Subepidermal autoimmune bullous diseases （SABD） are some autoimmune skin diseases that can present in a variety of forms and can be a challenging disease to treat. An overview of the different forms of SABD are disc...Subepidermal autoimmune bullous diseases （SABD） are some autoimmune skin diseases that can present in a variety of forms and can be a challenging disease to treat. An overview of the different forms of SABD are discussed including bullous pemphigoid （BP）, epidermolysis bullosa acquisita （EBA）, cicatricial pemphigoid （CP）, bullous systemic lupus erythematosus （BSLE）, and Anti-p200 pemphigoid. Emphasis on recent advancement is presented. In recent years, improved knowledge of the mechanisms of intercellular and cell-matrix adhesion has led to better understanding of the blistering process in some SABD. Defects of such structures cause the subepidermal bullous diseases and have also led to the discovery of new diseases （e.g. anti-p200-pemphigoid）. Recent studies have outlined the important role of autoantibodies, mast cell lymphocytes and their cytokines in pathogenesis of SABD.展开更多
Introduction:Numerous dermatoses associated with monoclonal gammopathy have been reported in the literature.Subepidermal autoimmune bullous diseases(SABD)are one of them which were not common.Case presentation:A 68-ye...Introduction:Numerous dermatoses associated with monoclonal gammopathy have been reported in the literature.Subepidermal autoimmune bullous diseases(SABD)are one of them which were not common.Case presentation:A 68-year-old male patient was admitted to our clinic with erosions on the oral mucosa,tense blisters,erosions,and ulcers on the trunk and extremities.Subepidermal vesicle formation was detected in the skin biopsy.Clinical examination revealed positivity for the Nikolsky phenomenon.The disease was unresponsive to conventional treatments and dysphagia and hoarseness occurred.The patient was screened for malignancy due to his unresponsiveness to the treatments and his severe oral mucosal involvement.Ig-G MGUS was detected in the patient.Discussion:The Nikolsky sign is an indicator of acantholysis and is known as a specific finding for pemphigus.However,when we look at gammopathy-associated autoimmune bullous dermatoses,skin fragility has been reported in cases.However,the meaning of fragility is not explained.The diagnosis of all these patients was Ig-M MGUS.Our patient was presented because of non-IgM MGUS,direct Nikolsky positivity,and severe mucosal involvement.Conclusion:Nikolsky positivity may be a clue for gammopathy-related subepidermal autoimmune bullous diseases.展开更多
Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired...Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired sensation,and reduced tissue tolerance.The etiology of DTPIs has been a subject of controversy,to which several explanatory models have been proposed,including direct mechanical insult,ischemia-reperfusion,lymphatic occlusion,and inflammatory cytokines.In line with these pathophysiological scenarios,ultrasound,subepidermal moisture detection,and biomarker technologies have been proposed as potential early detection methods of DTPIs.This paper provides a systematic review involving these three methods.The conclusion is that combining and implementing these methods at different time periods during DTPIs development and progression respectively is likely to be the most universal,effective and promising way for DTPIs diagnosis.展开更多
Objective:The clinical effectiveness of blood-heat psoriasis treated by Qingre Liangxue decoction and ultrasound imaging changes of lesions was observed.Methods:Patients with blood-heat psoriasis were selected and ran...Objective:The clinical effectiveness of blood-heat psoriasis treated by Qingre Liangxue decoction and ultrasound imaging changes of lesions was observed.Methods:Patients with blood-heat psoriasis were selected and randomly grouped into two groups:the treatment group taking the Qingre Liangxue decoction orally,the control group taking the Compound Glycyrrhizin Tablets orally,both groups applying topical emollient lotion for a 12-week treatment period.Ultrasound images of target lesions and healthy skin were collected at different treatment times.Results:The epidermal thickness thought,the dermal density incremented as well as the subepidermal low-echogenic band(SLEB)width narrowed in both groups during the treatment.Conclusion:Qingre Liangxue decoction has signified efficiency in the treatment of blood-heat psoriasis,and high-frequency ultrasound has the advantages of non-invasive,timely and objective in the evolution.展开更多
To the Editor:Bullous pemphigoid(BP)is a rare autoimmune skin disorder characterized by significant mortality,with BP prevalence ranging from 1.46 to 47.99 cases per 100,000 people.[1]The pathogenic mechanism of BP is...To the Editor:Bullous pemphigoid(BP)is a rare autoimmune skin disorder characterized by significant mortality,with BP prevalence ranging from 1.46 to 47.99 cases per 100,000 people.[1]The pathogenic mechanism of BP is attributed to pathogenic autoantibodies targeting BP180 and BP230 antigens,resulting in the formation of subepidermal blisters.[1]Reports indicate that some BP patients also have circulating anti-desmoglein(Dsg)autoantibodies,which are pathogenic antibodies in pemphigus.[2]However,it remains uninvestigated whether the concomitant anti-Dsg antibodies in BP are pathogenic and thereby represent a coincidental occurrence or signify the coexistence of the two diseases.This knowledge gap introduces uncertainty in patient care management.Therefore,a comprehensive analysis was performed to explore the clinicohistopathological characteristics,human leukocyte antigen(HLA)genetic risk factors,and pathogenicity of anti-Dsg antibodies in BP patients with anti-Dsg antibodies compared to those without.展开更多
文摘Subepidermal autoimmune bullous diseases （SABD） are some autoimmune skin diseases that can present in a variety of forms and can be a challenging disease to treat. An overview of the different forms of SABD are discussed including bullous pemphigoid （BP）, epidermolysis bullosa acquisita （EBA）, cicatricial pemphigoid （CP）, bullous systemic lupus erythematosus （BSLE）, and Anti-p200 pemphigoid. Emphasis on recent advancement is presented. In recent years, improved knowledge of the mechanisms of intercellular and cell-matrix adhesion has led to better understanding of the blistering process in some SABD. Defects of such structures cause the subepidermal bullous diseases and have also led to the discovery of new diseases （e.g. anti-p200-pemphigoid）. Recent studies have outlined the important role of autoantibodies, mast cell lymphocytes and their cytokines in pathogenesis of SABD.
文摘Introduction:Numerous dermatoses associated with monoclonal gammopathy have been reported in the literature.Subepidermal autoimmune bullous diseases(SABD)are one of them which were not common.Case presentation:A 68-year-old male patient was admitted to our clinic with erosions on the oral mucosa,tense blisters,erosions,and ulcers on the trunk and extremities.Subepidermal vesicle formation was detected in the skin biopsy.Clinical examination revealed positivity for the Nikolsky phenomenon.The disease was unresponsive to conventional treatments and dysphagia and hoarseness occurred.The patient was screened for malignancy due to his unresponsiveness to the treatments and his severe oral mucosal involvement.Ig-G MGUS was detected in the patient.Discussion:The Nikolsky sign is an indicator of acantholysis and is known as a specific finding for pemphigus.However,when we look at gammopathy-associated autoimmune bullous dermatoses,skin fragility has been reported in cases.However,the meaning of fragility is not explained.The diagnosis of all these patients was Ig-M MGUS.Our patient was presented because of non-IgM MGUS,direct Nikolsky positivity,and severe mucosal involvement.Conclusion:Nikolsky positivity may be a clue for gammopathy-related subepidermal autoimmune bullous diseases.
基金the Shanghai Pujiang Program(No.19PJ1406400)the Interdisciplinary Program of Shanghai Jiao Tong University(Nos.YG2019ZDB02 and YG2021QN142)。
文摘Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired sensation,and reduced tissue tolerance.The etiology of DTPIs has been a subject of controversy,to which several explanatory models have been proposed,including direct mechanical insult,ischemia-reperfusion,lymphatic occlusion,and inflammatory cytokines.In line with these pathophysiological scenarios,ultrasound,subepidermal moisture detection,and biomarker technologies have been proposed as potential early detection methods of DTPIs.This paper provides a systematic review involving these three methods.The conclusion is that combining and implementing these methods at different time periods during DTPIs development and progression respectively is likely to be the most universal,effective and promising way for DTPIs diagnosis.
基金Ma Lili Famous Veteran Teran Doctors of TCM Inheritance Studio(No.GZS2021019)Zhejiang Provincial Key Laboratory of Integrated Dermatology(No.2A11829).Abbreviations。
文摘Objective:The clinical effectiveness of blood-heat psoriasis treated by Qingre Liangxue decoction and ultrasound imaging changes of lesions was observed.Methods:Patients with blood-heat psoriasis were selected and randomly grouped into two groups:the treatment group taking the Qingre Liangxue decoction orally,the control group taking the Compound Glycyrrhizin Tablets orally,both groups applying topical emollient lotion for a 12-week treatment period.Ultrasound images of target lesions and healthy skin were collected at different treatment times.Results:The epidermal thickness thought,the dermal density incremented as well as the subepidermal low-echogenic band(SLEB)width narrowed in both groups during the treatment.Conclusion:Qingre Liangxue decoction has signified efficiency in the treatment of blood-heat psoriasis,and high-frequency ultrasound has the advantages of non-invasive,timely and objective in the evolution.
基金supported by grants from the Central Guidance for Local Scientific and Technological Development Projects of Shandong Province(No.YDZX2023058)the Shandong Province Taishan Scholar Project(No.tsqn201909141).
文摘To the Editor:Bullous pemphigoid(BP)is a rare autoimmune skin disorder characterized by significant mortality,with BP prevalence ranging from 1.46 to 47.99 cases per 100,000 people.[1]The pathogenic mechanism of BP is attributed to pathogenic autoantibodies targeting BP180 and BP230 antigens,resulting in the formation of subepidermal blisters.[1]Reports indicate that some BP patients also have circulating anti-desmoglein(Dsg)autoantibodies,which are pathogenic antibodies in pemphigus.[2]However,it remains uninvestigated whether the concomitant anti-Dsg antibodies in BP are pathogenic and thereby represent a coincidental occurrence or signify the coexistence of the two diseases.This knowledge gap introduces uncertainty in patient care management.Therefore,a comprehensive analysis was performed to explore the clinicohistopathological characteristics,human leukocyte antigen(HLA)genetic risk factors,and pathogenicity of anti-Dsg antibodies in BP patients with anti-Dsg antibodies compared to those without.
