基于倾向性评分匹配评价青海地区损容性皮肤病患者皮肤屏障功能及其临床意义

目的 采用倾向性评分匹配方法探讨青海地区损容性皮肤病患者面部皮肤屏障功能的差异，为临床护理与治疗提供依据。方法 收集损容性皮肤病患者资料1866例，其中黄褐斑239例，寻常痤疮545例，玫瑰痤疮1082例，此外选取185名健康体检者作为对照。通过倾向性评分匹配法按照1∶1或1∶n进行病例匹配，通过比较经表皮失水率、表皮含水量、表皮油脂含量、pH值，评估不同损容性皮肤病的皮肤屏障特点。结果 黄褐斑、寻常痤疮、玫瑰痤疮组表皮水含量均低于健康组，PH值均高于健康组，差异有显著统计学意义（P <0.05）；寻常痤疮、玫瑰痤疮组经皮失水率、表皮油脂含量高于健康组，差异有显著统计学意义（P <0.05）。PSM匹配前后结论一致。结论 3种损容性皮肤病的皮肤屏障均有不同程度的受损，提示在这3种损容性皮肤病的治疗中，修复皮肤屏障可能是疾病缓解的关键。健康对照组皮肤屏障功能也有异常，提示青海高原地区健康人群也应加强皮肤屏障的保护。     

不同原因导致敏感性皮肤的皮肤生理功能测试及临床意义

目的:探讨痤疮、激素依赖性皮炎、特应性皮炎和干燥性湿疹等不同原因导致敏感性皮肤的皮肤生理功能特点,指导敏感性皮肤的护理和治疗.方法:选取各种原因导致的敏感性皮肤受试者154名,均为女性.运用无创性皮肤生理功能测试仪测量受试者的皮肤皮脂含量、角质层含水量和经表皮水分丢失(TEWL).结果:与单纯敏感性皮肤比较,痤疮组皮脂含量较高(P＜0.05),激素依赖性皮炎组TEWL值较高(P＜0.05),特应性皮炎和干燥性湿疹组皮脂含量、角质层含水量较低,而TEWL值较高(P＜0.05),其余参数比较差异无统计学意义;与痤疮导致的敏感性皮肤比较,激素依赖性皮炎组皮脂含量较低(P＜0.05),TEWL值较高(P＜0.05),特应性皮炎和干燥性湿疹组皮脂含量、角质层含水量较低(P＜0.05),而TEWL值较高(P＜0.05),其余参数比较差异无统计学意义;与激素依赖性皮炎导致的敏感性皮肤比较.特应性皮炎和干燥性湿疹组皮脂含量较低(P＜0.05),其余参数比较差异无统计学意义.结论:不同原因导致敏感性皮肤的皮肤屏障功能状态不完全一致,应根据不同病因对敏感性皮肤进行治疗和护理.     

昆明地区皮肤美容专科门诊损容性皮肤病调查分析

目的了解昆明地区皮肤美容专科门诊损容性皮肤病发生情况,并对相关损容性皮肤病构成比差异的原因进行分析,提出防治对策。方法对2011年1月1日-2011年12月31日到昆明医科大学第一附属医院皮肤美容专科门诊初诊患者进行损容性皮肤病构成比调查。结果①构成比前15位的损容性皮肤病由高到低分别为痤疮495例(28.56%),湿疹260例(15.00%),黄褐斑77例(4.44%),日光性皮炎69例(3.98%),白癜风66例(3.80%),接触性皮炎53例(3.06%),色素痣46例(2.65%),敏感性皮肤45例(2.60%),斑秃44例(2.54%),激素依赖性皮炎41例(2.40%),特应性皮炎30例(1.73%),红斑狼疮29例(1.67%),光线性角化病28例(1.62),换肤综合征27例(1.56%),皮肤癌24例(1.38%)。②女性患者中损容性皮肤病构成比前3位分别是痤疮(40.00%)、湿疹(17.70%)和黄褐斑(7.54%);男性患者中损容性皮肤病构成比前3位分别是痤疮(30.78%)、湿疹(23.39%)和日光性皮炎(12.41%)。③(0～15)岁最高的三种损容性皮肤病构成比由高到低分别是:湿疹(31.51%),白癜风(26.03%)和特应性皮炎(16.44%);(15～30)岁分别是痤疮(70.58%),湿疹(8.95%)和斑秃(3.98%);(30～45)依次是痤疮(32.75%),湿疹(14.91%)和黄褐斑(12.54%);(45～60)分别是湿疹(31.64%),日光性皮炎(12.99%)和敏感性皮肤(12.43%);(60～85)岁分别是湿疹(37.35%),日光性皮炎(20.48%)和日光性角化症(10.84%)。结论昆明地区损容性皮肤病在皮肤美容科门诊中,构成比最高的前四位是痤疮、湿疹、黄褐斑和日光性皮炎,临床应加强对这四种皮肤病的防治工作。损容性皮肤病的构成比随年龄及性别不同各有不同,应根据不同年龄、性别做好预防治疗工作。     

多形性日光疹皮损中板层小体分布、神经酰胺酶表达与皮肤屏障功能

目的 探讨多形性日光疹（PLE）表皮中板层小体的分布、神经酰胺酶的表达与皮肤屏障受损的相关性。方法 选取PLE患者47例及正常人对照40例,通过电镜观察两组皮损处颗粒层、棘层板层小体的数量及分布情况,运用免疫组化测定皮损处神经酰胺酶的表达,采用无创性皮肤测试仪测量皮损处经皮水分丢失（TEWL）、角质层含水量及皮脂含量。结果 透射电镜结果显示：与对照组相比,PLE患者颗粒层、棘层板层小体数量明显少于正常人对照组,分布较正常人对照组紊乱。免疫组化结果显示：PLE患者皮损处神经酰胺酶表达20例阳性、21例弱阳性、6例阴性;正常人对照组中36例阳性、4例弱阳性,差异有统计学意义（P < 0.01）;皮损处TEWL（34.2191 ± 12.70）较正常人对照组（16.8350 ± 6.50）高,角质层含水量（22.7319 ± 8.71）较正常人对照组（29.4250 ± 5.08）低,差异有统计学意义（P < 0.01）;皮脂含量两者之间差异无统计学意义。结论 PLE患者存在神经酰胺合成障碍,可能是皮肤屏障受损的原因之一。     

含青刺果及马齿苋的医学护肤品对湿疹屏障修复作用的观察

目的 观察含马齿苋及青刺果提取物的医学护肤品恢复慢性湿疹患者皮肤屏障功能.方法 选取慢性湿疹患者80例,其中男46例,女34例.用自身对照试验,治疗侧使用含青刺果及马齿苋的医学护肤品及糠酸莫米松乳膏,对照侧单独使用糠酸莫米松乳膏,1周后双侧停用糠酸莫米松乳膏,但治疗侧继续使用使用含青刺果及马齿苋的医学护肤品,于第0天、7天、30天、60天进行随访,通过皮肤油脂含量、角质层含水量及经表皮水分流失量(TEWL)来评估皮肤屏障功能,于第60天观察患者症状和皮损改善情况评估疗效及复发率.结果 第60天,80例患者治疗侧使用医学护肤品后症状和体征改善的有效率较对照侧显著升高(P＜0.01);复发率较对照侧显著降低(P＜ 0.01).第0天、7天、30天、60天治疗侧皮脂含量、角质层含水量较治疗前及对照侧升高,TEWL值较治疗前及对照侧降低,差异有统计学意义(P＜0.01),随着治疗时间延长,皮肤油脂含量、角质层含水量及TEWL值逐渐恢复正常.结论 用含青刺果及马齿苋的医学护肤品可恢复慢性湿疹皮肤屏障功能,降低复发率.     

皮肤生理功能检测在慢性湿疹治疗中的指导意义

目的探讨慢性湿疹皮肤屏障功能受损的变化,指导临床对慢性湿疹的预防和治疗。方法选取慢性湿疹受试者136例,均为男性,运用无创性皮肤生理功能测试仪测量受试者皮肤pH、角质层含水量和经表皮水分丢失(TEWL),同时检测同1部位未受损皮肤。结果与未受损处皮肤比较,慢性湿疹处TEWL值明显升高(P0.05),与未受损处皮肤比较,慢性湿疹处角质层含水量显著降低(P0.05),而TEWL值较高,与未受损处皮肤比较,慢性湿疹处p H明显高(P0.05),其余参数比较差异无统计学意义。结论未受损处皮肤和慢性湿疹处皮肤屏障功能在pH、TEWL、角质层含水量有显著差异,应根据测试结果及时恢复或重建皮肤屏障功能,减少或阻止慢性湿疹的再复发。     

乌鲁木齐地区不同民族痤疮患者皮肤生理指标分析

目的检测乌鲁木齐地区维吾尔族、汉族痤疮患者面部皮肤生理指标,比较不同民族之间的差异。方法选取维吾尔族痤疮患者80例及汉族痤疮患者80例,两组患者年龄及性别分布相比差异均无统计学意义(P 0.05)。分别测定额部、鼻部、面颊部的经皮水分丢失量(TEWL)、面部含水量、皮脂量、皮肤红色素值;测定额部、眼部、面颊部的皮肤弹性的数据。结果维吾尔族痤疮患者面部角质层含水量在额部、鼻部、面颊部与汉族相比均低于汉族,差异均有统计学意义(P 0.05);维吾尔族痤疮患者面部TEWL在额部、鼻部、面颊部与汉族相比均高于汉族,差异均有统计学意义(P 0.05);维吾尔族痤疮患者面部皮肤油脂含量在额部、鼻部与汉族相比均高于汉族,差异均有统计学意义(P 0.05);维吾尔族和汉族痤疮患者前额、鼻部的皮肤红色素值差异无统计学意义(P 0.05),面颊部红色素值有统计学意义(P 0.05)。维吾尔族和汉族痤疮患者前额、眼角和面颊部的皮肤弹性值差异无统计学意义(P 0.05)。结论乌鲁木齐地区不同民族痤疮患者可能因为饮食习惯不同导致皮肤屏障功能的差异,需要个体化的干预治疗。     

旁氏无暇透白日霜改善黄褐斑及其皮肤屏障功能的疗效观察

目的观察旁氏无暇透白日霜(SPF 15 PA++)改善黄褐斑临床症状及皮肤屏障功能的疗效。方法采用随机双盲、自身对照的临床研究方法。选取30例面部皮损较对称的黄褐斑患者,受试者每天用温水清洁面部,半脸使用约0.5g测试产品,另外半脸使用等量对照产品,早晚各1次,2次/d。分别于首诊、治疗后第28天、56天评估皮损情况。结果①主观比较:实验组基本治愈0例,显效4例,好转10例,无效16例,总有效率46.6%。对照组基本治愈0例,显效1例,好转5例,无效24例,总有效率20.0%。治疗组与对照组疗效经卡方检验差异有统计学意义(P0.05)。②TEWL值:试验组与对照组随时间延长TEWL值均值均有所降低,治疗组与对照组相比0、28、56天P值均0.05,差异无统计学意义。③皮肤角质层含水量:试验组与对照组随时间延长皮肤角质层含水量均值均有所升高,治疗组与对照组相比0、28天P值均0.05,差异无统计学意义,第56天时,试验组角质层含水量(41.14±5.94)与对照组角质层含水量(41.90±5.81)比较,差异有统计学意义(P0.05)。④LAB值检测:随时间延长实验组与对照组LabL值均值均有所升高、LabA值均值无明显变化、LabB值均值均有所下降。实验组与对照组相比,LabL值0、28天P值均0.05,差异无统计学意义;56天时,实验组LabL值(58.92±3.52)与对照组LabL值(56.86±3.11)相比,差异有统计学意义(P0.05)。LabA值0、28、56天P值均0.05,差异无统计学意义。LabB值0、28天P值均0.05,差异无统计学意义;56天时,实验组LabB值(15.21±1.90)与对照组LabB值(16.16±1.52)相比,差异有统计学意义(P0.05)。结论受试品"旁氏无暇透白日霜"和对照品市售"凡士林保湿露"均具有良好的美白、保湿、恢复皮肤屏障的效果,并且"旁氏无暇透白日霜"美白效果显著优于对照品市售"凡士林保湿露"。     

银屑病患者皮肤屏障功能受损的研究

目的 探讨银屑病患者皮肤屏障功能受损的实验依据,以指导临床辅助治疗银屑病。方法 60例银屑病患者运用无创性皮肤生理功能测试仪检测皮损角质层含水量、皮脂含量及经表皮水分流失（TEWL）。电镜观察皮损处细胞超微结构,同时运用免疫组化方法检测皮损处酸性神经酰胺酶的表达。结果 与正常皮肤比较,银屑病皮损角质层含水量降低（P < 0.01）,TEWL值增加（P < 0.01）,皮脂含量差异无统计学意义。电镜下,皮损颗粒层角质形成细胞中板层小体数量较正常对照组减少,分布紊乱,体积大小不等;免疫组化染色显示酸性神经酰胺酶表达明显减少。结论 银屑病皮肤屏障功能明显受损,因此,恢复皮肤屏障功能,加强保湿是银屑病重要的辅助治疗手段之一。     

局部外用砷制剂对鼠角质层致密性的影响

目的：研究砷是否引起皮肤角质层功能的改变,为探索砷治疗皮肤病提供实验依据。方法：6-8周龄的裸鼠背部和躯干两侧分别外涂基质、0．5mmol／L和1．5mmol／L三氧化二砷。每日2次,每次60此,共2周。用Courage—Khazaka多功能皮肤生理仪测量皮肤表面的基础黑素（melanin）含量、角质层含水量、皮肤表面皮脂含量、皮肤通透屏障功能及角质层的酸碱度。此外,对皮肤屏障功能的恢复速度、角质层的致密性也进行测量。结果：在此动物模型中．0．5mmol／L和1．5mmol／L的三氧化二砷均导致角质层pH值升高和角质层的致密性降低;1．5mmol／L的三氧化二砷增加皮肤的黑素含量。与对照组相比,0．5mmol／L和1．5mmol／L的三氧化二砷对角质层含水量、基础皮肤通透屏障功能以及屏障功能的恢复速度均无明显的影响。虽然两种浓度的砷均引起皮肤表面皮脂含量的轻微增加,但与对照组相比．差异无统计学意义。结论：砷可以引起角质层生理功能的改变．可以导致皮肤对砷通透性增加。在预防或治疗皮肤砷中毒时．增强角质层的防御功能是不可忽视的环节。     

Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region

Aim of the study

To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.

三种波长发光二极管光对光老化皮肤的作用研究

【摘要】 目的 探讨并比较530 nm、630 nm以及850 nm发光二极管（LED）光对光老化皮肤的作用。 方法 选择14例皮肤光老化受试者,随机于其一侧前臂伸侧三个区域,分别给予530、630及850 nm LED光照射,每周3次,共12次。对照射部位皮肤进行皮肤镜检查,并比较照射前、照射第2、4和6周皮肤角质层含水量、经皮水分丢失量（TEWL）以及反映皮肤颜色的皮肤亮度（L*值）和皮肤黑素指数（MI值）的变化。同时,随机选择5例、5例、4例受试者在试验前和试验第6周分别取530、630及850 nm LED光照射皮肤进行组织病理检查。 结果 经12次630、850 nm LED光照射后,经皮肤镜检查,分别有10例、7例受试者皮肤纹理变浅,色素沉着减少;7例受试者530 nm LED光照射部位皮肤纹理加深,色素沉着增加。经630和850 nm LED光照射后,14例受试者皮肤角质层含水量均明显升高（6周时分别为37.9 ± 7.7和34.5 ± 7.1 au,照射前分别为33.1 ± 6.1和32.0 ± 7.0 au,照射前后比较,均P < 0.05）,TEWL值均明显降低（6周时分别为9.8 ± 2.5和10.9 ± 2.5 g·m-2·h-1,照射前分别为14.0 ± 1.8和14.2 ± 2.6 g·m-2·h-1,照射前后比较,均P < 0.05）,L*值与MI值均未发现明显改变（P > 0.05）。530 nm组皮肤角质层含水量及TEWL值较照射前差异均无统计学意义（P > 0.05）,L*值显著降低（P < 0.05）,MI值明显增高（P < 0.05）。组织病理检查显示,照射前真皮具有典型的光化性胶原纤维、弹性纤维变性损害,照射后3组均出现新生胶原纤维、弹性纤维,排列较照射前整齐致密。 结论 630和850 nm LED光均可以改善光老化皮肤外观、屏障功能,促进胶原纤维和弹性纤维增生和重排,530 nm LED光会增加皮肤色素沉着。     

The Efficacy,Longevity, and Safety of Combined Radiofrequency Treatment and Hyaluronic Acid Filler for Skin Rejuvenation

Background

Recent advances in hyaluronic acid (HA) fillers and radiofrequency (RF) devices have been made in the context of skin rejuvenation and cosmetic surgery. Moreover, combination regimens with both techniques are currently being developed.

Objective

The present study was designed to examine the clinical and histologic effects of a new needle that incorporates an RF device for HA injections.

Methods

A new intradermal needle RF device (INNOfill; Pacific Pharma, Korea) was assessed in the present study. In the animal arm, procollagen production was measured by using enzyme-linked immunosorbent assay, the filler volume was quantified by incorporating a dye with filler, and the filler distribution was assessed through the changes in tissue structure. In the human arm, the efficacy of the combination regimen was assessed by using the wrinkle severity rating scale (WSRS).

Results

In the animal study, RF treatment increased procollagen production in a time-dependent fashion. The total volume was significantly increased with the RF treatment when compared with the filler injections alone, and lasted for up to 7 weeks after treatment. Additionally, the filler distribution was reduced in animals treated with RF when compared with the untreated group. In the human study, the nasolabial folds of subjects treated with RF before filler injections exhibited a significantly greater change in the WSRS score from baseline when compared with the nasolabial folds treated with filler injections alone.

Conclusion

A new device incorporating RF treatment before HA filler injection may represent a biocompatible and long-lasting advance in skin rejuvenation.     

汉族和藏族人群肤色的测定

目的 测量并比较汉族和藏族人群皮肤反射系数。方法 用新的便携式装置测量３７２名汉族人和２７４名藏族人上臂内侧非暴露部位皮肤的光反射系数,分析有关因素,如年龄、性别、纬度和种族对皮肤反射系数的影响。并确定皮肤反射系数的正常值分布范围,结果 中国汉族和藏族人群之间皮肤反谢系数差异有显著性,同时发现藏族人的肤色深于汉族人;结果还表明肤色与个体年龄的关系不明显,结论 皮肤反射光谱测定是反映肤色深浅的一个客     

Assessment of skin erythema by eye,laser Doppler flowmeter,spectroradiometer, two-channel erythema meter and Minolta chroma meter

Visual grading, a laser Doppler flowmeter, a spectroradiometer, a two-channel erythema meter and a Minolta chroma meter were compared in the measurement of erythemas arising from immediate contact reactions produced either by 250 mM benzoic acid or 10 mM methyl nicotinate in petrolatum in an open application test or by ultraviolet irradiation. A good correlation between visual grading and objectively measured values was found for all the instruments, buth the laser Doppler flowmeter gave proportionally lower values for the ultraviolet erythemas than the skin reflectance meters, suggesting that these differ from erythemas induced by benzoic acid or methyl nicotinate. The laser Doppler flowmeter gave less repeatable results than other meters when measuring moderate and pronounced erythemas produced by ultraviolet irradiation. Measuring both the blood flow and the actual erythema may give more information about the reaction than either measurement system alone.     

The effect of pH-compatible cleansing cloths on skin pH and the development of pressure ulcers

AimSkin care plays an important role in the prevention of the development of pressure ulcers. The aim of this study was to determine the effect of skincare with a body pH-compatible cleansing cloth on the development time of pressure ulcers and on skin pH.MethodsThis experimental research was conducted with 156 patients hospitalized in intensive care clinics of a state hospital between September 2019 and 2020. The sample was calculated with a power of 80% and a significance level of 0.05 (α error) and as a result, 78 elderly patients formed the intervention group and another 78 elderly patients made up the control group. Data were collected using the Elderly Information Form, Braden Risk Assessment Scale, Pressure Ulcer Staging Tool and Skin pH Measurement Form. The pre- and post-care skin pH of both groups was measured with a skin pH meter. P < 0.05 was considered statistically significant.ResultsThe average development time for pressure ulcers was 14.9 days in the control group, 18.9 days in the intervention group and the difference was not statistically significant (p > 0.05). Skin pH decreased in the intervention group after the skin care routine was applied, whereas it increased in the control group.ConclusionIt can be said that care of one's skin with a body pH-compatible cleansing cloth has a positive effect on the development time of pressure ulcers and also positively changes the skin pH to acidic.     

点阵激光、射频和激光溶脂技术在紧肤除皱中的应用

点阵激光、射频和激光溶脂技术可以延缓皮肤的老化,特别是皮肤的光老化,在改善皮肤松弛和皱纹上各有优势.点阵激光、射频和激光溶脂技术已被用于改善皮肤皱纹,紧致皮肤.与其他紧肤、除皱方法相比,具有安全性高、不良反应少、患者耐受性好的优点,为希望皮肤年轻化的人群提供了一种微创、痛苦小而效果较明显的新选择.

Abstract：

Fractional lasers ,radiofrequency and laser lipolysis can delay skin aging ,especially photoaging,and each of them has its own advantages in improving skin slackness and wrinkles.These techniques have been applied to skin tightening and rhytidectomy.Compared with other methods,they show a higher safety with less side effects and better compliance,and provide a new option for skin rejuvenation.     

微生物群落与皮肤黏膜健康及相关疾病

通常认为皮肤黏膜表面的微生物是潜在致病菌且种类有限.近年,各种围绕16S rRNA基因序列不依赖培养的分子生物学技术已用于微生物群落的研究.研究发现,皮肤黏膜表面细菌及真菌等微生物群落表现出极大的多样性和个体差异性.微生物群落参与皮肤屏障及天然免疫形成,在皮肤黏膜相关疾病的病因学中,具有不容忽视的影响.因此,对微生物群落的组成和变化特征的准确把握有助于我们更好地理解疾病的发病过程.     

A decade of research on Incontinence-Associated Dermatitis (IAD): Evidence,knowledge gaps and next steps

Background

Incontinence-Associated Dermatitis (IAD) is one of the clinical manifestations of Moisture- Associated Skin Damage (MASD). IAD is a common problem in aged patients with fecal and/or urinary incontinence.