阿维A联合NB-UVB治疗寻常型银屑病的疗效分析

目的：观察阿维A联合NB-UVB照射治疗寻常型银屑病的疗效及安全性。方法：60例寻常银屑病患者随机分为2组，均予NB-UVB照射，3次/周。治疗组同时口服阿维A10mg（2次/d）。2组均治疗8周后判定疗效和随访6个月。结果：治疗组有效率90．0％，对照组63．34％，差异有统计学意义（P＜0．05）。结论：阿维A联合NB-UVB照射治疗银屑病有很好的临床疗效，不良反应小，值得推广应用。     

Pénfigo vulgar: estudio de cohorte retrospectivo de sus características clínicas,tratamientos empleados y evolución

BackgroundPemphigus vulgaris (PV) is an uncommon, serious disease that is treated with systemic corticosteroids and corticosteroid-sparing agents.ObjectivesTo describe and analyze the demographic and clinical characteristics of patients with PV.Material and methodsRetrospective cohort study of adults diagnosed with PV over a period of 12 years.ResultsPV presented with mucosal lesions in 20 of the 32 patients studied (63%); the most common site was the oral mucosa followed by the vulva. Mucosal involvement was more common in women (P = .03). Lesions were found at more than 1 mucosal site in patients whose disease began in the mucosa, independently of age or sex (P = .003). Disease onset before the age of 40 years was associated with generalized skin lesions (P = .003), a need for corticosteroid-sparing therapy (P = .05), and refractory PV (P = .02). Azathioprine was the most widely prescribed corticosteroid-sparing agent (in 22 patients). Eight patients (25%) were dependent on corticosteroids and disease recurred in 26 (81%). Complete remission, with or without treatment, was achieved in 15 patients (47%). Patients remained disease-free for a median of 14 months, and 2 patients died (6%).ConclusionOnset before the age of 40 years could be a sign of poor prognosis in patients with PV, as it was significantly associated with a higher risk of generalized skin involvement, a need for corticosteroid-sparing therapy, and refractory disease.     

寻常痤疮发病机制相关信号通路的研究进展

寻常痤疮是一种毛囊皮脂腺单位的炎症疾病,在青少年中的发病率高达85%,发病机制与雄激素、皮脂分泌、嗜脂性微生物感染、免疫-炎症反应等密切相关。本文从炎症信号通路、皮脂分泌通路方面,综述与痤疮相关的信号转导通路。     

寻常型银屑病患者血清IL-22水平与治疗转归的关系

目的：探究寻常型银屑病患者血清IL-22水平与治疗转归的关系。方法选取寻常型银屑病患者240例,设为观察组,选取健康人240例,设为对照组。用酶联免疫吸附法（ELISA）检测对照组患者,以及观察组治疗前与治疗后2周、4周及6周血清中的IL-22水平;评估观察组患者的疾病严重程度指数（PASI）。应用Pearson直线相关分析对观察组治疗期间IL-22水平与PASI评分进行相关性分析。结果观察组在治疗前血清中IL-22水平显著高于对照组（P＜0.05）,观察组治疗后血清中IL-22水平显著低于治疗前（P＜0.05）。应用Pearson直线相关分析显示血清IL-22水平与PASI评分呈正相关关系（r=0.832,P=0.001）。结论寻常型银屑病患者体内血清IL-22水平与疾病进展程度和预后转归相关性。     

Treatment of verruca vulgaris with topical cidofovir in an immunocompromised patient: a case report and review of the literature

Lesions caused by verrucus vulgaris are commonly refractory to therapy and may become large, painful, or disfiguring in immunocompromised patients. Cidofovir is a potent nucleoside analog antiviral agent shown to have in vitro and in vivo activity against a broad spectrum of DNA viruses. We report a successful use of topical cidofovir to treat verruca vulgaris lesions in a highly immunocompromised patient, who was not considered a candidate for conventional therapy.     

Mechanisms of synergy of autoantibodies to M3 muscarinic acetylcholine receptor and secretory pathway Ca2+/Mn2+-ATPase isoform 1 in patients with non-desmoglein pemphigus vulgaris

Pemphigus vulgaris (PV) is a potentially lethal mucocutaneous blistering disease characterized by IgG autoantibodies (AuAbs) binding to epidermal keratinocytes and inducing a devastating blistering disease affecting oral and/or esophageal surfaces and, sometimes, also the skin. Anti-keratinocyte AuAbs developed by the desmoglein (Dsg) 1/3 AuAb-negative acute PV patients are pathogenic, as they induced acantholysis and epidermal split in the experimental models of PV in vitro and in vivo. These PV patients have various combinations of AuAbs to keratinocyte muscarinic acetylcholine receptor subtype M3 (M3AR), the secretory pathway Ca²⁺/Mn²⁺-ATPase isoform 1 (SPCA1), and desmocollin 3 whose relative concentrations correlate with the disease activity. In this study, we identified new molecular mechanisms of the synergistic cooperation of AuAbs to M3AR and SPCA1 in inducing acantholysis in the anti-Dsg 1/3 AuAb-negative PV patients. Anti-M3AR AuAb was found to play an important role in determining the level of intraepidermal split just above the basal cells, caspase to mediate early pro-apoptotic events triggered by anti-SPCA1 AuAb, and the neonatal Fc receptor (FcRn) to contribute to the pathobiological actions of both anti-M3AR and anti-SPCA1 AuAbs. Altogether, these novel results support our original hypothesis that pemphigus acantholysis is a complex disease process (also known as apoptolysis) initiated by AuAbs directed against different keratinocyte proteins that play important roles in supporting cell viability and regulating vital cell functions.     

ANTI-ALLERGIC EFFECTS OF SANGUISORBA OFFICINALIS ON ANIMAL MODELS OF ALLERGIC REACTIONS

ABSTRACT

We investigated the effect of aqueous extract of Sanguisorba officinalis L.(Rosaceae) root (SOAE) on the immediate-type allergic reactions in vivo and in vitro. SOAE (0.01 to 1 g/kg) inhibited systemic allergic reaction induced by compound 48/80. When SOAE was employed in a systemic allergic reaction test, the plasma histamine levels were reduced in a dose-dependent manner. SOAE (0.001 to 1 g/kg) dose-dependently inhibited passive cutaneous anaphylaxis (PCA) activated by anti-dinitrophenyl (DNP) IgE. SOAE (0.001 to 1 mg/mL) also dose-dependently inhibited the histamine release from rat peritoneal mast cells (RPMC) activated by compound 48/80 or anti-DNP IgE. The level of cyclic AMP (cAMP) in RPMC, When SOAE was added, significantly increased compared with that of normal control. Moreover, SOAE (0.01 to 1 mg/mL) had a significant inhibitory effect on anti-DNP IgE-induced tumor necrosis factor-α (TNF-α) production. These results suggest that SOAE may be beneficial in the regulation of immediate-type allergic reaction.     

415 nm蓝光联合5%过氧苯甲酰凝胶治疗轻中度寻常性痤疮的疗效

 目的 观察415 nm蓝光联合5%过氧苯甲酰凝胶治疗轻中度寻常性痤疮的临床疗效与安全性。方法 选取武警湖北总队医院2019-03至2020-09轻中度寻常性痤疮90例,随机分为3组,每组30例。联合组同时予415 nm蓝光照射联合5%过氧苯甲酰凝胶外用;蓝光组和药物组分别予415 nm蓝光照射和5%过氧苯甲酰凝胶外用。3组均在治疗8周后判定疗效。结果 治疗8周后联合组有效率为83.3％。蓝光组和药物组有效率分别为30％和56.7％,与联合组有效率比较,差异均有统计学意义。治疗过程中不良反应少见且患者均可耐受。结论 415 nm蓝光联合5%过氧苯甲酰凝胶治疗轻中度寻常性痤疮疗效显著,不良反应少。     

复方丙酸氯倍他索联合他卡西醇治疗寻常型银屑病的疗效

目的：观察复方丙酸氯倍他索软膏与他卡西醇软膏联合治疗寻常型银屑病的疗效。方法将112例寻常型银屑病患者按照随机数字法分为研究组和对照组。对照组给予复方丙酸氯倍他索软膏,研究组给予复方丙酸氯倍他索软膏及他卡西醇软膏联合治疗,观察两组的临床治疗效果。结果研究组有效率为91.1％,明显高于对照组71.4％,差异有统计学意义（P＜0.05）。治疗后两组的上肢、躯干和下肢的靶损害部位评分较治疗前有明显改善,组间数据比较差异有统计学意义（P＜0.05）。研究组与对照组不良反应发生率为1.8％、3.5％,差异无统计学意义（P＞0.05）。结论复方丙酸氯倍他索软膏与他卡西醇软膏联合治疗寻常型银屑病效果显著,能有效改善患者临床症状,不良反应少,安全性高,值得临床应用。