595nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效观察

目的探讨595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤的疗效。方法应用595 nm脉冲染料激光治疗40例婴幼儿皮肤真性血管瘤并观察疗效。结果 40例患者中,治疗3次以内6例,治疗3次及以上34例。治愈18例(45%),显效15例(37.5%),有效3例(7.5%),无效3例(7.5%),总有效率82.5%。结论 595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效确切、安全,可在临床推广。     

普萘洛尔治疗婴幼儿血管瘤疗效及复发现象的分析

目的随访和观察29例婴幼儿血管瘤患儿口服普萘洛尔治疗后的疗效及复发情况,以指导临床合理用药。方法采用口服普萘洛尔治疗婴幼儿血管瘤患儿29例,年龄52d～11个月。普萘洛尔2.0mg（/kg·d）,分3次餐后口服,服药4～6个月后停药。结果口服普萘洛尔后平均1周,瘤体颜色开始变淡、萎缩变软。治疗3个月后,大部分瘤体明显萎缩。治疗6个月时,瘤体基本消退,表面遗留毛细血管扩张。停药后1个月,6例患儿出现血管瘤复发,且年龄均〈11个月。继续给予原方案治疗约3个月,瘤体显著萎缩,随访3个月,无复发。结论口服普萘洛尔治疗婴幼儿血管瘤具有良好疗效。患儿血管瘤复发现象可能与停药后血管瘤仍处于增生期有关,停药后毛细血管内皮细胞继续增生,异常血管再次形成,血管瘤复发。     

普萘洛尔治疗婴幼儿血管瘤临床观察

目的观察普萘洛尔口服治疗婴幼儿血管瘤的临床疗效及安全性。方法选择2011年3月-2012年4月本科住院的50例婴幼儿血管瘤于心电监护下予口服普萘洛尔治疗,男18例,女32例,平均年龄4个月,治疗前完善相关实验室检查,每月复查1次,并根据体重增减情况调整用药剂量,至皮损消退后减量并停药。结果 50例患儿在用药后24h内即出现瘤体颜色变浅、质地变软或缩小。有效率为80%,其中Ⅰ级0例(差),Ⅱ级10例(中),Ⅲ级25例(好),Ⅳ级15例(优),用药时间延长,治疗效果越明显(P<0.05)。平均用药时间5个月(2～13个月),停药时间平均年龄8个月(5～27个月)。合并溃疡者,溃疡愈合时间平均9d(7～15d)。不良反应轻微,主要表现为消化道症状。结论普萘洛尔口服治疗婴幼儿血管瘤临床疗效明显,安全性好,可作为婴幼儿血管瘤的一线治疗用药。     

婴幼儿血管瘤的局部药物治疗进展

目的 婴幼儿血管瘤是婴幼儿最常见的良性软组织肿瘤。普萘洛尔治疗婴幼儿血管瘤的安全性和有效性均优于传统的糖皮质激素,但口服普萘洛尔可导致系统性并发症。局部应用β受体阻滞剂成为婴幼儿血管瘤治疗研究的新热点,如局部外用0.5%噻吗洛尔滴眼液、0.1%噻吗洛尔凝胶、普萘洛尔纳米水溶胶等。另外,局部外用5%咪喹莫特软膏、局部注射药物以及联合不同波长激光等均可作为婴幼儿血管瘤的治疗选择。本文简要综述婴幼儿血管瘤局部药物治疗方法。     

皮质类固醇激素治疗婴幼儿体表血管瘤疗效再探

目的对皮质类固醇激素(以下简称激素)治疗婴幼儿体表血管瘤的疗效进行分析探讨,以期明确激素治疗婴幼儿血管瘤的适应症。方法对采用激素口服和局部注射治疗的56例婴幼儿血管瘤随访8年,依据瘤体生长的快慢和出生时有无皮损等临床特征,按Mu lliken的生物学分类法分为39例血管瘤和17例血管畸形,对疗效进行分析。结果39例真性血管瘤激素治疗有效并最终消退,而17例血管畸形激素治疗无效。结论激素治疗血管瘤的适应症应为生物学分类诊断方法中的增生期血管瘤,而血管畸形和消退稳定期的血管瘤则不应采用激素治疗。     

长脉宽1064nm Nd∶YAG激光或595nm脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤疗效分析

目的:总结分析长脉宽1 064 nm掺钕钇铝石榴石(Nd∶YAG)激光、595 nm脉冲染料激光(PDL)或两者联合治疗会阴部婴幼儿血管瘤临床疗效、不良反应及其影响疗效的有关因素。方法:应用长脉宽1 064 nm Nd∶YAG激光、脉冲染料激光或两者联合治疗会阴部婴幼儿血管瘤35例,治疗间隔4~8周。统计治疗效果并分析影响疗效的因素。结果:35例患儿,其中男3例、女32例,年龄40 d~2岁,皮损面积0.1~15 cm2。治疗有效率为100%,治疗次数1~5次。常见的不良反应为红肿和水疱,一般3~5 d内修复,其中2例出现糜烂及渗出,5例痊愈后皮肤质地有变化,2例遗留色素沉着,未见感染、瘢痕等其他不良反应。结论:长脉宽1 064 nm Nd∶YAG激光及595 nm脉冲染料激光治疗会阴部婴幼儿血管瘤安全有效,不良反应轻微,值得推广应用。     

皮肤血管瘤的治疗

皮肤血管瘤是先天性血管增生而形成的良性肿瘤,是软组织肿瘤中最常见的一种,多见于婴儿和儿童,一般分为三型:即鲜红斑痣,毛细血管瘤和海绵状血管瘤。复习国内近30年有关文献,仅就血管瘤的治疗综述如下。1　药物治疗11　系统给药疗法111　皮质类固醇激素:婴幼儿面积广泛或侵及五官的血管瘤,可采取皮质激素口服方法进行治疗。强地松片4ｍｇ/ｋｇ,隔日晨顿服,共8周,以后每周减量1/2,至5ｍｇ为止,疗程10～11周。赵平萍〔1〕用此方法治疗婴幼儿血管瘤186例,总有效率79%。112　中医中药:中医认为,血瘤多因先天不足,气滞血瘀,脉络壅聚所致。唐英用…     

广西汉族婴幼儿皮肤血管瘤与HLA-DRB1等位基因的相关性研究

目的:探讨HLA-DRB1等位基因多态性与广西汉族婴幼儿皮肤血管瘤的遗传相关性。方法:将广西汉族88例婴幼儿皮肤血管瘤患者(病例组)和105例正常汉族婴幼儿(对照组)作为研究对象。采用聚合酶链反应-序列特异性引物分型技术对两组HLA-DRB1等位基因进行分型,SPSS软件进行统计分析。结果:病例组HLA-DRB1*16等位基因频率为28.98%,明显高于对照组的14.76%(RR=3.29,P<0.05);病例组HLA-DRB1*1401等位基因频率为6.82%,明显低于对照组的16.67%(RR=0.32,P<0.05)。结论:HLA-DRB1*16可能为广西汉族婴幼儿皮肤血管瘤的易感基因。而HLADRB1*1401可能为其保护基因。     

药物治疗婴儿血管瘤的研究进展

婴儿血管瘤是婴幼儿最常见的良性肿瘤,发病率5％～10％,具有独特的生命周期,1岁内快速生长.部分血管瘤可自然消退,但有些血管瘤生长迅速,损害功能、形成溃疡或威胁生命,仍需积极治疗.目前常见的药物治疗方法,包括系统用药、局部外用药物和局部注射药物.普萘洛尔等β受体阻滞剂因其独特优点已逐渐成为首选方法,糖皮质激素仍是治疗血管瘤的重要方法.目前婴幼儿血管瘤的治疗已呈现出多种药物综合治疗的趋势,同时可联合激光治疗.临床中应根据血管瘤的类型、部位、大小、深浅、分布等选择不同的治疗方法.     

普萘洛尔治疗婴幼儿血管瘤研究进展

1概述血管瘤是婴幼儿时期最常见的良性肿瘤。大约10%的婴幼儿血管瘤需要干预,因为病变威胁了生命或功能或造成组织变形、破坏。20世纪60年代,由于皮质类固醇激素的偶然发现,促进了婴幼儿血管瘤的消退。对增殖期血管瘤,大剂量皮质类固醇激素口服成为一线治疗方案,但是由于用药方法及评价标准的不一,使其有效率差别甚大,约39%～100%不等;     

EAACI/GA2LEN/EDF/WAO荨麻疹指南:治疗

本指南经2008年第三次国际荨麻疹共识会议讨论达成,由EAACI、GA2LEN、EDF和WAO联合倡议。荨麻疹的一线治疗建议使用非镇静的H1受体拮抗剂。如果标准治疗剂量不起效,建议可将剂量增加到标准治疗剂量的四倍。如果仍无效果,建议采用二线治疗。选择二线治疗时,应权衡利弊和综合考虑治疗的费用。由于糖皮质激素具有不可避免的不良反应,故不推荐长期使用。     

Dermatology day care treatment centres

Day care treatment centres provide the best solution for the treatment of most patients with psoriasis. The centre is not only ideal for treatment but has other roles, such as education of patients and nurses. The specialist dermatology nurse is the key to success. Out patient treatment of psoriasis is less expensive than in patient treatment. The development of a treatment centre should be seen as an additional facility and not as a substitute for in patient beds.     

Mikrobielle Belastung von Haut und Wunden in Klinik und Praxis

The antibiotic treatment of microbial pathogens of the skin and wounds could so far not fulfil the expectations of an effective and permanent elimination of pathogens so that local treatment with antiseptic agents as a flanking measure to wound cleansing and debridement has become increasingly more established. Because an antiseptic treatment does not actually represent a treatment of infections, the current antimicrobial treatment strategy for infections in skin and wound areas consists of combined antibiotic and flanking antiseptic administration following debridement. However, the combined therapy is not always successful. There is an urgent need for new forms of therapy particularly to combat multiresistant pathogens in biofilms in infections of chronic and other complicated wounds.     

Cutaneous sarcoidosis treated with levamisole.

16 patients with cutaneous sarcoidosis were treated intermittently over a period of 6 months with levamisole in an open study. The skin lesions cleared in 2 of 13 patients completing the course of treatment. Aggravation of the sarcoidosis was noted in 2 other patients after a few weeks of treatment. Tuberculin sensitivity did not increase during the treatment period. Dinitrochlorobenzene sensitivity increased in 5 patients but the lesions did not clear in any of these patients. It is concluded that levamisole is not useful in the treatment of cutaneous sarcoidosis.     

Recurrence of port-wine stains after treatment with the flashlamp-pumped pulsed dye laser

OBJECTIVES: To assess the importance of the patient's age at the start of treatment of a port-wine stain (PWS) with the flashlamp-pumped pulsed dye laser (FPDL). BACKGROUND: FDPL treatment is safe and effective for PWSs, with a low risk of scarring and pigmentary changes. The degree of clearing of the lesion is, however, unpredictable, and the ideal time to start treatment has not yet been agreed. Patients/methods By means of a questionnaire, we investigated the frequency of recurrence in PWS in 147 patients after completion of treatment with the FPDL. RESULTS: In 24 patients (16.3%), partial redarkening of their PWS was observed. The patients who had a recurrence were not different from the group who did not regarding the colour of the PWS, the response to previous treatment or the frequency of side-effects. Children under 10 years of age did not show any PWS recurrence, at least in our group of patients. CONCLUSIONS: The age at the beginning of treatment may have an influence on the recurrence rate.     

An approach to the treatment of psychogenic parasitosis

Background Patients with psychogenic parasitosis typically seek help from nonpsychiatric physicians and can be difficult and time-consuming to treat. Pimozide has been promoted as the treatment of choice but is not indicated for every patient presenting with this symptom. Our purpose was to develop a realistic treatment protocol for the nonpsychiatric physician faced with these patients.
Methods Using what is known about this problem through review of the literature and our own experience with 20 patients, a practical treatment strategy is suggested.
Results It is proposed that dermatologists and primary care professionals seeing these patients determine (1) whether or not the patient's belief in infestation is shakable and (2) whether or not the patient is depressed, in order to chose a therapeutic plan.
Conclusions Dermatologists and psychiatrists can work together to develop treatment protocols that minimize risk and maximize therapy for patients with psychogenic parasitosis.     

The impact of the frequency of short contact dithranol treatment

Dithranol short contact treatment is usually applied once a day. For some patients this does not fit their possibilities or needs. Therefore we investigated the efficacy of two other treatment strategies in two small groups of patients. In the attempt to shorten the treatment time, one group of patients was treated twice daily. In order to not withhold short contact dithranol treatment from patients who are unable to perform the treatment daily or at home, a thrice-weekly treatment regimen was studied. 8 patients were treated twice daily and all achieved at least a 90% reduction of the area of involved skin (clearance) within 12.3 (+/- 1.6) weeks. In the thrice weekly group six out of eight patients achieved a clearance of their psoriasis within 13.1 (+/- 4.2) weeks. The aim of shortening the treatment period was not achieved by twice daily treatment in a day-care centre. However, the thrice-weekly treatment regimen certainly appeared to be an effective one. Further studies are needed on larger populations of patients to find out the optimal regimen for intermittent dithranol short contact treatment.     

Is Antibiotic Resistance in Cutaneous Propionibacteria Clinically Relevant?

It is well recognized that some patients with acne do not respond adequately to antibiotic therapy. It is important to distinguish antibiotic recalcitrant acne which we would suggest represents acne that shows a diminished response to treatment irrespective of the cause as opposed to 'antibiotic-resistant acne' which is acne that is less responsive to treatment as a direct consequence of skin colonization with resistant propionibacteria. Here we show that antibiotic-resistant acne is not just a theoretical possibility but a real phenomenon that could have important consequences for patients and prescribers. The relationship between skin colonization by antibiotic-resistant propionibacteria and treatment outcomes is a complex one that is explained at the follicular level by physiological differences affecting local drug concentrations. A systematic review of the literature on antibiotic-resistant propionibacteria revealed methodological shortcomings in studies of their prevalence and a paucity of evidence on their clinical significance. Despite the elucidation of resistance mechanisms in cutaneous propionibacteria, our continuing inability to distinguish between strains of Propionibacterium acnes means that we still do not fully understand how resistance spreads, although person-to-person transfer is most likely. Finally, we present a decision tree for acne management in an era of prudent antimicrobial prescribing that provides an alternative to existing treatment algorithms by placing topical retinoids and not antibiotics at the cornerstone of acne management.     

Verrucae vulgares in children: successful simulated X-ray treatment (a suggestion-based therapy)

BACKGROUND: Treatment of verrucae vulgares is sometimes difficult. Invasive methods should not be used for young children. OBJECTIVE: Evaluation of a special suggestion therapy for treatment of verrucae vulgares in children. METHODS: Nine children with warts on the hands and/or feet and in the face were treated with a simulated X-ray treatment. RESULTS: Five children showed a complete remission of warts, 3 children a partial remission. For 1 child, there was no response. On average, 3 treatment sessions were needed for children showing a complete remission. CONCLUSION: This therapy offers an easy-to-perform, alternative treatment option. It is noninvasive and does not depend on special psychological techniques for which training is required.     

S3 Guideline Urticaria. Part 2: Treatment of urticaria – German-language adaptation of the international S3 guideline

This publication is the second part of the German-language S3 guideline on urticaria. It covers the management of urticaria and should be used together with Part 1 of the guideline on classification and diagnosis. This publication was prepared according to the criteria of the AWMF on the basis of the international English-language S3 guideline with special consideration of health system conditions in German-speaking countries. Chronic urticaria has a high impact on the quality of life and daily activities of patients. Therefore, if causal factors cannot be eliminated, effective symptomatic treatment is necessary. The recommended first-line treatment is to administer new generation, non-sedating H1 antihistamines. If the standard dose is not sufficiently effective, the dose should be increased up to fourfold. For patients who do not respond to this treatment, the second-line treatment in addition to antihistamines in the treatment algorithm is omalizumab and, if this treatment fails, ciclosporin. Other low-evidence therapeutic agents should only be used if all treatments in the treatment algorithm agreed upon by the guideline group fail. Both the benefit-risk profile and cost should be considered. Corticosteroids are not recommended for long-term treatment due to their inevitable severe side effects.