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Pharmaceutical Management of Rosacea—An Australian/New Zealand Medical Dermatology Consensus Narrative 红斑痤疮的药物治疗--澳大利亚/新西兰皮肤病医学共识叙述
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-17 DOI: 10.1155/dth/9678447
M. Rademaker, P. Foley, J. Sullivan, K. Armour, C. Baker, A. Ferguson, K. Gebauer, M. Gupta, G. Marshman, E. McMeniman, D. Rubel, L. Wong

Rosacea, a common chronic, predominantly centro-facial dermatosis, has previously been classified into distinct subtypes with a range of morphological signs that overlap with other inflammatory skin disorders. Recently, there has been a move towards diagnosis of clinical phenotypes, largely driven by a better understanding of the pathophysiology of rosacea and clinical trial endpoints. Despite this, treatment remains a challenge. The Australasian Medical Dermatology Group held a Rosacea workshop in November 2022 to develop a practical narrative. Eighteen recommendations were agreed upon using a modified eDelphi process in the first round, including a rosacea treatment algorithm.

红斑痤疮是一种常见的慢性皮肤病,主要发生在面部中心,以前曾被分为不同的亚型,其形态特征与其他炎症性皮肤病重叠。最近,人们开始对临床表型进行诊断,这主要是由于人们对酒渣鼻的病理生理学和临床试验终点有了更深入的了解。尽管如此,治疗仍然是一项挑战。澳大拉西亚医学皮肤病学组于 2022 年 11 月举办了一次酒渣鼻研讨会,以制定一份实用说明。在第一轮研讨会上,与会人员采用修改后的 eDelphi 流程就 18 项建议达成一致,其中包括酒糟鼻治疗算法。
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引用次数: 0
A3669G Polymorphism of Glucocorticoid Receptor Is More Present in Patients With Pemphigus Vulgaris Than in Healthy Controls and Contributes to Steroid-Resistance 糖皮质激素受体的 A3669G 多态性在丘疹性荨麻疹患者中比在健康对照组中更常见,并且有助于产生类固醇抗药性
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-17 DOI: 10.1155/2024/5573157
Anfisa Lepekhova, Olga Olisova, Nikolay Shimanovsky, Natalia Teplyuk, Elizaveta Zhgelskaya, Ridhima Punj, Alina Mardanova, Alexander Dukhanin

There are two main isoforms of glucocorticoid receptor (GR) α- and β-isoforms. GRβ isoform is the dominant inhibitor of the GRα receptor and plays a significant role in a poor response to systemic glucocorticoids (GCs) under numerous conditions. The A3669G (rs6198) polymorphism (SNP) in the untranslated region of human GR stabilizes the mRNA of the dominant-negative GRβ isoform. However, the mechanisms which generate mRNA encoding the GRβ isoform have been poorly defined, especially in pemphigus patients who do not respond to GCs. The main aim was to study gene SNP of GR in patients with pemphigus vulgaris (PV) and healthy controls. We investigated whether the A3669G SNP of the human GRβ gene is a susceptibility allele for PV and contributes to GC resistance development. The presence of the A3669G SNP was determined by high-resolution melting analysis and then confirmed by direct sequencing. GR A3669G SNP (AG genotype) occurred more frequently in PV patients (n = 72; 25%) compared with healthy controls (n = 92; 3.2%; p < 0.001). Allele G was significantly more presented in PV patients (p < 0.001). Out of 48 patients with AA genotype of A3669G SNP, only 6 had GC resistance, whereas 11 out of 18 with AG genotype developed GC resistance (p < 0.0001). The frequency of a poor response to GC in the group of patients with AG genotype was 4.89 times higher compared to AG negative one (p < 0.0001).

Our study showed that the A3669G SNP was more present in PV patients. Moreover, GC resistance appeared more frequently in patients with the AG genotype (p < 0.0001). Since those patients predominantly with severe pemphigus had GC resistance (p = 0.001), we feel that A3669G SNP (AG genotype) contributes to its development. However, more studies are needed to determine whether A3669G SNP of the human GR gene associated with the disease severity and poor response to GCs in these patients.

糖皮质激素受体(GR)主要有两种异构体,即α异构体和β异构体。GRβ 异构体是 GRα 受体的主要抑制剂,在许多情况下对全身性糖皮质激素(GCs)反应不佳起着重要作用。人类 GR 非翻译区的 A3669G(rs6198)多态性(SNP)能稳定显性阴性 GRβ 异构体的 mRNA。然而,编码 GRβ 异构体的 mRNA 的生成机制尚不明确,尤其是在对 GCs 无反应的丘疹性荨麻疹患者中。我们的主要目的是研究寻常性天疱疮(PV)患者和健康对照者的 GR 基因 SNP。我们研究了人类 GRβ 基因的 A3669G SNP 是否是 PV 的易感等位基因,是否会导致 GC 抗药性的产生。我们通过高分辨率熔解分析确定了 A3669G SNP 的存在,然后通过直接测序进行了确认。与健康对照组(n = 92; 3.2%; p <0.001)相比,GR A3669G SNP(AG 基因型)更频繁地出现在 PV 患者中(n = 72; 25%)。等位基因 G 在帕金森病患者中的出现率明显更高(p <0.001)。在 48 名 A3669G SNP 基因型为 AA 的患者中,只有 6 人对 GC 产生耐药性,而在 18 名基因型为 AG 的患者中,有 11 人对 GC 产生耐药性(p < 0.0001)。与 AG 阴性组相比,AG 基因型患者对 GC 反应不佳的频率高出 4.89 倍(p < 0.0001)。 我们的研究表明,A3669G SNP 更多出现在 PV 患者中。此外,AG 基因型患者的 GC 耐药性出现得更频繁(p < 0.0001)。由于那些以重症丘疹性荨麻疹为主的患者具有 GC 耐药性(p = 0.001),我们认为 A3669G SNP(AG 基因型)有助于丘疹性荨麻疹的发生。然而,还需要更多的研究来确定人类 GR 基因的 A3669G SNP 是否与这些患者的疾病严重程度和对 GCs 的不良反应有关。
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引用次数: 0
Patient Awareness, Education, and Support for Atopic Dermatitis in Egypt and Lebanon: Results of a Physician Survey and Social Analytics 埃及和黎巴嫩患者对特应性皮炎的认识、教育和支持:医生调查和社会分析的结果
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-01 DOI: 10.1155/2024/5534555
Mahira ElSayed, Magdy Ragab, Jinane El Khoury, Mazen Kurban, Marcelle Ghoubar, Nehal Hassan

Background and Aim: Atopic dermatitis (AD) impacts the quality of life of patients and their families. This survey-based study aimed to understand the perspectives of physicians in Egypt and Lebanon regarding available educational initiatives and support programs for patients with AD, which was complemented by the social analytics study, offering a more comprehensive understanding of the perceptions of AD among social media users.

Methods: The survey included 200 physicians, comprising primary care physicians, family medicine physicians, pediatricians, and dermatologists from Egypt and Lebanon. The social analytics study leveraged artificial intelligence to analyze 100 million websites across the region, identifying mentions of AD-related terminologies.

Results: The physician survey uncovered gaps in AD awareness and education in Egypt and Lebanon, with limited educational initiatives and digital applications available for patients. The perceptions of physicians varied regarding the use of telemedicine in dermatological disease management. According to the social analytics study, online discussions about AD predominantly originated from Egypt, featuring educational content on causes, diagnosis, management, and AD patient journey. Discussions included news about training programs, AD-related healthcare initiatives, and drug approvals. Some authors, beauty clinics, and manufacturers actively promoted their services and products. Patients actively engaged in online discussions on self-care and natural remedies, sharing their experiences of living with AD. Notably, there were substantial volumes of incorrect and inaccurate information being shared and promoted by some authors.

Conclusion: Education about AD is crucial for patients and healthcare professionals. While social media offers opportunities for increased patient engagement, the prevalence of misinformation poses a significant challenge. Addressing issues related to education and discerning misinformation is essential for achieving optimal outcomes in the management of AD within the region.

背景和目的:特应性皮炎(AD)影响患者及其家人的生活质量。本研究以调查为基础,旨在了解埃及和黎巴嫩医生对特应性皮炎患者现有教育计划和支持项目的看法,并辅以社交分析研究,更全面地了解社交媒体用户对特应性皮炎的看法。 调查方法调查对象包括来自埃及和黎巴嫩的 200 名医生,包括初级保健医生、家庭医生、儿科医生和皮肤科医生。社交分析研究利用人工智能分析了该地区的 1 亿个网站,识别了与注意力缺失症相关的术语。 研究结果医生调查发现,埃及和黎巴嫩在注意力缺失症的认识和教育方面存在差距,为患者提供的教育计划和数字应用程序有限。在皮肤病管理中使用远程医疗方面,医生的看法各不相同。根据社交分析研究,有关注意力缺失症的在线讨论主要来自埃及,内容涉及病因、诊断、管理和注意力缺失症患者的治疗历程。讨论内容包括有关培训计划、AD 相关医疗保健计划和药物批准的新闻。一些作者、美容诊所和制造商积极宣传自己的服务和产品。患者积极参与有关自我保健和自然疗法的在线讨论,分享他们与 AD 患者共同生活的经验。值得注意的是,一些作者分享和宣传了大量错误和不准确的信息。 结论有关注意力缺失症的教育对患者和医护人员至关重要。虽然社交媒体为提高患者参与度提供了机会,但错误信息的盛行也带来了巨大挑战。解决与教育和辨别错误信息相关的问题,对于在该地区实现 AD 管理的最佳结果至关重要。
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引用次数: 0
Baricitinib for the Treatment of Chronic Pruritus of Unknown Origin 治疗不明原因慢性瘙痒症的巴利替尼
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-01 DOI: 10.1155/2024/5531111
Wei Hua, Yingrou Tan, Hong Liang Tey

Background: Chronic pruritus of unknown origin (CPUO) is a highly debilitating disease that lacks effective treatment. There have been case reports of effective use of Janus Kinase (JAK) inhibitors in CPUO, including a case treated with baricitinib, a selective JAK 1/2 inhibitor.

Objectives: To evaluate if itch in a cohort of CPUO patients was effectively reduced after treatment with baricitinib.

Patients and Methods: This is a retrospective case series examining all patients with CPUO who were treated with baricitinib from February 2022 to August 2023 at the National Skin Center, Singapore. Itch scores on a 0–10 numerical rating scale (NRS) at 0.5-point intervals were recorded and analyzed over time.

Results: Sixteen patients (56% women, mean age of 62.2 ± 19.7 years old) with CPUO were included in the analysis. Their mean [range] duration of chronic itch was 15.4 [1–50] years, and the mean follow-up period of baricitinib treatment was 10.2 ± 6.7 months. The median [IQR] NRS itch score before and after baricitinib treatment were 8.5 [6.5–10.0] and 3.5 [1.25–5.0], respectively, with a mean reduction in the itch score of 4.9 ± 2.7 (p < 0.0001). All except one patient reported significant improvement in itch severity. There were no reports of symptomatic side effects, except for a drop in hemoglobin in a patient with thalassemia and a dry throat in another patient. There were five cases of mild elevation in creatine kinase levels, three of which normalized over time, and two cases of mild elevation in creatinine levels.

Conclusion: This study suggests that baricitinib can effectively reduce pruritus in patients with CPUO and supports the conduct of randomized placebo-controlled trials to better elucidate the efficacy of JAK inhibitors in management of CPUO.

背景:原因不明的慢性瘙痒症(CPUO)是一种极易使人衰弱的疾病,但缺乏有效的治疗方法。有病例报告称,Janus 激酶(JAK)抑制剂可有效治疗慢性瘙痒症,其中包括使用巴利替尼(一种选择性 JAK 1/2抑制剂)治疗的病例。 研究目的评估CPUO患者在接受巴利昔尼治疗后是否能有效减轻瘙痒。 患者和方法这是一项回顾性病例系列研究,研究对象是2022年2月至2023年8月期间在新加坡国家皮肤中心接受巴利昔尼治疗的所有CPUO患者。以0.5分的间隔记录和分析了0-10数字评分量表(NRS)的瘙痒评分。 结果:16 名 CPUO 患者(56% 为女性,平均年龄为 62.2 ± 19.7 岁)参与了分析。他们的平均慢性瘙痒持续时间为 15.4 [1-50] 年,巴利昔替尼治疗的平均随访时间为 10.2 ± 6.7 个月。巴利昔替尼治疗前后的NRS瘙痒评分中位数[IQR]分别为8.5[6.5-10.0]和3.5[1.25-5.0],瘙痒评分平均降低了4.9±2.7(p <0.0001)。除一名患者外,其他患者的瘙痒严重程度均有明显改善。除一名地中海贫血患者血红蛋白下降和另一名患者咽喉干燥外,没有其他症状性副作用的报告。有五例肌酸激酶水平轻度升高的病例,其中三例随着时间的推移恢复正常,还有两例肌酐水平轻度升高的病例。 结论这项研究表明,巴利昔尼可以有效减轻CPUO患者的瘙痒症状,并支持开展随机安慰剂对照试验,以更好地阐明JAK抑制剂在治疗CPUO方面的疗效。
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引用次数: 0
Evaluation of Quality of Life in First-Degree Relatives of Patients With Hidradenitis Suppurativa Using Family Dermatology Life Quality Index 使用家庭皮肤科生活质量指数评估化脓性扁平湿疹患者一级亲属的生活质量
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-30 DOI: 10.1155/2024/3743560
Rojan Javaheri, Farhad Handjani, Mohammad Mahdi Parvizi, Dorra Bouazzi, Gregor Borut Ernst Jemec

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the quality of life (QoL) of afflicted patients. This current study was designed to assess the QoL of first-degree relatives of HS patients and the various associated parameters.

Methods: We conducted this cross-sectional study at the Outpatient Dermatology Clinics of Shahid Faghihi Hospital and Imam Reza Clinic, affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, from 2021 to 2022. Thirty-nine first-degree relatives of thirty-nine patients with HS were selected to enter this cross-sectional study, through the census sampling method. The Family Dermatology Life Quality Index (FDLQI) was used to determine the scores.

Results: A total of 39 patients (24 men and 15 women) with HS were included in the present study. The mean total score of the FDLQI questionnaire was 9.10 ± 6.77, which indicates a moderate impact on the QoL of the first-degree relatives of HS patients. In HS patients with underlying diseases, FDLQI scores were greater. Other first-degree relatives had a higher average overall FDLQI score than the patient’s spouse. Comorbid first-degree relatives showed considerably higher FDLQI scores than those without. FDLQI scores increased with first-kin age.

Conclusion: The FDLQI score of first-degree relatives of HS patients is considerably affected by any other underlying condition. Additionally, FDLQI scores were substantially associated with the first-degree relative’s relationship with the patient (spouse vs. other relation) and the patient’s and relative’s underlying diseases.

背景:化脓性扁平湿疹(HS)是一种慢性炎症性皮肤病,会影响患者的生活质量(QoL)。本研究旨在评估 HS 患者一级亲属的 QoL 以及各种相关参数。 研究方法我们于 2021 年至 2022 年在伊朗设拉子市设拉子医科大学附属沙希德-法吉希医院(Shahid Faghihi Hospital)和伊玛目-礼萨诊所(Imam Reza Clinic)的皮肤病门诊进行了这项横断面研究。这项横断面研究通过普查抽样法,选取了 39 名 HS 患者的 39 名一级亲属。采用家庭皮肤病生活质量指数(FDLQI)来确定分数。 研究结果本研究共纳入 39 名 HS 患者(24 名男性和 15 名女性)。FDLQI 问卷的平均总分为 9.10 ± 6.77,表明对 HS 患者一级亲属的生活质量影响适中。有基础疾病的 HS 患者的 FDLQI 得分更高。其他一级亲属的 FDLQI 平均总分高于患者配偶。有合并症的一级亲属的 FDLQI 分数明显高于无合并症的一级亲属。FDLQI 分数随一级亲属年龄的增长而增加。 结论HS 患者一级亲属的 FDLQI 分数受任何其他潜在疾病的影响很大。此外,FDLQI 分数还与一级亲属与患者的关系(配偶与其他关系)以及患者和亲属的基础疾病密切相关。
{"title":"Evaluation of Quality of Life in First-Degree Relatives of Patients With Hidradenitis Suppurativa Using Family Dermatology Life Quality Index","authors":"Rojan Javaheri,&nbsp;Farhad Handjani,&nbsp;Mohammad Mahdi Parvizi,&nbsp;Dorra Bouazzi,&nbsp;Gregor Borut Ernst Jemec","doi":"10.1155/2024/3743560","DOIUrl":"https://doi.org/10.1155/2024/3743560","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the quality of life (QoL) of afflicted patients. This current study was designed to assess the QoL of first-degree relatives of HS patients and the various associated parameters.</p>\u0000 <p><b>Methods:</b> We conducted this cross-sectional study at the Outpatient Dermatology Clinics of Shahid Faghihi Hospital and Imam Reza Clinic, affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, from 2021 to 2022. Thirty-nine first-degree relatives of thirty-nine patients with HS were selected to enter this cross-sectional study, through the census sampling method. The Family Dermatology Life Quality Index (FDLQI) was used to determine the scores.</p>\u0000 <p><b>Results:</b> A total of 39 patients (24 men and 15 women) with HS were included in the present study. The mean total score of the FDLQI questionnaire was 9.10 ± 6.77, which indicates a moderate impact on the QoL of the first-degree relatives of HS patients. In HS patients with underlying diseases, FDLQI scores were greater. Other first-degree relatives had a higher average overall FDLQI score than the patient’s spouse. Comorbid first-degree relatives showed considerably higher FDLQI scores than those without. FDLQI scores increased with first-kin age.</p>\u0000 <p><b>Conclusion:</b> The FDLQI score of first-degree relatives of HS patients is considerably affected by any other underlying condition. Additionally, FDLQI scores were substantially associated with the first-degree relative’s relationship with the patient (spouse vs. other relation) and the patient’s and relative’s underlying diseases.</p>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2024 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3743560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Specific IgE Distribution Characteristics of Dust Mite Allergen Components in Patients With Atopic Dermatitis 特应性皮炎患者尘螨过敏原成分的特异性 IgE 分布特点分析
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-26 DOI: 10.1155/2024/8961289
Zixing Cui, Ling Fang, Min Sun, Juan Liu, Hua Guo

Objective: To investigate the distribution characteristics of specific immunoglobulin E (IgE) to dust mite components in patients with atopic dermatitis (AD), aiming to provide a reference basis for the development of microarray protein chips for allergen component discrimination diagnosis and personalized desensitization therapy.

Methods: A total of 55 patients who visited Huishan District People’s Hospital of Wuxi City, Xishan People’s Hospital of Wuxi City, and People’s Hospital of Wuxi City from January 2023 to December 2023 were selected. The results of serum total IgE (total IgE) and specific IgE detection were analyzed.

Results: Among the 55 patients, 54 (98.2%) were positive (cutoff value > 0.35 Ua/mL, the normal value for serum total IgE is under 150–400 IU/mL) for serum total IgE antibodies, 52 (94.6%) were positive for Dermatophagoides pteronyssinus (Dp)–specific IgE antibodies, and 50 (90.9%) were positive for Dermatophagoides farinae (Df)–specific IgE antibodies. The protein chip results were consistent with the existing Phadia detection results.

Conclusion: The development of chips based on CRD (component-resolved diagnosis) cannot only rely on IgE binding rate to assist in precise treatment of patients but also choose personalized desensitization therapy, providing more practical recommendations for preventing cross-allergy, avoiding allergic environments, or ingesting sensitizing foods for susceptible individuals.

目的研究特应性皮炎(AD)患者体内针对尘螨成分的特异性免疫球蛋白E(IgE)的分布特征,旨在为过敏原成分鉴别诊断和个性化脱敏治疗的微阵列蛋白芯片开发提供参考依据。 研究方法选取2023年1月至2023年12月在无锡市惠山区人民医院、无锡市锡山区人民医院、无锡市人民医院就诊的55例患者为研究对象。分析血清总IgE(总IgE)和特异性IgE的检测结果。 结果55例患者中,54例(98.2%)血清总IgE抗体阳性(临界值> 0.35 Ua/mL,血清总IgE的正常值为150-400 IU/mL以下),52例(94.6%)Dermatophagoides pteronyssinus(Dp)特异性IgE抗体阳性,50例(90.9%)Dermatophagoides farinae(Df)特异性IgE抗体阳性。蛋白芯片结果与现有的 Phadia 检测结果一致。 结论基于CRD(成分分辨诊断)的芯片开发不仅可以依靠IgE结合率辅助对患者进行精确治疗,还可以选择个性化的脱敏疗法,为易感人群预防交叉过敏、避免过敏环境或摄入致敏食物提供更实用的建议。
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引用次数: 0
Herbal Agents Against Dermatophytes: Effect of 43 Herbal Agents on Dermatophyte Growth 抗皮癣菌的草药:43 种草药对皮癣菌生长的影响
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-24 DOI: 10.1155/2024/6727040
Johanna Albrecht, Martin Köberle, Sarah Preis, Tilo Biedermann, Hans Peter Seidl, Michèle Lindner, Ellen Florig, Alexander Zink

Dermatophyte infections of the skin and nails are frequent, but current antimycotics have several drawbacks. In search of new treatments, we looked into the vast array of herbal active agents. Derived from plants, they are sustainable, agreeable for patients, and may have less side effects than traditional antimycotics. In this study, we assessed 43 herbal agents for their effectiveness against Trichophyton rubrum (T. rubrum), Trichophyton benhamiae (T. benhamiae), Trichophyton tonsurans (T. tonsurans), and Microsporum canis (M. canis), four major human dermatophyte pathogens. The antifungal effect was tested by incorporating the agents into agar plates and measuring the dermatophyte growth after 7 days. Against T. rubrum, 16 out of 43 herbal agents showed total inhibition of dermatophyte growth. 14 out of 43 herbal agents inhibited the growth of T. benhamiae completely. 18 out of 43 herbal agents were effective against T. tonsurans. Against M. canis, 15 out of 43 herbal agents showed total growth inhibition. Twelve herbal agents inhibited the growth of all tested dermatophytes completely. This study demonstrates the high antimycotic potential of herbal therapeutics and identified promising candidates for the topical treatment of dermatomycoses. Substances are highly agreeable and should be tolerated well. Some might even provide new options for the systemic treatment of fungal diseases.

皮肤和指甲的皮癣菌感染很常见,但目前的抗霉菌药物存在一些缺点。为了寻找新的治疗方法,我们研究了大量草药活性剂。这些药剂从植物中提取,具有可持续发展性,患者易于接受,与传统抗霉菌药物相比副作用较小。在这项研究中,我们评估了 43 种草药对四种主要人类皮肤癣菌病原体--红色毛癣菌(T. rubrum)、苯哈米亚毛癣菌(T. benhamiae)、扁桃体毛癣菌(T. tonsurans)和犬小孢子菌(M. canis)的抗真菌效果。抗真菌效果的测试方法是将药剂加入琼脂平板,7 天后测量皮癣菌的生长情况。针对红癣菌,43 种草药中有 16 种完全抑制了皮癣菌的生长。43 种草药制剂中有 14 种完全抑制了 T. benhamiae 的生长。43 种草药中有 18 种对扁平苔藓菌有效。43 种草药中有 15 种完全抑制了犬毛癣菌的生长。12 种草药完全抑制了所有受测皮癣菌的生长。这项研究表明,草药疗法具有很高的抗真菌潜力,并为皮霉菌病的局部治疗找到了有前途的候选药物。这些药物具有很高的适应性和耐受性。有些物质甚至可以为真菌病的系统治疗提供新的选择。
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引用次数: 0
Follow-Up on Psoriasis Patients After Dead Sea Climate Therapy: Efficacy and Duration to Relapse 死海气候疗法后牛皮癣患者的随访:疗效和复发持续时间
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-24 DOI: 10.1155/2024/7835970
Abdullah Mansouri, Jørgen Serup

Studies find climate therapy (CT) at the Dead Sea of psoriasis efficient for induction therapy, but few studies address disease relapse, long-term maintenance using CT, confounders, and the patient perspective. CT combines sunlight, balneotherapy, stress reduction, and education. This study aimed to examine Dead Sea CT and relapse of psoriasis over a 2 years period, patients’ satisfaction, and treatment outcome and preference relative to other therapies. A structured questionnaire was offered to patients, who during the recent 2 years had undergone a 4 week course of CT at the Dead Sea. Patients included applied for a new CT session due to relapse of their psoriasis. Questionnaire items covered their recall of relapse, disease severity, potential triggers of relapse and patient’s preference relative to other treatment options. The study enrolled 40 patients, with an average age of 55.5 years. CT was highly effective and resulted in marked reduction in the affected skin area, from 16% to less than 1% of the body surface. The median time from CT to first visible new lesion was 4.8 months, to first bothersome relapse 6.1 months and to full blown relapse 8.0 months. Patient satisfaction with conventional therapeutic modalities, especially oral methotrexate, was reserved, and CT was generally preferred. Relapse after CT was an inclusion criterion, and patients with long-lasting healing were not assessed. CT for 4 week treatment course of moderate to severe psoriasis at the Dead Sea which was studied in patients with relapsing disease was highly efficient for induction for clearing of the skin, matching new biologicals. In the studied group, return to prestate level took median 8 months on average. Patients’ satisfaction with CT scored high, and maintenance through repeated Dead Sea treatments often is best treatment of this segment having intolerance or poor effect of other treatments, or fear of medicines as a personal attitude.

研究发现,死海银屑病气候疗法(CT)是一种有效的诱导疗法,但很少有研究涉及疾病复发、使用 CT 的长期维持、混杂因素和患者观点。气候疗法结合了阳光、浴疗法、减压和教育。本研究旨在探讨死海 CT 与两年内银屑病复发、患者满意度、治疗效果以及相对于其他疗法的偏好。研究人员向最近两年在死海接受过 4 周 CT 治疗的患者发放了一份结构化问卷。其中包括因银屑病复发而申请重新接受 CT 治疗的患者。调查问卷的项目包括患者对复发的回忆、疾病的严重程度、复发的潜在诱因以及患者对其他治疗方案的偏好。研究共招募了 40 名患者,平均年龄为 55.5 岁。CT 疗效显著,受影响的皮肤面积明显减少,从占体表面积的 16% 减少到不足 1%。从 CT 到首次出现可见新皮损的中位时间为 4.8 个月,到首次复发的中位时间为 6.1 个月,到完全复发的中位时间为 8.0 个月。患者对传统治疗方法(尤其是口服甲氨蝶呤)的满意度有所保留,而 CT 通常是首选。CT 治疗后的复发是一项纳入标准,而长期愈合的患者则不在评估之列。在死海对复发患者进行的为期 4 周的中重度银屑病 CT 治疗疗程研究表明,CT 在诱导清除皮肤方面非常有效,与新的生物制剂相匹配。在研究组中,恢复到治疗前水平平均需要 8 个月。患者对 CT 的满意度很高,对于不耐受其他疗法或其他疗法效果不佳,或因个人态度而惧怕药物的患者,通过反复死海治疗来维持病情往往是最好的治疗方法。
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引用次数: 0
Analysis and Identification of Methylation-Modifying Genes Associated with Hypoxia and Immunity in Keloids 分析和鉴定瘢痕疙瘩中与缺氧和免疫相关的甲基化修饰基因
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-23 DOI: 10.1155/2024/6210242
Chun-Hu Wang, Zi-Rong Li, Meng Wang, Jie Li, Xin Li, Xiao-Ning Yang, You-Bin Wang, Ji-Guang Ma

Background. Keloids are benign fibroproliferative tumors that are unique to humans. However, the exact mechanism of keloid formation remains unclear. The inflammatory cytokines released by immune cells can activate fibroblasts, connective tissue cell proliferation, and angiogenesis. Hypoxia is common in the process of fibrosis in many diseases. This study aimed to investigate the relationship between immune response, hypoxia, and keloid formation. Methods. Gene methylation and expression data were downloaded from the GEO database. Thereafter, differentially methylated genes associated with immunity and hypoxia were identified. Machine learning was performed to identify potential diagnostic/immunity/hypoxia-related differentially methylated/expressed genes, followed by analysis of functional enrichment, transcription factors, protein-protein interactions, and expression validation by reverse transcription quantitative polymerase chain reaction and immunohistochemistry. Results. In total, 16 immunity/hypoxia-related hypermethylated low-expression genes and 18 immunity/hypoxia-related hypomethylated high-expression genes were identified in keloids. Based on machine learning, nine differentially methylated and expressed genes were selected as potential diagnostic markers for keloids, including two hypoxia-related genes (CDKN1A and PGAM2) and seven immunity-related genes (DCD, PTGDS, WFIKKN1, SEMA5A, IL1R1, ITGAL, and SOS1). Some significantly enriched signaling pathways were identified, including the FoxO, PI3K-Akt, focal adhesion, and ErbB signaling pathways. SOS1 is involved in disease regulation with 65 transcription factors and has a higher interaction score with other molecules. Conclusions. Two hypoxia-related genes (CDKN1A and PGAM2) and seven immunity-related genes (DCD, PTGDS, WFIKKN1, SEMA5A, IL1R1, ITGAL, and SOS1) could be considered potential diagnostic markers for keloids, and may be helpful in understanding the importance of oxygen balance and immune regulation in keloids.

背景。瘢痕疙瘩是人类特有的良性纤维增生性肿瘤。然而,瘢痕疙瘩形成的确切机制仍不清楚。免疫细胞释放的炎性细胞因子可激活成纤维细胞、结缔组织细胞增殖和血管生成。缺氧是许多疾病纤维化过程中的常见现象。本研究旨在探讨免疫反应、缺氧和瘢痕疙瘩形成之间的关系。研究方法从 GEO 数据库下载基因甲基化和表达数据。然后,找出与免疫和缺氧相关的不同甲基化基因。通过机器学习确定潜在的诊断/免疫/缺氧相关的差异甲基化/表达基因,然后分析功能富集、转录因子、蛋白-蛋白相互作用,并通过逆转录定量聚合酶链反应和免疫组化进行表达验证。研究结果在瘢痕疙瘩中总共发现了16个免疫/缺氧相关的高甲基化低表达基因和18个免疫/缺氧相关的低甲基化高表达基因。基于机器学习,9个不同甲基化和表达的基因被选为瘢痕疙瘩的潜在诊断标记,包括2个缺氧相关基因(CDKN1A和PGAM2)和7个免疫相关基因(DCD、PTGDS、WFIKKN1、SEMA5A、IL1R1、ITGAL和SOS1)。发现了一些明显富集的信号通路,包括 FoxO、PI3K-Akt、病灶粘附和 ErbB 信号通路。SOS1 与 65 个转录因子一起参与疾病调控,与其他分子的相互作用得分较高。结论两个缺氧相关基因(CDKN1A和PGAM2)和七个免疫相关基因(DCD、PTGDS、WFIKKN1、SEMA5A、IL1R1、ITGAL和SOS1)可被视为瘢痕疙瘩的潜在诊断标志物,并有助于了解氧平衡和免疫调节在瘢痕疙瘩中的重要性。
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引用次数: 0
An Innovative Single-Stage Approach of High-Tension Keloid Excision and Reconstruction Using Acellular Dermal Matrix and Epidermal Skin Grafting 使用细胞真皮基质和表皮皮肤移植进行高张力瘢痕疙瘩切除和重建的单阶段创新方法
IF 3.7 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-22 DOI: 10.1155/2024/7551111
Wenbo Wang, Boya Zhou, Lingling Xia, Zongan Chen, Wei Liu, Zhen Gao, Xiaoli Wu

The treatment of keloids, particularly in high-tension areas, is challenging due to their extension beyond the original wound boundaries and high recurrence rates, thereby rendering traditional treatments ineffective. In this study, we investigated the effectiveness of a novel single-stage treatment approach that combined acellular dermal matrix (ADM) with keloid-specific epidermal skin grafting. To further prevent recurrence after neo-skin formation, the treatment was followed by fractionated laser and radiation therapy (LCR). Seven patients with high-tension keloids, including one with keloids at two locations, were treated and followed-up for an average of 15.9 months. The patients showed significant improvements in wound healing and skin appearance, with a marked reduction in the Patient and Observer Scar Assessment Scale (POSAS) (scores from 91.1 ± 5.6 to 23.8 ± 6.1 (p < 0.001)). This approach effectively minimizes tension, reduces the likelihood of keloid recurrence, and serves as a viable alternative to conventional methods that often involve challenges related to donor-site acquisition. No recurrence was observed during the follow-up period, indicating a promising innovation in the management of extensive keloids and offering improved healing and esthetic outcomes, particularly in high-tension areas.

瘢痕疙瘩(尤其是高张力部位的瘢痕疙瘩)的治疗极具挑战性,因为瘢痕疙瘩的范围超出了原来的伤口边界,而且复发率很高,从而导致传统治疗无效。在这项研究中,我们研究了一种新型单阶段治疗方法的有效性,这种方法结合了非细胞真皮基质(ADM)和瘢痕疙瘩特异性表皮移植。为了进一步防止新生皮肤形成后的复发,治疗后进行了分次激光和放射治疗(LCR)。七名高张力瘢痕疙瘩患者接受了治疗,其中一人的瘢痕疙瘩分布在两个部位,平均随访时间为 15.9 个月。这些患者的伤口愈合和皮肤外观均有明显改善,患者和观察者瘢痕评估量表(POSAS)(评分从 91.1 ± 5.6 降至 23.8 ± 6.1 (p < 0.001))明显降低。这种方法有效地减少了张力,降低了瘢痕疙瘩复发的可能性,是传统方法的一种可行替代方法,而传统方法往往涉及到供体部位获取的难题。在随访期间没有观察到复发现象,这表明在大面积瘢痕疙瘩的管理方面是一种很有前途的创新,并能改善愈合和美观效果,尤其是在高张力区域。
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Dermatologic Therapy
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