应用原位聚合酶链反应检测淋病患者HSV-Ⅱ感染情况的报告

为了解淋病患者ＨＳＶ Ⅱ的感染情况，应用原位聚合酶链反应（ＩＳＰＣＲ）和ＰＣＲ技术对５８例淋病患者进行ＨＳＶ Ⅱ检测。结果两种方法ＨＳＶ ⅡＤＮＡ阳性检出率均为５３．４５％（３１／５８）。ＩＳＰＣＲ显示，１１例有皮损者中，９例阳性信号存在于上皮细胞核及胞浆，既往有疱疹皮损者６例，阳性信号均存在于细胞核，４１例无明显皮损者，１６例阳性，其中１２例阳性信号在细胞核，４例在胞核及胞浆。结果提示，淋病患者合并有高的ＨＳＶ Ⅱ感染率。应用ＩＳＰＣＲ不仅可以敏感特异地检测ＨＳＶ Ⅱ，而且可以定位，为临床诊断和治疗提供重要依据     

酶联免疫吸附试验检测麻风特异性抗PGL－1抗体

用麻风菌特异性酚糖脂－１（ＰＧＬ－１）抗原（ＮＴ－Ｐ－ＢＳＡ）作酶联免疫吸附试验（ＥＬＩＳＡ），分别检测麻风病人５０例（ＬＬ４０例。阳性１６例，占４０．０ｆ％；ＢＬ９例，阳性４例，占４４．４％；Ⅰ１例为阴性），总阳性２０例，占４０．０％。治愈老残病人１３３例阳性１９例，占１４．３％；家内接触者１０２例，阳性９例，占８．８％。并作了结核病人８７例及正常人群１７４例。结果表明ＮＴ－Ｐ－ＢＳＡ－ＥＬＩＳＡ法具有较高的敏感性和特异性，将有助于麻风的早期诊断、判愈、复发予测及亚临床感染和免疫流行病学等研究。     

酶联免疫吸附试验检测麻风特异性抗PGL－1抗体

用麻风菌特异性酚糖脂－１（ＰＧＬ－１）抗原（ＮＴ－Ｐ－ＢＳＡ）作酶联免疫吸附试验（ＥＬＩＳＡ），分别检测麻风病人５０例（ＬＬ４０例。阳性１６例，占４０．０ｆ％；ＢＬ９例，阳性４例，占４４．４％；Ⅰ１例为阴性），总阳性２０例，占４０．０％。治愈老残病人１３３例阳性１９例，占１４．３％；家内接触者１０２例，阳性９例，占８．８％。并作了结核病人８７例及正常人群１７４例。结果表明ＮＴ－Ｐ－ＢＳＡ－ＥＬＩＳＡ法具有较高的敏感性和特异性，将有助于麻风的早期诊断、判愈、复发予测及亚临床感染和免疫流行病学等研究。     

原位聚合酶链反应技术检测结节性红斑皮损中Ⅱ型单纯疱疹...

目的 探讨结节性红斑（ＥＮ）的发病与Ⅱ型单纯疱疹病毒（ＨＳＶ－２）的关系。方法 用原位聚合酶链反应法（ＩＳＰＣＲ）,对３５ＮＥ皮损组织及１４例正常皮肤组织切片中的ＨＳＶ－２ＤＮＡ进行扩增,ＳＰ免疫组化染色,ＡＥＣ显色,结果 ＨＳＶ－２ＤＮＡ在ＥＮ及正常皮肤中的检出率分别为５７．１％（２０／３５）、８．３％（２／１４）,Ｐ〈０．０１,阳性信号主要位于皮损部位,以小血管为著,细胞内的分布以核内型为主,     

温州地区尖锐湿疣组织人乳头瘤病毒检测及型别分析

用人乳头瘤病毒（ＨＰＶ）通用引物（ＧＰ）及型特异性引物（ＳＰ）６、１１、１６、１８对４２例尖锐湿疣（ＣＡ）组织和４８例对照组进行多聚酶链反应（ＰＣＲ）检测。结果：ＣＡ组织五组引物扩增阳性率分别为８５．７％（３６／４２）、７３．８％（３１／４２）、１９．１％（８／４２）、２．４％（１／４２）、４．８％（２／４２），多重型别阳性率为１１．９％（５／４２）；对照组ＨＰＶ阳性率为６．３％（３／４８）。表明本地区ＣＡ以ＨＰＶ６型感染为主     

聚合酶链反应检测多形红斑皮损中单纯疱疹病毒DNA

为了研究多形红斑（ＥＭ）与单纯疱疹病毒（ＨＳＶ）之间的关系，特别是探讨与疱疹相关的ＥＭ的临床特点及其在ＥＭ发病中所占比例，应用聚合酶链反应（ＰＣＲ）方法检测了６０例ＥＭ的典型皮损的活检组织和３２例正常组织及疾病对照标本中的ＨＳＶＤＮＡ。结果显示：２１例（３５％）ＥＭ患者检测出ＨＳＶ特异ＤＮＡ，对照标本（１６份正常皮肤组织和１６份其它皮肤病的皮损标本）中未发现ＨＳＶＤＮＡ。根据病史提供，６０例ＥＭ中有５例是药物相关的ＥＭ，８例是病毒相关的ＥＭ，其余４７例为特发型ＥＭ。研究表明：２１例ＰＣＲＨＳＶＤＮＡ阳性的ＥＭ患者中，仅有２例发病前有口唇疱疹病史，１５／２１例（７１．４％）是复发性ＥＭ，发病高峰在冬季。尽管临床上无明显ＨＳＶ感染史，多数特发性ＥＭ也与疱疹病毒感染有关。ＰＣＲ技术是检测ＥＭ皮损中ＨＳＶ的快速、有效的方法，它可以决定病因上和ＨＳＶ感染有关的病例。     

PCR检测银屑病患者鳞屑中的乙型肝炎病毒

我们应用聚合酶链反应（ＰＣＲ）法。对３１例寻常性银屑病患者的鳞屑进行乙型肝炎病毒（ＨＢＶ）ＤＮＡ检测。结果报告如下。病例　住院病人皮损分布广泛,同形反应阳性的寻常性进行期银屑病患者３１例,男２３例,女８例,年龄１８～５９岁（平均４３．５岁）,病程３月～５０年。酶联免疫吸附试验和ＰＣＲ同时检测血清ＨＢｓＡｇ及ＨＢＶＤＮＡ。标本采集和处理　钝刀片刮下患者鳞屑约０．５ｇ,入蒸馏水中浸泡冲洗,再用无水乙醇浸洗,室温晾干,然后加０．５ｍｌＴＥＳ缓冲液和加１５ｍｌ蛋白酶Ｋ（２５ｇ／Ｌ）,３７℃保温１２ｈ～１…     

银屑病患者人巨细胞病毒感染的研究

用高敏感性酶联免疫吸附法和多聚酶链反应（ＰＣＲ）技术分别检测了８６例银屑病患者血清特异性人巨细胞病毒（ＨＣＭＶ）－ＩｇＭ和ＨＣＭＶ－ＩｇＡ及尿ＨＣＭＶ－ＤＮＡ的变化。结果显示，银屑病患者活动性ＨＣＭＶ感染率和尿ＨＣＭＶ－ＤＮＡ阳性率分别为５５．８％和２４．４％，而对照组则为４．０％和０，两组相比有显著性意义（Ｐ＜０．００１）。提示活动性ＨＣＭＶ感染与银屑病有一定关系。     

尖锐湿疣患者宫颈人巨细胞病毒和Ⅱ型单纯疱疹病毒感染的检测

近几年来的研究已证实,宫颈癌的发生与人乳头瘤病毒(ＨＰＶ)、人巨细胞病毒(ＨＣＭＶ)和Ⅱ型单纯疱疹病毒(ＨＳＶⅡ)感染有关。为了解尖锐湿疣(ＣＡ)患者中ＨＣＭＶ和ＨＳＶⅡ感染的流行情况,探讨其性传播可能性,我们采用ＰＣＲ技术对85例ＣＡ患者和156例一般孕妇进行宫颈ＨＣＭＶ和ＨＳＶⅡ感染的检测,并进行了比较观察,报道如下。一、临床资料1.实验组:85例女性ＣＡ患者为我院1994年5月至1996年5月性病门诊患者,临床诊断和病理诊断确诊为ＣＡ,年龄15～41岁,平均224±51岁;病程半个月至2年,平均28±25年。发病部位:大小阴唇、阴道口、宫颈…     

鲎试验诊断消眼衣原体性NGU的评价

以鲎试验（ＬＡＬ）检测了６２例男性非淋菌性尿道炎（ＮＧＵ）患者尿道分泌物中沙眼衣原体（ＣＴ）产生的内毒素样物质，以确定患者是否有ＣＴ感染，并同时作ＣＴ－ＰＣＲ检测。结果表明ＬＡＬ与ＣＴ－ＰＣＲ的结果间具有良好的相关性（Ｐ〉０．０５）。ＬＡＬ用于诊断男性ＮＧＵ患者ＣＴ感染的阳性预示值、灵敏度和特异性分别为８８．９％、９６％和９７．４％，因此该法是一种简便易行的ＣＴ实验诊断方法。     

Clinical evaluation of four recombinant Treponema pallidum antigen-based rapid diagnostic tests for syphilis

Objective  To evaluate the sensitivity, specificity and feasibility of four rapid tests in the diagnosis of syphilis in sexually transmitted disease diagnosis and treatment centre of Peking Union Medical College Hospital.
Methods  Tests were performed on consecutive clinic attendees, using whole blood in the clinic, and whole blood and serum in the laboratory. The sensitivity and specificity of each test was evaluated, using a standard treponemal test ( Treponema pallidum haemagglutination assay) as the gold standard.
Results  The results are as follows. Abbott Determine Syphilis TP test: for serum specimens, the sensitivity was 100% and specificity was 98.9%; for whole blood specimens, the sensitivity was 81.9% and specificity was 99.4%. SD Bioline Syphilis 3.0 test: for serum specimens, the sensitivity was 95.5% and specificity was 97.9%; for whole blood specimens, the sensitivity was 87.6% and specificity was 99.4%. VisiTect-Syphilis test: for serum specimens, the sensitivity was 94.0% and specificity was 98.1%; for whole blood specimens, the sensitivity was 73.5% and specificity was 99.7%. Syphicheck-WB test: for serum specimens, the sensitivity was 67.4% and specificity was 98.8%; for whole blood specimens, the sensitivity was 64.0% and specificity was 99.7%.
Conclusion  We therefore strongly believe that rapid serological tests for syphilis are an acceptable alternative to conventional laboratory tests. Since they do not require equipment or electricity, they could increase coverage of syphilis screening, and enable treatment to be given at the first clinic visit.

Conflicts of interest

None declared.     

Skin conditions in epileptics

The prevalence of skin and mucous membrane conditions occurring in 173 epileptics between the ages of 6 and 19 years was compared with that of an age-matched group of 211 non-epileptics. The most frequently used anticonvulants, singly or in combination, were carbamazepine in 54.9%, phenytoin in 47.8%, barbiturates in 36.6% and ethosuximide in 11.2% of epileptics. The most frequent combination was phenytoin and carbamazepine in 14% of the males and 18.4% of the females. An increased prevalence of acne was found in epileptic females; 80.3% compared to 30.2% in non-epileptic females. Hirsutism was found in 43.9% of the female epileptics compared to 7.5% of the non-epileptic females. Of interest was the finding of punctate and linear scars on the dorsum of the hands of 27.7% epileptics compared to 3.8% non-epileptics. Both ephilides and naevocellular naevi occurred in 12.7% of the epileptics compared to 29.4% and 52.1% respectively of the non-epileptics. Leukonychia was also found more frequently in epileptics than in non-epileptics; 52% and 28.9% respectively.     

Natural history of keratosis pilaris

A questionnaire was sent to 83 patients in the south Buckinghamshire area, in whom a primary diagnosis of keratosis pilaris (KP) had been made within the preceding 20 years. Of the 50 questionnaires returned, one was invalid, and 49 were evaluated. The age range of patients surveyed was 18 months-25 years; 61% were female and 39% male. Age of onset of KP was within the first decade in 51%, second decade in 35%, third decade in 12%, and fourth decade in 2%. Body sites affected were the arms (92%), legs (59%), face (41%), buttocks (30%) and eyebrows (8%). Other family members were affected by KP in 39%; 55% had no family history of KP, and 6% did not know. There was a personal history of atopy in 37%, 16% had associated dry skin, and 47% had neither. A seasonal variation in the severity of KP was noted in 80% of patients; 49% of these improved in the summer and 47% worsened in the winter. Overall, KP had improved with age in 35% of patients, remained unchanged in 43%, and worsened in 22%. The mean age of improvement was 16 years.     

A clinico-aetiological profile of 375 cases of lichen planus

The study of clinical, histopathological and aetiological pattern, of lichen planus (LP) in 375 patients was done in this part of Western Rajasthan. The incidence of LP was 0.8%. 58.7% cases were male and maximum number of cases (46.93%) were in age group of 20-39 years. In 70.66% of patients only skin was involved while in 10.18% of cases only mucous membrane was involved. In 61.6% patients the lower extremities were involved. Familial LP was seen in 8 families. Association of LP was found with hypertension (2.4%), polymorphic light eruption (2.1%), vitiligo (1.9%) and diabetes mellitus (1.6%). 48.5% of cases showed lymphocytosis with raised ESR. Actinic LP was seen in 14.1% of cases. 13.1% of patients showed combination of typical LP or its variants to which term lichen planus variata was given.     

白斑汤治疗178例白癜风疗效观察

目的观察蔡瑞康教授白斑汤治疗白癜风的临床疗效及临床经验。方法对入选每位患者选取面积最大或皮损面积最集中的部位进行观察,在门诊,按设计的表格进行定期观察,并作好详细记录(主要包括靶皮损面积、自觉症状、不良反应等),按拟定标准进行疗效评估,每2月为1疗程,共观察3个疗程。结果治疗6个月后,总有效率66.6%,治愈率9.0%,其中头颈部疗效最好,总有效率82.5%,治愈率11.6%,躯干部次之,总有效率61.9%,治愈率5.3%,四肢部疗效最低,总有效率25.0%,治愈率12.5%;按证型分肝肾不足型的总有效率为74.4%,高于气滞血瘀型的54.7%。结论白斑汤治疗白癜风适用于大多数白癜风患者。     

FS06.7The new fragrance mix II – test results of a multicentre European Study

A new fragrance mix (FM II) with 6 frequently used chemicals was evaluated in consecutive patients patch tested in 6 dermatological centres in Europe. 28% FM II contained 5% Lyral, 1% citral, 5% farnesol, 5% coumarin, 1% citronellol and 10% alpha‐hexyl cinnamic aldehyde (AHCA); in 14% FM II the single constituents’ concentrations was lowered to 50% and in 2.8% FM II to 10%. Each patient was classified regarding a history of adverse reactions to fragrances: certain, probable, questionable and none. The frequency of positive reactions to the currently used 8% fragrance mix (FM I) and the new mix in 1703 patients was as follows: FM I, 6.6%; 2.8% FM II, 1.3%; 14% FM II, 2.9%; 28% FM II, 4.1%. The number of doubtful/irritant reactions was 7.2% for FM I and ranged from 1.8% to 10.6% for FM II. 8.7% of tested patients had a certain fragrance history. Of these 25.2% were positive to FM I, reactivity to FM II was dose‐dependent and ranged from 8.1% to 17.6% in this subgroup. Comparing 2 groups of history – certain and none – values for sensitivity (sens) and specificity (spec) were calculated. Sens: FM I, 27.2%; 2.8% FM II, 8.7%; 14% FM II, 15.9%; 28% FM II, 21.5%. Spec: FM I, 96.3%; 2.8% FM II, 99.5%; 14% FM II, 98.7%; 28% FM II, 97.9%. 31/70 (44.3%) patients positive to 28% FM II were negative to FM I. In the group of patients with a certain history a total of 6 patients was found reacting only to FM II. Simultaneous break‐down testing with the single constituents produced positive reactions in 54.3% for 28% FM II and 48% for 14% FM II. Lyral was the dominating single constituent with positive reactions (37.1% for 28% FM II, 36% for 14% FM II), followed by citral, farnesol, citronellol, AHCA and coumarin. Chemical analysis for the 6 constituents of FM II was performed on 25 products used by 12 patients being patch test positive to FM II. Lyral was detected in 76% of these products, citral in 16% and AHCA in 8%. In conclusion, the new FM II detects additional patients with contact allergy to fragrances missed by the currently used FM I. The medium concentration, 14% FM II, is probably the most useful one for diagnostic screening.     

Comparative histopathology of scabies versus nodular scabies

Comparative histopathology was studied in 25 cases of scabies versus 25 cases of nodular scabies which were selected from Dermato-Venereology out patients. Salient differences observed were that in scabies lifting of stratum corneum at places was seen in all 100% cases, spongiosis in 100%, spongiotic vesicles in 28%, burrows in 56%, mite in 40% and vasculitis in 28% whereas in nodular scabies acanthosis was seen in 100%, pseudo epitheliomatous hyperplasia in 8%, burrows in 48%, mite in 24% and vasculitis in 84%. In nodular scabies, dermal infiltrate in 32% cases was arranged as lymphoid follicles with admixture of plasma cells and eosinophils.     

他克莫司软膏治疗成人中、重度特应性皮炎的临床研究

目的:比较0.1%,0.03%他克莫司软膏与赋形剂治疗中、重度特应性皮炎(AD)的疗效和安全性.方法:采用随机、双盲、赋形剂平行对照临床研究方法,入选病例按1:1:1比例分为三组,分别随机接受0.1%,0.03%他克莫司软膏或赋形剂治疗,每天2次外搽患处,共3周.结果:有效率:他克莫司软膏0.1%组和0.03%组分别为88.9%和87.5%,赋形剂组为25%;治愈率:他克莫司软膏0.1%组和0.03%组分别为55.6%和50%,赋形剂组为25%,差异有统计学意义(P＜0.05).结论:他克莫司软膏(0.1%和0.03%)治疗成人中、重度特应性皮炎疗效好,安全和耐受性均良好.     

Vitiligo: clinical findings in 1436 patients.

We retrospectively analyzed the clinical and epidemiological profiles of patients with vitiligo attending the pigmentary dermatoses clinic. One thousand four hundred and thirty-six patients were seen between 1989 and 1993. Males constituted 54.5% of the group and females 45.5%. Mean age of the patients was 25 years, and average disease duration at the time of hospital visit was 3.7 years. Vitiligo vulgaris was the commonest form of the disease in 1002 (69.8%) patients followed by focal vitiligo in 214 (14.9%) and segmental vitiligo in 72 (5.0%). The sites of onset were the face, trunk, and legs in descending order of frequency. Less than 20% body area involvement was seen in 1356 (94.4%) of the patients. Leukotrichia was present in 165 (11.5%), and Koebner's phenomenon was observed in 72 (5.0%). Twenty nine (2.0%) patients had associated halo nevi. Of the various diseases associated with vitiligo, atopic/nummular eczema was seen in 20 (1.4%) patients, bronchial asthma in 10 (0.7%), diabetes mellitus in 8 (0.6%), thyroid disease in 7 (0.5%), and alopecia in 6 (0.4%). A family history of vitiligo was present in 165 (11.5%) patients.     

Natural History of Psoriasis: A Study from the Indian Subcontinent

Clinical and epidemiological data from 1220 patients with psoriasis is presented. Psoriatics accounted for 2.3% of the total dermatology outpatients. There was a distinct male preponderance. Mean age of onset was lower in women at 27.6 years, although the severity of the disease was the same in both sexes. Family history was positive in just 2% of patients. Plaque type disease was the most common, seen in over 93% of the patients. Lesional pruritus was a problem in 65%. Remission in summer was experienced by 43%. The scalp was the first site of onset in 25.2%. Nail and joint involvement were seen in 55.7% and 4.4%, respectively. Complete remission of disease activity was experienced by 35% of the patients during some part of the year in the course of their disease.