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1.
患者女,11岁.因"颜面四肢皮疹1个月,咳嗽伴低热1周"入院.皮肤科情况:颜面四肢分布红色结节,中央有脐凹.胸片显示双肺间质性改变.组织病理检查示组织中有多核巨细胞,PAS染色可见孢子.HIV检测(-).诊断:播散性隐球菌病.  相似文献   

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报告1例艾滋病并发播散性皮肤隐球菌病。患者女,32岁。人免疫缺陷病毒(HIV)抗体阳性,无系统感染症状,皮损表现为传染性软疣样。皮损组织病理示组织细胞内外可见大量有荚膜的孢子,PAS染色阳性。皮损真菌培养阳性,菌种鉴定为新生隐球菌。治疗给予氟康唑静脉滴注,半个月后原有皮损结痂愈合,但右背部又新发带状疱疹。  相似文献   

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患者女性34岁,行肾移植术后6年,一直使用免疫抑制剂治疗。不明原因发热7天入院。体检:体温38℃,患者背部皮肤广泛3cm至6cm大小不等皮下结节,表面皮肤未见破损,呈红色、偏硬、有压痛。皮肤组织活检见深达赵皮层急性肉芽肿性炎,炎症组织中弥漫酵母样细胞。经培养鉴定并查血、脑脊液培养鉴定均可见新生隐球菌生长,诊断为播散性隐球菌病。予氟康唑200mg每日静脉滴注治疗。患者体温消退,皮疹也逐步消退。  相似文献   

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Two cases of longstanding rhinosporidiosis developed widespread asymptomatic nodular skin lesions. Cutaneous examination showed multiple, discrete, sessile and pedunculated, smooth and warty, friable nodular lesions of variable sizes and shapes. Histopathology of representative skin lesions showed hyperplastic epidermis with sporangia containing spores in the upper dermis diagnostic of rhinosporidiosis. Epidemiological data about rhinosporidiosis at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, is presented. Possible modes of dissemination to the skin and differential diagnosis are discussed in relation to this rare manifestation of rhinosporidiosis.  相似文献   

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Actinomycosis is an uncommon infectious disease caused predominantly by Actinomyces israelii. The cutaneous disseminated form is usually caused by hematogenous dissemination from a primary extra-cutaneous lesion. We report here cutaneous disseminated actinomycosis without any detectable extra-cutaneous lesions in a 42-year-old Japanese woman with acute lymphocytic leukemia. Multiple soft nodules developed on her upper and lower extremities. Histopathological examination revealed “sulfur granules”, which are a specific finding for actinomycosis. Cultures from biopsy specimens were not successful. There were no cervicofacial, thoracic, nor abdominal lesions. These findings suggest that cutaneous disseminated actinomycosis in our patient developed primarily in the skin. Although the patient was immunocompromised, antibiotic treatment with minocycline was effective.  相似文献   

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表现为皮肤溃疡和骨髓炎的播散性隐球菌病一例研究   总被引:8,自引:3,他引:5  
目的 报告一例播散性隐球菌病的临床、实验研究和治疗结果。方法和结果 患者女,33岁。1年前上臂、肩、臀及大腿长结节,此间怀孕并早产。产后半个月新发结节泛发全身。3个月前诊断为“血源播散性肺结核”,但抗结核治疗无效。体检发现面部、牙龈、躯干、臀部及四肢共39个结节和溃疡,左胫、腓骨骨质破坏及窦道。脓涂片及病理活检见脓液和坏死组织内有大量真菌孢子,培养酵母样菌落生长,尿素酶及咖啡酸试验阳性。经API酵母菌反应条和血清学鉴定为新生隐球菌血清型A.将菌种接种于大小鼠后发现脑、肺、肝等易受累。临床分离株核糖体内转录间隔2区序列分析法鉴定为新生隐球菌新生变种。停抗结核药,用抗真菌药治疗。强化段用两性霉素B和氟康唑,维持段口服伊曲康唑。局部用两性霉素B.30d后结节消失,200d后溃疡和窦道全部愈合,277d时停抗真菌药,患者痊愈。  相似文献   

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Cutaneous cryptococcosis is classified as localized cutaneous cryptococcosis and cutaneous manifestations of disseminated cryptococcosis. The former presents as lesions, confined to isolated parts of the skin, which are neither systemically disseminated nor associated with cryptococcal fungemia or antigenemia. The latter presents as lesions through dissemination of Cryptococcus from visceral organs such as the lungs, with most cases being immunosuppressed hosts. We report the case of an immunocompetent elderly long-term pigeon fancier who presented with disseminated cutaneous cryptococcosis caused by Cryptococcus neoformans. Although the patient had been at risk of inhaling the pathogen by keeping pigeons for many years, and had been treated with topical steroids for a localized nodular lesion, the cause of development of multiple skin lesions could not be determined. The patient paradoxically showed no pulmonary or central nervous system symptoms, fungemia or glucuronoxylomannan antigenemia. Treatment with oral itraconazole 200 mg/day was not effective, but combination therapy of 5-fluorocytosine 200 mg/kg per day and fluconazole 100 mg/day resolved the disease.  相似文献   

9.
患者女,63岁,农民。胸腹部结节、斑块、溃疡2年半。曾被误诊为"坏疽性脓皮病",并予糖皮质激素、米诺环素等反复治疗1年余,用药时皮疹有所好转,停药后皮疹加重。皮损组织病理示:呈炎性肉芽肿改变,脓液真菌培养鉴定为孢子丝菌。诊断:皮肤播散型孢子丝菌病。予特比萘芬口服,治疗3个月后皮损明显好转,目前仍在随访治疗中。  相似文献   

10.
A 40-year-old man who had received long term immunosuppressive treatment for 14 years following kidney transplantation developed multiple skin lesions on both antecubital fossae, scalp, and both lower extremities. Histopathologic findings from three skin regions revealed characteristic features of epidermolytic hyperkeratosis, verruca vulgaris, and disseminated superficial porokeratosis, respectively. Although immunocompromised individuals may demonstrate verruca vulgaris or porokeratosis, disseminated epidermolytic acanthoma (DEA) has not been reported to be associated with immunosuppressed status. We suggest that immunosuppression may play a role in the pathogenesis of DEA, as shown in our case.  相似文献   

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Abstract: A boy bom to a mother with unknown HIV infection was immunized with BCG In his first month of life. Seven months later axillary adenopathy developed. At the age of 10 months, 2 months after HIV Infection had been diagnosed, papular skin lesions appeared all over his body. Mycobacterium bovis, BCG strain, was cultured from a lymph node and blood. Ziehl-Neelsen stain of a skin biopsy specimen showed histiocytes loaded with numerous acid-fast bacilli. The patient died 10 days later, before the infection was confirmed. This is the first reported case of disseminated BCG infection in an HIV-infected child presenting with cutaneous lesions.  相似文献   

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A case of cutaneous disseminated sporotrichosis   总被引:1,自引:0,他引:1  
We described a case of cutaneous disseminated sporotrichosis. The condition was diagnosed based on isolation and identification of Sporothrix schenckii from the lesions. The patient was otherwise normal, including a negative HIV test. The blood culture did not grow S. schenckii. However, spores were detected in the biopsy histological sections and stained positively with PAS staining and ConA and LCA lectin histochemistry.  相似文献   

16.
Light microscopic studies of 55 patients with complete and incomplete types of Behçet's syndrome were reviewed. We reported here 39 skin biopsies from 30 patients with cutaneous lesions of oral, and genital ulcers, folliculitis, erythema multiforme, and thrombophlebitis. Leukocytoclastic vasculitis was seen in 5 of 12 (42%) cases of oral ulcers and 2 of 7 (29%) of genital ones. Lymphocytic vasculitis was demonstrated in 3 of 12 (25%) cases of oral ulcers and 4 of 7 (57%) of genital ulcers. However, the vasculitis was observed only locally in the areas with moderate or severe inflammation. From the biopsy specimens of our cases with fully developed mucocutaneous lesions of Behçet's syndrome, it appears that the forms of vasculitis that are often emphasized in the literature are a phenomenon secondary to the intense inflammation seen in such cutaneous lesions.  相似文献   

17.
Two patients with disseminated superficial porokeratosis (DSP) with amyloid deposition are reported. The skin lesions were distributed over both sun-exposed areas and sun-protected areas. No exacerbation by sun exposure was noted. Abundant amyloid substances were deposited at the papillary dermis, not only beneath the cornoid lamellae but also within the annular margin. The skin lesions and amyloid deposition regressed with topical application of dimethyl sulfoxide in one patient, suggesting that DSP is one of the clinical phenotypes of primary localized cutaneous amyloidosis. Another possibility is that amyloid substances are produced by poorly differentiated keratinocytes in DSP.  相似文献   

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患者,女,51岁。左下肢红斑及水疱伴阵发性疼痛20余天,泛发伴发热1周。皮肤科检查:全身散在分布粟粒至黄豆大暗紫红色斑疹、丘疹及丘疱疹,部分融合成片,中央处可见褐色痂皮。细胞涂片可见多核巨细胞及核内包涵体。诊断:播散性带状疱疹。予以甲泼尼龙、更昔洛韦等治疗有效。  相似文献   

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