自体表皮移植治疗白癜风供皮区两种取皮方法的比较

为评价负压吸疱取皮法与切削取皮法治疗白癜风的临床疗效.采用皮肤磨削机磨削皮损后,移植吸疱法和切削取皮法获得的自体表皮治疗稳定期白癜风.结果:两种方法的皮片总成活率分别为87.4%与96.3%,χ2=17.85,P<0.01,差异有统计学意义.对于小面积多点状皮损的白癜风患者,切削取皮法优于负压吸疱取皮法,手术时间短,效果更加满意.     

加压负压吸疱与磨削自体表皮移植治疗白癜风

目的：缩短白癜风自体表皮移植起疱时间和减少手术次数。方法：用加压负压吸疱结合磨削术对30例白癜风患者行自体表皮移植，并加压负压吸疱与单纯负压中疱的发疱时间进行比较。结果：加压负压吸疱移植皮片的痊愈率为72．2％，显效率14．9％，总有效率96．1％，与单纯负压吸疱相比，起疱时间有显著性差异，前者快于后者，结论：加压负压吸疱结合磨削术是一快速，安全，有效的方法，优于单纯的负压吸疱。     

应用刮除法处理眼睑部白癜风皮损进行白体表皮移植治疗的临床研究

目的研究和观察应用括除术处理眼睑部白癜风皮损进行自体表皮移植治疗的临床疗效与安全性。方法选择眼睑部和额、颊部的稳定期白癜风患者,分别应用括除术法和磨削法处理受皮区,常规进行负压加温吸疱自体表皮移植治疗,移植后对比分析临床疗效和安全性。结果11例眼睑部和10例面颊部、额部白癜风皮损,分别移植疱壁53、48片,移植后2组总成活率分别为94．34％、95．83％;2组3级以上的复色率分别为86．79％,89．58％,2组差异无统计学意义（P〉0．05）。移植过程和移植后均无不良反应。结论应用括除术处理受皮区进行自体表皮移植治疗眼睑部白癜风,具有临床疗效好与安全性可靠的优势,值得临床上推广和应用。     

SilkTouch激光磨削后自体表皮移植治疗非平整部位白癜风疗效观察

目的：观察自体表皮移植结合SilkTouch激光磨削治疗非平整部位白癜风的疗效。方法：118例稳定期白癜风患者共有白斑245片,白斑分布于面部五官周围,颈部,腕、肘关节以及手、足等非平整部位。每例患者先在其面积最大的1片皮损中随机选取4个象限中1个象限的部分皮损,用凹凸型吸盘负压发疱法去除表皮作为对照。其余白斑部位均采用SilkTouch激光磨削法去除表皮,制备自体表皮移植的受区;供区则用负压发疱法制备表皮,然后将供区表皮移植于受区,并加压包扎7d。结果：全部患者均连续观察1年以上,激光磨削组245片皮损痊愈53片(21．6％),显效171片(69．8％),有效率91．4％．对照组118片皮损痊愈30片(25．4％),显效80片(67．8％),有效率93．2％,两组疗效统计学上差异无显著性,激光磨削组较对照组白斑处色素恢复均匀。结论：自体表皮移植结合SilkTouch激光磨削治疗白癜风不受部位限制．操作简便．术后疗效满意。     

美兰标记法在负压吸疱自体表皮移植治疗白癜风中的应用

我们近年在负压吸疱自体表皮移植治疗白癜风中采用美兰标记法 ,省时省力 ,很好地解决了表、真皮面不易分清的难题。通过 30例临床应用 ,效果良好。特报告如下。操作方法　供皮区发疱 :供皮区常规消毒后 ,我们采用ＹＷ -ＩＩ型负压治疗仪(上海医科大学医用物理学教研室研制 ) ,将单孔或多孔吸盘紧贴皮肤 ,取负压 0 .0 4～0 .0 6ＭＰａ ,待水疱形成后 ,取下吸盘 ,然后在每个水疱顶端表面用美兰作“Ｆ”字标记 ,碘伏固定。皮损区除皮　按照传统的方法用磨削机磨削白斑区表皮至点状出血 ,生理盐水纱布压迫片刻 ,等待植皮皮片移植　用眼科剪沿供…     

采用磨削术与负压起疱法进行自身表皮移植术治疗白癜风的疗效比较

采用磨削术与负压起疱法进行自身表皮移植术治疗白癜风的疗效比较李铁男，刘岩作者对３７例不能平扣吸引杯的非平坦部位皮损，采用磨削术去除皮损，然后将供皮区产生的吸引疱疱皮移植到该处，并与４６例受皮区及供皮区采用负压吸引起疱法的病例进行了对照。治疗对象：二组...     

表皮移植治疗白癜风

自身皮肤移植治疗白癜风有肯定疗效,临床上我们感到无论点状皮肤移植或薄层皮片移植,很难使皮损完全恢复正常外观;负压吸引制取表皮需要一定设备,操作亦较复杂.为此,我们自1989年始试用以斑蝥制剂涂擦皮肤形成的疮壁为表皮片,移植于经磨削处理的白癜民皮损处.疗效较满意,兹报道如下.     

吸引发疱法自体表皮移植治疗白癜风

吸引发疱法自体表皮移植治疗白癜风涂彩霞，林熙然（指导）大连医科大学附属一院皮肤科（邮政编码１１６０１１）近年来，我们应用负压吸引发疱法，对２５例白癜风患者做了自体表皮移植，取得了一定的疗效。现将结果报告如下。病例和方法病例为对其他疗法无效，且处于非活...     

超脉冲CO2激光结合自体表皮移植治疗白癜风

目的 探讨CO2激光结合自体表皮移植治疗白癜风的临床疗效。方法 对1605例白癜风患者进行自体表皮移植治疗，共植皮30660片，其中局限型782例12151片，节段型319例8221片，泛发型226例7376片，散发型278例2912片。采用发疱取皮法，受皮区采用CO2激光汽化创面形成，治疗8周后判断疗效。结果 治愈率79．04％，有效率13．17％，总有效率92．21％。以局限型和散发型效果最好，泛发型效果较差，身体各部以面部效果最佳，胸背部次之，眉区及发际最差。结论 超脉冲CO2激光辅助自体表皮移植治疗白癜风具有操作简单、方便，手术时间短，出血少，皮片易存活，治愈率高的优点，值得临床推广。     

自体表皮移植治疗白癜风和老年疣

1964年Kiistala报告负压吸引产生表皮下水疱后,用其水疱顶自体表皮移植治疗白癜风、特发性点状色素减少症、炎症后白斑和斑驳病等色素性皮肤病的报告很多。Suvanprakorn等报告用负压吸引发疱法进行自体表皮移植,皮片的成活率高(84%),唯要求供受皮区部位平整;液氮法虽基本不受部位限制,但成活率较低(50%)。为此,我们根据受皮区部位,采用负压吸引或液氮冷冻发疱法;而供皮区均采用负压吸引发疱法,自1989年以来,对38例白癜风和6例老年疣进行了自体表皮移植。现将结果报告如下。     

Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers

A 42-year-old female shiitake grower was investigated to clarify the etiology of skin lesions which developed during the planting of shiitake hyphae into bed logs. She complained of repeated eczematous skin lesions during the planting season, from March to July, for 10 years. She handled 7,000 pieces of small conic blocks made of beech, with shiitake hyphae attached to their surface, per day, and 300,000 pieces altogether per season. She was positive on patch testing with extracts of shiitake hyphae. In contrast, female shiitake growers with skin lesions associated with work other than planting, and without skin lesions, were negative on patch testing to the hyphae. Moderate allergenicity was observed to extracts of shiitake hyphae in a guinea pig maximization test. These findings indicated the etiology of skin lesions in shiitake growers to be allergic contact dermatitis induced by shiitake hyphae.     

Contact allergy to aeroallergens in children with atopic dermatitis: comparison with allergic contact dermatitis

Immediate and delayed cutaneous hypersensitivity are believed to be implicated in the physiopathology atopic dermatitis (AD). The purpose of this study was to evaluate Type I and Type IV allergy to aeroallergens in children with AD. 59 children (mean age 5.2 years), presenting with AD according to Hanifin and Rajka's criteria, were skin tested (patch and corresponding prick tests) with common environmental aeroallergens and a restricted panel of the European standard series over a 1-year period. History and clinical data were carefully recorded using a standardized evaluation sheet: total and specific IgE serum levels were evaluated 17 of 59 patients (28.8%) had at least 1 positive patch test, 32 of 59 patients (54.2%) had at least 1 positive prick test. Corresponding patch and prick tests were observed in 8 out of 17 patients. 5 children with positive patch tests had negative prick tests. Irritant pustular reactions (2/59, i.e. 3%), "angry back" reactions (6/59, i.e. 10%) and doubtful reactions (3/59, i.e. 5%) were excluded from the positive group. Positive patch tests observed included, in decreasing order: D. pteronyssinus and D. farinæ (26.8%) garden trees (12.2%), plantain (9.8%), timothy grass, mugwort and damp area trees (4.9% each), and orchard grass (2.44%). 6 children with positive aeroallergen patch tests and 11 children with negative aeroallergen patch tests had at least 1 positive patch test to standard allergens. All children with an irritant reaction to aeroallergens had no reaction to standard patch tests. The relevance of aeroallergens in upgrading the severity of AD lesions has still to be explored by challenge studies and by long-term follow-up.     

Fluorescence characteristics and pharmacokinetic properties of a novel self-adhesive 5-ALA patch for photodynamic therapy of actinic keratoses

Actinic keratosis (AK) can be treated by photodynamic therapy (PDT), which is becoming a well-established tool in dermatology. Normally a precursor of the photosensitiser is applied topically and converted into protoporphyrin IX (PPIX) in the cells. By activating PPIX with light, the dysplastic cells will be destroyed. We report the results of two clinical studies investigating the properties of a novel self-adhesive 5-ALA-patch (PD P 506 A) intended for PDT of mild to moderate AK on the face and head. The studies investigated the influence of patch application duration on PPIX-specific fluorescence and the pharmacokinetic properties of the 5-ALA patch. The PPIX fluorescence in AK lesions and normal skin after patch application (intraindividual comparison; application for 2, 3, 4, 5 h) was investigated in 13 patients using DYADERM Professional (Biocam). In the subsequent pharmacokinetic study 12 patients were treated with 8 patches each (4 h application). 5-ALA and PPIX were analysed in plasma (over 24 h) and urine (over 12 h). PPIX-specific fluorescence measured immediately after patch removal increased with increasing application duration to a maximum at 4-h application. The fluorescence in AK lesions was more intense than in normal skin. A small increase of 5-ALA plasma concentrations was observed in 10 of 12 patients after applying 8 patches for 4 h, which rapidly declined to normal values after patch removal. The maximum increase was 3.7-fold of the pre-dose 5-ALA plasma concentration. No PPIX-concentrations above the lower limit of quantification were observed. PPIX-specific fluorescence in AK lesions can be steered by application duration of this novel 5-ALA patch. Application is safe and well tolerable. The observed small rise in 5-ALA plasma concentrations is regarded clinically irrelevant. Clinical efficacy of the patch in PDT will be investigated in further clinical trials.     

Hyperkeratotic dermatitis of the palms

Thirty two adult patients who presented with a sharply marginated, hyperkeratotic dermatitis of the palms (HDP), but with no skin lesions elsewhere, have been re-examined approximately 10 years later. Topical treatments had had limited effect. The morphological appearance and localization had remained unchanged, except in two individuals who were free from symptoms. One had developed psoriasis. The incidence of atopic disease and psoriasis in first degree relatives did not differ from that in control subjects, Mycological cultures and patch tests were negative. Serum IgE was normal. Skin biopsies in nine patients all revealed a chronic spongiotic dermatitis.     

不同剂量和不同剂型甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响

目的研究复方甘草酸制剂对甲醛和硫酸镍皮肤斑贴试验的影响。方法选择甲醛和硫酸镍皮肤斑贴试验阳性的患者96例,首次斑贴试验结束后先后给予不同剂量及不同剂型甘草酸苷制剂进行干预。中剂量复方甘草酸苷片50 mg,每日3次口服,连续治疗2周;2个月后给予高剂量复方甘草酸苷片75 mg,每日3次口服,连续治疗2周,均在治疗干预后2周进行斑贴重复试验;2个月后给予静脉干预(复方甘草酸苷注射液60 ml/d),于治疗干预后1周进行斑贴重复试验,并分析不同剂量及剂型复方甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响。结果中剂量干预后92例斑贴试验阳性,其中15例为弱阳性(+),75例为强阳性(++),2例为极强阳性(+++),无阴性检查结果,反应程度Z=-3.367,P=0.001。高剂量干预后79例阳性,其中40例为弱阳性(+),39例为强阳性(++),10例为阴性(-),反应性质Z=-5.792,P=0.000;反应程度Z=-8.774,P=0.000。静脉干预后23例阳性,其中11例为弱阳性(+),12例为强阳性(++),36例为阴性(-),反应性质Z=-8.024,P=0.000;反应程度Z=-9.683,P=0.000。结论复方甘草酸苷高剂量和采用静脉注射可对甲醛和硫酸镍皮肤斑贴试验产生明显抑制作用,并对诱发的变应性接触性皮炎有一定的临床疗效。     

Contact dermatitis due to topical treatment with garlic in Hong Kong

Contact dermatitis due to garlic is usually due to handling of garlic for cooking. Among the Chinese, garlic is also used as a form of topical medicament. 8 patients developed contact dermatitis after rubbing the cut end of a fresh garlic bulb onto the skin to treat fungal and other infections at the groin, neck, lower limb, hand or face. The distribution and morphology of the lesions were different from the classical form as described in the literature. Repeated open application tests with fresh garlic were all positive and patch tests with garlic extract were all negative. 5 controls tested by repeated open application with fresh garlic juice were also positive and patch tests in 10 controls with garlic extract were also negative. The results confirmed that the contact dermatitis was due to irritation. The patients were treated successfully with topical fluorinated steroid. For prevention, the practice of direct application of fresh garlic onto the skin for treating infections should be discouraged.     

Occupational dermatoses from colour developing agents. Clinical and histopathological observations

Exposure to colour developing agents that are derivatives of p-phenylenediamine, e.g. CD-2 and CD-3, are known to cause lichenoid lesions and allergic contact dermatitis. This study describes the clinical picture, course and patch test results in 24 patients with occupational skin disease caused by colour developing agents. Biopsies for histopathology of the occupationally-induced lesions and/or patch test reactions were obtained in 14 cases. The skin lesions cleared rapidly after exposure to colour developers had ceased. Sixteen patients had to leave their exposed work due to the skin disease. Contact allergy to colour developing agents was found in 23 cases. The clinical and histopathological findings showed that lichen planus and lichen planus-like lesions were common among the dermatoses caused by colour developers. It was not possible to provoke lichenoid lesions by patch testing. The histopathology of the patch test reactions showed dermatitis.     

Plants as the cause of contact allergy diagnosed at the Dermatological Clinic, Medical Academy, in Bia?ystok

In patients with allergic changes hospitalized in the years 1984-1988 in the Department a careful history was obtained for detection of correlations between the appearance of skin lesions and contact with plants. In patients with a positive history patch tests were done with a panel of routine allergens and leaves and/or flowers of certain plants. Positive tests with various plants were obtained in 14 cases. In 6 patients reporting contact with primrose positive tests were obtained with flowers and leaves of this plant, four of five tobacco planters tested who had eczematous lesions of the hands, aave also positive results of the test with tobacco leaves, and in three children reporting contact with butter-cup changes were observed resembling dermatitis pratensis bullosa. In one case allergy to parsnip was demonstrated. It is stressed that plants may give rise to contact dermatitis as well as to allergic-toxic changes.