Evaluation of reliability and validity of the Patient Health Questionnaire‐9 in patients with acne

To evaluate the reliability and validity of the Patient Health Questionnaire‐9 (PHQ‐9) in patients with acne. Three hundred acne patients were enrolled from January 2019 to December 2019. PHQ‐9 and Hamilton Depression Scale(HAMD) survey was conducted to evaluate their depression status. Cronbach's α coefficient and test‐retest reliability after 1 week were used to analyze the reliability of PHQ‐9. Factor analysis, Spearman correlation analysis, receiver operating characteristic curve (ROC curve) were used for validity analysis of the PHQ‐9.The screening validity was analyzed in different subgroups. Two hundred fifty‐eight patients with acne completed the questionnaire. Forty‐seven were diagnosed with depressive disorder. The best cut‐off point for the PHQ‐9 score is 9 points, with a sensitivity of 95.7%,a specificity of 88.6% and the area under the ROC curve(AUC) of 0.973.In validity analysis, the correlation coefficient between the total score of PHQ‐9 and HAMD was 0.766,the kappa value was 0.530.Factor analysis revealed two common factors (cognitive‐affective factor and somatic symptom factor),which explained 65.52% of the total variances. In reliability analysis, the Cronbach's α coefficient of the PHQ‐9 was 0.851,the test‐retest reliability value was 0.824.The time to complete the PHQ‐9 was significantly less than the time to complete HAMD (P < .001).The PHQ‐9 shows good reliability and validity for the diagnosis of depression in patients with acne, and can be used for preliminary screening of depression.     

Efficacy of acne vulgaris treatment protocols according to its clinical forms

To compare results of different treatment regimens based on stratification of acne to prescribe the right treatment protocol according to clinical form and grade of acne. A transversal, cohort study conducted in 230 patients with acne vulgaris. Patients were divided into three groups according to acne severity and the results of each protocol determined in 0, 4, 6, 8, 12, 18 and 24 weeks. Statistical analysis was conducted using Wilcoxon and Mann‐Whitney tests 230 patients (99 females and 131 males) took part in the study. In first grade acne (70 patients), the most effective drug for papulo‐pustular lesions was azelaic acid, where the average value of the reduction was 1.03% per week. For comedone reduction, the most effective drug resulted retinol with 17.7% mean reduction per week. In second grade acne (66 patients), the most effective scheme was: doxycycline + topical retinoid + benzoyl peroxide. In the third grade (92 patients), the most effective drug was oral isotretinoin. Accurate stratification, based on clinical characteristics is required for better outcome. Treatment success is related to the respective individually tailored treatment schemes in patients with acne.     

Pemphigus vulgaris with psoriasis vulgaris successfully treated with methotrexate and low‐dose methylprednisolone

Psoriasis and pemphigus are clinically well‐characterized chronic, inflammatory skin diseases. Many case reports have described the coexistence of psoriasis and bullous pemphigoid. However, the present report is about a rare case of pemphigus vulgaris in a patient with psoriasis vulgaris. We had a 68‐year‐old male psoriatic patient who developed blisters lesions and erosions on the trunk and extremities. The histopathology of a blister lesion showed the intraepidermal blisters that contained serous fluid and inflammatory cells. Both of desmoglein core protein 1 antibody and desmoglein core protein 3 antibody were detected. Diagnoses of pemphigus vulgaris and psoriasis vulgaris were made. The patient was treated with methotrexate (12.5 mg/week) and methylprednisone (16 mg/day) after his admission. Two weeks after admission, the patient's lesions gradually subsided. This case reminds us that the therapeutic effect of pemphigus vulgaris may be related to the incidence of psoriasis.     

Evaluation of subclinical atherosclerosis in Turkish patients with acne vulgaris receiving systemic isotretinoin

Studies conducted on isotretinoin have shown that it may indirectly lead to atherosclerosis. The objective of this study was to determine the effect of systemic isotretinoin on subclinical atherosclerosis. The present study included 63 patients with acne vulgaris who had used isotretinoin for 6 months. Glucose, insulin, and homeostatic model assessment of insulin resistance levels; body mass index; waist circumference; blood pressure; lipid profile; and lectin‐like oxidized low‐density lipoprotein receptor‐1 (LOX‐1), high‐sensitivity C‐reactive protein, and oxidized low‐density lipoprotein (Ox‐LDL) levels were compared in the patients at the initiation and discontinuation of the treatment. At the discontinuation of the treatment, LOX‐1 and Ox‐LDL levels showed a significant increase (P < .001 and P = .040, respectively). Differences in waist circumference were positively correlated with an increase in LOX‐1 levels (r = .274; P = .030). Isotretinoin causes an increase in the levels of subclinical atherosclerosis markers. Although the present study sample size was small, we believe that caution should be exercised considering the risk of atherosclerosis during isotretinoin use in men with high waist circumference and cardiovascular risk factors; further studies are warranted in this regard.     

准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮的临床疗效观察

目的探讨准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮的临床疗效。方法将99例患者随机平均分为激光和水杨酸的联合治疗组,水杨酸治疗组,激光治疗组。3组均治疗2周1次,总共治疗5次,比较3组患者临床疗效。结果第3次治疗后联合治疗组有效率明显高于激光治疗组,差异有统计学意义(P<0.05)。除第一次治疗外,后续治疗联合治疗组有效率均高于水杨酸治疗组,差异有统计学意义(P<0.05),激光治疗组与水杨酸治疗组有效率比较差异无统计学意义(P>0.05)。结论准长脉宽1064 nm Nd:YAG激光联合超分子水杨酸治疗面部轻中度痤疮起效快,效果显著,安全性高,复发率低,医患满意度高。     

护肤方式与青年学生面部痤疮发病关系的流行病学调查

目的观察青年学生的面部护理特点,探讨可能诱发面部痤疮的相关因素。方法指导2018年1月1日-2018年6月31日在北京市某综合医院皮肤科门诊就诊的青年学生填写调查问卷,调查内容包括是否患有痤疮、性别、年龄、皮肤类型、保湿类护肤品及遮盖类化妆品的使用情况,比较不同组间痤疮患病率。结果不同皮肤类型组间痤疮患病率差异有统计学意义,经两两比较油性皮肤与混合性皮肤、混合性皮肤与中性及干性皮肤的痤疮患病率差异有统计学意义(P<0.05)。不同性别、不同保湿方式、是否使用遮盖类化妆品各组间痤疮患病率差异均无统计学意义(P> 0.05)。结论皮肤类型是青春期痤疮患病的影响因素,性别及面部护理方式对青春期痤疮患病的影响不明显。     

超分子水杨酸联合强脉冲光治疗中重度痤疮的疗效分析

目的分析超分子水杨酸联合强脉冲光治疗中重度寻常痤疮的安全性及有效性。方法回顾性总结2015年12月-2017年12月在首都医科大学附属北京佑安医院皮肤科就诊的60例中重度痤疮患者,分为两组,每组各30例患者,分别给予强脉冲光联合30%超分子水杨酸治疗及单纯30%超分子水杨酸治疗。试验组首先给予强脉冲光治疗,根据患者皮损特点、肤色、耐受度选择治疗参数,炎症明显处治疗2次;强脉冲光治疗结束后,清洗面部,全面部涂抹30%超分子水杨酸,慢慢揉搓治疗区域,应用蒸馏水防止干燥且保证水杨酸缓慢释放,持续时间根据患者的耐受程度,一般为10~15 min,每月治疗1次,共治疗1次。对照组仅给予30%超分子水杨酸治疗,每月治疗1次,共治疗4次。治疗后1个月门诊随访。结果试验组的有效率(63.33%)高于对照组(36.67%);试验组治疗后粉刺、炎症丘疹及脓疱、囊肿结节数量比治疗前明显减低。结论超分子水杨酸联合强脉冲光治疗中重度痤疮疗效较好,减少患者治疗周期,未增加不良反应的发生。     

sprouty4蛋白对角质形成细胞增殖及分化的影响

 目的:探证sprouty4(SPRY4)蛋白对角质形成细胞增殖及分化的影响。方法：以人永生化表皮细胞株HaCaT细胞作为实验对象，实验组HaCaT细胞采用基因敲降技术进行SPRY4蛋白抑制物的转染，对照组HaCaT细胞不作任何处理。运用实时荧光定量PCR技术（RT-qPCR）检测实验组与对照组中sprouty4蛋白对HaCaT细胞分化指标Involucrin、CK1与CK10的影响，运用CCK-8实验检测HaCaT细胞的增殖功能。结果：RT-qPCR结果显示，实验组HaCaT细胞中SPRY4基因敲降成功，敲降率约为94.75%。与对照组相比，实验组HaCaT细胞中分化指标Involucrin、CK1与CK10表达水平降低；CCK-8实验结果显示，与对照组相比，实验组HaCaT细胞增殖能力增强。结论：SPRY4蛋白表达下降对细胞增殖起到促进作用，对细胞分化起到抑制作用。