Effect of acupuncture and moxibustion on skin barrier function in guinea pigs with eczema of skin damp-heat accumulation / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture and moxibustion on the water content of stratum corneum (WCSC), expression of serum inflammatory factors and aquaporin 3 (AQP3) in skin, lung and rectum in guinea pigs with eczema of skin damp-heat accumulation, and to explore the possible mechanism of acupuncture and moxibustion for regulating skin barrier function.@*METHODS@#A total of 24 male albino guinea pigs were randomly divided into a blank group (n=6) and a modeling group (n=18). The guinea pigs in the modeling group were induced by 2,4-dinitrochlorobenzene (DNCB) to establish the eczema model of skin damp-heat accumulation. The guinea pigs with successful modeling were further randomly divided into a model group, a medication group and an acupuncture-moxibustion group, 6 guinea pigs in each group. The guinea pigs in the medication group were treated with loratadine tablets (0.8 mg/kg) by gavage, once a day for 7 days; the guinea pigs in the acupuncture-moxibustion group were treated with acupuncture at "Feishu" (BL 13), "Pishu" (BL 20), "Quchi" (LI 11), "Zusanli" (ST 36) and "Xuehai" (SP 10); at the same time, moxibustion was applied at "Feishu" (BL 13) and "Zusanli" (ST 36), moxibustion intervention for 10 min and needle retaining for 15 min at each acupoint, once a day for 7 days. The eczema area and severity index (EASI) score was evaluated before and After intervention, and WCSC and trans-epidermal water loss (TEWL) were measured by skin tester. After intervention, The HE staining was used to observe the changes of skin histomorphology in each group; ELISA was used to measure the contents of serum immunoglobulin E (IgE), interleukin (IL)-4 and IL-17; Western blot was used to measure the protein expression of AQP3 in skin, lung and rectum.@*RESULTS@#Before the intervention, compared with the blank group, the EASI scores and TEWL were increased in the remaining groups (P<0.01), and the WCSC was decreased (P<0.01). After the intervention, compared with the model group, the EASI scores and TEWL were decreased (P<0.05, P<0.01), and WCSC was increased (P<0.01) in the medication group and the acupuncture-moxibustion group. The epidermal structure in the blank group was complete and the fibers in the dermis were arranged orderly; in the model group, epidermal hyperkeratosis, proliferation of granular layer, spinous cell layer and basal layer, and disordered arrangement of dermal fibers and infiltration of inflammatory cells were observed. The morphological performance in the medication group and the acupuncture-moxibustion group was better than that in the model group. Compared with the blank group, the contents of serum IgE and IL-17 were increased (P<0.01), and the content of serum IL-4 and the protein expression of AQP3 in skin, lung and rectum were decreased in the model group (P<0.01, P<0.05). Compared with the model group, the contents of serum IgE and IL-17 were decreased and the contents of serum IL-4 were increased in the medication group and the acupuncture-moxibustion group (P<0.01), and the protein expression of AQP3 in skin, lung and rectum in the acupuncture- moxibustion group were increased (P<0.05). Compared with the medication group, the contents of serum IgE and IL-17 were increased (P<0.01), and the content of serum IL-4 was decreased (P<0.01) in the acupuncture-moxibustion group.@*CONCLUSION@#Acupuncture and moxibustion could improve the epidermal water metabolism and skin tissue morphology in guinea pigs with eczema of skin damp-heat accumulation. Its mechanism may be related to regulating inflammatory factors, up-regulating the expression of AQP3, and then repairing the skin barrier function.

Dermatitis numular: presentación de dos casos pediátricos / Nummular dermatitis: report of two cases in children

La dermatitis o eccema numular es una patología poco frecuente en pediatría. El cuadro se caracteriza por un inicio con diminutas pápulas y vesículas eritematovioláceas que confluyen en placas exudativas de forma circular y evolucionan a placas eccematosas o liquenificadas de forma discoide o anular. Aparecen, predominantemente, en superficies extensoras de las extremidades, aunque pueden encontrarse en el tronco, las manos o los pies. El diagnóstico es clínico; solo en casos con mala evolución pueden ser necesarias pruebas complementarias. La base del tratamiento son los corticoides tópicos y, si se encuentra un desencadenante infeccioso, el tratamiento de la causa. Su evolución suele ser crónica o recidivante. Se presentan dos casos clínicos en población pediátrica con la finalidad de difundir entre los pediatras su conocimiento y manejo.

Nummular eczema or dermatitis is an uncommon paediatric pathology. It is presented as red-purplish small papules and vesicles that join to form exudative circular patches and then to eczematous or lichenified patches with discoid shape. The lesions appear predominantly on the extensor surface of extremities, although they can appear in trunk, hands or feet. This pathology has a clinical diagnosis; only few cases require complementary test. The topical corticosteroids are the mainstay of the treatment, and the causal treatment whether an infectious trigger is found. The patients have chronic or recurrent evolution. We report two cases in children with the aim of spreading knowledge among pediatricians.

La homeopatía frente a casos con tratamiento convencional / Treating patients on conventional drugs homeopathically

Durante mucho tiempo se creyó que un paciente no podía ser tratado con Homeopatía si es que, al momento de la consulta, se encontraba siguiendo un tratamiento alopático. Los doctores Morrison y Herrick establecen las pautas generales que deben seguirse al respecto y los inconvenientes que aparecen al momento de tratar de remplazar la medicina convencional por la medicina homeópata. Una parte del trabajo rescata la opinión que tienen algunos pacientes acerca de los dos sistemas clínicos terapéuticos, así como las expectativas de la familia (y de la sociedad, por extensión) en torno al método clínico configurado por Samuel Hahnemann.

For a long time it was believed that a patient could not be treated with Homeopathy if, at the time of consultation, was following an allopathic treatment. The doctorsHerrick Morrison established the general guidelines to be followed in this regard and disadvantages that appear when trying to replace the conventional medicine homeopathic medicine. Part of the work rescues the opinion they have some patients on the two treatment clinical systems as well as the expectations of the family (and society by extension) about the clinical method set by Samuel Hahnemann.

Disulfiram and low nickel diet in the management of hand eczema: a clinical study.

BACKGROUND: Hand eczema due to nickel sensitivity is a challenging task for the dermatologist. The average human diet provides sufficient amount of nickel, which acts as a provocating factor in nickel-sensitive individuals. When such patients are treated with steroid or other immunosuppressives, only short-term remission is obtained. This is because unless the dietary intake of nickel is minimized and the existing amount of nickel in the body of the sensitized individual is depleted, long-term remission is unlikely. AIM: To evaluate the efficacy of oral disulfiram, a nickel-chelating agent and low nickel diet (LND) in reducing the clinical symptoms and preventing frequent relapse of hand eczema in nickel-sensitive individuals. METHODS: A total of 21 patients with chronic vesicular hand eczema with nickel sensitivity were taken for this study. Patients were randomly divided into two groups: (a) Study group consisting of 11 patients (8 females and 3 males). They were prescribed disulfiram orally for a period of 4 weeks; they started LND 2 weeks prior to initiation of disulfiram therapy and continued till the end of follow-up period. (b) Control (placebo) group consisting of 10 patients (7 females and 3 males). They were allowed to continue with normal diet. Each of them received lactose tablet daily as placebo for 4 weeks. It was a comparative study and participants were not aware if they belonged to study group or control group (single blind trial). RESULTS: Hand eczema healed completely in 10 (90.9%) out of 11 patients treated with disulfiram and LND during the treatment period in the study group, compared with 1 out 10 patients in control (placebo) group (non significant). Mild relapse was noted in 5 patients in between 2-12 weeks of follow-up period. CONCLUSION: Low nickel diet and short course of oral disulfiram therapy can be considered a good option for the control of chronic hand eczema in nickel-sensitive individuals.