Psychiatric Sequelae of Chronic Pruritic Dermatoses

This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.

Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle 1917

AIM: To evaluate the effect of oral Escherichia coli (E. coli) Nissle application on the outcome of intestinal-borne dermatoses.METHODS: In a randomized, controlled, non-blinded prospective clinical trial 82 patients with intestinal-borne facial dermatoses characterized by an erythematous papular-pustular rash were screened. At the initiation visit 37 patients entered the experimental arm and 20 patients constituted the control arm. All 57 patients were treated with a vegetarian diet and conventional topical therapy of the dermatoses with ointments containing tetracycline, steroids and retinoids. In the experimental arm patients received a one month therapy with oral E. coli Nissle at a maintenance dose of 2 capsules daily. The experimental group was compared to a non-treatment group only receiving the diet and topical therapy. The primary outcome parameter was improvement of the dermatoses, secondary parameters included life quality and adverse events. In addition the immunological reaction profile (IgA, interleucin-8 and interferon-α) was determined. Furthermore the changes of stool consistency and the microbiota composition over the time of intervention were recorded.RESULTS: Eighty-nine percent of the patients with acne, papular-pustular rosacea and seborrhoic dermatitis responded to E. coli Nissle therapy with significant amelioration or complete recovery in contrast to 56% in the control arm (P < 0.01). Accordingly, in the E. coli Nissle treated patients life quality improved significantly (P < 0.01), and adverse events were not recorded. The clinical improvement was associated with a significant increase of IgA levels to normal values in serum as well as suppression of the proinflammatory cytokine IL-8 (P < 0.01 for both parameters). In the E. coli Nissle treated group a shift towards a protective microbiota with predominance of bifidobacteria and lactobacteria (> 107 CFU/g stool) was observed in 79% and 63% of the patients, respectively (P < 0.01), compared to no change in the control group without E. coli Nissle. Moreover, the detection rate of a pathogenic flora dropped from 73% to 14 % of the patients in the experimental arm (P < 0.01) with no significant change in the control arm (accounting 80% before and 70% after the observation period, P > 0.05). Accordingly, stool consistency, color and smell normalized in the E. coli Nissle treated patients.CONCLUSION: E. coli Nissle protects the mucus barrier by overgrowth of a favorable gut microbiota with less immunoreactive potential which finally leads to clinical improvement of intestinal borne dermatoses.

Esophagitis dissecans superficialis and autoimmune bullous dermatoses: A review

Esophagitis dissecans superficialis(EDS)is a rare and severe endoscopic finding characterized by sloughing of large fragments of esophageal mucosal lining.Although EDS has been reported in association with serious illnesses and certain medications,the pathophysiological association of autoimmune bullous dermatoses with EDS has gained remarkable attention.Among these dermatoses,pemphigus vulgaris and pemphigoid frequently present with various types of esophageal involvement including EDS.We review the pathophysiology and clinical features of this involvement with the presentation of our experiences.The importance of endoscopic evaluation of this entity is discussed.

Effect of radiotherapy on tumor markers and serum immune-associated cells in patients with esophageal cancer

Objective This study aimed to investigate the effect of radiotherapy on serum immune-associated cells and tumor markers in patients with esophageal cancer.Methods A total of 87 patients with esophageal cancer admitted to our hospital between October 2016 and July 2020 were selected as the observation group,and all patients received radiotherapy.A total of 87 healthy volunteers who underwent physical examination at our hospital during the same period were selected as the control group in order to compare the changes in serum immune-associated cells and tumor markers between the two groups.Results The levels of carcinoembryonic antigen(CEA),cancer antigen(CA)125,CA72-4,C-terminus of cytokeratin(CYFRA)21-1,and squamous cell carcinoma(SCC)antigen in the observation group before radiotherapy were higher than those in the control group,and the differences were significant(P<0.05).The levels of CEA,CA125,CA72-4,CYFRA21-1,and SCC antigen in the research group after radiotherapy were significantly lower than those before radiotherapy,but were still significantly higher than those in the control group(P<0.05).The levels of CD3+,CD4+,CD4+/CD8+,and natural killer cells in the research group before and after radiotherapy were significantly lower,while the levels of Treg and CD8+cells were significantly higher than those in the control group(P<0.05).The levels of CD3+,CD4+,and CD4+/CD8+cells in the observation group after radiotherapy were lower,while the levels of CD8+cells were significantly higher than those before radiotherapy(P<0.05).Conclusion Radiotherapy can effectively reduce the level of serum tumor markers in patients with esophageal cancer;these antigens and cells can be used as tumor markers of esophageal cancer in order to determine its prognosis.However,radiotherapy has adverse effects on the immune function of the body.The reasons behind this need to be further studied and analyzed.

Epidemiological and Clinical Aspects of Neonatal Dermatoses at the National Teaching Hospital HKM of Cotonou Benin

Neonatal dermatoses (NND) are frequent, varied and of variable prognosis. The objective of this work was to study the epidemiological and clinical aspects of NND at the NTH-HKM. Methods: This was a cross-sectional descriptive and analytical study from December 1, 2014 to February 28, 2015. All newborns received in the Department of Pediatrics and Medical Genetics and with dermatosis were included. The diagnosis of dermatoses was clinical. Results: During the study period, 355 newborns had at least one NND on a total of 580 newborns received, a prevalence of 61.2%. The sex ratio was 1.54 and the average age was 3.11 days. Transient dermatoses were more frequent (80%), dominated by desquamation + xerosis (33.75%). Congenital melanocytic nevi (40.74%) and malformations and vascular tumors (18.52%) were the most noted pathological neonatal dermatoses. Only age was statistically associated with NND. Conclusion: DNH is common in newborns at the NTH-HKM. They were mostly transitory. Pathological conditions should be treated where appropriate.

多功能激光光电平台联合重组牛碱性成纤维细胞生长因子凝胶治疗轻中度面部敏感性皮肤疗效观察

目的观察多功能激光光电平台联合重组牛碱性成纤维细胞生长因子凝胶治疗轻中度面部敏感性皮肤的临床疗效及安全性。方法选取2021年1月至2022年2月安徽医科大学第二附属医院门诊就诊的30例轻中度面部敏感性皮肤的病人,按随机数字表法分为对照组15例、治疗组15例。对照组单独外用重组牛碱性成纤维细胞生长因子凝胶(贝复新),1天2次;治疗组在对照组基础上联合应用多功能激光光电平台(舒敏专家)的电磁波模块及U光模块(830 nm/590 nm),1周1次。疗程均为4周,同时在疗程结束后1个月进行随访。对治疗前后病人的皮肤敏感症状评分及生活质量评分进行比较。结果治疗4周后,治疗组总有效率为93.33%(14/15),对照组为53.33%(8/15),治疗组明显优于对照组(P<0.05)。治疗组治疗前敏感症状积分和生活质量评分分别为(21.33±3.15)分及(12.13±2.17)分,治疗4周后分别为(3.67±2.58)分及(3.53±1.19)分。对照组治疗前敏感症状积分和生活质量评分分别为(20.6±2.47)分及(12.27±2.05)分,治疗4周后分别为(7.47±2.13)分及(5.80±1.15)分。治疗组和对照组的皮肤敏感症状积分和生活质量评分均较前降低(P<0.05),治疗组总体改善程度优于对照组(P<0.05)。随访1个月,对照组的复发率[53.3%(8/15)]高于治疗组[13.3%(2/15)](P<0.05)。结论多功能激光光电平台联合重组牛碱性成纤维细胞生长因子凝胶治疗轻中度面部敏感性皮肤能有效改善皮肤敏感症状和病人的生活质量,同时有效预防复发,且安全无不良反应。

紫外线与内分泌系统及激素水平相关性的研究进展

皮肤是人体面对外部损伤的第一道屏障,日光中的紫外线可直接作用于皮肤表面对内环境产生影响,而体内激素水平的不同也可使机体对于紫外线照射的反应不同。紫外线可通过调节局部糖皮质激素水平抑制炎症,在不同性激素水平的影响下发挥不同的免疫抑制作用,参与调控胰岛素相关的糖代谢和脂质代谢的过程,而褪黑素则可以抑制紫外线的光老化作用。本文就紫外线与皮质醇激素、性激素、胰岛素及褪黑素间的关系进行阐述,为疾病的防治提供更多的可能性。

血浆置换在重症免疫相关性皮肤病中的应用进展

血浆置换(plasma exchange, PE)在部分自身免疫性疾病中疗效肯定。PE主要的作用机制包括去除患者血液中的致病因子,调节患者免疫功能,补充正常的血浆成分等。在对寻常型天疱疮、中毒性表皮松解综合症和临床无肌病性皮肌炎等重症免疫相关性皮肤病的治疗中,PE的应用愈加广泛。本篇综述就近年来PE在国内外重症免疫相关性皮肤病中的应用进展做一概述,为临床重症皮肤病的治疗提供新思路。

Dermatosis as the initial presentation of gastric cancer: two cases

Paraneoplastic dermatoses are known to be certain dermatosis related with tumor. The common paraneoplastic dermatoses are acanthosis nigricans, acquired ichthyosis, dermatomyositis, erythroderma, and so on. Here we report two cases of paraneoplastic dermatoses associated with gastric cancer. One case was a 57-year-old man with dermatomyositis and proved to be associated with gastric cancer through stomachoscopy. The other was a 66-year-old man with erythroderma and proved to be associated with gastric cancer through stomachoscopy. Both cases were treated with radical total gastrectomy with lymphadenectomy（D2） and esophagojejunostomy of Roux-en-Y. The skin symptom of both cases had improved a lot but still existed after operation. Paraneoplastic dermatoses can be seen as the early manifestation of visceral carcinomas. As a result, gastric cancers should be excluded in the patients with paraneoplastic dermatoses.

白芍总苷在治疗免疫相关性皮肤病中的研究进展

白芍总苷(total glucosides of paeonia,TGP)具有抗炎、免疫调节、保肝镇痛等多种药理作用,临床上常用于某些自身免疫性疾病的辅助或联合治疗。随着对TGP作用机制研究的深入,其发挥抗炎与免疫调节的分子靶点被不断揭示,该药在免疫相关性皮肤病的应用逐渐增多,不仅能增效减毒,还可降低疾病复发率。本文就白芍总苷在治疗免疫相关性皮肤病中的研究进展进行综述。

脂代谢紊乱在炎症性皮肤病中的作用及相关药物研究进展

炎症性皮肤病是免疫系统失调导致皮肤屏障破坏的一类疾病,包括银屑病、特应性皮炎和Netherton综合征等。炎症性皮肤病患者血脂水平与炎症因子水平密切相关,两者共同参与疾病的发生发展。皮肤脂质分泌异常导致皮肤屏障功能受损,高水平炎症因子导致血脂水平异常,并影响脂代谢相关酶表达,进一步加重皮肤炎症。脂代谢调控转录因子过氧化物酶体增殖物激活受体和肝X受体可调控脂代谢和炎症信号通路,进而改善皮肤屏障功能。本文综述脂代谢紊乱在炎症性皮肤病的作用,并对目前炎症性皮肤病治疗药物予以汇总和展望。

自身免疫性大疱性皮肤病的实验室诊断进展

自身免疫性大疱性皮肤病(autoimmune bullous dermatoses,AIBD)与针对皮肤及黏膜组织中结构蛋白的自身抗体相关。天疱疮疾病中的自身抗体主要针对桥粒的组成部分,而类天疱疮疾病中的自身抗体主要针对真表皮连接的结构蛋白。这两类疾病的治疗方法不同,因此需要依靠实验室诊断予以鉴别。传统实验室诊断方法包括直接免疫荧光(direct immunofluorescence,DIF)、间接免疫荧光(indirect immunofluorescence,IIF)、酶联免疫吸附试验(enzyme⁃inked immunosorbent assay,ELISA)和免疫印迹(immunoblotting,IBT)。近年来,不断有新型实验室技术出现。生物芯片技术简化了IIF的判读,成本较低且高效,对桥粒芯糖蛋白(Dsg3)和大疱性类天疱疮抗原180(BP180)的检出率分别高达97%~100%和94%;EUROTide™孵育技术比传统DIF方法灵敏度和特异度更高,背景荧光更少;MESACUP anti⁃Skin profile TEST能同时检测多种抗体,对Dsg1和Dsg3的检测特异度可达100%;侧向流动免疫层析技术(lateral flow immunoassay,LFIA)可用于快速定性检测,能肉眼观察结果;化学发光酶免疫技术与ELISA相比符合率可达到94%~99%,且检测时间短、自动化程度高;荧光叠加抗原定位⁃激光扫描共焦显微镜技术(fluorescence overlay antigen mapping using laser-scanning confocal microscopy,FOAM⁃LSCM)能够一次性对皮肤基底膜带的不同成分进行区别染色,比传统手工DIF法效率更高,且有助于诊断在传统方法下难以与大疱性类天疱疮或获得性大疱性表皮松解症区分的AIBD。实验室诊断技术对AIBD的治疗和预后有着重要作用,本文基于传统实验室方法,比较并探讨了新技术在AIBD诊断中的应用价值。

皮秒激光在色素性皮肤病中的临床应用

基于光热选择原理和纳秒级激光技术的进步,不同波长的纳秒激光根据其不同的色素选择性,穿透深度等特性应用于多种色素性皮肤病的临床治疗。随着激光器械的不断创新,激光的脉冲持续时间进一步缩短,产生脉宽远远小于黑素小体热弛豫时间的皮秒级激光。皮秒级激光被认为在色素性治疗领域具有跨时代的意义。国内外研究者就皮秒激光对多种色素性皮肤病的治疗适应症,参数及综合治疗方案开展多种研究。本文针对皮秒激光在不同色素性皮肤病的治疗研究进行相关综述,旨在为进一步深入探讨皮秒激光在色素性皮肤病治疗中的最佳应用策略及相关治疗机制提供研究线索。

Purpura annularis telangiectodes of Majocchi:A case report

BACKGROUND Purpura annularis telangiectodes of Majocchi(PATM),also known as Majocchi,is a rare subclass of pigmented purpuric dermatoses.The etiology of PATM is unknown,but it seems more common in children and young women.The skin lesions are mostly symmetrical ring-shaped reddish-brown macules on the lower limbs.CASE SUMMARY A 9-year-old girl,who has received treated in our department,presented with reddish-brown ring-shaped rash on both lower limbs that had been present for 6 mo.These lesions,red brownish annular or petaloid patches,were mostly found on ankles and lower limber,which do not fade when adding pressure and no feel of infiltration and no atrophy when touching those lesions.Pathological examination showed deposition of hemosiderin in papillary dermis.However,dermoscopy showed the pigmentation in the center as well as the lavender patches on the edge of lesion.The child was thus diagnosed with PATM.After diagnosis,we suggested the patient avoid strenuous exercise.she was given vitamin C tablets for oral and mometasone furoate cream for external use.Followup examinations and treatment continue to support the clinical diagnosis to date.CONCLUSION This is the first report of investigating PATM using dermoscopy,which can differentiate PATM from other diseases due to its unique microscopic feature under dermoscopy.Although PATM is harmless,it still requires long-term follow-up.Moreover,dermoscopy technique can be applied for observation of multi-site lesions and correlated with histopathology.Thus,we believe this approach could be generalized for future diagnosis of PATM.

Diagnostic and classification value of immune-related lncRNAs in dilated cardiomyopathy

Background:Various physiological mechanisms are linked to dilated cardiomyopathy(DCM)development,including oxidative stress,immune irregularities,inflammation,fibrosis,and genetic changes.However,precise molecular drivers of DCM,especially regarding abnormal immune responses,remain unclear.This study investigates immune-related long non-coding RNAs(lncRNAs)in DCM’s diagnostic and therapeutic potential.Methods:GSE141910,GSE135055,and GSE165303 datasets were acquired from the GEO database.LASSO,SVM-RFE,and random forest algorithms identified DCM-associated immune-related lncRNAs.Diagnostic capabilities were assessed by Nomogram and receiver operating characteristic(ROC)curves.Multivariate linear regression explored lncRNA correlations with ejection fraction.Single-sample gene set enrichment analysis(ssGSEA)gauged immune cell infiltration/functions.Functional enrichment analyses were performed using Gene set variation analysis(GSVA),gene ontology(GO),and the Kyoto Encyclopedia of Genes and Genomes(KEGG).Consensus clustering categorized DCM cases.Results:Ten immune-related lncRNAs emerged:C10orf71-AS1,FHAD1-AS1,SCIRT,FNDC1-AS1,MELTFAS1,LOC101928834,GDNF-AS1,DCXR-DT,C3orf36,and LOC107985323.These lncRNAs,tied to immunomodulation,showed promising DCM diagnostic accuracy.Adjusted for confounders,they independently correlated with ejection fraction.Using lncRNA expression,DCM patients were grouped into subtypes.Subtype C1 displayed a higher level of immune cell infiltration and immune checkpoint expression compared to subtype C2,emphasizing the variations in the immune microenvironment.Conclusion:This study identifies ten immune-related lncRNAs for further exploration in DCM diagnosis and subtyping.Based on expression patterns,we propose two potential DCM subtypes.Notably,findings are preliminary and hypothesis-generating,demanding validation and further investigation.This research provides insights into DCM diagnosis and classification.

蓝海冰教授运用疏肝健脾法治疗皮肤病经验总结

所谓“有诸内必形诸外”,皮肤病虽然症状表现在肌肤腠理,但与体内脏腑病变密切相关。随着社会的不断进步,人们生活节奏、饮食结构变化,情志因素和饮食不节两大病因在皮肤病的发生发展中起着不容忽视的作用,而受这两大病因影响最大的脏腑为肝、脾。因此,蓝海冰教授临证治疗皮肤病,多重视肝脾二脏机能在皮肤病的形成、发展中的作用,并根据临床多年经验总结出了以调和肝脾为核心,或侧重疏肝理气,或侧重健脾祛湿的治法。她在治疗中以调和肝脾的逍遥散为基础方,根据疏肝、健脾偏重不同,采用柴胡疏肝散或参苓白术散加减,收效良好。

血浆输注及血浆置换治疗重症皮肤病

为证实血浆输注疗法在治疗重症炎性及自身免疫性皮肤病中的应用价值,对202例经过皮质类固醇和/或免疫抑制剂等治疗后仍难控制病情的结缔组织病、大疱性皮肤病及重型银屑病等患者予以新鲜冰冻血浆输注,并与血浆置换疗法进行比较。结果显示,血浆输注组总有效率为88.61%,血浆置换组为91.18%,两组的总有效率经统计学处理无显著性差异(P>0.05)。

大剂量静注丙球冲击疗法治疗皮肤病5例

采用大剂量静注丙球冲击疗法(HDIVIG)治疗2例伴发肿瘤的泛发性带状疱疹患者 ,常规治疗效果欠佳的皮肌炎、大疱性类天疱疮和系统性红斑狼疮患者各1例 ,剂量为0.4/(kg·d)共5天 ,并辅以中等剂量的皮质类固醇激素。经治疗患者的症状迅速缓解 ,治疗中无明显不良反应。

东南沿海部队官兵皮肤病患病情况调查

目的了解驻东南沿海部不同兵种官兵常见皮肤病的发生情况,为防治提供科学依据。方法对某部共324人进行皮肤病流行病学调查,通过临床检查确定皮肤病种类和感染例数(次),并对基层卫生人员进行培训。结果手足癣、痤疮、面部色素痣、体股癣、脂溢性皮炎、湿疹、花斑癣、慢性单纯性苔藓是东南沿海部队官兵常见的8种皮肤病。其中患手足癣158例(48.8%);痤疮、面部色素痣、体股癣、脂溢性皮炎、湿疹、花斑癣、慢性单纯苔藓的患病率依次为45.4%、29.3%、10.8%、12.3%、10.2%、7.4%、7.1%。结论皮肤病是部队官兵常见疾病之一,驻不同地区官兵某些皮肤病患病情况有统计学差异,手足癣的患病率福建高于浙江,体股癣和湿疹的患病率浙江高于福建。来自南方与北方的官兵8种常见皮肤疾病的患病率均无显著性差异。

东南沿海某特种兵部队高发皮肤病的调查与防治

目的：调查和防治东南沿海某特种兵部队高发皮肤病. 方法：对该部队共3 160人进行皮肤病流行病学调查,采用多种措施对皮肤病进行防治,对基层卫生人员进行培训. 结果：3 160人中,患浅部真菌病共1 872人,患病率为59.24%；痤疮、湿疹皮炎、病毒及细菌性皮肤病也较为多见,其发病率依次为18.99%、17.97%、5.32%和1.77%.驻区环境、工作特点、生活设施及基层皮肤病防治知识缺乏等是皮肤病高发的主要因素. 结论：该部队浅部真菌病发病率最高,其次为痤疮、湿疹皮炎和病毒、细菌性皮肤病,提示这些皮肤病可造成特种兵部队在执勤时发生非战斗减员.据此提出了特种兵部队皮肤病防治的建议.