外用0.5% MITF-siRNA霜治疗黄褐斑临床疗效及安全性观察

目的观察MITF-siRNA霜外用治疗黄褐斑的临床疗效及安全性。方法经临床诊断为黄褐斑的33例患者给予外用MITF-siRNA霜治疗,2次/d,并用MicroskinⅡ多功能偏振光皮肤镜图像分析系统对治疗前后黄褐斑皮损进行客观测量,通过测量L×,A×,B×值并计算ITAo值以评价局部外用siRNA霜的治疗效果。结果经MITF-siRNA霜外用治疗12周后,有效率90.3%,治疗前后ITAo值显著改善(P0.01)。观察过程中仅有1例局部出现红斑,停用至红斑消退后,继续外用siRNA霜后达到显效。结论局部外用MITF-siRNA霜可以显著淡化色斑,疗效确切且安全性好。     

应用皮肤镜评价滋肾化斑汤治疗女性黄褐斑的临床疗效

目的应用计算机数字图像分析系统(皮肤镜)评价滋肾化斑汤治疗女性黄褐斑的临床疗效方法70例患者随机分为两组,治疗组40例给予中药滋肾化斑汤方口服,2次/d;对照组30例给予口服维生素C200mg/次,3次/d,口服维生素E100mg/次,3次/d。两组患者均外用丝白去斑软膏,12周为1个疗程。采用皮肤镜对其疗效进行客观评价。结果 70例患者完成服药观察者65例,其间因各种原因脱落者5例(<20%)。其中38例治疗组患者有效率为71.1%;27例对照组患者有效率为37.0%。两组疗效比较,差异有统计学意义(P<0.05)。治疗组和对照组患者治疗前后皮损L*a、*、b*值及ITA°值有显著变化,差异有统计学意义(P<0.01)。治疗组治疗前后皮损L*、a*、b*值及ITA°值变化明显高于对照组,差异有显著性(P<0.01)。结论滋肾化斑汤治疗女性黄褐斑疗效显著,明显优于口服维生素C、E的对照组。无严重不良反应和不良事件。     

Q开关Nd:YAG激光治疗色素增加性皮肤病疗效分析

目的观察Q开关Nd:YAG激光治疗色素增加性皮肤病的临床疗效及治疗次数、间隔时间以及安全性。方法用Q开关Nd:YAG激光(1 064 nm,532 nm波长)治疗570例色素增加性皮肤病,观察、分析其疗效。结果 Q开关Nd:YAG激光治疗色素增加性皮肤病均有效。其中老年斑、雀斑、蓝黑纹身、雀斑样痣、褐青色痣、太田痣总有效率均达87.14%以上。黄褐斑总有效率为85.20%。咖啡斑、炎症后色素沉着总有效率分别为65.00%及60.00%。毛表皮痣总有效率为30.00%。痊愈率由高到低依次为老年斑、雀斑、雀斑样痣、蓝黑纹身、褐青色痣、太田痣、黄褐斑、咖啡斑、炎症后色素沉着、毛表皮痣。治疗次数1～13次,间隔时间1周～半年。临床疗效与治疗次数呈正相关,不良反应少。结论Q开关Nd:YAG激光治疗色素增加性皮肤病的疗效显著,安全性较好。毛表皮痣治疗效果相对较差。     

中药综合疗法治疗黄褐斑20例临床观察

目的观察中药综合疗法治疗黄褐斑的临床疗效。方法将60例患者随机分为中药组45例和对照组15例，中药组又分为A组15例（内服消斑养颜丸），B组10例（外用消斑养颜散），C组20例（同时采用上述两种疗法）。对照组服逍遥丸同时外用迪维霜。均1个月为1疗程，共连续治疗观察3个疗程。结果消斑养颜丸组有效率为66．67％，消斑养颜散组有效率为30．00％，联合组有效率为85．00％，对照组有效率为40．00％。结论中药综合疗法治疗黄褐斑疗效显著，无不良反应。     

雪夫霜治疗黄褐斑、炎症后色素沉着斑疗效观察

应用雪夫霜治疗黄褐斑、炎症后色素沉着斑 10 8例 ,有效率为 83 .3 % ,说明全反式维A酸霜剂外搽对 2种病具有祛斑、增白的肯定疗效 ,且副作用小     

局部用皮质类固醇治疗白癜风

作者选择20名白癜风患者,年龄14～66岁,外用O.1％倍他米松戊酸酯(BV)或O.05％C10一betas01 Propionate(CP)霜进行治疗。并在对称部位相似的白斑上用不含类固醇的霜作对照。每日外用霜2次,每月观察一次,治疗4～5月后结束观察。治疗3个月之后用BV的10名患者中有3名只在炎固醇治疗的部位有大量的色素再生,用CP的10名患者只一名有部分色素再生。色素再生最早发生在治疗开始后2个月,由毛囊周围或白斑边缘开始,逐渐扩大融合。似乎年青患者对治疗反应更好,白斑中毛发色素脱失者对治疗没有效应。     

低能量密度2 940 nm像素激光联合积雪苷治疗黄褐斑的疗效观察

目的 观察低能量密度2 940 nm像素激光联合积雪苷治疗黄褐斑的疗效及不良反应.方法 24例黄褐斑患者接受4次能量密度为400～500 J/cm2的2 940 nm像素激光治疗,并于术后外用积雪苷霜.于联合治疗12周时及治疗结束后6个月时由医生对治疗效果进行评估;由患者进行满意度评估.结果 24例患者中21例完成临床试验.联合治疗12周时及治疗结束后6个月时,总有效率分别为52.4％和47.6％;患者满意率分别为61.9％和57.1％.结论 低能量密度2 940 nm像素激光术后联合积雪苷霜治疗黄褐斑安全有效。     

中医药内外合治肝郁血滞型黄褐斑的临床疗效观察

目的观察中药内服、外用及耳穴压豆治疗肝郁血滞型黄褐斑的临床疗效。方法中医辨证分型为肝郁血滞型的黄褐斑患者,采用随机数字表进行分组,结果完成84例。治疗组46例,中药消斑1号方口服及中药祛斑膜1号方外用配合耳穴压豆治疗;对照组38例,维生素C片和维生素E胶丸口服,0.1%维A酸乳膏外用治疗,治疗12周后进行疗效判定。结果治疗组有效率为80.43%;对照组有效率为63.16%,2组疗效对比差异有统计学意义(P0.05)。结论中医药内外合治肝郁血滞型黄褐斑疗效好,安全性高。     

淡斑美白精华液改善黄褐斑的临床观察

目的:评估淡斑美白精华液改善黄褐斑的临床疗效及安全性。方法:采用双中心、随机、开放试验研究,将80例黄褐斑患者随机分为试验组(41例)和对照组(39例),分别于黄褐斑皮损处外用淡斑美白精华液及润白保湿乳,每天2次。在使用产品前以及使用后第2、4、8、12周评估黄褐斑皮损面积及严重程度指数(MASI)变化,皮肤色度仪定量测量皮肤颜色以及受试者自评。结果:在使用产品12周后,试验组和对照组的MASI下降率分别为55.44%和42.98%,属好转。治疗组有效率为95.1%,对照组为92.3%。两组疗效比较差异无统计学意义(P0.05)。结论:淡斑美白精华液对黄褐斑有效,耐受性良好。     

曲安奈德益康唑乳膏治疗糖尿病患者湿疹35例临床观察

目的观察派瑞松霜外用治疗糖尿病患者湿疹的疗效与安全性。方法采用单盲、自身对照的方法,对35例糖尿病合并湿疹的患者的自身对称或相邻皮损分别外用派瑞松或复方曲安奈德乳膏,2～3周观察疗效。结果35例患者对派瑞松耐受性好,治疗侧皮损有效率为85.71%,显著高于对照侧(60.00%)。结论派瑞松治疗糖尿病患者湿疹疗效好。     

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.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.