应用皮肤镜评价芦荟珍珠胶囊治疗黄褐斑的临床疗效

目的：观察芦荟珍珠胶囊外用治疗黄褐斑的临床疗效及安全性。方法：治疗组采用芦荟珍珠胶囊,外用,6粒/次,1次/3 d,15~20 min/次;其中油性皮肤及中性皮肤：芦荟珍珠胶囊6粒,蛋清1个,黄瓜去皮取汁3汤匙,调成膏状涂于面部;干性皮肤：芦荟珍珠胶囊6粒,蛋黄1个,黄瓜去皮取汁3汤匙,调成膏状涂于面部。4周为一疗程,使用2个疗程。对照组外用3%氢醌霜涂于患处。利用皮肤镜对治疗前、后黄褐斑皮损进行客观测量及评价。结果：治疗组总有效率为71.05%,对照组为74.07%,两组总有效率比较差异无统计学意义（P〉0.05）;治疗后两组L＊、ITA°较治疗前均显著升高（P〈0.05）,而a＊、b＊值显著降低（P〈0.05）;治疗后两组间L＊、a＊、b＊值及ITA0值比较差异无统计学意义（P〉0.05）。在临床治疗观察过程中未见明显不良反应发生。结论：局部外用芦荟珍珠胶囊可显著性改善黄褐斑患者黑色素沉积,可实现治疗黄褐斑的目的。     

Office capillaroscopy in systemic sclerosis

The aims of this study are to assess the reliability of two office techniques, the ophthalmoscope and the Dermlite dermatoscope, and to detect nailfold capillaroscopy abnormalities in systemic sclerosis (SSc). Two separate studies were performed. In the first, the nailfolds of two fingers on one hand of 13 SSc patients and two normals were examined by four rheumatologists using an ophthalmoscope. In the second, the nailfolds of the two fingers of each hand of six SSc patients and two normals were examined by six rheumatologists with a Dermlite dermatoscope. Widefield capillary microscopy was performed by one observer in the ophthalmoscope study to assess validity. The examiners determined the presence or absence of dilated loops, giant capillary loops, and/or avascular areas on each digit. The kappa coefficient was calculated to demonstrate agreement. With the ophtalmoscope, the inter-observer kappa coefficients were 0.43, 0.54, and 0.19; the average intra-observer agreements were 0.61, 0.56, and 0.31; and the ophthalmoscope-microscope agreement were 0.63, 0.52, and <0.1 for dilated capillaries, giant capillaries, and avascular areas, respectively. With the dermatoscope, the kappa values for inter-observer reliability were 0.63, 0.40, and 0.20; and intra-observer reliability was 0.71, 0.55, and 0.40 for dilated capillaries, giant capillaries, and avascular areas, respectively. The ophthalmoscope and the dermatoscope provide moderate to substantial reliability to detect the presence of giant and dilated capillaries but poor inter-observer agreement for avascular areas. The ophthalmoscope is valid when compared to the microscope for detecting giant or dilated capillaries. We conclude that these techniques are useful office tools to detect capillary abnormalities in SSc.     

纳晶微针导入氨甲环酸联合皮肤镜治疗黄褐斑的效果

目的 探究纳晶微针导入氨甲环酸联合皮肤镜在黄褐斑患者治疗中的应用效果。方法 选取2022年 6月-2023年6月本院收治的70例黄褐斑患者为研究对象,随机分为对照组和观察组,每组35例。对照组给予 氨甲环酸口服治疗,观察给予纳晶微针导入氨甲环酸联合皮肤镜治疗,比较两组临床疗效、黄褐斑严重程度指 数（MASI评分）、医生整体评价（PGA评分）、满意度及皮损积分。结果 观察组治疗总有效率为94.29%,高 于对照组的77.14%（P ＜0.05）;观察组治疗后MASI评分、PGA评分均低于对照组（P＜0.05）;观察组满意度 为97.14%,高于对照组的80.00%（P＜0.05）;观察组治疗后皮损总积分低于对照组（P ＜0.05）。结论 纳晶 微针导入氨甲环酸联合皮肤镜治疗黄褐斑的效果良好,可有效改善黄褐斑严重程度,减轻皮损症状,促进 恢复,有利于提高患者满意度。     

51例基底细胞癌初诊误诊分析

目的 分析51例基底细胞癌初诊误诊情况,提高诊断水平,避免误诊、漏诊。 方法 回顾性分析51例基底细胞癌初步诊断误诊病人临床及组织病理资料。 结果 51例病人诊断为基底细胞癌待查3例,包块性质待查29例,皮肤溃疡5例,误诊色素痣4例,鳞状细胞癌3例,脂溢性角化症2例,血管瘤2例,恶性黑色素瘤2例,皮脂腺囊肿1例。临床分型:结节溃疡型37例,色素型11例,纤维上皮瘤型2例,浅表型1例。病理分型:实体型31例,色素型14例,浅表型1例,硬化型2例,囊样型2例,腺样型1例。 结论 基底细胞癌皮损多样,易误诊。积累临床经验,仔细查体,结合皮肤镜检查可减少误诊的发生,确诊需要行组织病理检查。     

不同中医证候雄激素性脱发患者的皮肤镜图像特点

目的:探究皮肤镜在不同中医证候雄激素性脱发患者皮损中的皮肤镜图像特征及在中医辨证中的应用价值。方法:选取2017年3月至2018年2月北京中医药大学东直门医院确诊的且经中医辨证分别属肝肾不足证、血热风燥证及脾胃湿热证的雄激素性脱发患者120例,按证型分为3组,每组40例,每组拍摄120张皮肤镜图像,以毛周征、血管征、黄点征、蜂窝征为指标,观察3种证型患者图像的差异。结果:脾胃湿热组黄点征阳性率高于血热风燥组及肝肾不足组,差异有统计学意义(P 0. 05)。血热风燥组血管征阳性率高于肝肾不足组及脾胃湿热组,差异有统计学意义(P 0. 05),脾胃湿热组高于肝肾不足组,差异有统计学意义(P 0. 05)。肝肾不足组蜂窝征阳性率高于血热风燥组及脾胃湿热组,差异有统计学意义(P 0. 05)。肝肾不足组毛周征数量高于血热风燥组及脾胃湿热组,差异有统计学意义(P 0. 05)。3组患者毛周征数量与病程正相关(r=0. 369,P 0. 05)。脾胃湿热组及肝肾不足组患者毛周征数量与病程呈正相关(r=0. 410,P 0. 05; r=0. 549,P 0. 05)。结论:不同中医证候的雄激素性脱发患者的皮肤镜征象的阳性率及数量具有一定差异,皮肤镜可辅助应用于雄激素性脱发的中医辨证治疗。     

皮肤镜对恶性黑素瘤诊断体系的初步探讨

目的 研究恶性黑素瘤的电子皮肤镜所见及其在临床诊断中的意义.方法 利用电子皮肤镜观察临床上疑似恶性黑素瘤病灶50例,图像处理存储,术后经组织病理确认.结合国内、外相关资料,描述总结恶性黑素瘤的电子皮肤镜特征性所见.结果 恶性黑素瘤临床诊断符合率与皮肤镜诊断符合率,分别为56%和84%,两组比较,差异有显著性(P＜0.05);皮肤镜诊断组与病理诊断组相比较,无显著性差异(P＞0.05).结论 恶性黑素瘤在电子皮肤镜下的特征性所见可以为恶性黑素瘤的诊断及鉴别诊断尤其是早期诊断提供重要依据,具有重要临床意义.     

Eficacia del tratamiento con inyecciones intradérmicas de plasma rico en plaquetas para la alopecia androgenética en varones: estudio de «antes-después»

Background and aimsPlatelet rich plasma is a source of growth factors recently introduced to treat androgenetic alopecia (AGA) with conflicting results. Our aims are to assess the efficacy of platelet rich plasma in increasing hair density in males with AGA, and to investigate a correlation between positive response and each of patient's age and type and duration of AGA.Materials & methodsThis before and after study included 30 males with no history of hair treatments for at least 3 months prior to our study. Each patient received 3 injections at one-month intervals. Scalp hair density of each subject was measured manually by a dermatoscope before and following 2 and 6 months of the first intervention. Data were compared to evaluate efficacy.ResultsHair density was increased by 19.17% following our intervention (172.46 ± 59.04 hairs/cm² before treatment to 205.53 ± 68.20 hairs/cm² after 6 months) with minimal short-term side effects. Type III vertex was the least responsive pattern and no correlation was observed between positive response and either patient's age or duration of AGA.ConclusionPlatelet rich plasma injections for men with AGA has a positive effect on hair density.