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Research Progress of Genomic Variation in Psoriasis 银屑病基因组变异研究进展
Q3 Medicine Pub Date : 2022-12-01 DOI: 10.1097/jd9.0000000000000276
Liang Sun
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引用次数: 0
Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study 中国西北地区广泛性脓疱性银屑病特征的单中心回顾性研究
Q3 Medicine Pub Date : 2022-12-01 DOI: 10.1097/JD9.0000000000000275
Xiao-Na Li, B. Peng, S. Geng
Objective: This study was performed to investigate the clinical characteristics of patients with generalized pustular psoriasis (GPP) in Northwest China. Methods: The clinical data of patients with GPP were retrospectively collected in the Second Affiliated Hospital of Xi’an Jiaotong University from January 1, 2017, to December 31, 2021 and analyzed using the chi-square test and Mann-Whitney U test. Results: In total, 179 hospitalized patients were included. The male:female ratio was 1.16:1.00, and the mean age at onset was 35.05 ± 19.11 years. Psoriasis vulgaris was also present in 76.0% of patients, and a family history of psoriasis was present in 15.6%. The mean duration of hospitalization was 10.67 ± 4.31 days, and the mean duration of flares was 29.58 ± 24.32 days. Infections and suspected drugs were predisposing factors. A fever developed in 54.7% of patients, and pruritus developed in 70.9%. Some patients had involvement of the nails (38.0%), scalp (46.9%), and tongue (4.5%). Cardiovascular disease, hypertension, and gallbladder-related disease were common comorbidities. The efficacy of acitretin was 84.7%, that of methotrexate was 66.7%, and that of cyclosporine was 100%. Fifteen patients were treated with secukinumab or adalimumab and responded well. The mean response time was 6.34 ± 2.91 days based on the combination treatments. The mean duration of the treatment regimen was 111.35 ± 94.25 days, and approximately 46.6% (n = 131) of patients developed recurrence. Conclusion: Our retrospective study showed that most cases of GPP were accompanied by psoriasis vulgaris and associated with fever or pruritus. Acitretin had good therapeutic efficacy, but recurrence should be noted. Biologics are increasingly becoming effective treatments, but their superiority and safety need further research.
目的:探讨西北地区泛发性脓疱型银屑病(GPP)的临床特点。方法:回顾性收集西安交通大学第二附属医院2017年1月1日至2021年12月31日收治的GPP患者的临床资料,采用卡方检验和Mann-Whitney U检验进行分析。结果:共纳入179名住院患者。男女比例为1.16:1.00,平均发病年龄为35.05±19.11岁。76.0%的患者也有寻常型银屑病,15.6%的患者有银屑病家族史。平均住院时间为10.67±4.31天,平均发作时间为29.58±24.32天。感染和疑似药物是诱发因素。54.7%的患者出现发烧,70.9%的患者出现瘙痒。一些患者累及指甲(38.0%)、头皮(46.9%)和舌头(4.5%)。心血管疾病、高血压和胆囊相关疾病是常见的合并症。阿曲汀的疗效为84.7%,甲氨蝶呤的疗效为66.7%,环孢菌素的疗效为100%。15名患者接受了secukinumab或阿达木单抗治疗,反应良好。联合治疗的平均反应时间为6.34±2.91天。治疗方案的平均持续时间为111.35±94.25天,约46.6%(n=131)的患者出现复发。结论:我们的回顾性研究表明,大多数GPP病例伴有寻常型银屑病,并伴有发烧或瘙痒。阿曲汀治疗效果良好,但应注意复发。生物制品正日益成为有效的治疗方法,但其优越性和安全性需要进一步研究。
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引用次数: 0
Understanding the Pathogenesis of Generalized Pustular Psoriasis Based on Molecular Genetics and Immunopathology 基于分子遗传学和免疫病理学的广泛性脓疱性银屑病发病机制研究
Q3 Medicine Pub Date : 2022-12-01 DOI: 10.1097/JD9.0000000000000277
A. Zhao, Ming Li
Generalized pustular psoriasis (GPP) is a rare and life-threatening autoinflammatory skin disease characterized by recurrent and sudden episodes of widespread rashes with scattered sterile pustules. Clinical and genetic evidence indicates that the pathogenesis of GPP both overlaps and is separate from psoriasis vulgaris (PV). Interleukin (IL)-23/IL-17 immune pathway is well known to play a critical role in the immunopathogenesis of PV, while the inflammation of GPP is more inclined to involve the innate immune response via the IL-1/IL-36–chemokine pathway. Mutations in IL36RN, CARD13, AP1S3, MPO, TNIP1, SERPINA3, and SERPINA1 have been shown to be associated with GPP, among which loss-of-function mutation in IL36RN is the dominant mutation with the highest prevalence. Recent studies have shown that interaction of the IL-36 pathway and the IL-23/IL-17 axis underlies the immunological disturbances of GPP, indicating that innate and adaptive immune responses intertwine in the pathogenesis of GPP. With this deeper understanding of the pathogenesis of GPP, treatment by biologics targeting the IL-1/IL-36 pathway appears to be promising. IL-1 inhibitors, anakinra, canakinumab, and gevokizumab have reportedly been effective in some cases. Spesolimab and imsidolimab, which are antibodies to the IL-36 receptor, are undergoing investigation in a phase II trial and showing promising results. In the present review, we illustrate the current understanding of the pathogenesis of GPP based on recent updates on the molecular genetics and immunopathology of GPP and review recent clinical trials and case reports of novel biologics in the treatment of GPP.
广泛性脓疱性牛皮癣(GPP)是一种罕见且危及生命的自身炎症性皮肤病,其特征是反复发作和突然发作的广泛皮疹和分散的无菌脓疱。临床和遗传学证据表明GPP的发病机制与寻常型牛皮癣(PV)既有重叠又有分离。众所周知,白细胞介素(IL)-23/IL-17免疫途径在PV的免疫发病机制中起关键作用,而GPP的炎症更倾向于通过IL-1/IL-36趋化因子途径参与先天免疫应答。IL36RN、CARD13、AP1S3、MPO、TNIP1、SERPINA3、SERPINA1突变已被证实与GPP相关,其中IL36RN的功能丧失突变是显性突变,患病率最高。最近的研究表明,IL-36通路和IL-23/IL-17轴的相互作用是GPP的免疫学紊乱的基础,表明先天免疫反应和适应性免疫反应在GPP的发病机制中相互交织。随着对GPP发病机制的深入了解,靶向IL-1/IL-36通路的生物制剂治疗似乎很有希望。据报道,IL-1抑制剂,anakinra, canakinumab和gevokizumab在某些病例中有效。Spesolimab和imsidolimab是针对IL-36受体的抗体,正在进行II期试验,并显示出有希望的结果。在这篇综述中,我们根据GPP的分子遗传学和免疫病理学的最新进展,阐述了目前对GPP发病机制的理解,并回顾了最近治疗GPP的新生物制剂的临床试验和病例报告。
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引用次数: 1
Female Gender Was Associated With Increased Odds of Sleep Disturbance in Adult Chinese With Moderate-to-Severe Psoriasis: A Cross-Sectional Study 女性与中重度银屑病成年患者睡眠障碍几率增加相关:一项横断面研究
Q3 Medicine Pub Date : 2022-11-11 DOI: 10.1097/JD9.0000000000000274
M. Tan, Yan-Hua Luo, Jingjing Hu, Qiaolin Wang, Li-Cong Xu, Kun Hu, Xing-yu Li, Jing Yang, Jun-Chen Chen, Y. Kuang, Wu Zhu
Objective: Up to 85.3% of patients with psoriasis experience sleep disturbance (SD). However, SD has not been characterized in Chinese patients with psoriasis, and the factors that affect SD among adult patients with psoriasis remain unclear. This study was performed to examine the risk of SD in patients with psoriasis compared with a control group of healthy individuals and to identify factors contributing to SD in patients with psoriasis. Methods: This was a cross-sectional, questionnaire-based, case-control study involving 142 adult participants with psoriasis and 142 healthy controls. The Pittsburgh Sleep Quality Index (PSQI) was administered to assess SD. Mild psoriasis was defined by Psoriasis Area and Severity Index and body surface area cut-offs of <10, and mild to severe psoriasis was determined by Psoriasis Area and Severity Index and body surface area cut-offs of ≥10. Logistic regression was performed to investigate the associations. Results: The prevalence of SD (PSQI score of ≥6) was 47.9% in adult patients with psoriasis. The mean PSQI score in patients with psoriasis was 6.1 ± 3.7, which was higher than that in the control group (4.9 ± 2.5, P < 0.001). The risk of SD in the psoriasis group was 1.669 times higher (95% confidence interval, 1.008–2.761; P = 0.046) than that in the healthy group. Female sex (adjusted odds ratio, 4.130; 95% confidence interval, 1.306–13.058; P = 0.016) was significantly associated with an increased risk of SD in patients with moderate to severe psoriasis, whereas there were no significant factors affecting the risk of SD in patients with mild psoriasis. Conclusion: Patients with psoriasis were more likely than healthy controls to develop SD. In patients with moderate to severe psoriasis, but not in those with mild psoriasis, female sex was associated with a higher likelihood of SD.
目的:高达85.3%的银屑病患者存在睡眠障碍(SD)。然而,中国银屑病患者的SD尚未表现出来,影响成年银屑病患者SD的因素尚不清楚。本研究旨在检查牛皮癣患者与健康对照组相比发生SD的风险,并确定导致牛皮癣患者发生SD的因素。方法:这是一项横断面、基于问卷的病例对照研究,涉及142名成年牛皮癣患者和142名健康对照者。采用匹兹堡睡眠质量指数(PSQI)评估SD。以“银屑病面积及严重程度指数”和体表分割线<10定义轻度银屑病,以“银屑病面积及严重程度指数”和体表分割线≥10定义轻度至重度银屑病。采用Logistic回归分析其相关性。结果:成年银屑病患者SD (PSQI评分≥6)患病率为47.9%。银屑病患者PSQI平均评分为6.1±3.7分,高于对照组(4.9±2.5分,P < 0.001)。牛皮癣组SD风险高1.669倍(95%可信区间,1.008-2.761;P = 0.046)。女性(调整后优势比为4.130;95%置信区间为1.306-13.058;P = 0.016)与中重度牛皮癣患者SD风险增加显著相关,而轻度牛皮癣患者SD风险无显著影响因素。结论:银屑病患者发生SD的可能性高于健康对照组。在中度至重度牛皮癣患者中,但在轻度牛皮癣患者中,女性与SD的可能性较高相关。
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引用次数: 0
Pseudoainhum Associated With Lepromatous Leprosy: A Very Rare Association in Modern World 伪麻风病与麻风病:现代世界罕见的关联
Q3 Medicine Pub Date : 2022-11-09 DOI: 10.1097/JD9.0000000000000273
A. A. N. Nishad, M. Pathman, Seyed Ahamed Uwyse, A. Mendis, Prabath Kularathne Abeysundara, A. de Silva
Introduction: Pseudoainhum (dactylolysis spontanea) is characterized by the development of a fibrous band around the digit that gradually leads to autoamputation. Digital pain associated with Pseudoainhum may not be evident in patients with neuropathic conditions. Here, we present a rare case of pseudoainhum patient, which describes a very rare association of pseudoainhum with leprosy. Case presentation: A 48 year old male with lepromatous leprosy, with resorption of digits, charcot joints and tropical ulcers was seen in the clinic. The forth digit of the left hand had a narrowing due to a fibrous band at the 2nd inter phalangeal joint with shiny tethering distal phalanx. He could not recall the duration of the ainhum. He was not suffering from any pain. Discussion: The current report describes a very rare association of pseudoainhum with leprosy. The case involved a 48-year-old man in the dermatology ward with lepromatous leprosy presenting with a pseudoainhum. Conclusion: This case highlights the possibility of delayed presentation of patients with pseudoainhum to physicians when the patients have underlying neuropathic conditions that prevent feeling finger pain and cause abnormal appearance of the digits, especially in leprosy.
引言:假性指裂自发性指裂的特点是手指周围形成纤维带,逐渐导致自动截肢。神经性疾病患者的指关节疼痛可能不明显。在这里,我们介绍了一个罕见的伪麻风病患者,它描述了一个非常罕见的伪麻风病与麻风病的关联。病例介绍:一名48岁男性,患有麻风,伴有手指吸收、夏科关节和热带溃疡。左手第四指因第二指骨间关节处的纤维带而变窄,远端指骨有光泽。他记不起那嗡嗡声的持续时间了。他没有任何疼痛。讨论:目前的报告描述了一种非常罕见的伪麻风病与麻风病的关联。该病例涉及皮肤科病房的一名48岁男子,他患有麻风病,并表现为假安哼。结论:该病例强调了当患者有潜在的神经病变,阻止手指疼痛并导致手指异常外观时,特别是在麻风病患者中,假安哼患者延迟向医生就诊的可能性。
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引用次数: 0
Major Clinical Features and Epidemic Characteristics of Erosive Vulvar Lichen Planus: A Retrospective Analysis of 40 Patients 40例糜烂性外阴扁平苔藓的主要临床特征及流行病学特征回顾性分析
Q3 Medicine Pub Date : 2022-10-24 DOI: 10.1097/jd9.0000000000000272
Ya-Kun Shao, K. Sun, Min Yang, Wan Liu, Yu Fu, Jianmin Chang
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引用次数: 0
Correlation of Whole Blood Zinc Levels, CD4 Cell Count, Disease Stage, and Dermatologic Manifestations Among HIV Patients: A Single Center Experience in Philippines 全血锌水平、CD4细胞计数、疾病分期和HIV患者皮肤病表现的相关性:菲律宾单一中心经验
Q3 Medicine Pub Date : 2022-10-24 DOI: 10.1097/JD9.0000000000000271
Riza I. Sarne, M. T. Gabriel, E. G. Vista, Maria Jenina P. Aguado, Cynthia Angela Karim
Objective: Zinc deficiency is the most common micronutrient abnormality seen in human immunodeficiency virus (HIV) infection. Depletion of CD4 cells is a hallmark of HIV infection. The study aims to determine the association between whole blood zinc levels and CD4 cell count and stage of HIV infection among patients in a tertiary hospital in the Philippines. Methods: Sixty-five newly diagnosed HIV-positive patients of the institution were recruited. Demographic profile, whole blood zinc levels, CD4 cell count level, HIV disease stage, and presence of any dermatologic manifestations were noted. Prevalence of zinc deficiency and correlation between whole blood zinc levels and CD4 cell count were determined. The data were analyzed by chi-square and pearson correlation analysis. Results: Among the 65 patients, overall zinc deficiency was noted at 33.8%. Low CD4 count and HIV disease stage IV participants had the highest percentage of zinc deficiency at 54.6% and 50%, respectively. A correlation coefficient at r = 0.3364 was noted between whole blood zinc levels and CD4 cell count (P = 0.006). Twenty-nine patients presented with dermatologic manifestations, with 10 patients being zinc deficient. Conclusion: A weak positive correlation was seen between zinc levels and CD4 count. There is an increasing frequency of zinc level deficiency with a higher HIV disease stage. Dermatologic manifestations of HIV may be present in both patients with normal and deficient zinc levels.
目的:锌缺乏是人类免疫缺陷病毒(HIV)感染中最常见的微量营养素异常。CD4细胞的耗竭是HIV感染的标志。这项研究旨在确定菲律宾一家三级医院患者的全血锌水平、CD4细胞计数与HIV感染分期之间的关系。方法:招募该机构65名新诊断的HIV阳性患者。注意到人口统计学特征、全血锌水平、CD4细胞计数水平、HIV疾病分期和任何皮肤病表现的存在。测定了锌缺乏症的患病率以及全血锌水平和CD4细胞计数之间的相关性。数据采用卡方和pearson相关分析。结果:在65名患者中,总体锌缺乏率为33.8%。CD4计数低和HIV疾病IV期参与者的锌缺乏率最高,分别为54.6%和50%。全血锌水平与CD4细胞计数之间的相关系数为r=0.3364(P=0.006)。29名患者出现皮肤病表现,其中10名患者缺锌。结论:锌水平与CD4计数呈弱正相关。锌水平缺乏的频率越来越高,艾滋病的发病阶段越高。锌水平正常和锌缺乏的患者都可能存在HIV的皮肤病表现。
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引用次数: 1
Creeping hair: A case report 爬毛:一份病例报告
Q3 Medicine Pub Date : 2022-10-12 DOI: 10.1097/jd9.0000000000000255
Shan Cao, Xiangdong Lu, Baoxing Yang
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引用次数: 0
Recalcitrant pediatric pyoderma gangrenosum controlled with adalimumab 顽固性小儿坏疽性脓皮病用阿达木单抗控制
Q3 Medicine Pub Date : 2022-10-12 DOI: 10.1097/jd9.0000000000000258
Z. Wu, Qianyue Xu, Z. Yao
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引用次数: 0
Mechanism, impact, and effectiveness of herpes zoster vaccines: A comprehensive review 带状疱疹疫苗的作用机制、影响和有效性:综述
Q3 Medicine Pub Date : 2022-10-12 DOI: 10.1097/jd9.0000000000000256
Yaser Mansoor Almutawa, Emma Bhattarai, Jing-jun Zhao
{"title":"Mechanism, impact, and effectiveness of herpes zoster vaccines: A comprehensive review","authors":"Yaser Mansoor Almutawa, Emma Bhattarai, Jing-jun Zhao","doi":"10.1097/jd9.0000000000000256","DOIUrl":"https://doi.org/10.1097/jd9.0000000000000256","url":null,"abstract":"","PeriodicalId":34265,"journal":{"name":"International Journal of Dermatology and Venerology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43293228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Dermatology and Venerology
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