羊痘二例

报道2例人感染羊痘，通过临床及实验室经荧光PCR检测确诊。例1，女，55岁。有病羊接触史，左手无名指出现黄豆大感染性肉芽肿改变1个月，外阴多发疣状增生20天。例2，女，46岁。左手两个手指有红色结节伴触痛半月，发病前有病羊接触史。两例患者经PCR检测羊痘病毒DNA均阳性，经抗病毒及冷冻治疗后皮肤逐渐恢复正常。     

羊痘一例

本文报道一例羊痘患者,给予口服伐昔洛韦、外用夫西地酸乳膏及红光照射治疗,2周后皮损完全消退。     

羊痘3例报道

羊痘（orf）又名传染性脓疱性皮炎，羊口疮。我们于2003年8月29日31日及9月3日，相继发现3例，现报道如下。     

一家三口同患羊痘

报告一家三口同患羊痘。例1.患者男，41岁。有病羊接触史，左手背及右前臂脓疱、结节伴痛痒2周。皮肤科检查：左手背一直径约1 cm乳头瘤样结节；右前臂可见数个直径1～1.5 cm扁平脓疱。皮肤镜检查：镜下可见皮损中央溃疡结痂区及周围黄白色环状区域，可见点状血管。皮损组织病理检查：表皮细胞内及细胞间水肿、空泡形成及气球状变性；真皮血管内皮细胞和表皮细胞胞质可见嗜酸性包涵体。例2和例3患者分别为例1父亲及母亲，皮肤科检查与例1类似。例2发病前有病羊接触史，例3否认发病前有病羊接触史。3例患者结合典型临床表现及皮肤镜、组织病理检查结果，均诊断为羊痘。     

羊痘一家4例报告

报告一家 4例先后患羊痘及治疗情况。     

羊痘1例

羊痘又名传染性脓疱性皮病，感染性唇部皮炎等，现阶段由于条件的改善，各种防护工作做的比较好，此病已较少见，我院门诊发现1例，报道如下。临床资料 患者，女，42岁，因”双手及前臂起水疱、脓疱2周”来院就诊，患者自述3周前因家中数只羊口腔起水疱并化脓破溃，在未作任何防护的情况下自行给病羊行口腔食盐水冲洗，连续3天，2周前患者双手及前臂陆续出现数个紫红色小丘疹，质地坚硬，自觉轻度瘙痒，未作任何处理，渐扩大成为约黄豆大的水疱和脓疱，周围绕以红晕，曾在当地诊所治疗(具体诊断     

羊痘1例

患者男,58岁,牧羊人。左手指背部和腕部丘疹、水疱,伴瘙痒及疼痛1周。皮损为半球形水疱,呈暗红色,顶部平坦,中心有脐凹,周围有红晕,界限清楚。组织病理示:表皮内有明显细胞内及细胞间水肿,空泡形成;气球状变性,表皮内水疱形成,真皮乳头高度水肿,伴有致密浆细胞、淋巴细胞、中性粒细胞浸润。诊断:羊痘。     

羊痘1例

患者女，27岁。从事养殖业3年。因双手丘疹、结节伴瘙痒和疼痛20d，于2006年11月就诊。4周前患者与2位同事为山羊治疗“口疮”，1周后患者双手出现米粒大丘疹，不痛不痒，持续约10d后皮损变红增大，伴瘙痒，并有疼痛及烧灼感，3d后皮损逐渐变硬，症状减轻，2位同事的双手也出现类似皮损，但症状较本例患者轻。     

羊痘3例

例1，男，30岁。因双下肢散在蚕豆大结节伴瘙痒半月余，于2003年9月1日来我院就诊。患者系牧羊人，半个月前穿短裤放羊后左内踝瘙痒，抓破后局部形成结节，随后右下肢也在搔抓部位出现相同皮疹。患者无发热，局部淋巴结无增大。配偶及子女未见相同皮损。皮肤科检查：左内踝围棋子大半球形结节，表面破溃，少量渗血，上覆脓痂，基底暗红；右小腿散在4个蚕豆大半球形结节，     

羊痘1例

患者男,35岁。因左手拇指伸侧出现结节10天,于2009年8月来我科就诊。半月前患者因清理羊蹄不慎将左手拇指伸侧划伤,10天前,于伤口缝合处出现3个米粒大丘疹,紫红色,质硬,逐渐增大。无痛痒等自觉症状。体检：各系统检查无明显异常。皮肤科情况：左手拇指伸侧见一约5cm长线状瘢痕,其上见3个黄豆至花生大小紫红色结节质硬,顶端中心有脐凹和结痂,其外围有红色晕（图1）。患者拒绝行组织病理检查。诊断：羊痘。     

ORF. CLINICAL AND EPIDEMIOLOGICAL STUDY

Twenty eight human cases of orf were studied from clinical and epidemiological points of view. Most of the patients were shepherds who were inoculated from infected animals during all seasons of the year. Typical lesions of different stages of orf were located on the hands, and were accompanied by local symptoms such as pain, pruritus, lymphangitis and adenitis, or less frequently by systemic symptoms such as fever or malaise. Two cases developed erythema multiforme, one developed erysipelas and another a papulovesicular eruption. Tzanck test may contribute to the diagnosis. The course of the disease can not be influenced by antibiotics, and only measures of local hygiene are recommended, except in complicated cases.     

Immune responses of patients to orf virus infection

Orf is a disease of sheep and goats which is caused by a parapox virus. It can be transmitted to human.s, and is considered an occupational hazard by those handling sheep. In this paper we present the first report of both cell-mediated and humoral immune responses to naturally acquired orf virus infection in humans. Lymphoproliferative responses of peripheral blood mononuclear cells of patients to an orf virus antigen were vigorous soon after infection, but rapidly declined. Orf virus antibody levels, detected by KLISA, were shown to rise during infection. Western blot analysis confirmed this, and demonstrated that the antibody produced in response to the infection was directed against the 40-kDa viral surface tubule protein. Where direct comparisons were possible, the immune response of humans to orf virus infection was similar to that previously reported for sheep. Evidence was obtained suggesting that prior exposure to vaccinia virus (smallpox vaccination) provided no protection from subsequent orf virus infection. In addition, orf virus infection did not enhance immune responses to vaccinia virus antigens.     

Rapid improvement of human orf (ecthyma contagiosum) with topical imiquimod cream: report of four complicated cases

Orf is a zoonosis caused by an epitheliotropic DNA parapox virus. Human orf is a generally benign, self-limiting condition that usually regresses in 6-8 weeks without specific treatment. However, it may be accompanied by local symptoms including pain, pruritus, lymphangitis and axillary adenitis, or less frequently by systemic symptoms such as fever or malaise. Furthermore, it may be complicated by erythema multiforme, Stevens-Johnson syndrome, erysipelas, generalized mucocutaneous eruption, toxic erythema, eyelid oedema and giant, persistent or recurrent lesions in immunocompromised patients. Imiquimod, a potent topical immune response modifier, enhances both the innate and acquired immunity by stimulation of immune system cells resulting in local antiviral, antitumour and immunoregulatory activity. We present, for the first time, four complicated cases of orf successfully treated by topical imiquimod resulting in rapid regression of both orf and associated lesions. Two of the cases were complicated with erythema multiforme, one with recurrent eyelid oedema, and another had giant orf associated with axillary lymphadenitis. We suggest that topical imiquimod may be an effective and safe therapy for complicated orf cases.     

Human orf. A diagnostic consideration?

We saw four unrelated cases of human orf infection over a 3-month period. Each patient had a clear-cut history of contact with sheep and developed a characteristic painful pustular lesion on the hand. There were no significant systemic symptoms. Examination of an aspirate by electron microscopy confirmed the diagnosis. The lesions resolved spontaneously within 6 weeks. Human orf infection occurs in North America, and although seldom reported, it should be considered in the diagnosis of cutaneous lesions in patients who have exposure to animals associated with it.     

C10orf99下调对银屑病角质形成细胞LCN2表达的影响

目的:本研究旨在明确脂质运载蛋白2(LCN2)在银屑病细胞模型和动物模型中的表达水平及检测新炎症因子C10orf99下调对于银屑病角质形成细胞中LCN2表达水平的影响。方法:使用咪喹莫特乳膏构建银屑病小鼠模型，明确LCN2在该模型中的表达情况；体外培养HaCaT(人永生化角质形成细胞株),使用IL-1α、IL-17、IL-22、TNFα及OSM联合干预以构建银屑病细胞模型，明确LCN2在该银屑病模型中的表达水平；采用慢病毒转染方式敲低HaCaT中C10orf99的表达，采用反转录聚合酶链反应(RT-PCR)和蛋白质免疫印迹(Western Blot)检测C10orf99下调后银屑病HaCaT中LCN2的表达水平。结果:LCN2高表达于银屑病细胞模型及动物模型中。此外，C10orf99敲低下调了银屑病细胞模型中LCN2的表达量。结论:C10orf99可以通过调控LCN2的表达参与银屑病的发生发展。     

Orf: a family with unusual complications

Three members of a farming family and their local postman contracted orf. One of those affected had had no direct contact with infected sheep. Two ofthe family developed a widespread papulo-vesicular eruption of the skin and mucosae with pyrexia, malaise and lymphadenopathy lasting 4–5 weeks. The eruption did not resemble erythema multiforme or the toxic er5T:hemas usually associated with this infection.     

Alopecia and Hypotrichosis as Characteristic Findings in Woodhouse‐Sakati Syndrome: Report of a Family with Mutation in the C2orf37 Gene

Woodhouse‐Sakati syndrome (WSS) is a rare autosomal recessive disorder characterized by alopecia, hypogonadism, diabetes mellitus, intellectual disability, sensorineural deafness, extrapyramidal signs, and low insulinlike growth factor 1 levels. Inter‐ and intrafamilial phenotypic variability have been reported. Mutations in the C2orf37 gene cause WSS. The present report describes the clinical signs and symptoms of three affected siblings from a consanguineous Bedouin family from Kuwait. Direct sequencing of the C2orf37 gene revealed that the c.436delC (p.Ala147Hisfs*9) mutation was present in a homozygous state in all affected siblings and in a heterozygous state in the parents and a healthy sister. Nine C2orf37 mutations causing WSS have been identified. This family shared the mutation reported earlier in Saudi families and families of Bedouin tribes from Qatar and Israel. No phenotypic or genotypic correlation has been observed. Despite the great phenotypic variability of WSS, hypotrichosis has been observed in all individuals with WSS reported. This condition has not been reported in the dermatologic literature. WSS should be included in the differential diagnosis of syndromic congenital hypotrichosis.     

男性泌尿生殖道感染非淋病奈瑟菌的毒力相关基因检测

目的检测男性泌尿生殖道分离的非淋病奈瑟菌毒力相关基因,探讨非淋病奈瑟菌的致病机理。方法采用PCR扩增和核苷酸序列分析技术,检测从男性泌尿生殖道感染患者生殖道分离的6个菌种12株非淋病奈瑟菌的毒力相关基因orf1,nspA,PIA,PIB,opa,iga,pilE。结果 12个分离菌株中8株(检出率66.67%)检出毒力相关基因,其中orf1的阳性率为25.00%(3/12),opa为25.00%(3/12),PIB为16.67%(2/12),nspA为8.33%(1/12),各菌株均未检出PIA,pilE与iga。结论感染男性泌尿生殖道的部分非淋病奈瑟菌具有淋病奈瑟菌的毒力相关基因。但这些毒力相关基因并不是非淋病奈瑟菌引起男性生殖道感染的唯一致病因素,非淋病奈瑟菌的男性生殖道致病性可能与其黏膜寄生性等生物学特性有关。     

'Orf on the ear', in a patient with Guillain-Barré Syndrome

We report a case of orf on an ear in a patient admitted to hospital following the onset of Guillain-Barré syndrome. While the underlying causes of Guillain-Barré syndrome are not completely understood, immune stimulation appears to play a key role in pathogenesis. Any association between orf infection and Guillain-Barré syndrome has not been documented. A 22-year-old male sheep farmer, who was previously fit and well, presented to his local hospital with a 2-day history of distal upper and lower limb paraesthesia and weakness. He was transferred to a tertiary hospital where the diagnosis of Guillain-Barré syndrome was confirmed. History revealed that he had experienced a mild respiratory illness 3 weeks prior to presentation and an inflamed nodular lesion over his left ear, which had appeared 2 weeks prior to admission. Differential diagnoses of orf, atypical mycobacterial infection, subcutaneous mycosis and a squamous cell carcinoma were considered. Histopathology from a biopsy of the lesion was consistent with orf, which was confirmed by polymerase chain reaction testing. This case is of interest for two reasons: orf has not been described in association with Guillain-Barré syndrome, and orf on the ear is uncommon.