acne

痤疮
  • 文章类型: Case Reports
    PSTPIP1相关的骨髓相关蛋白血症炎性(PAMI)综合征是一种罕见的自身炎症性疾病,通常在儿科患者中出现。我们介绍了一个18岁女性的病例,有生长失败的病史,免疫球蛋白A肾病,和炎症性关节炎,他们出现在儿科皮肤科诊所,发现痤疮,银屑病样皮炎,和化脓性汗腺炎,其临床,遗传,实验室检查结果与PAMI综合征最为一致。我们进行了文献综述,以更好地描述这种罕见的皮肤病。识别在PAMI综合征中看到的独特皮肤发现可以帮助将其与其他炎症性疾病区分开来。加快诊断和治疗。
    PSTPIP1-associated myeloid-related proteinemia inflammatory (PAMI) syndrome is a rare autoinflammatory disorder often arising in pediatric patients. We present a case of an 18-year-old female with a past medical history of growth failure, immunoglobulin A nephropathy, and inflammatory arthritis who presented to a pediatric dermatology clinic with findings of acne, psoriasiform dermatitis, and hidradenitis suppurativa, whose clinical, genetic, and laboratory findings were most consistent with PAMI syndrome. We conducted a literature review to better characterize this rare condition in the context of dermatologic findings. Recognition of the distinctive skin findings seen in PAMI syndrome can help distinguish it from other inflammatory disorders, enabling expedited diagnosis and treatment.
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  • 文章类型: Journal Article
    目的:本研究的目的是系统地回顾研究各种类型的再生医学方法(例如富血小板血浆,基质血管分数,细胞疗法,条件媒体,等。)用于治疗特定的皮肤病。复兴,疤痕,伤口愈合,和其他继发性皮肤损伤情况在这项研究中没有调查。
    方法:主要数据库,包括PubMed,Scopus,和WebofScience,在2024年1月之前,我们精心搜索了RCT,重点是针对特定皮肤病的再生医学干预措施(如雄激素性脱发,白癜风,斑秃,等。).提取的关键数据包括参与者特征和样本量,再生疗法的类型,治疗功效,和不良事件。
    结果:在本系统综述中,共检查了64项研究,涉及2888名患者。女性占研究人群的44.8%,而男性占参与者的55.2%,平均年龄27.64岁。最常见的皮肤病是雄激素性脱发(AGA)(45.3%)和白癜风(31.2%)。研究这些疾病的最常见的再生方法是PRP和自体表皮黑素细胞/角质形成细胞的移植,分别。研究报告AGA改善高达68.4%,白癜风改善高达71%。该综述中包括的其他疾病是斑秃,黄褐斑,硬化性萎缩性苔藓(LSA),炎性寻常痤疮,慢性静止原污水,糜烂性口腔扁平苔藓,营养不良性大疱性表皮松解症。在所有这些研究中,再生医学被发现是一种有效的治疗选择,以及其他方法。这项研究中研究的再生医学技术包括自体表皮黑素细胞/角质形成细胞的移植,分离的黑素细胞移植,毛囊起源的细胞移植,PRP中的黑素细胞-角质形成细胞悬浮液,条件培养基注射,PRP和碱性成纤维细胞生长因子的组合,静脉内注射间充质干细胞,集中生长因子,基质血管分数(SVF),PRP和SVF的组合,并在PRP中保存头发移植物。
    结论:再生医学有望治疗特定的皮肤病。为了验证我们的发现,建议进行许多针对各种皮肤状况的临床试验。在我们的研究中,我们没有探索继发性皮肤损伤,如疤痕或溃疡。因此,评估这种治疗方法解决这些疾病的有效性需要进行单独的研究.
    OBJECTIVE: The aim of this study is to systematically review randomized controlled clinical trials (RCTs) studying various types of regenerative medicine methods (such as platelet-rich plasma, stromal vascular fraction, cell therapy, conditioned media, etc.) in treating specific dermatologic diseases. Rejuvenation, scarring, wound healing, and other secondary conditions of skin damage were not investigated in this study.
    METHODS: Major databases, including PubMed, Scopus, and Web of Science, were meticulously searched for RCTs up to January 2024, focusing on regenerative medicine interventions for specific dermatologic disorders (such as androgenetic alopecia, vitiligo, alopecia areata, etc.). Key data extracted encompassed participant characteristics and sample sizes, types of regenerative therapy, treatment efficacy, and adverse events.
    RESULTS: In this systematic review, 64 studies involving a total of 2888 patients were examined. Women constituted 44.8% of the study population, while men made up 55.2% of the participants, with an average age of 27.64 years. The most frequently studied skin diseases were androgenetic alopecia (AGA) (45.3%) and vitiligo (31.2%). The most common regenerative methods investigated for these diseases were PRP and the transplantation of autologous epidermal melanocyte/keratinocyte cells, respectively. Studies reported up to 68.4% improvement in AGA and up to 71% improvement in vitiligo. Other diseases included in the review were alopecia areata, melasma, lichen sclerosus et atrophicus (LSA), inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and dystrophic epidermolysis bullosa. Regenerative medicine was found to be an effective treatment option in all of these studies, along with other methods. The regenerative medicine techniques investigated in this study comprised the transplantation of autologous epidermal melanocyte/keratinocyte cells, isolated melanocyte transplantation, cell transplantation from hair follicle origins, melanocyte-keratinocyte suspension in PRP, conditioned media injection, a combination of PRP and basic fibroblast growth factor, intravenous injection of mesenchymal stem cells, concentrated growth factor, stromal vascular fraction (SVF), a combination of PRP and SVF, and preserving hair grafts in PRP.
    CONCLUSIONS: Regenerative medicine holds promise as a treatment for specific dermatologic disorders. To validate our findings, it is recommended to conduct numerous clinical trials focusing on various skin conditions. In our study, we did not explore secondary skin lesions like scars or ulcers. Therefore, assessing the effectiveness of this treatment method for addressing these conditions would necessitate a separate study.
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  • 文章类型: Journal Article
    世界上很大一部分人口受到寻常痤疮(AV)的影响,其中许多人是青少年。AV的潜在机制是由于雄激素过度刺激皮脂腺而引起的毛囊皮脂腺过度角质化和粉刺杆菌感染。二甲双胍是一种双胍药物,主要用于降低2型糖尿病患者的血糖水平。它已被证明可以降低胰岛素抵抗患者的循环雄激素水平,表明其治疗房室的潜力。使用Ovid医学文献分析和在线检索系统(MEDLINE)数据库开发并执行了搜索策略,摘录医学数据库(EMBASE),护理和相关健康文献累积指数(CINAHL),Cochrane控制的试验注册(中央),和WebofScience。搜索关键词“二甲双胍”和“痤疮”,以及相关医学主题词(MeSH)和其他主题词。符合纳入标准的研究是对照试验,2010年后出版,并以英语出版。考虑了有和没有合并症的参与者,例如多囊卵巢综合征(PCOS)。两名独立审稿人根据预定义的标准筛选研究,并从每项研究中提取数据,它们是定量组合的。本系统综述共纳入15项研究。在15项研究中,有1046名参与者,有13项研究专门针对PCOS女性。在剩下的两项研究中,一个人检查了代谢谱改变的男性,而其他包括男性和女性中度AV。值得注意的偏倚风险包括没有专门说明研究盲目性的研究。在检查的研究中,13显示二甲双胍降低AV,七项研究显示了统计学意义。寻常痤疮是一种炎症性疾病,由于可用的治疗选择有限,困扰患者多年。高血糖药物二甲双胍,用于2型糖尿病的管理,正在探索一种新的治疗方法,可能会被重新用于AV的治疗。假设在AV中使用二甲双胍破坏了所提出的胰岛素抵抗和AV增殖之间的联系。这项拟议的研究可以为医生提供治疗AV的新选择,并为患者提供替代AV治疗。
    A large portion of the world\'s population is affected by acne vulgaris (AV), with many of these individuals being adolescents. The underlying mechanism of AV is hyperkeratinization and Cutibacterium acnes infection of the pilosebaceous follicle secondary to excessive stimulation of sebaceous glands by androgens. Metformin is a biguanide medication primarily used in efforts to lower patients\' sugar levels in the management of type 2 diabetes. It has been proven to reduce levels of circulating androgens in patients with insulin resistance, indicating its potential for treating AV. A search strategy was developed and performed using the databases Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Controlled Register of Trials (CENTRAL), and Web of Science. The keywords \"metformin\" and \"acne\" were searched, along with related Medical Subject Headings (MeSH) and other subject headings. Studies that met the inclusion criteria were controlled trials, published after 2010, and in the English language. Participants with and without comorbidities such as polycystic ovary syndrome (PCOS) were considered. Two independent reviewers screened studies based on predefined criteria and extracted data from each study, which were quantitatively combined. A total of 15 studies were included in this systematic review. Across the 15 studies, there were 1,046 participants, with 13 studies looking exclusively at women with PCOS. Of the remaining two studies, one examined males with altered metabolic profiles, while the other included men and women with moderate AV. Notable risks of bias included studies that did not exclusively state the blindness of the study. Of the studies that were examined, 13 showed that metformin reduces AV, with seven studies showing statistical significance. Acne vulgaris is an inflammatory condition that has plagued patients for years due to the limited treatment options available. The hyperglycemic medication metformin, used in the management of type 2 diabetes, is being explored as a novel therapeutic that can possibly be repurposed for the treatment of AV. The use of metformin in AV is hypothesized to disrupt the proposed linkage between insulin resistance and AV proliferation. This proposed research could offer physicians a new option for the treatment of AV as well as render an alternative AV treatment for patients.
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  • 文章类型: Journal Article
    痤疮是一种常见的皮肤炎症性疾病,可显著影响患者的生活质量。因此,准确的评估量表对寻常痤疮的治疗和管理非常重要。这篇综述文章对各种痤疮严重程度评估量表进行了全面综述。在本文中,作者回顾了痤疮分级量表,比如皮尔斯伯里量表,库克的痤疮分级量表,利兹痤疮分级系统,全球痤疮评分系统,和调查员的全球评估,等。我们深入研究了这些特征,优势,局限性,以及这些量表的适用性。未来要制定的痤疮分级量表应具有客观性,准确,全面,易于使用,并适用于各种诊所和研究环境。当前技术,比如人工智能,可能有助于开发满足未满足需求的理想痤疮分级量表。
    Acne is a common skin inflammatory condition that can significantly affect the patient\'s quality of life. Therefore, accurate assessment scales are very important for treatment and management of acne vulgaris. This review article issues a comprehensive review of various acne severity assessment scales. In this text, the authors review the acne grading scales, such as the Pillsbury scale, Cook\'s acne grading scale, Leeds acne grading system, Global Acne Grading System, and investigator\'s global assessment, etc. And we delve into the characteristics, advantages, limitations, and applicability of these scales. The acne grading scale to be developed in the future should be objective, accurate, comprehensive, easy to use, and applicable in a variety of clinics and research settings. Current technologies, such as artificial intelligence, could potentially contribute to the development of ideal acne grading scales that meet unmet needs.
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  • 文章类型: Journal Article
    雄激素过多症是一种情况,其中血液中的雄激素激素水平显着增加,并且可能是肾上腺或卵巢起源。肾上腺雄激素,通常由网状带分泌,是具有弱雄激素活性的类固醇激素。高雄激素血症的原因是多种多样的,可能是内源性和外源性的。雄激素过量影响不同的组织和器官导致临床特征,如痤疮,多毛症,男性化,和生殖功能障碍,如少月症/闭经。尽管雄激素过量很少与肾上腺肿瘤相关,这很重要,因为它可以预测恶性肿瘤。仔细评估雄激素模式,也有明显的高雄激素血症症状的患者,可能是有用的。实验室评估应侧重于测量总睾酮水平,其次是其他雄激素的估计,如脱氢表雄酮和雄烯二酮,并在进一步的管理中使用可视化程序。肾上腺高雄激素血症的治疗主要是手术治疗,考虑到频繁的恶性起源。这篇综述的目的是通过描述肾上腺雄激素类固醇生成的生理机制来阐述和总结肾上腺起源的高雄激素血症的患病率和临床管理。高雄激素血症的临床表现,特别是肾上腺腺瘤和癌中的高雄激素血症,以及将导致我们根据患者的临床表现建立正确的诊断和不同的治疗方案来管理这种情况的诊断方法。
    Hyperandrogenism is a condition in which the levels of androgen hormones in the blood are significantly increased and could be of an adrenal or ovarian origin. The adrenal androgens, normally secreted by the zona reticularis, are steroid hormones with weak androgen activity. The causes of hyperandrogenism are diverse and could be endogenous and exogenous. Androgen excess affecting different tissues and organs results in clinical features such as acne, hirsutism, virilization, and reproductive dysfunction such as oligomenorrhoea/amenorrhoea. Although androgen excess is rarely associated with adrenal tumours, it is important as it could be predictive of malignancy. A careful evaluation of the androgen pattern, also in patients with clear signs of hyperandrogenism, could be useful. Laboratory evaluation should focus on measuring total testosterone levels, followed by the estimation of other androgens such as dehydroepiandrosterone and androstenedione, and using visualisation procedures in the further management. The treatment of adrenal hyperandrogenism is eminently surgical, in consideration of the frequent malignant origin. The aim of this review is to elaborate and summarize the prevalence and clinical management of hyperandrogenism of an adrenal origin by describing the physiological mechanisms of adrenal androgen steroidogenesis, the clinical manifestations of hyperandrogenism with a special reference to hyperandrogenism in adrenal adenomas and carcinomas, and the diagnostic methods that will lead us to establishing the correct diagnosis and different treatment options to manage this condition according to the clinical presentation of the patient.
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  • 文章类型: Systematic Review
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  • 文章类型: Journal Article
    痤疮疤痕是痤疮的常见并发症。疤痕对社会心理和身体健康产生负面影响。最佳治疗显著改善外观,生活质量,和有疤痕的人的自尊。已经提出了针对痤疮疤痕的广泛干预措施。这篇叙述性综述旨在关注面部萎缩性瘢痕的干预措施。痤疮疤痕的管理包括各种类型的表面置换(化学剥离,激光,和磨皮);使用可注射填料;和手术方法,比如针刺,打孔切除,冲床高程,或subcision。由于疤痕组织的再生能力受损,干细胞或祖细胞再生医疗技术的未来实施可能会增加相当大的价值。有限的随机对照试验旨在确定哪些治疗方案应被视为黄金标准。与实施单一方法相比,结合干预措施可能会产生更多的好处。
    Acne scarring is a frequent complication of acne. Scars negatively impact psychosocial and physical well-being. Optimal treatments significantly improve the appearance, quality of life, and self-esteem of people with scarring. A wide range of interventions have been proposed for acne scars. This narrative review aimed to focus on facial atrophic scarring interventions. The management of acne scarring includes various types of resurfacing (chemical peels, lasers, and dermabrasion); the use of injectable fillers; and surgical methods, such as needling, punch excision, punch elevation, or subcision. Since the scarred tissue has impaired regeneration abilities, the future implementation of stem or progenitor regenerative medical techniques is likely to add considerable value. There are limited randomized controlled trials that aimed to determine which treatment options should be considered the gold standard. Combining interventions would likely produce more benefit compared to the implementation of a single method.
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  • 文章类型: Journal Article
    痤疮是一种具有多因素病因的毛囊皮脂腺的慢性炎性疾病,是皮肤科医生和初级保健医生治疗的最常见病之一。在一个广泛而不断发展的治疗环境中,口服异维A酸已证明对治疗严重,顽固的痤疮。已经报道了异维甲酸的几种副作用,包括实验室异常,粘膜皮肤,和肌肉骨骼的影响,这可能会降低患者对治疗的依从性和满意度。在这篇叙述性评论中,我们的目的是回顾口服补充剂或局部辅助疗法在减轻与异维甲酸相关的粘膜皮肤和肌肉骨骼副作用方面的疗效和安全性.口服补充剂包括omega-3脂肪酸,维生素E,叶酸和维生素B12,抗组胺药,左旋肉碱,生物素,和联合口服补充剂。局部佐剂包括透明质酸,生物糖胶2和甘油凝胶乳膏;不油腻,非粉刺,无香料保湿霜;右泛醇;三氯乙酸;和组合霜。大多数补充剂和外用佐剂证明了疗效,具有足够的支持证据,没有报告的不良事件。表明足够的安全性。使用异维A酸的患者可能受益于使用口服补充剂和局部佐剂,以最大程度地减少粘膜皮肤副作用。增加对治疗的依从性,从而改善整体结果。
    Acne is a chronic inflammatory disease of the pilosebaceous unit with a multifactorial etiology and is one of the most common conditions treated by dermatologists and primary care physicians. Within an extensive and evolving treatment landscape, oral isotretinoin has demonstrated efficacy for treatment of severe, recalcitrant acne. Several side effects of isotretinoin have been reported, including laboratory abnormalities, mucocutaneous, and musculoskeletal effects, which may reduce compliance and patient satisfaction with treatment. In this narrative review, we aim to review the efficacy and safety profile of oral supplements or topical adjuvant therapies in mitigating isotretinoin-associated mucocutaneous and musculoskeletal side effects. Oral supplements reviewed include omega-3 fatty acids, vitamin E, folic acid and vitamin B12, antihistamines, l-carnitine, biotin, and combined oral supplements. Topical adjuvants include a hyaluronic acid, biosaccharide gum-2, and glycerine gel-cream; a nongreasy, noncomedogenic, fragrance-free moisturizing cream; dexpanthenol; trichloroacetic acid; and a combination cream. Most of the supplements and topical adjuvants demonstrated efficacy with an adequate level of supporting evidence and no reported adverse events, indicating an adequate safety profile. Patients on isotretinoin may benefit from using oral supplements and topical adjuvants to minimize primarily mucocutaneous side effects, increase adherence to treatment, and thereby improve overall outcomes.
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  • 文章类型: Review
    本文回顾了2022年欧洲光动力治疗学会(Euro-PDT)年度大会。PDT已经被研究用于治疗多种肿瘤,感染和炎症指征。新的研究证实了广泛使用局部PDT治疗痤疮和光老化的潜力,以及几种罕见的疾病,包括头癣,marinum分枝杆菌,皮肤交替病,抗性肢端疣,眼睑Bowen病,霉菌病,假性淋巴瘤,和移植物抗宿主病。化脓性汗腺炎患者也可从病灶内PDT获益。已经验证了几种提供PDT的方法,包括常规的,日光和人工日光PDT。发光织物已成为一种创新的解决方案,可以在头皮以及具有解剖学挑战性的部位上提供均匀的光。现在有机会通过手机应用程序控制和监控这些设备。患者的治疗前较厚,骨化三醇治疗光化性角化病(AK)似乎是一种提高疗效的实用方法,尽管这与局部皮肤反应增加有关。用日光-PDT和可注射NASHA凝胶对AK和光老化的顺序治疗表明这两种治疗方法提供了互补的效果。潜在的生物标志物可能有助于预测接受日光PDT的田野癌变和AK患者的反应性。原癌基因的过度表达,Myc,在反应不佳的人中观察到,而肿瘤抑制基因,PTEN,显示表达不足。用于皮肤病学适应症的局部PDT的使用和递送方法的潜力继续扩大提供给患者的治疗的增强选择。
    This article reviews the 2022 European Society for Photodynamic Therapy (Euro-PDT) Annual Congress. PDT has been investigated for the treatment of a broad number of oncologic, infectious and inflammatory indications. New studies confirm the potential for wider use of topical PDT for acne and photoaging, as well as several uncommon conditions including tinea capitis, Mycobacterium marinum, cutaneous alternariosis, resistant acral warts, eyelid Bowen\'s disease, mycosis fungoides, pseudolymphoma, and graft-versus-host disease. Hidradenitis suppurativa patients may also benefit from intra-lesional PDT. Several methods of delivering PDT have been validated, including conventional, daylight and artificial daylight PDT. Light-emitting fabrics have emerged as an innovative solution to the delivery of uniform light over the scalp as well as anatomically-challenging sites, with opportunities now to control and monitor these devices via mobile phone applications. Pre-treatment of patients with thicker, more difficult-to-treat actinic keratoses (AK) with calcitriol appears to be a practical approach to increasing efficacy, although this is associated with increased local skin reactions. Sequential treatment of AK and photoaging with daylight-PDT and injectable NASHA gel indicates that these two therapeutic approaches offer complementary effects. Potential biomarkers may help predict responsiveness of patients with field cancerization and AK receiving daylight PDT. Over-expression of the proto-oncogene, Myc, has been observed in poor responders, whilst the tumour suppressor gene, PTEN, showed under-expression. The potential for use and methods of delivery of topical PDT for dermatological indications continue to expand the enhanced choice of treatment offered to patients.
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  • 文章类型: Journal Article
    这篇叙述性综述严格审查了当前关于补充乳清蛋白(WP)对健康的影响的研究,关注潜在风险和不利影响。WP,通常用于肌肉锻炼和减肥,与各种健康问题有关。我们的全面分析涉及对多个数据库的彻底搜索,结果纳入了21项临床前和人体研究,这些研究共同提供了WP\的健康影响的详细概述。审查揭示了重要的发现,例如WP与肝肾损害的潜在联系,肠道微生物群的改变,痤疮发病率增加,对骨量的影响,以及情绪和行为的变化。这些发现强调了WP对人类健康影响的复杂性,表明在各种设置中与不同的姿势有关的有益和有害结果。我们的研究表明,在肝肾功能受损的情况下,蛋白质摄入应谨慎,以及在痤疮易感性,虽然可能的有益效果可以实现对肠道微生物群,体液和行为水平,最后是老年人的骨骼和肌肉质量。我们强调平衡WP消费的重要性,并呼吁进行更深入的研究以了解其长期健康影响。考虑补充WP的卫生专业人员和个人应意识到这些潜在风险,并谨慎使用。
    This narrative review critically examines the current research on the health implications of whey protein (WP) supplementation, with a focus on potential risks and adverse effects. WP, commonly consumed for muscle building and weight loss, has been associated with various health concerns. Our comprehensive analysis involved a thorough search of multiple databases, resulting in the inclusion of 21 preclinical and human studies that collectively offer a detailed overview of WP\'s health impacts. The review reveals significant findings, such as WP\'s potential link to liver and kidney damage, alterations in gut microbiota, increased acne incidence, impacts on bone mass, and emotional and behavioural changes. These findings underscore the complexity of WP\'s effects on human health, indicating both beneficial and detrimental outcomes in relation to different posologies in a variety of settings. Our study suggests caution for the protein intake in situations of hepatic and renal compromised functions, as well as in acne susceptibility, while possible beneficial effects can be achieved for the intestinal microbiota, humoral and behavioural level, and finally bone and muscle mass in elderly. We emphasizes the importance of balanced WP consumption and call for more in-depth research to understand its long-term health effects. Health professionals and individuals considering WP supplementation should be aware of these potential risks and approach its use with informed caution.
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