胸骨柄体关节受累的关节病性银屑病三例

近年来,我们采用螺旋CT骨重建和高频超声技术连续诊断3例胸骨柄体关节受累的关节病性银屑病,报道如下.     

Psoriasis associated with vulval scarring

Psoriasis is a chronic inflammatory skin disorder which is generally not associated with scarring. We report two patients with long-standing severe anogenital psoriasis, that was associated with loss of the labia minora, thus clinically mimicking the scarring associated with lichen sclerosus. Histopathological finding were however, consistent with psoriasis with no evidence of lichen sclerosus. Elastic fibres were present and there was no evidence of abnormal collagen or fibrous tissue. The association of vulval psoriasis with scarring has not been reported previously.     

银屑病合并代谢综合征的研究进展

银屑病合并代谢综合征日益增多.相同的炎症过程,遗传和环境因素可能是导致两种疾病并存的原因,银屑病增加代谢综合征的发病风险,治疗同时可降低代谢综合征的发病危险,针对代谢综合征的综合治疗有助于银屑病皮损的改善.为有效治疗和管理银屑病,需认清其与代谢综合征之间的关联,探讨更新的治疗标准,并采取多学科合作的综合治疗方式.     

掌跖脓疱病患者血清瘦素高水平表达的研究

目的:研究掌跖脓疱病的血清瘦素水平,探讨掌跖脓疱病与血清瘦素水平的相关性。方法:21例掌跖脓疱病患者与正常对照28例,采用放射免疫技术检测其血清瘦素,并进行统计学分析。结果:(1)掌跖脓疱病患者血清瘦素水平(9.56±5.30)ng/mL较正常对照(5.62±2.93)ng/mL显著增高(P=0.002);(2)血清瘦素水平可见显著的性别差异(P=0.001),与女性正常对照(6.60±2.69)ng/mL比较,女性掌跖脓疱病血清瘦素水平(9.85±5.25)ng/mL显著增高(P=0.017);(3)血清瘦素水平与掌跖脓疱病的发病年龄、病程无相关性。结论:掌跖脓疱病与血清瘦素水平相关,瘦素可能在掌跖脓疱病的发生及发展过程中起作用。     

Deposition of fibrinogen (FR-antigen) in skin diseases. I. Psoriasis vulgaris and Psoriasis arthropathica (with special reference to heparin-precipitable fraction).

Twenty-five in-patients with psoriasis arthropathica (ps.a.) and 18 in-patients with psoriasis vulgaris (ps.v.) were examined for cryofibrinogen as heparin-precipitable fraction (HPF), for total fibrinogen in plasma and by immuno-fluorescence (IF) technique for FR-antigen in tissue sections of affected and unaffected skin. A control group of 14 in-patients with various non-psoriatic dermatoses were examined with if for FR-antigen in unaffected skin. Pathological quantities of HPF were found in 6% in ps.v. and in 48% in ps.a. Total fibrinogen in plasma was normal in ps.v. (365 mg%), and moderately elevated in ps.a. (471 mg%). In psoriatics, FR-antigen was found in unaffected skin ps.v. in 50%, in ps.a. in 72%. In affected skin, the figures were 67% and 84% respectively. No direct relationship could be found between the incidence and the degree of HPF, and depositions of FR-antigen in the tissue sections in the skin at the time of the examination. In the control group, no FR-antigen could be found in unaffected skin, except in one case of acne cystica, with traces of FR-antigen in a few areas of the tissue section.     

MTX对关节病型银屑病患者血清TNF-α影响的研究

目的：研究肿瘤坏死因子α（TNF-α）在关节病型银屑病发病中的作用及MTX对其调节作用，探讨MTX治疗关节病型银屑病的机制。方法：应用双抗体夹心酶联免疫吸附法（ELISA），检测15例关节病型银屑病患者经MTX治疗前后外周血清中TNF-α的水平。结果：MTX治疗前血清中。的水平显著高于治疗后及正常人对照组（P〈0．001）。结论：TNF—α在关节病型银屑病致病中可能起重要作用。MTX治疗关节病型银屑病的机制可能是通过抑制TNF-α的分泌而达到治疗作用。     

Psoriasis associated with ulcerative colitis and Crohn's disease

Background  Numerous reports have demonstrated the epidemiological, pathogenic, and genetic association between psoriasis and Crohn's disease. Nevertheless, the association between psoriasis and ulcerative colitis was rarely described.
Objective  This study aims to investigate the association between psoriasis and inflammatory bowel disease.
Study design  Case-control study.
Setting  The study was performed utilizing the large medical dataset of Clalit Health Services.
Methods  Psoriasis patients were compared to controls regarding the prevalence of inflammatory bowel disease in a case–control study using logistic multivariate models.
Results  The study included 12 502 psoriasis patients aged 20 years and above and 24 287 age- and sex-matched controls. The prevalence of both Crohn's disease and ulcerative colitis was significantly higher in psoriasis patients compared with the control group. In multivariate analyses, psoriasis was associated with Crohn's disease [odds ratio (OR), 2.49; 95% confidence interval (95% CI), 1.71–3.62] as well as ulcerative colitis (OR, 1.64; 95% CI, 1.15–2.33). This association was independent of anti-tumour necrosis factor-α therapy.
Conclusion  Psoriasis is associated both with Crohn's disease and ulcerative colitis. Future studies on comorbidities in patients with psoriasis should focus on ulcerative colitis.

Conflicts of interest

None declared.     

Drug-induced hypersensitivity syndrome associated with transient hypogammaglobulinaemia and increase in serum IgE level

Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disease with multiorgan failure. Recently, the association of the human herpesvirus (HHV) family, particularly of HHV-6, with DIHS has been reported. We report a 43-year-old female diagnosed as having DIHS based on the clinical course and laboratory examinations. The HHV-6 reactivation was demonstrated by significantly increased levels of the specific antibody in her paired sera and by polymerase chain reaction of HHV-6 DNA. Notably, transient hypogammaglobulinaemia was detected in the early stage of the disease, which was associated with the disease activity. By contrast, the serum IgE level and eosinophils were increased 2 or 3 weeks later. In addition, serum levels of interferon gamma, interleukin (IL)-4 and soluble IL-2 receptor, which were increased in the early phase of the disease, decreased gradually after the corticosteroid therapy.     

Bowen's disease showing spontaneous complete regression associated with apoptosis

Spontaneous regression is sometimes seen in malignant skin tumours. We report a 68-year-old woman whose Bowen's disease showed spontaneous complete regression. Prominent infiltration of T cells and increased vascularity were found in the upper dermis of the regressed lesion. Strong expression of Fas (APO-1/CD95) antigen, an apoptosis-related tumour necrosis factor receptor family protein, in the primary lesion and faint expression following regression suggest the involvement of Fas-mediated apoptosis in the spontaneous complete regression of our patient's Bowen's disease.