长航对女性黄褐斑的影响研究

目的分析长航对女性黄褐斑的影响。方法选取参加长航任务的17例女性黄褐斑患者(黄褐斑组),并设对照组15例健康女性(健康组),检测长航前、后症状及血清促黑素细胞激素、过氧化脂质、超氧化物歧化酶水平的变化。结果长航3个月后黄褐斑患者皮损面积和颜色较长航前均不同程度扩大和加深(P<0.05),伴随症状失眠、便秘、月经不调均不同程度加重(P<0.05)。黄褐斑组和健康组长航3个月后血清促黑素细胞激素水平均较前升高(P<0.05),黄褐斑组血清促黑素细胞激素长航前、后较健康组均高(P<0.05);黄褐斑组长航3个月后过氧化脂质水平升高、超氧化物歧化酶水平降低(P<0.05),而健康组长航前、后差异无统计学意义(P>0.05)。结论长航能使黄褐斑皮损扩大、颜色加深,伴随症状加重,并使黄褐斑患者的血清促黑素细胞激素和过氧化脂质水平升高、超氧化物歧化酶水平降低。     

桃红四物汤加减治疗黄褐斑伴月经不调60例临床观察

目的：分析桃红四物汤加减治疗黄褐斑伴月经不调的临床效果。方法：选择2011年9月-2013年9月在我院接受治疗的黄褐斑伴月经不调患者60例,随机分为对照组、观察组,每组30例。对照组进行常规治疗,观察组在对照组治疗基础上,应用桃红四物汤进行治疗,分析两组的治疗效果。结果：对照组总有效率为80.0%,观察组总有效率为96.7%,观察组明显的大于对照组,差异显著。黄褐斑的面积、月经不调总评分明显变小,观察组明显低于对照组,P〈0.05,差异具有统计学意义。结论：基于常规治疗,应用桃红四物汤加减治疗,对黄褐斑伴月经不调的治疗效果较为明显,黄褐斑的面积明显的变小,月经不调明显好转,值得临床推广。     

无创性皮肤测试在黄褐斑临床分型中的应用及意义

目的探讨黄褐斑不同临床类型及其皮肤生理功能,以指导疾病治疗。方法采用无创性皮肤测试仪分析黄褐斑不同临床类型的皮肤生理功能。用伍氏灯及玻片压诊法对84例黄褐斑患者进行分型;采用德国CK公司的无创性皮肤测试仪检测84例患者皮损部位及40例正常对照的油份、水分、经表皮水分流失、血色素及黑色素,并两两比较各型黄褐斑的血色素及黑色素水平。结果根据伍氏灯及玻片压诊法初步将84例黄褐斑分为四型:单纯色素型(M)23例,单纯血管型(V)17例、M>V型24例及V>M型20例。84例患者与对照组相比,面颊部皮肤水分显著降低(p<0.01),经表皮水流失(TEWL)、血色素、黑色素水平显著增高(p<0.01),皮脂含量无显著性改变(p>0.05);V型与V>M型之间血色素水平无明显差异(p>0.05),但均高于其他两型(p<0.01);M型及M>V型的黑色素水平之间无显著差异(p>0.05),但高于其他两型(p<0.05)。结论黄褐斑在临床上存在四种不同类型,即M型、V型、M>V型及V>M型;四型均存在皮肤屏障功能受损,保湿是四型黄褐斑治疗的基础;M型及M>V型以黑色素值增高为主,V型及V>M型以血红蛋白增高为主,提示黄褐斑的治疗应以其类型为依据。     

Impact of Riehl’s melanosis on quality of life in Korean patients: A cross-sectional comparative study

The prevalence of Riehl’s melanosis in Korea is increasing. However, little is known about the psychosocial burden of patients with Riehl’s melanosis. This study was aimed to examine the level of psychosocial impact of Riehl’s melanosis. A cross-sectional study recruited 52 patients with Riehl’s melanosis who were asked to complete questionnaires requesting demographic characteristics, the Dermatology Life Quality Index (DLQI) and Melasma Quality of Life Scale (MELASQOL). The mean score of DLQI and MELASQOL was increased in patients with Riehl’s melanosis compared with that of patients with melasma and healthy controls, respectively. Of note, patients with a long duration of illness, of lower educational level and suffering comorbid disease are more associated with impairment in quality of life. Riehl’s melanosis poses serious negative impacts on the quality of life of the patients. Therefore, the psychological burden of patients with Riehl’s melanosis should be carefully considered.     

长脉宽1064 nm Nd:YAG激光治疗女性黄褐斑的Split-face模式观察

目的运用Split-face模式探讨长脉宽1 064 nm Nd:YAG激光治疗女性黄褐斑的有效性和安全性。方法选取24例双侧面部皮损对称的女性黄褐斑患者,固定选择右侧面部进行长脉宽1 064 nm Nd:YAG激光治疗5次,所有患者每次激光治疗前及末次治疗后第4、第8周均行MASI评分、VISIA皮肤图像分析、CK无创皮肤检测和反式共聚焦显微镜(RCM)检查,并记录治疗和随访期间出现的相关不良反应。结果 MASI评分、RCM总分、VISIA绝对分值及CK的血红蛋白、黑色素值均显示,首次治疗前治疗侧和对照侧差异无统计学意义(P>0.05);末次治疗后4周治疗侧分值较对照侧低,差异有统计学意义(P<0.05);治疗侧末次治疗后4周分值较首次治疗前低,差异有统计学意义(P<0.05);不管是根据Fitzpatrick皮肤分型,还是伍氏灯和玻片压诊分型,各型患者疗效与复发率差异均无统计学意义(P>0.05)。所有患者无明显不良反应发生。结论长脉宽1 064 nm Nd:YAG激光治疗女性黄褐斑安全、有效。     

Melasma. Classification and treatment

Melasma is a cosmetic problem that sometimes causes great emotional suffering. The two most important causative factors are sunlight and genetic predisposition. Moreover, natural and synthetic estrogens, the use of certain drugs and the use of cosmetics with certain components have been implicated as etiologic factors. For the treatment of melasma, the elimination of the factors that are associated with the abnormality of pigmentation, is essential (discontinuation of birth control pills, avoidance of sun exposure). From the many medications that have been used in the treatment of melasma, Hydroquinone alone at a concentration of 2-5%, or in combination with tretinoin or tretinoin and corticosteroids, is now the most widely used preparations. New phenolic compounds and Azelaic acid are also used. Medium depth chemical peeling alone or in combination with other bleaching agents has also been tried with success in some cases. Finally, the use of lasers is discussed.     

光子嫩肤技术治疗面部黄褐斑的临床观察

目的应用强脉冲光子嫩肤仪治疗面部黄褐斑,探索合理、有效、实用的治疗参数。方法对149例不同临床分型的黄褐斑患者进行系列治疗至少5次,每次间隔3~5周。结果本组14例患者治疗1个疗程后,面部黄褐斑消失60%,占10.6%;110例患者治疗3个疗程后,面部黄褐斑消失60%,占83.3%。132例患者随访2年无复发。结论强脉冲光子嫩肤仪治疗面部黄褐斑方便快捷,疗效好,较其他有损伤性治疗发生的并发症少,患者易于接受。     

黄褐斑病因及发病机制研究进展

黄褐斑是常见的色素代谢异常性疾病,多发生于中青年女性,不但影响容貌,而且给患者带来了诸多生活及精神方面的痛苦。但黄褐斑发病机理复杂,真正发病原因目前尚不十分清楚。本文就黄褐斑近年来在病因及发病机理方面的研究进展作一综述。     

Fibroblast morphology,growth rate and gene expression in facial melasma

BackgroundIn addition to melanocytic hyperfunction, changes are observed in the upper dermis of melasma, and fibroblasts play a central role in collagen synthesis and pigmentation induction.ObjectiveTo explore the morphology, growth rate, and gene expression profile of fibroblasts from the skin with melasma in comparison to fibroblasts from the adjacent healthy skin.MethodsTen women with facial melasma were biopsied (lesion and adjacent healthy skin), and the fragments were processed for fibroblast culture. Samples from five participants were seeded to evaluate growth (days 2, 5 and 8) and senescence (SA-β-gal) curves. The samples from the other participants were submitted to real-time PCR to comparatively evaluation of the expression of 39 genes.ResultsCultured fibroblasts from melasma skin were morphologically less fusiform in appearance and on average a 34% (95% CI 4%?63%) greater proportion of cells labeled with SA-β-gal than the fibroblasts from the adjacent skin. The cell growth rate was lower for the melasma samples after eight days (p < 0.01). TheWNT3A, EDN3, ESR2, PTG2, MMP1, and SOD2 genes were up-regulated, whereas the COL4A1, CSF2, DKK3, COL7A1, TIMP4, CCL2, and CDH11 genes were down-regulated in melasma skin fibroblasts when compared to the ones from adjacent healthy skin.Study limitationsSmall sample size; absence of functional tests.ConclusionsFibroblasts from the skin with melasma showed a lower growth rate, less fusiform morphology and greater accumulation of SA-β-gal than those from adjacent photo exposed skin. Moreover, their gene expression profile comprised factors that may contribute to upper dermis damage and sustained melanogenesis.