氟比洛芬酯在鲜红斑痣血卟啉单甲醚光动力疗法中镇痛效果的临床初步观察

目的观察氟比洛芬酯在鲜红斑痣血卟啉单甲醚光动力治疗过程中的镇痛效果。方法选择门诊大面积运用光动力治疗的面颈部鲜红斑痣成人患者20例,年龄18~30岁。第一次光动力治疗时不使用镇痛药物,术后5 min让患者用数字评分法对术中疼痛程度进行自我评估;第二次治疗前20 min静滴氟比洛芬酯注射液50 mg,术后5 min让患者再次评估术中疼痛程度。每次治疗后2个月对单次的疗效再进行评估。结果第二次治疗组(氟比洛芬酯组)疼痛评分低于第一次治疗组(对照组)的疼痛评分,差异具有统计学意义(P<0.001);两组治疗的单次疗效差异无统计学意义(P>0.05)。结论氟比洛芬酯用于鲜红斑痣血卟啉单甲醚光动力疗法的镇痛是安全有效的。     

获得性大疱性表皮松解症的研究进展

获得性大疱性表皮松解症是一种自身免疫性慢性大疱性皮肤病,临床可分为两种类型:经典型和炎症型,血循环中有抗Ⅶ型胶原的自身抗体。诊断获得性大疱性表皮松解症除根据临床表现、组织病理、直接和间接免疫荧光外,还需做一些特殊检查,包括盐裂免疫荧光、免疫印迹、免疫电镜和ELISA检查。需要与其他自身免疫性表皮下疱病相鉴别。治疗主要是系统应用糖皮质激素、免疫抑制剂和抗炎药物。     

Japanese Clinical Practice Guidelines for Vascular Anomalies 2017

The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety and systematizing treatment, employing evidence-based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQ) were decided based on the important clinical issues. For document retrieval, key words for published work searches were set for each CQ, and work published from 1980 to the end of September 2014 was searched in PubMed, Cochrane Library and Japana Centra Revuo Medicina databases. The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System technique. A total of 33 CQ were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.     

Oral Lichen Planus: An Update on Etiology,Pathogenesis, Clinical Presentation,Diagnosis and Management

The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP.     

Classification criteria for skin-sensitizing chemicals: a commentary

A formalized, standardized and effective mechanism for the identification of substances which possess significant skin sensitization potential is a necessary first step in the process of limiting the incidence of allergic contact dermatitis. Strategies to achieve such hazard identification are unified throughout the European Union and also have been publicised by the World Health Organization. Global harmonization of these and other approaches (e.g., in the USA) is being driven by the Organization for Economic Cooperation and Development. In this paper, the benefits and limitations of these classification systems are reviewed. A common element of all the systems is that they seek to distinguish important contact allergens from chemicals which are infrequent sensitizers. The European criteria are legal requirements in the EU member states and formal classification as a skin sensitizer leads to mandatory labelling. The most notable omission from current and proposed classification criteria relates to the relative potency of a classified skin sensitizer and the exposure dose. Such information is necessary for proper risk assessment and management measures to be implemented.     

皮下脂膜炎样T细胞淋巴瘤研究进展

皮下脂膜炎样T细胞淋巴瘤是近年新认识的少见的皮肤T细胞淋巴瘤,来源于αβTCRT细胞或γδTCRT细胞的细胞毒性T细胞。皮下脂膜炎样T细胞淋巴瘤主要表现为皮下多发性结节、斑块或皮下肿块,部分患者可伴有噬血细胞综合征,病情进展迅速。病理上可见皮下脂膜炎样改变,其中可见瘤细胞围绕单个脂肪细胞形成特征性的“花环样改变”,免疫组化分析为细胞毒性T细胞来源,表达αβTCR或γδTCR基因重排,对常规化疗反应欠佳,预后较差,其预后与其免疫表型有关。