性病

950723 原位分子杂交检测尖锐湿疣组织中HPVDNA的研究/孙建方…//中华皮肤科杂志。-1994,23(4).-179～180 检测了30例尖锐湿疣组织标本,结果为表皮细胞核呈棕红色,HPV6/11型的阳性检出率为86.6％,HPV16/18型为16.6％,其中4例合并6/11型感染,HPV31/33/35为阴性,总的阳性检出率为90％。作者     

尖锐湿疣HPV导流杂交快速基因分型及临床意义

目的：探讨外生殖器及子宫颈尖锐湿疣患者皮损脱落细胞或组织中人乳头瘤病毒(Human PapillomaVirus，HPV)9种常见的基因亚型感染分布状况及临床意义。方法：采集患者生殖器或子宫颈尖锐湿疣组织或脱落细胞样本，分离DNA，PCR扩增后与9种常见HPV亚型探针进行导流快速反斑点印迹杂交检测HPVDNA。结果：经PCR扩增并通过通用探针杂交分析后，108例患者标本中，101例标本呈HPVDNA阳性，7例HPV阴性。HPVPCR阳性标本中，98例成功分型。5种高危型HPV16，18，3l，33，58的检出率分别为31．5％(34／108)、16．7％(18／108)、6．5％(7／108)，4．6％(5／108)，13．0％(14／108)。三种低危型HPV6，11，53型的检出率分别为41．7％(45／108)，56．5％(61／108)和6．5％(7／108)。危险度待定HPV亚型CP8304检出率为4．6％(5／108)。结论：结论HPV11、6、16型感染是尖锐湿疣的主要型别。     

203例女性外阴尖锐湿疣患者宫颈HPV基因型检测及分析

目的:探讨206例女性外阴尖锐湿疣(CA)患者宫颈感染人乳头瘤病毒( HPV)的基因型分布.方法:采用核酸分子快速导流杂交基因芯片技术,对203例女性外阴尖锐湿疣患者宫颈进行HPV感染分型检测.结果:在203例宫颈标本中,本芯片共能检测21种HPV亚型,本实验检测出20种,未发现HPV43型.203份宫颈组织标本中HPV阳性123例,检出率是60.59％,其中单一型别阳性率是65.04％ (80/123),多重型别阳性率是34.95％ (43/123);各型别检出率由高到低依次是HPV11 (35.77％)、6(28.45％)、16( 12.19％)、52( 12.19％)、58(8.98％)、68(8.13％)、66( 6.50％)、CP8304 (5.69％),18(4.87％)、33(4.87％)、44(4.87％)、39(3.25％).结论:根据本组病例,对于女性外阴尖锐湿疣患者,应重视宫颈HPV基因分型的检测;高危型及多重型别感染者有必要进一步检查及随访.     

尖锐湿疣HPV的分型及宫颈阴道脱落细胞和疣组织中HPV检测的比较

目的:比较阴道脱落细胞和尖锐湿疣(CA)疣组织中HPV的基因型分布和差异.方法:采用液相芯片技术对116例CA的疣组织以及48例女性患者的宫颈阴道脱落细胞进行HPV分型.结果:116例疣组织中有114例HPV阳性,阳性检出率为98.3%,其中主要的基因型是HPV6型(61.4%),HPV11型(42.9%),HPV16型(5.3%),HPV52型(4.39%),HPV18型(3.51%).宫颈阴道脱落细胞和疣组织标本中HPV亚型的阳性检出率无显著性差异(P0.05).结论:上海地区CA患者HPV感染常见的基因型是HPV6、11、16、52和18型.应用宫颈阴道脱落细胞标本可以替代疣组织对HPV感染进行检测.     

基因芯片技术检测142例尖锐湿疣HPV基因型的临床分析

目的：评价核酸分子快速导流杂交基因芯片技术（HybriMax）检测尖锐湿疣（CA）组织中人乳头瘤病毒（HPV）基因型的临床应用。方法：采用HybriMax技术,对142例尖锐湿疣患者皮损组织进行HPV感染分型检测。结果：在受检的CA患者中21种HPV亚型共检出18种,未发现HPV18、35和56型。142份CA组织标本中HPV阳性137例,总检出率是96,48％,单一基因型别阳性率是58．45％（83／142）,多重基因型别阳性率是38．03％（54／142）;各基因型别检出率由高到低依次是HPV6（64．08％）、11（34．51％）、52（7．75％）、33（7．04％）、58（7．04％）、16（5．63％）、59（4．23％）、31（3．52％）和68（3．52％）。高危型HPV检出率为42．96％（61／142）,高危型HPV多以混合感染形式存在,其多重感染率达到86．89％（53／61）,其主要基因型中女性高危HPV型感染率55．56％（20／36）明显高于男性的31．13％（33／106）。结论：尖锐湿疣主要基因型感染是低危型HPV6,高危型HPV感染率高并多以混合感染形式存在。HybriMax技术检测尖锐湿疣患者HPV基因型准确性高,并可快速分型,是临床HPV感染分型检测有效方法。     

深圳市女性尖锐湿疣组织HPV感染的基因型分析

目的:检测女性尖锐湿疣(CA)皮损中人乳头瘤病毒(HPV)的基因型.方法:采用HybriMax技术,对116例女性尖锐湿疣患者皮损组织进行HPV感染分型检测.结果:HPV阳性107例,共发现20种HPV亚型;单一型别阳性率是51%(59/116),以低危型HPV11,6为主.多重基因型别阳性率是41.2%(48/116).高危型HPV检出率为47%(55/116),多重感染率达到87%(48/55);高危型与低危型HPV感染在皮损类型、病变部位无差异.结论:深圳市女性尖锐湿疣以低危型HPV11、6型感染为主;高危型感染多以混合感染形式存在.     

上海地区女性外阴尖锐湿疣患者宫颈HPV感染及分型研究

目的 探讨上海地区女性外阴尖锐湿疣患者的宫颈HPV感染情况.方法 采用美国FDA批准的捕获杂交试验和基因芯片技术对194例女性外阴尖锐湿疣患者皮损和宫颈脱落细胞进行HPV基因型别研究.结果 194例女性尖锐湿疣患者外阴皮损HPV检出率为100%,其中低危型HPV 144例占74.2%,高危型HPV 50例占25.8%.低危型中136例为单一型别感染,占94.4%,均为HPV6或HPV11;高危型中43例为低危与高危型HPV混合感染,占86%.194例患者中,166例(85.6%)合并宫颈HPV感染,其中低危型感染者119例,感染率为61.4%,高危型感染46例,感染率为23.7%.外阴和宫颈皮损HPV型别的一致性达到95.8%(159/166),低危型HPV感染率从高到低依次为HPV11＞HPV6＞HPV53,高危型依次为HPV16＞HPV18＞HPV52＞HPV31＞HPV45、HPV58.结论 上海地区女性外阴尖锐湿疣患者中高危型HPV感染率较高,且近1/4患者合并宫颈高危型HPV感染.     

性传播疾病

20063289尖锐湿疣患者感染不同型人乳头瘤病毒与临床复发关系研究/许良杰(广东汕头市皮肤病医院),黄进波,陈建宁∥中国麻风皮肤病杂志.-2006,22(7).-575~576采用荧光定量PCR法检测147例患者疣体HPV6/11,HPV16/18,并对101例低危型(HPV6/11)和40例高危型(HPV16/18)的患者进行激光联合干扰素治疗,随访个月。结果HPV6/11阳性101例,HPV16/18阳性20例,二者均阳性20例,均阴性6例;低危型24例复发(23.8%),高危型17例复发(42.5%),两组复发率比较有显著性差异(P<0.05)。认为高危型HPV16/18感染临床上易复发。表1参5(张江安)20063290尖锐湿疣…     

302例尖锐湿疣患者人乳头瘤病毒基因型检测及分析

目的:探讨302例尖锐湿疣(CA)患者人乳头瘤病毒(HPV)的基因型的感染情况.方法:采用核酸分子快速导流杂交基因芯片技术,对302例尖锐湿疣患者皮损组织进行HPV感染分型检测.结果:在302例病例标本中,本芯片所能检测的是21种HPV亚型,实际检测出20种,未发现HPV43型.302份CA组织标本中HPV阳性292例,检出率是96.68%,单一型别阳性率是61.59%(186/302),多重型别阳性率是35.10%(106/302);各型别检出率由高到低依次是HPV11(36.42%)、HPV6(28.81%)、HPV16(11.92%)、HPV52(11.92%)、HPV58(9.27%)、HPV68(8.28%)、HPV66(7.62%)、HPV-CP8304(4.30%),HPV18(3.64%)、HPV33(3.64%)、HPV44(3.64%)、HPV39(2.32%).结论:本研究中尖锐湿疣以低危型HPV11、HPV6为主,感染高峰年龄为20～29岁.     

347例尖锐湿疣患者人乳头瘤病毒基因型检测及分析

目的:分析尖锐湿疣(CA)患者人乳头瘤病毒(HPV)基因型的感染情况,为制定HPV感染的预防策略提供理论依据。方法:采用核酸分子快速导流杂交基因芯片技术,对347例尖锐湿疣患者皮损组织进行HPV感染21种基因亚型检测。结果:347份CA组织标本中HPV阳性330例,检出率95.10%,21种HPV亚型均能检测出。排名位于前6位的亚型检出率由高到低依次是HPV6(36.31%,126/347)、HPV11(29.39%,102/347)、HPV16(13.83%,48/347)、HPV52(11.24%,39/347)、HPV58(8.07%,28/347)、HPV39(8.07%,28/347)。单一低危型感染占31.82%(105/330),单一高危型感染占27.88%(92/330),多重感染占40.30%(133/330)。不同性别中,单一高危型和多重感染率存在明显差异(P0.05),而单一低危型感染率无明显差异(P0.05)。结论:本研究中尖锐湿疣以HPV6、HPV11、HPV16、HPV52、HPV58、HPV39为主,对今后研发针对本地区的预防性疫苗具有重要指导意义。     

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.