地氯雷他定治疗荨麻疹的疗效观察

目的：探讨地氯雷他定治疗荨麻疹的临床疗效及其安全性。方法：对门诊符合标准的95例患采用开放平行对照的方法进行临床研究，患分成两组。分别接受地氯雷他定和氯雷他定治疗，疗程14天。结果：地氯雷他定能有效缓解慢性荨麻疹患的瘙痒症状，有效减少风团的数目与风团的直径，地氯雷他定治疗慢性荨麻疹的有效率为91．5％，氯雷他定为89．6％，治疗过程中未见严重不良反应。结论：地氯雷他定治疗慢性荨麻疹疗效可靠，安全性好，略优于氯雷他定。     

地氯雷他定与昆明山海棠治疗慢性荨麻疹疗效观察

目的探讨地氯雷他定联合昆明山海棠与地氯雷他定单独应用治疗慢性荨麻疹的临床疗效及治疗机制。方法研究对象为118例慢性荨麻疹患者,分为治疗组(A组地氯雷他定联合昆明山海棠组)60例和对照组(B组地氯雷他定组)58例,各疗程结束后分别按临床疗效标准进行评定和统计。结果A组与B组在治疗18d、24d结束后的治愈率分别为41.67%、24.14%,50.00%、29.31%,总有效率分别为71.67%、53.45%,81.67%、63.79%,两组的临床疗效差异有显著性(均P<0.05)。结论地氯雷他定与昆明山海棠治疗慢性荨麻疹临床疗效显著,明显优于单独应用地氯雷他定。地氯雷他定联合昆明山海棠治疗慢性荨麻疹无明显不良反应、复发率明显降低。二者联用治疗慢性荨麻疹可能与充分发挥药物的相互作用相关。     

枸地氯雷他定对比氯雷他定治疗慢性荨麻疹有效性与安全性的Meta分析

目的探讨枸地氯雷他定对比氯雷他定治疗慢性荨麻疹的有效性以及安全性,为临床合理用药提供决策参考。方法检索数据库包括:Medline、CNKI、维普、万方等,关键词采用"疗效","枸地氯雷他定","氯雷他定"和"慢性荨麻疹",限定年限为1997-2017年,由两位研究者按照纳入排除标准独立筛选文献,进行文献质量评估和数据提取,结果采用Stata14.0软件进行Meta分析。结果本文纳入4篇临床研究,共466例患者。Meta分析结果显示,在有效性方面,枸地氯雷他定治疗慢性荨麻疹的临床疗效优于氯雷他定,其28天治愈率和28天有效率的OR值分别为:1.98(95%CI:1.15~3.42)和2.69(95%CI:1.49~4.87);在安全性方面,枸地氯雷他定相比氯雷他定治疗慢性荨麻疹在不良反应发生率组间差异无统计学意义:OR=0.43(95%CI:0.18~1.02),最常见的不良反应为嗜睡、口干、头晕、恶心。结论枸地氯雷他定治疗慢性荨麻疹的临床有效性优于氯雷他定,而安全性两者差异无统计学意义。     

复方甘草酸苷与氯雷他定联合治疗慢性荨麻疹43例

目的观察复方甘草酸苷、氯雷他定联合治疗慢性荨麻疹的疗效。方法81例患者随机分成2组，治疗组口服复方甘草酸苷与氯雷他定，对照组单服氯雷他定，疗程4周，评估疗效，记录不良反应。结果治疗组和对照组有效率分别为83．7％和63．1％，差异有显著性（P〈0，05）。结论复方甘草酸苷、氯雷他定联合治疗慢性荨麻疹疗效好，安全可靠。     

润燥止痒胶囊联合氯雷他定治疗慢性荨麻疹60例临床观察

目的观察润燥止痒胶囊联合氯雷他定治疗慢性荨麻疹的临床疗效。方法将120例慢性荨麻疹患者随机分成2组,治疗组60例,润燥止痒胶囊4粒口服,3次/d,氯雷他定10mg口服,1次/d,疗程4周;对照组60例口服氯雷他定,方法疗程同治疗组。结果治疗组有效率为91.67%,对照组为76.67%。两组比较差异有显著性意义(χ2=5.07,P<0.05)。结论润燥止痒胶囊联合氯雷他定治疗慢性荨麻疹安全、有效。     

枸地氯雷他定治疗慢性特发性荨麻疹100例临床疗效观察

为进一步评价枸地氯雷他定治疗慢性特发性荨麻疹的临床疗效和安全性,我科于2010年4月至2011年4月,应用枸地氯雷他定(商品名:贝雪,扬子江药业集团)治疗慢性特发性荨麻疹100例,并对其疗效及不良反应进行了观察评估,现将结果报告如下:     

荆肤止痒颗粒联合氯雷他定颗粒治疗儿童慢性荨麻疹疗效观察

目的观察荆肤止痒颗粒联合氯雷他定颗粒治疗儿童慢性荨麻疹的临床疗效。方法治疗组48例口服荆肤止痒颗粒联合氯雷他定颗粒;对照组42例给予氯雷他定颗粒口服,疗程均为4周,观察两组有效率及复发率。结果治疗组和对照组有效率及复发率比较差异有统计学意义(P<0.05),治疗前后积分差异有统计学意义(P<0.05)。结论荆肤止痒颗粒联合氯雷他定治疗儿童慢性荨麻疹疗效确切,复发率低。     

地氯雷他定治疗慢性荨麻疹疗效观察

目的 评价地氯雷他定治疗慢性荨麻疹的疗效.方法 治疗组66例,给予地氯雷他定口服;对照组58例,给予氯雷他定口服.疗程均为4周.结果 两组患者有效率比较差异无统计学意义(P>0.05),治疗组不良反应发生率明显低于对照组(P<0.05).结论 地氯雷他定治疗慢性荨麻疹疗效满意.     

氯雷他定联合复方甘草酸苷治疗慢性荨麻疹的疗效观察

以随机开放平行对照的方法将120例慢性荨麻疹分别应用氯雷他定（北京双鹭药业股份有限公司生产）、复方甘草酸苷（商品名：美能，深圳建安医药公司）及氯雷他定联合复方甘草酸苷治疗，研究氯雷他定与复方甘草酸苷联合应用治疗慢性荨麻疹的疗效与安全性。经随访观察，联合用药控制风团和止痒效果优于氯雷他定及复方甘草酸苷单独使用。现将结果报道如下。     

雷公藤多苷联合地氯雷他定治疗慢性荨麻疹临床观察

目的 观察雷公藤多苷和地氯雷他定治疗慢性荨麻疹的疗效.方法 108例患者随机分为2组,治疗组54例采用雷公藤多苷联合地氯雷他定口服,对照组54例采用单纯口服地氯雷他定.结果 两组疗效比较差异有统计学意义(P<0.01),治疗组复发率明显低于对照组(P<0.01).结论 雷公藤多苷联合地氯雷他定治疗慢性荨麻疹疗效及复发率优于单纯地氯雷他定.     

寻常性银屑病并发成人型线状IgA大疱性皮病

报告l例寻常性银屑病并发成人型线状IgA大疱性皮病.患者男,36岁.因全身红色斑疹伴白色鳞屑反复发生20年.躯干、双上肢出现环状排列的水疱10d伴瘙痒就诊.皮损组织病理检查:表皮下水疱,疱内、真皮浅层和真皮乳头见中性粒细胞、嗜酸性粒细胞浸润;皮损周围皮肤直接免疫荧光显示基膜带Iga、IgG呈带状沉积;取患者血清行BP180NC16A(大疱性类天疱疮18 000抗原的近膜片段)-ELISA检查显示阴性;以盐裂正常人皮肤为底物,取患者血清行间接免疫荧光检查显示IgA、IgG呈带状沉积在真皮侧.诊断为寻常性银屑病并发成人型线状TgA大疱性皮病.     

Congenital Linear Psoriasis: A Case Report

A 10-year-old girl had two localized psoriasiform plaques at birth. Subsequently, she developed generalized, asymptomatic, scaly plaques arranged in linear bands and streaks along the lines of Blaschko. The morphologic and histopathologic features, the clinical course, and HLA (CW6,A2) association were characteristic of psoriasis. Although rare, true linear psoriasis exists.     

Does inflammatory linear verrucous epidermal nevus represent a segmental type 1/type 2 mosaic of psoriasis?

BACKGROUND: A 6-year-old girl with a symmetric linear eruption on both of her legs, clinically and histologically resembling inflammatory linear verrucous epidermal nevus (ILVEN) or linear psoriasis (LP), with concomitant psoriasis of the guttata type and a positive family history of psoriasis is presented. The questions as to whether LP actually exists and ILVEN represents a distinct entity are still under debate. OBJECTIVE AND METHODS: The recent literature concerning case reports of ILVEN and LP is reviewed. RESULTS: Case reports of ILVEN and LP can be subdivided into four different groups: (1) ILVEN with or without concomitant psoriasis, only in part reacting to antipsoriatic treatment, (2) ILVEN without concomitant psoriasis, (3) LP with concomitant psoriasis vulgaris, with both groups 2 and 3 reacting successfully to antipsoriatic treatment, and (4) LP without concomitant psoriasis vulgaris and with no family history of psoriasis (very rarely reported). CONCLUSION: It is hypothesized that inflammatory linear verrucous eruption besides nevoid psoriasis/LP represents a further segmental type 1/type 2 mosaic of psoriasis which, if a (verrucous) epidermal nevus exists, shows a high affinity of occurrence in close context to such a nevus. Heritability is thought to be possible.     

Inflammatory linear verrucous epidermal nevus associated with erosive monoarthritis

Inflammatory linear verrucous epidermal nevus and linear psoriasis are different entities with clinical and histopathologic similarities. Isolated reports of inflammatory linear verrucous epidermal nevus with concomitant psoriasis or a positive family history of psoriasis have been described, and the possibility that inflammatory linear verrucous epidermal nevus may be a mosaic form of cutaneous psoriasis has been postulated. We report a 17‐year‐old boy with a congenital, linear, erythematous, keratotic plaque on the dorsum of the fifth finger of the left hand with ipsilateral nail dystrophy. Histopathologic examination showed epidermal hyperplasia with alternating orthokeratosis and parakeratosis. During follow‐up, he developed erosive monoarthritis of the distal interphalangeal joint. This case seems to confirm the association between inflammatory linear verrucous epidermal nevus and arthritis and supports a possible relationship between inflammatory linear verrucous epidermal nevus and psoriasis.     

Immunohistochemical differentiation between inflammatory linear verrucous epidermal nevus (ILVEN) and psoriasis

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare skin disorder with a clinical and histological resemblance to psoriasis. In the past clinical and histological criteria have been defined. However, there remains a discussion as to whether ILVEN is a disease entity distinct from linear psoriasis. Our objective was to compare by quantitative immunohistochemistry the subsets of T-lymphocytes and markers for epidermal growth and keratinisation in biopsies taken from skin lesions of 4 patients with psoriasis and 3 patients with ILVEN: 1. patients with psoriasis (case 1-4) 2. patient with ILVEN cum psoriasis (case 5) 3. patients with ILVEN sine psoriasis (case 6 and 7). Our aim was to delineate ILVEN from psoriasis. Four patients with active psoriasis and three patients with signs and symptoms of ILVEN are described in this case report. Two patients of the ILVEN group had only linear verrucous lesions (ILVEN sine psoriasis), and one patient had linear lesions combined with widespread psoriasis outside the linear verrucous lesion (ILVEN cum psoriasis). The following markers were investigated in skin biopsies taken from the aforementioned patients by quantitative immunohistochemistry: CD2, CD4, CD8, CD25, CD161, CD94, CD45RO, CD45RA, HLA-DR, Keratin-10, Ki-67. In patients with ILVEN (cum and sine psoriasis) the number of Ki-67 positive nuclei, tended to be lower, the number of keratin-10 positive cells and HLA-DR expression higher as compared to psoriasis. In ILVEN sine psoriasis all T-cell subsets and cells expressing NK receptors were reduced as compared to psoriasis, except for CD45RA+ cells, whereas in the patient with ILVEN cum psoriasis the number of these T cell subsets had an intermediary position. In particular the density of CD8+, CD45RO+ and CD2+, CD94 and CD161 showed a marked difference between ILVEN sine psoriasis and psoriasis. In addition to the increased keratin 10 expression in ILVEN sine psoriasis, T cells relevant in the pathogenesis of psoriasis are markedly reduced in ILVEN sine psoriasis as compared to psoriasis. T-cell subsets in ILVEN cum psoriasis had an intermediary position.     

Isolated linear blaschkoid psoriasis

Linear psoriasis (LPs) is considered a rare clinical presentation of psoriasis, which is characterized by linear erythematous and scaly lesions along the lines of Blaschko. We report the case of a 20‐year‐old man who presented with asymptomatic linear and S‐shaped erythematous, scaly plaques on right side of his trunk. The plaques were arranged along the lines of Blaschko with a sharp demarcation at the midline. Histological examination of a skin biopsy confirmed the diagnosis of psoriasis. Topical calcipotriol and betamethasone dipropionate ointments were prescribed for 2 months. A good clinical improvement was achieved, with reduction in lesion thickness and scaling. In patients with linear erythematous and scaly plaques along the lines of Blaschko, the diagnosis of LPs should be kept in mind, especially in patients with asymptomatic lesions of late onset.     

Skin carotenoid levels in adult patients with psoriasis

Background Psoriasis is an inflammatory disease that not only affects the skin but can also have systemic implications such as obesity and nutritional deficiencies. Carotenoids are vitamin A provitamins with anti‐oxidant properties that are present in human tissues including skin. Objectives To determine whether psoriasis is associated with lower levels of skin carotenoid levels. Methods In this cross‐sectional study, skin carotenoid levels were measured on the palms of 44 patients with psoriasis and 72 patients without psoriasis. A linear regression model was used to evaluate the relationship between psoriasis and carotenoid levels (primary aim) and to determine if severity of disease was associated with carotenoid levels (secondary aim). Potential confounders included demographic factors, smoking status, body mass index and multivitamin intake. Results The mean carotenoid levels in the psoriasis and no psoriasis groups were respectively 22 099 and 29 180 and presence of psoriasis was found to be significantly related to lower levels of carotenoids in both univariable and multivariable analysis (P < 0.05). In the psoriasis group, the Psoriasis Area and Severity Index score was not significantly related to carotenoid levels (P = 0.07). Conclusions Patients with psoriasis appear to have lower skin carotenoid counts than patients without psoriasis.     

One device,one equation: The simplest way to objectively evaluate psoriasis severity

The erythema, scale and thickness of psoriasis lesions could be converted to bioengineering parameters. An objective psoriasis severity assessment is advantageous in terms of accuracy and reproducibility over conventional severity assessment. We aimed to formulate an objective psoriasis severity index with a single bioengineering device that can possibly substitute the conventional subjective Psoriasis Severity Index. A linear regression analysis was performed to derive the formula with the subjective Psoriasis Severity Index as the dependent variable and various bioengineering parameters determined from 157 psoriasis lesions as independent variables. The construct validity of the objective Psoriasis Severity Index was evaluated with an additional 30 psoriasis lesions through a Pearson correlation analysis. The formula is composed of hue and brightness, which are sufficiently obtainable with a Colorimeter alone. A very strong positive correlation was found between the objective and subjective psoriasis severity indexes. The objective Psoriasis Severity Index is a novel, practical and valid assessment method that can substitute the conventional one. Combined with subjective area assessment, it could further replace the Psoriasis Area and Severity Index which is currently most popular.     

Superimposed linear psoriasis: differential therapeutic response of linear and nonlinear lesions

Linear psoriasis is a very unusual clinical variation of psoriasis. Typical clinical features include early onset of erythematosquamous lesions along Blaschko's lines, ability to elicit psoriatic features, absence of pruritus and positive family history for psoriasis. Recently, the term 'superimposed linear psoriasis' was coined for cases with development of nonlinear psoriatic lesions at predilection sites in later life. We report a 19-year-old woman meeting all criteria for the diagnosis of superimposed linear psoriasis including typical histological features. Remarkably, treatment with topical steroids and dithranol cleared the psoriatic lesions on predilection sites whereas the linear lesions were resistant to topical therapy. Linear psoriatic lesions are believed to be caused by genetic alterations in early embryogenesis leading to loss of heterozygosity at a gene locus involved in the pathogenesis of psoriasis. Comparison of mosaic keratinocytes derived from linear lesions with wild-type keratinocytes from the same person may therefore allow identification of key regulatory genes.     

Epidermolysis bullosa acquisita associated with psoriasis vulgaris

We report a case of epidermolysis bullosa acquisita (EBA) associated with psoriasis vulgaris. A 71-year-old woman with psoriasis vulgaris developed subepidermal blisters on the extremities. Direct immunofluorescence demonstrated linear deposit of IgG at the basement membrane zone, which bound to the dermal side of normal human skin split with 1 mol/L NaCl. Immunoblot analysis using recombinant full-length type VII collagen detected a 290-kDa band, confirming the diagnosis of EBA. A literature search for previous reports found a few cases of EBA associated with psoriasis, and all cases, including our own, presented with widespread inflammatory vesicles and bullae, and responded to conventional therapy with corticosteroids and immunosuppressive agents. This study suggests that western blotting using recombinant full-length type VII collagen could be useful for diagnosis of EBA, and that EBA associated with psoriasis may have a tendency to be the inflammatory type.