抗惊厥药所致药物超敏综合征19例临床特征分析

目的：探讨抗惊厥药所致药物超敏综合征（DHS）的临床特征。方法：回顾分析19例抗惊厥药所致DHS患者的临床表现、实验室检查、治疗方法、并发症及预后。结果：抗惊厥药所致DHS潜伏期长，皮损形态多样，以发疹型为主，常伴有紫癜样斑疹、皮肤肿胀及反复脱屑，多有发热、黏膜损害、浅表淋巴结增大及血常规异常。脏器受累以肝脏为主，肾脏次之。糖皮质激素治疗有效。结论：DHS为具有特征性表现的临床综合征，病程较长，早期、足量地应用糖皮质激素有助于预后的改善。     

原发性系统性淀粉样变病1例

报告1例原发性系统性淀粉样变病。患者男，39岁。1年前肩关节突然出现酸痛，症状渐渐加重，双手掌皮肤发硬，肢体上抬及下蹲困难，舌不能外伸，吞咽时有梗阻感。曾经患有胸椎椎体骨髓瘤。皮肤科检查示面颈部、双侧腋下、腹部、阴茎、双大腿内侧泛发对称性的蜡样半球形丘疹，有融合，呈肤色或琥珀色。口腔黏膜肥厚，舌弥漫性浸润、质硬，呈巨舌。皮损组织病理检查示表皮萎缩，真皮与皮下组织淀粉样物质沉积，甲基紫染色阳性，诊断为原发性系统性淀粉样变病。给予泼尼松和雷公藤治疗，症状明显改善。     

家族性良性天疱疮误诊1例

患者男,48岁.因肛周、外阴、腹股沟反复出现红斑、瘙痒30年,于2007年3月5日至第二军医大学长征医院皮肤科就诊.患者自1977年开始肛周出现红斑、瘙痒,在当地医院诊治,外用氟轻松等药膏好转,但病情反复.     

阿维A治疗寻常性银屑病120例

为了解阿维A胶囊(商品名方希)治疗寻常性银屑病的临床疗效及安全性,中国医学科学院皮肤病医院、上海长征医院及第三军医大学西南医院于2005年8月至2006年3月共同对120例寻常性银屑病进行临床观察,并比较分次给药与一次性给药在临床疗效及安全性方面的差异.     

加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.     

加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.     

新生隐球菌不同变种所致小鼠原发性皮肤感染的比较

目的：探讨新生隐球菌不同变种在原发性小鼠新生隐球菌皮肤感染中的作用。方法：按照我们建立的原发性皮肤隐球菌感染模型的方法，将新生隐球菌新生变种标准野生株B3501与格特变种标准株ATCC32609分别皮内接种于免疫抑制与非抑制的BALB／c小鼠，皮损真菌培养与组织病理检查确证感染。观察2种隐球菌感染的病程，比较皮损形成与消退的平均时间。结果：2种变种的新生隐球菌皮下接种于BALB／c小鼠后，可以在免疫抑制与非抑制的BALB／c小鼠皮肤上产生丘疹、结节、溃疡、传染性软疣样皮损，皮损可以自愈，真菌培养与病理确证为隐球菌感染。2种菌株只在免疫正常小鼠的皮损形成时间上存在差异。结论：新生变种与格特变种的新生隐球菌均可以造成BALB／c小鼠相似的皮肤感染。推测2种变种对原发性皮肤感染的致病力可能无差异，新生变种发病较多可能与其分布有关。     

用流式细胞术研究中药对白念珠菌的抗菌作用

目的 应用流式细胞仪测定中药有效成分小檗碱、黄芩甙、丁香酚和姜黄素对白念珠菌细胞周期的影响。方法 将白念珠菌培养在含不同药物浓度的YEPD培养基中，培养48h，流式细胞仪检测细胞生长周期、DNA荧光强度和细胞体积大小。结果 4种抗真菌中药有效成分对白念珠菌细胞生长周期有不同程度的影响，随着药物浓度的增高，其处于S-G2-M期的细胞比率越低，亦即细胞分裂受抑制越明显。在含药物培养基中生长的真菌细胞的荧光强度减弱，反映了细胞DNA片段的丢失，并随着药物浓度的升高，荧光强度减弱越明显，反映细胞体积大小、折光度和颗粒度的散点图向下和向左移动，随着药物浓度的升高，这种图形变化越明显。结论 中药单体通过抑制细胞分裂发挥抗真菌作用，流式细胞仪可用于抗真菌药物敏感性测定。     

乳房部位局限性硬皮病1例

患者女,21岁。因右侧乳房部位皮肤变硬、紧绷感半年,于2003年1月14日就诊。患者半年前发现右侧乳房有一黄豆大红斑,自觉紧绷感,无痛痒,此后皮损逐渐变硬。近2个月皮损范围扩大,呈淡黄色。体检:一般情况好,关节活动自如,无雷诺现象,系统检查无异常。皮肤科情况:右侧乳房内上方见2cm×5cm淡黄色斑片,表面有蜡样光泽(图1A),触之有皮革样硬度。患者平素身体健康,家族中无类似疾病病史。实验室检查:血、尿、粪常规无异常,肝肾功能、血沉、胸部X线片和腹部B超检查均未见异常。皮肤组织病理检查:表皮轻度萎缩,基层色素增加,真皮胶原纤维均质化,呈…     

皮肤T细胞淋巴瘤并发原发性皮肤曲霉病1例

报道1例皮肤T细胞淋巴瘤患者并发上曲霉引起的原发性皮肤曲霉病，患者女性，41岁，左胫前2处相连的巨大黑痂，刮取物直接镜检有透明的分枝分隔菌丝，组织病理检查见较多粗细均匀的有隔菌丝，菌丝呈Y型分枝，菌种鉴定为土曲霉。