幽门螺杆菌感染致慢性荨麻疹诱发或加重的机制探讨

目的观察幽门螺杆菌(Helicobacter pylori,Hp)感染的BALB/c小鼠模型外周血及胃黏膜组胺和类胰蛋白酶的变化,以探讨Hp在诱发慢性荨麻疹(CU)或使病情加重过程中的机制。方法 90只健康BALB/c小鼠随机分成3组(实验1组、实验2组和对照组),每组各30只。实验1、2两组分别灌胃高毒力株(VacA+CagA+)和低毒力株(VacA-CagA+)Hp菌悬液,对照组灌胃牛血清白蛋白(BAS)。分别采用组胺荧光测定法、类胰蛋白酶免疫组化法及ELISA法检测三组标本灌胃前后外周血、胃黏膜组胺和类胰蛋白酶含量。结果实验1、2组小鼠外周血及胃黏膜组胺含量均高于对照组(P<0.01),实验1、2两组小鼠外周血组胺含量无显著性差异(P>0.01),但实验1组小鼠胃黏膜内组胺含量低于实验2组(P<0.01);实验1、2两组小鼠外周血及胃黏膜类胰蛋白酶含量均高于对照组(P<0.01),实验1组小鼠胃黏膜类胰蛋白酶含量低于实验2组(P<0.01),但外周血类胰蛋白酶含量高于实验2组(P<0.01)。结论 Hp感染可导致小鼠模型外周血及胃黏膜组胺和类胰蛋白酶含量均增加,这可能是Hp诱发或加重CU的重要原因之一。     

Acne vulgaris aggravated by sunlight

The symptoms of approximately 3 percent of our patients with acne vulgaris worsen during the summer months even though they maintain previously effective therapy. We show herein that the addition of 5 percent para-aminobenzoic acid (PABA) in alcohol (used as a sunscreen) resulted in marked improvement in their ability to tolerate sunlight. This condition, acne vulgaris aggravated by sunlight, has been compared to acne aestivalis which is another sunlight-induced disorder.     

Skin diseases aggravated by pregnancy

During pregnancy, immunologic, endocrine, metabolic, and vascular changes occur that make the pregnant woman susceptible to aggravation of certain skin diseases. These diseases can be organized into five broad categories: infections, diseases of altered immunity, metabolic diseases, connective tissue disorders, and miscellaneous conditions. A discussion of how each of these diseases is altered by pregnancy and how treatment may differ during gestation is presented.     

肥胖对皮肤生理功能的影响及其伴发和加重的皮肤病

肥胖已被认为是主要的公共健康问题之一[1].肥胖可增加冠心病、高血压、高脂血症、骨关节炎、糖尿病的发病风险,与失眠、内分泌失调、直肠癌、胆囊疾病、骨骼肌疾病、重症胰腺炎、营养不良、尿失禁、特发性颅内高压等直接相关,还与焦虑、抑郁、社交障碍等间接相关.然而,肥胖对皮肤的影响则很少有人关注.肥胖可使皮肤屏障功能、皮脂腺和汗腺功能、胶原结构和功能、创伤愈合、皮肤微循环以及皮下脂肪等皮肤生理功能发生改变.此外,肥胖可伴发或加重多种皮肤病,如黑棘皮病、毛周角化病、软纤维瘤、多毛症、萎缩纹、痛性肥胖症、皮肤淋巴水肿、掌跖角化症、蜂窝织炎、化脓性汗腺炎、痛风、银屑病等.我们综述了其临床特征以及与肥胖的关系,以阐明肥胖对某些皮肤病的重要影响.     

Is Frictional Lichenoid Dermatitis a Minor Variant of Atopic Dermatitis or a Photodermatosis

Context:

Frictional lichenoid dermatitis.

Background:

Frictional lichenoid dermatitis (FLE) is an entity that is probably under diagnosed and has been variably associated with either friction and/or atopy with a distinctive seasonal variation.

Aims and Objectives:

To study correlation of FLE with UV index and to assess its association with atopic dermatitis.

Materials and Methods:

A cross sectional analysis of children with FLE was done, over a period of 6 years in two tertiary hospitals. A detailed history and examination was done to assess the features of atopic dermatitis. The number of cases seen per month was compared with the mean monthly UV index. Two-tailed significance tests using Pearson''s coefficient of correlation and T-test were used to interpret the data. (P < 0.05).

Results:

One hundred seventy-four patients were studied using the UKC criterion 17.2% of the patients had AD while xerosis (40.3%) was the predominant cutaneous finding. The number of patients seen in summer was more than in winter (P < 0.05) but there was no statistical difference between the cases in winter and spring. There was a significant correlation of the number of cases per month with UV index (P = 0.019). Almost 42% of patients gave a history of recurrence.

Conclusions:

FLE is probably not associated with atopic dermatitis and is likely to be related to the ambient UV index though a larger cohort with meticulous follow up may be needed to draw a final conclusion.

Statistical Analysis Used:

The Pearson''s coefficient of correlation was used for comparing the cases per month with the UV index. The tests of hypothesis used included the paired T-tests. F-test of variance, Welch test, Wilcoxon rank sum test and the Kolmogorov-Smirnov Test. P < 0.05 was considered significant.     

Dermatitis artefacta induced in a patient by one of her multiple personalities

A young woman suffered for 5 weeks with an inexplicable, severe dermatitis limited to her left arm. During hospitalization it was found that she had multiple personalities, one of whom had been applying the leaves of the poison ivy plant each night to her left arm, using 'his' gloved right hand. The factitial nature of the dermatitis was further documented by the fact that when the 'responsible personality' was cut off from supplies of poison ivy in the hospital, 'he' produced factitious haematomas by trauma to her left hand. Although this appears to be the first report of dermatitis artefacta associated with the multiple personality disorder, it is suggested that psychiatric study of other dermatitis artefacta patients might reveal the presence of unsuspected occult multiple personalities, responsible for skin lesions that patients cannot explain.     

以湿疹皮炎表现的梅毒6例

6例中男3例,女3例;年龄31~64岁,平均46.7岁;病程20天~3月。均已婚。3例有不洁性生活史。6例皮损表现均类似湿疹皮炎,伴有剧烈瘙痒,按皮炎湿疹或真菌感染治疗(口服抗组胺药、外用皮质类固醇激素或抗真菌制剂)均无效。确诊后予苄星青霉素治疗,瘙痒消失,皮损消退,全部治愈。     

Drug-induced lupus erythematosus aggravated by oral zinc therapy.

A woman with hypertension had been treated with hydralazine and propranolol for the past 6 years. Leg ulcers and mild joint involvement had been observed for 3 years. When oral zinc therapy was started, multisystemic manifestations of a lupus erythematosus-like syndrome developed within one week. The possible implication of zinc in drug-induced lupus is discussed.     

Probiotics for the Treatment or Prevention of Atopic Dermatitis

Probiotics are defined as live microorganisms which, when administered in adequate amounts, confer a health benefit on the host. To synthesize the evidence for the effectiveness of probiotics in the treatment or prevention of atopic dermatitis (AD) in children, we reviewed the results of 13 relevant randomized (placebo)-controlled trials (RCTs), 10 of which evaluated probiotics as treatment and 3 for prevention of AD. The main outcome measure in 9 RCTs was the change in SCORAD (SCORing Atopic Dermatitis). Four RCTs suggested that there was a statistically significant decrease in SCORAD after probiotic administration to infants or children with AD for 1 or 2 months compared with that after placebo, while in two RCTs SCORAD was significantly reduced after treatment with lactobacilli only in children with IgE-associated AD. In four of these six RCTs, clinical improvement was associated with a change in some inflammatory markers. In three RCTs, the change in SCORAD was not statistically significant between probiotic- and placebo-treated children, although in one of these trials SCORAD was significantly lower after probiotic than with placebo treatment in food-sensitized children. In most RCTs, probiotics did not cause a statistically significant change in interferon-gamma, interleukin-4, tumor necrosis factor-alpha, eosinophil cationic protein or transforming growth factor-beta compared with placebo. Regarding the effectiveness of probiotics in the prevention of AD, in two RCTs, infants at high risk for atopy who received probiotics developed AD significantly less frequently during the first 2 years of life than infants who received placebo. In these studies, mothers were administered Lactobacillus rhamnosus GG with or without other probiotics perinatally, followed by treatment of the infants with the same probiotics for the first 6 months of life. However, in another trial, neither the frequency nor the severity of AD during the first year of life were significantly different between infants with atopic mothers who received L. acidophilus for the first 6 months of life compared with infants who received placebo.Probiotics, especially L. rhamnosus GG, seem to be effective for the prevention of AD. They were also found to reduce the severity of AD in approximately half of the RCTs evaluated, although they were not found to change significantly most of the inflammatory markers measured in the majority of the RCTs evaluated. More RCTs need to be conducted to elucidate whether probiotics are useful for the treatment or prevention of AD.