中药治疗原发性胆汁性肝硬化引起的皮肤瘙痒2例

皮肤瘙痒是原发性胆汁性肝硬化临床常见症状之一，通过中医辨证施治，以养血润燥、祛风止痒法，或利湿退黄、祛风止痒法，有一定疗效。并举验案2则佐证。     

A dynamic system for delivering controlled bromine and chlorine vapor exposures to weanling swine skin

Context: Assessing the hazards of accidental exposure to toxic industrial chemical (TIC) vapors and evaluating therapeutic compounds or treatment regimens require the development of appropriate animal models.

Objective: The objective of this project was to develop an exposure system for delivering controlled vapor concentrations of TICs to the skin of anesthetized weanling pigs. Injury levels targeted for study were superficial dermal (SD) and deep dermal (DD) skin lesions as defined histopathologically.

Materials and methods: The exposure system was capable of simultaneously delivering chlorine or bromine vapor to four, 3-cm diameter exposure cups placed over skin between the axillary and inguinal areas of the ventral abdomen. Vapor concentrations were generated by mixing saturated bromine or chlorine vapor with either dried dilution air or nitrogen.

Results: Bromine exposure concentrations ranged from 6.5?×?10^?4 to 1.03?g/L, and exposure durations ranged from 1 to 45?min. A 7-min skin exposure to bromine vapors at 0.59?g/L was sufficient to produce SD injuries, while a 17-min exposure produced a DD injury. Chlorine exposure concentrations ranged from 1.0 to 2.9?g/L (saturated vapor concentration) for exposures ranging from 3 to 90?min. Saturated chlorine vapor challenges for up to 30?min did not induce significant dermal injuries, whereas saturated chlorine vapor with wetted material on the skin surface for 30–60?min induced SD injuries. DD chlorine injuries could not be induced with this system.

Conclusion: The vapor exposure system described in this study provides a means for safely regulating, quantifying and delivering TIC vapors to the skin of weanling swine as a model to evaluate therapeutic treatments.     

丹皮酚软膏治疗老年人皮肤瘙痒症的临床和实验研究

目的观察丹皮酚软膏治疗老年皮肤瘙痒症的疗效,并通过动物实验,对比丹皮酚软膏和氢化可的松软膏的抗过敏止痒效果。方法将80例老年皮肤瘙痒症患者按1︰1的比例随机分为治疗组40例和对照组40例,治疗组用润燥止痒胶囊配合丹皮酚软膏治疗,对照组用润燥止痒胶囊配合氢化可的松软膏,均外用3周后观察临床疗效。以4氨基吡啶诱发小鼠舔体反应,观察丹皮酚软膏对舔体反应的影响;以组胺使豚鼠皮肤瘙痒,观察丹皮酚软膏对豚鼠致痒阈的影响。低分子右旋糖酐诱发小鼠皮肤瘙痒,观察丹皮酚软膏的止痒作用。结果对比丹皮酚软膏和氢化可的松软膏的临床疗效,治疗组有效率为100%;对照组有效率为92.5%,两组差异无统计学意义(P﹥0.05)。丹皮酚软膏显著抑制4-氨基吡啶诱发的小鼠舔体反应;显著提高豚鼠对组胺的致痒阈;显著抑制低分子右旋糖酐诱发的小鼠皮肤瘙痒。结论丹皮酚软膏对多种动物模型有止痒作用,丹皮酚软膏治疗老年人皮肤瘙痒症效果好。     

Evaluation of sodium stibogluconate in the treatment of cutaneous leishmaniasis in Syria

Summary

A series of 31 patients presenting with skin lcsions with positive stnears for leishmania parasites were treated with sodium stibogluconate (each ml of injection containing the equivalent of 100?mg pentavalent antimony). The drug was administered either intramuscularly at a dosage of 6 ml daily for at least 10 days or infiltrated around the lesion (maximum 2 ml per lesion) at weekly intervals for 3 to 4 consecutive weeks. Twenty-four (77%) of the patients were assessed as showing a successful response, with parasites absent from the smear and the lesions healing at the end of treatment. Poor results, however, were reported in 5 of the 16 patients treated solely by infiltration. Follow-up of n few patients at 3 months showed that the healing process was prompt and little disfiguration was produced, lesions on the trunk tending to heal more quickly than those on the face.     

Dermal pleomorphic liposarcoma resembling pleomorphic fibroma: report of a case and review of the literature

Pleomorphic liposarcoma (PLPS) is a rare, high‐grade sarcoma defined by the presence of pleomorphic lipoblasts. Constituting 5% of all liposarcomas, PLPS usually arises in deep soft tissues of the extremities, with rare occurrences in the dermis and subcutis. We describe a unique case of an 85‐year‐old Caucasian gentleman with a 1 year history of a pedunculated, pink, non‐tender papule on the dorsum of his left arm, measuring 1.0 cm in maximum dimension. Biopsy revealed a dermal collection of atypical epithelioid and spindle cells superimposed on a sclerotic background, resembling a pleomorphic fibroma on low power. On high power, a central focus of discrete adipocytic differentiation with pleomorphic lipoblasts was present. Tumor cells were positive for S‐100 and negative for desmin, actin, CD68, keratin, MART‐1 and CD34. Clinicopathologic findings were consistent with PLPS and the diagnosis was made. PLPS is rarely localized to the dermis and one with low power features resembling a pleomorphic fibroma has not been previously described in the literature.     

Lipomatous metaplasia of superficial dermis

Lipomatous metaplasia is an uncommon phenomenon. After identifying the presence of a band of adipocytes in the superficial reticular dermis underlying two excisions for basal cell carcinoma, we prospectively reviewed all skin specimens accessioned in our laboratory over a 6‐month period and identified eight additional cases. In each example there was a band of adipocytes in the upper dermis, at the level of solar elastosis that was widely separated from the subcutaneous fat by a normal appearing reticular dermis. The cells were positive for S100 and negative for CD163. No connection between the superficial band of adipocytes and the subcutaneous or periappendageal fat was seen. The alterations were flat in configuration without polypoid changes. Eyerich et al. reported lipomatous metaplasia in the dermis of a patient with acute generalized exanthematic pustulosis and psoriasis, and postulated this to be a postinflammatory phenomenon. Fatty metaplasia occurs within a variety of cutaneous neoplasms including nevi, adnexal tumors and peripheral nerve sheath tumors. However, superficial dermal fatty metaplasia beneath cutaneous neoplasms is a newly described phenomenon and we suspect this process represents fatty metaplasia within solar elastosis and that it may occur more frequently than recognized.