利用血液透析开展血液灌流治疗皮肤瘙痒的疗效观察

目的:观察利用血液透析开展血液灌流治疗皮肤瘙痒的疗效。方法:选择2013年1月~2018年12月本院肾内科接收的66例老年慢性肾衰竭皮肤瘙痒患者,以血液透析时机作为分组标准,分为观察组和对照组,观察组每两周进行1次血液灌流+6次血液透析。对照组每周进行3次血液透析。比较两组患者的比较治疗前和治疗后的血肌酐、血尿素氮、血磷和治疗疗效。结果:①与治疗前对比,两组患者治疗后血肌酐水平、血尿素氮水平、血磷水平明显下降,APACHE-Ⅱ评分明显减少,数据差异存在统计学意义,P<0.05。和对照组对比,观察组治疗后血肌酐水平、血尿素氮水平、血磷水平明显更低,APACHE-Ⅱ评分明显更少,数据差异存在统计学意义,P<0.05。②观察组治疗疗效明显高于对照组,数据差异存在统计学意义,P<0.05。结论:HP+HD能够有效地改善维持性血透患者的皮肤瘙痒症状,解除患者的痛苦,提高尿毒症患者的生活质量。     

Intralesional triamcinolone acetonide in notalgia paresthetica: Treatment outcomes in five patients

Numerous treatment modalities have been tried with diverse results for pruritus due to notalgia paresthetica (NP). Corticosteroids suppress ectopic neural discharges from injured nerve fibers and also have short‐lived suppressive effect on transmission in normal C‐fibers. Herein, we evaluated the efficacy of intralesional triamcinolone acetonide in the treatment of NP. The medical reports of five patients who had been diagnosed with NP and treated with intralesional triamcinolone acetonide injections were retrospectively evaluated. Triamcinolone acetonide solution was injected intradermally (10 mg/mL; 0.1 mL/cm²) every 3 weeks for a maximum of four treatments. The severity of itch was scored by the patients on a combined numerical and visual analogue scale. After treatment, reduction in itch severity scores varied between 33% and 100%.     

Vulvar lichen sclerosus: A single‐center retrospective study in China

Vulvar lichen sclerosus (VLS) is an uncommon, chronic inflammatory skin disease lacking clinical data of large sample size in China. This study was intended to provide missing data on this condition through investigating the clinical characteristics of Chinese VLS patients. The medical records of 129 VLS patients from our vulvar outpatient clinic were analyzed with SPSS version 18.0 software. The age of onset followed a normal distribution, with the peak at 25–30 years. Of all cases, the incidence rate during the postmenopausal period was 14.0% with an average duration of 9.22 years. The most frequently involved site was the bilateral labia minora (71.3%). Itching was the principal symptom (94.6%); meanwhile, patients with severe itching more commonly experienced longer duration, flaring at night, hyperkeratotic lesions or rashes on the posterior commissure than those with mild to moderate itching (P < 0.05). Furthermore, 60% of the enrolled patients suffered from sexual dysfunction. The major sign was pallor (92.2%), followed by hyperkeratosis (55.0%) and atrophy (40.3%). The patients with atrophy had a significantly longer duration of the disease, and the older patients presented more frequently with edema in the area of lesions (both P < 0.05). Of our patients, 9.3% suffered concomitantly from autoimmune diseases, mostly thyroid with one case being complicated by vulvar squamous cell carcinoma (SCC). In our study, the severity of pruritus was partly related to clinical manifestations. Moreover, Chinese patients could have developed VLS mostly in the reproductive period, with less complications of autoimmune diseases or SCC.     

Prevention of Topical Surfactant–Induced Itch-Related Responses by Chlorogenic Acid Through the Inhibition of Increased Histamine Production in the Epidermis

Effects of chlorogenic acid on surfactant-induced itching were studied in mice. Topical application of sodium laurate increased hind-paw scratching, an itch-related response, 2 h after application, which was inhibited by topical post-treatment with chlorogenic acid. Sodium laurate increased the histamine content and 53-kDa l-histidine decarboxylase in the epidermis, which were also inhibited by post-treatment with chlorogenic acid. These results suggest that topical chlorogenic acid is effective in the prevention of itching induced by anionic surfactants. The inhibitory activity of chlorogenic acid may be due to the inhibition of an increase in histamine in the epidermis.     

谷胱甘肽联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症孕妇皮肤瘙痒症状及妊娠结局的影响

目的探讨分析谷胱甘肽联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症(ICP)孕妇皮肤瘙痒症状及妊娠结局的影响。方法选取2016年3月至2020年2月我院收治的ICP孕妇62例,随机平均分为两组。对照组在常规治疗基础上采用多烯磷脂酰胆碱治疗,观察组在对照组基础上采用谷胱甘肽治疗。治疗10 d后,比较两组孕妇的Ribaha评分及妊娠结局。结果治疗后,两组的Ribaha评分均低于治疗前,且观察组的Ribaha评分低于对照组(P <0.05);观察组的宫内窘迫、早产、产后出血发生率低于对照组(P <0.05)。结论谷胱甘肽联合多烯磷脂酰胆碱可显著改善ICP孕妇皮肤瘙痒及妊娠结局,值得临床推广应用。     

润肤止痒乳对银屑病患者角质形成细胞增殖和VEGF分泌的影响

目的:观察润肤止痒乳对银屑病患者角质形成细胞增殖和VEGF分泌的影响。方法:对银屑病患者表皮角质形成细胞进行原代培养,通过四甲基偶氮唑蓝微量酶反应比色法(MTT法)及酶联免疫吸附法(ELISA)体外观察润肤止痒乳对表皮角质形成细胞增殖及VEGF分泌的影响。结果:润肤止痒乳在0-485.5 mg/mL浓度范围内对角质形成细胞无毒副作用,在该浓度范围内有明显抑制角质形成细胞增殖的作用,其抑制作用与他扎罗汀比较,差异无统计学意义(P>0.05);且在该浓度范围内润肤止痒乳可减少角质形成细胞分泌VEGF的含量。结论:润肤止痒乳在一定浓度范围内可抑制角质形成细胞的增殖作用,且能减少VEGF的分泌。     

益气逐瘀汤治疗气虚血瘀型银屑病临床疗效观察

[目的]探究益气逐瘀汤治疗气虚血瘀型银屑病的临床疗效。[方法]收集2019年8月至2020年2月来我院皮肤科门诊治疗的气虚血瘀型银屑病患者共82例,根据发病时间,采用随机数字表法分为对照组和治疗组,两组分别包含患者41例。对照组患者予复方甘草酸苷50mg口服,3次/d,治疗组患者在此基础上同时联合益气逐瘀汤口服,两组患者均治疗21d。观察治疗前后两组患者的中医症候积分、皮损面积及严重程度指数评分、瘙痒程度评分及皮肤病生活质量评分。[结果]治疗前,两组患者中医症候积分、皮损面积及严重程度指数评分、瘙痒程度评分及皮肤病生活质量评分差异均无统计学意义(P0.05)。治疗后两组患者的中医症候积分、皮损面积及严重程度指数评分、瘙痒程度评分及皮肤病生活质量评分较治疗前均有所降低,且治疗组均明显低于对照组,差异具有统计学意义(P0.05,P0.01,P0.001)。[结论]益气逐瘀汤联合复方甘草酸苷能有效改善气虚血瘀型银屑病患者皮肤暗红、瘙痒、脱屑等症状,修复受损皮肤,提高患者生活质量。     

452例妇女外阴瘙痒病因调查分析

目的 :　对皮肤性病科门诊妇女外阴瘙痒患者进行病因调查分析。方法 :　对以外阴瘙痒为主诉的妇女患者进行皮肤性病科临床检查 ;取阴道分泌物进行pH值、胺试验及念珠菌、滴虫和线索细胞检查 ;取宫颈分泌物作淋球菌、解脲支原体培养和沙眼衣原体荧光抗原检查 ;可疑部位取材作HSV和HPV检测及梅毒血清学检查。结果 :　在 45 2例入选患者中 ,外阴阴道念珠菌病、非淋菌性宫颈炎和细菌性阴道病分别占 2 5 .44 %、2 0 .79%和 13.5 0 % ,外阴湿疹、滴虫性阴道炎和外阴瘙痒症也较多见。结论 :　与性传播因素有关的病原体感染及外阴湿疹和瘙痒等是皮肤性病科就诊妇女外阴瘙痒的主要原因。