窄谱UVB治疗前后银屑病患者皮损中TGF-βs的表达

采用免疫组化方法检测TGF-β1、TGF-β2及TGF-β3在经NB-UVB治疗后银屑病患者皮损中的表达.结果:TGF-β1 、TGF-β2 、TGF-β3在银屑病皮损表皮基底层及棘层表达明显减少;而经NB-UVB照射后其表达明显增强.NB-UVB照射对银屑病的治疗作用可能与其上调银屑病表皮中TGF-βs的表达有关.     

Evaluation of the effects of NB-UVB in both segmental and non-segmental vitiligo affecting different body sites

BACKGROUND: Narrow band (NB)-UVB has been used in the treatment of vitiligo for years but statistical evaluation of the clinical response in both segmental and non-segmental vitiligo patients has yet to be assessed. OBJECTIVES: Statistical evaluation of the clinical response of vitiligo patients to NB-UVB in both segmental and non-segmental types affecting different body sites. METHODS: This study included 150 patients with vitiligo either segmental (10%) or non-segmental (90%). NB-UVB therapy was given twice weekly till reaching our end point of 100% re-pigmentation or a cut point in unresponsive cases. Evaluation of the percentage of re-pigmentation was performed by total body photography and planimetry every 8 weeks. RESULTS: The overall response to therapy in the non-segmental vitiligo group demonstrated that 48% of the patients showed marked response, 27% showed moderate response and 25% showed mild response after UVB therapy. The patients showed marked response in 76.3% in face lesions, 41.9% in trunk lesions and 37.6% in limbs lesions. None of the patients in the acral areas achieved marked response. The mean duration of therapy was 7.8 months. Moreover, the results demonstrated that the earlier the patient was treated, the better the response was especially for lesions on the face, trunk and limbs. On the other hand, in the segmental vitiligo group, patients showed no more than mild response to NB-UVB whatever the site of the lesion was. No side effects were encountered with NB-UVB therapy except for aggravation of the disease in two cases and erythema in one patient who was an outdoor worker and was skin type II. CONCLUSION: The type of vitiligo, the affected anatomical area and the disease duration are important factors that influence potential re-pigmentation.     

窄谱中波紫外线不同照射剂量治疗寻常性银屑病临床疗效观察

目的：观察311nm窄谱中波紫外线（NB—UVB）不同照射剂量以及维持照射治疗寻常性银屑病的疗效及安全性。方法：采用半身、单盲、不同照射剂量方案治疗25例寻常性银屑病患者．回顾性分析维持照射以及不干预方案对银屑病复发的影响。结果：92％的患者银屑病皮损面积和严重度指数（PASI）评分改善率〉75％;大剂量方案起效较快;低增量方案的平均累积剂量较低,平均治疗次数较多,平均治疗费用也较高;维持照射以及不干预方案对于患者1年后的复发率无明显影响。结论：NB—UVB治疗寻常性银屑病疗效好、不良反应小;低增量方案有望在取得满意疗效的同时降低紫外线治疗的潜在风险;对已取得满意疗效的银屑病患者不建议采用维持光疗方案。     

NB-UVB照射联合复方青黛胶囊治疗玫瑰糠疹疗效观察

目的：观察NB-UVB照射联合复方青黛胶囊治疗玫瑰糠疹临床疗效。方法：120例患者随机分为对照组（60例）和治疗组（60例）,对照组给予复方青黛胶囊2g,口服,3次／d,疗程2周;治疗组NB-UVB照射治疗,照射剂量为0．2J／cm^2,每周3次,疗程2周,同时联合复方青黛胶囊2g,口服,3次／d,疗程2周。结果：对照组总有效率为65．0％,治疗组总有效率为88．3％,经统计学处理,两组间差异极显著（P〈0．01）;治疗期间治疗组3例患者照射后出现轻度红斑和瘙痒,减少照射剂量,红斑消退,瘙痒减轻,继续完成了治疗;随访1个月,治疗组60例均痊愈,对照组3例仍无效,5例躯干部留有少许红斑,偶有瘙痒。结论：NB-UVB照射联合复方青黛胶囊治疗玫瑰糠疹临床疗效优于单纯应用复方青黛胶囊口服。     

Intravenous immunoglobulin-induced severe vesicular eczematous eruption successfully treated with narrow band-ultraviolet B therapy

Intravenous immunoglobulins (IVIg) are increasingly being used to treat a wide spectrum of dermatological and neurological autoimmune diseases. Although the administration of IVIg does not usually result in severe adverse reactions, side effects of IVIg reportedly occur in 6-13% of patients. Most reported cases were not severe, and IVIg is considered a relatively safe drug. Some reports described a vesicular eczematous eruption caused by IVIg that was cured by applying topical steroid ointments or systemic steroids. Herein, we present, to the best of our knowledge, the first case of severe vesicular eczematous eruption all over the body induced by IVIg that was unresponsive to topical steroid ointment and was subsequently treated with narrow band-ultraviolet B (NB-UVB) therapy successfully. NB-UVB was started at a dose of 400 mJ/cm² once a week, and swift improvement was observed. The skin rash disappeared in the first 2 months, and the pathogenesis of IVIg-induced eczematous eruption remains unelucidated. No change in eosinophils and complement levels were observed in our case. Given the increase in the widespread use of IVIg, we have shown that NB-UVB therapy is a candidate choice for the treatment of IVIg-induced severe vesicular eczematous eruption.     

NB-UVB照射联合乙氧苯柳胺软膏治疗局限性慢性湿疹疗效观察

目的探讨NB-UVB联合乙氧苯柳胺软膏治疗局限性慢性湿疹的疗效。方法按门诊就诊顺序把局限性慢性湿疹89例患者随机分为两组,治疗组采用NB-UVB照射联合乙氧苯柳胺软膏;对照组单用乙氧苯柳胺,两组疗程均为4周,观察疗效。结果治疗组有效率95.5%,对照组有效率79.5%,两组有效率比较差异有统计学意义（P〈0.05）。结论 NB-UVB照射联合乙氧苯柳胺软膏治疗局限性的慢性湿疹疗效明显,值得推广。     

窄谱中波紫外线联合吡美莫司乳膏对成人型特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

 目的:检测窄谱中波紫外线（NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎 (AD) 患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达，以探讨其治疗特应性皮炎的相关机制。方法: 采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平; 同时用流式细胞仪分析外周血中CCR3的表达。结果: 治疗前，AD患者血清eotaxin水平为(133.86±42.23) pg/mL，CCR3表达水平为(23.10±6.31)%；治疗后，AD患者血清eotaxin水平为(101.54±35.63) pg/mL，较治疗前明显降低(t=3.20,P＜0.01);外周血 CCR3表达水平为(16.52±6.59)%，较治疗前亦明显降低(t=3.59,P＜0.01)。结论: 窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达，从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

NB-UVB联合酮康唑洗剂、伊曲康唑治疗马拉色菌毛囊炎疗效评价

目的:评价NB-UVB联合酮康唑洗剂、伊曲康唑治疗中重度马拉色菌毛囊炎的疗效。方法:181例中重度马拉色菌毛囊炎患者,随机分为3组。A组58例,给予NB-UVB照射(每周3次)、2%酮康唑洗剂外洗(每天1次)及小剂量伊曲康唑口服(100 mg,日1次),治疗4周;B组60例,给予2%酮康唑洗剂外洗及小剂量伊曲康唑口服;C组63例,仅予小剂量伊曲康唑口服。结果:A、B、C组总有效率分别为91.38%、78.33%及61.90%,平均治愈时间分别为(27.80±3.15)天、(32.13±3.98)天及(35.83±3.42)天。结论:NB-UVB联合酮康唑洗剂在中重度马拉色菌毛囊炎治疗中能提高伊曲康唑疗效。     

进展期白癜风患者窄谱中波紫外线治疗前后血清抗黑素细胞抗体的变化

目的：检测白癜风患者血清抗黑素细胞IgG抗体的水平,以及窄谱中波紫外线（narrow band ultraviolet B,NB-UVB）治疗前后血清中抗黑素细胞IgG抗体的变化,探讨NB-UVB对白癜风的治疗效应及抗黑素细胞抗体的意义。方法：采用间接免疫荧光技术检测56例白癜风患者血清中抗黑素细胞IgG抗体。选择16例抗黑素细胞IgG抗体阳性的进展期患者给予窄谱中波紫外线治疗,然后再检测该抗体。结果：进展期白癜风患者血清抗黑素细胞IgG抗体阳性率显著高于稳定期患者及正常人,NB-UVB治疗后进展期白癜风患者抗黑素细胞抗体水平明显低于治疗前,差异有统计学意义。结论：白癜风患者血清中抗黑素细胞IgG抗体与疾病的活动性有一定的关系,支持白癜风与自身免疫有关。进展期白癜风患者血清中抗黑素细胞IgG抗体水平随着治疗后病情的好转而降低,表明NB-UVB治疗白癜风有明显效果。     

NB-UVB联合泛昔洛韦、氯雷他定治疗玫瑰糠疹疗效观察

目的探讨NB-UVB联合泛昔洛韦、氯雷他定治疗玫瑰糠疹的疗效。方法将108例患者随机分为A,B,C三组,A组采用NB-UVB联合泛昔洛韦、氯雷他定治疗,B组采用口服泛昔洛韦、氯雷他定治疗,C组采用单纯NB-UVB照射治疗。结果A组、B组与C组有效率分别为100.00%,52.78%和58.82%。A组有效率与B组、C组比较差异均有统计学意义(P0.01);B组与C组有效率比较差异无统计学意义(P0.05)。结论NB-UVB联合泛昔洛韦、氯雷他定治疗玫瑰糠疹疗效高、疗程短且安全可靠。