可调控眉毛密度的眉再造术同期治疗瘢痕性秃发的临床护理

目的:探索专项护理在眉再造同期治疗瘢痕性秃发术中的应用效果。方法:根据手术过程分两期进行专项临床护理。扩张器一期置入术后进行扩张器相关专项护理,严密监测扩张注水情况,密切观察扩张部位,防止扩张皮瓣坏死或感染;眉再造和瘢痕性秃发修复二期术后密切观察再造眉毛头皮条的颜色,避免静脉回流不畅发生。结果:本组12例患者进行了眉再造的全方位密切护理,岛状头皮瓣全部存活,头皮瘢痕全部修复,无一例皮瓣坏死。随访6~24个月,再造眉毛毛发密度与健侧非常接近,眉形自然逼真,手术效果满意。结论:在可调控眉毛密度的眉再造同期治疗瘢痕性秃发术中进行全方位护理是手术成功的重要保障。     

窄谱中波紫外线联合复方甘草酸苷治疗斑秃疗效观察

目的 探讨窄谱中波紫外线（NB-UVB）联合复方甘草酸苷治疗斑秃的疗效及机制。方法 将73例斑秃患者随机分为联合组37例和药物组36例,另选37例健康查体者作为对照组。药物组及联合组均口服复方甘草酸苷50 mg,3次/d,联合组在此基础上行NB-UVB照射治疗,治疗3个月后判定两组疗效。采用流式细胞仪检测三组治疗前后外周血CD3^＋、CD4^＋、CD8^＋及CD4^＋/CD8^＋细胞水平变化。结果 联合组及药物组有效率分别为91.9%、71.2%,P〈0.05。治疗前联合组及药物组CD3^＋、CD4^＋及CD4^＋/CD8^＋水平均明显低于对照组,P均〈0.05;治疗后联合组及药物组CD3^＋、CD4^＋及CD4^＋/CD8^＋均明显高于治疗前（P均〈0.05）,CD8^＋水平无明显变化;联合组CD3^＋、CD4^＋及CD4^＋/CD8^＋明显高于药物组（P〈0.05）,CD8^＋无明显变化。结论 斑秃患者免疫功能存在异常,NB-UVB联合复方甘草酸苷治疗斑秃疗效确切;其机制可能为改善患者的免疫功能。     

青年男性雄激素性秃发与动脉粥样硬化的相关性及机制研究

目的分析雄激素性秃发与动脉粥样硬化之间的相关性;探讨雄激素性秃发与动脉粥样硬化之间相关性的可能机制。方法采用病例对照研究方法,比较雄激素性秃发患者与健康对照者血压（BP）、体重指数（BMI）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、空腹血糖（FPG）、超敏C反应蛋白（hs—CRP）等动脉粥样硬化危险因素,超声前臂反应性充血试验（FMD）、脉搏波传导速度（PWV）、大动脉顺应性／小动脉顺应性（C1／C2）,外周血中内皮祖细胞的数量、培养7d后的内皮祖细胞迁移和粘附能力等,分析雄激素性秃发与动脉粥样硬化之间的相关性及其相关性的可能机制。结果雄激素性秃发患者BMI、BP、TC、LDL—C、TC／HDL-C、LDL-C及PWV较无秃发的健康体检者均明显增高,FMD、外周血内皮祖细胞的数量以及体外的迁移、粘附能力明显降低。结论青年男性雄激素性秃发与动脉粥样硬化存在明显相关性;外周血中内皮祖细胞的数量和功能减低引起的血管内皮功能下降可能是青年男性雄激素性秃发与动脉粥样硬化相关性的机制。     

纳晶微针联合5%米诺地尔酊治疗男性雄激素脱发的临床观察

目的评估纳晶微针联合5%米诺地尔酊治疗男性雄激素脱发(AGA)的治疗效果及安全性.方法于我院皮肤科门诊收集男性AGA患者90例,随机分为3组,各组均30人.纳晶微针联合外用5%米诺地尔酊(A组)、单独纳晶微针治疗组(B组)和单独外用5%米诺地尔酊治疗组(C组),三组患者均连续治疗24周后评估疗效.结果治疗24周后,医师疗效评分方面:A组明显改善率40%,B组和C组明显改善率均为6.7%,三组患者均有改善.两组间相比,A组与B组(P<0.001)、A组与C组(P<0.001),差异均有统计学意义.患者疗效平均分:A组3.03分>C组1.93分>B组1.73分.两组间对比,A组与B组(P<0.001),A组与C组(P<0.001),差异均具有统计学意义.治疗过程中三组患者均未出现明显不良反应.结论纳晶微针联合5%米诺地尔酊治疗男性AGA比单独应用纳晶微针及单独外用米诺地尔治疗效果更佳,值得临床推广应用.     

CD80CD86 deficiency disrupts regulatory CD4+FoxP3+T cell homoeostasis and induces autoimmune‐like alopecia

Alopecia areata (AA) is an autoimmune disease that results in spot baldness in humans. Adequate animal models for AA are currently lacking. The objective of this study was to elucidate the mechanism of autoimmune-like alopecia (ALA) in C57BL/6.CD80CD86-deficient (B6.CD80CD86^−/−) mice. Incidence and severity of alopecia were analysed in 58 B6.CD80CD86^−/− mice using histological examination, flow cytometry, multiplex enzyme-linked immunosorbent assay, quantitative RT-PCR and CD25 inhibition test. Both male and female B6.CD80CD86^−/− mice showed almost 100% incidence of hair loss at 40 weeks of age. Moreover, CD4+FoxP3+Treg (Treg) cell population in B6.CD80CD86^−/− mice was significantly lower than in B6 mice, which presumably underlined autoimmune reaction. Histologically, B6.CD80CD86^−/− mice showed CD4+ and CD8+ T-cell infiltration around terminal follicle region and exhibited hair follicle destruction in the anagen or catagen stage. Negative correlation between the number of CD4+FoxP3+ Tregs and ALA was confirmed by the CD25 depletion test in B6 mice, as follicle destruction was similar to that observed in B6.CD80CD86^−/− animals. CD80CD86 deficiency disrupted CD4+FoxP3+ Treg homoeostasis and prompted the development of ALA. We demonstrated that B6.CD80CD86^−/− mice might have several advantages as an ALA model, because they exhibited high incidence of disease phenotype and epipathogenesis similar to that observed in human AA.     

Lichenoid folliculitis: A unifying concept

Skin diseases presenting with keratotic papules, atrophy, cicatricial alopecia and/or “lichenoid” histopathologic changes have been described under at least 30 names. This family of diseases contains 2 subgroups, largely based on clinical features: keratosis pilaris atrophicans (KPA; including keratosis pilaris atrophicans faciei/ulerythema ophryogenes, atrophoderma vermiculatum, and keratosis follicularis spinulosa decalvans); and the lichen planopilaris (LPP) subgroup (including LPP, frontal fibrosing alopecia, Graham‐Little‐Piccardi‐Lassueur Syndrome and fibrosing alopecia in a pattern distribution). An interface dermatitis with lichenoid inflammation is characteristic of the LPP group of disorders, but the literature provides scant information about the histopathology of the KPA group. Our experience has been that the 2 subgroups show a unifying histologic similarity as well as considerable clinical overlap. Because these conditions overlap clinically and histologically, we propose that the term lichenoid folliculitis (LF) be used to refer to this group of diseases, thus simplifying cumbersome nomenclature and highlighting the possibility of shared pathogenesis and treatment options.     

Usefulness of TrichoScan professional in the evaluation of hair loss in females. Report of 180 cases

Background TrichoScan Professional is a computerized program used for digital measurement of hair growth and hair loss. The aim of our study was to undertake an evaluation with TrichoScan Professional of female patients consulting at our hospitals for hair loss. The purpose of our study was to determine whether TrichoScan was able to identify differences in hair parameters that would correlate with the pattern of alopecia or according to the age of the patients evaluated. Material and methods One hundred‐eighty women that consulted consecutively for loss of hair were included. Patients were aged between 8 and 85 years (mean age 36 years). Data including age, the number of hairs, hair density per square centimetre, anagen and telogen percentage and percentage of terminal and miniaturized hair were analysed. Results Results observed with TrichoScan were as below: number of hairs (mean 154.9; range 34–316). Hair density per square centimetre (mean 239; range 52–486). Hair in anagen phase (mean 62.4%; range 9–93%). Hair in telogen phase (mean 37.4%; range 7–91%). Terminal hair (mean 95.2%; range 82–100%). Vellus hair (mean 4.7%; range 0–17%). Pearson′s correlation test was used to measure the strength of the association of age with the rest of parameters. The statistical analysis showed a significant correlation between age and both the number of hairs and the hair density per square centimetre. However, no significant correlation between age and rest of the parameters was observed. Conclusions TrichoScan Professional may help to quantify hair density and in our sample, this was the only parameter showing a significant decrease according to age in various types of alopecia affecting the females.     

Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita

Background Several patients, especially women, seek advice because of hair loss. They may be diagnosed clinically as having telogen effluvium (TE) or androgenetic alopecia (AGA), but histopathology may reveal that a proportion of them have in fact alopecia areata incognita (AAI). Objectives To detect dystrophic anagen hairs in such patients. Methods We studied 1932 patients with hair loss and no signs of classical alopecia areata. They were submitted to the modified wash test (which counts the total number of telogen hairs lost and the percentage of vellus hairs) and divided into patients having pure TE (403), patients with AGA + TE (1235) and patients with pure AGA (294). Dystrophic hairs were detected with a low magnification microscope. Results Dystrophic hairs were observed in 13 patients with TE (3.2%), in 54 with AGA + TE (4.4%) and in none with AGA. In addition, 7 patients with TE and 32 with AGA + TE developed small patches of alopecia areata in 6 to 9 weeks. No patches developed in patients with AGA. Conclusions The presence of dystrophic hairs and the development of patches of alopecia areata (and their absence in pure AGA) provide a first evidence of the possibility that within the heterogenous condition named TE some patients have in fact AAI.     

祛脂防脱片治疗早期雄激素源性脱发疗效观察

目的:观察祛脂防脱片治疗早期雄激素源性脱发(AGA)的临床疗效。方法:84例早期脱发患者,随机分为试验组和对照组。试验组48例服祛脂防脱片,对照组36例服除脂生发片,治疗1个月为1个疗程,疗程结束后统计分析。结果:两组有效率分别为60.42%、22.22%,试验组疗效优于对照组(P<0.01)。结论:祛脂防脱片治疗早期雄激素源性脱发(AGA)临床效果好。     

雄激素源性脱发的辨证论治

介绍中医辨证治疗雄激素源性脱发的临床经验。临床分为湿热熏蒸证、阴虚血瘀证，治疗上重视辨病与辨证相结合，内治与外治相结合。