Expert Review of Dermatology最新文献

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The role of dynamic infrared imaging in melanoma diagnosis. 动态红外成像在黑色素瘤诊断中的作用。

Expert Review of Dermatology

Pub Date : 2013-04-01 DOI: 10.1586/edm.13.15

Cila Herman

Melanoma incidence and the lifetime risk are increasing at an alarming rate in the United States and worldwide. In order to improve survival rates, the goal is to detect melanoma at an early stage of the disease. Accurate, sensitive and reliable quantitative diagnostic tools can reduce the number of unnecessary biopsies, the associated morbidity as well as the costs of care in addition to improving survival rates. The recently introduced quantitative dynamic infrared imaging system QUAINT measures differences in the infrared emission between healthy tissue and the lesion during the thermal recovery process after the removal of a cooling stress. Results from a clinical study suggest that the temperature of cancerous lesions is higher during the first 45-60 seconds of thermal recovery than the temperature of benign pigmented lesions. This small temperature difference can be measured by modern infrared cameras and serve as an indicator for melanoma in modern quantitative melanoma detectors.

在美国和世界范围内，黑色素瘤的发病率和终生风险正以惊人的速度增长。为了提高生存率，我们的目标是在黑色素瘤的早期发现它。准确、灵敏和可靠的定量诊断工具除了可以提高生存率外，还可以减少不必要的活组织检查次数、相关发病率以及护理费用。最近推出的定量动态红外成像系统古朴测量在去除冷却应力后热恢复过程中健康组织和病变组织之间红外发射的差异。一项临床研究结果表明，在热恢复的前45-60秒，癌性病变的温度高于良性色素病变的温度。这种微小的温差可以被现代红外摄像机测量，并在现代定量黑色素瘤检测器中作为黑色素瘤的指标。

引用次数: 49

The diagnosis of melanoma 黑色素瘤的诊断

Expert Review of Dermatology

Pub Date : 2013-04-01 DOI: 10.1586/EDM.13.13

J. Grant-Kels

引用次数: 2

Targeted chemotherapy of metastatic melanoma: the impact of tumor cell heterogeneity 转移性黑色素瘤的靶向化疗:肿瘤细胞异质性的影响

Expert Review of Dermatology

Pub Date : 2013-04-01 DOI: 10.1586/EDM.13.3

Diane Kovacic, J. Carlson, A. Slominski

Evaluation of: Flaherty KT, Infante JR, Daud A et al. Combined BRAF and MEK inhibition in melanoma with BRAF V600 mutations. N. Engl. J. Med. 367(18), 1694–1703 (2012).The treatment of metastatic melanoma with BRAF inhibitors initially gave dramatic results compared with standard chemotherapy with significant progression-free survival times. Unfortunately, within a matter of months, the melanomas become refractory to anti-BRAF-targeted therapy and some patients experience toxicity in the form of primary cutaneous squamous cell carcinomas. While recent reports of dual therapy targeting the MAPK pathway (e.g., dabrafenib and trametinib) show increased response rates and less toxicity, it is not apparent that overall survival has been significantly impacted. While targeted therapy has significantly altered the management of melanoma, novel approaches and strategies will likely have to be employed to counter melanoma cell heterogeneity and the selection of resistant clones.

评价:Flaherty KT, Infante JR, Daud A等。BRAF和MEK联合抑制BRAF V600突变黑色素瘤。心血管病。中华医学杂志，367(18)，1694-1703(2012)。与标准化疗相比，BRAF抑制剂治疗转移性黑色素瘤最初取得了显著的效果，无进展生存期显著。不幸的是，在几个月内，黑色素瘤对抗braf靶向治疗变得难治性，一些患者以原发性皮肤鳞状细胞癌的形式出现毒性。虽然最近报道的针对MAPK通路的双重治疗(例如，达非尼和曲美替尼)显示出更高的反应率和更低的毒性，但总体生存率并未明显受到显著影响。虽然靶向治疗已经显著改变了黑色素瘤的治疗，但可能必须采用新的方法和策略来对抗黑色素瘤细胞的异质性和耐药克隆的选择。

引用次数: 1

Medical honey in professional wound care 医用蜂蜜用于专业伤口护理

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.66

B. Biglari, T. Swing, Axel Büchler, T. Ferbert, A. Simon, G. Schmidmaier, A. Moghaddam

Many physicians and wound care professionals still think honey is a ‘folk remedy’ with no scientific evidence for its use in modern wound care. They believe that after the development of antibiotics and professional treatment strategies, the use of honey to treat wounds is obsolete. Researchers have shown that honey derived from Leptospermum scoparium, so called manuka honey, displays significant antibacterial effects on all clinically relevant bacterial species and also works well in combination with antibiotics. Of particular interest has been manuka honey’s intriguing activity against methicillin-resistant Staphylococcus aureus. Hospitals all over Germany, New Zealand, Australia and Austria are convinced of its benefits and use it regularly. Medical-grade honey and ready-to-use honey dressings are widely available in the EU since 2004. This manuscript intends to deal with the benefits of medical honey in professional wound care.

许多医生和伤口护理专家仍然认为蜂蜜是一种“民间疗法”，没有科学证据证明它在现代伤口护理中的应用。他们认为，在抗生素和专业治疗策略发展之后，使用蜂蜜治疗伤口已经过时了。研究人员已经证明，从钩尾精中提取的蜂蜜，即所谓的麦卢卡蜂蜜，对所有临床相关的细菌物种都有显著的抗菌作用，并且与抗生素结合使用效果良好。特别令人感兴趣的是麦卢卡蜂蜜对抗耐甲氧西林金黄色葡萄球菌的有趣活性。德国、新西兰、澳大利亚和奥地利的医院都相信它的好处，并经常使用它。自2004年以来，医用级蜂蜜和即食蜂蜜敷料在欧盟广泛使用。这份手稿打算处理医疗蜂蜜在专业伤口护理的好处。

引用次数: 6

Nestin-expressing multipotent hair follicle stem cells for regenerative medicine 表达巢蛋白的多能毛囊干细胞用于再生医学

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.68

R. Hoffman

Nestin-expressing hair follicle stem cells of the mouse can differentiate into neurons, glia, keratinocytes, smooth muscle cells and melanocytes in vitro. Nestin-expressing hair follicle stem cells enhanced the rate of nerve regeneration and the restoration of nerve function in mouse models. The nestin-expressing hair follicle stem cells transdifferentiate largely into Schwann cells when implanted in severed nerves or injured spinal cord, which may enhance neuron regrowth. The bulge area of the follicle is the source of the nestin-expressing stem cells of the hair follicle, which migrate from the bulge area to the dermal papilla as well as into the surrounding skin tissues during wound healing. Nestin-expressing stem cells can also be readily isolated from the human scalp, thereby providing an accessible, autologous and safe source of stem cells for potential clinical use.

巢蛋白表达的小鼠毛囊干细胞在体外可分化为神经元细胞、神经胶质细胞、角化细胞、平滑肌细胞和黑色素细胞。在小鼠模型中，表达巢蛋白的毛囊干细胞提高了神经再生和神经功能恢复的速度。将表达巢蛋白的毛囊干细胞植入断神经或损伤脊髓后，可大量转分化为雪旺细胞，促进神经元再生。毛囊的凸起区域是毛囊表达巢蛋白干细胞的来源，这些干细胞在伤口愈合过程中从凸起区域迁移到真皮乳头以及周围的皮肤组织。表达巢蛋白的干细胞也可以很容易地从人类头皮中分离出来，从而为潜在的临床应用提供了一种可获得的、自体的和安全的干细胞来源。

引用次数: 0

Treating atopic dermatitis at the source: corrective barrier repair therapy based upon new pathogenic insights 从源头上治疗特应性皮炎:基于新的致病见解的纠正性屏障修复疗法

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.73

P. Elias, R. Sun, J. Wakefield, M. Man

Until recently, atopic dermatitis (AD) has been linked to Th1/Th2 cell dysregulation. But now, the opinion that inflammation in AD results from a convergence of inherited and acquired insults to the cutaneous permeability barrier, with variable contributions from inherited abnormalities in innate/adaptive immunity, is becoming increasingly accepted. Current therapy is however, still largely directed towards ameliorating immunologically triggered inflammation, rather than correcting the barrier abnormality. In this article, the authors provide an overview of epidermal barrier function; a review of recent molecular genetic studies pointing to a primary barrier abnormality in AD; a detailed description of new pathogenic insights into AD; and they compare the efficacy of several putative ‘barrier repair’ products currently utilized as adjunctive or primary therapy for AD. The authors also explore the potential of ‘next-generation’ barrier repair approaches that attack specific pathogenic mechanisms in AD (hig...

直到最近，特应性皮炎(AD)一直被认为与Th1/Th2细胞失调有关。但是现在，越来越多的人认为，AD中的炎症是由于遗传和获得性对皮肤渗透性屏障的损害，以及先天/适应性免疫的遗传异常的不同贡献，这一观点越来越被接受。然而，目前的治疗仍然主要是针对改善免疫引发的炎症，而不是纠正屏障异常。在本文中，作者提供了表皮屏障功能的概述;最近的分子遗传学研究综述指出阿尔茨海默病的原发性屏障异常;对阿尔茨海默病病原学新见解的详细描述;他们比较了目前用作AD辅助或主要治疗的几种假定的“屏障修复”产品的疗效。作者还探索了“下一代”屏障修复方法的潜力，这些方法可以攻击阿尔茨海默病的特定致病机制。

引用次数: 19

Can understanding the effect of solar UV radiation on skin’s biomechanical function help prevent skin damage? 了解太阳紫外线辐射对皮肤生物力学功能的影响是否有助于预防皮肤损伤?

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.72

Krysta Biniek, R. Dauskardt

引用次数: 0

Topical treatments for cutaneous warts: an update 皮肤疣的局部治疗:最新进展

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.74

G. Micali, M. Nasca, S. Gibbs, C. Bennett, R. Holland

Evaluation of: Kwok CS, Gibbs S, Bennett C, Holland R, Abbott R. Topical treatments for cutaneous warts. Cochrane Database Syst. Rev. 9, CD001781 (2012).Cutaneous warts are common skin lesions caused by human papillomavirus infection. Their treatment is aimed at relieving a patient’s physical and psychological discomfort, and at preventing spread of infection by autoinoculation. The aim of the article under review is to describe the outcome of current therapies for cutaneous warts according to randomized controlled trials. Results from pooled data show that significantly higher remission rates may be expected with salicylic acid and cryotherapy, best if used in combination. Limited data on adverse effects suggest that these are mild, well tolerated and more common with cryotherapy.

郭国强，张国强，张国强，等。皮肤疣局部治疗的疗效评价。Cochrane数据库系统。Rev. 9, CD001781(2012)。皮肤疣是由人乳头瘤病毒感染引起的常见皮肤病变。他们的治疗旨在减轻患者的身体和心理不适，并通过自身接种防止感染的传播。这篇文章的目的是根据随机对照试验来描述目前治疗皮肤疣的结果。汇总数据的结果显示，水杨酸和冷冻治疗的缓解率可能更高，最好是联合使用。有限的不良反应数据表明，这些不良反应是轻微的，耐受性良好，并且在冷冻治疗中更常见。

引用次数: 5

The epidemiology, etiology and Chuh and Zawar’s diagnostic criteria of Gianotti–Crosti syndrome Gianotti-Crosti综合征的流行病学、病因学及Chuh和Zawar诊断标准

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.69

A. Chuh, V. Zawar

Gianotti–Crosti syndrome (GCS) consists of a sudden eruption of small papules or papulovesicles over the face, buttock and extensor surfaces of limbs, generalized lymphadenopathy and acute nonicteric hepatitis in young children. Most early cases were caused by hepatitis B virus. Adults could also suffer from GCS. Other viruses may now be more pertinent than hepatitis B virus. The authors no longer need lymphadenopathy or hepatitis to make a diagnosis. The disease is self-limiting. Complications are uncommon. The inclusion and exclusion criteria of studies in GCS are nonuniform, rendering low homogeneity of study subjects. A validated diagnostic criteria would allow subjects in all studies more homogenous so that valid meta-analyses and systemic reviews can be performed. Data from subjects with GCS seen in specialist settings only might be biased. Recruitment in primary care settings with specifically trained primary care physicians and application of a valid and standardized diagnostic criteria might be c...

gianoti - crosti综合征(GCS)由面部、臀部和四肢伸肌表面突然出现小丘疹或丘疹小囊泡，全身性淋巴结病和急性非黄疸性肝炎组成。大多数早期病例是由乙型肝炎病毒引起的。成年人也可能患有GCS。其他病毒现在可能比乙型肝炎病毒更相关。作者不再需要淋巴结病或肝炎来进行诊断。这种疾病是自限性的。并发症并不常见。GCS研究的纳入和排除标准不统一，导致研究对象的同质性较低。有效的诊断标准将使所有研究中的受试者更加同质，以便进行有效的荟萃分析和系统评价。仅在专业环境中观察到的GCS患者的数据可能存在偏差。在初级保健机构招募受过专门训练的初级保健医生并应用有效和标准化的诊断标准可能是可行的。

引用次数: 2

Dermatological aspects of rhinosporidiosis 鼻孢子虫病的皮肤病学方面

Expert Review of Dermatology

Pub Date : 2013-02-01 DOI: 10.1586/EDM.12.76

S. Arseculeratne, G. Arseculeratne

Rhinosporidial lesions in the skin are pathogenetically classified as primary, secondary and as components of disseminated disease. Estimates of the incidence of rhinosporidiosis in various sites vary between 1 and 8% of all cases of rhinosporidiosis. The disease is mainly of occupational origin after exposure to ground waters and is noncontagious and noninfectious. Cutaneous rhinosporidial lesions are diverse in morphologies, and definitive diagnosis is provided by skin-histopathology with the conventional HE multiple extensive sessile growths, when surgery is difficult, will need drug therapy. Surface application of biocides is ineffective.

皮肤中的鼻孢子虫病变在病理学上分为原发性、继发性和弥散性疾病的组成部分。估计不同部位的鼻孢子虫病发病率在所有鼻孢子虫病例的1%至8%之间。该疾病主要是职业性的，在接触地下水后引起，非传染性和非传染性。皮肤鼻孢子虫病变在形态上是多样的，明确的诊断是由皮肤组织病理学与传统的HE多发广泛的无底生长提供的，当手术困难时，需要药物治疗。表面施用杀菌剂效果不佳。

引用次数: 1

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