自体表皮移植治疗白癜风的临床观察

目的 探讨自体表皮移植治疗白癜风的临床疗效.方法 73例稳定期白癜风患者(局限型62例、泛发型11例)将受皮区、供皮区发疱,常规消毒后手术移植.结果 局限型有效率96.26%,泛发型有效率92.98%,总有效率94.12%.结论 自体表皮移植治疗白癜风,简便、易行、治愈率高,愈后不留瘢痕.     

自体表皮移植及皮肤磨削术治疗白癜风疗效观察

目的：探讨表皮移植术及皮肤磨削术治疗白癜风的疗效。方法：采用高温负压起疱及皮肤磨削术治疗110例白癜风患者,其中局限型96例,节段型10例,泛发型4例,共移植皮片1 350张,皮片直径0.5～1.2 cm。结果：治愈80.90%,显效93.63%,无效6.37%。对93例患者进行0.5～1.5年的随访,有80例局限型及9例节段型患者未见复发,10例眉弓移植部位眉毛半年后由白色恢复黑色,4例泛发型患者色素恢复后又逐渐消失。未见瘢痕、感染及同型反应。结论：此方法治疗稳定期局限型及节段型白癜风疗效确切,安全,不良反应小,而泛发型患者不适于此法治疗。     

自体表皮移植治疗白癜风78例

白癜风是一种常见的后天性色素脱失性皮肤病[1]。因其病因不明,目前对白癜风的治疗方法虽然很多,但疗效多不理想。我科使用Br-Ⅱ型表皮移植白癜风治疗仪,取得一定疗效,现报     

钢丝环固定自体表皮移植治疗白癜风

目的探索特殊部位白癜风自体表皮移植治疗的包扎固定方法。方法试验组移植区边缘用钢丝环绕一周,缝合固定于皮肤上,并留置长线,皮片移植后将包扎敷料打包固定。对照组包扎敷料用胶带封包。结果自体表皮移植治疗眼睑及唇部易活动部位白癜风,采用钢丝环固定包扎,术区护理方便,对正常生活影响小,其治疗效果与传统的包扎方法相比有效率有明显提高(P<0.01)。结论钢丝环固定包扎是一种简单有效的包扎固定方法,可以提高活动大的部位白癜风手术治疗的成功率。     

自体表皮移植联合白芍总苷治疗稳定期白癜风的临床研究

目的 自体表皮移植联合白芍总苷治疗稳定期白癜风的临床疗效及安全性,为白癜风提供安全有效的治疗方法.方法 210例稳定期白癜风患者随机分为2组,治疗组110例自体表皮移植联合白芍总苷治疗,对照组100例单用表皮移植治疗,8周后观察疗效并随访10个月.结果 治疗组总有效率为96.4%,对照组为84.0%,2组总有效率比较差异有统计学意义(χ2=4.646,P=0.031).结论 自体表皮移植联合白芍总苷治疗稳定期白癜风,疗效显著,治愈率高.     

皮肤磨削术加自体表皮移植治疗白癜风600例观察

目的观察自体表皮移植术治疗白癜风疗效。方法供皮区选择腹部或大腿内侧正常皮肤 ,用PFJ -Ⅱ表皮细胞分离机分离表皮与真皮。受皮区用磨削术去除表皮 ,将供皮区表皮植于受皮区上包扎固定。结果 6 0 0例痊愈 480例 ,有效 10 0例 ,无效 2 0例。结论该方法治疗白癜风总有效率为 96 7%。     

移植微小皮片治疗白癜风11例疗效观察

国外报道采用移植微小皮片治疗稳定期白癜风取得良好疗效。我们根据文献报道,进行改良后采用移植微小皮片治疗稳定期白癜风11例,取得较满意的疗效。现报道如下。     

白癜风自体表皮移植临床观察

目的:探讨用自体表皮移植法治疗白癜风。方法:用负压吸引成疱、自体表皮移植的方法治疗35例109区白癜风。术后病人每2周随访1次,共3个月。结果:显效率、有效率及总有效率分别为89.9%、0.9%和90.8%。无效率为9.2%,主要发生于用止血贴固定的患者。另有1区在2周时有显效,但1个月后又变白。不良反应为1区继发感染,2区接触性皮炎,1区的皮肤及皮下组织在吸头内嵌顿。结论:自体表皮移植治疗白癜风是一种疗效好、不良反应少的方法。     

自体表皮移植治疗白癜风84例临床观察

白癜风是临床常见的碍容性疾病,传统口服及外用疗法疗效均欠佳。近年来我们应用负压吸引发疱法,对84例白癜风患者做了自体表皮移植,疗效满意,现报道如下。1对象和方法1.1病例:稳定期(指近6月无新皮损出现)白癜风84例,男35例,女49例,年龄13～42岁,平均27.2岁。病程1～18年,平均5.7年。限局型65例,皮节型13例,泛发型6例。1.2方法:首先,供受皮区皮肤均用75%酒精消毒(供皮区选择皮肤色素正常的非暴露部位皮肤,通常为上肢屈侧或腹部),使用ZT-II型白癜风治疗仪(浙江绍兴医疗器械厂生产,工作负压20～60kPa)于供受皮区同时负压吸引1～3h产生水疱,0…     

皮胰磨削术加自体表皮移植治疗白癜风600例观察

目的：观察自体表皮移植术治疗白癜风疗效。方法：供皮区选择腹部或大腿内侧正常皮肤，用PFJ－Ⅱ表皮细胞分离机分离表皮与真皮。受皮区用磨去除表皮，将供皮区表皮植于受皮区上包扎因定。结果：600例痊愈480例，有效100例，无效20例。结论：该方法治疗白癜风总有效率为96．7％。     

局部皮瓣加植皮术结合创面负压治疗颈部中重度瘢痕挛缩畸形15例

目的:探讨局部皮瓣加植皮术结合创面负压治疗颈部中重度瘢痕挛缩畸形的效果。方法 采用局部皮瓣加植皮术结合创面负压治疗15例颈部中重度瘢痕病人。结果 本组15例病人中感染1例,切口延迟愈合2例,经换药等对症处理后基本痊愈。术后随访2月,皮片无回缩,颈部活动度良好,效果满意。结论 局部皮瓣加植皮术结合创面负压治疗是解决颈部中重度瘢痕可靠且有效的方法。     

皮肤多重扩张技术在烧伤患者头面颈部瘢痕整形中的应斥

目的探讨皮肤多重扩张技术在治疗头面颈部烧伤后瘢痕整形中的应用。方法采集并分析2008年1月～2010年12月德阳金荣医学美容专科医院收治的32例头面颈部烧伤后瘢痕患者,应用皮肤多重扩张技术植入扩张器于头部、面部、颈部,经注水1～3个月后行扩张皮瓣修复瘢痕创面,观察皮肤多重扩张技术的有效扩张情况及术后并发症的发生情况。结果所有患者均获得较好的治疗效果,经过6个月～1年的随访,修复创面的功能及外形较满意,其中1例扩张器外露,2例局部血肿,经对症处理后痊愈。结论在治疗头面颈部烧伤后瘢痕中,应用皮肤多重扩张技术是一种较好的方法。     

距骨颈骨折和距骨体脱位的解剖与临床研究

目的探讨吻合血管股前外侧髂骨皮瓣修复距骨颈骨折和距骨体脱位的临床效果。方法于2005年1月～2008年1月收治8例距骨颈骨折、距骨体脱位伴皮肤缺损患者,采用吻合血管的股前外侧髂骨骨皮瓣,行距骨颈骨折复位,脱位距骨体钢板内固定,然后带血供髂骨瓣植入,将皮瓣修复踝前部皮肤缺损。结果8例均获满意效果。8例患者中创面一期愈合7例,延迟愈合1例。将带血供髂骨瓣植骨距骨颈部骨折端,达到重建距骨体血供,促进了距骨颈骨折愈合,并修复踝部创面,从而防止距骨体缺血性坏死。经2个月至3年的随访,距骨颈骨折愈合好,未发现距骨体缺血坏死,踝关节活动功能正常。结论对距骨颈骨折、距骨体脱位,以往多采用单纯距下关节或胫距关节融合,或邻近骨瓣转位治疗,但对伴有皮肤缺损的患者一次修复缺乏修复材料。作者自行设计吻合血管的股前外侧髂骨瓣,可重建距骨体血运,促进距骨颈骨折愈合,防止距骨体坏死,同时修复踝部创面,是距骨颈骨折、距骨脱位伴皮肤缺损修复的新方法。     

扩张皮瓣在面部烧伤瘢痕修复中的应用体会

目的研究与探讨扩张皮瓣在面部烧伤瘢痕修复中的应用。方法选取本院治疗面部烧伤瘢痕修复患者20例,手术分为两期,I期阶段于瘢痕四周正常皮肤下将扩张器置入皮肤,使皮肤得到充分扩张;Ⅱ期将扩张器取出,并行瘢痕切除与皮瓣转移手术。结果20例患者共置入32个扩张器,其中6处（18．75％）出现扩张器并发症,全部患者均得到有效治疗和满意修复。结论扩张皮瓣对面部烧伤瘢痕的修复取得良好效果,是修复面部皮肤损伤的理想治疗方法。     

预置皮瓣扩张延迟修复颈部挛缩瘢痕

目的:探讨预置皮瓣扩张延迟修复颈部挛缩瘢痕的临床效果.方法:2005年1月～2007年2月应用预置皮瓣扩张延迟修复颈部挛缩瘢痕8例.结果:预置皮瓣扩张延迟修复颈部挛缩瘢痕5例,预置皮瓣扩张延迟修复加植皮3例,术后均随访1年以上,优6例,良1例,进步1例.结论:能充分利用大面积烧伤病人非常有限的皮源,为尽可能修复颈部挛缩瘢痕找到了一条途径;分期手术解决了病人耐受问题和术中输血的难题;不易损伤血管和神经,易于操作,皮瓣成活率高,修复效果满意.     

New treatment modalities for vitiligo: focus on topical immunomodulators

The development of effective treatment modalities for vitiligo is dependent on an understanding of the events leading to depigmentation. However, the exact pathogenesis of vitiligo is still mostly unknown. Abnormalities in both humoral and cell-mediated immunity have been documented in vitiligo patients and they present a basis for using immunomodulating agents, such as corticosteroids and macrolide immunomodulators, in the treatment of vitiligo. Macrolide immunomodulators, such as tacrolimus and pimecrolimus, which can be used topically, are known as topical immunomodulators (TIMs). TIMs inhibit the action of calcineurin, and consequently inhibit T-cell activation and the production of various cytokines; this is considered the working mechanism of action of TIMs in vitiligo. Several small studies and case reports on the use of TIMs in vitiligo have been published so far. Tacrolimus achieves better results on the face and neck than on other body areas.Particular advantages of TIMs are safety in treating these areas because of lack of skin atrophy and good tolerability. The incidence of application site adverse events in vitiligo seems to be lower than in the treatment of atopic dermatitis. On the face and neck, TIMs may become a useful tool in the treatment of adults and children with vitiligo despite possibly lower efficacy than topical corticosteroids. Further, larger, controlled clinical studies are warranted to determine the definite role of TIMs as monotherapy or in combination with other modalities in the treatment of vitiligo.     

不同皮瓣修复术在手部深组织外露中应用的效果比较

目的:探讨不同皮瓣修复术在手部深组织外露中的治疗效果,以为其治疗提供依据.方法:选取2005年5月～2009年1月于本院进行治疗的46例手部深组织外露患者为研究对象,将其随机分为对照组(中、全厚皮瓣组)23例和观察组(超薄皮瓣组)23例,后将两组的治疗总有效率、并发症发生率及患者满意率进行统计分析,并加以比较.结果:经...     

PD-1/PD-L1抑制剂在非黑色素瘤治疗中致白癜风的文献病例分析

目的 探讨程序性死亡受体1（PD-1）/程序性死亡配体1（PD-L1）抑制剂在非黑色素瘤治疗中所致白癜风的临床特点。方法 检索中国知网、万方医学、PubMed、Embase、Web of Science建库至2022年7月31日收录的PD-1/PD-L1抑制剂在非黑色素瘤中所致白癜风的病例报告类文献进行描述性统计分析。结果 纳入分析的患者共25例,其中男性18例,女性7例;年龄32～79岁;25例患者首次使用PD-1/PD-L1抑制剂至发生白癜风最短时间为6 d,最长时间为5年,中位发生时间为用药后5个月。白癜风主要分布在头皮、面部、手部、四肢和躯干,可伴有其他免疫相关性不良事件,以甲状腺居多;皮肤活检表现为病变及病灶周围皮肤黑色素细胞及黑色素的缺失。20名患者进行了疗效评估,完全缓解6例,部分缓解3例,疾病稳定8例,疾病进展3例。结论 白癜风是PD-1/PD-L1抑制剂在非黑色素瘤治疗中的一种罕见不良反应,白癜风的发生可能与良好的临床结果相关。     

Cryosurgery for advanced malignant melanoma of the facial skin. A case report

BACKGROUND: Cryosurgery is safely employed for the treatment of skin precancerous and malignant lesions of the head and neck in selected patients. The case of a 101-year-old female patient with advanced malignant melanoma of the facial skin, undergoing cryosurgery, is reported in order to assess the feasibility and tolerability of the technique, as well as the biological implications of cryosurgical treatment in this specific neoplasm. CASE REPORT: A 101-year-old woman, with a large (pT4b N0 M0) cutaneous melanoma of the facial skin on the right cheek, was treated at the Division of Surgical Oncology of the National Cancer Research Institute, Italy, from June to August 2003. The treatment was accomplished by means of serial cryosurgical applications which were performed within three months; the bulk of the lesion was cryotreated with a liquid nitrogen cryoprobe, while the residual disease was treated with a nitrous protoxide cryoprobe, by means of the insertion technique. The treatment was well tolerated, with a good aesthetic result, and the patient is recurrence- and distant-disease-free two years after the initial cryosurgical application. CONCLUSION: Cryosurgery is feasible in the treatment of head and neck melanoma, mostly for mucosal melanomas and cutaneous lesions in anatomically critical sites, as well as in high-risk surgical patients. Here, a good aesthetic result was obtained in a very elderly patient with a large cutaneous melanoma of the facial skin, avoiding skin flap transposition for tissue repair and postoperative complications (e.g., serious bleeding or postoperative pain), with a satisfactory functional and oncological outcome at two years.     

Comparative analysis between nasolabial and island pedicle flaps in the ala nose reconstruction. Prospective study

The goals of reconstructing deformities of the face secondary to skin cancer include reconstructing the area with similar tissue. The comparison between different types of local flaps for reconstruction of nasal ala is presented in a prospective, randomized study. The objective of this study was to compare the functional and esthetic outcomes between the nasolabial and island flaps. A total of 60 patients with skin cancer of the nose underwent ala reconstruction: 30 cases by nasolabial flap (group A) and 30 by island flap (group B). The two groups were homogeneous for sex, age, and anatomical area. Complications, scarring according to the scale of Vancouver, cosmetic appearance, and disorders of sensations were analyzed and statistical analysis was performed. In group A, early complications were more common than in group B. The scars of group B patients were more like those of undamaged skin. A total of 10% patients of group A evaluated the cosmetic appearance of their nose as very good, while in group B, 30% patients gave such an evaluation. Local flaps provide better reconstruction and the island flap appears to have more efficacy when compared with nasolabial flap for nasal ala reconstruction.