185例面部皮炎患者临床及斑贴试验结果分析

目的:测定面部皮炎患者过敏原.方法:对185例面部皮炎患者进行国际接触性皮炎研究组认定产品-瑞敏接触变应原斑贴试验.结果:斑贴试验阳性者136例(73.5%),其中常见的致敏原依次为硫酸镍(25.9%),硫柳汞(20.5%)、重铬酸钾(16.2%)、甲醛(13.5%)、对苯二胺(11.4%)、芳香混合物(10.3%)等.结论:所有面部皮炎患者均应进行斑贴试验以寻找可能致敏原.     

变应性接触性皮炎167例变应原分析

目的 分析变应性接触性皮炎患者的变应原.方法 对167例变应性接触性皮炎患者做斑贴试验.结果 面部变应性接触性皮炎92例,占55.1％.斑贴试验阳性者148例,占88.6％.前6位变应原依次为:硫酸镍、芳香混合物、对苯二胺、硫柳汞、辛酸盐和阿必醇.结论 斑贴试验是确证变应性接触性皮炎病因的有效手段.     

534例变应性接触性皮炎斑贴试验结果分析

目的:了解变应性接触性皮炎常见的过敏原。方法:采用瑞敏斑贴试验器,对2011年2月至2015年7月到我院就诊的534例变应性接触性皮炎患者进行斑贴试验,并对试验结果进行统计分析。结果:534例受试者中1项或1项以上阳性反应的有471例,总阳性率88.20%。阳性反应率较高的变应原依次是:重铬酸钾(61.78%)、氯化钴(53.29%)、硫酸镍(43.10%)、芳香混合物(34.61%)、卡巴混合物(33.33%)。结论:重铬酸钾、氯化钴、硫酸镍、芳香混合物、卡巴混合物是本地变应性接触性皮炎的常见过敏原。斑贴试验是检测变应性接触性皮炎过敏原安全、有效、简便的方法。     

129例颜面再发性皮炎患者斑贴试验临床分析

目的：通过斑贴试验研究颜面再发性皮炎的病因。方法：对临床诊断为颜面再发性皮炎的133例患者进行问卷调查和斑贴试验（瑞典产“瑞敏牌”斑贴试剂）。结果：133例检测患者中有116例斑贴试验阳性，占受试者的87.22％，其中对1种阳性者42例（35.90％），对2种阳性者37例（31.62％），对3种阳性者19例（16.24％），对4种及4种以上阳性者19例（16.24％）。阳性发生率较高的前6位过敏原依次为甲醛、卡巴混合物、重铬酸钾、硫酸镍、硫酸汞、对苯类。阳性率与年龄、环境相关，与性别、化妆品的使用无关。结论：颜面再发性皮炎的发生与接触变应原关系密切，斑贴试验是指导颜面再发性皮炎治疗的一个有力手段。     

湿疹及皮炎

980780 徐州地区接触性皮炎常见致敏原研究/刘彦群（徐州医学院附院皮肤科）…//临床皮肤科杂志.-1997,26（5）.-300～301 斑贴试验所用抗原及斑试器均由南京医科大学附一院提供。结果311例中201例呈阳性反应,与现病史及临床接触史符合的有163例（77.6％）。最常见的可疑接触致敏物是化妆品、金属镍制品及染发剂,其次为洗涤品、橡胶制品及外用药物等。常见致敏原为芳香类混合物、硫酸镍、对苯二胺、松香、甲醛、氯化钴、重铬酸钾、秘鲁香油、卡巴混合物、苯唑卡因、羊毛醇、秋兰姆混合物、硫酸新霉素、黑橡胶混合物及硫柳汞等。表1参8 （张志灵）     

无锡市1065例皮炎湿疹类皮肤病的接触性变应原分析

目的 探讨无锡市皮炎湿疹类皮肤病患者的接触性变应原及其临床意义。 方法 斑贴试剂盒对门诊确诊的1065例皮炎湿疹类皮肤病患者进行斑贴试验,并对结果作统计学处理。 结果 斑贴试验总阳性率83.19%,性别、年龄差异无统计学意义。阳性率居前6位的变应原依次为重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物。其中重铬酸钾和卡巴混合物的阳性检出率男性显著高于女性,硫酸镍和甲醛的阳性检出率女性显著高于男性,差异有统计学意义（P < 0.01）。氯化钴的阳性检出率中青年组和老年组显著高于儿童组,硫酸镍的阳性检出率中青年组显著高于儿童组,差异有统计学意义（P < 0.05）。结论 重铬酸钾、氯化钴、硫酸镍、甲醛、卡巴混合物和芳香混合物是无锡市引起皮炎湿疹类皮肤病的主要变应原。     

84例皮炎湿疹类皮肤病斑贴试验结果分析

分析本地区皮炎湿疹患者斑贴试验的结果及临床意义,并比较成人组与儿童组阳性结果的异同.对东营市人民医院门诊确诊的84例变应性接触性皮炎和湿疹患者进行斑贴试验,对结果进行统计学分析.斑贴试验总阳性率60.71%,成人组阳性率为64.81%,儿童组阳性率53.33%,两组间差异无统计学意义(P>0.05).20种变应原中总阳性率排前5名的分别是氯化钴、重铬酸钾、硫酸镍、对苯二胺、芳香混合物.成人组阳性率较高的分别是氯化钴、重铬酸钾、硫酸镍;儿童组阳性率较高的分别是:硫酸镍、甲醛、芳香混合物.氯化钴、重铬酸钾、硫酸镍是东营地区变应性接触性皮炎和湿疹的常见变应原,斑贴试验对寻找变应原及日常防护均有意义.     

皮炎湿疹599例致病因素分析

目的探讨环境接触性因素在皮炎湿疹类疾病发病中的作用及影响因素。方法对诊断皮炎湿疹的患者做斑贴试验并进行问卷调查。结果 599例皮炎湿疹患者中变应性接触性皮炎167例(27.88%),在整个患者中所占比例最高。斑贴试验结果变应原呈阳性反应者有441例(73.62%)。阳性率由高到低排列的前6位变应原为:硫酸镍、硫柳汞、辛酸盐、芳香混合物、卡巴混合物和重铬酸钾。结论斑贴试验是寻找皮炎湿疹病因的有效手段。     

湿疹及皮炎

２００００２０３ １１６例接触性皮炎及湿疹的斑贴试验分析／毛虎（洛阳市二院）／／中华皮肤科杂志．－１９９９，３２（３）．－１９８ ６２例接触性皮炎和２５例湿疹患者，进行可疑过敏原斑试，结果皮炎患者３１例、湿疹患者１０例呈阳性反应，可疑过敏原与斑试结果的符合率为６４％和３１．３％。主要致敏原为对苯二胺、硫酸镍、重铬酸钾为多，其它依次为橡胶、香料、白降汞、苯唑卡因、乙二胺、环氧树脂、咪唑烷基脲、硫酸新霉素、布罗波尔、对羟基苯甲酸混合物等。对松香、甲醛无１例呈阳性反应。受试者对０．９％生理盐水均无反应。…     

326例接触性皮炎和湿疹患者斑贴试验分析

本科应用瑞典化学技术诊断AB公司提供的斑贴试验标准试剂对326例接触性皮炎和湿疹患者进行斑贴试验,阳性率为57.36％。阳性率高的抗原依次为硫酸镍、重铬酸钾、4-苯二胺、芳香混合物、氯化钴和硫柳汞。接触性皮炎组的斑试阳性率显著高于湿疹组(P<0.01)。斑试阳性结果与临床接触史的符合率为82.35％。结果提示发生在头面部的皮炎、湿疹应考虑化妆品、染发剂过敏的可能,而发生于手部的皮炎、湿疹应首先考虑刺激性因素所致。     

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.     

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.     

Leprosy in a University Hospital in Southern Brazil

BACKGROUND

Leprosy is an infectious disease that may lead to irreversible nerve damage, compromising patient''s quality of life and leading to loss of working years.

OBJECTIVES

To evaluate the epidemiological profile of patients followed at a University Hospital.

MATERIALS AND METHODS

This is a retrospective observational study, based on a review of medical records. We studied the clinical and epidemiological features of patients with leprosy monitored at the Hospital de Clínicas of the Federal University of Paraná between January 2005 and January 2010.

RESULTS

The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female rate was 1.8:1. The most prevalent occupations were: retired, students or rural workers. Patients came mainly from Curitiba or nearby areas, but there were also patients from the countryside. The mean diagnostic delay was 24.57 months. Multibacillary forms prevailed, with the lepromatous variety being the most common, closely followed by the borderline type. Neural enlargement was found in more than 50% of the patients and 48.44% of them developed reactional states. Hemolysis was the most commonly detected drug side effect. Initial functional evaluation was possible in 70% of patients, 55% of whom had disabilities upon diagnosis. The most prevalent associated disease was hypertension.

CONCLUSIONS

This study showed an important diagnostic delay and a high rate of sequelae in this specific population. Brazil is one of the few remaining countries that has not yet eradicated leprosy and it is important to improve health policies in order to prevent sequelae and achieve eradication.     

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.