反射式共聚焦显微镜监测玫瑰痤疮治疗前后毛囊蠕形螨数量变化

目的：利用反射式共聚焦显微镜（RCM）观察玫瑰痤疮患者治疗前后毛囊蠕形螨数量的变化。方法：收集我科50例玫瑰痤疮患者,治疗前后分别用RCM对其面部特定部位进行毛囊蠕形螨的检测。结果：50例患者均检出毛囊蠕形螨,5 mm×5 mm扫描面积下,治疗前后毛囊蠕形螨总数分别为91.60±25.57和42.95±10.20,受累毛囊数量分别为33.38±8.10和21.05±4.98,差异均具有统计学意义（均P<0.05）。结论：随着治疗及临床症状的改善,玫瑰痤疮患者毛囊蠕形螨感染数量下降。     

面部蠕形螨感染6例临床分析

目的 解析面部皮损、蠕形螨感染虫荷与杀螨治疗效果三者间的关系，探讨蠕形螨病的诊治依据，减少临床误诊和漏诊。方法 对2009年1月-2021年12月前来西安交通大学医学节肢动物研究室进行咨询的6例蠕形螨病患者进行临床资料回顾性分析。结果 6例患者面部均出现程度不同的潮红、瘙痒、鳞屑、红斑、丘疹、脓疱和结节等皮损症状，且在病灶部位查见大量蠕形螨，经杀螨治疗症状缓解或痊愈。结论 面部皮损伴随大量蠕形螨寄生且杀螨治疗有效是蠕形螨病诊断的重要依据。     

酒渣鼻各期患者细菌定植情况及其与蠕形螨感染的关系

目的：确定酒渣鼻患者临床各期面部皮损和非皮损处细菌定植情况及其与蠕形螨感染的关系。方法：对100例酒渣鼻患者各期的皮损和非皮损处,进行细菌培养和蠕形螨检查。结果：红斑期皮损处的细菌定植和蠕形螨感染率与非皮损处比较,差别无统计学意义（P〉0．05）：丘疹脓疱期及鼻赘期皮损处的细菌定植和蠕形螨感染率均高于非皮损处,差别有统计学意义（P〈0．05）。酒渣鼻患者细菌定植和蠕形螨感染密切相关。结论：酒渣鼻患者皮损处的细菌定植和蠕形螨感染率高于非皮损处,但它不是酒渣鼻发病的始发因素,而是作为继发因素参与和加重酒渣鼻病情。     

反射式共聚焦激光扫描显微镜检测毛囊蠕形螨感染的临床应用

目的:探讨反射式共聚焦激光扫描显微镜(RCM)在毛囊蠕形螨检测中的临床应用。方法:对临床52例酒渣鼻患者采用挤压法、标准化皮肤表层取材法(SSSB)及RCM进行毛囊蠕形螨检测,并对其阳性率、高螨密度检出率(蠕形螨≥5个/cm~2)及单位面积内毛囊蠕形螨平均密度进行对比分析。结果:挤压法、标准化皮肤表层取材法(SSSB)及RCM法的阳性率分别为69.23%、78.85%、100%。单位面积内毛囊蠕形螨平均密度分别为8.21±6.45、16.22±13.12、410.8±203.2。结论:RCM法在毛囊蠕形螨检测中是一种更为敏感、准确、简便的方法。     

面部皮脂溢出性皮炎及激素依赖性皮炎与蠕形螨的相关性

目的探讨蠕形螨感染与面部皮肤病的相关性。方法使用纯刮法检查200例面部皮肤病患者（研究组）,同时检查143例无面部皮损的其他皮肤病人（对照组）,比较两组感染情况的差异。结果200例面部皮肤病人蠕形螨感染率59．5％远高于对照组的19．58％（28／143）,（P〈0．01）。两组均显示蠕形螨感染无性别差异,随着年龄的增大,蠕形螨感染率相应增加。纯刮法检查蠕形螨感染的阳性率以颊部最高（45．5％）,其次为鼻部（26％）。结论蠕形螨感染与面部皮肤病的发生有一定关系,在面部皮肤病治疗时可配合进行抗蠕形螨的治疗。     

共聚焦激光显微镜扫描在面部毛囊蠕形螨检测中的应用

目的：评价共聚焦激光显微镜扫描（CLSM）在面部毛囊虫检测中的价值。方法：对180例拟诊为脂溢性皮炎、酒渣鼻样皮炎、痤疮等患者分别进行CLSM及蠕形螨直接镜检,比较两者阳性率的差异。结果：CLSM检测蠕形螨阳性率为68.9%,直接镜检阳性率为58.9%,差异有统计学意义（P〈0.05）。结论：CLSM蠕形螨检测阳性率高于直接镜检,且具有无创、高分辨、可多点重复操作等优势。     

毛囊蠕形螨与玫瑰痤疮

玫瑰痤疮是一种以面中部持久性红斑伴或不伴有水肿、毛细血管扩张、面部潮红等为特征的一种慢性炎症性皮肤病.毛囊蠕形螨感染是玫瑰痤疮发病的重要因素之一.该文就毛囊蠕形螨感染与玫瑰痤疮发病相关性及毛囊蠕形螨感染的治疗进行了综述.     

酒渣鼻中蠕形螨感染及皮肤生理指标测定

为了解酒渣鼻患者面部蠕形螨感染密度及其面部皮肤生理功能特点,选取酒渣鼻患者65例为实验组,对照组为60名健康志愿者.采用粉刺挤压器挤压患者和健康者前额、鼻和下颌三个部位,刮除面积为1 cm2,蠕形螨的数目取以上三个部位的平均值.酒渣鼻患者面部蠕形螨的感染密度明显高于正常对照组(P＜0.05);丘疹脓疱期和鼻赘期蠕形螨感染密度均高于红斑期(均P＜0.05);面部感染蠕形螨酒渣鼻患者面部的油脂高于未感染蠕形螨的健康对照组(P＜0.05).面部蠕形螨感染可能是酒渣鼻的致病因素之一,面部皮肤油脂分泌过多是蠕形螨感染的易感因素.     

1103例健康人群及面部皮肤疾病患者蠕形螨调查分析

目的调查健康人群和痤疮、酒渣鼻、脂溢性皮炎、类固醇皮炎等患者面部蠕形螨的检出情况,为临床治疗提供依据。方法用挤压法采集标本并镜下计数。结果95例健康成人和1008例面部疾病患者蠕形螨的总检出率分别为65.26%和77.38%;健康成人检出的蠕形螨均在50条以内;痤疮、酒渣鼻、脂溢性皮炎、类固醇皮炎患者的蠕形螨检出率分别为74.91%、91.93%、81.43%和89.58%,分别与正常对照组蠕形螨的检出率比较,差异有统计学意义(χ2=3.921P0.05,χ2=14.548P0.005,χ2=7.8655P0.01和χ2=16.189P0.005)。结论痤疮、酒渣鼻、脂溢性皮炎、类固醇皮炎患者的蠕形螨检出率高于健康成人。     

昆虫、寄生虫性皮肤病

２００００８４６蠕形螨病的流行病学现状（综述）／赵淑肖（河北医大三院）／／河北医药．－１９９９，２１（３）．－１６５ 资料分析表明，蠕形螨大多寄生于哺乳动物、人群感染者中儿童男女感染率无差别，成人男高于女，且有随年龄增长而逐渐增高的趋势。人群感染蠕形螨的种类以毛囊蠕形螨最常见，其感染途径和方式主要为直接接触，其中家庭成员密切接触是造成蠕形螨传播的主要方式，尤其是母亲传播给子女的机会较大。其感染时期主要是雌虫，人体对蠕形螨的感染不产生免疫力。（汤亚娥）２００００８４７ 复方灭螨霜的研制及其应用／杨素…     

The clinical importance of demodex folliculorum presenting with nonspecific facial signs and symptoms

Demodex folliculorum (D. folliculorum), found in the pilosebaceous unit, is the most common ectoparasite of humans. Various clinical forms such as pustular folliculitis, papulopustular scalp eruptions, perioral dermatitis, and blepharitis have been defined, although in general, the disease has been classified into three main groups as "pityriasis folliculitis", "rosacea-like demodicidosis", and granulomatous rosacea-like "demodicidosis gravis". Our aim was to test for the presence of D. folliculorum in pathogenic numbers in patients who came to our clinic with non-specific symptoms such as facial itching with or without erythema, seborrheic dermatitis-like or perioral dermatitis-like lesions, papulopustular lesions, and an acneiform clinical appearance without telengiectasia or flushing. Twenty-eight (87.5%) female and 4 male (12.5%), patients and 33 age-and-sex matched healthy subjects enrolled in this study. D. folliculorum was sought in the lesion sites using the non-invasive method known as the Standardised Skin Surface Biopsy (SSSB). The discovery of more than five parasites in an area of 1 cm2, was evaluated as pathogenic. For treatment, 5% permethrine cream was applied twice daily for 15 to 30 days. The clinical symptoms of the patients were classified into clinical groups and evaluated as facial itching in 2 (6.3%), nonspecific erythema and itching in 21 (65.6%), erythema and pityriasiform squamous lesions in 3 (9.4%), acneiform in 3 (9.4%), papulopustular lesions in 1 (3.1%), granulomatous rosacea-like in 1 (3.1%), and perioral dermatitis-like symptoms in 1 (3.3%), D. folliculorum density was determined as 5>D/cm2 in all clinical lesions. A significant clinical healing and density of D. folliculorum at <=5 D/cm2 was determined in all but two patients after treatment. We consider that D. folliculorum presentation with different symptoms and signs than classical forms is not rare. For this reason, we suggest that it is useful to test for D. folliculorum in patients with non-classical presentations like facial itching, itching accompanied by non-specific erythema, itching and non-specific pityriasiform squamous lesions, and acneiform lesions.     

多功能激光光电平台联合生长因子治疗面部皮炎和敏感性皮肤的疗效观察

目的观察多功能激光光电平台联合生长因子治疗面部皮炎及敏感性皮肤的疗效及安全性。方法对6例面部皮炎及20例敏感性皮肤患者进行多功能激光光电平台联合生长因子治疗,1次/周,治疗4次。对主观症状瘙痒、刺痛、灼热、紧绷感及客观体征红斑、丘疹、鳞屑、毛细血管扩张进行评分,检测a值、L值、皮肤厚度及密度值。结果治疗2周及4周瘙痒、刺痛、灼热、紧绷、红斑及鳞屑均有明显改善(P<0.05)。丘疹4周时改善明显(P<0.05),毛细血管扩张无明显改善(P>0.05)。治疗后皮肤红度降低(P<0.05)、亮度增加(P<0.05),皮肤厚度增加(P<0.05),密度降低(P<0.05),随治疗次数增加疗效增加。无明显不良反应。结论多功能激光光电平台联合生长因子导入治疗是一种安全有效的治疗方法。     

Facial skin complaints and work at visual display units. A histopathological study

Facial punch biopsies from 83 patients with skin complaints with or without skin lesions and supposedly associated with work at visual display units (VDUs) were compared to biopsies from 51 subjects with no VDU exposure with or without skin lesions. Coded slides were assessed by three independent observers regarding hyperplasia of sebaceous glands, occurrence of telangiectases, intensity of inflammatory infiltrate, degree of hydropic degeneration of basal cells, occurrence of demodex folliculorum, number of mast cells and degree of degenerative changes in elastic fibers. No parameter was significantly more common in exposed subjects than in non-exposed persons with equivalent skin signs. The controls without skin lesions also showed various degrees of histologic changes. Hyperplasia of sebaceous glands was more common in men and in young persons. Degenerative changes in elastic fibers increased with age, but were also obvious in some persons under 35 years of age. In this study no characteristic histologic changes in facial skin were found in individuals with skin symptoms claimed to be associated with exposure to VDUs.     

Demodex folliculorum: aetiopathogenesis and therapy of rosacea and perioral dermatitis (author's transl)

In 16 out of 18 patients with rosacea, mites of the species, Demodex folliculorum were isolated in mostly great numbers from lesions of the facial skin. In patients with perioral dermatitis, the mite was demonstrated in 17 out of 29 patients. All patients, however, including those where no mites were found, could be completely cured by nightly application of hexachlorocyclohexane 0.25% (Jacutin). The average treatment time was 7 weeks for rosacea and 5 weeks for perioral dermatitis. 2 patients with rosacea and 4 patients with perioral dermatitis relapsed, but cleared again after treatment was repeated. The initial flare-up of the dermatitis, which is observed regularly after starting the Jacutin-therapy, is described. Quantitative aspects of Demodex infestation and its histopathological alterations are discussed in relation to present-day knowledge.     

Sun exposure is an aggravating factor responsible for the recalcitrant facial erythema in adult patients with atopic dermatitis

BACKGROUND: In Japan, a considerable number of adult patients with atopic dermatitis suffer from recalcitrant facial erythema that resists common treatment with topical corticosteroids and antihistamines. OBJECTIVE: Our purpose was to investigate the potential role of sun exposure in the aggravation of these facial lesions. METHODS: The history of photoaggravation was taken from 74 adult patients with atopic dermatitis who suffered from recalcitrant facial erythema. Repeated UVB and UVA phototests were performed in 36 patients. Surface markers of infiltrating cells in UVB-provoked lesions were characterized immunohistochemically. RESULTS: Forty-one of 74 patients experienced an exacerbation of the facial lesions after sun exposure. UVB testing revealed an abnormal, papular response in 14 of 36 patients. All of the 14 patients complained of clinical aggravation after sun exposure. No abnormal reactions were observed at UVA testing. In UVB-provoked lesions, CD4+ cells were predominant to CD8+ cells. CONCLUSION: Exposure to UVB radiation may be responsible for the recalcitrant facial erythema in at least some of the patients with atopic dermatitis.     

吡美莫司联合中药当归饮子加减治疗面部激素依赖性皮炎疗效观察

目的观察1%吡美莫司联合中药当归饮子加减治疗面部激素依赖性皮炎的疗效和安全性。方法80例患者随机分为两组,治疗组41例,予1%吡美莫司乳膏外涂,口服中药当归饮子,均2次/d;对照组39例,予咪唑斯汀10mg 1次/d口服,外涂复硅霜。两组均30天为一疗程,连用2个疗程。结果治疗组有效率为87.80%,对照组为28.21%,两者比较差异有显著性(P<0.005)。以红斑、脱屑、丘疹为主要表现的患者反应良好,以毛细血管扩张和皮肤萎缩为主要表现的反应较差;红斑、脱屑、丘疹治疗后皮损积分下降明显(P<0.01);6例(14.6%)患者出现局部刺激反应,均在治疗后第1天。结论1%吡美莫司联合中药当归饮子加减对面部激素依赖性皮炎疗效好,无不良反应。     

Increased production of vascular endothelial growth factor in the lesions of atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by severe itching, erythema and edema resistant to anti-histamine therapy. Vascular endothelial growth factor (VEGF) is a potent agent that causes hyperpermeability of blood vessels and endothelial cell proliferation, and might be involved in the persisting erythema and edema in AD. In this study, we used extraction of stratum corneum with physiological saline to detect VEGF produced in the lesions of AD. Biological activity of VEGF was assayed by proliferation of cultured human umbilical vein endothelial cells in vitro. As a result, we found that the amount of VEGF produced in lesional scales was approximately 25 times higher than that in normal stratum corneum. Moreover, VEGF 121 isoform that exclusively induces hyperpermeability of blood vessels was a predominant component in the lesional scales suggesting that this factor plays an important role in the persisting erythema and edema in the AD lesions.     

Seborrheic dermatitis-like tinea faciei

We report a 10-year-old Caucasian child who had erythema and abundant scaling on the nasolabial folds, the upper lip, and on the nose. Both the abundant scaling and the localization on the central part of the face led us to suspect seborrheic dermatitis. Direct microscopic examination of some scales removed from the lesions showed septate and ramified ectothrix hyphae. Cultural examination on Sabouraud medium led to the identification of the Trichophyton mentagrophytes species. We described this patient to highlight the importance of considering tinea faciei in the differential diagnosis of all facial eruptions and the value of mycologic examination.