Introduction: Autoimmune blistering skin disorders such as Bullous Pemphigoid and Pemphigus Vulgaris present diagnostic challenges. The Systemic Immune-Inflammation Index (SII) and Neutrophil-Lymphocyte Ratio (NLR), a...Introduction: Autoimmune blistering skin disorders such as Bullous Pemphigoid and Pemphigus Vulgaris present diagnostic challenges. The Systemic Immune-Inflammation Index (SII) and Neutrophil-Lymphocyte Ratio (NLR), are inflammatory markers used to assess the body’s immune-inflammatory response. Objectives: The study aims to evaluate the significance of hematologic markers, specifically the Systemic Immune-Inflammation Index (SII) and Neutrophil-Lymphocyte Ratio (NLR), as diagnostic predictors of bullous pemphigoid (BP) and pemphigus vulgaris (PV). Methods: A retrospective study of 64 patients (36 with BP and 28 with PV). Patient clinical data: age, gender, complete blood count, autoimmune antibody levels (Dsg1, 3 and BP180, 230), IgE and C-reactive protein, and history of hypertension, diabetes, brain infarction, and coronary heart disease. The data was analyzed using SPSS. Results: The study involved 36 (56.3%) diagnosed with bullous pemphigoid (BP) and 28 (43.75%) with pemphigus vulgaris (PV). The average age in BP was 71 ± 8 and 52 ± 13 in PV. Laboratory findings showed high levels of Dsg1, Dsg3, neutrophil count, and lymphocyte count in PV, while high levels of eosinophils with a significant increase in C-reactive protein (CRP) in BP. Blood biomarkers, including NLR, PLR, SII, MPV, CRP, and IgE, proved an overall of 84.4% in disease prediction. Dsg1, Dsg3, BP180, and BP230 showed an overall of 88.1%. No significant relationship was noted between NLR, SII, and patients with comorbidities. Conclusion: The study highlights the diagnostic potential of SII and NLR in addition to hematologic markers in BP and PV, emphasizing their role in early diagnosis and therapeutic interventions, requiring further validation in larger patient cohorts.展开更多
Objective This study aimed to evaluate the epidemiological,clinical and mycological characteristics of invasive candidiasis(IC)in China.Methods A ten-year retrospective study including 183 IC episodes was conducted in...Objective This study aimed to evaluate the epidemiological,clinical and mycological characteristics of invasive candidiasis(IC)in China.Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing,China.Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges.Candidemia(71.0%)was the major infective pattern;70.3%of the patients tested positive for Candida spp.colonization before IC and the median time to develop an invasive infection after colonization was13.5 days(interquartile range:4.5–37.0 days).Candida albicans(45.8%)was the most prevalent species,followed by Candida parapsilosis(19.5%),Candida glabrata(14.2%)and Candida tropicalis(13.7%).C.non-albicans IC was more common in patients with severe anemia(P=0.018),long-term hospitalization(P=0.015),hematologic malignancies(P=0.002),continuous administration of broad-spectrum antibiotics(P<0.001)and mechanical ventilation(P=0.012).In vitro resistance testing showed that11.0%of the Candida isolates were resistant/non-wild type(non-WT)to fluconazole,followed by voriconazole(9.6%),micafungin(3.8%),and caspofungin(2.9%).Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis(52.6%and 54.6%,respectively).The 30-day and 90-day all-cause mortality rates were 24.5%and 32.7%,respectively.Conclusion The incidence of IC has declined in the recent five years.C.non-albicans contributed to more than half of the IC cases.Fluconazole can be used as first-line therapy if resistant strains are not prevalent.Prospective,multi-center surveillance of the clinical and mycological characteristics of IC is required.展开更多
Up to date,in literature,it is still debated the role of anti-tumor necrosis factors(TNF)-α treatments in hepatitis C virus(HCV) patients.TNF-α performs a lot of functions,it is an important pro-inflammatory cytokin...Up to date,in literature,it is still debated the role of anti-tumor necrosis factors(TNF)-α treatments in hepatitis C virus(HCV) patients.TNF-α performs a lot of functions,it is an important pro-inflammatory cytokine and it is involved in the host's immunity.Since TNF-α is implicated in the apoptotic signaling pathway of hepatocytes infected by HCV,anti TNF-α therapy may increase the risk of viral replication or their reactivation.However the treatment of anti TNF-α could have a healthful role because TNF-α appears to be engaged in the pathogenesis of liver fibrosis,inducing apoptotic pathways.We describe the case of a patient with plaquetype psoriasis and concomitant chronic HCV,who was treated successfully with anti-TNF agents simultaneously to cyclosporine without sign of reactivation of HCV and increase of liver enzymes.Our personal experience shows that anti-TNF-α agents are not only effective but also safe.Furthermore the combination therapy of cyclosporine and anti-TNF-α appears to be well-tolerated and able to reduce the amount of liver enzymes as well as HCV-viral-load.However systematic,large-scale studies with long follow-ups will be needed to confirm our results,in association with close liver function monitoring.展开更多
HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease a...HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.展开更多
Objective : To investigate the role and clinical significance of p16 protein in Condyloma Acuminatum (CA) and its cancerization. Methods: The expression of p16 protein was tested in 33 CA samples and 7 cancerized CA s...Objective : To investigate the role and clinical significance of p16 protein in Condyloma Acuminatum (CA) and its cancerization. Methods: The expression of p16 protein was tested in 33 CA samples and 7 cancerized CA samples by immunohistochemical assays. Results: There was abnormal expression of p16 protein in CA and cancerized CA, mainly major protein expression. The p16 protein expresseed in different locations in different cases was as follows: In basal layer cells in normal cuits; in spinous layer, granular layer and stratum corneum layer cells in CA;in keratin pearl peripheral and spinous layer cells in cancerized CA. Conclusion.. There was major expression of p16 protein in CA and cancerized CA, and these protein of the two groups might not naturally be the same. Our study indicated that in clinical practice, when major p16 protein expression in CA occurs, it's risk of cancerization shoud be suspected.展开更多
1 Introduction A prevalent clinical dermatologic condition, chronic urticaria is characterized by urticaria lasting longer than six weeks and more than two episodes per week.1-2 Patients typically experience the abrup...1 Introduction A prevalent clinical dermatologic condition, chronic urticaria is characterized by urticaria lasting longer than six weeks and more than two episodes per week.1-2 Patients typically experience the abrupt onset of urticaria and itching on their face, limbs, and trunk.3 The disease has a quite complicated etiology.展开更多
Objectives: To understand genital ulcer disease(GUD) among patients attending sexually transmitteddisease (STD) clinics in Guangzhou, China, and itsassociation with HIV infection.Methods: Between September 9th, 1997 a...Objectives: To understand genital ulcer disease(GUD) among patients attending sexually transmitteddisease (STD) clinics in Guangzhou, China, and itsassociation with HIV infection.Methods: Between September 9th, 1997 and Octo-ber 30th, 2002, 8 962 patients with STDs wereevaluated. 285 patients were diagnosed with GUD basedon clinical manifestations and microbiologic evalua-tions including dark field microscopy and serologytest for syphilis (RPR, TPPA). Swabs of each genitalulcer were processed in a multiplex PCR assay (M-PCR) for simultaneous detection of Herpes simplexvirus (HSV), Treponema pallium, and Haemophilusducreyi. Other STDs were classified by routine diag-nostic criteria, including microscopy or culture forNeisseria gonorrhoeae, Chlamydia trachomatis,Urea- plasma urealyticum, Human papillomavirus,Trichomonas, etc.Results: Of the 8 962 patients with STDs, the HIVseroprevalence in patients with and without GUD was1.75% (5/285) and 1.53% (133/8677), respectively,with no statistically significant difference (χ 2=0.09,P>0.05; OR=1.15, 95%CI=0.47-2.81) . HIVseroprevalence in patients with syphilis, genital her-pes and other STDs was 2.81% (22/784), 0.74% (6/814) and 1.49% (110/7 364), respectively. Prevalencein patients with syphilis was significantly higher thanthat in patients with genital herpes and other STDs,(χ 2=9.92, P<0.005, OR=3.89, 95%CI=1.67-9.05;χ 2=7.66, P<0.001, OR=1.90, 95%CI=1.21-3.00).Conclusions: The study shows that the HIV sero-prevalence in this population of patients with GUDis very low. The results also indicate an associationbetween syphilis and HIV infection. The relationshipbetween genital herpes and HIV infection needsfurther research.展开更多
In the past decade,there has been increasing interest in whether a widespread childhood varicella immunization scheme may increase the age-specific incidence of herpes zoster in adults.This proposition is based on evi...In the past decade,there has been increasing interest in whether a widespread childhood varicella immunization scheme may increase the age-specific incidence of herpes zoster in adults.This proposition is based on evidence that exposure to endemic varicella boosts varicella-zoster virus-specific immunity in adults and that cessation of varicella in the community would result in a decline in the T-cell-mediated immunity required to maintain dormancy of varicella-zoster virus in neurons.However,numerous epidemiological studies have failed to fully explore this effect.Quantifying the efficacy of the varicella vaccine is a crucial step in understanding its benefits.We conducted this review to quantify the efficacy of the varicella vaccine(HZ/su vaccine)which will contribute immensely to our understanding of how the vaccine benefits the population in prevention against the herpes zoster,especially during the outbreak of Covid-19.展开更多
To the Editor:Livedoid vasculopathy(LV)is a thromboocclusive disorder involving superficial and mid-dermis vessels,characterized by painful erythematous or purpuric macules or papules,small crusted ulcers,and porcelai...To the Editor:Livedoid vasculopathy(LV)is a thromboocclusive disorder involving superficial and mid-dermis vessels,characterized by painful erythematous or purpuric macules or papules,small crusted ulcers,and porcelainwhite atrophic scars that remain after several months.[1,2]Dermoscopy is a non-invasive and effective image analysis technology[3]that can aid dermatologists in visualization of the pigmentation pattern and vascular structure,as well as other morphologic features of the epidermis and dermis.This study was performed to identify the clinical and dermoscopic features of LV in patients with LV who were treated in our hospital from October 2017 to August 2018.The study was approved by the Ethical Committee of the First Affiliated Hospital of Zhengzhou University(No.2018-YB-05).The study was performed in accordance with the established guidelines and regulations.We have obtained all appropriate patient consent forms.In the form,the patients have given their consents for their images and other clinical information to be reported in the journal.展开更多
Background: Compared with Caucasians, unique demographic and clinical features have been reported in Chinese patients with malignant melanoma, but similar comparative studies of melanocytic nevi (MN) are lacking. This...Background: Compared with Caucasians, unique demographic and clinical features have been reported in Chinese patients with malignant melanoma, but similar comparative studies of melanocytic nevi (MN) are lacking. This study examined the clinical and dermoscopic features of MN in surgically treated Chinese cases. Methods: Clinical data and dermoscopic findings from 1046 cases of MN were collected and analyzed. Cases were treated from January 1 to December 31, 2014 at the Department of Dermatology and Venerology, Peking University First Hospital. The association between nevi location and histologic subtypes was examined with Chi-squared test and univariate logistic regression. Chi-squared test was also used to analyze the proportion of globular patterns across different body sites, and proportion of parallel furrow patterns across different histologic subtypes. Results: The majority of the nevi were from female patients, irrespective of location. The range of age at the time of nevi onset was from 0 (birth) to 79 years. There were 381 (36.4%, 381/1046) congenital nevi;of these 81.6%(311/381) were present at birth. Nevi appeared before 30 years of age in 83.2%(870/1046) of the cases. Median values of length growth rate in congenital and acquired MN were 2.0 and 1.6, respectively. Median values of length growth rates in four age groups (0–9, 10–19, 20–29, and ≥30 years) of congenital nevi were 2.2, 2.0, 2.4, and 2.0, respectively. In acral nevi, which often need to be differentiated from acral lentiginous melanoma, 50.2%(109/217) were junctional (odds ratio [OR];95% confidence interval [CI]: 91.572 [52.210–160.959], P < 0.05). Acral location was also associated with a higher likelihood of compound nevi subtype (OR [95% CI]: 14.468 [8.981–23.306], P < 0.05). The globular (59.4%, 354/596) and pseudonetwork (48.8%, 291/596) dermoscopic patterns were often seen in the head and neck region. In areas other than head and neck and acral regions, the globular pattern was the commonest pattern (34.8%, 71/204) regardless of age. Parallel furrow pattern occurred in 46.0%(87/189) of acral MN, followed by fibrillar pattern (21.7%, 41/189). Conclusion: Unique clinical and dermoscopic features exist in Chinese patients with MN compared with observations reported in other population.展开更多
Introduction: Psoriasis is a chronic multi-systemic inflammatory skin disease that presents with erythema, thickness, and scaling of the skin. Genetic and environmental factors are associated with its etiology. Recent...Introduction: Psoriasis is a chronic multi-systemic inflammatory skin disease that presents with erythema, thickness, and scaling of the skin. Genetic and environmental factors are associated with its etiology. Recently systemic immune inflammatory index, has been proposed as a biomarker for prognosis and severity prediction. Although it has been studied in psoriasis in general, no study exists for its association with the individual types of psoriasis. This study thus aimed to determine its association with clinical characteristics of psoriasis subtypes. Materials and Methods: Data were retrospectively retrieved from the hospital electronic medical database from January 2020 to August 2022. Only patients with CBC results were included. Clinical data retrieved were: Patients’ age, gender, type of psoriasis diagnosed, body mass index, duration of the disease, family history of psoriasis, history of smoking, diabetes, and hypertension records. Laboratory data retrieved were: Complete blood count (CBC), C-reactive protein, Immunoglobulin E (IgE), Total cholesterol, Triglycerides and Low-density lipoprotein cholesterol. Data were analyzed in SPSS and GraphPad prism. Results: The study enrolled 85 patients with psoriasis;56.47% males, and 43.53% females. 7.6% had psoriasis for less than 10 years, while 42.4% had the disease for more than 10 years. Psoriasis vulgaris was the most common diagnosis, 41.2%, followed by p. pustular, 30.6% and then p. erythroderma 28.2%. Mean age ± SD of the p. vulgaris, p. pustular and p. erythroderma patients were 47.3 ± 15.3;45.3 ± 14.6, and 57.1 ± 11.7 respectively. SII was significantly higher in p. pustular than the rest, (p Conclusion: In summary, systemic immune inflammatory index (SII) was significantly higher in psoriasis pustular than other subtypes of psoriasis, and had an association with hypertension in psoriasis pustular patients. These findings suggest a possible association between SII and psoriasis pustular that should be investigated in an independent study.展开更多
Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preven...Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0<sup>th</sup>, 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventative measure for postoperative atrial fibrillation in such cases.展开更多
Acne inversa/hidradenitis suppurativa is a chronic,recurrent,inflammatory skin disease that affects the pilosebaceous units,causinfollicular occlusion.The etiology and pathogenesis of acne inversa/hidradenitis suppura...Acne inversa/hidradenitis suppurativa is a chronic,recurrent,inflammatory skin disease that affects the pilosebaceous units,causinfollicular occlusion.The etiology and pathogenesis of acne inversa/hidradenitis suppurativa involves internal and external factors such as genetic susceptibility,inflammation and immunity,microorganisms,obesity,and smoking.acne inversa/hidradenitis suppurativa is difficult to treat,and the current aim of treatment is to control the frequency and duration of disease flares and improve the quality of life.Treatment protocols for acne inversa/hidradenitis suppurativa should be selected based on the disease severity grade.Medical treatments include antibiotics,retinoids,biologics,immunosuppressive agents,and antiandrogen agents.Adjuvant treatments include surgery and laser/light therapies.This consensus aims to further standardize the diagnosis and treatment procedures of acne inversa/hidradenitis suppurativa in China to facilitate its diagnosis and treatment.展开更多
Genetic factors predisposing individuals to Behet’s disease(BD) are considered to play important roles in the developmentof the disease. Patients with BD exhibit elevated levels of proinflammatory cytokines, and af...Genetic factors predisposing individuals to Behet’s disease(BD) are considered to play important roles in the developmentof the disease. Patients with BD exhibit elevated levels of proinflammatory cytokines, and affected organs show a significant neutrophil and lymphocyte infiltration. Current evidence suggests that the activated lymphocytes contribute to neutrophil and endothelial cell activation in these patients. The cytotoxic T lymphocyte-associated antigen (CTLA)-4 molecule plays an important role in immune regulation by downregulating T-cell activation, and the CTLA-4 49A/G polymorphism in the exon 1 has been shown to be associated with a number of autoimmune diseases. In an attempt to demonstrate whether there is an association of the CTLA-4 49A/G polymorphism with BD in the Turkish population, we genotyped 59 Turkish patients and 99 healthy individuals for single-nucleotide polymorphisms. For this purpose, genomic DNA was obtained from the peripheral blood of individuals and the region of interest was amplified using PCR. Genotyping was performed using the BbvI restriction endonuclease. It was shown that the distribution of the CTLA-4 exon 1 49A/G allele and genotype frequencies did not differ between patientswith BD and healthy controls.However, allele and genotype frequencies of CTLA-4 49 A and A/A were significantly higher in patients with ocular involvement compared with patients without these symptoms (90.6%vs. 65.1%, odds ratio (OR) = 9.67, P = 0.011; and 81.25%vs. 39.5%,OR = 9.56, P = 0.015, respectively). A statistically significant difference in the A allele frequency was observed in patients with erythema nodosum-like lesions (86.1%vs. 65.8%, OR =6.24, P = 0.04). There was also an increase in A/A genotype frequency, but the difference was not statistically significant (72.2%vs. 41.5%, OR = 6.5, P = 0.068). Our data suggest that BD patients with ocular involvement and erythema nodosumlike lesions have a higher frequency of both the A allele and the A/A genotype at position 49 of exon 1 of CTLA-4. These results may also indicate that CTLA-4 is a disease-modifying rather than a susceptibility gene for BD.展开更多
Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chro...Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chronic urticaria as well as delayed urticarial dermographism. Pressure challenge gave rise to a deep weal covered by multiple vesicles and bullae after 24 h. Histological examination of a skin biopsy specimen obtained 24 h after pressure challenge demonstrated intraepidermal bullae filled with eosinophils accompanied by a dense, predominantly eosinophilic infiltrate in the dermis. Whereas the numbers and morphology of mast cells were unaltered, the extracellular deposition of eosinophil cationic protein revealed evidence for eosinophil activation. Concomitantly, both CD4+and CD8+T lymphocytes were present in the infiltrate and expressed interleukin 5. As bullous DPU may represent the maximal variant of DPU, the investigation of the cellular infiltrate and the chemokines/cytokines released may reveal potential pathogenic mechanisms. A possible effector role of eosinophilic granulocytes, T-cell subsets and mast cells is discussed.展开更多
A prospective cohort study was undertaken to determine the clonal dynamics of Staphylococcus aureus colonization and infection during 1 y in children with atopic dermatitis, and to correlate specific clones, accessory...A prospective cohort study was undertaken to determine the clonal dynamics of Staphylococcus aureus colonization and infection during 1 y in children with atopic dermatitis, and to correlate specific clones, accessory gene regulator (agr) groups, and production of virulence factors with eczema activity. Eleven children were examined every 6 wk with swaps taken from active eczema, anterior nose, axillae and perineum, and scoring of eczema activity by severity scoring of atopic dermatitis (SCORAD). Individual S. aureus clonal types were identified and examined for production of superantigens, toxins, and were assigned to agr groups. S. aureus colonization patterns ranged from rare colonization over transient colonization to persistent colonization by a single clone or a dynamic exchange of up to five clones. Production of no single virulence factor including superantigens and toxins was significantly associated with exacerbation of eczema. In four children there was a shift between visits in agr group of colonizing clones. These shifts were associated with an increased SCORAD value of 19 (SE = 7, p = 0.009). Change of clones belonging to the same agr group was not associated with a higher SCORAD value. In 11 of 12 cases with two different clones co-colonizing a child the clones belonged to the same agr group. In conclusion, this limited group of children with atopic dermatitis showed highly variable colonization patterns of S. aureus, and communication between strains by use of agr encoded octa peptides appeared to be active in vivo. Increased severity of eczema was related to a change in agr group and may have been because of inflammation triggered by the takeover of an antigenically different clone, as agr groups represent ancient phylogenetic lineages.展开更多
Sirolimus is a new immunosuppressive agent used to prevent rejection in renal allograft recipients in order to reduce the need of potentially nephrotoxic calcineurin inhibitors (cyclosporine, tacrolimus). The cutaneou...Sirolimus is a new immunosuppressive agent used to prevent rejection in renal allograft recipients in order to reduce the need of potentially nephrotoxic calcineurin inhibitors (cyclosporine, tacrolimus). The cutaneous side effects of sirolimus are not well known and they may have been underestimated. We report 2 cases of follicular acneiform eruptions induced by sirolimus in renal allograft recipients. This dermatologic complication was severe and difficult to treat, and resolved only after discontinuation of sirolimus.展开更多
Having considered the impact of the function of TLR2 in there cognition of several microorganisms that are thought to havean association with disease(BD),we aimed to determinea possible association between the TLR2 Ar...Having considered the impact of the function of TLR2 in there cognition of several microorganisms that are thought to havean association with disease(BD),we aimed to determinea possible association between the TLR2 Arg753Gln polymorphism and susceptibility to BD.We genotyped 83 patients with BD,95 ethnically matched healthy controls,12patients with recurrent aphthous stomatitis(RAS)and 21 patientswith rheumatoid arthritis(RA)by restriction fragment length polymorphism after PCR amplification of the genomicregion encompassing the polymorphic site.Comparison of the TLR2 Arg753Gln A allele and A/G genotype frequencies did not show a significant difference between patients with BD andhealthy controls(1.2%vs.0.6%,and 2.1%vs.1.1%,respectively).None of the patients from the RAS and RA groups had the A allele or A/G genotype.Our results indicate that the TLR2 Arg753Gln polymorphism does not play a role in the aetiopathogenesis of BD.展开更多
Background Despite modern advances in medical science and in the social attitude of people,vitiligo on exposed areas still is a stigmatizing condition leading to serious psychological problems in daily lives of the vi...Background Despite modern advances in medical science and in the social attitude of people,vitiligo on exposed areas still is a stigmatizing condition leading to serious psychological problems in daily lives of the victim.Treatment of vitiligo is difficult and prolonged and despite the advancement made in the field of vitiligo surgery over the past four decades,cutaneous surgeons still struggle to select among various surgical modalities which have a promising outcome.The basic principle of all the available surgical techniques as well as their advantages and disadvantages have been reviewed.Objective The purpose of this review is to find out if we can select a proper method of surgical modalities available to treat a vitiliginous area depending on the size and distribution of the lesions in order to achieve the best possible cosmetic results.Methods This article is based on a review of various articles regarding vitiligo and its emerging surgical treatments.Conclusion Although the treatment of vitiligo keeps on changing with new developments available,discussing the present surgical modalities available for treating vitiligo along with their limitations and advantages provides with great medical knowledge about the disease and its treatment.展开更多
Background：PM2.5 （aerodynamic diameter ≤ 2.5 μtm） is a dominant and ubiquitous air pollutant that has become a global concern as PM2.5 exposure has been linked to many adverse health effects including cardiovascu...Background：PM2.5 （aerodynamic diameter ≤ 2.5 μtm） is a dominant and ubiquitous air pollutant that has become a global concern as PM2.5 exposure has been linked to many adverse health effects including cardiovascular and pulmonary diseases.Emerging evidence supports a correlation between increased air PM2.5 levels and skin disorders although reports on the underlying pathophysiological mechanisms are limited.Oxidative stress is the most common mechanism of PM2.5-induced adverse health effects.This study aimed to investigate PM2.5-induced oxidative damage and apoptosis in immortalized human keratinocyte （HaCaT） cells.Methods：HaCaT cells were exposed to 0,25,50,100,or 200 μtg/ml PM2.5 for 24 h.Reactive oxygen species （ROS） generation,lipid peroxidation products,antioxidant activity,DNA damage,apoptotic protein expression,and cell apoptosis were measured.Results：PM2.5 exposure （0-200 μtg/ml） for 24 h resulted in increased ROS levels （arbitrary unit：201.00 ± 19.28,264.50 ± 17.91,305.05 ± 19.57,427.95 ＋ 18.32,and 436.70 ± 17.77） and malondialdehyde production （0.54 ± 0.05 nmol/mg prot,0.61 ± 0.06 nmol/mg prot,0.68 ± 0.05 nmol/mg prot,0.70 ± 0.05 nmol/mg prot,and 0.76 ± 0.05 nmol/mg prot）,diminished superoxide dismutase activity （6.47 ± 0.28 NU/mg prot,5.97 ± 0.30 NU/mg prot,5.15 ± 0.42 NU/mg prot,4.08 ± 0.20 NU/mg prot,and 3.76 ± 0.37 NU/mg prot）,and increased DNA damage and apoptosis in a dose-dependent manner in HaCaT cells.Moreover,cytochrome-c,caspase-3,and caspase-9 expression also increased proportionately with PM2.5 dosing.Conclusion：PM2.5 might elicit oxidative stress and mitochondria-dependent apoptosis that likely manifests as skin irritation and damage.展开更多
文摘Introduction: Autoimmune blistering skin disorders such as Bullous Pemphigoid and Pemphigus Vulgaris present diagnostic challenges. The Systemic Immune-Inflammation Index (SII) and Neutrophil-Lymphocyte Ratio (NLR), are inflammatory markers used to assess the body’s immune-inflammatory response. Objectives: The study aims to evaluate the significance of hematologic markers, specifically the Systemic Immune-Inflammation Index (SII) and Neutrophil-Lymphocyte Ratio (NLR), as diagnostic predictors of bullous pemphigoid (BP) and pemphigus vulgaris (PV). Methods: A retrospective study of 64 patients (36 with BP and 28 with PV). Patient clinical data: age, gender, complete blood count, autoimmune antibody levels (Dsg1, 3 and BP180, 230), IgE and C-reactive protein, and history of hypertension, diabetes, brain infarction, and coronary heart disease. The data was analyzed using SPSS. Results: The study involved 36 (56.3%) diagnosed with bullous pemphigoid (BP) and 28 (43.75%) with pemphigus vulgaris (PV). The average age in BP was 71 ± 8 and 52 ± 13 in PV. Laboratory findings showed high levels of Dsg1, Dsg3, neutrophil count, and lymphocyte count in PV, while high levels of eosinophils with a significant increase in C-reactive protein (CRP) in BP. Blood biomarkers, including NLR, PLR, SII, MPV, CRP, and IgE, proved an overall of 84.4% in disease prediction. Dsg1, Dsg3, BP180, and BP230 showed an overall of 88.1%. No significant relationship was noted between NLR, SII, and patients with comorbidities. Conclusion: The study highlights the diagnostic potential of SII and NLR in addition to hematologic markers in BP and PV, emphasizing their role in early diagnosis and therapeutic interventions, requiring further validation in larger patient cohorts.
基金the Major Infectious Diseases Such as AIDS and Viral Hepatitis Prevention and Control Technology Major Projects[2018ZX10712001-011]。
文摘Objective This study aimed to evaluate the epidemiological,clinical and mycological characteristics of invasive candidiasis(IC)in China.Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing,China.Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges.Candidemia(71.0%)was the major infective pattern;70.3%of the patients tested positive for Candida spp.colonization before IC and the median time to develop an invasive infection after colonization was13.5 days(interquartile range:4.5–37.0 days).Candida albicans(45.8%)was the most prevalent species,followed by Candida parapsilosis(19.5%),Candida glabrata(14.2%)and Candida tropicalis(13.7%).C.non-albicans IC was more common in patients with severe anemia(P=0.018),long-term hospitalization(P=0.015),hematologic malignancies(P=0.002),continuous administration of broad-spectrum antibiotics(P<0.001)and mechanical ventilation(P=0.012).In vitro resistance testing showed that11.0%of the Candida isolates were resistant/non-wild type(non-WT)to fluconazole,followed by voriconazole(9.6%),micafungin(3.8%),and caspofungin(2.9%).Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis(52.6%and 54.6%,respectively).The 30-day and 90-day all-cause mortality rates were 24.5%and 32.7%,respectively.Conclusion The incidence of IC has declined in the recent five years.C.non-albicans contributed to more than half of the IC cases.Fluconazole can be used as first-line therapy if resistant strains are not prevalent.Prospective,multi-center surveillance of the clinical and mycological characteristics of IC is required.
文摘Up to date,in literature,it is still debated the role of anti-tumor necrosis factors(TNF)-α treatments in hepatitis C virus(HCV) patients.TNF-α performs a lot of functions,it is an important pro-inflammatory cytokine and it is involved in the host's immunity.Since TNF-α is implicated in the apoptotic signaling pathway of hepatocytes infected by HCV,anti TNF-α therapy may increase the risk of viral replication or their reactivation.However the treatment of anti TNF-α could have a healthful role because TNF-α appears to be engaged in the pathogenesis of liver fibrosis,inducing apoptotic pathways.We describe the case of a patient with plaquetype psoriasis and concomitant chronic HCV,who was treated successfully with anti-TNF agents simultaneously to cyclosporine without sign of reactivation of HCV and increase of liver enzymes.Our personal experience shows that anti-TNF-α agents are not only effective but also safe.Furthermore the combination therapy of cyclosporine and anti-TNF-α appears to be well-tolerated and able to reduce the amount of liver enzymes as well as HCV-viral-load.However systematic,large-scale studies with long follow-ups will be needed to confirm our results,in association with close liver function monitoring.
文摘HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.
文摘Objective : To investigate the role and clinical significance of p16 protein in Condyloma Acuminatum (CA) and its cancerization. Methods: The expression of p16 protein was tested in 33 CA samples and 7 cancerized CA samples by immunohistochemical assays. Results: There was abnormal expression of p16 protein in CA and cancerized CA, mainly major protein expression. The p16 protein expresseed in different locations in different cases was as follows: In basal layer cells in normal cuits; in spinous layer, granular layer and stratum corneum layer cells in CA;in keratin pearl peripheral and spinous layer cells in cancerized CA. Conclusion.. There was major expression of p16 protein in CA and cancerized CA, and these protein of the two groups might not naturally be the same. Our study indicated that in clinical practice, when major p16 protein expression in CA occurs, it's risk of cancerization shoud be suspected.
基金financed by the grant from Hebei Provincial Administration of Traditional Chinese Medicine,Traditional Chinese Medicine Research Plan in 2021 (No. 2021434)。
文摘1 Introduction A prevalent clinical dermatologic condition, chronic urticaria is characterized by urticaria lasting longer than six weeks and more than two episodes per week.1-2 Patients typically experience the abrupt onset of urticaria and itching on their face, limbs, and trunk.3 The disease has a quite complicated etiology.
基金Financially supported by Guangdong Key project Foun-dation (No. 99049), and Medical Research Foundation ofGuangdong Province (No. B2001100).
文摘Objectives: To understand genital ulcer disease(GUD) among patients attending sexually transmitteddisease (STD) clinics in Guangzhou, China, and itsassociation with HIV infection.Methods: Between September 9th, 1997 and Octo-ber 30th, 2002, 8 962 patients with STDs wereevaluated. 285 patients were diagnosed with GUD basedon clinical manifestations and microbiologic evalua-tions including dark field microscopy and serologytest for syphilis (RPR, TPPA). Swabs of each genitalulcer were processed in a multiplex PCR assay (M-PCR) for simultaneous detection of Herpes simplexvirus (HSV), Treponema pallium, and Haemophilusducreyi. Other STDs were classified by routine diag-nostic criteria, including microscopy or culture forNeisseria gonorrhoeae, Chlamydia trachomatis,Urea- plasma urealyticum, Human papillomavirus,Trichomonas, etc.Results: Of the 8 962 patients with STDs, the HIVseroprevalence in patients with and without GUD was1.75% (5/285) and 1.53% (133/8677), respectively,with no statistically significant difference (χ 2=0.09,P>0.05; OR=1.15, 95%CI=0.47-2.81) . HIVseroprevalence in patients with syphilis, genital her-pes and other STDs was 2.81% (22/784), 0.74% (6/814) and 1.49% (110/7 364), respectively. Prevalencein patients with syphilis was significantly higher thanthat in patients with genital herpes and other STDs,(χ 2=9.92, P<0.005, OR=3.89, 95%CI=1.67-9.05;χ 2=7.66, P<0.001, OR=1.90, 95%CI=1.21-3.00).Conclusions: The study shows that the HIV sero-prevalence in this population of patients with GUDis very low. The results also indicate an associationbetween syphilis and HIV infection. The relationshipbetween genital herpes and HIV infection needsfurther research.
文摘In the past decade,there has been increasing interest in whether a widespread childhood varicella immunization scheme may increase the age-specific incidence of herpes zoster in adults.This proposition is based on evidence that exposure to endemic varicella boosts varicella-zoster virus-specific immunity in adults and that cessation of varicella in the community would result in a decline in the T-cell-mediated immunity required to maintain dormancy of varicella-zoster virus in neurons.However,numerous epidemiological studies have failed to fully explore this effect.Quantifying the efficacy of the varicella vaccine is a crucial step in understanding its benefits.We conducted this review to quantify the efficacy of the varicella vaccine(HZ/su vaccine)which will contribute immensely to our understanding of how the vaccine benefits the population in prevention against the herpes zoster,especially during the outbreak of Covid-19.
文摘To the Editor:Livedoid vasculopathy(LV)is a thromboocclusive disorder involving superficial and mid-dermis vessels,characterized by painful erythematous or purpuric macules or papules,small crusted ulcers,and porcelainwhite atrophic scars that remain after several months.[1,2]Dermoscopy is a non-invasive and effective image analysis technology[3]that can aid dermatologists in visualization of the pigmentation pattern and vascular structure,as well as other morphologic features of the epidermis and dermis.This study was performed to identify the clinical and dermoscopic features of LV in patients with LV who were treated in our hospital from October 2017 to August 2018.The study was approved by the Ethical Committee of the First Affiliated Hospital of Zhengzhou University(No.2018-YB-05).The study was performed in accordance with the established guidelines and regulations.We have obtained all appropriate patient consent forms.In the form,the patients have given their consents for their images and other clinical information to be reported in the journal.
基金The work was supported by grants from Clinical Characteristics and Application Research of Capital, Beijing Municipal Science and Technology Commission (No. Z121107001012162)the National Natural Science Foundation of China (No. 81572675).
文摘Background: Compared with Caucasians, unique demographic and clinical features have been reported in Chinese patients with malignant melanoma, but similar comparative studies of melanocytic nevi (MN) are lacking. This study examined the clinical and dermoscopic features of MN in surgically treated Chinese cases. Methods: Clinical data and dermoscopic findings from 1046 cases of MN were collected and analyzed. Cases were treated from January 1 to December 31, 2014 at the Department of Dermatology and Venerology, Peking University First Hospital. The association between nevi location and histologic subtypes was examined with Chi-squared test and univariate logistic regression. Chi-squared test was also used to analyze the proportion of globular patterns across different body sites, and proportion of parallel furrow patterns across different histologic subtypes. Results: The majority of the nevi were from female patients, irrespective of location. The range of age at the time of nevi onset was from 0 (birth) to 79 years. There were 381 (36.4%, 381/1046) congenital nevi;of these 81.6%(311/381) were present at birth. Nevi appeared before 30 years of age in 83.2%(870/1046) of the cases. Median values of length growth rate in congenital and acquired MN were 2.0 and 1.6, respectively. Median values of length growth rates in four age groups (0–9, 10–19, 20–29, and ≥30 years) of congenital nevi were 2.2, 2.0, 2.4, and 2.0, respectively. In acral nevi, which often need to be differentiated from acral lentiginous melanoma, 50.2%(109/217) were junctional (odds ratio [OR];95% confidence interval [CI]: 91.572 [52.210–160.959], P < 0.05). Acral location was also associated with a higher likelihood of compound nevi subtype (OR [95% CI]: 14.468 [8.981–23.306], P < 0.05). The globular (59.4%, 354/596) and pseudonetwork (48.8%, 291/596) dermoscopic patterns were often seen in the head and neck region. In areas other than head and neck and acral regions, the globular pattern was the commonest pattern (34.8%, 71/204) regardless of age. Parallel furrow pattern occurred in 46.0%(87/189) of acral MN, followed by fibrillar pattern (21.7%, 41/189). Conclusion: Unique clinical and dermoscopic features exist in Chinese patients with MN compared with observations reported in other population.
文摘Introduction: Psoriasis is a chronic multi-systemic inflammatory skin disease that presents with erythema, thickness, and scaling of the skin. Genetic and environmental factors are associated with its etiology. Recently systemic immune inflammatory index, has been proposed as a biomarker for prognosis and severity prediction. Although it has been studied in psoriasis in general, no study exists for its association with the individual types of psoriasis. This study thus aimed to determine its association with clinical characteristics of psoriasis subtypes. Materials and Methods: Data were retrospectively retrieved from the hospital electronic medical database from January 2020 to August 2022. Only patients with CBC results were included. Clinical data retrieved were: Patients’ age, gender, type of psoriasis diagnosed, body mass index, duration of the disease, family history of psoriasis, history of smoking, diabetes, and hypertension records. Laboratory data retrieved were: Complete blood count (CBC), C-reactive protein, Immunoglobulin E (IgE), Total cholesterol, Triglycerides and Low-density lipoprotein cholesterol. Data were analyzed in SPSS and GraphPad prism. Results: The study enrolled 85 patients with psoriasis;56.47% males, and 43.53% females. 7.6% had psoriasis for less than 10 years, while 42.4% had the disease for more than 10 years. Psoriasis vulgaris was the most common diagnosis, 41.2%, followed by p. pustular, 30.6% and then p. erythroderma 28.2%. Mean age ± SD of the p. vulgaris, p. pustular and p. erythroderma patients were 47.3 ± 15.3;45.3 ± 14.6, and 57.1 ± 11.7 respectively. SII was significantly higher in p. pustular than the rest, (p Conclusion: In summary, systemic immune inflammatory index (SII) was significantly higher in psoriasis pustular than other subtypes of psoriasis, and had an association with hypertension in psoriasis pustular patients. These findings suggest a possible association between SII and psoriasis pustular that should be investigated in an independent study.
文摘Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0<sup>th</sup>, 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventative measure for postoperative atrial fibrillation in such cases.
文摘Acne inversa/hidradenitis suppurativa is a chronic,recurrent,inflammatory skin disease that affects the pilosebaceous units,causinfollicular occlusion.The etiology and pathogenesis of acne inversa/hidradenitis suppurativa involves internal and external factors such as genetic susceptibility,inflammation and immunity,microorganisms,obesity,and smoking.acne inversa/hidradenitis suppurativa is difficult to treat,and the current aim of treatment is to control the frequency and duration of disease flares and improve the quality of life.Treatment protocols for acne inversa/hidradenitis suppurativa should be selected based on the disease severity grade.Medical treatments include antibiotics,retinoids,biologics,immunosuppressive agents,and antiandrogen agents.Adjuvant treatments include surgery and laser/light therapies.This consensus aims to further standardize the diagnosis and treatment procedures of acne inversa/hidradenitis suppurativa in China to facilitate its diagnosis and treatment.
文摘Genetic factors predisposing individuals to Behet’s disease(BD) are considered to play important roles in the developmentof the disease. Patients with BD exhibit elevated levels of proinflammatory cytokines, and affected organs show a significant neutrophil and lymphocyte infiltration. Current evidence suggests that the activated lymphocytes contribute to neutrophil and endothelial cell activation in these patients. The cytotoxic T lymphocyte-associated antigen (CTLA)-4 molecule plays an important role in immune regulation by downregulating T-cell activation, and the CTLA-4 49A/G polymorphism in the exon 1 has been shown to be associated with a number of autoimmune diseases. In an attempt to demonstrate whether there is an association of the CTLA-4 49A/G polymorphism with BD in the Turkish population, we genotyped 59 Turkish patients and 99 healthy individuals for single-nucleotide polymorphisms. For this purpose, genomic DNA was obtained from the peripheral blood of individuals and the region of interest was amplified using PCR. Genotyping was performed using the BbvI restriction endonuclease. It was shown that the distribution of the CTLA-4 exon 1 49A/G allele and genotype frequencies did not differ between patientswith BD and healthy controls.However, allele and genotype frequencies of CTLA-4 49 A and A/A were significantly higher in patients with ocular involvement compared with patients without these symptoms (90.6%vs. 65.1%, odds ratio (OR) = 9.67, P = 0.011; and 81.25%vs. 39.5%,OR = 9.56, P = 0.015, respectively). A statistically significant difference in the A allele frequency was observed in patients with erythema nodosum-like lesions (86.1%vs. 65.8%, OR =6.24, P = 0.04). There was also an increase in A/A genotype frequency, but the difference was not statistically significant (72.2%vs. 41.5%, OR = 6.5, P = 0.068). Our data suggest that BD patients with ocular involvement and erythema nodosumlike lesions have a higher frequency of both the A allele and the A/A genotype at position 49 of exon 1 of CTLA-4. These results may also indicate that CTLA-4 is a disease-modifying rather than a susceptibility gene for BD.
文摘Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chronic urticaria as well as delayed urticarial dermographism. Pressure challenge gave rise to a deep weal covered by multiple vesicles and bullae after 24 h. Histological examination of a skin biopsy specimen obtained 24 h after pressure challenge demonstrated intraepidermal bullae filled with eosinophils accompanied by a dense, predominantly eosinophilic infiltrate in the dermis. Whereas the numbers and morphology of mast cells were unaltered, the extracellular deposition of eosinophil cationic protein revealed evidence for eosinophil activation. Concomitantly, both CD4+and CD8+T lymphocytes were present in the infiltrate and expressed interleukin 5. As bullous DPU may represent the maximal variant of DPU, the investigation of the cellular infiltrate and the chemokines/cytokines released may reveal potential pathogenic mechanisms. A possible effector role of eosinophilic granulocytes, T-cell subsets and mast cells is discussed.
文摘A prospective cohort study was undertaken to determine the clonal dynamics of Staphylococcus aureus colonization and infection during 1 y in children with atopic dermatitis, and to correlate specific clones, accessory gene regulator (agr) groups, and production of virulence factors with eczema activity. Eleven children were examined every 6 wk with swaps taken from active eczema, anterior nose, axillae and perineum, and scoring of eczema activity by severity scoring of atopic dermatitis (SCORAD). Individual S. aureus clonal types were identified and examined for production of superantigens, toxins, and were assigned to agr groups. S. aureus colonization patterns ranged from rare colonization over transient colonization to persistent colonization by a single clone or a dynamic exchange of up to five clones. Production of no single virulence factor including superantigens and toxins was significantly associated with exacerbation of eczema. In four children there was a shift between visits in agr group of colonizing clones. These shifts were associated with an increased SCORAD value of 19 (SE = 7, p = 0.009). Change of clones belonging to the same agr group was not associated with a higher SCORAD value. In 11 of 12 cases with two different clones co-colonizing a child the clones belonged to the same agr group. In conclusion, this limited group of children with atopic dermatitis showed highly variable colonization patterns of S. aureus, and communication between strains by use of agr encoded octa peptides appeared to be active in vivo. Increased severity of eczema was related to a change in agr group and may have been because of inflammation triggered by the takeover of an antigenically different clone, as agr groups represent ancient phylogenetic lineages.
文摘Sirolimus is a new immunosuppressive agent used to prevent rejection in renal allograft recipients in order to reduce the need of potentially nephrotoxic calcineurin inhibitors (cyclosporine, tacrolimus). The cutaneous side effects of sirolimus are not well known and they may have been underestimated. We report 2 cases of follicular acneiform eruptions induced by sirolimus in renal allograft recipients. This dermatologic complication was severe and difficult to treat, and resolved only after discontinuation of sirolimus.
文摘Having considered the impact of the function of TLR2 in there cognition of several microorganisms that are thought to havean association with disease(BD),we aimed to determinea possible association between the TLR2 Arg753Gln polymorphism and susceptibility to BD.We genotyped 83 patients with BD,95 ethnically matched healthy controls,12patients with recurrent aphthous stomatitis(RAS)and 21 patientswith rheumatoid arthritis(RA)by restriction fragment length polymorphism after PCR amplification of the genomicregion encompassing the polymorphic site.Comparison of the TLR2 Arg753Gln A allele and A/G genotype frequencies did not show a significant difference between patients with BD andhealthy controls(1.2%vs.0.6%,and 2.1%vs.1.1%,respectively).None of the patients from the RAS and RA groups had the A allele or A/G genotype.Our results indicate that the TLR2 Arg753Gln polymorphism does not play a role in the aetiopathogenesis of BD.
文摘Background Despite modern advances in medical science and in the social attitude of people,vitiligo on exposed areas still is a stigmatizing condition leading to serious psychological problems in daily lives of the victim.Treatment of vitiligo is difficult and prolonged and despite the advancement made in the field of vitiligo surgery over the past four decades,cutaneous surgeons still struggle to select among various surgical modalities which have a promising outcome.The basic principle of all the available surgical techniques as well as their advantages and disadvantages have been reviewed.Objective The purpose of this review is to find out if we can select a proper method of surgical modalities available to treat a vitiliginous area depending on the size and distribution of the lesions in order to achieve the best possible cosmetic results.Methods This article is based on a review of various articles regarding vitiligo and its emerging surgical treatments.Conclusion Although the treatment of vitiligo keeps on changing with new developments available,discussing the present surgical modalities available for treating vitiligo along with their limitations and advantages provides with great medical knowledge about the disease and its treatment.
文摘Background：PM2.5 （aerodynamic diameter ≤ 2.5 μtm） is a dominant and ubiquitous air pollutant that has become a global concern as PM2.5 exposure has been linked to many adverse health effects including cardiovascular and pulmonary diseases.Emerging evidence supports a correlation between increased air PM2.5 levels and skin disorders although reports on the underlying pathophysiological mechanisms are limited.Oxidative stress is the most common mechanism of PM2.5-induced adverse health effects.This study aimed to investigate PM2.5-induced oxidative damage and apoptosis in immortalized human keratinocyte （HaCaT） cells.Methods：HaCaT cells were exposed to 0,25,50,100,or 200 μtg/ml PM2.5 for 24 h.Reactive oxygen species （ROS） generation,lipid peroxidation products,antioxidant activity,DNA damage,apoptotic protein expression,and cell apoptosis were measured.Results：PM2.5 exposure （0-200 μtg/ml） for 24 h resulted in increased ROS levels （arbitrary unit：201.00 ± 19.28,264.50 ± 17.91,305.05 ± 19.57,427.95 ＋ 18.32,and 436.70 ± 17.77） and malondialdehyde production （0.54 ± 0.05 nmol/mg prot,0.61 ± 0.06 nmol/mg prot,0.68 ± 0.05 nmol/mg prot,0.70 ± 0.05 nmol/mg prot,and 0.76 ± 0.05 nmol/mg prot）,diminished superoxide dismutase activity （6.47 ± 0.28 NU/mg prot,5.97 ± 0.30 NU/mg prot,5.15 ± 0.42 NU/mg prot,4.08 ± 0.20 NU/mg prot,and 3.76 ± 0.37 NU/mg prot）,and increased DNA damage and apoptosis in a dose-dependent manner in HaCaT cells.Moreover,cytochrome-c,caspase-3,and caspase-9 expression also increased proportionately with PM2.5 dosing.Conclusion：PM2.5 might elicit oxidative stress and mitochondria-dependent apoptosis that likely manifests as skin irritation and damage.
