This prospective study aimed to investigate the efficacy and safety of fractional CO2 laser with different parameters, in combination with topical halometason, for the management of chronic eczema. Each lesion of the patients were divided into four groups and given fractional CO2 laser treatment with different parameter and a negative control. After treatment, all four groups were treated with topical halometasone cream once daily for a week. The modified Eczema Area and Severity Index (mEASI) scores were evaluated before treatment, 1-week post-treatment and 4-weeks post-treatment respectively. Numerical rating scale was used to assess the pain degree during the treatment and other adverse reaction were recored. The results suggest that the efficacy of CO2 fractional laser combined with halometasone cream in the treatment of chronic eczema is better than that of halometasone treatment alone. The efficacy at 4 weeks after treatment was better than at 1 week after treatment. The efficacy varied depending on the laser parameters used. In group B (30 mJ) and group C (50 mJ) with the same spot spacing (0.6 mm), the higher energy group showed faster onset and better efficacy at 1 week post-treatment. However, at 4 weeks, both groups exhibited similar efficacy but the higher-energy group experienced more pain. In group A (1.0 mm) and group B (0.6 mm) with the same energy parameter (30 mJ), dot spacing had little effect on the efficacy at 1 week after treatment. At 4 weeks, the group with smaller dot spacing (0.6 mm) showed better long-term efficacy. This study suggests that the clinical application of CO2 fractional laser treatment for chronic eczema requires careful selection of therapeutic parameters, and the recommended parameters from this study are 30 mJ energy, 0.6 mm dot spacing, but further research is warranted to confirm these findings.

A total of 181 citrus-based products, including dried fruits, canned fruits, and fruit juices, collected from China and from abroad in 2021 were analyzed for the four Alternaria toxins (ALTs): alternariol (AOH), alternariol monomethyl ether (AME), tentoxin (TEN), and tenuazonic acid (TeA) via ultra-high-performance liquid chromatography–electrospray ionization–tandem mass spectrometry (UPLC-ESI-MS). Although the concentrations of the four ALTs varied by product and geographically, TeA was the predominant toxin followed by AOH, AME, and TEN. Products made in China showed higher levels of ALTs than those made abroad. Maximum levels of TeA, AOH, and AME in analyzed domestic samples were 4.9-fold, 1.3-fold, and 1.2-fold, respectively, higher than those in imported products. Furthermore, 83.4% (151/181) of the analyzed citrus-based products were contaminated with at least two or more ALTs. There were significant positive correlations between AOH and AME, AME and TeA, and TeA and TEN in all analyzed samples. More importantly, the solid and the condensed liquid products had higher concentrations of ALTs than the semi-solid product samples, as well as tangerines, pummelos, and grapefruits compared to the other kinds of citrus-based products. In conclusion, co-contamination with ALTs in commercially available Chinese citrus-based products was universal. Extensive and systematic surveillance of ALTs in citrus-based products, both domestic and imported, is required to obtain more scientific data for the determination of the maximum allowable concentrations of ALTs in China.

Background: Aspergillosis is an uncommon fungal infection in which primary cutaneous sites are very rare, and most cases occur in patients with immunocompromised status. Although primary cutaneous aspergillosis is usually encountered in immunocompromised patients, it also occurs in immunocompetent individuals. Case Presentation: We report a case of primary cutaneous aspergillosis in a 46-year-old immunocompetent woman with diabetes mellitus after tattooing. She presented with erythematous papules, papulopustules and a plaque on the right lower limb of more than two years duration which had failed to respond to antihistamine treatment. Histological examination of a skin biopsy sample showed oval spores in the corneous layer, a slightly thickened epidermis, and infiltrating lymphocytes and neutrophils around the blood vessels in the superficial dermis. Aspergillus fumigatus was isolated and identified in cultures. Clinical and biological examinations did not reveal any systemic localization of aspergillosis, ruling out a hypothesis of blood dissemination. Lesions resolved completely after systemic antifungal treatment with itraconazole. Conclusion: Clinical lesions of primary cutaneous aspergillosis are nonspecific and usually present as a variety of lesions, including macules, papules, nodules, plaques, purpura, blood blisters, and pustules. The nonspecific features and variety of lesions can lead to misdiagnosis and delayed treatment. Direct microscopy, microbiological culture, and histopathological examination are helpful for diagnosing primary cutaneous aspergillosis. Moreover, the physicians should be aware of the possibility of Aspergillus infection in tattooed cases.

BACKGROUND:Biological phenotypes are important characteristics of microorganisms, and often reflect their genotype and genotype changes. Traditionally, Trichophyton rubrum (T. rubrum) phenotypes were detected using carbon source assimilation tests, during which the types of tested substances are limited. In addition, the operation is complicated, and only one substance can be tested at once. To observe the changes of the metabolic phenotype of T. rubrum after laser irradiation, a high-throughput phenotype microarray system was used to analyze the metabolism of different carbon, nitrogen, phosphorus and sulfur source substrates in a Biolog metabolic phenotyping system.RESULTS:The strain of T. rubrum used in this study can effectively utilize 33 carbon, 20 nitrogen, 16 phosphorus, and 13 sulfur source substrates prior to laser irradiation. After laser irradiation, the strain was able to utilize 10 carbon, 12 nitrogen, 12 phosphorus, and 8 sulfur source substrates. The degree of utilization was significantly decreased compared with the control. Both groups efficiently utilized saccharides and organic acids as carbon sources as well as some amino acids as nitrogen sources for growth. The number of substrates utilized by T. rubrum after laser irradiation were significantly reduced, especially carbon substrates. Some substrates utilization degree in the laser treated group was higher than control, such as D-glucosamine, L-glutamine, D-2-Phospho-Glyceric Acid, D-glucosamine-6-phosphate, and D-methionine.CONCLUSION:Laser irradiation of T. rubrum may lead to changes in the metabolic substrate and metabolic pathway, thus weakening the activity of the strain.

BACKGROUND:According to the results of the clinical trials, laser therapy is effective for the treatment of onychomycosis, but the in vitro findings are inconsistent among studies. This study aimed to explore the experimental conditions of laser for the inhibition of Trichophyton rubrum growth in vitro. A 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser was used to irradiate colonies using a small (6-mm diameter) or large (13-mm diameter) area, and using 300, 408, or 600 J/cm2. The surface temperature of the colony was measured after irradiation and every 2 min. The growth area was calculated until the 7th or 10th day of incubation daily. RESULTS:For the small area group, at 300 J/cm2, the immediate surface temperature was 25.2 ± 0.2°C, but without effect on growth (P = 0.516). At 408 J/cm2, the immediate surface temperature was 32.0 ± 0.4°C; growth was inhibited for 7 days (P < 0.001). At 600 J/cm2, the immediate surface temperature was 38.1 ± 0.4°C; the growth was completely stopped for at least 10 days (P < 0.001). For the large area group, the temperature patterns were similar to those of the small area group, but the highest temperature was lower than in the small area groups, and no growth inhibition effect was observed (all P > 0.05). CONCLUSIONS:When the irradiation area is small, a 1064-nm Nd:YAG laser at 408 or 600 J/cm2 can be effective in suppressing T. rubrum growth in vitro.

BackgroundA combination of minimally invasive modalities can induce collagen regeneration more quickly and promote the penetration of topical agents, thus promoting skin rejuvenation. In this study, we aimed to investigate the synergistic efficacy of extracellular matrix compound (ECM-C) via microneedle (MN) and radiofrequency (RF) on periorbital wrinkles.MethodA total of 25 participants with periorbital wrinkles were selected for this study. The left and right side of the periorbital area was randomly given ECM-C via MN or ECM-C via MN combined with RF. MN combined with ECM-C treatment was given 5 times at 2 weeks intervals, whereas RF treatment was given 3 times at 4-week intervals. The following items were assessed: wrinkles by VISIA® system; biophysical parameters such as skin hydration, transepidermal water loss (TEWL), erythema index, and melanin index by CK multiple probe adapter; and skin elasticity and skin thickness by DermaLab Combo® photographs were taken at the baseline and 2 weeks after the last treatment. Subjective assessments, such as Crow's Feet Grading Scale (CFGS) and Global Aesthetic International Scale (GAIS), were also recorded.ResultA total of 25 participants with an average age of 43 years participated in this trial. Periorbital wrinkles on both sides decreased after the treatment, and the side treated with ECM via MN and RF showed better improvement than the other side with ECM-C via MN alone. Skin hydration increased after the treatment on both sides. TEWL, skin erythema, and skin melanin indexes were not changed. Skin elasticity and skin thickness increased more on the side of ECM-C via MN and RF than on the other side of ECM-C via MN alone. The evaluation scores for CFGS improved on either side; however, no difference was found for CFGS and GAIS between intergroup comparisons after the treatment.ConclusionThe objective assessment of wrinkles, elasticity, and thickness of periorbital skin improved more on the side with ECM-C treatment via MN combined with RF than on the other side of ECM-C treatment via MN only. However, no statistically significant difference was found between the subjective CFGS and GAIS evaluation of the two sides.

Trichophyton rubrum is one of the most common types of dermatophyte, causing superficial skin mycosis in human populations. Although laser treatment of onychomycosis has been proven to be effective in the clinic, the underlying mechanism of the effect of the laser on fungal growth is not clear. The objective of the present study was to observe the ultrastructural changes of Trichophyton rubrum following laser irradiation and compare the transcriptome differences between the laser irradiation group and control group. In the present study, scanning electron microscopy and transmission electron microscopy were used to observe the ultrastructural changes following the laser irradiation of Trichophyton rubrum. We also performed RNA-seq to investigate the effects of laser irradiation on Trichophyton rubrum by comparing the transcriptome pattern with the control. Morphological observation with electron microscopy indicated that laser irradiation resulted in the destruction of the cell membrane system. A significant induction of apoptosis was noted compared with the control group, which was confirmed by the formation of the myeloid body and protein aggregates in the cytoplasm. RNA-seq demonstrated that the expression levels of Acyl-CoA N-acyltransferase and S-adenosyl-L-methionine-dependent methyltransferase were increased in the laser irradiation group. This result indicated that laser irradiation triggered the initiation of the damage repair pathway. In conclusion, the present study suggested that laser irradiation caused physiological injury and therefore inhibited the growth of Trichophyton rubrum.

Purpose. To examine the benefits of different numbers of 1064-nm Nd-YAG laser treatments in patients with onychomycosis. Methods . This was a pilot study of patients with onychomycosis who were divided into three groups: four treatment sessions (group A), eight sessions (group B), and 12 sessions (group C). Only infected nails of degrees II–III (Scoring Clinical Index for Onychomycosis) were included. Treatment was given once a week using a long-pulse Nd-YAG 1064-nm laser. Patients were followed at 8, 16, and 24 weeks after the first treatment. Side effects were recorded. Results . Treatments were completed for 442 nails in 102 patients. The efficacy rates at 8, 16, and 24 weeks were 35.5%, 38.7%, and 37.4% for group A; 31.4%, 41.7%, and 44.0% for group B; and 27.7%, 50.0%, and 55.4% for group C, respectively. There was a significant difference in the efficacy rate at 24 weeks (P=0.016) between groups A and C, but not for groups A vs. B, or for groups B vs. C. No difference in the efficacy rate at 8 or 16 weeks was observed among the three groups. In all three groups, the efficacy was better for degree II nails than for degree III nails (all P<0.05). No side effects occurred. Conclusions . The 1064-nm Nd-YAG laser had clinical benefits against onychomycosis. Higher numbers of treatments provided better long-term (24-week) benefits, but had no impact on the short-term outcomes. The efficacy of laser treatment on degree II onychomycosis was better than for degree III.

Background: This is a systematic review and meta-analysis on the effectiveness of Photodynamic Therapy (PDT) in Bowen's Disease (BD), with further summary of the data from all randomized controlled trials (RCTs). Methods: Relevant data were extracted after conducting a literature search via PubMed, Embase, Scopus, the Cochrane Library, CNKI, and Wanfang databases, from inception until 31 July 2019. Meta-analyses of the data were performed using RevMan V.5.3. A total of 392 published RCTs related to the efficacy of PDT in BD treatment were identified. The papers were screened for duplicates and excluded based on title and abstract. Subsequently, 85 full-text articles were thoroughly reviewed and finally, data from 446 patients with 1147 skin lesions across 12 eligible studies were collated. Results: Our findings revealed significant differences between the efficacies of PDT and other treatments, where a higher lesion reduction rate was observed after the first treatment session following PDT (P < 0.00001, Z = 4.98). PDT was found to be more effective than 5-fluorouracil (P < 0.00001, Z = 4.42) and cryotherapy (P = 0.008, Z = 2.67). However, there were no significant differences in recurrence rates following treatments with PDT, cryotherapy, and 5-fluorouracil. Conclusions: This systematic review and meta-analysis confirms and collates data from all RCTs pertaining to the efficacy of PDT for BD treatment. Our study has reiterated that PDT is more effective than 5-fluorouracil and cryotherapy for the treatment of BD.

Vulvar intraepithelial neoplasia (VIN) is a pre-malignant condition of the vulvar skin that is found in 50% to 70% of patients with vulvar squamous cell cancer and is regarded as a precursor of vulvar tumors. Thus far, treatment remains lesion- and patient-specific. Here, we describe a VIN patient who presented with a 15-month history of large lesions in the bilateral labium, associated with human papillomavirus infection. The lesions were inappropriate for surgical excision and laser ablation because of their size; therefore, they were treated with photodynamic therapy and concurrent topical 5-aminolevulinic acid hydrochloride. The patient showed no recurrence throughout 2 years of post-treatment follow-up, and reported only slight pain during treatment. Moreover, no significant side effects or scarring were detected. Thus, we conclude that photodynamic therapy can be a useful alternative treatment for large VIN in the bilateral labium that cannot be excised or ablated.

目的 了解老年人甲真菌病临床及致病菌特点,指导老年人甲真菌病的防治.方法 前瞻性选取2016年1月至2018年6月首都医科大学附属北京友谊医院皮肤科收治的93例老年甲真菌病患者(437个病甲,老年组)及102例非老年人甲真菌病患者(401个病甲,非老年组),记录并比较两组病甲分型、位置、感染菌种、混合感染情况等.结果 老年组437个病甲中,最常见的临床损害为全甲毁损型(TDO)196个(44.85％),其次为远端侧位甲下型(DL-SO)174个(39.82％),白色浅表型(WSO)30个(6.87％).非老年组401个病甲中,最常见的临床损害为DLSO 261个(65.09％),其次为TDO 74个(18.45％),近端侧位甲下型(PSO)21个(5.24％);老年组患者手足同时感染者为18个(19.35％),非老年组为9个(8.82％);老年组与非老年组均以红色毛癣菌为主要致病菌,分别为31株(64.58％)、28株(68.29％);老年组5例(5.38％)培养出两种菌感染,非老年组均为单一菌种感染.结论 老年人病甲以TDO为主,且易手足同时感染,红色毛癣菌是其主要致病菌,但较非老年人更易出现混合菌种感染.

目的 观察抗菌肽联合透明质酸敷料治疗中度寻常痤疮的有效性和安全性,比较抗菌肽联合透明质酸敷料与外用过氧化苯甲酰治疗中度寻常痤疮的疗效差异.方法 选取80例面部中度寻常痤疮患者,随机分为试验组和对照组,各40例.试验组给予抗菌肽联合透明质酸敷料,对照组给予过氧化苯甲酰,均连续治疗28 d,在0、7、14、28 d进行随访,比较各组治疗后炎性及非炎性皮损改善情况、有效率及研究者总体评估(IGA)评分.结果 对炎性皮损的改善第14天、28天试验组优于对照组,且差异具有统计学意义;对非炎性皮损的改善两组之间差异无统计学意义;试验组与对照组治疗结束后有效率分别为55.0％、32.5％,P＜0.05;两组研究者总体评估在14d、28 d均明显下降,两组之间差异无统计学意义(P＞ 0.05).结论 抗菌肽联合透明质酸敷料治疗中度寻常痤疮安全有效,对炎性皮损优于非炎性皮损,短期疗效优于过氧化苯甲酰.

OBJECTIVE:To evaluate the effectiveness and safety of Qingpeng ointment on eczema-associated pruritus.TRIAL DESIGN AND METHOD:This single center randomized double-blinded placebo-controlled trial enrolled 60 patients with nonexudative eczema, who were randomized at 1:1 ratio to the Qingpeng ointment and placebo control groups (n=30 in each group). The investigational and control ointment were applied on lesions twice daily for two weeks. Visual analogue scale (VAS) and pruritus symptom scores were used to assess pruritus severity, frequency, and duration. Eczema lesions were evaluated by eczema area and severity index (EASI) and lesion morphology scores. Subjects were evaluated after the first treatment and at the end of the first and second week.RESULTS:The average age and disease duration were 50.1±13.5 years and 30.9±16.0 weeks, respectively. Baseline EASI and VAS scores were similar between the two groups. VAS scores of the Qingpeng ointment group were significantly lower than those of the placebo control group at 10 minutes and 30 minutes after the first treatment and the first and second week follow-up (all P < 0.05). The scores of pruritus severity, frequency, and duration were significantly lower in the Qingpeng ointment group than in the control group at the end of week 1 and week 2 of the study (all P < 0.05). The scores of lesion morphology at the end of week 1 of the study were not significantly different between the two groups, but the Qingpeng ointment group showed significantly lower score than the placebo control group at the end of week 2 of the study. No adverse event was observed in the study.CONCLUSION:Qingpeng ointment can effectively alleviate pruritus and reduce skin lesions in patients with nonexudative eczema. The antipruritic effects occurred early and at a greater magnitude than the effects on lesion attenuation.

Daylight photodynamic therapy (dPDT) is suggested to be effective for actinic keratosis (AK). We performed a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of dPDT versus conventional photodynamic therapy (cPDT) in patients with AK. Relevant studies were identified through a systematic search of PubMed, Embase, and the Cochrane Library. A fixed or random effect model was applied, depending on the heterogeneity. Six RCTs with 369 patients with 5,556 AK lesions that were undergoing dPDT or cPDT with red light and methyl aminolevulinate (MAL) were included. Overall, the incidence of complete response (CR) was not significantly different between the two groups (risk ratio [RR]: 0.93, p = 0.07). Subgroup analyses indicated that dPDT was non-inferior to cPDT for CR in studies only included grade I-II AK lesions (RR: 0.97, p = 0.41), but less effective for CR in studies which also included grade III lesions (RR = 0.87, p < 0.001). Subsequent meta-analyses showed that dPDT was associated with a significantly reduced maximal pain score (mean difference = -4.51, p < 0.001) and a lower risk of adverse events (RR = 0.70, p < 0.001) as compared with cPDT. These results suggested although dPDT was better tolerated, the treatment efficacy of dPDT is non-inferior to cPDT with red light and MAL only in grade I-II AK lesions. The relative therapeutic efficacy of dPDT in AK of grade III lesions in comparison with cPDT should be further evaluated.

目的 探讨特应性皮炎(atopic dermatitis,AD)的发病情况以及不同性别、发病年龄和部位的聚集效应.方法 收集2014年1月至2015年12月在中国13个城市31所三级医院皮肤科就诊的湿疹患者,回顾性分析5 953例湿疹患者的资料,其中AD患者964例.通过对性别、年龄和部位的AD发病情况进行统计处理,分析和总结AD发病的聚集效应.结果 5 953例湿疹患者中,AD共964例,占16.19％.男性与女性患者间AD比例差异无统计学意义(P＞0.05);男性与女性患者间年龄因素未见明显影响(P＞0.05).婴儿期(＜3岁)和儿童期(3岁≤年龄＜ 12岁)比例均高于其他年龄组(P＜0.05),差异有统计学意义.婴幼儿(＜3岁组)71例患者中70例为头面眼睑,而老年(≥61岁组)以四肢伸侧为主.低年龄(＜24岁)患者发病部位为头面眼睑的占比高于其他年龄组;24≤年龄＜41岁患者足-四肢伸侧、躯干-手-四肢伸侧、项颈-躯干的占比高于其他年龄组;24岁以上患者四肢伸侧占比高于其他年龄组.差异均有统计学意义(P ＜0.001).964例患者中,发病部位为四肢伸侧最多(50.10％),其次为头面眼睑(41.08％);前10位的发病部位共有583例患者,占60.48％;发病部位个数平均为(2.07±1.12)个,1个和2个发病部位分别占35.06％和37.66％.1个发病部位患者以头面眼睑和四肢伸侧为主(共占71.01％),双部位发病患者以足-四肢伸侧、头面眼睑-项颈、躯干-四肢伸侧为主.女性发病部位为足-四肢伸侧和项颈-躯干的比例高于男性(P＜0.001),男性躯干-四肢伸侧和肘窝膝窝-项颈的比例高于女性(P ＜0.001).低年龄组(＜24岁)患者发病部位为头面眼睑的占比高于其他年龄组(P ＜0.001),24岁≤年龄＜41岁患者足-四肢伸侧、躯干-手-四肢伸侧、项颈-躯干的占比高于其他年龄组(P＜0.001),24岁以上年龄组四肢伸侧占比高于其他年龄组(P ＜0.001).结论 性别对于不同年龄患者AD发病情况并无显著影响;年龄具有明显“聚集效应”,好发于婴儿期(＜3岁)和儿童期(3岁≤年龄＜12岁);发病部位具有一定“聚集效应”,尤其是不同年龄患者的发病部位存在明显的差异.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

Objective To explore the therapeutic effect of antimicrobial peptides and hyaluronic acid on patients with moderate to severe acne,in order to provide a new treatment for acne.Methods Forty-five patients with moderate to severe acne treated in our hospital from June 2014 to August 2015 were selected for this study.All of them were treated with antibacterial peptides once a day for 28 days and followed up after 1 week,2 weeks and four weeks.And the efficacy of the patients were compared between pre-treatment and post-treatment,and the incidence of inflammatory lesions,noninflammatory lesions and investigator''s global assessment (IGA) were compared,too.Skin physiological indicators were detected and compared at the same time.Results After treatment,the number of inflammatory lesions and the total lesions was significantly less than that pre-treatment,the difference had statistical significance (P<0.05),non-inflammatory lesions had no significant difference (P>0.05).The total effective rate was 51.11%.After treatment,IGA score was significantly lower than that pre-treatment (P<0.05).The skin physiology indexes showed that the degree of hydration was significantly higher than that pre-treatment,and the TEWL and erythema values were significantly lower than those before treatment (P<0.05).The M values had no significant difference (P>0.05).Conclusion Antimicrobial peptides and hyaluronic acid are effective in the treatment of moderate to severe acne patients,can significantly reduce the inflammatory response,improve the degree of skin hydration,reduce percutaneous dehydration.That can be used for the treatment of moderate and severe acne.

目的:分析1例以皮损为首发表现,同时累及呼吸系统的结节病的临床及影像学特征,提高本病诊治水平,减少误诊.方法:分析患者临床资料、辅助检查及诊治过程,并结合文献进行回顾性分析.结果:女性患者,34岁.因皮疹4个月,胸闷2周而入院.皮损组织病理发现非干酪样肉芽肿浸润,经胸部CT、支气管镜等检查除外结核、真菌等微生物感染及肿瘤后,确诊为结节病.给予糖皮质激素治疗,效果满意.结论:皮肤结节病发病隐匿,常出现误诊,确诊需依赖组织活检及影像学检查,治疗以糖皮质激素为首选,但给药前需除外结核、真菌感染及肿瘤等疾病.

目的:比较免疫荧光蛋白质芯片法与目前临床应用的免疫印迹法检测特异性IgE的敏感性和特异性.方法:分别用免疫荧光蛋白质芯片试剂盒和免疫印迹试剂盒检测1200例过敏性皮肤病患者血清中6种过敏原(尘螨、猫毛皮屑、鸡蛋清、虾、蚌与蟹)特异性IgE抗体.结果:免疫荧光蛋白质芯片法检测的阳性率为:尘螨62.5％、猫毛皮屑25.3％、鸡蛋清34.7％、虾36.4％、蟹41.5％;免疫印迹法阳性率分别为:尘螨60.2％、猫毛皮屑23.3％、鸡蛋清26.6％、虾33.8％、蟹36.7％.此5种过敏原用两种方法检测结果具有良好一致性;免疫荧光蛋白质芯片检测出蚌特异性IgE阳性率为27.6％,免疫印迹法仅为0.3％,用蚌标准阳性血清证实免疫荧光蛋白质芯片法结果可靠.结论:免疫荧光蛋白质芯片试剂盒与免疫印迹诊断试剂盒的检测结果具有良好的一致性,几种方法对于蚌特异性IgE检测结果的不一致性可能与过敏原来源有关.免疫荧光蛋白质芯片法检测过敏原特异性IgE敏感、特异、快速.

Objective To evaluate the efficacy of Qingpeng ointment for the treatment of asteatotic eczema and its effect on skin barrier function.Methods A self-controlled clinical study was performed.Totally,78 patients with asteatotic eczema symmetrically located on both lower extremities were enrolled into this study.The left and right lower extremities of these patients were treated with Qingpeng ointment (Qingpeng group) and hydrocortisone butyrate ointment (hydrocortisone butyrate group) respectively,twice a day for 4 consecutive weeks.At the end of treatment,therapeutic effect and skin barrier function were compared between the 2 groups.Results The response rate was significantly higher in the hydrocortisone butyrate group than in the Qingpeng group after 1-and 2-week treatment (week 1:58.97％ vs.39.74％,x2 =5.77,P ＜ 0.05;week 2:76.92％ vs.60.26％,x2 =5.03,P ＜ 0.05),but insignificantly different between the 2groups after 4-week treatment (80.77％ vs.87.18％,P ＞ 0.05).Compared with the hydrocortisone butyrate group,theQingpeng group showed significantly increased water content of the stratum corneum after 4-week treatment (P ＜ 0.05),and decreased transepidermal water loss after 2-and 4-week treatment (both P ＜ 0.05).Conclusion Qingpeng ointment is safe and effective for the treatment of asteatotic eczema with gradually increasing and stable effects,and also has a favoring effect on the restoration of skin barrier function.