Analysis of 602 Chinese cases of nevus of Ota and the treatment results treated by Q-switched alexandrite laser.

BACKGROUND: Nevus of Ota is a congenital or acquired pigmentary disorder of the skin and mucous membranes, which are areas innervated by the first and second branches of the trigeminal nerve. Nevus of Ota is very common in Asia. Nevus of Ota was effectively treated with Q-switched alexandrite (755 nm) laser, but no detailed report existed on many Chinese cases treated with Q-switched alexandrite laser. OBJECTIVE: The objective was to gauge clinical and treatment data and material statistics for 602 cases of nevus of Ota and analyze its pathogenic mechanism and therapeutic results. METHODS: A total of 602 cases of clinical data on nevus of Ota were collected by means of clinical registration, photo verification, and telephone inquiry or correspondence. CONCLUSIONS: There are some differences in sex, age, and local regions in nevus of Ota. Nevus of Ota can combine with other diseases. The treatment of Nevus of Ota by a Q-switched alexandrite laser is safe and effective. Additional treatment will achieve good results. The results correlate to the eyelids and Tanino's classification.

Comparison between immunofluorescence and PCR in detecting human papilloma virus in condyloma acuminata.

OBJECTIVE: To compare the effectiveness of immunofluorescence and polymerase chain reaction (PCR) in detecting human papilloma virus (HPV) in condyloma acuminata (CA). METHODS: HPVs in CA tissues from 60 patients were detected by immunofluorescence and PCR, respectively. Different subtypes of HPVs were also identified with restriction fragment length polymorphism (RFLP). RESULTS: The positive detective rates of immunofluorescence and PCR were 56.67% (34/60) and 96.67% (58/ 60), respectively (P < 0.01). RFLP results showed HPV6 and HPV11 were the main subtypes in the detected virus, which accounted for 98.28%. CONCLUSION: The sensibility of PCR is superior to that of immunofluorescence.

[Flashlamp-pumped pulsed dye laser (585 nm) in the treatment of port-wine stains--a retrospective study of 2317 Chinese patients].

OBJECTIVE: To evaluate the efficacy and safety of 585 nm flashlamp-pumped pulsed dye lasers (PDL) in the treatment of port-wine stains (PWS). METHODS: A retrospective review was performed in 2 317 patients with PWS who visited the Dermatology Laser Centre of PUMC Hospital and accepted treatment with 585 nm PDL. The correlation between the treatment efficacy and the treatment sessions, lesion types, and usage of other therapies were analyzed. The adverse effects were also observed. RESULTS: All the 2 317 patients with PWS received 1-13 consecutive treatments with PDL at 2-3-month intervals. The median number of treatment was 4.93 and the median energy density was 8.29 J/cm2. The response rate after 8 treatments sessions were 84%. The response rate in patients whose lesions are characterized as purple plaques with proliferation and treated with isotope, CO2, cryotherapy, and other treatments was significantly lower than the total response rate (P < 0.05). Superficial scar, hyperpigmentation, and hypopigmentation were found in 5.2%, 2.5%, and 4.0% of these patients, respectively. CONCLUSION: 585 nm PDL is effective and safe in treating PWS.

[Clinical efficacy of Q-switched Alexandrite laser for pigmentary skin diseases in 4656 patients].

OBJECTIVE: To evaluate the clinical efficacy and safety of Q-switched Alexandrite laser in the treatment of pigmentary skin, diseases ( PSDs). METHODS: Totally 4 656 patients with PSDs were treated with Q-switched Alexandrite laser. These PDSs included nevus of Ota, seborrheic keratosis, tattoo, naevus fusco-caeruleus zygomaticus, cafe-au-lait-spots, lentigo, naevus of Ito, and spilus naevus. The outcomes and adverse events after treatment were oberserved. RESULTS: The response rate was 92.31% and the cure rate was 55.39% for nevus of Ota after six times of treatment, and the cure rate was 100% after nine times of treatment. The response rate was 100% for freckles, seborrheic keratosis, and naevus fuscocaeruleus zygomaticus after four times of treatment. The response rate was more than 77.18% and the cure rate was more than 50% for tattoos after three times of treatment, including amateur tattoo, artificial eyebrow, eyelid lines, and traumatic tattoo. However, after four times of treatment, the response rate and the cure rate were only 50. 00% and 21.43% for cafe-au-lait spots, and 50.00% and 25.00% for spilus naevus, respectively. The response rate was 35.29% for lentigo and 25.00% for naevus of Ito/ spilus naevus after four times of treatment. CONCLUSION: Q-switched Alexandrite laser is effective in the treatment of nevus of Ota, seborrheic keratosis, tattoo, and naevus fusco-caeruleus zygomaticus, but has limited efficacy for cafe-au-lait-spots, lentigo, naevus of Ito, and spilus naevus.

[Effectiveness and safety of long-pulsed Alexandrite laser for hair removal in 1702 patients].

OBJECTIVE: To evaluate the effectiveness and safety of long-pulsed Alexandrite laser for hair removal. METHODS: Hair removal was performed in 1702 hirsute patients with long-pulsed Alexandrite laser. Among them 1603 patients received two or more operations. RESULTS: In patients who received 2, 3, 4, 5, and > or =6 operations, the effectiveness rates were 9.79%, 18.33%, 29.10%, 37.64%, and 82.68%, respectively. The number of operation correlated with the effectiveness, and > or =6 operations resulted in superior outcomes. Pigmentation occurred in 0.94% of the patients (16/1702). CONCLUSION: The long-pulsed Alexandrite laser system is effective and safe in removing hair.

Correlation between deoxyribonucleic acid loads of human papillomavirus and recurrence of condylomata acuminata.

To determine the correlation between deoxyribonucleic acid (DNA) loads of human papillomavirus (HPV) and recurrence of condylomata acuminata (CA), 31 cases of primary CA and 32 cases of recurrent CA were assayed for the HPV6/11 and HPV16/18 DNA loads by real-time fluorogenic quantitative PCR. The results showed 62 of the 63 cases were HPV6/11 DNA positive (98.4%). The ranges of HPV6/11 DNA contained in primary and recurrent CA were 1.4 x 10(3)-6.7 x 10(7) and 1.2 x 10(4)-3.6 x 10(8) copies/mL, respectively. Of the 62 cases which were HPV6/11 DNA positive, seven cases were also HPV16/18 DNA positive (11.3%). The ranges of HPV16/18 DNA levels in primary and recurrent CA were 1.9 x 10(3)-1.6 x 10(4) and 1.4 x 10(5)-1.7 x 10(7) copies/mL, respectively . The HPV6/11 and HPV16/18 DNA loads in recurrent CA were statistically higher than that found in primary CA (P = 0.041 and 0.023, respectively). The DNA loads of HPV6/11 were correlated with the duration, extent of the disease and frequency of recurrence. There is a significant correlation between loads of HPV DNA and recurrence of CA. These findings have important implications for the treatment of CA.

[Immunogenicity of mutant and wild HPV16 DNA vaccines].

OBJECTIVE: To evaluate the efficacy of mutation of human papillomavirus 16 (HPV16) E7 in two zinc-binding motifs on HPV16 E7 C terminus on antigen-specific immunity. METHODS: pcDNA3.1/16E7 and pcDNA3.1/ME7 were successfully constructed by inserting the E7 (ME7) into pcDNA3.1 BamH I, EcoR I cut sites. After intramuscular injection with pcDNA3.1, pcDNA3.1/16E7, and pcDNA3.1/16ME7 on C57BL/6 mice, splenocytes from vaccinated mice was isolated. After have been stimulated with E7-specific peptide, interferon gamma (IFN-gamma), interleukin 2 (IL-2), and cytotoxic T lymphocyte (CTL) were detected by ELISA, Eli-spot, and LDH assay respectively; splenocytes without E7 peptide stimulation were used as control group. RESULTS: Splenocytes from mice vaccinated with pcDNA/ME7, stimulated with E7 peptide, generated significantly larger number of E7-specific IL-2 compared with pcDNA3.1/16E7, pcDNA3.1, and control group. The E7-specific IL-2 generated in pcDNA-ME7 group was 5-fold of that of pcDNA3.1/16E7, and the difference was statistically significant (P < 0.05). Splenocytes from mice vaccinated with pcDNA/ME7 and stimulated with E7 peptide, generated significantly larger number of E7-specific IFN-gamma compared with other vaccines. pcDNA-ME7 generated a 2-fold increase in the number of E7-specific IFN-gamma compared with wild-type E7 and the difference was statistically significant (P < 0.05). The highest CTL activity in mice vaccinated with pcDNA/ME7 at an E:T ratio of 45:1 was achieved compared with mice vaccinated with other vaccines. The percents of specific lysis generated by pcDNA3.1/ME7, pcDNA3.1/E7, pcDNA3.1, and without vaccination were of (28.7+/-1.2) %, (55+/-2.2) %, (12.5+/-2.0) %, and (11.5+/-1.2) % respectively, and significant difference existed between the former and the latter two groups (P < 0.05). However, no significant difference was found among all the groups without specific E7 peptide stimulation (P > 0.05). CONCLUSIONS: The mutation of zinc-binding motifs on HPV16 E7 C terminus may greatly enhance the immunogenicity.

[Correlation between DNA load of human papillomavirus and recurrence of condyloma acuminata].

OBJECTIVE: To determine the correlation between DNA load of human papillomavirus (HPV) and recurrence of condyloma acuminata (CA). METHODS: The HPV6/11 and HPV16/18 DNA load of 31 cases of primary CA and 32 cases of recurrent CA were detected by real-time fluorogenic quantitative PCR. RESULTS: Among the 63 CA patients, 62 cases were HPV6/11 DNA positive. The positive rate was 98.4%. The ranges of HPV6/11 DNA load in primary and recurrent CA were 1.4x10(3)-6.7x10(7) copies/ml and 1.2x10(4)-3.6x10(8) copies/ml respectively. Of 62 cases with HPV6/11 DNA positive, 7 cases were HPV16/18 DNA positive (11.3%). The ranges of HPV16/18 DNA load in primary and recurrent CA were 1.9x10(3)-1.6x10(4) copies/ml and 1.4x10(5)-1.7x10(7) copies/ml respectively. The HPV6/11 and HPV16/18 DNA load in recurrent CA were higher than in primary CA (P < 0.05). The DNA load of HPV6/11 was positively correlated with times of recurrence and course of disease (r=0.37 and 0.30 respectively). CONCLUSION: Certain correlation exists between DNA load of HPV and recurrence of CA.

Construction and immunogenicity of human papillomavirus type 6b L1 recombinant plasmid.

OBJECTIVE: To construct a DNA vaccine as a prophylactic model to prevent condyloma acuminatum and detect its immunogenicity in mice. METHODS: The major capsid protein (L1) gene of human papillomavirus (HPV) 6b was inserted into an eukaryotic expression plasmid (pcDNA3.1). The recombinant plasmid was transfected into COS-7 cells. Western blot were performed to detect whether L1 protein can be expressed in eukaryotic cells. Eighteen female BALB/c mice were tested for immunogenicity study. RESULTS: The recombinant plasmid (pcDNA3.1-HPV6bL1) was verified as HPV6b L1 gene by sequencing. Western blot showed specific strip. Anti-L1 protein antibodies could be detected in the mice's sera inoculated with pcDNA3.1-HPV6bL1. Similarly, IL-4, IL-2, and IFN-gamma were increased in the same mice. CONCLUSION: HPV6b L1 recombinant plasmid was constructed successfully which had immunogenicity for BALB/c mice. It provided experimental evidence for the research of DNA vaccine of condyloma acuminata.

[Analysis of 602 cases of nevus of Ota and study of ultrastructures on the melanocytes].

OBJECTIVE: To analyze clinical information and efficacy of 602 cases of nevus of Ota, and investigate the histopathology and ultrastructure on the melanocytes before and after Q-switched Alexandrite laser irradiation. METHODS: Clinical information of 602 cases of nevus of Ota were collected by applying clinical records, checking photos, and inquiry to patients by letters and telephones. Ten cases of biopsies were observed by light microscopy and 6 cases by electron microscopy before and after laser irradiation. RESULTS: Nevus of Ota included congenital and acquired cases. Skin lesions mainly occurred in adolescence for the acquired cases. The main colours of lesions were brown and blue. The most local lesions were zygomata, temporal regions, and lower eyelids. According to multiple regression, the more treatment times, the better results. The effective rate was 85.20% and 100% after 6 and 9 treatment times, respectively, while the cure rate was 55.72% and 98.46%, respectively. The eyelids involved and Tanino types influenced the treatment times by COX models analysis. Electron microscopy showed many melanosomes in the dermal melanocytes. After laser irradiation, the outlines of the dermal melanocytes were observed, the melanosomes were broken to dense and tiny granules. CONCLUSIONS: Q-switched Alexandrite laser is safe and effective for the treatment of nevus of Ota. The results of treatment are correlated with the area and size of the lesion. The dermal melanocytes in nevus of Ota can be selectively destroyed by Q-switched Alexandrite laser with less injury around tissues.

[Detecting HPV DNA in tissues of external genital squamous cell carcinoma in situ by PCR-RFLP technique].

OBJECTIVE: To study the relationship between the infection of human papillomavirus (HPV) and external genital squamous cell carcinoma in situ. METHODS: HPV DNA was detected with the consensus primer by polymerase chain reaction (PCR) and its type was determined by restriction fragment length polymorphism (RFLP). RESULTS: HPV DNA was detected and HPV16 was the most frequently identified type in 29 (56.9%) of 51 cases of external genital squamous cell carcinoma in situ. HPV DNA was positive in 22 (55%) of 40 cases of bowenoid papulosis, among which 20 were of HPV16 type, one of HPV31 type, and one of HPV6 + 16 type. HPV DNA was positive in all 5 cases (100%) of Bowen's disease, among which 4 were HPV16 type and one of HPV6 + 16 type. HPV DNA was positive in 2 (33.3%) of 6 Queyrat erythroplasia cases and all were of HPV16 type. CONCLUSION: HPV16 infection is strongly associated with the external genital squamous cell carcinoma in situ including bowenoid papulosis, Bowen's disease, and Queyrat erythroplasia.

[Identification and assessment of multiple human papillomavirus types in condyloma acuminata lesions from patients with genital warts in Beijing area].

OBJECTIVE: To identify and assess multiple human papillomavirus types in condyloma acuminatum lesions from patients with genital warts in Beijing area, and compare different features between otherwise healthy and immunosuppressed patients. METHODS: PCR, RFLP and nucleotide sequencing analysis were used to determine HPV types from individual lesions. RESULTS: The predominant type from other healthy patients was HPV6, secondly HPV11. The mean age of patients infected by HPV6 was lower than that of HPV11 and HPV6 + 11. While lesions from immunosuppressed patients were often contained HPV11 or mixed with HPV6. Besides, HPV types 16 and 53 were detected from infected lesions than other HPV types. CONCLUSIONS: HPV6 was the major pathogen of condyloma acuminatum, but infected patients were at lower ages. While HPV11 was most often detected from immunosuppressed patients. As a low risk virus in normal genital tract, HPV53 also could be a pathogen in genital warts.