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Abstract Background: Lichen simplex chronicus is a dermatological condition due to excessive scratching, with few studies on psychoneuroimmunology. Objective: We aimed to estimate the levels of stress, depression, and anxiety, and to measure serum levels of neurotrophins in patients with lichen simplex chronicus, and to correlate these parameters with the severity of the disease and pruritus. Methods: Thirty-six patients with lichen simplex chronicus and 36 age- and sex-matched healthy controls were included. Each participant was administered the Hospital Anxiety and Depression Scale and Perceived Stress Scale questionnaires, along with a visual analog scale for pruritus. Levels of neurotrophins (brain-derived neurotrophic factor, neurotrophin-3, nerve growth factor, glial cell line-derived neurotrophic factor) were determined by ELISA assays. Results: The scores of Perceived Stress Scale-10, Hospital Anxiety and Depression Scale were statistically higher in patients (p < 0.05 for all). The serum levels of all neurotrophins were significantly lower in patients compared to healthy controls (p < 0.05 for all). Disease severity showed no correlation with all four neurotrophins. In linear regression models applied for increased visual analog scale-pruritus scores and disease severity these two variables were statistically significant predictors (p = 0.043). Study limitations: A direct causal relationship was not addressed. Conclusion: Lichen simplex chronicus patients are at risk of increased levels of stress, anxiety, depression, and present decreased levels of neurotrophins, that may suggest a role in the pathophysiology of this disorder.
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Humans , Neurodermatitis , Anxiety , Anxiety Disorders , Pruritus , DepressionABSTRACT
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 investigate the clinical efficacy of plum blossom acupuncture plus focused ultrasound therapy for neurodermatitis. Method Sixty neurodermatitis patients were randomized to a treatment group (30 cases) and a control group (30 cases). The treatment group received plum blossom acupuncture plus focused ultrasound therapy and the control group, conventional treatment with halometasone cream. The clinical therapeutic effects were evaluated. Result The total skin lesion score had no statistically significant post-treatment difference between the two groups of patients (P>0.05) and had a statistically significant pre-/post-treatment difference within the groups (P<0.01). The total efficacy rate was 96.7% in the treatment group and 86.7% in the control group. At three and six months after treatment the recurrence rate was lower in the treatment group than in the control group and the difference was statistically significant (P<0.05, P<0.01). Conclusion Plum blossom acupuncture plus ultrasound has a marked therapeutic effect on neurodermatitis. It is a simple and ideal therapeutic method.
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Objective:To observe the clinical effects of collateral-pricking and cupping therapy plus moxibustion for localized neurodermatitis. Methods:A total of 94 cases with localized neurodermatitis were randomly divided into two groups by their visit order, 47 cases in each group. The cases in the treatment group were treated by bleeding method with a plum blossom needle, cupping method and moxibustion. The cases in the control group were treated by subcutaneous injection of Triamcinolone Acetonide Acetate Injection. Results:After treatment, the curative rate and total effective rate were respectively 80.9% and 100% in the treatment group and were 48.9% and 87.2% in the control group. The differences in the curative rate and total effective rate between the two groups were statistically significant (P Conclusion:Bleeding method by a plum blossom needle, in combination with cupping method and moxibustion, is an effective therapy for localized neurodermatitis.
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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.
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Objective To evaluate the safety and efficacy of single and local use of a China-made compound betamethasone injection in the treatment of lichen simplex chronicus. Methods A multi-center,randomized, parallel controlled study was conducted. Patients with lichen simplex chronicus were divided into test and control groups to receive a single dose of intralesional compound betamethasone injection made in China or Schering-Plough Labo N.V. Belgium. Patients were visited for the evaluation of efficacy and safety of the China-made injection at the beginning of the treatment (DO), on week 2 (D14) and 4 (D28) after the initiation of treatment. Results A total of 144 patients were enrolled, among which, 68 in the control group and 71 in the test group completed the trial. FAS analysis on week 4 revealed that the response rate and healing rate were 86.11% and 59.72% in the control group, respectively, 86.11% and 54.17% in the test group, respectively (χ2=0.00,0.45,respectively,both P>0.05).There was no severe adverse event in either group after the treatment, and only mild atrophoderma occurred in one patient in the control group, which was improved spontaneously within several weeks of follow-up. There was no statistically significant difference in the occurrence of side reactions between the two groups (P> 0.05). Conclusion The China-made compound betamethasone injection is effective and safe for the treatment of lichen simplex chronicus.
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OBJECTIVE:To evaluate the therapeutic effect of compound glycyrrhizin plus mizolastine for patients with generalized neurodermatitis(GND)and its influence on patietents' psychology.METHODS:60 patients with GND were randomly assigned to receive compound glycyrrhizin plus mizolastine(treatment group)or mizolasitine alone(control group)for 28 days.The psychological factors were examined before and after treatment using self-rating anxiety scale(SAS),and the curative effects and the psychological changes between two groups were compared.RESULTS:The SAS scores of treatment group and control group were 30.53? 1.50 and 33.20? 1.67,respectively(P
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OBJECTIVE: To observe the curative effect of Compound Flumetasone Ointment in treating neurodermatitis. METHODS: A total of 48 patients with neurodermatitis were enrolled: 30 were treated with Compound Flumetasone Ointment (treatment group), and 18 with Compound Dexamethasone Ointment (control group). The curative effects were compared between the two groups after 2-week treatment. RESULTS: The total effective rate in the treatment group was 90.0%, significantly higher than 61.1% in control group. The drugs took effect on the second day of medication yet without appearing of obvious adverse drug reactions. CONCLUSION: Compound Flumetasone Ointment was proved to be a quick, safe and effective therapy for neurodermatitis.
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Objective To observe the clinical efficacy and safety of 0.1% mometasone furoate cream in the topical treatment of eczematous dermatoses including neurodermatitis and eczema. Methods A randomized double-blind parallel controlled clinical trial was conducted. The home made mometasone furoate cream or imported Eloson cream was topically used in patients with such dermatoses once daily for 4 weeks, respectively. Symptom/sign scores were evaluated at the beginning of the treatment and at the 1st, 2nd, 3rd, 4th week after the initiation of the treatment. Results Two hundred and eighty-four patients were enrolled in the trial, including 143 patients with eczema and 141 patients with neurodermatitis. There are 142 patients each in test group and control group separately. All symptom/sign scores and total scores were significantly decreased 1, 2, 3, and 4 week after the treatment. No statistically significant difference was observed between the two groups. The cure rate and improvement rate in eczema patients were 78.87% and 97.18% in the test group; 84.51% and 92.96% in the control group; respectively. While the cure rate and improvement rate in neurodermatitis patients were 75.71% and 100% in the test group; 80.28% and 94.37% in the control group; respectively. The cure rate and improvement rate of total patients were 77.30% and 98.58% in the test group; 82.39% and 93.64% in the control group; respectively. No statistically significant difference in efficacy was observed between the two groups. There was no severe side effect in the two groups. One patient had mild contact dermatitis in the test group. Conclusions These results suggest that 0.1% mometasone furoate cream is an effective and safe drug in the treatment of neurodermatitis and eczema.
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We report herein two cases of localized curaneous amyloidosis (LCA) associated with neurodermatitis. Both patients suffered from persistent pruritus during several years and had small brown discrete lichenoid papules or neurodermatitis like lesion. Biopsy specimen taken from lichehoid papules revealed amyloid deposition in the papillary dermis. In histologic examination of the neurodermatitis like lesion, hematoxylin eosin stain revealed only chronic eczematous changes but special stain and election microscopic examination revealed amyloid deposition in the papillary dermis. Although neurodermatitis and LCA may be able to develop concomitantly in one patient, it was suggested that neurodermatitis may transfrom into LCA.
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Humans , Amyloidosis , Biopsy , Dermis , Eosine Yellowish-(YS) , Hematoxylin , Neurodermatitis , Plaque, Amyloid , PruritusABSTRACT
A quantitative study of effect of mental factor on neurodermatitis and alpoecia areata was made. Minnesota Multiphasic Personality Inventory (MMPI) and Holmes's Socia Redjustment Rating Scale (SRRS) were used to evaluate individuality and mental stress. The results showed that the effect of mental stress was more obvious on alopecia areata than neurodermatitis, and that either intensity or frequent of mental stress showed no significant difference between patients and health person. The score of the patients is higher than the Chinese norm in five divided scale of MMPI. Therefore, the mental factor is only in inducing factor in these two dematoses. Methodology studing effect of factors on somatic diseases is discussed.