胸腺肽对扁平疣患者IL-10、IFN-γ水平的影响及疗效分析

双抗体夹心ELISA技术检测扁平疣患者治疗组、对照组治疗前后及正常人血清IL - 10、IFN -γ水平。结果 :治疗前两组扁平疣患者IL - 10水平都明显高于正常人 ,IFN -γ水平则明显低于正常人 (均P <0 .0 1)。胸腺肽组治疗后IL - 10水平显著降低 ,IFN -γ水平显著升高 (均P <0 .0 1)。而对照组治疗前后IL - 10、IFN -γ水平差异无显著性 ,且治疗组的疗效 (有效率 80 .76 % )明显高于对照组 (P <0 .0 5 )。扁平疣患者存在Th1 Th2型细胞因子失衡 ,胸腺肽可能通过调节细胞因子失衡而改善患者免疫功能 ,提高治疗效果。     

23例面部扁平疣的光动力治疗

目的：评价5-氨基酮戊酸光动力治疗扁平疣的疗效。方法：23例扁平疣患者采用5-氨基酮戊酸光动力阶梯治疗,对治疗效果和不良反应进行了评价。结果：23例患者中20例第1次治疗后痊愈,3例显效;第2次治疗后,2例痊愈,1例显效;所有患者在光动力治疗后2-3天均出现红斑、结痂等急性不良反应,5例患者治疗后1个月,仍有明显色素沉着,所有患者3个月色素沉着消退。结论：5-氨基酮戊酸光动力阶梯治疗扁平疣效果好,但少数患者可出现暂时眭色素沉着。     

维胺酯联合维A酸乳膏及干扰素乳膏治疗扁平疣疗效观察

我科于2008年9月至2009年9月应用维胺酯胶囊、0.1%维A酸乳膏和重组人干扰素α-2b乳膏治疗扁平疣取得满意疗效,现将结果报道如下. 1 资料与方法 1.1 临床资料 60例扁平疣患者均为我科就诊患者,男20例,女40例,年龄18-45岁,平均27.2岁,病程1个月-5年,平均1.8年.发病部位:单纯面部37例,单纯手背、手腕8例,同时发病者15例.入选标准:符合<临床皮肤病学>扁平疣诊断标准,年龄18周岁以上,1个月内未外用及口服维A酸类药物及免疫调节剂,无肝肾、高血脂、高血压、糖尿病及造血系统疾病患者.女性患者非妊娠、哺乳期及半年内无生育愿望.     

卡介菌多糖核酸对扁平疣患者细胞免疫功能的影响

我们使用卡介菌多糖核酸治疗扁平疣,并对其治疗前后患者血清中白介素-2以及外周血CD4、CD8的变化进行对比观察,以评价免疫调节剂在扁平疣治疗中的作用及对患者细胞免疫功能的影响.     

超声导入复方5-氟脲嘧啶液加针刺治疗扁平疣疗效观察

目的观察超声导入复方5-氟脲嘧啶液加针刺治疗扁平疣的疗效。方法将扁平疣的患者随机分为三组:治疗组采用超声导入复方5-氟脲嘧啶液加针刺治疗;对照1组采用超声导入复方5-氟脲嘧啶液治疗;对照2组外用复方5-氟脲嘧啶液加针刺治疗。结果治疗组的疗效明显优于对照1组和对照2组,痊愈率、有效率和复发率比较差异有显著性(P均<0.05)。结论超声导入复方5-氟脲嘧啶液加针刺治疗扁平疣疗效好、疗程短、安全、复发率低。     

5%咪喹莫特乳膏与重组人干扰素凝胶预防扁平疣冷冻后复发的疗效比较

目的对比液氮冷冻后局部外用5%咪喹莫特乳膏和重组人干扰素α-2b凝胶对预防扁平疣复发的作用。方法将66例扁平疣患者给予液氮冷冻去除肉眼可见的疣体后,随机分两组,治疗组外用5%咪喹莫特乳膏,1次/qod;对照组外用重组人干扰素α-2b凝胶,(3~4)次/d,疗程均为8周,随访3个月,比较两组患者治愈、复发情况及不良反应。结果治疗组和对照组的治愈率分别为90.9%和63.6%。差异具有统计学意义(P0.05)。结论扁平疣液氮冷冻后局部使用5%咪喹莫特乳膏比重组人干扰素α-2b凝胶更阻止扁平疣复发。     

皮损内注射α-2b干扰素加中药治疗扁平疣疗效观察

目的:观察皮损内注射干扰素联合中药治疗扁平疣的疗效。方法:扁平疣患者154例分为两组,治疗组78例皮损内注射α-2b干扰素100万u,每周1次,中药煎服每日2次;对照组76例,肌注聚肌胞2 mL、皮下注射转移因子3 mg,每3天1次。结果:治疗组治愈率76.92%,有效率97.44%;对照组分别为34.21%、73.68%。两组有效率比较差异有统计学意义(P<0.01)。结论:皮损内注射干扰素联合中药治疗扁平疣疗效显著。     

异维A酸联合重组人干扰素α-2b凝胶治疗扁平疣45例

我科于2003年1月—2005年12月使用异维A酸胶囊联合重组人干扰素α-2b凝胶治疗扁平疣,取得较满意疗效,现报道如下。1资料与方法1.1病例选择90例皆来自我科门诊就诊的患者,根据典型皮损确诊为扁平疣。排除妊娠期及哺乳期女性患者,并嘱育龄期女性患者严格遵守停药1年后方可怀孕。9     

重组人干扰素α-2b乳膏联合阿昔洛韦膏等治疗扁平疣疗效观察

目的观察重组人干扰素α-2b乳膏等联合阿昔洛韦膏治疗扁平疣的疗效。方法患者随机分成三组。第一组采用重组人干扰素α-2b乳膏联合阿昔洛韦膏交替外用,第二组单独应用重组人干扰素α-2b乳膏外用,第三组单独应用阿昔洛韦膏外用,共30天。三组患者均同时口服病毒灵、多抗甲素。结果治疗结束后第1,2月末观察结果,联合用药与单一用药有效率比较差异有显著性(P<0.05)。结论重组人干扰素α-2b乳膏联合阿昔洛韦膏等治疗扁平疣经济、实用、疗效好、副作用小。     

卡舒宁治疗尖锐湿疣24例、扁平疣22例疗效综合报告

我科于 2 0 0 0年 1 1月～ 2 0 0 1年 6月 ,应用由成都生物制品研究所研制出品的卡舒宁 (卡介菌多糖核酸制剂 )注射液 ( 0 5ｍｇ/1ｍｌ/1支 ) ,主要用于治疗尖锐湿疣 (ＣＡ)患者 2 4例、扁平疣患者 2 2例。由于国内关于卡舒宁用于皮肤科临床资料尚缺报道 ,我们进行了临床观察 ,疗效满意。现将结果报告如下 :1　资料与方法1 .1　临床资料　 2 4例ＣＡ患者和 2 2例扁平疣患者均来自本科门诊 ,临床表现典型 ,病理诊断明确。1 .1 .1　 2 4例ＣＡ患者中 ,男 1 8例 ,女 6例 ,年龄 2 1～4 9岁 ,平均 3 1 5岁。病程 2周～ 1 1个月 ,平均 5 75个月…     

接受生物制剂治疗的银屑病患者COVID-19疫苗接种情况及对原发病影响的单中心横断面研究

目的了解接受生物制剂治疗的银屑病患者COVID-19疫苗接种和不良反应发生情况及对原发病的影响。方法在已经构建的生物制剂治疗银屑病患者管理平台中调取香港大学深圳医院2019年5月至2021年6月登记的572例18 ～ 60岁银屑病患者的相关资料, 采用电话访问的方式调查疫苗接种情况, 由固定人员在固定时间内按照已经制定的问卷获得疫苗接种相关信息。两组间计量资料比较采用t检验, 计数资料比较采用卡方检验或Fisher确切概率检验。结果完成电话访问的524例患者中, 疫苗接种率为43.13%(226例);生物制剂治疗组接种率(30.79%, 105/341)明显低于传统药物治疗组(66.12%, 121/183), χ2 = 60.60, P < 0.001;未接种的主要原因是患者恐惧(49.66%, 148/298), 其次为医生不推荐(26.51%, 79/298)。生物制剂治疗组接种疫苗的患者延长治疗间隔后出现皮损加重的比例(6/14)明显高于规律治疗的患者(4.40%, 4/91), Fisher确切概率检验显示两组间差异有统计学意义(P < 0.001)。2例接种CO...     

口服阿莫西林后发生天疱疮

报告1例口服阿莫西林后发生天疱疮的病例。患者男,40岁。因全身出现红斑、水疱1个月后就诊。1个月前患者全身皮肤出现散在黄豆大红斑、瘙痒,2d后在红斑和正常皮肤上出现水疱,水疱破裂后干燥结痂,但仍有新发水疱,皮损多分布在胸、背、颈部和腋下。经口服泼尼松20mg/d治疗2周后,皮损基本消退,5d前全身又出现红斑和水疱,皮损瘙痒。患者2次发病前均有口服阿莫西林史。皮肤科检查:躯干和四肢可见大小不一的散在水肿性红斑,部分红斑上可见松弛性水疱,尼氏征阳性,皮损组织病理检查示表皮内水疱和棘刺松解细胞,免疫组化组织病理示在表皮内IgG、C3呈网状沉积。体外γ干扰素释放实验阳性。最终诊断为药物诱发的天疱疮。     

How are solar keratoses treated by general practitioners in Australia?

BACKGROUND: This study aimed to obtain clinical and economic information about patterns of treatment of solar keratoses (SKs) by general practitioners in Australia. The study design was a retrospective survey relating to the treatment of patients presenting to their doctor with previously untreated SKs. METHODS: Data were collected between May and June 2000, from a sample of doctors who were asked to randomly select two SK patients from their medical records and complete a self-administered postal questionnaire. Information about treatment types, number of visits, treatment complications, and specialist referrals were directly extracted from the patient records. RESULTS: A total of 156 patients were recruited to the study (61% male) who had been treated for a total of 251 SKs (average 1.6 lesions/patient). The most common treatment employed was cryotherapy (63%). Excision was also commonly used (18%). Five per cent of patients were treated with a mixture of excision and cryotherapy. Topical agents were not commonly employed. Of those patients who consulted a doctor, 9% were referred to a specialist for diagnosis or treatment, of which 57% were referred to a dermatologist. CONCLUSION: The typical number of doctor visits varied from 1.9 to 4.6 with a range of cost per patient of 55.13-249.70 Australian dollars depending on complexity of the case and the need for referral.     

新型冠状病毒疫苗接种后发生急性荨麻疹19例临床分析

回顾分析2021年1月至2021年6月我院新型冠状病毒疫苗(北京生物生产)接种后发生的19例急性荨麻疹的临床资料。19例患者中,男8例,女11例,最小年龄18岁,最大年龄60岁。1例患者于疫苗注射后1小时,周身出现红色风团,喉头水肿,轻微憋喘症状,其余18例均于注射疫苗24小时内周身出现风团,瘙痒明显,无发热、关节痛等伴随症状,19例患者给予相应治疗后,均痊愈。     

结核T淋巴细胞斑点试验辅助诊断鱼刺伤肉芽肿一例

患者,男,65岁。右手拇指肿胀1个月余,脓肿切开引流术后10天。就诊时因切口未愈合,未进行组织病理及组织细菌培养等检查。查血结核T淋巴细胞斑点试验(T-SPOT.TB)阳性。经PPD实验及胸片排除结核杆菌感染后,反复询问病史,疑似带鱼刺伤史,结合病史及T-SPOT.TB高度怀疑鱼刺伤肉芽肿。3周后切口愈合后行病理示炎性肉芽肿改变,组织qPCR海分枝杆菌阳性。最终确诊为海分枝杆菌感染。给予口服克拉霉素治疗,3.5个月后病情痊愈。     

浅层X线治疗12例难治性掌跖疣疗效分析

目的:评价2021年9月至2022年6月于我院门诊诊治的12例掌跖疣患者使用浅层X线治疗的效果。方法:12例患者均进行过多次冷冻治疗且效果不佳,判定为难治性掌跖疣,其疣体厚度均在3～5 mm。对这12例患者均给予浅层X线放射治疗,每次剂量为5 Gy,管电压70 kV,每周1次,治疗3次,治疗结束后随访1个月。结果:12例患者已经结束治疗。10例患者最终皮损消退,治疗结束后1个月随访未复发,其中1例患者治疗结束后出现皮损周围感染,4周后治愈,未遗留瘢痕及色素沉着。1例多发跖疣的男性患者皮损未完全消退,结束治疗后有新发皮损判定为复发。1例多发跖疣的男性患者皮损消退不明显,失访。结论:本研究中浅层X线对难治性掌跖疣显示出了较好疗效,不良反应相对较少,复发率较低,疗程短。     

Lichen planus induced by hepatitis B vaccination: a new case and review of the literature

In May 1996, as part of his routine antihepatitis B (hepB) vaccination plan, a 28-year-old HbsAg-negative man, hospital worker, received his first dose (20 microg) of a recombinant vaccine (EngerixB-B, Smith Kline and Beecham, Belgium), administered via deltoid injection. The patient was otherwise healthy and taking no medication. Thirty days after the 2nd booster dose, several pruritic, polygonal, purple, papules appeared on the volar aspect of the patient's wrists. New lesions gradually spread to the arms and trunk (Fig. 1). The clinical diagnosis of lichen planus (LP) was confirmed by histology, which revealed hyperorthokeratosis, hypergranulosis, vacuolar degeneration of the basal layer cells and a dense, band-like lymphocytic infiltrate in the superficial dermis. The disease started to heal after treatment with topical clobetasol propionate 0.05% and sun exposure during the following summer. Five days after the 3rd booster dose, in November 1996, the dermatosis relapsed on the forearms, trunk, and legs. On that occasion, routine laboratory tests, including a complete blood count, blood chemistry and liver function tests, were within normal limits. Screening serologic tests for autoantibodies including antinuclear antibodies, antidouble-stranded DNA, anti-SS-A, anti-SS-B and anti-Sm were all negative. As a result of the inadequate levels of antihepatitis B antibodies, less than 10 IU/l in May 1998, in a high-risk patient who was frequently exposed to blood and its products, an additional booster dose was performed. Three days later a new recurrence of disseminated lichen planus occurred. The patient was successfully treated with prednisone 1 mg/kg/day for 2 weeks. There was no recurrence the following year.     

The follow-up of anogenital warts in a specialized consultation: study of patients lost to follow-up

INTRODUCTION: The treatment of condylomata acuminata relies on prolonged management, partly related to the need for repeated applications with regard to destructive therapeutic measures and the clinical supervision because of the high prevalence of relapses. This implies that patients are ready to consult their doctor at regular intervals during a relatively prolonged period of time. We wanted to assess the patients lost to follow-up in a population of patients exhibiting anogenital warts together with the factors associated with the loss to follow-up. PATIENTS AND METHODS: This was a prospective observational study conducted in France among dermatologists and gynecologists between May and December 2000. The physicians were free to prescribe the treatment of their choice. The social data of the patients and the classical characteristics of the condylomata acuminata were assessed. A patient was considered as lost to follow-up when he/she no longer came in for the consultation assessing the treatment. The data of the patients lost to follow-up were compared to those of the other patients. RESULTS: Two hundred ninety-seven cases, with 57 p. 100 men, were included during the study period. The mean age of the patients was of 33.8 +/- 11.4 years, with 43 p. 100 of patients aged under 30. In 40 p. 100 of cases, the lesions had existed for more than 3 months and were symptomatic in 30 p. 100 of cases. At the end of the study, 28.3 p. 100 of patients were considered as lost to follow-up. With multivariate analysis, the loss to follow-up appeared related to the patients' age (more frequent, the younger the patient; p<0.04) and not to the fixing of a precise appointment at the end of treatment (p<0.001). The asymptomatic nature of the lesions, recognized as a loss to follow-up risk factor in univariate analysis, was at the limit of significance in multivariate analysis (p=0.06). DISCUSSION: Clinicians should be particularly attentive with young and asymptomatic patients that they treat for condylomata acuminata, and attempt to reduce the rate of lost to follow-up and improve the quality of their management.     

FURUNCULAR CUTANEOUS MYIASIS CAUSED BY DERMATOBIA HOMINIS LARVAE EOLLOWING TRAVEL TO BRAZIL

A 62-year-old Japanese man had visited Rondonia in central Brazii on May 28, 1994, at which time he suffered insect bites on the left axiila and ieft chest regions. Three bites persisted and became tender and painfui. These areas developed into tender nodules with moderate serous drainage from a central pore. Malaise and an intermediate-grade fever accompanied the eruption. The tender nodules continued after he returned to Japan on July 7. The diagnosis of furunculosis was made by his family physician, but treatment with oral cefdinir (300 mg per day) and naproxen (600 mg per day) for 2 days and application of ointment containing 0.1% gentamicin sulfate failed to resolve the lesions. The patient complained of a crawling sensation under the skin. Since a maggot was removed from the axillary lesion with the aid of the patient's fingers, he was referred to the Dermatology Clinic of the Kurume University Hospital on August 1, for evaluation of parasitic diseases. Physical examination revealed two firm furuncle-like erythematous nodules, 2.0 cm in diameter, with a centrally placed 4 mm punctum on the left side of the chest (Fig. 1). There was serous drainage from each punctum and a motile larva was seen in each cavity. A lesion on the axilla had healed spontaneously. Laboratory tests were normal. Two florid lesions on the chest were surgically removed under local anesthesia with 0.5% lidocaine hydrochloride. Histologic examination revealed a mixed cell inflammatory infiltrate throughout the dermis with a tract containing a larva. Examination of the larva revealed a segmented ovoid organism, 1.5 × 0.5 cm in size (Fig. 2). The lesions healed completely within 2 weeks without further treatment. The larva removed by the patient was forwarded to the Department of Medical Zoology, Faculty of Medicine, Tokyo Medical and Dental University, and was identified as third instar larvae of Dermatobia hominis, the human botfly. The other two of the third instar larvae were transplanted under the skin of a rat and a mouse to obtain pupae or adults, but they failed to pupate and died.     

CHILD综合征长期随访一例

【摘要】 患儿女，87 d龄，出生后因右侧躯体片状红色斑块伴同侧肢体畸形于2012年1月就诊。皮肤科检查：右下腹、右臀部、右侧会阴部、右腿及右足部见明显红色斑块，表面附着黄色鳞屑，边界清楚，无明显渗出及异味；右下颌、右颈部、右腋下及右手第1 ~ 4指指背见淡黄色疣状增生；右足第2、3、4趾只有1个趾间关节且甲板缺如。右足X线片显示右足畸形及骨质缺损。诊断：CHILD综合征。患儿间断口服阿维A胶囊，外用凡士林、他卡西醇软膏、弱效糖皮质激素软膏6年余，用药时皮损可缓解，停药易反复，后改外用辛伐他汀软膏2年。皮损随年龄增长等比例增大，患肢较健侧肢体生长速度稍快。至2020年1月患儿右下颌、右颈部及右手第1 ~ 4指皮损消退，右手第5指出现新发带状疣状增生性斑块，右小腿皮损较前稍好转；无其他系统受累表现。