儿童白癜风1125例的临床特征与治疗总结

目的:通过对1 125例儿童白癜风患者的临床特点和治疗进行总结,以期对白癜风的早期预防及治疗提供依据。方法:对1 125例第四军医大学西京医院皮肤科确诊的儿童白癜风病例进行回顾性分析。结果:1 125例白癜风患儿中,男女比1.04∶1,平均始发年龄7.03岁,发病年龄以5～9岁最多见(62.04%),平均病程15.32月。227例(20.1%)有家族史,春夏季发病或病情加重者所占百分比高;15.29%患儿发病前有外伤、精神因素、日晒等诱因。临床表现以寻常型最常见(86.31%),6.84%伴发其他疾病,其中晕痣最多,共50例(4.44%),且伴发晕痣者平均发病年龄早于无合并晕痣者。治疗包括中医中药、局部或系统使用糖皮质激素、免疫调节剂、光疗法及外科手术等方法,以联合治疗为主,疗程1年有效率达54.93%。结论:家族史阳性、伴发晕痣、氧化应激损伤均是儿童白癜风发病的危险因素。儿童白癜风的治疗受限,疗效不理想,有待进一步探索。     

儿童白癜风1125例的临床特征与治疗总结

目的:通过对1 125例儿童白癜风患者的临床特点和治疗进行总结,以期对白癜风的早期预防及治疗提供依据。方法:对1 125例第四军医大学西京医院皮肤科确诊的儿童白癜风病例进行回顾性分析。结果:1 125例白癜风患儿中,男女比1.04∶1,平均始发年龄7.03岁,发病年龄以5～9岁最多见(62.04%),平均病程15.32月。227例(20.1%)有家族史,春夏季发病或病情加重者所占百分比高;15.29%患儿发病前有外伤、精神因素、日晒等诱因。临床表现以寻常型最常见(86.31%),6.84%伴发其他疾病,其中晕痣最多,共50例(4.44%),且伴发晕痣者平均发病年龄早于无合并晕痣者。治疗包括中医中药、局部或系统使用糖皮质激素、免疫调节剂、光疗法及外科手术等方法,以联合治疗为主,疗程1年有效率达54.93%。结论:家族史阳性、伴发晕痣、氧化应激损伤均是儿童白癜风发病的危险因素。儿童白癜风的治疗受限,疗效不理想,有待进一步探索。     

红外线(IR)与窄谱中波紫外线(NB-UVB)联合治疗白癜风的疗效观察

目的:研究红外线紫外线(ultraviolet infrared,UI)联合治疗与紫外线(ultraviolet,UVB)、红外线(infrared,IR)单独治疗对稳定期白癜风患者患处皮肤的疗效和安全性。方法:对34例白癜风患者,分别选取三处皮损,给予UVB、IR、UI治疗。照射部位均每周照射2次,每月为一个疗程,连续3个疗程做出评价。结果:疗效:34例患者经UI治疗的有效率为64.71%,高于红外治疗有效率(20.59%)和紫外线治疗的有效率(38.23%),卡方检验显示差异具有显著性(χ2=14.29,P0.01)。部位差异:UI联合治疗,对于不同部位的有效率为:躯干面颈部四肢手足,但无显著性差异(χ2=5.38,P=1.146)。不良反应:IR组无患者出现不良反应,NB-UVB组8例患者局部出现不良反应,UI组12例患者在治疗过程中出现类似不良反应,停止照射3~5天后症状消退。结论:本次试验结果显示:UI联合治疗对稳定期白癜风皮损的疗效明显好于UVB或者IR单独治疗。     

曲安奈德局部注射治疗儿童病理性瘢痕的单组率Meta分析

目的：通过分析曲安奈德局部注射治疗儿童病理性瘢痕的有效率、显效率和不良反应发生率来评价该治疗方法的临床疗效和安全性。方法：检索CNKI、万方、PubMed、Embase、CochraneLibrary数据库，搜集关于曲安奈德局部注射治疗儿童病理性瘢痕的随机对照试验、非随机对照试验、队列研究及病例报告论文，提取资料后，采用Stata软件进行Meta分析。结果：共将5篇文献650例患儿纳入Meta分析，曲安奈德局部注射治疗儿童病理性瘢痕的有效率是88%(95%CI:0.82,0.94)，治疗儿童病理性瘢痕的显效率是48%(95%CI:0.25,0.71)，局部注射曲安奈德的不良反应发生率是7%(95%CI:0.05,0.08)。结论：曲安奈德局部注射治疗儿童病理性瘢痕的疗效确切，使用低浓度（10 mg/ml）药物注射具有较高的安全性。     

308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效观察

目的:探讨308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风的疗效及安全性。方法:选取门诊面部白癜风患者180例,随机平均分为三组,共有167例完成了试验观察,A组为治疗组57例,308nm准分子激光(2次/周)联合0.1%糠酸莫米松乳膏(1次/天)治疗;B组为对照1组56例,单用308nm准分子激光治疗(2次/周);C组为对照2组54例,单用0.1%糠酸莫米松乳膏外用治疗(1次/天),疗程均为12周或至皮损完全复色,观察三组治疗方法治疗面部白癜风的疗效及不良反应。结果:A组显效率为75.43%,B组为48.21%,C组为14.81%,A组和B组及C组比较,显效率差异有统计学意义(P<0.05)。三组患者均未出现严重不良反应。结论:308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效好、副作用少,显效率明显高于单独治疗。     

综合护理干预对308nm准分子激光治疗儿童白癜风临床疗效及生活质量评分的影响分析

目的:研究综合护理干预对308nm准分子激光治疗儿童白癜风临床疗效及生活质量评分的影响。方法:选取2011年5月-2015年8月于笔者医院就诊的89例白癜风患儿作为研究对象。按随机数字表法将其分为对照组(42例)和研究组(47例),对照组患儿采用308nm准分子激光治疗,研究组患儿采用308nm准分子激光治疗联合综合护理干预。对比两组患儿的VAS、WHOQOL-BREF评分、DLQI量表、临床疗效及护理总满意度。结果:研究组患儿干预后VAS评分、WHOQOL-BREF评分及DLQI评分各项明显高于对照组,且有统计学意义(P0.05),另外,对照组及研究组患儿VAS评分、WHOQOL-BREF评分及DLQI评分各项均高于各自干预前(P0.05)。两组患儿显效率对比有统计学意义(P0.05),两组患儿总有效率对比无显著性差异(P0.05),对照组护理总满意度为69.05%,明显低于研究组91.49%,且有统计学意义(P0.05)。结论:308nm准分子激光可有效改善患者的生活质量,具有疗程短,起效快,疗效佳,不良反应少等优点,治疗期间配合综合护理干预,如饮食、皮肤和心理护理等,可提高和确保儿童白癜风308nm准分子激光的治疗效果。     

308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效观察

目的:探讨308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风的疗效及安全性。方法:选取门诊面部白癜风患者180例,随机平均分为三组,共有167例完成了试验观察,A组为治疗组57例,308nm准分子激光(2次/周)联合0.1%糠酸莫米松乳膏(1次/天)治疗;B组为对照1组56例,单用308nm准分子激光治疗(2次/周);C组为对照2组54例,单用0.1%糠酸莫米松乳膏外用治疗(1次/天),疗程均为12周或至皮损完全复色,观察三组治疗方法治疗面部白癜风的疗效及不良反应。结果:A组显效率为75.43%,B组为48.21%,C组为14.81%,A组和B组及C组比较,显效率差异有统计学意义(P<0.05)。三组患者均未出现严重不良反应。结论:308nm准分子激光联合0.1%糠酸莫米松乳膏治疗面部白癜风疗效好、副作用少,显效率明显高于单独治疗。     

刺络拔罐法联合全虫方加减治疗白癜风60例疗效观察

目的:观察刺络拔罐法联合全虫方加减治疗白癜风的临床疗效及安全性。方法:选择2017年3月-2019年8月就诊于笔者医院的118例风湿郁热型白癜风患者为研究对象,随机分为观察组60例,对照组58例。对照组予口服中药汤剂全虫方加减治疗,观察组在口服全虫方加减的基础上加皮损区刺络拔罐疗法,疗程结束后观察疗效。结果:两组患者治疗后临床疗效比较,观察组的总有效率为86.7%,观察组为72.4%,两组比较差异有统计学意义(P0.05);观察组平均皮损消退率54.72%,对照组平均皮损消退率为35.38%,两组差异有统计学意义(P0.05);观察组中医症候改善率79.10%,对照组治疗后的中医症候平均改善率为56.73%,两组差异有统计学意义(P0.05)。研究过程中有4例患者出现轻微消化道症状,查肝肾功能、血尿常规均未见明显异常。其中观察组不良反应发生率为5.0%,对照不良反应发生率为3.4%,两组比较无显著性差异(P0.05)。结论:刺络拔罐法联合全虫方加减治疗风湿郁热型白癜风安全、有效。     

中药局部熏蒸治疗儿童多发性扁平疣临床疗效分析

目的:评价中药局部熏蒸治疗儿童多发性扁平疣的临床疗效。方法:选择皮肤科门诊确诊的多发性扁平疣患儿60例,随机分为治疗组和对照组,每组各30例。其中治疗组采用自拟方中药煎煮后倒入智能型中药熏蒸自控治疗仪。每天治疗1次,每次熏蒸时间约为20min,2周为1个疗程,连续治疗3个疗程,观察治疗疗效。对照组采用0.05%维A酸软膏,每晚涂抹1次,观察时间与治疗组一致。结果:治疗组痊愈4例,显效5例,有效14例,无效7例,总有效率为76.7%。对照组痊愈0例,显效2例,有效7例,无效21例,总有效率30%,两组有效率比较,差异具有统计学意义(P0.01)。结论:中药局部熏蒸治疗儿童多发性扁平疣安全有效,值得推广。     

复方倍他米松注射联合甘草锌颗粒口服治疗中重度斑秃疗效分析

目的:探究复方倍他米松联合甘草锌颗粒治疗中重度斑秃的临床疗效。方法:选取2016年4月-2018年2月笔者医院收治的80例斑秃患者,随机分为观察组(n=40)与对照组(n=40),按照斑秃严重程度将观察组分为中度组(n=22)及重度组(n=18),观察组给予复方倍他米松局部注射与甘草锌颗粒口服联合治疗;对照组仅给予复方倍他米松局部注射治疗。以3周为1个疗程,连续治疗3个疗程,观察治疗1、2、3个疗程后两组患者的临床疗效、不良反应发生率及复发率。结果:治疗3个疗程后,观察组总有效率42.50%,明显高于对照组的20.00%(P<0.05);观察组总有效率42.50%明显高于本组治疗1个疗程后15.00%(P<0.05),其中中度组总有效率59.09%,高于本组治疗1个疗程(22.72%)及2个疗程后的有效率(27.27%)(P<0.05);中度组总有效率59.09%,高于重度组22.22%(P<0.05);中度组转阴率68.18%明显高于重度组44.44%(P<0.05)。治疗1、2、3个疗程后观察组总不良反应发生率7.50%、17.50%、25.00%,与对照组12.50%、15.00%、22.50%比较,均无显著性差异(P>0.05)。治疗结束后6个月,观察组复发率17.50%与对照组32.50%比较,无显著性差异(P>0.05)。结论:对中、重度斑秃患者采用复方倍他米松注射法联合甘草锌颗粒口服治疗,具有较好的临床治疗效果,尤其对中度斑秃患者治疗有效率高。     

光疗法与免疫调节在白癜风治疗中的应用效果

比较光疗法与免疫调节在白癜风治疗中的应用效果。方法 选取寿光市皮肤病防治站 2021年10月-2023年10月收治的130例白癜风患者为研究对象,采用随机数字表法均分为对照组与观察 组,每组65例。对照组采用免疫调节治疗,观察组采用光疗法治疗,比较两组临床疗效及不良反应发 生情况。结果 观察组治疗总有效率为95.38%,高于对照组的86.15%,差异有统计学意义（P＜0.05）;观 察组不良反应发生率低于对照组,差异有统计学意义（P＜0.05）。结论 光疗法和免疫调节治疗白癜风均 可达到治疗目的,但光疗法效果更佳,且不良反应发生风险较低,值得临床应用。     

UVA1 phototherapy in the treatment of palmoplantar pustulosis: a pilot prospective study

Palmoplantar pustulosis (PPP) is recalcitrant to traditional topical and systemic therapies. Ultraviolet A1 (UVA1) phototherapy, a new therapeutic approach, has recently been shown good efficacy in the treatment of PPP. The purpose of this study was to evaluate the efficacy and safety of UVA1 therapy for the treatment of PPP. Patients with PPP were treated with UVA1 irradiation three times a week for up to 30 sessions and had a 3-month follow-up visit. UVA1 therapy was conducted with a fixed dose (80 J/cm²). Clinical evaluation was based on the Palmoplantar Pustular Psoriasis Area and Severity Index (PPPASI) score. Totally, 62 patients completed the study. The mean PPPASI score decreased from a baseline value of 9.4?±?2.8 to a value of 4.9?±?2.4 at 15 sessions, 1.7?±?1.9 at 30 sessions, and 2.0?±?2.1 at follow-up visit. A reduction of 75 % in the PPPASI score was observed in 4 (6.5 %) patients at 15 sessions and 45 (72.6 %) patients at 30 sessions. The adverse effects were limited including burning sensation, pruritus, and hyperpigmentation. UVA1 is an effective therapy for PPP with mild side effects.     

Depigmentation with Q-switched Nd:YAG laser in universal vitiligo: a long-term follow-up study of 4 years

Q-switched (QS) lasers are used for depigmentation in universal vitiligo, but there is limited data on long-term results after laser treatment. This study was conducted to assess the safety and long-term follow-up results of QS Nd:YAG laser treatment in combination with need-based topical depigmentation therapy for universal vitiligo. A retrospective study was performed on patients with universal vitiligo who had received QS Nd:YAG laser treatment from 2010 to 2013. All patients were contacted and called for follow-up. Patients who reported were assessed clinically and information regarding adverse effects and relapse (repigmentation) in the follow-up period were obtained. Any need for topical depigmenting creams or other interventions and overall satisfaction to treatment were also documented. Records of 34 patients were retrieved, out of whom 28 cases reported for the follow-up visit. Duration of follow-up ranged from 2 to 5 years (mean, 2.78). No long-term adverse effects were reported and the majority of patients were highly satisfied with treatment. Satisfactory results with >90% clearance of pigment was reported by 89.3% (25/28) of patients, out of whom 72% (18/25) had retained the therapeutic effect with the use of sunscreens with/without intermittent topical depigmentation therapies. In seven cases, partial to complete relapse was observed. QS Nd:YAG laser is an effective tool for treating residual pigmentation in universal vitiligo, and the therapeutic effect can be maintained in most cases with regular sunscreen use and need-based topical therapies.     

窄谱中波紫外线联合他克莫司治疗颜面白癜风疗效观察

目的：评价窄谱中波紫外线联合0．03％他克莫司软膏治疗稳定期颜面白癜风的疗效和安全性。方法：采用随机对照方法,将77例稳定期白癜风患者颜面病损部位分为三组：A组：23例,窄谱中波紫外线照射,隔日一次;B组：20例,局部外用0．03％他克莫司软膏,每天2次;C组：34例,两者联合治疗。疗程均3个月。结果：C组显效率和有效率均好于A组和B组,各时间段A组和B组之间显效率和有效率均无统计学意义（P〉0．05）。其中19例患者出现一过性皮肤刺激症状等副作用,均可耐受并不影响继续治疗。A、B、C组不良反应发生率分别为26．1％、25．0％和23．5％,各组间均无统计学意义（P〉0．05）。结论：窄谱中波紫外线照射联合局部外用0．03％他克莫司软膏治疗颜面稳定期白癜风安全性高、疗程短且效果好。     

激光联合吡美莫司乳膏及他克莫司软膏治疗白癜风的临床效果

分析激光与吡美莫司乳膏及他克莫司软膏联合治疗白癜风的临床效果。方法 选取北京京城 皮肤医院皮肤科2022年6月-12月收治的82例白癜风患者为研究对象,采用随机数字表法分为常规组和联 合组,各41例。常规组予以激光治疗,联合组在激光治疗基础上应用吡美莫司乳膏及他克莫司软膏联合 治疗,比较两组临床疗效、免疫功能、症状改善情况及不良反应发生情况。结果 联合组治疗总有效率 为97.56%,高于常规组的82.93%,差异有统计学意义（P ＜0.05）;联合组治疗后IgA、IgM及IgG水平高 于常规组,差异有统计学意义（P ＜0.05）;联合组治疗后白斑数量少于常规组,白斑面积小于常规组, 差异有统计学意义（P ＜0.05）;联合组不良反应发生率为7.32%,低于常规组的29.27%,差异有统计学 意义（P＜0.05）。结论 激光与吡美莫司乳膏及他克莫司软膏联合治疗白癜风可提高治疗效果,提升机体 免疫功能,减少白斑个数和白斑面积,降低不良反应发生几率,值得临床应用。     

CO2点阵激光联合外用药物治疗白癜风疗效分析

目的:探究CO2点阵激光联合外用药物综合治疗白癜风的临床疗效。方法:选择笔者医院收治的白癜风患者90例,根据随机数字法将其分为两组。观察组:45例,采用CO2点阵激光+卤米松软膏+他克莫司软膏治疗;对照组:45例,采用卤米松软膏+他克莫司软膏治疗,比较两组的治疗效果、不良反应发生情况、治疗后及随访的QOL和满意度评分,观察两组治疗前后的抗酪氨酸酶IgG抗体(TYRsIgG)、抗酪氨酸酶IgM抗体(TYRsIgM)的滴度(A值)及人可溶性细胞间粘附分子1(sICAM-1)水平。结果:观察组治疗总有效率88.89%,明显高于对照组的68.89%(P<0.05)。观察组治疗结束后1周、1个月、3个月的QOL及满意度评分均高于对照组(P<0.05)。治疗后一个月后,观察组的IgG、IgM抗体滴度及sICAM-1水平明显低于对照组(P<0.05)。观察组的不良反应发生率6.67%,与对照组的4.44%比较,无显著性差异(P>0.05)。结论:CO2点阵激光联合外用药物综合治疗白癜风,疗效显著,不良反应较少,提高了患者满意度。     

Efficacy assessment of UVA1 and narrowband UVB for treatment of scalp psoriasis

To compare the efficacy and safety of UVA1 and narrowband UVB (NB-UVB) therapy in the treatment of scalp psoriasis. Patients with scalp psoriasis were randomly assigned to either UVA1 or NB-UVB therapy. Both treatments were performed three times weekly for 6 weeks. Clinical efficacy was evaluated by using Psoriasis Scalp Severity Index (PSSI), and patient-reported quality of life (QoL) was assessed by Dermatology Life Quality Index (DLQI). Totally 68 patients completed the study. Both UVA1 and NB-UVB phototherapy achieved a statistically significant reduction of PSSI and DLQI scores at the end of the treatment period. Compared with the NB-UVB group, the significantly greater improvements occurred in UVA1 treatment group at week 3, although differences declined thereafter through week 10. Both UVA1 and NB-UVB therapy were well-tolerated in this study, and the occurrence of adverse events (AEs) was uncommon. Both UVA1 and NB-UVB phototherapy could offer relief of scalp symptoms in patients with scalp involvement. Furthermore, UVA1 treatment could improve the clinical manifestations and QoL more quickly than NB-UVB therapy.     

Effectiveness of a 308-nm excimer laser in treatment of vitiligo: a review

Vitiligo is a relatively common acquired disorder, characterized by progressive loss of melanocytes from the epidermis and the epidermal appendages. The disease is associated with considerable morbidity because of a major impact on the quality of life. The treatment for vitiligo is generally unsatisfactory and challenging. There are a variety of therapeutic possibilities including topical corticosteroids, topical calcineurin inhibitors, as well as phototherapy with Psoralen plus UVA (PUVA), narrow-band UVB, and a 308-nm excimer laser and/or lamps. Furthermore, surgical methods encompass grafting and transplantation while depigmentation treatments and psychological support may also be considered. The objective is to assess the effect of the 380-nm excimer laser in the treatment of vitiligo based on the available studies and case series. We searched the relevant literature about vitiligo and excimer laser published between 1990 and 2012 using the MEDLINE database. We reviewed all relevant articles about 308-nm excimer laser and light sources assessing their efficacy in the management of vitiligo as well as their side effects. The value of combination treatment methods was also analyzed. The available studies provide strong evidence that the excimer laser represents the most effective approach to treat vitiligo compared to ordinary phototherapy. Excimer laser is relatively safe and effective for localized disease. UV-sensitive areas respond best as well as a short duration of the disease. More frequent treatments achieve better results. Compared to other treatment modalities, the excimer laser most likely constitutes the treatment of choice for localized vitiligo. Its efficacy can be further improved in combination with other therapies such as corticosteroids, pimecrolimus, or tacrolimus.     

先天性白癜风73例临床特征分析与治疗总结

目的:总结分析先天性白癜风患者的临床特点及治疗方法,比较先天性白癜风与儿童白癜风的异同点。方法:对本院2000年1月～2011年12月诊治的73例先天性白癜风患者的临床资料进行回顾性分析。结果:73例先天性白癜风患者男女比例为0.92∶1。神经节段型占15.1%,病情处于进展期者占56.2%,伴发晕痣者3例,有阳性家族史者占21.9%,治疗后好转或稳定者占86.7%。结论:①白癜风并非完全后天发病,出生时即可发生;②日晒可能是一种诱发加重因素;③有阳性家族史者符合多基因遗传规律;④联合治疗有较好的效果。