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Objective:To investigate clinical and histopathological features of adult erythema nodosum (EN) .Methods:Clinical data were collected from 54 adult inpatients with histopathologically confirmed EN in Department of Dermatology and Venereology, the First Affiliated Hospital of Wannan Medical College from November 2019 to July 2022, and analyzed retrospectively.Results:Among the 54 EN patients, there were 6 males and 48 females, their ages were 42.50 ± 11.68 years (range, 18 - 73 years), and their disease course ranged from 1 day to 10 years; 30 patients (55.56%) were diagnosed with idiopathic EN, and 24 (44.44%) with secondary EN. The most common etiological factor in secondary EN was infection (17 cases), including respiratory tract infection (9 cases), tuberculosis infection (6 cases), upper respiratory tract infection comorbid with active hepatitis B virus infection (2 cases) ; the following common etiological factor was connective tissue disease (7 cases), including Behcet′s syndrome (4 cases), Sj?gren′s syndrome (1 case), and undifferentiated connective tissue diseases (2 cases). The patients′ ages were significantly younger in the secondary EN group (38.33 ± 12.15 years) than in the idiopathic EN group (46.17 ± 10.20 years, t = 2.58, P = 0.013). All patients had skin lesions on their lower limbs, lesions were limited to both lower limbs in 24 patients with idiopathic EN and 12 with secondary EN, and the proportion of patients with lesions limited to both lower limbs was significantly lower in the secondary EN group than in the idiopathic EN group ( χ2 = 5.44, P = 0.020). Compared with the idiopathic EN group, the secondary EN group showed significantly increased white blood cell counts ([7.56 ± 2.46] × 10 9/L vs. [6.04 ± 1.60] × 10 9/L, t = 2.62, P < 0.05) and C-reaction protein levels (34.34 ± 46.48 mg/L vs. 11.45 ± 18.13 mg/L, t = 2.28, P < 0.05). In the idiopathic EN group, 23 patients mainly showed histopathological features of septal panniculitis, while 17 patients in the secondary EN group mainly showed histopathological features of mixed panniculitis or lobular panniculitis, and the proportion of patients with histopathological features of mixed panniculitis or lobular panniculitis was significantly higher in the secondary EN group than in the idiopathic EN group ( χ2 = 12.18, P < 0.001) . Conclusion:EN was more common in female adults; idiopathic EN was the most common type, and secondary EN may be a cutaneous sign of systemic diseases; for EN patients at a relatively young age, with lesions involving both lower limbs or more sites, higher white blood cell counts and C-reaction protein levels, and histopathological manifestations of lobular panniculitis, systemic examinations were required to rule out underlying causes.
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Mucosal pemphigoid is a rare subepidermal immune bullous disease, mainly involving the oral cavity, eyes and other mucous membranes, with the risk of scarring, which can be life-threatening in severe cases. For patients with mucosal pemphigoid, early diagnosis and early treatment can avoid serious complications. For mild patients, dapsone or topical glucocorticoids can be used; for severe patients, combination of immunosup-pressants helps to improve clinical efficacy and reduce the dosage of glucocorticoid, including cyclophosphamide, azathioprine, methotrexate, and mycophenolic acid esters. For some refractory cases without any response to the treatments of dapsone, glucocorticoids and immunosuppressants, biological agents (including rituximab, etanercept, infliximab, and braziltinib), intravenous immune globulin and other therapies can be selected. For some patients with mucosal scarring, surgery or laser therapy can be considered to improve symptoms. However, it is necessary to further demonstrate the clinical efficacy of some immunosuppressants and biologic agents on mucosal pemphigoid in a lot of larger clinical trials.
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Objective To investigate the predisposing factors and clinical features of disseminated herpes zoster, and to explore factors influencing postherpetic neuralgia. Methods Clinical data were collected from 53 patients with disseminated herpes zoster and 809 patients with common herpes zoster between 2012 and 2015, and analyzed retrospectively. Logistic regression analysis was used to assess factors influencing the occurrence of and pain intensity in disseminated herpes zoster, as well as the occurrence of postherpetic neuralgia. Results No significant difference in patients′age was observed between the disseminated and common herpes zoster groups(56.66 ± 17.24 vs. 56.50 ± 15.51 years, t=0.071, P>0.05), but there was a significant difference in the gender ratio between the two groups(χ2 = 8.16, P = 0.004). The incidence rates of bullae, pustules and fever were all significantly higher in the disseminated herpes zoster group than in the common herpes zoster group(15.09%vs. 3.58%,χ2=16.04, P<0.01;47.17%vs. 26.82%,χ2=10.20, P<0.01;30.19%vs. 8.03%,χ2=28.68, P<0.01). The disseminated herpes zoster group also showed significantly higher pain scores at admission compared with the common herpes zoster group (Median[P25- P75]: 6[4- 7.5] vs. 5[3- 7], Z =-3.460, P = 0.001). Logistic regression analysis revealed that gender, age, fatigue and HIV infection were significantly associated with the occurrence of disseminated herpes zoster (all P<0.05). Additionally, HIV infection(OR=5.570, 95%CI:1.196-25.939, P=0.029), gender(OR=0.166, 95%CI:0.029-0.945, P=0.043), age(OR=1.064, 95%CI:1.010-1.119, P=0.019)and the number of days that antiviral therapy lasted(OR=0.669, 95%CI:0.505-0.885, P=0.005)were all factors influencing the occurrence of postherpetic neuralgia. Conclusion Male, old age, fatigue and especially HIV infection are risk factors for the occurrence of disseminated herpes zoster, and male, old age and antiviral therapy duration may be associated with the occurrence of postherpetic neuralgia.
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<p><b>OBJECTIVE</b>To detect mutation of ADAR1 gene in a family affected with dyschromatosis symmetrica hereditaria.</p><p><b>METHODS</b>Clinical data and blood samples of the family were collected. Potential mutation of the ADAR1 gene were scanned in 3 patients and 3 unaffected members by PCR amplification and direct sequencing. The coding sequences of the ADAR1 were also screened in 50 normal controls.</p><p><b>RESULTS</b>A frameshift mutation (c.2252insG) of the ADAR1 gene was identified in all of the 3 patients. The same mutation was not found in the 3 unaffected members and 50 normal cases.</p><p><b>CONCLUSION</b>The frameshift mutation of ADAR1 gene (c.2252insG) is probably responsible for the disease in this family.</p>
Subject(s)
Adult , Child , Female , Humans , Male , Adenosine Deaminase , Genetics , Base Sequence , China , DNA Mutational Analysis , Exons , Frameshift Mutation , Molecular Sequence Data , Pedigree , Pigmentation Disorders , Genetics , Point Mutation , RNA-Binding Proteins , GeneticsABSTRACT
AIM: To evaluate the effect of mizolastine in patients with ch ronic urticaria and to explore the role of IL-4 in the process of chronic urtic aria. METHODS: 32 cases of chronic urticaria were treated with m izolastine, and the therapeutic effects and the side-effect were evaluated. The serum IL-4 levels were tested by ELISA. RESULTS: The total ef fective rates were 62.5 % and 84.4 % (P 0.05 ), and before treatment were significantly higher than tho se after treatment (P