Furen Zhang

Prevalence and characteristics of psoriatic arthritis in Chinese patients with psoriasis

Background  The prevalence and clinical characteristics of psoriatic arthritis (PsA) in patients with psoriasis vary widely in different countries and studies on Chinese population are rarely reported.

Histological classification of melasma with reflectance confocal microscopy: a pilot study in Chinese patients.

Objective: To investigate the histological classification of melasma with reflectance confocal microscopy (RCM) in vivo.

Treatment of port wine stains with pulsed dye laser: a retrospective study of 848 cases in Shandong Province, People's Republic of China.

Background Currently, 595 nm pulsed dye laser (PDL) therapy is offered as one of the effective treatments of port wine stains (PWSs). However, the efficacy of PDL differs in different populations. Objective The purpose of the study was to investigate the efficacy, and related factors, of 595 nm PDL in the treatment of PWSs in Chinese patients with skin type III to IV. Methods A total of 848 cases that were treated with PDL were enrolled and analyzed in this study. An independent dermatologist evaluated these lesions according to the before and after photographs. Results The response rate (RR) of all the 848 PWS patients was 69.9%, within which the cure rate was 6.3%. The patients aged ≤1 year had the highest RR (93.9%), whereas those treated after age 50 reacted the worst (RR =25%). We analyzed the anatomical distribution of the lesion and found that the temporal region had the highest lesion clearance (RR =75.3%), while the extremities had the lowest clearance (RR =44.5%). Compared with the patients whose lesion size was larger than 80 cm2, the patients with small lesion size, of 0–20 cm2, had better clinical effect (RR =73.8% vs 53.2%). The reactions of the patients with hyperplastic lesion were worse than those with red patches (RR =36.4% vs 71.7%). As well, increasing treatment numbers could achieve higher clearance rates (P=0.005). Conclusion The PDL had a relatively high RR but a low clearance rate in Chinese patients with PWS, although the earlier the intervention, the better was the efficacy. The response of PDL was, not only related to the anatomical area, but also, to the lesion size, type of lesion (ie, the presence of existing hyperplastic lesions), and the number of treatment, all of which are essential for the evaluation of therapeutic effect and acquisition of patients consent before treatment.

Dermatitis herpetiformis in China: a report of 22 cases.

Background  Although dermatitis herpetiformis (DH) is a relatively common disease in Caucasian populations, it is very rare in the Far East, including China.

Evaluation of the combination of BP180-NC16a enzyme-linked immunosorbent assay and BP230 enzyme-linked immunosorbent assay in the diagnosis of bullous pemphigoid

BACKGROUND Bullous pemphigoid (BP) is an acquired autoimmune subepidermal blistering disease characterized by circulating IgG autoantibodies directed against BP180 and BP230 hemidesmosomal proteins. Previous studies have demonstrated that antibodies against the NC16a domain of BP180 mediate BP pathogenesis, while antibodies against BP230 enhance the inflammatory response. Recently, commercial BP180-NC16a enzyme-linked immunosorbent assay (ELISA) and BP230 ELISA kits were developed to detect anti-BP180 and anti-BP230 autoantibodies in human BP sera. AIMS To evaluate the efficacy of BP180-NC16a ELISA and BP230 ELISA in the initial diagnosis of BP. METHODS Sera from 62 BP patients and 62 control subjects were tested by BP180-NC16a ELISA and BP230 ELISA and compared with findings from indirect immunofluorescence (IIF) and immunoblotting (IB) to determine the sensitivity and specificity of these assays. RESULTS The sensitivities of BP180-NC16a ELISA and BP230 ELISA were 87.1% (54/62) and 56.5% (35/62), respectively, and the specificities of both were 100% (62/62). Using both ELISAs for diagnosis increased the sensitivity to 95.2% (59/62) and was statistically comparable with IB sensitivity. CONCLUSIONS ELISA is a convenient, effective, and reliable method for serodiagnosis of BP, and combined use of BP180-NC16a ELISA and BP230 ELISA can increase the sensitivity of this diagnostic approach.

Mutation analysis of the CYLD gene in two Chinese families with multiple familial Trichoepithelioma

Multiple familial trichoepithelioma (MFT) is an autosomal dominant inherited disease characterized by multiple skincoloured papules on the centre of the face. Mutations in the CYLD gene on chromosome 16q12-q13 have been identified as the cause of MFT, and is also responsible for familial cylindromatosis (cylindromas only) and Brooke–Spiegler syndrome (a combination of cylindromas, trichoepitheliomas and spiradenomas). We performed mutation analysis of the CYLD gene in two Chinese MFT families (Fig. 1a) and identified two mutations of the CYLD gene. The patients, whose onset age varied from 20 years to 38 years, were diagnosed based on facial trichoepitheliomas and histopathological findings (Fig. 1b). After informed consent, genomic DNA was extracted from the peripheral blood of family members and 96 healthy controls. Exons of

Seborrheic keratosis or verruca plana? A pilot study with confocal laser scanning microscopy.

Background: Differentiation of some seborrheic keratosis (SK) and verruca plana (VP) lesions is a challenge. Confocal laser scanning microscopy (CLSM) has been proved to be useful in the diagnosis of skin diseases; however, to date, there is no report on the differential study of the two diseases with CLSM.

Accuracy of indirect immunofluorescence on sodium chloride-split skin in the differential diagnosis of bullous pemphigoid and epidermolysis bullosa acquisita

BACKGROUND Previous reports have shown that indirect immunofluorescence (IIF) performed on sodium chloride-split skin (SSS) is helpful to differentiate epidermolysis bullosa acquisita (EBA) from bullous pemphigoid (BP). Antibodies of BP may bind to the epidermal side of SSS, while antibodies of EBA bind to the dermal side. AIMS To determine the accuracy of IIF-SSS in the differential diagnosis of EBA and BP utilizing immunoblotting (IB) analysis. METHODS Sera from 78 patients, diagnosed with BP by clinical features, histopathology, and direct immunofluorescence (DIF), were assayed using IIF-SSS and IB. RESULTS Of the 43 serum samples with an epidermal reaction to IIF-SSS assay, 42 were recognized with BP antigens (180 kDa or 230 kDa). Of the 11 serum samples with a dermal reaction pattern, 7 were recognized with the 290 kDa antigen of EBA and 3 with sera bound BP antigens. Seven serum samples with epidermal and dermal combined staining, of which 5 of them reacted with BP antigens, 1 reacted with both BP and EBA antigens. One serum sample from each group showed a negative result by IB. Approximately 9.0% (7/78) of patients diagnosed with BP using regular methods were actually EBA. CONCLUSIONS Epidermal reaction using the IIF-SSS assay highly correlated with the diagnosis of BP. However, dermal reactions correlated poorly with EBA, with some serum samples from BP patients binding to dermal-side antigens. In both epidermal and dermal stained sera using IIF-SSS, there was a possibility of BP and EBA. Differential diagnosis should be confirmed using IB, especially in cases of dermal and double staining patterns assayed using IIF-SSS.

Treatment of vitiligo with 308-nm excimer laser: our experience from a 2-year follow-up of 979 Chinese patients.

The 308‐nm excimer laser had been proved to be a time‐efficient and potent therapeutic alternative for the management of vitiligo. Different results had been reported in different ethnic populations.

In Vivo Imaging of Lichen Nitidus With Confocal Laser Scanning Microscopy

A 33-YEAR-OLD MAN, A 20-YEAR-OLD WOMAN, AND a 10-year-old boy with the clinical diagnosis of lichen nitidus (Figure 1A, Figure 2A, and Figure 3A, respectively) underwent imaging with confocal laser scanning microscopy (CLSM) (Vivascope 1500; Lucid-Tech Inc, Henrietta, New York). The mosaic CLSM images (Figure 1B, Figure 2B, and Figure 3B [3 3 mm, 2 2 mm, and 2 2 mm, respectively]) revealed round, enlarged, well-circumscribed dermal papillae. The basal cell layer over the top of the dilated dermal papilla was poorly refractile, possibly because of the depletion of melanocytic cells. The enlarged dermal papillae were heavily laden with individual highly refractive cells, consistent with melanophages and, possibly, mononuclear cells. These findings appear to be a repeatable CLSM pattern for lichen nitidus. Histologically, these lesions revealed a focal well-circumscribed infiltrate of lymphocytes and histiocytes closely attached to the epidermis as well as rete ridges on the margins of the granuloma, which were elongated to create the “claw clutching a ball” image (Figure 1C, Figure 2C, and Figure 3C).