Gene therapy for recessive dystrophic epidermolysis bullosa / 中华皮肤科杂志

Recessive dystrophic epidermolysis bullosa (RDEB) is caused by loss-of-function mutations in the COL7A1 gene encoding the α-1 chain of type Ⅶ collagen, leading to reduced or absent expression of basement membrane type Ⅶ collagen (C7) . Currently, there is no effective treatment for this rare disease, and the management is mainly palliative and supportive. Gene therapy is expected to be an effective treatment of RDEB. This review summarizes current strategies of gene therapy in clinical trials for RDEB, as well as their progress, pros and cons, and prospects.

Analysis of factors associated with skin lesion distribution in 1 125 patients with non-segmental vitiligo / 中华皮肤科杂志

Objective To analyze correlations of the distribution of non-segmental vitiligo lesions with gender,age of onset,duration of disease,personal and family history of autoimmune diseases,family history of vitiligo,and so on.Methods Clinical data were collected from 1 125 patients with confirmed nonsegmental vitiligo in Department of Dermatology,Beijing Hospital from January 2009 to January 2019,and analyzed retrospectively.Statistical analysis was carried out with SPSS 20.0 software by using independentsample t test and chi-square test.Results Of the 1 125 patients with non-segmental vitiligo,599 were males and 526 were females,with a male-to-female ratio of 1.14:1.Their age of onset was 27.9 ± 17.1 years,and duration of disease was 5.2 ± 8.0 years.Skin lesions mostly occurred on the trunk (544 cases,48.4％) and face (535 cases,47.6％),followed by acral regions (430 cases,38.2％),extremities (297 cases,26.4％) and neck (231 cases,20.5％).The perioral region (17.2％),hands (47.9％) and genital region (14.5％) in the 599 male patients were more frequently affected than those in the 526 females (9.7％,22.6％,6.3％,x2 =13.33,77.66,20.01,respectively,all P ＜ 0.001),while the neck (27.0％) was more frequently affected in the female patients than in the male patients (14.9％,x2 =25.29,P ＜ 0.001).The age of onset was significantly lower in the patients with vitiligo lesions involving the legs,knees,feet,trunk,genital and periocular regions than in those without skin lesions on the above corresponding body sites (all P ＜ 0.05),but significantly higher in the patients with vitiligo lesions involving the arms and hands than in those without lesions on the above 2 sites (both P ＜ 0.05).Vitiligo lesions more likely occurred on the hands of patients with a personal or family history of autoimmune thyroid diseases compared with those without the personal or family history (50.0％ vs.27.9％,x2 =6.62,P =0.010).The trunk was more frequently affected in the patients with a family history of vitiligo than in those without (59.6％ vs.45.7％,x2 =13.36,P ＜ 0.001).Conclusion The distribution of non-segmental vitiligo lesions are correlated to some extent with gender,age of onset,personal and family history of autoimmune diseases and family history of vitiligo.

Clinical analysis of 11 cases of vulvovaginal-gingival syndrome / 中华皮肤科杂志

Objective To investigate clinical features and therapeutic protocols of vulvovaginal-gingival syndrome(VVGS). Methods Clinical data were collected from 11 female patients with VVGS and analyzed. Results Among the 11 patients, the mean and median ages at a definite diagnosis of VVGS were both 46 years, and the average disease duration was 4 years. Painful erosive erythema was found on the vaginal vestibule in 7 patients, on the gingiva in 10, as well as on the bilateral buccal mucosa in 5. Additionally, 8 and 4 patients reported dyspareunia and vaginal hemorrhage, respectively. Seven patients were treated with low-dose oral methylprednisolone combined with hydroxychloroquine or colchicine, and the other 4 were treated with oral hydroxychloroquine alone. Furthermore, all of the 11 patients applied topical tacrolimus 0.1%ointment. Finally, 8 patients were cured or markedly improved. No obvious adverse reactions were observed in any of the patients. Conclusions VVGS mostly occurs in middle-aged women, with the vaginal vestibule and gingiva as predilection sites of painful erythema and dyspareunia as common symptoms. Patients have good responses to methylprednisolone combined with hydroxychloroquine, and hydroxychloroquine alone also shows good efficacy in patients with mild VVGS. Tacrolimus 0.1%ointment can be one of drugs for topical maintenance treatment of VVGS.

Clinical analysis of elderly type 2 diabetes mellitus patients with skin complications / 中华老年医学杂志

Objective To analyze the prevalence and characteristics of skin diseases in elderly patients with type 2 diabetes mellitus (T2DM).Methods Clinical out patient records for both elderly and non-elderly individuals with T2DM were collected from the dermatology department of Beijing Hospital.Statistical comparisons were performed between the elderly group and the non-elderly group on the prevalence of common skin complications and disease characteristics.Analysis was performed in the elderly group to identify any association of common skin disorders with gender,age,duration of T2DM,or level of glycosylated hemoglobin (HbA1c).Results Among 679 elderly T2DM cases,pruritus was the most common complication (26.1％),followed by eczema (21.t ％) and tinea pedis/onychomycosis (18.3％).Pruritus was more prevalent in the elderly group (177 cases,26.1％) compared to the non-elderly group (34 cases,9.8％) (x2 =6.006,P＜0.01).On the other hand,tinea pedis/onychomycosis was less prevalent in the senior group (124 cases,18.3 ％) than in the non-senior group (112 cases,32.2 ％) (x2 =37.437,P＜0.01).In the senior group,pruritus was more prevalent among male patients (105 out of 358 cases,29.3％) than among female patients(72 out of 321 cases,22.4％) (x2 =4.181,P =0.041).On average,patients with eczema were older[(72.3 ± 2.2)years] and had a longer history of T2DM [(8.3 ± 0.3)years] compared with patients without eczema[age:(65.2±1.9)years,history of T2DM:(5.2±0.1)years] (t=1.250,P=0.023 for age;t=1.680,P=0.033 for disease duration).Patients with tinea pedis/onychomycosis had higher HbA1c levels (6.7 ± 0.4) ％ than patients without tinea pedis/onychomycosis (6.1 ± 0.3) ％ (t =0.790,P＜0.01).Conclusions Pruritus is the most common skin complication in elderly patients with type 2 diabetes and is more common in elderly patients and male patients.Risk factors for developing eczema in elderly patients with type 2 diabetes may include older age and long disease duration.High levels of glycosylated hemoglobin in elderly patients with type 2 diabetes indicates increased risk for foot fungi infections.

Correlation of personality characteristics and quality-of-life in patients with chronic urticaria / 中华全科医师杂志

WHO quality-of-life scales (WHOQOL-BREF) and Eysenck personality questionnaire (EPQ) were used for evaluating the quality-of-life and personality characteristics of 60 outpatients with chronic urticaria.According to statistical correlation analysis, a positive correlation existed between education level and psychological field (P ＜ 0.05).And there were negative correlations between N scale, P scale and psychological field (P ＜ 0.05, P ＜ 0.01).The incidence and incurability of chronic urticaria was more correlated with anxiety and depression.The patients with chronic urticaria were more likely to have a worse quality-of-life than normal population.

Clinical efficacy of 0.1％ tacrolimus ointment combined with paroxetine for the treatment of neurodermatitis / 中华皮肤科杂志

ObjectiveTo evaluate the clinical efficiency of 0.1％ tacrolimus ointment combined with paroxetine in patients with neurodermatitis associated with insomnia.MethodsTotally,74 patients suffering from neurodermatitis and insomnia were consecutively enrolled in this study,and randomly assigned into the combination group and control group according to their number(odd or even).Both groups were given topical 0.1％ tacrolimus ointment twice a day,and the combination group was additionally given oral paroxetine 10 mg once a day,for 8 weeks.The outcome parameters included main symptoms of neurodermatitis and Pittsburgh sleep quality index(PSQI) score.ResultsNo significant difference was observed in the cure rate (54.3％(19/35) vs.53.1％ (17/32),P＞ 0.05) or response rate (82.9％ (29/35) vs.81.3％ (26/32),P＞ 0.05),between the combination group and control group.PSQI score was significantly lower in the combination group than in the control group after 8 weeks of treatment(P ＜ 0.05).ConclusionsThe 0.1％ tacrolimus ointment can be used to treat neurodermatitis safely.Antianxiety treatment can reduce the recurrence of neurodermatitis associated with insomnia,and improve the quality of sleep in patients.

Clinical efficacy of ALA-PDT in the treatment of condyloma acuminatum / 中华皮肤科杂志

Objective To evaluate the clinical efficacy of 5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) in the treatment of condyloma acuminatum. Methods Thirty-six cases of condyloma acuminatum were treated with ALA-PDT. Results After the treatment, 33 (91.67%) patients were cured, 35 (97.22%) improved. Relapse occurred in 3 (8.33%) patients. Side effects were noted in 2 (5.56%) patients. Conclusions ALA-PDT is a relatively simple, effective and safe treatment with a lower recurrence rate for condyloma acuminatum, especially for small skin lesions or lesions at specific area. However, the high expense required for multiple treatments with ALA-PDT may restrict its application.

Clinical analysis on 826 cases of vitiligo / 中华全科医师杂志

We retrospectively reviewed the clinical data of 826 cases with vitiligo treated in Beijing Hospital from 1998 to 2008. Most of patients present vitiligo in early age;20. 6% patients had positive family history. There were 44. 12 %, 41.18% and 10. 00 % of patients with vitiligo in their first, second and third degree relatives, respectively. Patients with family history had an earlier onset than those without a family history ( t = 1.97, P < 0. 05 ). Vitiligo vulgaris was found in 91.40 % patients. The most common affected site was head and face (31.5%) ;8. 1% of the patients was associated with other autoimmune diseases, including thyroid diseases, diabetes. There were more females than males in patients aged below 14. The child patients were more likely to present with Koebner' sign and halo nevus than the elder ones (P<0.05).

A clinical analysis of the predisposing factors for toenail onychomycosis in the elderly / 中华老年医学杂志

Objective To evaluate the susceptibility to toenail fungal infection (FI) in the elderly. Methods Two hundred patients with toenail FI aged 60 years or older from 2005 to 2007 in our hospital were collected in our study, including one hundred elderly patients with toenail fungal infection (case group) and one hundred elderly patients without toenail fungal infection (control group). The clinical data of the patients in two groups were analysed. Results In case group, diabetes mellitus was the most common complication, accounting for 24% (24/100), while there were only 6 cases with diabetes mellitus (6%) in control group (P<0. 05). In case versus control group, there were 31 cases vs 12 cases with lower extremity varicose vein (P<0. 05), and 36 cases vs 19 cases with foot deformity, 11 cases vs 3 cases with toenail onychomychosis following trauma of their toes (P<0.05) ,32 cases vs 12 cases with history of wearing tight shoes (P<0. 05). In case group, 12 of 47 female patients used to wear high-heel shoes. Conclusions Toenail trauma, foot malformation, lower extremity varicose vein and diabetes mellitus are predisposing factors for toenail onychomycosis in the elderly.

Study on the Correlation Between Depression,Anxiety and Chronic Urticaria / 中华皮肤科杂志

14)than those of group C(3.3%,P 17)than group C(6.7%,P0.05).Conclusion The onset and delayed cure of some chronic urticaria may be related to anxiety and depression.