皮肤美容及整容

皮肤软组织扩张器在四肢的应用；脉冲强光对光老化的治疗作用（综述）；日光对皮肤弹性的影响；防晒霜的应用和评价（综述）；皱纹研究的现状与进展（综述）；     

中国女性面部老化征象的季节性研究及日常光防护对其的影响

大量文献报道,日光照射会对人皮肤造成各种损伤,例如,皮肤色素沉着问题,多种明显的面部老化征象等.与此同时,日光引起的光老化还会加速和(或)改变皮肤自然老化进程.然而,对于不同的种族,其自然老化和光老化所致的皮肤渐进性变化有差异,这些差异可以在不同种族的皮肤老化图谱、书籍中找到.2015年《中华皮肤科杂志》医学简讯栏目曾报道“日光对白种人皮肤老化可见临床征象的影响”,该研究在日光充足的法国南部招募了生活习惯不同的两组女性志愿者(“sun-seekers”与“sun-phobic”),通过对比她们面部老化征象的临床图片,发现皮肤色素沉着相关的临床参数与光老化联系最紧密,而与年龄的相关性较弱.     

痤疮患者皮肤生理功能测定

目的 探讨痤疮患者面部皮肤生理功能的特点，以期指导痤疮患者的治疗。方法 选取受试对象120例，试验组为痤疮患者60例，其中男20例，女40例，平均年龄23.4岁；对照组为健康志愿者60例，其中男20例，女40例，平均年龄25.1岁。运用无创性皮肤生理功能测试仪，测量受试者的面颊及T区（油脂分泌旺盛区域）皮肤油脂、面颊皮肤弹性和水分。结果 试验组面部T区油脂量为（199.98 ± 58.21） μg/cm2，健康对照组为（117.55 ± 63.16） μg/cm2，两组差异有统计学意义（t = 7.34，P < 0.05）。试验组面颊油脂量为（154.45 ± 55.06） μg/cm2，健康对照组为（87.50 ± 47.36） μg/cm2，两组差异有统计学意义（t = 7.14，P < 0.05）。试验组皮肤弹性（0.7931 ± 0.0755R）与健康对照组（0.7882 ± 0.0498R）比较，差异无统计学意义（P > 0.05），试验组皮肤水分（30.75% ± 3.87%）与健康对照组（30.94% ± 2.91%）比较，差异也无统计学意义（P > 0.05）。结论 痤疮患者颜面皮肤油脂分泌过多。     

皮肤光老化与光老化的防护

皮肤光老化是同长期日光照射有关，与皮肤自然老化有着明显的本质上的差别。引起皮肤光老化的主要作用光谱是中波紫外线和长波紫外线。合理的使用复合性遮光剂，外用抗氧化制剂或外用全反式维甲酸制剂，有利于皮肤光老化的预防和修复。当今最重要的是需要制定评价对长波紫外紫外线光防护作用的标准试验方法和改进复合性遮光剂配方中对长波紫外线的防护作用。     

皮肤共振传导时间的测量及其意义

皮肤的生物物理特性是由皮肤局部及机体系统的生物功能所决定。皮肤弹性的改变系多种因素所导致真皮胶原或/和弹力纤维的变化而引起。这些变化可体现在皮肤共振传导时间的改变。通过测量同一部位不同方向共振传导时间,不仅能判断皮肤弹性的变化,同时还可推测哪个方向胶原或/和弹力纤维发生了改变。此外,本测量方法简便。因此,在判断皮肤老化(光老化和自然老化)程度和评估改善皮肤弹性产品的效果时,测量皮肤共振传导时间是值得一试的手段之一。     

上海地区黄褐斑人群皮肤生理参数与微生物群落特征分析

目的 探讨黄褐斑人群与健康人群面部皮肤生理参数和微生物群落的差异。方法 随机调查上海地区494名志愿者,采用无创检测方法测量面部皮肤的生理参数,采集志愿者面颊处皮肤拭子样本,分别通过16S rRNA和ITS测序分析细菌和真菌多样性和物种组成。将其中25～50岁年龄段的47例女性黄褐斑患者设为黄褐斑组,以45例年龄和性别匹配的健康志愿者为对照组,比较分析两组间的皮肤生理参数和微生物群落差异。结果 与对照组相比,黄褐斑组的红斑、a*、b*、色斑、棕斑和紫外线斑水平显著升高(P<0.05),而L*值显著降低(P<0.05)。两组人群细菌和真菌的Alpha多样性、Beta多样性及物种组成差异无统计学意义(P>0.05)。结论 黄褐斑与血红素水平升高、肤色发黄、色素沉着加剧以及亮度降低等皮肤状况的显著变化有关。黄褐斑的发生与面部皮肤微生物菌群变化没有相关性。     

皮肤肿瘤

20121015皮肤鳞状细胞癌组织中E-钙黏素和α-SMA的表达/李小静(中国医科院皮研所),张磊,程芳…∥中国麻风皮肤病杂志.-2011,27(2).-87～89用免疫组化法检测30例皮肤鳞状细胞癌(鳞癌)组织中E-钙黏素和α-SMA蛋白的表达。结果:与癌旁及正常皮肤组织相比,E-钙黏素在皮肤鳞癌中表达减弱或缺失,中低合化与高分化癌组织组间比较差异有     

弹性纤维与皮肤衰老

成熟的弹性纤维主要由弹性蛋白、原纤维蛋白微纤维及与弹性纤维有关的蛋白组成。内源性老化的皮肤弹性和柔韧度降低,弹性纤维网断裂和衰退。光老化皮肤不仅是富含原纤维蛋白的微纤维在表皮真皮交界处丢失,弹性蛋白变性,更重要的是在真皮深层混乱的弹性纤维蛋白物质的沉积,弹性蛋白的功能也受到影响。弹性纤维的修复可归纳为促进组成蛋白表达、改善组装条件、减少破坏因素3方面。     

灯盏花素灌胃对紫外线致SD大鼠皮肤光老化的保护作用

目的探讨灯盏花素抗光老化的作用机制,为防治光老化性疾病提供实验依据。方法 SD大鼠随机分成6组,正常对照组(A组)、模型对照组(B组)、模型+维生素E30mg/kg对照组(C组)、模型+灯盏花素35mg/kg低剂量组(D组)、模型+灯盏花素70mg/kg中剂量组(E组)、模型+灯盏花素140mg/kg高剂量组(F组),模拟日光中UV(UVA+UVB)长期照射,造成皮肤光老化模型。观察皮肤的肉眼改变、组织结构改变及核转录因子κB(NF-κB)和增殖细胞核抗原(PCNA)在大鼠皮肤中的表达与分布情况。结果 E组、F组大鼠皮肤红斑、脱屑、皱纹等光老化改变明显比B组轻;D组、E组、F组皮肤光老化病理改变逐渐减轻;D组、E组、F组分别与B组比较,NF-κB和PCNA的表达均有所减少,D组与B组间比较及F组与E组间比较差异均无统计学意义(P>0.05)。结论 NF-κB,PCNA在光老化模型中的高表达提示两者可能与光老化的形成有关;灯盏花素可能通过抑制PCNA的表达,抑制表皮细胞的增殖及通过抑制NF-κB的活化,从而下调炎症介质的合成,发挥其抗皮肤光老化的作用。     

面部痤疮、湿疹、黄褐斑及日光皮炎皮肤屏障功能评价及其临床意义

目的 探讨痤疮、亚急性湿疹、黄褐斑及日光皮炎的皮肤屏障功能的差异.方法 选损容性皮肤病300例,其中痤疮80例,亚急性湿疹80例;黄褐斑80例;日光皮炎60例.健康人60例为对照.运用德国Courage+Khazaha公司的无创性皮肤生理功能测试仪,测量受试者面部皮肤的皮脂含量、角质层含水量和经表皮水分流失值(TWEL).结果 4种损容性皮肤病组与健康对照组相比,痤疮的皮脂含量及TWEL值较健康对照高,角质层含水量较健康对照低,差异有统计学意义(P＜0.01).亚急性性湿疹、日光皮炎及黄褐斑的皮脂含量、角质层含水量均较健康对照组低,TWEL值均较健康对照高,差异有统计学意义(P＜0.01).4种皮肤病组问进行比较,痤疮的皮脂含量比其他3组高,差异有统计学意义(P＜0.01),其余3组间皮脂含量差异无统计学意义(P＞0.05);亚急性湿疹的角质层含水量比痤疮及黄褐斑低,差异有统计学意义(P＜0.01),与日光皮炎的角质层含水量相比,差异无统计学意义(P＞0.05);日光皮炎的角质层含水量比痤疮及黄褐斑低,差异有统计学意义(P＜0.01);痤疮的角质层含水量比黄褐斑低,差异有统计学意义(P＜0.01);黄褐斑的TWEL值比其他3组低,差异有统计学意义(P＜0.01),其余3组TWEL值相比差异无统计学意义(P＞0.05).结论 4种损容性皮肤病皮肤屏障功能均存在损伤,提示恢复皮肤的屏障功能有助于治疗这4种损容性皮肤病.     

Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region

Aim of the study

To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.

The effect of pH-compatible cleansing cloths on skin pH and the development of pressure ulcers

AimSkin care plays an important role in the prevention of the development of pressure ulcers. The aim of this study was to determine the effect of skincare with a body pH-compatible cleansing cloth on the development time of pressure ulcers and on skin pH.MethodsThis experimental research was conducted with 156 patients hospitalized in intensive care clinics of a state hospital between September 2019 and 2020. The sample was calculated with a power of 80% and a significance level of 0.05 (α error) and as a result, 78 elderly patients formed the intervention group and another 78 elderly patients made up the control group. Data were collected using the Elderly Information Form, Braden Risk Assessment Scale, Pressure Ulcer Staging Tool and Skin pH Measurement Form. The pre- and post-care skin pH of both groups was measured with a skin pH meter. P < 0.05 was considered statistically significant.ResultsThe average development time for pressure ulcers was 14.9 days in the control group, 18.9 days in the intervention group and the difference was not statistically significant (p > 0.05). Skin pH decreased in the intervention group after the skin care routine was applied, whereas it increased in the control group.ConclusionIt can be said that care of one's skin with a body pH-compatible cleansing cloth has a positive effect on the development time of pressure ulcers and also positively changes the skin pH to acidic.     

汉族和藏族人群肤色的测定

目的 测量并比较汉族和藏族人群皮肤反射系数。方法 用新的便携式装置测量３７２名汉族人和２７４名藏族人上臂内侧非暴露部位皮肤的光反射系数,分析有关因素,如年龄、性别、纬度和种族对皮肤反射系数的影响。并确定皮肤反射系数的正常值分布范围,结果 中国汉族和藏族人群之间皮肤反谢系数差异有显著性,同时发现藏族人的肤色深于汉族人;结果还表明肤色与个体年龄的关系不明显,结论 皮肤反射光谱测定是反映肤色深浅的一个客     

额部隆突性皮肤纤维肉瘤一例

患者男,56岁,因左前额部肿块1年余入院.患者20年前左前额部因黄豆大小肿块,曾行切除术.1年前肿块复发并增大,无明显自觉症状来我院就诊.皮肤科检查:左前额部见3 cm×2 cm×1 cm大小的肿块,呈淡红色半球形隆起于皮面,表面皮肤光滑,紧张,质地较硬,与皮肤粘连,但与深筋膜无明显粘连,无触压痛.肿块周围可见明显凹陷区.皮损组织病理:真皮中下层及脂肪内可见大量梭形细胞增生,细胞轻度异形,呈编织状排列.免疫组化染色:CD34(+),波形蛋白(+),CK(-),S-100(-),上皮膜抗原(-).诊断为隆突性皮肤纤维肉瘤.切除肿瘤并行游离全厚皮片移植,术后皮片生长良好,效果满意.     

Validity of skin blot examination for albumin and nerve growth factor β to detect itching of the skin in Indonesian older adults

AimItching, a common skin disorder, impacts the quality of life of individuals. Itchy skin occurs more with increasing age and the prediction of itchy skin prognosis is necessary to provide good skincare. This study validated biomarkers in skin blotting to identify and measure itching sensation as well as conventional methods to measure skin barrier function.Materials and methodsFrom a cross-sectional study conducted in Long-term Care (LTC) facilities in Indonesia itching symptoms were obtained through a questionnaire. Skin conditions were assessed using photographs, stratum corneum (SC) hydration, skin pH, and skin blotting for biomarkers: albumin, interleukin 2 (IL2), nerve growth factor β (NGFβ), and thymic stromal lymphopoietin (TSLP). Association of skin measurements with the presence of skin blotting and trends analysis were conducted.ResultsAltogether, 564 LTC residents (average age, 70 years) participated. The SC hydration, skin pH, albumin, and NGFβ were associated with the presence of itch (p value= <0.001, <0.001, <0.001, and <0.001, respectively). The signal levels of skin blotting biomarkers were higher in itch group than in the non-itch group. Additionally, the higher quantile of SC hydration was significantly associated with a lower intensity level of NGFβ and TSLP (p value = 0.005, 0.003, respectively). The lower quantile of skin pH (better skin condition) was significantly associated with lower albumin, NGFβ, and TSLP (p value = 0.048, 0.035, and <0.001, respectively).ConclusionThe albumin, NGFβ, and TSLP could be a candidate for measurement of itchy skin among older adult with disrupted skin barrier function and local skin inflammation.     

内脏恶性肿瘤的皮肤表现

内脏恶性肿瘤的皮肤表现按病理生理学特点可分为两类:肿瘤的直接效应和间接效应.肿瘤的直接效应是指恶性肿瘤转移灶生长影响周围器官或组织;间接效应即副肿瘤性皮肤病.文中复习了皮肤转移瘤的临床特点及常见的副肿瘤性皮肤病.皮肤表现可能是患者潜在肿瘤的首发临床表现.因此,认识肿瘤的皮肤表现,将有助于潜在肿瘤的早期发现.     

Clinical study of skin changes in low and high risk pregnant women

BACKGROUND

During pregnancy there is immunological, metabolic, endocrine and vascular changes responsible for physiological and pathological skin changes.

OBJECTIVES

determine the prevalence of specific physiological changes and pregnancy, comparing the period of gestation of their appearances and compare type of prenatal care as the skin changes.

METHODS

A cross-sectional study with 905 pregnant women.

RESULTS

The prevalence of physiological skin changes was 88.95% and the most common was pigment. The prevalence of specific dermatoses was 8.72% and atopic eruption was the most common.

CONCLUSION

Physiological changes were seen more in the 3rd quarter, as well as the specific dermatoses. No statistical difference in prenatal low risk compared to high risk was observed, whereas the cutaneous physiological changes and specific pregnancy dermatoses.     

Tumor of follicular infundibulum with unique features

Tumor of the follicular infundibulum is a rare benign cutaneous adnexal neoplasm with variable clinical presentation. In most cases the diagnosis is made with the help of histopathology, due to lack of a characteristic clinical presentation. The most common form is a solitary lesion, but it can be multiple or eruptive, then called infundibulomatose. This case report illustrates a patient with multiple lesions of tumor of the follicular infundibulum with bizarre aspect and atypical location.     

组织蛋白酶在皮肤科的研究进展

组织蛋白酶是溶酶体内的蛋白水解酶,与多种器官的纤维化和肿瘤有密切关系.近儿年,组织蛋白酶在皮肤科的研究主要集中于:其在正常表皮分化、毛囊形成、皮肤损伤修复及瘢痕形成中的作用;与多种慢性炎症性皮肤病的相关性;对其与皮肤肿瘤发生、转移关系的研究已深入至细胞信号与基因调控,并初涉基因治疗领域.     

GentleYAG 1064nm激光治疗对小鼠皮肤屏障功能及弹性的影响

目的研究GentleYAG1064nm激光嫩肤治疗对皮肤屏障功能的影响。方法GentleYAG1064nm激光照射小鼠背部皮肤,每周1次,在激光照射前、首次照射后1周、连续3次照射后1周和连续4次照射后4周时检测皮肤经表皮失水(tramsepidermalwaterloss,TEWL)、含水量和皮肤弹性的变化。结果首次激光照射小鼠皮肤后1周时TEWL,皮肤含水量和皮肤弹性基本上较正常对照组无显著性改变(P>0.05);连续3次激光照射小鼠皮肤后1周时TEWL值和皮肤含水量仍较正常对照组无显著性改变(P>0.05),但是皮肤弹性较正常对照组有显著性改善(P<0.05);连续4次激光照射小鼠皮肤后4周时TEWL值和皮肤含水量仍较正常对照组无显著性改变(P>0.05),皮肤弹性较正常对照组有显著性改善(P<0.05),其值高于连续3次激光照射后1周时,但两者间差异无显著性(P>0.05);用动态冷却系统(dynamiccoolingdevice,DCD)组和不用DCD组的TEWL值、皮肤含水量和皮肤弹性值在各个时间点上均无显著性差异(P>0.05)。结论①单次GentleYAG1064nm激光照射小鼠皮肤对皮肤屏障功能无明显的损伤。②多次GentleYAG1064nm激光照射可以改善皮肤弹性,说明多次GentleYAG1064nm激光照射有显著的嫩肤效果。③使用DCD对激光嫩肤效果无明显的促进作用。