Objective: To study the effect of laser treatment on rosacea, a common facial skin disease with symptoms of blushing, redness, telangiectasis, papules, pustu les, and diffuse swelling of the skin, we focused on the st...Objective: To study the effect of laser treatment on rosacea, a common facial skin disease with symptoms of blushing, redness, telangiectasis, papules, pustu les, and diffuse swelling of the skin, we focused on the stinging sensation and performed immunohistochemical evaluation of nerve density and neuropeptide expre ssion. Design: Clinical investigation as well as the lactic acid (stinger) test was performed before and 3 months after the treatment with flashlamp pulsed dye laser, when skin biopsy specimens were also taken. Setting: University hospital. Patients: Thirty-two patients with rosacea, all with positive results from th e lactic acid “ stinger” test, were treated by flashlamp pulsed dye laser. Ma in Outcome Measures: The biopsy specimens were taken from the stinger-positive areas in the nasolabial folds, fixed in Lanas fixative (10% formalin and 0.4 % picric acid), and analyzed for the expression of protein gene product 9.5 (g eneral nerve marker), substance P, calcitonin gene-related peptide, and vasoac tive intestinal polypeptide, using a biotinylated streptavidin technique. Result s: Thirtyone patients who were stinger positive before treatment showed decrease d scores after treatment, and 1 patient had the same stinger test score before a nd after treatment. The number of protein gene product 9.5-positive fibers in the epidermis (P < .05) as well as the papillary dermis (P< .01) was decreased. This was also the case for substance P in the papillary dermis (P< .001),whereas no evident differencewas noted for vasoactive intestinal polypeptide and calcit onin gene-related peptide. No difference was found for contact between nerves and vessels (factor VIII positive). Conclusions: Laser treatment of rosacea that destroys small vessels has a good medical relevance because it reduces the unpl easant symptoms of the sensitive skin. A neurogenic etiology of stinging may be possible.展开更多
Patients with atopic dermatitis (AD) often have increased skin sensitivity and this symptom often worsens during stress. We sought to find out whether patients with AD had stinging,andto identify the pathocausal neuro...Patients with atopic dermatitis (AD) often have increased skin sensitivity and this symptom often worsens during stress. We sought to find out whether patients with AD had stinging,andto identify the pathocausal neuroimmune mechanisms, including the role of stress. In all, 25 patients with AD with histories of stress worsening were tested using a stinger test. Skin biopsy specimens were processed for immunohistochemistry. Stress inquiries and salivary cortisol tests were performed. In all, 16 patients were stinger-positive and 9 were negative. The stingerpositive papillary dermis had an increased number of mast cells, vasoactive intestinal polypeptide-positive fibers,and a tendency to a higher number of substance P- positive nerve fibers, but a decrease of calcitonin gene- related peptide fibers. Patients who were stinger- positive had a tendency to lower salivary cortisol. The majority of patients with AD experience stinging. Substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide, and mast cells may have a pathocausal role, as might chronic stress.展开更多
文摘Objective: To study the effect of laser treatment on rosacea, a common facial skin disease with symptoms of blushing, redness, telangiectasis, papules, pustu les, and diffuse swelling of the skin, we focused on the stinging sensation and performed immunohistochemical evaluation of nerve density and neuropeptide expre ssion. Design: Clinical investigation as well as the lactic acid (stinger) test was performed before and 3 months after the treatment with flashlamp pulsed dye laser, when skin biopsy specimens were also taken. Setting: University hospital. Patients: Thirty-two patients with rosacea, all with positive results from th e lactic acid “ stinger” test, were treated by flashlamp pulsed dye laser. Ma in Outcome Measures: The biopsy specimens were taken from the stinger-positive areas in the nasolabial folds, fixed in Lanas fixative (10% formalin and 0.4 % picric acid), and analyzed for the expression of protein gene product 9.5 (g eneral nerve marker), substance P, calcitonin gene-related peptide, and vasoac tive intestinal polypeptide, using a biotinylated streptavidin technique. Result s: Thirtyone patients who were stinger positive before treatment showed decrease d scores after treatment, and 1 patient had the same stinger test score before a nd after treatment. The number of protein gene product 9.5-positive fibers in the epidermis (P < .05) as well as the papillary dermis (P< .01) was decreased. This was also the case for substance P in the papillary dermis (P< .001),whereas no evident differencewas noted for vasoactive intestinal polypeptide and calcit onin gene-related peptide. No difference was found for contact between nerves and vessels (factor VIII positive). Conclusions: Laser treatment of rosacea that destroys small vessels has a good medical relevance because it reduces the unpl easant symptoms of the sensitive skin. A neurogenic etiology of stinging may be possible.
文摘Patients with atopic dermatitis (AD) often have increased skin sensitivity and this symptom often worsens during stress. We sought to find out whether patients with AD had stinging,andto identify the pathocausal neuroimmune mechanisms, including the role of stress. In all, 25 patients with AD with histories of stress worsening were tested using a stinger test. Skin biopsy specimens were processed for immunohistochemistry. Stress inquiries and salivary cortisol tests were performed. In all, 16 patients were stinger-positive and 9 were negative. The stingerpositive papillary dermis had an increased number of mast cells, vasoactive intestinal polypeptide-positive fibers,and a tendency to a higher number of substance P- positive nerve fibers, but a decrease of calcitonin gene- related peptide fibers. Patients who were stinger- positive had a tendency to lower salivary cortisol. The majority of patients with AD experience stinging. Substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide, and mast cells may have a pathocausal role, as might chronic stress.
