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.

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.

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。

  外用糖皮质激素;副作用

痤疮是累及毛囊皮脂腺的慢性炎症性皮肤病，其发病机制复杂，不仅与雄激素介导的皮脂腺分泌增加、皮脂成分改变、毛囊皮脂腺导管角化异常、痤疮丙酸杆菌增殖及炎症反应有关，遗传因素以及饮食习惯也是痤疮发病的重要因素，饮食因素可经胰岛素及IGF1通过PI3k/Akt 信号通路影响痤疮发病，而增强肿瘤坏死因子相关凋亡诱导配体（TRAIL）表达，上调转录因子p53被认为是治疗痤疮的关键。本文综述痤疮各发病机制的最新研究进展,希望能为临床诊治以及科研工作提供新的思路。

Syphilis, a sexually transmitted disease, is caused by Treponema pallidum subspecies pallidum. Although syphilis is curable with appropriate antibiotics, there are still challenges in the management of syphilis due to its diversity of clinical manifestations，difficulty in the interpretation of test results and the diagnosis of neurosyphilis. Therefore, U.S. CDC released the latest guidelines on the diagnosis and the treatment of syphilis in 2021. Aiming to assist healthcare providers in the management of syphilis, we interpret this guideline mainly on the special considerations of different tests, reverse sequence algorithm, tests of neurosyphilis, syphilis during pregnancy, JarischHerxheimer reaction and the management of sex partners.

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.

目的:比较TPPA法与化学发光法检测梅毒螺旋体特异性抗体的敏感性与特异性.方法:202份性病门诊患者的血清标本分别用TPPA法和化学发光法进行梅毒螺旋体特异性抗体检测.结果:TPPA阳性49例,阳性率24.26%,化学发光法阳性52例,阳性率25.74%.以TPPA法为金标准,化学发光法检测梅毒螺旋体特异性抗体敏感性为94.23%,特异性为98.04%.结论:化学发光法作为国内新开发的梅毒确诊试剂,其敏感性和特异性都很高,可应用于临床.

目的:观察夫西地酸乳膏治疗寻常痤疮效果及不良反应.方法:将寻常性痤疮患者78例分为两组,分别外用夫西地酸乳膏和口服米诺环素治疗.结果:夫西地酸乳膏在治疗痤疮炎症性皮损1、2和3个月平均皮损减少分别为21.3%、41.8%和60.9%,在治疗1个月与2个月时与内服米诺环素疗效比较差异有统计学意义(P＜0.05);在治疗痤疮非炎症性皮损方面与内服盐酸米诺环素疗效比较无明显差别(P＞0.05).不良反应主要为局部皮肤疼痛、瘙痒.结论:夫西地酸乳膏在治疗痤疮尤其在减少炎症性皮损数量方面有良好疗效,短期无明显不良反应.

目的:观察1%吡美莫司乳膏治疗面部脂溢性皮炎的疗效.方法:80例面部脂溢性皮炎患者随机分成治疗组和对照组.治疗组予1%吡美莫司乳膏外用,对照组予5%氟芬那酸丁酯软膏外用,均每日2次,连续4周.结果:治疗组的总有效率为 90%,对照组的总有效率为67.5%,两组差异有统计学意义(P<0.05).结论:1%吡美莫司乳膏治疗面部脂溢性皮炎疗效好,副作用少.

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.

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。

Objective：To explore the transdermal absorption of longterm topical tacrolimus ointment and the influence of longterm topical tacrolimus ointment on peripheral blood lymphocyte subpopulations in patients with atopic dermatitis.  Methods：12 patients with atopic dermatitis were treated with tacrolimus ointment(01%) for 12 months. Lymphocyte subpopulations was measured by flow cytometry before and after treatment respectively. Tacrolimus blood concentration was detected by ELISA  at 1 week treatment and after treatment respectively. Results：The changes of lymphocyte subpopulations before and after treatment do not have statistical difference (P>005). The blood concentration of tacrolimus were (173±0.48) ng/mL at 1 week of treatment and (107±042) ng/mL after 12 months of treatment. The difference showed statistical significance (P＜005). Conclusion：Systemic absorption on topical tacrolimus ointment in longterm therapy were less, the blood concentration of tacrolimus does not have an impact on peripheral blood lymphocyte subpopulations of patients with atopic dermatitis.

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。

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。

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.

特应性皮炎是一种常见的慢性、复发性、炎症性、瘙痒性皮肤病，严重影响患者生活质量。近年来国内外AD研究进展迅速，为了进一步规范和指导AD的诊断和治疗，中华医学会皮肤性病学分会免疫学组和特应性皮炎协作研究中心组织相关专家对原指南进行了修订。本文就2020年版《中国特应性皮炎诊疗指南》中更新部分作一简要解读。

细菌是人体常驻菌群中最重要的一类，细菌感染也是最常见的皮肤病之一，自无症状到中毒性休克、多脏器衰竭，甚至危及生命。本文按由表及里的次序简要介绍细菌感染所引起的皮肤疾患。即表皮感染、皮肤附属器感染、真皮及其它深部组织感染。涉及的疾病包括窝状角质松解症、体臭、足臭、红癣、腋毛癣、痱、脓疱疮、葡萄球菌烫伤样皮肤综合症、毛囊炎、疖及疖病、痈、丹毒、淋巴管炎、蜂窝织炎、丹毒、坏死性筋膜炎。

目的:比较传染性软疣四种治疗方法的疗效.方法:将163例患者随机分成4组,分别采用冷冻、电灼、血管钳挤压和血管钳挤压配合外涂咪喹莫特治疗.结果:临床治愈率是:血管钳挤压配合外涂咪喹莫特(93.0%)>电灼(92.9%)>冷冻(84.2%)>血管钳挤压(77.5%);疼痛程度为:电灼>血管钳挤压配合外涂咪喹莫特>血管钳挤压>冷冻;局部反应情况:冷冻>血管钳挤压配合外涂咪喹莫特>血管钳挤压>电灼.结论:血管钳挤压配合外涂咪喹莫特和电灼两种方法治愈率高,咪喹莫特具有调节免疫功能、清除残余病毒和提高治愈率的作用.

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。

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.

目的:探讨对脱发性毛囊炎诊疗的认识及其抗菌治疗的药物选择.方法:回顾性分析17例脱发性毛囊炎患者的临床资料,分析抗菌药物疗效.结果:17例患者中男女比为3.25:1,其中7例 (41.2%)顶枕部均有累及,2例患者可见簇状发.治疗主要使用盐酸米诺环素、克拉霉素与利福平,总疗程2周至1年,除2例患者出现复发外,余患者均得到良好的控制,毛囊炎症消失.结论:病程长、而抗菌药物疗程短是复发的主要因素.盐酸米诺环素是治疗轻症患者的非常有效的抗菌药物,与利福平或者克拉霉素联用可以有效治疗中度甚至耐药病例.阿维A及复方甘草酸苷的使用有助于缩短疗程、早期控制炎症.