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。

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.

  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。

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。

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。

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: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: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.

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。

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。

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.

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.

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.

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。

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。

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。

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.

潜伏梅毒的特点是患者在血清学检测阳性的情况下从未发生任何临床症状或者症状已消失,这往往给临床医师在判断病程及确定治疗方案时带来一定难度.近年来,潜伏梅毒患者大幅上升,且逐渐取代一期梅毒成为了报告病例中的主要梅毒类型.血清学检测对潜伏梅毒有重要的诊断意义.梅毒螺旋体IgM抗体产生的时间较早,可看作是梅毒早期感染并活动的一项血清学标志.本文就梅毒螺旋体IgM抗体对评估潜伏梅毒传染性的意义做一概述.

拔毛癖是由人工性牵拉引起的外伤性脱发，好发于儿童，容易误诊成其他脱发性疾病，尤其是斑秃。皮肤镜、脱发斑病理改变有助于鉴别诊断。本病病因不详，患儿与监护人的沟通不良和学习压力是常见的诱因。现认为本病患者有其心理行为特征，即有具强迫症特点的习惯行为。治疗中可采用行为治疗如强化训练、惩罚、习惯逆转训练等，或使用抗精神病药物治疗。本病复发率较高，监护人的监督和心理引导很有帮助。