白癜风的焦油疗法

五例局部涂焦油治疗的白癜风患者,其结果均产生了有美容学意义的色素再生。全部为30岁以内的患者,其白斑面积都未超过总面积的30%。绝大多数治疗的部位是非暴露区。配方:每毫升聚山梨酸(Polysorbate)混合液中含粗制煤焦油300毫克。大约每周由医生亲自在白斑上涂药一次,至少保持2小时后洗去。作为对照的另一例的白斑上不涂     

B_(663)治愈B型麻风伴白癜风一例

李×,女,64岁,1987年3月诊断为BB型麻风。按多菌型化疗方案治疗。患者同时患白癜风半年余,入院时左额部有3×4cm椭圆形脱色斑,周围绕以卫星状脱色斑点,双臂及腰腹部散在白斑数处。白斑处组织活检,未发现麻风性改变,基底色素细胞减少。入院后对白癜风未治疗。用麻风三联疗法一个月,皮肤着色呈棕红色,白斑中间未着色而边缘色素沉着较其他处更深,呈典型的白癜风静止期损害;服药三个月,白斑中间出现岛状色素沉着点,并缓慢扩大、融合,小白斑逐渐减少;治疗八个月时,白癜风皮损全部消退,原白斑处的皮色与周围皮肤一致,未留任何痕迹。经两年联合化疗,皮肤查菌BI从3.1降到2.0,停药后持续下降,两年后阴转,再次活检符合麻风治愈。     

白癜风患者血浆和皮肤组织液内皮素1的测定

目的了解白癜风患者血浆和皮肤组织液内皮素1(ET-1)水平,并讨论其临床意义。方法采用放射免疫方法对30例白癜风患者和12例健康体检者血浆中ET-1水平进行测定,以及对20例稳定期白癜风白斑部位和对侧部位非白斑的皮肤组织液中ET-1水平进行测定。结果患者白斑部位皮肤组织液ET-1值明显低于非白斑部位(P<0.01);白癜风患者血浆ET-1水平与正常人群差异无显著性(P>0.05)。结论在白癜风色素恢复过程中不仅受黑素细胞存在与否的影响,还与邻近角质形成细胞ET-1分泌功能异常有关。     

白癜风合并特发性点状色素减少症2例

报告2例白癜风合并特发性点状色素减少症。患者均为老年男性,白癜风病程分别为1个月和9年,特发性点状色素减少症的病程分别为5年和20年。检查可见在白癜风的白斑区中有点状瓷白色的白斑。本文对两种色素减退性皮肤病发生于同一患者的现象进行了讨论。     

色素障碍性皮肤病

20 0 32 80 4　白癜风患者血浆和皮肤组织液内皮素1的测定 /管晓春 (武汉市一院皮肤科 )…∥中国中西医结合皮肤性病学杂志 .- 2 0 0 3,2 ( 1) .- 2 7～2 8采用放射免疫法 ,共测定 30例白癜风患者和12例健康体检者。结果 ,进行期白癜风患者血浆内皮素 1( ET - 1)与正常对照组差异无显著性 ;稳定期患者白斑部位组织细胞液 ET - 1明显低于非白斑部。提示白癜风患者白斑部位不仅缺乏黑素细胞 ,还存在角质形成细胞功能异常 ,在白癜风色素恢复过程中不仅受黑素细胞存在与否的影响 ,还与邻近角质形成细胞 ET - 1分泌功能异常有关。表 2参 5　 (…     

白癜风的改进局部疗法

手背、踝部、足和指端的白癜风损害最为顽固难治,常用口服和局部联合疗法,局部疗法常加用日光或人工紫外线照射。El Mofti 认为联合疗法可使色素形成加速。作者报告9例一般疗法无效的白癜风加用0.5％Psoralen 10％尿素霜获得满意效果。另有4例胸、腹、股、面部的损害用0.25％Methoxypsoralen10％尿素霜治疗很快有色素点形成。     

乙酰胆碱对黑色素细胞的活性有调节作用

在白癜风的白斑皮肤中乙酰胆碱脂酶(acetylcholin esterase,AChE)的活性是低的。作者对52例白癜风患者的色素再生处和色素消失处进行了AChE活性的研究。发现色素消失边缘的树枝状色素细胞AChE活性为阴性,而色素再生处者则为阳性。无树枝状边缘性色素细胞的表现无     

遮盖疗法及其在白癜风治疗中的应用

遮盖疗法是用各种防水、不透明、能提供有效而自然掩盖作用的产品来遮盖皮肤瑕疵.白癜风遮盖剂起效快,能显著提高患者的生活质量.常见遮盖剂可分为物理性遮盖剂和化学性遮盖剂两类,物理性遮盖剂主要为各种含色素颗粒的成分均匀覆盖于白斑上起到掩盖作用,化学性遮盖剂有二羟基丙酮、植物提取液等,主要通过与表皮发生化学反应起效.制剂工业的发展使得白癜风遮盖剂能防水耐磨.     

白癜风免疫发病机制研究进展

白癜风是一种以局部表皮黑素细胞减少,形成白斑为特征的后天性色素减退性皮肤病.其发病机制现尚未阐明,遗传及免疫因素在发病中起重要作用.目前支持白癜风是自身免疫性疾病的证据:发现了与免疫功能或自身免疫性疾病密切相关的易感基因和候选基因,如SLEV1、AIS1、HLA等基因;体液免疫和细胞免疫机制均参与了白癜风发病;白癜风患者常合并其他自身免疫性疾病;临床上使用免疫调节疗法治疗白癜风取得了较好的疗效.     

遮盖疗法及其在白癜风治疗中的应用

遮盖疗法是用各种防水、不透明、能提供有效而自然掩盖作用的产品来遮盖皮肤瑕疵.白癜风遮盖剂起效快,能显著提高患者的生活质量.常见遮盖剂可分为物理性遮盖剂和化学性遮盖剂两类,物理性遮盖剂主要为各种含色素颗粒的成分均匀覆盖于白斑上起到掩盖作用,化学性遮盖剂有二羟基丙酮、植物提取液等,主要通过与表皮发生化学反应起效.制剂工业的发展使得白癜风遮盖剂能防水耐磨.     

Vitiligo following intense pulsed light treatment

Vitiligo is an acquired depigmenting disorder characterized by the progressive loss of melanocytes from the epidermis and epidermal appendages, which results in milky‐white macular lesions. Various factors are suspected to affect the induction and progression of vitiligo such as emotional shock, sunburn, pregnancy, physical illness and trauma. The intense pulsed light (IPL) device which mostly affects redness and dyspigmentation has a broad spectrum of emissions of white light with wavelengths between approximately 515 and 1200 nm. Adverse effects such as purpura and pigmentary changes are known to be rare. We present a 41‐year‐old woman who developed multiple round, hypopigmented macules on both the cheek and mandibular area following the treatment with IPL for lentigines and dyspigmentation. Based on biopsy and Wood’s lamp examination, diagnosis as vitiligo was made. She was treated with a 308‐nm excimer laser. After 3 months of treatment, almost complete repigmentation was seen but another coin‐sized hypopigmented patch was noted after 5 months later. Herein, we report a case of vitiligo which developed after IPL treatment. This is the first case to be reported which vitiligo developed after IPL treatment. Therefore, dermatologists should be aware of unsighted vitiligo lesion before IPL treatment.     

NB-UVB治疗儿童白癜风诱发脂溢性角化病一例

UVB治疗白癜风的不良反应主要有局部出现轻度瘙痒、红斑、光毒反应,儿童白癜风在接受NB-UVB治疗后,皮损区域出现脂溢性角化样的改变既往尚未报道。本文报道一例13岁右下肢屈侧白癜风女性患者,予31次NB-UVB照射治疗后局部出现褐色斑丘疹,组织病理学特点符合脂溢性角化病改变。     

Possible mechanisms in the induction of vitiligo-like hypopigmentation by topical imiquimod

The pathogenesis of vitiligo was examined for clues to the pigmentary changes that may occur after treatment with topical imiquimod. The literature varies on the pigmentary changes induced by topical use of imiquimod. The US Food and Drugs Administration lists 68 reports of pigmentary changes out of a total of 1257 reports related to imiquimod lodged from 1997 to 2003. Some studies describe vitiligo-like hypopigmentation associated with imiquimod treatment of genital warts (as with the patient described in this report), molluscum contagiosum, basal cell carcinoma, extramammary Paget's disease and murine melanoma. Other studies report hyperpigmentation associated with imiquimod. The possible mechanisms of hypopigmentation associated with imiquimod treatment are discussed, including antibodies found in sera of patients with vitiligo to nonpigment cell antigens, cytoplasmic pigment cell antigens and pigment cell-surface antigens; stimulation by imiquimod of both the innate immune response and cell-mediated adaptive immunity; and increased sensitivity of melanocytes to oxidative stress. The vitiligo-like hypopigmentation following topical imiquimod treatment is in line with the mode of action of this drug.     

Sulfasalazine‐induced generalized vitiligo in a patient with dermatitis herpetiformis and celiac disease

Vitiligo is an acquired idiopathic pigmentary skin disorder characterized by the development of white macules and patches due to the loss of functioning melanocytes. In this report, we describe a case of a patient with a longstanding history of dermatitis herpetiformis (DH) and celiac disease that developed rapidly progressing, biopsy‐confirmed generalized vitiligo after 11 months of treatment with anti‐inflammatory medication sulfasalazine, prescribed for the patient's DH. To the best of our knowledge, this is the first case report which has demonstrated the possible biochemical pathways, triggered by sulfasalazine, in the development of vitiligo.     

International Initiative for Outcomes (INFO) for vitiligo: workshops with patients with vitiligo on repigmentation

In order to develop and test a treatment, researchers measure an ‘outcome’. For example the ‘outcome’ might include a measure of how fast a white patch gets its color back (repigmentation) in vitiligo. Vitiligo is a skin condition, which causes white patches of the skin and sometimes hair. Currently, there is no cure nor firm clinical recommendations for the treatment of vitiligo. One of the main reasons behind this is that different studies measure different outcomes; therefore the studies can't be combined and compared. Recently, the International INitiative for Outcomes for vitiligo (INFO for vitiligo), which includes patients, their caregivers, medical journal editors and doctors from over 24 countries worldwide, have come to an agreement over a set of outcomes for vitiligo, which should be measured in every trial: repigmentation of skin lesions, side effects/harms of treatment and how long the colour stays after repigmentation of vitiligo lesions has occurred. Still, there was no agreement amongst patients and clinicians on which scale (outcome measure) should be used to measure repigmentation. This means that even if all the future trials measure repigmentation, but use different scales to do so, study results still can't be combined and compared. This international study was conducted with an aim to define successful repigmentation from patients’ point of view and propose how and when repigmentation should be evaluated in clinical trials in vitiligo. The authors conducted 3 workshops with vitiligo patients and their parents/care givers in the U.S.A. 73 participants were recruited. “Successful repigmentation” from patients’ perspective means achieving over 80% of repigmentation in a vitiligo patch. Both percentage of repigmentation quartiles (0-25%, 26-50%, 51-79%, 80-100%) and cosmetic acceptability of the results from patients’ point of view, should be measured in every trial. In conclusion, this was the largest patients’ outcomes workshop. Unity among the researchers on using the same scales to measure repigmentation in future trials will bring richer data and therefore clearer clinical recommendations.     

先天性色素痣合并白癜风2例

报告2例白癜风合并先天性色素痣。例1的初发白斑在左上肢先天性毛痣周围，表现为晕痣，1个月后身体其他部位出现多发白斑；例2为节段型白癜风患者，除了在身体其他部位出现白斑外，在右足背先天性色素痣周围出现白斑，表现为痣周围白癜风。白癜风合并先天性色素痣这一现象值得进一步研究。     

白癜风白斑面积测量方法现状与展望

白癜风白斑面积测量在白癜风治疗的临床疗效评价中占有重要地位。当前已有的测量方法包括目测估算法、点估算法以及应用各种软件测算法,各有其优势与不足。目前认为image-pro-plus软件能较方便计算白斑面积和灰度值,较适合白癜风白斑面积与色泽的测量,数码成像结合image-pro-plus分析的方法值得进一步深入研究。本文就目前测量评价白癜风疗效的常用方法进行综述,并对数码成像结合image-pro-plus分析的方法进行展望。     

Assessment methods for the evaluation of vitiligo

There is no standardized method for assessing vitiligo. In this article, we review the literature from 1981 to 2011 on different vitiligo assessment methods. We aim to classify the techniques available for vitiligo assessment as subjective, semi‐objective or objective; microscopic or macroscopic; and as based on morphometry or colorimetry. Macroscopic morphological measurements include visual assessment, photography in natural or ultraviolet light, photography with computerized image analysis and tristimulus colorimetry or spectrophotometry. Non‐invasive micromorphological methods include confocal laser microscopy (CLM). Subjective methods include clinical evaluation by a dermatologist and a vitiligo disease activity score. Semi‐objective methods include the Vitiligo Area Scoring Index (VASI) and point‐counting methods. Objective methods include software‐based image analysis, tristimulus colorimetry, spectrophotometry and CLM. Morphometry is the measurement of the vitiliginous surface area, whereas colorimetry quantitatively analyses skin colour changes caused by erythema or pigment. Most methods involve morphometry, except for the chromameter method, which assesses colorimetry. Some image analysis software programs can assess both morphometry and colorimetry. The details of these programs (Corel Draw, Image Pro Plus, AutoCad and Photoshop) are discussed in the review. Reflectance confocal microscopy provides real‐time images and has great potential for the non‐invasive assessment of pigmentary lesions. In conclusion, there is no single best method for assessing vitiligo. This review revealed that VASI, the rule of nine and Wood’s lamp are likely to be the best techniques available for assessing the degree of pigmentary lesions and measuring the extent and progression of vitiligo in the clinic and in clinical trials.     

高频电刀在表皮移植治疗不平整部位白癜风的临床应用

目的：观察高频电刀在表皮移植治疗不平整部位白癜风的疗效。方法：采用负压吸疱和高频电刀相结合进行自体表皮移植。结果：治疗37例白癜风患，共植入皮片267区，其中治愈201区(75.28％)，显效39区(14．61％)，有效10区(3．74％)，无效17区(6．38％)，总有效率93．63％。结论：采用高频电刀去除受皮区表皮的方法更适合于非平整部位白癜风表皮移植，且简单易掌握，疗效好。     

The hair follicle melanocytes in vitiligo in relation to disease duration

Background and aims  Vitiligo is an acquired pigmentary disorder of skin and hair. Active melanocytes in hair follicles can be detected by DOPA and immunohistochemical staining, while amelanotic melanocytes can only be detected by the latter. None of the studies on hair melanocytes in vitiligo discussed the effect of disease duration on these melanocytes.
Here, we study the presence of melanotic and amelanotic melanocytes in vitiligo hair follicles and statistically correlating their presence with the disease duration.
Methods  This study was conducted on 30 patients with vitiligo and 10 normal volunteers. Three biopsies were taken from each patient: two from black and white hairs from vitiliginous areas and the third from apparently normal skin of the same patients. Sections were stained by DOPA reaction and NKI/beteb then examined for the presence of melanocytes. The presence of melanocytes and the disease duration were correlated statistically using the t -test.
Results  Active melanocytes were detected in black hairs of 6.7% of vitiligo patients and in 100% of apparently normal skin of the same patients and controls. On examining black hairs of the 28 vitiligo patients with negative DOPA reaction, 19 of them (67.9%) showed positive NKI/beteb stain. Disease duration was inversely correlated with the melanocytes' presence within hair follicles. Melanocytes were absent from 100% of white hairs.
Conclusions  The melanotic melanocytes were the first target of the disease process followed by the amelanotic melanocytes. Since the disappearance of the latter was inversely correlated with the disease duration, early treatment in vitiligo is advised.

Conflicts of interest

None declared.