Skin Diseases

皮肤病
  • 文章类型: Journal Article
    在过去的几十年中,皮肤超声呈指数级增长,并且已经从实验阶段过渡到了多个国家的常规日常实践。这种成像技术的性能需要彩色多普勒超声设备与高频探头一起工作,在成像和皮肤病学方面受过训练的操作员,以及用于正确获取解剖数据的标准化协议的性能。在这次审查中,我们分析了皮肤的超声解剖,头发,和指甲,技术要求和注意事项,准则,和推荐的协议,并为自信地练习这种考试提供最好的技巧。
    Dermatologic ultrasound has grown exponentially during the last decades and has passed from the experimental phase to the routine daily practice in multiple countries. The performance of this imaging technique requires color Doppler ultrasound devices working with high-frequency probes, a trained operator on imaging and dermatologic conditions, and the performance of standardized protocols for obtaining the anatomical data properly. In this review, we analyze the ultrasonographic anatomy of the skin, hair, and nails, the technical requirements and considerations, the guidelines, and the recommended protocols, and provide the best tips for practicing this type of examination confidently.
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  • 文章类型: English Abstract
    BACKGROUND: Anogenital disorders encompass a broad spectrum of conditions with diverse pathogenetic origins, often presenting with nonspecific symptoms and overlapping causative factors, thereby posing diagnostic and therapeutic challenges. Effective management requires interdisciplinary knowledge and the use of medical guidelines. Guidelines can play an important role in translating current knowledge into clinical practice and ensuring consistent care, minimizing complications, and optimizing patient outcomes.
    OBJECTIVE: The dermatologically relevant guidelines for anogenital disorders, categorized by etiological groups, are reviewed.
    METHODS: A selective literature review was conducted, incorporating data from the guideline repository of the Association of the Scientific Medical Societies in Germany (AWMF).
    RESULTS: A broad range of current guidelines pertinent to the management of anogenital disorders with relevance for dermatologists is available. These encompass guidelines for the management of chronic inflammatory dermatoses with (potential) involvement of the anogenital region, such as anal eczema, psoriasis, lichen sclerosus, or lichen ruber, as well as sexually transmitted infections and associated conditions, involving a broad range of pathogens, including gonorrhea, chlamydia, syphilis, or human papillomaviruses (HPV)-associated disorders. In this article, we provide an overview of the available guidelines.
    CONCLUSIONS: The present article does not claim to be exhaustive. The validity of the mentioned guidelines and the availability of updates needs to be verified in each case.
    UNASSIGNED: HINTERGRUND: Im Anogenitalbereich treten vielfältige Erkrankungen mit sehr unterschiedlichen pathogenetischen Ursachen auf. Teils unspezifische Symptome und überlappende Ursachen erschweren die Diagnose und Behandlung. Die effektive Diagnose und Behandlung erfordern interdisziplinäres Wissen und die Anwendung von medizinischen Leitlinien. Leitlinien spielen eine wichtige Rolle beim Transfer des aktuellen Wissensstands in die klinische Praxis und bei der Gewährleistung einer konsistenten Versorgung, Minimierung von Komplikationen und Optimierung der Ergebnisse für Patient*innen.
    UNASSIGNED: Ziel war die Erstellung einer Übersicht über die aktuell vorliegenden dermatologisch relevanten Leitlinien für das Management von ausgewählten Erkrankungen des Anogenitalbereichs.
    METHODS: Es erfolgte eine elektive Literaturrecherche unter Einbezug des Leitlinienregisters der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).
    UNASSIGNED: Es liegt eine Vielzahl aktueller Leitlinien zur Behandlung anogenitaler Erkrankungen von dermatologischer Relevanz vor. Dies umfasst insbesondere Leitlinien für chronisch entzündliche Dermatosen mit (möglicher) Beteiligung des Anogenitalbereichs, wie etwa das Analekzem, die Psoriasis, den Lichen sclerosus oder Lichen ruber, sowie sexuell übertragbare Infektionen und assoziierte Erkrankungen mit einer großen Bandbreite an Pathogenen, etwa Gonorrhö, Chlamydien, Syphilis oder HPV(humane Papillomaviren)-assoziierte Erkrankungen. Im vorliegenden Beitrag geben wir eine Übersicht über die bestehenden Leitlinien.
    UNASSIGNED: Die vorliegende Übersicht erhebt keinen Anspruch auf Vollständigkeit. Die Gültigkeit der genannten Leitlinien oder das Vorliegen von Aktualisierungen ist im Einzelfall zu prüfen.
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  • 文章类型: Journal Article
    皮肤毒性在接受癌症治疗的患者中非常常见,并且发现所有类型的癌症治疗干预措施都会发生(细胞毒性化疗,靶向治疗,免疫疗法,和放射治疗)。Further,皮肤毒性可导致某些患者中断甚至停止抗癌治疗,转化为次优结果。皮肤化妆品(或药妆品)-定义为包含皮肤病学活性成分(超出赋形剂作用)的护肤溶液,可直接改善各种皮肤状况的症状-越来越多地用于癌症护理中以预防和管理皮肤毒性。这些产品中的活性成分在皮肤中具有可测量的生物作用;它们通常改善皮肤完整性(屏障功能/水合作用和其他因素),同时缓解皮肤症状。法语国家协会(AFSOS)和跨国癌症支持协会(MASCC)合作,选择了一个多学科的医疗保健专业人员小组参与癌症和皮肤毒性患者的管理。该小组审查了现有文献,并通过在线会议和交流创建了管理这些毒性的建议摘要。在本出版物中,该小组(1)回顾了肿瘤药物的新皮肤毒性,(2)评价了皮肤化妆品在改善患者预后和减少癌症治疗中断方面的作用.我们为所有肿瘤患者的皮肤护理的开始和选择提供一般建议,以及在特定类型的皮肤毒性中使用皮肤化妆品时应考虑的因素的建议。
    Skin toxicities are very common in patients undergoing cancer treatment and have been found to occur with all types of cancer therapeutic interventions (cytotoxic chemotherapy, targeted therapies, immunotherapy, and radiotherapy). Further, skin toxicities can lead to interruption or even discontinuation of anticancer treatment in some patients, translating to suboptimal outcomes. Dermocosmetics (or cosmeceuticals)-defined as skincare solutions incorporating dermatologically active ingredients (beyond vehicle effects) that directly improve symptoms of various skin conditions-are increasingly being used in cancer care to prevent and manage skin toxicities. The active ingredients in these products have a measurable biological action in skin; they typically improve skin integrity (barrier function/hydration and other factors) while relieving skin symptoms. The Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC) partnered to select a multidisciplinary group of healthcare professionals involved in the management of patients with cancer and skin toxicities. The group reviewed existing literature and created a summary of recommendations for managing these toxicities through online meetings and communication. In this publication, the group (1) reviews new skin toxicities seen with oncology drugs and (2) evaluates the role of dermocosmetics in improving patient outcomes and minimizing cancer treatment interruptions. We provide general recommendations for initiation and selection of skin care in all oncology patients as well as recommendations for what factors should be considered when using dermocosmetics in specific types of skin toxicities.
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    文章类型: Review
    背景:炎性皮肤病损害皮肤屏障健康。早期和日常使用护肤旨在维持终身健康的皮肤屏障。皮肤屏障特性的种族/种族和年龄变化,文化差异,炎性皮肤病的临床表现影响治疗和皮肤护理的选择。含神经酰胺的皮肤护理可以在恢复和维持健康的皮肤屏障中发挥作用。
    方法:由6位皮肤科医生组成的小组根据他们以前发表的8篇关于使用含神经酰胺的皮肤护理在整个生命中促进皮肤屏障健康的出版物达成共识声明。这些出版物涵盖了新生儿和婴儿的皮肤屏障完整性,和皮肤屏障在减轻特应性皮炎(AD)中的作用;皮肤屏障的种族/种族差异和对皮肤护理的影响;皮肤屏障在炎性皮肤病中的作用,包括痤疮,彩色皮肤(SOC)人群中的AD和牛皮癣;酒渣鼻患者的皮肤屏障完整性;糖尿病患者的干燥病。小组综合了8份出版物,从文献综述中选择的信息,以及他们的专家意见和经验来创建声明。通过改进的Delphi方法达成了共识,在该方法中,专家组面对面会面并进行了实质性跟进。
    结果:小组通过了6项共识声明,强调了皮肤护理在恢复/维持上述人群健康皮肤屏障中的重要性。适合这个角色的皮肤护理是温和的,具有接近生理的pH值,使用起来很愉快,含有神经酰胺。这种类型的皮肤护理可以促进健康的皮肤屏障并减轻或延迟炎性皮肤状况。
    结论:一生中的辅助日常皮肤护理可促进健康的皮肤屏障,并有益于所有人群的各种炎症性皮肤病的管理。然而,选择最佳治疗和皮肤护理时,医生应该考虑年龄的变化,皮肤属性,病情的介绍,和文化差异。J药物Dermatol.2023年;22:2(补编1):s3-14。
    BACKGROUND: Inflammatory skin disorders compromise skin barrier health. Early and daily skincare use aims to maintain a life-long healthy skin barrier. Racial/ethnic and age variations in skin barrier properties, cultural differences, and clinical presentation of the inflammatory skin disorder influence the choice of treatment and skin care. Ceramide-containing skin care may play a role in restoring and maintaining a healthy skin barrier.
    METHODS: A panel of 6 dermatologists met to develop consensus statements based on their 8 previous publications on promoting skin barrier health throughout life using ceramide-containing skin care. The publications covered skin barrier integrity in the newborn and infant, and the role of the skin barrier in mitigating atopic dermatitis (AD); racial/ethnic variations in the skin barrier and implications for skin care; the role of the skin barrier in inflammatory skin conditions including acne, AD and psoriasis in skin of color (SOC) populations; skin barrier integrity in patients with rosacea; and xerosis in patients with diabetes mellitus. The panel synthesized the 8 publications, selected information from a literature review, and their expert opinions and experiences to create the statements. The consensus was reached through a modified Delphi method where the panel met face-to-face and followed up virtually.
    RESULTS: The panel adopted 6 consensus statements highlighting the importance of skin care in restoring/maintaining a healthy skin barrier in the populations mentioned above. Skin care suited to this role is gentle, has near-physiologic pH, is pleasant to use, and contains ceramides. This type of skin care can promote a healthy skin barrier and attenuate or delay inflammatory skin conditions.
    CONCLUSIONS: Adjunctive daily skin care throughout life promotes a healthy skin barrier and is beneficial in managing various inflammatory skin disorders in all populations. However, when choosing optimal treatment and skin care, physicians should consider variations in age, skin properties, presentation of the condition, and cultural differences. J Drugs Dermatol. 2023;22:2(Suppl 1):s3-14.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:治疗,洁面,保湿,光保护是皮肤病整体护肤的四个主要组成部分。虽然治疗(T)被认为是皮肤病管理的关键组成部分,清洁的辅助作用缺乏实际指导,保湿,和光保护(“CMP”)。患者知识有限,产品选择混乱,缺乏如何选择和使用CMP护肤品(与药物疗法结合使用)的指导是建立针对皮肤病的整体护肤常规的主要障碍。
    目的:本研究旨在回顾当前的临床证据,找出差距,并提供有关CMP常规的概念化和实施的实用指导,以管理潜在的痤疮引起的敏感皮肤,特应性皮炎,或者酒渣鼻,包括患有特发性原因的疾病,称为特发性敏感性皮肤综合征。
    方法:由来自澳大利亚的10名皮肤科医生组成的专家小组,中国,香港,台湾,印度,印度尼西亚,菲律宾,新加坡,韩国,和泰国召开会议,就痤疮的整体皮肤护理达成共识,酒渣鼻,特应性皮炎,和特发性敏感性皮肤综合征使用Delphi方法。
    结果:共识被定义为≥80%的小组评级声明为≥8或中位评级≥8。对最后的陈述进行了整理,以制定有关整体皮肤护理的共识建议。
    结论:皮肤科医生指导的整体皮肤护理常规对于提高患者信心和减少对产品选择的混淆至关重要。这里提出的协商一致建议强调了清洁的重要性,保湿,和整体皮肤护理中的光保护,以及如何将其用作医生和患者的沟通工具,以实现整体更好的患者依从性,满意,和治疗结果。
    BACKGROUND: Treatment, cleansing, moisturizing, and photoprotection are four major components of holistic skin care for dermatological conditions. While treatment (T) is recognized as a key component in the management of dermatological conditions, there is a lack of practical guidance on the adjunctive role of cleansing, moisturizing, and photoprotection (\"CMP\"). Limited patient knowledge, confusion over product selection, and lack of guidance on how to choose and use CMP skin care products (in conjunction with pharmacological therapy) are the main barriers to establishing a holistic skin care routine for dermatological conditions.
    OBJECTIVE: This study aimed to review current clinical evidence, identify gaps, and provide practical guidance on conceptualization and implementation of CMP routine in the management of sensitive skin due to underlying acne, atopic dermatitis, or rosacea, including conditions with idiopathic causes referred to as idiopathic sensitive skin syndrome.
    METHODS: An expert panel comprising of 10 dermatologists from Australia, China, Hong Kong, Taiwan, India, Indonesia, Philippines, Singapore, South Korea, and Thailand convened to develop consensus statements on holistic skin care in acne, rosacea, atopic dermatitis, and idiopathic sensitive skin syndrome using the Delphi approach.
    RESULTS: Consensus was defined as ≥80% of panel rating statement as ≥8 or median rating of ≥8. The final statements were collated to develop consensus recommendations on holistic skin care.
    CONCLUSIONS: A dermatologist-guided holistic skin care routine is essential to improve patient confidence and reduce confusion over product selection. The consensus recommendations presented here highlight the importance of cleansing, moisturization, and photoprotection in holistic skin care and how it can be utilized as a communication tool for physicians and patients to achieve overall better patient compliance, satisfaction, and treatment outcomes.
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  • 文章类型: Journal Article
    目的:就用于定义造口的术语达成共识,造山体,和澳大利亚的造口并发症。
    方法:造口列表,造山体,造口周围的并发症是通过小组对话产生的,这是由研究人员的临床和学术知识提供的。进行了广泛的文献综述,以确定任何其他术语并创建定义/描述数据库。生成与所识别的条件相关的图像库。在一名代表中进行了在线Delphi流程,澳大利亚专家伤口的目的样本,造口术,以及失禁护士和结直肠外科医生。向小组提交了十个术语,并提供了每个并发症的描述性照片。最多三轮Delphi,如有必要,进行了优先投票。
    结果:10项条款中有7项在第一轮中达成一致。一个术语(过敏性皮炎)被细化(过敏性接触性皮炎),并在第二轮中达成协议。小组认为两个术语(粘膜皮肤肉芽肿和粘膜肉芽肿)在不同解剖位置是相同的情况,并合并为一个术语(肉芽肿)。两项(皮肤剥离和张力水疱)合并为一项(医用粘合剂相关皮肤损伤),并在第2轮中达成协议。
    结论:在用于描述造口或造口旁/造口周围并发症的术语方面达成共识将加强患者和卫生专业人员之间的沟通,并增加造口教育和基准测试的机会,造山体,和全国的造口并发症。
    OBJECTIVE: To establish a consensus on terminology used to define stomal, parastomal, and peristomal complications in Australia.
    METHODS: A list of stomal, parastomal, and peristomal complications was generated through group dialogue, which was informed by clinical and academic knowledge of the researchers. An extensive literature review was undertaken to identify any additional terms and to create a database of definitions/descriptions. A library of images related to the identified conditions was generated. An online Delphi process was conducted among a representative, purposive sample of Australia expert wound, ostomy, and continence nurses and colorectal surgeons. Ten terms were presented to the panel with descriptive photographs of each complication. Up to three Delphi rounds and, if necessary, a priority voting round were conducted.
    RESULTS: Seven of the 10 terms reached agreement in the first round. One term ( allergic dermatitis ) was refined ( allergic contact dermatitis ) and reached agreement in the second round. Two terms ( mucocutaneous granuloma and mucosal granuloma ) were considered by the panel to be the same condition in different anatomical locations and were combined as one term ( granuloma ). Two terms ( skin stripping and tension blisters ) were combined as one term ( medical adhesive-related skin injury ) and reached agreement in round 2.
    CONCLUSIONS: A consensus in terminology used to describe stomal or parastomal/peristomal complications will enhance communication among patients and health professionals and advance opportunities for education and benchmarking of stomal, parastomal, and peristomal complications nationally.
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  • 文章类型: Journal Article
    背景:弓形虫皮炎(TD)是过敏性接触性皮炎的常见形式,每年影响数百万美国人。研究表明,尽管目前对TD的治疗有普遍的建议,当患者出现TD时,临床医生没有可遵循的治疗算法.
    目的:本研究的目的是就TD的治疗达成共识,为治疗TD的医生制定实用的指南。
    方法:数据收集时间为2020年3月至2021年4月。这项研究包括半结构化焦点小组和皮肤科医生的Delphi研究,以达成共识。
    结果:共有51名皮肤科医生纳入Delphi。与建议的严重性标准的最终一致性范围为90.9%至100.0%。疾病严重程度的主要指标是体表面积,瘙痒的存在和严重程度,和喷发的解剖位置有77.4%的一致性。治疗算法的最终同意超过阈值多数同意,为67.6%。
    结论:指导TD治疗的文献很少。使用德尔菲法和焦点小组可以帮助扩大皮肤病学和其他可能需要治疗皮肤病的专业的皮肤病学资源。
    BACKGROUND: Toxicodendron dermatitis (TD) is a common form of allergic contact dermatitis that affects millions of Americans every year. Studies have shown that although there are general recommendations for the treatment of TD, there are no treatment algorithms for clinicians to follow when patients present with TD.
    OBJECTIVE: The objective of this study was to achieve consensus on the treatment of TD to create practical guidelines for physicians who treat TD.
    METHODS: Data were collected from March 2020 to April 2021. This study included semistructured focus groups and a Delphi Study with dermatologists to achieve consensus.
    RESULTS: A total of 51 dermatologists were included in the Delphi. Final agreement with proposed severity criteria ranged from 90.9% to 100.0%. Primary indicators of disease severity were body surface area, presence and severity of pruritus, and anatomic locations of eruptions with 77.4% agreement. Final agreement for the treatment algorithm was over the threshold majority agreement at 67.6%.
    CONCLUSIONS: Literature guiding the treatment of TD is scarce. The use of the Delphi method and focus groups can help expand dermatological resources both within dermatology and to other specialties that may need to treat skin conditions.
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  • 文章类型: Journal Article
    抗菌光动力疗法已成为人类感染治疗的重要组成部分。这篇评论考虑了历史准则,和科学文献来设想未来治疗皮肤感染的临床指南可能包括什么。抗生素耐药性,描述了垂直和水平感染控制策略以及一系列有效根除微生物而不建立新耐药性的技术。还包括这些治疗的作用机制及其临床应用的实例。还回顾了NICE指南关于微生物感染的皮肤病学表现的研究建议,以确定PDT的潜在应用。一些微生物对抗生素的抗性可以停止,甚至通过使用补充药物逆转,因此,它们很可能会继续作为感染的治疗方法。鉴于现有的医疗保健基础设施和大量的证据基础,传统的PDT无疑将继续用于一系列皮肤疾病。日光PDT可能会发现更广泛的抗菌应用,而不仅仅是痤疮和皮肤利什曼病,和动态PDT设备可能在资源有限或日光暴露不可能或不适当的地区变得流行。纳米介体被发现是高度相关的,通常包括PDT,然而,新的治疗方法和新的应用以及现有治疗方法的组合将接受临床试验。
    Antimicrobial photodynamic therapy has become an important component in the treatment of human infection. This review considers historical guidelines, and the scientific literature to envisage what future clinical guidelines for treating skin infection might include. Antibiotic resistance, vertical and horizontal infection control strategies and a range of technologies effective in eradicating microbes without building up new resistance are described. The mechanism of action of these treatments and examples of their clinical use are also included. The research recommendations of NICE Guidelines on the dermatological manifestations of microbial infection were also reviewed to identify potential applications for PDT. The resistance of some microbes to antibiotics can be halted, or even reversed through the use of supplementary drugs, and so they are likely to persist as a treatment of infection. Conventional PDT will undoubtedly continue to be used for a range of skin conditions given existing healthcare infrastructure and a large evidence base. Daylight PDT may find broader antimicrobial applications than just Acne and Cutaneous Leishmaniasis, and Ambulatory PDT devices could become popular in regions where resources are limited or daylight exposure is not possible or inappropriate. Nanotheranostics were found to be highly relevant, and often include PDT, however, new treatments and novel applications and combinations of existing treatments will be subject to Clinical Trials.
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