ABSTRACT
Objective:To evaluate the efficacy and safety of adalimumab in the treatment of severe plaque psoriasis.Methods:From June 2018 to April 2019, 20 patients with severe plaque psoriasis were collected from Department of Dermatology, Henan Provincial People′s Hospital. After initial subcutaneous injection of adalimumab at a dose of 80 mg, these patients were subcutaneously injected with adalimumab at a dose of 40 mg at weeks 1, 3, 5, 7, 9 and 11. At weeks 4, 8 and 12, psoriasis area and severity index (PASI) was recorded, and changes in skin lesions were observed by reflectance confocal microscopy (RCM) . Adverse reactions were monitored during treatment.Results:At week 4, 12 patients achieved a 50% reduction in PASI (PASI50) ; at week 8, 14 achieved PASI75; at week 12, 20 patients achieved PASI75, of which 5 achieved PASI90 and 2 achieved PASI100. As RCM showed, the melanin content in the basal layer of skin lesions was lower compared with that of perilesional normal skin before treatment, gradually increased within 4 weeks, and nearly returned to normal at week 12. No infections, tumors or other related adverse reactions occurred in the 20 patients.Conclusion:Subcutaneous injection of adalimumab every other week is markedly effective in the treatment of severe psoriasis, with few related adverse reactions.
ABSTRACT
Objective:To report 7 cases of vitiligo caused by eyebrow tattooing.Methods:Seven cases of vitiligo caused by eyebrow tattooing were collected from Department of Dermatology, Henan Provincial People′s Hospital from December 2017 to May 2019, and their clinical features were retrospectively analyzed.Results:One month to 1 year after eyebrow tattooing, several eyebrows became white in the 7 patients. In the early stage, only several eyebrows became white, and the surrounding skin was normal, but white patches with unclear boundaries gradually appeared around the eyebrows in the later stage. Reflectance confocal scanning microscopy of skin lesions on the eyebrow showed depigmentation in the basal layer and around hair follicles, and highly refractive amorphous substances (colorants) in the superficial and middle dermis. The 7 patients all showed negative patch test reactions to eyebrow colorants but positive reactions to sodium dodecyl sulfate.Conclusion:No depigmentation was observed on the eyebrow skin in the early stage of vitiligo caused by eyebrow tattooing, and reflectance confocal scanning microscopy of eyebrow lesions may be beneficial in reducing its misdiagnosis.
ABSTRACT
Objective To identify mutations in keratin genes (KRT1 and KRT10) in a pair of twins with bullous congenital ichthyosiform erythroderma (BCIE),and to explore the relationship between the causative genes and phenotypes.Methods Clinical data were collected from a pair of twins with BCIE and their family members.Peripheral blood samples were obtained from the twins,their old brother and parents,and DNA was extracted from these blood samples.Polymerase chain reaction (PCR)was performed to amplify all the coding exons and their flanking sequences of the KRT1 and KRT10 genes,and 100 unrelated healthy persons served as controls.Results The 11-year-old male proband presented with recurrent blisters,hypertrophy and desquamation all over the body for 11 years.His twin brother had similar skin lesions.Skin examination of the proband showed diffuse erythema covered with thick scaly crusts on the trunk and extremities.Blisters,bullae and erosions due to ruptured blisters were observed locally with tenderness on palpation.There were obvious hyperkeratotic and hard lesions on the big joints of the extremities.Diffuse hyperkeratosis could be seen on the palms and soles.A mutation c.591 + 1G ＞ A was identified at position 1 in intron 1 of the KRT1 gene in the twins,but not in the 3 healthy family members or the 100 unrelated healthy controls.Conclusion The mutation c.591 + 1G ＞ A at position 1 in intron 1 of the KRT1 gene may contribute to the clinical phenotype of the twins with BCIE.