关节病性银屑病临床分型标准的初步评价

目的：评价关节病性银屑病的Moll和Wright临床分型标准。方法：对确诊的61例关节病性银屑病患者应用Moll和Wright临床分型标准进行分型，仅符合1种临床亚型者为单纯型，同时符合2种或2种以上亚型者称为重叠型，不能纳入任何类型者称为未定型。结果：5例符合单纯型，36例符合重叠型，20例属于未定型。结论：Moll和Wright临床分型标准是一非特异性分型标准，单纯根据5种临床表现分型对关节病性银屑病的早期诊断、推测预后及制定治疗方案缺乏指导意义。需采用前瞻性的研究方法探讨并验证有意义的临床分型标准。     

皮肤红斑狼疮中医药治疗现状

中医药治疗皮肤红斑狼疮（cutaneous lupus erythematosus，CLE）在长期的实践中积累了大量经验，文章从皮肤红斑狼疮的分型、临床表现、病因病机、辨证论治几个方面对中医药治疗皮肤红斑狼疮的现状进行综述，在此基础上对中医辨证分型的规范化、经验方药总结及今后的研究方向和研究方法进行探讨，中医药治疗皮肤红斑狼疮将获得更好的发展。     

淋病奈瑟菌基因分型的研究进展

淋病奈瑟菌是引起淋病的病原体.淋病奈瑟菌基因分型方法在淋病奈瑟菌疫苗的研究、制定流行病学控制措施和淋病的治疗上均起到重要的作用.常见基因分型方法如:opa分型、脉冲电场凝胶电泳、por分型、随机扩增多态性DNA分型、多位点序列分型等.由于不同基因分型方法有着其各自不同的优点和不足,依据不同的需要,可选择合适有效的基因分型方法以达到实验的要求.     

淋球菌基因分型方法的研究进展

淋球菌是引起淋病的病原菌,如不及时治疗可以引起严重的并发症。为了更好的研究淋球菌的流行特点、遗传学、免疫学等科学问题,有必要研究淋球菌的分型方法。目前淋球菌分型可分为传统分型和基因分型,其中后者应用较多。在基因分型中,又可分为凝胶电泳DNA条带分型和序列分型。应用除多位点可变数串联重复序列分型以外的凝胶电泳DNA条带分型方法所得到的结果较主观,实验室之间的结果不具有可比性。     

解脲支原体第一群的分型研究

目的 利用分子生物学方法对解脲支原体第一群进行分型，建立简便，可靠的分型方法。方法 设计分型引物，用ＣＲ和限制性内切酶消化的方法进行分型。结果 设计了解脲支原体的分型引物ＵＭＳ５１１ＵＭＡＵ１和ＵＭＳ５１１ＵＭＡＵ３，前者扩增出Ｕｕｌ型和Ｕｕ６型，后者扩增出Ｕｕ３型和Ｕｕ１４型。     

肢端恶性黑素瘤100例临床和病理分析

目的 探讨肢端恶性黑素瘤的临床、病理特点和外伤在发病中的意义以及现行分型方法的有效性。方法 选取最近诊断的具有完整临床、病理资料的100例肢端恶性黑素瘤，对其临床、病理数据进行统计分析。结果 原发于手28例，其中拇指甲下14例；足72例，足掌跖29例，足跟18例，拇趾甲下12例。31例原发部位有外伤史。40例肢端恶性黑素瘤难以用目前的分型方法分型，依据现行病理分型方法，肢端雀斑样痣性、结节性、浅表扩散性黑素瘤在肿瘤浸润深度、临床分期等方面差异无显著性。结论 足部是肢端恶性黑素瘤的好发部位，外伤是发病的重要诱因，现行分型方法的临床意义尚需进一步研究。     

TNF-α与银屑病中医相关研究进展

该文主要从中医证型、中医药治疗与TNF-α的关系进行综述，以期找出传统医学和现代医学在研究中相互渗透的切入点，希望能为银屑病中西医结合的诊断与治疗研究提供一些参考资料，从而为中医辨证分型和治疗提供依据，并进一步了解中药治疗的作用机理。     

高频电熨治疗酒渣鼻32例临床疗效观察

酒渣鼻非手术疗法多数疗效欠佳。我所自1996年以来，运用电熨法治疗红斑期、丘疹期酒渣鼻，取得一定疗效，现总结报告如下。1材料与方法1．1临床资料共58例酒渣鼻患者，治疗组32例，男26例，女6例；年龄35－54岁，病期2－12年；临床分型红斑期14例，丘疹期18例。对照组26例，男19例，女7例；年龄38－52岁，病期2一15年；临床分型红斑期间例，丘疹期14例。所有病例疗前1月内均未接受过其它治疗。1．2治疗方法治疗组采用高频手术器（上海医用电子仪器厂），运用鼓作状电熨极连接治疗仪电熨电流输出端，铅板电极连接皮肤形成电路，输出功率调至…     

泰舒滴丸治疗寻常痤疮

泰舒滴丸治疗寻常痤疮徐子江临床资料：７２例痤疮患者，男，２６例，女４６例；年龄１５岁～３６岁；病程１年内３６例，１年～３年２４例，３年～５年８例，５年以上４例。按粉刺型、丘疹脓疱型、囊肿结节型和混合型进行分型。皮疹以面部为主，少数累及胸背部。治疗方法...     

CO2激光烧灼甲床治疗足趾慢性甲沟炎

目的：探讨CO2：激光治疗甲沟炎的可行性。方法：将甲沟炎分型并选择嵌甲型、扁平型甲沟炎病例进行CO2激光烧灼治疗，观察治疗效果。结果：治愈62例（93．9％），有效4例（6．1％），随访8～12个月，未见复发。结论：CO2激光烧灼甲床治疗足趾慢性甲沟炎疗效显著，不易复发。     

Dedifferentiation of human epidermal melanocytes into melanoblasts in vitro

Melanoblasts (MB) are also called melanocyte (MC) precursor cells. In recent years, people have successfully cultivated human and mouse MB. Previous studies have shown that EDN3 induces cultivated bird MC to re-differentiate into double potential progenitor cells of MB. However, no study has reported whether in vitro cultivated human MC can be dedifferentiated. Our research on MC that were purified and cultivated in vitro found that adding 10 nm endothelin 1 (EDN1) (ET-1) to the MC medium without phorbol 12-myristate 13-acetate (PMA) induced a few MC to dedifferentiate and become a new type of cell. This new cell type was separated, purified, cloned and identified using multiple approaches. The results show that 88.7%, 8.69% and 2.5% of this new cell type were cells in the G(0) -G(1) , G(2) -M and S stages, respectively. The new cell type did not exhibit an apparent apoptotic peak, and its apoptotic rate was 0.09%. Stage I melanosomes were observed in the cytoplasm and were negative for the DOPA reaction. The cell surface antigen expression was positive for tyrosinase-related protein 2, negative or positive for c-kit and negative for S-100 and HMB45, showing that these cells were dedifferentiated MB of MC. Our findings provided evidence for atavism of mature human MC under certain conditions.     

Immune activity in Merkel cell carcinoma

Merkel cell carcinoma (MCC) is widely known as a highly malignant skin cancer. The pathogenesis of MCC, however, remains mysterious due to the extremely small number of cases and its prevalence in the elderly. Despite its high-grade malignancy, spontaneous regression occurs with some frequency. The immune activity of the tumor underlies this peculiar behavior. In recent years, immune checkpoint blockade therapies, including the anti-programmed death ligand 1 antibody, have provided successful results. These therapies, however, are ineffective in approximately half the patients with advanced MCC and few treatments are available for those patients. In this review, we summarize the increasing body of evidence relating to the immune activity of MCC and immunological biomarkers. The interesting and sometimes peculiar behavior of MCC, such as their spontaneous regression, is largely due to their high immunosensitivity. Understanding the tumor immunokinetics of MCC should provide critical insight for understanding cancer immunotherapy. Here, we introduce a new classification for MCC according to its immune activity. Combined application of programmed death ligand 1 (a prognostic factor and predictor of the efficacy of immune checkpoint inhibitors in various cancers) with glucose-6-phosphate dehydrogenase (a new promising biomarker for MCC) may enable classification of MCC based on its immune status. Whether the new classification can be used to predict the efficacy of immune checkpoint blockade therapies remains to be evaluated in future studies, but the classification may facilitate future treatment selection.     

Mastocytosis – an update

Mastocytosis (MC) encompasses a range of disorders characterized by a clonal, pathological accumulation of mast cells having a somatic activating mutation of the tyrosine kinase receptor Kit (exon 17, codon 816; D816V) in more than 90 % of adult patients. The mutation is much less common in children. Skin and bone marrow are most often affected. Symptoms and clinical course are very heterogeneous due to a variable degree of local or systemic mediator release or organ dysfunction as a result of mast cell infiltrates. Pruritus, wheals, flushing and gastrointestinal symptoms are often reported. The majority of pediatric patients experience spontaneous remission of MC. Adults usually have chronic disease, rarely transforming into an aggressive or lethal type. Indolent systemic MC with involvement of skin and bone is the most common type. In MC the risk for anaphylactic reactions following an insect sting (and other causes of mast cell activation) is increased significantly. Diagnostic hallmarks are biopsies from skin and bone marrow using tryptase antibodies for staining as well as serum tryptase levels. At present a curative treatment for MC is not available. Systemic histamine H₁ receptor antagonists are widely used. Aggressive types of MC respond partially to IFN‐α or cladribine. A variety of receptor tyrosine kinase inhibitors is still under critical evaluation for systemic treatment of MC. After introduction of the WHO classification for MC and the development a German MC guideline, as well as the foundation of national and international competence networks for MC, a significantly improved quality of medical care for MC patients can be expected for the future.     

Efficacy of topical treatment in psoriasis with MC903, a new vitamin D analogue

In 10 in-patients with chronic plaque psoriasis, the antipsoriatic effect of MC903, a new synthetic analogue of vitamin D was evaluated. In each patient two symmetrical located psoriatic plaques were selected for the study. Topical treatment with MC903 cream (containing 1.2 mg MC903 per g cream) was compared with placebo cream in a double-blind, controlled, left-right, randomized way during 6 weeks of therapy. Compared with baseline, the clinical (erythema, scaling and infiltration) improvement was significant after 1 week of therapy with MC903 cream, while lateral comparison showed MC903 cream significantly better than cream base after 4 weeks of therapy (p less than 0.05). Measurements of skin blood flow by the laser Doppler technique in evaluating the disease activity was not superior to the clinical assessments. In 3 patients the psoriatic lesions treated with MC903 cream cleared completely during 6 weeks of therapy. No essential adverse reactions were observed. MC903 has a potent effect on cell proliferation and cell differentiation, but has minimal effect on calcium metabolism. It is concluded that this synthetic vitamin D analogue is potentially useful in the treatment of psoriasis.     

The topical corticosteroid classification called into question: towards a new approach

Vasoconstrictor assay described in 1962 was an interesting assessment of potency of topical corticosteroids at the beginning of these new therapies, however knowledge and technology have evolved and the classification should follow. A topical corticosteroids with a strong vasoconstrictor effect, as determined by vasoconstrictor assay, has not necessary a strong anti‐inflammatory effect. Therefore a specific classification adapted to the therapeutic target is needed to be more efficient and thus reduce side effects and corticophobia.     

Membrane‐bound stem cell factor is the major but not only driver of fibroblast‐induced murine skin mast cell differentiation

The maintenance and modulation of cutaneous mast cell (MC) numbers is held to be important for skin immune responses to allergens and pathogens. The increase in MC numbers in the skin is achieved by proliferation and the differentiation of precursor to mature MCs. Fibroblast‐derived SCF is thought to be the major skin MC growth factor and it potently induces MC proliferation. The mechanisms of fibroblast‐induced skin MC differentiation, including the role of SCF, however, remain insufficiently characterized and understood. Using cocultures of immature murine MCs and fibroblasts, we found that the adhesion of immature MCs to fibroblasts via VCAM‐1 and α₄β₇ integrin is very important for subsequent differentiation, which is driven by fibroblast membrane‐bound SCF and additional fibroblast‐derived membrane‐bound signals. Thus, our results show that fibroblast‐induced MC differentiation is induced by direct cell–cell contact and involves both Kit‐dependent and Kit‐independent pathways. Our findings add to the understanding of how immature mast cells mature in murine skin and encourage further analyses of the underlying mechanisms, which may result in novel targets for the modulation of skin mast cell driven diseases.     

Different interaction of mast cells with human endothelial cells and fibroblasts

In a number of chronic inflammatory conditions resulting in fibrosis, perivascular mononuclear cell infiltration including mast cells (MC) has been shown before the onset of vascular injury and interstitial fibrosis. These observations suggest a role for MC in inducing endothelial cell (EC) injury and fibroblast (FB) proliferation and collagen synthesis. In view of these observations, the interactions of MC with EC and FB were studied. MC adhesion to EC and FB showed time-dependent increase reaching a plateau at 1 and 3 hrs, respectively. With added MC, the proliferation of EC showed a dose-dependent decrease, but that of FB, a dose-dependent increase. MC, MC surpernatant and sonicated MC induced dose-dependent cytotoxic activity to EC, whose cytotoxicy was inhibited by trypsin inhibitor. FB cocultured with MC showed 9.95 times collagen synthesis and 11.0 times protein synthesis compared with FB without MC. These results showed that 1) MC attached to EC inhibited the proliferation by cytotoxic activity to EC, which was due to a kind of proteolytic enzyme involving trypsin, 2) MC had proliferative and collagen synthetic activity to FB. These results suggest the possibility that MC have a role in a number of chronic inflammatory diseases resulting in vascular injury and interstitial fibrosis.     

Itch associated with skin disease: advances in pathophysiology and emerging therapies

Itch, also known as pruritus, is the major symptom in skin diseases with a variety of etiologies and pathophysiologies. Significant progress has been achieved in understanding the pathophysiology of itch in the last 5 years. Neurophysiological experiments in humans and animals have revealed that itch is carried by specific C nerve fibers. Recent studies have demonstrated that peripheral mediators other than histamine are involved in induction of itch. Mast cell tryptase seems to be an important mediator in itch by its activation of proteinase activated receptor 2 in the sensory nerves. Opioids have central and peripheral itch producing activity. Neuropeptides, such as substance P, induce itch by their effect on mast cells. Based upon our improved understanding of the neurophysiology of itch a clinical classification of itch has been proposed. The classification highlights differences between peripheral pruritoceptive itch, neuropathic itch (itch related to damage to afferent nerve fibers) and neurogenic itch (itch originating in the central nervous system without any evidence of nerve damage). Emerging therapies based on these findings include topical vanilloid receptor antagonists, topical antihistamines, and topical arachidonic acid inhibitors, as well as inhibitors of non-histamine inflammatory mediators, immunomodulators and strontium salts. Systemic therapies include thalidomide, opioid antagonists, phototherapy with narrow band UVB and experimental treatments with cutaneous field stimulation and vagal nerve stimulation. With the new information it seems we will be able to better help our dermatologic patients who have itch, however we are not closer to identifying a single agent specifically targetable to this symptom.