面部蠕形螨病90例临床分析

目的　探讨面部蠕形螨病的临床特征及治疗。方法　对 90例门诊蠕形螨病患者的临床表现及治疗进行临床观察。结果　 90例患者男女之比为 0 .5 5 :1,疾病始发年龄平均 3 2 .70± 9.62岁 ,外用糖皮质激素为最常见诱发和加重因素 ;临床主要表现为脂溢性皮炎型和酒渣鼻型。治疗有效率米诺环素组 86.67% ,甲硝唑组 63 .3 3 % ,两组比较差异有显著性 (P <0 .0 5 )。结论　本病好发于青壮年 ,米诺环素治疗蠕形螨病起效迅速 ,疗效肯定 ,不良反应少。     

氟芬那酸丁酯软膏治疗面部糖皮质激素依赖性皮炎疗效观察

<正>1资料与方法1.1一般资料2009年10月-2011年9月本科门诊共收治面部糖皮质激素依赖性皮炎118例。入选及排除标准见文献[1]。曾经使用过皮炎平、皮康王、肤轻松、恩肤霜及院内各种自制的激素类外用药物,药物主要成分为地塞米松、倍他米松和氯倍他松等糖皮质激素。将入选患者采用双盲随机配对法分为两组,治疗组66例,男24例,女42例;年龄18～60岁,平均(36.5±9.9)岁;病程2个月～3年,平均(6.5±3.1)个月。     

地奈德乳膏治疗儿童特应性皮炎的疗效观察

笔者于2007年10月至2009年4月应用0.05%地奈德乳膏和0.1%丁酸氢化可的松乳膏外用治疗101例儿童特应性皮炎,对其临床疗效的观察和评价如下. 1 资料与方法 1.1 临床资料入选的101例患儿均来自我院门诊,符合特应性皮炎的诊断标准,既往1个月内未系统应用糖皮质激素,2周内未使用抗组胺药或外用糖皮质激素治疗.病例随机分两组:治疗组52例,男28例,女24例,年龄2～13岁,平均6.6岁,病程半个月～6年,平均1.8年;对照组49例,男26例,女23例,年龄2～14岁,平均5.8岁,病程1个月～5.5年,平均1.9年.两组性别、年龄、病程、病情等无显著性差异.     

高频电离子手术治疗手足黏液样囊肿37例疗效观察

<正>高频电离子治疗仪治疗手足黏液样囊肿国内尚未见报道。本科2003年1月-2010年5月采用高频电离子治疗仪治疗手足黏液样囊肿37例,结果报告如下。1资料与方法1.1一般资料37例手足黏液样囊肿为本科及昆明医学院第一附属医院的门诊患者,男14例,女23例;年龄34～66岁,平均(46±12.53)岁;病程3个月～2年,平均6月±17.26天。     

替硝唑治疗酒渣鼻20例

1996年 6月～ 2 0 0 0年 4月 ,我们应用替硝唑治疗酒渣鼻2 0例 ,并与甲硝唑进行临床疗效对比 ,取得较好疗效 ,现报告如下。1　资料和方法1 1　一般资料　本组病人 3 5例 ,男 10例 ,女 2 5例 ,男∶女为 1∶2 5 ,发病年龄 2 0～ 60岁 ,平均 4 0 3 2岁。病程慢性 ,平均 4 0 2年。1 2　病例选择　 ( 1)临床症状及体征符合酒渣鼻的诊断标准〔1〕;( 2 )酒渣鼻红斑与毛细血管扩张期、丘疹脓疱期 ;( 3 )面部未并发酒渣鼻外的其它皮肤病 ;( 4 )治疗前 1个月内未用过任何影响酒渣鼻病情的内服及外用药物 ;( 5 )患者自愿参加者 ;( 6)能合作坚持完成…     

三种药物联合治疗面部激素依赖性皮炎30例疗效观察

从 1999年 11月～ 2 0 0 1年 1月 ,我们应用抗组胺药克敏、复方蛇脂软膏、异雷洗剂 (本院自制剂 )联合应用治疗面部激素依赖性皮炎 30例 ,取得了满意疗效 ,现汇报如下。临床资料　 30例患者均为不正确使用糖皮质激素类药膏 ,治疗面部疾患后引发的糖皮质激素依赖性皮炎 ,其中男 8例 ,女 2 2例 ,年龄 15～ 4 0岁 ,使用激素类药膏时间为 1～ 8个月。治疗方法　患者就诊后首先停掉外用糖皮质激素类药膏 ;而后按照下面的方法治疗 :克敏 2 .5ｍｇ,1日 2次 ,连服 4周 ;复方蛇脂软膏 ;外用 ,早上、中午各 1次 ,连用 8周 ;异雷洗剂 :外用 ,晚上睡前 1…     

糖皮质激素性皮炎的研究进展

由于不适当外用糖皮质激素引起的糖皮质激素性皮炎的发病率逐年增高,表现为皮肤潮红、丘疹、萎缩变薄、毛细血管扩张、脱屑、痤疮样及酒渣鼻样皮疹等,伴灼热、疼痛、瘙痒、干燥、紧绷感,停用糖皮质激素后则出现反跳现象。为此,综述有关糖皮质激素性皮炎的病因、发病机制、临床特点、组织病理、非侵入性检查、诊断及治疗等。     

维胺脂胶囊(三蕊)治疗痤疮和脂溢性皮炎临床疗效观察

笔者所在科室于2001年3月起采用维胺脂胶囊(商品名:三蕊,重庆华邦制药有限公司)治疗痤疮和脂溢性皮炎,获得良好的效果,现报告如下。1临床资料病例:将50例门诊就诊的痤疮及脂溢性皮炎患者分为两组,痤疮组患者30例,男10例,女20例,年龄14～40岁,病期3个月～10年,平均病期(3.5±1.4)年。脂溢性皮炎组患者20例,男10例,女10例,年龄22～40岁,病期1～10年,平均病期(3.6±1.5)年。所有患者治疗前均未服用过皮质类固醇、维A酸类药物,育龄期妇女在服药期间和停药后的半年内均采取避孕措施,孕妇及有高血脂、肝肾功能异常者均不列入观察。2治疗及观察方…     

派瑞松霜治疗皮炎湿疹临床疗效观察

我科于１９９９年４月～１０月应用派瑞松霜（西安杨森制药有限公司生产）治疗皮炎湿疹１２０例,现将结果报告如下。临床资料１２０例均为门诊病人。男７２例,女４８例,平均年龄３２岁（１８－６８岁）;病程平均１２天（４天～５年）。其中神经性皮炎３６例,脂溢性皮炎２２例,接触性皮炎１２例,传染性湿疹样皮炎１０例．亚急性湿疹１６例,慢性湿疹２４例。所有患者均有典型临床表现,对此类药物过敏者忌用。治疗方法均外用派瑞松霜,每天早晚各１次,薄涂于患处,轻轻揉搓片刻,３周为１疗程。治疗期间停用其他内服、外用药物。观察…     

成人面部难辨认癣12例临床分析

回顾性分析我科自2013年1月至2019年6月成人面部难辨认癣患者的临床特点,共分析12例成人难辨认癣,其中男10例,女2例,年龄34~73岁,平均60.5岁,病程6~42个月,平均16.2个月。发病前均外用糖皮质激素类软膏。皮损表现:6例为湿疹样,3例为银屑病样,2例为脂溢性皮炎样,1例为玫瑰痤疮样。12例患者皮损真菌镜检均为阳性,7例真菌培养中4例为须癣毛癣菌,1例为红色毛癣菌。12例均合并足癣,2例合并股癣。     

重症药疹52例治疗分析

目的探讨大剂量静脉注射免疫球蛋白(HD-IVIG)联合糖皮质激素治疗重症多形红斑型药疹、中毒性表皮坏死松解型药疹、剥脱性皮炎型药疹的临床疗效和副作用。方法应用HD-IVIG0.4g/(kg.d),静滴,连续5天为1个疗程,并联合糖皮质激素治疗重症药疹52例。结果HD-IVIG联合糖皮质激素治疗重症多形红斑型药疹、中毒性表皮坏死松解型药疹、剥脱性皮炎型药疹的药物热有较好临床疗效,退热时间分别为(1.26±3.78)天,(3.26±1.65)天,(2.28±2.35)天;皮疹开始收敛时间分别为(2.37±2.55)天,(1.46±0.58)天,(4.34±3.18)天;住院时间分别为(22.57±12.19)天,(12.14±10.29)天和(36.96±24.26)天;HD-IVIG的副作用发生率仅11.54%(6/52),均为轻微反应;治疗中未发生严重的副作用。结论HD-IVIG联合糖皮质激素方案是治疗重症药疹的有效选择之一,并具有较好的安全性。     

Efficacy and Safety of Cyclophosphamide, Azathioprine, and Cyclosporine (Ciclosporin) as Adjuvant Drugs in Pemphigus Vulgaris

Background:Pemphigus vulgaris is a potentially life-threatening, autoimmune bullous disease of the skin and mucous membranes. Most commonly, the disease is treated with prednisone in combination with an immunosuppressant agent, frequently referred to as adjuvant drug. However, there is no consensus regarding the first-choice adjuvant drug for the treatment of pemphigus vulgaris or the recommended dosage. Objective:To evaluate the efficacy and safety of prednisone as monotherapy and in combination with the three most popular adjuvant agents — azathioprine, cyclosporine (ciclosporin), and cyclophosphamide in the treatment of pemphigus vulgaris time to immunologic remission (non-detectable circulating pemphigus vulgaris antibodies), proportion of patients who remained free of clinical relapse within 5 years after discontinuation of therapy, time from treatment discontinuation until first relapse, and incidence of adverse effects. Results:The average (± SD) time to clinical remission was 7.2 ± 13.1 months in patients who received prednisone monotherapy, 6.8 ± 10.5 months in patients receiving additional azathioprine, 8.1 ± 11.8 months in the cyclosporine group, and 4.9 ± 6.9 months (which was significantly shorter than all other treatment groups, p < 0.05) in patients receiving cyclophosphamide. The average (± SD) times to immunologic remission were 33 ± 27 months, 28 ± 24 months, 30 ± 21 months, and 23 ± 17 months for prednisone monotherapy, azathioprine, cyclosporine, and cyclophosphamide, respectively. The proportions of patients who remained free of clinical relapse within 5 years after discontinuation of therapy were 55%, 50%, 43%, and 69% for prednisone monotherapy, azathioprine, cyclosporine, and cyclophosphamide, respectively. In patents who experienced relapse, the average (± SD) time from treatment discontinuation to clinical relapse was 10.50 ± 6.86 months in patients receiving prednisone monotherapy, 16.40 ± 17.36 months in the azathioprine group, 12.44 ± 6.48 months in the cyclosporine group, and 21.16 ± 20.13 months in the cyclophosphamide group. The safety profiles of all treatment regimens were comparable. Conclusion:Oral prednisone with cyclophosphamide is the most effective treatment for pemphigus vulgaris. All therapy regimens had a similar safety profile. In our opinion, cyclophosphamide at a dose of 1.1–1.5 mg/kg/day should be the adjuvant drug of choice in the treatment of moderate-to-severe pemphigus vulgaris.     

抗结核药物所致药物性皮炎282例临床分析

目的探讨抗结核药物所致药物性皮炎患者的临床特征,为临床诊疗提供参考依据。方法对本院2013年1月-2017年12月住院结核病患者中出现抗结核药所致药物性皮炎的282例患者进行回顾性分析。结果282例患者中男女性别比为1.59∶1,21~40岁、41~60岁年龄段出现药物性皮炎的患者较多;发生药物性皮炎的潜伏期较短,多见于1~7 d,8~14 d;类型以发疹型和湿疹型为主,发疹型131例(46.45%),湿疹样型111例(39.36%);最常见致敏药物是利福平(34.04%),其次是乙胺丁醇(24.11%)、吡嗪酰胺(16.67%)、异烟肼(10.64%)。多药过敏中利福平+异烟肼致敏率最高。药物性皮炎伴发其他不良反应中以肝功能损害者较高(59.93%)。结论抗结核药物种类多,使用疗程长,不同药物的致敏率、发生药物性皮炎的潜伏期、常见致敏类型等可为临床预防及诊治提供参考依据。     

An open-label pilot study to evaluate the safety and efficacy of topically applied pimecrolimus cream for the treatment of steroid-induced rosacea-like eruption

BACKGROUND: Steroid-induced rosacea-like eruption is characterized by facial rosacea-like dermatitis in patients that have been treated with topical steroids for relatively long periods. OBJECTIVE: To evaluate the efficacy and tolerability of 1% pimecrolimus topical cream for steroid-induced rosacea-like eruption. METHODS: In an open-label pilot study, 40 patients were enrolled and instructed to apply 1% pimecrolimus cream twice daily for 6 weeks. Patients were evaluated by a rosacea clinical score, investigator's global assessment, overall erythema severity, and tolerability at weeks 0, 2, and 6. RESULTS: In 35 patients, the rosacea clinical score decreased significantly from 16.0+/-4.3 at baseline to 8.1+/-3.3 at week 2 and 4.2+/-2.5 at week 6 (P<0.0001). Investigator's global assessment was 4.1+/-1.1 (baseline), then decreased to 1.4+/-0.8 (week 2) and 0.5+/-0.6 (week 6) (P<0.0001). By week 6, 48.6% of the patients were clear. Overall erythema severity was 2.4+/-0.7 (baseline), 0.9+/-0.4 (week 2), and 0.3+/-0.4 (week 6) (P<0.0001). Cutaneous adverse events (local burning, stinging, and itching) occurred in 17.5%. CONCLUSION: Pimecrolimus cream might be efficacious, safe, and well tolerated for steroid-induced rosacea-like eruption. The small sample size and open label nature of this study is its limitation. Further double-blind, vehicle-controlled studies are needed.     

大疱性表皮坏死松解型药疹23例临床分析

目的：探讨大疱性表皮坏死松解型药疹的临床特征及治疗效果以指导今后临床。方法：对23例大疱性表皮坏死松解型药疹的临床资料进行了回顾性分析。结果：23例中男13例，女10例，年龄1月～66岁。致病药物以解热镇痛药，抗癫痫药，磺胺药为主。皮损累及全身者18例(78．3％)，所有患者均有粘膜损害。经糖皮质激素，局部护理及抗感染支持治疗后，治愈21例(91．3％)，死亡2例。结论：大疱性表皮坏死松解型药疹皮损范围广泛，粘膜损害严重，早期足量糖皮质激素和局部护理是治疗成功的关键因素。     

Successful management of steroid‐resistant vascular tumors associated with the Kasabach–Merritt phenomenon using sirolimus

Vascular tumors associated with Kasabach–Merritt phenomenon (KMP) are life‐threatening and the mortality is as high as 10–30%. Steroids are considered the primary choice for drug therapy. However, there are many steroid‐resistant cases. In the present study, analyzed data are presented to support the use of sirolimus in clinical practise for the treatment of corticosteroid‐resistant vascular tumors with KMP in eight infants between June 2015 and April 2017 in a single hospital. The time to initial response was 6.8 ± 2.7 days. The average stabilization time for the platelet count was 19.1 ± 8.5 days. At the time of publication, the average duration of sirolimus treatment was 14.1 ± 4.0 months, and the average time for sirolimus treatment as a single agent was 12.6 ± 4.2 months. The side‐effects were tolerable and included oral ulcer, fever, pain, skin rash and transient ascension of serum transaminase and cholesterol. Our study indicated that sirolimus therapy is an effective and safe method for the treatment of corticosteroid resistant vascular tumors associated with KMP in infants.     

A novel cosmetic approach for partial matricectomy in treating ingrown toenails

Background

Toenails play a great part in protecting toes and peripheral soft tissues, simultaneously playing a cosmetic role. The ideal treatment should result in a functional and aesthetic outcome.

Objective

To describe a novel, aesthetic and minimally invasive method to treat ingrown toenail.

Methods

We retrospectively analyzed 436 lesions of 395 ingrown toes in 353 patients with a mean age of 26.0 ± 13.4 (range 10–55) from June 2014 to March 2020 in our department. A novel cosmetic approach for partial matricectomy in treating ingrown toenails was undergone. The average follow-up time was 27.5 ± 2.8 months. The average period prior to work resumption, recurrence rate, and infection rate were measured. Mean pain Visual Analogue Scale (VAS) and Mean satisfaction VAS were used to evaluate the foot appearance.

Results

The average period prior work resumption was 2.2 ± 2.1 days (range, 0–7 days). The recurrence rate was 1.6% (7 lesions in 6 patients) at more than 2 years of follow-up. There was no critical complication except infection (0.46%). Mean pain VAS reduced from a preoperative score of 7.7 ± 1.5 points (range, 6–10 points) to a postoperative 3-day score of 2.2 ± 1.0 points (range, 1–4 points; p < 0.001) while Mean satisfaction VAS improved from 1.5 ± 1.3 points (range, 0–3 points) to 9.2 ± 0.6 points (range, 8–10 points; p < 0.001).

Conclusion

Our proposed approach is minimally invasive relative to conventional methods, which can achieve comparable efficacy to treat ingrown toenails with granulation tissue. Therefore, it can serve as another option to treat this specific type of ingrown toenails.     

破伤风抗毒素所致药疹42例临床特点分析

目的：明确破伤风抗毒素所致药疹的临床特点。方法：对42例破伤风抗毒素所致药疹的临床资料进行回顾性分析。结果：42例患者中破伤风抗毒素皮试阴性40例,阳性2例。发疹潜伏期6 ~12天,平均为6.5天,皮疹表现为注射局部红斑2例,全身泛发性皮疹40例(发疹型6例,荨麻疹型32例,多型红斑型2例)。42例患者中伴发热5例,呕吐5例,关节痛12例。糖皮质激素治疗有效。结论：破伤风抗毒素所致药疹最常见类型为荨麻疹型,可伴发热、消化道症状及关节痛。药疹的发生与皮试结果无关。     

妊娠多形疹26例临床分析

目的探讨妊娠多形疹对孕妇和胎儿的影响。方法回顾性分析26例妊娠多形疹孕妇的体重、性激素水平、免疫学指标及新生儿评分等临床资料,并以26例同期健康孕妇为对照。结果观察组孕妇体重71.5～98.6(81±11.21)kg,对照组为65.3～88.6(71±10.62)kg,两组孕妇平均体重比较,差异有统计学意义(P<0.05);β-绒毛膜促性腺激素(β-hCG)和游离雌三醇(uE3)水平观察组分别为368±47和65.3±7.96,对照组分别为354±41和63.5±6.54,两组差异均无统计学意义(P均>0.05);血液IgA、IgM、IgG及循环免疫复合物(CIC)水平观察组依次为1.76±0.6、11.47±0.49、12.89±1.15和25.86±3.23,对照组依次为1.62±0.54、11.68±0.38、12.33±1.21和24.13±3.56,差异均无统计学意义(P均>0.05);新生儿平均体重及1分钟Apgar评分比较,差异均无统计学意义(P均>0.05)。结论妊娠多形疹对孕妇和胎儿无明显不良影响。     

Clinicopathological characteristics of lichen planus pigmentosus and its response to tacrolimus ointment: an open label,non‐randomized,prospective study

Background Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus, for which no effective treatment is available. Objectives The aim of this study was to determine the clinical, epidemiological and histopathological characteristics of LPP patients in Kuwait. Methods Thirty‐three LPP patients who attended the Dermatology outpatient clinics at Farwaniya Hospital, Kuwait from the year 2002 to 2008 were studied for clinical, epidemiological and histopathological findings. Thirteen of these patients were treated with topical tacrolimus 0.03%. Ointment applied topically twice daily for the duration varying from 6 to 12 weeks. Results Of the 33 patients, 21 were men and 12 were women. The duration of eruption ranged from 6 weeks to 3 years. The face and neck were the commonest sites, affecting 18 (54.5%) patients. The pattern of pigmentation was diffuse in 18 (54.54%) patients, reticular in seven (21.2%), blotchy in five (15.2%), linear in two (6.1%) and perifollicular in one (3%). Twenty patients had positive serology for hepatitis C virus (HCV), with significantly higher serum liver enzymes (ALT and AST). Of the 13 patients, who were treated with tacrolimus Ointment, seven (53.8%) showed appreciable lightening of the pigmentation after an average of 12 weeks. Conclusions We conclude that HCV may be one of the factors associated with LPP, in those who have a tendency to develop LPP. However, this possible association should be interpreted carefully. In addition, tacrolimus ointment could have a beneficial role in the treatment of LPP.