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Dupilumab as a treatment for a case of benign familial pemphigus 用杜匹单抗治疗一例良性家族性丘疹性荨麻疹
Pub Date : 2024-08-09 DOI: 10.18203/issn.2455-4529.intjresdermatol20242272
Kyle T. Machynia
Hailey-Hailey disease (HHD) is an uncommon autosomal dominant genodermatosis characterized by recurrent blistering eruptions primarily affecting intertriginous areas, leading to the formation of eroded, erythematous plaques within flexural skin folds. The condition significantly impairs quality of life due to the frequency of infections, exacerbated by the limited and often ineffective therapeutic options currently available for HHD. In this report, we present a compelling case of HHD successfully treated with dupilumab, highlighting remarkable improvement observed within just two weeks of initiating treatment with this novel therapeutic agent. This promising outcome underscores the potential of dupilumab in managing challenging cases of HHD and warrants further exploration in larger clinical trials.
海利-海利病(Hailey-Hailey disease,HHD)是一种不常见的常染色体显性遗传性皮肤病,其特点是反复发生水疱性糜烂,主要影响三叉神经间区域,导致皮肤褶皱内形成糜烂性红斑。由于感染频发,这种疾病严重影响了患者的生活质量,而目前针对 HHD 的治疗方案有限且往往效果不佳,更加剧了这种疾病的恶化。在本报告中,我们介绍了一例成功使用杜匹单抗治疗 HHD 的病例,该病例在开始使用这种新型治疗药物治疗的短短两周内就得到了显著改善。这一令人鼓舞的结果凸显了双鲁单抗在治疗具有挑战性的 HHD 病例方面的潜力,值得在更大规模的临床试验中进一步探索。
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引用次数: 0
A phase III randomized controlled clinical trial evaluating the efficacy and safety of naftifine 2% cream versus terbinafine 1% cream in patients with superficial fungal infection of the skin 一项 III 期随机对照临床试验,评估萘替芬 2% 乳膏和特比萘芬 1%乳膏对皮肤浅表真菌感染患者的疗效和安全性
Pub Date : 2024-06-05 DOI: 10.18203/issn.2455-4529.intjresdermatol20241599
Nibedita Patro, Prerna R. Suryatale, Ipsa Pandya, Nadia Zakir Mian, Monika Chinda, Pavankumar M. Daultani, Ravindra Mittal, Ashok D. Jaiswal, Anit Singh
Background: Dermatophytosis is the prevailing fungal infection, typically addressed through topical, systemic antifungal medications, or a combination of both. Naftifine hydrochloride, belonging to the allylamine group, is a topical antifungal, exhibiting fungicidal properties alongside antibacterial and anti-inflammatory effects. This study evaluated the efficacy and safety of naftifine hydrochloride 2% w/w in 268 patients with dermatophytosis versus terbinafine hydrochloride 1% w/w.Methods: The drugs were applied daily for two weeks, with the primary endpoint being a clinical cure at the end of the treatment. Secondary endpoints included mycological cure, composite cure, global efficacy assessment, and post-treatment relapse.Results: In both groups, most patients experienced both clinical and mycological cures, with composite cures observed in 94.07% of the test group and 87.97% of the reference group. The global assessment of efficacy was 3.59 in the test group and 3.48 in the reference group, showing no notable difference between the two groups. All adverse events in both groups were mild and resolved within four days. Overall tolerability was comparable between the study groups.Conclusions: The study concluded that topical naftifine was effective and safe in patients with dermatophytosis and its efficacy and safety were found comparable to topical terbinafine. 
背景:皮肤癣菌病是最常见的真菌感染,通常通过局部用药、全身用抗真菌药物或两者结合来治疗。盐酸萘替芬属于烯丙基胺类,是一种外用抗真菌药,具有杀真菌、抗菌和消炎的作用。本研究评估了盐酸萘替芬(2% w/w)与盐酸特比萘芬(1% w/w)在 268 名皮真菌病患者中的疗效和安全性:每天用药两周,主要终点是治疗结束时临床治愈。次要终点包括真菌学治愈、综合治愈、总体疗效评估和治疗后复发:在两组患者中,大多数患者都获得了临床治愈和霉菌学治愈,其中试验组的综合治愈率为 94.07%,参照组为 87.97%。试验组的总体疗效评估为 3.59,参照组为 3.48,两组之间没有明显差异。两组的所有不良反应均较轻微,并在四天内缓解。研究组的总体耐受性相当:研究认为,萘替芬外用药对皮肤癣菌病患者有效且安全,其疗效和安全性与特比萘芬外用药相当。
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引用次数: 0
Tofaticinib as a potential therapeutic agent: a review 托法替尼作为一种潜在的治疗药物:综述
Pub Date : 2024-06-04 DOI: 10.18203/issn.2455-4529.intjresdermatol20241595
S. Mohan, Neelu Singh, Lalit Mohan
Tofacitinib is a Food and Drug Administration (FDA) approved second generation immunosuppressive disease-modifying anti-rheumatic drug (DMARD) that is used in the treatment of conditions like rheumatoid arthritis, ulcerative colitis polyarticular course juvenile idiopathic arthritis and psoriatic arthritis. Tofacitinib can be used to treat adult RA patients who are intolerant to methotrexate. At cellular level tofacitinib selectively inhibits Janus kinase (JAKs) in human genome and thereby stops the cytokine receptor-based signalling of interleukins viz., IL2, IL4, IL6, IL7, IL15, IL21, interferon alpha (IFNa) and IFNc in synovial fibroblasts and CD14 monocytes, thereby leading to disruption of immune and inflammatory responses. Tofacitinib is marketed as orally administered conventional tablets (5 mg and 10 mg doses) extended-release tablets (11 mg dose) and oral solutions (1 mg/ml dose). Tofacitinib is quickly absorbed after oral administration with systemic bioavailability of 74%. Tofacitinib is metabolized majorly by CYP3A4 and clearance is 70% via hepatic metabolism and 30% via renal excretion. Half-life of orally administered tofacitinib was observed to be 3 hours. Patients receiving tofacitinib therapy should be monitored for TB, renal impairment, hepatic impairment or any kind of bacterial, viral or fungal infections before initiating or during therapy. Most common reported adverse events of tofacitinib are headache, diarrhoea, nasopharyngitis, sore throat, hypertension and respiratory tract infections. Tofacitinib therapy should be cautiously used in females of reproductive age and in patients receiving renal transplant. Tofacitinib is not recommended with other immunosuppressants and vaccines. Thus, tofacitinib being a potential therapeutic agent the current review elaborates the history, detailed pharmacology, dosing, adverse events, interactions and contraindications of tofacitinib.
托法替尼是美国食品和药物管理局(FDA)批准的第二代免疫抑制性改变病情抗风湿药(DMARD),用于治疗类风湿性关节炎、多关节溃疡性结肠炎、幼年特发性关节炎和银屑病关节炎等疾病。托法替尼可用于治疗对甲氨蝶呤不耐受的成年类风湿关节炎患者。在细胞水平上,托法替尼选择性地抑制人类基因组中的Janus激酶(JAKs),从而阻止滑膜成纤维细胞和CD14单核细胞中白细胞介素(即IL2、IL4、IL6、IL7、IL15、IL21、α干扰素(IFNa)和IFNc)基于细胞因子受体的信号传导,从而导致免疫和炎症反应紊乱。托法替尼以口服常规片剂(5 毫克和 10 毫克剂量)、缓释片剂(11 毫克剂量)和口服溶液(1 毫克/毫升剂量)的形式在市场上销售。托法替尼口服后吸收迅速,全身生物利用度为 74%。托法替尼主要通过 CYP3A4 进行代谢,肝脏代谢清除率为 70%,肾脏排泄清除率为 30%。据观察,口服托法替尼的半衰期为 3 小时。接受托法替尼治疗的患者在开始治疗前或治疗期间应监测是否患有肺结核、肾功能损害、肝功能损害或任何类型的细菌、病毒或真菌感染。据报道,托法替尼最常见的不良反应是头痛、腹泻、鼻咽炎、咽喉痛、高血压和呼吸道感染。育龄女性和接受肾移植的患者应慎用托法替尼治疗。托法替尼不宜与其他免疫抑制剂和疫苗同时使用。因此,托法替尼是一种潜在的治疗药物,本综述阐述了托法替尼的历史、详细药理、剂量、不良反应、相互作用和禁忌症。
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引用次数: 0
The evaluation of serum vitamin D3 in androgenetic alopecia: a case-control study 雄激素性脱发患者血清维生素 D3 的评估:一项病例对照研究
Pub Date : 2024-05-04 DOI: 10.18203/issn.2455-4529.intjresdermatol20241284
Raj Kumar, Swale Iftikhar, Durga Prasad Dubey, Urjasweta Singh, Anil Kumar Gupta
Background: Androgenetic alopecia (AGA) is a common hereditary condition characterized by progressive hair loss influenced by androgens. Vitamin D has been implicated in various hair disorders, yet its association with AGA, particularly in South Asian populations, remains inconclusive.Methods: We conducted a case-control study involving 100 male subjects from eastern Uttar Pradesh, India, comprising 50 AGA cases and 50 age-matched controls. Serum vitamin D levels were measured, and participants underwent clinical evaluations. Statistical analyses were performed using unpaired t tests and chi-square tests.Results: Vitamin D deficiency (<20 ng/ml) was significantly more prevalent in AGA cases (56%) compared to controls (24%) (p<0.001), with an odds ratio of 4.0303. Mean serum vitamin D levels were significantly lower in cases (33.1±10.6 ng/ml) than controls (40.3±9.51 ng/ml) (p=0.0005). Severe AGA cases exhibited lower vitamin D levels compared to mild to moderate cases, although the difference was not statistically significant (p=0.32).Conclusions: This study highlights the importance of vitamin D in AGA pathogenesis and suggests the need for routine monitoring of serum vitamin D levels in AGA patients. Further large-scale studies are warranted to confirm these findings and investigate the efficacy of vitamin D supplementation as a therapeutic intervention for AGA.
背景:雄激素性脱发(AGA)是一种常见的遗传性疾病,其特征是受雄激素影响而出现进行性脱发。维生素 D 与多种毛发疾病有关,但它与 AGA 的关系,尤其是在南亚人群中,仍无定论:我们进行了一项病例对照研究,涉及印度北方邦东部的 100 名男性受试者,其中包括 50 名 AGA 病例和 50 名年龄匹配的对照者。研究人员测量了血清维生素 D 水平,并对参与者进行了临床评估。统计分析采用非配对 t 检验和卡方检验:AGA病例(56%)与对照组(24%)相比,维生素D缺乏症(<20 ng/ml)的发病率明显更高(p<0.001),几率比为4.0303。病例的平均血清维生素 D 水平(33.1±10.6 ng/ml)明显低于对照组(40.3±9.51 ng/ml)(p=0.0005)。与轻中度病例相比,重度AGA病例的维生素D水平较低,但差异无统计学意义(P=0.32):这项研究强调了维生素 D 在 AGA 发病机制中的重要性,并表明有必要对 AGA 患者的血清维生素 D 水平进行常规监测。有必要开展进一步的大规模研究,以证实这些发现,并调查补充维生素 D 作为 AGA 治疗干预措施的疗效。
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引用次数: 0
A case report on Kyrle’s disease in patient with diabetes mellitus 糖尿病患者克氏病病例报告
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240975
Yashmeen Nikhat P., Jutla V. Kumar, Chennasamudram C. Kesavulu
Kyrles disease classified under acquired perforating dermatosis, is a rare skin condition predominantly affecting 30-50-year-old females. Characterized by pruritic hyperkeratotic and ulcerated nodules, the disease involves the transepidermal clearance of aberrant endogenous components, leading to inflammatory reactions and expulsion of keratin and cellular material. The etiology though not fully understood, suggests changes in dermal connective tissue may play a role. In case report, a 56-year-old male with type II diabetes mellitus presented knee pain and 3 mm papules on lower limbs. Laboratory findings revealed hematological and metabolic abnormalities, and a skin biopsy confirmed Kyrle’s disease features. Laboratory reports indicated abnormalities in hematology, blood glucose, lipid profile, hepatic and renal function. Biopsy results confirmed acanthosis, hyperkeratosis, dysplsia and granulomatous inflammation. The association of Kyrle’s disease and metabolic abnormalities, emphasizing diabetes and chronic renal failure. Potential pathways involve oxidative damage, endoplasmic stress, and vasculopathy. Treatment options include keratolytics, emollients, antihistamines. Kyrle’s disease often linked to diabetes and chronic renal failure, is a chronic condition with variable remission periods. Early detection and appropriate management are crucial for improving patients’ quality of life. Understanding the association with metabolic abnormalities guides effective therapeutic approaches for this rare dermatological condition.
Kyrles 病属于获得性穿孔性皮肤病,是一种罕见的皮肤病,主要影响 30-50 岁的女性。该病以瘙痒性角化过度和溃疡性结节为特征,涉及经表皮清除异常的内源性成分,导致炎症反应以及角蛋白和细胞物质的排出。虽然病因尚未完全清楚,但真皮结缔组织的变化可能是其中的一个原因。在病例报告中,一名 56 岁的 II 型糖尿病男性患者出现膝关节疼痛,下肢出现 3 毫米的丘疹。实验室检查结果显示其血液和代谢异常,皮肤活检证实了柯尔氏症的特征。实验室报告显示血液学、血糖、血脂、肝功能和肾功能异常。活检结果证实了棘皮症、角化过度、发育不良和肉芽肿性炎症。柯尔氏症与代谢异常有关,重点是糖尿病和慢性肾功能衰竭。潜在的发病途径包括氧化损伤、内质应激和血管病变。治疗方法包括角质溶解剂、润肤剂、抗组胺剂。柯尔氏症通常与糖尿病和慢性肾功能衰竭有关,是一种慢性疾病,缓解期不定。早期发现和适当治疗对改善患者的生活质量至关重要。了解这种疾病与代谢异常的关系,可以为这种罕见的皮肤病提供有效的治疗方法。
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引用次数: 0
Screening of diabetes mellitus in patients at risk in dermatology outpatient department 皮肤科门诊高危患者的糖尿病筛查
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240968
Kanishka Kaul
Background: Type 2 diabetes mellitus (T2DM) is a widely spread multidisciplinary condition that requires the attention of many different disciplines; yet, the involvement of dermatologists in this regard has not been recognized. The current study focused on the role of dermatologists in screening the prevalence and pattern of cutaneous manifestations in diabetic and pre-diabetic patients.Methods: A randomized study was carried out from April 2023 to October 2023 in the department of dermatology at SSB Heart and Multispecialty Hospital in Faridabad, Haryana. In the current study, patients with dermatological problems suspected of diabetes mellitus were enrolled. Dermatological problems such acanthosis nigricans, dermatophyte infections, psoriasis, endogenous eczema, chronic urticaria, generalized pruritus, lichen simplex chronicus, patients older than 40, and coexisting conditions like obesity were focused in this study.Results: This study enrolled a total of 100 patients. Only 37 patients were recognized as having a high risk of diabetes, with 67.57% having a verified history of the disease. Furthermore, 32% of T2DM patients were examined for specific skin symptoms during their initial visits, with 4 individuals being found to have generalized pruritus and dermatophyte infection.Conclusions: This study finally concluded that dermatologists may play a crucial role in fighting the T2DM epidemic by early detection of T2DM and treatment initiation which may reduce the risk of serious complications.
背景:2 型糖尿病(T2DM)是一种广泛传播的多学科疾病,需要许多不同学科的关注;然而,皮肤科医生在这方面的参与尚未得到认可。本研究重点关注皮肤科医生在筛查糖尿病患者和糖尿病前期患者皮肤表现的患病率和模式方面的作用:哈里亚纳邦法里达巴德 SSB 心脏和多专科医院皮肤科于 2023 年 4 月至 2023 年 10 月开展了一项随机研究。本研究招募了疑似糖尿病的皮肤病患者。本研究重点关注的皮肤病包括黑棘皮病、皮癣菌感染、银屑病、内源性湿疹、慢性荨麻疹、全身瘙痒症、慢性单纯性苔藓、40 岁以上患者以及肥胖等并存病症:本研究共招募了 100 名患者。只有 37 名患者被认定为糖尿病高危人群,其中 67.57% 的患者有确诊病史。此外,32%的 T2DM 患者在初次就诊时接受了特定皮肤症状的检查,其中 4 人被发现患有全身性瘙痒症和皮癣菌感染:这项研究最后得出结论:皮肤科医生在抗击 T2DM 流行病方面可以发挥关键作用,他们可以及早发现 T2DM 并开始治疗,从而降低出现严重并发症的风险。
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引用次数: 0
Symmetrical acrokeratoderma: a case series 对称性角化棘皮症:一个病例系列
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240971
Swale Iftikhar, Anil Kumar Gupta, Rajkumar, Urjasweta Singh
Symmetrical acrokeratoderma is rare keratinization disorder which is characterized by symmetrical acral brown to black hyperpigmented keratotic plaques. In this case series, all three patients presented with asymptomatic symmetrical thick raised dark brown skin lesions with rough surface on flexural surface of wrists and dorsum of hands and feet. Palms and soles were spared in all three patients. White maceration and swelling of skin lesions were noticed after soaking in water. All Patients showed good response to oral acitretin and patients were asked for regular follow up every 4 weekly.
对称性角化性皮炎是一种罕见的角化障碍性疾病,其特征是对称性角化性褐色至黑色色素沉着角化斑块。在本病例系列中,三名患者均表现为无症状的对称性厚突起黑褐色皮损,表面粗糙,位于手腕屈曲面、手背和足背。三名患者的手掌和足底均无病变。浸水后发现皮损处有白色浸渍和肿胀。所有患者对口服阿曲汀均有良好反应,患者被要求每四周进行一次定期随访。
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引用次数: 0
Aleukemic leukemia cutis: a rare case report 角膜白血病:罕见病例报告
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240976
Akshara Kharabanda, Sudhir Singh
Leukemia cutis is a rare case disorder characterised by infiltration of neoplastic leukocytes (myeloid or lymphoid) in clinically identifiable cutaneous lesions. It can occur before the onset of hematological presentation of leukemia or during the disease course. The lesions may be highly variable ranging from flesh coloured to violaceous papules, nodules or plaques. A 52-year-old male patient came to the Dermatology Department with multiple asymptomatic erythematous papulonodular lesions involving the face, trunk as well as the extremities from the past 6 months. Systemic examination and counts were normal. On histopathological examination diffuse dense infiltrate of neutrophils and eosinophils throughout the dermis with extension of infiltrate in the interstitium of reticular dermis. Scattered amidst the infiltrate were several large cells with abundant pale cytoplasm and irregular nuclei. Immunohistochemistry was done, radiotherapy was planned and poor prognosis was explained to the patient. The case is being reported due to its rarity and the role of dermatopathologist in early diagnosis.
皮肤白血病是一种罕见的病例,其特征是肿瘤性白细胞(髓系或淋巴细胞)浸润临床上可识别的皮肤病变。它可以发生在白血病的血液学表现之前或病程中。病变的范围很广,从肉色到暴发性丘疹、结节或斑块不等。一名 52 岁的男性患者在过去 6 个月中因面部、躯干和四肢出现多处无症状红斑丘疹性皮损而来到皮肤科就诊。全身检查和计数正常。组织病理学检查显示,中性粒细胞和嗜酸性粒细胞在整个真皮层弥漫性密集浸润,并向网状真皮层间质扩展。浸润中散布着几个大细胞,细胞质丰富苍白,细胞核不规则。对患者进行了免疫组化检查,计划进行放射治疗,并向其解释了不良预后。由于该病例非常罕见,而且皮肤病理学家在早期诊断中起着重要作用,因此对该病例进行了报道。
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引用次数: 0
Expert opinion on the prescription practice of topical calamine lotion for chronic urticaria and other dermatologic conditions in Indian clinical settings 关于印度临床上使用炉甘石洗剂治疗慢性荨麻疹和其他皮肤病的处方做法的专家意见
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240969
M. S, K. Kumar M
Background: Calamine is suggested as a potentially effective treatment for skin exudation, itching, and rashes. However, there aren't many thorough analyses of the drug prescription patterns for treating urticaria in the Indian literature. This study aimed to gather expert opinions on the prescription practice of topical calamine lotion for chronic urticaria and other dermatologic conditions in Indian clinical settings.Methods: The cross-sectional questionnaire-based survey, comprising 25 questions, gathered data regarding the prescription practice of topical calamine lotion for the management of chronic urticaria and other dermatological conditions.Results: Of the 467 participants, 62% indicated that they would prescribe topical calamine lotion for pruritus management. About 39% of the participants preferred the cream formulation of the calamine lotion for treating diaper dermatitis in 11-25% of patients. About 76% of the respondents stated that they would recommend an oral antihistamine along with topical calamine lotion to treat chronic urticaria. For the treatment of pruritus, 44% of the participants preferred menthol in addition to calamine. Sixty-eight per cent of the respondents stated that approximately 5% of those with chronic urticaria need to be treated with calamine and tetrahydrocurcumin. Most specialists (69.38%) preferred using calamine lotion on 5-10% of patients with itchy skin conditions during pregnancy.Conclusions: Experts recommend the topical calamine lotion for managing various skin conditions including pruritus and chronic urticaria. Specialists recommended it as a safe option for managing itchy skin conditions during pregnancy.
背景:炉甘石被认为是治疗皮肤渗出、瘙痒和皮疹的潜在有效方法。然而,印度文献中对治疗荨麻疹的药物处方模式的深入分析并不多。本研究旨在收集专家对印度临床上外用炉甘石洗剂治疗慢性荨麻疹和其他皮肤病的处方做法的意见:这项横向问卷调查包括 25 个问题,收集了有关外用炉甘石洗剂治疗慢性荨麻疹和其他皮肤病的处方做法的数据:结果:在 467 名参与者中,62% 的人表示会处方外用炉甘石洗剂来治疗瘙痒症。约 39% 的受访者倾向于使用炉甘石洗剂的膏状配方来治疗 11-25% 的尿布皮炎患者。约 76% 的受访者表示,在治疗慢性荨麻疹时,他们会推荐口服抗组胺药和外用炉甘石洗剂。在治疗瘙痒症时,44% 的受访者除炉甘石外,还首选薄荷醇。68%的受访者表示,约有 5%的慢性荨麻疹患者需要使用炉甘石和四氢姜黄素治疗。大多数专家(69.38%)倾向于对 5-10% 的孕期皮肤瘙痒症患者使用炉甘石洗剂:专家建议外用炉甘石洗剂可用于治疗各种皮肤病,包括瘙痒症和慢性荨麻疹。专家建议将炉甘石洗剂作为治疗孕期皮肤瘙痒症的安全选择。
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引用次数: 0
A rare case of azathioprine induced anagen effluvium and plica neuropathica 一个罕见的硫唑嘌呤诱发增生性流出和神经性斑块病病例
Pub Date : 2024-04-24 DOI: 10.18203/issn.2455-4529.intjresdermatol20240973
M. Rijhwani, Meet D. Patel, Amrit Malik, M. Nijhawan
Anagen effluvium is a type of hair loss that results from a sudden decrease in the metabolic activity of the hair follicle’s matrix cells. The condition is commonly associated with cancer treatments such as chemotherapy and radiation, but can also be caused by other factors. Plica neuropathica, on the other hand, is a condition where hair on the scalp becomes irreversibly matted. It is often linked to psychiatric disturbances, poor hair care, scalp infestations, and the use of ionic surfactants in shampoos. In rare cases, it has also been associated with certain medications. Here we present a rare case of a 16-year-old female who was on azathioprine and was diagnosed with an overlap of both conditions.
脱发是由于毛囊基质细胞的新陈代谢活动突然减少而导致的一种脱发。这种情况通常与化疗和放疗等癌症治疗有关,但也可能由其他因素引起。另一方面,头皮神经性脱发是指头皮上的头发不可逆转地变得枯黄。它通常与精神障碍、头发护理不当、头皮感染以及在洗发水中使用离子表面活性剂有关。在极少数情况下,它还与某些药物有关。在此,我们介绍一例罕见病例,患者是一名 16 岁女性,当时正在服用硫唑嘌呤,被诊断为这两种病症的重叠。
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引用次数: 0
期刊
International Journal of Research in Dermatology
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