The combination of CO2 laser vaporation and photodynamic therapy in treatment of condylomata acuminata.

The aim of this study was to investigate the effectiveness of CO2 laser vaporation and topical PDT combination on condylomata acuminate (CA) located in the perianal and external genital area. A total of 119 patients (perianal CA=52 cases and external genital CA=67 cases) with at least one CA lesion >2mm were treated with monopulse CO2 laser followed by topical ALA-PDT. PDT was repeated till complete response was achieved. Approximately half of the patients only needed one session of PDT treatment and another half needed multiple PDT treatments to achieve complete response. During the 6-month follow-up 7.1% of patients relapsed. In terms of complete response rate and recurrence rate there were no statistical differences between perianal and genital groups. No severe adverse effects were observed. CO2 laser vaporation plus ALA-PDT is a highly effective modality for treating CA.

Decreased copper and zinc in sera of Chinese vitiligo patients: a meta-analysis.

Abnormalities of copper (Cu) and zinc (Zn) are involved in the etiology and pathogenesis of vitiligo. However, controversial results exist now on Cu and Zn in serum of vitiligo patients. The purpose of this study is to compare the serum levels of Cu and Zn between vitiligo patients and healthy controls. In the meta-analysis, 16 studies with a total of 891 vitiligo cases and 1682 healthy controls were included. The levels of serum Cu and Zn were compared between groups of case and control. The serum levels of Cu were significantly lower in vitiligo patients than in healthy controls (Z = 4.04, P < 0.0001; standardized mean difference [SMD], -0.9; 95% confidence interval [CI], -1.34 to -0.47). The levels of serum Zn were also significantly lower in vitiligo patients than in healthy controls (Z = 4.88, P < 0.00001; SMD, -1.09; 95% CI, -1.51 to -0.64). These results demonstrate that decreased levels of serum Cu and Zn are generally present in Chinese vitiligo patients. This may offer support for clinical administration of oral Cu and Zn supplements.

[Propranolol in the treatment of problematic infantile hemangiomas].

OBJECTIVE: To evaluate the short-term efficacy and safety of propranolol for problematic infantile hemangiomas. METHODS: Oral propranolol was administered to 68 infants with heamngiomas diagnosed by clinical evaluation and adjuvant examination at 1.0~2.0 mg per kilogram of body weight per day, divided to 2 or 3 times. The patients revisited once a month. The changes of the tumor size, texture, and color were monitored and recorded at a regular interval.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system. RESULTS: All the 68 infants were followed up for 3-13 months, except that 1 infants combined with other diseases and 4 withdrew.The overall response was Scale 1 in 8 infants, Scale II in 13, Scale III in 29, and Scale IV in 13. No serious adverse effects were seen, but none cured entirely as well. CONCLUSION: Oral propranolol is safe and effective for infantile heamngioma with good short-term result. It could be used as the primary drug for problematic infantile hemangiomas at the rapid growth stage of hemangiomas.

IPL irradiation rejuvenates skin collagen via the bidirectional regulation of MMP-1 and TGF-ß1 mediated by MAPKs in fibroblasts.

The efficacy of intense pulsed light (IPL) in remodeling the extracellular matrix of aged skin had been proven by an increasing number of clinical trials. However, because of the lack of research about the underlying molecular and signaling mechanisms, its efficiency had not been accepted universally. A potential mechanism of IPL rejuvenation effects is due to its different effects on diverse cytokines, the impact of IPL on them may determine the phenotype and prognosis of the aged skin. We designed this study to evaluate the impact of IPL on the secretion of matrix metalloproteinase-1 (MMP-1), transforming growth factor-ß1 (TGF-ß1), and the mitogen-activated protein kinase (MAPK) signaling pathway in human skin fibroblasts, and tried to study the respective functions of MAPKs as mediators of the MMP-1, TGF-ß1 secretion. Results showed that the MMP-1 secretion was only enhanced by IPL at 10 J/cm(2); while the TGF-ß1 secretion was inhibited by IPL when the fluence was below 36 J/cm(2), but enhanced at 72 J/cm(2). Meanwhile, ERK inhibitor PD98059 decreased MMP-1 secretion, but did not show a significant influence on TGF-ß1; JNK inhibitor SP600125 increased the secretion of MMP-1 and decreased the TGF-ß1 secretion; P38 inhibitor SB203580 had no significant influence on MMP-1 but increased the secretion of TGF-ß1. Our findings indicated that the bidirectional influence of IPL on the secretion of MMP-1 and TGF-ß1 is a potential mechanism of its skin rejuvenation effect; and the secretion of these two cytokines can be mediated by MAPKs.

Identification of two novel DSRAD mutations in two Chinese families with dyschromatosis symmetrica hereditaria.

Dyschromatosis symmetrica hereditaria (DSH) is a hereditary skin disease characterized by the presence of hyperpigmented and hypopigmented macules on face and dorsal aspects of the extremities that appear in infancy or early childhood. Genetic studies have identified mutations in the double-stranded RNA-specific adenosine deaminase (DSRAD) gene, encoding double-stranded RNA-specific adenosine deaminase, to be responsible for this disorder. Here, we report two novel mutations c.2116 G > A (E706K) and c.2848 C > T (Q950X) in the DSRAD gene identified in two Chinese pedigrees with DSH. This study should be useful for genetic counseling and prenatal diagnosis for affected families and in expanding the database on DSRAD gene mutations in DSH.

[Female urogenital mycoplasma infection and drug sensitivity status in Changsha].

OBJECTIVE: To survey mycoplasma infection in female urogenital tract and analyze the drug sensitivity of mycoplasma in Changsha. METHODS: Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) were detected in 6566 cases of female urogenital tract infection by means of mycoplasma culture and drug sensitivity reagent kit. Sensitivity tests for 10 antibiotics were also performed. RESULTS: A total of 2938 cases were mycoplasma-positive (positivity rate of 44.75%), including 2469 Uu-positive cases (37.6%), 52 Mh-positive cases (0.08%) and 417 cases positive for both Uu and Mh (6.35%). Josamycin, doxycycline, clarithromycin and azithromycin were more effective against Uu infection. Josamycin, doxycycline and thiamphenicol were more effective against Mh infection. Mixed infection with Uu and Mh was more resistant to most antibiotics but Josamycin and doxycycline. CONCLUSION: The female urogenital mycoplasma infection results mainly from Uu. Compared with simple Uu or Mh infection, mixed infection with Uu and Mh has significantly greater resistance to a wider variety of drugs. Josamycin and doxycycline are the primary choice for female urogenital mycoplasma infection in Changsha.

[Apoptosis of psoriatic keratinocytes and the severity of patients' condition].

OBJECTIVE: To investigate the correlation between the apoptosis of psoriatic keratinocytes (KCs) in the psoriatic lesions and patient's condition. METHODS: Thirty patients with psoriasis were included. Activated caspase-3 was examined by colorimetric method in skin biopsy specimens. The apoptotic KCs were detected with terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay in skin biopsy specimens. The severities of 26 patients with psoriasis vulgaris (PV) were assessed using the PASI scoring system and the severities of psoriatic lesions. RESULTS: Apoptotic indexes (AI) were higher in the pustular psoriatic lesions than those in the vulgaris psoriatic lesions (P<0.05). In 26 patients with PV, AI and activated caspase-3 in the lesions were significantly higher in the progressive stage than those in the static and the regressive stages (P<0.05). There were no correlations between PASI and AI or the expression of activated caspase-3 in PV lesions (P>0.05). The severities of psoriatic lesions were positively correlated to AI or the expression of activated caspase-3 in PV lesions (P<0.05). CONCLUSION: The amount of apoptotic KCs may be related to varied types, stages of psoriasis, and severities of psoriatic lesions.

[Effects of BCG-PSN on serum levels of IL-4 and IL-12 in patients with condyloma acuminatum].

OBJECTIVE: To determine the effects of polysaccharide nucleic acid fraction of bacillus calmette guerin (BCG-PSN) on serum levels of interleukin-4 (IL-4) and interleukin-12 (IL-12) in patients with condyloma acuminatum (CA) and to investigate the mechamism of immunoregulation of BCG-PSN on CA. METHODS: Sixty CA cases were randomly divided into 2 groups. The serum levels of IL-4 and IL-12 were respectively measured by Double-antibody sandwich ELISA method before and after the treatment. The serum levels of IL-12 and IL-4 of health control were also measured. The recurrent rate of each group was used as an index to assess the effect of BCG-PSN in CA patients. RESULTS: Compared with healthy controls, the serum levels of IL-12 in patients with CA were decreased significantly (P < 0.05), while the serum levels of IL-4 were increased significantly (P < 0.05) before the treatment. The serum levels of IL-12 were negatively correlated with the serum levels of IL-4 (r = -0.287, P < 0.05). After the treatment, the serum levels of IL-12 were increased significantly( P < 0.05), and the serum levels of IL4 were decreased significantly (P < 0.05) in the treatment group. But in the control group, the serum levels of IL-12 and IL-4 were similar before and after the treatment (P > 0.05). The recurrent rate of treatment group was significantly lower than that of the control group (chi2 = 4.356, P < 0.05). CONCLUSIONS: There is an imbalance of Th1/Th2 cytokines production in patients with condyloma acuminatum. BCG-PSN could increase the serum level of IL-12 and decrease the serum level of IL-4 in CA patients. BCG-PSN could decrease the recurrent rate of CA. The effect may be related to the regulation and modulation of BCG-PSN to Thl/Th2 cytokines imbalance,which then enhances the cellular immunity in CA patients.