0.1％他克莫司软膏治疗青少年寻常型银屑病临床疗效观察

目的观察应用0.1%他克莫司软膏治疗青少年寻常型银屑病的临床疗效。方法选取我中心皮肤病性病门诊部治疗的寻常型银屑病未成年患者66例,利用随机数表法分为两组,每组33例,观察组应用0.1%他克莫司软膏治疗,对照组应用卤米松乳膏治疗,选取治疗前、治疗2周、治疗4周、治疗8周为观察点,比较两组患者皮损面积及严重程度的改善情况,并评价疗效。结果治疗2周、4周、8周,与治疗前相比,观察组患者的PASI(银屑病面积与严重性指数)改善水平均显著优于对照组(P <0.05);治疗期间,观察组不良反应率为6.1%,也明显低于对照组15.2%(P <0.05)。结论 0.1%他克莫司软膏用于治疗青少年寻常型银屑病安全有效,且副作用小,值得临床应用。     

IL-12/23抑制剂乌司奴单抗在银屑病治疗中的应用

银屑病是一种免疫紊乱介导的以皮肤慢性炎症性改变为主的系统性疾病,临床表现为皮肤红斑鳞屑,可累及指(趾)甲及关节。IL-12和IL-23是参与银屑病发病的重要细胞因子,乌司奴单抗是靶向抑制IL-12和IL-23共有亚基p40的全人源单克隆抗体制剂,多项国内外随机对照临床试验结果表明,乌司奴单抗应用于中重度斑块型银屑病和关节病型银屑病的治疗可显著改善病情,提高患者生活质量,具有良好的有效性、长期稳定性和安全性。     

Periodontitis en individuos con psoriasis en Chile

IntroductionAlthough psoriasis has recently been associated with periodontitis, the evidence is limited, with no studies in Chilean population. This study evaluated the potential association between psoriasis and periodontitis in Chilean adults.MethodA case-control study was conducted that included 39 patients with psoriasis and 47 systemically healthy subjects (>18 years) recruited from the San José Hospital and the Dental Clinic of Andrés Bello University. The presence and severity of psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI), the Dermatology Life Quality Index (DLQI), and the physician's global assessment and body surface area (PGA and BSA) index. All patients were examined for the presence of oral lesions, and a full periodontal examination was carried out.ResultsThose with psoriasis were older, had worse periodontal parameters and worst hygiene habits than controls (P<.05). A higher frequency of severe periodontitis was found in psoriatic patients (P<.05). Psoriatic patients had an increased risk of severe periodontitis (OR: 7.05; 95% CI: 1.22-40.52, P<.029).ConclusionsThis study shows an association between psoriasis and the presence of severe periodontitis in Chilean adults. Periodic periodontal evaluations of a preventive nature should be carried in psoriatic patients.     

白细胞介素17A在银屑病发病及治疗中的研究进展

【摘要】 近十余年来的基础和临床研究发现并确立了Th17/白细胞介素17A（IL-17A）在银屑病发病中的核心地位。IL-17A不仅能影响角质形成细胞的增殖活性和细胞功能,对银屑病免疫病理环境中的免疫细胞和相关细胞因子也有很重要的调控作用。近年来针对IL-17A通路的单抗如司库奇尤单抗、ixekizumab、brodalumab等在国内外陆续上市,在临床应用中展现出了显著的疗效。本文介绍IL-17A在银屑病发病机制中的作用以及靶向IL-17A及其受体IL-17RA生物治疗的最新进展。     

银屑病患者皮损间充质干细胞的培养鉴定及其表达HES1和CXCL6的研究

【摘要】 目的 培养鉴定银屑病患者皮损处真皮间充质干细胞（DMSC）,并研究DMSC的发状分裂相关增强子1（HES1）和趋化因子配体6（CXCL6）表达情况。方法 分离培养15例银屑病患者皮损及18例正常人皮肤的DMSC,利用流式细胞仪进行表型鉴定,实时荧光定量聚合酶链反应（RT-PCR）及免疫印迹（Western blot）检测HES1和CXCL6的mRNA及蛋白表达水平,两组间比较采用t检验。结果 银屑病组DMSC形态与正常对照组无差异,但HES1 和CXCL6基因的mRNA水平分别是对照组的3.56和3.44倍,且差异有统计学意义（P < 0.05）。在蛋白水平,银屑病组DMSC中HES1和CXCL6的表达明显高于对照组（P < 0.05）。结论 银屑病患者皮肤DMSC HES1及CXCL6表达升高可能参与银屑病的发病。     

甲氨蝶呤皮下注射治疗应用与展望

【摘要】 研究表明,甲氨蝶呤皮下注射较口服途径可以获得更快、更好的吸收和更高的血药浓度以及较低的生物利用度变异度。在类风湿关节炎患者和银屑病患者,甲氨蝶呤皮下注射的疗效显著优于口服途径,并且胃肠道不良反应发生率更低。对于甲氨蝶呤口服疗效欠佳或者不耐受的患者,改为皮下注射后仍然可以获得较好的治疗反应。甲氨蝶呤皮下注射可以作为生物制剂使用前的治疗选择,可节省大量费用。总之,甲氨蝶呤皮下注射具有较好的临床应用前景。     

Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study

BackgroundInternalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons'' illness, has not been studied previously in pediatric psoriasis patients.ObjectiveWe aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients.MethodsThis multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study.ResultsThe mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores.ConclusionInternalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds.     

Characteristics of Pruritus according to Morphological Phenotype of Psoriasis and Association with Neuropeptides and Interleukin-31

BackgroundPruritus is a common symptom in psoriasis. However, few studies have assessed the characteristics of pruritus according to morphological phenotypes of psoriasis.ObjectiveTo investigate the characteristics of pruritus according to morphological phenotypes of psoriasis and to assess the association with inflammatory mediators related to pruritus.MethodsPsoriasis patients were divided into 2 groups according to clinical phenotype: eruptive inflammatory (EI) and chronic stable (CS). Clinical data of pruritus were assessed by an itch questionnaire. Serum neuropeptides and cytokines including substance P, histamine, vasoactive intestinal peptide, neuropeptide Y, calcitonin gene-related peptide and interleukin-31 (IL-31) were quantitatively measured.ResultsIn total, 50 patients with psoriasis (30 male, 20 female; mean age, 45.7 years) were studied (EI, n=15 and CS, n=35). Pruritus was reported by 80% of EI and CS patients. There were no significant differences in prevalence of pruritus, pruritus intensity, severity of psoriasis, serum neuropeptides, or IL-31 between the 2 groups.ConclusionThe morphological phenotype does not seem to be an important factor affecting the prevalence and characteristics of pruritus in psoriasis.     

The Gut Microbiome: Human Health and Inflammatory Skin Diseases

The human microbiome is a rich environment consisting of bacteria, fungi and other commensal microorganisms of the gut, mucosa and skin. The functional role of the gut microbiome includes facilitation in metabolism of macronutrients, maturation of the immune system, and production of pro- or anti-inflammatory signaling molecules and peptides. The identification of these resident organisms has brought about a new understanding of disease processes. Nevertheless, more questions remain regarding the interactions within the microbiome, its interactions with the host, and its contributions to the pathophysiology of disease. The purpose of this review is to examine the existing medical literature to highlight the role of the gut microbiome in human health, also paying attention to its role in several inflammatory skin diseases, namely atopic dermatitis, psoriasis, and rosacea.