The skin, touch, and human development

Most of us take our skin for granted, except when it breaks out in pimples, wrinkles, or otherwise becomes blemished. At such times we tend to become somewhat irritated with it, and wish it would go away. Most people seem to think of the skin as a sort of binding or wrapper that keeps the skeleton from falling apart, or out of which, at least in other animals, shoes and various leather articles are made. In hot weather the skin sweats unpleasantly, and in cold weather it grows uncomfortably chilly. Perhaps worst of all, it sprouts hairs in the wrong places, which have to shaved, and where hair is desired most thickly it grows most thinly, and only too early takes on the color least desired. And this is the skin.     

Comedogenicity of current therapeutic products, cosmetics, and ingredients in the rabbit ear

Cosmetics continue to be used by acne-prone individuals. Often as more acne develops, more cosmetics are applied. In order to protect against this natural tendency, physicians should provide more patient information on the currently available products and ingredients. This presentation is designed to help in that effort. The data presented were gleaned from the rabbit ear assay, which is not an ideal animal model but is the best we have. If an ingredient is negative in the rabbit ear assay, we feel it is safe on the acne-prone skin. A strong, positive ingredient or cosmetic should be avoided. Ingredient offenders include isopropyl myristate and its analogs, such as isopropyl palmitate, isopropyl isostearate, butyl stearate, isostearyl neopentanoate, myristyl myristate, decyl oleate, octyl stearate, octyl palmitate or isocetyl stearate, and new introductions by the cosmetic industry, such as propylene glycol-2 (PPG-2) myristyl propionate. Lanolins continue to be a problem, especially derivatives such as acetylated or ethoxylated lanolins. Our most troublesome recent finding is the comedogenic potential of the D & C Red dyes. They are universally used in the cosmetic industry, especially in blushers. This may explain the predominance of cosmetic acne in the cheekbone area. All of these D & C Red dyes tested to date, the xanthenes, monoazoanilines, fluorans, and indigoids, are comedogenic. Actually, this is not surprising as they are coal tar derivatives. The natural red pigment, carmine, is noncomedogenic and can serve as a substitute for D & C dyes in blushers. Many finished products are comedogenic. Most troublesome to the dermatologists are the therapeutic tools that we use, such as Liquimat, Retin-A cream, Hytone, Staticin, Sulfoxl, Desquam-X, and Persadox HP cream. These should be reformulated. We have been unable to confirm that precipitated sulfur (U.S.P.) is a potent comedogen in the rabbit ear assay. Clinically, we still find sulfur quite effective as an adjuvant to the benzoyl peroxide therapy for the treatment of acne vulgaris. We would suggest that the bias against sulfur be reconsidered.     

Dermatologic therapy: December, 1981, through November, 1982

In this paper I have reviewed the literature on dermatologic therapy from December, 1981, through November, 1982. This information was presented to a forum at the 41st Annual Meeting of the American Academy of Dermatology in New Orleans in December, 1982. Readers should review the original article in toto before attempting any new, experimental, or controversial therapy summarized.     

湿疹、银屑病患者血清特异性IgG、IgE检测结果及分析

目的了解湿疹、银屑病患者的特异过敏原及血清IgG、IgE水平变化一方法采用酶联免疫吸附法（ELISA）对30例湿疹及30例银屑病患者血清IgG、IgE水平检测。结果湿疹患者食物组以鳕鱼38％（11／30）最高，吸入组以尘螨21％（6／30）最高；银屑病患者食物组以蛋黄、蛋清27％（8／30）最高；吸入组以桑、梧树叶17％（5／30）最高；同时根据两组过敏程度显著不同，发现湿疹患者对鳕鱼、尘螨敏感发生率高：银屑病患者对牛肉、桑、梧树叶敏感发生率高。讨论采用酶联免疫吸附法（ELISA）操作简单，特异性较高，能帮助临床医生诊断治疗，指导患者正确饮食。     

美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病疗效观察

目的评价美克(1%联苯苄唑乳膏)治疗体股癣、手足癣、花斑癣和皮肤念珠菌病的临床疗效和安全性。方法采用多中心、随机、平行对照的方法,试验组外用美克,对照组外用欣欣(1%盐酸布替萘芬乳膏)。结果体股癣患者停药时试验组与对照组痊愈率分别为42.20%和39.45%,有效率分别为94.49%和91.74%;停药2w时,试验组与对照组痊愈率分别为85.32%和82.56%,有效率分别为97.24%和96.33%。手足癣停药时试验组与对照组痊愈率分别为39.87%和37.34%,有效率分别为85.54%和84.81%;停药2w时,试验组与对照组痊愈率分别为59.49%和58.22%,有效率分别为89.24%和86.70%。花斑癣患者停药时试验组与对照组痊愈率分别为50.72%和52.17%,有效率分别为79.71%和76.81%;停药2w时,试验组与对照组痊愈率分别为66.67%和63.76%,有效率分别为84.05%和81.16%。皮肤念珠菌病患者停药时试验组与对照组痊愈率分别为34.88%和39.53%,有效率分别为72.09%和76.74%;停药2w时,试验组与对照组痊愈率分别为65.11%和67.44%,有效率分别为88.37%和86.04%。局部不良反应发生率各试验组合计为5.27%;各对照组合计为5.54%。上述各项指标,各病种试验组与对照组比较差异均无统计学意义。结论美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病安全有效。     

窄谱中波紫外线联合外用药治疗炎性线状疣状表皮痣一例

【摘要】 目的 评价窄谱中波紫外线(NB-UVB)联合卡泊三醇和卤米松局部序贯疗法治疗炎性线状疣状表皮痣的疗效及不良反应。 方法 分析我科收治的1 例成年后发病炎性线状疣状表皮痣的临床、病理、实验室检查特点及诊疗经过, 并对文献进行复习,以治疗前后的皮损变化评价疗效。结果 患者2周后瘙痒减轻;6周后部分皮损消退、部分皮损变平,痒感消失。无不良反应发生。结论 NB-UVB联合局部序贯疗法（卡泊三醇联合卤米松）可能是治疗ILVEN的一个安全有效的方法。     

甲银屑病的诊断与治疗研究进展

临床上,甲银屑病容易与甲真菌病相混淆,也是目前最难治的银屑病损害之一。约有10％ ~ 78％的银屑病患者伴有指（趾）甲损害［1］,发病无性别差异。甲银屑病与关节型银屑病密切相关,至少70％的银屑病关节炎患者存在甲病损［2］。Lavaroni 等［3］发现52 例关节型银屑病患者的甲损害率甚至可达86.5%。许多因素可以诱发甲银屑病。Tham等［4］发现,病情中度至重度、病期5 年以上、年龄50 岁以上、伴关节型银屑病、头皮银屑病或甲皱银屑病的患者更易发生甲损害……     

皮肤型结节性多动脉炎

皮肤型结节性多动脉炎是结节性多动脉炎的变异型,病情相对比较良性,不会发生严重的内脏损害,其典型的表现为小腿部复发性、压痛性的结节,也可出现网状青斑、溃疡等,有时有肌痛和外周神经受累。由于国内关于本病的报道较少,故本文就该病的病因、临床特点、皮肤组织病理、鉴别诊断和治疗等方面进行了较全面的介绍。     

儿童银屑病的治疗

儿童银屑病不同于成人银屑病,常有瘙痒,皮损相对较薄,鳞屑少。在荷兰［1］、新加坡［1］、中国［２］、瑞典［３］、美国［４］等地进行的大规模回顾性及队列研究显示,儿童银屑病斑块型是最常见的类型,点滴型次之,红皮病性、关节病性、局限性及泛发性脓疱性银屑病较为少见,儿童滴状银屑病发病率高于成人。四肢是最易受累的部位,其次是头皮。大部分患儿皮肤受累面积小于全身面积的5%,因此,大多数儿童银屑病患者局部用药就能控制病情,常作为一线用药,其中糖皮质激素和维生素D3衍生物是首选用药,钙调磷酸酶抑制剂常用于面部及皱褶部位……     

阴囊大汗腺汗囊瘤

患者男,73岁。阴囊处出现一米粒大肤色丘疹,渐增大10年,无明显自觉症状。组织病理检查：真皮内可见多个扩大的囊腔,囊壁由单层和双层扁平或柱状细胞组成,内层细胞可见断头分泌,外层为扁平或立方形肌上皮细胞。诊断为阴囊大汗腺囊瘤。