PB型麻风复发转型2例

米易县麻风防治工作始于1959年,截至2006年共发现病人609例,1986年前主要采用氨苯砜(DDS)单疗为主,1986年7月开始实施WHO的MDT方案治疗麻风,现将1例DDS单疗治愈、1例MDT治愈后复发,发生病型转型报告如下。1临床资料例1男,52岁,汉族,农民。1967年诊断为TT型麻风,采用DDS治疗,于1976年12月判愈出院,1997年复查时发现患者面部、胸部浸润大小不等、边界不清的淡红斑,双足干燥,皮肤涂片查菌BI2 ,病理查菌阳性(3 )~(4 ),病理诊断BL型麻风。例2男,53岁,汉族,农民。1986年发现左侧腰部一块4cm×4cm大小红斑,皮肤涂片查菌阴性,病理查菌阳性…     

少菌型麻风病人解除登记后复发成为多菌型病人的危险性

1975～1979年有2027例少菌型麻风经4.5至15年以上DDS单疗,皮肤抹片查菌阴性后,解除了登记。1979～1980年随访了其中的1701例(包括一部分死亡及外迁的患者)。这些患者构成的总年复发危险人次(Person years at risk,PYR)为5254。有51例复发,依PYR计的复发率(RR)为9.7‰,粗算总复发率为3％。随访病人中,有41％的未定类、33％的结核样型和43％的BT在解除登记前麻风菌素     

中国12403例麻风复发病例分析

目的研究1949～1998年用氨苯砜单疗或联合化疗后麻风患者的复发趋势和特点 .方法应用电脑对收集自中国1949～1998年的麻风复发个案资料进行分析.结果1949～1998 年间累计复发患者12403例,累计复发率为3.28%.其中氨苯砜单疗复发11803例,复发率为 3.83%.联合化疗复发236例,复发率为0.57%.经治少菌型麻风联合化疗半年的复发率(0 .84%)显著高于初治少菌型麻风联合化疗半年的复发率(0.36%).经治多菌型麻风联合化疗2年的复发率(0.37%)也显著高于初治多菌型麻风联合化疗2年的复发率(0.23%). 复发患者Ⅱ级畸残率及细菌的阳性率分别为49.9%和69.3%.结论氨苯砜单疗复发高峰出现于1959～1988年间,联合化疗复发出现于80年代末,并在未来的10～20年可能达高峰.     

麻风治愈10年后复发的54例分析

新疆1952～1987年间累计治愈麻风患者3001例。经随访和自动就诊从中发现复发203例,累计复发率为6.76％;其中治愈10年后复发的有54例(26.1％),说明麻风治愈并终止监测期后仍有一部分病人会复发。本文报导了以DDS单疗治愈10年后复发的54例,其中男性9例、女性14例;原属IL型12、BL型1例、BB型1例、BT型12     

44例麻风MDT后复发报告

目的探讨(2010~2017)年云南省麻风MDT治疗后复发病例的特点。方法通过"全国麻风疫情管理信息系统"(LEPMIS)对云南省(2010~2017)年麻风联合化疗治疗后复发者个案资料进行分析。结果 8年中MDT疗后复发44例,同期单一DDS复发34例,平均间隔期389.4个月。MDT复发者以多菌型为主,平均复发间隔17.3个月。结论麻风MDT疗后复发具有长期危险性,并且复发与患者的含菌量有关。     

多菌型麻风用WHO联合化疗方案治疗和长期随访后的复发

作者报告用WHO联合化疗(MDT)方案治疗多菌型麻风(MB)病人长期随访后的复发。 35例MB病人用WHO/MDT方案治疗2年。疗前,35例病人中14例从未接受过抗麻风治疗,15例曾经不同疗期的氨苯砜(DDS)单疗,5例在DDS单疗后又经不同疗期的利福平(RFP)合并DDS治疗,1例接受过6个月的RFP+DDS+氯苯吩嗪(CLO)治疗。35例病人     

少菌型麻风复发转为多菌型的危险性研究

作者对解除管理的1701例少菌型麻风进行随访,观察其复发及转型情况。按解除管理的时间计算,1701例会计为5254人年,复发51例,复发率为4.7/1000人年。这些病例中,麻素阳性者的复发率为6.4/1000人年;阴性者为15.5/1000人年(P<0.01)。在资料完整的47例少菌型复发者中有29例麻素试验阴性者,复发时转为多菌型者有11例;麻素阳性的18例,没有一例复发时转为多菌型,可见麻素试验阴性的少菌型治愈者复发时转为多菌型的危险性比麻素试验阳性者高得多(P<0.01)。作者认为,在治疗上应把麻素阴性的少菌型与麻     

麻风病

20 0 4 14 0 3　 ND- O- BAS- ELISA测定正常人和麻风治愈者血清抗体水平的应用研究 /费实 (广州市皮防所 )… / /中国麻风皮肤病杂志 .- 2 0 0 4 ,2 0 (1) .- 5 2采用 ND- O- BAS- EL ISA检测了正常人和麻风治愈者的血清抗体活性。结果治愈 2 0年以上个体的血清抗体水平稳定在 0 .0 4～ 0 .0 6 ,愈后 5～ 10年为 0 .0 6～0 .1,证实了DDS长期单疗后部分患者体内仍残留麻风菌 ,但抗体水平随麻风菌不断清除而下降的假设。提示该地在预测麻风复发方面有深入研究的价值。表 2参 3　 (汤亚娥 )2 0 0 4 14 0 4　西藏林芝地区 6 78例麻风…     

瘤型麻风复发率与规则治疗的关系

作者对单用氨苯(DDS)治疗皮肤涂片阴性的瘤型麻风砜(LL)及界线类偏瘤型麻风(BL)的复发率进行了分析,以确定涂片阴性时,继续治疗是否象涂片阳性时一样对复发率有重大影响。复发的定义是查菌阴转的病人皮肤涂片上重新出现麻风菌。自1977年12月31日至1981年2月28日,在南印     

麻风逆向反应及其处理

少菌型麻风常发生Ⅰ型反应或升级反应。Wade 在 DDS 单疗初期曾提出逆向反应(RR) 一词,WHO 麻风专家委员会在第6次报告中正式用了逆向反应。RR 是细胞免疫力增加所致皮     

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.     

Evidence‐based skin care in preterm infants

Most guidelines on neonatal skin care emphasize issues pertaining to healthy, term infants. Few address the complex task of skin barrier maintenance in preterm, very preterm, and extremely preterm infants. Here, we provide an evidence‐based review of the literature on skin care of preterm neonates. Interestingly, the stratum corneum does not fully develop until late in the third trimester, and as such, the barrier function of preterm skin is significantly compromised. Numerous interventions are available to augment the weak skin barrier of neonates. Plastic wraps reduce the incidence of hypothermia while semipermeable and transparent adhesive dressings improve skin quality and decrease the incidence of electrolyte abnormalities. Tub bathing causes less body temperature variability than sponge bathing and can be performed as infrequently as once every four days without increasing bacterial colonization of the skin. Topical emollients, particularly sunflower seed oil, appear to reduce the incidence of skin infections in premature neonates—but only in developing countries. In developed countries, studies indicate that topical petrolatum ointment increases the risk of candidemia and coagulase‐negative Staphylococcus infection in the preterm population, perhaps by creating a milieu similar to occlusive dressings. For preterm infants with catheters, povidone‐iodine and chlorhexidine are comparably effective at preventing catheter colonization. Further studies are necessary to examine the safety and efficacy of various skin care interventions in premature infants with an emphasis placed on subclassifying the patient population. In the interim, it may be beneficial to develop guidelines based on the current body of evidence.     

Occupational allergic contact dermatitis from spices

About 1000 patients were investigated at our clinic during 1991 for occupational skin disease. and 5 had occupational allergic contact dermatitis from spices. The patients were chefs, or kitchen, coffee room, and restaurant workers. All patients had hand (or finger) dermatitis. The causative spices were: garlic, cinnamon, ginger, allspice and clove, The same patients also had allergic patch test reactions to foods: tomato, lettuce and carrot. Paprika elicited a weak allergic patch test reaction in 2 patients. Occupational allergic contact dermatitis from spices is relatively rare, but needs to be taken into consideration in patients who have hand dermatitis, and work with spices and foods, Patch testing with spices as is useful, but testing with dilutions in pet, may be needed to confirm that the patch test reactions are allergic. Patients also need to be prick tested with spices and foods.     

Subfascial endoscopic perforator vein surgery

Chronic venous insufficiency is a tremendous health care problem in western societies. Venous disease can affect any combination of the superficial, deep, and perforator venous systems of the lower extremities. Generally the superficial venous deficits are addressed through sclerotherapy, enovenous ablation, stab phlebectomy, and or stripping. Patients with advanced clinical sequelae (lipodermatosclerosis or ulceration) of CVI should also be evaluated for the presence of incompetent perforating veins. Open surgical approached to the calf perforating veins (ie. Linton procedure) were complicated by significant wound complications and have largely been replaced by the less invasive Subfascial Endoscopic Perforator Surgery (SEPS). The use of SEPS in patients with ulceration has been shown to be safe and to reduce the time that patients will have ulcers during follow-up. This chapter will review the pathophysiology, diagnosis, and treatment of incompetent perforating veins of the legs with particular attention to surgical issues.