外根鞘灶性萎缩或消失，局部多核巨细胞反应性增生，毛囊周围及真皮血管周围见较多淋巴细胞浸润。诊断：秃发性毛发角化症。     

雄激素源性脱发的治疗进展

雄激素源性脱发(AGA)是常见的毛发脱失性疾病,好发于中年人,呈慢性进行性发展.表现为头顶部毛囊变小,生长期缩短,生长期/休止期毛囊比值下降,毛发直径变小,毳毛代替终毛,出现脱发.该病发生与遗传因素、雄激素代谢失常等因素有关.在治疗上有药物、物理治疗、手术等方法.     

棘状秃发性毛发角化病

报告1例棘状秃发性毛发角化病.患者男,22岁.因头皮弥漫性毛囊角化性丘疹伴脱发10余年就诊.皮肤科检查:头皮弥漫性瘢痕性脱发和毛囊角化性丘疹,并可见散在分布细小和稀疏的头发.组织病理检查可见表皮毛囊角化过度和轻度的毛囊周围纤维化,毛囊和血管周围有少量慢性炎性细胞浸润.结合临床和组织病理检查,符合棘状秃发性毛发角化病的诊断.临床上,该病需与棘状秃发性毛囊炎、毛囊性鱼鳞病伴脱发和畏光综合征(IFAP)、角膜炎-鱼鳞病-耳聋综合征(KID综合征)和无萎缩脱毛性毛发角化病等病鉴别.     

021 伴有毛囊粘蛋白沉积的毛囊性蕈样肉芽肿一例

毛囊性蕈样肉芽肿 (ＦＭＦ)是一种少见的皮肤型Ｔ细胞淋巴瘤 ,以毛囊内及其周围有异形性淋巴细胞浸润为特征 ,一般无表皮受累或毛囊粘蛋白沉积。有文献报道毛囊之间表皮不受累以及无毛囊粘蛋白沉积是ＦＭＦ与伴有毛囊粘蛋白沉积的ＭＦ的主要区别点。该文报道了 1例伴有毛囊粘蛋白沉积的ＦＭＦ。5 0岁男性 ,手足发生瘙痒性、多发性、毛囊性丘疹及黑头粉刺样皮损 6年 ,后逐渐扩展至整个上、下肢。曾系统性口服米诺环素、13 顺维Ａ酸及外用 3%红霉素凝胶 ,效果欠佳。皮肤科情况 :四肢可见点状、毛囊角化性丘疹 ,部分融合成轻微隆起的斑块 ,其间…     

复方虎杖散颗粒联合盐酸伐昔洛韦片治疗女性生殖器疱疹的疗效观察

目的:探讨复方虎杖散颗粒联合盐酸伐昔洛韦片在治疗女性生殖器疱疹中的临床疗效,并初步探讨复方虎杖散颗粒在治疗女性生殖器疱疹中的作用机理。方法:以84例2015年6月至2016年6月期间于本院就诊治疗女性生殖器疱疹的患者资料作为研究资料,按治疗方案分为单一用药组(41例)和联合用药组(41例),单一用药组给予盐酸伐昔洛韦片口服治疗,联合用药组在给予盐酸伐昔洛韦片口服治疗基础上联合复方虎杖散颗粒治疗,对比分析患者治疗后生殖器疱疹改善情况、近期临床疗效、抗复发性疗效以及免疫学相关因子改善情况。结果:联合用药组患者治疗后生殖器疱疹止疱时间、结痂时间、疱疹消失时间、皮损愈合时间和疾愈时间均明显短于单一用药组(P0.05);治疗1个疗程后,联合用药组患者治疗总有效率为97.67%,显著高于常规疗法组的90.24%;患者结束用药6个月内,联合用药组患者治疗总有效率为93.02%,显著高于常规疗法组的65.85%;患者结束用药6个月内,联合用药组患者治疗总有效率为93.02%,显著高于常规疗法组的65.85%。治疗后联合用药组的外周血IL-2和IFN-γ检测水平分别为(324.62±28.54)mol/L和(331.42±24.83)mol/L,显著高于单一用药组的(287.49±21.53)mol/L和(279.81±22.49)mol/L,比较差异均具有统计学意义(P0.05)。结论:复方虎杖散颗粒联合盐酸伐昔洛韦片可有效改善生殖器疱疹症状,提升治疗总有效率,降低治疗复发率,并能有效改善患者免疫功能,可作为治疗女性生殖器疱疹的有效方案。     

Cost-effectiveness analysis of a psoriasis care instruction programme with dithranol compared with UVB phototherapy and inpatient dithranol treatment

BACKGROUND: This study was part of a large national cost-effectiveness analysis, and was funded by the National Fund for Investigational Medicine of the Health Care Insurance Board. OBJECTIVE: To compare the costs of treatment of moderate to severe psoriasis by dithranol short contact therapy in a care instruction programme (short contact therapy) with ultraviolet B phototherapy (UVB) and inpatient dithranol treatment (inpatient treatment), and relate these costs to treatment effectiveness. METHODS: An open randomized controlled multicentre study was performed. The costs (both medical and non-medical) were calculated for the following periods: during treatment, per month during remission, after a relapse, and following an unsuccessful treatment. The effectiveness measures were the clinical response rate and the number of clearance days during follow-up. RESULTS: The data from 216 patients were analysed. The mean overall costs per patient during treatment were euro;1641, euro;1258 and euro;7706 for short contact treatment, UVB and inpatient treatment, respectively. During the clearance period the mean costs per month per patient were euro;19, euro;5 and euro;25, respectively. The clinical response rates were 57%, 57% and 85%, respectively. The mean number of clearance-days after short contact treatment was 160 [median 119; interquartile range (0-357)], which was not significantly different from the other two strategies: 211 clearance-days after inpatient treatment [241 (99-350)] and 136 clearance-days after UVB [81 (0-266)]. CONCLUSIONS: Short contact treatment is an attractive alternative for patients with moderate to severe psoriasis currently treated by inpatient treatment, as the costs of short contact treatment were significantly lower and the number of clearance days was comparable. Considering the higher costs, short contact treatment is not a first choice treatment when compared with UVB.     

苁蓉益肾颗粒联合左卡尼汀治疗少弱精子症的临床观察

目的:观察苁蓉益肾颗粒联合左卡尼汀治疗少弱精症的临床疗效及对精子参数水平的影响。方法:将400例本病患者随机分为治疗组与对照组各200例,对照组采用左卡尼汀治疗,治疗组服苁蓉益肾颗粒和左卡尼汀治疗,疗程3个月。观察临床疗效和治疗前后精液各参数(精子密度、活动率、活力)的变化。结果:治疗组总有效率为92.00%,显著高于对照组的65.00%(P0.01);两组治疗前各精液指标比较,差异均无统计学意义(P0.05);两组治疗后各精液指标均较治疗前显著改善(P0.01),且治疗组治疗后精子计数、精子成活率、a级及a+b级指标依次为(33.1±13.4)×10~6/mL、(67.9±19.8)%、(24.7±5.9)%、(52.6±17.9)%,改善程度均更优于对照组(P0.05)。结论:苁蓉益肾颗粒联合左卡尼汀可明显改善少弱精子症不育患者的精液质量,提高临床疗效。     

勃起功能障碍的中西医结合治疗临床疗效观察

目的:观察中西医结合疗法在勃起功能障碍治疗中的效果.方法:收集92例勃起功能障碍患者,分为治疗组和对照组,分别使用中西医结合和单纯西医疗法进行治疗,对比两组的疗效差异.结果:对照组治疗总的有效率为76.1％,治疗组治疗总的有效率为89.1％,治疗组疗效优于对照组,差异具有统计学意义(P＜0.05).结论:中西医结合疗法效果较单一西医治疗更好,是一种较理想的勃起功能障碍治疗方法.     

Effectiveness and side effects of UVB-phototherapy, dithranol inpatient therapy and a care instruction programme of short contact dithranol in moderate to severe psoriasis

The efficacy of UVB-phototherapy (UVB) and dithranol treatment for psoriasis is well established. However, well-conducted clinical trials on the efficacy of dithranol are not available, making comparison between these time-honoured treatments with currently available therapies impossible. We studied the effectiveness of dithranol in a care instruction programme using short time exposures (short contact treatment), UVB-phototherapy and dithranol treatment in an inpatient setting. In an open randomised study we included 250 patients with moderate to severe psoriasis. The intention to treat group existed of 238 patients. 100 patients were treated with short contact dithranol, 78 Patients were treated with UVB and 60 patients underwent inpatient dithranol treatment. We found UVB and dithranol treatment to be effective and safe in moderate to severe psoriasis. The efficacy of short contact dithranol treatment equals the efficacy of UVB-phototherapy. Dithranol treatment at the inpatient department showed superior efficacy in clinical response rate and treatment duration as compared to UVB and short contact treatment. The median number of days in remission was significantly longer after short contact treatment as compared to inpatient treatment. Although the use of dithranol is hampered by skin irritation and staining, the present study shows that dithranol treatment has an outstanding efficacy and safety profile. Comparison between different antipsoriatic treatments should, besides clearing capacity, reconcile duration of remission, safety, patient acceptability and costs.     

中药治疗过敏性紫癜临床疗效观察

目的观察中医辨证治疗过敏性紫癜的疗效。方法将124例患者分为治疗组66例和对照组58例,治疗组分为2型,采用中医辨证治疗;对照组采用西药常规治疗。结果治疗组总有效率为93．4％,对照组总有效率为75．9％,二者有统计学意义（P〈0．05）。结论中药治疗过敏性紫癜具有较好疗效。     

伐昔洛韦联合小牛脾提取物治疗带状疱疹48例疗效评价

目的:评价伐昔洛韦联合小牛脾提取物治疗带状疱疹的疗效和安全性。方法:将95例带状疱疹患者随机分为2组,治疗组(48例)给予伐昔洛韦片和小牛脾提取物注射液;对照组(47例)仅给予伐昔洛韦片,10天后观察疗效。结果:治疗组总有效率为85.42%,对照组总有效率68.09%,治疗组的止疱、结痂、止痛时间和总病程明显缩短。结论:伐昔洛韦联合小牛脾提取物治疗带状疱疹疗效优于单用伐昔洛韦。     

Dermatology day care treatment centres

Day care treatment centres provide the best solution for the treatment of most patients with psoriasis. The centre is not only ideal for treatment but has other roles, such as education of patients and nurses. The specialist dermatology nurse is the key to success. Out patient treatment of psoriasis is less expensive than in patient treatment. The development of a treatment centre should be seen as an additional facility and not as a substitute for in patient beds.     

窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹疗效分析

目的观察窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹的疗效。方法对照组采用窄谱中波紫外线照射(2天一次)治疗,治疗组采用窄谱中波紫外线照射联合复方甘草酸苷(2片3次/d口服)治疗,两组均20天为1个疗程。结果治疗组有效率为95.83%,对照组为66.67%,治疗组疗效优于对照组,两组间差异有显著性(P<0.05);治疗组不良反应发生率为16.67%,对照组为20.83%,治疗组不良反应略少于对照组,但两组间差异无显著性(P>0.05)。结论窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹疗效好,安全可靠。     

地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹疗效观察

目的评价0.05%地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹的有效性及安全性。方法将门诊2014年1月—2014年12月诊治的婴幼儿湿疹100例随机分成试验组和对照组。试验组先给予薇诺娜柔润保湿霜外用,5 min后再外用地奈德乳膏;对照组仅外用地奈德乳膏,每日2次,7 d为1个疗程。在第1个疗程和第2个疗程后判定疗效。8周后随访,观察预后及复发情况。结果第1个疗程试验组有效率为70.2%,对照组为64%,两组有效率比较差异无统计学意义。第2个疗程试验组有效率为94%,对照组为82%,两组相比差异有统计学意义。8周后随访,试验组有效率为84%,对照组为60%,两组相比差异有统计学意义。结论地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹疗效好,并能减少皮损的反复。