β—七叶皂甙钠治疗银屑病疗效观察

我科从 1996年开始应用山东烟台绿叶制药有限公司生产的β -七叶皂甙钠治疗寻常型银屑病 (进行期 ) 6 5例 ,并与复方丹参作对比观察 ,取得较好疗效 ,现报告如下 :1　临床资料1 1　病例情况　本组病例均为我科自 1996年来住院治疗的银屑病患者 ,病例均具备以下两项①寻常型银屑病 (进行期 ) ;②皮损分布于躯干、四肢 ,共 116例 ,男 71例 ,女 45例 ,随机分为两组 ,治疗组 6 5例 ,其中男 39例 ,女 2 6例 ,点滴状 30例 ,钱币状 2 0例 ,地图状 15例 ,年龄 14～ 6 9岁 ,平均年龄 48 5岁。对照组 5 1例 ,其中男 32例 ,女 19例 ,点滴状 2 5例 ,钱币…     

蝮蛇抗栓酶治疗银屑病前后血液流变学及甲皱微循环观察

蝮蛇抗栓酶治疗银屑病前后血液流变学及甲皱微循环观察李国阳，王金海，陈燕，陈荣娟应用蝮蛇抗栓酶治疗银屑病，并观察治疗前后血液流变学及甲皱微循环的变化，报告如下：临床资料：观察银屑病患者８７例，均为寻常型。其中进行期４５例，静止期４２例；病程半月～１６年...     

自拟中药"润肤饮"治疗银屑病150例

我科采用本院自制的“润肤饮”治疗银屑病取得满意疗效现将我们观察的 15 0例治疗结果报告如下 :1　资料与方法1 1　临床资料病例选择 :15 0例患者均为银屑病专科门诊病例 ,其中男性 95例 ,女性 5 5例 ,年龄 16～ 6 2岁 ,其中 2 0～ 5 0岁 10 5例 ,占 70 % ,病程 3周～ 32年不等。皮损情况 :寻常型 12 2例 ,关节型 6例 ,脓疱型 18例 ,红皮病型 4例。寻常型皮疹形态以点滴状进行期占多数。发病情况 :初发者 35例 ,复发者 115例。除初发者外 ,其它患者均为应用过多种中西药物治疗无效者。实验室检查 :15 0例患者均作血、尿常规 ,肝、肾功能检…     

山莨菪碱和高压氧治疗高原银屑病57例

银屑病是一种常见的、易复发的慢性皮肤病,神经血管学说认为银屑病与微循环有一定关系。我们观察了拉萨地区57例寻常型银屑病的微循环改变,并采用山莨菪碱和高压氧疗法分别进行治疗,取得满意的近期疗效,且副作用小,现报道如下。一、病例和方法(一)病例选择及分组:57例皆为寻常型进行期银屑病患者,为1985～1994年间在西藏军区总医院和西藏自治区人民医院就诊的门诊及住院患者,随机分为山莨菪碱(654-2)治疗组和高压氧治疗(HBOT)组。654-2组:男26例,女4例;年龄18岁以下1例,18～25岁25例,25～40岁4例;移居汉人27例,进藏时间3年以内20例,3年以…     

自制银右石榴煎剂治疗寻常型银屑病54例

我们应用本院自制的以银杏叶、五味子为主要成分的“银杏石榴煎剂”治疗寻常型银屑病并与银屑冲剂作对照观察。现将结果报告如下 :1　临床资料全部病例均为我科门诊就诊的寻常型银屑病患者。治疗组 5 4例 ,男 35 ,女 19;年龄 17～ 76岁 ,平均 31 5岁 ;病程2月～ 35年 ,平均 7年 ;静止期 2 6例 ,进行期 2 8例 ;冬季型 46例 ,夏季型 5例 ,全年发作型 3例。对照组 36例 ,男 2 1,女 15 ;年龄 16～ 72岁 ,平均 32岁 ;病程 1月～ 30年 ,平均 6 5年 ;静止期 14例 ,进行期 2 2例 ;冬季型 30例 ,夏季型 6例。治疗组与对照组ＰＡＳＩ评分经统计学处理…     

羟基喜树碱治疗银屑病的临床观察

为了观察羟基喜树碱注射液治疗顽固性寻常型银屑病的疗效 ,我们于 1999年 1月～ 12月对我科收治的病人进行了有针对性的治疗 ,并取得了满意的效果 ,现将结果报告如下 :1　临床资料及方法共收住院 92例寻常型银屑病患者 ,治疗过程中随机分为两组 ,治疗组 46例 ,其中男 2 6例 ,女 2 0例 ,年龄 2 4～ 6 1岁 ,病程 2～ 2 8年 ,其中病程 2～ 5年 18例 ,5～ 10年 12例 ,10年以上 16例 ,病情进行期患者 35例 ,稳定期 11例 ;对照组 46例中 ,男 30例 ,女 16例 ,年龄 2 0～ 6 5岁。病程 1年～2 5年 ,其中病程 1～ 5年 2 6例 ,5～ 10年 14例 ,10年以上 …     

火把花根片与鳞屑多肽注射液联合治疗寻常型银屑病的疗效观察

我们自 1998年 3月至 1999年 10月 ,应用火把花根片 (四川省中药研究所制药厂产 )与鳞屑多肽注射液 (西安长城制药厂产 ,商品名甘加乐注射液 )联合治疗寻常型银屑病 15 8例 ,并以银屑灵冲剂治疗寻常型银屑病 5 0例作疗效对照观察 ,现将结果报告如下。临床资料　入选病例为我科门诊就诊的寻常型银屑病患者 ,非孕期及哺乳妇女 ;近 1个月来均未接受皮质类固醇、免疫抑制剂或其他方法治疗 ;无肝、肾等系统疾病。共入选 2 0 8例患者随机分为 2组 ,治疗组 :15 8例 ,男 98例 ,女 6 0例 ;年龄 8～ 6 4岁 ;病程 30天～ 2 0年 ;进行期 10 2例 ,静止期 …     

迪维霜治疗寻常型银屑病73例

我科于 1998年 12月～ 1999年 4月使用重庆华邦制药有限公司生产的迪维霜 (0 1%全反式维A酸霜 )治疗寻常型银屑病 73例 ,取得了较好疗效 ,现总结如下。1　资料和方法　1 1　病例选择　全部病例均为我科门诊就诊的寻常型进行期银屑病患者。所有病例 4周内均未接受全身皮质类固醇、免疫抑制剂或其它方法治疗 ,2周内未进行外用药物治疗。1 2　病例资料　 73例中 ,男 4 8例 ,女 2 5例 ,年龄 16～ 72岁 ,平均 4 3 30± 13 6 8岁 ,病程 1个月～ 4 0年 ,平均 8 6 4±7 38年。1 3　药物及治疗方法　 0 1%迪维霜 ,每日 2次涂抹患处 ,连用 6周 ,头…     

阿维A胶囊配合NB-UVB治疗斑块状寻常型银屑病疗效观察

2006年1月至2008年12月,我们应用阿维A胶囊配合窄谱中波紫外线(NB-UVB)治疗斑块状寻常型银屑病68例,疗效显著,现报道如下. 1 资料和方法 1.1 临床资料全部病例均来自我院门诊,均为静止期斑块状寻常型银屑病患者,皮损表现有钱币状、地图状、混合性等,皮损面积占整个体表面积10%以上,随机分为治疗组与对照组:治疗组68例,男35例,女33例,年龄18～66岁,平均39岁,病程6～28年,平均8年;对照组56例,男29例,女27例,年龄17～65岁,平均38岁,病程5～29年,平均9年.两组患者的年龄、性别、病程及病情严重程度经统计学处理,无显著性差异.     

复方甘草酸苷(美能)治疗银屑病临床疗效观察

银屑病病因复杂,易反复发作,临床治疗较困难。我们应用复方甘草酸苷(SNMC)治疗银屑病,取得满意疗效,现报道如下。临床资料　所有病人均为我科住院患者,均为寻常型银屑病,治疗前一个月内未用过任何药物治疗。随机分为2组:治疗组16例,男10例,女6例,年龄32～4 8岁,平均4 2岁;病程3个月～2 0年,平均14个月;对照组16例,男8例,女8例,年龄2 8～6 0岁,平均4 5岁,病程1个月～18年,平均16个月。治疗方法:对照组给予综合药物治疗:迪银片8片,每日1次,晨起顿服。斯奇康1ml,隔日1次,肌肉注射。胸腺肽5 0mg,每日1次,静脉滴注。综合治疗时间为4周。治疗组…     

Chondroid syringoma associated with hidrocystoma-like changes. Possible differentiation into eccrine gland. A histologic, immunohistochemical and electron microscopic study

A case of chondroid syringoma associated with hidrocystoma-like changes was investigated by histology, immunohistochemistry and electron microscopy. Chondroid syringoma was histologically compatible with apocrine mixed tumor, and hidrocystoma-like changes did not fulfill diagnostic criteria of either eccrine hidrocystoma or apocrine hidrocystoma. However, epithelial cellular elements composing both chondroid syringoma and hidrocystoma-like changes suggested, immunohistochemically and electron microscopically, differentiation into eccrine gland. The lesions of both had an apparent transition of ductal structures of chondroid syringoma into hidrocystoma-like changes. Therefore, chondroid syringoma and hidrocystoma-like changes in this case may be organized as a peculiar type of cutaneous appendage tumor differentiating toward eccrine gland.     

Histopathological Features of Recalcitrant Erythema of the Face in Adult Patients with Atopic Dermatitis

Recalcitrant erythema on the face of 21 adult patients with atopic dermatitis was histologically examined. All patients had been applying topical corticosteroids to the facial erythema for three years or more. The histopathology of the recalcitrant facial erythema was not homogeneous. Thus, the facial erythema was roughly classified into three categories: 1) erythema which mainly showed eczematous changes, 2) erythema which mainly showed steroid-induced rosacea-like changes, and 3) erythema which showed both eczematous changes and steroid-induced rosacea-like changes. The majority (75%) of recalcitrant facial erythema belonged to the third category.     

Inhibition of the in vivo effects of concanavalin-A on mammalian epidermis by alpha-methyl-D-glucopyranoside.

Concanavalin-A (Con-A) injected intradermally into newborn rats produces inhibition of granular-cell formation, accumulation of spinous cells, glycogen deposition, and a decrease followed by an increase in the number of basal cells in DNA synthesis. These changes were maximal with a dose of 0.1 mg Con-A, although 0.005, 0.01, and 0.05 mg caused some epidermal changes. The Con-A effects were partially blocked when 0.1 ml of 0.3 or 0.1 M alpha-methyl-D-glucopyranoside (alphaMG) solution was injected 2 hr after 0.1 mg Con-A and completely inhibited by injection of 0.1 ml of 3.0 M alphaMG solution. The inhibitory effects were not seen after injection of 0.1 ml of 3.0 M N-acetyl-galactosamine saline solution, or 0.1 ml normal saline. Injection of alphaMG alone did not cause any changes in epidermal cells. These results indicate that specific sugar inhibits Con-A effects on mammalian epidermis in vivo.     

Ultrastructural studies of allergic contact dermatitis in man

Summary Early epidermal lesions of allergic contact dermatitis were examined by electron microscopy. Normal human volunteers were sensitized to DNCB, and contact reactions were elicited sequentially. Epidermal cell changes at 3 h included: the occurrence of small vacuoles with or without membrane, focal dilatation of intercellular spaces, and the alteration of tonofilaments into short, aggregated bundles. Non-sensitized skin to which DNCB was applied also showed small vacuoles with or without membrane. Monocytes infiltrated into the intercellular spaces which were not dilated, and the neighboring tonofilaments of keratinocytes remained normal.     

The transition of pemphigus vulgaris into pemphigus foliaceus: a reflection of changing desmoglein 1 and 3 autoantibody levels in pemphigus vulgaris

The transition of pemphigus vulgaris (PV) into pemphigus foliaceus (PF) is rare and the immunological changes underlying this event are not well understood. We report a 44-year-old woman who presented with oral and cutaneous erosions typical of PV. Over a 9-year period, the clinical features evolved into those of PF. To examine whether quantitative changes in desmoglein (Dsg) antibodies were associated with this transition, Dsg1 and Dsg3 antibody levels were measured by enzyme-linked immunosorbent assay in 82 sequential serum samples collected over this period. At presentation, when the phenotype was PV with oral and cutaneous erosions, antibodies to both Dsg1 and Dsg3 were detected. The disappearance of oral involvement was associated with a decline in Dsg3 antibodies, which are now undetectable, while the development of more severe skin involvement was associated with rising Dsg1 antibody levels. These data strongly suggest that the change in clinical features is a reflection of qualitative and quantitative changes in antibody profile. It is not known whether the transition to PF is permanent or whether disease relapses in the future may be associated with the re-emergence of Dsg3 antibodies, oral ulceration and a PV phenotype.     

Ultrastructural Study of Anti-Tumor Effects of Tamoxifen in Two Malignant Melanoma Patients

In order to clarify the mode of action (tumor cell death) of tamoxifen in treatment for estrogen receptor (ER) negative malignant melanoma, we administered the usual adult dose (20 mg/day) or a low dose, 1/4 of the usual dose (5 mg/day), of tamoxifen for 2 months to 2 male patients and investigated ultrastructural changes in their melanoma cells from metastatic lesions before and after the treatment. After the 2-month adminisration, metastatic nodules in both patients were reduced in size by approximately 50%. Histologically, their reduced nodules presented coagulation necrosis around the blood vessels. Electron microscopy of the necrosis revealed that melanoma cells were degenerated and disappeared; numerous aggregated melanosomes, free melanosomes, granular endoplasmic reticula, and lysosomes were present in the extracellular matrix and in the space between collagen fibers. The remaining melanoma cells had swollen cytoplasm and mitochondria with vacuolar changes. Cristae of mitochondria had disappeared. There was no infiltration of lymphocytes or histiocytes into the nodules. The organic changes of necrosis lesions were not observed. Because our two patients were ER negative, these effects of tamoxifen could be attributable to an action not mediated by ER.     

The effect of ageing on phenotype and function of monocyte-derived Langerhans cells

Background With increasing age the immune system shows functional decline. In the skin this is associated with an increased incidence of epidermal malignancies and infections. Epidermal Langerhans cells (LCs) act as sentinels of the immune system, recognizing, processing and presenting antigen and inducing T‐cell responses. Previous investigations have demonstrated a reduction in the number of epidermal LCs in elderly subjects. Moreover, the ability of LCs to migrate in response to tumour necrosis factor (TNF)‐α, but not interleukin (IL)‐1β, is significantly impaired in the elderly. Objectives To characterize further the changes in LC function that are associated with increasing chronological age, we have evaluated age‐related changes in the response of monocyte‐derived LCs (mLCs) to IL‐1β and TNF‐α. Methods The phenotype and function of mLCs were compared in six young (≤ 30 years) and six aged (≥ 70 years) healthy individuals using a combination of flow cytometry, cytokine and chemokine array, and a Transwell migration assay. Results Monocytes from aged individuals were able to differentiate into LCs. There were no significant differences in expression of activation markers, or in baseline or inducible cytokine secretion, by mLCs derived from aged or young subjects. Furthermore, migration in response to a chemokine ligand, CCL19, was equivalent in both age groups. Conclusions These data demonstrate that changes in LC function in the elderly are not associated with changes in systemic dendritic cell phenotype and function. Conditioning of LCs in situ by the epidermal microenvironment is likely to be more important.     

Effects of repeated skin exposure to low nickel concentrations: a model for allergic contact dermatitis to nickel on the hands

We studied the effects of repeated daily exposure to low nickel concentrations on the hands of patients with hand eczema and nickel allergy. The concentrations used were chosen to represent the range of trace to moderate occupational nickel exposure. The study was double-blinded and placebo controlled. Patients immersed a finger for 10 min daily into a 10-p.p.m. nickel concentration in water for the first week, and during the second week into a 100-p.p.m. nickel concentration. This regimen significantly increased (P = 0.05) local vesicle formation and blood flow (P = 0.03) as compared with a group of patients who immersed a finger into water. The nickel concentrations used also provoked significant inflammatory skin changes on sodium lauryl sulphate (SLS)-treated forearm skin of the patients, whereas inflammatory skin changes were not observed in healthy volunteers without hand eczema and nickel allergy, either on normal or on SLS-treated forearm skin. The present study strongly suggests that the changes observed were specific to nickel exposure. Standardized methods to assess trace to moderate nickel exposure on the hands, and the associated effects in nickel-sensitized subjects, are needed.     

Three years dermoscopic follow‐up of atypical nevi

Atypical nevi are dynamic lesions and may progressively transform into more or less atypical lesions. We aimed to investigate the dermoscopic features of atypical nevi and dynamic changes in these lesions over a period of 3‐years. Patients with 3‐year dermoscopic follow‐up records were enrolled in the study. We compared the dermatoscopic features of the nevus recorded in the first dermoscopic examination and at the end of the third year. Changes in size (mm), pattern, and color were investigated. The most common dermoscopic patterns were reticular (18 patients; 34%), reticular‐homogeneous (17 patients; 32.1%), and reticular‐globular (7 patients; 13.2%). The most common pigmentation patterns were central hyperpigmentation (28 patients; 52.8%), regular pigmentation (nine patients; 17.0%), and multifocal hypo/hyperpigmentation (eight patients; 15.1%). Twenty‐one (39.6%) patients showed changes in pattern. The transformation from reticular‐homogeneous pattern to the homogeneous pattern was the most frequent change in pattern (7 of 21 patients; 33.3%). The transformation from reticular pattern to reticular‐homogeneous pattern was the second most common change in pattern (5 of 21 patients; 23.8%). Fourteen (26.4%) patients experienced symmetrical enlargement. Symmetrical enlargement was statistically more frequent in patients who showed dermoscopic changes in pattern than in those who did not show any changes in the pattern (p: .038). In this study, we did not observe any new dermoscopic clues for the diagnosis of melanoma during the follow‐up. The nevi tended to turn into a homogeneous (structureless) pattern. We observed that the most common dermoscopic change in pattern was the transformation from reticular‐homogeneous pattern to homogeneous pattern, and the lesions had symmetrical enlargement during this transformation. In conclusion, despite the known association between atypical nevi and the risk of developing melanoma, most atypical nevi do not transform into melanoma. Therefore, our study suggests that the excision of atypical nevi is not necessary and dermatoscopic follow‐up can reduce the number of unnecessary excisions.