Filaggrin和Caspase-14主要分布于表皮.它们不仅在表皮细胞的分化及皮肤屏障中起着重要的作用,而且与许多皮肤疾病存在一定联系.本文阐述它们在皮肤屏障功能和某些皮肤疾病中的作用,为进一步预防皮肤损伤及治疗相关皮肤疾病提供新的研究思路.

多磺酸粘多糖乳膏(喜辽妥)的活性成分是脏器类低分子肝素,具有抗凝血酶、抗炎、保湿、抑制胶原纤维细胞增生、促进透明质酸合成的作用,在皮肤科应用于变态反应性、干燥性、瘢痕增生性等皮肤病.

黄褐斑是临床上常见而难治的色素障碍性疾病，其发病原因及机理尚不明确。传统医学认为黄褐斑与肝、情志、脾、肾、血瘀等有关，现代医学认为黄褐斑与紫外线、内分泌因素、遗传因素等有关。现将传统医学及现代医学对黄褐斑的病因及发病机制的研究进展作一综述。

Th17和Treg细胞是不同于Th1、Th2细胞的CD4+T细胞亚型，两者在分化及功能上相互调节。Th17细胞主要参与炎症反应及自身免疫性疾病的发生，Treg细胞在维持免疫耐受及防止自身免疫性疾病的发生中有重要作用。本文就Th17和Treg细胞的作用和调节及其与银屑病的关系作一综述，期望可以对银屑病的发病机制有更进一步的认识。

中药抗真菌作用研究历史悠久，从天然中药中寻找筛选抗真菌新药或研发针对耐药白念珠菌的药物，是近年研究的热点。本文对中药活性成分、中药单体和中药复方对白念珠菌的干预作用实验研究进展方面进行了综述。

报告2例女性外阴血管角皮瘤，患者分别为58岁和69岁，临床表现均为大阴唇出现多个紫红色、蓝黑色类圆形丘疹。病理表现均为表皮角化过度，棘层不规则增生，真皮浅层可见扩张的血管腔，内充满红细胞。诊断：血管角皮瘤。

寻常型鱼鳞病(ichthyosis vulgaris，IV)是一种常见的基因遗传性疾病，以干燥，鳞屑为特征，在人类遗传性疾病中占有较高发病率；寻常型鱼鳞病常与其他过敏性疾病相伴随，丝聚合蛋白（filaggrin,FLG）基因的突变导致表皮屏障功能的受损，可加重或者诱发过敏反应。鱼鳞病尚无满意的治疗方法，目前治疗以外用药为主，主要用润肤剂，因此，进一步探讨寻常型鱼鳞病的发病机制，研制新的、高效的药物，对治疗寻常型鱼鳞病及其相关疾病都具有重要意义。

银屑病是一种由T细胞介导的疾病,以表皮过度增殖、角质形成细胞异常分化伴血管增生及皮损处免疫细胞浸润为特征。近来发现了一群独立于Th1、Th2及Th17细胞的新型CD4+记忆性T细胞——Th22细胞,其在银屑病等一些炎症性皮肤病中不同程度升高,使免疫调节机制进一步完善,通过了解其作用机理或许可开展将其作为一个治疗银屑病的新型靶点的研究。本文就Th22细胞及其细胞因子在银屑病中的作用机制进行综述。

目的:观察伊曲康唑和特比萘芬序贯疗法治疗甲真菌病的临床疗效及安全性.方法:对照组采用伊曲康唑胶囊冲击疗法,每日中晚餐各口服200 mg,连用1周,停药3周为一个疗程.实验组在对照组的基础上接着应用盐酸特比萘芬冲击疗法,每日中晚餐各口服250 mg,连用1周,停药3周为一个疗程.指甲真菌病治疗2个疗程,3、6个月时各复诊一次.趾甲真菌病治疗3个疗程,4、6、9个月时各复诊一次.治疗前后均进行血、尿常规、肝肾功能检查,并记录不良反应情况.结果:实验组治疗3个月后的有效率明显高于对照组,差异有统计学意义(P0.05).停用后随访,实验组的复发率明显低于对照组(P<0.05).结论:伊曲康唑和特比萘芬序贯疗法治疗甲真菌病疗效确切,二者联用疗效优于单独应用伊曲康唑疗效,两种药物从不同途径抗真菌,不良反应少,复发率低,值得广泛推广.

报告1例羟基脲治疗原发性血小板增多症引起的双下肢溃疡。患者男,64岁,双下肢溃疡伴疼痛反复发作7年,加重伴左下肢肿胀1月余。患者因“原发性血小板增多症”一直服用羟基脲治疗,入院诊断：1.双下肢溃疡；2.原发性血小板增多症。

比较平阳霉素皮损内注射与超脉冲CO2激光治疗跖疣的疗效。方法：将160例跖疣患者随机分为治疗组和对照组，治疗组使用平阳霉素皮损内注射，对照组用超脉冲CO2激光治疗，1月后比较两组患者的疗效；6月后随访，比较两组患者的复发率。结果：1月后治疗组痊愈率为77.5%，对照组为60%；治疗组总有效率为91.25%，对照组为78.75%；6月后治疗组复发率为3.23%，对照组为20.8%，差异均有统计学意义。结论：平阳霉素皮损内注射较超脉冲CO2激光治疗跖疣的疗效好，不良反应少，复发率低。

Objective：To study serological test for syphilis of the newborns delivered by pregnant women with latent syphilis and the situation of negative Conversion. Methods：567 newborns delivered by pregnant women with latent syphilis from 2004 to 2011 in Shenzhen Futian were enrolled for this retrospective study. Serological tests of RPR/TPPA/19SIgM were conducted on the newborns in 1 month, 3 months, 6 months, 9 months, 12 months and 18 months after birth, respectively. Factors such as RPR titers in mothers, stage to start treatment during pregnancy and treatment of the newborn after birth were analyzed when discussing influence on the transformation of the test results. Results：Among the 567 cases, 10 cases suffered from congenital syphilis, 23 cases had negative results for both RPR and TPPA, 102 cases showed positive result for TPPA only, and 432 cases showed positive results for both RPR and TPPA. The average time for conversion of the newborns positive results of RPR and TPPA into negative results were (268±208)months and (525±186)months for TPPA, respectively. Average time for conversion of positive results of both RPR and TPPA into negative were significantly shorter in newborns from mothers with low RPR titer (≤1∶8) than that with high RPR titer (≥1∶16) (P＜0001 for both). No statistical significance was found among different pregnancy treatment groups and the two newborn groups with or without treatment. Conclusion：Pregnancy with latent syphilis can lead to congenital syphilis, and intervention in pregnancy or newborns can prevent development of congenital syphilis. Positive serological tests for syphilis can automatically convert into negative results in newborns without congenital syphilis. Low RPR titer of the mothers is probably one of the protective factors, and it is not affected by treatment during pregnancy or after birth.

Objective：To investigate the clinical features of lupus erythematosus panniculitis (LEP), and to enhance awareness of the disease and the diagnosis. Methods：A retrospective analysis of the clinical data from 8 patients with lupus panniculitis from outpatient department of dermatology in our center was conducted including clinical, pathological features, treatment modality and prognosis. Results：Skin lesions of LEP presented as atrophy, erythema, subcutaneous nodules, infiltrated erythema and ulceration over the scalp, face, upper limbs and buttock. Histopathological features showed lobular panniculitis in the subcutaneous fatty tissue. Hydroxychloroquine sulfate alone or combined with corticosteroid were prescribed and most of the patients responded well to the treatment. Conclusion：LEP is a rare cutaneous variant of lupus erythematosus. The diagnosis of LEP is mainly based on clinical findings and pathological features. Hydroxychloroquine sulfate and lowand middledose corticosteroid are effective in the treatment of LEP.

目的:观察中药荆防方颗粒治疗慢性荨麻疹的疗效和安全性.方法:采取随机对照临床试验,治疗组每日冲服荆防方颗粒,疗程2周;对照组每日口服地氯雷他定5 mg,疗程2周.结果:共观察124例,治疗组63例,对照组61例,治疗组总有效率为81.6%,对照组为83.5%,两组比较差异无统计学意义(P＞0.05),不良反应发生率治疗组为3.0%,对照组为11.0%,两组比较差异无统计学意义(P＞0.05).结论:中药荆防方颗粒是治疗慢性荨麻疹较安全有效的药物.

目的:研究慢性荨麻疹的常见过敏原。方法: 选取280例慢性荨麻疹患者，采用皮肤点刺方法，进行28种吸入性、食入性变应原检测。结果:吸入性变应原中阳性率居前三位的依次为：粉尘螨(45.0％)、屋尘螨(41.2％)、花粉(27.9％)；食物性变应原中阳性率居前三位的依次为：螃蟹(36.4％)、虾(33.2％)、芒果(25.7％)。结论: 变应原检测能发现部分慢性荨麻疹的发病原因，指导患者进行预防及治疗。

Objective：The objective of this study was to determine the morphological characteristics of a strain of Pennicillium griseofulvum causing facial infection. Methods：The strain of Pennicillium griseofulvum was inoculated on SDA medium and the colony characteristics were investigated. The microculture was adopted by slide method and its micromorphological characteristics were observed by the scanning electron microscope. Results：The colonies were 1~15 cm in diameter on the 5th day after inoculating and the color was gray-green to dark brown. There were radial wrinkles and umbilical-like protrusions on the surface. The texture of colonies was velvet-like with a slight flocculent and granular at the edge. Pale yellow pigment ring was visible around the colonies. Reverse side of colonies was milky yellow and had a smooth surface with radial folds. This strain of Pennicillium griseofulvum had long conidiophores and complicated broom sticks. Its phialide was ampulliform and the top of metula was not expanded. Conidial chain was long and arranged in a close cylinder form with conidia showing subglobose or broadly elliptical. Both conidiophores and conidial had rough surfaces.Conclusion：The morphological characteristics of this Pennicillium griseofulvum are consistent with the wild strain.

特应性皮炎(atopic dermatitis, AD)是常见慢性炎症性皮肤病，目前认为Th1/Th2/Th17/Treg细胞亚群失衡导致的免疫调节网络异常在AD的发病机制中发挥着重要作用，而Treg细胞尤其是CD4+CD25+Tr对于打破平衡发挥着重要作用。本文就Treg细胞的作用及其与AD的关系作一综述，以期对AD的发病机制有更进一步的认识。

Objective：To explore the relationship between itraconazole resistance of Candida albicans and cross-reactive degree with anti-LDH antibody. Methods：The whole intracellular proteins of Candida albicans were extracted by P0013B RIPA lysis buffer from 30 isolates (including ten strains resistant to itraconazole, ten medium strains and ten sensitive strains), respectively followed to react with anti-LDH antibody by ELISA, then the combination degree of 3 groups of strains were measured and analysised. Results：The relative combination degree with anti-LDH antibody was 34871±3436 for resistant Candiada albicans isolates, and it was significantly lower than that for sensitive isolates(44343±3564) and medium isolates(32700±8560;F=852,P＝0003). Conclusion：The occurrence of itraconazole resistance in Candida albicans may be relatated with the decrease of combination degree of anti-LDH antibody.

白癜风是一种常见的皮肤色素脱失性疾病,导致皮损中黑素细胞损伤的分子机制迄今尚未明确.该病发病机制复杂,涉及遗传、免疫-炎症、氧化应激、功能性黑素细胞凋亡和(或)丢失、神经体液等假说.目前比较推崇的观点是氧化应激在遗传易感个体可能为始动因素,而固有免疫所致炎症的作用也不容忽视,这两者均可直接抑制或损害黑素细胞,并通过激发链式适应性免疫反应来清除黑素细胞,诱发白斑.

目的:观察595 nm脉冲染料激光联合口服甲硝唑治疗红斑毛细血管扩张型和丘疹脓疱型酒渣鼻的临床疗效。方法：治疗组31例,用595 nm脉冲染料激光治疗,每4周1次,连续治疗3次, 同时口服甲硝唑,每天3次,每次02克,连续28天；对照组30例,外用5%过氧化苯甲酰凝胶,每天一次,连续12周, 同时口服甲硝唑片,用法用量及疗程同治疗组。观察比较两组治疗前后丘疹脓疱数目、红斑毛细血管扩张评分情况。结果：治疗组总有效率100%,显效率为838%。对照组总有效率为9333%,显效率为5667%,两组显效率和红斑血管扩张评分比较差异有统计学意义（P<005）,总有效率和丘疹脓疱数目差异无统计学意义（P>005）。结论：595 nm脉冲染料激光联合口服甲硝唑治疗酒渣鼻疗效显著,尤其对红斑毛细血管扩张型病变疗效明显,值得临床推广。

  Objective：To explore the role of Jak/STAT pathway in RNA expression level in patients with psoriasis. Methods：The expression levels of STAT1, STAT3, SOCS1, SOCS3 genes were valuated in keratinocytes from lesional and nonlesional skin of 10 patients with psoriasis by using realtime quantitative PCR technique. Relationships of the expression levels of STAT1, STAT3, SOCS1, SOCS3 mRNA to the pathogenesis of psoriasis were analyzed. Results：Difference between expression levels of STAT1, STAT3, SOCS1, SOCS3 mRNA in keratinocytes of lesional skin and internal reference standard GAPHDH Ct (△Ct) were -19±16、06±16、01±10、-06±11 respectively，which were significantly higher than that of nonlesional skin (△Ct were 10±16, 37±15, 42±12, 39±13) respectively. The expression levels of STAT1, STAT3 mRNA of keratinocytes was found highly correlate to the that of SOCS1, as well as SOCS3 mRNA (r= 084、083，P<001). Conclusion：Jak/STAT pathway is involved in the pathogenesis of psoriasis. Further investigation is required for the understanding of the function of these abnormally expressed genes.

  外用糖皮质激素;副作用