Efficacy and safety of fractional radiofrequency in treatment of acne scar / 中华医学美学美容杂志

Objective:To observe the efficacy and adverse reactions of fractional radiofrequency (FRF) in the treatment of facial acne scars.Methods:Fifty-seven patients with facial acne depressed scars were enrolled with the nature of Dreno scars as the diagnostic criteria. They were treated with lattice radiofrequency. The treatment heads were arranged in a matrix with a treatment area of 1.2 cm ×1.2 cm, an energy density of 80-100 mJ/pin, and an interval of five-seven once a week. And they were followed up and evaluated for the clinical efficacy and adverse reactions 6 months after the last treatment. Scoring was carried out according to the ECCA weight scores, and the efficacy judged according to complete improvement, significant improvement, moderate improvement, and mild improvement.Results:After 3 times of fractional radiofrequency treatment of 57 patients, the effective rate was 44 cases, accounting for 77.2%; the ECCA weight scores before and after treatment were 65.9±25.0 and 47.7±20.2, respectively; the difference was statistically significant ( t=13.92, P<0.001); At the same time of improvement, 32 cases of patients' complexion, fineness of pores, and skin elasticity had been improved to varying degrees, and patient satisfaction was high. Adverse reactions were mainly mild burning sensation, erythema and edema, and some patients had pale yellow exudate, etc, which could be relieved in 5-7 days. Conclusions:Fractional radiofrequency treatment of facial acne scars is safe and effective, with short recovery period, few adverse reactions and high patient satisfaction.

Efficacy and safety of 308-nm SQ light-emitting diode light and 308-nm excimer light in the treatment of facial vitiligo: a retrospective study / 中华皮肤科杂志

Objective:To compare efficacy and safety of 308-nm SQ light-emitting diode (LED) light versus 308-nm excimer light in the treatment of facial vitiligo.Methods:Patients with stable facial vitiligo were retrospectively collected from Department of Physical Therapy, Hospital of Dermatology, Chinese Academy of Medical Sciences from June 2018 to June 2020, who received treatment with 308-nm SQ LED light (LED group) or 308-nm excimer light (excimer light group). The treatment was performed once or twice a week, and patients who had received more than 8 sessions of treatment were included in the analysis of efficacy and safety. Statistical analysis was carried out by using chi-square test.Results:Totally, 68 patients with 90 lesions were enrolled into the LED group, including 36 males and 32 females, aged 25.01 ± 13.37 years; 20 patients with 28 lesions were enrolled into the excimer light group, including 13 males and 7 females, aged 27.15 ± 14.30 years. After 8 and 16 sessions of treatment, there was no significant difference in the response rate between the LED group (23.33%, 46.67%, respectively) and excimer light group (14.29%, 46.43%, χ2 = 1.05, < 0.001, respectively, both P > 0.05). During the treatment, 36 (52.94%) patients in the LED group developed persistent erythema, 17 (85%) in the excimer light group developed persistent erythema or blisters. The incidence of adverse reactions was significantly lower in the LED group than in the excimer light group ( χ2 = 16.43, P < 0.001) . Conclusion:Compared with the 308-nm excimer light, the 308-nm SQ LED light showed similar effect but higher safety for the treatment of facial vitiligo.

Application of phototherapy in cutaneous T-cell lymphomas / 中华皮肤科杂志

Cutaneous T-cell lymphomas (CTCL) are malignancies derived from T cells. The aim of its treatment is to control symptoms and achieve long-term remission, and phototherapy alone or in combination is one of important treatment methods. Phototherapy of CTCL includes psoralens and ultraviolet A radiation, narrowband and broadband ultraviolet B radiation, extracorporeal photochemotherapy, photodynamic therapy, ultraviolet A1 radiation, 308-nm excimer laser, and so on. Efficacy of phototherapy is associated with various factors, such as stage of disease, sites of lesions, types of skin photoreaction, etc. In clinical practice, phototherapy involves clearance, consolidation and maintenance phases, but it is still disputed whether maintenance treatment can control the recurrence of CTCL. Understanding action mechanisms, indications, therapeutic effects and adverse effects of phototherapy is helpful in selecting the best treatment protocol.

Expression of proprotein convertase subtilisin/kexin type 9 in the plasma of patients with psoriasis and its effect on the activation of peripheral CD4+ T cells / 中华皮肤科杂志

Objective To investigate the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in the pathogenesis of psoriasis by detecting the level of PCSK9 in the plasma of patients with psoriasis and evaluating its effect on the secretion of interferon gamma (IFN-γ) and interleukin-17A (IL-17A) by peripheral CD4+ T cells.Methods Totally,30 outpatients with psoriasis vulgaris and 30 healthy volunteers (controls) were enrolled from Hospital for Skin Diseases,Chinese Academy of Medical Sciences between February 2016 and December 2017.Of the 30 patients,16 were males,and 14 were females.Their age varied from 18 to 66 years,and the course of disease ranged from 1 month to 15 years.Peripheral venous blood samples were obtained from the patients and controls,and the plasma and was performed to measure mRNA expression of PCSK9 in the PBMC,and enzyme-linked immunosorbent assay (ELISA) to determine the concentration of PCSK9 in the plasma.Peripheral CD4+ T cells were isolated from the PBMC by magnetic bead method,and divided into 2 groups to be co-cultured with (experiment group) or without PCSK9 protein (control group).After 24-hour treatment,ELISA was conducted to detect the levels of IFN-γ and IL-17A in the culture supernatant.Statistical analysis was carried out by using two-sample t test for the comparison between the two groups,and Pearson correlation analysis for analyzing correlations between the plasma level of PCSK9 and psoriasis area and severity index (PASI) score in the patients with psoriasis.Results PCSK9 mRNA expression was undetected in the PBMC of the patients with psoriasis and controls.The plasma level of PCSK9 was significantly higher in the patients with psoriasis ([243.58 ± 11.91] μg/L) than in the healthy controls ([199.74 ± 31.09] μg/L,t =5.761,P ＜ 0.001).After co-culture of the peripheral CD4+ T cells from patients with PCSK9 protein,the levels of IFN-γ and IL-17A both significantly increased ([6 150.00 ± 212.13] ng/L,[1 532.00 ± 11.31] ng/L,respectively) compared with the control group co-cultured without PCSK9 protein ([4 650.00 ± 212.13] ng/L,[698.5 ± 266.58] ng/L,respectively;t =7.071,4.418 respectively,both P ＜ 0.05).IFN-γand IL-17A were undetected in the culture supernatant of CD4+ T cells from the healthy controls in the experiment group or control group.Conclusion The plasma level of PCSK9 increases in patients with psoriasis,which may be involved in the pathogenesis of psoriasis by activating peripheral CD4+ T cells.

mRNA expression of DNA methyltransferase 2 and 3a in the epidermis of patients with psoriasis vulgaris / 中华皮肤科杂志

Objective To investigate the expression of DNA methyltransferase 2 (DNMT2) and 3a (DNMT3a) in the epidermis of patients with psoriasis vulgaris.Methods Between March 2009 and December 2010,46 patients with psoriasis vulgaris were enrolled from the Department of Dermatology,Hospital for Skin Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,and the Department of Dermatology of Yixing People's Hospital,and 28 healthy controls were enrolled from the Department of Dermatologic Surgery,Hospital for Skin Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College.Real-time quantitative PCR was performed to determine the mRNA expression of DNMT2 and DNMT3a in the epidermis of the lesional and nonlesional skin of patients with psoriasis vulgaris,as well as in the epidermis of normal skin of the healthy controls.Results The mRNA expression of DNMT2 (expressed as 2-△△Ct) in the lesional skin,non-lesional skin of the patients and normal skin of the healthy controls was 0.62 ± 0.02,0.36-± 0.05 and 0.15 ± 0.11,respectively.The mRNA expression of DNMT2 was significantly higher in the lesional skin than in the non-lesional skin of the patients (t =6.23,P ＜ 0.01),and higher in the non-lesional skin of the patients than in the normal skin of the healthy controls (t =7.33,P ＜ 0.01).Additionally,the mRNA expression of DNMT3a was significantly higher in the lesional skin (0.85 ± 0.03) than in the non-lesional skin (0.43 ± 0.04) of the patients (t =5.66,P ＜ 0.01),and higher in the non-lesiona] skin of the patients than in the normal skin of healthy controls (0.18 ± 0.09,t =8.62,P ＜ 0.01).Conclusion Both DNMT2 and DNMT3a mRNA were abnormally expressed in the epidermis of patients with psoriasis vulgaris.

Detection of T cells and melanocytes in skin of patients with psoriasis and their clinical significance / 中华皮肤科杂志

Objective To investigate the relationship of CD4+ and CD8+ T cells with melanocytes in skin of patients with psoriasis,and to study their clinical significance.Methods Tissue specimens were obtained from both lesional and nonlesional skin of 29 patients with progressive psoriasis and 5 patients with regressive psoriasis,as well as from normal skin of 6 healthy individuals.Immunohistochemical staining was performed to determine the quantity and distribution of CD4+ T and CD8+ T cells,as well as the quantity of melanocytes and proportion of cells containing pigment granules in the basal layer of these specimens.Statistical analysis was carried out with the software SPSS 18.0 by one-way analysis of variance (ANOVA),least significant difference (LSD) test and Pearson correlation analysis.Results In patients with psoriasis,the mean number of CD4+ T cells per high-power (× 200) field was significantly larger in lesional skin than in nonlesional skin (epidermis:5.29 ± 4.66 vs.0,P＜ 0.05;dermis:77.50 ± 43.66 vs.9.67 ± 7.73,P＜ 0.05),so was the mean number of CD8+ T cells per high-power (× 200) field (epidermis:7.83 ± 6.27 vs.0.71 ± 1.20,P＜ 0.05;dermis:46.08 ± 34.26 vs.5.54 ± 4.43,P ＜ 0.05).A significant increase was also observed in the number of CD4+ and CD8+ T cells in lesional skin of patients with psoriasis compared with the normal control skin (both P ＜ 0.05).The lesional skin of patients with psoriasis also showed significandy increased number of melanocytes (103.45 ± 16.96),but decreased proportion of pigment granule-containing cells (7.45％ ± 3.86％) in the basal layer compared with nonlesional skin (43.62 ± 14.20,P＜ 0.05;43.10％ ± 14.91％,P＜ 0.05) and normal control skin (43.33 ± 14.02,P＜ 0.05;54.17％ ± 29.40％,P ＜ 0.05).There were no significant differences in either the mean number of CD4+ T cells,CD8+ T cells and melanocytes or the proportion of pigment granule-containing cells between nonlesional psoriatic skin and normal control skin (all P ＞ 0.05).The mean number of melanocytes was significantly higher in regressive psoriatic lesions than in white patches arising in subsided psoriatic lesions (P ＜ 0.05) and normal control skin (P ＜ 0.05),but similar between white patches and normal control skin (P ＞ 0.05),while the proportion of pigment granule-containing cells was insignificantly lower in regressive psoriatic lesions than in white patches (P ＞ 0.05),and significantly lower in regressive psoriatic lesions and white patches than in normal control skin (both P ＜ 0.05).Neither the number of CD4+ T cells nor that of CD8 + T cells was correlated with the number of melanocytes or the proportion of pigment granule-containing cells in progressive psoriatic lesions (both P ＞ 0.05),while the number of both CD4 + T cells and CD8 + T cells was positively correlated with that of melanocytes (r =0.46 and 0.56,respectively,both P ＜ 0.05),but uncorrelated with the proportion of pigment granule-containing cells in nonlesional psoriatic skin (both P ＞ 0.05).Conclusions In progressive psoriatic lesions,there is a significant increase in the number of CD4+ and CD8 + T cells as well as melanocytes in the basal layer,but a significant decrease in the proportion of pigment granule-containing cells.After subsidence of psoriatic lesions,both the number of melanocytes and proportion of pigment granule-containing cells gradually reach the levels in normal skin of healthy individuals.

Detection of tissue-resident memory T lymphocytes in patients with psoriasis / 中华皮肤科杂志

Objective To investigate the role of tissue-resident memory T lymphocytes in the pathogenesis of psoriasis.Methods Clinical information was collected from 32 patients with progressive plaque psoriasis.Tissue specimens were obtained from both lesional and nonlesional psoriatic skin of all the patients,as well as from faded lesions in 9 of these patients.Tissue specimens from the normal skin of 10 healthy individuals served as the controls.Immunohistochemical staining was performed to detect the two characteristic surface markers CD69 and CDI03 on tissue-resident memory T lymphocytes and to analyze the status of these T lymphocytes at different stages of psoriasis.The results of immunohistochemical staining were compared by t test.Results The mean number of CD69+CD103+ T lymphocytes per high-power field was significantly higher in lesional skin than in nonlesional skin of the 32 patients (11.34 ± 7.60 vs.2.72 ± 4.20,t =8.46,P ＜ 0.01),but similar between psoriatic lesions in the 9 patients before and after subsidence (14.33 ± 2.21 vs.12.00 ± 4.58,t =1.98,P =0.08).There was no significant difference in the mean number of CD69+CD103+ T lymphocytes between nonlesional psoriatic skin and normal control skin (2.72 ± 4.20 vs.1.70 ± 2.98,t =0.71,P ＞ 0.05).Conclusion Tissue-resident memory T lymphocytes may play a role in the formation and recurrence of psoriatic lesions in patients.