Shiitake dermatitis: toxic or allergic reaction?
Shiitake dermatitis: toxic or allergic reaction?
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香菇皮炎：中毒还是过敏反应？
DOI：
10.1111/jdv.12505
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发表时间：
2015
影响因子：
9.2
通讯作者：
A. Virgili
中科院分区：
文献类型：
--
作者：
M. Corazza;S. Zauli;M. Ricci;A. Borghi;M. Pedriali;L. Mantovani;A. Virgili
可接触并据报道瘙痒评分有临床显着改善。我们进一步进行了敏感性分析，假设所有停止治疗或违约的受试者在 6 周时其结果指标没有改善，并重复上述比较 (n = 40)。所有结果的总体改善仍具有统计学显着性（P ≤ 0.001）。阴囊 LSC 的治疗具有挑战性。有限的证据表明，局部钙调神经磷酸酶抑制剂可能对患有外阴 LSC 的女性有效。在这项研究中，发现 0.1% 他克莫司软膏可有效降低阴囊 LSC 的瘙痒强度，同时改善瘙痒频率、睡眠、生活质量以及病变的身体范围和严重程度。除了其免疫抑制和抗炎作用外，他克莫司软膏还被证明具有单独的止痒作用。他克莫司有利于神经元上瞬时受体电位香草酸 1 (TRPV1) 离子通道的磷酸化，导致 P 物质的初始释放，这可能解释了初始烧灼感的副作用。随后，感觉神经元的脱敏抑制了瘙痒信号的传递。这扰乱了瘙痒-抓挠循环，而痒-抓循环是LSC发病机制的基石。外用钙调神经磷酸酶抑制剂的安全性已得到充分证实，最常见的不良反应是使用部位出现暂时的烧灼感。在我们的研究中，40 名受试者中有 12 名 (30.0%) 报告有温暖或烧灼感，其中 6 名受试者有轻微且短暂的感觉。对于其他六名受试者来说，这是无法忍受的，或者伴随着瘙痒的显着增加，他们自己停止了治疗。没有观察到其他不良反应。总之，在我们的研究人群中，局部使用 0.1% 他克莫司软膏（在耐受情况下）是治疗阴囊 LSC 的有效且安全的方法。
contactable and reported clinically significant improvement in itch scores. We further performed a sensitivity analysis assuming that all the subjects who stopped treatment or defaulted had no improvement in their outcome measures at 6 weeks and repeated the comparisons above (n = 40). The overall improvements in all the outcomes remained statistically significant (P ≤ 0.001). Treatment of scrotal LSC is challenging. Limited evidence suggests that topical calcineurin inhibitors may be useful in women with vulvar LSC. In this study, 0.1% tacrolimus ointment was found to be effective in reducing itch intensity in scrotal LSC, with concurrent improvements in itch frequency, sleep, quality of life and physical extent and severity of the lesions. In addition to its immunosuppressive and anti-inflammatory effects, tacrolimus ointment has been shown to have a separate antipruritic effect. Tacrolimus favours the phosphorylation of transient receptor potential vanilloid 1 (TRPV1) ion channels on neurons, resulting in an initial release of substance P, and this likely explains the side effect of initial burning sensation. Subsequently, the desensitization of sensory neurons inhibits transmission of itch signals. This disrupts the itch-scratch cycle which is a cornerstone in the pathogenesis of LSC. The safety profile of topical calcineurin inhibitors has been well established, with the most common adverse effect being a temporary burning sensation at the application site. In our study, a warm or burning sensation was reported in 12 (30.0%) of 40 subjects, which was mild and transient in six subjects. This was intolerable or was accompanied by a significant increase in itch in the other six subjects, who discontinued treatment themselves. No other adverse effects were observed. In conclusion, topical 0.1% tacrolimus ointment, when tolerated, was an effective and safe treatment for scrotal LSC in our study population.