Journal of clinical and investigative dermatology最新文献_第3页

Syphilitic Alopecia: Report of a Challenging Case and Review of the Literature 梅毒性脱发:一个具有挑战性的病例报告和文献回顾

Journal of clinical and investigative dermatology

Pub Date : 2020-12-30 DOI: 10.13188/2373-1044.1000064

Syphilitic alopecia (SA) is a rare manifestation of syphilis, which may be the only manifestation of the disease. Two clinical forms are described; a symptomatic alopecia and an essential alopecia. This last clinical form is the most frequently observed, presenting as a “moth-eaten” or “patch-form” appearance, in a more diffused hair loss pattern. The term neurosyphilis refers to the infection of the Central Nervous System (CNS) by Treponema Pallidum (T. pallidum) and can occur at any time during the course of the disease. We present the case of a 61-year-old man who was diagnosed with early neurosyphilis presenting with syphilitic alopecia, and a review of the current literature. Although there are numerous reports of individual cases of both syphilitic alopecia and neurosyphilis, to our knowledge there are only three reports that describe their simultaneous presentation. We emphasize the importance of recognizing this presentation of syphilis in clinical practice, in order to carry out a timely treatment of the patient and their contacts.

梅毒性脱发(SA)是梅毒的一种罕见表现，可能是该病的唯一表现。描述了两种临床形式;症状性脱发和本质性脱发。最后一种临床形式是最常观察到的，表现为“虫蛀”或“斑片状”外观，在更弥漫性的脱发模式中。神经梅毒是指梅毒螺旋体(T. Pallidum)对中枢神经系统(CNS)的感染，可在病程中的任何时间发生。我们提出的情况下，一个61岁的男子谁被诊断为早期神经梅毒呈现梅毒性脱发，并检讨目前的文献。尽管有许多关于梅毒性脱发和神经梅毒的病例报告，但据我们所知，只有三份报告描述了它们同时出现。我们强调在临床实践中认识到这种梅毒表现的重要性，以便对患者及其接触者进行及时治疗。

引用次数: 0

Targeting Keloid Fibroblasts by Inhibition of Hypoxia Signaling 通过抑制缺氧信号靶向瘢痕疙瘩成纤维细胞

Journal of clinical and investigative dermatology

Pub Date : 2020-12-30 DOI: 10.13188/2373-1044.1000066

J. Richert-Jones, L. Ricks-Santi

Keloids are persistent raised scars that are difficult to treat because attempts at removal typically results in recurrence. Keloid fibroblasts are the abnormal cell type responsible for the continuous scar protein deposition in this fibrotic skin disease that involves enhanced TGFβ activity. An effective therapy that can eliminate keloid fibroblasts and promote normal healing is needed. We examined the cellular and molecular differences between keloid and normal skin fibroblasts to identify characteristics that may be targeted for therapy. By limiting serum and/ or glucose availability, we found that keloid fibroblasts are sensitive to glucose levels but not to serum withdrawal. Treatment with 2deoxyglucose, a preclinical drug that blocks glycolytic metabolism, can reduce keloid fibroblast cell size. However, recovery occurs upon drug removal, indicating a cytostatic effect. To eliminate keloids, it would be necessary to induce cell death in order to disrupt the cycle of continuous fibrosis. Thus, we examined the role of HIF-1, a central transcription factor that regulates both glycolytic metabolism and fibrosis, to determine whether blocking its activity in keloid fibroblasts could yield a cytotoxic outcome. Using a chemical inhibitor against HIF-1, we observed a significant reduction in keloid fibroblast numbers. Although small molecule HIF-1 inhibitors have been under development for anemia and cancer therapy, their role in regulating fibrotic genes has led researchers to consider their potential use in the treatment of lung or kidney fibrosis. Since keloid disease may be considered a form of chronic skin fibrosis, reducing HIF-1 activity could provide a therapeutic strategy for keloid treatment. Avens Publishing Group Inviting Innovations Citation: Richert-Jones J, Mantel A, Ricks-Santi L, Harvey VM, Chan J. Targeting Keloid Fibroblasts by Inhibition of Hypoxia Signaling. J Clin Investigat Dermatol. 2020;8(2): 5 J Clin Investigat Dermatol 8(2): 5 (2020) Page 02 ISSN: 2373-1044 blot luminol reagent (Bio-Rad cat. no. P10026378/ P10026379, 1000 Alfred Nobel Drive Hercules, CA, USA). Primary antibodies were: phospho-SMAD2 (pSMAD2) and phospho-S6 (pS6) (Cell Signaling Technology, Inc. cat. no. 18338T and no. 4857S, respectively; 3 Trask Lane, Danvers, MA 01923, USA). Statistical analysis The results were expressed as the mean ± Standard Deviation (SD). Statistical analyses were performed using the SPSS 22.0 software, one-way ANCOVA for group comparisons or a paired T-test for pairwise comparisons. A value of p ≤ 0.05 was considered statistically significant. Results and Discussion Keloids are often compared with cancers in terms of their chronic and persistent growth. Some of these features are preserved in keloid fibroblasts (KFs); therefore, with the absence of an animal model, fibroblasts derived from keloid scars provide an important cellbased model that retains key features of keloids. Of the 10 hallmarks of cancer, keloids share 6 of them [

瘢痕疙瘩是难以治疗的持续性凸起疤痕，因为试图去除通常会导致复发。瘢痕疙瘩成纤维细胞是一种异常细胞类型，在这种纤维化皮肤病中导致持续的疤痕蛋白沉积，涉及TGFβ活性增强。需要一种能够消除瘢痕疙瘩成纤维细胞并促进正常愈合的有效疗法。我们检查了瘢痕疙瘩和正常皮肤成纤维细胞之间的细胞和分子差异，以确定可能针对治疗的特征。通过限制血清和/或葡萄糖的可用性，我们发现瘢痕疙瘩成纤维细胞对葡萄糖水平敏感，但对血清停药不敏感。用2脱氧葡萄糖(一种阻断糖酵解代谢的临床前药物)治疗可以减少瘢痕疙瘩成纤维细胞的大小。然而，恢复发生在药物去除，表明细胞抑制作用。为了消除瘢痕疙瘩，有必要诱导细胞死亡，以破坏持续纤维化的循环。因此，我们研究了HIF-1(一种调节糖酵解代谢和纤维化的中心转录因子)的作用，以确定在瘢痕疙瘩成纤维细胞中阻断其活性是否会产生细胞毒性结果。使用抗HIF-1的化学抑制剂，我们观察到瘢痕疙瘩成纤维细胞数量显著减少。尽管小分子HIF-1抑制剂一直处于贫血和癌症治疗的开发阶段，但它们在调节纤维化基因方面的作用使研究人员考虑它们在治疗肺或肾纤维化方面的潜在用途。由于瘢痕疙瘩病可能被认为是慢性皮肤纤维化的一种形式，降低HIF-1活性可能为瘢痕疙瘩治疗提供一种治疗策略。引用本文:Richert-Jones J, Mantel A, Ricks-Santi L, Harvey VM, Chan J.瘢痕疙瘩成纤维细胞缺氧信号的抑制。J clinical Investigat Dermatol. 2020;8(2): 5 J clinical Investigat Dermatol 8(2): 5 (2020) Page 02 ISSN: 2373-1044 blot luminol reagent (Bio-Rad cat.;)不。P10026378/ P10026379, 1000阿尔弗雷德诺贝尔驱动器赫拉克勒斯，CA)。一抗为:phospho-SMAD2 (pSMAD2)和phospho-S6 (pS6) (Cell Signaling Technology, Inc. cat.)。不。18338T和no。4857年代,分别;美国马萨诸塞州丹佛斯市查斯克巷3号统计分析结果以均数±标准差(SD)表示。统计学分析采用SPSS 22.0软件，组间比较采用单因素方差分析，两两比较采用配对t检验。p≤0.05认为有统计学意义。结果和讨论瘢痕疙瘩常被拿来与癌症比较，因为它们的生长是慢性和持续性的。其中一些特征在瘢痕疙瘩成纤维细胞(KFs)中得以保留;因此，在缺乏动物模型的情况下，来自瘢痕疙瘩疤痕的成纤维细胞提供了一个重要的基于细胞的模型，保留了瘢痕疙瘩的主要特征。在癌症的10个特征中，瘢痕疙瘩共有6个特征[1](表1)。为了验证其中的一些特征[1]，我们使用western和免疫荧光分析来检测瘢痕疙瘩成纤维细胞(KFs)中相关蛋白的表达和激活途径，但在正常皮肤成纤维细胞(NFs;图1 a)。KFs通常表达高水平的平滑肌肌动蛋白(SMA)，这是公认的移行性肌成纤维细胞[10]的特性。正如其他人报道的那样，我们还注意到TGF-β的表达和phospho-SMAD2 (pSMAD2)的检测表明未受刺激的KFs中存在慢性通路激活。此外，磷酸化- s6 (pS6)检测显示，mTORC1(哺乳动物或雷帕霉素复合物1的机制靶点)活性在KFs中也升高(图1A)。为了证明这些激活信号的特异性，我们还使用IGF1刺激，单独或在高选择性化学抑制剂的存在下阻断几个节点的信号通路:IGF1受体(使用NVP-AEW541)， PI3Kα(磷酸肌肽3-激酶- α，使用PI3Kα抑制剂MLN1117)，或PI3K和mTORC1(使用双重抑制剂NVP-BEZ235[12,13])。此外，我们还观察到KF细胞大小增大，与SMA[5]免疫荧光染色显示的mTORC1活性增强一致(图1B)。虽然一些蛋白质的表达高度升高，但另一些则没有。例如，纤维连接蛋白在两种类型的成纤维细胞中的表达是相似的(图1a和1B)。先前的研究表明，KFs更倾向于糖酵解代谢，其中使用针对该途径的化学抑制剂来评估其在瘢痕疙瘩治疗中的潜在用途[3,14]。在Vincent等人(2008)的一项综合研究中;当糖酵解被3种结构不同的抑制剂破坏时，乳酸或ATP生成的变化减少。在另一项研究中，Li等人(2018;[14])， 2-脱氧葡萄糖(2-DG)在4天内降低KF活力。尽管这两项研究都表明，化学糖酵解阻断可以靶向治疗瘢痕疙瘩，但尚不清楚是否可以选择性地抑制KFs，同时允许NFs存活。为了进一步研究这一点，我们研究了限制葡萄糖可用性是否可以揭示NF和KF之间活力的差异。因此，我们测定了这些成纤维细胞在低糖和/或血清培养基中生长时的活细胞数量，并与图1:瘢痕疙瘩成纤维细胞的特征和活力进行了比较。(A)瘢痕疙瘩成纤维细胞(KF)蛋白表达和信号通路激活与对照正常成纤维细胞(NF)的Western分析。α-SMA、纤维连接蛋白、TGFβ和pSMAD2在未刺激KFs中的表达升高。对KF和NF中IGF1 (10 ng/ml)信号的分析表明，在刺激后30分钟，pAKT、pS6被激活。对于KF，这些激酶在基础状态被激活。抑制剂(NVP, 1μM NVPAEW541;Mln, 3μm mln1117;如图所示，在IGF1刺激前30分钟加入BEZ, 100nM BEZ235)。在每条车道上装载20微克细胞裂解液。用GAPDH或β-actin表示负载相等。(B)瘢痕疙瘩成纤维细胞的免疫荧光染色，使用α-SMA、纤维连接蛋白或phalloidin;细胞核用DAPI染色(蓝色)。标尺，100 μm。(C)在图例中指定的条件下绘制的存活率变化百分比。葡萄糖(++，4.5g/L;+， 1g/L)和/或血清(+，存在;-，无)显示基底完整介质的变化。经ANCOVA分析，差异无统计学意义(p < 0.05);还指出了4种差异最大的情况(中间图)。引用本文:Richert-Jones J, Mantel A, Ricks-Santi L, Harvey VM, Chan J.瘢痕疙瘩成纤维细胞缺氧信号的抑制。J clinical Investigat Dermatol. 2020;8(2): 5 J clinical Investigat Dermatol 8(2): 5 (2020) Page 03 ISSN: 2373-1044 complete media。对于每种类型的成纤维细胞，在第0天每瓶至少接种3次30万个细胞。从第3-7天使用血细胞计数法计数细胞数量(图1C)。为了突出葡萄糖特异性效应，我们给出了一个简化的图表，显示当葡萄糖水平降低到22%或0%时，NF和KF细胞受到的影响率相似。因此，在糖酵解途径中限制葡萄糖可用性或拮抗酶可能不是瘢痕疙瘩治疗的有效手段。使用协方差分析(ANCOVA)证实了这一观察结果，表明降低血糖和/或血清水平不会产生细胞间的统计学差异(p < 0.05;图1 c)。我们还研究了临床前药物拮抗KFs中过度激活的通路是否可以破坏这种异常细胞类型(图1，数据未显示)。其中包括抑制糖酵解的

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引用次数: 0

Inter- and Intra-physician variation in quantifying actinic keratosis skin photodamage. 量化光化性角化病皮肤光损伤的医师之间和医师内部差异。

Journal of clinical and investigative dermatology

Pub Date : 2020-09-01 Epub Date: 2020-09-06

Benjamin Schmeusser, Christina Borchers, Jeffrey B Travers, Samia Borchers, Julian Trevino, Max Rubin, Heidi Donnelly, Karl Kellawan, Lydia Carpenter, Shalini Bahl, Craig Rohan, Elizabeth Muennich, Scott Guenthner, Holly Hahn, Ali Rkein, Marc Darst, Nico Mousdicas, Elizabeth Cates, Ulas Sunar, Trevor Bihl

We investigated the variations in physician evaluation of skin photodamage based on a published photodamage scale. Of interest is the utility of a 10-level scale ranging from none and mild photodamage to actinic keratosis (AK). The dorsal forearms of 55 adult subjects with various amounts of photodamage were considered. Each forearm was independently evaluated by 15 board-certified dermatologists according to the Global Assessment Severity Scale ranging from 0 (less severe) to 9 (the most progressed stage of skin damage). Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion. Results show substantial disagreement amongst the dermatologists on the severity of photodamage. Our results indicate that ratings could be more consistent if using a scale of less levels (5-levels or 3-levels). Ultimately, clinicians can use this knowledge to provide better interpretation of inter-rater evaluations and provide more reliable assessment and frequent monitoring of high-risk populations.

我们根据公布的光损伤量表调查了医生评估皮肤光损伤的差异。我们感兴趣的是从无和轻度光损伤到光化性角化病(AK)的10级量表的效用。研究了55例不同程度光损伤的成人前臂背侧。每个前臂由15名委员会认证的皮肤科医生根据全球评估严重程度量表进行独立评估，范围从0(较轻)到9(最严重的皮肤损伤阶段)。皮肤科医生以盲法根据照片对光损伤程度进行评级。结果显示，皮肤科医生对光损伤的严重程度存在实质性分歧。我们的结果表明，如果使用较少级别的量表(5级或3级)，评分可能更加一致。最终，临床医生可以利用这些知识来更好地解释评分者之间的评估，并提供更可靠的评估和对高危人群的频繁监测。

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引用次数: 0

Inter- and Intra-physician variation in quantifying actinic keratosis skin photodamage. 量化光化性角化病皮肤光损伤的医师之间和医师内部差异。

Journal of clinical and investigative dermatology

Pub Date : 2020-09-01 DOI: 10.13188/2373-1044.1000065

Schmeusser, J. Travers, Borchers, J. Trevino, Kellawan, L. Carpenter, S. Bahl, C. Rohan, E. Muennich, S. Guenthner, H. Hahn, Ali M Rkein, Mousdicas, E. Cates, U. Sunar

We investigated the variations in physician evaluation of skin photodamage based on a published photodamage scale. Of interest is the utility of a 10-level scale ranging from none and mild photodamage to actinic keratosis (AK). The dorsal forearms of 55 adult subjects with various amounts of photodamage were considered. Each forearm was independently evaluated by 15 board-certified dermatologists according to the Global Assessment Severity Scale ranging from 0 (less severe) to 9 (the most progressed stage of skin damage). Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion. Results show substantial disagreement amongst the dermatologists on the severity of photodamage. Our results indicate that ratings could be more consistent if using a scale of less levels (5-levels or 3-levels). Ultimately, clinicians can use this knowledge to provide better interpretation of inter-rater evaluations and provide more reliable assessment and frequent monitoring of high-risk populations.

我们根据公布的光损伤量表调查了医生评估皮肤光损伤的差异。我们感兴趣的是从无和轻度光损伤到光化性角化病(AK)的10级量表的效用。研究了55例不同程度光损伤的成人前臂背侧。每个前臂由15名委员会认证的皮肤科医生根据全球评估严重程度量表进行独立评估，范围从0(较轻)到9(最严重的皮肤损伤阶段)。皮肤科医生以盲法根据照片对光损伤程度进行评级。结果显示，皮肤科医生对光损伤的严重程度存在实质性分歧。我们的结果表明，如果使用较少级别的量表(5级或3级)，评分可能更加一致。最终，临床医生可以利用这些知识来更好地解释评分者之间的评估，并提供更可靠的评估和对高危人群的频繁监测。

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引用次数: 0

Nourkrin® Woman with Marilex® Enhances Hair Growth and Appearance and Improves Hair Confidence in Women with Diffuse Hair Loss from Brazil: An Investigatorinitiated Clinical Study 使用Marilex®的Nourkrin®女性增强巴西弥漫性脱发女性的头发生长和外观，提高头发自信：一项由研究者发起的临床研究

Journal of clinical and investigative dermatology

Pub Date : 2020-06-12 DOI: 10.13188/2373-1044.1000063

M. Simoes

Background: Female Pattern Hair Loss (FPHL) and Telogen Effluvium (TE) are common dermatological conditions in women, affecting half of the female population. Treating hair loss in women is more challenging since its pathogenesis is not fully understood and it commonly leads to more serious psychosocial consequences compared to hair loss in men. Recent evidence highlights the involvement of proteoglycan dysmetabolism and follicular hypoglycania as a mediating pathology. Follicular hypoglycania disturbs cellular activity and is behind the gradual deterioration of hair follicles, a condition known as Proteoglycan Follicular Atrophy (PFA). Proteoglycan Replacement Therapy (PRT) with Nourkrin® with Marilex® is a unique approach that helps to treat PFA and restore a normal hair growth cycle. Methods: We aimed to investigate the treatment satisfaction and subjective efficacy of Nourkrin® with Marilex®. To this end, 67women with moderate to severe FPHL or TE (mean age=42.73 years) were enrolled into an investigatorinitiated, subjective, cohort study carried out by practicing dermatologists in Brazil in collaboration with the World Hair Council. Study participants were randomly selected by several collaborating dermatologists and have voluntarily started a 6 month course of monotherapy with Nourkrin® Woman (600mg Marilex® per day). They were interviewed every 3 months using a semi-structured questionnaire. Results: Just after 3 months, 94.03% and 95.52% of participants reported having experienced improved hair growth and appearance, respectively; and 83.58% were more confident with their hair. All Nourkrin® users were satisfied with the results at this point and were willing to continue with the treatment. At endpoint, 94.03% of subjects experienced enhanced hair growth and 92.54% reported improved appearance of their hair. These positive changes have led 83.58% of participants to feel more confident with their hair. Overall treatment satisfaction rate with Nourkrin® therapy was 97.01%. Conclusion: Our findings indicate that women with diffuse hair loss found PRT with Nourkrin® an effective approach that stimulates hair growth and improves hair appearance. Treated patients felt more self-confident and were satisfied with Nourkrin® monotherapy. Avens Publishing Group Inviting Innovations Citation: Mattos Simoes M, Thom E, Wadstein J. Nourkrin® Woman with Marilex® Enhances Hair Growth and Appearance and Improves Hair Confidence in Women with Diffuse Hair Loss from Brazil: An Investigator-initiated Clinical Study. J Clin Investigat Dermatol. 2020;8(1): 4 J Clin Investigat Dermatol 8(1): 4 (2020) Page 02 ISSN: 2373-1044 thinning has led to the utilisation of proteoglycan-based therapies as a novel approach to hair loss. The Originator Nourkrin® with Marilex®(produced by Pharma Medico Aps, Aarhus, Denmark) uses a specific combination of bioactive proteoglycans with ‘anagen inducing’ and ‘anagen maintaining’ properties to mitigate FHG and treat PFA. This uniqu

背景：女性型脱发（FPHL）和Telogen Effluvium（TE）是女性常见的皮肤病，影响了一半的女性。治疗女性脱发更具挑战性，因为其发病机制尚不完全清楚，而且与男性脱发相比，它通常会导致更严重的心理社会后果。最近的证据强调，蛋白多糖代谢障碍和卵泡低血糖是一种介导病理。毛囊低血糖症扰乱细胞活动，是毛囊逐渐退化的原因，这种情况被称为蛋白聚糖毛囊萎缩（PFA）。Nourkrin®与Marilex®的蛋白聚糖替代疗法（PRT）是一种独特的方法，有助于治疗PFA并恢复正常的头发生长周期。方法：我们旨在调查Nourkrin®与Marilex®的治疗满意度和主观疗效。为此，67名患有中度至重度FPHL或TE的女性（平均年龄=42.73岁）被纳入了一项由巴西执业皮肤科医生与世界头发理事会合作进行的调查性、主观的队列研究。研究参与者由几位合作的皮肤科医生随机选择，并自愿开始接受为期6个月的Nourkrin®女性单药治疗（每天600mg Marilex®）。他们每3个月接受一次半结构化问卷调查。结果：3个月后，94.03%和95.52%的参与者报告说，他们的头发生长和外观分别有所改善；83.58%的人对自己的头发更有信心。所有Nourkrin®使用者都对目前的结果感到满意，并愿意继续治疗。终点时，94.03%的受试者头发生长增强，92.54%的受试人报告头发外观改善。这些积极的变化使83.58%的参与者对自己的头发更有信心。Nourkrin®治疗的总体治疗满意率为97.01%。结论：我们的研究结果表明，患有弥漫性脱发的女性发现，使用Nourkrin-®进行PRT是一种刺激头发生长和改善头发外观的有效方法。接受治疗的患者感到更加自信，并对Nourkrin®单药治疗感到满意。Avens出版集团邀请创新引文：Mattos Simoes M，Thom E，Wadstein J.Nourkrin®女性使用Marilex®增强巴西弥漫性脱发女性的头发生长和外观，提高头发自信：一项由研究人员发起的临床研究。皮肤病临床研究杂志。2020年；8（1）:4 J Clin Investigator Dermatol 8（1。Originator Nourkrin®with Marilex®（由丹麦奥胡斯的Pharma Medico Aps生产）使用具有“诱导生长”和“维持生长”特性的生物活性蛋白聚糖的特定组合来减轻FHG和治疗PFA。这种独特的方法在临床文献中被称为“蛋白聚糖替代疗法（PRT）”。大量临床试验和论文已经证实并证明了使用Nourkrin®的PRT治疗弥漫性脱发患者的临床疗效和安全性[6-9]。为了更全面地了解努克林®PRT的治疗效果、耐受性和治疗满意度，由执业皮肤科医生进行了一项临床队列研究。在这项研究中，我们努力阐明Nourkrin®的客观临床改善是如何被患者主观感知的。材料和方法

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引用次数: 0

Oral Lichen Planus Developing after PD-1 Inhibitor Therapy in Two Patients with Malignant Melanoma 2例恶性黑色素瘤患者PD-1抑制剂治疗后出现口腔扁平苔藓

Journal of clinical and investigative dermatology

Pub Date : 2019-12-30 DOI: 10.13188/2373-1044.1000056

引用次数: 1

Comparison of the Efficacy of Topical Human Breast Milk versus Hydrocortisone 1% Lotion in the Clinical Improvement of Atopic Eczema in Infants: A Non-inferiority Trial 局部人乳与1%氢化可的松洗剂对婴儿特应性湿疹临床改善的疗效比较:一项非劣效性试验

Journal of clinical and investigative dermatology

Pub Date : 2018-06-30 DOI: 10.13188/2373-1044.1000051

Erica T. Rogando-Tan, E. Tianco, D. King-Ismael, Deana Dabay-Tan

Increasing evidence from these published researches also support the anti-inflammatory property of HBM. A study done my Farahani et al. comparing the effect of human milk and topical hydrocortisone 1% on diaper dermatitis, showed that treatment with HBM was as effective as hydrocortisone 1% ointment in reducing severity scores in seven days [13]. This was attributed to milk components that directly exert an anti-inflammatory effect or indirectly create unfavorable environment conditions for bacterial growth by modifying the commensal flora the pH or bacterial substrates [13]. Lactation consultants have been advocates in promoting topical HBM application on sore nipples and infantile rash [13]. Mohammadzadeh et al. has shown that it is comparable to lanolin in improving sore nipples in breastfeeding women [10]. It was postulated that human milk being a source of two classes of major growth factors, transforming growth factors alpha (TGF-α) and beta (TGF-β) and the Insulin-like Growth Factors (IGF) may have roles in wound healing. TGF-α and TGF-β are involved in normal cell activities such as embryonic development, cell proliferation and tissue repair.

这些已发表的研究中越来越多的证据也支持HBM的抗炎特性。Farahani等人进行的一项研究比较了人乳和局部1%氢化可的松治疗尿布皮炎的效果，结果表明，在7天内，HBM治疗与1%氢化可的松软膏在降低严重程度评分方面一样有效。这是由于牛奶成分直接发挥抗炎作用，或通过改变共生菌群pH值或细菌底物[13]间接为细菌生长创造不利的环境条件。泌乳顾问一直提倡在乳头痛和婴儿皮疹上局部应用HBM。Mohammadzadeh等人的研究表明，在改善母乳喂养妇女乳头疼痛方面，它与羊毛脂相当。据推测，母乳是两类主要生长因子转化生长因子α (TGF-α)和β (TGF-β)以及胰岛素样生长因子(IGF)的来源，可能在伤口愈合中起作用。TGF-α和TGF-β参与胚胎发育、细胞增殖和组织修复等正常细胞活动。

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引用次数: 2

Recurrence Rate of Melanoma in Situ when Treated with Serial Disk Staged Excision: A Case Series. 连续椎间盘分期切除治疗原位黑色素瘤的复发率:一个病例系列。

Journal of clinical and investigative dermatology

Pub Date : 2017-02-01 Epub Date: 2017-02-27 DOI: 10.13188/2373-1044.1000037

Daniel Garcia, Robert E Eilers, S Brian Jiang

Background: Cutaneous melanoma is one of the fastest rising cancer diagnoses in recent years. Melanoma in situ (MIS) constitutes a large proportion of all diagnosed melanomas. While surgical excision is considered the standard of therapy, the literature is not clear on which surgical technique minimizes local recurrence. A common technique is serial staged excision (SSE), in which a series of mapped excisions are made according to histopathological examination of tissue. Previously published recurrence rates for SSE ranges from 0-12%, over a range of 4.7-97 months of mean follow-up.

Objective: To investigate the recurrence rate of MIS when excised using a serial disk staged excision technique with tissue marked at 12 O'clock for mapping, rush permanent processing and histologic examination, 3-suture tagging for subsequent stages, and "breadloafing" microscopic analysis. Additionally, to determine the relationship between initial lesion size and subsequent stages of excision required for clearance, and final surgical margin.

Methods: Single-institution retrospective chart review of 29 biopsy confirmed MIS lesions treated with our variant of SSE. Statistical analysis via independent t-tests.

Results: No recurrences were observed with mean follow-up of 31.5 months (SD 13.9), over range of 12-58 months. Mean surgical margin of 13.1 mm (SD 5.9). A trend towards larger surgical margin was seen with increasing pre-operative lesion size.

Conclusion: This method of SSE for treatment of MIS is comparable in efficacy to other SSE techniques, and may offer physicians a relatively simple, efficacious, and accessible alternative to wide local excision and Mohs micrographic surgery.

背景:皮肤黑色素瘤是近年来发病率上升最快的癌症之一。原位黑色素瘤(MIS)在所有诊断的黑色素瘤中占很大比例。虽然手术切除被认为是标准的治疗方法，但文献并不清楚哪种手术技术可以最大限度地减少局部复发。一种常见的技术是连续分期切除(SSE)，其中根据组织病理学检查进行一系列映射切除。先前公布的SSE复发率为0-12%，平均随访时间为4.7-97个月。目的:探讨采用连续盘分阶段切除技术切除MIS后的复发率，该技术将组织标记为12点钟定位，并进行快速永久处理和组织学检查，对后续阶段进行3-缝合标记，并进行“面包切片”显微分析。此外，确定初始病变大小与清除所需的后续切除阶段和最终手术切缘之间的关系。方法:对29例活检证实的MIS病变进行单机构回顾性分析。通过独立t检验进行统计分析。结果:随访12 ~ 58个月，平均31.5个月(SD 13.9)，无复发。平均手术切缘13.1 mm (SD 5.9)。随着术前病变大小的增加，手术切缘有增大的趋势。结论:这种SSE治疗MIS的方法与其他SSE技术的疗效相当，可以为医生提供一种相对简单、有效和可获得的替代大面积局部切除和Mohs显微摄影手术的方法。

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引用次数: 12

Clinical Characteristics of Non-Melanoma Skin Cancers Recurring within 5 years after Mohs Micrographic Surgery: Single Institution Retrospective Chart Review. 莫氏显微摄影手术后5年内复发的非黑色素瘤皮肤癌的临床特征:单机构回顾性图表回顾。

Journal of clinical and investigative dermatology

Pub Date : 2017-01-01 Epub Date: 2017-01-10 DOI: 10.13188/2373-1044.1000036

Tina Vajdi, Robert Eilers, Shang I Brian Jiang

Background: Mohs micrographic surgery (MMS) is used to treat certain high-risk non-melanoma skin cancers (NMSC) due to its high cure rate. However, clinical recurrences do occur in a small number of cases.

Objective: We examined specific clinical characteristics associated with NMSC recurrences following MMS.

Methods: We employed a retrospective chart review of the 1467 cases of NMSC that underwent MMS at UC San Diego from January 1, 2008 through December 31, 2009. A total of 356 cases were excluded due to lack of follow-up.

Results: Five (0.45%) of 1111 cases developed recurrences of NMSC at the site of MMS. There were 741 cases of basal cell carcinomas (BCC); 3 were recurrences (0.40%). There were 366 cases of squamous cell carcinomas (SCC); 2 were recurrences (0.55%). Review of MMS histopathology of these recurrent tumors showed that there were no errors or difficulty with the processing or interpretation of the slides.

Conclusion: Five-year recurrence rate of NMSC following MMS at our institution is below the reported average. Our retrospective chart review identified specific clinical characteristics associated with NMSC recurrence including a history of smoking, anatomical location on the cheeks, ears or nose, and a history of immunosuppression for SCCs.

背景:莫氏显微摄影手术(Mohs micrographic surgery, MMS)因其治愈率高而被用于治疗某些高危非黑色素瘤皮肤癌(NMSC)。然而，临床复发确实发生在少数病例。目的:我们研究与MMS后NMSC复发相关的特定临床特征。方法:我们对2008年1月1日至2009年12月31日期间在加州大学圣地亚哥分校接受MMS治疗的1467例NMSC患者进行了回顾性分析。356例因缺乏随访而被排除。结果:1111例患者中有5例(0.45%)在MMS部位发生NMSC复发。基底细胞癌(BCC) 741例;复发3例(0.40%)。鳞状细胞癌(SCC) 366例;2例为复发(0.55%)。回顾这些复发肿瘤的MMS组织病理学显示，在处理或解释载玻片时没有错误或困难。结论:我院MMS术后NMSC的5年复发率低于文献报道的平均水平。我们的回顾性图表回顾确定了与NMSC复发相关的特定临床特征，包括吸烟史，脸颊、耳朵或鼻子的解剖位置，以及SCCs的免疫抑制史。

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引用次数: 6

Seborrheic Dermatitis and Dandruff: A Comprehensive Review. 脂溢性皮炎和头皮屑:综合综述。

Journal of clinical and investigative dermatology

Pub Date : 2015-12-01 Epub Date: 2015-12-15 DOI: 10.13188/2373-1044.1000019

Luis J Borda, Tongyu C Wikramanayake

Seborrheic Dermatitis (SD) and dandruff are of a continuous spectrum of the same disease that affects the seborrheic areas of the body. Dandruff is restricted to the scalp, and involves itchy, flaking skin without visible inflammation. SD can affect the scalp as well as other seborrheic areas, and involves itchy and flaking or scaling skin, inflammation and pruritus. Various intrinsic and environmental factors, such as sebaceous secretions, skin surface fungal colonization, individual susceptibility, and interactions between these factors, all contribute to the pathogenesis of SD and dandruff. In this review, we summarize the current knowledge on SD and dandruff, including epidemiology, burden of disease, clinical presentations and diagnosis, treatment, genetic studies in humans and animal models, and predisposing factors. Genetic and biochemical studies and investigations in animal models provide further insight on the pathophysiology and strategies for better treatment.

脂溢性皮炎(SD)和头皮屑是同一疾病的连续谱，影响身体的脂溢性区域。头皮屑局限于头皮，包括瘙痒，剥落的皮肤，没有明显的炎症。SD可以影响头皮和其他脂溢性区域，包括皮肤发痒、脱落或脱屑、炎症和瘙痒。各种内在和环境因素，如皮脂腺分泌物、皮肤表面真菌定植、个体易感性以及这些因素之间的相互作用，都有助于SD和头皮屑的发病。本文综述了SD和头皮屑的流行病学、疾病负担、临床表现和诊断、治疗、人类和动物模型的遗传研究以及易感因素等方面的知识。遗传和生化研究以及动物模型的研究为进一步了解病理生理学和更好的治疗策略提供了帮助。

引用次数: 223