儿童与成人重症药疹比较分析

重症药疹包括重症多形红斑型药疹(SJS)、大疱性表皮松解型药疹(TEN)及剥脱性皮炎型药疹(ED).为了解儿童与成人重症药疹的异同,分析了我院2000年1月至2007年12月住院的84例重症药疹病历资料.     

300例住院药疹患者临床特征分析

目的 旨在从我院皮肤科住院药疹患者的病历资料,了解住院药疹的患病情况和重症药疹的临床特点.方法 回顾性分析2001年1月-2008年12月间我科收治的确诊药疹患者300例.结果 药疹致敏药物主要构成比为抗微生物类(33.19%)、生物制品类(29.74%)、抗痛风类(11.64%)和解热镇痛抗炎类(11.21%).药疹疹型主要构成比为发疹型(46.33%)、荨麻疹型(30.33%)及重症多形红斑型(6.67%).重症药疹患者的年龄、潜伏期、合并发热、黏膜受累及并发肝脏损害、感染、低钾之率较非重症药疹差异有统计学意义(P＜0.05).结论 抗微生物类是药疹主要致敏药物.抗痛风类及抗癫痫类药是重症药疹主要致敏药物.住院重症药疹患者年龄较大、潜伏期长,易合并发热、黏膜糜烂,易并发肝脏损害、感染、低钾.     

儿童重症药疹25例临床分析

药疹是近年来病死率最高的皮肤病之一,重症药疹是指伴有全身中毒症状及内脏器官损害的药疹,包括重症多形红斑型药疹(Steven-Johnson syndrome, SJS)、中毒性表皮坏死松解型药疹(toxic epidermal necrolysis,TEN)和剥脱性皮炎型药疹(exfoliative dermatitis, ED).重症药疹在儿童中虽然少见,但病情重,易出现严重并发症.病死率较高,需引起足够的重视.我院2004年1月至2008年6月共收治25例儿童重症药疹患者,取得了良好的治疗效果,现分析报道如下.     

重症药疹的护理体会

重症药疹是严重危及生命的药物反应,常见的重症药疹包括剥脱性皮炎型、多形红斑型和大疱表皮松解型.该病复杂多变,.如果治疗护理不当,会造成严重的后果,甚至死亡.本科2005年2月～2007年2月共诊治重症药疹10例,治疗及护理报告如下.     

23例重症药疹的临床分析及治疗

目的：探讨重症药疹的临床特征,分析致敏药物,总结治疗经验,以提高临床治疗效果.方法：回顾性分析我院2005年～2008年23例重症药疹患者的诊疗情况.结果：重症药疹的致敏药物为解热镇痛类,其次是镇静催眠药及抗生素类.23例患者其中有10例给予糖皮质激素;13例给予激素联合静脉注射免疫球蛋白,比较发现后者皮疹消退时间、病程明显缩短.结论：解热镇痛类药物所致重症药疹仍为首位.治疗上应早期,足量使用免疫球蛋白联合激素治疗,可明显缩短病程,控制病情,疗效显著.     

42例重症药疹临床分析

药疹皮损广泛,特别是重症药疹易出现严重的并发症,治疗不及时易导致死亡,常见的类型有:重症多形红斑型药疹、剥脱性皮炎型药疹、中毒性表皮松解型药疹及近年提出的药物超敏综合征。本文分析我科5年来住院的重症药疹患者的发病及治疗情     

46例重症药疹临床分析

重症药疹包括大疱性表皮坏死松解型(BENL)、重症多形红斑型(SJS)、剥脱性皮炎型(ED)、药物超敏反应综合征(DIHS)及急性泛发性发疹性脓疱病(AGEP)等.重症药疹患者病情危重,易出现严重并发症,病死率较高,必须及时治疗[1].现就我院皮肤科2006年6月-2011年6月住院治疗的46例重症药疹患者的临床资料分析结果报告如下.     

重症药疹72例临床分析

重症药疹临床上是指重症多形红斑型药疹、大疱性表皮松解型药疹和剥脱性皮炎型药疹 ,这些药疹是皮肤科重症 ,如诊疗不当 ,常导致严重后果 ,甚至死亡。近年来 ,随着新药不断出现 ,药疹患者有增多趋势 ,为探讨临床用药与重症药疹的关系 ,现将 1990年 1月～ 2 0 0 0年 5月我科所住 72例重症药疹患者情况进行分析如下。1　临床资料1.1　一般资料　 72例重症药疹患者均为本院住院病例 ,占同期住院药疹人数18.5 % ,其中男 39例、女 33例 ,年龄 6个月～ 6 9岁、平均 32岁。原发病多为感染性疾病、神经精神科疾病 (如癫痫病、神经痛等 )、外伤及其它…     

539例药疹临床分析

目的 探讨临床应用药物与药疹发生的关系以及药疹的防治.方法 对我院1994年1月至2003年12月10年间因药疹住院的患者临床资料进行分析.结果 539例患者中有68.09%(367/539)可明确为一种致敏药物.由青霉素类引起的药疹共有114例,其中阿莫西林79例.解热镇痛药引起的药疹共有96例.青霉素引起的药疹中发疹型占81.6%(93/114).重症药疹共64例,其中由解热镇痛药及抗癫痫药引起的分别有19例及18例.抗癫痫药和别嘌呤醇引起的药疹中重症药疹分别占72%(18/25)及90%(4/5),治疗所需的糖皮质激素控制剂量多为80-120mg/d,病程较长.结论 青霉素、阿莫西林及解热镇痛类药物是引起药疹最常见的药物.引起重症药疹的药物主要为解热镇痛药以及抗癫痫药.     

静脉注射用人免疫球蛋白治疗20例重症药疹并发严重皮肤感染患者疗效分析

目的:探讨重症药疹并发严重皮肤感染的合理治疗方法.方法:回顾性分析20例重症药疹并发严重皮肤感染患者的治疗情况.结果:20例患者经过糖皮质激素联合静脉注射用人免疫球蛋白、敏感抗生素抗感染、局部皮损处理、营养支持等治疗后均痊愈出院.结论:糖皮质激素联合静脉注射用人免疫球蛋白能有效治疗重症药疹,应尽早选用敏感抗生素控制皮肤感染.尤其是耐甲氧西林金黄色葡萄球菌感染的抗生素.局部皮损的处理及全身营养支持也极为重要.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Background and objectives

The negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.