大疱性类天疱疮抗原1和2在大疱性类天疱疮并发神经系统损害中的作用

大疱性类天疱疮可见于多种神经系统疾病患者,二者并发的机制尚不清楚.动物研究证实鼠大疱性类天疱疮抗原(BPAG)1至少存在3种亚型:皮肤亚型、神经业型和肌肉亚型.BPAG2除在皮肤有表达外,在人脑神经元也有广泛表达.有可能神经系统病变导致BPAG1和BPAG2神经亚型暴露于免疫系统,产生拮抗神经亚型的抗体,与皮肤亚型发生免疫反应及交叉反应,导致大疱性类天疱疮发生.     

大疱及疱疹性皮肤病

20100574大疱性类天疱疮抗原1和2在大疱性类天疱疮并发神经系统损害中的作用/陈金波(中国医科院协和医大北京协和医院皮肤科),王宝玺,李丽∥临床皮肤科杂志.-2009,38(7).-477～479大疱性类天疱疮(BP)是一种自身免疫性皮肤病,可见于多种神经系统疾病者。流行病学调查发现BP和神经系统疾病在老年人中发病率均较高,两者并发是偶然还是存在必然联系,其机制尚未阐明。动物研究证实鼠BP抗原(BPAG)1至少存在3种亚型:皮肤亚型、神经亚型和肌肉亚型。BPAG2除在皮肤有表达外,在人脑神经元也有广泛表达。有可能神经系统病变导致BPAG1和BPAG2神经亚型暴露于免疫系统,产生拮抗神经亚型     

大疱性类天疱疮抗原1各亚型在小鼠皮肤和神经组织中的表达

目的：明确大疱性类天疱疮抗原1（BPAg1）各亚型在不同组织中表达情况,探讨大疱性类天疱疮（bullous pemphigoid,BP）与神经系统疾病（neurological disease,ND）二者之间可能存在的病理机制联系。方法：采用反转录（RT）-PCR方法检测昆明小鼠BPAg1各亚型在大脑、心肌、皮肤和脊髓组织中的表达。结果：BPAg1的神经亚型（BPAg1-a）在小鼠大脑、脊髓、皮肤组织中均有表达;肌肉亚型（BPAg1-b）在大脑、脊髓、心肌、皮肤组织中均有表达;而皮肤亚型（BPAg1—e）仅在皮肤组织中有表达。结论：证实皮肤与神经组织中均存在BPAg1。由于BPAg1亚型的存在,免疫交叉反应可能在BP与神经系统疾病并发的机制中起一定的作用。     

大疱及疱疹性皮肤病

大疱性类天疱疮抗原1各亚型在小鼠皮肤和神经组织中的表达；大疱性类天疱疮合并神经系统损害研究进展；调节性T细胞与天疱疮；家族性良性天疱疮的治疗进展；家族性良性天疱疮误诊2例；副肿瘤性天疱疮一例；角层下脓疱性皮肤病的研究进展；无菌性脓疱病的发病机制；嗜酸性脓疱性毛囊炎。     

大疱及疱疹性皮肤病

不同免疫佐剂对寻常型天疱疮抗原ECl-2表位抗体亚型的影响;来氟米特治疗皮质激素减量困难的寻常型天疱疮临床研究;糖尿病并发寻常型天疱疮1例;副肿瘤性天疱疮（综述）;大疱性类天疱疮并获得性血友病A患血浆IgG亚型及FⅧ结合表位鉴定;大疱性类天疱疮合并神经系统疾病22例临床分析……[第一段]     

大疱性类天疱疮临床评估指标的研究进展

大疱性类天疱疮是一类自身免疫性疱病。针对自身免疫性大疱病,有专门的评分指标用以评估病情的严重程度和对治疗的反应。常用的评价指标有自身免疫性疱病严重程度评分,专门针对大疱性类天疱疮的大疱性类天疱疮疾病面积指数评分,以及其他的一些评分方式。自身免疫性大疱病严重程度评分已经经过了效度检验,广泛地应用在寻常型天疱疮和其他一些自身免疫性疱病的评估中。大疱性类天疱疮疾病面积指数评分尚处于检验的过程中,应用该评分的临床试验较少。上述两种评分方式均对全身的皮肤、黏膜皮损情况,主观瘙痒程度进行了评分。     

大疱性疾病正常皮肤免疫荧光检测的临床意义

本文DIF检测天疱疮正常皮肤阳性率为93.2%,大疱性类天疱疮正常皮肤阳性率为100%,因此作者认为进行正常皮肤的DIF检测对无皮肤损害的天疱疮、大疱性类天疱疮的早期诊断、鉴别诊断、推测予后具有重要意义。     

大疱性类天疱疮患者皮损中CXCR5的表达及意义

目的 检测滤泡辅助性T细胞（Tfh）趋化因子受体5（CXCR5）在大疱性类天疱疮患者皮损中的表达,分析和探讨CXCR5在大疱性类天疱疮发病机制中的作用。 方法 应用免疫组化法检测16例大疱性类天疱疮患者皮损及10例健康人皮肤中CXCR5的表达。 结果 CXCR5在健康人皮肤表达于基底细胞层,主要表达于细胞质、细胞膜处;在大疱性类天疱疮皮损中表达于基底细胞层与棘细胞层。CXCR5在健康人皮肤中阳性细胞表达均数为11.16 ± 4.47,在大疱性类天疱疮患者皮损中为35.70 ± 12.20,两组差异有统计学意义（t = 6.07,P < 0.01）。 结论 CXCR5可能参与大疱性类天疱疮的发病。     

类天疱疱的临床类型

类天疱疮的典型皮损是发生在成年患者正常皮肤或红斑基础上的紧张性大疱。临床各类型类天疱疮的诊断标准如下:1.表皮下水疱大疱,2.免疫荧光可见沿基底膜带(BMZ)有呈管状或线状的免疫反应沉积物。一、全身性类夭疱疮 (一)全身性大疱性类天疱疮(GBP):G     

皮肤中的补体系统

补体系统对某些皮肤病的发病机理方面可能起重要作用,这些皮肤病包括水疱大疱性皮肤病(天疱疮、大疱性类天疱疮、疤痕性类天疱疮、疱疹样皮炎和妊娠疱疹)及皮肤型红斑性狼疮与脉管炎。本文介绍对天疱疮、大疱性类天疱疮和妊娠疱疹中补体的研究,并扼要介绍在这些病中免疫复合物形成的新的证据。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.