Effective treatment of uremic pruritus and acquired perforating dermatosis with amitriptyline

Generalised pruritus and acquired perforating dermatosis occurring in chronic kidney disease are not uncommon and are often debilitating. However, treatment options are limited. We present two patients with uremic pruritus and acquired perforating dermatosis who were successfully treated with amitriptyline.     

外用丁酸氢化可的松乳膏联合一种皮肤膏剂敷料治疗特应性皮炎的随机开放对照研究

目的:评价外用丁酸氢化可的松乳膏联合一种皮肤膏剂敷料治疗轻中度特应性皮炎（AD）的疗效和安全性。方法:2019年7月至2020年6月,于首都医科大学附属北京友谊医院入组60例轻中度AD患者,采用随机数字表法分为两组,试验组先搽一种皮肤膏剂敷料（商品名芙汭膏剂）后涂丁酸氢化可的松乳膏,对照组先搽上述皮肤膏剂敷料的基质,后...     

三乙醇胺乳膏治疗皮肤慢性溃疡疗效观察

目的探讨三乙醇胺乳膏治疗皮肤慢性溃疡的疗效和安全性。方法38例皮肤慢性溃疡的患者分为两组，治疗组21例和对照组17例，治疗组在清创和换药的基础上待创面表面清洁后外敷厚层三乙醇胺乳膏，对照组仅用常规清创和换药。结果治疗组21例中痊愈18例，占85．71％，显效2例，占9．52％，好转1例，占4．76％，总有效率为95．24％；对照组17例中痊愈8例，占47．06％，显效2例，占11．76％，好转5例，占29．41％，总有效率为58．82％，两组比较差异有统计学意义（P〈0．05）。治疗组者肉芽组织出现时间、皮肤溃疡愈合时间均优于对照组，两组比较差异有统计学意义（P〈0．01）。结论三乙醇胺治疗皮肤慢性溃疡疗效确切，患者耐受性好。     

凯普斯泰冷敷凝胶联合地奈德乳膏治疗儿童特应性皮炎的随机双盲对照研究

【摘要】 目的 评估凯普斯泰冷敷凝胶联合地奈德乳膏治疗儿童特应性皮炎（AD）的短期有效性和安全性。方法 采用随机、双盲、对照研究，2019年11月至2020年9月收集就诊于四川大学华西医院皮肤科的儿童AD患者60例，最终56例完成随访，试验组和对照组各28例。试验组前3 d早晚外涂地奈德乳膏，中午外涂凯普斯泰冷敷凝胶，后11 d早中晚外涂凯普斯泰冷敷凝胶，对照组前3 d早晚外涂地奈德乳膏，中午外涂安慰剂，后11 d早中晚外涂安慰剂，治疗2周。分别于治疗前、治疗（7 ± 3） d及治疗（14 ± 3） d随访，记录湿疹面积及严重程度指数（EASI评分）、瘙痒视觉模拟评分法（VAS）评分、研究者总体评分（IGA评分）、皮肤生活质量评分（DLQI评分）等临床指标及不良反应。结果 治疗1周时，试验组1例（3.57%），对照组1例（3.57%）有效；治疗2周时，试验组12例（42.86%）有效，对照组2例（7.14%）有效；经秩和检验，治疗1周和2周时两组疗效差异有统计学意义（Z = -4.318、-5.474，均P < 0.05）。治疗前，试验组和对照组EASI、VAS、IGA、DLQI评分差异均无统计学意义（P > 0.05）；经非参数Friedman检验，两组EASI评分随治疗时间的变化差异具有统计学意义（χ2 = 45.720，P < 0.05）。经两因素重复测量方差分析，治疗1周后，两组间VAS评分差异有统计学意义（F = 10.738，P = 0.002），IGA、DLQI评分差异无统计学意义（F = 0.066、0.804，P = 0.135、0.374）；治疗2周后，两组间VAS、IGA、DLQI评分差异均有统计学意义（F = 67.313、38.949、51.503，均P < 0.001）。研究期间，试验组和对照组各发生1例不良反应事件，均表现为外用药物部位刺痛感或刺激感，两组不良事件发生率差异无统计学意义（P > 0.05）。结论 短期应用凯普斯泰冷敷凝胶联合地奈德乳膏可有效治疗儿童AD，且与安慰剂比较未增加不良反应的发生。     

1%吡美莫司乳膏治疗剥脱性唇炎疗效观察

剥脱性唇炎的确切病因和发病机制尚不清楚,临床上缺乏比较有效的治疗方法和药物。我们采用1%吡美莫司乳膏外用治疗剥脱性唇炎,获得了满意的疗效。 一、临床资料 1. 一般资料：73例剥脱性唇炎患者均来源于唐山市工人医院皮肤科门诊,符合剥脱性唇炎诊断标准［１］。根据随机数字表法随机分为2组,吡美莫司组38例,男11例,女27例,年龄16 ~ 45（29.97 ± 9.26）岁,病程2 ~ 18（10.30 ± 4.92）个月;丁酸氢化可的松组35例,男10例,女25例,年龄14 ~ 47（29.64 ± 10.24）岁,病程1 ~ 20（9.65 ± 5.97）个月。两组一般资料比较,差异均无统计学意义,具有可比性……     

A comparative study on the effects of naltrexone and loratadine on uremic pruritus

BACKGROUND: Two recent studies have provided opposite results on the efficacy of naltrexone on uremic pruritus. We have performed a third study. OBJECTIVE: To compare the efficacy and tolerance of naltrexone and loratadine in uremic pruritus. PATIENTS/METHODS: Among 296 hemodialyzed patients, 65 suffered from uremic pruritus. Fifty-two patients participated in the study. The patients were treated for 2 weeks with naltrexone (50 mg/day; 26 patients) or loratadine (10 mg/day; 26 patients), after a washout of 48 h. Pruritus intensity was scored by a visual analogue scale (VAS). Adverse events were carefully searched for. The two groups were statistically equivalent. RESULTS: There was no significant difference in the mean VAS scores after treatment, but naltrexone allowed a dramatic decrease in VAS scores (Delta >3/10) in 7 patients. Adverse events (mainly nausea and sleep disturbances) were observed in 10/26 patients. CONCLUSIONS: Naltrexone is effective only in a subset of patients. Adverse events are very frequent. The differences of efficacy and tolerance between patients might be due to metabolism. Naltrexone might be considered as a second-line treatment.     

[开放获取] 含低聚麦芽糖X的皮肤护理软膏辅助治疗轻中度湿疹患者瘙痒的多中心随机双盲对照研究

【摘要】 目的 评价一种含低聚麦芽糖X的皮肤护理软膏辅助治疗湿疹瘙痒的临床疗效和安全性。方法 采用多中心、随机、双盲、模拟剂对照临床研究,2021年3 - 9月于首都医科大学附属北京友谊医院、河北省中医院、湖北省第三人民医院及浙江省台州市中心医院4家医院皮肤科门诊收集轻、中度湿疹患者,采用随机数字表法随机分为两组,观察组外用一种含低聚麦芽糖X的皮肤护理软膏,模拟剂组外用该皮肤护理软膏模拟剂,每天瘙痒发作时即使用,连续使用14 d。分别于辅助治疗前和治疗7、14 d随访,根据湿疹面积及严重程度指数（EASI）、视觉模拟标尺法（VAS）等评价疗效,记录不良事件。主要采用χ2检验和t检验进行疗效和安全性分析。结果 入组患者232例,男90例、女142例,年龄（40.13 ± 13.36）岁;观察组156例,模拟剂组76例。辅助治疗前两组患者EASI评分［（2.07 ± 2.24）分比（2.29 ± 2.28）分］、VAS评分［（6.22 ± 1.78）分比（6.20 ± 1.79）分］差异均无统计学意义（t值分别为-0.70、0.06,P值分别为0.486、0.955）。治疗1 d,两组VAS评分相对各自基线的变化即有统计学意义（P值分别＜0.001、 = 0.003）。治疗14 d,观察组VAS评分均值2.67分,显著低于模拟剂组3.35分（t = -2.28,P = 0.024）。治疗7 d和14 d,与基线相比两组EASI评分均显著下降（均P＜0.001）,但两组间差异均无统计学意义（P = 0.853、0.731）。两组均无器械相关不良事件发生。结论 含低聚麦芽糖X的皮肤护理软膏辅助治疗湿疹瘙痒安全、有效,可用于临床。     

A questionnaire for the assessment of pruritus: validation in uremic patients

A questionnaire was constructed for the evaluation and measurement of pruritus. The questionnaire, based on the short form of the McGill Pain Questionnaire, was tested in 145 patients suffering from uremic pruritus and currently undergoing hemodialysis treatment in 3 centers. The newly developed questionnaire proved to be reliable and provided valid data on the sensory, affective and overall intensity of uremic pruritus. The data suggest that uremic pruritus tends to be prolonged, frequently intense and a major source of distress to the patient. Dialysis was not found to influence the pruritus. The questionnaire may also be useful in pruritus secondary to other causes.     

红蓝光联合地奈德乳膏治疗肛周湿疹疗效观察

肛周湿疹因其发病部位特殊,皮疹迁延不愈,反复发作且瘙痒剧烈,严重影响患者的生活质量。我们自2013年3月起采用红蓝光照射联合地奈德乳膏治疗肛周湿疹,取得较好的疗效,报道如下……     

他扎罗汀乳膏治疗寻常痤疮疗效观察

2007年1-6月,我们使用0.1%他扎罗汀乳膏治疗寻常痤疮,评价其疗效与不良反应. 一、病例与方法 1.临床资料:入选患者均来自本科门诊,按痤疮国际分类法临床确诊为Ⅰ级～Ⅱ级痤疮[1].共收集患者150例,采用随机数字表法将患者分为治疗组和对照组,失访6例,完成观察者144例,其中治疗组74例,男35例,女39例;年龄15～35岁,病程3个月至lO年;对照组70例,男32例,女38例,年龄14～35岁,病程1个月至10年,均无全身性疾病,治疗前1个月内未用过任何治疗痤疮的药物,治疗期间停用其他药物.     

窄谱中波紫外线联合保湿霜对寻常性银屑病的作用观察

银屑病作为一种反复发作的皮肤病,严重影响患者的生活质量［１］。皮肤病的辅助治疗越来越引起皮肤科医师的重视［2］。为探讨薇诺娜柔润保湿霜对寻常性银屑病的辅助作用,我们对门诊银屑病患者用窄谱中波紫外线（UVB）联合该护肤品观察其效果以及对皮肤生理指标的影响……     

Efficacy of oral naltrexone on pruritus in atopic eczema: a double-blind, placebo-controlled study

Aim  The intent of our study was to determine the efficacy of oral naltrexone, an opiod antagonist, in the treatment of pruritus in patients with chronic eczema.
Methods  This double-blind, placebo-controlled study recruited 38 patients with eczema complaining from pruritus. Pruritus scores were evaluated. Patients were given placebo ( n  = 20) or naltrexone 50 mg ( n  = 18) for 2 weeks period. During the study, pruritus scores based on visual analogue scale system (VAS) were assessed three times: at the start of study, after 1 week, and after 2 weeks.
Results  In both groups, decreased VAS scores were observed, but naltrexone showed to be significantly more effective than placebo in decreasing VAS score after 1 week ( P <  0.005) and 2 weeks ( P <  0.001).
Conclusion  Naltrexone is more effective than placebo in the treatment of pruritus in patient with eczema. Naltrexone might be considered as an adjunct treatment in the treatment of pruritus. However, further studies in this aspect are highly fostered.

Conflicts of interest

This study and the authors were not supported by any company with a vested interest in the product being studied and the project was funded by Skin Research Center.     

辣椒素霜治疗冬季皮肤瘙痒症33例的疗效观察

我们选用0.075%的辣椒辣素霜与1%尿囊素霜,经单盲自体对照,治疗了36例冬季瘙痒症患者,完成33例（男17例,女16例,年龄平均59岁）。结果：治疗第3天治疗组痊愈率为15.2%,总有效率为78.8%;第4周治疗组痊愈率为63.6%,总有效率为81.8%,但与对照组无统计学差异。治疗的起效时间治疗组（中位数为1天）明显短于对照组（中位数为3天）。本组不良反应发生率为烧灼感66.7%,刺痛感36.4%,红斑15.2%,但多发生于治疗初期,经一般时间治疗都能耐受,本观察结果表明用辣椒辣素霜治疗冬季瘙痒症起效快,疗效肯定。