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Upadacitinib for the treatment of alopecia areata – A case report 乌达帕替尼治疗斑秃--病例报告
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-30 DOI: 10.4103/ds.ds-d-23-00110
Jui-Wen Yeh, Chao-Chun Yang
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引用次数: 0
Risk of thyroid cancer among patients with vitiligo: A systematic review and meta-analysis 白癜风患者罹患甲状腺癌的风险:系统回顾与荟萃分析
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-29 DOI: 10.4103/ds.ds-d-23-00089
Yi-Rong Li, Ting-An Chang, Jen-Hung Wang, Li-Yu Chen, Jing-Wun Lu, Ching-Hui Loh, Tai-Li Chen

Background: 

Whether patients with vitiligo have an increased risk of thyroid cancer remained controversial.

Objectives: 

To study the risk of developing thyroid cancer among vitiligo patients using meta-analysis.

Methods: 

This meta-analysis was performed via a literature review of four databases (Web of Science, Embase, PubMed, and Cochrane Library) from their respective inception till February 17, 2023. Relevant reviews and the bibliographies of eligible studies were also scrutinized. During searching in databases, no filter was placed regarding the language or geography of the study. Only observational studies presenting with adjusted risk estimates were eligible for meta-analysis. The random-effects model was employed for performing this meta-analysis.

Results: 

Four studies with 200,629 vitiligo patients and 404,124 nonvitiligo controls were included in this meta-analysis, and patients with vitiligo were found to have an elevated risk of thyroid cancer (pooled relative risk, 1.341; 95% confidence interval, 1.083–1.661).

Conclusion: 

Our systematic review and meta-analysis found that vitiligo patients are at a slightly elevated risk of thyroid cancer, although the exact underlying mechanisms remain unclear. Even though the evidence is limited, clinicians should not ignore the possible susceptibility of developing thyroid malignancy among vitiligo patients.

背景:白癜风患者是否会增加患甲状腺癌的风险一直存在争议:白癜风患者是否会增加罹患甲状腺癌的风险仍存在争议:采用荟萃分析法研究白癜风患者罹患甲状腺癌的风险:这项荟萃分析是通过对四个数据库(Web of Science、Embase、PubMed 和 Cochrane Library)进行文献综述而完成的,这四个数据库的文献综述时间分别从开始到 2023 年 2 月 17 日。此外,还仔细研究了相关综述和符合条件的研究文献目录。在数据库搜索过程中,没有对研究的语言或地域进行过滤。只有提供调整后风险估计值的观察性研究才有资格进行荟萃分析。荟萃分析采用随机效应模型:结果发现,白癜风患者罹患甲状腺癌的风险较高(汇总相对风险为1.341;95%置信区间为1.083-1.661):我们的系统综述和荟萃分析发现,白癜风患者罹患甲状腺癌的风险略有升高,但确切的内在机制仍不清楚。尽管证据有限,但临床医生不应忽视白癜风患者患甲状腺恶性肿瘤的可能性。
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引用次数: 0
Treatment responses of four different biologics in a patient with recurrent generalized pustular psoriasis harboring IL36RN mutation 一名携带 IL36RN 基因突变的复发性泛发性脓疱型银屑病患者对四种不同生物制剂的治疗反应
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-22 DOI: 10.4103/ds.ds-d-23-00107
Chang-Yu Hsieh, Tsen-Fang Tsai
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引用次数: 0
Anatomical distribution of basal cell carcinoma and squamous cell carcinoma in the Taiwanese population 基底细胞癌和鳞状细胞癌在台湾人口中的分布情况
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-20 DOI: 10.4103/ds.ds-d-23-00075
Hsin-Yu Huang, Chao-Chun Yang
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引用次数: 0
Use of cyclosporine in the treatment of patients with possible neurogenic rosacea presenting as persistent facial edema with burning sensation: A case series 应用环孢素治疗以持续面部水肿伴烧灼感为表现的可能神经源性酒渣鼻患者:一个病例系列
4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-10 DOI: 10.4103/ds.ds-d-23-00041
I-Heng Chiu, Tsen-Fang Tsai
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引用次数: 0
Efficacy of alprostadil in chilblain lupus erythematosus 前列地尔治疗冻疮红斑狼疮疗效观察
4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-10 DOI: 10.4103/ds.ds-d-23-00065
Wei-En Wang, Chung-Hsing Chang
Dear Editor, A 56-year-old woman presented with chronic pain in her digits. She had worked in the seafood frozen-packaging line of a food factory for many years. Physical examination revealed ulcerations on the pulps and knuckles of her digits, with hyperkeratosis and fissures [Figure 1a-d]. No similar lesions on toes were found. The lesions were worsened by exposure to a cold environment. Raynaud’s phenomenon and sclerodactyly were not observed. In addition, a patch of cicatricial alopecia was observed on the vertex of the scalp [Figure 1e]. Discoid lupus erythematosus was confirmed by skin biopsy.Figure 1: (a-d) Erythematous plaques with fissures and ulceration on the fingers and pulps of the digits. (e) A patch of cicatricial alopecia on the vertex of the scalp. (f and g) Bilateral hand magnetic resonance angiography showed patent distal radial arteries, ulnar to interdigital arteries, and postcontrast enhancement of soft tissue swelling over the 1st to 5th digits.Blood tests revealed high titers of anti-Ro/SSA antibodies (50.1 EliA U/mL) and low C4 levels (18.2 mg/dL). However, she tested negative for antinuclear antibodies (ANA), anticardiolipin antibodies, anti-Scl-70 antibodies, and anti-double-stranded DNA antibodies. The cryoglobulin and cold agglutinin tests were negative. A diagnosis of systemic lupus erythematosus (SLE) was not fulfilled. Bilateral hand magnetic resonance angiography showed patent distal radial arteries, ulnar to interdigital arteries, and postcontrast enhancement of soft-tissue swelling over the 1st to 5th digits [Figure 1f and g]. Based on her clinical symptoms and laboratory results, she was diagnosed with chilblain lupus erythematosus (CHLE). The proposed CHLE diagnostic criteria have not yet been validated, although the Mayo Clinic diagnostic criteria proposed by Su et al. include clinical presentation, laboratory findings, and histopathology.[1] She was treated with oral pentoxifylline and nifedipine for 5 months; however, only mild improvement was seen. We further administrated a 10-day regimen of intravenous alprostadil at a dose of 60 µg/day. Significant improvement in the digital ulcers was observed within 2 weeks [Figure 2a]. Laser Doppler flowmetry revealed increased microvascular perfusion in the digits of the left hand at 30°C and 44°C during the 8-week follow-up [Figure 2b].Figure 2: (a) The digital ulcers showed significant improvement within 2 weeks (left hand). (b) Laser Doppler flowmetry revealed an increase in microvascular perfusion in the middle digit of the left hand both at 30°C and 44°C after alprostadil treatment during an 8-week follow-up.CHLE is a rare form of cutaneous lupus erythematosus; based on previous studies, it coexists with SLE in 33%–88% of patients.[2,3] Moreover, SLE developed in these patients before or after the onset of CHLE.[2,3] CHLE lesions initially present as violaceous-erythematous papules and plaques on the toes, fingers, or face, and they worsen during exposure to co
亲爱的编辑:一位56岁的女性,因手指慢性疼痛而就诊。她曾在一家食品厂的海鲜冷冻包装生产线工作多年。体格检查显示其指髓和指关节溃疡,角化过度和裂缝[图1a-d]。足趾未见类似病变。暴露在寒冷的环境中会使病变恶化。未观察到雷诺现象和指关节硬化。此外,在头皮顶点处观察到一块瘢痕性脱发[图1e]。皮肤活检证实为盘状红斑狼疮。图1:(a-d)手指和指髓的红斑斑块伴裂隙和溃疡。(e)头皮顶点的一块瘢痕性脱发。(f和g)双侧手磁共振血管造影显示桡动脉远端通畅,尺侧至指间动脉通畅,1 - 5趾软组织肿胀增强。血液检查显示抗ro /SSA抗体高滴度(50.1 EliA U/mL)和低C4水平(18.2 mg/dL)。然而,她的抗核抗体(ANA)、抗心磷脂抗体、抗scl -70抗体和抗双链DNA抗体检测均为阴性。冷球蛋白和冷凝集素试验均为阴性。诊断为系统性红斑狼疮(SLE)不满足。双侧手磁共振血管造影显示桡动脉远端通畅,尺侧至指间动脉通畅,1 - 5趾软组织肿胀增强[图1f和g]。根据她的临床症状和实验室结果,诊断为冻疮红斑狼疮(CHLE)。虽然Su等人提出的梅奥诊所诊断标准包括临床表现、实验室结果和组织病理学,但建议的CHLE诊断标准尚未得到验证。[1]口服己酮茶碱、硝苯地平5个月;然而,只看到了轻微的改善。我们进一步以60µg/天的剂量静脉注射前列地尔,为期10天。2周内观察到手指溃疡的显著改善[图2a]。激光多普勒血流仪显示,在8周的随访中,在30°C和44°C时,左手手指微血管灌注增加[图2b]。图2:(a)手指溃疡在2周内明显改善(左手)。(b)激光多普勒血流测量显示,在8周的随访中,前列地尔治疗后,左手中指在30°C和44°C时微血管灌注增加。CHLE是一种罕见的皮肤红斑狼疮;根据以往的研究,33%-88%的患者与SLE共存。[2,3]此外,这些患者在CHLE发病之前或之后发生SLE。[2,3] CHLE病变最初表现为脚趾、手指或面部的紫色红斑丘疹和斑块,并在暴露于寒冷刺激或温度降低时恶化。随着CHLE病变的进展,可能会出现角化过度、溃疡和色素沉着。CHLE的抗体谱是非特异性的[4]。一项涉及30例CHLE患者的回顾性研究显示,80%的CHLE患者ANA阳性,50%的CHLE患者抗ssa阳性[3]。CHLE的治疗尚未标准化,尽管防寒是其管理的一个组成部分。目前的治疗方案包括局部或全身皮质类固醇、局部钙调磷酸酶抑制剂、抗疟药或免疫调节剂,如霉酚酸酯,这取决于疾病的严重程度。此外,据报道,钙通道阻滞剂对血管收缩有益。[5]前列腺素E1,又称前列地尔,已被用于治疗外周循环功能不全,因为它能诱导血管舒张和血管生成,抑制血小板聚集、白细胞粘附和炎症。[6,7]在目前的研究中,前列地尔是第一个用于治疗CHLE患者手指溃疡的药物。将前列地尔(30 μg)溶于0.9%生理盐水(500 mL)中,静脉滴注2 h,每日2次,连用10 d。2周内疼痛和溃疡明显改善。激光多普勒血流测量显示,在8周的随访期间,手指微血管灌注增加。很少有研究讨论CHLE,本病例报告强调了前列地尔治疗CHLE的疗效。将进行进一步调查和长期随访。患者同意声明作者证明他们已经获得了所有适当的患者同意表格。在此表格中,患者已同意她的图像和其他临床信息将在杂志上报道。患者明白姓名和首字母不会被公布,并将尽力隐藏身份,但不能保证匿名。
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引用次数: 0
A case of cutaneous nocardiosis successfully treated with third-generation cephalosporin 第三代头孢菌素成功治疗皮肤诺卡菌病1例
4区 医学 Q2 DERMATOLOGY Pub Date : 2023-11-03 DOI: 10.4103/ds.ds-d-23-00109
Tzu-Yu Liu, Feng-Ling Lin
Dear Editor, Cutaneous nocardiosis is a type of skin and soft-tissue infection caused by Nocardia species, a kind of bacteria isolated from the environment. Sulfamethoxazole is the priority choice of oral medication,[1] but impaired renal function is a concern. Herein, we present a case successfully treated with oral cefixime as an alternative. An 87-year-old man with diabetes mellitus, congestive heart failure, and stage 4 chronic kidney disease (estimated glomerular filtration rate: 28.5 mL/min/1.73 m²) suffered from painful lesions on the face after falling to the ground. Abrasion wound and ecchymosis developed initially, so he was brought to local clinic for management. The patient did not receive systemic immunosuppressant or glucocorticoids, nor was he diagnosed with malignancy or an autoimmune disease. Topical antibiotic was given, and his wound gradually healed. However, pustular eruptions at the trauma site developed 1 week later. Cellulitis was impressed first, so topical fusidic acid cream and oral doxycycline were applied after obtaining the wound culture. The primary wound culture yielded coagulase-negative Staphylococcus epidermidis, which indicated colonization or contamination of the specimen. His symptoms also did not improve after 1-week oral antibiotic treatment. He then came to the dermatology clinic. Physical examination revealed erythematous firm nodules and pustules with erythematous-based patches on the left cheek [Figure 1a]. The patient was afebrile then.Figure 1: Clinical presentation: (a) before treatment: erythematous nodules and pustules on left cheek; (b) after treatment: erythema and pustules on left cheek resolved.Differential diagnoses included bacterial cellulitis, atypical infection (e.g. sporotrichosis, nocardiosis, tuberculosis, nontuberculous mycobacterium, or leishmaniasis), or Majocchi granuloma. He then received skin biopsy with tissue culture. Pathology report revealed suppurative microabscesses with aggregation of histiocytes [Figure 2a]. Immunohistochemistry stain showed negative for Gram’s stain [Figure 2b], periodic acid–Schiff stain [Figure 2c], or acid-fast stain [Figure 2d]. The tissue culture yielded Nocardiabrasiliensis, so cutaneous nocardiosis was diagnosed. The chest X-ray only showed enlarged heart size without increased infiltration or nodule at the lung field. Considering the impaired renal function of the patient, sulfamethoxazole was not given. We prescribed alternative treatment with oral cefixime 100 mg twice a day. After 4-week treatment, the skin lesion of the patient almost resolved [Figure 1b].Figure 2: Histopathological investigation: (a) Histopathology stain of the skin biopsy revealed suppurative microabscesses with aggregation of histiocytes (H and E, ×200); immunohistochemical stain of skin biopsy revealed negative for (b) Gram’s stain (×200), (c) periodic acid–Schiff stain (×200), and (d) acid-fast stain (×200).Cutaneous nocardiosis is skin and soft-tissue infection from a ki
皮肤诺卡菌病是一种由诺卡菌引起的皮肤和软组织感染,诺卡菌是一种从环境中分离出来的细菌。磺胺甲恶唑是口服药物的首选[1],但肾功能受损是一个问题。在这里,我们提出了一个案例成功地治疗口服头孢克肟作为一种选择。一名87岁男性,患有糖尿病、充血性心力衰竭和4期慢性肾脏疾病(估计肾小球滤过率:28.5 mL/min/1.73 m²),跌倒后面部出现疼痛病变。最初出现擦伤和瘀斑,因此被带到当地诊所治疗。患者未接受全身免疫抑制剂或糖皮质激素治疗,也未被诊断为恶性肿瘤或自身免疫性疾病。局部给予抗生素治疗,伤口逐渐愈合。然而,创伤部位1周后出现脓疱。首先是蜂窝织炎,因此在获得伤口培养后,局部应用夫西地酸乳膏和口服强力霉素。最初的伤口培养产生凝固酶阴性表皮葡萄球菌,这表明定植或污染标本。口服抗生素治疗1周后症状未见改善。然后他来到了皮肤科诊所。体格检查显示左脸颊有红斑性硬结节和脓疱,伴有红斑性斑块[图1a]。病人当时不发烧。图1:临床表现:(a)治疗前:左脸颊红斑性结节、脓疱;(b)治疗后:左脸颊红斑、脓疱消退。鉴别诊断包括细菌性蜂窝织炎、非典型感染(如孢子虫病、诺卡病、结核病、非结核分枝杆菌或利什曼病)或马氏肉芽肿。然后接受皮肤活检和组织培养。病理报告显示化脓性微脓肿伴组织细胞聚集[图2a]。免疫组化染色革兰氏染色阴性[图2b],周期性酸-希夫染色阴性[图2c],抗酸染色阴性[图2d]。组织培养产生诺卡菌,诊断为皮肤诺卡菌病。胸部x线片仅显示心脏增大,未见肺野浸润或结节增加。考虑到患者肾功能受损,未给予磺胺甲恶唑治疗。我们开了另一种治疗方法,口服头孢克肟100毫克,每天两次。治疗4周后,患者皮肤病变基本消退[图1b]。图2:组织病理学检查:(a)皮肤活检组织病理学染色显示化脓性微脓肿,组织细胞聚集(H和E, ×200);皮肤活检免疫组化染色(b)革兰氏染色(×200), (c)周期性酸-希夫染色(×200)和(d)抗酸染色(×200)为阴性。皮肤诺卡菌病是由一种需氧革兰氏阳性丝状细菌引起的皮肤和软组织感染。进入途径包括由于创伤和免疫功能低下宿主的血液直接接种。皮肤表现可表现为结节性脓疱病变,伴或不伴孢子毛样分布,蜂窝织炎或溃疡性病变。[2]最常见的皮外病变是肺诺卡菌病,尤其是免疫抑制患者。一线治疗是磺胺类药物,如磺胺甲恶唑加或不加甲氧苄啶。其他替代品包括米诺环素、阿米卡星、亚胺培南、替加环素和第三代头孢菌素。[3]严重或复杂病例建议联合治疗。对于免疫抑制状态的患者,强烈建议延长抗生素使用1-4个月。当给予适当的抗生素治疗时,原发性皮肤诺卡菌病的预后良好。回到我们的病人,由于肾功能受损,我们排除了磺胺甲恶唑和阿米卡星的治疗选择。米诺环素不可行,因为先前对强力霉素缺乏反应。患者拒绝住院治疗,无法给予亚胺培南、替加环素治疗。因此,口服形式的第三代头孢菌素可能是一个适当的选择,基于先前的文章综述和患者的临床表现的反应。总之,皮肤诺卡菌病可能源于与植物和土壤有关的局部创伤,导致脓肿、蜂窝织炎或孢子毛样淋巴性皮肤结节。磺胺甲恶唑是一线治疗,但第三代头孢菌素可能是不能耐受磺胺类药物的患者的有效选择。患者同意声明作者证明他们已经获得了所有适当的患者同意表格。在这张表格中,患者已经同意他的图像和其他临床信息将在杂志上报道。 患者明白,他的姓名和首字母不会被公布,并将尽力隐藏他的身份,但不能保证匿名。数据可用性声明数据共享不适用于本文,因为在当前研究中没有生成或分析数据集。财政支持及赞助无。利益冲突没有利益冲突。
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引用次数: 0
Cutaneous mucinosis of infancy: A case report 婴儿皮肤黏液病1例报告
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-07-01 DOI: 10.4103/ds.ds-d-23-00018
Q. Luo, Guoying Wang, Qin He, Xiangang Fang
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引用次数: 1
Dupilumab for patients with photoaggravated dermatoses with skin nodules as main manifestations: A case series 杜匹单抗用于以皮肤结节为主要表现的光加重性皮肤病患者:一个病例系列
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-07-01 DOI: 10.4103/ds.ds-d-22-00172
Rui-Xian Ye, X. Tian, Jingyao Liang, Rujun Xue, Qiongxiao Huang, Yimin Liang, YuMei Liu
Photoaggravated dermatoses (PD) are diseases that occur without ultraviolet (UV) radiation but are sometimes or frequently exacerbated by UV radiation. The clinical manifestations of PD are varied, some patients may present with pruritic nodular lesions at the site of light exposure, which possibly through a light-induced type 2 inflammatory response. Some cases may be difficult to treat, safe and effective treatment methods are constantly being explored. Here, we reported five patients with moderate to severe PD with skin nodules as main manifestations successfully treated with dupilumab, who were previously resistant to conventional treatment. After the 16-week treatment period, dupilumab showed good efficacy and safety in PD mainly characterized by nodules.
光加重性皮肤病(PD)是一种在没有紫外线照射的情况下发生的疾病,但有时或经常因紫外线照射而加重。PD的临床表现多种多样,部分患者可能在光照部位出现瘙痒性结节状病变,这可能是光诱导的2型炎症反应。有些病例可能难以治疗,人们正在不断探索安全有效的治疗方法。在这里,我们报告了5例以皮肤结节为主要表现的中重度PD患者,他们以前对常规治疗有耐药性,但杜匹单抗治疗成功。经过16周的治疗期,dupilumab在以结节为主的PD中显示出良好的疗效和安全性。
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引用次数: 1
Paraneoplastic bullous pemphigoid presented with figurate erythema: A case report and review of literature 副肿瘤大疱性类天疱疮伴象状红斑1例并文献复习
IF 2.5 4区 医学 Q2 DERMATOLOGY Pub Date : 2023-07-01 DOI: 10.4103/ds.ds-d-22-00210
Yu-Hua Lee, Nai-Wen Kang, P. Cheng
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引用次数: 1
期刊
Dermatologica Sinica
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