白癜风治疗最新进展

白癜风是色素脱失性皮肤病,诊断容易而治疗棘手。治疗主要有口服药物、外用药物、光疗联合疗法、皮下注射及手术等,这些方法的疗效尚需更多临床试验的探索。近年来,联合治疗已成为临床最常用的治疗模式,如光疗联合药物治疗,手术治疗联合光疗等。该文就最新有关白癜风联合治疗的临床研究进展、手术方法的改进、新技术的研究以及联合治疗进行综述。     

光疗在白癜风治疗中的临床应用

白癜风是一种常见的慢性获得性色素减少性疾病,其发病机制尚不清楚,可能的机制有自身免疫、黑素细胞自毁、神经精神因素、表皮因子失衡及遗传因素等.临床上治疗白癜风的方法很多,光疗及其联合疗法是目前有效的治疗方法之一,尤其适用于泛发性及难治性白癜风.而临床应用中,光疗疗效受多因素影响,如疾病分型、患病年龄、皮损部位等.因此了解各种光疗的作用机制,适应证,临床疗效及不良反应,有助于临床医生选择最佳的治疗方案.     

308 nm准分子激光治疗白癜风的现状

白癜风的治疗仍是皮肤科医生面临的一大难题。光疗作为有效、安全的治疗手段,在白癜风治疗中的应用正在逐步推广。308nm准分子激光治疗白癜风快速有效、不良反应少。联合其他治疗方法可提高紫外线抵抗区的疗效。为此,综述308nm准分子激光治疗白癜风的新进展,以供临床参考。     

儿童白癜风及其治疗的研究进展

儿童白癜风因其临床表现及免疫学的特点而有别于成人白癜风。研究显示儿童白癜风有明显的性别差异 ,节段型的比例高 ,伴发自身免疫性疾病少。常用的治疗方法有外用糖皮质激素、光疗和手术方法 ,近年卡泊三醇、他克莫司外用治疗儿童白癜风也取得较好的疗效     

激光磨削后表皮移植术联合光疗治疗白癜风的疗效观察

目的:探讨激光磨削后自体表皮移植术结合光疗治疗白癜风的疗效及临床应用意义。方法:选45例局限性静止期白癜风患者,白斑为躯干、四肢、颈部和腋下等部位。进行激光磨削联合自体表皮移植术治疗,并加压包扎7 d,术后合用紫外线照射治疗。结果:45例白癜风患者,共植皮片132片,术后随访观察疗效1年后,皮损痊愈42片(31.8%),显效88片(66.4%),有效率98.2%,且白斑处色素恢复均匀。结论:激光磨削联合自体表皮移植和光疗治疗白癜风可缩短疗程,提高疗效,减少复发,且治疗不受部位限制,术后色素恢复好,是一种行之有效的治疗技术。     

白癜风治疗的新进展

白癜风为特发性色素脱失性疾病。常规治疗方法如局部外用皮质类固醇、PUVA等对于临床上部分病例疗效不佳。随着对白癜风研究的深入和医疗手段的进步 ,不断有新的治疗方法和思路出现 ,在一定程度上提高了疗效。现将光疗、移植治疗、细胞因子治疗和治疗方法的选择等进展作一综述 ,以便于临床参考     

儿童白癜风及其治疗的研究进展

儿童白癜风因其临床表现及免疫学的特点而有别于成人白癜风。研究显示儿童白癜风有明显的性别差异，节段型的比例高，伴发自身免疫性疾病少.常用的治疗方法有外用糖皮质激素、光疗和手术方法，近年卡泊三醇、他克莫司外用治疗儿童白癜风也取得较好的疗效.     

自体表皮移植联合窄谱UVB照射治疗白癜风临床观察

我们采用自体表皮移植联合窄谱中波紫外线(NB-UVB)照射治疗白癜风,取得较好临床效果,现报道如下.临床资料所有病例均为2004-2005年本所门诊诊治的稳定期白癜风患者共45例,疤痕体质及紫外线光疗禁忌证者除外,近3个月内未采用其它治疗.     

白癜风治疗新进展

<正>白癜风是一种CD8~+T淋巴细胞介导的以破坏黑素细胞,形成皮肤色素脱失斑为特征的慢性自身免疫性疾病,严重损毁患者形象,治疗相当困难。局部外用糖皮质激素、钙调神经磷酸酶抑制剂,并联合光疗治疗头面部或躯干部白癜风效果较好,但目前尚无针对肢端型白癜风的理想治疗方法。Janus激酶(Janus kinase,JAK)抑制剂,如鲁络     

难治部位白癜风的治疗进展

白癜风是一种与黑素细胞缺失有关的色素脱失性皮肤病,易诊难治,尤其对难治部位,诸如嘴唇、生殖器、头皮、眼睑、肘膝部及四肢、掌跖足底等疗效更差.就近年来对难治部位的有效疗法,如药物、外科移植术、光疗及联合疗法等进行概述.根据难治部位的临床特点,选用合理的治疗方案,以提高难治部位的疗效,指导临床治疗.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Background and objectives

The negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.

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.