Topical halometasone cream combined with fire needle pretreatment for treatment of primary cutaneous amyloidosis:Two case reports

BACKGROUND Primary cutaneous amyloidosis(PCA)is a chronic metabolic skin disease that has a detrimental impact on physical and mental health.It appears as mossy papules and severe itching,which is long-term and recurrent.Traditional treatments are unsatisfactory,especially for refractory cases.Fire needle therapy,which is widely used in China,has shown good clinical efficacy,as well as advantages concerning safety and cost.Clinical reports about fire needle treatment of this disease are few at present.CASE SUMMARY We report two older men who had developed maculopapules with itchiness on the trunk and arms for more than 10-15 years.Due to the dermatopathological findings,PCA was our primary consideration.They received topical halometasone cream and pretreatment with fire needle for 8-16 wk.Both patients showed significant improvement of lesions.Neither patient had recurrence with a minimum of 2 years of follow-up.CONCLUSION Topical halometasone cream and pretreatment with fire needle could be a fast,safe,and economic treatment for PCA.

Perianal Giant Condyloma Acuminatum:A Case Report

Rare giant condyloma acuminatum （CA） reported by this paper is an interesting unusual case in China. Giant CA is a tumor that primarily affects the genital and perianal areas. Its feature is the high rate of local recurrence and transformation into squamous cell carcinoma. Making choice of wide surgical excision and using interferon as antiviral and immunoenhancement for CA after operation, we obtain satisfactory functional and cosmetic results.

Risky Meetings Despite Knowledge of the Risk: A Qualitative Study of Young Adults Treated for Chlamydia Infection at a Sexual Transmitted Infection Clinic

The aim of the study was to describe the attitudes to risk behavior among patients diagnosed with a Chlamydia infection at a Sexual Transmitted Infection (STI) clinic. Qualitative interviews face-to-face were conducted with twenty patients, aged 18 - 30 years, with confirmed Chlamydia infections were included. An interview guide was used and the participants described the behavior that had led to the infection. The material was analyzed using qualitative content analysis. Eighteen informants were included and the theme was risk. Recurrent among the informants was risk behavior in sexual relations when using alcohol, while risk behavior in life in general was almost non-existent. Of the 18 informants, sixteen had previously been tested for STIs, and ten had had an STI before. Alcohol consumption emerged as a common denominator among the informants and as a contributor to risk. In contrast, almost none of the informants exposed themselves to any unnecessary risks in life in general.

T Lymphocytes and Th1/Th2 Cytokines in Peripheral Blood of Patients with Recurrent Genital Herpes

Objective: This study analyzed the T lymphocytes andThl/Th2 type cytokine profile shift in the peripheral blood ofpatients with recurrent genital herpes (RGH). Methods: Immunofluorescent staining of cell surface antigenand intracellular cytokines(IL-2, IL-4, IL-12, IFN-r)inperipheral blood from 20 RGH patients and 10 controls wereanalyzed using flow cytometric techniques. Results: RGH patients had significantly lower levels of CD3^+T cells, CD4^+T cells and CD4^+ T / CD8^+ T cells ratiocompared to control levels (P<0.001), and IL-2-producing,IFN-r-producing and IL-12-producing T cells were increasedin RGH patients (CD4^+T: P<0.001, CD8^+T: P<0.05respectively), whereas IL-4-producing T cells were increased inRGH patients compared to controls (CD4+T: P<0.05; CDS^+T:P<0.001 respectively). Conclusions: RGH patients have T lymphocyte subsetvariations and Thl/Th2 cytokine changes. The increase in Th2cells Thl/Th2 imbalance may have important implications forRGH pathogenesis.

Ageing-Related Features of Hair and Scalp in Chinese Women by Clinical Evaluation Study

There are previous studies of ageing hair and scalp in Caucasians and some Asians, such as Koreans and Japanese. However, the characteristics of scalp and hair have not yet been studied in Chinese, the largest population in the world, especially in terms of ageing. The purpose of this study is to investigate ageing features in Chinese women’s hair and scalp. Methods: In total, 1343 women in China aged 20 to 65 participated in this research. Hair density and diameter were measured and analysed with Folliscope&reg. Hair color and scalp conditions such as dandruff and erythema were evaluated through microscopic images. Measuring equipment was also used to detect scalp water content, barrier function and sebum secretion. Results: Hair density decreased gradually with ageing, while hair diameter peaked at 40s. The color of hair became bright with ageing because of gray hair and color fading. The degree of scalp sebum and dandruff was higher at younger ages. Interestingly, scalp erythema became more severe with ageing. Conclusion: This study shows the physical and physiological changes of Chinese women’s hair and scalp. Most aging features (hair diameter, scalpsebum contents, dandruff and erythema) were noticeable in their 40s, but hair density began to decline in their 30s. This first study of aging hair and scalp in Chinese women would be helpful for understanding the ageing phenomenon and development of hair and scalp care products.

2例Hailey-Hailey病患者ATP2C1基因的新突变

Benign familial chronic pemphigus (Hailey-Hailey disease,HHD) is a rare hereditary condition characterized by development of blisters at sites of friction and in the intertriginous areas. Mutations in the ATP2C1 gene, which encodes the human secretory pathway calcium ATPase 1 (hSPCA1), have been identified as possible causative mutations. Studying Hungarian patients with HHD, we found two novel, distinct, heterozygous mutations. In a 65-year-old man with a 41-year history of severe recurrent symptoms, a single nucleotide insertion,1085insA, was detected. In a patient whose symptoms were induced by environmental contact allergens, we found a nonsense mutation, Q506X, in exon 17. Our study further illustrates the diversity of mutational events in the pathogenesis of HHD.

婴儿特应性湿疹诊断标准的比较

Background: Epidemiological studies have shown different estimates of the frequency of atopic eczema (AE) in children. This may be explained by several factors including variations in the definition of AE, study design, age of study group, and the possibility of a changed perception of atopic diseases. The role of IgE sensitization in AE is amatter of debate. Objectives: To determine the prevalence and cumulative incidence of AE in a group of unselected infants followed prospectively from birth to 18 months of age using different diagnostic criteria; to evaluate the agreement between criteria; and to describe the association between atopic heredity and postnatal sensitization, respectively, and the development of AE according to the different diagnostic criteria. Methods: During a 1-year period a consecutive series of 1095 newborns and their parents were approached at the maternity ward at the Odense University Hospital, Denmark and a cohort of 562 newborns was established. Infants were examined and followed prospectively from birth and at 3, 6, 9, 12 and 18 months of age. AE was diagnosed using four different criteria, the Hanifin and Rajka criteria, the Schultz-Larsen criteria, the Danish Allergy Research Centre (DARC) criteria developed for this study and doctor-diagnosed visible eczema with typical morphology and atopic distribution. Additionally, the U.K. diagnostic criteria based on a questionnaire were used at 1 year of age. Agreement between the four criteria was analysed at each time point and over time, and agreement between the four criteria and the U.K. questionnaire criteria was analysed. Results: The cumulative 1-year prevalence of AE using the Hanifin and Rajka criteria was 9.8%(95%confidence interval, CI 7-13%), for the Schultz-Larsen criteria it was 7.5%(95%CI 5-10%), for the DARC criteria 8.2%(95%CI 6-11%), for visible eczema 12.2%(95%CI 9-16%) and for the U.K. criteria 7.5%(95%CI 5-10%). The pairwise agreement between criteria showed good agreement, with rates varying between 93%and 97%and kappa scores between 0.6 and 0.8. Agreement analysis of diagnoses between the four criteria demonstrated that cumulative incidences showed better agreement than point prevalence values. Conclusions: Agreement between different criteria for diagnosing AE was acceptable, but the mild cases constituted a diagnostic problem, although they were in the minority. Repeated examinations gave better agreement between diagnostic criteria than just one examination. Atopic heredity was less predictive for AE than sensitization to common food and inhalant allergens in early childhood.

Ultraviolet A Enhances Cathepsin L Expression and Activity via JNK Pathway in Human Dermal Fibroblasts

Background： Cathepsin L （CatL） is a cysteine protease with strong matrix degradation activity that contributes to photoaging. Mannose phosphate-independent sorting pathways mediate ultraviolet A （UVA）-induced alternate trafficking of CatL. Little is known about signaling pathways involved in the regulation of UVA-induced CatL expression and activity. This study aims to investigate whether a single UVA irradiation affects CatL expression and activity and whether mitogen-activated protein kinase （MAPK）/activator protein- 1 （AP- 1 ） pathway is involved in the regulation of UVA-induced CatL expression and activity in human dermal fibroblasts （HDFs）. Methods： Primary HDFs were exposed to UVA. Cell proliferation was determined by a cell counting kit. UVA-induced CatL production and activity were studied with quantitative real-time reverse transcription polymerase chain reaction （RT-PCR）, Western blotting, and fluorimetric assay in cell lysates collected on three consecutive days after irradiation. Time courses of UVA-activated JNK and p38MAPK signaling were examined by Western blotting. Effects ofMAPK inhibitors and knockdown of dun and Fos on UVA-induced CatL expression and activity were investigated by RT-PCR, Western blotting, and fluorimetric assay. Data were analyzed by one-way analysis of variance. Results： UVA significantly increased CatL gene expression, protein abundance, and enzymatic activity for three consecutive days after irradiation （F = 83.11, 56.14, and 71. 19, respectively; all P 〈 0.05）. Further investigation demonstrated phosphorylation of JNK and p38MAPK activated by UVA. Importantly, inactivation of JNK pathway significantly decreased UVA-induced CatL expression and activity, which were not affected by p38MAPK inhibition. Moreover, knockdown of dun and Fos significantly attenuated basal and UVA-induced CatL expression and activity. Conclusions： UVA enhances CatL production and activity in HDFs, probably by activating JNK and downstreaming AP- 1. These findings provide a new possible molecular approach for antiphotoaging therapy.