结节性痒疹治疗进展

结节性痒疹的治疗主要包括局部治疗、光疗和系统治疗，近年来出现了一些新的治疗方法，如神经激肽-1受体（NK-1R）拮抗剂、白介素-31受体（IL-31R）拮抗剂、Dupilumab和μ-阿片受体拮抗剂/κ-阿片受体激动剂等。本文対结节性痒疹的治疗进展进行综述。     

泛发性结节性痒疹

报告1例泛发性结节性痒疹。患者男,26岁。2年前双大腿伸侧出现许多质地坚实的小丘疹,剧痒,并逐渐累及四肢及躯干,就诊前20d皮损突然增多、增大。皮损组织病理学检查示结节性痒疹样改变。免疫组化染色结果示S-100蛋白染色阳性的树突状细胞在表皮内显著增多,真皮内可见数量增多的嗜酸性粒细胞,S-100蛋白染色阳性的树突状细胞和神经结构,还有较多散在分布的富含颗粒的肥大细胞。抗酸染色示增生的表皮内可见大量抗酸染色阳性颗粒。     

结节性痒疹中医药治疗研究进展

中医治疗结节性痒疹,目前应用广泛疗效确切。本文通过文献学习总结中医各家治疗结节性痒疹的方案,分析传统医学的不同治疗方法的疗效,为中医临床与基础研究提供参考依据。治疗按照不同病机分型,从湿毒内蕴、气血瘀滞和其他如阳虚、脾虚寒湿等方面,给予清热解毒、搜风除湿、散结止痒等不同方法治疗。治法上中西医联合治疗多为西药联合中药内服外用。中医综合疗法是中药的内服外用。针药联合治疗分为中药联合火针、中药联合梅花针等,此外还有贴棉灸等外治法。而其中火针作为中医特色疗法,既有针的作用,又有灸的温热刺激作用。火针治疗在于借火之力刺激穴位或局部,有祛风止痒、活血通络、软坚散结、扶正祛邪以及以热引热、行气散毒的作用。临床治疗时应根据皮疹分型选择不同治疗方案,采取个体化治疗。     

肤痒冲剂联合火把花根治疗结节性痒疹

目的观察肤痒冲剂联合火把花根治疗结节性痒疹的疗效。方法35例患者,每日冲服肤痒冲剂并口服火把花根片共30天。结果患者经治疗后,症状、体征明显改善,有效率74%,无不良反应。结论肤痒冲剂联合火把花根治疗结节性痒疹疗效满意。     

沿Blaschko线分布的结节性痒疹2例

例1.男,46岁.因左下肢结节瘙痒5年余于2009年3月12日就诊.2004年前因足癣反复在外足浴,左脚踝内侧出现一绿豆大红色丘疹,瘙痒剧烈,未予诊治,渐增多,丘疹沿左下肢内侧成线状分布,2005年在某医院做组织病理检查诊断为"扁平苔藓",并曾多次在外院及我院用药治疗,采用柳酸软膏封包、糖皮质激素封包,无明显改善,之后无新发皮疹,亦未继续治疗.     

高能紫外线治疗儿童结节性痒疹的临床疗效观察

目的:探讨高能紫外线治疗儿童结节性痒疹的临床疗效和安全性。方法:将106例儿童结节性痒疹随机分为2组,对照组口服盐酸西替利嗪片,皮损处涂抹本院协定处方制剂硅油Ⅰ号软膏;观察组在对照组基础上联合高能紫外线照射治疗。4周后对比两组治疗的有效率及不良反应的出现情况。结果:最终完成观察者100例,其中观察组和对照组各50例,两组患儿治疗前积分比较,差异无统计学意义(t=0.41,P>0.05);治疗4周后,观察组积分明显低于对照组(t=4.29,P<0.01),患儿症状积分下降指数明显高于对照组(t=-4.41,P<0.01),有效率为60.00%,亦明显高于对照组的34.00%(2=6.78,P<0.01),差异均有统计学意义。两组不良反应发生率对比,差异无统计学意义(2=0.33,P>0.05)。结论:临床应用高能紫外线治疗儿童结节性痒疹有效、安全,值得推广。     

结节性痒疹发病机制及治疗的部分研究进展

结节性痒疹（PN）是以四肢发生结节并伴严重瘙痒为主要特征的皮肤病.其发病机制尚不清楚,目前治疗多不能取得满意疗效.本文仅就近几年国外有关本病的研究进展进行了综述.     

阿维A联合他扎罗汀凝胶治疗结节性痒疹临床观察

结节性痒疹为好发于四肢的疣状结节性损害,常伴剧痒。临床治疗方法多种,但疗效欠佳,常因剧痒给患者造成巨大痛苦。我科试用阿维A口服联合他扎罗汀凝胶外用治疗,取得较好效果,现报告如下。     

中西药结合治疗结节性痒疹58例

结节性痒疹是一种好发于四肢伸侧、伴有剧痒的慢性炎症性增生性皮肤病,其治疗非常棘手。笔者采用中药痒疹方加抗组胺药内服、外用糖皮质激素软膏联合治疗结节性痒疹58例,疗效满意,现将结果报告如下。1资料和方法1.1临床资料105例患者均为我院门诊确诊为结节性痒疹的患者,年龄12周岁以上,近1周内未使用过抗过敏和止痒药物。所有患者随机分为两组。治疗组58例中,男26例,女32例;年龄27～75岁,平均31.2岁;病程3个月～7年,平均6.1个月。对照组47例中,男20例,女27例;年龄23～70岁,平均30.1岁;病程2个月～6年,平均5.9个月。两组性别、年龄和病程经…     

液氮冷冻治疗结节性痒疹临床观察

目的探讨液氮冷冻的方法治疗结节性痒疹的疗效和安全性。方法利用液体氮的低温（-196℃）作用于结节性痒疹皮损做二次冻融，使其水肿、松解、坏死、结痂、脱落；迅速减轻原有的瘙痒感觉；阻断不良刺激减少搔抓。结果单用液氮冷冻的方法治疗结节性痒疹，有效率为84％，复发率仅为7．6％。结论液氮冷冻可作为治疗结节性痒疹的一种方法。     

Thalidomide treatment of prurigo nodularis

Four patients with classic recalcitrant prurigo nodularis had symptomatic and physical responses to thalidomide with remissions. Three of the four patients had increased IgE levels that decreased during therapy. In two patients, short-term treatment (2 to 3 months) was not sufficient to produce remission, but retreatment was effective. Two patients had long-term remission with more than 6 months of treatment. No significant side effects occurred.     

Dermoscopy of prurigo nodularis

The diagnosis of prurigo nodularis is mainly clinical, based on its distinctive features. However, in some cases it may be difficult to differentiate it from other nodular dermatoses only on the clinical basis, thus requiring histopathological examination to reach a definitive diagnosis. The aim of this study was to describe for the first time the dermoscopic features of prurigo nodularis and the useful contribution of dermoscopy in the differential diagnosis of such dermatoses. Fourteen patients with histopathologically proven prurigo nodularis were included in the study. The results of our study suggest that the detection of a “white starburst pattern” surrounding brown‐reddish/brown‐yellowish crust(s), erosion(s) and/or hyperkeratosis/scales is a useful clue to support the clinical diagnosis of prurigo nodularis, distinguishing it from the other main differential diagnoses.     

The combined occurrence of macular amyloidosis and prurigo nodularis

The association of prurigo nodularis (PN) and macular amyloidosis (MA) has not been reported before. Although pruritus related frictional trauma is a well-known cause of PN, its role in the development of MA has always been questioned. We herein report two cases with chronic liver disease and iron deficiency who concomitantly developed MA and PN lesions. Pruritus was the preceding factor and both lesions were confined to scratched areas. The association of two otherwise uncommon dermatoses in pruritic patients and their characteristic distribution might indicate an important role for pruritus-induced scratching in the pathogenesis of MA, too.     

Treatment of prurigo nodularis with lenalidomide

Prurigo nodularis (PN) is an intensely pruriginous dermatological disorder whose treatment is challenging for dermatologists. It is characterized by eruptions of papules and hyperkeratotic nodules, some of which are eroded, on the extensor surfaces of the limbs. The most commonly used treatments for this condition are oral antihistamines and topical or systemic steroids. Thalidomide is an effective treatment option in cases of recalcitrant PN; however, its most frequent adverse effect is neurotoxicity, which often results in its discontinuation. Lenalidomide is an analogue of thalidomide that is more powerful and associated with less neurotoxicity than thalidomide. We report the third case of PN treated with lenalidomide, which involved a patient who was refractory to thalidomide. Lenalidomide may be a more effective treatment for PN than thalidomide and has a more favorable side effects profile than its counterpart.     

白芍总苷胶囊联合窄谱中波紫外线治疗寻常性银屑病

2009年1月至2011年9月,我们采用白芍总苷胶囊联合窄谱中波紫外线(NB-UVB)治疗寻常性银屑病,并与单用NB-UVB进行对照研究,现将结果报道如下. 一、病例和方法 1.病例选择:入选标准为符合寻常性银屑病的诊断;年龄18 ～ 70岁;皮损面积占体表面积10％以上;病程≥6个月;近1个月内未接受过其他系统药物治疗、UVB或光化学疗法.每例入选的银屑病患者均有2名固定的皮肤科医生进行评分、治疗、随访.排除标准为肝、肾功能不全及有严重心、脑血管病史;严重贫血、白细胞减少;活动性感染性疾病;有紫外线照射禁忌证;孕妇及哺乳期妇女;对白芍总苷过敏者.