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  • 1.

    【2hr】Rosacea: a Clinical Review

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    机译 酒渣鼻：临床评价
    摘要：Rosacea is a field within dermatology with new insight within immunological research and new treatment-algorithm. Patient education on rosacea and appropriate treatments is an important aspect in helping patients succeed with therapy. Treatment should be tailored to each individual patient, taking into account: symptoms, trigger factors, patients’ wishes, most bothersome symptoms, psychological aspect, individual needs. A combination of clinical therapies to treat different symptoms concomitantly may offer the best possible outcomes for the patient. In this review article we describe these aspects.
  • 2.

    【2hr】Erythrodermic Psoriasis Treated with Apremilast

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    机译 普雷司司特治疗红皮病性牛皮癣
    摘要：Erythroderma is a rare potentially deadly exfoliative dermatitis characterized by diffuse cutaneous erythema which may be associated with multi-organ dysfunction. Therefore, it is imperative to recognize and treat it promptly. Erythrodermic psoriasis is the most common form of erythroderma. Management of this condition is largely based on aggressive supportive care and the use of anti-inflammatory immunosuppressive and biologic agents. We describe a case of psoriatic erythroderma which was triggered by withdrawal from systemic steroids and successfully treated with apremilast and cyclosporine. Apremilast induced atrial fibrillation limited its continued use after the initial response period.
  • 3.

    【2hr】Signet-ring Cells in the Skin: A Case of Late-onset Cutaneous Metastasis of Gastric Carcinoma and a Brief Review of Histological Approach

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    机译 皮肤中的印戒细胞：胃癌迟发性皮肤转移的病例和组织学方法的简要回顾
    摘要：Up to 10% of patients with visceral malignancies develop skin metastases during their clinical course and these metastases constitute about 2% of all skin cancers. Skin metastasis may be the first sign of a clinically silent visceral cancer or represent recurrence of an internal malignancy. In both situations, they are associated with poor prognosis, which can partly be attributed to underdiagnosis. In this paper, a case of relapsing gastric adenocarcinoma, which manifested itself as asymptomatic cutaneous papules and nodules on a patient’s head and neck, is reported and histopathological approach to the cutaneous lesions containing signet-ring cell is briefly reviewed.
  • 4.

    【2hr】Surgical Pearl on Reconstructing Surgical Defects of the Nasal Tip

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    机译 手术珍珠在重建鼻尖的手术缺损中
    摘要：Repairing surgical defects of the nasal tip is challenging, mainly because of the lack of freely mobile skin available peripherally. The Peng flap is a one-stage cutaneous flap that circumvents this difficulty by recruiting skin from the nasal dorsum and sidewall regions. The design produces a tridimensional shape perfectly adapted to the configuration of the nasal tip and allows for an inconspicuous closure of the defect. We present three examples of full-thickness skin defects involving the nasal tip, reconstructed using a modified version of the Peng flap, and present the experience at our department with this surgical technique.
  • 5.

    【2hr】Unilateral Demodicidosis of Face Mimicking Hansens Disease

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    机译 模仿汉森氏病的面部单侧蠕虫病
    摘要：Demodicosis is a common parasitic infection of the hair follicles and the pilosebaceous unit by the Demodex mites viz. Demodex folliculorum and Demodex brevis. Infection by this parasite is common among immunocompromised and elderly. We report a case of facial Demodicosis which presented like atypical rosacea with a gradually progressing swelling and redness on right side of face which was initially diagnosed as a case of Hansen’s disease. Skin biopsy revealed follicular dilatation with presence of Demodex mite along with intense perifollicular lymphomononuclear infiltrate. Patient was treated with oral tab Ivermectin 12 mg stat along with topical gel metronidazole twice daily to which he responded favourably.
  • 6.

    【2hr】Severity of Depression and Anxiety in Patients with Alopecia Areata in Bandar Abbas, Iran

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    机译 伊朗阿巴斯港脱发症患者抑郁和焦虑的严重程度
    摘要：Alopecia areata (AA) is a chronic disease which esthetic outcomes may result in deep effects on mental disorders of patients. In this case-control study, we compared the mental health of 68 patients diagnosed with AA with 68 healthy individuals using Hamilton anxiety and depression rating scales. There were significant differences between the case and control groups regarding the prevalence of anxiety and depression. The means of anxiety scores in cases and control group were 12.76±7.21 vs 8.54±6.37, P=0.003. Likewise, the means of depression scores for the groups were 12.84±4.03 vs 6.22±4.95, P=0.001. Further-more, patients with AA were exposed to depression approximately five times and to anxiety about three times more than normal people. Our study revealed a high prevalence of anxiety and depression in AA patients. Dermatologists should pay more attention on psychological effect of the disease on the patients.
  • 7.

    【2hr】Subclinical Onychomycosis in Patients With Type II Diabetes

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    机译 II型糖尿病患者的亚临床甲癣
    摘要：Fungal organisms could be present in the nail without any clinical manifestations. As onychomycosis in diabetics has more serious complications, early detection of such infection could be helpful to prevent them. We aim in this study to assess the possibility of detecting subclinical onychomycosis in type II diabetic patients and addressing possible associated neuropathy. A cross sectional, observational study included patients with type II diabetes with normal big toe nail. All were subjected to nail clipping of the big toe nail, followed by staining with Hematoxylin and Eosin and Periodic-Acid-Schiff (PAS) stains and examined microscopically. A total of 106 patients were included, fungal infection was identified in eight specimens, all were uncontrolled diabetes, and six had neuropathy. Using the nail clipping and microscopic examination with PAS stain to detect such subclinical infection could be an applicable screening test for diabetic patients, for early detection and management of onychomycosis.
  • 8.

    【2hr】Giant Condyloma Acuminate Due to Human Papillomavirus Type 16 in an Infant Successfully Treated with Topical Imiquimod Therapy

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    机译 急性尖锐湿疣因人乳头瘤病毒16型在婴儿中成功通过局部咪喹莫特疗法成功治疗
    摘要：Anogenital warts related to human papillomavirus (HPV) have been observed in children. Definition of the transmission mode, therapy, and follow-up for long term potential complications is important. A 27-month old girl was admitted with multiple pedunculated red-purple colored cauliflower-like lesions of 1.5 years duration. Clinical/histopathological and microbiological diagnosis was condyloma acuminate due to HPV type 16. After 12 weeks of imiquimod 5% cream application (pea-sized) overnight three times per week, the perianal warts had completely disappeared. The mode of transmission of HPV 16 in our case was probably horizontal, related to the sharing of common personal hygiene items in the women’s shelter. We report herein the case of an infant living in a women’s shelter with giant condyloma acuminata due to HPV 16, which was successfully treated with topical imiquimod therapy. This patient should be followed up for recurrence and potential malignant lesions related to HPV type 16.
  • 9.

    【2hr】Exploring Valrubicin's Effect on Propionibacterium Acnes-Induced Skin Inflammation in Vitro and in Vivo

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    机译 探索Valrubicin对丙酸丙酸杆菌诱导的体内和体外皮肤炎症的影响
    摘要：Acne is a common skin disease involving colonization with Propionibacterium acnes (P. acnes), hyperproliferation of the follicular epithelium and inflammatory events. Valrubicin is a second-generation anthracycline, non-toxic upon contact, and available in a topical formulation. Valrubicin’s predecessor doxorubicin possesses antibacterial effects and previously we demonstrated that valrubicin inhibits keratinocyte proliferation and skin inflammation suggesting beneficial topical treatment of acne with valrubicin. This study aims to investigate valrubicin’s possible use in acne treatment by testing valrubicin’s antibacterial effects against P. acnes and P. acnes-induced skin inflammation in vitro and in vivo. Valrubicin was demonstrated not to possess antibacterial effects against P. acnes. Additionally, valrubicin was demonstrated not to reduce mRNA and protein expression levels of the inflammatory markers interleukin (IL)-1β, IL-8, and tumor necrosis factor (TNF)-α in vitro in human keratinocytes co-cultured with P. acnes. Moreover, in vivo, valrubicin, applied both topically and intra-dermally, was not able to reduce signs of inflammation in mouse ears intra-dermally injected with P. acnes. Taken together, this study does not support beneficial antibacterial and anti inflammatory effects of topical valrubicin treatment of acne.
  • 10.

    【2hr】Two Episodes of Cutaneous Non-Tuberculous Mycobacterial Infection in a Patient with Psoriasis

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    机译 银屑病患者皮肤非结核分枝杆菌感染的两集
    摘要：Non-tuberculous mycobacteria (NTM) are a group of environmental pathogens, which cause a broad spectrum of disease. The incidence of NTM infection is increasing, especially in immunocompromized patients. The past three decades also saw a rapid increase in the incidence of NTM infection involving otherwise healthy subjects. We report a case of cutaneous NTM infection in a 79-year-old Chinese woman, who was receiving methotrexate for psoriasis. Mycobacterial culture grew Mycobacterium abscessus, and the lesions cleared with a combination of oral clarithromycin, ciprofloxacin and doxycycline. Interestingly, she then developed a second episode of cutaneous NTM infection with Mycobacterium haemophilum over the same body region, five years after stoppage of methotrexate. Both episodes were separated in time and involved different species, indicating that they were independent from each other. We further discuss the risk factors for cutaneous NTM infection, treatment, and highlight the need for diagnostic vigilance.
  • 11.

    【2hr】Treatment Modalities of Necrobiosis Lipoidica: A Concise Systematic Review

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    机译 脂质坏死病的治疗方法：简要的系统评价。
    摘要：Necrobiosis lipoidica (NL) is a rare inflammatory granulomatous skin disorder closely associated with diabetes mellitus. The aim of this paper is to review and discuss all the treatment modalities proposed and tested for this disease. A systematic review of the existing literature was conducted to investigate all the available data and summarize all the clinical trials, case reports and original articles on NL. Two major databases (PubMed and Google Scholar) were used. We have examined about 70 articles. Numerous treatment modalities have been currently investigated to compare recalcitrant NL. Being rare, most of the studies regarding this disease are case reports or small-scale clinical trials. We have found that, in spite of plentiful investigations carried out during the years, there is no treatment modality that has proved to be utterly satisfactory in treating NL.
  • 12.

    【2hr】The Use of Chemotherapeutics for the Treatment of Keloid Scars

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    机译 化学疗法在瘢痕loid疤痕治疗中的应用
    摘要：Keloid scars are pathological scars, which develop as a result of exaggerated dermal tissue proliferation following cutaneous injury and often cause physical, psychological and cosmetic problems. Various theories regarding keloidogenesis exist, however the precise pathophysiological events remain unclear. Many different treatment modalities have been implicated in their management, but currently there is no entirely satisfactory method for treating all keloid lesions. We review a number of different chemotherapeutic agents which have been proposed for the treatment of keloid and hypertrophic scars while giving insight into some of the novel chemotherapeutic drugs which are currently being investigated. Non-randomized trials evaluating the influence of different chemotherapeutic agents, such as 5-fluorouracil (5-FU); mitomycin C; bleomycin and steroid injection, either alone or in combination with other chemotherapeutic agents or alternative treatment modalities, for the treatment of keloids were identified using a predefined PubMed search strategy. Twenty seven papers were identified. Scar improvement ≥50% was found in the majority of cases treated with 5-FU, with similar results found for mitomycin C, bleomycin and steroid injection. Combined intralesional 5-FU and steroid injection produced statistically significant improvements when compared to monotherapy. Monotherapy recurrence rates ranged from 0-47% for 5-FU, 0-15% for bleomycin and 0-50% for steroid injection. However, combined therapy in the form of surgical excision and adjuvant 5-FU or steroid injections demonstrated lower recurrence rates; 19% and 6% respectively. Currently, most of the literature supports the use of combination therapy (usually surgery and adjuvant chemotherapy) as the mainstay treatment of keloids, however further investigation is necessary to determine success rates over longer time frames. Furthermore, there is the potential for novel therapies, but further investigation is required to elucidate their true efficacy.
  • 13.

    【2hr】An Epidemiological Study of 97 Cases of Primary Cicatricial Alopecia in Iran

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    机译 伊朗97例原发性瘢痕性脱发的流行病学研究
    摘要：Cicatricial alopecia can produce major psychosocial disturbance. This study aimed to evaluate epidemiological features of primary cicatricial alopecia (PCA). Epidemiological and histological types of scarring alopecia were determined. The chi-squared test and t-test were performed to examine the relationship between different variables using SPSS 16. A total of 97 cases, 35 (36.1%) men and 62 (63.9%) women, with an average age of 37 (SD=12.7), were included in this study. The female/male (F/M) ratio was 1.7:1 for total cases, 1.92:1 for the lymphocytic type, and 1:1.5 for the neutrophilic type. No relationship was found between type of job (indoor or outdoor), clinical findings and histological types. Discoid lupus erythematous (DLE) was the most common histological type (63.9%). PCA was found to mainly affect middle-aged individuals. The high percentage of DLE in the present study is in agreement with some similar studies.
  • 14.

    【2hr】Onychomycosis by Syncephalastrum Racemosum: Case Report from Kerala, India

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    机译 头孢霉菌引起的甲癣：印度喀拉拉邦的病例报告
    摘要：We report a rare case of onychomycosis caused by Syncephalastrum racemosum in a 50-year-old diabetic patient. The patient’s nail was surgically excised and thorough debridement was done. The patient was successfully treated with topical nystatin.
  • 15.

    【2hr】Efficacy of Intravenous Immunoglobulin Monotherapy in Patients with Cutaneous Lupus Erythematosus: Results of Proof-of-Concept Study

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    机译 皮肤红斑狼疮患者静脉注射免疫球蛋白单一疗法的疗效：概念验证研究的结果
    摘要：Cutaneous lupus erythematosus (CLE) is a chronic inflammatory autoimmune skin disease. Evidence-based therapy for CLE is lacking in the most part. Intravenous immunoglobulin (IVIg) is being increasingly utilized as off-label therapy for a variety of autoimmune and inflammatory conditions, especially in dermatology. The usefulness of IVIg in CLE is not well established. The goal of the present study was to obtain the proof-of-concept evidence that IVIg can control acute CLE and thus replace current systemic immunosuppressive therapy that causes severe side effects and adverse reactions. Sixteen patients who tried and failed various systemic treatments for CLE were screened and consented to use IVIg as a monotherapy. The IVIg was administered at 500 mg/kg/day on 4 consecutive days up to a total of 2 g/kg/month for 3 months, and the subjects were monitored for additional 6 months off any drug for a possible relapse. The cumulative results revealed an overall improvement, as evinced by a decrease of both objective and subjective measures of disease activity. The most sensitive and specific objective and subjective instruments for assessment of the therapeutic effect of IVIg were CLASI-A (Cutaneous Lupus Erythematosus Disease Area and Severity Index) measuring disease activity and Skindex-29 scores, respectively. The CLASI-A score dropped down from the initial value taken as 100%, and remained in the range of approximately 70% until the last visit. Three patients (18.8%) had a temporary flare of CLE symptoms but recovered within a month from the relapse. No serious side effects and adverse reactions occurred. Thus, IVIg monotherapy in CLE allowed to achieve: i) rapid and persistent decreased in disease activity; ii) steady improvement of patients’ quality of life assessed by Skindex-29; iii) low relapse rate; and iv) mild nature and short duration of relapses. Since healing was maintained for months after IVIg treatment, it is possible that the IVIgtriggered molecular events mediating the therapeutic action of IVIg that continued to unfold after the end of therapy.
  • 16.

    【2hr】Severe Scratcher-Reaction: An Unknown Health Hazard?

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    机译 严重的Scratcher反应：未知的健康危害？
    摘要：Tattoos are well known to cause skin problems and the number of reported adverse reactions after tattooing has increased. Illegally imported tattoo ink is unrestrained and can contain unknown ingredients and contamination thereby posing a serious health hazard. We present a case illustrating the risk of pronounced phototoxic allergic reaction and other severe complications after using home kit tattoo ink.
  • 17.

    【2hr】Delayed Immune Mediated Adverse Effects to Hyaluronic Acid Fillers: Report of Five Cases and Review of the Literature

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    机译 延迟的免疫介导的透明质酸填充剂的不良反应：五例报告并文献复习。
    摘要：Hyaluronic acid (HA) fillers in cosmetic medicine have been considered relatively safe, though fillers used in European countries and throughout the world are not necessarily approved by the Food and Drug Administration. As their use continues to expand worldwide, physicians in a wide range of medical specialties are authorized to perform HA injections, including general medicine practitioners and even dentists. An increasing number of reports have appeared regarding side effects to these products. It is now known that reactions to Hyaluronic acid are related not only to technical faults of the injections, but also to immune responses, including delayed hypersensitivity and granulomatous reactions. Herein, we describe five cases treated by a variety of treatment modalities, all with delayed reactions to different brands of hyaluronic acid fillers. As there is currently no standardization of treatment options of adverse effects, these cases accentuate the debate regarding the approach to the individual patient and the possible need for pre-testing in patients with an atopic tendency.
  • 18.

    【2hr】Treatment of Primary Cutaneous Anaplastic Large Cell Lymphoma with Superficial X-Rays

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    机译 浅表X线治疗原发性皮肤间变性大细胞淋巴瘤
    摘要：The optimal radiation schedule for primary cutaneous anaplastic lymphoma (PCALCL) has not been investigated. We report here satisfactory outcomes of low-dose (16-20 Gy, 3-5 fractions), superficial X-ray radiation (40-50 kV) in a series of 10 patients with PCALCL. Only 1 patient developed a local relapse during the median observation time of 25 months; complete remission was recorded in the other patients. This observation indicates that superficial, low dose X-ray therapy may provide a cost-effective alternative to the traditional 35-45 Gy schedules.
  • 19.

    【2hr】Orofacial Granulomatosis in Children can be the Initial Manifestation of Systemic Disease: A Presentation of Two Cases

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    机译 儿童口面部肉芽肿可能是系统疾病的最初表现：两例病例
    摘要：Orofacial granulomatosis is a chronic granulomatous condition characterized by relapsing and remitting lip swelling and oral involvement that may include deep ulcers, tags and cobblestone formation. It occurs as an independent entity but also in conjunction with systemic diseases such as tuberculosis, sarcoidosis and Crohn’s disease. The clinical presentation is not indicative of concomitant systemic disease. To highlight the importance of thorough examination to rule out systemic disease, we present two childhood cases of orofacial granulomatosis, one of which was associated to Crohn’s disease.
  • 20.

    【2hr】Verrucous Lichen Planus: A Rare Presentation of a Common Condition

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    机译 疣状扁平苔藓：一种常见病的罕见表现
    摘要：Lichen planus is a chronic papulosquamous dermatoses in which both skin and mucosae are involved. There are various morphological forms of lichen planus. Hypertrophic lichen planus is one of the rare clinical variants. Herein, we report a very unusual presentation of hypertrophic lichen planus. A similar presentation has not been reported in literature yet, to the best of our knowledge.
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