紫外线照射充氧自血回输疗法治疗多形性红斑临床及甲皱微循环观察

采用紫外线充氧自血回输治疗多形性红斑的治疗组总有效率为１００％，对照组为４０％；甲皱微循环改善率治疗组为１００％，对照组为７５％，组间差异均有非常显著性（Ｐ＜０．０１）．观察证明，紫外线照射充氧自血回输疗法是治疗多形性红斑的一种好方法．     

我国东北林区莱姆病的调查

1987~1988年我们在牡丹江和延边林区对莱姆病进行了流行病学调查和临床观察,发现一些林场莱姆病的患病率和自然感染率较高。大青林场共有人口1 030人,在检查的628人中,发现莱姆病患者37例。在小白林场人群中进行了血清流行病学调查,发现伯氏包柔氏体自然感染率为22.5%。从牡丹江林区收集的全沟硬蜱中,分离出了3株包柔氏体,其中M7菌株经单克隆抗体测定和电镜观察,确证为伯氏包柔氏体。在医院收集162份疑似森林脑炎病人血清,其中38份血清抗伯氏包柔氏体抗体阳性。对15例经临床和血清学确诊的莱姆病患者进行了临床观察和治疗,证明大剂量青霉素可以治愈全身性红斑。并从1例慢性游走性红斑患者血液中分离出1株包柔氏体。     

Reduction of nickel-induced contact hypersensitivity reactions by topical tea tree oil in humans

Objective and Design: Whilst the anti-microbial properties of tea tree oil (TTO) are established, the anti-inflammatory effects of TTO in human skin remain largely anecdotal and require evaluation. This study examined the effect of topically applied TTO on nickel-induced contact hypersensitivity reactions in human dorsal skin.Treatment: TTO (100%), a 5% TTO lotion, a placebo lotion (no TTO), or 100% macadamia oil were applied at days 3 and 5 after nickel exposure.Methods: The flare area and erythema index were measured on days 3, 5 and 7. The regulatory effects of TTO were also investigated on the proliferative response to nickel or polyclonal mitogens by peripheral blood mononuclear cells from nickel-sensitive and control subjects.Results: TTO (100%) significantly reduced the flare area and erythema index when compared to the nickel-only sites. With respect to the erythema index, the anti-inflammatory effects were predominantly, but not exclusively, seen in a subgroup of nickel-sensitive subjects with a prolonged development phase of nickel-induced contact hypersensitivity response. The 5% TTO lotion, the placebo lotion and the 100% macadamia oil were all without significant effect. TTO significantly inhibited proliferation to nickel but not to non-specific polyclonal mitogens by peripheral blood mononuclear cells from nickel-sensitive subjects.Conclusions: Topical application of 100% TTO may have therapeutic benefit in nickel-induced contact hypersensitivity in human skin. The mode of action of TTO requires further investigation, but may be an effect on the antigen presenting cells or the antigen presenting process in nickel-induced contact hypersensitivity, as well as vascular changes associated with this response.Received 14 February 2004; returned for revision 30 June 2004; accepted by J. S. Skotnicki 13 September 2004     

通络活血汤治疗结节性红斑的临床观察

目的：观察通络活血汤对结节性红斑的治疗作用。方法：对确诊的结节性红斑患者给予通络活血汤治疗,每日一剂,水煎服,疗程 １个月。结果：４９例结节性红斑患者治愈 ３６例,有效 １３例,复发 ３例,总有效率 １００％,复发率 ６．１２％,其治愈率（７３．４６％）同对照组比较有显著性差异（Ｐ＜０．０１）。结论：通络活血汤治疗结节性红斑疗效高、复发率低、无副作用,与西药相比,更适合于临床治疗。     

Amelanotic melanoma in situ

Amelanotic lentigo malignant melanoma is a very rare skin tumor, and no similar case of the in situ stage has been found in the literature. Clinically, the lesion presents itself as a localized ill defined macular erythema, but the diagnosis can only be made histologically. The treatment consists of surgical excision and years of careful follow-up.Presented at the Spring Meeting of the Belgian Society of Plastic Surgery, 1993     

Lyme-Borreliose

Zusammenfassung Die Lyme-Borreliose ist die häufigste durch Zecken übertragene Infektionskrankheit. Ihre Entdeckung vor 25 Jahren bildete einen Meilenstein in der modernen Infektiologie. Kinder sind häufiger als Erwachsene von Zeckenstichen betroffen und tragen damit ein höheres Infektionsrisiko. Als Multisystemerkrankung manifestiert sich die Lyme-Borreliose bei 75% der Fälle mit Hautsymptomen, das Zentralnervensystem und die Gelenke sind deutlich seltener betroffen. Die akute periphere Fazialisparese und die seröse Meningitis prägen das klinische Bild der Neuroborreliose im Kindesalter. Lyme-Borreliose ist eine klinische Diagnose, bei der Anamnese, klinischer Befund und Antikörperbefunde gleichberechtigt gewürdigt werden. Die spezifische Antikörperdiagnostik ist mit Sensitivitäts- und Spezifitätsproblemen behaftet, was das Risiko der Überdiagnose und -therapie beinhaltet. Speziell bei der Neuroborreliose ist der Liquorbefund wichtig: Eine Liquorpleozytose gilt als Conditio sine qua non für die Diagnose. Die Prognose der Lyme-Borreliose ist umso günstiger, je frühzeitiger antibiotisch behandelt wird. Gesicherte Langzeitfolgen einer Neuroborreliose sind bei Kindern nicht bekannt, können aber noch nicht gänzlich ausgeschlossen werden.     

Successful differentiation of herpes zoster‐associated erythema multiforme from generalized extension of herpes by rapid polymerase chain reaction analysis

The polymerase chain reaction (PCR) assay for varicella zoster virus (VZV), herpes simplex virus (HSV)‐1 and HSV‐2 is available for use. Sometimes the differential diagnosis of the generalized herpes zoster (HZ), HSV1/2, and drug eruption is difficult. We report a case of HZ followed by the vesicular erythema multiforme (EM)‐like lesion. In this case the use of PCR was of great assistance. A 78‐year‐old Japanese man without any significant previous history of disease was admitted to our hospital complaining of zosteriform vesicle on an erythematous base from his right shoulder to the upper arm. We diagnosed him with HZ at the level of right Th2. In spite of the prompt start of antiviral therapy, a secondary new vesiculous erythema developed on his trunk. Clinically, it was quite difficult to differentiate the lesion from the generalized HZ. Rapid PCR assay of effusion and crust for VZV was performed. A PCR assay of VZV was positive for the crust taken from the primary lesion, while it was negative for the effusion and crust of the secondary widespread lesion. We diagnosed the secondary widespread lesion as an EM‐type drug eruption induced by acyclovir, or an EM associated with herpes zoster. We then stopped the use of acyclovir and applied steroid ointment of a very strong class for the secondary lesions, which improved after a few days. A PCR assay for VZV was useful for ruling out the generalized HZ in our case with secondary developed vesiculous lesions.