噻吗洛尔和卡替洛尔外用治疗婴幼儿血管瘤疗效观察

目的 评价和比较噻吗洛尔和卡替洛尔溶液外用治疗婴幼儿浅表型血管瘤的疗效.方法 163例婴幼儿浅表型血管瘤,分为噻吗洛尔组和卡替洛尔组,用0.5％马来酸噻吗洛尔滴眼液或2％盐酸卡替洛尔滴眼液滴于纱布湿敷于瘤体,每天2次,每次30分钟,治疗4个月,观察疗效及不良反应.结果 噻吗洛尔组82例,平均瘤体厚度从治疗前(2.51±1.36)mm减至(1.54±1.55)mm,疗前后比较P＜0.01.卡替洛尔组81例,瘤体厚度从(2.45±1.37)mm减至(2.00±1.41)mm,疗前后比较P＜0.05.噻吗洛尔组治疗有效率81.71％,显著高于卡替洛尔组的46.91％,两组比较P＜0.01.两组增生期瘤体治疗有效率均高于消退期(P＜0.05).结论 噻吗洛尔溶液湿敷治疗婴幼儿浅表型血管瘤方便且效果确切,增生期瘤体效果更佳.     

不同β受体阻滞剂外用联合脉冲染料激光治疗婴儿血管瘤临床疗效观察

目的 对比0.5％马来酸噻吗洛尔滴眼液和2％卡替洛尔滴眼液分别联合脉冲染料激光(595nm)治疗中低风险、浅表性婴儿血管瘤的临床疗效及安全性.方法 收集符合入组标准的患儿241例,随机分为噻吗洛尔联合激光治疗组123例,卡替洛尔联合激光治疗组118例;观察临床疗效及不良反应.结果 噻吗洛尔联合激光组患儿在治疗后1、3,...     

外用噻吗洛尔和激光治疗婴幼儿血管瘤疗效比较

目的：比较外用噻吗洛尔和激光治疗婴幼儿浅表型血管瘤的疗效。方法： 回顾性分析91例外用0.5%噻吗洛尔与85例PDL和Nd:YAG双波长激光治疗的婴幼儿浅表型血管瘤的疗效,瘤体连续2个月无继续改善停止治疗。结果： 噻吗洛尔组总有效率84.6%,激光组总有效率88.2%,差异无统计学意义（P＞0.05）。激光组平均治疗时间及瘤体消退76%～100%的时间分别为2.95±1.30和2.27±1.21个月,短于噻吗洛尔组的7.57±3.28和6.57±2.22个月,两组比较差异均有统计学意义（均P＜0.01）。结论： 两种方法治疗婴幼儿浅表型血管瘤疗效相近,激光治疗较外用噻吗洛尔控制快、疗程短。     

婴幼儿血管瘤的局部药物治疗进展

目的 婴幼儿血管瘤是婴幼儿最常见的良性软组织肿瘤。普萘洛尔治疗婴幼儿血管瘤的安全性和有效性均优于传统的糖皮质激素,但口服普萘洛尔可导致系统性并发症。局部应用β受体阻滞剂成为婴幼儿血管瘤治疗研究的新热点,如局部外用0.5%噻吗洛尔滴眼液、0.1%噻吗洛尔凝胶、普萘洛尔纳米水溶胶等。另外,局部外用5%咪喹莫特软膏、局部注射药物以及联合不同波长激光等均可作为婴幼儿血管瘤的治疗选择。本文简要综述婴幼儿血管瘤局部药物治疗方法。     

外用2%盐酸卡替洛尔和0.5%马来酸噻吗洛尔滴眼液治疗浅表性婴儿血管瘤临床观察

目的观察外用2%盐酸卡替洛尔滴眼液和0.5%马来酸噻吗洛尔滴眼液治疗中低风险、浅表性、增殖期婴儿血管瘤的疗效及安全性。方法采用随机开放平行对照试验将240例患者分为卡替洛尔组和噻吗洛尔组,最后分析201例患者的临床资料,分别对治疗后1个月、3个月和6个月时的疗效及不良反应进行组内和组间比较。结果卡替洛尔组(105例)和噻吗洛尔组(96例)治疗后1个月、3个月、6个月时的有效率分别为18.10%和22.92%、63.81%和83.33%、82.86%和91.67%,表明随着用药时间的延长,有效率逐渐增高,疗程和疗效呈正相关(P均=0.00)。两组在用药后1个月和6个月时的有效率差异无统计学意义(P均>0.05),表明两种药物的起效时间和远期疗效无明显差别。总不良反应发生率:卡替洛尔组为6.67%(7/105),噻吗洛尔组为4.17%(4/96),差异未见统计学意义(P>0.05)。湿疹和溃疡为常见局部不良反应,其中卡替洛尔组7例(湿疹5例、溃疡2例)、噻吗洛尔组4例(湿疹3例、溃疡1例)。仅噻吗洛尔组的1例患者出现一过性不完全性房室传导阻滞,两组均未出现其他系统不良反应。结论2%盐酸卡替洛尔滴眼液和0.5%马来酸噻吗洛尔滴眼液局部治疗中低风险、浅表性、增殖期婴儿血管瘤疗效肯定,随用药时间的延长,疗效增加。湿疹为局部常见不良反应,长期使用极少发生系统不良反应。两药均可作为婴儿血管瘤的治疗选择。     

普萘洛尔联合噻吗洛尔滴眼液治疗婴幼儿血管瘤

目的:评价普萘洛尔联合噻吗洛尔滴眼液治疗婴幼儿血管瘤的临床疗效和安全性。方法:血管瘤患儿130例,普萘洛尔2 mg/(kg·d),分3次口服,皮损表面外搽噻吗洛尔滴眼液适量,日4次,治疗3个月。结果:治疗8个月后随访,66例(49%)患者的瘤体缩小76%~100%,53例(42%)瘤体缩小51%~75%,10例(8%)瘤体缩小26%~50%,1例(1%)瘤体缩小25%。治疗期间无严重不良反应。结论:普萘洛尔联合噻吗洛尔滴眼液治疗婴幼儿血管瘤安全有效。     

β受体阻滞剂对体外培养血管内皮细胞增生及凋亡的影响

目的了解普萘洛尔、阿替洛尔、醋丁洛尔及噻吗洛尔对体外培养的血管内皮细胞增生及凋亡的影响。方法对人脐静脉血管内皮细胞进行体外培养,分别加入9种浓度的4种药物,设立阴性及阳性对照,采用cell counting kit-8(CCK-8)法检测细胞增生,Annexin-V FITC/PI双染法检测细胞凋亡。结果 1同一药物不同浓度之间抑制率比较:普萘洛尔和阿替洛尔结果一致,各个浓度之间抑制率P均0.05;醋丁洛尔和噻吗洛尔结果一致,3.125μmol/L与12.5μmol/L及12.5μmol/L与50μmol/L抑制率P均0.05,其余浓度间抑制率P均0.05。2同一浓度的不同药物之间抑制率比较:在200、100、50μmol/L 3种浓度时,普萘洛尔与阿替洛尔、醋丁洛尔及噻吗洛尔抑制率比较P均0.05,后3种药物抑制率比较P均0.05;在25μmol/L浓度时,普萘洛尔与醋丁洛尔抑制率比较P均0.05;其余药物抑制率比较P均0.05。在12.500、6.250、3.125、1.562 5、0.781 3μmol/L这5种浓度中,同一浓度的不同药物抑制率比较P均0.05。3对细胞凋亡的诱导:普萘洛尔、阿替洛尔与阴性对照组凋亡率比较P均0.05;阿替洛尔、普萘洛尔、醋丁洛尔和噻吗洛尔与二氯化钴组凋亡率比较P均0.05;而阿替洛尔、普萘洛尔、醋丁洛尔和噻吗洛尔4种药物凋亡率比较P均0.05。结论 4种药物均可抑制细胞增生,普萘洛尔作用最强,且随着药物浓度增加抑制作用也明显增强;4种药物均可诱导细胞凋亡,但彼此之间无明显差异。     

β受体阻滞剂治疗婴儿血管瘤中国专家共识

【摘要】 β受体阻滞剂是目前治疗婴儿血管瘤的一线药物，主要包括口服普萘洛尔和外用噻吗洛尔/卡替洛尔滴眼液。β受体阻滞剂药物选择及给药方式主要根据患儿年龄、瘤体部位、分型、分类及大小等因素综合决定。本共识对口服普萘洛尔的适应证及禁忌证、治疗起始时间及剂量、疗程与停药指征、用药期间注意事项和不良反应的监测及处理和特殊人群治疗剂量、疗程以及外用β受体阻滞剂适应证、应用具体方法等进行总结，希望为皮肤科及相关专业医生规范应用β受体阻滞剂治疗婴儿血管瘤提供参考依据。     

马来酸嘍吗洛尔局部湿敷治疗婴幼儿头皮浅表性血管瘤的临床观察北大核心CSCD

目的:观察外用0.5%马来酸廛吗洛尔滴眼液治疗婴幼儿头皮浅表性血管瘤的疗效及安全性。方法:回顾性分析206例外用0.5%马来酸廛吗洛尔滴眼液治疗头皮浅表性血管瘤患儿的临床资料,记录患者的一般资料、临床特征、位置和治疗过程。观察头皮血管瘤的分布特点,了解年龄、血管瘤厚度、疗程对疗效的影响。结果:位于头顶部的血管瘤比例最高(42.7%),其次为额部(36.4%)、颖部(14.6%),枕部的比例最低(6.3%)。治疗3月后的有效率为91.3%。治疗开始的年龄越小、血管瘤的厚度越薄、治疗疗程越长有效率越高(P<0.05)o不良反应轻微,仅有2例患儿出现局部刺激反应。结论:外用马来酸廛吗洛尔滴眼液治疗婴幼儿头皮浅表性血管瘤效果较好,不良反应轻。     

白三烯及抗白三烯药物与皮肤病相关性的研究进展

白三烯作为一种重要的炎症介质参与了多种皮肤病的发生发展,抗白三烯药物对皮肤病的治疗也有一定的疗效。本文回顾了白三烯与相关皮肤病的文献,阐述了白三烯在皮肤病发展中的作用以及抗白三烯药物在皮肤病治疗中的应用。     

A pyogenic granuloma treated with topical timolol

Pyogenic granulomas are benign vascular tumours usually surgically treated by excision or curettage. The only topical therapy reported to date is imiquimod 5% cream but it produces a marked inflammatory response with discomfort generally worse than simple surgical excision or curettage. Here we report the use of timolol 0·5% ophthalmic gel used successfully to treat a teenager with a clinically classical pyogenic granuloma on the finger. There were no reported adverse effects and the lesion completely resolved. It has not recurred after 7 months. Timolol may be an effective and preferable alternative treatment to surgery for a classical small pyogenic granuloma, particularly in children and young people.     

Topical Timolol Solution Versus Laser in Treatment of Infantile Hemangioma: A Comparative Study

Lasers, 595‐nm pulsed dye and 1,064‐nm neodymium‐doped yttrium aluminum garnet (Nd:YAG), have been used successfully for the treatment of infantile hemangiomas (IHs). Recently the use of a topical β‐blocker, specifically timolol maleate, has been promising in the treatment of IHs. The objective of this study was to compare the effectiveness of topical timolol 5 mg/mL solution with that of combined sequential dual‐wavelength laser in the treatment of IHs. Sixty children with IHs were divided randomly into two equal groups. Group 1 was treated with applications of timolol drops (5 mg/mL) twice daily. Group 2 was treated with sequential pulsed dye and Nd:Yag laser. Treatments were performed every month for a maximum of six sessions. Efficacy was evaluated clinically and by measuring the average hemoglobin level. A significant decrease in the average hemoglobin level was determined in both groups and a dramatic response was observed in superficial hemangiomas in the timolol group. The timolol group received treatment for an average of 4.0 ± 1.1 months and the laser group for 5.5 ± 0.9 months. The degree of improvement of mixed hemangiomas to laser treatment was greater than that of the timolol group. During 3 months of follow‐up, no further improvement or relapse was reported in either group. Timolol solution is a safe and effective alternative to laser treatment in superficial hemangiomas. In mixed hemangiomas, the combined sequential 595‐nm and 1,064‐nm dual‐wavelength laser provided better results than timolol solution because it penetrated deeply so that deep dermal blood vessels were reached.     

A prospective self‐controlled study of topical timolol 0.5% cream for large superficial infantile hemangiomas

Timolol has recently been reported to be an effective and safe treatment for small and superficial infantile hemangiomas (IH). However, it is controversial to choose it as an alternative to oral propranolol for large superficial IH. In this study, we generated a new modified timolol agent as the base of an ointment. To evaluate the efficacy and safety of this new agent, we recruited 20 patients with large superficial IH. The average age was 4 months old. The average area of the IH was 28.8 cm². The treatment was continued for 2–6 months. Three assessors were asked to judge the changes in both the treated and untreated parts separately by comparing photographs. After an average of 3.25 months of treatment, the average visual analog scale scores were 5.5 and 4.3 for those with and without the medication, respectively. The treated parts regressed significantly more than the untreated parts (P < 0.05). There were no side‐effects observed during treatment. High performance liquid chromatography was used to detect the serum concentration of timolol, and no timolol was detected in any of the blood samples (<0.02 μg/mL). Our new modified timolol agent is proven to be an effective therapy option for IH. Prospective studies with high‐precision serum timolol concentrations, with heart rate or blood pressure monitoring during treatment, are needed to evaluate potential systemic absorption when using timolol on large IH.     

Timolol maleate 0.5% or 0.1% gel-forming solution for infantile hemangiomas: a retrospective, multicenter, cohort study

Therapeutic options for superficial infantile hemangiomas (IH) are limited. Recently, timolol maleate gel, a topical nonselective beta-blocker, has been reported as a potentially effective treatment for superficial IH. This study is an extension of a previously published pilot study designed to further investigate the efficacy and safety and to identify predictors of good response of topical 0.5% or 0.1% timolol maleate gel-forming solution. This was a retrospective cohort study including patients enrolled from five centers. Patients were included if they were treated with timolol maleate 0.1% or 0.5% gel-forming solution and had photographic documentation of the IH and at least one follow-up visit. Patients with concomitant active treatment using other IH treatments were excluded. The primary endpoint was change in the appearance of IH as evaluated using a visual analog scale (VAS). Data from 73 subjects were available for final analysis. Timolol maleate gel-forming solution 0.5% was used in 85% (62/73) of patients, the remainder being treated with 0.1%. The median age at treatment initiation was 4.27 months (interquartile range [IQR] 2.63-7.21 mos), and patients were treated for a mean of 3.4 ± 2.7 months. All patients except one improved, with a mean improvement of 45 ± 29.5%. Predictors of better response were superficial type of hemangioma (p = 0.01), 0.5% timolol concentration (p = 0.01), and duration of use longer than 3 months (p = 0.04). Sleeping disturbance was noted in one patient. This study further demonstrates the efficacy and tolerability of topical timolol maleate and gradual improvement with longer treatment in patients with superficial IH.     

光动力疗法治疗细菌感染性皮肤病研究进展

光动力疗法是一种非侵人性治疗手段,通过光敏剂选择性聚集于靶细胞,并被相应波长光源激发,产生单线态氧和自由基等细胞毒素从而对靶细胞产生选择性杀伤作用.在近20年的皮肤科临床应用中,该技术愈加成熟与完善,不但用于治疗增生性疾病还涉及多种皮肤病的治疗,尤其是在一些细菌感染性皮肤病方面表现出较好的临床疗效.概述近年来与光动力疗法治疗细菌感染性皮肤病相关的体外实验、动物实验及临床应用的研究.     

光动力疗法在感染性皮肤病中的应用

光动力疗法是通过局部或系统给予光敏剂后以特定波长光照射从而对靶组织产生选择性杀伤作用.20世纪90年代以前光动力疗法的研究主要集巾于肿瘤的诊断和治疗,随着新光敏剂的出现和应用,光动力疗法更加广泛地应用在各种疾病的治疗中,尤其是在一些局部感染性皮肤病方面表现出较好的临床疗效,局部微生物感染的光动力治疗成为新的研究热点.     

Recent advances in chemical peeling in Japan

Chemical peeling is one of the dermatological treatments available for certain cutaneous diseases and conditions or aesthetic improvement. This treatment consists of the application of one or more chemical agents to the skin. Recently in Japan, chemical peeling has been very popular for medical as well as aesthetic treatment. Because the scientific background and an adequate approach have not been completely established, medical and social problems have been reported. To address these issues, the Japanese Dermatological Association has established standard guidelines for chemical peeling, and the scientific background and validity of chemical peeling has been assessed. In this review, a set of guidelines for chemical peeling is introduced, and we will discuss several clinical and histological studies including the effects of glycolic acid, and the application of deer peeling to skin tumors in our department.     

The cost effectiveness of larval therapy in venous ulcers

The treatment of necrotic ulcers involves considerable nursing time and expense. The current standard treatment involves repeated application of hydrogels. Larval debridement therapy (LDT) has been shown anecdotally to clear ulcers of necrotic slough but has never been compared directly with 'modern' therapies. The aim of this study has been to compare LDT with hydrogel dressings in the treatment of necrotic venous ulcers. 12 patients with sloughy venous ulcers were randomised to receive either LDT or the control therapy--a hydrogel. Effective debridement occurred with a maximum of one larval application in 6/6 patients. 4/6 patients [corrected] in the hydrogel group still required dressings at one month. The median cost of treatment of the larval group was 78.64 Pounds compared with 136.23 Pounds for the control treatment group (p < 0.05). The study confirms both the clinical efficacy and cost effectiveness of larval therapy in the debridement of sloughy venous ulcers.     

硫唑嘌呤治疗免疫相关性皮肤病专家建议

【摘要】 硫唑嘌呤系巯嘌呤的咪唑衍生物,广泛用于自身免疫性疾病的治疗。为了规范硫唑嘌呤在皮肤科的正确应用,中国医师协会皮肤科医师分会自身免疫病专业委员会相关专家在检索和研究国内外硫唑嘌呤治疗免疫相关性疾病相关文献（主要是随机对照临床试验、专家共识或专家建议）的基础上,经反复讨论,提出硫唑嘌呤在免疫性大疱性皮肤病、皮肤血管炎、系统性红斑狼疮、皮肌炎、硬皮病等免疫性皮肤病治疗中的建议,分析硫唑嘌呤与其他药物的相互作用以及使用中的注意事项。     

Transcutaneous electronic nerve stimulation in the treatment of generalized pruritus

Generalized pruritus is a notoriously troublesome condition for both patient and dermatologist. This paper describes the favourable therapeutic effect of transcutancous electrical nerve stimulation (TENS) in two elderly patients with severe chronic generalized pruritus unresponsive to other treatment. The therapeutic application of TENS to the treatment of generalized pruritus has not previously been described.