Sharpin蛋白在寻常型银屑病皮损内的表达及其与PASI评分关系的研究

目的:探讨Sharpin蛋白在寻常型银屑病皮损内的表达及其与PASI评分的关系。方法:采用实时荧光定量PCR及免疫组织化学方法检测Sharpin在寻常型银屑病及正常皮肤内的表达,并探讨其与临床病理特征的关系。结果:Sharpin mRNA在寻常型银屑病皮损内较正常皮肤内表达明显升高,两者差异有统计学意义(t=0.03,P0.05);免疫组化结果提示Sharpin蛋白在寻常型银屑病皮损内高表达,且在寻常型银屑病皮损内的阳性表达率高于正常皮肤组织,平均染色得分亦高于正常皮肤(P值均0.05)。此外,Sharpin蛋白表达与治疗前寻常型银屑病PASI评分呈正相关(r=0.83,P0.05)。结论:Sharpin蛋白可能参与了银屑病发病机制,对提示银屑病病情及预后可能具有一定的意义。     

寻常性银屑病皮损表皮中Smad7表达的检测及其临床意义

目的:探讨Smad7基因及其蛋白在寻常性银屑病皮损区表皮中的表达及其意义。方法:采用逆转录(RT)-PCR和SP免疫组化法分别检测寻常性银屑病皮损和正常对照皮肤中Smad7的表达。结果:寻常性银屑病皮损中Smad7表达水平上调。与正常对照皮肤相比,寻常性银屑病皮损区表皮角质形成细胞Smad7的免疫组化染色显著增强(P<0.01)。结论:寻常性银屑病皮损区表皮Smad7的过度表达可能是通过阻断转化生长因子(TGF)-β信号转导,从而有助于银屑病皮损区表皮过度增生。     

CXCL9和Smad3在新疆维吾尔族寻常性银屑病患者皮损中的表达

目的比较新疆维吾尔族寻常性银屑病患者皮损及正常维吾尔族人群皮肤中CXCL9和Smad3的表达差异。方法 Envision免疫组化法分别检测新疆维吾尔族寻常性银屑病患者皮损及正常人皮肤中CXCL9和Smad3的表达情况。结果与维吾尔族人群正常皮肤相比,CXCL9在寻常性银屑病皮损中的表达明显增加,主要以真皮乳头顶端为主,且差异具有明显统计学意义(χ2=17.874,P0.01);Smad3在寻常性银屑病皮损中主要表达于细胞浆和细胞核,与正常皮肤中Smad3的表达相比,χ2=0.000,P0.05,差异无统计学意义。结论新疆维吾尔族寻常性银屑病皮损中CXCL9蛋白表达升高,通过JAK/STAT信号通路在寻常性银屑病的炎症反应中发挥重要作用。     

HIF-1α与TREM-1在寻常性银屑病皮损中的表达及其意义

目的探讨HIF-1α与TREM-1在寻常性银屑病发病中可能的作用机制。方法采用免疫组织化学与实时荧光定量PCR的方法检测缺氧诱导因子1α(HIF-1α)与髓样细胞触发受体-1(TREM-1)在寻常性银屑病与正常皮肤组织中的表达情况,并分析HIF-1α与TREM-1在银屑病组织中表达的相关关系。结果正常皮肤组织中HIF-1α与TREM-1主要表达于基底细胞层,在寻常性银屑病患者皮损中HIF-1α与TREM-1表达增加,主要表达于表皮全层,其表达水平差异具有统计学意义(P0.05)。HIF-1αmRNA与TREM-1 mRNA在寻常性银屑病皮损表达均升高,与正常组织相比,差异具有统计学意义(P0.05)。并且HIF-1α与TREM-1在寻常性银屑病组织中表达呈正相关(P0.05)。结论 HIF-1α与TREM-1在寻常性银屑病的异常表达可能参与了寻常性银屑病发生、发展,并在此过程中存在共同路径,TREM-1可能成为治疗寻常性银屑病的潜在靶点。     

Fractalkine和其受体Cx3CR1在寻常性银屑病中的表达及意义

目的探讨Fractalkine/Cx3CR1在寻常性银屑病发病中的作用。方法应用免疫组化SABC法分别检测寻常性银屑病(进展期)皮损26例、皮损周边0.5 cm皮肤8例和正常皮肤15例中Fractalkine/Cx3CR1的表达情况。分析其与PASI(疾病严重度评分)之间的关系。结果寻常性银屑病患者角质形成细胞和真皮浅层血管内皮细胞中Fractalkine/Cx3CR1阳性率较皮损周围0.5 cm范围皮肤明显增强(P<0.05),正常皮肤中未见Fractalkine/Cx3CR1表达。寻常性银屑病皮损中Fractalkine的表达与PASI呈正相关(γ=0.6097,P<0.01),Cx3CR1的表达与PASI无相关性(γ=0.2965,P>0.05)。结论Fractalkine/Cx3CR1的异常表达可能在寻常性银屑病发病中发挥重要作用。     

CXCL9在新疆寻常型银屑病患者中的表达

目的比较新疆地区寻常型银屑病患者皮损及正常人群皮肤中干扰素伽玛诱导的单核细胞因子(CXCL9)的表达差异。方法 Envision免疫组织化学法(IHC)检测新疆寻常型银屑病患者皮损及正常人皮肤中CXCL9的表达情况。结果与正常皮肤组织相比,CXCL9在寻常型银屑病皮损中的表达明显增加,主要以真皮乳头顶端为主,且差异具有明显统计学意义(χ2=34.80,P0.01);新疆地区汉族寻常型银屑病患者和维吾尔族寻常型银屑病患者皮肤组织中CXCL9的表达差异无统计学意义(χ2=1.64,P0.05)。结论新疆寻常型银屑病患者皮损中CXCL9的表达升高,通过JAK/STAT信号通路在寻常型银屑病的炎症反应中发挥重要作用;但汉族和维吾尔族寻常型银屑病患者皮损中CXCL9的表达相似。     

COX-2在银屑病皮损中的表达及其与血管新生的关系

目的:检测环氧化酶-2(COX-2)在寻常型银屑病炎性皮损中的表达,并分析与血管新生的关系.方法:用免疫组织化学SP法检测30例寻常型银屑病炎性皮损组织和10例正常皮肤组织中COX-2、血管内皮生长因子(VEGF)的表达,并进行相关性分析.结果:寻常型银屑病炎性皮损中COX-2表达水平明显高于对照组(P<0.05),COX-2与VEGF表达呈正相关(r=0.866,P＜0.05).结论:寻常型银屑病炎性皮损中存在COX-2高表达,后者可能通过上调VEGF的表达促进银屑病皮损处血管新生,在寻常型银屑病进展期起重要作用.     

Dectin-1 mRNA在寻常型银屑病患者皮损中的表达

目的检测寻常型银屑病患者皮损组织中dectin-1 mRNA的表达,探讨dectin-1在银屑病发病中的可能机制。方法采用实时荧光定量聚合酶链反应(RFQ-PCR)检测15例寻常型银屑病患者皮损组织及15例正常皮肤组织中dectin-1 mRNA的表达。结果寻常型银屑病患者皮损中dectin-1 mRNA的表达为(0.01020±0.00686),较正常皮肤组织(0.00232±0.00073)明显升高,差异有统计学意义(P0.05)。结论 Dectin-1 mRNA表达水平在寻常型银屑病患者皮损中明显升高,其可能在寻常型银屑病患者皮肤局部免疫反应中起作用。     

miR-17-3p在寻常型银屑病患者中的表达研究

目的:研究miR-17-3p在寻常型银屑病皮损及外周血中的表达情况,探讨其参与寻常型银屑病的发病机制。方法:收集寻常型银屑病患者(17例)的皮损组织和外周血及正常对照组(4例)皮肤组织和外周血,提取miRNA。采用Real-time PCR技术检测miR-17-3p miRNA的表达并进行比较。免疫组化法检测寻常型银屑病皮损组织(25例)和正常皮肤组织(15例)中miR-17-3p的可能靶基因FNIP1蛋白的表达,Pearson相关分析银屑病患者外周血中miR-17-3p的表达水平与患者PASI评分的相关性。结果:Real-time PCR显示miR-17-3p miRNA在寻常型银屑病患者组皮损及外周血中表达量较正常对照组均明显降低(t值分别为34.62、9.16,P值均<0.05)。miR-17-3p外周血中表达量与患者PASI评分呈负相关(r=-0.56,P=0.019)。寻常型银屑病患者皮损中FNIP1蛋白表达阳性率明显高于对照组(X~2=9.72,P<0.05)。结论:寻常型银屑病患者皮损及外周血中miR-17-3p表达下调可能与银屑病的发病有关,miR-17-3p可能通过调节靶基因FNIP1参与银屑病发病。通过检测外周血中miR-17-3p的表达量可能可以评估患者病情严重程度。     

miR-320及下游靶基因survivin在银屑病皮损中的表达

目的检测寻常性银屑病皮损中miR-320及其下游靶基因survivin mRNA的表达水平。方法采用实时定量聚合酶链反应(RT-PCR)检测40例寻常性银屑病患者皮损及40名健康对照皮肤中miR-320、survivin mRNA的表达水平,运用双荧光素酶报告实验验证survivin是miR-320的靶基因。miR-320和survivin表达水平两组间比较采用t检验,寻常性银屑病皮损中miR-320与survivin表达的相关性采用Pearson相关分析。结果与健康对照皮肤相比,寻常性银屑病皮损中miR-320表达量为对照组的(0.561±0.11)倍,表达明显下调(t=3.06,P0.05);survivin mRNA表达量为对照组的(2.034±0.26)倍,表达水平明显上调(t=3.35,P0.05);双荧光素酶报告实验结果提示survivin是miR-320的靶基因,寻常性银屑病皮损中miR-320与survivin mRNA呈负相关(r2=0.634,P0.05)。结论 miR-320可能通过调控其下游靶基因survivin的异常表达参与寻常性银屑病皮损的形成过程。     

Deutliche Einschränkung der Lebensqualität bei Patienten mit Pemphigus vulgaris: Ergebnisse der deutschen Bullous Skin Disease (BSD)‐Studiengruppe

Background: Pemphigus vulgaris is a potentially life‐threatening autoimmune disorder of the skin and mucous membranes characterized by antibodies against epidermal adhesion molecules. Clinically characteristic are painful chronic blisters or erosions of mucous membranes and skin. There are no published studies on the impact o this disease on quality of life. Patients and methods: This registration was performed within the scope of the German BSD (Bullous Skin Disease) study group, from November 1997 until January 2002. A total of 36 patients with the first diagnosis of pemphigus vulgaris were registered at the university hospitals of Dresden, Erlangen, Kiel, Mannheim, München and Würzburg. Thirty of the 36 (83 %) patients participated in the quality of life questionnaire utilizing the German version of ‘Dermatology Life Quality Index’ (DLQI) provided by A. Y. Finlay. The DLQI varies from 0 to 30 with an increased DLQI score indicating a decrease in quality of quality. Results: The overall DLQI total score of 10 ± 6,7 in the investigated pemphigus patients was significantly increased in comparison to other skin diseases. Conclusions: These results suggest that the DLQI can be a very useful additional outcome criteria for clinical studies with pemphigus vulgaris and in the treatment of these patients.     

Mutations in mevalonate pathway genes in patients with familial or sporadic porokeratosis

Porokeratosis comprises heterogeneous keratinization disorders that are characterized by one or more atrophic patches surrounded by a ridge‐like cornoid lamella. In this study, we evaluated seven families affected by porokeratosis and five sporadic patients of the disease in a Chinese population. We performed Sanger sequencing of exons and flanking intron–exon boundaries of mevalonate pathway genes (MVD, MVK, PMVK and FDPS) and of SLC17A9. In five familial and three sporadic patients, we detected six variations, including four novel mutations (MVD c.1A>G; p.Met1?, c.916G>A; p.Ala306Thr, c.1013+1G>A, and PMVK c.65A>G; p.Lys22Arg) and two recurrent mutations (MVD c.746T>C; p.Phe249Ser, and MVK c.1028T>C; p.Leu343Pro). We then applied I‐TASSER and iGEMDOCK to assess these variants for probable functional impacts. The findings of this study extend the mutation spectrum of porokeratosis and provide further evidence for the genetic basis of this disease.     

[Translated article] Pruritus in Dermatology: Part 1—General Concepts and Pruritogens

Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify or confirm the cause. Translational medicine has led to the discovery of new mediators of itch, or pruritogens, as well as new receptors. Knowing how to properly recognize the main pathway that mediates itch in each patient is the key to successful treatment. Although the histaminergic pathway predominates in conditions like urticaria or drug-induced pruritus, it is the nonhistaminergic pathway that predominates in nearly all other skin diseases covered in this review. Part 1 of this 2-part review discusses the classification of pruritus, additional testing, the pathophysiology of itch and the pruritogens implicated (including cytokines and other molecules), and central sensitization to itch.     

Anästhesieverfahren in der Dermatologie

Zusammenfassung Die Verfahren der Lokalanästhesie sind integraler Bestandteil der operativen Dermatologie. Sie gewährleisten eine effiziente und sichere Analgesie in umschriebenen Haut- und Weichteilregionen und ermöglichen, einen sonst schmerzhaften diagnostischen oder therapeutischen Eingriff bei erhaltenem Bewusstsein zu tolerieren. Einzelne Methoden der Applikation sind "konkurrenzlos", wie die topische Applikation von EMLA^® oder die Kryoanästhesie, andere bieten alternative Optionen zur Allgemeinanästhesie. Die Tumeszenzlokalanästhesie wurde—jenseits der kosmetischen Liposuktion—zu einer effizienten Anästhesieform für größere Operationen bei Tumoren der Haut, plastische Rekonstruktionen und in der Phlebochirurgie weiterentwickelt. Die Wahl des Verfahrens im Einzelfall wird vom Alter, der Kooperationsfähigkeit und der Komorbidität des Patienten bestimmt. Für Infiltrationsanästhesien werden heute vorwiegend Lokalanästhetika vom Amidtyp eingesetzt. Fundierte Kenntnisse über die Anatomie der sensiblen Nerven sind Voraussetzung für erfolgreiche operationsfeldnahe periphere Blockaden. Wenn die Wirkungsweise der Lokalanästhetika, ihre toxischen Effekte und potenzielle Arzneimittelinteraktionen bei ihrem Metabolismus in der Praxis beachtet werden, dann ist das Risiko von Komplikationen relativ gering. Es sollte dennoch nicht unterschätzt, und adäquate Notfallmaßnahmen im Operationsteam sollten regelmäßig trainiert werden.     

Occupational allergic contact dermatitis caused by decorative plants

12 cases of occupational allergic contact dermatitis caused by decorative plants were diagnosed in a 14-year period. The patients were middle-aged, and their average exposure time was 13 years. The plant families and plants causing occupational contact dermatitis were Compositae (5 patients: chrysanthemum, elecampane, gerbera, feverfew), Alstroemeriaceae (5 patients, Alstroemeria ), Liliaceae (4 patients; tulip, hyacinth). Amaryllidaceae (2 patients: narcissus) and Caryophyllaceae (2 patients; carnation, cauzeflower). The known chemical allergens causing dermatitis were tuliposide-A and sesquiterepene lactones, such as alantolactones and parthenolide, in the Liliaceae and Compositae families. 7 of the 12 patients were able to continue their work; 5 were not because of severe relapses of skin symptoms. The plant allergen and extract series currently available are of great help in the diagnosis.     

Leprosy in a University Hospital in Southern Brazil

BACKGROUND

Leprosy is an infectious disease that may lead to irreversible nerve damage, compromising patient''s quality of life and leading to loss of working years.

OBJECTIVES

To evaluate the epidemiological profile of patients followed at a University Hospital.

MATERIALS AND METHODS

This is a retrospective observational study, based on a review of medical records. We studied the clinical and epidemiological features of patients with leprosy monitored at the Hospital de Clínicas of the Federal University of Paraná between January 2005 and January 2010.

RESULTS

The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female rate was 1.8:1. The most prevalent occupations were: retired, students or rural workers. Patients came mainly from Curitiba or nearby areas, but there were also patients from the countryside. The mean diagnostic delay was 24.57 months. Multibacillary forms prevailed, with the lepromatous variety being the most common, closely followed by the borderline type. Neural enlargement was found in more than 50% of the patients and 48.44% of them developed reactional states. Hemolysis was the most commonly detected drug side effect. Initial functional evaluation was possible in 70% of patients, 55% of whom had disabilities upon diagnosis. The most prevalent associated disease was hypertension.

CONCLUSIONS

This study showed an important diagnostic delay and a high rate of sequelae in this specific population. Brazil is one of the few remaining countries that has not yet eradicated leprosy and it is important to improve health policies in order to prevent sequelae and achieve eradication.