Observations on the Efficacy of Fire Needling Therapy for Vitiligo / 上海针灸杂志

Objective To assess the clinical efficacy and safety of fire needling therapy for vitiligo. Method A self-control study was carried out. Fifty-six vitiligo patients with 124 skin lesions were allocated by long-axis random to two groups. The treatment group received fire needling therapy weekly for 12 times or until cure and the control group, no treatment as a blank control. The clinical efficacy and safety were assessed after the completion of treatment. Result The total efficacy rate of local fire needling therapy for vitiligo skin lesions was 79.8% and there was a statistically significant difference as compared with the control group (P<0.05). The therapeutic effect was better in patients with faciocervical skin lesions or short course of disease. The therapeutic effect increased with an increase in the course of treatment at the early stage of treatment but did not significantly increase after 8 weeks of treatment. Main adverse reactions were mild pain and skin infection. Conclusion Local fire needling has a definite therapeutic effect on vitiligo with high safety.

Clinical features of 70 cases of psoriatic arthritis / 中华皮肤科杂志

Objective To investigate the prevalence of psoriatic arthritis (PsA) in patients with psoriasis and its clinical features.Methods A cross-sectional study was conducted among patients diagnosed with psoriasis from January 2014 to January 2015.Through a questionnaire survey,the diagnosis of PsA was confirmed according to the Classification Criteria for Psoriatic Arthritis (CASPAR) in patients with suspected PsA.Clinical data were collected from patients with newly and previously diagnosed PsA.Statistical analysis was carried out by t test for two-group comparisons,one-way analysis of variance (ANOVA) for multi-group comparisons,and chi-square test for comparisons of rates.All the statistical tests were two-sided.Results Totally,1 062 outpatients with psoriasis were enrolled into this study,and 125 were suspected to have PsA.According to the CASPAR,70 (6.59％) patients were finally diagnosed with PsA,with the ratio of male to female being 2.1 ∶ 1,and 45 of them (64.29％) were newly diagnosed.Psoriasis vulgaris lesions were observed in 50 (71.43％) patients with PsA,and were the most common type of skin lesions in patients with PsA.There were 5 clinical types of PsA in these patients,including asymmetrical oligoarthritis (23 cases,32.86％),symmetric polyarthritis (19 cases,27.14％),distal interphalangeal predominant arthritis (10 cases,14.29％),vertebral or sacroiliac arthropathy (7 cases,10.00％),and arthritis mutilans (11 cases,15.71％),with some overlap among these clinical types.As relatively distinctive manifestations of PsA,dactylitis and enthesitis were observed in 14 (20.00％) and 8 cases (11.43％) respectively.In addition,43 (61.43％) cases had nail involvements.Conclusion To master clinical features of PsA and to diagnose it early are of great significance for long-term prognosis of PsA patients.

Adult-onset atopic dermatitis / 中华皮肤科杂志

Atopic dermatitis (AD) is an inflammatory skin disease closely related to impairment of skin barrier function.Hereditary factors,life style and exposure to the environment all contribute to the occurrence of AD.Even though AD occurs mostly in infants,sometimes it may initially occur in adults,which is called adult-onset AD (AOAD).There are evident differences in types,immunological mechanisms and association with other diseases between childhood AD and AOAD.The lesional distribution of AOAD is similar to that of childhood AD,while AOAD is characterized by subacute and chronic dermatitis,and mainly manifests as dry hypertrophic lesions rarely complicated with exudation.Th1/Th2 imbalance and hyperfunction of antigen-presenting cells are immunological basis of AD occurrence.Moreover,FLG gene mutations are associated with the occurrence of AD.Acquired expression defect in the FLG gene induced by elevated levels of interleukin-13 (IL-13) only occurs in adults,suggesting that AOAD is different from AD that initially occurs during infancy and continues into adulthood.Infection,changes of bacterial flora in the skin and intestinal tract,and smoking are all important causative factors of AOAD,thus enquiries about histories of related diseases and smoking are helpful for the diagnosis of AOAD.

Mutation analysis of GJB2 gene in a patient with keratitis-ichthyosis-deafness syndrome / 中华皮肤科杂志

Objective To investigate the clinical features of and GJB2 gene mutations in a Chinese Han patient with keratitis-ichthyosis-deafness syndrome (KID syndrome),in hope to offer evidence for the clinical and genetic diagnosis of KID syndrome.Methods Clinical data were collected from a patient with KID syndrome.DNA was extracted from peripheral blood of the patient and his two family members (mother and brother).PCR was performed to amplify the exon 2 and its flanking splicing sites of GJB2 gene followed by bidirectional direct DNA sequencing. Results The patient presented with the typical triad of vascularizing keratitis,ichthyosis and congenital deafness.A G148A mutation in the exon 2 of GJB2 gene,resulting in the substitution of aspartic acid by asparagine at position 50 of the junction protein connexin 26 (Cx26),was identified in the patient,but not in either of his family members.Conclusion The G148A mutation in GJB2 gene may be responsible for the clinical phenotype of KID syndrome in this Chinese patient.