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Metabolic syndrome (MS) is a set of clinical symptoms characterized by multiple concurrent metabolic disorders, and is an important risk factor for type 2 diabetes and cardiovascular diseases in individuals. Its pathogenesis is still unclear, and may be associated with insulin resistance, chronic inflammatory reactions and oxidative stress. Studies have shown that MS is closely related to papulosquamous skin diseases, skin adnexal diseases, dermatitis and eczematous skin diseases, pigmentary skin disorders and so on. This review summarizes the relationship between MS and related skin diseases.
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Objective To investigate risk factors for and clinical features of steroid-induced diabetes mellitus due to glucocorticoid treatment.Methods Clinical data were collected from 798 patients who received systemic glucocorticoid treatment in Department of Dermatology of Hangzhou Third People's Hospital from 2013 to 2016,and analyzed retrospectively.Logistic regression analysis was performed to analyze the factors influencing the occurrence of steroid-induced diabetes mellitus (SDM),repeatedmeasures analysis of variance to compare peripheral blood glucose levels of patients with SDM after breakfast,lunch and dinner,and t test to compare the levels of fasting blood glucose and glycosylated hemoglobin (HbA1 c) between patients with SDM and those with type 2 diabetes mellitus.Results Of the 798 patients,38 developed SDM due to glucocorticoid treatment.The average age was significantly older in the patients with SDM ([66.86 ± 13.30] years,n =38) than in those without SDM ([39.95 ± 17.01] years,n =760;t =8.86,P < 0.01),but there was no significant difference in the gender ratio between the patients with and thhose without SDM (x2 =1.61,P =0.20).The prevalence of fatty liver,hyperlipidemia,hypertension,abnormal liver function and family history of diabetes mellitus was significantly higher in the patients with SDM than in those without SDM (x2 =12.25,19.25,32.69,21.47,16.70 respectively,all P <0.01).Logistic regression analysis showed that age,fatty liver,hyperlipidemia,hypertension,abnormal liver function,dosage of glucocorticoids,duration of glucocorticoid therapy,use of immunosuppressive agents and family history of diabetes mellitus were risk factors for SDM (all P < 0.05).There were no significant differences in fasting blood glucose levels or postprandial peripheral blood glucose levels among the SDM patients receiving glucocorticoid therapy at different dosages of 0.50-0.74,0.75-0.99,1.00-1.25 mg·kg-1· d-1 (P > 0.05).The peripheral blood glucose levels after breakfast,lunch and dinner were (11.50 ± 2.90),(16.02 ± 5.81) and (16.81 ± 4.52) mmol/L respectively in the patients with SDM.The levels of fasting blood glucose and glycosylated HbA 1 c were both significantly lower in the patients with SDM than in those with type 2 diabetes mellitus (t =3.74,9.92 respectively,both P < 0.001).Conclusions The risk factors for SDM are age,dosage of glucocorticoids,duration of glucocorticoid therapy,fatty liver,hyperlipidemia,hypertension,abnormal liver function,use of immunosuppressive agents and family history of diabetes mellitus.The patients with SDM showed obviously elevated blood glucose levels mostly after lunch and dinner,but slightly increased levels of fasting blood glucose and glycosylated HbA 1c,which can be used to distinguish between SDM and type 2 diabetes mellitus.
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Objective To analyze the clinocopathological characteristics of infectious granulomas.Methods The clinical features,histopathological manifestations of 39 patients with infectious granulomas were analyzed retrospectively.Results Among 39 cases of infectious granulomas,there were 15 males and 24 females,and 17 cases of fungal granuloma and 22 cases of tuberculous granuloma.There was no statistically significant difference in gender and age between fungal granulomas and tuberculous granulomas.The mean course of tuberculous granuloma aud tuberculous granuloma was (0.88 ± 0.67) years and (5.54 ± 3.49) years,respectively (t =4.51,P =0.00);there was no significant difference in mean age of onset in fungal granuloma patients and tuberculous granuloma patients [(54.6 ± 19.6) vs.(47.6 ± 18.1) years,P >0.05)].There were 4 and 18 cases of fungal and tuberculous granulomatosis at the face,and 13 and 3 cases at the extremities (all P =0.00);the lesions occurred in the trunk in one case of tuberculous granuloma.The clinical manifestations of fungal and tuberculous granulomas as plaques/nodules were in 14 cases aud 22 cases (P =0.08);as ulcers and pus exudates were in 10 and 2 cases,respectively (P =0.00).The histopathological features showed epidermal hyperplasia in 12 and 4 cases,infiltrative patterns in 4 and 21 cases,infiltration of neutrophils in 14 and 3 cases,infiltration of plasma cells in 15 and 5 cases,infiltration of eosinophils in 10 and 0 cases,necrosis in 1 and 10 cases in fungal granulomas and tuberculous granulomas,respectively (P =0.00,0.00,0.00,0.00,0.00,0.01).Conclusion Fungal granuloma and tuberculous granuloma are different in the lesion sites,clinical manifestations and histopathological features.
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Objective To evaluate the effect of green tea polyphenol epigallocatechin-3-gallate (EGCG)and ultraviolet B (UVB) on the expression of aquaporin 3 and epidermal growth factor receptor (EGFR)/extracellular signal-regulated protein kinase (ERK) signaling pathway in keratinocytes.Methods Twenty healthy human subjects were enrolled in this study.Both legs of each subjects were separated into 4 areas to remain untreated (control area),be topically treated with 3% and 1% EGCG cream and the vehicle of EGCG cream respectively once a day for 2 weeks followed by the measurement of skin moisture content and transepidermal water loss (TEWL).Cultured keratinocytes were classified into various groups to be irradiated with different doses (10,20 and 30 mJ/cm2) of UVB,or be pretreated with different concentrations of EGCG (10-7,10-6,10-5 mol/L) or EGFR/ERK phosphorylation inhibitors for 1 hour followed by irradiation with UVB of 30 mJ/cm2.After various durations of additional culture,Western blot was conducted to quantify the expression of AQP3 and phosphorylated-EGFR (p-EGFR) and-ERK (p-ERK) of keratinocytes.Data were processed by SPSS 10.0 software,and statistical analysis was carried out by t test.Results Skin moisture content was significantly increased,while TEWL was decreased in healthy skin after treatment with 1% and 3% EGCG cream compared with vehicle-treated skin areas and untreated skin areas.Increased AQP3 expression was observed in keratinocytes pretreated with EGCG of 10-7,10-6,10-5 mol/L (172.36 ± 12.42,320.66 ± 15.51 and 368.10 ± 11.39 vs.100.00,t =12.16,26.75 and 38.62 respectively,all P < 0.05) and in those pretreated with the EGFR inhibitor PD153035 of 1.0 μmol/L and ERK inhibitor U0126 of 10 μmol/L (413.85 ± 25.27 and 268.85 ± 16.33 vs.100.00,t =35.16,19.25 respectively,both P < 0.05)compared with those irradiated with UVB of 30 mJ/cm2 alone.UVB irradiation stimulated the phosphorylation of EGFR/ERK in keratinocytes,and the stimulation was markedly inhibited by the pre-treatment with EGCG of 10-7,10-6 and 10-5 mol/L (all P < 0.05).Conclusions EGCG can enhance skin barrier function.AQP3 expression is down-regulated by UVB irradiation in keratinoctyes,while EGCG can inhibit the downregulation likely by suppressing the UVB-induced activation of EGFR and ERK.
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ObjectiveTo evaluate the effect of large-spot and low-energy Q switched Nd:YAG laser on melasma,and to observe the changes of melasma lesions with confocal laser scanning microscopy (CLSM) before and after the laser treatment.MethodsTotally,45 patients aged from 24 to 48 years and diagnosed with facial melasma were included in this study,and treated with large-spot and low-energy Q switched Nd:YAG once a week for 10 or more sessions.CLSM was used to estimate the melanin content in melasma lesions before each irradiation and after the last irradiation.ResultsAmong the 45 patients,8 ( 17.78% ) were nearly cured,25 (55.56%) markedly improved,11 (24.44%) improved,and only 1 (2.22%) unimproved after the laser irradiation.The total response rate was 73.33%.As CLSM showed,there was an increment in melanin granules in melasma lesions compared with the normal skin surrounding melasma lesions,but a reduction in melanin granules was induced by the laser treatment in melasma lesions.ConclusionsLarge-spot and lowenergy Q switched Nd∶YAG laser is substantially effective and highly safe for the treatment of melasma,and CLSM can be used to evaluate the therapeutic effect of laser on melasma.
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Objective To explore the influences of extracellular matrices (ECM) secreted by ultraviolet B (UVB)-induced senescent fibroblasts on the proliferation of and extracellular signal-regulated kinase (ERK) signaling in HaCaT cells. Methods Fibroblasts were irradiated with UVB of 15 mJ/cm2 once daily for 5 days to induce premature senescence, which was identified by SA-β-gal staining 72 hours after the last irradiation.HaCaT cells were divided into 3 groups and inoculated into plates coated with extracellular matrices secreted by non-senescent (PRE-ECM) or senescent fibroblasts (SIPS-ECM) or into uncoated plates (NON-ECM), fol-lowed by additional culture. U0126, an inhibitor of ERK1/2, was used to treat the HaCaT cells 1 hour before inoculation. Then, MTT assay was carried out to detect the proliferation of HaCaT cells after a 3-day culture,Western blot to assess the phosphorylation of ERK at 0.5, 1, 2 and 4 hours after the inoculation, flow cytometry to analyse cell cycle and apoptosis after 24 hours of culture. Results The most rapid and intense phosphory-lation of ERK was observed in SIPS-ECM group. Inhibiting the activation of ERK pathway with U0126 could completely suppress the promoting effect of ECM from senescent fibroblasts on the proliferation of HaCaT cells.After the blocking of ERK activation, the proportion of HaCaT cells in S and G2/M phase decreased from 37.40%, 41.34% and 43.31% to 29.41%, 36.48% and 39.96%, respectively, in NON-ECM, PRE-ECM and SCIP-ECM group. Conclusion The ECM produced by UVB-induced senescent fibroblasts promote the prolifera-tion of HaCaT cells via inducing the phosphorylation of ERK.
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Objective To investigate the mechanism of repigmentation in vitiligo induced by narrow band ultraviolet B (NB-UVB) via observing the effects of 311 nm NB-UVB on the proliferation of, apoptosis and melanogenesis in melanocytes. Methods Immortalized B10BR melanocytes were irradiated with NB-UVB at varying doses (400, 800 and 1200 mJ/cm2). Subsequently, the proliferation of and apoptosis in melanocytes were detected by MTT assay and flow cytometry, respectively, and the content of melanin was determined by NaOH assay. The expression of BCL-2 mRNA was examined by RT-PCR, and MC-1R expression of melanoeytes by immunocytochemistry and Western blotting. Results The proliferation of and apoptosis in melanocytes experienced no obvious change after irradiation with NB-UVB at the three tested doses. In B10BR melanocytes irradiated with NB-UVB at 400, 800 and 1200 mJ/cm2, the melanin content was 1.42, 1.78, 2.05 times, the mRNA expression of BCL-2 was 1.75, 2.32, 3.28 times, and the protein expression of MC-1R was 1.68, 2.35 and 3.01 times, that in unirradiated melanocytes, respectively. Conclusion NB-UVB irradiation at therapeutic doses could promote the melanogenesis in, enhance anti-oxidative stress activities of melanocytes,by upregulating the expressions of BCL-2 and MC-1R, with no marked effects on the apoptosis in melanocytes.
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ngthen cellular immunity, especially Th1-type immune response to HPV11-E7 DNA vaccine in mice.