Clinical Characteristics and Therapeutic Aspects of Blaschko Linear Psoriasis.

INTRODUCTION: Blaschko linear psoriasis (BLP) is characterized by the linear distribution of psoriatic skin lesions along the Blaschko lines. BLP can be divided into type I and type II, mainly on the basis of clinical manifestations. BLP can easily cause psychological burdens in patients and clinical confusion for physicians. Here, we summarize clinical cases to provide a better understanding of BLP. METHODS: The subjects included patients with BLP who visited our dermatology departments and those reported in the literature obtained from the PubMed and Wanfang databases. Quantitative data were presented as means ± SD (standard deviation), and qualitative data were represented by the frequency. Student's t test was employed to compare means, whereas chi-square tests were used for analyzing qualitative data. RESULTS: A total of 74 patients with BLP (5 our patients, 69 from literature) were included, with 61 type I and 13 type II patients. We summarize BLP's characteristics as follows: (1) More frequent in male individuals, especially in type II; (2) Earlier onset than classical psoriasis; (3) Mainly distributed unilaterally, and no preference for left or right site; (4) Asymptomatic or slight pruritus; (5) Mostly negative family history of psoriasis; (6) Possible involvement of the nails/scalp (mainly for type II); (7) Possible exogenous triggering or aggravation factors; (8) Possible concomitant classical plaque or guttate psoriasis lesions, especially in type II; (9) Conforming to histopathology features of classical psoriasis; (10) Relatively favorable response to antipsoriatic treatment, although poor for superimposed areas in type II. CONCLUSION: This study analyzed the clinical characteristics and therapeutic aspects of BLP. Compared with published studies, we have new findings, such as gender bias. Besides traditional antipsoriatic treatment, a personalized selection of biologics may also be a promising choice. Dermatologists should recognize and understand the significance of this disease, and provide patients with appropriate psychological counseling and clinical treatments.

Analysis of CD8+ TCRß Chain repertoire in peripheral blood of vitiligo via high-throughput sequencing.

Vitiligo is an autoimmune depigmentation dermatosis induced by melanocyte destruction, and CD8+ T cells play a pivotal role in melanocyte destruction. However, an accurate profile of the CD8+ T cell receptor (TCR) repertoire in vitiligo patients has not been reported, and the clonotype features of the involved CD8+ T cells remain largely unknown. This study aimed to assess the TCRß chain repertoire diversity and composition of blood in nine nonsegmental vitiligo patients via high-throughput sequencing. Vitiligo patients manifested a low TCRß repertoire diversity with highly expanded clones. Differential usage of TRBV, the TRBJ gene, and the TRBV/TRBJ combination were compared between patients with vitiligo and healthy controls. A set of TRBV/TRBJ combinations could differentiate patients with vitiligo from healthy controls (area under the curve = 0.9383, 95% CI: 0.8167-1.00). Our study revealed distinct TCRß repertoires of CD8+ T cells in patients with vitiligo and will help explore novel immune biomarkers and potential therapeutic targets for vitiligo.

Stem Cells from Human Exfoliated Deciduous Teeth Attenuate Atopic Dermatitis Symptoms in Mice through Modulating Immune Balance and Skin Barrier Function.

Atopic dermatitis (AD) is a chronic skin inflammatory disease associated with immune abnormalities and disrupted skin barrier function. Mesenchymal stem cells (MSCs) have been suggested as an alternative therapeutic option in AD. Stem cells from human exfoliated deciduous teeth (SHEDs) are a unique postnatal stem cell population with high immunomodulatory properties. The aim of this study was to explore the effects of SHEDs on AD in the BALB/c mouse model induced by 2,4-dinitrochlorobenzene (DNCB). SHEDs were administrated intravenously or subcutaneously, and clinical severity, histopathological findings, skin barrier function, and organ indexes were evaluated. Skin tissue cytokine mRNA levels and serum cytokine protein levels were further analysed. SHED administration significantly alleviated AD clinical severity, including dermatitis scores, ear thickness, scratching behaviour, and infiltration of mast cells. In addition, disrupted skin barrier function and enlarged spleens were restored by SHED administration. Further, SHED treatment reduced the levels of IgE, IgG1, and thymic stromal lymphopoietin (TSLP) in the serum and the modulated expression of Th1-, Th2-, and Th17-associated cytokines in skin lesions. In conclusion, SHEDs attenuated AD-like skin lesions in mice by modulating the immune balance and skin barrier function. SHEDs could be a potential new treatment agent for AD.

Warfarin-induced Stevens-Johnson syndrome with severe liver injury.

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a life-threatening mucocutaneous disease that is predominantly drug-induced. Warfarin is the most commonly used drug for long-term anti-coagulant therapy; however, warfarin-induced SJS/TEN is seldom reported. In this study, we presented the case of a 61-year-old man who developed SJS after receiving multiple-drug therapy following aortic valve replacement surgery. The patient was diagnosed with drug-induced liver injury (DILI) based on significantly abnormal liver function test results. Warfarin was identified as the culprit drug using the algorithm of drug causality for epidermal necrolysis (ALDEN) score, enzyme-linked immunospot (ELISPOT) assay, and Roussel Uclaf Causality Assessment Method (RUCAM). After warfarin discontinuation and corticosteroid therapy, the lesions and liver function test findings improved. Human leukocyte antigen typing was conducted to detect the risk allele. To our knowledge, this is the first reported case of warfarin-induced SJS/TEN with DILI. This case suggests that commonly used and safe pharmaceutical agents such as warfarin can potentially cause serious adverse events, including SJS/TEN and DILI. The application of ALDEN, the ELISPOT assay, and RUCAM could be useful in identifying culprit drugs.

Fluxes of CH4 and N2O from soil under a tropical seasonal rain forest in Xishuangbanna, Southwest China.

CH4 and N2O fluxes from soil under a tropical seasonal rain forest in Xishuangbanna, Southwest China were measured for one year using closed static chamber technique and gas chromatography method. Three treatments were set in the studied field: (A) litter-free, (B) with litter, and (C) with litter and seedling. The results showed that the soil in our study was a sink of atmospheric CH4 and source of atmospheric N2O. The observed mean CH4 fluxes from treatments A, B, and C were -50.0 +/- 4.0, -35.9 +/- 2.8, -31.6 +/- 2.8 microgC/(m2 x h), respectively, and calculated annual fluxes in 2003 were -4.1, -3.1, and -2.9 kgC/hm2, respectively. The observed mean N2O fluxes from treatments A, B, and C were 30.9 +/- 3.1, 28.2 +/- 3.5, 50.2+/-3.7 microgN/(m2 x h), respectively, and calculated annual fluxes in 2003 were 2.8, 2.6, and 3.7 kgN/hm2, respectively. Seasonal variations in CH4 and N2O fluxes were significant among all the three treatments. The presence of litter decreased CH4 uptake during wet season (P < 0.05), but not during dry season. There was a similar increase in seedlings-mediated N2O emissions during wet and dry seasons, indicating that seedlings increased N2O emission in both seasons. A strong positive relationship existed between CH4 fluxes and soil moisture for all the three treatments, and weak relationship between CH4 fluxes and soil temperature for treatment B and treatment C. The N2O fluxes correlated with soil temperature for all the three treatments.

[On-line analysis and mass concentration characters of the alkali metal ions of PM10 in Beijing].

The mass concentration characters and the sources of water-soluble alkali metal ions in PM10 in 2004 and 2005 in Beijing were analyzed by using the system of rapid collection of particles. The result showed that the average concentration of Na+, K+, Mg2+ and Ca2+ was 0.5-1.4, 0.5-2.5, 0.1-0.5 and 0.6-5.8 microg/m3, respectively. The highest and lowest concentration appeared in different seasons for the alkali metal ions, which was related to the quality and source. The concentration of alkali metal ions was no difference between the heating period and no heating period, which meant the heating was not the main source. Sea salt and soil were the important sources of Na+. The source of K+ came from biomass burning and vegetation. Soil was the large source of Mg2+ and Ca2+. The alkali metal ions appeared different daily variation in different seasons. Precipitation could decrease the concentration of Na+, K+, Mg2+ and Ca2+, which was 10%-70%, 20%-80%, 10%-77%, 5%-80% respectively.

Prognosis of unclassified eczema: a follow-up study.

OBJECTIVE: To investigate the outcome of unclassified eczema (UE). Eczema refers to a set of highly heterogeneous clinical conditions including contact dermatitis (CD) and several types of endogenous eczema. In clinics, however, the eczema of a large proportion of patients does not fit any known patterns and has been diagnosed as unclassified eczema. The prognosis of UE is largely unknown. DESIGN: Cohort study with 1-year follow-up. SETTING: Dermatology clinic in Peking University Third Hospital, Beijing, China. Patients All cases of UE in 655 consecutive patients with eczema patch tested with the European Standard series occurring during a 2-year period. Interventions At 1 year after patch testing, all patients were asked to revisit the clinic, and 599 patients returned (91.5%); of these, 192 had UE (32.1%). MAIN OUTCOME MEASURES: The rate of symptom-free skin for at least 3 months without relapse before evaluation. RESULTS: During the follow-up period, only 15.1% of patients with UE had their lesions cleared, which was a much lower rate than for those with CD (50.4%) (P < .001; chi(2) test) but close to the rate of those with atopic dermatitis (7.1%). A total of 11.0% of patients with UE had atopic diathesis, and 72.4% of those with UE had a positive reaction to at least 1 contact allergen, which was a lower rate than that of patients with allergic CD (88.6%) but higher than that for patients with irritant CD (53.8%) (P < .001 and P = .004, respectively; chi(2) test); however, none of these results were relevant to eczema. CONCLUSIONS: Unclassified eczema is a common type of eczema with a very poor prognosis. This important category of eczema should be recognized and studied further.

Etiology and prognosis of hand eczema in a dermatology clinic in China: a follow-up study.

BACKGROUND: Prognosis of hand eczema (HE) has not been reported in China. OBJECTIVES: To investigate the etiology and outcome of HE in 655 consecutive patients patch tested with European standard series in Peking University Hospital in a 2-year period. METHODS: All patients were re-examined at 1 year after patch testing, and prognosis of dermatitis was evaluated by the rate of clearance of skin symptoms for at least 3 months without relapse before the evaluation. RESULTS: Of 599 patients examined, 82 (13.7%) were HE. Allergic, irritant, and unclassified HE accounted for 23.2%, 17.1%, and 51.3% of HE, respectively. The overall clearance rate of HE was much lower than that of eczema elsewhere (18.3% versus 29.6%, P < 0.05, chi-squared test). 35.7% of patients with allergic HE and 26.3% with irritant HE cleared their lesions, of those with unclassified HE only 11.9% (P < 0.05, chi-squared test). The lowest healing rate (5.7%) was found in unclassified HE patients with disease duration over 6 months. CONCLUSIONS: The outcome of HE was worse than eczema elsewhere. Allergic HE had a better prognosis than unclassified HE. Longer disease duration was the main risk factor for poor prognosis of unclassified HE.

Prevalence and 1-year outcome of facial allergic contact dermatitis in patients patch tested in a university hospital.

Little is known about the prognosis of facial allergic contact dermatitis (FACD). The objective of the study was to investigate the prevalence and 1-year outcome of FACD in patients patch tested. 655 consecutive patients patch tested with European standard series in Peking University Hospital in a 2-year period were studied. At 1 year after testing, all patients were asked a revisit and prognosis of FACD was assessed by the rates of clearance of dermatitis, relapse, and improvement at the final evaluation. Of 599 patients examined, 92 were affected by FACD. All their dermatitis improved. The clearance rate was 55.4%, which was much higher than that (23.1%) of other patients tested in the same period (P < 0.05, chi-square test); however, the relapse rate was also high (42.4%). Concurrence of atopic diathesis, icthyosis, or drug allergy history had no influence on the clearance rates. The clearance rate was significantly lower (40.9%) in patients with disease duration over 3 months before testing. FACD is common among patients patch tested and has a better prognosis than other eczema. Patients with suspected FACD should be tested early and more work is needed to decrease the relapse rate.

[Water-soluble chloride in aerosol PM10 in Beijing].

Water-soluble chloride is one of the most important components in aerosols. The chloride in PM10 measured from January to December 2004 in Beijing was determined using a system by combing rapid collection of fine particles and ion chromatography (RCFP-IC). The results showed that the annual average concentration of water-soluble chloride at the urban area in Beijing was about (3.1 +/- 1.7) microg x m(-3); the average concentration of chloride during the heating period was (4.6 +/- 2.1) microg m(-3) while it was (2.6 +/- 1.6) microg x m(-3) during the period no heating. The lowest concentration of (1.3 +/- 0.8) microg x m(-3) appeared in May, and the highest concentration appeared of (5.8 +/- 5.3) microg x m(-3) in December. Trends of the diurnal variation of water-soluble chloride depended on seasons. In autumn and winter, the higher concentration appeared in the daytime and the lower concentration appeared at night. In spring and summer, the higher concentration appeared at forenoon and the lower appeared at afternoon. Overall, the concentration of chloride in autumn and winter was higher than in spring and summer.

An improved gas chromatography for rapid measurement of CO2, CH4 and N2O.

Combining improved injector, gas line and valve-driving modules, a GC equipped with FID and ECD, could simultaneously measure CH4, CO2 and N2O in an air sample within 4 min. Test results showed that the system has high sensitivity, resolution and precision; the linear response range of the system meets the requirement of in situ flux measurements. Thus, the system is suitable for monitoring fluxes of main greenhouse gases in terrestrial ecosystem since it is easy to use, efficacious, stable and reliable to collect data.

[Trends and variation of CFC-11 in the atmosphere of Beijing].

In recent years, concentration of CFC in the atmosphere has undergone rapid changes especially in association with human activities. For the influence of CFC on climate changes and environment changes, the concentration of atmospheric CFC-11 in Beijing is continuously observed and analyzed by a gas chromatography-mass spectrometry. The seasonal variation concentration and trends of CFC-11 are reported. The results show that the seasonal variation of CFC-11 was basically similar from 1999 to 2003. There was one peak value in the seasonal variation of CFC-11 in 1999-2003. The highest monthly average concentration of CFC-11 was 1149.5 +/- 531.9 x 10(12) ( V x V(-1)) in summer and the lowest monthly average concentration of CFC-11 was 487.5 +/- 131.5 x 10(-12) (V x V(-1)) in spring. The annual average concentration of CFC-11 was increasing in Beijing atmosphere from 1995 to 1998, and the average increasing ratio was 17.9%. The annual average concentration of CFC-11 was slowly decreasing from 1999, and the average decreasing ratio was 10.7%. The average concentration of CFC-11 in the atmosphere of Beijing was 3 to approximately 5 times of the average concentration of CFC-11 in the atmosphere of Mauna Loa Station of U.S.A.

[Measurement and study on the atmospheric trace BTEX in Beijing].

Atmospheric trace BTEX in Beijing was observed by a gas chromatography/mass spectrometry in the latest 4 years. The diurnal, lunar and annual concentration variations of these pollutants were reported. In winter and spring, the diurnal profiles exhibited two peak values corresponding to the daily rush hours 08:00-10:00 am and 17:00 pm; in autumn, there was the third peak value in the night at 22:00; the highest concentration of BTEX in summer appeared in the midday and totally three daily maxima were in the sampled day. In the lunar variation of the BTEX from 2000 to 2002, the average concentration was about (44.1 +/- 24.5) nmol/mol (C unit), and the seasonal maximum value appeared in summer. The trend of BTEX was decreased greatly from 1999 to 2002.

[Characteristics of atmospheric CO2 variations and some affecting factors in urban area of Beijing].

The diurnal variation of the atmospheric CO2 at the urban area in Beijing displayed a very clear cycle, generally with the lowest value being recorded at about 15:00 local time and the highest in the nighttime. The differences between the maximums and the minimums ranged from 23.2 to 39.0 mumol.mol-1 in the four seasons and the ones of summer and fall were bigger than that of winter and spring. It showed a large seasonal cycle with a maximum in winter, from 421.5 to 441.0 mumol.mol-1, and a minimum in summer, between 367.4 and 371.6 mumol.mol-1. The peak-to-peak amplitude of atmospheric CO2 in Beijing, controlled mostly by the anthropogenic activities and seasonal variation of vegetation, was higher than that in Xinglong Station, Hebei Province and China Global Atmosphere Watch Baseline Observatory (Waliguan). The concentration of atmospheric CO2 in Beijing increased rapidly at a mean growth rate of 3.7%.a-1 from 1993 to 1995. After displaying a peak of 409.7 +/- 25.9 mumol.mol-1 in 1995, it decreased slowly.

[Greenhouse gases emission or uptake in Inner Mongolia natural and free-grazing grasslands].

GC-MS was used to measure the greenhouse emission of Inner Mongolia Grassland. The results showed that four kinds of typical semi-arid grasslands in Inner Mongolia had their own special seasonal patterns as the source of atmospheric N2O and CO2 emission and the sink of atmopsheric CH4, which were controlled by seasonal weather variation. Different soil and vegetation types and precipitation influenced the intensity of emission and upatake of the gases. Compared with natural grassland, free grazing decreased CH4 uptake and N2O emission, but increased CO2 emission.