皮肤癣菌病的某些研究进展

近年来皮肤癣菌病发病率呈上升趋势,现就皮肤癣菌与人类宿主间的相互作用、皮肤癣菌某些少见结构的观察及新技术、新方法的应用作一概述,为进一步探讨皮肤癣菌病的发病与转归、寻找更有效的治疗手段提供依据。     

红色毛癣菌病—皮肤癣菌病的新命名和分类方法

从1949-1983年,我科门诊真菌室培养阳性的红色毛癣菌感染8586例.本文总结了有记录可查的3673例红色毛癣菌病的表皮、甲板、毛发和深在组织的临床表现,与病原菌关系,鉴别诊断及菌学特点.提出皮肤癣菌病按病原菌(不是按解剖部位)命名和分类的新方法.     

Amorolfine和联苯苄唑治疗皮肤癣菌病的双盲比较研究

amorolfine(Ro 14-4767)即苯丙基1,4氧氮环已烷(phenyl-propyl morpholine),是一种新推出的局部抗真菌药物,体内外试验已发现此药具有高度的抗皮肤癣菌和酵母菌作用。作者采用双盲平行对照研究评价此药与联苯苄唑对皮肤癣菌病的治疗情况。共选232例(有9例退出)皮肤癣菌病患者,直接镜检与真菌培养皆为阳性,年龄16岁以上(含16岁),病程3天至40年,多为足癣、体癣与股癣。孕妇或皮损伴细菌感染者、毛发癣菌病及甲癣病,以及疗前2周或疗中需用抗真菌药物者除外。病人随机分4组,分别外用0.125%、0.25%,0.5%的 amorolfine 和1%     

花斑癣患者表皮郎格罕细胞的观察

作者采用ATP酶染色方法对10例花斑癣患者皮损表皮内郎格罕细胞(LC)进行了观察,并对4例患者与皮损相对应部位的正常皮肤进行了同样检查.与此同时,取4名正常人胸腹部正常皮肤作对照检查.结果表明:花斑癣皮损表皮内LC密度明显减少,与正常对照组相比,P<0.001,有灶性集聚现象,许多LC的树枝突缩短、减少或消失.4例花斑癣患者与皮损相对应部位的正常皮肤表皮内LC的变化与皮损表皮内LC的变化相类似.作者认为,LC在花斑癣的免疫病理中可能起着重要作用.     

联苯苄唑凝胶治疗皮肤癣菌病的疗效观察

为了观察联苯苄唑凝胶制剂对皮肤癣菌病的疗效,我们使用重庆华邦制药有限公司研制的联苯苄唑凝胶(必伏)以联苯苄唑霜剂为对照治疗皮肤癣菌病140例,同时测定联苯苄唑体外抗皮肤癣菌活性,现将结果报道如下。     

一些皮肤癣菌的脂类分解活性

皮肤癣菌能浸入表面覆盖着脂类的表皮角质层.因此,在感染的早期阶段,在真菌建立与角蛋白的持久性接触以前,皮肤癣菌的脂类分解活性可能是特别重要的.有人发现皮肤癣菌能够水解动物和植物的脂类.从组织化学上和在皮肤癣菌菌丝体的滤液里,都证明了有脂酶的存在.作者对较常见的皮肤癣菌是否存在脂酶进行了筛选.材料和方法:一、皮肤癣菌株:从病人身上分离絮状表皮癣菌、犬小芽胞菌、须疮毛癣菌和红色毛癣菌各9株,以挑选单个孢子进行繁殖.二、底     

动物源性皮肤癣菌病32例菌种鉴定与流行病学分析

目的对动物源性皮肤癣菌病进行病原菌鉴定,了解引起动物源性皮肤癣菌病的病原菌分布情况。方法收集2013年10月-2014年11月就诊于本科并被临床诊断为动物源性皮肤癣菌病患者的临床资料,收集患者和动物分离的皮肤癣菌,用形态学及生理生化学方法鉴定菌种。以微卫星序列(GACA)4为引物对菌株的DNA进行扩增,随后针对非转录间隔区(NTS)设计引物,用随机扩增DNA多态性(RAPD)方法鉴定来源于患者和动物间菌株的差异性。结果 42例病例中,有10例与所接触动物分离出的菌种不一致,只有32例和所接触动物分离出的菌种一致。32例患者与所接触动物分离出57株菌,共鉴定出3种皮肤癣菌:犬小孢子菌、趾间毛癣菌(原:须癣毛癣菌)和石膏样小孢子菌,经RAPD的结果表明,患者和所接触动物感染的皮肤癣菌具有同源性。结论动物源性皮肤癣菌病的致病菌以犬小孢子菌最常见,其次为趾间毛癣菌和石膏样小孢子菌;猫为主要的传染源,其次为狗和兔;人和所接触动物同时患癣菌病不一定都是动物源性皮肤癣菌病。     

动物源性皮肤癣菌病32例菌种鉴定与流行病学分析北大核心CSCD

目的对动物源性皮肤癣菌病进行病原菌鉴定,了解引起动物源性皮肤癣菌病的病原菌分布情况。方法收集2013年10月-2014年11月就诊于本科并被临床诊断为动物源性皮肤癣菌病患者的临床资料,收集患者和动物分离的皮肤癣菌,用形态学及生理生化学方法鉴定菌种。以微卫星序列(GACA)4为引物对菌株的DNA进行扩增,随后针对非转录间隔区(NTS)设计引物,用随机扩增DNA多态性(RAPD)方法鉴定来源于患者和动物间菌株的差异性。结果 42例病例中,有10例与所接触动物分离出的菌种不一致,只有32例和所接触动物分离出的菌种一致。32例患者与所接触动物分离出57株菌,共鉴定出3种皮肤癣菌:犬小孢子菌、趾间毛癣菌(原:须癣毛癣菌)和石膏样小孢子菌,经RAPD的结果表明,患者和所接触动物感染的皮肤癣菌具有同源性。结论动物源性皮肤癣菌病的致病菌以犬小孢子菌最常见,其次为趾间毛癣菌和石膏样小孢子菌;猫为主要的传染源,其次为狗和兔;人和所接触动物同时患癣菌病不一定都是动物源性皮肤癣菌病。     

华芙消毒液治疗免疫抑制小鼠皮肤癣菌病的研究

目的建立免疫抑制小鼠皮肤癣菌病模型,探讨华芙消毒液对免疫抑制小鼠皮肤癣菌病的疗效.方法60只小鼠分别予腹腔注射氢化可的松30 mg/kg,隔日1次,共3次,然后在小鼠皮肤上接种须癣毛癣菌,建立免疫抑制小鼠皮肤癣菌病模型;皮损局部外涂华芙消毒液和3%克霉唑液,观察二者对免疫抑制小鼠皮肤癣菌病疗效.结果华芙消毒液及3%克霉唑液对免疫抑制小鼠皮肤癣菌病治疗的总有效率分别为80%和75%,真菌学治愈率分别为85%和80%,两者之间无显著性差异(P＞0.05).结论华芙消毒液对免疫抑制小鼠皮肤癣菌病具有良好的疗效.     

250例头部皮肤癣菌病误诊情况分析

２５０例头部皮肤癣菌病误诊情况分析陈建德（江苏省溧阳市肤病防治站，２１３００１）皮肤癣菌病位于手、足或躯干者易于诊断，然位于头面者往往被误诊。本文就１９９０年５月～１９９３年５月门诊所遇２５０例头面部皮肤癣菌患者误诊情况进行分析，现报告如下：１临床资...     

豚鼠郎格罕细胞光、电镜共用ATP酶组织化学技术探讨

我们结合光镜下ATP酶染色法.摸索出光、电镜共用的LCMg²⁺-ATP酶的组织化学方法,把光镜下LC计数和电镜下ATP酶的活性及细胞超微结构同时显示出来,既解决了电镜下LC难找的问题,又为研究在LC抗原性改变等某些病理情况下LC的变化提供了有效手段.和国外同类方法的最新报道相比,在保存酶的活性和细胞超微结构方面均有其特点.     

In vivo PUVA and UVB sensitivity of various human epidermal Langerhans cell markers (ATPase, HLA-DR and T6)—Dose-response and time-sequence studies

To form a comprehensive view of the UV-sensitivity of human epidermal Langerhans cells (LC), the time-sequence and close response effects of single doses of UVB or 8-methoxypsoralen plus UVA (PUVA) radiation on three different LC surface markers were studied with histochemical and immunohistochemical staining. An increasing PUVA dose from 1 to 10 J/cm² caused an almost linear decrease in the surface enzyme (ATPase) positive LC count, whereas the cell surface antigens (HLA-DR and T6) were rather more resistant, up to a PUVA dose of 5 J/cm². A single dose of 5 J/cm² of PUVA induced an LC depletion that was similar during the 21 days of observation, irrespective of whether the cells were visualized with ATPase staining or with monoclonal antibodies against the cell surface antigens HLA-DR or T6. In each case, the nadir was reached 14 days after irradiation; the average residual LC count was then 57%. The cell counts 21 days after PUVA irradiation were still only approximately 74% of the nontreated skin counts. Langerhans cell depletion induced by an erythemagenic dose of UVB irradiation was swifter and more pronounced than that induced by 5 J/cm² of PUVA but, again, a similar time schedule was recorded with ATPase, HLA-DR and T6 staining.     

Reduction in murine Langerhans cell ATPase staining following topical but not systemic treatment with steroid and non-steroid immunosuppressants

The effects on murine Langerhans cells (LC) of steroid and non-steroid immunosuppressive drugs which are commonly used for long-term immunotherapy of human patients were investigated. Hydrocortisone, prednisolone, cyclosporin A or azathioprine was administered daily for 7 consecutive days either topically by application to the skin, or systemically by intraperitoneal injection. LC densities were determined on the day following cessation of treatment by staining for the plasma membrane-bound enzyme adenosine triphosphatase (ATPase). All immunosuppressants caused a significant reduction in ATPase-positive LC when administered topically, but not systemically. The systemically administered drugs, although given in high concentration, may not have penetrated the epidermis in sufficient concentrations to disrupt the LC membrane. These observations are consistent with long term immunosuppressants depleting cutaneous LC by bone marrow suppression rather than by a direct effect on LC.     

Effect of glucocorticoids and gamma radiation on epidermal Langerhans cells

The effect of 750 rads of gamma radiation on the rate of return of epidermal Langerhans cells (LC) following suppressive doses of topical glucorticoids was studied in guinea pigs. Gamma radiation alone had no effect on the LC as assessed by staining for cell membrane ATPase activity and Ia antigen. It did, however, delay the expected return of Ia but not ATPase surface markers on the LC after perturbation with glucocorticoids. The delayed return of surface Ia antigen is possibly related to a radiation-induced defect in the production of a required lymphokine and/or in intracellular Ia transport. Although our data do not rule out a cytolytic effect of steroids on the LC, they do strongly suggest that, at least in part, glucocorticoids act on the LC by altering cell surface characteristics.     

豚鼠体癣模型表皮郎格罕细胞的动态观察

应用ＡＴＰａｓｅ组化法对豚鼠实验性皮肤真菌病进行皮损表皮ＬＣ的动态观察。结果发现，在感染非治疗侧，ＬＣ受损，其密度明显降低，与正常对照例及感染治疗侧比较差异均有显著性意义。说明皮肤真菌感染后可造成皮损表皮ＬＣ的减少，从而引起一系列免疫病理变化。     

EPIDERMAL LANGERHANS CELLS IN VARIOUS SKIN DISEASES (2)

We compared the density of epidermal Langerhans cells (LC) in specimens taken from involved areas and peripheral normally pigmented skin in vitiligo, idiopathic guttate hypomelanosis (IGH) and photoleukomelanoderma, principally by means of staining for ATPase. Ia antigen staining was used as supplementary identification method for LC. A decrease in the density of LC in peripheral normally pigmented skin was observed in 4 of 8 specimens from normoimmunological vitiligo, and in 4 of 5 specimens from dysimmunological vitiligo. A remarkable decrease in the density of LC in involved areas was observed in IGH. The differences in LC density between vitiligo and IGH were highly suggestive of possible differences in the pathogenesis of leukoderma. We also discussed some possible roles of LC in the pathogenesis of vitiligo.     

Perturbation of epidermal Langerhans cells in basal cell carcinomas

Epidermal Langerhans cells (LC) play a pivotal role in a variety of local immune responses. Using ATPase-stained preparations, we evaluated the density and morphologic features of these cells in the skin of 12 patients with basal cell carcinoma (BCC). In three patients, we compared the density of LC in the tumor to that in the perilesional skin. In these cases, there was no difference in the numbers of LC/mm2 in the two sites. Perturbations of ATPase-positive, dendritic LC were evident in all specimens. These perturbations included various degrees of disruption of the usually uniform LC network and alterations in the morphology of LC. Many LC had rounded, deformed cell bodies, dendrites that were shortened or completely absent, and variations in the intensity of ATPase staining. With the use of an image analyzer, a measure of the deviation from circularity--a "dendricity index" (DI)--was obtained, based on the area and perimeter of the LC. A significantly lower DI, implying a predominance of less dendritic, more rounded LC, was observed in LC at the BCC surface than in LC present in perilesional skin. This finding raises the possibility that BCC may arise in areas where the morphology, or activity, of these immune cells has been altered; alternatively, the perturbations could reflect an effect of the tumor cells on LC morphology.     

Quantitative and morphometric analysis of Langerhans cells in non-exposed skin in renal transplant patients

Renal transplant recipients have a high incidence of cutaneous complications such as neoplasia and viral or fungal infections. Morphologic alterations of epidermal Langerhans cells (LC) have furthermore been described in these patients. Since these changes have been mainly found in sun-exposed skin, a direct effect of immunosuppressive therapy remains a matter of discussion. A quantitative and morphometric study of epidermal LC in non-exposed skin was performed in 28 renal transplant patients (RTP). RTP were divided in two groups according to immunosuppressive treatment: group A; azathioprine + prednisone (14 cases) and group B; cyclosporine + prednisone (14 cases). Twenty sex-age matched non-immunosuppressed patients acted as controls (group C). Epidermal sheets were obtained by incubation in EDTA and stained for ATPase activity and with the monoclonal antibody T6 (CD1) using the avidin-biotin peroxidase method. Langerhans cells were counted using a calibrated graticule (400x) and expressed as the mean number of LC/mm2. The mean area of the LC and the number of primary dendrites (pd) and secondary dendrites (sd) were determined with a morphometer adapted to an Apple II computer. The mean number of positive cells in controls was: ATPase, 677 +/- 157; T6, 695 +/- 164. Patients in group A had the maximum reduction in both ATPase and T6 LC density (ATPase, 339 +/- 142; T6, 402 +/- 194). Patients in group B had an intermediate reduction in the number of LC (ATPase, 494 +/- 121; T6, 529 +/- 112).(ABSTRACT TRUNCATED AT 250 WORDS)     

银屑病皮损中郎格罕氏细胞的初步观察

本文应用ATP酶法和抗T6单克隆抗体OKT6直接免痊荧光法,对6例寻常型银屑病皮损及其邻近正常皮中的LC进行了初步对比观察.结果两法在正常皮肤部位显示表皮内的LC带有树枝状突起,分布均匀,主要位于中层;且OKTs法尚可显示真皮内少最散在的LC.而皮损部位则表皮内LCJL平消失,偶见1~2七且其突起消失.呈小圆圈状;真皮内未见可辨认的LC.以上所见提示皮肤中的LC可能与银屑病的发病机理有关.