透明细胞棘皮瘤1例

患者男,45岁。右上臂结节3个月余,破溃、结痂1个月。皮损组织病理示:表皮角化过度,棘层显著肥厚,棘层内见较多大而透明的细胞团块;表皮嵴不规则延长、增宽处胞浆丰富,呈透明状,细胞间桥清晰可见,真皮浅层毛细血管扩张,血管周围见中性粒细胞为主的炎细胞浸润。PAS染色示透明细胞胞浆内有大量的糖原沉积。结合临床和组织病理特点诊断为透明细胞棘皮瘤。     

透明细胞棘皮瘤1例

报告1例透明细胞棘皮瘤。患者,女,38岁。左外踝上方结节5年余,破溃,结痂半年。患者组织病理检查显示：表皮轻度角化过度伴角化不全,棘层明显肥厚。肥厚的棘层内可见大量大而透明的细胞,胞浆丰富,胞质呈透明状,与两侧正常表皮分界清楚。细胞间可见大量中性粒细胞浸润,并形成munro微脓肿。真皮乳头内毛细血管扩张,血管周围可见以中性粒细胞为主的炎细胞浸润。肿瘤组织内可见大量汗管增生。结合临床和组织病理特点诊断为透明细胞棘皮瘤。     

透明细胞鲍温病1例

报告1例透明细胞鲍温病。患者女,52岁。左上胸部出现一黄豆大小红斑3年,缓慢增大至1 cm×2 cm,伴瘙痒、疼痛。皮损组织病理:表皮角化过度伴角化不全,棘层肥厚,棘细胞排列紊乱,可见角化不良细胞,部分细胞具有异型性,核大深染,可见散在病理性核分裂象,棘层上部的细胞胞质淡染,在核周呈明显空泡状,基底层完整,真皮浅层见慢性炎性细胞浸润。诊断:透明细胞鲍温病。手术切除。随访1年,无复发。     

皮肤角质粘贴技术与临床应用

皮肤最外面的表皮主要由角质形成细胞构成。从基底层、棘层、颗粒层、透明层到角质层是角质形成细胞的增殖、分化、移动、死亡和脱落的动态变化过程。电镜下，死亡细胞的胞膜内面附有不溶性蛋白质，使细胞膜坚固。     

透明细胞鲍恩病

报告1例透明细胞鲍恩病.患者女,64岁.下腹部暗红色斑块、结痂伴瘙痒10年.皮肤科检查:下腹部见一4 cm×5 cm不规则暗红色斑,稍高出皮面,表面有黑褐色痂.皮损组织病理检查示:表皮角化过度伴角化不全,棘层增生肥厚,其中可见核大浓染的细胞、角化不良细胞及核分裂象,棘层上部细胞胞质丰富淡染透亮.诊断:透明细胞鲍恩病.     

表皮内透明细胞肿瘤

图1的皮损组织病理特征为：①表皮角化过度，伴有角化不全，棘层肥厚。②表皮的大部分由胞质透明的细胞组成，细胞排列紊乱，细胞大小不一，形态各异，部分细胞未见细胞核，或细胞核偏于一侧，可见双核或多核细胞及核丝分裂像。③表皮下1/5（包括基底细胞层）未见异常。④真皮中上部血管扩张，有以淋巴细胞为主的炎性细胞浸润。免疫组化染色结果示，表皮内透明细胞细胞角蛋白（CK）阳性，HMB45，S-100蛋白及CEA阴性。     

透明细胞棘皮瘤1例

患者男,40岁。左足内侧两处褐色斑块10年余,门诊行手术切除,皮损组织病理示:角化不全,棘层肥厚,皮损部位细胞胞浆较透明,与正常角质细胞界限明显,PAS染色阳性,具有透明细胞棘皮瘤典型的病理表现。     

表皮松解性角化过度鱼鳞病1例

患儿男,22天。出生时周身皮肤潮红、大疱,伴脱屑。组织病理示角化过度,中度棘层肥厚,颗粒层和棘层上部细胞内透明角质颗粒粗大、深染而不规则,明显的空泡形成,见网状变性、表皮内水疱和棘层松解细胞,棘层下部和基底细胞层无异常。诊断:表皮松解性角化过度鱼鳞病。     

手指暗褐色斑块——伴表皮松解性角化过度的先天性黑素细胞皮内痣

诊断:伴表皮松解性角化过度的先天性黑素细胞皮内痣(incidental epidermolytic hyperkeratosis in a congenital melanocytic nevus). 皮损组织病理检查:表皮角化过度与角化不全在水平方向交替出现,颗粒层增厚,棘层肥厚,颗粒层及棘层上部细胞胞质透明、空泡化,真皮内见境界清楚的痣细胞巢.     

透明细胞棘皮瘤一例

34岁男性患者,右大腿出现无痛性结节1年余。皮肤科检查:右侧大腿前方可见一约绿豆大小红色圆顶丘疹,其上及其周边可见薄层细小鳞屑附着,无触痛。皮损组织病理示:角化过度伴角化不全,棘层增厚,表皮突延长,增生的棘细胞胞质淡染,与周围细胞分界清楚。诊断:透明细胞棘皮瘤。手术完整切除后随访半年无复发。     

In vitro and in vivo interactions of drugs used in multidrug therapy in leprosy.

Interactions of different drugs commonly used in multiple drug therapy were evaluated using both in vitro culture (cell-free as well as macrophage) system and mouse footpad. No additive effects were obtained in the in vitro system when dapsone was combined with either rifampicin or clofazimine, while a strong antagonism was observed when clofazimine was combined with rifampicin but not with rifabutin. In the mouse footpad system, a strong synergism was obtained when clofazimine was combined with either rifampicin or rifabutin, but significant antagonism was observed with the combination of clofazimine and dapsone.     

Hypergammaglobulinemic Purpura Associated with Sjögren's Syndrome and Chronic C Type Hepatitis

Although hypergammaglobulinemic purpura usually occurs secondarily on the lower legs in several disorders, purpura has also recently been reported to be associated with chronic C type hepatitis (HCV). To define the differences in the clinical, histological and laboratory findings and the prognosis of hypergammaglobulinemic purpura associated with those two disorders, we examined ten patients with hypergammaglobulinemic purpura, 6 patients with hypergammaglobulinemic purpura associated with Sjögren's syndrome (SjS) and 4 patients with hypergammaglobulinemic purpura with chronic C type hepatitis. Five of 6 patients with SjS were female. Attacks of purpura occurred in the pretibial area in all cases. Triggering factors included long walks and prolonged standing. The mean duration of attacks was 6.4 days. No systemic manifestations were associated. Anti-Ro/SS-A and anti-La/SS-B antibodies were expressed in one case. Spontaneous regression was noted in all cases; however, recurrence was noted in one. On the other hand, all the 4 patients with hypergammaglobulinemic purpura associated with HCV were men. Purpura was indurated in a few cases. Involved sites included the knee, forearm, abdomen and thigh in addition to the lower leg. The mean duration of attacks was 12.6 days. Recurrent purpura was noted in one case. Cryoglobulin was positive in three cases. In one patient with severe recurrent purpura, attacks stopped with prednisolone 10 mg/day. Histologically, leukocytoclastic vasculitis was detected in three cases associated with SjS and two cases with HCV. In conclusion, hypergammaglobulinemic purpura associated with HCV appears to occur unilaterally with a sex predilection for men and the manifestations last longer than those associated with SjS. Severe palpable purpura was also noted in association with HCV; systemic prednisolone resulted in good control.     

CELL-MEDIATED IMMUNITY IN MYCOSIS FUNGOIDES*

The immunologic status of patients with mycosis fungoides in various stages was studied by testing skin reaction to PPD, by sensitization with topical application of 2,4 dinitrochlorbenzene, and by in vitro lymphocyte transformation test with PHA. Skin reaction to PPD was depressed in 7 of 8 patients and sensitization to dinitrochlorbenzene was impaired in 6 of 8 patients. In PHA-induced lymphocyte transformation, when autologous serum was added to the culture medium, the transformation rate was below normal in 7 of 8 patients. When autologous serum was replaced by normal serum, the rate was usally improved and, in 3 patients, recovered to normal range. However, in the remaining 4 patients of whom 3 were at the infiltrative plaque stage, the rate was still below normal (21.5–36.6%). It is suggested that at least in 3 patients there was a serum factor which lymphocyte transformation by PHA. In 2 patients with poikiloderma atrophicans vasculare and parapsoriasis en plaques, no influence of serum was noted.     

Increased platelet aggregation in psoriasis

Platelet aggregation was measured in fasting platelet-rich plasma in 25 psoriatics, 6 of whom were diabetic, 50 normal controls, and 24 diabetics. The aggregating agents employed to induce platelet aggregation included ADP, epinephrine and collagen. Platelet aggregation was significantly increased in psoriatics compared with normal controls. An additive effect was observed when diabetes was associated with psoriasis, with platelet aggregation being further increased by ADP. Platelet aggregability was re-evaluated in 7 psoriatics after they presented with clearing of the rash. The increased platelet aggregation with ADP and epinephrine was significantly reduced when the skin lesions had cleared.     

Microbiological and serological study of non-gonococcal urethritis with special reference to Mycoplasma genitalium.

Twenty-two men with non-gonococcal urethritis (NGU), 19 with gonorrhoea, and 22 without urethritis were examined for various micro-organisms. Chlamydia trachomatis was isolated from the urethra of 45% of men with NGU, 21% of those with gonorrhoea, but from none without urethritis. Ureaplasma urealyticum but not Mycoplasma hominis was recovered from a larger proportion of men with NGU than from those in the other groups. M genitalium was isolated presumptively from 32% of men with NGU, 12% of those with gonorrhoea, from 10% of men without urethritis, and from 42% of the men with NGU from whom chlamydiae were not isolated. U urealyticum, M hominis, and M genitalium were sought also in the rectum of men in the three groups. The first two micro-organisms were confined almost exclusively to homosexual men, whereas M genitalium was apparently not restricted in this way and was found particularly in this site in men with NGU. The latter mycoplasma may be a resident primarily of the intestinal tract. A fourfold or greater rise in the titre of antibody to C trachomatis was detected in about 20% of the patients with NGU, but not in other men. A similar rise in the titre of antibody to M genitalium was seen in 29% of the patients with NGU and in 12% of those without urethritis. A concomitant antibody response to M pneumoniae, which is antigenically related to M genitalium, was seen in one patient only. The responses to M genitalium suggest infection by this mycoplasma and indicate the need for further serological studies.     

Glucose tolerance test in leprosy

Glucose tolerance test was carried out in 43 cases of leprosy. They included cases of tuberculoid, borderline, lepromatous leprosy and those with lepra reaction. It was observed that normal curve was common in tuberculoid leprosy. Flat glucose tolerance curve was observed in borderline and lepromatous leprosy. However, the diabetic curve was common in Lepra reaction. Fasting blood sugar was low in lepromatous leprosy and it tended to be marginally high in lepra reaction. Normal GTT response was observed in those with duration of disease between 0-6 months, flat curves in those with duration of disease between 7-12 months while diabetic curve was more common in those with disease duration of more than 2 years.     

Leukocyte migration in vivo and in vitro in patients with psoriasis

Leukocyte migration in vivo was studied with a skin chamber technique in 21 patients with active psoriasis vulgaris and 18 with cleared psoriasis vulgaris. Measuring over 24 h, no difference was found between healthy volunteers and most patients with active psoriasis, although a subgroup of patients with long-lasting relapses showed subnormal migration values. In patients with cleared psoriasis on the other hand the in vivo leukocyte migration values were increased. In addition, leukocyte migration in vitro under agarose was studied, but no difference was found between healthy controls and patients with psoriasis, active or cleared.     

Spiradenocarcinoma with low-grade basal cell adenocarcinoma pattern: report of a case with varied morphology and wild type TP53

We present a patient with a 2-cm spiradenocarcinoma of the left arm resembling low-grade salivary gland basal cell adenocarcinoma. In addition to showing attributes of conventional spiradenoma, the benign component showed prominent areas of cystic change with focal apocrine differentiation, glands with and without mucinous differentiation, clear cell change and focal adenoid cystic carcinoma-like areas. The malignant component was composed of nodules of basaloid cells arranged in sheets with variable tendency to luminal differentiation. The nuclear atypia was low-grade, and the mitotic index was high in the malignant component (to 8/10 high power fields). Immunohistochemically, there was diffuse but variable positivity for cytokeratin 7 in both the benign and malignant components. Epithelial membrane antigen was focally positive, highlighting cells with ductal (luminal) differentiation. Expression of p63 was observed in 50 and 80% of the cells in the benign and malignant components, respectively. Calponin was negative. The proliferative index (MIB-1/Ki-67) was <3% in the benign component and up to 10% in the malignant component. Although the malignant component displayed patchy areas with nuclear p53 immunoreactivity with variable intensity, no mutation in the TP53 gene was identified.     

1%环吡酮胺软膏治疗浅部真菌病的疗效观察

目的 :评价环吡酮胺软膏治疗皮肤浅部真菌病的疗效和安全性。方法 :1 3 0例浅部真菌病分成二组 ,治疗组外用环吡酮胺软膏 ,对照组外用特比萘芬乳霜 ,体股癣疗程 2周 ,手足癣疗程 4周。结果 :治疗组 66例中治愈 42例 ,显效 1 8例 ,临床总有效率 90 91 % ,真菌清除率 89 3 9% ;对照组总有效率为 92 1 9% ,真菌清除率为 90 63 % ,两组疗效差异无显著性 (P >0 0 5 )。结论 :环吡酮胺软膏治疗皮肤浅部真菌病疗效显著且安全     

Chromoblastomycosis in India

BACKGROUND: Four patients with chromoblastomycosis are presented. An additional 30 infected Indian patients are reviewed. RESULTS: These 34 patients ranged in age from 12 to 80 years with a male to female ratio of 5.8 : 1. Onset before the age of 20 years was seen in 24% of cases which was comparatively high. Culture was positive in 72% of cases and sclerotic bodies were observed in 84% of cases. A relatively higher prevalence (15%) of Fonsecaea compacta was observed. Unusual cutaneous sites afflicted were the penile shaft, vulva, and ala of the nose, and unusual extracutaneous spread was seen in the pleural cavity, ileocecal region, laryngotracheal area, and tonsils. Extracutaneous involvement was seen in 24% of cases. Overlapping infection with another fungus, Geotrichum candidum, was seen in one case. CONCLUSIONS: Combination therapy with two azoles was attempted with some success for clinical cure.