点阵铒激光治疗面部皮肤老化

目的探讨点阵铒激光治疗面部皮肤老化的有效性和安全性。方法面部皮肤老化患者150例,以点阵铒激光垂直扫描照射面部皮肤老化区。激光能量600～1000 mJ,光斑直径3.5或7 mm。照射至被照射区皮肤出现点状出血为止,共照射2次。以治疗后皮肤的肤色、毛细血管扩张、毛孔粗大、色素沉着和皮肤变化的改善程度判断疗效。结果治疗后肤色、毛细血管扩张、毛孔粗大、色素沉着及皮肤质地5项指标的症状积分均有较显著下降,治疗前症状积分均在中度,治疗后均达轻度,其中色斑评分下降最多,最少的是毛细血管扩张。结论点阵铒激光治疗面部皮肤老化安全性较高,疗效较好,副作用小,不影响患者的学习及工作。     

皮肤创伤修复过程中表皮生长因子与黑素细胞及黑素生成关系的研究进展

创伤修复是一个复杂的过程,包括炎症反应、细胞增殖、基质沉积以及组织重塑过程.多种细胞及细胞因子共同参与促进创伤愈合.表皮生长因子被认为是其中的关键因素.表皮生长因子在创伤愈合中的积极作用已在动物实验及临床应用上得以证实,而在创伤修复过程中,表皮生长因子与黑素细胞及黑素生成的关系并不明确.近年来,研究发现,表皮生长因子可以抑制激光术后黑素细胞表达黑素,从而改善炎症后色素沉着.     

冷冻、激光及手术治疗皮肤色素痣的效果比较

目的 比较冷冻、激光及手术治疗皮肤色素痣的临床效果。方法 选择本院2021年1月-2022年 5月收治的120例皮肤色素痣患者为研究对象,按照随机数字表法分成冷冻组、激光组和手术组,每组40 例。冷冻组应用冷冻治疗,激光组应用激光治疗,手术组应用手术治疗,比较三组的临床疗效、复发情况 及并发症发生情况。结果 手术组治疗总有效率为97.50%,高于冷冻组的77.50%和激光组的80.00%,差异有 统计学意义（P＜0.05）;手术组治疗半年后复发率为5.00%,低于冷冻组的27.50%和激光组的25.00%, 差异有统计学意义（P＜0.05）;手术组治疗后不良反应总发生率为5.00%,低于冷冻组的25.00%和激光 组的22.50%,差异有统计学意义（P＜0.05）。结论 在皮肤色素痣的治疗中,手术治疗效果优于冷冻、激 光治疗,且复发率和不良反应发生率均较低,应用安全性较高,可作为皮肤色素痣的首选治疗方式,值 得临床应用。     

皮肤美容对面部烧伤后色素沉着患者的康复治疗作用

目的 分析皮肤美容治疗面部烧伤后色素沉着的临床效果。方法 选择2018年1月-2022年11月我院收治的100例面部烧伤色素沉着患者为研究对象,按照随机数字表法分为对照组与观察组,每组50例。对照组给予常规治疗,观察组给予皮肤美容治疗,比较两组临床疗效、面部外观恢复时间、疾病治愈时间及色素值改善情况。结果 观察组治疗总有效率为96.00%,高于对照组的68.00%（P ＜0.05）;观察组治疗后色素值低于对照组（P ＜0.05）;观察组面部外观恢复、疾病治愈时间均短于对照组（P ＜0.05）。结论 皮肤美容对面部烧伤后色素沉着患者的康复治疗作用良好,可有效改善色素沉着现象,促进皮损恢复,值得临床应用。     

Q开关Nd：YAG激光治疗仪治疗色素性疾病的疗效评价

目的分析评价国产GlobalCure-SC6型Q开关掺钕钇铝石榴石（Neodymium Yttrium Alumi-num Garnet,Nd：YAG）激光治疗色素增多性皮肤病的疗效及副反应。方法门诊随机选取80例色素增多性皮肤病患者,其中表层和真皮层色素性疾病各30例,雀斑、老年斑等表层色素性疾病采用532nm波长,2～4mm光斑,能量密度2.0～3.0 J/cm2;褐青色斑、文身等真皮层色素病变选择1064nm波长,2～4mm光斑,能量密度为3.0～6.0J/cm2。每次治疗间隔1～3个月,给予2～4疗程治疗,随访2～6个月,观察疗效和不良反应。结果经2～4次治疗,80例患者的总有效率达到90.0%,总痊愈率为32.5%;其中表皮层色素增多的有效率为92.5%,痊愈率为42.5%;真皮层色素增多的有效率为87.5%,痊愈率为22.5%。两组间总有效率和总痊愈率均无显著性差异（P〉0.05）。术后出现暂时性色素沉着5例（6.25%）,无瘢痕发生。结论 GlobalCure-SC6型Q开关Nd：YAG激光用于治疗色素增多性皮肤病变具有较好的疗效。     

Clinical and Laboratory Findings of Pigmented Purpuric Dermatoses

Background

Pigmented purpuric dermatoses (PPD) are chronic, recurrent group of disorders characterized by petechial and pigmentary macules usually localized on the lower limbs. Its etiopathogenesis is unknown. There are very few clinical and etiological studies on PPD in the literature.

Objective

We aim to examine the etiopathogenetic factors of PPD retrospectively.

Methods

Demographic characteristics, history of co-morbid disorders and drug usage, hepatitis markers, levels of serum lipids, findings of Doppler ultrasonography in lower extremities, and patch test results of the 24 patients of PPD were examined retrospectively. The patch test results, history of drug use, and co-morbid disorders of the patients were compared with those of the control groups.

Results

The male-to-female ratio was 1 : 2, and 83.3% of the patients had Schamberg disease. Seventeen patients had co-morbid disorders and 16 used various drugs, but there was no statistically significant difference between the controls and patients. One patient was positive for hepatitis B surface antigen and 1, for anti-hepatitis C virus antibody. Nine had elevated total cholesterol levels, and 5 had elevated triglyceride levels. Further, 30% of them were positive for at least 1 allergen, while 16% of the control subjects were positive for at least 1 allergen, but statistically significant difference was not found between the 2 groups. Variable degrees of venous insufficiency were detected in 75% of the patients on Doppler ultrasonography of the lower extremities.

Conclusion

Venous insufficiency and hypercholesterolemia might be the basic predisposing factors for PPD. Further studies are needed to show if diabetes mellitus and hypertension may cause perivascular inflammation in PPD.     

咖啡牛奶色斑

咖啡牛奶色斑是人群中常见的色素异常性疾病，大量咖啡牛奶色斑常提示有系统性疾病的存在，其表皮黑素细胞增多，可见巨大的黑素体。发病机制可能与DNA错配修护基因的突变有关，多种细胞因子，如肝细胞生长因子、干细胞生长因子也参与咖啡牛奶色斑的形成。激光治疗的成功率变化很大，常见复发。咖啡牛奶色斑的发病机制及治疗等尚有待进一步的研究。     

Expressional changes in the intracellular melanogenesis pathways and their possible role in the pathogenesis of vitiligo

BACKGROUND: Main pathway in human melanocytes through which signal from the melanocortin system reaches the melanogenesis enzymes is cAMP/PKA pathway and it is modulated by Wnt and MAPK pathways. In our previous study we established significant increase of melanocortin receptor expression in unaffected skin of vitiligo patients compared to healthy subjects. OBJECTIVE: The aim of this study was to assess the gene expression profile of the intracellular signalling pathways linking melanocortin system with enzymes involved in melanogenesis. METHODS: Using QRT-PCR method, mRNA expression levels of eight genes related to signal transduction from the melanocortin system to melanogenesis enzymes was measured in lesional and non-lesional skin of vitiligo patients and in the skin of healthy control subjects. Following genes were analyzed in the study: MITF, CREB1, p38, USF1, PIK3CB (PI3K), RPS6KB1, LEF1 and BCL2. RESULTS: The mRNA levels of MITF, LEF1, p38, PIK3CB and RPS6KB1 were decreased in lesional skin of vitiligo patients compared to skin of healthy control subjects. We also found increased expression of USF1 and BCL2 in non-lesional skin of vitiligo patients compared to skin of healthy control subjects. mRNA levels of MITF and BCL2 were decreased in lesional skin of vitiligo patients compared to non-lesional skin of vitiligo patients. CONCLUSIONS: Present study indicates increased expression of the genes of the intracellular melanogenesis pathway in the non-lesional skin of vitiligo patients. This finding suggests activation of melanogenesis pathway in the non-lesional skin of vitiligo.     

Influence of ethanol dose and pigmentation on the incorporation of ethyl glucuronide into rat hair

Ethyl glucuronide (EtG) is a minor and specific metabolite of ethanol. It is incorporated into growing hair, allowing a retrospective detection of alcohol consumption. However, the suitability of quantitative EtG measurements in hair to determine the quantity of alcohol consumed has not clearly been demonstrated yet. The purpose of this study was to evaluate the influence of ethanol dose and hair pigmentation on the incorporation of EtG into rat hair. Ethanol and EtG kinetics in blood were investigated after a single administration of ethanol.Eighteen rats were divided into four groups receiving 0 (control group), 1, 2, or 3 g ethanol/kg body weight. Ethanol was administered on 4 consecutive days per week for 3 weeks by intragastric route. Twenty-eight days after the initial ethanol administration, newly grown hair was shaved. Pigmented and nonpigmented hair were analyzed separately by gas chromatography coupled to tandem mass spectrometry. Blood samples were collected within 12 h after the ethanol administration. EtG and ethanol blood levels were measured by liquid chromatography coupled to tandem mass spectrometry and headspace gas chromatography-flame ionization detector, respectively. No statistically significant difference was observed in EtG concentrations between pigmented and nonpigmented hair (Spearman's rho = 0.95). Thus, EtG incorporation into rat hair was not affected by hair pigmentation. Higher doses of ethanol resulted in greater blood ethanol area under the curve of concentration versus time (AUC) and in greater blood EtG AUC. A positive correlation was found between blood ethanol AUC and blood EtG AUC (Spearman's rho = 0.84). Increased ethanol administration was associated with an increased EtG concentration in hair. Blood ethanol AUC was correlated with EtG concentration in hair (Pearson's r = 0.89). EtG concentration in rat hair appeared to reflect the EtG concentration in blood. Ethanol was metabolized at a median rate of 0.22 g/kg/h, and the median elimination half-life of EtG was 1.21 h. This study supports that the bloodstream is likely to display a major role in the hair EtG incorporation.