中外白癜风诊疗指南及共识比较

本文从白癜风分型、分期、病情评估、药物治疗及非药物治疗等方面比较了欧洲、美国、日本、韩国、中国等地区和国家的白癜风诊疗指南或共识, 概要分析各指南及共识中推荐的白癜风疗法和强调理念的异同, 以帮助临床医生为白癜风患者提供合适的个体化治疗方案。     

两种氯雷他定药物治疗湿疹、皮炎的成本效果分析

目的：对两种氯雷他定(百为坦和开瑞坦)治疗湿疹、皮炎的成本效果进行分析．方法：将患者分为两组，每组30例，分别服用百为坦和开瑞坦，除观察疗效外还进行成本效果分析。结果：两组疗效相当，均无明显的不良反应。但百为坦的治疗成本明显低于开瑞坦．结论：氯雷他定治疗湿疹、皮炎疗效高，安全性好。百为坦比开瑞坦治疗成本低。     

Treatment and prevention of rickettsial and ehrlichial infections

Rickettsial and ehrlichial infections are both carried by arthropod vectors. Both Rickettsia and Ehrlichia are small intracellular gram-negative coccobacilli. Clinical manifestations of Rickettsia range from spotted fevers to various forms of typhus. Human ehrlichiosis can present as monocytic ehrlichiosis or granulocytic anaplasmosis. Prevention is by avoidance of the responsible vectors. Therapy is usually with doxycycline, but chloramphenicol can also be used.     

Visual attention to and perception of undamaged and damaged versions of natural and colored female hair

Female hair color is thought to influence physical attractiveness, and although there is some evidence for this assertion, research has yet not addressed the question if and how physical damaging affects the perception of female hair color. Here we investigate whether people are sensitive (in terms of visual attention and age, health and attractiveness perception) to subtle differences in hair images of natural and colored hair before and after physical damaging. We tracked the eye‐gaze of 50 men and 50 women aged 31–50 years whilst they viewed randomized pairs of images of 20 natural and 20 colored hair tresses, each pair displaying the same tress before and after controlled cuticle damage. The hair images were then rated for perceived health, attractiveness, and age. Undamaged versions of natural and colored hair were perceived as significantly younger, healthier, and more attractive than corresponding damaged versions. Visual attention to images of undamaged colored hair was significantly higher compared with their damaged counterparts, while in natural hair, the opposite pattern was found. We argue that the divergence in visual attention to undamaged colored female hair and damaged natural female hair and associated ratings is due to differences in social perception and discuss the source of apparent visual difference between undamaged and damaged hair.     

Stigmatization and quality of life of patients with psoriasis and atopic dermatitis

ZusammenfassungHintergrund und Fragestellung Psoriasis- und Neurodermitispatienten sind häufig von den psychosozialen Konsequenzen ihrer Hauterkrankungen beeinflusst. Um diese Erfahrungen reliabel zu bestimmen, wurden das Stigmatisierungserleben und die Einschränkung der Lebensqualität dieser Patientengruppen untersucht.Patienten/Methodik Die Kurzform des "Fragebogens zum Erleben von Hautbeschwerden" (FEH) mit 23 Items wurde an einer Stichprobe von 463 stationär behandelten Psoriasis- und Neurodermitispatienten validiert. Außerdem wurde der Dermatologische Lebensqualitäts-Index (DLQI) erhoben.Ergebnisse Die 4 FEH-Skalen "Beeinträchtigung des Selbstwertgefühls und Rückzug", "Erfahrene Zurückweisung", "Verheimlichung" und "Gelassenheit" konnten durch eine Faktorenanalyse bestätigt werden. Es fanden sich erwartungsgemäß mittelhohe korrelative Zusammenhänge zwischen den FEH-Skalenwerten und dem DLQI-Gesamtwert bei beiden Patientengruppen. Das Stigmatisierungsgefühl und die Lebensqualität einer Subgruppe der Psoriasis- und Neurodermitispatienten mit vergleichbaren soziodemographischen Charakteristika war nicht signifikant unterschiedlich.Schlussfolgerungen Die Kurzform des FEH ist ein valides Untersuchungsinstrument zur Erfassung sozialer und psychischer Belastungen von Psoriasis- und Neurodermitispatienten. Mit der Bestimmung des Stigmatisierungsgefühls und der Lebensqualität werden unterschiedliche, sich ergänzende Aspekte der krankheitsbezogenen Belastung von Patienten mit chronischen Dermatosen erfasst.

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肢端血管角化瘤伴手足多汗症1例

报告1例肢端血管角化瘤伴手足多汗症。患者因手指背暗红丘疹伴多汗6年就诊,有明确冻伤史,手指背侧分布暗红角化丘疹,手、足多汗如洗,皮疹处病理回报表皮角化过度,棘层不规则增厚,乳头瘤样增生,真皮浅层毛细血管扩张。     

Sterilization and care of surgical instruments and supplies

Adequate instrument handling and sterilization are important aspects of office surgery. Heat sterilization is the most reliable choice. The steam autoclave is highly recommended. Dry heat is effective but can pose some storage problems. Gas sterilization is useful for heat-sensitive materials but not practical for the private office. Cold "sterilization" is not reliable for incisional surgery. In addition to proper sterilization modality selection, the surgeon must observe important standards of instrument care, packing, and storage.     

Role of oxidative stress and autoimmunity in onset and progression of vitiligo

Vitiligo is an acquired depigmentation disorder characterized by the loss of functional melanocytes from the epidermis. Two major theories of vitiligo pathogenesis include autoimmunity and oxidative stress‐mediated toxicity in melanocytes. The present study aimed to evaluate both the hypotheses in vitiligo patients and to investigate their role in the disease onset and progression. Antimelanocyte antibody levels and lipid peroxidation (LPO) levels were evaluated in 427 patients and 440 controls; antithyroid peroxidase (TPO) antibody levels were estimated in 102 patients and 72 controls. Patients showed a significant increase in LPO and antimelanocyte antibody levels compared to controls. Antimelanocyte antibody and LPO levels were higher in active vitiligo compared to stable. Only 9.8% of patients showed the presence of anti‐TPO antibodies in their circulation. Oxidative stress may be the initial triggering event to precipitate vitiligo in Gujarat population, which is exacerbated by contributing autoimmune factors together with oxidative stress.     

龙岩市男男性行为人群HIV感染与行为学监测

目的:调查龙岩市男男性行为(MSM)人群中HIV感染和行为学情况.方法:2012年1～11月对龙岩市208名MSM进行问卷调查和血清学检测.结果:该人群平均年龄28.1岁,小于40岁占92.3％.208份标本中HIV抗体阳性率为7.2％、梅毒抗体阳性率为2.88％.近6个月与男性发生肛交时每次都用安全套者占58.2％;与异性发生性行为时每次使用安全套14人(21.9％).结论:该人群安全套使用率低,因此应大力推广安全套的使用.     

Ageing and photoageing of keratinocytes and melanocytes

An overview of keratinocyte and melanocyte function is provided. The processes of cutaneous ageing and photoageing are defined, and age-associated modulations in gene expression are described. The changes in keratinocytes and melanocytes that occur with skin ageing and photoageing and the characteristics of chronologically aged vs. photoaged skin are delineated. Mutations that are found in malignant and premalignant tumors of epidermal origin are described.     

Dissociation of intra- and extracellular domains of desmosomal cadherins and E-cadherin in Hailey-Hailey disease and Darier's disease

In order to clarify the pathomechanism of acantholysis in Hailey-Hailey disease (HHD) and Darier's disease (DD), the distribution of desmosomal and adherens junction-associated proteins was studied in the skin of patients with HHD (n = 4) and DD (n = 3). Domain-specific antibodies were used to determine the cellular localization of the desmosomal transmembrane glycoproteins (desmogleins 1 and 3 and desmocollin), desmosomal plaque proteins (desmoplakin, plakophilin and plakoglobin) and adherens junction-associated proteins (E-cadherin, alpha-catenin, beta-catenin and actin). A significant difference in staining patterns between intra- and extracellular domains of desmosomal cadherins and E-cadherin was demonstrated in acantholytic cells in both HHD and DD, but not in those in pemphigus vulgaris and pemphigus foliaceus samples used as controls. In acantholytic cells in HHD and DD, antibodies against attachment plaque proteins and intracellular epitopes of desmosomal cadherins exhibited diffuse cytoplasmic staining, whereas markedly reduced staining was observed with antibodies against extracellular epitopes of the desmogleins. Similarly, membrane staining of an intracellular epitope of E-cadherin was preserved, while immunoreactivity of an extracellular epitope of E-cadherin was destroyed. While the DD gene has been identified as ATP2A2, the gene for HHD has not been clarified. The dissociation of intra- and extracellular domains of desmosomal cadherin and E-cadherin is characteristic of the acantholytic cells in HHD and DD, and not of pemphigus. This common phenomenon in HHD and DD might be closely related to the pathophysiological mechanisms in both conditions.