NB-UVB联合他克莫司软膏治疗面部脂溢性皮炎疗效评价

目的:评价NB-UVB联合他克莫司软膏治疗面部脂溢性皮炎的疗效及安全性.方法:140例面部脂溢性皮炎患者随机分为2组,治疗组70例采用NB-UVB照射联合他克莫司软膏外用;对照组70例,外用他克莫司软膏,每日2次,治疗4周后评估疗效及不良反应.结果:治疗组的总有效率为94.29％,明显高于对照组(77.14％),差异有统计学意义(P＜0.05).两组均未见明显不良反应.结论:NB-UVB照射联合他克莫司软膏外用治疗面部脂溢性皮炎安全有效.     

强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的探讨强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎的临床疗效。方法纳入面部脂溢性皮炎患者60例,随机分为试验组和对照组。试验组予以强脉冲光联合他克莫司软膏治疗,对照组予以他克莫司软膏治疗,疗程共8周,治疗结束后评估疗效及不良反应。结果试验组临床症状改善明显优于对照组,试验组有效率更高(64.52%vs.34.48%),差异有统计学意义(P0.05)。两组均未见明显不良反应。结论强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎安全有效。     

他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎疗效观察1孙巧梅1,2,刘艳玲3

目的 评价应用他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎的临床疗效。方法 选取50例鼻周脂溢性皮炎患者,随机分为治疗组和观察组,每组各25例。治疗组:患者外涂0.03%他克莫司软膏2次/d,同时联合使用强脉冲治疗1次/2周;对照组:单独外用0.03%他克莫司软膏,2次/d。在治疗后的第2、4、6、8周各复诊1次,记录评分及不良反应。结果 治疗2周后,两组患者在症状总评分方面差异无统计学意义(P 0.05),治疗组治疗4周、6周及8周后的临床症状总评分相比对照组明显降低(P0.05)。治疗6周、8周后治疗组患者临床疗效明显优于对照组(P 0.05)。结论 采用他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎,与单独使用他克莫司软膏相比,远期效果好。     

0.03%他克莫司软膏治疗面部脂溢性皮炎临床疗效观察

目的探讨外用0.03%他克莫司软膏治疗面部脂溢性皮炎临床疗效和安全性。方法将78例患者随机分成两组,治疗组40例,外用0.03%他克莫司软膏2次/d;对照组38例,外用丁苯羟酸软膏。疗程均为4周。结果治疗组和对照组临床有效率分别为87.50%和60.53%,治疗组疗效优于对照组。治疗组7例局部出现刺激症状,均发生在用药后1周内。他克莫司组不良反应发生率高于丁苯羟酸组,但二者差异无显著性(P>0.05)。结论他克莫司软膏治疗面部脂溢性皮炎安全、有效。     

红蓝光联合他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的观察红蓝光联合0.03%他克莫司软膏治疗面部脂溢性皮炎的疗效和安全性。方法将入选的86例面部脂溢性皮炎患者随机分为两组,治疗组43例,每周光疗2次,红光与蓝光交替进行,同时给予外用0.03%他克莫司软膏,2次/d;对照组43例,仅外用0.03%他克莫司软膏,2次/d。两组均治疗4周后判定疗效,并随访2月,观察复发率。结果治疗组有效率和复发率分别为92.50%和10.71%,对照组有效率和复发率分别为73.17%和39.13%,有效率和复发率比较,差异均有显著性(P均0.05)。两组患者均未出现严重不良反应。结论红蓝光联合0.03%他克莫司软膏治疗面部脂溢性皮炎安全,有效,复发率低。     

二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎的疗效观察

目的评价二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎伴重度人体蠕形螨感染患者的临床疗效和安全性。方法用SAS 8.0软件将面部脂溢性皮炎伴重度人体蠕形螨感染患者随机分为2组,治疗组(50例)每天予2.5%二硫化硒洗剂外敷,同时外搽0.03%他克莫司软膏(2次/d),治疗2周后,仅予0.03%他克莫司软膏外搽(2次/d)继续治疗2周。对照组(50例)外搽0.03%他克莫司软膏,方法、用量和疗程均同治疗组。治疗前、后检测2组患者面部蠕形螨数量。结果治疗组和对照组临床疗效(88%和82%)的差异无统计学意义(P0.05)。治疗组蠕形螨驱除率(74%)明显高于对照组(16%),而治疗组复发率(13.64%)低于对照组(31.71%)。治疗组患者干涩、鳞屑及灼热感发生率(50%)高于对照组(24%),2组患者均未发生严重不良反应。结论二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎伴重度人体蠕形螨感染疗效肯定,能提高蠕形螨驱除率,降低脂溢性皮炎复发率,安全性较好。     

百癣夏塔热片联合他克莫司治疗面部糖皮质激素依赖性皮炎疗效观察

目的 探讨百癣夏塔热片内服联合他克莫司软膏外用治疗面部糖皮质激素依赖性皮炎的疗效和安全性.方法 将80例面部糖皮质激素依赖性皮炎患者分为百癣夏塔热片内服联合他克莫司软膏外用治疗组和单用他克莫司软膏外用对照组,4周为1个疗程,疗程结束后2周随访,观察2组的临床疗效.结果 百癣夏塔热片联合他克莫司组有效率为90％,他克莫司组有效率为84.6％,2组疗效差异无统计学意义(P＞0.05).但疗程结束时及随访时症状评分百癣夏塔热片联合他克莫司组均明显低于他克莫司组(P＜0.01).结论 百癣夏塔热片内服联合他克莫司软膏外用治疗面部糖皮质激素依赖性皮炎优于他克莫司软膏.     

他克莫司软膏联合肤痒颗粒治疗面部激素依赖性皮炎疗效观察

目的他克莫司软膏联合肤痒颗粒治疗面部激素依赖性皮炎的疗效。方法 85例患者随机分成两组,治疗组外用他克莫司软膏,每日2次,口服肤痒颗粒每次12 g,每天3次;对照组外用维生素E乳膏,每日2次。结果治疗组的有效率达88.88%,对照组为52.5%,2组比较差异有统计学意义(P0.05)。结论他克莫司软膏联合肤痒颗粒治疗面部激素依赖性皮炎优于对照组,是一种可选用于治疗面部激素依赖性皮炎的方法。     

0.1％他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的：观察0.1%他克莫司软膏治疗面部脂溢性皮炎的疗效和安全性。方法44例面部脂溢性皮炎患者外用0.1%他克莫司软膏,每日2次,治疗4周后改为每周2次给药,于治疗后第4周和第8周复诊,观察疗效和不良反应。结果0.1%他克莫司软膏治疗第4周和第8周皮损平均积分与治疗前相比均明显下降（P＜0.05）,第4周和第8周皮损积分下降相比差异无统计学意义（P＞0.05）。结论他克莫司软膏治疗面部脂溢性皮炎疗效显著,不良反应少,每周2次给药维持治疗可以有效防止皮损复发。     

0.1%他克莫司乳膏联合复妍柔润修复霜治疗脂溢性皮炎疗效观察

目的观察0.1%他克莫司乳膏联合复妍柔润修护霜外用治疗脂溢性皮炎的临床疗效。方法 78例面部脂益性皮炎患者随机分为两组,治疗组每日外用0.1%他克莫司乳膏和复妍柔润修护霜;对照组每日仅用0.1%他克莫司乳膏,治疗6周后评判临床疗效。结果治疗组痊愈率81.58%,有效率94.74%;对照组痊愈率43.59%,有效率74.36%。两组痊愈率及有效率比较差异均有统计学意义(P0.01);两组患者均无明显不良反应。结论 0.1%他克莫司乳膏联合复妍柔润修护霜外用治疗用于脂溢性皮炎疗效显著。     

Occupational allergic contact dermatitis caused by decorative plants

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients: chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria ), Liliaceae (4 patients; tulip, hyacinth). Amaryllidaceae (2 patients: narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterepene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.     

Deutliche Einschränkung der Lebensqualität bei Patienten mit Pemphigus vulgaris: Ergebnisse der deutschen Bullous Skin Disease (BSD)‐Studiengruppe

Background: Pemphigus vulgaris is a potentially life‐threatening autoimmune disorder of the skin and mucous membranes characterized by antibodies against epidermal adhesion molecules. Clinically characteristic are painful chronic blisters or erosions of mucous membranes and skin. There are no published studies on the impact o this disease on quality of life. Patients and methods: This registration was performed within the scope of the German BSD (Bullous Skin Disease) study group, from November 1997 until January 2002. A total of 36 patients with the first diagnosis of pemphigus vulgaris were registered at the university hospitals of Dresden, Erlangen, Kiel, Mannheim, München and Würzburg. Thirty of the 36 (83 %) patients participated in the quality of life questionnaire utilizing the German version of ‘Dermatology Life Quality Index’ (DLQI) provided by A. Y. Finlay. The DLQI varies from 0 to 30 with an increased DLQI score indicating a decrease in quality of quality. Results: The overall DLQI total score of 10 ± 6,7 in the investigated pemphigus patients was significantly increased in comparison to other skin diseases. Conclusions: These results suggest that the DLQI can be a very useful additional outcome criteria for clinical studies with pemphigus vulgaris and in the treatment of these patients.     

Metástasis cutáneas de tumores sólidos. Estudio descriptivo retrospectivo

Introduction

Cutaneous metastases are a rare event compared with other metastases. Their incidence is estimated between 0.7% and 9% of patients with cancer. Their presence always indicates a disseminated malignant disease and could also be the first manifestation of a tumor, appearing simultaneously or after a diagnosis of cancer.

Objectives

To describe the epidemiological and clinical characteristics of cutaneous metastases in our hospital.

Material and method

We performed an observational retrospective study. We included all patients with cutaneous metastases diagnosed in the Dermatology Service of our hospital during a 7-year period. Patients with metastases from sarcomas, melanomas and hematologic malignances were excluded.

Results

We studied 102 patients with cutaneous metastases. The primary tumor was identified in 87 patients (85%). The most frequent tumors were breast cancer in women (48%) and lung cancer in men (11%). Cutaneous metastases were the first sign of malignancy in 12 patients (11%). The predominant clinical form was the nodular form. The most common localization of the metastases was the thoracic region. The most common histologic diagnosis was adenocarcinoma. The mean survival after the development of metastases was 22.1 months.

Conclusion

There is an association between the frequency of cutaneous metastases and the most frequent malignancies in each sex.Our results were similar to those of other studies regarding age, sex distribution, the predominant clinical form, location, and histological diagnosis of cutaneous metastases.     

Mutations in mevalonate pathway genes in patients with familial or sporadic porokeratosis

Porokeratosis comprises heterogeneous keratinization disorders that are characterized by one or more atrophic patches surrounded by a ridge‐like cornoid lamella. In this study, we evaluated seven families affected by porokeratosis and five sporadic patients of the disease in a Chinese population. We performed Sanger sequencing of exons and flanking intron–exon boundaries of mevalonate pathway genes (MVD, MVK, PMVK and FDPS) and of SLC17A9. In five familial and three sporadic patients, we detected six variations, including four novel mutations (MVD c.1A>G; p.Met1?, c.916G>A; p.Ala306Thr, c.1013+1G>A, and PMVK c.65A>G; p.Lys22Arg) and two recurrent mutations (MVD c.746T>C; p.Phe249Ser, and MVK c.1028T>C; p.Leu343Pro). We then applied I‐TASSER and iGEMDOCK to assess these variants for probable functional impacts. The findings of this study extend the mutation spectrum of porokeratosis and provide further evidence for the genetic basis of this disease.     

[Translated article] Pruritus in Dermatology: Part 1—General Concepts and Pruritogens

Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify or confirm the cause. Translational medicine has led to the discovery of new mediators of itch, or pruritogens, as well as new receptors. Knowing how to properly recognize the main pathway that mediates itch in each patient is the key to successful treatment. Although the histaminergic pathway predominates in conditions like urticaria or drug-induced pruritus, it is the nonhistaminergic pathway that predominates in nearly all other skin diseases covered in this review. Part 1 of this 2-part review discusses the classification of pruritus, additional testing, the pathophysiology of itch and the pruritogens implicated (including cytokines and other molecules), and central sensitization to itch.     

Anästhesieverfahren in der Dermatologie

Zusammenfassung Die Verfahren der Lokalanästhesie sind integraler Bestandteil der operativen Dermatologie. Sie gewährleisten eine effiziente und sichere Analgesie in umschriebenen Haut- und Weichteilregionen und ermöglichen, einen sonst schmerzhaften diagnostischen oder therapeutischen Eingriff bei erhaltenem Bewusstsein zu tolerieren. Einzelne Methoden der Applikation sind "konkurrenzlos", wie die topische Applikation von EMLA^® oder die Kryoanästhesie, andere bieten alternative Optionen zur Allgemeinanästhesie. Die Tumeszenzlokalanästhesie wurde—jenseits der kosmetischen Liposuktion—zu einer effizienten Anästhesieform für größere Operationen bei Tumoren der Haut, plastische Rekonstruktionen und in der Phlebochirurgie weiterentwickelt. Die Wahl des Verfahrens im Einzelfall wird vom Alter, der Kooperationsfähigkeit und der Komorbidität des Patienten bestimmt. Für Infiltrationsanästhesien werden heute vorwiegend Lokalanästhetika vom Amidtyp eingesetzt. Fundierte Kenntnisse über die Anatomie der sensiblen Nerven sind Voraussetzung für erfolgreiche operationsfeldnahe periphere Blockaden. Wenn die Wirkungsweise der Lokalanästhetika, ihre toxischen Effekte und potenzielle Arzneimittelinteraktionen bei ihrem Metabolismus in der Praxis beachtet werden, dann ist das Risiko von Komplikationen relativ gering. Es sollte dennoch nicht unterschätzt, und adäquate Notfallmaßnahmen im Operationsteam sollten regelmäßig trainiert werden.     

Skin microbiome and acne vulgaris: Staphylococcus,a new actor in acne

Propionibacterium acnes (P. acnes), the sebaceous gland and follicular keratinocytes are considered the three actors involved in the development of acne. This exploratory study investigated the characteristics of the skin microbiota in subjects with acne and determined microbiota changes after 28 days of application of erythromycin 4% or a dermocosmetic. Skin microbiota were collected under axenic conditions from comedones, papulo‐pustular lesions and non‐lesional skin areas from subjects with mild to moderate acne according to the GEA grading using swabs. Samples were characterized using a high‐throughput sequencing approach that targets a portion of the bacterial 16S rRNA gene. Overall, microbiota samples from 26 subjects showed an overabundance of Proteobacteria and Firmicutes and an under‐representation of Actinobacteria. Staphylococci were more abundant on the surface of comedones, papules and pustules (P=.004 and P=.003 respectively) than on non‐lesional skin. Their proportions increased significantly with acne severity (P<.05 between GEA‐2 and GEA‐3). Propionibacteria represented less than 2% of the bacteria on the skin surface. At Day 28, only the number of Actinobacteria had decreased with erythromycin while the dermocosmetic decreased also the number of Staphylococci. A significant reduction (P<.05) from Day 0 of comedones, papules and pustules with no significant difference between the products was observed. The bacterial diversity on all sampling areas was similar. The dermocosmetic decreased the number of Actinobacteria and Staphylococcus spp. after 28 days. Staphylococcus remained the predominant genus of the superficial skin microbiota. No significant reduction in Staphylococcus spp. was observed with the topical antibiotic.