Purpose Despite recent advances in the treatment of prurigo nodularis, conventional treatment suffers from a dilemma of poor efficacy. The clinical use of Janus kinase (JAK) inhibitors in the treatment of Prurigo nodularis has rarely been explored. Patients and Methods We present a case of prurigo nodularis successfully treated with, JAK inhibitor tofacitinib with no adverse effects. Results This case report of successful treatment shows a good clinical efficacy of using JAK inhibitor tofacitinib in the treatment of prurigo nodularis. Cytokines may be an important cause of prurigo nodularis. Conclusion JAK inhibitor tofacitinib may be a new option for the treatment of prurigo nodularis, especially for patients who have failed conventional treatment.
Grover's disease (GD), also known as Transient acantholytic dermatosis, has no typical clinical rash features. It usually occurs in elderly white men but very rarely in China. This is a disease of acantholysis and dyskeratosis, which is usually considered to be spontaneous remission. The skin lesions of the disease are diverse, and the main symptom is severe itching. We have reported a case of GD in a 14-year-old Chinese Tibetan male whose clinical manifestations were pruritic red papule, generalized red papules, papulo vesicles and blisters ranging from millet rice to soybean size. Skin lesions change rapidly and variously. In order to confirm the diagnosis, we have done skin biopsies, immunofluorescence, dermoscopy, microscopy and other examinations. Pathological skin biopsy showed acantholysis. Intraepidermal blisters and the presence of blisters on the basal cells as well as under the stratum corneum can be observed on the same pathological section. Type IV collagen immunohistochemistry showed blisters in the epidermis. The diagnosis of GD depended on the exclusion of other diseases. After we performed whole exon sequencing (WES) on DNA from the patient's blood, pathogenic gene mutations were not found. Pustular psoriasis, Subcorneal pustular dermatosis, Herpesvirus infections, Dermatitis herpetiformis, Pemphigus vulgaris, Norwegian scabies, Darier's disease, and Hailey-Hailey disease were all excluded. We successfully treated adolescent GD with minocycline combined with methotrexate. The patient was followed up for 19 months without recurrence.
Background: Chronic urticaria (CU) is a common skin disease characterized by a short-term (<24 hours) spontaneous skin rash (urticaria) with or without angioedema that lasts longer than 6 weeks. CU is not life-threatening but has been shown to have a significant impact on the physical and mental health of patients. Because of chronic itching or physical discomfort in patients with CU, symptoms such as the repeated occurrence of red, swollen, itchy, anxiety, insomnia, and psychological stress are prone to occur. Whereas, there is no related systematic review and meta-analysis. Thus, this systematic review protocol aims to describe a systematic review and meta-analysis to testify the efficacy and safety of compound glycyrrhizin (CG) combined with desloratadine in the treatment of CU.Methods: Our systematic review will search all randomized controlled trials (RCTs) for CG combined with desloratadine in the treatment of CU, electronically and manually, regardless of publication status and language, until January 14, 2020. Databases include PubMed, EMBASE, Web of Science, Cochrane Controlled Trials Register (CENTRAL), China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Chinese Science Journal Database (VIP Database) and Wanfang database. Other sources, including reference lists of identified publications and meeting minutes, will also be searched. Manually search for grey literature, including unpublished conference articles. The main outcomes contain the total effective rate, the urticaria activity score (UAS), Itching score, the chronic urticaria quality of life questionnaire (CU-Q2oL), or other validated symptom scores and the effective rate and adverse events from baseline to the end of studies. This study will provide a comprehensive review of the available evidence for the treatment of CU with this therapy. We will assess the risk of bias with the Cochrane Risk of Bias Tool, narratively synthesize the extracted data and conduct a meta-analysis of studies with similar characteristics. Two independent raters will screen articles and assess the risk of bias.Discussion: This study will provide a high-quality synthesis of the effects of compound glycyrrhizin (CG) combined with desloratadine in the treatment of CU. We hope that this review will give more convincing proof to assist clinicians during the decision-making process when dealing with CU.Systematic review registration: PROSPERO CRD42020165478
Background: Psoriasis vulgaris (PV) is a refractory and relapsing skin disease that affects the physical and mental health of patients and leads to poor quality of life. Current conventional systemic therapy shows a large side effect, which can not be used for a long time, easy to relapse after drug withdrawal, long-term efficacy is poor. At present, traditional Chinese medicine treatment of psoriasis vulgaris effective, can alleviate symptoms, improve the quality of life, stabilize the condition, prolong the remission period. Whereas, there is no related systematic review and meta-analysis. Thus, we intend to conduct a systematic review and meta-analysis to testify autologous blood or autologous serum acupoint injection therapy for Psoriasis Vulgaris. Methods: Our systematic review will search all randomized controlled trials for autologous blood therapy of PV, electronically and manually, regardless of publication status and language, until March 19, 2020. Databases include PubMed, EMBASE, Web of Science, Cochrane Controlled Trials Register, China National Knowledge Infrastructure, China Biomedical Literature Database, Chinese Science Journal Database, and Wanfang database. Other sources, including reference lists of identified publications and meeting minutes, will also be searched. Manually search for grey literature, including unpublished conference articles. Result: The main outcomes contain the variation of Psoriasis area and severity index, dermatology life quality index, itching score, the effective rate and adverse events from baseline to the end of studies. This study will provide a comprehensive review of the available evidence for the treatment of PV with this therapy. Conclusion: We will summarize sufficient evidence to confirm the therapeutic effect and safety of autologous blood or autologous serum acupoint injection therapy for PV. Due to the data is not individualized, formal ethical approval is not required. INPLASY registration number: INPLASY202040052.
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