火针联合阿维A胶囊治疗掌跖脓疱病临床疗效观察

目的观察火针疗法联合阿维A胶囊治疗掌跖脓疱病的临床疗效及安全性。方法将掌跖脓疱病患者94例随机分为治疗组和对照组,治疗组48例采用火针联合阿维A胶囊口服,对照组46例采用阿维A胶囊口服,治疗8周后,观察治疗前后红斑深浅、脓疱数目、结痂多少和瘙痒程度4个指标来进行疗效判定。结果治疗后对2组患者进行疗效判定,治疗组疗效高于对照组(P0.05)。结论火针联合阿维A胶囊治疗掌跖脓疱病具有较好的疗效,不良反应少,操作简便,值得临床推广使用。     

口服阿维A联合窄谱UVB治疗掌跖脓疱病疗效观察

目的观察口服阿维A联合窄谱UVB治疗掌跖脓疱病的疗效。方法治疗组口服阿维A 10~30 mg/d,同时窄谱UVB照射患处,隔日1次;对照组窄谱UVB照射患处,隔日1次,疗程均为40天。结果两组有效率分别为85.29%和60.71%(P<0.05),治疗组疗效优于对照组。结论口服阿维A联合窄谱UVB治疗掌跖脓疱病疗效确切,不良反应少。     

口服药物联合局部封包治疗掌跖脓疱病临床观察1唐维斌

目的 观察口服阿维A、雷公藤多甙片联合复方氯倍他索软膏封包治疗掌跖脓疱病临床疗效。方法 将入选的42例掌跖脓疱病患者随机分为两组,治疗组23例,口服阿维A、雷公藤多甙片,同时病灶处复方氯倍他索软膏封包治疗,治疗2个月;对照组19例,单独采用复方氯倍他索软膏局部封包治疗治疗2个月。于第1月末、2月末观察临床疗效。结果 治疗第1月末、2月末时,治疗组有效率分别为56.52%和78.26%,对照组分别为26.32%和36.84%,两组比较差异均有统计学意义(P0.05)。结论 口服阿维A、雷公藤多甙片联合复方氯倍他索软膏封包治疗掌跖脓疱病安全有效,临床疗效高于复方氯倍他索软膏单独使用。     

口服药物联合局部封包治疗掌跖脓疱病临床观察

目的观察口服阿维A、雷公藤多甙片联合复方氯倍他索软膏封包治疗掌跖脓疱病临床疗效。方法将入选的42例掌跖脓疱病患者随机分为两组,治疗组23例,口服阿维A、雷公藤多甙片,同时病灶处复方氯倍他索软膏封包治疗,治疗2个月;对照组19例,单独采用复方氯倍他索软膏局部封包治疗治疗2个月。于第1月末、2月末观察临床疗效。结果治疗第1月末、2月末时,治疗组有效率分别为56.52%和78.26%,对照组分别为26.32%和36.84%,两组比较差异均有统计学意义(P0.05)。结论口服阿维A、雷公藤多甙片联合复方氯倍他索软膏封包治疗掌跖脓疱病安全有效,临床疗效高于复方氯倍他索软膏单独使用。     

凉血消风汤联合阿维A治疗银屑病血热型34例临床疗效观察

目的观察凉血消风汤联合阿维A治疗银屑病血热型疗效观察。方法将34例银屑病患者随机分为2组,每组17例,对照组予以口服阿维A,1次/d;治疗组予以口服阿维A加凉血消风汤治疗。比较2组的疗效差异。结果 2组治疗前银屑病损面积和严重程度指数(PASI)评分比较差异无统计学意义(P0.05),治疗后2组PASI评分差异有统计学意义(P0.05),治疗组治疗前后比较PASI评分差异有统计学意义(P0.05);2组临床疗效对比差异有统计学意义(P0.05)。结论凉血消风汤联合阿维A治疗银屑病血热型疗效确切,值得临床推广。     

阿维A联合舒肤散熏洗治疗寻常型银屑病临床观察

目的观察阿维A联合舒肤散治疗寻常型银屑病的临床疗效及安全性。方法将128例银屑病患者随机分为治疗组和对照组。治疗组口服阿维A联合舒肤散熏洗,对照组仅口服阿维A,观察2组治疗前后的皮损面积和严重程度指数(PASI)评分及靶皮损不同症状(红斑、鳞屑、浸润)的评分。结果 2组PASI评分治疗后均较治疗前降低(P0.05)。治疗后PASI评分组间比较差异有统计学意义(P0.05)。治疗组有效率为82.8%,对照组为65.6%,2组比较差异有统计学意义(χ2=4.940,P=0.026)。2组均无明显不良反应。结论阿维A联合舒肤散熏洗治疗寻常型银屑病临床疗效确切,安全性良好。     

中药联合UVN照射治疗掌跖脓疱病28例疗效观察

目的观察万应胶囊、中药外洗方熏洗联合UVN照射治疗掌跖脓疱病的临床疗效。方法44例掌跖脓疱病患者随机分为两组。治疗组28例,口服万应胶囊2粒,2次/d,加中药外洗方熏洗联合UVN照射治疗,共4周;对照组1 6例,UVN照射同时外用地塞米松霜治疗。运用PASI评分判断疗效。结果治疗组PASI评分治疗前为1 0.9 3±2.26,治疗后为2.43±2.08,有效率82.14%。对照组有效率43.75%,两组比较有显著性差异(P<0.05)。结论中药联合UVN照射治疗掌跖脓疱病疗效好。     

小剂量阿维A联合中药浸泡及西药外用治疗掌跖脓疱病疗效观察

目的观察口服小剂量阿维A联合外用清热解毒利湿中药浸泡治疗掌跖脓疱病的疗效。方法阿维A组(A组)32例,中药组(B组)28例,联合治疗组(C组)37例,分别于治疗4周、8周后进行症状评分和观察疗效。结果治疗4周、8周后C组疗效明显优于A组和B组,差异有统计学意义(P<0.05)。结论小剂量阿维A联合外用清热解毒利湿中药浸泡是治疗掌跖脓疱病的有效方法之一     

白芍总苷联合阿维A治疗中、重度银屑病32例临床观察

目的观察白芍总苷联合阿维A治疗中、重度银屑病的临床疗效和安全性。方法 62例中、重度银屑病患者随机分为2组,治疗组32例,予口服白芍总苷600mg3次/d,阿维A0.5mg/(kg.d)治疗,对照组30例仅予口服阿维A0.5mg/(kg.d)治疗,疗程8周。以银屑病皮损面积和严重程度(PASI)评分评价疗效并记录不良反应。结果治疗8周后,治疗组PASI评分(4.36±3.12)低于对照组(6.38±2.81),差异有统计学意义(P<0.05);治疗组有效率(90.62%)高于对照组(76.67%)。差异有统计学意义(P<0.05)。两组未见明显不良反应。结论白芍总苷联合阿维A治疗中、重度银屑病的患者疗效好,安全性高。     

阿维A胶囊联合银屑胶囊治疗血虚风燥型银屑病48例临床观察

目的观察阿维A胶囊联合银屑胶囊联合治疗血虚风燥型银屑病的临床疗效和安全性。方法 100例血虚风燥型银屑病患者随机分为治疗组(48例)予阿维A胶囊联合银屑胶囊口服治疗,对照组(52例)仅予阿维A胶囊口服治疗。比较两组患者的临床疗效和不良反应情况等。结果治疗组、对照组PASI和有效率分别为(6.25±2.36)、(3.65±2.06)和95.83%、82.69%,两组间差异均有统计学意义(P0.05);治疗组眼干、皮肤干燥、鼻出血、毛囊炎、转氨酶升高、高脂血症等不良反应发生率均显著低于对照组,两组间差异均有统计学意义(P0.05)。结论阿维A胶囊联合银屑胶囊治疗血虚风燥型银屑病疗效显著,不良反应少,值得推广。     

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.