BACKGROUND:Evidence on tofacitinib and baricitinib in pediatric alopecia areata is limited. OBJECTIVE:To evaluate the comparative tolerability and efficacy of tofacitinib and baricitinib with unorthodox dosing in pediatric moderate-to-severe alopecia areata over 24 weeks. METHODS:One hundred pediatric patients (severity of alopecia tool [SALT] score 21-100) were randomized 1:1 to tofacitinib (n = 51) or baricitinib (n = 49). PRIMARY OUTCOMES:SALT score ≤10 (moderate, 21-49) and SALT score ≤20 (severe, 50-94, and very severe, 95-100) at week 24. RESULTS:For moderate patients, 33.33% (tofacitinib) and 41.18% (baricitinib) achieved SALT score ≤10 (P = .87). For severe patients, 45.45% (tofacitinib) and 30.77% (baricitinib) achieved SALT score ≤20 (P = .75). For very severe patients, 47.37% (tofacitinib) and 31.58% (baricitinib) achieved SALT score ≤20 (P = .51). For secondary outcomes, the proportion of patients achieving SALT90 in the baricitinib group (36.73%) was numerically higher than that in the tofacitinib group (21.57%) (P = .16). Both were well-tolerated and no serious adverse events occurred. LIMITATIONS:Short duration and efficacy findings may not generalize to standard dosing regimens. CONCLUSIONS:Unorthodox-dosed tofacitinib and baricitinib showed comparable efficacy and were well-tolerated in pediatric alopecia areata over 24 weeks, supporting short-term use.

Androgenic alopecia(AGA)is the most common type of clinical alopecia.Androgen receptor(AR)is the most logical candidate gene for regulating the occurrence of AGA.Dermal papilla cells(DPCs)are a special kind of mesen-chymal cells,located in the hair bulb of hair follicles.DPCs play a role in maintaining and inducing the periodic cycling of hair follicles,and are considered as a key cell target of androgen in hair follicles.Tcf4 is a positive regulator of the maintenance of DPC biological features.Previously,we reported that Twist1 can enhance the inductive effect of Tcf4.1 As a transcription factor,AR can bind with Tcf4 to regulate the proliferation in prostate growth and tumori-genesis.2,3 However,whether and how AR interacts with Tcf4 in DPCs remains unknown.

三天不洗头,头发油得打绺不说,还痒,一挠,指缝里满是"白泥". 这些"白泥"是什么?就三天没洗头,至于脏出泥吗? 正常情况下,从头皮抠出来的"白泥"是头皮新陈代谢的角质细胞(头皮屑)、油脂分泌物、灰尘、汗液、细菌等的混合物.跟大家平时搓澡时搓下来的泥差不多,属于皮肤污垢,日常清洁即可去除.

Ureaplasma urealyticum (U. urealyticum) is a normal commensal that colonizes the human genital tract and usually of low virulence; however, it can trigger serious extragenital infections in immunocompromised patient. In this case, a 48-year-old female immunocompromised patient with a four-year history of recurrent ulcer on extremities was presented to our hospital due to aggravation of lesions 10 months before. She was initially diagnosed as Pseudomonas aeruginosa infection secondary to lupus panniculitis and slightly responded to ceftazidime treatment; however, a new rash appeared on her left hip 16 days after admission, which was aggravated even under antibiotic treatment. After multiple negative cultures, U. urealyticum was identified in her left hip tissue using metagenomic next-generation sequencing (mNGS). U. urealyticum was also confirmed in her secretion samples from left hip, left thigh, right calf and uterine neck using mycoplasma culture and quantitative real-time polymerase chain reaction. Her lesions, especially the new rash, were positively responded to sensitive antibiotic treatment. To the best of our knowledge, this is the first case of U. urealyticum induced recurrent skin and soft-tissue infections (SSTIs) in an immunocompromised adult patient. This case suggests that the prevalence of this kind of infections may be underestimated because of the limitation of routine culture. mNGS may be considered to look for atypical pathogens to improve the antimicrobial treatment of complicated infections.

Balamuthia mandrillaris infection is a rare infectious disease around the world, with high rates of morbidity and mortality. Its early and correct diagnosis is a big challenge for us, and without it the delay in starting effective treatment can lead to the development of encephalitis. This is a report of a case of Balamuthia mandrillaris infection in a Chinese boy, with red plaques on the nasal dorsum as the first presentation, who finally developed into fatal encephalitis. The authors have reviewed the related literature and share the special skin features in order to favor the early diagnosis of the disease and increase the chances of survival.

OBJECTIVE: Diabetes mellitus is closely related to osteoarthritis (OA) and may be an independent risk factor for the development of OA. As one of the main characteristics of diabetes, endoplasmic reticulum (ER) stress resulting from glucose metabolism disorder is one of the main causes of cartilage degeneration. The aim of our study is to illuminate the effect of high glucose to chondrocytes (CHs) and the role of Skp2 in high-glucose induced ER stress in CHs. PATIENTS AND METHODS: We compared the ER stress status between healthy and diabetic OA cartilage using Western blot and quantitative reverse-transcription polymerase chain reaction (RT-PCR) methods. Different concentration of glucose was used to culture CHs for both 24 h and 72 h. Furthermore, Tunicamycin (TM) and 4-Phenylbutyric acid (4-PBA) were used to mediate ER stress of CHs, and human recombinant Skp2 protein was used to promote Skp2 expression. CH viability was determined by CCK8 assay, and cell proliferation was determined by flow cytometry. Western and RT-PCR were performed to measure related gene expression. RESULTS: ER stress makers GADD34, GRP78, and MANF were upregulated in diabetic OA cartilage. The long-term high glucose increased GADD34, GRP78, and MANF expression, but decreased collagen II and proliferation of CHs, and Skp2 expression was negative related to the ER stress level. Additionally. Skp2 overexpression partly reversed ER stress-induced collagen II and proliferation suppression by the suppression of p27 expression. CONCLUSIONS: High glucose raises the ER stress in CHs and overexpression of Skp2 promotes CH proliferation under high glucose treatment.

49岁男性患者,胸背部皮损1年余.皮肤科情况:颈部、胸部、背部、双前臂可见片状红斑、瘀点、瘀斑,伴轻度糜烂.组织病理:真皮内可见团块状淀粉样物质沉积,部分围绕在毛囊及血管周围.刚果红染色阳性.骨髓穿刺:多发性骨髓瘤.诊断:原发性系统性淀粉样变病.

上皮细胞和间质细胞相互作用形成不同的皮肤附属器.毛囊周期更替使其成为研究器官再生机制的主要模型,其核心是毛乳头,毛囊上皮、表皮干细胞协同对毛乳头信号做出反应.最近的研究揭示了毛乳头内新的分子调控机制,发现毛乳头是脱发和毛发再生的治疗靶点,鉴定其中新的分子靶点将有助于脱发的治疗.该文对毛乳头中分子调控机制的研究进展作一综述.

51岁女性患者,双手背结节逐渐增多伴压痛10年,否认关节痛病史.系统检查无异常.皮损组织病理学示真皮及皮下组织内组织细胞形成的栅栏状肉芽肿,中央可见胶原纤维变性.辅助检查:类风湿因子(RF)及抗溶血性链球菌O(ASO)阴性,血尿酸值正常,结核菌纯蛋白衍生物(PPD)试验阴性,胸部X线片示双肺纹理增多,自身抗体谱阴性.结合临床诊断:结节型环状肉芽肿.给予沙利度胺口服及皮损内曲安奈德注射治疗后皮损大部分消退.

患者,女,58岁.躯干四肢散在红斑丘疹4个月余.皮肤科检查:躯干四肢散在红斑丘疹,丘疹中央可见瓷白色萎缩性斑片,边缘隆起伴红晕,伴腹痛.皮损组织病理示:表皮萎缩变薄,真皮浅中层胶原变性,血管周围散在小片状的淋巴细胞及组织细胞浸润.诊断:恶性萎缩性丘疹病.给予阿司匹林、双嘧达莫、雷贝拉唑钠、美沙拉嗪、阿嗪米特口服治疗1个月后腹痛症状缓解,全身皮疹颜色变淡.2个月后患者腹痛加重诊断为肠穿孔,术后无明显改善.4个月后去世.

患者,女,54岁.左侧腰部皮疹伴针刺样疼痛10年.皮肤科查体:左侧腰部可见黄豆至蚕豆大暗红色斑丘疹,触摸软,边界不规则.皮损组织病理:真皮中部可见增生的血管,形状不规则,呈丛状分布,管壁可见单层内皮细胞,周围有少量纤维组织包绕.诊断:丛状血管瘤.

耳饰是备受大家喜爱的配饰之一,但若想戴上耳饰需要先打耳洞.早在2009年,当时的卫生部办公厅印发的《医疗美容项目分级管理目录》就已经将“穿耳术”明确列为“医疗美容操作”.因此打耳洞实际上是一项需要专业人员操作的项目.现存市面上打耳洞只需一两秒,看似简便,实际上存在安全隐患.

Objective:To develop an efficient and rapid method for the isolation and cultivation of human scalp dermal papilla cells from small specimens.Methods:Hair-bearing skin specimens measuring 0.5 cm × 0.5 cm -0.5 cm × 1 cm in size were obtained from the scalp of 3 patients with pigmented nevus and 6 with sebaceous nevus during surgery in Department of Dermatology, the First Hospital Affiliated to Army Medical University from September 2018 to January 2019. The subcutaneous fat layer containing hair follicles was cut out of the specimens, and hair follicles were sorted with ophthalmic forceps, which were subsequently digested with 0.6% dispase Ⅱ for 30 minutes, then with 0.2% collagenase Ⅳ at 37 ℃ for 30 - 60 minutes, and were centrifuged to obtain hair papillae. Morphological observation was performed on the isolated hair papillae, and dermal papilla cells were cultured, passaged and identified.Results:Under the microscope, the hair papillae isolated by two-step enzyme digestion of small scalp specimens were intact, and showed an inverted pear-like shape, and residual dermal sheaths could be observed around some hair papillae. However, no hair papilla was isolated by one-step enzyme digestion. With the two-step enzyme digestion method, the hair papilla separation rate was 60.8% ± 2.1%, the adherence rate of the dermal papilla cells at 72 hours was 86.6% ± 3.9%, the time for cells to emigrate out of hair papillae was 0.5 - 3.0 days, the total operation duration was 2.0 - 3.0 hours, and the actual operation duration after subtraction of digestion duration was 1.0 - 1.5 hours. The dermal papilla cells isolated by the two-step enzyme digestion method could grow in an aggregative pattern in early stage, but grew in a non-aggregative pattern after 8 passages.Conclusion:The two-step enzyme digestion of small specimens is a simple and efficient method for isolating human scalp dermal papilla cells.

在《本草纲目》里,李时珍详细记载了一个治疗狐臭的方子:“腋下胡臭,鸡子(即鸡蛋)两枚,煮熟去壳,热夹,待冷,弃之三叉路口,勿回顾.如此三次效.”按照他的说法,治疗狐臭很简单,用鸡蛋就能搞定,夹俩鸡蛋,路口放下,反复做3次就有效果.

1.剥脱性角质松解症.这个病听起来陌生,但在生活中很常见.白领小周最近就深受手脱皮的困扰.一是上班没办法刷指纹打卡,几个指腹“光溜溜”,指纹机根本不识别;二是这种脱皮很容易撕,越撕越多,越撕面积越大.因为他姓周,竟得了个“周扒皮”的外号.以上就是典型的剥脱性角质松解症表现,该病既不传染,也不遗传.它好发于春夏和秋冬之交,病情大多在几周内可以自行痊愈.轻者可外用保湿霜、尿素乳膏等温和润滑剂缓解症状;严重的大面积脱皮者,可外用维A酸乳膏、2％水杨酸软膏等.

这里介绍常见的脱发类型: 雄激素性脱发:又称脂溢性脱发,俗称"秃顶",是最常见的脱发类型.该病多见于青壮年男性,初期表现为前额两侧头发纤细、稀疏,逐渐向头顶延伸,额部发际向后退缩,前额变高呈M形.随着脱发逐渐发展,额部与头顶部脱发可互相融合,严重时仅枕部及两颞残留头发,呈"地中海"表现.女性病情相对较轻,主要表现为头顶部头发弥漫性稀疏,但前额发际线并不上移,形似"圣诞树"样改变,但极少发生顶部全秃.

1.剥脱性角质松解症 这个病听起来陌生,但在生活中很常见.剥脱性角质松解症既不传染,也不遗传.它好发于春夏和秋冬之交,病情大多在几周内可以自行痊愈.轻者可外用保湿霜、尿素乳膏等温和润滑剂缓解症状;严重的大面积脱皮者,可外用维A酸乳膏、2％水杨酸软膏等.

近年来,随着人们对美发的追求,由染发引发过敏的新闻报道屡见不鲜:宁波一位44岁的刘女士3个月内染了3次头发后,头皮出现红肿、水疱、疙瘩等过敏现象;大连曾发生一位47岁女教师赵女士在染发10天后死亡的事件.据赵女士的丈夫回忆,死者生前有染发过敏史,曾多次染发,此次染发后她回家就出现了过敏反应.去医院连续打了4天治疗过敏的吊瓶依然不见好转,且越发严重,眼睛肿得已经看不到东西,呼吸也越来越费劲儿.

Australasian Journal of DermatologyVolume 61, Issue 1 p. 61-63 Letter to the Editors Cutaneous intravascular NK/T-cell lymphoma Juan Wang, Juan Wang Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorXichuan Yang, Xichuan Yang Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorZhiqiang Song, Zhiqiang Song Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorYi You, Corresponding Author Yi You youyi_cq@163.com orcid.org/0000-0003-3436-2133 Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this author Juan Wang, Juan Wang Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorXichuan Yang, Xichuan Yang Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorZhiqiang Song, Zhiqiang Song Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this authorYi You, Corresponding Author Yi You youyi_cq@163.com orcid.org/0000-0003-3436-2133 Department of Dermatology, Southwest Hospital, Army Military Medical University, Chongqing, ChinaSearch for more papers by this author First published: 01 August 2019 https://doi.org/10.1111/ajd.13123Citations: 2 Conflict of interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume61, Issue1February 2020Pages 61-63 RelatedInformation