lichen simplex chronicus

慢性单纯性地衣
  • 文章类型: Journal Article
    慢性单纯性地衣(LSC)由于其难以捉摸的致病机制而在皮肤病学中提出了挑战。虽然观察到循环炎症细胞因子和LSC之间的关联,确定的因果动力学仍有待阐明。我们的研究使用了双样本孟德尔随机化(MR)方法来研究因果关系。我们应用了一套MR方法,包括IVW,加权中位数,MR-Egger,加权模式,简单模式,MR-PRESSO,还有施泰格测试,以确保稳健的因果推理。我们的分析证实了遗传决定的细胞因子水平对LSC风险的因果影响,尤其是MMP-10(OR=0.493,P=0.004)和DNER(OR=0.651,P=0.043)在风险降低方面。我们还发现GDNF水平(OR=1.871,P=0.007)与LSC患病率之间存在正相关。值得注意的是,在DNER和LSC之间观察到双向因果关系。各种MR分析和敏感性分析的一致性证实了水平多效性的缺失,验证因果估计。这项开创性的MR研究揭示了MMP-10,DNER,GDNF和LSC风险。尽管需要进一步验证,我们的发现增强了对LSC中细胞因子介导的理解,并强调了前瞻性研究途径.
    Lichen simplex chronicus (LSC) presents a challenge in dermatology due to its elusive pathogenic mechanisms. While associations between circulating inflammatory cytokines and LSC were observed, the definitive causal dynamics remain to be elucidated. Our study used a two-sample Mendelian randomization (MR) approach to investigate causal relationships. We applied a suite of MR methodologies, including IVW, Weighted Median, MR-Egger, Weighted Mode, Simple Mode, MR-PRESSO, and the Steiger test, to ensure robust causal inference. Our analysis confirmed the causal impact of genetically determined cytokine levels on LSC risk, particularly MMP-10 (OR = 0.493, P = 0.004) and DNER (OR = 0.651, P = 0.043) in risk attenuation. We also found a positive causal correlation between GDNF levels (OR = 1.871, P = 0.007) and LSC prevalence. Notably, bidirectional causality was observed between DNER and LSC. Consistency across various MR analyses and sensitivity analyses confirmed the absence of horizontal pleiotropy, validating the causal estimates. This pioneering MR investigation unveils a novel genetically anchored causal relationship between the circulating levels of MMP-10, DNER, and GDNF and LSC risk. Although further validation is requisite, our findings augment the understanding of cytokine mediation in LSC and underscore prospective avenues for research.
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  • 文章类型: Journal Article
    血管增生是结节性痒疹/慢性单纯性苔藓(LSC)的常见病。最近提出了术语瘙痒样血管瘤病,以描述LSC患者明显的血管增生为特征的组织学模式。这项研究的目的是确定具有这种模式的LSC病例,并分析与临床和病理特征以及病程的关联。我们回顾了54例经组织学证实的LSC,并在10例(18.5%)中发现了与瘙痒样血管瘤病一致的发现。患者(7名男子,3名女性)的平均年龄为59.7岁。病变为瘙痒,主要位于四肢和躯干。最显着的组织学发现是与淋巴细胞炎性浸润相关的浅表真皮中的血管增生。瘙痒样血管瘤病的识别是重要的,因为它不仅有助于将LSC与其他实体(主要是血管肿瘤)区分开,而且有助于检测由于对局部治疗的反应差而需要手术切除的病变。
    Vascular hyperplasia is a common finding in prurigo nodularis/lichen simplex chronicus (LSC). The term prurigiform angiomatosis was recently proposed to describe a histologic pattern characterized by prominent vascular hyperplasia in patients with LSC. The aim of this study was to identify cases of LSC with this pattern and analyze associations with clinical and pathologic features and disease course. We reviewed 54 cases of histologically confirmed LSC and detected findings consistent with prurigiform angiomatosis in 10 (18.5%). The patients (7 men, 3 women) had a mean age of 59.7 years. The lesions were pruritic and predominantly located on the extremities and trunk. The most notable histologic finding was vascular proliferation in the superficial dermis associated with a lymphocytic inflammatory infiltrate. Recognition of prurigiform angiomatosis is important as it helps not only to distinguish LSC from other entities (mainly vascular tumors) but also to detect lesions that need to be surgically excised due to poor response to topical treatment.
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  • 文章类型: Case Reports
    隐源性组织性肺炎(COP)是特发性弥漫性间质性肺病(ILD)的一种形式,可响应各种未知的刺激物而发展。组织性肺炎(OP)发展的重要组成部分是对II型肺细胞和肺泡基底膜的损害。一种称为系统性硬化症(SSc)的自身免疫性疾病因心肺受累而具有显着的死亡率,例如肺动脉高压和ILD。关节炎是一种自身免疫性疾病,患者在疾病过程中会出现关节外症状,如ILD,和COP经常与这些条件共存。它是非常罕见的OP发生作为关节炎的最初迹象,其临床特征尚不清楚。本报告介绍了与COP相关的硬皮病和炎性多关节炎。
    Cryptogenic organising pneumonia (COP) is a form of idiopathic diffuse interstitial lung disease (ILD) that develops in response to a variety of unknown irritants. An essential component of the development of organising pneumonia (OP) is damage to type II pneumocytes and the alveolar basement membrane. An autoimmune illness called systemic sclerosis (SSc) has a significant death rate from cardiopulmonary involvement such as pulmonary hypertension and ILD. Arthritis is an autoimmune disorder, in which the patients experience extra-articular symptoms such as ILD during the course of their disease, and COP frequently coexists with these conditions. It is exceedingly uncommon for OP to occur as the initial sign of arthritis, and its clinical characteristics are still unclear. Scleroderma and inflammatory polyarthritis related to COP are presented in this report.
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  • 文章类型: Journal Article
    血管增生是结节性痒疹/慢性单纯性苔藓(LSC)的常见病。最近提出了术语瘙痒样血管瘤病,以描述LSC患者明显的血管增生为特征的组织学模式。这项研究的目的是确定具有这种模式的LSC病例,并分析与临床和病理特征以及病程的关联。我们回顾了54例经组织学证实的LSC,并在10例(18.5%)中发现了与瘙痒样血管瘤病一致的发现。患者(7名男子,3名女性)的平均年龄为59.7岁。病变为瘙痒,主要位于四肢和躯干。最显着的组织学发现是与淋巴细胞炎性浸润相关的浅表真皮中的血管增生。瘙痒样血管瘤病的识别是重要的,因为它不仅有助于将LSC与其他实体(主要是血管肿瘤)区分开,而且有助于检测由于对局部治疗的反应差而需要手术切除的病变。
    Vascular hyperplasia is a common finding in prurigo nodularis/lichen simplex chronicus (LSC). The term prurigiform angiomatosis was recently proposed to describe a histologic pattern characterized by prominent vascular hyperplasia in patients with LSC. The aim of this study was to identify cases of LSC with this pattern and analyze associations with clinical and pathologic features and disease course. We reviewed 54 cases of histologically confirmed LSC and detected findings consistent with prurigiform angiomatosis in 10 (18.5%). The patients (7 men, 3 women) had a mean age of 59.7 years. The lesions were pruritic and predominantly located on the extremities and trunk. The most notable histologic finding was vascular proliferation in the superficial dermis associated with a lymphocytic inflammatory infiltrate. Recognition of prurigiform angiomatosis is important as it helps not only to distinguish LSC from other entities (mainly vascular tumors) but also to detect lesions that need to be surgically excised due to poor response to topical treatment.
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  • 文章类型: Journal Article
    慢性眼睑和眼痒影响许多寻求皮肤病或眼科护理的患者,并且对患者的生活质量有很高的负担。当接近眼睛或眼睑瘙痒持续超过六周的患者时,临床医生应考虑广泛的可能诊断。过敏性结膜炎和过敏性接触性皮炎是眼睛和眼睑慢性瘙痒的最常见原因,分别。其他需要考虑的诊断包括特应性皮炎,干燥症,神经源性瘙痒,干眼症,脂溢性皮炎,眼睑炎,酒渣鼻,慢性单纯性地衣和丘疹鳞状疾病。如果不能阐明有机病因,可以考虑诊断为精神性瘙痒或不明原因的慢性瘙痒。在这里,我们讨论了慢性眼睑和眼部瘙痒的可能病因,包括临床表现,诊断考虑因素和目前的治疗方法。
    Chronic eyelid and ocular itch affect many patients seeking dermatologic or ophthalmologic care and have a high burden on patient quality of life. Clinicians should consider the broad range of possible diagnoses when approaching the patient with itch of the eyes or eyelids lasting more than 6 weeks. Allergic conjunctivitis and allergic contact dermatitis are the most common causes of chronic itch of the eyes and eyelids, respectively. Other diagnoses to consider include atopic dermatitis, xerosis, neurogenic itch, dry eye syndrome, seborrheic dermatitis, blepharitis, rosacea, lichen simplex chronicus, and papulosquamous disorders. If no organic cause can be elucidated, diagnoses of psychogenic pruritus or chronic pruritus of unknown origin may be considered. Herein, we discuss the possible etiologies of chronic eyelid and ocular itch inclusive of clinical presentation, diagnostic considerations, and current therapies.
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  • 文章类型: Journal Article
    瘙痒是许多皮肤病和全身性疾病的主要症状。特应性皮炎,牛皮癣,接触性皮炎,荨麻疹,慢性单纯性地衣,霉菌病,疤痕,自身免疫性疾病,除其他外,肾脏或肝脏疾病都与瘙痒有关,可能需要不同的治疗方法。虽然抗组胺药似乎是一线治疗,实际上,它们的作用仅限于荨麻疹和药物引起的反应。事实上,本综述涵盖的每种疾病的病理生理机制都不同.近年来出现了新药,其疗效和安全性对于临床实践中瘙痒的治疗非常有吸引力。显然,我们正处于皮肤病学的关键时刻,在治疗瘙痒患者时,我们有机会更加雄心勃勃地实现我们的目标。
    Pruritus is the main symptom of many dermatologic and systemic diseases. Atopic dermatitis, psoriasis, contact dermatitis, urticaria, lichen simplex chronicus, mycosis fungoides, scars, autoimmune diseases, kidney or liver diseases among others are all associated with itch that may require different approaches to management. Although antihistamines seem to be the first line of therapy, in reality their role is limited to urticaria and drug-induced reactions. In fact, the pathophysiologic mechanisms of each of the conditions covered in this review will differ. Recent years have seen the emergence of new drugs whose efficacy and safety profiles are very attractive for the management of pruritus in clinical practice. Clearly, we are at a critical moment in dermatology, in which we have the chance to be more ambitious in our goals when treating patients with pruritus.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    瘙痒是许多皮肤病和全身性疾病的主要症状。特应性皮炎,牛皮癣,接触性皮炎,荨麻疹,慢性单纯性地衣,霉菌病,疤痕,自身免疫性疾病,除其他外,肾脏或肝脏疾病都与瘙痒有关,可能需要不同的治疗方法。虽然抗组胺药似乎是一线治疗,实际上,它们的作用仅限于荨麻疹和药物引起的反应。事实上,本综述涵盖的每种疾病的病理生理机制都不同.近年来出现了新药,其疗效和安全性对于临床实践中瘙痒的治疗非常有吸引力。显然,我们正处于皮肤病学的关键时刻,在治疗瘙痒患者时,我们有机会更加雄心勃勃地实现我们的目标。
    Pruritus is the main symptom of many dermatologic and systemic diseases. Atopic dermatitis, psoriasis, contact dermatitis, urticaria, lichen simplex chronicus, mycosis fungoides, scars, autoimmune diseases, kidney or liver diseases among others are all associated with itch that may require different approaches to management. Although antihistamines seem to be the first line of therapy, in reality their role is limited to urticaria and drug-induced reactions. In fact, the pathophysiologic mechanisms of each of the conditions covered in this review will differ. Recent years have seen the emergence of new drugs whose efficacy and safety profiles are very attractive for the management of pruritus in clinical practice. Clearly we are at a critical moment in dermatology, in which we have the chance to be more ambitious in our goals when treating patients with pruritus.
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  • 文章类型: Journal Article
    慢性单纯性苔藓通常表现为严重引起的令人痛苦的阴道病变,周期性瘙痒-划痕行为。通过获得详细的病史来诊断慢性单纯性苔藓,进行身体检查,记录自我报告的症状。慢性单纯性苔藓可以用皮质类固醇治疗,免疫调节剂,抗癫痫药,抗组胺药,抗抑郁药,和光疗。我们的病例描述了一名55岁的女性患者,她出现了复发性阴道瘙痒,结合扰乱日常功能的强迫性抓挠行为。体格检查显示位于小阴唇上的肥大结节有鳞屑和色素沉着。病人被诊断患有慢性单纯性地衣。在6个月的随访中,通过行为改变和丙酸氯倍他索乳膏加上闭塞性敷料的经验性治疗显着改善了症状。单纯性慢性地衣可能有不寻常的表现;因此,必须仔细区分感染性和恶性皮肤病变。
    Lichen simplex chronicus commonly presents as a distressing vaginal lesion caused by severe, cyclical itch-scratch behavior. Lichen simplex chronicus is diagnosed by obtaining a detailed medical history, performing a physical exam, and recording of self-reported symptoms. Lichen simplex chronicus can be treated by corticosteroids, immunomodulators, antiepileptics, antihistamines, antidepressants, and phototherapy. Our case describes a 55-year-old female patient who presented to a clinic with recurrent vaginal itching, combined with compulsive scratching behavior that disrupted daily functioning. Physical examination revealed hypertrophic nodules located on the labia minora with scaling and hyperpigmentation. And the patient was diagnosed with lichen simplex chronicus. Empirical treatment with behavioral modifications and clobetasol propionate cream with an occlusive dressing produced significant improvements in symptoms at a six-month follow-up. Lichen simplex chronicus can have unusual presentations and; therefore, must be carefully differentiated from infectious and malignant skin lesions.
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  • 文章类型: Case Reports
    大麻二酚是大麻素的成员,由大麻衍生的各种化合物组成。根据来源有三种类型的大麻素:内源性大麻素(内源性),植物大麻素(植物衍生),和合成大麻素(合成)。内源性大麻素系统在皮肤稳态中起着关键作用,如扩散,分化,和炎症信号。据报道,一名64岁的女性有多发性鳞状细胞癌的病史,她的双侧背侧手出现皮肤病变。她的皮肤活检显示左手上有单纯的慢性苔藓,右手上有鳞状细胞癌;局部应用20%大麻二酚后,两种病变均得到解决。还总结了与大麻素使用相关的皮肤不良事件以及大麻素在炎症性皮肤病和皮肤癌中的潜在治疗用途。
    Cannabidiol is a member of the cannabinoids, consisting of a diverse class of compounds derived from Cannabis sativa. There are three types of cannabinoids based on origin: endocannabinoids (endogenous), phytocannabinoids (plant-derived), and synthetic cannabinoids (synthesized). The endocannabinoid system plays a key role in skin homeostasis, such as proliferation, differentiation, and inflammatory signaling. A 64-year-old woman with a history of multiple squamous cell carcinomas who presented with skin lesions on her bilateral dorsal hands is reported. Her skin biopsies showed lichen simplex chronicus on her left hand and squamous cell carcinoma on her right hand; both lesions resolved with topical application of 20% cannabidiol. Cutaneous adverse events associated with cannabinoid use and potential therapeutic uses of cannabinoids in inflammatory skin diseases and skin cancer are also summarized.
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