系统性红斑狼疮401例发病情况分析

目的　探讨SLE的发病特点。方法　分析 40 1例SLE发病时临床表现及实验室检查 ,并进行不同性别与不同年龄间的比较。结果　关节痛的发生率最高 (88.66% ) ,其次为疲乏 (86.63 % )与脱发 (75 .0 7% ) ;男女患者关节痛的发生率差异有高度显著性 (χ2 =12 .918,P <0 .0 1) ;关节痛、失眠、心悸的程度在不同年龄组间差异有显著性。结论　SLE初期临床表现较复杂 ,但仍有一定的规律可循。     

儿童与成人SLE临床特征比较

目的　探讨儿童系统性红斑狼疮 (SLE)的临床特点 ,及其与成人SLE的差异。方法　对本院 5年来收治的 3 8例儿童SLE与随机选取的同期 2 0 0例成人SLE患者的临床资料进行回顾性对照研究 ,统计分析其初发症状、临床表现及实验室检查结果。结果　儿童SLE相对成人SLE症状和体征更不典型。儿童SLE皮肤损害具有多形性和多变性 ,典型的盘状损害和蝶形红斑较成人SLE少见 (P <0 .0 5 ) ;肾脏损害的发病率与严重程度高于成人SLE(P <0 .0 5 ) ;ANA滴度明显高于成人患者 (P <0 .0 5 )。结论　儿童SLE与成人SLE相比 ,其临床表现存在某些差异。     

SLE患者肾脏受损552例临床及实验室检查结果分析

目的探讨系统性红斑狼疮(SLE)伴肾脏系统受累住院患者的临床表现、实验室检查及影像学检查,为及时诊断、及时治疗及改善SLE患者的预后提供临床依据。方法回顾性分析1 029例SLE住院患者的临床资料,对有肾脏系统损伤的552例患者的临床表现、实验室检查、影像学检查进行统计分析。结果 SLE患者中符合狼疮肾炎(LN)诊断者399例(38.78%),有肾损害未达到LN标准的153例(14.87%),无肾脏损害组477例(46.36%)。LN患者的病理分型以Ⅳ型最为多见38例(43.68%)。SLEDAI评分以LN组最高(10.86±0.26),差异有统计学意义(P0.000)。Logisitic多因素分析示,血红蛋白和补体C_3与SLEDAI呈负相关;高龄、病情活动、补体C_3水平重度降低者肾功能损害重、病理分型较严重。结论 SLE常累及肾脏,LN的临床表现和实验室指标与其病理类型存在一定的联系,根据临床表现和实验室指标可以在一定程度上评估LN的严重程度,但是仍不能替代肾活检在LN病理诊断中的重要地位。     

系统性红斑狼疮228例临床分析

目的探讨系统性红斑狼疮患者男女临床特点及预后。方法对228例系统性红斑狼疮住院患者进行回顾性分析。结果患者男25例,女203例,男女比例1:8.12,平均发病年龄(32.72±13.49)岁(6~71岁),平均病程(2.33±2.82)年(20d~10年);男性组肾脏损害、口腔溃疡、神经系统损害、血小板减少、抗Sm抗体阳性较女性组多见(P<0.05),而女性组则以蝶形红斑、关节受累、雷诺现象、抗SSA阳性较多见(P<0.05);经治疗女性组好转率(83.74%)较男性组(60.00%)高(P<0.05),死亡率(5.42%)则较男性组(16.00%)低(P<0.05)。结论 SLE患者男女临床表现、实验室检查及预后有一定差别,与女性相比,男性内脏损害发生率较高且预后较差,临床应引起重视。     

神经精神性狼疮25例临床分析

目的:探讨神经精神性狼疮(NPLE)的临床特征、实验室检查情况和活动性评分。方法:回顾性分析25例.NPLE患者的临床资料,同时将160例非NPL.E患者设为对照组,比较两组患者的临床表现及实验室检查情况。根据有无癫痫发作将NPLE组分为两亚组,比较亚组间相关指标的差异。结果:SLE患者中NPLE患者占13.9%,且多发生在SLE的早期(前3年占68%)及活动期(SLEDAI 10分者占88%)。25例NPLE患者中癫痫发作(21.4%)、头痛(12.5%)和情绪障碍(12.5%)。NPLE患者常并发多系统损害(92%),以血液系统损害(68%)和狼疮性肾炎(44%)常见。NPLE组血沉增高、血小板减少及皮肤血管炎的发生率高于非NPLE组(P0.05)。NPLE患者中癫痫发作组抗SSA抗体、抗Sm抗体阳性率显著高于无癫痫发作组(P0.05)。NPLE患者脑电图、脑部CT、磁共振(MRI)检查多正常或轻度非特异性改变。结论:NPLE多发生在SLE的早期及活动期;NPLE神经精神学表现以癫痫发作及头痛常见;SLE患者出现血沉增高、血小板减少及皮肤血管炎并有神经精神症状时,应考虑NPLe的可能:抗SSA抗体及抗Sm抗体可作为NPLE患者癫痫发作的参考指标。     

儿童与成人系统性红斑狼疮临床特点对比分析

目的:分析儿童系统性红斑狼疮(SLE)的临床特点.方法:回顾性分析了78例住院儿童SLE与同期50例成人SLE患者的临床资料,统计分析其临床表现及实验室检查结果.结果:儿童SLE典型的盘状损害和蝶形红斑较成人SLE多见(P＜0.05);C3、C4降低较成人组明显(P＜0.05);成人SLE心脏、肝脾、肺间质损害的发病率比儿童患者高(P＜0.05);成人SLE的IgA、IgM升高较儿童明显(P＜0.05).结论:儿童与成人系统性红斑狼疮的临床特点存在某些差异.     

39例成人与16例儿童皮肌炎比较分析

目的：比较成人与儿童皮肌炎临床与实验室检查上的差异,指导临床实践。方法：回顾性总结和分析资料完整的皮肌炎患的临床表现及实验室检查结果,采用精确概率法统计分析两组患之间的差异。结果：在儿童组中女性发病明显高于男性,男：女为1：7,在临床表现上并发疾病及合并肿瘤的发生率成人组高于儿童组;儿童组表现发热、肌压痛、甲周红斑和／或毛细血管扩张（X^2＝11．75,P＜0．05）的发生率高于成人组;实验室检查上LDH、CPK、AST在儿童的敏感性高于成人;成人组ESR值升高发生率高于儿童组,心肌受损和肺部感染发生率高于儿童组。结论：对儿童皮肌炎的皮损除检查眼睑外,应仔细检查甲周,对成人皮肌炎应注意排除存在恶性肿瘤的可能和注意心肌受损及肺部感染。     

痤疮病程与圆形糠秕孢子菌感染关系的初步探讨

目的 :探讨痤疮病程与圆形糠秕孢子菌 (P orb)感染的关系。方法 :按病程分组对 1 1 3例该类患者进行皮损内容物镜检、真菌培养、病理检查及抗真菌治疗。结果 :Ⅰ组 2 3例 ( 63 9% )患者阳性 ,Ⅱ组 1 7例 ( 4 0 5 % )阳性 ,Ⅲ组 4例 ( 1 6% )阳性。Ⅰ组明显高于Ⅱ、Ⅲ组 ( χ2 =4 2 5 ,P <0 0 5和 χ2 =1 3 71 ,P <0 0 0 1 ) ,)Ⅱ组明显高于Ⅲ组 ( χ2 =4 3 6,P <0 0 5 )。结论 :痤疮病程越长 ,糠秕孢子菌感染的可能性越大。     

泌尿生殖道沙眼衣原体、支原体感染与慢性荨麻疹的关系探讨

慢性荨麻疹是皮肤科门诊常见的难治性变态反应性疾病之一 ,病因复杂 ,多数患者查不到病因。我所皮肤科门诊自1995年 10月以来 ,对 84例慢性荨麻疹患者进行泌尿生殖道沙眼衣原体支原体感染的检查 ,现报告如下 :临床资料　 84例慢性荨麻疹患者有典型的临床表现 ,其中男 32例 ,女 5 2例 ,年龄 18～ 6 0岁 ,平均 34岁 ,病程 2～ 8个月 ,平均 4个月。其中 2 6例患者 (男 6例 ,女 2 0例 )有不程度的尿道刺激症状或白带多、色黄 ,外阴痒等症状。所有患者均经过Ｈ1或和Ｈ2 受体拮抗剂 ,钙剂、皮质激素及一般抗生素治疗 ,效果不佳。实验室检查　所有…     

316例女性系统性红斑狼疮患者临床表现及实验室回顾性分析

探讨316例女性系统性红斑狼疮(SLE)住院患者的临床表现及实验室检查结果是否具有差异性.收集武汉大学人民医院皮肤性病科2005-2008年316例住院女性SLE患者病案资料,用SPSS 13.0软件进行统计学分析.结果显示316例患者中,未婚年龄组面部红斑、肾脏损害、浆膜积液和白细胞升高四项指标较之已婚生育年龄组和围绝经期及其以上年龄组有统计学差异;未婚年龄组肾脏损害和浆膜积液发生率低于后两组,而白细胞升高和面部红斑发生率高于后两组.已婚生育年龄组和围绝经期及其以上年龄组SLE患者临床表现和实验室检查结果没有明显统计学差异.未婚年龄组女性SLE患者与已婚生育年龄组和围绝经期及其以上年龄组部分临床表现和实验室检查结果存在差异性,对SLE病因学研究和临床治疗有部分参考价值.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.