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Objective To evaluate the clinical efficacy and safety of adalimumab for the treatment of severe psoriasis.Methods Between December 2015 and August 2017,14 patients with severe psoriasis who showed no response to traditional therapy were enrolled into this study.All the patients received subcutaneous injection of adalimumab at an initial dose of 80 mg,which decreased to a dose of 40 mg once every 2 weeks after l-week treatment.At week 4,8 and 12,the psoriasis area severity index (PASI)and physician's global assessment (PGA) scores were recorded,and clinical efficacy and adverse drug reactions were observed.In patients with psoriatic arthritis,the improvement of arthritis was evaluated according to the American College of Rheumatology 20％ response criteria (ACR20).Results All the 14 patients received the drug treatment for at least 12 weeks.At week 4,8 patients achieved 50％ reduction in PASI (PASI 50).At week 8,8 patients achieved PASI 75,and 2 of the 8 patients achieved PASI 90.At week 12,14 patients achieved PASI 75,7 of them achieved PASI 90,and 3 of them achieved PASI 100.Before the treatment,the average PGA score of the 14 patients were 4.92 ± 0.02,and decreased to 1.21 ± 0.02 at week 12.The arthritis symptom was markedly improved in the 3 patients with psoriatic arthritis.At week 8,2 patients achieved ACR20,and 3 achieved ACR20 at week 12.There were no serious adverse drug reactions such as serious infections and malignant tumors in any of the patients.Urticaria occurred in 3 patients,and was relieved after antihistamine treatment.Conclusion Subcutaneous injection of adalimumab every other week is markedly effective and safe for the treatment of severe psoriasis with few adverse drug reactions,and it provides a new treatment choice for patients with severe psoriasis who show no response to traditional therapy.
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Objective To evaluate the reliability and clinical practicality of colony PCR in rapid detection of pathogenic fungi causing tinea capitis.Methods Totally,17 children with tinea capitis were enrolled from the Department of Dermatology of Wuxi No.2 People's Hospital between January 2016 and March 2017.Colony PCR was performed to detect pathogenic fungi.The results of colony PCR were compared with those of routine PCR and morphological identification,so as to evaluate the reliability of colony PCR in the identification of pathogenic fungi causing tinea capitis.Results After clinical specimens (broken hairs and scales) from the 17 patients were subjected to fungal culture,the mycelia were collected and successfully amplified by colony PCR.The time of clony PCR (mean,3.82 ± 0.50 days) for DNA template preparation was short than that of traditional morphological identification (14 days).Based on the results of conventional PCR,the accuracy of colony PCR for fungal identification was 100％,which was superior to that of conventional PCR (88.2％).Conclusions Colony PCR can be applied to the clinical detection of pathogenic fungi causing tinea capitis at specy level,and is a kind of rapid,economic and reliable molecular detection technique.
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Objective To investigate changes of thyroid function indices and their correlation with blood routine examination results, high-sensitivity c-reactive protein(hsCRP)levels and erythrocyte sedimentation rate(ESR)in 30 inpatients with acute urticaria. Methods Thyroid function indices were retrospectively analyzed in 30 inpatients with acute urticaria (patient group)and 30 healthy controls (control group), including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin antibody(TG-Ab)and anti-thyroid peroxidase antibody(TPO-Ab). A correlation analysis was done between thyroid function indices and blood routine examination results (white blood cell [WBC]count, neutrophil count, hemoglobin), hsCRP levels and ESR. Results Abnormal thyroid function indices were observed in 23 (23/30, 76.7%) patients with acute urticaria. Compared with the control group, the patient group showed significantly decreased levels of FT3, TT3, TT4 and hemoglobin(t = 6.39, 5.55, 3.57, 3.70, all P < 0.01), but significantly increased positive rates of thyroid autoantibodies (χ2 = 7.68, P < 0.01)as well as WBC counts, neutrophil counts, hsCRP levels and ESR (t = 3.96, 8.73, 2.51, 2.35, all P < 0.05). There was a positive correlation between hemoglobin level and FT3, TT3, TT4 levels(r = 0.63, 0.59, 0.37, all P < 0.05), but a negative correlation between neutrophil count and FT3, TT3, TSH levels(r = -0.45,-0.50, -0.37, all P < 0.05), as well as between TT3 and hsCRP levels (r = -0.39, P < 0.05)in the patient group. Conclusion Patients with severe acute urticaria usually show abnormal thyroid function during attacks, which mainly manifests as low T3 syndrome and high positive rates of thyroid autoantibodies, and may be associated with decreased hemoglobin levels and infection.
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Objective To analyze the expression characteristics of annexin A2 in dermal papilla cells (DPCs) with aggregative behavior.Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot were performed to measure the mRNA and protein expressions of annexin A2 respectively in DPCs with or without aggregative behavior.Results The mRNA expression level of annexin A2 was significantly higher in DPCs with aggregative behavior than in those without aggregative behavior (0.50 ± 0.15 vs.0.35 ± 0.19, t =8.26, P ＜ 0.05).Western blot showed that annexin A2 had two isoforms, including one isoform with a relative molecular mass of 40 000 and the other one with a relative molecular mass of 36 000.The annexin A2 isoform with a relative molecular mass of 40 000 was highly expressed in both DPCs with aggregative behavior and those without aggregative behavior, while the other isoform was only expressed in DPCs with aggregative behavior.Conclusion Annexin A2 may be closely related to the aggregative growth of DPCs.
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Objective To study the expression ot secreted proteins in aggregated dermal papilla cells (DPCs).Methods DPCs were isolated from human scalp tissue and subjected to primary culture and subculture.Aggregated and non-aggregated DPCs served as the subject of this study.Secreted proteins were prepared from these cells and subjected to two-dimensional polyacrylamide gel electrophoresis.Differentially expressed proteins were screened by the PDQuest image analysis software.Protein spots were digested and identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry,and finally analyzed using the National Center for Biotechnology Information (NCBI) non-redundant (Nr) protein database.Results Two-dimensional electrophoresis maps with good repeatability and high resolution were established.Image analysis of 2-D gels revealed that the average number of detected protein spots was 1 134 ± 52 and 1 078 ± 36 in aggregated and nonaggregated DPCs respectively,and the majority of these protein spots were matched between aggregated and nonaggregated DPCs.Twenty-eight protein spots showed more than 5-fold difference between the two groups of cells,and 10 proteins were preliminarily identified as differentially expressed proteins by peptide-mass fingerprinting.Of these differentially expressed proteins,8 proteins including Rhogdi 1,filamin A,cystatin C,fibronectin,cyclophilin A,procollagen C proteinase enhancer 1,tissue inhibitor of metalloproteinase and tissue inhibitor of metalloproteinase-2 were up-regulated,and 2 proteins including neuropolypeptide h3 and matrix metalloproteinase-3/tissue inhibitor of metalloproteinase-1 complex were down-regulated in aggregated DPCs compared with non-aggregated DPCs.Conclusions Differentially expressed proteins between aggregated and non-aggregated DPCs are mainly implicated in cell signaling pathway,cellular proliferation and differentiation,extracellular matrix synthesis and degradation,and so on.
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Objective To compare the short-term efficacy of high-intensity ultraviolet B (UVB) versus 308-nm excimer laser for the treatment of vitiligo.Methods Eighty patients with vitiligo were equally divided into two groups to be treated with high-intensity UVB twice a week or 308-nm excimer laser once a week for eight weeks.Repigmentation was evaluated at the end of the treatment.Results After eight weeks of treatment,repigmentation of different degrees was observed in 83.6％ and 86.1％,and marked repigmentation in 42.1％ and 50％,of the UVB-and excimer laser-treated lesions,respectively.The response rate was significantly lower in facial lesions receiving high-intensity UVB radiation than in those receiving excimer laser radiation (49.1％ vs.68.4％,x2 =4.32,P ＜ 0.05),but similar at the other body sites between the two treatment (all P ＞ 0.05).The cumulative dosage required for initial repigmentation was similar between high-intensity UVB and 308-nm excimer laser (t =0.89,P ＞ 0.05),while the treatment sessions and cumulative dosage required for marked or better repigmentation were significantly increased in UVB-compared with excimer laser-treated lesions (both P ＜ 0.01).In addition,both high-intensity UVB and 308-nm excimer laser were suitable for childhood and active vitiligo.Conclusions Both high-intensity UVB and 308-nm excimer laser are safe and effective in the treatment of vitiligo with rapid onset of action,and the latter appears to be superior to the former in efficacy.
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A 26-year-old woman presented with scaly atrophic erythema on the chest and abdomen for nearly 2 years.Direct microscopic examination of the lesion scrapings revealed numerous stubby hyphae and clustered spores.Periodic acid-Schiff (PAS) staining of the biopsy tissue showed the presence of numerous hyphae and spores in the horny layer.The stain for elastic fibers revealed that the number of elastic fibers decreased,and some elastic fibers became fine and disrupted.The patient was diagnosed with atrophying pityriasis versicolor.The lesions subsided and direct microscopic examination was negative after 1-week treatment with oral itraconazole of 200 mg once daily and 4-week treatment with topical 2％ sertaconazole cream.
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Objective To determine contact allergens and their clinical significance in patients with dermatitis or eczema in Wuxi city.MethodsPatch test was conducted in 1065 patients with a clinical diagnosis of dermatitis or eczema.A statistical analysis was carried out.Results Positive patch test reactions were observed in 83.19％ of the patients,with no statistical differences in the frequency of positive patch test reactions between female and male patients or between patients of different age groups.The most frequent 6 allergens were potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix in these patients.Female patients showed a higher frequency of positive patch test reaction to nickle sulfate and formaldehyde,but a lower frequency to potassium dichromate and carba mix compared with male patients (all P＜ 0.01 ); young,middle-aged,and old patients exhibited an increased frequency of positive reaction to cobaly chloride compared with child patients,while young and middle-aged patients showed a decreased frequency to nickel sulfate compared with child patients (all P ＜ 0.05).Conclusion Potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix are the main allergens causing dermatitis and eczema in Wuxi city.
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ObjectiveTo observe clinical features and identify causative genes of reticulate pigmented anomaly of the flexures in a pedigree.Methods A survey was conducted in a pedigree with reticulate pigmented anomaly of the flexures.Clinical manifestations were recorded in details for each patient in this pedigree.Tissue specimen was obtained from the proband for histopathological examination and ultrastructural observation.Mutation scanning was carried out by PCR and direct sequencing in 3 patients in the family.ResultsAll the patients in this pedigree presented with reticular pigmentation of the flexures and idiopathic guttate hypomelanosis on the abdomen and back.Histopathological and ultrastructural study revealed epidermal hyperpigmentation with an increase in melanin content in epidermal keratinocytes but no changes in the number of melanocytes.No mutation was found in the KRT5 gene in this family.ConclusionsThis is the first case report of reticulate pigmented anomaly of the flexures associated with idiopathic guttate hypomelanosis.No mutation is identified in the KRT5 gene of patients with reticulate pigmented anomaly of the flexures in this family,indicating the existence of other causative genes.
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<p><b>OBJECTIVE</b>To identify the mutation in the keratin 6A(K6A) gene in a pedigree with pachyonychia congenita type I (PC-I).</p><p><b>METHODS</b>Blood samples were obtained from 2 affected, 3 unaffected members in this family, and 100 unrelated healthy individuals. Mutation detection was carried out by PCR amplification of the K6A gene and direct DNA sequencing.</p><p><b>RESULTS</b>A heterozygous mutation of T--> C transition at position 521 in exon 1 of the K6A gene was found in the 2 affected, but not in the unaffected members and 100 unrelated healthy individuals.</p><p><b>CONCLUSION</b>The mutation of 521T--> C in the K6A gene is the disease causing mutation in this PC-I family.</p>
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Adult , Child , Child, Preschool , Female , Humans , Male , Base Sequence , Keratin-6 , Genetics , Molecular Sequence Data , Pachyonychia Congenita , Genetics , Pedigree , Point MutationABSTRACT
Objective To investigate the relationship of fascin-1 protein expression with the metastasis of basal cell carcinoma and squamous cell carcinoma. Methods Skin specimens were obtained from 10 normal human controls, 13 patients with basal cell carcinoma (8 nodular variant and 5 superficial variant) and 24 patients with SCC (11 SCC in situ and 13 invasive SCC). Immunohistochemical staining was performed to analyze the expression of fascin-1 protein. The staining results were quantitatively assessed with computer image analysis system (Image-pro Plus 6.0). Results The optical density of fascin-1 averaged 0.1152±0.04574 in SCC in situ, 0.1257±0.03096 in invasive SCC, and 0.0293±0.00981 in normal controls; the expression of fascin-1 was significantly higher in SCC tissue than in normal control skin (both P<0.05). Increased optical density was also observed for fascin-1 in nodular variant of SCC (0.0808 ±0.05642) and superficial variant of SCC (0.0806±0.04346) compared with the normal controls, whereas no statistical difference was observed between nodular and superficial variant of SCC. Conclusion In BCC and SCC, there is an over expression of fascin-1, which may be linked to the local invasion of carcinoma,
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Objective To investigate the clinical, histopathological and immunopathological charac teristics of erythema annulare centrifugum (EAC). Methods A retrospective study was performed on 54 cases of EAC collected from 2001 to 2005. Information was gathered about patients' sex, age, disease course, distribution and morphology of eruptions, symptoms, complications. Also, the findings of histopathology and direct immunofluorescence examination in some patients were evaluated. Remits EAC most commonly occurred on the lower limb, and was usually complicated by various diseases among which mycosis predominated. Histological examination revealed compact lymphocyte infiltration in dermal vessels in 32 of these 54 patients. Direct immunofluorescence showed the deposition of IgG, lgM, or C3 on the walls of small vessels in 6 of 12 tissue samples tested. Conclusions EAC is a multifactorial disease, and it seems that the infiltration of lymphocytes and deposition of circulatory immune complex on small blood vessels in dermis may play important roles in its pathogenesis.
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Objective To analyse the mutation of K17 gene in a pedigree with steatocystoma multi-plex. Methods Blood samples were obtained from 3 affected and 3 normal individuals in a family with steatocystoma multiplex, as well as from 50 unrelated healthy individuals. Mutation scanning was carried out by PCR and direct sequencing. Results A heterozygous nucleotide transition (C→T) at position 428 in exon 1 of KI7 gene, which leads to the substitution of CGC (arginine) by TGC (histidine) at codon 94, was detected in the affected individuals, but not in normal family members or the 50 unrelated individuals. Conclusion A missense mutation (428C→T) in KI7 gene has been detected in affected individuals of this family, which seems to be a molecular basis of pathogenesis of steatocystoma multiplex.
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0.05).Conclusions The SCIO system is practical to assess the therapeutic effects of itraconazole and terbinafine for patients with onychomycosis.Treatment of onychomycosis with the two drugs is equally effective and safe.
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Objectives To develop a rapid genotyping method of clinical isolates of Malassezia from patients with tinea versicolor by PCR-RFLP,and to evaluate reliability of the approach as compared with biochemical classification.Methods Tween assimilation test and catalase reaction were carried out to identify 74 isolates of Malassezia species from patients with tinea versicolor and 7 Malassezia reference strains.The sequence of 28S rDNA of Malassezia species was amplified by PCR,and then the product was analyzed by RFLP with Eco88I,Bsp143Ⅱ and BshNⅠ,respectively.Results M.restricta,M.obtusa and M.pachydermatis were successfully identified by three restriction endonucleases.M.restricta was found to be more diverse from the other 6 species in genetic homology.By comparison with PCR-RFLP technique,a possible mistake was discovered with biochemical method.Conclusion PCR-RFLP is a promising molecular biological technique,which could rapidly and correctly classify Malassezia species.
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Objective To study the chemical components in Rabdosia excisoides.Methods The isolation and purification were carried out on silica gel column chromatography,the chemical structures were determind by physico-chemical properties and spectral analysis.Results Two compounds were isolated from R.excisoides and their structures were identified,one was named as excisoidesin A(Ⅰ),a new diterpenoid and the other was a known compound,oleanolic acid(Ⅱ).Conclusion Excisoidesin A is a new diterpenoid.