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Imatinib mesylate is the first-line drug for the treatment of chronic myeloid leukemia and malignant gastrointestinal stromal tumors, and causes mucocutaneous adverse reactions at a high frequency. Based on Chinese and international literature, the authors comprehensively describe various mucocutaneous symptoms induced by imatinib mesylate, and summarize their pathogenesis and management strategies, aiming to help dermatologists improve their understanding of mucocutaneous adverse reactions to this drug, and provide timely diagnosis and treatment.
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OBJECTIVE：To investigate the effects and its mechanism of pseudostrychnine on the apoptosis of human colon can - cer HT- 29 cells. METHODS ：Human colon cancer HT- 29 cells were randomly divided into blank group ，pseudostrychnine low-dose，medium-dose and high-dose groups （125，250，500 μmol/L）. They were cultured with culture medium without medicine or relevant concentration of pseudostrychnine for 48 h. The cell apoptosis and mitochondrial transmembrane potential were detected by flow cytometry. Western blotting assay was employed to detect the protein expression of P 53，Caspase-3，Caspase-9，DNA re - pair enzyme from rabbit （c-PARP）and Bcl- 2. RESULTS ：Compared with blank group ，apoptotic rate of cells was increased signifi - cantly in pseudostrychnine low-dose ，medium-dose and high-dose groups ，while mitochondrial transmembrane potential was de - creased significantly （P＜0.01），in concentration-dependent manner. The protein expression levels of P 53，Caspase-3，Caspase-9 and c-PARP were increased in pseudostrychnine medium-dose and high-dose groups ，compared with blank group ；while those of Bcl-2 were decreased significantly in pseudostrychnine low-dose ，medium-dose and high-dose groups （P＜0.05 or P＜0.01）. CON - CLUSIONS：Pseudostrychnine may change mitochondrial membrane potential by up-regulating the protein expression of P 53 and down-regulating the protein expression of Bcl- 2，and activate the expression of Caspase- 3，c-PARP and Caspase- 9，so as to acti - vate endogenous mitochondrial pathway and promote the apoptosis of HT- 29 cells.
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Objective:To analyze changes in melanocyte density and epidermal thickness in vulvar lichen sclerosus (VLS) lesions.Methods:Vulvar skin tissues were collected from 15 adult female patients with VLS in Department of Dermatology, Beijing Hospital from June to December in 2018. According to pathological manifestations, 15 skin lesions were divided into early-stage VLS group ( n = 7) and late-stage VLS group ( n = 8) , and subjected to immunofluorescent staining. Then, density of melanocytes, and thickness of the whole epidermis and cell layers (from the bottom of the stratum corneum to the bottom of the basal layer) were calculated by using an image analysis software. Normal vulvar skin tissues were obtained from 15 healthy adult females after vulvar plastic surgery in Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and served as control group. Results:The density of melanocytes in the epidermis was significantly lower in the early-stage VLS group (0.170 ± 0.071) and late-stage VLS group (0.110 ± 0.035) than in the control group (0.275 ± 0.036; F = 36.426, P < 0.001) . There was no significant difference in the thickness of the whole epidermis among the early-stage VLS group (203.682 ± 137.997 μm) , late-stage VLS group (150.020 ± 70.914 μm) and control group (194.030 ± 82.996 μm; F = 0.738, P = 0.487) . The thickness of cell layers did not differ between the early-stage VLS group (154.603 ± 121.984 μm) and control group (176.974 ± 80.296 μm; P = 0.899) , but was significantly thinner in the late-stage VLS group (83.455 ± 37.129 μm) than in the control group ( P = 0.003) . Conclusions:The density of epidermal melanocytes decreased in the early-stage and late-stage VLS skin lesions. Compared with the normal skin tissues, the early-stage VLS lesions showed no significant changes in the thickness of the whole epidermis and cell layers, but the late-stage VLS lesions showed decreased thickness of cell layers.
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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.
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Objective To investigate clinical features of vulvar lichen simplex chronicus (VLSC).Methods Clinical data were collected from 137 VLSC patients who visited a Vulvar Clinic in the Department of Dermatology,Beijing Hospital from 2017 to 2018,and analyzed retrospectively.Non-normally distributed measurement data (age and disease duration) were described as median (P25,P75),and analyzed by using rank sum test,and enumeration data were compared by using chi-square test.Results Among the 137 patients with VLSC,the age at onset was 32.0 (25.5,40.0) years,and the disease duration was 36.0 (15.0,72.0) months.Thirty-two (23.4％) patients had a history of atopic diseases,and the age at onset of VLSC was significantly lower in these patients with a history of atopic diseases (29.5 [25.0,35.8]years) than in those without a history of atopic diseases (33.0 [27.0,41.0] years,Z =2.03,P =0.042).The most frequently involved site was the labia majora (130/137,94.9％),and the labia minora was rarely involved (13/137,9.5％).Bilateral lesions were observed in 103 (75.2％) patients,and hypopigmentation occurred in 8 (5.8％) patients.All the patients experienced itching to different extents,including moderate itching in 44 (32.1％) cases and severe itching in 80 (58.4％).The ratio of patients with severe itching to those with disease duration ＞ 2 years (68.1％) was significantly higher than that of patients with severe itching to those with disease duration ＜ 2 years (47.7％,x2 =5.830,P =0.016).Patients reported that local wetness and sweating (55 cases,40.1％),spicy diet (41 cases,29.9％) and mental stress (36 cases,26.3％) could aggravate itching,Conclusions VLSC commonly occurs in patients aged 20-39 years,and atopic predisposition may be an important factor for VLSC.VLSC mostly involves bilateral labia majora,and the longer the disease duration,the more severe the itching.
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Objective To analyze special histopathological characteristics of melanocytic nevi and their associations with age,gender,anatomical locations and pathological subtypes.Methods Clinical and histopathological data were collected from 1 011 patients with melanocytic nevi,who visited Beijing Hospital from January 2005 to January 2019,and analyzed retrospectively.Statistical analysis was carried out by using chi-square test for comparing enumeration data,and t test for comparing measurement data.Results Among the 1 011 patients with melanocytic nevi,the age at the clinic visit was 40.90 + 19.19years,and there were 289 males and 722 females.Lesional (biopsy) sites included the trunk (402 cases,39.8％),face and neck (268 cases,26.5％),extremities (138 cases,13.6％),hands and feet (133 cases,13.2％),scalp (53 cases,5.2％) and vulva (17 cases,1.7％).Pathological subtypes included intradermal nevus (580 cases,57.4％),compound nevus (333 cases,32.9％) and junctional nevus (98 cases,9.7％).Among special histopathological characteristics,neuralization and adipose cell hyperplasia were observed in 172 (17.0％) and 155 (15.3％) cases respectively,and the prevalence of neuralization and adipose cell hyperplasia was significantly higher in female patients than in male patients,higher in elderly patients than in young patients,and higher on the scalp than on the other sites (all P ＜ 0.05);vascular proliferation was observed in 313 (31.0％) cases,and more commonly occurred on the scalp than on the other sites (P＜0.05);nevus cells distributed along the hair follicles/sebaceous glands were observed in 502 (49.7％)cases,and more commonly seen on the face and neck than on the other sites (P ＜ 0.05);nevus cell lysis occurred in 203 (20.1％) cases,and fissures were observed in 384 (38.0％).All the above histopathological characteristics were more frequently observed in the intradermal nevus subtype than in the compound nevus subtype (all P＜0.05).Nevus cells distributed along the blood vessels were observed in 20 (2.0％) cases,and more commonly seen on the extremities than on the trunk,hands and feet (P ＜ 0.05),as well as in the compound nevus subtype than in the intradermal nevus subtype (P ＜ 0.05).Conclusions There are many special histopathological characteristics in melanocytic nevi,such as neuralization,adipose cell hyperplasia,vascular proliferation,and nevus cells distributed along the hair follicles/sebaceous glands,which are associated with patients' age,gender,lesional locations and histopathological subtypes.
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Objective To investigate clinical features of vulvar lichen sclerosus (VLS).Methods Clinical data were collected from patients with VLS in Department of Dermatology of Beijing Hospital,and analyzed retrospectively with respect to age,duration of disease,medical history,complications,clinical symptoms and signs,and features of skin lesions.Results A total of 129 patients with VLS were enrolled into this study from March 2016 to February 2017.The age of onset in these patients presented a normal distribution,with the highest frequency at the age range of 25-30 years.Of the 129 patients,only 18 (14％) developed VLS after menopause,and 12 (9.3％) were complica1ed by autoimmune diseases,especially thyroid diseases.Pruritus was reported as the main symptom in 122 (94.6％) of the 129 patients,and 51 (60％) reported that their sexual life had been affected.Labia minora was the most commonly involved site in 92 (71.3％)patients,but unilateral labia majus was rarely involved.The most common skin lesion was hypopigmentation (92.2％,119/129),followed by lichenification (55.0％,71/129) and skin atrophy (40.3％,52/129).Patients with skin atrophy had significantly longer duration of disease than those without skin atrophy (Z =3.124,P =0.002),and the incidence of skin atrophy was lower in the patients who had been treated with topical glucocorticoids or calcineurin inhibitors than those who had not received these treatment (x2 =5.074,P =0.024).Conclusions VLS is more common in women of childbearing age than in postmenopausal women,and basically characterized by pruritus and hypopigmentation.VLS commonly involves bilateral labia minora,and usually affects sexual life.
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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.
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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.
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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.
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Objective To investigate the serum levels of Th1 and Th2 cytokines and explore its roles in development and clinical features in the elderly patients with eczema. Methods The serum levels of interleukin-2(IL-2),interleukin 4(IL-4),interleukin-10(IL-10),interleukin-12(IL-12) and tumor necrosis factor alpha (TNF-α) were derected in 50 elderly patients with eczema and 34 healthy elderly as control by enzyme-linked immunosorbent assay (ELISA). The above cytokines were compared between acute and chronic,generalized and localized eczema. Results The serum levels of IL-2 [(16.03±0.47)vs.(15.72±0.33) μg/L],IL-4[(14.04±0.56) vs.(13.56±0.16) μg/L],IL-10 [(33.01±5.40) vs.(29.49± 1.07) μg/L],IL-12 [(39.32± 3.54) vs.(37.93± 1.17) μg/L]and TNF-α [(27.33±0.72) vs.(26.38±0.48) μg/L] were higher in elderly eczema than in control (t/t'=3.55,5.74,4.49,2.58,6.69,all P＜0.05).The serum levels of all cytokines tested in acute eczema(t/t'=3.59,4.68,3.35,2.00,6.44,all P＜0.05),the levels of IL2,IL-4,IL-10 and TNF-α t'=2.46,5.50,3.83,3.10,P＜0.05,but not IL-12 (t'=1.77,P＜0.05) inchronic elderly eczema were increased as compared with control ( P ＜0.05).No significant difference was found in cytokines levels between acute and chronic eczema (P＞0.05)as well as between generalized and localized eczema(t=0.18,5.74,4.49,0.91,0.25,1.11,P＞0.05). Conclusions Changes of Th1 and Th2 cytokines may play some role in the pathogenesis of elderly eczema,but not characterized by clinical types of eczema.
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An unusual case of primary cutaneous anaplastic large cell lymphoma induced by influenza vaccination is reported.A 79-year-old man developed an erythematous nodule at the injection site on the upper left arm 2 months after vaccination against influenza A virus,which gradually grew and ulcerated.Pathological examination of the lesion revealed epidermal infiltrate of lymphocytes and numerous clumps of densely distributed lymphocytes with lightly stained cytoplasm,nuclear atypia and karyokinesis.Immunohistochemistry showed that the tumor cells stained positive for CD3 (90％),CD5 (90％),LCA (90％),CD30 (90％),CD10 (a few),Ki-67 (80％),but negative for CD20,CD56,cytokeratin 1-3,epithelial membrane antigen,synaptophysin,and anaplastic lymphoma kinase.The patient was diagnosed with primary cutaneous anaplastic large cell lymphoma at the injection site following vaccination against influenza A virus.
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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.
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Objective To evaluate the role of genetic factors in the pathogenesis of vitiligo. Methods A questionnaire survey was performed to collect clinical data on 1005 cases of vitiligo in Beijing Hospital from September 1997 to March 2009. Data analysis was carried out by SPSS 13.0 software. Results There were 206 (20.5%) patients with positive family history among the 1005 cases of vitiligo. The mean age at onset was younger and bilateral vitiligo lesions were more frequently observed in patients with positive family history than those without (24.45 ± 15.87 years vs 28.12 ± 16.88 years, 71.3% vs 60.8%, both P ＜ 0.05). Blood type B predominated among patients with positive family history (19.9%), while blood type O among those without ( 16.8% ), and no statistical difference was noted in the distribution of blood type between the two groups of patients (P ＞ 0.05). Conclusions ①The incidence of vitiligo accords with the rules of polygenic inheritance and shows a familial aggregation, and the closer the blood relationship, the higher the incidence of vitiligo.②The incidence of vitiligo seems unrelated to sex. ③The mean age at onset is younger in patients with positive family history than those without, but appears unaffected by paternal or maternal inheritance. ④Patients with positive family history show a higher frequency of bilateral distribution of vitiligo lesions, but no difference in other clinical manifestions from patients without.
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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).
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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.
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Objective To study the expression of endothelin 1 (ET 1) mRNA in keratinocytes in patients with vitiligo. Methods Fourteen patients with progressive vitiligo were measured by hybridization in situ. Results Our results showed that the expression of ET 1 mRNA was markedly decreased. Conclusion The results revealed that decreased ET 1 expression may be associated with the pathogenesis of vitiligo. The cause and role of decreasing of ET 1 expression of keratinocyte in vitiligo lesion need to be studied further.
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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.
