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Pathology in Atopic Dermatitis: How it Affects Skin? 特应性皮炎的病理:它如何影响皮肤?
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.12.564
K. Jones
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引用次数: 0
Clinicopathological Differences between Acquired Reactive Perforating Collagenosis and Prurigo Nodularis 获得性反应性穿孔性胶原病与结节性痒疹的临床病理差异
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.S8.550
M. Kawamura, Madoka Inoue, K. Matsuyama, Y. Mizutani, E. Shu, T. Miyazaki, M. Seishima
Background: Acquired reactive perforating collagenosis (ARPC) is a skin disease characterized by multiple itchy nodules, which is notably similar to the skin eruptions of prurigo nodularis (PN). The aim of this study was to prove the clinicopathological differences between ARPC and PN. Methods: We examined 22 patients with ARPC (6 males and 16 females) and 38 patients with PN (27 males and 11 females), diagnosed clinically and histologically. Transepidermal elimination of collagen which is characteristic histological findings for ARPC was found in all ARPC patients, but not in PN patients even in a serial section. Clinical findings, laboratory data, histological findings, immunohistochemical results, and efficacy of the therapies were compared between the two groups. Results: On evaluation of laboratory data, thymus and activation-regulated chemokine (TARC) levels and peripheral eosinophil counts were lower in ARPC than in PN. Histologically, we observed greater infiltration of neutrophils, histiocytes, and lymphocytes and more extensive capillaries in ARPC than in PN. Upon immunohistochemical analysis, CD163+ macrophages were found to be more abundant in the upper-to-deep dermis of ARPC, and both CD4+ T cells and CD8+ T cells were significantly increased in the mid-to-deep dermis of ARPC. The efficacies of topical steroid and antihistamines were improved by the addition of emollients in ARPC. Conclusion: This is the first report to show the histological differences in cell infiltration between the lesions of ARPC and PN. It is likely that inflammation mediated by neutrophils and M2 macrophages may be involved in the formation of ARPC lesions, as against PN lesions mediated by epidermal changes such as spongiosis. It is suggested that the addition of emollients can increase the efficacy of treatments for ARPC. However, further studies are necessary to define the precise pathomechanisms of ARPC and the effects of emollients on ARPC.
背景:获得性反应性穿孔性胶原病(ARPC)是一种以多发发痒结节为特征的皮肤病,与结节性痒疹(PN)的皮肤疹明显相似。本研究的目的是证明ARPC和PN之间的临床病理差异。方法:对22例ARPC患者(男6例,女16例)和38例PN患者(男27例,女11例)进行临床和组织学诊断。经皮胶原消除是ARPC的特征性组织学表现,在所有ARPC患者中均发现,但即使在连续切片中也未在PN患者中发现。比较两组患者的临床表现、实验室资料、组织学表现、免疫组化结果及治疗效果。结果:根据实验室数据评估,ARPC患者胸腺和活化调节趋化因子(TARC)水平和外周嗜酸性粒细胞计数低于PN患者。组织学上,我们观察到ARPC比PN有更多的中性粒细胞、组织细胞和淋巴细胞的浸润以及更广泛的毛细血管。免疫组化分析发现,ARPC真皮上至深部CD163+巨噬细胞更为丰富,ARPC真皮中至深部CD4+ T细胞和CD8+ T细胞均显著增加。在ARPC中添加润肤剂可改善局部类固醇和抗组胺药的疗效。结论:本文首次报道了ARPC和PN病变细胞浸润的组织学差异。与海绵状病等表皮变化介导的PN病变不同,中性粒细胞和M2巨噬细胞介导的炎症可能参与了ARPC病变的形成。提示润肤剂的加入可提高ARPC的治疗效果。然而,需要进一步的研究来明确ARPC的确切病理机制以及润肤剂对ARPC的影响。
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引用次数: 0
Psoriasis: Common Skin Disease 牛皮癣:常见的皮肤病
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.12.E112
S. Alper
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引用次数: 0
Nodular Melanoma what are the Threats and how to Treat this Disease 结节性黑色素瘤有哪些威胁以及如何治疗这种疾病
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.12.565
Leroy Olaechea Varona
Nodular Melanoma (NM) is the most aggressive form of melanoma. It tends to grow more rapidly in thickness(vertically penetrate the skin) than in diameter compared to other melanoma subtypes. Instead of arising from a pre-existing mole, it may appear in a spot where a lesion did not previously exist. Since NM tends to grow in depth morequickly than it does in width, and can occur in a place that did not have a previous lesion, the prognosis is oftenworse because it takes longer for a person to be aware of the changes.
结节性黑色素瘤(NM)是最具侵袭性的黑色素瘤。与其他黑色素瘤亚型相比,它的厚度(垂直穿透皮肤)比直径增长得更快。它不是由先前存在的痣引起的,而是出现在以前不存在病变的地方。由于NM在深度上比宽度上生长得更快,并且可能发生在以前没有病变的地方,预后通常更差,因为患者需要更长的时间才能意识到这些变化。
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引用次数: 0
Efficiency of Telemedicine in Atopic Dermatitis 远程医疗在特应性皮炎中的应用效果
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.S10.E119
P. R. Cunha
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引用次数: 0
Resurface, Retone and Reboost: A Multi-Modality Approach for Prejuvenation of Millennial Patients 表面修复,再修复和再提升:一种多模态的方法来预防千禧年患者的青春
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.S8.549
V. Wong
Background: Millennials represent a growing segment of the population that requires aesthetic treatments. Commonly, these individuals seek to undergo minimally invasive procedures to achieve ‘prejuvenation’ in order to delay the signs of aging because these procedures offer good aesthetic outcomes without the downtime and cost associated with more invasive options. Objective: Agents used for resurfacing, skin tone correction, and biorevitalising have been shown individually to address skin quality, melanogenesis, and rejuvenation, respectively. In this case report, the aim was to evaluate the overall prejuvenation effects of the combination of these agents in millennial subjects. Case description: Two patients with hyperpigmentation were evaluated prior to and after the prescribed regimen. Apparent improvements in skin quality and tone were documented after treatment. Conclusion: The combination of agents for prejuvenation was found to improve the overall quality of the skin and objectively reduced hypermelanosis in both male and female subjects.
背景:千禧一代代表了越来越多的需要美容治疗的人群。通常,这些人寻求通过微创手术来实现“预年轻化”,以延缓衰老的迹象,因为这些手术提供了良好的美学效果,而没有停机时间和成本与更多的侵入性选择相关。目的:用于面部重塑、肤色矫正和生物活化的药物已经分别被证明可以解决皮肤质量、黑色素生成和年轻化问题。在本病例报告中,目的是评估这些药物组合在千禧一代受试者中的总体预年轻化效果。病例描述:对两例色素沉着患者在治疗前后进行评估。治疗后皮肤质量和色调明显改善。结论:综合使用预幼剂可改善皮肤整体质量,客观上减轻男女受试者的黑色素沉着症。
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引用次数: 3
Sex Hormones Assessment in Vitiligo Patient's Serum 白癜风患者血清性激素的测定
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.S8.547
S. Hussein, M. Sorour, A. Hossain, Shaimaa Ahmed Abd el Azim, A. Soliman, Hany Shehata, Noha S Hanafy
Vitiligo is an idiopathic disorder of skin and hair characterized by melanin loss. Nonetheless thyroid disorder is a major cause of this pathology, other factors participate in its expression. Hormones such as, testosterone and estrogen have been suspected as drivers of this disorder. The present study aimed to determine the levels of testosterone and estrogen in serum of vitiligo patients. The study included 30 patients with vitiligo lesions (18 males and 12 females; ages ranged from 28–40 years and 30 healthy volunteers as control group (17 males and 13 females; ages ranged from 25-40years). All patients of vitiligo were recruited from Medical research center of excellence of National Research Centre, Egypt, during a period of 4 months (August 2020 to November 2020). Average period of the disorder in vitiligo group was 5.0 years. Vitiligo diagnosis is done clinically and confirmed using Wood’s lamp. Blood samples were taken from both the patient and control groups, testosterone and estrogen were assessed. Results: The present study declared a significant increase in the level of testosterone in males of VP compared to control, while significant increase in estrogen level in females of VP related to their corresponding control. Conclusion: some hormonal indicators have a role in pathogenesis of vitiligo where their disturbance leads to melanocyte destruction and/or depigmentation.
白癜风是一种皮肤和头发的特发性疾病,其特征是黑色素丢失。尽管如此,甲状腺疾病是这种病理的主要原因,其他因素参与其表达。激素,如睾酮和雌激素被怀疑是这种疾病的驱动因素。本研究旨在测定白癜风患者血清中睾酮和雌激素的水平。该研究纳入了30例白癜风病变患者(男性18例,女性12例;年龄在28-40岁之间,30名健康志愿者作为对照组(男性17名,女性13名;年龄在25-40岁之间)。所有白癜风患者均从埃及国家研究中心卓越医学研究中心招募,为期4个月(2020年8月至2020年11月)。白癜风组平均病程为5.0年。白癜风的诊断是在临床上进行的,并使用伍德灯进行确认。从患者组和对照组抽取血液样本,评估睾丸激素和雌激素。结果:本研究发现,与对照组相比,VP雄性血清睾酮水平显著升高,而VP雌性血清雌激素水平显著升高。结论:一些激素指标在白癜风发病中起作用,它们的紊乱导致黑素细胞破坏和/或色素脱色。
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引用次数: 1
Hyperpigmentation is a Common Skin Condition 色素沉着是一种常见的皮肤状况
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.S9.E118
P. R. Cunha
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引用次数: 0
The Role of Oral Cyclosporine in the Management of Steven Johnson Syndrome and Toxic Epidermal Necrolysis: A Retrospective Multicentric Observational Study 口服环孢素在史蒂文约翰逊综合征和中毒性表皮坏死松解治疗中的作用:一项回顾性多中心观察研究
Pub Date : 2021-01-01 DOI: 10.46889/jdr.2021.2303
Rajnish Kumar, Rashmi Singh, U. Udayan
Background: SJS and TEN are severe life threatening muco-cutaneous reactions characterised by extensive epidermal sloughing with mucosal erosions. Objective: The main objective of this study was to observe the effectiveness of cyclosporine in reducing the mortality and healing time of lesions in patients of SJS and TEN. Methods: The present work was designed as a retrospective tertiary urban hospital based, observational study during the period from March 2019 to Feb 2020. Detailed history, physical examination including cutaneous examination was done at the time of admission and the assessment of lesions using SCORTEN scoring was done at baseline, on day 3 and on tenth day of cyclosporine. All the routine investigations were done in each case. As per hospital records, oral cyclosporine in the dose of 5 mg/kg body weight per day was given to each patient for ten days.
背景:SJS和TEN是严重危及生命的皮肤粘膜反应,其特征是广泛的表皮脱落和粘膜糜烂。目的:本研究的主要目的是观察环孢素对降低SJS和TEN患者的死亡率和病变愈合时间的有效性。方法:本研究以2019年3月至2020年2月的回顾性城市三级医院为基础,进行观察性研究。入院时进行详细的病史和体格检查,包括皮肤检查,并在基线、环孢素第3天和第10天使用SCORTEN评分对病变进行评估。所有的例行调查都在每个病例中完成。根据医院记录,每名患者口服环孢素10天,剂量为每天5mg /kg体重。
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引用次数: 0
Clinical Efficacy, Cosmetic Acceptability, and Local Tolerability of a New Formulation of Topical 5% Minoxidil without Propylene glycol: A 6-month, Multicentre, Real-life, Prospective, Assessor-Blinded Study in 196 Subjects with Hair Loss. The andldquo;NOMINALandrdquo; Trial 不含丙二醇的5%米诺地尔外用新制剂的临床疗效、美容可接受性和局部耐受性:一项196名脱发患者6个月、多中心、真实、前瞻性、评估盲法研究andldquo; NOMINALandrdquo;试验
Pub Date : 2021-01-01 DOI: 10.35248/2155-9554.21.12.566
Laura Alessi, M. Aloisi, V. Amadu, A. Arena, Y. Balice, S. Bano, S. Barruscotti, A. Bartolotta, Silvia Bondino, A. Corsini, D. Nunno, S. Farina, P. Nappa, L. Pisano, Fabrizio Presta, N. Rivetti, E. Saccani, M. Tomassini, S. Torti, F. Vaira, G. Zanframundo, M. Puviani, K. Eisendle, M. Milani
Background and trial objectives: A new propylene glycol (PG)-free 5% minoxidil (PG-Free-Mnx) lotion has been recently commercialized. Clinical efficacy and local tolerability have been, so far, documented in a limited number of patients. The aim of this study was to evaluate the clinical efficacy, cosmetic acceptability, and local tolerability of 6-month application of this new PG-Free Mnx lotion in a real-life situation. Materials and methods: The NOMINAL (NO-PG MINoxidil reAL life study) trial was performed in 22 out-patients Italian dermatology clinics. A total of 196 subjects of both sexes with a diagnosis of AGA/FAGA were enrolled in the trial, after their written informed consent. PG-Free-Mnx lotion was applied 1 ml twice daily for 6 months. Clinical efficacy was evaluated in an open fashion in all the enrolled subjects with a 5-grade scale score (from-2: severe worsening, to +2: very good improvement in comparison with baseline condition). In a subgroup of subjects (n=60) an assessor-blinded clinical efficacy evaluation has been also performed using high definition standardized and coded scalp global pictures at baseline, and after 6 months by an assessor unaware of the temporal sequence using a 3-grade score (from 0: no improvement to 3: very high improvement). Cosmetic acceptability evaluation was assessed using a 7-item questionnaire using a 10-point scale score, with score 1meaning not at all and score 10 meaning the worst possible condition. Cosmetic acceptability and clinical efficacy were evaluated after 12 and 24 weeks of treatment. Global tolerability, assessed at week 24, was evaluated with a 4-grade scale score (from -1: very low tolerability to +2: very good tolerability). Results: All but seven (3.6%) subjects concluded the study. Clinical efficacy scores (open evaluation) were 0.8 ± 0.7 and 1.0 ± 0.7 at week 12 and 24, respectively. Good or very good clinical response (score +1 or +2) at week 12 and week 24 was observed in 64% and 74% respectively of the subjects with a similar response in women (75%) and men (73%). Baseline severity of AGA/FAGA was inversely correlated with the clinical response with a better outcome in subjects with AGA type II in comparison with subjects with types III/ IV AGA. The clinical efficacy was confirmed by the assessor-blinded evaluation of the subgroup of 60 subjects’ pictures at baseline (clinical score at baseline: 0.2 ± 0.4 vs. 1.8 ± 0.7 after 6 months; p=0.0001; absolute mean difference: 1.6; 95% CI: 1.1 to 2.0). Cosmetic acceptability score mean values were always 7) burning, itching or redness sensations. Conclusion: This new PG-free lotion shows, in real-life conditions, a very good cosmetic acceptability and tolerability profile. Clinical efficacy, evaluated both in open and assessor-blinded fashions, was also documented, and it was in line with the available data of traditional Mnx formulations with propylene glycol.
背景和试验目的:一种新的不含丙二醇(PG)的5%米诺地尔洗剂(PG -free - mnx)最近已经商业化。到目前为止,在有限数量的患者中记录了临床疗效和局部耐受性。本研究的目的是评估临床疗效,美容可接受性,以及在现实生活中6个月应用这种新的无pg的Mnx洗剂的局部耐受性。材料和方法:在22名意大利皮肤科门诊患者中进行了NOMINAL (NO-PG米诺地尔现实生活研究)试验。共有196名诊断为AGA/FAGA的男女受试者在获得书面知情同意后参加了试验。PG-Free-Mnx洗剂每日两次,每次1毫升,连续使用6个月。所有入组受试者的临床疗效以开放的方式进行评估,评分为5级(从2:严重恶化,到+2:与基线状况相比改善非常好)。在一个受试者亚组(n=60)中,评估者盲法临床疗效评估也在基线时使用高清晰度标准化和编码的头皮全局图像进行,6个月后由不知道时间序列的评估者使用3级评分(从0:无改善到3:非常高改善)。化妆品可接受性评估采用7项问卷,采用10分制评分,1分表示完全没有,10分表示可能出现的最坏情况。分别于治疗12周和24周后评价两组患者的美容可接受性和临床疗效。在第24周评估整体耐受性,用4级量表评分进行评估(从-1:非常低的耐受性到+2:非常好的耐受性)。结果:除7名(3.6%)受试者外,其余受试者均结束了研究。临床疗效评分(开放评估)在第12周和第24周分别为0.8±0.7和1.0±0.7。在第12周和第24周,分别有64%和74%的受试者观察到良好或非常好的临床反应(评分为+1或+2),女性(75%)和男性(73%)的反应相似。AGA/FAGA的基线严重程度与临床反应呈负相关,与III/ IV型AGA患者相比,II型AGA患者的预后更好。临床疗效通过评估者-盲法评估60名受试者基线时的图像(基线时临床评分:0.2±0.4 vs. 6个月后1.8±0.7;p = 0.0001;绝对平均差:1.6;95% CI: 1.1 ~ 2.0)。化妆品接受度评分的平均值总是灼烧、瘙痒或发红的感觉。结论:该新型无pg乳液在实际使用中具有良好的化妆品接受度和耐受性。临床疗效,通过开放和评估盲法进行评估,也被记录,并且与传统的丙二醇Mnx配方的可用数据一致。
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Journal of clinical & experimental dermatology research
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