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Objective:To summarize clinical manifestations and histopathological features of granular parakeratosis (GP) after exposure to benzalkonium chloride.Methods:A retrospective analysis was performed on 7 GP cases with a history of benzalkonium chloride exposure in the Department of Dermatology at Wuhan No.1 Hospital from April to August 2022. Data were collected on the general condition, skin lesion manifestations, pathological examination, treatment, and follow-up of the patients, and retrospectively analyzed.Results:The 7 adult patients with GP typically presented with erythema and brown scales in the intertriginous area, exhibiting an annular distribution pattern. All the 7 patients reported recent exposure to disinfectants containing benzalkonium chloride. A total of 10 skin biopsies were taken from the 7 patients. Histopathological examination showed characteristic hyperkeratosis and fine blue-gray parakeratotic granules in the stratum corneum. All skin lesions improved 1 month after cessation of exposure to benzalkonium chloride.Conclusion:GP has a distinct clinical pattern and histopathological manifestations, and a history of exposure to benzalkonium chloride can be helpful for the diagnosis of GP.
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Objective:To retrospectively analyze clinical characteristics and treatment of pemphigus/bullous pemphigoid (BP) complicated by herpes simplex virus (HSV) infection.Methods:Inpatients with pemphigus/BP complicated by HSV infection were collected from Wuhan No.1 Hospital from 2016 to 2021, and their clinical characteristics, treatment and follow-up results were retrospectively analyzed.Results:Among the 8 patients with pemphigus/BP complicated by HSV infection, there were 2 males and 6 females, and their age was 50.6 ± 8.3 years. Five of them were diagnosed with pemphigus vulgaris (PV), 1 with pemphigus foliaceus (PF), and 2 with BP. Seven were infected with HSV-1, and 1 with HSV-2. All the 8 patients were given systemic glucocorticoids and immunosuppressive agents for the treatment of pemphigus or BP, and were admitted to the hospital due to resistance to the treatment. Seven patients presented with exacerbation or recurrence of primary lesions, and 1 presented with enlarged lesions all over the body. HSV infection-induced lesions were located on the trunk in 4 cases, on the oral mucosa in 4, on the scalp in 3, and on the face in 2; lesions mainly manifested as irregular erosions with blood crusts, and some centrally umbilicated pustules; 7 patients had obvious pain at the lesional sites. During HSV infection, anti-desmoglein 1 antibody levels decreased in all the 6 patients with pemphigus, and anti-desmoglein 3 antibody levels decreased in 4 of the 5 patients with pemphigus vulgaris; anti-BP180 antibody levels decreased in 1 patient with BP, but increased in the other one with BP. After antiviral therapy at adequate doses for adequate durations (7- to 14-day treatment with valacyclovir alone or in combination with ganciclovir), HSV infection was controlled, the autoimmune bullous skin disorder intensity scores decreased compared with those before the antiviral therapy, and pain was significantly relieved in all the patients. No dose adjustment of glucocorticoids or other immunosuppressive agents was made during antiviral therapy in all patients.Conclusion:HSV infection should be considered when patients with pemphigus/BP suffer from recurrence or exacerbation and poorly respond to conventional treatment; for patients with pemphigus/BP complicated by HSV infection, systemic antiviral therapy at adequate doses can be used to control the disease condition without modifying the conventional immunosuppressive regimen.
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Objective:To investigate the risk factors of pressure injury in patients with advanced cancer.Methods:100 patients with advanced malignant tumors who received treatment in The First People's Hospital of Huzhou from January to December 2019 were included in this study. After filling in data registration form, all patients received the first pressure injury risk assessment to assess their skin conditions within 2 hours after admission. At the same time, Karnofsky Performance Scale (KPS), Braden Scale score, serum albumin and hemoglobin levels were determined and assessed. Logistic multiple regression was used to analyze the correlation between various factors and stress injury.Results:Among the 100 patients, five patients had pressure injury. The incidence of hospital-acquired pressure injury was 5.00%. These five patients, consisting of three males (60.0%) and two females (40.00%), were aged 38-89 years. One (20%) patient had stage I pressure injury, three (60%) patients had type II pressure injury, and one (20.00%) patient had non staged injury. Pressure injury was compared between patients at different ages, with different Braden Scale scores, serum albumin and hemoglobin levels, KPS scores ( χ2 = 7.916, 34.657, 5.432, 18.034, 38.922, all P < 0.05). The incidence of pressure injury in patients aged ≥ 70 years with low serum albumin level, low hemoglobin level, KPS score ≤ 30 points, Braden Scale score ≤ 16 points was significantly higher than that in patients aged < 70 years with high serum albumin level, high hemoglobin level, KPS score > 30 points, Braden Scale score > 16 points ( χ2 = 18.034, 5.432, 7.916, 38.922, 34.657, all P < 0.05). Taking pressure injury as the dependent variable and a single factor as the independent variable, correlation analysis results revealed that low serum albumin level, low hemoglobin level, age ≥ 70 years, KPS score ≤ 30 points, Braden Scale score ≤ 16 points were independent risk factors for pressure injury in advanced cancer. Conclusion:KFS score, Braden scale score, serum albumin and hemoglobin levels are closely related to the occurrence of pressure injury in patients with advanced cancer. They are independent risk factors for pressure injury in patients with advanced cancer.
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Objective@#To observe the clinical effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis(SAP) complicated with paralytic ileus.@*Methods@#A total of 60 SAP patients complicated with paralytic ileus treated in the First People's Hospital of Huzhou from June 2015 to June 2017 were selected and randomly divided into two groups by random lottery method, with 30 cases in each group.The two groups were treated with routine anti-infection and rehydration.The control group was treated with traditional Chinese medicine enema combined with placebo, and the observation group was treated with traditional Chinese medicine enema combined with rhubarb on Shenque acupoint, and the two groups were treated for 7d.The recovery time of blood amylase, bowel sounds recovery time, first self defecation time, local complications and mortality were observed in the two groups.@*Results@#The recovery time of blood amylase, the recovery time of intestinal sound and the time of the first defecation were (8.87±2.30)d, (2.88±1.09)d and (3.51±1.32)d, respectively, which were significantly shorter than those of the control group [(10.29±2.01)d, (3.67±1.30)d and (4.57±1.41)d], the differences were statistically significant(t=-3.601, -3.607, -4.251, all P<0.001). The incidence rate of local complications in the observation group was 6.7%(2/30), which was significantly lower than 36.7%(11/30) in the control group(χ2=16.875, P<0.001), and there was no statistically significant difference in the mortality rate between the two groups(χ2=3.333, P=0.068).@*Conclusion@#The application of Chinese medicine enema combined with the acupoint of rhubarb in the treatment of SAP patients complicated with paralytic ileus can effectively promote the recovery of intestinal peristalsis, shorten the duration of paralytic intestinal obstruction, reduce the complications and improve the clinical effect.
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Objective To observe the clinical effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis(SAP) complicated with paralytic ileus.Methods A total of 60 SAP patients complicated with paralytic ileus treated in the First People's Hospital of Huzhou from June 2015 to June 2017 were selected and randomly divided into two groups by random lottery method,with 30 cases in each group.The two groups were treated with routine anti-infection and rehydration.The control group was treated with traditional Chinese medicine enema combined with placebo,and the observation group was treated with traditional Chinese medicine enema combined with rhubarb on Shenque acupoint,and the two groups were treated for 7d.The recovery time of blood amylase,bowel sounds recovery time,first self defecation time,local complications and mortality were observed in the two groups.Results The recovery time of blood amylase,the recovery time of intestinal sound and the time of the first defecation were (8.87 ± 2.30) d,(2.88 ± 1.09) d and (3.51 ± 1.32) d,respectively,which were significantly shorter than those of the control group [(10.29 ± 2.01) d,(3.67 ± 1.30) d and (4.57 ± 1.41) d],the differences were statistically significant (t =-3.601,-3.607,-4.251,all P ＜ 0.001).The incidence rate of local complications in the observation group was 6.7％ (2/30),which was significantly lower than 36.7％ (11/30) in the control group(x2 =16.875,P ＜ 0.001),and there was no statistically significant difference in the mortality rate between the two groups (x2 =3.333,P =0.068).Conclusion The application of Chinese medicine enema combined with the acupoint of rhubarb in the treatment of SAP patients complicated with paralytic ileus can effectively promote the recovery of intestinal peristalsis,shorten the duration of paralytic intestinal obstruction,reduce the complications and improve the clinical effect.