自体表皮细胞移植加神经生长因子治疗白癜风

为了探讨神经生长因了（NFG）治疗白癜风的疗效，在自体表皮细胞移植的同时加用NFC观察35例白癜风患者的疗效，并与单纯使用自体表皮细胞移植病例对照，结果添加NFG的皮片全部存活，且色素恢复较快，色斑扩大更为显著，未见明显副作用，为目前治疗白癜风的一种更安全有效的治疗方法。     

Efficacy of erbium YAG laser-assisted autologous epidermal grafting in vitiligo

BACKGROUND: Of the various modalities of therapy available for the treatment of vitiligo, a combination of psoralen + ultraviolet A (PUVA) with autologous epidermal grafting appears to offer the best results. The erbium YAG laser can be used to prepare the recipient site in both punch grafting and suction blister grafting. METHODS: In this study 29 subjects, 26 with localized and three with generalized stable vitiligo, had received pregrafting PUVA and underwent further PUVA starting 2 weeks after surgery until maximal pigmentation was achieved. The erbium YAG laser was used on 16 subjects; the recipient site for punch grafting was prepared with laser and minigrafts harvested by manual punch were placed into the prepared sites. For suction blister grafting, the site was dermabraded with a laser and the harvested blister roof (created using suction apparatus) was transplanted on to the site. RESULTS: More than two-thirds (68.75%) of the subjects who were punch grafted using a laser showed repigmentation of more than 75%, but only one-half of those who underwent conventional punch grafting showed a similar response. All subjects with laser-assisted suction blister grafting showed a good response, compared with only 60% of those who underwent conventional suction blister grafting. CONCLUSIONS: The results obtained with laser-assisted grafting are more satisfactory than those achieved with conventional grafting techniques. We found that the repigmentation zones are larger (up to 9 mm in the former vs. 3 mm in the latter) and cobblestoning does not occur with laser-assisted grafting. Also, the procedure is precise, relatively atraumatic and can be performed rapidly even when covering vast areas.     

Modified technique of suction blistering for epidermal grafting in vitiligo

BACKGROUND: Suction blister epidermal grafting is a useful modality of treatment of resistant and stable vitiligo; however, it requires expensive and heavy suction apparatus. This study is an attempt to develop a cheap and small apparatus which can be assembled in the physician's own office. PATIENTS AND METHODS: The method was tried in 22 vitiligo/leukoderma patients. The apparatus consisted of a cylindrical funnel connected with a three-way tap, and suction was given by a 50-mL syringe. The pressure inside the suction cup was retained by changing the position of lock of the three-way tap. The pressure was measured by connecting the three-way tap to a vacuum gauge. The apparatus remained adhered to the donor area because of negative pressure. The blister was formed in about 1.5 h. The roof of the blister was grafted onto the dermabraded recipient site. RESULTS: The pigmentation was complete in 20 out of 22 patients. There were no complications. CONCLUSIONS: The technique is inexpensive and easy and obviates the need of cumbersome and heavy equipment.     

Strict anatomical coexistence of vitiligo and psoriasis vulgaris – a Koebner phenomenon?

We describe a patient who developed typical psoriptic plaques covering completely or partly the vitiliginous areas of her skin. Her psoriasis was strictly limited to the vitiliginous patches with no involvement of the normal skin. Strict anatomical coexistence of both diseases is extremely rare and suggests a causal mechanism, possibly due to a Koebner phenomenon, but genetic and environmental factors mav also be involved.     

Expression of the l-fucose moiety on epidermal keratinocytes in psoriasis induced by the Koebner phenomenon: a sequential study

The expression of Ulex europaeus agglutinin (UEA I) binding sites on cell-surface glycoproteins has been used as a marker for terminal differentiation. Increased number of UEA I binding sites of L-fucose specificity have been demonstrated in psoriatic epidermis. The results of lectin-binding studies in a series of biopsies taken sequentially (0 min, 5 min, 24 h, 7 days and 8 weeks) after tape-stripping of uninvolved skin in 12 psoriatic patients (three of whom were taking diltiazem, a calcium blocker at the time of the study) and six controls are presented. UEA I binding sites, which were expressed on the granular layer and upper layers of the stratum spinosum of pre-tape stripped uninvolved skin in psoriatic individuals, were progressively more numerous, with the expression of the L-fucose moiety on the lower stratum spinosum keratinocytes in the 7-day post-tape-stripping biopsies and 8-week biopsies, correlating with a moderate and marked increase in the proliferative index, respectively. In the Koebner-negative and non-psoriatic individuals who failed to develop psoriasis after tape-stripping, the UEA I binding sites were not expressed on keratinocytes of the lower stratum spinosum in any of the biopsies, although a mild increase in the proliferative index was noted in the 7-day biopsies. Our data suggest that the increased commitment of keratinocytes to terminally differentiate may be involved in the psoriatic process.(ABSTRACT TRUNCATED AT 250 WORDS)     

压力对白癜风负压吸疱自体表皮移植的影响

负压吸疱自体表皮片移植是治疗稳定期白癜风常用方法之一.供皮区一般选择腹部、臀部等不影响美容的部位.我们通过观察不同压力下腹部起疱情况、真表皮分离部位,黑素细胞培养观察黑素细胞数量,寻求腹部起疱最合适的压力,从而提高负压吸疱移植治疗白癜风的疗效.     

Large acquired nevocytic nevi induced by the Koebner phenomenon

A patient with characteristic clinical, histopathological, ullrastruclural and family history of cpidermolysis bullosa simplex (EBS) developed large acquired nevocytic at the sites of some healing blisters. An isomorphic reaction may have initiated the development of these ncvi. Such large acquired nevi should be considered in the differential diagnosis of large and giant congenital nevi which have the potential to evolve into malignant melanoma.     

自体表皮移植术治疗白癜风的疗效观察

为了探讨表皮移植术对白癜风的疗效,观察了３５例白风病人采用自体表皮移植术,其中局限型２９例,节段型５例,泛发型１例,共移植５６个白斑区,植入直径０．５￣０．８ｃｍ皮片１１２０处,皮片存活率９５．０９％,有以素细胞再生率９０．００％,其中治愈２４例,显效８例,有效２例,无效１例,总有效率９１．４３％,所有患者观察随访半年以上,移植后半月左右色素开始形成,１个月左右色素基本恢复正常,并逐渐向周围扩展,     

白癜风患者表皮角质形成细胞凋亡及其与表皮片移植疗效的关系

目的 探讨稳定期白癜风患者皮肤角质形成细胞(KC)的凋亡与表皮片移植疗效的相关性.方法 取44例稳定期白癜风患者的正常腹部皮肤和白斑区皮肤,采用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记技术(TUNEL)检测KC的凋亡状况,同时采用免疫组化法检测28例稳定期白癜风患者KC凋亡相关蛋白Caspase 3、8、9及bcl-2、P53的表达情况.结果 TUNEL结果显示,皮损区阳性细胞数与供皮区皮肤相比差异有统计学意义.免疫组化结果:阳性反应定位于KC的胞膜与胞质,阳性细胞主要分布于表皮的中下层.白斑区Caspase 3有19例表达为阳性,而供皮区皮肤为9例.白斑区Caspase 8和9的阳性表达分别为15和16例,供皮区皮肤分别为5和4例.P53在两组标本中的表达都为阴性;Bcl-2在皮损区为阴性,供皮区皮肤中表达为弱阳性.表皮片移植失败组供皮区皮肤中凋亡的KC数目(15.83±2.69)明显多于移植成功组供皮区皮肤(9.24±1.80).结论 白癜风患者皮损区KC凋亡比供皮区皮肤明显,凋亡相关蛋白Caspase 3、8、9表达升高.KC凋亡可能与移植疗效存在一定的相关性.     

自体表皮移植术加碱性成纤维细胞生长因子（bFGF）治疗白癜风的疗效观察

为了探讨碱性成纤维细胞生长因子对白癜风的疗效,在自体表皮移植的同时加用bFGF观察15例白癜风患者的疗效。添加bFGF的皮片存活率为100%。且色素恢复较快,色斑扩大更为显著。未见明显副作用,为目前治疗白癜风的一种更安全有效的治疗途径。     

Many faces of Koebner phenomenon in psoriasis

Two patients with unusual skin stimuli causing koebner phenomenon in psoriasis are reported. First patient, a 33-year-old man, had psoriasis and multiple keloids for the last 26-years. At few places, the lesions of psoriasis and multiple keloids for the last 26-years. At few places, the lesions of psoriasis healed with keloid formation, and psoriatic plaques appeared selectively on the top of the keloids in addition to palms, soles and scalp. In the second patient (a 67-year -old man), the psoriatic lesions appeared at the site of healing herpes zoster lesions. Koebner phenomenon in psoriasis due to herpes zoster or varicella is rare, while that due to keloid has not been reported.