CO_2点阵激光联合改良法微波治疗难治性跖疣一例

报道1例CO_2点阵激光联合改良法微波治疗儿童难治性跖疣。患儿除左拇趾趾腹表现为巨大镶嵌疣外,其余趾腹、趾旁、跖部散在较多粟粒至绿豆大疣体,临床表现复杂,治疗困难。对患儿左拇趾趾腹巨大镶嵌疣采用CO_2点阵激光治疗,其余部位散在疣体采用改良法微波治疗。治疗1个月后皮损完全消退,随访3个月无复发,疗效显著。     

联合使用浅层X线照射治疗60例跖疣的临床疗效观察

目的观察使用联合浅层X线照射治疗跖疣的临床疗效观察。方法选择门诊跖疣患者60例,随机分为对照组与治疗组各30例。基础治疗采用重组人干扰素(IFN)α-2b软膏,在疣体部位适量外涂,4次/d,涂药后按摩患处2～3 min以助药物吸收。对照组采用液氮冷冻治疗,2周1次,12周为1个疗程。治疗组在采用浅层X线照射跖疣部位,1次/周,6次为1个疗程,治疗2个疗程(12周)。治疗结束后观察临床疗效、复发情况及不良反应。结果第1个疗程治疗结束时对照组总有效率60.0%,治疗组总有效率70.0%。第2个疗程治疗结束时对照组总有效率73.3%,治疗组总有效率83.3%。2个疗程后3个月随访复发率对照组33.3%,治疗组16.7%。治疗过程中不良反应治疗组少于对照组。结论联合使用浅层X线照射治疗跖疣,临床治疗效果满意,临床上值得推广。     

浅层X线放射治疗掌跖脓疱病42例临床观察

目的 观察浅层X线放射治疗掌跖脓疱病的临床疗效和安全性。方法 将入选的42例掌跖脓疱病患者随机分为两组,治疗组(21例)予SRT-100浅层X线治疗仪局部照射治疗,对照组(21例)每天予阿维A胶囊,比较两组患者治疗前、后和治疗结束6个月和12个月后的皮疹变化情况。结果 治疗组有效率显著高于对照组。治疗结束6个月、12个月后,治疗组复发率低于对照组。结论 浅层X线放射治疗掌跖脓疱病疗效显著,并能有效降低其远期复发率。     

浅层X线放射治疗29例顽固性寻常疣患者疗效评价

目的:评价浅层X射线治疗顽固性寻常疣的疗效和不良反应。方法:回顾性分析29例应用浅层X线照射治疗的顽固性寻常疣患者，治疗1～2次，第一次照射剂量8 Gy, 4周后复诊，如皮疹仍然未愈，再次照射8 Gy。结果:29例患者共有54处皮疹，第一次治疗后，29处皮疹完全消退，疣体消退率53.7%,10例患者痊愈，痊愈率34.5%。第二次对17例患者的21处疣体进行治疗，14处疣体消退，消退率66.7%,11例患者痊愈，痊愈率64.7%。最终共有27例患者完成疗程，21例患者痊愈，痊愈率77.8%. 50处疣体，43处疣体消退，消退率86%。不良反应主要为一过性放射性皮炎，第一次和第二次治疗后分别有3例和5例发生，均在3个月内消失。结论:浅层X线放射对于顽固性寻常疣具有较好的疗效，为临床治疗提供了新的选择。     

伊可尔皮肤消毒液治疗掌跖疣、甲周疣40例临床观察

目的观察伊可尔皮肤消毒液治疗掌跖疣、甲周疣的临床疗效。方法将患处先用温水浸泡15min以上,再削去疣体表面角质层。取消毒棉片蘸取足量伊可尔原液,敷于处理后的皮损表面,其上覆盖一层塑料薄膜封包。1次/d,每次8h左右。连用5～7天为1疗程,共治疗1～2个疗程。结果临床有效率在第4周达到72.50%,其中甲周疣的有效率达100%,掌疣80%,跖疣65.38%,患者对用伊可尔治疗的满意度达到90%。结论伊可尔皮肤消毒液治疗掌跖疣、甲周疣安全有效。     

艾条灸快速治疗跖疣

为了探讨更加简便、快速、高效的方法治疗跖疣 ,我们自 1992年 8月～ 1997年 8月 ,用艾条灸的方法 ,快速治疗跖疣 2 0 1例 ,其中 112例进行自身对照研究。临床资料　选择年龄在 18岁以上 ,皮损数目≤ 10个 ,无任何其它疾病 ,未经任何治疗的跖疣患者 2 0 1例 ,男 117例 ,女 84例 ,病期 1周～ 1年。其中 89例为单发损害 ,大小直径在 2～ 12ｍｍ ,平均 5 .2ｍｍ ;112例为多发损害 ,跖疣 2～ 10个 ,共计 5 0 7个 ;随机选择治疗跖疣 370个 ,同时 ,至少保留一个跖疣不作任何治疗 ,作为自体对照 ,共计 137个。治疗方法　将艾条一端点燃 ,待其燃烧稳…     

皮损内注射聚肌胞治疗寻常疣及跖疣126例疗效观察

目的探讨皮损内注射聚肌胞对寻常疣及跖疣的治疗效果。方法对我科近年来采用皮肤内注射聚肌胞方法治愈的126例寻常疣及跖疣患者的临床资料进行回顾性分析。结果第1疗程结束时,痊愈81例,有效率为89.7%;第2疗程结束时,痊愈111例(88.1%),有效率95.2%。结论皮损内注射聚肌胞治疗寻常疣及跖疣疗效好,副作用少,不留疤痕,复发率低,值得应用,对于多发性寻常疣或跖疣患者可作为首选治疗。     

电离子加用5—Fu治疗跖疣、寻常疣62例

跖疣、寻常疣均系人类乳头瘤病毒所致的病毒性皮肤病。用电离子治疗后大部分患者可获得满意疗效 ,但也有部分患者经电离子治疗后疣体反复出现。最近我院门诊对跖疣、寻常疣患者采用电离子治疗后再配合 5 % 5 -Ｆｕ软膏外涂治疗 ,取得了满意疗效。1　病例与方法1 1　 6 2例患者均在门诊接受电离子治疗 ,其中男 49例 ,女13例 ,发病年龄 7～ 40岁 ,发病时间半年～ 4年。皮损数目1～ 12个。发病部位 :手指、手背、手掌心及甲缘的寻常疣2 2例 ,疣体数为 39个 ;发生手足底、足跖及趾甲缘者 40例 ,跖疣数目 12 7个。1 2　方法　先用手触摸疣体的大…     

Subungual exostosis: 9-case report

目的:探讨甲下外生性骨疣的临床、组织病理学特点及治疗方法.方法:回顾分析西京医院全军皮肤病研究所2005-2010年间诊断和治疗的9例甲下外生性骨疣患者的临床、组织病理学及外科治疗特点.结果:男性5例,女性4例,发病年龄8～44岁,平均12岁.临床表现为指(趾)甲下或远端缓慢增长的外生性结节肿块,质硬,部分患者疼痛明显,伴有不同程度的指(趾)甲变形或缺损.X线检查示指(趾)骨背侧或偏于一侧骨性增生物.组织病理检查示真皮内类似骨刺的成熟骨结构,分为4层:纤维细胞层、成纤维细胞层、纤维软骨层和软骨化骨层.手术切除后皮损无复发.结论:甲下外生性骨疣是多发于青少年的单发良性骨软骨增生性病变,发生于指(趾)末节骨的远端,结合临床、病理学检查和X线可确诊.外科手术切除治疗可痊愈.     

水杨酸粉封包联合CO_2激光治疗跖疣疗效评价

目的:评价自制水杨酸粉封包联合CO_2激光治疗跖疣的临床疗效。方法:将152例跖疣患者(总疣体个数819个)给予水杨酸粉封包后刮除联合CO_2激光治疗,观察创面愈合情况及原位复发情况。结果:水杨酸粉封包联合CO_2激光治疗后创面愈合时间缩短,随访12周,85%跖疣疣体完全消除。结论:自制水杨酸粉封包联合CO_2激光治疗跖疣安全有效。     

棒状光源盐酸5-氨基酮戊酸光动力治疗肛管内尖锐湿疣

目的:评价棒状光源盐酸5-氨基酮戊酸光动力疗法治疗肛管内尖锐湿疣的临床疗效。方法:棒状光源盐酸5-氨基酮戊酸治疗肛管内尖锐湿疣男性患者46例,每周1次,共4次。结果:35例(76.1%)患者疣体完全清除,无感染、溃疡、瘢痕、痔疮病例。随访12周复发5例,复发率为14.3%。疼痛程度可视模拟评分(VAS)为(6.96±1.41)分。结论:棒状光源盐酸5-氨基酮戊酸治疗肛管内尖锐湿疣疗效好,中度疼痛,复发率低,不良反应少。     

盐酸丁卡因胶浆联合CO_2激光治疗尖锐湿疣的临床疗效观察及安全性分析

目的:观察盐酸丁卡因胶浆联合CO_2激光治疗尖锐湿疣的疗效及安全性,为尖锐湿疣的治疗探索一条新途径,以期为尖锐湿疣患者的治疗提供帮助。方法:随机选取2014年10月至2015年10月,我院符合纳入标准的尖锐湿疵患者60例,其中男性24例、女性36例,分为治疗组和对照组,每组各30例。两组患者男性均12例、女性均18例,对照组采用CO_2激光治疗,而治疗组采用盐酸丁卡因胶浆联合CO_2激光治疗。治疗后第7d、第15d、1个月、2个月和3个月对两组患者观察,比较其痊愈率、复发率以及不良反应情况。结果:治疗结束时,治疗组的痊愈率为93.3%,对照组为66.7%,治疗组明显高于对照组,两组差异有统计学意义(P<0.05);治疗组复发率为6.6%,明显低于对照组的20%,差异无统计学意义(P>0.05);观察组不良反应发生率为9.8%,对照组为4.9%,差异无统计学意义(P>0.05)。结论:盐酸丁卡因胶浆联合CO_2激光治疗尖锐湿疣疗效显著且安全性好,提高了痊愈率,可以作为治疗尖锐湿疣的好方案之一。     

Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial

BACKGROUND: Viral warts are common dermatological diseases; although the rate of spontaneous recovery is high, it usually takes a long time, and some patients might not show this spontaneous healing. Zinc has an important effect on the immune system and it has been used as an immunomodulator to treat a variety of skin disorders. OBJECTIVE: To assess whether oral zinc was effective in treating viral warts of patients evaluated between May 1999 and April 2000. PATIENTS AND METHODS: This was a placebo-controlled clinical trial. Eighty patients with viral warts (common, plantar and plane) were all resistant to all forms of treatment. Each patient had > 15 warts. Forty patients were treated by oral zinc sulphate at a dose of 10 mg kg(-1) daily up to 600 mg day(-1) and followed-up for resolution of their warts and for any evidence of recurrence for 2-6 months. Another 40 patients were given a placebo oral treatment in the form of glucose, and followed-up for the same period. RESULTS: Only 23 patients of the first group (zinc treated) and 20 patients of the second group (placebo treated) completed the study. In all patients the serum level of zinc was low. In the zinc-treated group, the overall response was complete clearance of warts observed in 20 patients (86.9%) after 2 months of treatment. Fourteen patients (60.9%) showed complete disappearance of their warts after 1 month. Three patients (13.3%) failed to respond to the treatment after 2 months of therapy. The response to treatment was directly related to the increment in serum zinc level. No patient of the placebo-treated group showed any response. CONCLUSIONS: We conclude that zinc sulphate at a dose of 10 mg kg(-1) daily seems to be a highly efficacious therapeutic option for recalcitrant viral warts and proved to be safe with few adverse effects.     

Intralesional immunotherapy with killed Mycobacterium w vaccine for the treatment of ano-genital warts: an open label pilot study

Background  Intralesional immunotherapy with skin test antigens and vaccines has been found to be effective in the management of genital and extragenital warts.
Objective  To evaluate the efficacy and safety of intralesional Mycobacterium w (M w ) vaccine monotherapy for the treatment of ano-genital warts.
Patients and methods  Ten patients clinically diagnosed to have external ano-genital warts, including three with giant ano-genital warts (Buschke Löwenstein tumour), were included in this open-label pilot study. Two patients were human immunodeficiency virus seropositive, and one was on iatrogenic immunosuppression for renal transplantation. M w vaccine (0.1 mL) was initially injected intradermally in the deltoid region on both the sides, followed 2 weeks later by intradermal intralesional injection into the genital warts. Intralesional injections were repeated weekly until either complete clearance or a maximum of 10 injections was achieved.
Results  One patient was lost to follow-up after the first intralesional injection. In 8 out of remaining 9 patients (88.9%), the genital warts cleared completely. In one patient with giant perianal wart, the lesion was reduced to less than 5% of its volume after 10 intralesional injections, which was later electrosurgically excised. The treatment was well tolerated by the majority of the patients. The adverse reactions were noted in four patients, which were reversible. No recurrence was seen after a mean follow-up of 5.1 months.
Conclusion  Intralesional immunotherapy of ano-genital warts with M w vaccine seems to be a promising new approach, which needs to be evaluated in the randomized controlled trials.     

浅层X线放射治疗基底细胞癌和鳞状细胞癌27例疗效分析

目的：评价浅层X射线治疗皮肤基底细胞癌（BCC）和鳞状细胞癌（SCC）的疗效。方法：回顾分析2014年6月至2017年7月在我院应用浅层X射线治疗的27例原发性BCC(14例)和SCC(13例)患者,所有患者均经过组织病理学确诊,因健康状况、年龄、皮损部位等原因不适用手术而选用浅层X线治疗。结果：27例患者的31处皮损均痊愈,受照总剂量为45.6-53.2 Gy,随访 2年 仅1例患者1处皮损复发。不良反应主要为放射性皮炎及皮损处的溃烂,皮损体积较大者多伴有疼痛,一般1个月内消失。结论：浅层X射线放射治疗SCC和BCC疗效好,复发率低,对因各种原因不适合手术治疗的患者,是较为理想的方法。     

Treatment of genital warts in males by pulsed dye laser

Objective: To determine the safety and efficacy of the flashlamp‐pumped pulsed dye laser for the treatment of uncomplicated genital warts in adult males. Methods: This was a prospective observational study set in the outpatient clinics of the Department of Andrology and Sexually Transmitted Diseases, National Institute of Laser Enhanced Sciences, the Dermatology Clinic, Cairo University, and the Department of Dermatology and Venereology, Suez Canal University. A total of 174 adult male patients with 550 uncomplicated anogenital warts were included. Selective photothermolysis and photocoagulation of the lesions with the flashlamp‐pumped pulsed dye laser was carried out. A pulsed dye laser (wavelength 585?nm, 450?s pulse duration; Cynosure, USA) was used with the following settings: spot size 5–7?mm; fluence 9–10 J/cm². Results: Complete resolution of treated warts was achieved in 96% of lesions. Side effects were limited, transient and infrequent. Lesion recurrence rate was 5%. Conclusion: The pulsed dye laser has been found to be safe, effective and satisfactory for the treatment of anogenital warts in males. It could be used to selectively destroy warts without damaging the surrounding skin.     

Intralesional immunotherapy of common warts: successful treatment with mumps,measles and rubella vaccine

Background Despite numerous therapeutic modalities reported in the literature, treatment of common warts remains a continuing challenge and there is no universal consensus about optimal treatment. Recently, intralesional immunotherapy by different antigens has proved efficacy in the treatment of different types of warts. Objective To evaluate the efficacy and safety of intralesional mumps, measles and rubella (MMR) vaccine in the treatment of common warts. Methods The study included 135 patients with single or multiple recalcitrant or non‐recalcitrant common warts. They were randomly assigned to two groups; the first group (85 patients) received intralesional MMR vaccine, and the second group (50 patients) received intralesional saline as a control group. Both treatments were injected into single lesions or largest wart in case of multiple lesions at 2‐week intervals until complete clearance or for a maximum of five treatments. Follow‐up was made every 2 months for 6 months to detect any recurrence. Results A highly significant difference was found between the therapeutic response of common warts to MMR vaccine and saline control group (P < 0.001). In the MMR group, complete response was achieved in 80% and 84.6% of patients presenting with recalcitrant and multiple warts respectively. No recurrence was observed in the MMR group and side effects included pain during injection and flu‐like symptoms. Conclusions Intralesional immunotherapy by MMR vaccine is a promising effective and safe treatment modality for common warts, particularly the multiple ones.     

电灼联合胸腺五肽治疗男性肛周尖锐湿疣97例的疗效观察

目的:观察电灼联合胸腺五肽用于治疗男性肛周尖锐湿疣的疗效。方法:97例于初次发病的男性肛周尖锐湿疣患者,年龄在17~52岁之间,予以随机分为治疗组及对照组。两组患者均予以电灼清除所有可见皮损,治疗组术后肌肉注射胸腺五肽10mg/d,持续10d,两组随访观察3~6个月后分析讨论。结果:治疗组患者在随访期间复发率为4.0%,显著低于对照组(19.2%),差异具有统计学意义(P<0.05)。结论:电灼联合胸腺五肽治疗男性肛周尖锐湿疣在控制复发率方面疗效满意,值得临床应用。     

Successful treatment of periungual warts with topical cidofovir

Periungual warts represent a treatment challenge because of its high recurrence rate and recalcitrance. These are benign lesions produced by the human papilloma virus (HPV) that often do not respond to habitual treatment. Cidofovir is a potent antiviral drug that acts inactivating viral DNA polymerase. Topical cidofovir for the treatment of HPV‐related cutaneous and mucous lesions is becoming increasingly common. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral periungual warts. We undertook a retrospective observational study of patients with periungual warts who received treatment with topical cidofovir between January 2010 and December 2013 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data were recorded about the rate of treatment response, the adverse effects and recurrences, as well as the characteristics of the patient cohort. We identified 41 patients who had received some previous treatment. The concentration of cidofovir was 3% in all cases, usually applied twice a day (in 37 of the 41 cases). A greater or lesser response was noted in 35 cases. There were six recurrences in the follow‐up period. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant periungual common warts that fail to respond to usual treatment. Our experience with the use of this antiviral agent has been satisfactory, although in our opinion, it should be reserved for specific cases as its economical cost represents an important limitation.     

5-氨基酮戊酸光动力疗法治疗面部扁平疣疗效评价

目的：评价5-氨基酮戊酸光动力（5-ALA—PDT）治疗面部扁平疣的疗效。方法：面部扁平疣患者48例,治疗组24例,采用5-氨基酮戊酸光动力疗法每周1次。对照组24例,用波长532nm的Q开关Nd：YAG激光照射皮损每周1次。疗程均为3周。治疗结束后判定两组疗效。末次观察后3个月判定两组复发率。结果：治疗组痊愈率为91．67％。3个月后随访,复发l例,复发率为4．17％;对照组痊愈率为83．33％,复发5例,复发率为20．83％,两组复发率有显著性差异（P〈0．05）。结论：5-ALA—PDT治疗扁平疣有效、复发率低。