43例硬化萎缩性苔藓临床观察

观察43例硬化萎缩性苔藓患者,女24例,男19例,发病年龄4～55岁。从本组病例证明本症发病与内分泌紊乱有关,经免疫球蛋白测定,泛发性病例中 IgG 水平升高,表明本病可能与免疫有关。     

Homoeopathy for the treatment of lichen simplex chronicus: a case series

Twenty-seven patients with chronic lichen simplex involving various parts of the body were treated. Hydrocotyle was prescribed to 21 patients in different potencies (6c, 30c, 200c, 1 M, 10 M), Thuja to three patients (1 M, 10 M), Graphites (6c), Kali bich (30c) and Sulphur (200c) to one patient each during 1 year study period. Only two patients showed complete improvement with Thuja and one with Graphites. In other cases, the response was limited to partial relief of [corrected] itching.     

Lichen sclerosus

Lichen sclerosus (LS) is an inflammatory skin disease predominantly affecting the anogenital region. If untreated, progressive sclerosis results in scarring with distortion of the normal architecture. LS occurs more commonly in women than men but may occur in all age groups, including adolescents and prepubertal children. Its exact prevalence is unknown, but estimates range from 1:60 to 1:1000. In this article, LS is discussed in detail with respect to disease management in adults and children, risk of malignancy, and association with other diseases.     

Erosive diseases of the vulva

Vesicobullous and inflammatory diseases produce vulvar erosions that may exhibit nonspecific morphology and represent a diagnostic challenge. An approach to arriving at the correct diagnosis is presented. Most common etiologies are reviewed.     

Frontal fibrosing alopecia: a clinical review of 36 patients

Background Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia with a distinctive clinical pattern of progressive frontotemporal hairline recession. Currently, there are no evidence‐based studies to guide treatment for patients with FFA; thus, treatment options vary among clinicians. Objectives We report clinical findings and treatment outcomes of 36 patients with FFA, the largest cohort to date. Further, we report the first evidence‐based study of the efficacy of hydroxychloroquine in FFA using a quantitative clinical score, the Lichen Planopilaris Activity Index (LPPAI). Methods A retrospective case note review was performed of 36 adult patients with FFA. Data were collected on demographics and clinical findings. Treatment responses to hydroxychloroquine, doxycycline and mycophenolate mofetil were assessed using the LPPAI. Adverse events were monitored. Results Most patients in our cohort were female (97%), white (92%) and postmenopausal (83%). Apart from hairline recession, 75% also reported eyebrow loss. Scalp pruritus (67%) and perifollicular erythema (86%) were the most common presenting symptom and sign, respectively. A statistically significant reduction in signs and symptoms in subjects treated with hydroxychloroquine (P < 0·05) was found at both 6‐ and 12‐month follow up. Conclusions In FFA, hairline recession, scalp pruritus, perifollicular erythema and eyebrow loss are common at presentation. Despite the limitations of a retrospective review, our data reveal that hydroxychloroquine is significantly effective in reducing signs and symptoms of FFA after both 6 and 12 months of treatment. However, the lack of a significant reduction in signs and symptoms between 6 and 12 months indicates that the maximal benefits of hydroxychloroquine are evident within the first 6 months of use.     

长链非编码RNA基因芯片技术筛选口腔扁平苔藓唾液外泌体差异表达基因

目的研究利用基因芯片技术筛选长链非编码RNA（lncRNA）和信使RNA（mRNA）在口腔扁平苔藓（OLP）唾液外泌体中的异常表达,分析和探讨lncRNA和mRNA在OLP发生、发展中可能的分子机制。 方法收集9例OLP患者和3名健康对照者的唾液样本,分离得到样本中的外泌体。对外泌体进行纳米颗粒跟踪分析（NTA）检测、透射电子显微镜检测和外泌体特异性生物标志物的蛋白免疫印迹法（Western blot）鉴定。使用lncRNA基因表达芯片技术比较糜烂型OLP患者（EOLP组）和网纹型OLP患者（ROLP组）与健康对照者唾液外泌体中lncRNA和mRNA的表达谱,筛选得到差异表达基因并进行基因本体（GO）功能富集分析和京都基因与基因组百科全书（KEGG）信号通路富集分析。 结果NTA、透射电子显微镜和Western blot检测均证实分离得到外泌体。唾液外泌体lncRNA基因表达芯片结果显示,与对照组相比,EOLP组中有267个差异表达的lncRNA,其中上调99个、下调168个;有122个差异表达的mRNA,其中上调38个、下调84个;ROLP组中有201个差异表达的lncRNA,其中上调83个、下调118个;有86个差异表达的mRNA,其中上调32个、下调54个。两组有50个相同的差异表达mRNA和128个相同的差异表达lncRNA。GO和KEGG分析显示,差异表达基因涉及到基因转录、蛋白翻译和免疫反应等多个生物学过程。 结论本研究确定了OLP患者唾液外泌体中lncRNA和mRNA的表达谱,筛选出了与OLP相关的差异表达lncRNA和mRNA,可作为诊断和阐明OLP发病机制的重要候选者。     

扁平苔藓样角化病临床及皮肤镜特征分析

目的 探讨扁平苔藓样角化病(LPLK)的临床表现及皮肤镜特征.方法 回顾性分析2017年1月至2019年9月在上海市皮肤病医院门诊就诊并行皮肤镜及皮肤组织病理检查确诊的21例扁平苔藓样角化病患者的临床及皮肤镜特征.结果 21例患者年龄(64.69±13.29)岁,男女比例为1∶2.18例皮损位于面部,3例位于小腿.10...     

The role of perforin-mediated apoptosis in lichen planus lesions

Lichen planus is recognized as a T-cell-mediated disease. Histologically, it is characterized by the formation of colloid bodies representing apoptotic keratinocytes. The apoptotic process mediated by CD8⁺ cytotoxic T lymphocytes (CTLs) and NK cells mainly involves two distinct pathways: the perforin/granzyme pathway and the Fas/FasL pathway. So far, little is known regarding the role of perforin-mediated apoptosis in lichen planus. In the present study, the expression and distribution of perforin, T and NK cell subsets in the epidermis and dermis of lesional and nonlesional lichen planus skin were studied. Skin biopsy specimens from lesional and nonlesional skin of ten patients with lichen planus and eight healthy persons were analysed by immunohistochemistry. Significant accumulation of T cells, particularly of CD4⁺ and CD8⁺ subsets, was found in both epidermis and dermis of lichen planus lesions compared with nonlesional and healthy skin. There were no significant differences in the incidence of NK cells (CD16⁺ and CD56⁺) between lesional, nonlesional and healthy skin. Perforin expression was significantly upregulated in the epidermis of lichen planus lesions. In conclusion, accumulation of perforin⁺ cells in the epidermis of lichen planus lesions suggest a potential role of perforin in the apoptosis of basal keratinocytes.     

Treatment of scleromyxoedema with hydroxychloroquine

Background: Scleromyxoedema is a rare disease of unknown aetiology that is characterized by deposition of mucin and sclerotic induration of the skin; it is associated with paraproteinaemia. Patients suffer from progressive disability due to immobilization and cosmetic disfigurement. Treatment of scleromyxoedema is a therapeutic challenge. The antimalarial hydroxychloroquine has a rapid and reliable effect in reticular erythematous mucinosis. Patients and methods: Four consecutive patients (two women, two men; median age: 50 years) with scleromyxoedema, three of them with IgG λ paraprotein, were treated with hydroxychloroquine. Treatment was initiated with 600 mg p. o. for 10 days, followed by 400 mg for at least 4 weeks, and 200 mg thereafter. Results: Complete remission of skin manifestations was achieved in one patient, whereas three patients achieved a partial remission of 61+, 5 and 25 months' duration. Notably, three patients felt increased mobility and reduced firmness of skin during the first week of treatment, which was reflected in a rapid reduction in dermal thickness. In one patient, dysphagia was reverted as evidenced by normalization of oesophageal clearance. Paraproteinaemia was not influenced at all. Side effects included one case of electroretinogram abnormalities after 19 months of therapy and one case of leucopenia after 3 months. Conclusion: Hydroxychloroquine is an effective form of therapy for scleromyxoedema, leading to rapid and prolonged alleviation of symptoms.