Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 102
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Photodiagnosis Photodyn Ther ; : 101596, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31704505

RESUMO

BACKGROUND: This study aimed to evaluate the effects of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on the improvement of symptoms and recurrence rate in patients with vulvar lichen sclerosus (VLS) and observe its side effects. METHODS: The symptom scores before and after photodynamic therapy (PDT) in 13 enrolled patients with VLS were analyzed retrospectively. All patients were followed-up for at least 6 months to evaluate the recurrence rate after PDT. The patients were treated with PDT only during the study period. During the PDT treatment, a 20% 5-aminolevulinic acid solution was applied to the lesions and marginal areas for 3 hours, and the entire area was then irradiated with 635 nm red light of 80 J/cm2 at 80 mW/cm2 for 30 minutes. RESULTS: In this study, the effective rate of PDT was 92.31%. Lesions recurred in two patients at 6 months after PDT. Post-treatment, the total subjective, total objective, and the Dermatological Life Quality Index scores changed from 11.4, 4.3, and 13.4 at baseline to 4.9, 2, and 5.9, respectively. The difference was statistically significant (p <0.05). PDT was mildly toxic in most patients. CONCLUSIONS: ALA-PDT is a safe and effective method for the treatment of VLS, and the therapeutic effects can be maintained for at least 3 months. The therapeutic effects may decrease during the 3-6-month period after PDT.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31479803

RESUMO

BACKGROUND: Aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) is used to treat condyloma acuminata (CA), yielding a high clearance rate and low recurrence rate. Consecutive human papillomavirus (HPV) DNA detection can be used to dynamically monitor the therapeutic efficiency of PDT. Here, we evaluated the efficacy of ALA-PDT in the context of different HPV infection states. METHODS: One hundred thirty-eight patients with HPV infection and visible anogenital warts were enrolled. Microwave or radiofrequency was used to remove visible lesions before PDT. HPV DNA detection was performed using real-time polymerase chain reaction before each PDT session and at follow-up. Treatment was halted after the patient showed two negative results for HPV DNA detection in a row. RESULTS: Of the 138 patients enrolled in the study, 72 completed treatment. Multisite HPV-infected patients required more sessions of PDT than did single-site infected patients to reach the endpoint of treatment. Compared with patients with only external CA, individuals with internal CA required more sessions to eliminate HPV infection. The total number of PDT sessions performed in the multitype HPV-infected group was significantly higher than that in the single-type infected group. Patients with non-high-risk (HR)-HPV infection required fewer PDT sessions than did those with HR-HPV infection by the end of treatment. Sixty-nine patients were followed-up for at least 6 months, only 2.9% of whom showed recurrence. CONCLUSIONS: Combined ALA-PDT and HPV DNA detection was an effective strategy for the treatment of CA. Patients with multisite and multitype HPV infection required more PDT sessions to eliminate the virus.

3.
Dermatology ; : 1-13, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31522174

RESUMO

OBJECTIVE: Investigate the role of Yes-associated protein (YAP1) in the development of condyloma acuminatum (CA). METHODS: We enrolled 30 male patients with CA and 20 healthy individuals as a control group, to compare the YAP1 expression in their tissue samples. Following this, we overexpressed and downregulated YAP1 expression in HaCaT cells to examine the migratory, proliferative, and apoptotic potential of HaCaT cells expressing different levels of YAP1. RESULTS: In the CA patient tissue samples, an increase in YAP1 expression can be observed. In vitro,the overexpression of YAP1 was shown to promote the growth and migration of HaCaT cells and to activate epidermal growth factor receptor (EGFR) pathway-associated proteins, while the downregulation of YAP1 inhibited cell growth and migration of these cells. CONCLUSIONS: YAP1 promotes the growth of keratinocytes in CA through the activation of the EGFR pathway, and it may mediate the development of human papilloma virus-associated diseases.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31398516

RESUMO

The facial angiofbromas due to tuberous sclerosis complex produced significant social and emotional distress for affected individuals, but there is no specific therapeutic strategy up to now. Herein, we report a case of facial angiofibromas successfully treated by 5-aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) with no recurrence for 6 years, thus providing a promising therapeutic option.

5.
Mol Genet Genomic Med ; 7(7): e00703, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31074163

RESUMO

BACKGROUND: Epidermolytic palmoplantar keratoderma (EPPK) is a rare skin disorder and its pathogenesis and inheritability are unknown. OBJECTIVE: To investigate the inheritance and pathogenesis of EPPK. METHODS: Two EPPK cases occurred in a three-generation Chinese family. Patient-parents trio EPPK was carried out and the identified candidate variants were confirmed by Sanger sequencing. RESULTS: A heterozygous missense pathogenic variant, c.488G > A (p.Arg163Gln), in the keratin (KRT) 9 gene was detected in the proband and his son via targeted exome sequencing, and then validated by Sanger sequencing. This pathogenic variant cosegregated with the EPPK in extended family members, and was predicted to be pathogenic by SIFT, PolyPhen2, PROVEAN, and Mutation Taster. This heterozygous variation was not evident in 100 healthy controls. CONCLUSION: This report describes a KRT9 c.488G > A (p.Arg163Gln) variant causing a diffuse phenotype of Chinese EPPK. The current results broaden the spectrum of KRT9 pathogenic variants responsible for EPPK and have important implications for molecular diagnosis, treatment, and genetic counseling for this family.

6.
Dermatol Ther ; 32(3): e12898, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30963687

RESUMO

Pemphigoid gestationis (PG) is a rare, autoimmune, subepidermal bullous dermatosis associated with pregnancy. It is mainly caused by autoantibodies against hemidesmosomal proteins-bullous pemphigoid 180, and usually presents in the second or third trimester of pregnancy sometimes exacerbates spontaneously after delivery. Here we reported a case of PG with polycystic ovary syndrome (PCOS). This patient received assisted reproduction technology and suffered PG in her third trimester of pregnancy. To the best of our knowledge, there is no similar case has been reported.

7.
Mol Genet Genomic Med ; 7(6): e670, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30924322

RESUMO

BACKGROUND: Erythrokeratodermia variabilis et progressiva (EKVP, OMIM 133200) is a rare hereditary disorder characterized by varies from transient, fast moving erythema to persistent brown hyperkeratotic plaques. Recently, mutations in the genes gap junction alpha 1 gene (GJA1), GJB3, and GJB4 have been reported to cause EKVP. Here, we report the identification of two de novo missense mutations in the GJA1 gene in two unrelated individuals with EKVP. METHODS: The patients and his family members were subjected to mutation detection in the candidate gene GJA1, GJB3, and GJB4 by Sanger sequencing. The expression of connexin (Cx) 43 was detected by immunohistochemistry and immunofluorescence (IF) studies in the lesions. RESULTS: A 12-year-old boy presented with multiple hyperkeratotic plaques on the face, neck, elbows, wrists, limbs, knees, inguinal region, hands, and feet. A 7-year-old girl presented with symmetrical erythematous, plaques on the hands, feet, wrists, and ankles. A novel heterozygous missense mutation c.848C > T (p.P283L) in exon 2 of the GJA1 gene was identified in both patients. A novel heterozygous missense mutation c.869C > A (p.T290N) in exon 2 of the GJA1 gene was also identified in the boy. These mutations were not found in the unaffected family members and 100 normal controls. In the patients' lesions, Cx43 protein was located to the cytomembrane and cytoplasm in the stratum corneum, and granular layer. Compound heterozygous mutations in the boy showed a more severe clinical phenotype and cytoplasmic mislocalization. CONCLUSIONS: The novel mutations c.848C > T (p.P283L) and c.869C > A(p.T290N) arose de novo and were considered as the cause of two Chinese EKVP. GJA1 P283L and T290N mutations lead to Cx43 protein cytoplasmic mislocalization. Our finding expands the mutant spectrum of GJA1 gene and adds new understanding of the genotype-phenotype correlation.

8.
J Photochem Photobiol B ; 194: 46-55, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30925276

RESUMO

Human papillomavirus (HPV) infection is linked to several diseases, the most prominent of which are cervical cancer and genital condyloma acuminatum. Previous studies have suggested an effective role for 5-aminolevulinic acid photodynamic therapy (ALA-PDT) against various cancers by the induction of autophagy and apoptosis. However, few reports have focused on the effectiveness of ALA-PDT on HPV related disorders. To identify the role of ALA-PDT in the context of HPV infection, we initially investigated 111 patients suffering from genital condyloma acuminatum. HPV viral load detected before and after ALA-PDT treatment was compared during this procedure; a significant difference was noted. HeLa (HPV18) cells were exposed to ALA-PDT in vitro to further explore the underlying mechanisms. Western blot analysis showed that ALA-PDT induces LC3II and p62 expression, along with the up regulation of caspase-3 and cleaved caspase-3. Our study also demonstrated that ALA-PDT treatment inhibits the proliferation of HeLa cells in a dose dependent manner and effectively reduces HPV viral load via autophagy and apoptosis by regulating the Ras/Raf/MEK/ERK and PI3K/AKT/mTOR pathways. Hydroxychloroquine (HCQ), although it inhibited autophagy degradation, functioned to activate reactive oxygen species (ROS) levels of ALA-PDT to enhance the observed effect. These findings suggest strategies for the improvement of PDT efficacy in patients.


Assuntos
Morte Celular/efeitos dos fármacos , Morte Celular/efeitos da radiação , Ácidos Levulínicos/farmacologia , Papillomaviridae/fisiologia , Fotoquimioterapia , Carga Viral/efeitos dos fármacos , Carga Viral/efeitos da radiação , Apoptose/efeitos dos fármacos , Apoptose/efeitos da radiação , Autofagia/efeitos dos fármacos , Autofagia/efeitos da radiação , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Relação Dose-Resposta a Droga , Relação Dose-Resposta à Radiação , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Células HeLa , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Sistema de Sinalização das MAP Quinases/efeitos da radiação , Papillomaviridae/efeitos dos fármacos , Papillomaviridae/efeitos da radiação , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Quinases raf/metabolismo , Proteínas ras/metabolismo
9.
Photodiagnosis Photodyn Ther ; 26: 13-14, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30769166

RESUMO

Chromoblastomycosis is a long-term fungal infection of the skin and subcutaneous tissue, usually presenting as partial hypertrophic and warty plaques. Effective treatment is necessary to control the development of lesions, especially in patients with associated diseases. But till now, the treatment is still a challenge. Photodynamic therapy (PDT) is an efficient and non-invasive treatment option. Here, we reported the case of a 52-year-old male with refractory chromoblastomycosis and leukopenia, who was successfully treated with 5-aminolevulinic acid-based PDT (ALA-PDT). A complete cure, confirmed by clinical improvement and mycological detection, was achieved after six sessions of every-other-week treatment. Post six months follow up no recurrence was observed. The case here suggests that ALA-PDT is a valuable anti-infective therapy for refractory chromoblastomycosis.

10.
Psychol Health Med ; 24(7): 769-780, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30784297

RESUMO

To investigate the psychological health and related risk factors in patients suffering from psoriasis. A total of 245 inpatients and outpatients with psoriasis were selected from January 2014 to December 2015. Patients with psoriasis were assessed a homemade questionnaire as well as the Psoriasis Area and Severity Index (PASI), Selfrating Anxiety Scale, Self-rating Depression Scale, Trait Coping Style Questionnaire and Social Avoidance and Distress Scale.Differences in sex, age, marital status, type of medical payment, occupation, economic situation, disease severity, and type of psychological state of psoriasis patients were significant, there was no significant difference in psychological health between psoriasis patients with different levels of educational attainment. Scores for anxiety, depression, social avoidance, and social distress were positively correlated with disease severity and negative-coping scores, but a significant negative correlation was observed with scores for social support and positive coping. Stepwise regression analysis of factors influencing psychological health showed that total social support and negative-coping scores could explain 65.2% of the variation. Patients with psoriasis can suffer from anxiety, depression, social distress, and social avoidance. Physicians should pay greater attention to deterioration in mental health of psoriasis patients.

11.
Photodiagnosis Photodyn Ther ; 25: 460-462, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30738225

RESUMO

5-aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) is a highly effective, safe, and promising treatment for human papillomavirus (HPV)-induced anogenital condyloma acuminata (CA). Specific HPV subtypes are responsible for the pathogenesis of CA and dynamic changes in viral loads may reflect the efficiency of PDT. Here we present two cases of anogenital CA successfully treated by ALA-PDT under the guidance of HPV DNA detection including genotype identification and viral load measurement, which provided clues for unexpected intra-anal infection. Both of these male patients were free of detectable HPV at the end of the treatment and no recurrence was observed after 1 year. We conclude that the HPV DNA detection can accurately guide ALA-PDT, indicate unnoticed lesions, as well as improve and evaluate the efficiency.


Assuntos
Ácido Aminolevulínico/uso terapêutico , Condiloma Acuminado/tratamento farmacológico , Papillomaviridae/genética , Infecções por Papillomavirus/tratamento farmacológico , Fotoquimioterapia/métodos , Adulto , Condiloma Acuminado/virologia , DNA Viral , Genótipo , Humanos , Lasers de Gás , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/genética , Fármacos Fotossensibilizantes/uso terapêutico , Reação em Cadeia da Polimerase , Carga Viral
13.
J Dermatolog Treat ; : 1-18, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30427239

RESUMO

Condyloma acuminatum are the most common sexually transmitted diseases worldwide, and they are closely associated with human papillomavirus (HPV) infections. Urethral meatus warts are uncommon. And many treatments are limited by a difficult approach, recurrences, and potential complications. In our study, 21 patients diagnosed with urethral condyloma acuminatum were included. After 4h treatment of 5-aminolevulinic acid (ALA), patients received photodynamic therapy (PDT). Each patient received HPV test before every PDT cycle. The frequency of PDT was dependent on viral load changes. As a result, all patients achieved complete clinical remission after the last session of ALA-PDT. There were significant differences in HPV viral loads between pretherapy and after one or three rounds of PDT treatment. So we concluded that ALA-PDT is a safe and effective method for treatment of condyloma acuminatum in urethra meatus. Dynamic monitoring of HPV viral loads can more objectively demonstrate the effectiveness and guide the treatment of PDT.

15.
Am J Med Sci ; 356(4): 344-349, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30360802

RESUMO

BACKGROUND: The study was a retrospective case-controlled study. We aimed to determine the clinical and laboratory features of systemic lupus erythematosus (SLE) and compared the features of autoimmune thyroid disease (AITD) with those of SLE. MATERIALS AND METHODS: The study included 38 patients with SLE with AITD (SLE-AITD) and 190 age- and gender-matched SLE patients. The distribution of sociodemographic and clinical factors was compared between the SLE-AITD and SLE groups using Chi-square tests for gender and t tests for others. Univariate and multivariate logistic regression models were used to identify factors associated with the prevalence of AITD among SLE patients. RESULTS: In univariate analysis, malar rash, oral ulcers, serositis, anti-double-stranded DNA antibody positivity (anti-dsDNA+), anti-Sjögren's syndrome type A antibodies (SSA), anti-Sjögren's syndrome type B antibodies (SSB), low complement 3 (C3), and low complement 4 (C4) were significantly different between the SLE-AITD and SLE groups. There were no significant differences among other clinical or laboratory features. In multivariate analysis, serositis (adjusted odds ratio [AOR], 3.64; P = 0.00), anti-dsDNA+ (AOR, 0.30; P = 0.01) and low C3 (AOR, 0.30; P = 0.02) were all associated with SLE-AITD. CONCLUSIONS: In our study, serositis was a risk factor for AITD, so we propose that AITD should be considered in lupus patients with serositis.

17.
Photodiagnosis Photodyn Ther ; 23: 230-234, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30224029

RESUMO

BACKGROUND: Anal canal condyloma acuminata are common, sexually transmitted lesions, most often caused by the human papillomavirus. The relatively high recurrence rate of anal canal condyloma acuminata can be attributed to the unsuccessful elimination of viruses in areas of subclinical and latent infection. This study aimed to observe and evaluate the effectiveness of 5-aminolevulinic acid-photodynamic therapy combined with monitoring of human papillomavirus load changes in patients with anal canal condyloma acuminata. METHODS: A total of 19 patients with anal genital warts were recruited for this study. Firstly, visible warts around the anus were removed. Next, an anoscope examination was performed. Human papillomavirus detection, using real-time polymerase chain reaction assays, was performed before every cycle of treatment. Absorbent cotton rolls soaked with a concentration of 20% 5-aminolevulinic acid were inserted into the anus for 3 h. Finally, photodynamic therapy was applied to the lesions. Each patient required multiple PDT sessions to achieve complete response. RESULTS: All patients achieved complete clinical remission one week after the last session of treatment, and human papillomavirus loads decreased significantly. Six months follow-up after completion of therapy, none of the patients had recurrence. CONCLUSIONS: 5-aminolevulinic acid-photodynamic therapy is an effective and safe approach for anal canal condyloma acuminata. Dynamic human papillomavirus viral quantitative monitoring can aid in the evaluation of therapeutic effects and lead to better treatment outcomes.

20.
Infect Genet Evol ; 65: 406-413, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30172014

RESUMO

Human papillomavirus (HPV) is the most common sexually transmitted agent in the world. It can cause condyloma acuminatum, anogenital malignancies, and head and neck cancers. The host immune responses to HPV involve multiple cell types that have regulatory functions, and HPV-mediated changes to regulatory T cells (Tregs) in both the local lesion tissues and the circulatory system of patients have received considerable attention. The role of Tregs in HPV infections ranges from suppression of effector T cell (Teff) responses to protection of tissues from immune-mediated injury in different anatomic subsites. In this review, we explore the influence of Tregs in the immunopathology of HPV-related diseases and therapies targeting Tregs as novel approaches against HPV.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA