173例寻常型银屑病患者外周血T淋巴细胞亚群、免疫球蛋白及补体水平与PASI相关性分析

目的：探讨寻常型银屑病患者外周血T淋巴细胞亚群、免疫球蛋白及补体的水平变化及临床意义。方法：对173例银屑病患者进行PASI评分,采用流式细胞仪及全自动酶标仪对患者组和150例正常人外周血T淋巴细胞亚群、IgM、IgG、IgA及补体C3、C4的表达水平进行检测和分析。结果：寻常型银屑病患者外周血CD8^＋T细胞数量显著高于对照组（P〈0．05）,且与患者PASI呈正相关（r=0．845,P〈0．01）;补体C3较对照组显著降低（P〈0．05）,且与患者PASI呈负相关（r=0．699,P〈0．01）。而CD3^＋及CD4^＋T细胞、IgG、IgM、IgA及补体C4水平与对照组相比差异无统计学意义（P〉0．05）。结论：寻常型银屑病患者外周血免疫功能处于紊乱状态,CD8^＋T细胞百分率及补体C3水平与银屑病患者的病情密切相关。     

体液免疫因素在痤疮瘢痕形成过程中的作用

目的通过检测中度以上痤疮患者血清中免疫球蛋白和补体水平,探讨痤疮瘢痕患者形成的免疫学方面机制。方法采集中度以上痤疮瘢痕患者(瘢痕组)的血清,用免疫速率散射比浊法检测受试者血清IgE、IgG、IgM和补体C3、C4水平,并以中度以上痤疮无瘢痕(无瘢痕组)、Ⅰ级(轻度)痤疮以及正常人作为对照组。分析痤疮瘢痕组患者血清免疫球蛋白和补体与瘢痕形成的相关性。结果瘢痕组血清IgG、IgE、IgM和C3水平高于其他3组,经比较差异均有统计学意义(P0.05)。痤疮瘢痕组患者血清3种免疫球蛋白相关性分析结果显示:IgG与IgM显著相关(P0.01),IgE与IgG相关(P0.05)。结论体液免疫中抗体和补体与痤疮瘢痕发生密切有关。     

细胞免疫和体液免疫在寻常性痤疮发病中的作用

观察59例I-III度寻常性痤疮患者外周血免疫指标,以24例健康志愿者为对照。结果:痤疮患者外周血IgG,sIL-2R水平比正常人显著增高(P<0.05和P<0.01)。III度患者组比I度I、I度患者组外周血IgG和补体C3的水平显著增高(均P<0.01)。III度组比I度I、I度组外周血IL-2的水平明显升高(P<0.05);病情越重,外周血IgG、C3、IL-2的水平越高。寻常性痤疮患者存在着特异性免疫反应,增强的免疫反应参与了痤疮的致病过程,并促使痤疮炎症形成。     

混合性结缔组织病患者免疫球蛋白和补体及肌酶的相关性研究

目的：探讨混合性结缔组织病患者血清免疫球蛋白和补体C3C4及肌酶的相关性及其临床意义。方法：用免疫速率比浊法测定混合性结缔组织病患者血清免疫球蛋白和补体C3C4。的含量。使用酶速率化学法检测肌酶的水平。分别和健康体检者进行对比分析。结果：患者组血清免疫球蛋白IgG，IgA，C4，多项肌酶和对照组相比有统计学意义（P〈0．05）。补体C3和肌酶ALT具有直线相关关系（P〈0．05）。结论：混合性结缔组织病患者血清免疫球蛋白IgG，IgA，补体C3C4，肌酶ALT、LDH的含量与病情有关，可以用于病情判断和预后的评价。     

血清中抗酪氨酸酶抗体的检测与白癜风活动性的关系

目的：探讨白癜风患者血清中抗酪氦酸酶IgG、IgM抗体滴度与疾病活动程度的关系和意义。方法：抗酪氯酸酶IgG、IgM抗体检测采用酶联免疫吸附试验（ELISA）方法。结果：①白癜风患者血清抗酪氨酸酶IgG抗体、平均滴度为0．316，显著高于正常对照组0．082（P〈0．001）；抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常对照组0．065（P〈0．001），②活动期白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期白癫风患者（均P〈0.001）；泛发型白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于局限型白癜风患者（均P〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IGg抗体性呈正相关（均P〈0．001）；抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgM抗体阳性呈正相关（均P〈0．001）。①糖皮质激素治疗后患者抗酪氨酸酶IgG、IgM抗体滴度均低于治疗前（均P〈0．001）。结论：白癜风患并血清抗酪氨酸酶IgG、IgM抗体与疾病活动性和严重程度相关。     

过敏性紫癜皮损免疫球蛋白和补体的检测

目的 探讨免疫球蛋白和补体在过敏性紫癜发病中的作用.方法 应用免疫组化LAB-SA法对过敏性紫癜皮损及健康皮肤进行IgG、IgA、IgM及补体C3检测.结果 过敏性紫癜皮损IgG、IgA、IgM及补体C3阳性检出率分别为90.91%、63.64%、90.91%、27.27%,IgG与补体C3、IgM与补体C3差异有统计学意义(P＜0.05).8例健康皮肤均呈阴性.结论 免疫复合物在过敏性紫癜发病中可能起重要作用.     

痤疮患者血清性激素水平的研究

采用放射免疫法测定了33例痤疮患者血清黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（E2）、睾酮（T）、孕酮（P）水平。发现女性患者LH、FSH、E2皆低于正常组（P＜0．001），T与正常组差异不显著（P＞0．05），P高于正常组（P＜0．01）。男性患者LH、FSH低于正常组（P＜0．001），E2和T较正常组差异不显著（P＞0．05）。提示血清LH、FSH水平的异常可能在痤疮发病中起一定作用。     

结节性红斑血循环及皮损免疫球蛋白和补体的检测

目的:检测结节性红斑患者血循环及皮损免疫球蛋白和补体水平.方法:应用全自动生化分析仪采用透射比浊法检测结节性红斑患者治疗前后及正常对照组血液IgG、IgA、IgM、C3和C4.应用免疫组化 LAB-SA法对结节性红斑皮损及正常组织进行IgG、IgA、IgM及补体C3检测.结果:结节性红斑血中除IgG在治疗前其水平高于正常组外(P<0.05),其余各项指标治疗前后及正常组三者之间两两比较,其差异均无统计学意义(P＞0.05).结节性红斑皮损IgG、IgA、IgM及C3阳性率分别为83.33%,66.67%,100%和94.44%,其阳性率除IgA,IgM之间差异有显著性意义外(P< 0.05),其余均无显著性意义(P>0.05).结论:免疫球蛋白和抗原形成的免疫复合物在结节性红斑血管壁的形成和沉积在发病中起重要作用.     

白癜风患者血清中抗酪氨酸酶抗体及可溶性细胞问黏附分子1的检测

目的探讨白癜风患者血清中抗酪氨酸酶IgG、IgM抗体滴度和可溶性细胞间黏附分子1（sICAM-1）水平与疾病活动程度的关系和临床意义。方法抗酪氨酸酶IgG、IgM抗体和sICAM-1检测采用酶联免疫吸附试验（ELISA）方法。结果①白癜风患者血清中抗酪氨酸酶IgG抗体平均滴度为0．316，显著高于正常人对照组0．082（P〈0．001）；白癜风患者血清中抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常人对照组0．065（P〈0．001），②白癜风患者进展期血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期（P均〈0．001），泛发型明显高于局限型（P均〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgG抗体阳性及IgM抗体阳性均呈币相关（P均〈0．001）。④白癜风患者血清sICAM-1平均水平为697．40ng／mL，显著高于正常人对照组602．40ng／ml（P〈0．001）；进展期高于稳定期（P〈0．001）；泛发型高于局限型（P〈0．001）：稳定期和局限型白癜风患者血清中sICAM-1水平与正常人对照组差异无统计学意义（P均〉0．05）。结论白癜风患者血清中抗酪氨酸酶IgG、IgM抗体和sICAM-1与疾病活动性和严重程度相关。     

发疹型药疹皮损内免疫球蛋白和补体C3的免疫组化检测

为研究体液免疫与发疹型药疹发病机制的关系,用免疫组化PAP法对34例发疹型药疹患者皮损组织中免疫球蛋白IgG、IgM 、 IgA、IgE和补体C3进行了检测。结果真皮浅层及中层的小血管壁及管腔中和胶原纤维有IgG、IgM、IgA及C3的沉积,无IgE的沉积。结果示体液免疫在发疹型药疹的发病中起重要作用。     

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.