1.Association analysis between HLA-DRB1 alleles and pemphigus vulgaris in a Han population in Sichuan
Dengmei XIA ; Wei YAN ; Fei XU ; Lian WANG ; Wei LI
Chinese Journal of Dermatology 2017;50(8):589-591
Objective To investigate the association between HLA-DRB1 alleles and pemphigus vulgaris (PV) in a Han population in Sichuan.Methods Polymerase chain reaction with sequencespecific primer (PCR-SSP) method was used for low-resolution and high-resolution typing of HLA-DRB1 alleles in 19 patients of Han nationality with PV and 25 healthy controls in Sichuan.Allele frequencies were calculated,and differences in the allele frequency between the above two groups were compared by using chisquare test.Results Totally,9 kinds of DRB 1 low-resolution alleles and 19 kinds of DRB 1 high-resolution alleles were identified in the PV patients and healthy controls.Frequencies of the DRB1* 14 allele (39.47%[15/38] vs.8.00%[4/50],x2 =17.43,P < 0.05) and DRB1*1405 allele (15.79%[6/38] vs.2.00%[1/50],x2 =4.25,P < 0.05) were significantly higher in the PV patients than in the healthy controls.Conclusion The HLA-DRB1*14 allele may be a common susceptibility gene for PV in the Han population in Sichuan,and the HLA-DRB1* 1405 allele may be most closely associated with PV.
2.The clinical significance of blood relevant parameters in psoriasis vulgaris
Dengmei XIA ; Jixiang XU ; Jinnan CHENG ; Xia XIONG
The Journal of Practical Medicine 2017;33(24):4061-4064
Objective To investigate the characteristics and the clinical significance of relevant parame-ters of blood in psoriasis vulgaris(PV). Methods A retrospective analysis among 38 PV patients and 40 normal controls was done. The comparing parameters contained NLR,CRP,total cholesterol,triglyceride,serum uric acid.Pearson correlation analysis was used to detect the correlations.Results NLR,total cholesterol,triglyceride, serum uric acid in psoriasis vulgaris patients were significantly higher than in the normal controls(P < 0.05). There was a statistically significant correlation between NLR and PASI in the PV patients,but no correlation of CRP with NLR and PASI(P > 0.05). In the patients with PASI ≥ 7,the serum uric acid level was significantly higher than in those with PASI < 7. Conclusions NLR is indicateive of the severity and state of inflammation. The severer PV,the higher the level of serum uric acid.
3.Retrospective analysis of 13 patients with epidermolysis bullosa acquisita
Dengmei XIA ; Xingli ZHOU ; Mi WANG ; Xun FENG ; Jishu LI ; Yiyi WANG ; Xiaohong LI ; Wei LI
Chinese Journal of Dermatology 2024;57(10):910-916
Objective:To analyze clinical, immunopathological, therapeutic, and prognostic features of epidermolysis bullosa acquisita (EBA) .Methods:A retrospective study was conducted on patients with confirmed EBA at the Department of Dermatology, West China Hospital, Sichuan University from January 1, 2015 to July 30, 2022. Their clinical, immunopathological, therapeutic and prognostic features were analyzed. The autoimmune bullous skin disorder intensity score (ABSIS) was used to assess the severity of lesions in patients with EBA, and the visual analogue scale (VAS) to assess itch intensity. Descriptive statistical analysis was primarily carried out, and the correlation between disease severity scores and itch scores was analyzed using Pearson correlation analysis.Results:A total of 13 patients with EBA were included, including 9 males and 4 females, with the age at the clinic visit being 49.0 ± 20.6 years and ABSIS scores being 24.2 ± 10.7 points. One patient was diagnosed with classical EBA, while the remaining 12 patients with inflammatory EBA. Mucosal involvement was observed in 6 cases, whose oral mucosae were all affected. All patients had itching to varying degrees, with VAS scores of 5.6 ± 2.2 points; 9 of the 12 inflammatory EBA patients had VAS scores of ≥ 5 points, whereas 1 classical EBA patient had a VAS score of 2 points; there was no significant correlation between the ABSIS scores and VAS scores ( r = -0.02, P > 0.05). Histopathological examination showed subepidermal cleavages or blister formation and varying degrees of perivascular inflammatory cell infiltration in the superficial dermis of patients with inflammatory EBA. Direct immunofluorescence assay demonstrated linear IgG deposits along the basement membrane zone in all 13 patients, including 12 with concomitant linear C3 deposits in the basement membrane zone, 5 with linear IgA deposits, and 2 with IgM deposits. Indirect immunofluorescence on salt-split skin showed IgG deposition on the dermal side of the salt-split skin in the 13 patients. An elevated eosinophil count in the peripheral blood was observed in 1 out of 11 patients, while increased total IgE levels were noted in 3 out of 9 patients. Among the 13 EBA patients, 11 were treated with systemic glucocorticoids (equivalent to 10 - 100 mg/d of prednisone), and the other 2 were treated with compound glycyrrhizin tablets, sulfasalazine, hydroxychloroquine sulfate, and minocycline hydrochloride alone or in combination. During the follow-up period of 34.0 (27.5, 66.0) months in the 13 patients, 8 achieved complete remission after drug withdrawal, 2 achieved complete remission on therapy, 1 achieved partial remission on minimal therapy, and 2 presented with uncontrolled condition. The time to complete remission off/on therapy was 6.0 (3.8, 17.5) months. Conclusions:The inflammatory phenotype seems to be relatively common in EBA patients, with itching to varying degrees, and oral mucosa was the most commonly involved mucosa in those with mucosal damage. After treatment with systemic glucocorticoids alone or in combination with immunomodulators, most patients could achieve complete remission.