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Cutaneous metaplastic synovial cyst in the buttock: A comprehensive analysis of etiologic, clinical, ultrasonic, and pathological aspects 臀部皮肤变性滑膜囊肿:病因、临床、超声波和病理方面的综合分析
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2024-06-27 DOI: 10.4103/ds.ds-d-24-00032
Li-Cheng Tsai, Chih-Jung Hsu

Cutaneous metaplastic synovial cyst (CMSC) is a rare cutaneous cystic lesion, which frequently occurs subsequent to trauma or surgery, forming through the reparative and healing process. It is often misdiagnosed as foreign body granuloma or recurrent epidermoid cyst. Histologically, it is characterized by a cystic structure with multiple villous projections pointing toward the cystic space, lined by cells resembling hyperplastic synovium. To date, only 32 cases have been reported in the English literature. In this article, we present two cases of CMSC with distinctive clinical features and ultrasonic findings. Furthermore, we found only three case reports of CMSC in the gluteal region. All of these cases were elderly patients and developed CMSC at the medial aspect of the buttock. Based on their unique clinical and ultrasonic characteristics, we propose that CMSC in the buttock may be considered a distinct subgroup within CMSC, demonstrating a spectrum of degenerative diseases along with ischiogluteal bursitis.

皮肤变性滑膜囊肿(CMSC)是一种罕见的皮肤囊性病变,常发生于创伤或手术后,在修复和愈合过程中形成。它常被误诊为异物肉芽肿或复发性表皮样囊肿。从组织学角度看,它的特征是囊性结构,多个绒毛状突起指向囊腔,内衬细胞类似增生的滑膜。迄今为止,英文文献中仅报道了 32 个病例。在本文中,我们介绍了两例具有独特临床特征和超声检查结果的 CMSC 病例。此外,我们发现仅有三例关于臀部 CMSC 的报道。这些病例均为老年患者,臀部内侧出现 CMSC。根据其独特的临床和超声波特征,我们认为臀部 CMSC 可被视为 CMSC 中的一个独特亚组,表现出一系列退行性疾病和峡部滑囊炎。
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引用次数: 0
Physician visits for psoriasis and reduced risk of adverse pregnancy outcomes: A nationwide study in Taiwan 银屑病就诊与降低不良妊娠结局风险:台湾一项全国性研究
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2024-06-27 DOI: 10.4103/ds.ds-d-23-00163
Li-Ting Kao, Hui-Wen Yang, Yu-Tien Chang, I-Hsun Li, Liang-Hsuan Chen, Ya-Chiao Hu, Yi-Hsien Chen

Background: 

It is unclear whether women with psoriasis who receive adequate management or achieve better control of their psoriasis before and during pregnancy could eliminate the negative effects.

Objectives: 

The objective of this study was to investigate the association between physician visits for psoriasis and adverse pregnancy outcomes.

Methods: 

This study used the National Health Insurance database and Birth Certificate Application in Taiwan. This research further categorized the study subjects into mothers with mild/severe psoriasis who visited physicians for psoriasis before delivery, mothers with mild/severe psoriasis who did not visit a physician for psoriasis before delivery, and mothers without psoriasis. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of adverse pregnancy outcomes, including maternal and neonatal outcomes.

Results: 

3,339 mothers with severe psoriasis, 41,296 mothers with mild psoriasis, and 2,017,271 mothers without psoriasis were included in this study. The mothers with mild/severe psoriasis demonstrated a significantly higher risk of labor complications and maternal risk factors. After adjusting for confounders, mothers with severe psoriasis who did not visit a physician for psoriasis demonstrated significantly higher odds of labor complications (OR 1.217), maternal risk factors (OR 1.507), having low-birth weight infants (OR 1.236), etc., than mothers without psoriasis.

Conclusion: 

This study demonstrated that mothers with psoriasis had a higher risk of adverse pregnancy outcomes. In addition, seeking medical care for psoriasis, particularly for women with severe psoriasis, appeared to exert a protective effect against adverse pregnancy outcomes.

背景:目前尚不清楚患有银屑病的妇女在怀孕前和怀孕期间接受适当的治疗或更好地控制银屑病是否能消除其负面影响:本研究旨在调查银屑病就诊与不良妊娠结局之间的关联:本研究使用了台湾的国民健康保险数据库和出生证明申请表。本研究进一步将研究对象分为分娩前曾就诊的轻度/重度银屑病母亲、分娩前未就诊的轻度/重度银屑病母亲和无银屑病母亲。采用逻辑回归法计算不良妊娠结局(包括孕产妇和新生儿结局)发生的几率比(ORs)和95%置信区间(CIs):本研究共纳入 3,339 名重度银屑病母亲、41,296 名轻度银屑病母亲和 2,017,271 名无银屑病母亲。患有轻度/重度银屑病的母亲出现分娩并发症的风险明显较高,产妇风险因素也较高。在对混杂因素进行调整后,患有重度银屑病但未因银屑病就医的母亲出现分娩并发症(OR 1.217)、孕产妇风险因素(OR 1.507)、低体重儿(OR 1.236)等的几率明显高于无银屑病的母亲:本研究表明,患有银屑病的母亲发生不良妊娠结局的风险更高。此外,银屑病就医,尤其是患有严重银屑病的妇女,似乎对不良妊娠结局有保护作用。
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引用次数: 0
Postherpetic nevus comedonicus with annular pattern: A rare isotopic response 带状疱疹后的环状痣:罕见的同位素反应
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-06-14 DOI: 10.4103/ds.ds-d-23-00215
Ching-Li Chen, Chia-Lun Li, Chen-Yi Wu
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引用次数: 0
Rare manifestation of metastatic calcinosis cutis with milky calcific fluid in a patient with end-stage renal disease 一名终末期肾病患者伴有乳白色钙化液的转移性皮肤钙化症的罕见表现
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-06-10 DOI: 10.4103/ds.ds-d-23-00212
Huei-Jing Wang, Yue-Chiu Su, Sarah Hsin Cheng, S. Hu
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引用次数: 0
Taiwanese Dermatological Association consensus recommendations for the diagnosis, treatment, and management of generalized pustular psoriasis 台湾皮肤病协会关于诊断、治疗和管理泛发性脓疱型银屑病的共识建议
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-06-04 DOI: 10.4103/ds.ds-d-24-00070
Chao-Kai Hsu, Yu-Huei Huang, Chung-Hsing Chang, Yi-Ju Chen, Tsu-Man Chiu, Wen-Hung Chung, Chiau-Sheng Jang, Shang-Hung Lin, Chun-Wei Lu, Nan-Lin Wu, Sebastian Yu, Tsen-Fang Tsai
Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening skin disease characterized by relapsing and remitting flares of sterile neutrophilic pustules and systemic inflammation. The definition of GPP is inconsistent globally, with large discrepancies in clinical management. To provide clinical guidance on managing GPP, we conducted a systematic literature search for articles published within the last decade on PubMed and the Cochrane Library in October 2022 and held four consensus meetings with 12 Taiwanese dermatologists between October 2022 and July 2023. Upon review of 153 articles, we agreed to adopt the European Rare and Severe Psoriasis Expert Network GPP definition with additional clarifications on pustular flares in psoriatic plaques, circinate or annular lesions, and localized pustules. We also drafted a diagnostic algorithm to facilitate GPP diagnosis. Twenty-seven statements on GPP treatment reached consensus. We recommend using an oral retinoid or spesolimab injection for the first-line treatment in both acute (treating flares) and maintenance (preventing flares) settings in adults with GPP. For infants and juveniles with GPP, retinoids are recommended as a first-line treatment. Evidence for other conventional and investigational therapies was reviewed, and a treatment algorithm was proposed. We hope this consensus provides practical guidance for clinicians in Taiwan and helps improve outcomes for GPP patients.
泛发性脓疱型银屑病(GPP)是一种罕见的、可能危及生命的皮肤病,其特征是无菌性嗜中性粒细胞脓疱和全身炎症的复发和缓解。全球对 GPP 的定义并不一致,临床治疗也存在很大差异。为了给管理 GPP 提供临床指导,我们于 2022 年 10 月在 PubMed 和 Cochrane 图书馆对过去十年内发表的文章进行了系统性文献检索,并于 2022 年 10 月至 2023 年 7 月期间与 12 位台湾皮肤科医生举行了四次共识会议。在审阅了 153 篇文章后,我们同意采用欧洲罕见和严重银屑病专家网络的 GPP 定义,并对银屑病斑块中的脓疱性发作、环状或环状皮损以及局部脓疱进行了补充说明。我们还起草了一种诊断算法,以方便 GPP 的诊断。关于 GPP 治疗的 27 项声明已达成共识。我们建议在成人 GPP 患者的急性期(治疗复发)和维持期(预防复发)的一线治疗中使用口服维甲酸类药物或斯贝单抗注射液。对于婴幼儿 GPP 患者,建议将维甲酸类药物作为一线治疗药物。我们回顾了其他常规疗法和研究疗法的证据,并提出了一种治疗算法。我们希望这份共识能为台湾的临床医生提供实用的指导,并帮助改善 GPP 患者的治疗效果。
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引用次数: 0
The pathological function of neutrophils in pemphigoid diseases 嗜中性粒细胞在丘疹性荨麻疹疾病中的病理功能
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-05-13 DOI: 10.4103/ds.ds-d-24-00027
Daisuke Matsumoto, Beni Amatya, Daisuke Tsuruta, S. Hiroyasu
Pemphigoid diseases (PDs) are a group of autoimmune blistering diseases, including bullous pemphigoid, epidermolysis bullosa acquisita, mucous membrane pemphigoid, linear immunoglobulin A disease, and other rare variants. These diseases are characterized by the presence of autoantibodies that target proteins at the dermal-epidermal junction, resulting in the formation of tense blisters and erosions on the skin and/or mucosa. The current therapeutic approaches, such as systemic corticosteroid, are associated with significant adverse effects, highlighting that safer and more effective treatment options are an urgent clinical need. To address this unmet need, a comprehensive understanding of the detailed mechanisms underlying PDs is essential. Based on their histopathological infiltration in pemphigoid lesions, neutrophils have long been implicated as major contributors to the initiation and progression of the diseases. Numerous in vivo and in vitro studies have investigated the role of neutrophils in the pemphigoid pathology, revealing various pathological mechanisms induced by these cells, including the release of neutrophil elastase and matrix metalloproteinase-9, as well as the formation of neutrophil extracellular traps. The present review provides a comprehensive summary and critical evaluation of the current understanding regarding the role of neutrophils in PDs. In addition, it discusses the potential of targeting neutrophil-associated pathways as a novel therapeutic approach for the diseases.
大疱性类天疱疮是一组自身免疫性大疱性疾病,包括大疱性类天疱疮、大疱性表皮松解症、粘膜类天疱疮、线性免疫球蛋白 A 病和其他罕见变种。这些疾病的特点是存在针对真皮-表皮交界处蛋白质的自身抗体,从而在皮肤和/或粘膜上形成紧张性水疱和糜烂。目前的治疗方法,如全身使用皮质类固醇激素,会产生严重的不良反应,因此临床迫切需要更安全、更有效的治疗方案。要满足这一尚未满足的需求,就必须全面了解脓疱疮的详细发病机制。中性粒细胞在丘疹性荨麻疹病变中的组织病理学浸润长期以来一直被认为是导致疾病发生和发展的主要因素。大量体内和体外研究探讨了中性粒细胞在丘疹性荨麻疹病理中的作用,揭示了这些细胞诱导的各种病理机制,包括释放中性粒细胞弹性蛋白酶和基质金属蛋白酶-9,以及形成中性粒细胞胞外陷阱。本综述全面总结和批判性评估了目前对中性粒细胞在腹膜透析中作用的认识。此外,它还讨论了以中性粒细胞相关通路为靶点作为一种新型疾病治疗方法的潜力。
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引用次数: 0
Fractional CO2 laser as monotherapy or combined with platelet-rich plasma in the treatment of atrophic postacne scars: A narrative review 二氧化碳点阵激光作为单一疗法或结合富血小板血浆治疗萎缩性痤疮后疤痕:综述
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-03-29 DOI: 10.4103/ds.ds-d-23-00154
Abeer Attia Tawfik, Mahmoud A. Rageh

Acne scars are the unfortunate outcome of acne vulgaris. It is a common problem that faces many young adults and can cause severe distress and impair their quality of life. Different therapeutic modalities have been tried for atrophic acne scars; however, no standard treatment has been identified yet. In this review, we are focusing on fractional CO2 laser (FCL), whether used as monotherapy or combined with platelet-rich plasma (PRP), trying to highlight the efficacy and safety of such modalities in the treatment of atrophic acne scarring. PubMed, Embase, and Cochrane Library databases were used to search for relevant studies that were published in the period from January 2017 to December 2022. We used a combination of the following keywords: “acne scar,” “acne scars,” “modalities for acne scars” in addition to the names of additional therapies studied in this review, such as “laser and acne scars,” “plateletrich plasma,” “platelet-rich plasma,” “PRP,” and “platelet-rich plasma therapy and acne scars”. Twelve studies were found utilizing the use of FCL whether used as monotherapy or combined with PRP in the treatment of atrophic acne scarring. Most of the studies showed that acne scars improved with both treatment modalities, but the combination approach yielded better results with less incidence of side effects.

痤疮疤痕是寻常痤疮的不幸后果。痤疮疤痕是许多年轻人面临的常见问题,会给他们带来严重的痛苦,影响他们的生活质量。针对萎缩性痤疮疤痕,人们尝试了不同的治疗方法,但尚未找到标准的治疗方法。在这篇综述中,我们将重点关注二氧化碳点阵激光(FCL),无论是作为单一疗法还是与富血小板血浆(PRP)联合使用,我们都试图强调这种方法在治疗萎缩性痤疮疤痕方面的有效性和安全性。我们使用 PubMed、Embase 和 Cochrane Library 数据库搜索 2017 年 1 月至 2022 年 12 月期间发表的相关研究。我们使用了以下关键词组合:"痤疮疤痕"、"痤疮疤痕"、"治疗痤疮疤痕的方法",以及本综述中研究的其他疗法名称,如 "激光与痤疮疤痕"、"富血小板血浆"、"血小板丰富血浆"、"PRP "和 "血小板丰富血浆疗法与痤疮疤痕"。研究发现,有 12 项研究利用 FCL 治疗萎缩性痤疮疤痕,无论是作为单一疗法还是与 PRP 联合使用。大多数研究表明,两种治疗方法都能改善痤疮疤痕,但联合使用效果更好,副作用更少。
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引用次数: 0
Effectiveness of adding educational video in patients with atopic dermatitis to facilitate shared decision-making 为特应性皮炎患者添加教育视频以促进共同决策的效果
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-03-08 DOI: 10.4103/ds.ds-d-23-00196
Shou-En Wu, Yi-Hsien Chen, Chen-Yeu Soong, Chien-Ping Chiang, Wei-Ming Wang, Chih-Tsung Hung

Background: 

Shared decision-making (SDM) is becoming more popular in various medical specialties as a core component of patient-centered care. However, patients’ lack of sufficient disease knowledge remains a barrier to implementing SDM.

Objectives: 

This study aims to examine the effectiveness of two educational approaches for atopic dermatitis (AD) patients, a pamphlet and pamphlet plus video, using assessments of knowledge level and satisfaction.

Methods: 

From August 2021 to February 2023, patients with AD from the dermatology outpatient clinic at Tri-Service General Hospital were included. Educational pamphlets were provided before educational videos, and patients were asked to complete an identical five-question test postpamphlet and postpamphlet plus video, respectively. A questionnaire was used to evaluate patients’ satisfaction. The two test scores were compared, and the satisfaction levels were analyzed.

Results: 

The mean postpamphlet plus video score (94.84 ± 10.20) was significantly higher than the mean postpamphlet score (77.42 ± 17.17, P < 0.001) across 62 eligible samples. Gender and age subgroups showed similar trends. In addition, most patients preferred educational pamphlet plus videos (ranging from 37.5% to 75.0% in different subgroups) compared with educational pamphlets (ranging from 0.0% to 3.85%). The educational pamphlet plus video demonstrated high satisfaction in promoting disease knowledge and treatment options for AD.

Conclusion: 

Adding educational video is an efficient approach toward reinforcement of patients’ knowledge of AD and further facilitates the implementation of SDM in dermatology practice.

背景:共同决策(SDM)作为 "以患者为中心 "医疗服务的核心组成部分,在各医学专科越来越受欢迎。然而,患者缺乏足够的疾病知识仍然是实施 SDM 的障碍:本研究旨在通过知识水平和满意度评估,研究针对特应性皮炎(AD)患者的两种教育方法(小册子和小册子加视频)的有效性:方法:2021年8月至2023年2月,三军总医院皮肤科门诊的特应性皮炎患者被纳入研究对象。在播放教育视频之前先提供教育小册子,要求患者分别在小册子播放后和小册子播放后加视频播放后完成一个相同的五题测试。问卷调查用于评估患者的满意度。对两次测试得分进行比较,并对满意度进行分析:在 62 个符合条件的样本中,后记手册加视频的平均得分(94.84 ± 10.20)明显高于后记手册的平均得分(77.42 ± 17.17,P < 0.001)。性别和年龄分组显示出相似的趋势。此外,与教育小册子(0.0% 至 3.85%)相比,大多数患者更喜欢教育小册子加视频(在不同亚组中占 37.5% 至 75.0%)。教育手册加视频在宣传疾病知识和 AD 治疗方案方面的满意度很高:结论:添加教育视频是加强患者对 AD 知识了解的有效方法,可进一步促进 SDM 在皮肤科实践中的实施。
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引用次数: 0
Adult-onset Still’s disease following severe acute respiratory syndrome coronavirus 2 vaccination presenting with persistent psoriasis-like dermatitis: A case report 接种严重急性呼吸系统综合征冠状病毒 2 疫苗后出现成人型斯蒂尔病,并伴有持续性牛皮癣样皮炎:病例报告
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-02-23 DOI: 10.4103/ds.ds-d-23-00151
Chia-Jung Hsu, Tsen-Fang Tsai
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引用次数: 0
Atypical fixed drug eruption in confetti due to paracetamol 扑热息痛引起的纸屑状非典型固定药物疹
IF 2.5 4区 医学 Q3 Medicine Pub Date : 2024-02-23 DOI: 10.4103/ds.ds-d-23-00161
Corey Stone, Antoine Bertolotti, L. Davey, D. Murrell
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引用次数: 0
期刊
Dermatologica Sinica
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