外用辣椒素治疗银屑病

神经系统通过皮肤感觉神经末梢释放的肽如P物质(SP)来影响银屑病.SP与肥大细胞上的受体结合导致脱颗粒;使巨噬细胞和T细胞释放介质;增加来源于角朊细胞的炎症介质、白细胞介索-1和粒细胞-巨噬细胞集落刺激因子,这些都可能与银屑病的发病有关.辣椒素可导致初级感觉神经元功能降低而减少SP.本文作者试用辣椒素治疗10例寻常型银屑病(7俐男性,3例女性,平均年龄32岁).患者皮损累及整个身体表面积的15%～30%,共进行8周     

精神神经免疫学在银屑病发病机制中的作用

尽管人们熟知应激能诱发和加重银屑病,但其确切机制仍不太清楚,本文根据精神神经免疫学的新近发现,提出在银屑病患者,许多皮肤感觉神经释放神经肽(如:P物质)增多.初步资料提示,在应激过程中,同一种神经肽浓度在银屑病皮损中和脑中均有改变;本文提出了大脑信息是怎样下传引起皮肤神经肽释放从而诱发银屑病的解剖学通道以及支持应激和银屑病之间关系的生化和临床证据.     

肥大细胞释放组胺机制的研究进展

肥大细胞释放组胺在变态反应和非变态反应发病机制中均起重要作用.研究表明,肥大细胞主要通过免疫学途径和非免疫学途径释放组胺,多种物质参与组胺释放过程.特异性IgE介导肥大细胞释放组胺是肥大细胞激活的典型方式.抗FcεRI抗体和抗IgE抗体在慢性特发性荨麻疹肥大细胞释放组胺机制中起作用.凝血机制中生成的凝血酶可激活蛋白酶激活受体,介导肥大细胞黏附于纤维连接蛋白,诱发肥大细胞释放组胺.遗传因素、神经精神因素及物理因素也参与荨麻疹患者肥大细胞释放组胺.     

皮肤中神经肽与银屑病及某些皮肤病的关系

近十十年来在皮肤中陆续发现多种神经肽类物质其广泛的生物学活情怀民某些皮肤病如银屑病、异位性皮炎、接触过敏性皮炎、荨麻疹等的关系已日益受到关注。这些由感觉神经末稍释放的神经肽具有促进肥大细胞释放组胺，调节小汗腺分泌刺激淋巴细胞增强、影响皮肤血管活性等功能。因此，对神经肽的深入研究可能有助于进一步发现某些与神经精神因素有关的疾病的发病机理。     

慢性荨麻疹患者血清组胺释放活性检测

目的 检测慢性荨麻疹患者血清组胺释放活性,探讨慢性荨麻疹的发病机制.方法 通过体外分离人皮肤肥大细胞,进行肥大细胞组胺释放试验,测定组胺释放率.结果 62例慢性荨麻疹患者中,自体血清皮肤试验阳性者24例占38.71%.混合细胞悬液中肥大细胞的组胺自发释放率<5%.血清活化皮肤肥大细胞引起的组胺释放率从3.1%～79.5%(16.44%±14.26%),明显高于正常人对照组(P<0.01),其中27例组胺释放率>15%(43.55%);自体血清皮肤试验(+)组的组胺释放率及阳性率均明显高于自体血清皮肤试验(-)组(P<0.01).结论 部分慢性荨麻疹患者血清中存在组胺释放活性,可直接活化肥大细胞,释放组胺等血管活性介质,引起荨麻疹.     

银屑病中免疫细胞和细胞因子的作用

银屑病是一种与T淋巴细胞相关的自身免疫性疾病,新近研究发现除与Th1细胞有关外,Th17细胞及其相关的细胞因子在银屑病发病中也起重要的作用.T淋巴细胞的活化和分化需要抗原提呈细胞参与,肥大细胞活化后释放的细胞因子也参与银屑病发病.因此,银屑病是由多种免疫细胞和细胞因子共同参与的疾病.阐明银屑病发病的免疫机制可为银屑病治疗开辟新疗法提供理论依据.     

神经源性炎症因子在白癜风发病机制中的研究进展

白癜风作为一种获得性色素脱失性疾病, 神经因素可能在其发病机制中起着重要作用, 支配皮肤的感觉神经释放的神经源性炎症因子可以直接或间接调节角质形成细胞、黑色素细胞、朗格汉斯细胞、真皮树突细胞、肥大细胞、真皮微血管内皮细胞和免疫细胞的功能。本文综述与白癜风发生发展密切相关的几种神经源性炎症因子的作用, 包括神经肽Y、降钙素基因相关肽、儿茶酚胺和神经生长因子等, 以期为临床上治疗白癜风提供新的思路。     

寻常型银屑病患者心理评估

近年来，心理社会因素与银屑病的关系越来越被人们关注。Farber证实４０％的银屑病皮损出现于焦虑时，且病情在焦虑时加重［１］。心理因素如紧张、情绪异常等使皮肤感觉神经释放P物质，刺激角质形成细胞增殖，还通过免疫系统异常加重或诱发银屑病［２］。发病后由于心理压力大，患者吸烟、嗜酒增多，吸烟可刺激中性粒细胞活化后过氧化酶的释放，使其分布、利用加速，趋化性、黏附性增强，改变吞噬细胞的氧化代谢，导致皮损的发生和炎症的加重［３］。在对寻常性银屑病患者采用心理治疗后发现有显著疗效，如复发率下降，用药量减少，生活质…     

银屑病瘙痒皮损中肥大细胞的数量与分布研究

目的探讨肥大细胞在银屑病瘙痒症状发生中的作用。方法应用免疫组化技术对30例患者(无瘙痒12例,瘙痒18例)皮损区、非皮损区以及2例正常人皮肤组织中肥大细胞数量进行检测。结果银屑病伴有瘙痒症状的患者皮损中肥大细胞数量明显增多(Z=-2.732,P<0.05)。结论皮损中肥大细胞的数量变化与银屑病的瘙痒症状具有相关性。     

P物质的外周致痒机制研究进展

P物质（SP）是一种重要的瘙痒介质，参与了多种瘙痒性皮肤病如特应性皮炎、银屑病的发生和发展。卵与角质形成细胞上神经激肽1（NK1）受体结合，促进白三烯B4释放或一氧化氮合成而引起或增强瘙痒；也可通过作用于传导痒觉的无髓C纤维上NK1受体直接引起瘙痒。虽然SP可通过激活皮肤肥大细胞上NK1受体释放组胺，但其在卵诱发的瘙痒中可能不起主要作用。     

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.