Management of resistant halo nevi

Background: Halo nevus (HN) is a rare dermatologic disorder characterized by typical whitish rim surrounding an existing melanocytic nevus resembling halo. It is a cosmetic problem that may be linked to vitiligo, and it is advised to remove these nevi in order to avoid development of vitiligo.

Objectives: The aim of the present study is to evaluate the cosmetic outcome after nevus removal and leukoderma dermabrasion with epithelial graft followed by narrow-band ultraviolet B (NB-UVB) phototherapy as management of resistant halo nevi and avoidance of development of vitiligo.

Patients and Methods: Ten patients with persisting halo nevi were selected as candidates in this study. Superficial dermabrasion was carried out using proper diamond fraises on depigmented rim and then punch biopsy probes with suitable size were used to harvest the nevus. Thiersch graft was prepared and applied on the dermabraded depigmented area. After 1 week of the procedure, patients were exposed to NB-UVB twice weekly and were followed up for 3 months.

Results: Repigmentation was noticed in 2 weeks and was nearly fully accomplished in all 10 patients within the 3-month period. No other vitiligo lesions developed during this period in all patients except for one case.

Conclusion: Excision of Sutton’s nevus with combined dermabrasion and Thiersch grafting followed by phototherapy is a good aesthetic maneuver in treating halo nevi and helps in avoiding further vitiligo depigmentation.     

NB-UVB及羟氯喹和糖皮质激素三联疗法治疗泛发性扁平苔藓1例

患者男,57岁。口腔溃烂、手足及躯干起疹1月余。背部皮损组织病理可见胶样小体,诊断:泛发性扁平苔藓。予NB-UVB联合糖皮质激素口服及羟氯喹治疗,8周后皮疹消退。     

Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis

Background

Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation.

Objectives

To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis.

Methods

We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.

Results

A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy [OR = 32.35, 95% CI (1.79, 586.05)], Er: YAG laser+ topical 5% 5-FU [OR = 10.74, 95% CI (4.05, 28.49)], needling/micro-needling [OR = 3.42, 95% CI (1.18, 9.88)], betamethasone intramuscular injection [OR = 3.08, 95% CI (1.17, 8.13)], topical tacrolimus [OR = 2.54, 95% CI (1.30, 4.94)], and oral Chinese herbal medicine compound [OR = 2.51, 95% CI (1.40, 4.50)] integrated with NB-UVB were more efficacious in excellent to complete repigmentation response rate (≥75%). Besides, NB-UVB+ Er: YAG laser+ topical 5% 5-FU [OR = 0.17, 95% CI (0.04, 0.67)] and NB-UVB+ needling/micro-needling [OR = 0.24, 95% CI (0.06, 0.88)] were less likely evaluated as ineffective repigmentation response (≤25%).

Conclusions

All combination therapies ranked higher than NB-UVB monotherapy in inducing successful repigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5% 5-FU and NB-UVB+ needling/microneedling would be the preferred therapeutic approaches.     

他克莫司软膏联合窄谱中波紫外线治疗面颈部白癜风疗效观察

目的:评价外用0.1%他克莫司软膏联合窄谱中波紫外线(NB-UVB)治疗面、颈部白癜风的临床疗效和不良反应.方法:将82例面颈部自癜风患者随机分成3组.A组:外用0.1%他克莫司软膏联合NB-UVB照射.B组:单独给予NB-UVB照射.C组:单独外用0.1%他克莫司软膏.疗程均为16周.试验结束时依据治疗前、后患者皮损的照片进行疗效评价.结果:治疗结束后,A、B、C3组有效率分别为78.6%(22/28),48.1%(13/27),51.9%(14/27);A组有效率与B、C两组相比.差异有统计学意义(P值均<0.05).A组与C组的复色开始平均时间相比,差异无统计学意义(P>0.05),但二者分别与B组相比,差异均有统计学意义(P值均<0.05).A组、c组中患者不同分期皮损的有效率差异有统计学意义(P<0.05),B组差异则无统计学意义(P>0.05).3组患者中不同部位皮损的疗效比较差异均无统计学意义(P值均>0.05).3组患者治疗部位出现灼热感、瘙痒的概率很低,且症状轻微.结论:他克莫司软膏治疗面、颈部白癜风起效快、疗效好、不良反应少,联合NB-UVB照射能进一步提高疗效.     

窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹疗效分析

目的观察窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹的疗效。方法对照组采用窄谱中波紫外线照射(2天一次)治疗,治疗组采用窄谱中波紫外线照射联合复方甘草酸苷(2片3次/d口服)治疗,两组均20天为1个疗程。结果治疗组有效率为95.83%,对照组为66.67%,治疗组疗效优于对照组,两组间差异有显著性(P<0.05);治疗组不良反应发生率为16.67%,对照组为20.83%,治疗组不良反应略少于对照组,但两组间差异无显著性(P>0.05)。结论窄谱中波紫外线照射联合复方甘草酸苷治疗玫瑰糠疹疗效好,安全可靠。     

NB-UVB辐射对HUVEC分泌sE-selectin及sICAM-1的影响

目的研究NB-UVB辐射对TNF-α刺激人脐静脉血管内皮细胞(HUVEC)表达可溶性E选择素(sE-se-lectin)及可溶性细胞间黏附分子(sICAM-1)的影响。方法体外培养人脐静脉血管内皮细胞(HU-VEC),将HUVEC接种于96孔塑料培养板,分为对照组,TNF-α组,TNF-α+NB-UVB60mJ/cm2剂量组,TNF-α+NB-UVB40mJ/cm2剂量组,TNF-α+NB-UVB20mJ/cm2剂量组。TNF-α刺激浓度为10ng/mL;NB-UVB高,中,低剂量组剂量分别为20,40,60mJ/cm2。采集上清,ELISA法检测可溶性E选择素(sE-selectin)和可溶性细胞间黏附分子1(sICAM-1)含量。结果 NB-UVB能剂量依赖性地抑制TNF-α刺激后HUVEC分泌sE-selectin和sICAM-1。结论 NB-UVB可能通过抑制血管内皮细胞表达黏附分子在治疗炎症性皮肤病中发挥免疫调节作用。     

阿维A胶囊联合窄频中波紫外线治疗寻常型银屑病疗效观察

目的:评价阿维A胶囊联合窄频中波紫外线治疗寻常型银屑病的临床疗效.方法:根据随机数字表法将符合入选标准的140例患者分成两组,每组70例,对照组口服阿维A胶囊;实验组口服阿维A胶囊联合窄频中波紫外线照射,两组均连续治疗8周.结果:实验组和对照组有效率分别为97.1%和84.3%,差异有显著性(P＜0.05).结论:阿维A胶囊联合窄频中波紫外线治疗寻常型银屑病疗效显著.     

阿维A药物应用于银屑病治疗的临床价值分析

目的探讨阿维A应用于银屑病治疗的临床应用价值。方法将2010年10月～2012年10月陕西省安康市汉滨区中医医院诊治的80例银屑病患者随机分成两组：对照组40例,采用窄谱中波紫外线（NB-UVB）全身照射治疗;实验组40例,采用NB-UVB＋阿维A治疗。观察和比较两组的临床疗效、银屑病皮损面积和严重程度指数（PASI）、皮肤病生活质量指数（DLQI）、炎症因子指标水平的改变情况。结果实验组较对照组的总有效率明显为高,差异有统计学意义（P〈0.05）;治疗后实验组的PASI、DLQI指标水平显著低于对照组（P〈0.05）;实验组患者治疗后的白介素-17（IL-17）、白介素-22（IL-22）、白介素-23（IL-23）指标水平均显著性小于对照组（P〈0.05）。结论阿维A辅助NB-UVB治疗银屑病能更好地控制皮损,调节炎症因子水平,提高患者的生活质量。     

旱莲胶囊、NB-UVB照射联合心理干预治疗白癜风的临床研究

目的 探讨旱莲胶囊、NB-UVB联合心理干预治疗白癜风的临床效果.方法 将180例白癜风患者随机分为对照组90例和治疗组90例,对照组采用口服旱莲胶囊、NB-UVB照射;治疗组在对照组的基础上加心理干预治疗.通过评价患者治疗前后心理健康状况：皮肤病生活质量指数（DLQI）、症状自评量表（SCL-90）、抑郁自评量表（SDS）、焦虑自评量表（SAS）、临床白斑数量及复色情况评定疗效.结果 治疗组总显效率及总有效率均明显优于对照组（P＜0.05）,治疗组治疗后DLQI、SCL-90、SDS、SAS评价均优于对照组（P＜0.05）.结论 旱莲胶囊、NB-UVB联合心理干预治疗白癜风起效快、疗程短,患者的生活质量得到明显提高.     

NB-UVB联合盐酸西替利嗪治疗慢性荨麻疹的疗效和安全性

 目的 评价照射窄谱紫外线B(narrowband ultraviolet B,NB-UVB)联合盐酸西替利嗪治疗慢性荨麻疹的疗效及安全性。方法 选择2016-01至2018-01 64例慢性荨麻疹患者,随机分为两组。治疗组(32例) 照射NB-UVB,同时口服盐酸西替利嗪,对照组(32例)单纯口服盐酸西替利嗪。疗程均为1个月。治疗前及治疗后1、2、4周进行随访,评价疗效及不良反应。结果 治疗后,治疗组与对照组在第1,2和4周症状指标总积分中均有显著下降(P＜0.05)。第4周总体效果评价,治疗组痊愈率为59.4%,有效率为93.8%;对照组痊愈率为37.5%,有效率为62.5%,两组有效率差异具有统计学意义(P＜0.05)。结论 照射NB-UVB联合口服盐酸西替利嗪治疗慢性荨麻疹近期疗效显著,其临床效果明显优于单纯口服盐酸西替利嗪片治疗。