盐裂皮损围围皮肤直接免疫荧光检查诊断表皮下水泡病

本文报告了应用盐裂皮损周围皮肤直接免疫荧光检查（ＤＩＦ），诊断２２例表皮下水疱病的结果，所有２２例表皮下水泡病盐裂皮损周围皮肤ＤＩＦ均显示ＩｇＧ免疫复事物沉淀在表皮侧，真皮侧或表皮真皮两侧，阳性率为１００％，其中表皮侧１７例，表皮真皮两侧均有２例，此１９例的均为大泡性类天疱疮（Ｂｐ），真皮侧３例，２例为获得性大疱性表皮性松解症（ＥＢＡ），１例大疱性系统性红斑狼疮（ＢＳＬＥ），３例天疱疹和４例正常人     

表皮下大疱病的鉴别诊断和抗原表达区域性差别的研究

通过间接免疫荧光和盐裂皮损周围皮肤直接免疫荧光（简称盐裂ＤＩＦ），分别研究正常人皮肤、类天疱疮（ＢＰ）及获得性大疱性表皮松解症（ＥＢＡ）抗原表达的区域性差别和表皮下大疱病鉴别诊断。 窝、肘窝、上背、下背、股内侧和下腹部皮肤ＢＰ抗原表达率较高；膝、阳窝、足背、肘、肘窝和下腹部皮肤ＥＢＡ抗原表达率较高。皮肤ＤＩＦ显示２５例表皮下大疱病中１６例（６４％）基底膜带有Ｃ３或ＩｇＧ或伴Ｃ３和ＩｇＡ沉积；盐裂ＤＩＦ表明２５例（１００％）均有ＩｇＧ或伴Ｃ３和ＩｇＡ沉积在表皮侧或真皮侧。结果提示，ＢＰ抗原高表达率与皮损好发部位相一致；ＥＢＡ抗原高表达率一部分与皮损好发部位一致。盐裂ＤＩＦ不仅提高ＤＩＦ阳性率，而且根据免疫反应物沉积部位可以鉴别出ＢＰ与ＥＢＡ以及大疱性系统性红斑狼疮。     

盐裂皮肤直接和间接免疫荧光联合应用鉴别诊断表皮下大疱病的研究

本文探讨盐裂皮肤ＤＩＦ和盐裂皮肤ＩＩＦ联合应用鉴别诊断表皮下大疱病的价值。２０例两种盐裂皮肤免疫荧光均阳性的病例比较表明，盐裂皮肤ＩＩＦ示抗基底膜带抗体结合表皮侧或真皮侧与盐裂皮肤ＤＩＦ示免疫反应物（ＩｇＧ、ＩｇＡ、Ｃ＿３等）沉积于表皮例或真皮侧的部位基本一致。提示多数情况下盐裂皮肤ＤＩＦ或ＩＩＦ均可单独用于表皮下大疱病诊断，两者对比分析可以提高诊断率。     

儿童获得性大疱表皮松解症(附4例报道)

儿童获得性大疱表皮松解症（ＥＢＡ）是一种自身免疫性表皮下大疱病,比较少见。本文报道４例儿童ＥＢＡ,年龄为１、４、７、１４岁,均为男性。临床上似营养不良性大疱表皮松解症２例,儿童型线形ＩｇＡ大疱病２例。３例有口腔损害,伴血疱,萎缩性瘢痕和栗丘疹。病理为表皮下水疱。ＤＩＦ均示ＩｇＧ和Ｃ３呈线状分布于基底膜带,３例还见ＩｇＡ,１例见ＩｇＭ沉积于基底膜带。盐裂ＤＩＦ示３例ＩｇＧ沉积于真皮侧。ＩＩＦ示３例Ｉ     

盐裂皮肤直接和间接免疫荧光联合应用鉴别诊断表上大疱病的…

本文探讨盐裂皮肤ＤＩＦ和盐裂皮肤ＩＩＦ联合应用鉴别诊断表皮下大疱病的价值。２０例两种盐裂皮肤免疫荧光均阳性的病例比较表明，盐裂皮肤ＩＩＦ示抗基底膜带体结合表皮侧或真皮侧与盐裂皮肤ＤＩＦ示免疫反应物（ＩｇＧ、ＩｇＡ、Ｃ３等）沉积于表皮侧或真皮侧的部位基本一致。提示多数情况下盐裂皮肤ＤＩＦ或ＩＩＦ均可韵用于表皮下大将民病诊断，两者对比可以提高诊断率。     

盐裂解皮损周围皮肤直接免疫荧光鉴别诊断表皮下水疱病

应用盐裂皮损周围皮肤直接免疫荧光检查２２例表皮下水疱病的结果：ＩｇＧ免疫复合物沉积在表皮侧１７例，表皮真皮两侧均有２例，均为在性类天疱疮，真皮仙３例，２例为获得性大疱性表皮松解症，１例为大疱性系统红斑狼疮，对照组均阴性。此法简易易行，经济实用，准确可靠，值得推广使用。     

1mol／L NaCl分离表皮DIF染色法的临床实用价值

对１９例大疱性类天疱疮（ＢＰ）和５例获得性大疱性表皮松解症（ＥＢＡ）病人进行了常规ＤＩＦ、１ｍｏｌ／Ｌ ＮａＣｌ分离表皮ＤＩＦ和１ｍｏｌ／Ｌ ＮａＣｌ分离正常人皮肤ⅡＦ的对比研究。结果显示１ｍｏｌ／Ｌ ＮａＣｌ分离皮肤ＤＩＦ染色法是诊断和鉴别诊断ＢＰ和ＥＢＡ的一种简单、可靠、敏感的方法。     

疱液在诊断表皮下自身免疫性大疱病中的意义

目的：探讨表皮下自身免疫性大疱病疱液中抗基底膜带（ＢＭＺ）自身抗体的情况及在诊断中的意义。方法：应用非盐裂皮肤及盐裂皮肤间接免疫荧光技术（ＩＦ）检测３８例表皮下自身免疫性大疱病患者疱液和血清中ＩｇＧ、ＩｇＡ、ＩｇＭ、ＩｇＥ及ＩｇＧ亚型ＩｇＧ１～ＩｇＧ４抗ＢＭＺ抗体及滴度，并检测疱液和血清中结合补体Ｃ３的特异性抗ＢＭＺ抗体。结果：（１）疱液和血清中抗ＢＭＺ抗体及滴度和结合补体Ｃ３的特异性抗ＢＭＺ抗体均无显著性差异。（２）大疱性类天疱疮患者的疱液和血清中ＩｇＧ抗ＢＭＺ抗体的亚型分布相同，主要为ＩｇＧ１和ＩｇＧ４。结论：疱液可作为ＩＩＦ检测表皮下大疱病抗ＢＭＺ抗体的另一个有价值的标本来源。     

1M NaCl分离皮肤的免疫荧光法在表皮下大疱疹诊断中的应用

该文介绍了１Ｍ ＮａＣｌ分离皮肤免疫荧光法诊断表皮下大疱病的原理和优越性。同时介绍了盐裂正常人皮肤ＩＩＦ法以及盐裂皮损周围皮肤的ＤＩＦ法对表皮下大疱病诊断与鉴别诊断的价值。     

盐裂皮损周围皮肤直接免疫荧光鉴别诊断表皮下水疱病

应用盐裂皮损周围皮肤直接免疫荧光 (DIF)检查 2 2例表皮下水疱病的结果 :IgG免疫复合物沉积在表皮侧 1 7例 ,表皮真皮两侧均有 2例 ,均为大疱性类天疱疮 (BP) ;真皮侧 3例 ,2例为获得性大疱性表皮松解症 (EBA) ,1例为大疱性系统性红斑狼疮 (BSLE)。对照组均阴性。此法简便易行 ,经济实用 ,准确可靠 ,值得推广使用     

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.