Transplantation of autologous noncultured epidermal cell suspension in treatment of patients with stable vitiligo

Treatment of vitiligo by transplantation of noncultured melanocytes containing keratino-cytes has been successful since 1992,1 We report the encouraging results of autologous epidermal cell suspension in the treatment of 24 patients with stable vitiligo since 1998.     

白癜风患者心理调查与结果分析

目的:对白癜风患者心理进行调查并作结果分析。方法:采用心理健康症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)以及汉密尔顿焦虑量表(HAMA),对40例暴露部位白癜风患者和30例非暴露部位白癜风患者进行问卷调查分析。结果:SCL-90测评结果显示:白癜风患者暴露组、白癜风患者非暴露组在人际关系、焦虑和抑郁项的得分明显高于对照组,差异有显著性(P<0.05)。HAMD、HAMA测评结果显示:白癜风患者暴露组、白癜风患者非暴露组的得分明显高于对照组,差异有显著性(P<0.05)。白癜风患者暴露组HAMA得分大于14分,存在焦虑症状。结论:白癜风患者可能存在焦虑、抑郁等心理障碍,本研究为白癜风患者的心理干预治疗提供了依据。     

Incident alopecia areata and vitiligo in adult women with atopic dermatitis: Nurses’ Health Study 2

We aimed to determine the risk of alopecia areata (AA) and vitiligo associated with atopic dermatitis (AD) in a large cohort of US women, the Nurses’ Health Study 2. We used logistic regression to calculate age‐ and multivariate‐adjusted odds ratios to determine the risk of incident AA and vitiligo associated with AD diagnosed in or before 2009. A total of 87 406 and 87 447 participants were included in the AA and vitiligo analyses, respectively. A history of AD in 2009 was reported in 11% of participants. There were 147 incident cases of AA and 98 incident cases of vitiligo over 2 years of follow‐up. AD was associated with increased risk of developing AA (OR 1.80, 95% CI 1.18–2.76) and vitiligo (OR 2.14, 95% CI 1.29–3.54) in multivariate models. In this study of US women, AD was associated with increased risk of incident vitiligo and AA in adulthood.     

白癜风证候分类及维吾尔医用药规律分析

目的:整理分析维吾尔医辨证施治白癜风的证候分类及维吾尔药用药规律。方法:采用回顾性整理分析方法,收集整理新疆5家维吾尔医医院10年内维吾尔医药治疗白癜风的临床住院病历,整理分析白癜风的维吾尔医证候分类与治疗原则、方法、方药及其用药情况,挖掘维吾尔医辨证施治白癜风的证候分类及用药规律。结果:符合纳入标准的异常黏液质型白癜风病历362例,其中无味黏液质173例(47.79%),石灰样黏液质46例(12.71%),酸味黏液质43例(11.88%),甜味黏液质40例(11.05%),涩味黏液质36例(9.94%),咸味黏液质24例(6.63%)。采用成熟及清除疗法,内服药物疗法,外用药物疗法和非药物疗法等综合治疗方法进行治疗。结论:白癜风的维吾尔医证候分类及用药规律符合临床辨证实际,为其维吾尔医辨证施治的规范化提供了客观依据。     

308nm准分子激光联合0.1%他克莫司乳膏治疗白癜风的临床体会

目的:比较应用0.1%他克莫司软膏联合308nm准分子激光与单用308nm准分子激光治疗白癜风的效果。方法:64例白癜风患者,每个部位选择1～2处皮损将自身皮损分为A、B两组,分别108处皮损,A组予308nm准分子激光治疗,2次/周,共30次;B组在激光治疗的基础上外用0.1%他克莫司乳膏,2次/天。治疗过程中记录疗效及不良反应。结果:两组分别108处皮损,所有患者完成了治疗。总有效率:A组65.74%(71/108),B组89.81%(97/108),(χ2=18.10,P<0.05);其中面颈部有效率:A组88.10%(38/42),B组92.86%(39/42)(χ2=0.26,P>0.05);躯干部有效率:A组53.84%(28/52),B组94.23%(49/52)(χ2=22.06,P<0.05);四肢有效率A组50.00%(5/10),B组80.00%(8/10);手足有效率:A组0(0/4),B组25.00%(1/4);平均治疗次数:A组21.8次、B组19.4次,平均出现色素次数:A组7次、B组5.5次。结论:308nm准分子激光联合他克莫司乳膏治疗白癜风起效快、疗效好,副作用少;面颈部单用308nm准分子激光亦可获良效。     

儿童白癜风1125例的临床特征与治疗总结

目的:通过对1 125例儿童白癜风患者的临床特点和治疗进行总结,以期对白癜风的早期预防及治疗提供依据。方法:对1 125例第四军医大学西京医院皮肤科确诊的儿童白癜风病例进行回顾性分析。结果:1 125例白癜风患儿中,男女比1.04∶1,平均始发年龄7.03岁,发病年龄以5～9岁最多见(62.04%),平均病程15.32月。227例(20.1%)有家族史,春夏季发病或病情加重者所占百分比高;15.29%患儿发病前有外伤、精神因素、日晒等诱因。临床表现以寻常型最常见(86.31%),6.84%伴发其他疾病,其中晕痣最多,共50例(4.44%),且伴发晕痣者平均发病年龄早于无合并晕痣者。治疗包括中医中药、局部或系统使用糖皮质激素、免疫调节剂、光疗法及外科手术等方法,以联合治疗为主,疗程1年有效率达54.93%。结论:家族史阳性、伴发晕痣、氧化应激损伤均是儿童白癜风发病的危险因素。儿童白癜风的治疗受限,疗效不理想,有待进一步探索。     

窄谱中波紫外线联合中药治疗白癜风的临床疗效对比分析

目的:观察窄谱中波紫外线(NB-UVB)在白癜风治疗中的临床疗效。方法:动员门诊患者,将病例按1:1比例随机入组,A组为观察组,采用口服中药及免疫调节剂并联合窄谱中波紫外线(NB-UVB)全身照射,B组为对照组,单纯口服中药及免疫调节剂,A、B两组治疗周期为9个月,每3个月进行疗效、不良反应判定。结果:动员入组240例,脱落16例,完成治疗共224例,A组114例,B组110例。两组间年龄、性别、病程、分期、分类、分型差异均无统计学意义(P>0.05)。治疗3、6、9个月后,A组有效率分别为13.33%、20.51%、48.25%,B组有效率分别为10.28%、20.00%、7.27%,其中治疗3个月及6个月后A、B两组有效率均无显著性差异(χ2=0.952,P>0.05;χ2=0.009,P>0.05),治疗9个月后,A组有效率显著高于B组,两组差异有显著性(χ2=29.865,P<0.01)。治疗3、6、9个月后,A组平均复色率分别为18.18%、23.95%、52.73%,B组平均复色率分别为15.57%、18.34%、17.77%,其中治疗3个月后,A、B两组复色率无显著性差异(t=1.303,P>0.05),治疗6个月及9个月后,A组复色率显著高于B组,两组差异有显著性(t=2.401,P<0.05,t=11.96,P<0.01)。在治疗中,A组中10例(8.78%)、B组中8例(7.27%)出现不同程度红斑、瘙痒等不良反应。结论:窄谱中波紫外线(NB-UVB)联合中药治疗白癜风安全有效,在维持疗效及防止复发方面具有显著优势。     

A prospective,randomized clinical study to compare the efficacy of recipient site preparation using dermabrasion,cryoblister, and dermaroller in autologous noncultured epidermal cell suspension in stable vitiligo

Noncultured epidermal cell suspension (NCES) is a well‐established surgical treatment modality for stable vitiligo. The outcome of this procedure significantly depends on the method of recipient site preparation, a critical step to achieve cosmetically acceptable repigmentation. To compare the efficacy of recipient site preparation using three methods namely, dermabrasion, cryoblister, and dermaroller followed by NCES in stable vitiligo. In this single‐center, prospective, intra‐patient, randomized clinical trial; 36 participants having at least three vitiligo patches in same anatomic region with minimum lesional stability of 1 year were randomized 1:1:1 for recipient site preparation using manual dermabrasion, cryoblister, and dermaroller followed by NCES. Patients were followed up at 4, 8, and 12 weeks and assessment of extent and pattern of repigmentation, color match and patient satisfaction were done. Among 36 patients, 22 (61.1%) were females; mean (SD) age was 28.33 (9.4) years. Dermabrasion and cryoblister techniques showed equal efficacy with respect to extent of repigmentation (>75% repigmentation; 55.6% vs 47.2%; P = .63) and patient satisfaction score (20.2 ± 9.6 vs 19.9 ± 7.9, P = .194). However, dermabrasion was superior to cryoblister in terms of rapidity (65% vs 32.5% at 4 weeks, P = .04) and color match (47.2% vs 19.4%, P = .004). Dermaroller had poor repigmentation outcomes compared to both dermabrasion and cryoblister. Cryoblister as a method of recipient site preparation is equally effective as manual dermabrasion in NCES for attaining good to excellent repigmentation, but with risk of hyperpigmentation. However, dermaroller is inferior to both dermabrasion and cryoblister.     

308 nm准分子激光联合富血小板血浆治疗白癜风有效性与安全性Meta分析

目的：比较308 nm准分子激光联合富血小板血浆(platelet-rich plasma, PRP)与单用308 nm准分子激光治疗白癜风的有效性与安全性。方法：检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库中关于308 nm准分子激光联合PRP治疗白癜风的研究,并对文献进行筛选及数据提取。以有效率、显效率作为疗效指标进行统计分析,计算OR及相应的95% CI值。结果：本文共纳入4篇研究,统计分析显示,308 nm准分子激光联合PRP与单用308 nm准分子激光比较有效率：OR=3.39,95% CI 1.98~5.80;显效率：OR=10.31,95% CI 2.43~43.72。两种疗法均无严重不良反应发生。结论：308 nm准分子激光联合PRP治疗白癜风疗效优于单用308 nm准分子激光。