Follow-up survey of 308-nm laser treatment of psoriasis

BACKGROUND AND OBJECTIVES: UVB treatment with a 308-nm excimer laser is a new treatment modality for localized psoriasis. The purpose of this study is to assess patients' impressions and satisfaction with 308-nm laser treatment of mild to moderate psoriasis. STUDY DESIGN/MATERIALS AND METHODS: Telephone survey data were obtained from patients after participation in a case series study of 124 patients with mild to moderate psoriasis treated with 308-nm UVB laser treatment for a target plaque and other lesions. The survey included information on changes in the target plaque, remission time, changes in other areas of psoriasis, satisfaction with the result, side effects of treatment, and efficacy relative to other treatments. RESULTS: Patients (55% of total) reported overall satisfaction with the treatments, and 63% of patients thought they needed additional laser treatments, including for maintenance. Subjects (25%) reported that the laser treatments were better than any other treatment they had tried. Adverse effects were mild and had either disappeared or were significantly decreased in 86% of patients. Self reported length of remission compared favorably to those for other therapies for localized disease. CONCLUSIONS: UVB laser treatments provide a well-tolerated means to clear psoriasis plaques. The treatment provides a high level of patient satisfaction.     

SAPHO syndrome associated spondylitis

The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship between SAPHO syndrome with spinal lesions and seronegative spondyloarthropathy. Thirteen patients with spondylitis in SAPHO syndrome were analyzed. The features of spinal lesions were a chronic onset with a slight inflammatory reaction, and slowly progressing non-marginal syndesmophytes at multi spinal levels, besides the coexistence of specific skin lesions. SAPHO syndrome, especially spinal lesions related to palmoplantar pustulosis, can be recognized as a subtype of seronegative spondyloarthropathy.     

新疆地区哈萨克族、汉族男性银屑病患者骨代谢结果分析

目的探讨新疆地区哈萨克族、汉族男性寻常型银屑病患者可能存在的骨代谢结果差异及影响因素。方法入选对象为2012年1月至2017年10月在新疆生产建设兵团医院皮肤科就诊并已明确诊断的哈萨克族男性寻常型银屑病患者共112例,作为研究组。同时,根据年龄、体重等选择同期就诊且已行相关检查的112例汉族男性银屑病患者作为对照组。结果由两组患者血清Ca、P、ALP、GLU、25-OH-D_3的浓度比较可见,哈萨克族组血清Ca、ALP、25-OH-D_3明显高于汉族组,其差异具有统计学意义(P0.05)。腰椎、股骨颈及Ward三角骨密度比较,哈萨克族男性银屑病组骨密度值均略高于汉族组,其差异在L_1、L_3、L_4,但无统计学意义(P0.05),在L_2、股骨颈及ward三角具有统计学意义(P0.05)。结论哈萨克族男性银屑病患者组骨代谢水平明显高于汉族男性银屑病患者组。     

Hemodialysis Therapy for Psoriasis

Twenty-five patients with extensive plaque psoriasis resistant to conventional treatment were evaluated for study of the effects of dialytic therapy on the skin lesions. Twenty patients were dialyzed twice a week for six hours each time with a 1.0 m² Cuprophan membrane dialyzer. Eighteen patients responded to this therapy with regression of skin lesions. Twelve of them have not developed recurrence of lesions during a followup period extending from 6 to 27 months. A few new lesions were observed after two to six months in four patients, but the lesions were not severe enough to justify reinstitution of dialysis. Two patients developed relapse within two months after cessation of dialytic therapy. One of them was started on dialysis a second time and this was followed by remission of lesions. Five patients were taken as controls and were treated with other modes of therapy including sham dialysis, ultrafiltration without dialysis, or systemic heparinization before they were taken on the dialysis program. Whereas sham dialysis and systemic heparinization had no effect on the skin lesions which responded later to dialytic therapy, the ultrafiltration procedure was followed by partial regression of psoriasis. Dialysis appears to have a definite role in the treatment of psoriasis.     

Malignant melanoma in association with palmoplantar keratoderma

A case of malignant melanoma arising on the hyperkeratotic little finger of a 46-year-old patient with palmoplantar keratoderma is reported. A pigmented lesion had been present since childhood, over a period of two years it became larger and darker and had occasionally bled over the past two months. Histopathologic investigation revealed hyperkeratosis, hypergranulosis, and acanthosis on the left palm and malignant melanoma on the macule of the left little finger. Received: 18 March 1998 / Accepted: 22 July 1998     

Is Apremilast a Safe Option in Patients with History of Melanoma? A Case Series and a Review of the Literature

BackgroundRecently it has been reported that apremilast might promote melanogenesis and it would therefore not be safe to use this drug in patients with psoriasis who have a history of melanoma.MethodsFrom January 2017 to December 2020, we retrospectively identified, within a cohort of 635 patients in follow-up care for melanoma, 16 cases of patients with psoriasis treated with apremilast and history of melanoma. Patients were monitored at our unit for a mean duration of 36 months of follow up.ResultsThe use of apremilast, in our case series was, thus, effective in managing psoriasis without causing recurrence of previous melanoma or any new suspicious lesions which would need removal.DiscussionIt has been speculated that apremilast might not be safe in patients who have a history of melanoma as it would be involved in the stimulation of melanogenesis and consequent possibility of recurrence of previous melanoma.ConclusionOur data show that none of the patients treated with apremilast developed recurrence of melanoma at 36 months of follow-up. Further studies are necessary to confirm the safety of apremilast in a larger number of patients with concurrent malignancies, specifically melanoma, and for a longer follow-up period.     

血浆置换在重症银屑病治疗中的疗效观察

目的：探讨血浆置换治疗重症银屑病的疗效。方法：入选患者均采用深静脉置管建立临时血液通路,置换总量1 800～2 200 ml/次,每周治疗1～2次根据患者皮损及症状改善情况连续4～6次不等。结果：9例患者经45例次血浆置换治疗后,血液中TNF-α、IL-1β、IL-6、IL-8、IgG、IgA促炎细胞因子和免疫球蛋白呈显著降低趋势。皮损明显好转,脓疱结痂、脱落,关节红、肿、疼痛消失,经药物使用逐渐减量治疗后病情好转。结论：血浆置换对重症银屑病是一种疗效快、疗程短的治疗方法,它能迅速清除体内的炎症介质及免疫复合物,有效地控制临床症状。     

308nm准分子激光联合哈西奈德溶液治疗头皮银屑病的疗效观察

目的：探讨308nm准分子激光治疗头皮银屑病的临床疗效。方法：将80例头皮银屑病患者分为两组：治疗组40例,给予308nm准分子激光照射治疗,2次／周,期间外用哈西奈德溶液,2次／天;对照组40例,外用哈西奈德溶液,2次／天。两组均治疗4周后观察疗效。结果：治疗组与对照组总有效率分别为97．5％和70％,两组比较有显著性差异（r=11．11,P〈0．01）。结论：308nm准分子激光联合哈西奈德溶液治疗头皮银屑病疗效确切,不良反应少。     

Laser and novel light source treatments for psoriasis

BACKGROUND AND OBJECTIVES: There are many treatment modalities for psoriasis including topical therapy, ultraviolet light therapy, systemic agents, and more recently the advent of the biologic agents. STUDY DESIGN/MATERIALS AND METHODS: In addition, selective treatment using lasers and light sources that target the individual psoriatic plaques have also been employed. RESULTS/CONCLUSION: This article will highlight and review the employment of laser-assisted devices in the treatment of plaque psoriasis.     

仙方消银片对模拟银屑病模型小鼠阴道上皮细胞有丝分裂的影响

目的：旨在探索仙方消银片对寻常型银屑病的疗效与作用机制。方法：采用己烯雌酚腹腔注射法造模观察小鼠阴道上皮基底细胞中的有丝分裂数。结果：实验组小鼠阴道上皮细胞有丝分裂指数较对照组明显降低。差异具有显著性意义（P〈0．05）。结论：仙方消银片具有抑制动物模型表皮有丝分裂的作用，提示该方在临床应用时可能纠正银屑病的表皮增生。     

骨桥蛋白及白细胞介素-18在寻常型银屑病患者血清中的表达及临床意义

目的:检测寻常型银屑病患者外周血骨桥蛋白(OPN)、白细胞介素-18(IL-18)的表达水平,并探讨其临床意义。方法:采用酶联免疫吸附试验(ELISA)法检测30例寻常型银屑病患者(其中进行期18例,静止期12例)及30例对正常照者血清OPN、IL-18的表达水平。结果:寻常型银屑病组患者血清骨桥蛋白和IL-18的表达水平明显高于正常对照组(P<0.001);进行期银屑病患者骨桥蛋白和IL-18的表达水平明显也高于静止期(P<0.001),且骨桥蛋白、IL-18的表达水平和银屑病的活动性均呈显著正相关(P均<0.001);骨桥蛋白和IL-18的表达水平也呈显著正相关(P<0.001)。结论:OPN与IL-18在寻常型银屑病中的表达上调提示它们可能参与了寻常型银屑病的发病过程,且二者在该病的发生中起着协同作用。联合检测血清OPN、IL-18可以作为诊断银屑病活动性的有效的指标之一。     

Membranoproliferative Glomerulonephritis Associated with Psoriasis Vulgaris

Psoriasis is a hereditary, chronic inflammatory disorder of the skin. Generally, the psoriatic process is limited to the skin; however, internal organs such as the kidneys may be involved in the course. Several glomerular diseases have been distinguished due to renal histological findings of psoriatic patients to date. The underlying pathogenetic mechanisms of these associations remain unclear because of the limited number of cases. We report a case of primary membranoproliferative glomerulonephritis (MPGN) in a psoriatic patient. This is the first reported case that demonstrates the coexistence of MPGN and psoriasis.     

半身式窄谱中波紫外线治疗寻常型银屑病疗效观察

目的:探讨半身式窄谱中波紫外线治疗寻常型银屑病的疗效。方法:将100例寻常型银屑病患者分为A、B两组:A组:采用半身式窄谱中波紫外线照射,起始量为0.4J/cm2,每周3次,每次递加0.1J/cm2,共12次;B组:采用卤米松乳膏、卡泊三醇软膏外涂,每天各1次,共用4周。两组中瘙痒剧烈者均口服盐酸依匹斯汀胶囊10mg,2次/日。结果:A组有效率达58%,B组有效率达30%,两组有效率比较差异有统计学意义(P0.05)。结论:半身式窄谱中波紫外线治疗寻常型银屑病疗效较好,不良反应少,采用起始量为0.4J/cm2,每次递加0.1J/cm2,每周3次的照射起始量,递加剂量安全、有效。     

Stress management for psoriasis patients: The effectiveness of biofeedback and relaxation techniques

Previous studies have found evidence of a connection between stress and the appearance of psoriasis symptoms. It was therefore hypothesized that stress management techniques such as biofeedback and relaxation could be effective in ameliorating the severity of the symptoms. Thirty-two psoriatics were randomly divided into three groups, one trained in biofeedback and relaxation techniques, one in relaxation alone and the third receiving no treatment. The subjects' condition was evaluated by a physician at the start and end of the 3-month study. Additionally, at the end of the study, the subjects were asked to assess the degree to which their symptoms had improved relative to the start of the study and relative to the same season of the previous year. The results indicated that, in comparison to the waiting list group, the biofeedback and relaxation group reported considerable improvement in their condition relative to the same season of the previous year. No significant differences were found between the groups regarding the degree of improvement relative to the start of the study. It is suggested that the fact that psoriasis is subject to seasonal variations may account for the differential findings.     

Anaesthesia for caesarean section in a patient with acute generalised pustular psoriasis

We describe a 30-year-old parturient with acute generalised pustular psoriasis who presented for urgent caesarean section. A multidisciplinary team was involved and general anaesthesia was used successfully. Management of this condition is discussed and the literature reviewed. While generalised pustular psoriasis or impetigo herpetiformis is well recognised in pregnancy, it has not hitherto been reported in obstetric anaesthesia literature. The purpose of this article is to delineate the clinical picture of this disease, its treatment, and the effect on the mother and the fetus.     

健脾解毒汤联合阿维A 治疗红皮病型银屑病的临床效果

目的 探究健脾解毒汤联合阿维A治疗红皮病型银屑病的临床效果。方法 选取2018年7月-2022年7月 于新疆医科大学第一附属医院昌吉分院就诊的红皮病型银屑病患者56例,按照随机数字表法分为观察组和 对照组,每组28例。对照组采用阿维A进行治疗,观察组在对照组基础上采用健脾解毒汤进行治疗,比较两 组临床疗效、促炎细胞因子[肿瘤坏死因子（TNF-ɑ）、白细胞介素6（IL-6）、白细胞介素8（IL-8）]水 平、银屑病皮损面积严重程度（PASI评分）、皮肤病生活质量指数（DLQI）评分、中医证候积分及 不良反应发生情况。结果 观察组治疗总有效率为96.42%,高于对照组的82.14%（P ＜0.05）;观察组 治疗后TNF-ɑ、IL-6、IL-8水平低于对照组（P ＜0.05）;观察组治疗后PASI及DLQI评分低于对照 组（P ＜0.05）;观察组治疗后中医证候积分低于对照组（P ＜0.05）;两组不良反应发生率比较,比较差 异无统计学意义（P ＞0.05）。结论 健脾解毒汤联合阿维A治疗红皮病型银屑病具有较好的效果,能降低 促炎性细胞因子水平,改善患者临床症状,具有一定的安全性。     

青鹏软膏联合刮痧治疗湿热型银屑病的效果

目的 探讨青鹏软膏联合氯雷他定与刮痧治疗湿热型银屑病的效果。方法 选取2022年12月- 2023年12月江苏省中医院皮肤科收治的湿热型银屑病患者84例作为研究对象,依据随机数字表法分为对 照组和观察组,各42例。对照组采取常规口服氯雷他定结合刮痧治疗,观察组在对照组基础上联合青鹏软 膏治疗。比较两组银屑病严重程度、临床疗效、生活质量、不良反应。结果 观察组治疗后PASI评分低于 对照组（P ＜0.05）;观察组治疗总有效率为90.48%,高于对照组的73.81%（P ＜0.05）;观察组DLQI各维 度评分低于对照组（P ＜0.05）;观察组不良反应发生率为4.76%,低于对照组的19.04%（P ＜0.05）。结论 青鹏软膏联合氯雷他定与刮痧治疗湿热型银屑病的效果满意,有助于改善银屑病的病情,提升患者生活质 量,且具有较高安全性。