单株毛囊移植联合光疗治疗白癜风白发疗效评价

目的：评价单株毛囊移植（FUE）联合光疗治疗顽固性白癜风伴毛发变白的治疗效果。方法：选取2019年6月至2020年12月稳定期伴毛发变白的白癜风患者,将单株毛囊移植于白癜风皮损区域内, 血痂脱落后,皮损区给予308准分子激光照射,初始剂量50 mJ,1周照射2~3次,3个月一个疗程。结果：入选患者20例, 共25处白斑,治疗3个月后,19处出现移植毛囊周围的色素恢复,其中痊愈2处,显效17处;24处皮损出现黑色毛发生长。结论：单株毛囊移植（FUE）联合光疗治疗顽固性白癜风可有效改善顽固性白癜风伴毛发变白。     

先天性白甲病1例报告

先天性白甲病１例报告朱淳①范志莘②白甲系指甲板呈点状、线状或全部变白，有多种疾病可引起部分或全部白甲。先天性白甲甚为少见，现报道１例。患儿男性，２岁６个月，回族。１９９５年８月其父母亲随同来院就诊，主诉患儿出生后全部指甲呈白色，４个月时白色更加明显，...     

巨大晕痣合并白癜风2例

1临床资料例1女,6岁.右下颌及右枕部巨痣6年,周围皮肤、毛发变白1年余就诊.出生时,发现右侧枕部一黑色胎记,随年龄增长逐渐增大.1年前右下颌出现一小片色素脱失斑,同时发现右枕部巨痣周围皮肤及表面少数头发变白,此后,头顶和颞部头皮出现相同色素脱失斑伴部分头发变白（图1）,遂来本院就诊,诊断：巨大晕痣合并白癜风.……     

6月龄女婴患甲真菌病及泛发性体癣1例

临床资料 患婴女，6月龄，出生15天时右手拇指甲出现点状白斑，逐渐扩大，随后右手中指，无名指指甲出现类似表现，躯干部散布许多圆形红斑。皮肤科检查：患婴右手拇指，中指，无名指指甲甲板表面见雾状白色混浊的斑，白斑大小不一，不规则，相互融合（图1）；胸背部皮肤散布许多环形斑块，边界     

计算机图像分析对自体表皮移植治疗白癜风的疗效评定

应用计算机数字图像分析系统测定6例白癜风患者自体表皮移植前后的面积和平均灰度。结果皮损面积平均消失56．93％，皮损区治疗前后的平均灰度相差明显（平均值分别为130．67和114．83），治疗后的效果与皮损相邻近正常皮肤的平均灰度（平均值为114．17）接近。     

阿维A联合血管扩张剂治疗6例系统性硬皮病疗效观察

目的：观察阿维A联合血管扩张剂治疗系统性硬皮病（SSc）的疗效和安全性。方法：收集2000-2005年住院和门诊就诊的6例SSc患者,主要使用阿维A0．5～0．6mg／（kg·d）和扩张血管药物等治疗。皮肤受累程度采用改良的Rodnan评分法评估,治疗后评分减少75％以上为临床显效。结果：6例患者中有5例伴有关节疼和雷诺征（83．33％）。另1例伴有吞咽困难（16．67％）,均无其他内脏受累;治疗前皮肤硬化程度评分平均为（22．00±6．96）分（12～30分）。治疗2周后,所有患者的关节疼、雷诺征及吞咽困难逐渐缓解,部分患者面部等处皮肤开始变软;8周后,所有患者的皮肤症状改善,皮肤硬化程度平均评分下降至（7．17±3．92）分（2～12分）,与治疗前比较差异有统计学意义（P〈0．05）。4例患者疗效显著,2例患者在治疗2周后出现肝功能异常、血脂升高。结论：阿维A联合血管扩张剂治疗SSc有效。     

白癜风2 008例临床分析

目的：总结及分析白癜风患者的临床特点及意义，探讨白癜风发病机理。方法：对2008例白癜风门诊患者进行认真填写问卷调查表，对各种可能涉及的因素进行统计分析。结果：白癜风主要发生于青少年，5－10岁为发病高峰，该年龄段占发病总数的近18．4％。泛发者占34．4％，神经节段型占7．0％，有阳性家族史者占7．4％，合并自身免疫性疾病者占11．2％，晕痣占6．3％。结论：（1）目前的观察尚未能提出有意义的诱发因素；（2）有阳性家族史者符合多基因遗传规律；（3）白癜风并非完全后天发病，少数出生时即可发生。     

一家系五代8例先天性部分白甲

临床资料先证者男,20岁。指趾甲部分白甲20年,患者出生时20甲即为部分白甲。无季节性变化,无自觉症状,未治疗。体检:各系统检查无异常。皮肤科检查:全身皮肤无色素减退和脱失,毛发呈黑色。甲质地和厚度无明显异常,指、趾甲近端部分白色,远端呈淡黄色(图1、2);甲皱襞无异常;手指和足趾皮温正常;甲板弯曲度增加;右小指甲板粗糙,凹凸不平;左足拇指及第五趾甲甲分离。诊断:先天性部分白甲。家系调查:家系中无近亲婚配,全家五代32人中有8例患有同样病症,先证者(IV6)出生时即有20甲部分白甲,8例患病者中男7例,女1例,病程经过与图1、2先证者指、趾…     

三色白癜风20例临床分析

报告20例三色白癜风，其中男11例、女9例。患者就诊时平均年龄17岁。皮损初发年龄平均12．8岁。至就诊时病程平均4．4年。白癜风皮损首发部位以躯干和四肢近端为多(85％)，而三色白癜风皮损除1例位于右小腿外，余19例均位于躯干(95％)。三色白癜风皮损的临床表现大致可分为4种：①单块皮损与周围正常皮肤形成典型三色性，即皮损中央呈纯白色，周围绕以乳白色中间带，周边是外观正常皮肤；②在正常肤色皮肤上，部分皮损呈纯白色，部分呈乳白色；③在正常肤色皮肤上，纯白色与乳白色皮损混杂、交织存在；④乳白色中间带不是围绕在纯白色皮损周围，而位于纯白色皮损的某一侧边缘。组织病理主要改变为：银染色可见从正常皮肤、乳白色中间带至纯白色皮损，基底层黑素颗粒逐渐减少至完全消失。经查阅文献国内尚未见报告。     

分段毛囊移植治疗毛发部位白癜风

【摘要】 目的 探讨分段毛囊移植治疗特殊部位白癜风的疗效。方法 2016年12月至2018年12月在杭州市第三人民医院皮肤科纳入10例19 ~ 28岁稳定期白癜风患者（男4例，女6例），共26处白斑合并白发，其中18处为头皮，8处为眉部。采用毛囊单位提取法从枕部或耳后区域获取毛囊，并均分为上下两部分。患者每处白斑合并白发皮损分为2部分，上下两部分毛囊分别移植于白斑的不同区域。术后每4周随访1次，观察复色及毛发生长情况。结果 12周时，移植毛囊上部26处白斑中痊愈3处，显效5处，好转12处，无效6处，有效率30.8%（8/26），且均未见毛发生长；移植毛囊下部的26处皮损中痊愈5例，显效7例，好转11例，无效3例，有效率46.2%（12/26），8处皮损出现毛发生长。移植毛囊上部组与移植毛囊下部组有效率差异无统计学意义（χ2 = 1.30，P = 0.25）。结论 分段毛囊移植术适用于头皮和眉部白癜风合并白发的治疗。     

Tazarotene 0.1% gel in the treatment of fingernail psoriasis: a double-blind, randomized, vehicle-controlled study.

A double-blind, randomized, vehicle-controlled, parallel-group trial was performed to compare the efficacy and tolerability of tazarotene 0.1% gel and vehicle gel in 31 patients with fingernail psoriasis. Patients were randomized to receive tazarotene or vehicle gel, which they applied each evening for up to 24 weeks to 2 target fingernails, one under occlusion and one unoccluded. The tazarotene treatment resulted in a significantly greater reduction in onycholysis in occluded nails (P < or = .05 at weeks 4 and 12) and a significantly greater reduction in onycholysis in nonoccluded nails (P < or = .05 at week 24). Tazarotene also resulted in a significantly greater reduction in pitting in occluded nails (P < or = .05 at week 24). There were no other significant between-group differences in pitting, subungual hyperkeratosis, leukonychia, nail plate crumbling/loss, splinter hemorrhage, or nail growth rate. Tazarotene 0.1% gel was well tolerated with only 5 of the 21 tazarotene-treated patients reporting a treatment-related adverse event (all mild or moderate). In conclusion, tazarotene 0.1% gel can significantly reduce onycholysis (in occluded and nonoccluded nails) and pitting (in occluded nails) and is well tolerated in the treatment of nail psoriasis.     

White fingernails preceded by multiple transverse white bands

In a patient with hepatocellular damage due to abuse of alcoholic liquors, multiple transverse white bands were found in all fingernails. On examination 3 months later the bands had disappeared, and the nails had developed into typical white nails. The changes were located in the nail bed, and were possibly caused by vascular alterations.     

Leukonychia totalis and ectodermal dysplasia. Report of 2 cases

The authors describe two brothers showing leukonychia totalis in association with deafness, hyperkeratosis palmaris and plantaris, scalp modifications and dental lesions. The onychopathia began during early childhood and was also present in four other members of the same family. All nails of both hands and feet were affected and appeared white, dull and with inconspicuous lunulae. The hair was rough, dark, bristly, looking like steel wire. In particular, the changes of the hair shaft were studied under scanning electron microscope. Hair dysplasia, accompanied by structural changes such as complete and incomplete twistings, longitudinal grooves and modified imbrication, was found. After briefly reviewing the literature on the subject, the authors point out the suggestive hypothesis that all these manifestations might possibly we ascribed to a single genetic defect, in spite of their different clinical features in the various patients.     

Nail pathology in patients with hemiplegia

BACKGROUND: It is well known that nails can be involved in some diseases of the central nervous system; however, no systematic study has been carried out in order to evaluate the incidence and the possible mechanisms of these nail changes in hemiplegia. OBJECTIVES: To study the presence of nail pathology specifically associated with hemiplegia and to evaluate its incidence and its temporal relationship with the onset of the neurological deficit. METHODS: In an open study, fingernails and toenails were examined by a dermatologist; 108 were patients with hemiplegia due to a stroke, consecutively admitted to our Department of Neurology between 1995 and 1998, and 121 were normal controls. RESULTS: Onychodystrophy of fingernails and onychomycosis of toenails were found in both patients with hemiplegia and normal controls. However, three conditions (longitudinal reddish striation, neapolitan nails and unilateral clubbing) were only observed in some patients, always affecting fingernails of the limb affected by hemiplegia. Neapolitan nails were present in three (3%) patients with hemiplegia which had its onset 3-14 months earlier. Hemiplegia had occurred approximately 40 months earlier, on average, in six patients (6%) with longitudinal reddish striation, and 60-120 months prior to unilateral clubbing in another two patients (2%). CONCLUSIONS: In this study we were able to assess the presence of three different fingernail conditions that were characteristically associated with hemiplegia (longitudinal reddish striation, neapolitan nails and unilateral clubbing), to evaluate their incidence and to study the delay with which these changes occur after a stroke.     

Autosomal recessive pachyonychia congenita

We report the second and third cases of pachyonychia congenita inherited as an autosomal recessive disorder. Our cases were unusual, with the fingernails showing a striking leukonychia and appearing clinically as Terry's nails. These patients were originally diagnosed as having epidermolysis bullosa simplex because of a history of a life-long blistering disorder. The clinical features and inheritance of pachyonychia congenita, as well as the reasons for the long delay in diagnosis of our cases, are discussed.     

Pigmentary abnormalities of the nails with emphasis on systemic diseases

The nails can change colors for many reasons. White bands called leukonychia are especially common. The shape of the white band, that is, concave or convex, indicates the site of injury. Color changes in the nails may also be a sign of a variety of cutaneous or systemic disorders.     

Ultrastructural observations on the hair bulb melanocytes and melanosomes in acute alopecia areata

It is well recognized that alopecia areata (Aa) may preferentially affect pigmented hair and may spare white hair, and that regrowing hair in the disease is often initially white. In addition, there is an association with vitiligo and ocular depigmentation. To date, the pathomechanisms of the melanocyte effects are unclear. We have studied 10 patients with untreated acute alopecia areata, and three normal patients without hair loss. Morphologic changes, studied by conventional light and electron microscopy, in the cytoplasm of affected melanocytes often predated nuclear hyperchromatism. Increased numbers of bizarre melanosomes were found in affected melanocytes compared with normal ones; such melanosomes had incomplete or "aborted" melanization, resulting in poor pigment deposition, and were disrupted, enlarged and rounded, with loss of normal ellipsoidal shape. An unusual outer root sheath (ORS) distribution of hair bulb melanocytes was seen. Other atypical melanosome effects included marked pigment displacement into peribulbar and DP melanophages. In the DP clumped melanin granules formed giant spherical complexes without discernible limiting membranes, which were sometimes associated with lymphocytes. These morphologic changes indicate an active involvement of hair bulb melanocytes in alopecia areata.     

The incidence of leukotrichia in segmental vitiligo: implication of poor response to medical treatment

Background In vitiligo, the melanocyte of the hair follicle is one of the major sources for repigmentation. Segmental vitiligo seems to be often associated with white hairs. However, in the case of small vellus hairs, it is often difficult or impossible to detect hair color. Thus, the real incidence of leukotrichia in segmental vitiligo has not been known. Materials and methods In this study, we investigated the existence of white hairs in the lesional skin of 82 patients with segmental vitiligo. When it was difficult to detect hair color with the naked eye or a magnifier, a digital microscope with 30× magnification was used. Results Interestingly, all 82 patients showed leukotrichia in segmental vitiligo independent of age and disease duration. Some patients had more than 90% white hairs in the lesional skin, and they showed poor response to medical treatment. Conclusions Based on our results, a very high percentage of patients with segmental vitiligo may be associated with leukotrichia. Many white hairs in segmental vitiligo may contribute to the lack of response with medical treatment. The examination of hair color with a digital microscope may be very useful for the prediction of treatment outcome and decision of treatment modalities.     

Nail changes in Meleda disease

11 patients with Mal de Meleda (keratoderma palmoplantaris transgrediens) had changes of the finger-and toenails. A peculiar alteration of the fingernails, in which the proximal part of the nails was pink, the distal part pale, was found in 3 patients. Polymorphous changes of the fingernails, but uniform changes of the toenails were found seen.