非特应性的湿疹皮炎患者皮肤马拉色菌携带情况

为探讨非特应性的湿疹皮炎患者皮肤马拉色菌携带情况，选取非特应性的温疹皮炎患者，参照Faergemann的方法取材，采用马拉色菌培养基培养。结果急性及慢性湿疹皮炎患者非脂溢部位皮损马拉色菌检出率显著高于正常人非脂溢部位，接触性皮炎及未分类湿疹患者非脂溢部位皮损马拉色菌检出率也显著高于正常人非脂溢部位。自身对照研究发现，慢性湿疹皮炎患者非脂溢部位皮损马拉色菌检出率显著高于自身正常非脂溢部位。结论示马拉色菌可能与一部分非特应性的湿疹皮炎有一定关系。     

湿疹及皮炎

20 0 5 0 2 41　特应性皮炎皮损金黄色葡萄球菌检出情况的研究 /田美华 (南京医科大一附院皮肤科 )…∥中国麻风皮肤病杂志 . 2 0 0 4,2 0 (2 ) . 1 1 0～ 1 1 2以 3 9例患者非皮损处和 1 0例健康人皮肤标本为对照 ,用浸湿的棉拭子于 43例AD患者皮损处取材 ,进行细菌培养、菌落计数及药敏试验。结果显示 ,AD患者皮损细菌阳性率为 74.42 % ,主要为金葡萄 ,占65 63 % ;非皮损处也可分离出细菌 ,但金葡菌阳性率及密度均明显低于皮损处 (P <0 0 0 1 )。提示微生物感染因素尤其是金葡菌感染或定植在AD的发病中起重要作用。表 2参 9　 (张江…     

湿疹皮炎患者皮损细菌学研究与药敏分析

为进一步探讨湿疹皮炎皮损处的细菌学特点、金黄色葡萄球菌（简称金葡菌）在湿疹中的作用以及金葡菌耐药情况,我们于2010年1月至2011年8月对131例湿疹皮炎患者进行皮损处微生物感染情况及药敏试验研究。     

金黄色葡萄球菌超抗原与特应性皮炎及湿疹关系的初步探讨

目的：探讨皮损部位金黄色葡萄球菌(金葡菌)超抗原(SAg)与特应性皮炎(AD)及湿疹(EC)的关系。方法：反向被动乳胶凝集法测定来自91例AD和174例EC患者皮损共123株金葡菌SAg的产生情况,结合患者的严重度指数(EASI)评分、6种不同皮疹的评分以及血清学指标进行分析。结果：AD组皮损处SAg总阳性率(55．4％)及中毒休克综合征毒素(TSST)-1阳性率(21．4％)均高于EC组(37．3%、4．5％)。AD组内金葡菌肠毒素B(SEB)阳性组EASI评分高于SEB阴性组和金葡菌阴性组。EC组SAg产生与EASI评分无关,但SAg阳性组其皲裂评分较高。AD患者血清白介素(IL)-4、γ干扰素(IFN-γ)及总IgE水平与SAg无关,EC患者SAg阳性组血清总IgE水平高于金葡菌阴性组,IL-4和IFN-γ水平与SAg无关。结论：与EC相比,AD与金葡菌SAg的关系更为密切,某些型别SAg分型与AD临床严重度可能有一定联系。     

特应性皮炎和湿疹皮肤金黄色葡萄球菌肠毒素及中毒休克综合征毒素-1的检测

目的 探讨皮肤金黄色葡萄球菌(金葡菌)肠毒素及中毒休克综合征毒素-1(TSST-1)在特应性皮炎及湿疹中的致病作用。方法 反向被动乳胶凝集法测定来自117例特应性皮炎和199例湿疹患者皮肤共140株金葡菌的肠毒素/TSST-1。结果 140株金葡菌中60株产生超抗原,阳性率为42.9%,其中43株只产生一种超抗原,17株产生至少两种超抗原。特应性皮炎组超抗原总阳性率为51.5%,皮损与非皮损处无差别。湿疹组超抗原总阳性率为34.7%,阳性株均为皮损处菌。特应性皮炎组超抗原总阳性率、皮损处超抗原总阳性率及中毒休克综合征毒素-1阳性率均高于湿疹组。结论 与湿疹相比,特应性皮炎与金葡菌超抗原的关系较为密切。     

特应性皮炎和湿疹患者血清金黄色葡萄球菌肠毒素B特异性抗体的检测及其意义

目的 探讨特应性皮炎(AD)和湿疹患者血清金黄色葡萄球菌肠毒素B(SEB)特异性抗体水平及其意义。方法 采用多中心、随机双盲、对照法,将118例AD和207例湿疹患者分为莫匹罗星治疗组和对照组,于治疗前和治疗28d取血清行间接酶联免疫吸附测定法测定抗SEB特异性IgG、IgM水平,采用链霉亲和素-生物素法检测抗SEBIgE水平。结果 治疗前,抗SEBIgE水平AD组显著高于正常人对照组(P=0.019)和湿疹组(P=0.048),湿疹组与正常人对照组之间差异无统计学意义(P=0.883);抗SEBIgM水平AD组(P=0.012)和湿疹组(P=0.000)均显著高于正常人对照组,AD组与湿疹组之间差异无统计学意义(P=0.088);抗SEBIgG水平各组间均差异无统计学意义(P=0.897)。临床症状评分与抗SEBIgE水平之间AD组(P=0.842)和湿疹组(P=0.134)均无显著相关性。治疗28d后,抗SEBIgM水平AD组显著下降(P=0.003),湿疹组亦显著下降(P=0.000),但治疗组与对照组间AD组(P=0.331)和湿疹组(P=0.815)差异均无统计学意义。结论 AD和湿疹患者血中抗SEBIgM、IgE升高,反映皮损处近期金黄色葡萄球菌定植并参与了皮肤变应性炎症性反应。     

皮炎湿疹类皮肤病变微生物学检测及其对派瑞松霜的疗效观察

对38例皮炎湿疹患者进行了细菌学和真菌学检测,结果：湿疹皮损处与正身正常皮肤对照组金葡菌的分离率分别为61．11％和5．56％,具有显著性差异（P＜0．001）,真菌培养阳性率15．38％（4／26）,均为白念珠菌,派瑞松霜外用治疗,疗程3周,痊愈率73．68％,有效率84．21％,细菌转阴率97．06％真菌全部转阴,疗程中未发现不良反应。     

湿疹和特应性皮炎皮损处细菌定植情况及药物联合治疗的分析

目的 探讨湿疹和特应性皮炎(AD)皮损处金黄色葡萄球菌(金葡菌)及其他细菌的定植情况,评价抗菌药物与糖皮质激素联合用药的疗效。方法 采用多中心、随机、双盲试验,在筛选日及治疗后第7、14和28天对皮损评分,并在皮损和非皮损处分离细菌。试验组外用抗菌药物和糖皮质激素,对照组外用基质和糖皮质激素。结果 共入选患者327例,湿疹208例,AD119例。湿疹皮损处细菌的阳性率为70.19%,金葡菌占47.26%;非皮损部位细菌阳性率为32.69%,金葡菌占27.94%。AD皮损处细菌阳性率为74.79%,金葡菌占79.78%;非皮损部位细菌阳性率为34.45%,金葡菌占80.49%。湿疹和AD皮损部位金葡菌的定植量均高于非皮损部位(P<0.01,P<0.05),细菌的定植量与皮损的严重程度呈正相关。两组患者治疗后总体疗效无明显差异(P>0.05),但湿疹临床症状评分指数>8分者及AD评分指数>7分者,在治疗的第7天,试验组与对照组的症状评分指数改善率存在显著差异(P<0.05),在治疗的第14天和第28天,两组差异均无显著性(P>0.05)。结论 湿疹和AD患者皮损部位细菌的检出率和金葡菌的带菌率均明显增高,说明金葡菌与湿疹皮炎的关系密切,早期联用抗菌药物可提高疗效。     

皮肤微生物群与特应性皮炎

皮肤的微生物群与机体保持着稳态关系,影响皮肤的屏障和免疫功能。皮肤微生物群的构成受多种因素的影响,具有多样性和特异性。以金黄色葡萄球菌为优势菌和皮肤微生物群的多样性降低是特应性皮炎的主要特点。金黄色葡萄球菌的过度繁殖 加重了特应性皮炎的炎症反应。表皮葡萄球菌虽然也是特应性皮炎优势菌,但通过树突细胞、分泌IL?17A的Th17细胞/IL?17通路调节皮肤屏障免疫反应,拮抗金黄色葡萄球菌过度繁殖,发挥保护性免疫防御作用。马拉色菌可以通过定植、致敏和交叉反应等多种机制诱导和加重特应性皮炎的炎症反应。皮肤益生菌的研究有望为特应性皮炎的治疗提供新的方向。     

特应性皮炎与皮肤微生态的研究进展

特应性皮炎是一种慢性、复发性、炎症性皮肤病.其发病机制复杂,在遗传基础上,表皮屏障功能异常、环境过敏原暴露、金黄色葡萄球菌定植等诱发的免疫炎症反应均参与其发病.皮肤微生态是皮肤表面微生物构成的复杂生态系统,近年研究提示,微生态异常在特应性皮炎的发病过程中起重要作用,特应性皮炎患者的皮肤除了存在金黄色葡萄球菌定植增多外,还存在表皮葡萄球菌等其他微生物数量和功能的改变.因此,进一步揭示各种微生物群落与特应性皮炎发病的关系,有助于特应性皮炎的防治.     

特应性皮炎皮损金黄色葡萄球菌检出情况的研究

目的 :　探讨特应性皮炎 (AD)皮损微生物定植情况 ,为临床合理选用抗菌药物有效控制该病提供依据。方法 :　无菌生理盐水浸湿的棉拭子于 4 3例AD患者皮损处取标本 ,同时对 39例患者非皮损处及 10例健康人取标本作对照 ,进行细菌培养及菌落计数 ,金葡菌予常规药敏试验。结果 :　AD患者皮损细菌阳性率为 74 .4 2 % ,金葡菌为主要的致病菌 ,占 6 5 .6 3% ;非皮损处也可分离出细菌 ,但金葡菌阳性率及密度均明显低于皮损处 (P <0 .0 0 1)。结论 :　微生物感染因素 ,尤其金葡菌感染或定植 ,在AD的发病中起着重要的作用     

儿童特应性皮炎患者肠道菌群中益生菌的构成比研究

目的：比较特应性皮炎(AD)患儿与正常儿童肠道菌群中益生菌的构成差异。方法：应用Illumina MiSeq测序平台对特应性皮炎患儿和健康对照儿童粪便细菌的16SrRNA基因V3-V4区进行高通量测序,比较两组益生菌属、种水平的构成差异。结果: 共纳入35例 AD 患儿和27例正常对照,在属水平,AD组患者双歧杆菌属(Bifidobacterium)物种丰度较对照组升高,而乳酸杆菌属(Lactobacillus)物种丰度较对照组降低,但二者差异均无统计学意义（P＞0.05）。在种水平,AD组患者双歧杆菌属下Bifidobacterium pseudocatenulatum DSM 20438 JCM 1200 LMG 10505、unclassified_g__Bifidobacterium、Bifidobacterium_adolescentis、Bifidobacterium_animalis 物种丰度较对照组升高,而Bifidobacterium_breve物种丰度降低,差异均无统计学意义（P＞0.05）;AD组患者乳酸杆菌属下Lactobacillus_salivarius物种丰度较对照组降低,差异无统计学意义（P＞0.05）,而unclassified_g__Lactobacillus、Lactobacillus_plantarum_subsp._plantarum物种丰度升高,差异有统计学意义（P＜0.05）。结论:特应性皮炎患儿肠道菌群中益生菌物种丰度与正常儿童存在差异。     

面部糖皮质激素依赖性皮炎患者经皮水分丢失和皮肤含水量分析

目的 分析面部糖皮质激素依赖性皮炎患者的皮肤屏障功能。方法 将面部分为额部、鼻尖、下颌、双面颊、双侧口角的皮损区及左耳后无皮损区共8个点，分别测量95例面部糖皮质激素依赖性皮炎患者及25例健康对照者的经皮水分丢失（TEWL）和皮肤含水量。结果 与健康组相比，面部糖皮质激素依赖性皮炎组下颌、双侧口角、双面颊TEWL值均显著升高（t值分别为4.90，2.60，2.57，2.54，3.77，P < 0.01）；双侧口角、右面颊及额部的皮肤含水量均显著降低（t值分别为3.27，3.81，2.02，2.78，P < 0.05）。在8个测量点中，面部糖皮质激素依赖性皮炎组与健康组TEWL值均为下颌及双侧口角 > 双面颊及额部 > 耳后无皮损区；皮肤含水量降低均为下颌及双侧口角 > 双面颊及额部 > 耳后无皮损区。结论 面部糖皮质激素依赖性皮炎患者下颌、双侧口角、双面颊区域皮肤屏障功能受损，口周区域TEWL值较高，而面颊皮肤水分含量较少。     

Qualitative and quantitative investigations on the resident bacterial skin flora in healthy persons and in the non-affected skin of patients with seborrheic eczema

Summary The composition of the aerobic and anaerobic bacterial skin flora was investigated quantitatively and qualitatively in 25 patients with seborrheic eczema (SE) and in 35 healthy persons. In SE patients, the geometric mean count for propionibacteria in the pilosebaceous ducts of the forehead was reduced to a statistically significant extent in comparison with the control group. There was the same tendency with regard to the geometric mean count of the superficial anaerobic bacterial flora of the back, whereas the geometric mean counts of the coagulase-negative staphylococci were the same in the two groups. These results may explain earlier findings of a reduction of free fatty acids in the surface lipids in SE patients. According to the results of differentiation in 295 propionibacteria and 157 micrococcaceae, 7 biotypes and 10 phage types of propionibacteria which were so far unknown could be demonstrated. Significant differences between the groups with regard to the frequency of different biotypes, serotypes, and phage types could be demonstrated neither in propionibacteria nor in coagulase-negative staphylococci. The results of typing, however, showed that patients with SE displayed much more frequently several different propionibacterial species and types as well as several different micrococcal species and types than persons with healthy skin.Partly supported by research grants of the Deutsche Forschungsgemeinschaft     

Comparative study of skin sebum and elasticity level in patients with sulfur mustard‐induced dermatitis and healthy controls

Background: Sulfur mustard (SM) – a chemical agent – has both acute and chronic effects on skin. Xerosis, which is deemed to be due to the damage of hydrolipidic barrier of the skin, is the most common complaint of veterans exposed to the chemical. This study was designed to evaluate skin sebum and elasticity in veterans with a history of SM contact. Methods: Three hundred and ten subjects were enrolled in this study and were divided into four groups: SM‐exposed patients with current skin lesions (n=87); SM‐exposed patients without skin lesions (n=71); patients with dermatitis (n=78); and normal controls (n=74). The skin sebum and elasticity were measured in four areas (forehead, suprasternal, palm and back of the hands) using a Sebumeter and a Reviscometer. Results: Skin sebum was higher in participants who presented with dermatitis and had history of contact with SM than others; the difference was only statistically significant on the forehead. There was no significant difference in the skin elasticity between the four groups. Conclusion: While SM may increase skin sebum in long term, there is no evidence that it has a substantial effect on skin elasticity.     

Sex,constancy, and skin bacteria

Summary Quantitative studies of the aerobic flora of seven skin sites in 16 volunteers were repeated after 3 months. The total aerobic densities of the sites differed, male carried more organisms than females and also more biotypes. Qualitative differences in the flora could be detected.     

Staphylococci of the normal human skin flora

Summary 352 strains of Staphylococci of the normal human skin flora were sampled from one volunteer by single scrabbing in a ca. 3 cm² measuring area. They were biotyped by the scheme of Pelzer et al. (1973)—a modified Baird-Parker-Scheme (1963)— and the resistance to antibiotics was investigated by the method of Bauer et al. (1966).All the nine biotypes of Staphylococci were found in variable quantities. It seems problematic to call one biotype as the main type. Morphologically identical colonies of Staphylococci from the indigenous flora of the human skin were not identical in their biotypes as previously described by Pelzer (1976).Only the investigation of all Staphylococci colonies from the culture plate can evaluate all biotypes of Staphylococci of the normal human skin flora, and can give the right quantitative correlation. Staphylococci were found to be sensitive and resistant up to four antibiotics, and one biotype did not show one type of antibiogram.