中国国际救援队在巴基斯坦救援中皮肤病患者的救治

目的 分析巴基斯坦洪灾后皮肤病的特点,为今后的类似气候、纬度下的救援工作提供科学参考.方法 回顾分析在中国救援队临时医院就诊的1 326例皮肤病患者临床数据.结果 就诊的1 326例皮肤病患者(男527例,女799例)情况如下:变态反应性皮肤病(548例,41.3%);细菌感染性皮肤病(388例,29.3 %);真菌感染性皮肤病(202例,15.2 %);昆虫性皮肤病(73例,5.5 %);其它皮肤病(115 例,8.7 %).结论 洪灾后卫生条件差,各种病因容易导致感染和变态反应性皮肤病的发生,加强健康教育和尽早治疗有助于洪灾后皮肤病的防控,此次皮肤病防治数据的总结有助于日后类似气候、纬度条件下皮肤病的救援工作准备.     

昆明地区皮肤美容专科门诊损容性皮肤病调查分析

目的了解昆明地区皮肤美容专科门诊损容性皮肤病发生情况,并对相关损容性皮肤病构成比差异的原因进行分析,提出防治对策。方法对2011年1月1日-2011年12月31日到昆明医科大学第一附属医院皮肤美容专科门诊初诊患者进行损容性皮肤病构成比调查。结果①构成比前15位的损容性皮肤病由高到低分别为痤疮495例(28.56%),湿疹260例(15.00%),黄褐斑77例(4.44%),日光性皮炎69例(3.98%),白癜风66例(3.80%),接触性皮炎53例(3.06%),色素痣46例(2.65%),敏感性皮肤45例(2.60%),斑秃44例(2.54%),激素依赖性皮炎41例(2.40%),特应性皮炎30例(1.73%),红斑狼疮29例(1.67%),光线性角化病28例(1.62),换肤综合征27例(1.56%),皮肤癌24例(1.38%)。②女性患者中损容性皮肤病构成比前3位分别是痤疮(40.00%)、湿疹(17.70%)和黄褐斑(7.54%);男性患者中损容性皮肤病构成比前3位分别是痤疮(30.78%)、湿疹(23.39%)和日光性皮炎(12.41%)。③(0～15)岁最高的三种损容性皮肤病构成比由高到低分别是:湿疹(31.51%),白癜风(26.03%)和特应性皮炎(16.44%);(15～30)岁分别是痤疮(70.58%),湿疹(8.95%)和斑秃(3.98%);(30～45)依次是痤疮(32.75%),湿疹(14.91%)和黄褐斑(12.54%);(45～60)分别是湿疹(31.64%),日光性皮炎(12.99%)和敏感性皮肤(12.43%);(60～85)岁分别是湿疹(37.35%),日光性皮炎(20.48%)和日光性角化症(10.84%)。结论昆明地区损容性皮肤病在皮肤美容科门诊中,构成比最高的前四位是痤疮、湿疹、黄褐斑和日光性皮炎,临床应加强对这四种皮肤病的防治工作。损容性皮肤病的构成比随年龄及性别不同各有不同,应根据不同年龄、性别做好预防治疗工作。     

北京市海淀区14570例外来人口皮肤病回顾性分析

目的:了解北京市海淀区外来人口皮肤病的发病情况。方法:对本院皮肤病初诊患者门诊资料进行统计分析。结果:皮肤病初诊患者17 218例中,外来人口14 570例(84.62%),男∶女=1.037∶1,平均年龄为(25.58±24.62)岁;外来人口皮肤病种构成比由高至低依次为:湿疹皮炎类皮肤病(49.10%)、病毒性皮肤病(16.65%)、昆虫寄生虫性皮肤病(8.89%)、真菌感染性皮肤病(6.79%)、皮肤附属器疾病(6.17%)等,常见皮肤病构成比较高的有:湿疹(21.86%)、寻常疣(11.51%)、丘疹性荨麻疹(11.46%)、荨麻疹(9.30%)、疥疮(6.77%)等。非外来人口2 648例(15.38%),男∶女=0.954∶1,平均年龄为(55.47±20.16)岁;常见皮肤病主要有湿疹(23.11%)、手足癣(19.60%)和脂溢性角化病(8.64%)等。外来人口年龄明显小于非外来人口(t=14.57,P<0.01)。湿疹、丘疹性荨麻疹、荨麻疹、痤疮构成比在外来人口与非外来人口中无明显差异(P值均>0.01),手足癣和脂溢性角化病构成比在非外来人口中较高(χ2分别为6.58、1.62,P值均<0.01),但寻常疣构成比在外来人口中较高(χ2=3.07,P<0.01)。结论:本院皮肤科门诊患者外来人口比例高,患病年龄较小。除湿疹、丘疹性荨麻疹、荨麻疹、痤疮外,常见皮肤病与非外来人口的发病情况有区别。     

949例皮肤病住患者综合分析

对１９８６－１９９３年期间９４９例住院皮肤病患者作了综合分析，结果表明；男性占６１．４％－２１－５０岁的中青年占５６．４％；农民居第一位；银屑病居各病种之首，占２２．７％；湿疹皮炎位居第二。结缔组织病和大疱性皮肤病相对较少，但病情多危重是住院治疗之指征。出入院诊断符合率９４．７％，人均住院天数２４天，人均住院费用用１９９３年为１９８６的８．６倍，对其原因进行了讨论。     

老年性皮肤病599例临床分析

目的了解老年性皮肤病的构成。方法对本科门诊60岁以上的初诊患者详细记录其姓名、性别、年龄、职业、皮肤病史及基础疾病。结果前五位老年性皮肤病的构成比分别是:皮肤瘙痒症17.03%、湿疹12.52%、手足癣11.35%、带状疱疹9.02%、接触性皮炎8.01%。结论皮肤瘙痒症是最常见的老年性皮肤病,其次是湿疹、手足癣、带状疱疹及接触性皮炎。     

化妆品致皮肤病157例临床分析

笔者将近5年来我科诊治的化妆品致皮肤病157例进行临床分析，总结如下。     

高原地区1006例老年皮肤病临床分析

10 0 6例老年患者中有 74种皮肤病 ,其中发病率高的皮肤病有 2 0种。     

阴囊瘙痒性皮肤病578例临床分析

本文对我科于2004年1月~2006年6月,诊治的578例阴囊瘙痒性皮肤病患者的临床资料进行回顾性分析,现报道如下。1临床资料与方法1.1临床资料所有的病例均来源于我科门诊及住院患者,共578例,发病年龄从出生10天~82岁,平均(32.31±17.15)岁,其中<1岁者94例(16.26%),1~20岁143例(占24     

Pattern analysis of drug-induced skin diseases

Drug eruptions are common adverse reactions to drug therapy and are a frequent reason for consultation in clinical practice. Even though any medication can potentially cause an adverse cutaneous reaction, some drugs are implicated more commonly than others. Histologically, drugs can elicit a variety of inflammatory disease patterns in the skin and panniculus, no pattern being specific for a particular drug. The most common pattern elicited by systemically administered medications is the perivascular pattern. Psoriasiform or granulomatous patterns are rarely caused by medications. The usual histologic patterns of drug eruptions are discussed in this review using the basic patterns of inflammatory diseases. Clinicopathologic correlation is established for relevant patterns. However, the changes of drug-induced skin disease must be made considering clinical presentation, histopathological analysis, and course of the disease.     

Application of computerized image analysis in pigmentary skin diseases

BACKGROUND: Melanocyte number and the amount of melanin pigment are related to diagnosis and treatment of pigmentary skin diseases. Various histologic methods are used, such as Fontana-Masson stain for melanin pigment or immunohistochemical stain for melanocytes. Recently, computerized image analysis has been applied to many fields to avoid interobserver bias. In this study, we applied a computerized image analysis to assess the melanin content and melanocyte density of human epidermis. METHODS: We evaluated the skin biopsy specimens (paraffin blocks) from normal human skin (33 +/- 6.6, n = 11) and diseased skins; vitiligo (32 +/- 10.0, n = 8), melasma (35 +/- 8.6, n = 11), and lentigo senilis (40 +/- 7.2, n = 11) (mean age +/- SD). Each specimen was stained with Fontana-Masson for melanin pigments and immunohistochemical method for melanocytes. Quantitative analysis of melanin pigment and melanocyte number (density) were investigated through two methods: (1) two dermatologists measured the visual scales; and (2) computerized image analysis was used to measure melanin content indices (MCI). The data were evaluated using one-way ANOVA. RESULTS: The visual scale of the Fontana-Masson stain was the highest for lentigo senilis (3.8 +/- 0.40), followed by melasma (2.6 +/- 0.67), normal skin (1.8 +/- 0.60) and vitiligo (0) (P < 0.05). These findings were consistent with objective measurements made by computerized image analysis. MCI values were 120.3 +/- 20.74 for lentigo senilis, 81.1 +/- 19.27 for melasma, 45.5 +/- 16.92 for normal skin, and 0.3 +/- 0.30 for vitiligo in decreasing order (P < 0.05). MC/1E (melanocyte number per 1 mm epidermis) was about two fold larger in lentigo senilis (18.1 +/- 8.92) than melasma (9.7 +/- 2.40) or normal skin (9.3 +/- 2.67) (P < 0.05). MC/1B (melanocyte number per 1 mm basal layer) was about 1.5 fold higher in lentigo senilis (13.5 +/- 4.17), compared to normal skin (9.0 +/- 3.55) (P < 0.05). Melasma showed increased melanocyte numbers compared to normal skin, but it was not statistically significant (P > 0.05). CONCLUSION: We believe this computerized image analysis could be useful tool for diagnosis and comparison of interval changes in pigmentary diseases like melasma or lentigo senilis by quantifying melanin pigments or melanocytes in skin biopsy specimens.     

细胞自噬及与皮肤病的研究进展

自噬是一种细胞自我降解的过程,清除受损或多余的蛋白质和细胞器.当细胞代谢能量不足时,细胞依靠自噬作用实现细胞内成分的循环利用,从而维持自我稳态和生存.自噬与凋亡虽同为程序性细胞死亡,但两者既有区别又相互作用.近来研究表明,多种皮肤病的病理过程中均伴有细胞自噬功能的改变,如带状疱疹、系统性红斑狼疮、黑素瘤和白癜风等.因此,研究皮肤病的细胞自噬具有重要的临床意义,为通过调节细胞的自噬水平来控制和治疗皮肤病打下基础.     

Period of remission after treatment with UVA-1 in sclerodermic skin diseases

Background Sclerodermic skin diseases can cause severe morbidity and disability. UVA‐1 has shown to be an effective therapy for sclerodermic skin diseases. However, the period of remission in these patients is not clear. In this study, the effect and remission period of UVA‐1 phototherapy in various sclerotic skin diseases is described using a semiquantitative clinical score combined with the durometer score as an objective apparatus to measure the hardness of the skin. Objective Our purpose was to determine the effectiveness of UVA‐1 phototherapy and the duration of remission in sclerodermic skin diseases. Methods In this prospective study, 10 patients with various sclerodermic skin diseases were treated with UVA‐1 phototherapy. The durometer was used to observe the hardness of the skin. Hardness of the skin was measured by one investigator at 10 locations, distributed evenly on the representative sclerotic skin. Each spot was measured three times, and the average of each of these measurements was summed to give the total durometer score. Durometer scores were recorded weekly until the final treatment date and 4 weeks after treatment. Clinical scores were carried out at the end date of the treatment using a 6‐point scale semiquantitative score. Long‐term effects were evaluated up to 29–46 months. Results The patients were treated with UVA‐1 in a cumulative dose of 1286 ± 58.8 (SEM) J/cm² (range, 846–1470 J/cm²) divided over five times a week for 4 weeks. In all patients studied, the sclerotic skin lesions were markedly softer after UVA‐1 treatment. All durometer scores improved highly significant during the first 3 weeks of treatment and borderline significant during the last week of treatment. There was no significant improvement between the end of UVA‐1 phototherapy and 1 month after ending the therapy (P > 0.05). All patients noted improvement of the semiquantitative clinical score during treatment. Clinical improvement was associated with improvement of the durometer score (95% confidence interval). With a follow‐up until 46 months, the remission period was stable up to 26 months in six patients. The duration of sclerodermic skin diseases before start of treatment did not influence improvement in the clinical or durometer score. One patient had an acute side effect of minimal erythema. No other side effects, except tanning and fatigue, were noted. Limitations This is an open‐label uncontrolled study. Conclusion UVA‐1 is an effective treatment for sclerodermic skin diseases with a long period of remission and clinical improvement even in patients with a long history of a sclerotic skin disease. UVA‐1 should be considered among the first approaches in the management of sclerotic skin diseases.     

Complement in skin diseases

Complement is one of the most important mechanisms of natural resistance preventing infections in humans and animals. It is actively involved in the pathogenesis of several diseases, including skin diseases, characterized by the presence of autoantibodies, foreign microorganisms, altered tissue cells, and the presence of mannan. Complement is intended to kill invading microorganisms but it can also destroy the organism's own damaged or altered cells. It is characterized by vigorous activity and is also potentially harmful for the host if triggered in its own body. This review discusses the significance of complement activation for emerging skin diseases and highlights the importance of serological laboratory tests for the detection of complement system activity alterations in skin diseases such as pemphigus vulgaris, bullous pemphigoid, herpes gestationis, dermatitis herpetiformis, porphyria, urticaria, angioedema, cutaneous vasculitis, systemic lupus erythematosus, partial lipodystrophy, lichen planus, xeroderma pigmentosum, psoriasis, and recurrent cutaneous infections. Finally, we draw attention to the current potential for treating these diseases with complement inhibitors.