银屑病伴发疾病的研究进展

银屑病是一种慢性炎症性皮肤病,除皮肤表现外,银屑病患者还可能存在其他多系统疾病,其中包括心血管疾病、肥胖症、糖尿病、高血压、血脂异常、代谢综合征、肝脏疾病、炎症性肠病、哮喘、精神疾病、多囊卵巢综合征及牙周病等.这些疾病在银屑病患者中的患病率明显高于健康人群.因其涉及多系统疾病,临床中对银屑病患者尚需更全面的筛查及评估,多学科交叉探讨,以制定有效的治疗方案.     

新疆维吾尔族寻常型银屑病伴发代谢相关性疾病分析

目的分析新疆维吾尔族寻常型银屑病患者伴发代谢相关性疾病的情况。方法对2010年1月—2013年3月新疆维吾尔自治区人民医院皮肤科住院的106例维吾尔族寻常型银屑病患者伴发代谢相关性疾病的临床资料进行回顾性分析,并与300例同期健康体检者伴发代谢相关性疾病的情况作比较。结果新疆维吾尔族寻常型银屑病患者伴发高血压、Ⅱ型糖尿病、高尿酸血症、代谢综合症和肥胖的几率均高于健康对照组;银屑病组中男性患代谢综合症(22.22%)和高尿酸血症(30.00%)均高于女性患者(6.25%,6.25%,P0.05)。对照组性别方面差异无统计学意义(P0.05)。银屑病合并各种代谢相关性疾病与无代谢相关性疾病比较,在年龄方面差异有统计学意义,合并代谢性疾病的患者年龄更大。在病程、发病年龄和文化程度方面差异无统计学意义。在严重程度方面组间差异有统计学意义,且代谢相关性疾病的发生随着严重程度的增加而增加。同时合并有多种代谢相关性疾病的银屑病患者,合并的代谢相关性疾病数量越多,银屑病的严重程度越重。结论新疆维吾尔族寻常型银屑病患者常伴发高血压、Ⅱ型糖尿病、高尿酸血症、代谢综合征及肥胖等代谢相关性疾病。男性较女性患者更易伴发高代谢综合征和高尿酸血症,合并代谢性疾病的患者年龄更大,代谢相关性疾病的发生随着严重程度的增加而增加,合并的代谢相关性疾病数量越多,银屑病的严重程度越重。因此应重视银屑病患者健康宣教。     

311例银屑病患者合并代谢综合征调查分析

目的:调查银屑病合并代谢综合征(metabolic syndrome,MS)的患病率。方法:按照MS诊断标准对311例银屑病确定合并MS的患病率。结果:银屑病组MS患病率(30.9%);男性合并MS的患病率为35.0%(54例),高于女性的21.65%(17例)(P0.05)。结论:对银屑病患者应注意MS的筛查。     

银屑病患者410例合并代谢综合征分析

目的观察银屑病合并代谢综合征(metabolicsyndrome,MS)的患病情况并分析相关危险因素。方法对本院2010年1月-12月诊治的410例银屑病和同期诊治的490例无免疫系统疾病的带状疱疹患者MS发病率、身高、体质量、血压、空腹血糖、三酰甘油和高密度脂蛋白等临床资料进行分析。结果银屑病组MS患病率(37.56%)较带状疱疹对照组(21.02%)高(P<0.05);银屑病组女性MS患病率(53.00%)高于男性患病率(32.58%)(P<0.05),对照组无性别差异(P>0.05);银屑病组BMI,FPG,SBP,DBP和TG检测值明显高于对照组,HDL-C明显低于对照组,差异均有统计学意义(P均<0.05)。结论银屑病患者MS的患病率较高,且存在一定的诱发危险因素,应重视银屑病患者健康宣教。     

银屑病伴发高脂血症的相关因素分析

目的探讨银屑病伴发高脂血症的相关因素及内在机制。方法对413例住院银屑病患者病例资料进行回顾性统计分析。结果伴有高脂血症的银屑病患者占同期住院银屑病患者总数的25.91%,其住院时平均年龄、平均病程及银屑病平均始发年龄均明显大于不伴高脂血症者;伴高脂血症的银屑病患者中,吸烟者比例及高血压、糖尿病、高尿酸血症、脂肪肝、肝功异常及肾脏损害发生率均高于不伴高脂血症者,而饮酒者比例亦较高。银屑病严重型比例则低于不伴高脂血症者。结论高脂血症是一种与年龄相关的代谢性疾病,银屑病严重型、高血压、糖尿病、高尿酸血症、脂肪肝、肝功异常及肾脏损害可能与银屑病伴发高脂血症有关。     

银屑病患者并发代谢性疾病的调查分析

银屑病是一种慢性炎症性皮肤病,其组织病理改变主要为角质形成细胞过度增生,表皮和真皮有炎性细胞浸润,同时伴有真皮血管增生.我们在临床中发现,银屑病患者易并发糖尿病、高脂血症、高血压等多种代谢性疾病,提示二者之间有一定关系.代谢综合征是由遗传异质性和环境因素所导致的一系列心血管疾病危险因素的聚集状态,肥胖症是代谢综合征发生的源头,胰岛素抵抗是代谢综合征发生的核心因素,炎症反应在代谢综合征发生中扮演了重要角色[1].代谢性炎症涉及到银屑病与慢性代谢与心血管疾病之间的相互联系.     

银屑病相关疾病的研究

本文综述了近年来银屑病相关疾病的研究进展情况,结果表明:银屑病患者克隆病和溃疡性结肠炎的发病率是普通人群的3.8～7.5倍;多发性硬化症家族成员易患银屑病;发生心血管疾病、代谢综合征的风险较普通人群高;BMI明显高于普通人群,肥胖和超重是女性发生银屑病较强的危险因素.     

寻常性银屑病患者血浆肿瘤坏死因子水平检测

检测４０例银屑病患者血浆ＴＮＦ含量和ＩｇＡ、ＩｇＧ、ＩｇＭ、Ｃ_３水平。结果：银屑病组血浆ＴＮＦ较正常组显著升高，男性高于女性（Ｐ＜０．０５），进行期高于静止期，伴甲部损害者ＴＮＦ明显升高，ＴＮＦ水平与病情严重程度呈正相关，与ＩｇＡ、ＩｇＧ、ＩｇＭ、Ｃ_３无明显线性关系。结果分析表明ＴＮＦ参与银屑病病理生理变化过程，是其进展中重要影响因素。     

银屑病患者非酒精性脂肪肝发生率和相关临床指标分析

目的 调查我院银屑病患者中非酒精性脂肪肝(NAFLD)的发生率.方法 纳入120例银屑病患者和年龄及性别相匹配的98例对照病例,应用腹部超声检测2组中NAFLD的发生率.同时,测定血清谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)、y-谷氨酰转移酶(GGT)、总胆固醇(TC)、高密度脂蛋白(HDL-L)、低密度脂蛋白(LDL-L)、甘油三酯(rG)及空腹血糖(FBS)水平.结果 银屑病组中NAFLD发病率升高(46.7％vs.30.6％,P=0.016).银屑病并发与无并发NAFLD者比较,2组血清AST、TC、HDL-L及LDL-L相比差异无统计学意义.银屑病并发NAFLD者血清ALT、GGT、TG和FBS明显高于无并发者(均P＜0.01).结论 银屑病易并发NAFLD,合并NAFLD银屑病患者常伴随肝酶、血脂及血糖代谢异常.     

老年银屑病患者的临床特征分析

目的 探讨老年银屑病患者的临床特征及其共病情况.方法 回顾性分析186例年龄≥60岁的老年银屑病患者和166例年龄＜60岁的非老年银屑病患者在临床特征上的差异.结果 与非老年银屑病患者相比,老年银屑病患者发病较晚,关节病性银屑病的比例、银屑病累及头皮和关节及甲的比例明显增高.老年银屑病患者常并发高血压、糖尿病、高尿酸血...     

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.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.