1.Efficacy and safety of needle-free injection of interferon-α2a for the treatment of palmoplantar warts: a prospective, randomized, controlled, open-label trial
Yaxin DU ; Meihong DA ; Yakun HU ; Wenjie WU ; Mi TAO ; Qiao YAN ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2025;58(5):440-445
Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.
2.Clinical features of 78 cases of herpes zoster in immunocompromised populations
Xiaoyuan PAN ; Xinyu ZHU ; Fei WANG ; Zhengbang DONG
Chinese Journal of Dermatology 2025;58(3):239-244
Objective:To investigate clinical characteristics of immunocompromised individuals with herpes zoster.Methods:A retrospective study was conducted on 78 immunocompromised patients with herpes zoster hospitalized at Zhongda Hospital affiliated to Southeast University from January 2016 to December 2023, and these patients were assigned to the observation group. During the same period, 78 immunocompetent inpatients with herpes zoster matched (1∶1 ratio) by age and admission time served as a control group. General data, clinical manifestations, and laboratory findings (including blood routine test, liver and kidney function, and inflammatory markers) were compared between the two groups.Results:In the observation group, there were 27 males and 51 females, with the age being 65.76 ± 14.47 years; the main causes of immunocompromise in this group were solid tumors (47 cases, 60.26%) and hematologic tumors (7 cases, 8.97%) ; 26 (33.33%) patients with autoimmune diseases were treated with prednisone at a dose of ≥ 10 mg/d for more than 2 weeks. In the control group, there were 35 males and 43 females, with the age being 67.73 ± 13.89 years. No significant differences were found between the two groups in terms of gender, age, time from the onset of rashes or pain to hospitalization, time to lesion healing, the order of appearance of pain and rashes, the affected side of the body, or the proportion of patients with disseminated herpes zoster (all P > 0.05). However, there was a significant difference in the distribution of affected nerve segments between the two groups ( P = 0.013) ; the main affected nerves were the thoracic and brachial nerves (34 cases, 43.59%) and the lumbosacral nerves (29 cases, 37.18%) in the observation group, while the lumbosacral nerves (31 cases, 39.74%) and cranial-cervical nerves (25 cases, 32.05%) were more commonly affected in the control group. The skin lesions in both groups mainly manifested as blisters, pustules and/or hemorrhagic blisters, and the proportion of patients with pustules and/or hemorrhagic blisters was significantly higher in the observation group (25 cases, 32.05%) than in the control group (11 cases, 14.10%; χ2 = 7.08, P = 0.008). The observation group showed a significantly higher proportion of patients with fever (24 cases, 30.77%), frequency of oral analgesic use during hospital stay [2.00 (1.26, 2.33) times/day], and recurrence rate (6 cases, 7.69%) compared with those in the control group (13 cases, 16.67%; 1.43 [1.00, 2.00] times/day; 0, respectively). Additionally, the observation group exhibited significant increases in several parameters compared with the control group, including the proportions of patients with anemia (27 cases [34.62%] vs. 6 cases [7.69%]), kidney function abnormalities (9 cases [11.54%] vs. 2 cases [2.56%]), elevated alanine aminotransferase/aspartate aminotransferase ratios, increased erythrocyte sedimentation rates, and with elevated C-reactive protein levels, as well as those with decreased white blood cell counts, albumin levels, prealbumin levels, and with CD8 + T cell counts (all P < 0.05). In terms of novel inflammatory markers, the observation group showed significantly increased neutrophil/lymphocyte ratios, red blood cell distribution width/hemoglobin ratios, and C-reactive protein/albumin ratios, but significantly decreased albumin/fibrinogen ratios and platelet/neutrophil ratios compared with the control group (all P < 0.05) . Conclusion:Compared with the immunocompetent patients with herpes zoster, the immunocompromised patients with herpes zoster showed poorer cell-mediated immunity, more complex clinical manifestations, more severe systemic inflammatory responses, more pronounced pain, and higher likelihood of recurrent herpes zoster.
3.Clinical and prognostic analysis of nine cases of immune checkpoint inhibitor-related Stevens-Johnson syndrome/toxic epidermal necrolysis
Yongjun WAN ; Haijing YANG ; Qiao YAN ; Mei CHEN ; Fengyuan WANG ; Qianya SU ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2025;58(4):347-351
Objective:To summarize clinical characteristics and prognosis of immune checkpoint inhibitor (ICI) -related Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:A retrospective analysis was conducted on patients diagnosed with ICI-related SJS/TEN in Zhongda Hospital, Southeast University from January 2018 to October 2023. Data on clinical manifestations, laboratory examinations, treatment and prognosis of the patients were analyzed.Results:A total of 9 patients were diagnosed with ICI-related SJS/TEN, including 8 males and 1 female, with the onset age ranging from 58 to 77 (67.56 ± 7.33) years. ICI were applied to all the 9 patients before onset of SJS/TEN. The latent period was 6 - 261 d, and the median duration was 76 d. All the patients presented with erythema as initial lesions, 3 cases with target lesions, 6 with blisters, and 5 cases with a positive Nikolsky's sign. Oral mucosal damage occurred in 7 cases, eye damage occurred in 6 cases, and urogenital damage occurred in 6 cases. All the 9 cases were treated with systematic glucocorticoids, 7 cases with intravenous immunoglobulin and 7 cases with antibiotics. Eight cases recovered and 1 case died. Among 6 patients followed for an average of 6.92 months, none achieved complete or partial remission, 3 died and 3 experienced disease progression.Conclusions:ICI-related SJS/TEN occurred with a relatively long latent period, and all the cases presented with erythema initially, with mucosal damage present in most of the cases. Management required discontinuation of ICI, and most patients recovered with corticosteroids and intravenous immunoglobulin, however, the prognosis for the primary malignancy remained poor.
4.Efficacy and safety of needle-free injection of interferon-α2a for the treatment of palmoplantar warts: a prospective, randomized, controlled, open-label trial
Yaxin DU ; Meihong DA ; Yakun HU ; Wenjie WU ; Mi TAO ; Qiao YAN ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2025;58(5):440-445
Objective:To investigate the clinical efficacy and safety of needle-free and needle-based injections of recombinant human interferon (IFN) -α2a in the treatment of palmoplantar warts.Methods:Patients aged 6 to 75 years with palmoplantar warts were prospectively enrolled from the Department of Dermatology, Zhongda Hospital, Southeast University between March and September 2023, and baseline data were collected. The patients were randomly and equally divided into a needle-free injection group and a needle-based injection group by using a random number table method, and received needle-free and needle-based injections of recombinant human IFN-α2a once every 2 to 3 weeks, respectively, with a maximum of 4 treatment sessions. Efficacy was assessed based on changes in wart size and skin lines under a dermoscope. Pain degrees and adverse reactions were recorded, and patients were followed up for 6 months after the end of treatment. Chi-square test was used to compare the cure rates, recurrence rates, and incidence rates of adverse reactions between the two groups. Logistic regression analysis was employed to identify factors related to the clearance of palmoplantar warts.Results:A total of 160 patients with palmoplantar warts were included, with 80 patients in each group. In the needle-free injection group, there were 45 females (56.2%) and 35 males (43.8%) ; their ages ( M[ Q1, Q3]) were 27 (23, 40) years, and the duration of disease ( M[ Q1, Q3]) was 12 (3, 24) months; warts were located on the hands in 12 cases (15.0%), on the feet in 60 cases (75.0%), and on both sites in 8 cases (10.0%) ; warts measuring ≤ 1 cm in diameter were observed in 71 cases (88.8%), and those measuring > 1 cm were observed in 9 cases (11.3%). In the needle-based injection group, there were 37 females (46.2%) and 43 males (53.8%) ; their ages were 28 (22, 39) years, and the duration of disease was 6 (2, 12) months; warts were located on the hands in 23 cases (28.7%), on the feet in 55 cases (68.8%), and on both sites in 2 cases (2.5%) ; warts measuring ≤ 1 cm in diameter were observed in 67 cases (83.8%), and those measuring > 1 cm in diameter were observed in 13 cases (16.3%). There were no significant differences in gender distribution, age, wart diameters, prior treatment status, or number of warts between the two groups (all P > 0.05). The duration of disease was longer in the needle-free injection group than in the needle-based injection group ( P = 0.041), and the dose of interferon was lower in the needle-free injection group than in the needle-based injection group ( P < 0.001). After treatment, 44 patients (55.0%) were cured in the needle-free injection group, and 39 (48.8%) in the needle-based injection group, with no significant difference in the cure rates between the two groups ( χ2 = 0.63, P = 0.429). Among patients with multiple warts, 54.8% (23/42) were cured in the needle-free injection group, and 47.4% (18/38) in the needle-based injection group, with no significant difference in cure rates between the two groups ( χ2 = 1.28, P = 0.509). The most common adverse reaction was fever or flu-like symptoms (186 instances), which resolved spontaneously in 141 instances and resolved after treatment with oral ibuprofen in 45 instances; the incidence rate of flu-like symptoms was significantly lower in the needle-free injection group (57 instances, 21.6%) than in the needle-based injection group (129 instances, 53.3%; χ2 = 54.63, P < 0.001). The pain score was significantly lower in the needle-free injection group (3.65 ± 1.25 points) than in the needle-based injection group (5.16 ± 1.17 points, t = -7.90, P < 0.001). The logistic regression analysis showed that the duration of disease, lesion sites, patient age, and previous treatment history had no impact on the efficacy in either the needle-free injection group or the needle-based injection group (all P > 0.05) . Conclusions:The efficacy of needle-free and needle-based injections of interferon was similar in the treatment of palmoplantar warts, whereas needle-free injections resulted in less pain and a lower incidence of interferon-related adverse reactions. None of the duration of disease, lesion sites, patient age, or prior treatment status showed significant impact on the efficacy in the two groups.
5.Clinical features of 78 cases of herpes zoster in immunocompromised populations
Xiaoyuan PAN ; Xinyu ZHU ; Fei WANG ; Zhengbang DONG
Chinese Journal of Dermatology 2025;58(3):239-244
Objective:To investigate clinical characteristics of immunocompromised individuals with herpes zoster.Methods:A retrospective study was conducted on 78 immunocompromised patients with herpes zoster hospitalized at Zhongda Hospital affiliated to Southeast University from January 2016 to December 2023, and these patients were assigned to the observation group. During the same period, 78 immunocompetent inpatients with herpes zoster matched (1∶1 ratio) by age and admission time served as a control group. General data, clinical manifestations, and laboratory findings (including blood routine test, liver and kidney function, and inflammatory markers) were compared between the two groups.Results:In the observation group, there were 27 males and 51 females, with the age being 65.76 ± 14.47 years; the main causes of immunocompromise in this group were solid tumors (47 cases, 60.26%) and hematologic tumors (7 cases, 8.97%) ; 26 (33.33%) patients with autoimmune diseases were treated with prednisone at a dose of ≥ 10 mg/d for more than 2 weeks. In the control group, there were 35 males and 43 females, with the age being 67.73 ± 13.89 years. No significant differences were found between the two groups in terms of gender, age, time from the onset of rashes or pain to hospitalization, time to lesion healing, the order of appearance of pain and rashes, the affected side of the body, or the proportion of patients with disseminated herpes zoster (all P > 0.05). However, there was a significant difference in the distribution of affected nerve segments between the two groups ( P = 0.013) ; the main affected nerves were the thoracic and brachial nerves (34 cases, 43.59%) and the lumbosacral nerves (29 cases, 37.18%) in the observation group, while the lumbosacral nerves (31 cases, 39.74%) and cranial-cervical nerves (25 cases, 32.05%) were more commonly affected in the control group. The skin lesions in both groups mainly manifested as blisters, pustules and/or hemorrhagic blisters, and the proportion of patients with pustules and/or hemorrhagic blisters was significantly higher in the observation group (25 cases, 32.05%) than in the control group (11 cases, 14.10%; χ2 = 7.08, P = 0.008). The observation group showed a significantly higher proportion of patients with fever (24 cases, 30.77%), frequency of oral analgesic use during hospital stay [2.00 (1.26, 2.33) times/day], and recurrence rate (6 cases, 7.69%) compared with those in the control group (13 cases, 16.67%; 1.43 [1.00, 2.00] times/day; 0, respectively). Additionally, the observation group exhibited significant increases in several parameters compared with the control group, including the proportions of patients with anemia (27 cases [34.62%] vs. 6 cases [7.69%]), kidney function abnormalities (9 cases [11.54%] vs. 2 cases [2.56%]), elevated alanine aminotransferase/aspartate aminotransferase ratios, increased erythrocyte sedimentation rates, and with elevated C-reactive protein levels, as well as those with decreased white blood cell counts, albumin levels, prealbumin levels, and with CD8 + T cell counts (all P < 0.05). In terms of novel inflammatory markers, the observation group showed significantly increased neutrophil/lymphocyte ratios, red blood cell distribution width/hemoglobin ratios, and C-reactive protein/albumin ratios, but significantly decreased albumin/fibrinogen ratios and platelet/neutrophil ratios compared with the control group (all P < 0.05) . Conclusion:Compared with the immunocompetent patients with herpes zoster, the immunocompromised patients with herpes zoster showed poorer cell-mediated immunity, more complex clinical manifestations, more severe systemic inflammatory responses, more pronounced pain, and higher likelihood of recurrent herpes zoster.
6.Clinical and prognostic analysis of nine cases of immune checkpoint inhibitor-related Stevens-Johnson syndrome/toxic epidermal necrolysis
Yongjun WAN ; Haijing YANG ; Qiao YAN ; Mei CHEN ; Fengyuan WANG ; Qianya SU ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2025;58(4):347-351
Objective:To summarize clinical characteristics and prognosis of immune checkpoint inhibitor (ICI) -related Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:A retrospective analysis was conducted on patients diagnosed with ICI-related SJS/TEN in Zhongda Hospital, Southeast University from January 2018 to October 2023. Data on clinical manifestations, laboratory examinations, treatment and prognosis of the patients were analyzed.Results:A total of 9 patients were diagnosed with ICI-related SJS/TEN, including 8 males and 1 female, with the onset age ranging from 58 to 77 (67.56 ± 7.33) years. ICI were applied to all the 9 patients before onset of SJS/TEN. The latent period was 6 - 261 d, and the median duration was 76 d. All the patients presented with erythema as initial lesions, 3 cases with target lesions, 6 with blisters, and 5 cases with a positive Nikolsky's sign. Oral mucosal damage occurred in 7 cases, eye damage occurred in 6 cases, and urogenital damage occurred in 6 cases. All the 9 cases were treated with systematic glucocorticoids, 7 cases with intravenous immunoglobulin and 7 cases with antibiotics. Eight cases recovered and 1 case died. Among 6 patients followed for an average of 6.92 months, none achieved complete or partial remission, 3 died and 3 experienced disease progression.Conclusions:ICI-related SJS/TEN occurred with a relatively long latent period, and all the cases presented with erythema initially, with mucosal damage present in most of the cases. Management required discontinuation of ICI, and most patients recovered with corticosteroids and intravenous immunoglobulin, however, the prognosis for the primary malignancy remained poor.
7.High-frequency ultrasonography-assisted evaluation of treatment outcomes of erysipelas: a prospective controlled study
Shiying JIN ; Jinjun SHI ; Qi GAO ; Mei CHEN ; Zhengbang DONG ; Qiao YAN ; Jijian LI ; Fei WANG
Chinese Journal of Dermatology 2023;56(5):434-438
Objective:To measure the skin thickness in patients with erysipelas by high-frequency ultrasonography (HF-USG), and to compare the clinical efficacy of systemic antibiotics alone versus their combination with glucocorticoids in the treatment of erysipelas.Methods:Hospitalized patients with erysipelas were enrolled from Zhongda Hospital, Southeast University from January to December in 2021, and randomly divided into the study group and control group according to the order of visits. The study group was treated with systemic cefathiamidine for 7 days followed by oral methylprednisolone at a dose of 0.4 mg·kg -1·d -1, while the control group was treated with cefathiamidine alone. Before and after the treatment for 10 days, the thicknesses of the epidermis-dermis layers and subcutaneous tissues were measured by HF-USG at the sites of the most severe skin lesions on the affected limbs and at the corresponding sites on the healthy limbs, and white blood cell (WBC) counts, neutrophil (NEU) counts, as well as C-reaction protein (CRP) levels were determined. The t test and non-parametric test were used to compare the efficacy between two groups. Results:A total of 23 patients with erysipelas were enrolled. Among the 12 patients in the study group, 8 were males and 4 were females, and their age was 71.4 ± 11.4 years. Among the 11 patients in the control group, 7 were males and 4 were females, and their age was 67.4 ± 11.1 years. Before treatment, the thicknesses of the epidermis-dermis layers (0.33 ± 0.12 cm) and subcutaneous tissues (1.08 ± 0.49 cm) in the study group were not significantly different from those in the control group (0.25 ± 0.09 cm, 0.98 ± 0.46 cm; t = -1.83, -0.49, P = 0.081, 0.626, respectively). After the 10-day treatment, the thicknesses of the epidermis-dermis layers and subcutaneous tissues of the skin lesions on the affected limbs significantly decreased in both groups compared with those before treatment (both P < 0.05), and the decrease in the thicknesses of subcutaneous tissues was significantly stronger in the study group (0.32 ± 0.33 cm) than in the control group (0.10 ± 0.07 cm; t = 2.20, P = 0.039). Before treatment, the WBC counts ([11.16 ± 4.42] × 10 9/L), NEU counts ([8.26 ± 4.16] × 10 9/L) and CRP levels (median [ Q1, Q3]: 72.20 [19.28, 140.50] mg/L) in the study group were not significantly different from those in the control group ([10.10 ± 4.53] × 10 9/L, [7.21 ± 3.00] × 10 9/L, 34.40 [8.00, 74.20] mg/L, respectively; t or Z = 0.60, 0.71, -0.85, P = 0.578, 0.496, 0.196, respectively). After the 10-day treatment, the WBC counts, NEU counts, and CRP levels significantly decreased in both groups compared with those before treatment (all P < 0.05) . Conclusion:The combined treatment with systemic antibiotics and glucocorticoids could effectively alleviate skin inflammation, and more rapidly reduce the thicknesses of inflamed subcutaneous tissues in patients with erysipelas compared with systemic antibiotics alone.
8.Clinical features of coronavirus disease 2019 in patients with autoimmune blistering diseases
Xinyu ZHU ; Xiaoyuan PAN ; Haijing YANG ; Fei WANG ; Zhengbang DONG
Chinese Journal of Dermatology 2023;56(11):1023-1027
Objective:To analyze clinical features of coronavirus disease 2019 in patients with autoimmune blistering diseases (AIBDs), and to explore risk factors for the development of severe coronavirus disease 2019 in patients with AIBDs.Methods:Clinical data were collected from patients with AIBDs who were hospitalized in Zhongda Hospital, Southeast University from August 2021 to December 2022, and were retrospectively analyzed. Independent sample t-test, Mann-Whitney U test, or chi-square test (Fisher′s exact test) were used to analyze factors associated with severe coronavirus disease 2019 in AIBD patients. Results:A total of 30 patients with AIBDs accompanied by coronavirus disease 2019 were included, they were aged 62.90 ± 15.72 years, and included 16 males and 14 females; pemphigus vulgaris (12 cases, 40.00%) and bullous pemphigoid (13 cases, 43.33%) predominated in the disease spectrum of AIBDs in these patients. The common clinical manifestations of coronavirus disease 2019 were cough (25 cases, 83.33%), fatigue (22 cases, 73.33%), and fever (15 cases, 50.00%) ; most patients had mild clinical symptoms, while 7 (23.33%) developed into severe coronavirus disease 2019, including 2 out of 14 aged 30 - 59 years and 5 out of 16 elderly patients aged ≥ 60 years, and 2 out of the 5 elderly patients finally died. According to the clinical classification criteria of coronavirus disease 2019, the 30 patients were divided into the mild-to-moderate group (23 cases) and severe group (7 cases) ; the duration of AIBDs was significantly shorter in the severe group (10.71 ± 10.72 months) than in the mild-to-moderate group (27.61 ± 19.67 months, t = 2.16, P = 0.040) ; the remission rate of AIBDs was significantly higher in the mild-to-moderate group (21/23) than in the severe group (4/7, χ2 = 4.36, P = 0.037) ; the average daily dosage of methylprednisolone during the last month was significantly lower in the mild-to-moderate group ( M[ Q1, Q3]: 8 [4, 14] mg) than in the severe group (24 [12, 47] mg, U = 133.50, P = 0.007), and the proportion of patients treated with methylprednisolone at an average dosage of > 8 mg was significantly higher in the severe group (6/7) than in the mild-to-moderate group (8/23, χ2 = 5.59, P = 0.031) . Conclusions:Among the patients with AIBDs accompanied by coronavirus disease 2019, the incidence and mortality of severe coronavirus disease 2019 were higher in elderly patients than in young patients. The short course and no-remission of AIBDs, and the average daily dosage of methylprednisolone being>8 mg/d during the last month were risk factors for the development of severe coronavirus disease 2019 in the patients with AIBDs.
9.Skin adverse reactions to afatinib and their correlation with anti-lung cancer efficacy
Meihong DA ; Meiqi SHI ; Qiao YAN ; Haijing YANG ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2021;54(1):64-67
Objective:To investigate the type and severity of skin adverse reactions induced by afatinib in the treatment of lung cancer, and to analyze their correlation with anti-lung cancer efficacy.Methods:A case-case-control study was conducted on lung cancer patients treated with afatinib in ZhongDa Hospital, Southeast University from December 2016 to January 2018. The type and severity of skin adverse reactions were evaluated in 76 patients with lung cancer based on the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0, and these patients were divided into 3 groups according to the severity of skin lesions, including grade-0, -1, and -2/3 groups. The patients underwent chest computed tomography (CT) examination every 3 months, and the tumor response to afatinib was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) . Anti-lung cancer efficacy of afatinib was compared among the patients with different grades of skin lesions by using the Kruskal-wallis H rank sum test. Results:After treatment with afatinib, 44 of the 76 patients with lung cancer achieved stable condition or partial remission, and 32 experienced disease progression. Skin adverse reactions occurred in 69 patients, and manifested as acneiform lesions in 42 (55.3%) patients, paronychia in 35 (46.1%) , mucosal erosions in 30 (39%) , hair changes in 8 (10.5%) , and hand-foot syndrome in 6 (7.9%) . Improvement was achieved in 3, 7 and 34 cases in the grade-0, -1, and -2/3 groups ( n = 7, 19 and 50 respectively) , respectively. There was a significant difference in the response rate among the 3 groups ( χ2 = 6.117, P = 0.047) , and the response rate was significantly higher in the grade-1 and -2/3 groups than in the grade-0 group (both P < 0.001) , and higher in the grade-2/3 group than in the grade-1 group ( P < 0.001) . Conclusion:The treatment of lung cancer with afatinib can cause various types of skin lesions, such as acneiform lesions, paronychia, mucosal erosions, hair changes and hand-foot syndrome, and the higher the severity of the skin lesions, the more marked the anti-lung cancer efficacy of afatinib.
10.Preparation of tissue-engineered skin grafts with hTERT cells carrying human papillomavirus type 6 genome in vitro:a preliminary study
Fei WANG ; Zongke GUO ; Hongye ZHANG ; Yongzheng PAN ; Zhengbang DONG ; Mei CHEN ; Ying SHAN ; Qiao YAN ; Weiping YU
Chinese Journal of Dermatology 2015;(5):321-325
Objective To establish a model for preparation of tissue-engineered skin grafts with hTERT cells carrying human papillomavirus type 6 (HPV 6) genome in vitro, so as to lay a foundation for studying HPV life cycle. Methods The full-length linear HPV6 genome and plasmid pEGFP-▲EGFP were electrophoretically cotransferred into hTERT cells. After selection using G418 resistance, Southern blotting was performed to determine the viral load of HPV6 in transfected cells. 3T3 J2 trophoblastic cells, type I rat-tail collagen and hTERT cells containing the full-length HPV6 genes (HPV6.hTERT cells)were mixed and cocultured on metal meshes to form skin graft-like structures. Hematoxylin and eosin (HE)staining was performed to observe the structure of formed skin grafts, an immunohistochemical assay to measure the expression of HPV6 L1 protein, and electron microscopy to observe virus particles in the skin grafts. Results The linear HPV6 gene was successfully transferred into hTERT cells, and Southern blotting showed the presence of HPV6 DNA in the transferred hTERT cells. The HPV6.hTERT cells, which were cocultured with 3T3 J2 trophoblastic cells and type I rat-tail collagen, proliferated and differentiated over time, and gradually formed skin grafts giving the appearance of verrucous hyperplasia. HE staining showed that the cocultured HPV6.hTERT cells could form typical stratified structure of skin after 7 days of cultivation, and histopathologic features of HPV infection, including obvious papillomatous hyperplasia, presence of vesicular cells, hyperkeratosis and parakeratosis, could be observed after 21 days. The immunohistochemical assay showed the expression of HPV6 L1 protein in the upper portion of skin grafts, and electron microscopy revealed the presence of HPV6 virus particles in skin grafts. Conclusions The established model for preparation of tissue-engineered skin grafts using HPV 6 genome-carrying cells provides a basis for biological studies of HPV, but its application is limited to some degree.

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