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Case report Squamous cell carcinoma as a long-term effect after skin vascular malformation radiotherapy 皮肤血管畸形放疗后长期影响的鳞状细胞癌一例报告
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32397
B. Mańkowski, A. Osmola-Mańkowska, R. Olszański, A. Bielecki, P. Grala, K. Slowinski
In the past, vascular anomalies were divided into vascular malformations and vascular tumors. Radiotherapy was one of the leading methods of treatment for vascular malformations and infantile haemangiomas in the past and considered as harmless in those days. Many years later it turned out that management was not necessary and dan - gerous, even responsible for possible skin cancers appeared within areas exposed to radiotherapy in the future. The case report shows the presence of squamous cell carcinoma within the irradiated vascular malformation of the frontotemporal area in early childhood. The lesion was surgically removed, the defect was covered by split thick - ness skin graft. The histopathological evaluation confirmed the carcinoma as well as its complete resection. Assess - ing the adult patients with vascular anomaly one should be aware of possible radiation therapy for that malformation in the past, then the evaluation of the skin must be careful and focused on possible neoplasmatic lesions.
以往将血管异常分为血管畸形和血管肿瘤。放射治疗是过去治疗血管畸形和婴儿血管瘤的主要方法之一,在当时被认为是无害的。许多年后,人们发现治疗是不必要的,而且是危险的,甚至可能导致将来暴露在放射治疗区域内的皮肤癌。本病例报告显示儿童早期额颞区辐照血管畸形内存在鳞状细胞癌。手术切除病变,用厚皮片覆盖缺损。组织病理学检查证实了癌变,并完全切除。对血管异常的成人患者进行评估时,应注意过去可能对该畸形进行的放射治疗,然后对皮肤的评估必须谨慎,并关注可能的肿瘤病变。
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引用次数: 1
Original paper Type A behavior in individuals with psoriasis as a determinant of acceptance of illness 牛皮癣患者的A型行为是疾病接受度的决定因素
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32390
M. Basińska, M. Drozdowska
Introduction: Type A behavior (TAB) pattern is a complex of behavioral characteristics or a life style expressing exces sive vigilance, aggressiveness, excitability, inclination to compete and a feeling of time pressure and excessive respon sibility. It is known to be a risk parameter of somatic illnesses and affects the course of disease. Aim: To qualify the relation between TAB and acceptance of illness (AI) in a group of individuals with psoriasis. Material and methods: The sample included 60 patients with psoriasis. Patients were subjected to three testing meth ods: Framingham Type A Behavior Pattern Measure, Acceptance of Illness Scale and a personal survey. Results: The results show differences in the intensity of a typical subcomponent of TAB pattern, time urgency, between healthy women and diseased men and between women and men in the diseased group of people. Women, in com parison to men, are predisposed to time urgency regardless of their health condition. The clinical state of diseased people does not differentiate the level of TAB. In the group of women with psoriasis there is a negative correlation between a tendency to follow the TAB pattern and its subcomponent time urgency and AI. Diseased women with a lower AI have a higher predisposition to functioning according to TAB. Type A is related to functioning in the state of illness by AI. Conclusions: Type A behavior plays the role of a risk predictor in the investigated group, but its role as a risk pre dictor of psoriasis requires further research.
A型行为模式(Type A behavior, TAB)是一种行为特征或生活方式的综合体,表现为过度的警惕、攻击性、兴奋性、竞争倾向以及时间压力和过度的责任感。已知它是躯体疾病的一个危险参数,并影响疾病的进程。目的:探讨银屑病患者TAB与疾病接受度(AI)的关系。材料与方法:研究对象为60例银屑病患者。采用Framingham A型行为模式量表、疾病接受度量表和个人问卷三种测试方法对患者进行测试。结果:结果显示TAB模式的一个典型子成分,时间紧迫性的强度在健康女性和患病男性之间以及患病人群中女性和男性之间存在差异。与男子相比,无论健康状况如何,妇女都倾向于时间紧迫。患者的临床状态不能区分TAB的水平。在银屑病妇女组中,遵循TAB模式的倾向及其子成分时间紧迫性和AI之间存在负相关。根据TAB,低AI的患病女性有更高的功能倾向。A型与人工智能在疾病状态下的功能有关。结论:A型行为在被调查人群中具有风险预测因子的作用,但其对银屑病风险的预测作用有待进一步研究。
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引用次数: 2
Original paper Skin cancer in the elderly – epidemiological, clinical and surgical treatment analysis of 254 patients 老年人皮肤癌——254例患者的流行病学、临床及手术治疗分析
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32386
M. Sobjanek, I. Michajłowski, M. Malek, M. Zabłotna, A. Włodarkiewicz, R. Nowicki
Introduction: The incidence of non-melanoma skin cancer (NMSC) and melanoma is increasing rapidly in the Euro pean population. There are only a few reports about cutaneous malignancy in the elderly population. Aim: Epidemiological, clinical, histopathological and surgical treatment result analysis of skin cancers in patients over 75 years old. Material and methods: A group of 254 patients over 75 years old operated on during 2002-2006 in the Department of Dermatology, Venerology and Allergology of the Medical University of Gdansk was included in the study. Sex ratio F/M was 1.2. The average age was 81.1 years old. Results: Patients over 75 years old comprised 40% of all operated patients because of malignancy in the analyzed period. Non-melanoma skin cancer were diagnosed in 92.5% of cases, melanoma in 5.9%. Basal cell carcinoma (BCC) was the most common malignancy, diagnosed in 72% of the patients. The incidence of squamous cell carcinoma (SCC) was statistically significantly higher compared to the general population (20.5% vs. 10.9%; p = 0.0002). BCC/SCC ratio was 3.5. In 39 patients (16.6%) multiple NMSC were observed. Exposure to UV radiation was the most com mon (52%) risk factor of cutaneous malignancy. The local recurrence rate of NMSC was 5.51%. Conclusions: The incidence of skin cancers in the northern Polish population over 75 years old is increasing. The clin ical and histopathological profile of skin cancer in the elderly differs from the general population. Surgical treatment is safe and effective management in these cases.
简介:在欧洲人群中,非黑色素瘤皮肤癌(NMSC)和黑色素瘤的发病率正在迅速增加。关于老年人群皮肤恶性肿瘤的报道很少。目的:分析75岁以上皮肤癌患者的流行病学、临床、组织病理学及手术治疗结果。材料和方法:研究纳入格但斯克医科大学皮肤、性病和过敏症科2002-2006年间接受手术的75岁以上患者254例。性别比率F/M为1.2。平均年龄为81.1岁。结果:75岁以上患者占分析期内因恶性肿瘤手术患者的40%。非黑色素瘤皮肤癌确诊率为92.5%,黑色素瘤确诊率为5.9%。基底细胞癌(BCC)是最常见的恶性肿瘤,诊断率为72%。与普通人群相比,鳞状细胞癌(SCC)的发病率有统计学意义(20.5% vs. 10.9%;P = 0.0002)。BCC/SCC比值为3.5。39例(16.6%)患者出现多发性NMSC。紫外线照射是皮肤恶性肿瘤最常见的危险因素(52%)。局部复发率为5.51%。结论:波兰北部75岁以上人群皮肤癌发病率呈上升趋势。老年人皮肤癌的临床和组织病理学特征不同于一般人群。手术治疗是安全有效的治疗方法。
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引用次数: 8
Original paper Patient characteristics of children with cow’s milk allergy presenting with an allergy to extensively hydrolyzed whey and/or casein formulae used as part of an elimination diet 牛奶过敏儿童的患者特征表现为对作为消除饮食一部分的广泛水解乳清和/或酪蛋白配方过敏
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32389
Z. Nowacki
Introduction: In the recent years the number of children with cow’s milk protein allergy (CMPA) presenting with aller gies to extensively hydrolyzed whey (eHF-W) and casein formulae (eHF-C) respectively has increased. Aim: To present the patient characteristics of children with CMPA who presented with allergic reactions to eHF-W and/or eHF-C used as part of an elimination diet. Material and methods: A retrospective study was carried out for a group of 65 selected from of 359 children (3 to 12 months) affected with CMPA and allergy to eHF. Results: 18.1% (65/359) and 7.8% (28/359) from the group presented with allergic reactions to eHF-W and eHF-C, respectively. An allergic reaction to eHF-C occurred in 43% of the patients from the group (28/65). IgE-mediated CMPA presented with one of the following clinical manifestations: atopic dermatitis (AD) 94%, gastrointestinal symptoms (GI) 47%, respiratory symptoms (RS) 44%, anaphylactic reactions (AR) 26%. Non-IgE-mediated CMPA, on the other hand, manifested with: AD 97%, GI 22%, RS 10% .The observations showed that all 31 from the non-IgE mediated CMPA group with GI and AD manifestations presented with symptoms of eHF-C allergy ( p = 0.001). In the IgE-medi ated CMPA ( n = 34) the following factors were statistically significant with relation to eHF-C allergy: CMPA mani festing with GI ( p = 0.014) and AD. The occurrence of AR in response to cow’s milk protein (CMP) decreased the prob ability of an eHF-C allergy ( p = 0.028) in a statistically significant way. Conclusions: Children with CMPA who presented with allergies to eHF-W and eHF-C had a higher frequency of clin ical manifestation with GI and AD.
简介:近年来,牛奶蛋白过敏(CMPA)儿童分别对广泛水解乳清(eHF-W)和酪蛋白配方(eHF-C)过敏的人数有所增加。目的:介绍对eHF-W和/或eHF-C作为消除饮食的一部分出现过敏反应的CMPA患儿的患者特征。材料和方法:从359例患有CMPA和eHF过敏的儿童(3 - 12个月)中选择65例进行回顾性研究。结果:组中分别有18.1%(65/359)和7.8%(28/359)对eHF-W和eHF-C出现过敏反应。该组43%的患者(28/65)发生对eHF-C的过敏反应。ige介导的CMPA临床表现为:特应性皮炎(AD) 94%,胃肠道症状(GI) 47%,呼吸道症状(RS) 44%,过敏反应(AR) 26%。另一方面,非ige介导的CMPA表现为:AD 97%, GI 22%, RS 10%。观察显示,具有GI和AD表现的非ige介导CMPA组31例患者均出现eHF-C过敏症状(p = 0.001)。在ige介导的CMPA (n = 34)中,与eHF-C过敏相关的因素有统计学意义:CMPA与GI (p = 0.014)和AD。对牛奶蛋白(CMP)反应的AR的发生降低了eHF-C过敏的可能性(p = 0.028),具有统计学意义。结论:对eHF-W和eHF-C过敏的CMPA患儿临床表现为GI和AD的频率更高。
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引用次数: 3
Original paper Evaluation of surgical treatment of rhinophyma with tangential shear of the lesion 鼻肿切向切变手术治疗的评价
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32387
H. Witmanowski, E. Lewandowicz, Daria Sobieszek, Magdalena Łuczkowska, J. Rykala
Introduction: Tuberosity of the nose is a slow, progressive, gentle process, leading to distortion and dysfunction of the nose. Underlying the change is perifollicular hypertrophy of the sebaceous glands, fibrous tissue proliferation and vascular changes of telangiectasia type. It is believed that it is the final stage of rosacea. Aim: To evaluate the effectiveness of surgical treatment using the method of tangential shear, based on a medical examination and subjective assessment of the effects of treatment by the patient. Material and methods: In the years 1998 to 2008 nine patients with moderate degree of rhinophyma were treated surgically by tangential shear, followed by electrocoagulation. The results were assessed according to a 4-point scale as very good, good, fair and poor. We evaluated the presence of postoperative complications (bleeding, infection, or other), healing time, the shape of the nose (size and symmetry), improved patency, reduction in the number of inflammatory conditions, widening of the field of view and long-term effects of treatment: disfiguring scars, uneven surface of the nose, nasal deformity and recurrence. Results: Among the 9 patients studied in 2 cases a very good result was achieved, in 5 good and in 2 satisfactory; no poor result was observed. Healing took an average of 6 weeks (1-15 weeks). None of the patients had postoper ative complications. Seven patients were satisfied with both the size and symmetry of the nose, one unsatisfied with the size and 1 dissatisfied with the symmetry. Following the operation, 1 patient had disfiguring scars, 3 uneven sur face of the nose, nasal deformity was observed in 2 cases and there was 1 recurrence. Of the 2 patients with a sat isfactory result, 1 has been re-operated on, while the other was set an additional term of treatment. Conclusions: Surgical treatment of nasal tuberosity by tangential shear followed by electrocoagulation is effective, and burdened by low rates of complications. To achieve a good aesthetic and functional effect, a very experienced operator is recommended.
鼻结节是一个缓慢、渐进、温和的过程,导致鼻子变形和功能障碍。这种变化的基础是皮脂腺的毛囊周围肥大,纤维组织增生和毛细血管扩张型血管改变。一般认为这是酒渣鼻的最后阶段。目的:在医学检查和患者对治疗效果的主观评价的基础上,评价切向切线法手术治疗的有效性。材料与方法:对1998 ~ 2008年9例中度鼻肿患者行切向切变后电凝手术治疗。结果根据4个等级被评估为非常好、好、一般和差。我们评估了术后并发症(出血、感染或其他)、愈合时间、鼻子形状(大小和对称)、通畅程度的改善、炎症数量的减少、视野的扩大和治疗的长期影响:毁容疤痕、鼻子表面不均匀、鼻畸形和复发。结果:研究的9例患者中,2例效果很好,5例良好,2例满意;未观察到不良结果。愈合时间平均为6周(1-15周)。所有患者均无术后并发症。7例患者对鼻部大小和对称性均满意,1例患者对鼻部大小不满意,1例患者对鼻部对称性不满意。术后1例出现毁容疤痕,3例鼻面凹凸不平,2例出现鼻畸形,1例复发。结果满意的2例患者中,1例再次手术,另1例延长治疗期。结论:切向切变后电凝治疗鼻结节有效,并发症发生率低。为达到良好的美观和功能效果,建议由经验丰富的操作人员操作。
{"title":"Original paper Evaluation of surgical treatment of rhinophyma with tangential shear of the lesion","authors":"H. Witmanowski, E. Lewandowicz, Daria Sobieszek, Magdalena Łuczkowska, J. Rykala","doi":"10.5114/PDIA.2012.32387","DOIUrl":"https://doi.org/10.5114/PDIA.2012.32387","url":null,"abstract":"Introduction: Tuberosity of the nose is a slow, progressive, gentle process, leading to distortion and dysfunction of the nose. Underlying the change is perifollicular hypertrophy of the sebaceous glands, fibrous tissue proliferation and vascular changes of telangiectasia type. It is believed that it is the final stage of rosacea. Aim: To evaluate the effectiveness of surgical treatment using the method of tangential shear, based on a medical examination and subjective assessment of the effects of treatment by the patient. Material and methods: In the years 1998 to 2008 nine patients with moderate degree of rhinophyma were treated surgically by tangential shear, followed by electrocoagulation. The results were assessed according to a 4-point scale as very good, good, fair and poor. We evaluated the presence of postoperative complications (bleeding, infection, or other), healing time, the shape of the nose (size and symmetry), improved patency, reduction in the number of inflammatory conditions, widening of the field of view and long-term effects of treatment: disfiguring scars, uneven surface of the nose, nasal deformity and recurrence. Results: Among the 9 patients studied in 2 cases a very good result was achieved, in 5 good and in 2 satisfactory; no poor result was observed. Healing took an average of 6 weeks (1-15 weeks). None of the patients had postoper ative complications. Seven patients were satisfied with both the size and symmetry of the nose, one unsatisfied with the size and 1 dissatisfied with the symmetry. Following the operation, 1 patient had disfiguring scars, 3 uneven sur face of the nose, nasal deformity was observed in 2 cases and there was 1 recurrence. Of the 2 patients with a sat isfactory result, 1 has been re-operated on, while the other was set an additional term of treatment. Conclusions: Surgical treatment of nasal tuberosity by tangential shear followed by electrocoagulation is effective, and burdened by low rates of complications. To achieve a good aesthetic and functional effect, a very experienced operator is recommended.","PeriodicalId":7212,"journal":{"name":"Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii","volume":"90 1","pages":"411-416"},"PeriodicalIF":0.0,"publicationDate":"2012-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81527553","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: 2
Ichthyosis as a paraneoplastic syndrome and atypical variant of mycosis fungoides: two cases report 鱼鳞病作为一种副肿瘤综合征和蕈样真菌病的非典型变异:2例报告
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32396
M. Malek, H. Majewska, R. Nowicki, J. Roszkiewicz, W. Biernat
Acquired ichthyosis is a known paraneoplastic sign of lymphoproliferative malignancies, but ichthyosiform eruption can also constitute a rare atypical variant of mycosis fungoides. Ichthyosiform mycosis fungoides differs from acquired ichthyosis associated with mycosis fungoides in histopathology. Histological pictures of paraneoplastic ichthyosis usually do not show any aspect related to malignancy in the skin. In both cases thinning of the granular layer and decrease of filaggrin in that layer are observed. We describe here 2 patients with mycosis fungoides, who were treat ed in the Department of Dermatology, the first one with ichthyosiform mycosis fungoides and the other one with acquired ichthyosis with coexisting mycosis fungoides.
获得性鱼鳞病是一种已知的淋巴增生性恶性肿瘤的副肿瘤征象,但鱼鳞状疹也可以构成一种罕见的非典型蕈样真菌病。在组织病理学上鱼鳞状真菌病不同于获得性鱼鳞病合并真菌病。副肿瘤鱼鳞病的组织学图片通常不显示任何与皮肤恶性肿瘤相关的方面。在这两种情况下,都观察到颗粒层变薄和该层中的聚丝蛋白减少。本文报告2例在皮肤科就诊的蕈样真菌病患者,1例为鱼鳞状蕈样真菌病,1例为获得性鱼鳞病合并蕈样真菌病。
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引用次数: 2
Review paper Vitamin C: is it time to re-evaluate its role in health and disease? 维生素C:是时候重新评估它在健康和疾病中的作用了吗?
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32394
R. Rutkowski, K. Rutkowski, Joanna Rutkowska-Talipska, P. Sowa, S. Sułkowski
A b s t r a c t Vitamin C (VC; ascorbic acid, AA) is synthesised from glucose in the liver of most mammals, but not in humans. Syn thetic AA supplementation is often necessary to prevent vitamin C deficiency. Intracellularly AA is reversibly oxidized to an ascorbic radical which converts into dehydroascorbic acid (DHA). Ascorbic acid crosses cell membranes with SVCT1, SVCT2 or GLUT1, GLUT3 and GLUT4 transporters. Recommended daily allowance for VC is around 75 mg/day for women and 90 mg/day for men. This seems to be too low in relation to real human body needs and does not ensure true health protection. There are ongoing studies re-evaluating the role of VC in cancer treatment. There fore, it would be also appropriate to reassess its use as a specific drug in the prevention and therapy of asthma, aller gic rhinitis and atopic dermatitis.
维生素c (VC);抗坏血酸(AA)是由大多数哺乳动物肝脏中的葡萄糖合成的,但人类却不是。合成AA补充通常是必要的,以防止维生素C缺乏。细胞内AA被可逆氧化为抗坏血酸自由基,转化为脱氢抗坏血酸(DHA)。抗坏血酸通过SVCT1、SVCT2或GLUT1、GLUT3和GLUT4转运蛋白穿过细胞膜。推荐的每日VC摄取量为女性每天75毫克,男性每天90毫克。与人体的实际需求相比,这似乎太低了,不能确保真正的健康保护。正在进行的研究重新评估了VC在癌症治疗中的作用。因此,重新评估其作为预防和治疗哮喘、变应性鼻炎和特应性皮炎的特异性药物的使用也是合适的。
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引用次数: 3
Review paper Allergic diseases – current state of knowledge 变态反应性疾病的知识现状
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32393
W. Żukiewicz-Sobczak, E. Krasowska, J. Zwoliński, P. Sobczak, J. Chmielewska-Badora, P. Wróblewska, J. Piątek, A. Wojtyła
Allergic diseases are very common in developed countries, particularly among children, adolescents and young adults. Currently, allergies are being considered as an epidemic of the 21 st century. According to the Polish Society of Aller - gology, the percentage of adults suffering from asthma in our country is 5.4%, and in children 10%. The authors describe current knowledge regarding the pathomechanism, incidence, epidemiology and diagnostics of the most common sig - nificant allergic diseases, including allergic rhinitis, asthma, allergic conjunctivitis, atopic dermatitis and urticaria. One of the most common allergic diseases is allergic rhinitis, which is the result of an allergic inflammation of the nasal mucosa mediated by immunoglobulin E. Asthma is a lifelong chronic inflammatory disorder of the airways associat - ed with a variety of structural changes occurring in children and adults of all ages. This disease is characterized by bronchial hyperreactivity and obstruction which often disappear either spontaneously or with treatment. Atopic der - matitis is a chronic and relapsing inflammatory skin disease with a varying clinical spectrum, and may often play the role of the first stage of the atopic march. Urticaria is a heterogeneous group of diseases, characterized by the pres - ence of wheals and/or angioedema. The mainstay of allergy diagnosis is in vivo and in vitro testing. In vivo testing includes skin prick tests, prick-by-prick tests, atopy patch tests and also skin application skin test. In vitro testing includes mea - surement of serum total and antigen-specific IgE using various methods. During the last years, also component-resolved diagnostics have gained growing importance as a useful tool in clinical investigation of IgE-mediated allergies.
过敏性疾病在发达国家非常常见,特别是在儿童、青少年和年轻人中。目前,过敏被认为是21世纪的一种流行病。根据波兰过敏症学会的数据,我国成人哮喘患者的比例为5.4%,儿童为10%。作者描述了目前关于最常见的重大变应性疾病的发病机制、发病率、流行病学和诊断的知识,包括变应性鼻炎、哮喘、过敏性结膜炎、特应性皮炎和荨麻疹。过敏性鼻炎是最常见的过敏性疾病之一,它是免疫球蛋白e介导的鼻黏膜过敏性炎症的结果。哮喘是一种与各种气道结构改变相关的终身慢性炎症性疾病,发生在儿童和所有年龄的成人中。这种疾病的特点是支气管高反应性和阻塞,通常自发或治疗后消失。特应性皮炎是一种慢性和复发性炎症性皮肤病,具有不同的临床谱,并可能经常发挥特应性行军的第一阶段的作用。荨麻疹是一种异质性的疾病,其特征是存在荨麻疹和/或血管性水肿。过敏诊断的主要方法是体内和体外试验。体内试验包括皮肤点刺试验、逐个点刺试验、特应性斑贴试验和皮肤应用皮肤试验。体外测试包括使用各种方法测量血清总IgE和抗原特异性IgE。在过去的几年里,成分解析诊断作为一种有用的工具在ige介导的过敏的临床研究中越来越重要。
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引用次数: 26
Review paper Keloids: current prophylactic and therapeutic methods 瘢痕疙瘩:目前的预防和治疗方法
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32392
Wojciech Bienias, A. Kaszuba
Prophylaxis and therapy of keloids present a big challenge for medicine, despite the increasing knowledge about their pathogenesis. There are a lot of therapeutic methods but their effectiveness is still limited and unsatisfacto ry. These methods are divided into surgical, pharmacological and physical ones as well as the most frequently applied combined therapy, which is the most effective one. A surgical way of removing keloids is becoming less common and the method of intralesional application of steroids still remains the treatment of choice. In addition to the above there are cryotherapy, laser therapy, pressure therapy, X-ray irradiation and silicone products in a form of gels and dressings. Relatively new methods are intralesional injections of verapamil and 5-fluorouracil. Enalapril and trogli tazone, which are currently used in the treatment of hypertension and diabetes, are expected to be of use as well. Biological drugs like monoclonal antibodies against tumor growth factor (TGF)- β1, TGF- β2 and vascular endothelial growth factor and analogues of TGF- β3 are also potential solutions in the treatment of keloids. Further studies on the treatment of keloids should result in more efficient therapies.
尽管对瘢痕疙瘩的发病机制了解越来越多,但预防和治疗瘢痕疙瘩对医学来说是一个巨大的挑战。治疗方法很多,但效果有限,令人不满意。这些方法分为手术、药物和物理三种,最常用的是联合治疗,这是最有效的一种。手术切除瘢痕疙瘩的方法越来越不常见,病灶内应用类固醇仍然是治疗的选择。除此之外,还有冷冻疗法,激光疗法,压力疗法,x射线照射和硅胶产品的凝胶和敷料的形式。相对较新的方法是局部注射维拉帕米和5-氟尿嘧啶。目前用于治疗高血压和糖尿病的依那普利和曲格利他酮也有望投入使用。抗肿瘤生长因子(TGF)- β1、TGF- β2、血管内皮生长因子及TGF- β3类似物的单克隆抗体等生物药物也是治疗瘢痕疙瘩的潜在解决方案。对瘢痕疙瘩治疗的进一步研究应该会产生更有效的治疗方法。
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引用次数: 2
Review paper Insights into Behçet’s disease 综述论文洞察behaperet病
Pub Date : 2012-12-21 DOI: 10.5114/PDIA.2012.32395
Fatemeh Shahneh, Zohreh Babalo, B. Baradaran, Koushan Sineh Sepehr
Behcet’s disease is a chronic relapsing multi-organ inflammatory disorder characterized as a triad of oral and gen ital ulcers, uveitis. Characteristic manifestations of Behcet’s disease are joints, skin, central nervous system and gas trointestinal tract involvement. Behcet’s disease has a complicated genetic etiology. However, epidemiological stud ies recommend that genetic factors have a significant role in its pathogenesis, the same as other autoinflammatory disorders. Antigenic stimuli, antigen-presenting cells, T cells, monocyte, neutrophil and endothelial cells are most important parts of the pathology of the disease. Inflammatory response was triggered by an infectious agent in a genetically susceptible host. Understanding the pathogenesis based on the molecular mechanism of the disease highlights the new therapeutic modalities. Enhanced inflammatory activity and over-expression of proinflammato ry cytokines are the striking features of Behcet’s disease, and they are accordant with the result in other auto inflam matory disorders. Moreover, there is evidence of antigen-driven immune response in Behcet’s disease, but it prob ably advances in further innate immune reactivity. New therapeutic modalities target specific and nonspecific suppression of the immune system. The diagnosis is a clinical one, and although there is no single laboratory test enough for the diagnosis of Behcet’s disease. In this paper, a new aspect of the studies on genetic susceptibility, immunopathogenesis of Behcet’s disease and novel treatment modalities will be discussed.
白塞氏病是一种慢性复发的多器官炎症性疾病,其特征是口腔和牙龈溃疡、葡萄膜炎。白塞病的特征性表现是关节、皮肤、中枢神经系统和气肠管受累。白塞氏病具有复杂的遗传病因。然而,流行病学研究表明,与其他自身炎症性疾病一样,遗传因素在其发病机制中起着重要作用。抗原刺激、抗原呈递细胞、T细胞、单核细胞、中性粒细胞和内皮细胞是本病病理的重要组成部分。炎症反应是由遗传易感宿主的感染因子引发的。基于分子机制了解疾病的发病机制凸显了新的治疗方式。炎症活性增强和促炎细胞因子的过度表达是白塞氏病的显著特征,这与其他自身炎性疾病的结果一致。此外,有证据表明抗原驱动的免疫反应在白塞氏病中,但它可能进一步推进先天性免疫反应。新的治疗方式针对免疫系统的特异性和非特异性抑制。这是一个临床诊断,虽然没有单一的实验室检查足以诊断白塞病。本文就白塞病的遗传易感性、免疫发病机制和新的治疗方法等方面的研究作一综述。
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引用次数: 3
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Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii
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