Pathogenesis of ulcerations in deficiency of prolidase. The role of angiopathy and of deposits of amyloid

The structure of the skin and the pattern of alteration in chronic ulcerations associated with deficiency of prolidase have been studied superficially in the past. We examined histologically several biopsies taken from apparently normal skin and from ulcerations afflicting a young woman with such a syndrome. Deposits of amyloid were found within the walls of medium-sized vessels and occasionally occluding their lumens. Impaired cutaneous microcirculation resulting from statis, moderate vasculitis, and abnormal structure of the dermis may be responsible for the regional preponderance of deposits of amyloid and ulcerations in the legs.     

红皮病120例病因分析

目的：探讨红皮病的病因及并发感染的情况。方法：回顾性分析120例红皮病患者的临床资料。结果：120例患者中73．3％红皮病继发于原有皮肤病，其他致病原因依次为药物过敏、肿瘤，部分原因不明。28．3％并发感染的红皮病患者中，41～60岁组和〉60岁年龄组的感染率高于≤40岁年龄组，差异有统计学意义（P均〈0．05）；血浆白蛋白降低组患者感染率高于血浆白蛋白正常组患者，差异亦有统计学意义（P〈0．01）。结论：红皮病病因多种多样，不能忽视非常见病因的存在。随着年龄的增长和血浆白蛋白的降低，红皮病患者的感染率增加，应注意皮肤护理及早期支持治疗。     

先天性皮肤缺损12例临床分析

先天性皮肤缺损（ＣＡＳ）是一种少见的出生时皮肤局限或广泛缺损的疾病，以一定部位的皮肤缺损为特征，伴随多种异常、若干异常综合征及遗传方式。报告１２例ＣＡＳ，均有典型的皮肤症状，其中４例伴有其他异常：大疱性表皮松解症，趾甲缺损，胫腓骨远端细小畸形及二胫骨长短不一。     

243例太田痣临床分析

目的 对湖北及周边地区太田痣患者进行临床分析.方法 回顾分析243例太田痣患者在发病时间、色素性疾病家族史及患者母亲妊娠期间是否有用药史等方面进行统计学比较.结果 太田痣出生时发病者占58.0%,出生后发病者占42.0%,主要集中于5～15岁.有色素性疾病家族史者占60.1%,其中以雀斑和咖啡斑为主.患有太田痣与女性妊娠期间是否有用药史无明显关系.结论 太田痣可能具有遗传性,具有色素性疾病史的患者,其后代患太田痣的可能性较大.     

Characteristics of the course of latent forms of syphilis

Seven patients with latent syphilis are described, in whom the routine serologic tests (RST) were negative during the first examination and over the course of therapy, and the specific tests (T. pallidum immobilization and immunofluorescence) were repeatedly positive before therapy. Early latent seropositive recurrent forms of syphilis were detected in the majority of these patients' sexual partners. The patients were not administered antisyphilis therapy before. The diagnosis of latent seronegative early syphilis negative in the RST is epidemiologically significant, for it helps timely carry out the necessary treatment and prophylaxis measures to prevent the disease dissemination.     

Epidemiological evidence of carcinogenicity of sunbed use and of efficacy of preventive measures

The International Agency for Research on Cancer classified, in July 2009, exposure to artificial tanning devices (sunbeds) as carcinogenic to humans. This classification was based on evidence from epidemiological and experimental animal studies. The present chapter will review these epidemiological evidences. The summary risk estimates from 27 epidemiological studies obtained through a meta‐analysis showed an increased risk of melanoma: summary relative risk (SRR) = 1.20 [95% confidence interval (CI) 1.08–1.34]. The risk was higher when exposure took place at younger age (SRR = 1.59; 95% CI 1.36–1.85). The risk was independent of skin sensitivity or population and a dose response was evident. A meta‐analysis of 12 studies was conducted for non‐melanoma skin cancers and showed a significantly increased risk for basal cell carcinoma (SRR = 1.29; 95% CI 1.08–1.53) and for squamous cell carcinoma (SRR = 1.67; 95% CI 1.29–2.17). As for melanoma, the risk for other skin cancers increased for first exposures at young age. Epidemiological studies have gradually strengthened the evidence for a causal relationship between indoor tanning and skin cancer and they fit with prior knowledge on relationship between UV exposure and skin cancer. Additionally, several case–control studies provided consistent evidence of a positive association between use of sunbed and ocular melanoma, also with greater risk for first exposures at younger age. Preventive measures based on information on risk or by requiring parental authorization for young users proved to be inefficient in several studies. The significant impact of strong actions or total ban, such as performed in Iceland, or a total ban of sunbed use, as in Brazil or Australian states, needs to be further assessed.     

综合疗法治疗复发性念珠菌性包皮龟头炎

目的探讨口服氟康唑胶囊、外用曲安奈德益康唑乳膏联合包皮环切术防治复发性念珠菌包皮龟头炎的疗效。方法采用随机分组法,治疗组(46例)给予氟康唑胶囊200mg,1次/d,连服3d,外用曲安奈德益康唑乳膏,早、晚各1次,2周为1个疗程,炎症控制后行包皮环切术。对照组(40例)给予氟康唑胶囊连服6d,曲安奈德益康唑乳膏外用2周。治疗后2周及2,4和6个月时随访。结果 2周后,两组痊愈率分别为89.13%和85.00%,差异无统计学意义(P>0.05)。两组有效率分别为100.00%和95.00%,差异无统计学意义(P>0.05)。2,4,6个月治疗组复发率分别为4.88%,9.76%和9.76%,对照组复发率分别为23.53%,38.24%和50.00%,两组比较差异均有统计学意义(P均<0.05)。结论综合疗法治疗复发性念珠菌包皮龟头炎安全有效,并能有效减少复发。     

Method of histological control of the edges of surgical specimens of basal cell epitheliomas

For histologic control of excisional margins, routinely fixed tumor specimens or under certain conditions, specimens fixed immediately in warm formalin are processed in the histology laboratory. Strips are then cut from the undersurface, edge and cross section of the specimen and processed further by routine paraffin techniques until HE-stained sections of the entire periphery and midsection are available. The average follow-up time was of 4 years with a recurrence rate of 0.4 per cent.     

天疱疮合并症的研究进展

天疱疮是一种以表皮内棘层松解为特征的自身免疫性大疱性皮肤病。天疱疮可以合并银屑病、神经系统疾病、血液系统疾病、其他自身免疫性疾病以及肿瘤等。近年来有关天疱疮合并症的报道越来越多,本文对天疱疮合并症的研究进展作一综述。     

泼尼松治疗麻风神经炎疗效评价

目的：评价泼尼松治疗麻风神经炎的疗效.方法：对麻风急性神经炎32例和无痛性神经炎28例,共60例患者给予泼尼松顿服治疗6个月,定期评价神经功能变化.结果：急性神经炎患者痊愈率65.3%,总有效率为95.7%;无痛性神经炎患者痊愈率35.1%,总有效率为78.4%.结论：泼尼松治疗对急性神经炎患者疗效显著,6个月内的无痛性神经炎患者也有较好的疗效,可作为治疗麻风神经炎首选药物.     

3种抗真菌药治疗甲真菌病疗效对比观察

应用伊曲康唑、特比萘芬、氟康唑３种不同抗真菌药物治疗１２０例甲真菌病患者,并作疗效对比观察,结果显示,３种药物均有较艰的抗真菌疗效,特比萘芬疗效优于伊曲康唑及氟康唑,伊曲康唑疗效优于所经康唑。３种药物近、中、远期临床治愈率及真菌学阴转率,复发率Ｐ值均〉０．０５,无统计学意义。     

A review of the mechanisms of action of dimethylfumarate in the treatment of psoriasis

Fumaric acid esters (FAEs) such as dimethylfumarate (DMF) are used for the treatment of adults with moderate‐to‐severe psoriasis. The mode of action of FAEs is complex. Here, we provide a comprehensive review of the literature to describe the molecular mechanisms by which DMF and its active metabolite monomethylfumarate (MMF) exert their anti‐inflammatory and immune modulatory effects. MMF can bind to the hydroxy‐carboxylic acid receptor 2 (HCA2) on the cell surface and both DMF and MMF react with intracellular glutathione following cell penetration. DMF and to some extent also MMF modulate the activity of certain cellular signalling proteins such as the nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2), nuclear factor kappa B (Nf‐κB) and the cellular concentration of cyclic adenosine monophosphate. Some studies show that DMF can also affect the hypoxia‐inducible factor 1‐alpha (HIF‐1α). These actions seem to be responsible for i) the downregulation of inflammatory cytokines and ii) an overall shift from a proinflammatory Th1/Th17 response to an anti‐inflammatory/regulatory Th2 response. Both steps are necessary for the amelioration of psoriatic inflammation, although additional mechanisms have been proposed. There is a growing body of evidence to support the notion that DMF/MMF may also exert effects on granulocytes and non‐immune cell lineages including keratinocytes and endothelial cells. A better understanding of the multiple molecular mechanisms involved in the cellular action of FAEs will help to adapt and further improve the use of such small molecules for the treatment of psoriasis and other chronic inflammatory diseases.     

脉冲强光系统治疗太田痣临床疗效观察

目的：观察全波长脉冲强光系统（PhotoDerm)治疗太田痣的临床疗效。方法：74例太田痣患应用全波长脉冲强光治疗系统（PhotoDerm)进行治疗。选用645nm滤光器、能量密度318J/cm^2至42J／cm^2、三脉冲、脉宽为2.5ms至3．0ms、脉冲间歇30ms至50ms，治疗间隔3个月－6个月。结果：1次治疗后有效率（治愈＋显效＋有效）为43．2％，2次治疗后有效率为80％，3次治疗后有效率为97．6％，4次治疗后有效率为100％，5次治疗后显效率为100％。治疗次数和疗效（有效率）呈正相关（R＝1，P＜0．001）。有4例患获得治愈。结论：PhotoDerm治疗系统治疗太田痣有较好的临床疗效。     

Treatment of hemangiomas of infancy

Hemangiomas of infancy are the most common tumors of childhood. They are clinically heterogeneous and as such require individualized treatment plans. Although there are no Food and Drug Administration (FDA)-approved agents for treatment of hemangiomas of infancy, there are many widely used therapeutic options available. This review highlights the treatments currently in use and the factors that direct treatment.     

Modulation of Growth of Melanoma

Combined heparin-cortisone treatment induces regression of growth in a variety of murine tumors including melanoma. We injected 92 inbred C 57 b1/6 male mice each with 5 X 10(5) melanoma cells (B16, B16 F1, and B16 A6 lines) with different metastatic potential. Heparin (400 U/ml) and cortisone acetate (250 mg/kg SC injections) were given daily. Control experiments were performed both with the administration of no drugs and with administration of cortisone alone. Plasminogen activator activity, which is notoriously related to tumor growth, was evaluated using fibrin plate technique in 10 fragments taken before and 20 days after the combined heparin-cortisone treatment of B16 F1 and B16 A6 melanomas. The combined heparin-cortisone treatment slowed tumor growth, but no tumour regression was observed. Cutaneous fibrinolytic activity appeared increased in all specimens after the treatment.     

慢性荨麻疹400例变应原检测结果分析

目的探讨各种变应原与慢性荨麻疹发病的关系,为患者的预防提供指导依据。方法采用国际标准的皮肤点刺试验对400例慢性荨麻疹患者进行23种变应原的检测。结果400例慢性荨麻疹患者进行23种变应原的检测阳性率达65.75%(263例):变应原中粉尘螨45.25%(181例)阳性率最高,其次为螨Ⅱ36.50%(146例)。结论对于慢性荨麻疹患者在诊疗过程中应积极寻找病因,避免在日常生活中接触相应的致病变应原,降低发病率。     

麻风免疫学研究进展

麻风是由麻风分枝杆菌引起的慢性传染性疾病,发病与机体免疫密切相关。本文就麻风细胞免疫、体液免疫、免疫逃逸及遗传易感性等方面的研究进展作一综述。     

Lack of efficacy of etanercept in acrodermatitis continua of Hallopeau

A 40‐year‐old man was referred to our department in January 2000 with persistent, scaly, pustular and tender plaques on the distal portion of the digits. He first noted pustulation around the nail, which was followed by scaling and crust formation, and subsequently led to nail dystrophy. Earlier treatment had included topical antibiotics, antimycotics, and corticosteroids, as well as systemic antibiotics, without any success. His past medical history was otherwise unremarkable. Post‐traumatic fingertip amputation of the third finger of the right hand was repaired with a full‐thickness skin graft. On dermatologic examination, there was a severe erythematosquamous, psoriasiform, pustular eruption surrounded by a hyperemic area affecting the terminal phalanges of nine of the 10 digits. The skin of the graft was intact. Examination of the digits revealed anonychia of six of the 10 fingernails ( Fig. 1 ) The rest of the physical examination was normal. Clinical and histologic findings led to the diagnosis of acrodermatitis continua of Hallopeau (ACH). X‐Rays of both hands showed osteolysis of two of the 10 terminal phalanges.

Figure 1 Open in figure viewer PowerPoint Before therapy: acrodermatitis continua of Hallopeau demonstrating acral pustule formation