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991.
Combined Excimer Laser and Topical Tacrolimus for the Treatment of Vitiligo: A Pilot Study 总被引:8,自引:0,他引:8
Adam Z. Kawalek BA James M. Spencer MD MS Robert G. Phelps MD 《Dermatologic surgery》2004,30(2):130-135
Background. Vitiligo is an acquired skin disorder that is characterized by well-defined, often symmetric white patches. Although current therapeutic modalities are directed toward increasing melanocyte melanin production, few treatment modalities address the immunologic nature of the disease.
Objective. To determine whether excimer laser, a known therapeutic modality, in combination with tacrolimus, a topical immunomodulator, accelerate response time and/or improve the degree of response in patients with this disorder.
Methods. Eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board–approved double-blind, placebo-controlled study. Twenty-four symmetric vitiliginous patches (elbows, knees) from eight subjects received excimer laser treatment three times per week for 24 treatments or 10 weeks. Additionally, topical tacrolimus 0.1% ointment (Protopic) and placebo (Aquaphor) were applied to randomized patches (left or right) twice daily throughout the length of the trial. Vitiliginous patches were monitored with photographs at baseline, every 2 weeks, and 6 months after treatment. Biopsies were performed on subjects with significant results.
Results. Twenty vitiliginous patches from six subjects qualified for evaluation. Fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response (75% repigmentation) compared with 20% for the placebo group. Subjects who responded successfully repigmented faster (19%) with combination therapy compared with excimer laser alone. Additionally, three subjects experienced transient hyperpigmentation in lesions treated with combination therapy.
Conclusion. Combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease. 相似文献
Objective. To determine whether excimer laser, a known therapeutic modality, in combination with tacrolimus, a topical immunomodulator, accelerate response time and/or improve the degree of response in patients with this disorder.
Methods. Eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board–approved double-blind, placebo-controlled study. Twenty-four symmetric vitiliginous patches (elbows, knees) from eight subjects received excimer laser treatment three times per week for 24 treatments or 10 weeks. Additionally, topical tacrolimus 0.1% ointment (Protopic) and placebo (Aquaphor) were applied to randomized patches (left or right) twice daily throughout the length of the trial. Vitiliginous patches were monitored with photographs at baseline, every 2 weeks, and 6 months after treatment. Biopsies were performed on subjects with significant results.
Results. Twenty vitiliginous patches from six subjects qualified for evaluation. Fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response (75% repigmentation) compared with 20% for the placebo group. Subjects who responded successfully repigmented faster (19%) with combination therapy compared with excimer laser alone. Additionally, three subjects experienced transient hyperpigmentation in lesions treated with combination therapy.
Conclusion. Combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease. 相似文献
992.
993.
Arthroscopic shoulder surgery has become a safe tool for evaluation and treatment of a wide range of shoulder problems with few complications. With ever-improving technology (and commitment to motor skill development among arthroscopists), we can expect to maintain this low rate despite increasing procedure complexity. Avoiding complications in arthroscopic shoulder surgery requires careful preoperative planning, judicious patient selection, a thorough understanding of arthroscopic anatomy, and facility with arthroscopic techniques. 相似文献
994.
Over the last few decades the there has been a huge increase in the incidence of oesophageal adenocarcinoma, surpassing that of any other solid tumour. Barrett's oesophagus is recognised as a pre-malignant cursor. Surveillance programmes have evolved to monitor Barrett's oesophagus, with the intention to detect early malignant transformation. Using photosensitive agents photodiagnosis is developing to detect this transformation before it is visible endoscopically to allow early treatment. Photodynamic therapy is a non-thermal endoscopic ablative technique, which incorporates the same photosensitive agents to treat Barrett's oesophagus as well as malignant disease. In this article we review the present status of photodiagnosis and photodynamic therapy in the management of Barrett's oesophagus and early oesophageal carcinoma. 相似文献
995.
996.
Dr. Yen-Chun Lin MD Jiahn-Shing Lee MD Shiu-Chen Wu MD Ling-Yuh Kao MD Chia-Yun Li MD Ken-Kuo Lin MD 《Annals of Ophthalmology》2003,35(1):19-24
This study analyzed the feasibility of fitting keratoconus-affected corneas with nonkeratoconus rigid gas-permeable (RGP)
contact lenses. We retrospectively studied patients with a diagnosis of keratoconus in the past 10 years who were fitted successfully
with nonkeratoconus RGP lenses by the same physician. Results confirmed nonkeratoconus RGP lenses as the first-line correction
tool. Additionally, we found a simple equation to speed the choice of the base curves of the lenses.
The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer
or provider of services discussed in this article. 相似文献
997.
998.
Urinary tract infections (UTI) are one of the most common and serious infections among pediatric patients in the emergency department. Detection of UTI requires a systematic approach to urine testing and an understanding of the limitations to common screening tests. Proper culturing techniques are essential to the diagnosis. Accurate diagnosis and prompt treatment can reduce morbidity associated with UTIs. 相似文献
999.
Jonas T. Johnson MD Editor John K. Niparko MD Editor-in-Chief Paul A. Levine MD Editor David W. Kennedy MD Editor Pete Weber MD Editor-in-Chief Randal S. Weber MD Editor Michael S. Benninger MD Past Editor in Chief Richard M. Rosenfeld MD MPH Editor in Chief Robert J. Ruben MD Editor in Chief Richard J.H. Smith MD Editor in Chief Robert Thayer Sataloff MD DMA Editor in Chief Neil Weir MA FRCS Editor Emeritus 《Otolaryngology--head and neck surgery》2006,135(6):829-830
1000.