皮肤链格孢病

皮肤链格孢病是由链格孢引起的皮肤真菌病，可分为表皮型和真皮型，主要侵犯皮肤，偶有报告累及皮下组织邻近骨骼。至１９９４年共报告７０余例，随着肾上腺皮质激素和免疫抑制剂应用的增多，其发病率在不断增加，深部感染机会增多，可通过真菌培养，组织病理学检查确诊，表皮型外用匹马利星等珂治愈，真皮型治疗比较困难，二性霉素Ｂ咪康唑皮损内注射，氟康唑，伊曲康唑或结合外科治疗都显示了较好的疗效。     

皮肤免疫、皮肤亚健康与皮肤能量的思考

谈到皮肤能量，我觉得应该先从皮肤免疫功能和皮肤亚健康谈起。     

黑素细胞与皮肤免疫

黑素细胞是人体皮肤中一种能够合成黑色素的细胞,它通过合成黑色素,保护皮肤免受紫外线辐射损伤。近年来研究结果表明,黑素细胞具有免疫学潜能,是皮肤免疫系统的重要参与者。     

免疫检查点在皮肤肿瘤中的研究进展

近年来研究发现,免疫检查点(CTLA-4、PD-1、TIM-3、TIGIT和LAG-3等)表达于免疫细胞表面,与肿瘤的增殖、侵袭和转移紧密相关。免疫检查点抑制剂,已广泛地应用于皮肤肿瘤的临床治疗,并取得了显著的疗效。本文将从免疫检查点的类型、作用机制、其在皮肤肿瘤中的研究及临床应用等方面进行系统综述。     

皮肤靶向基因免疫

基因免疫是指将编码特定抗原的ＤＮＡ序列克隆入合适的真核表达质粒中,再将重组质粒导入宿主体内,经组织细胞摄取、表达蛋白质,并诱导机体产生针对编码抗原的特异性体液和细胞免疫反应。鉴于表皮朗格汉斯细胞和真皮树突细胞在诱导细胞免疫反应中的重要作用以及皮肤组织在生理、生物和免疫学等方面的一些特点,皮肤细胞已被认为是基因免疫中的一种理想靶细胞,皮肤靶向基因免疫技术有望在人类疾病,特别是感染性疾病发挥重要作用。     

沙眼衣原体感染免疫和DNA疫苗的免疫效应

沙眼衣原体是沙眼和性传播疾病的主要病原体之一,沙眼衣原体感染还使HIV-1更易传播。沙眼衣原体感染宿主能诱发机体保护性的体液免疫和细胞免疫,在初次感染,是细胞免疫而不是抗体起主要保护作用;对于继发感染,保护性免疫高度依赖Th1型CD4^ T细胞,并且诱导迟发型超敏反应。发展疫苗是预防沙眼衣原体感染的有效途径。     

皮肤靶向基因免疫

基因免疫是指将编码特定抗原有DNA序列克隆人合适的真核表达质粒中,再将重组质粒人宿主体内,经组织细胞摄取、表达蛋白质,并诱导机体产生针对编码抗原的特异性体液和细胞免疫反应。鉴于表皮朗格汉斯细胞和真皮树突细胞在诱导细胞免疫反应中的重要作用以及皮肤组织在生理、生物和免疫学等方面的一些特点,皮肤细胞已补认为是基因免疫中的一种理想靶细胞,皮肤靶向基因免疫技术有望在人类疾病,特别是感染性疾病发挥重要作用。     

伊曲康唑治疗皮肤粘膜真菌病临床疗效观察

伊曲康唑（itraconazole）商品名斯皮仁诺是比利时杨森公司90年代推出的广谱抗真菌药。我科采用短程疗法治疗体股癣、手足癣。花斑癣及粘膜真菌病等取得满意效果，现总结如下。1临床资料门诊和病房随机选择通过临床和真菌学检查确诊的体股癣、手足癣、念珠菌病（包括念珠菌性龟头炎、阴道炎、口腔念珠菌病）、汗斑及头癣患者共152例。其中男93例、女59例。最小年龄4岁、最大年龄75岁，4－14岁儿童13例。病程最长10年，最短3天。工人53例，干部40例、学生19例农民12例，其它职业28例。60％的患者既往外用过抗真菌药或皮炎平膏。30％的患者合…     

神经系统、免疫与皮肤的关系

皮肤内神经纤维分泌神经介质,表达神经激素;皮肤细胞也可分泌神经介质和神经激素,表达受体。这些物质可调节表皮和真皮细胞功能。短时间存在于皮肤内的免疫细胞(即:巨噬细胞和淋巴细胞)由神经介质通过受体进行调节。皮肤病,特别是炎症性反应使神经免疫皮肤系统变为不稳定,银屑病尤为典型。这种不稳定性可能为继发性,也可能由炎症过程的诱发和维持所致。神经系统、免疫与皮肤相互影响,紧密联系。本文提出了一个新概念:神经免疫皮肤系统。     

Cutaneous Fungal Infections in the Oncology Patient

There are two main types of fungal infections in the oncology patient: primary cutaneous fungal infections and cutaneous manifestations of fungemia. The main risk factor for all types of fungal infections in the oncology patient is prolonged and severe neutropenia; this is especially true for disseminated fungal infections. Severe neutropenia occurs most often in leukemia and lymphoma patients exposed to high-dose chemotherapy. Fungal infections in cancer patients can be further divided into five groups: (i) superficial dermatophyte infections with little potential for dissemination; (ii) superficial candidiasis; (iii) opportunistic fungal skin infections with distinct potential for dissemination; (iv) fungal sinusitis with cutaneous extension; and (v) cutaneous manifestations of disseminated fungal infections. In the oncology population, dermatophyte infections (i) and superficial candidiasis (ii) have similar presentations to those seen in the immunocompetent host. Primary cutaneous mold infections (iii) are especially caused by Aspergillus, Fusarium, Mucor, and Rhizopus spp. These infections may invade deeper tissues and cause disseminated fungal infections in the neutropenic host. Primary cutaneous mold infections are treated with systemic antifungal therapy and sometimes with debridement. The role of debridement in the severely neutropenic patient is unclear. In some patients with an invasive fungal sinusitis (iv) there may be direct extension to the overlying skin, causing a fungal cellulitis of the face. Aspergillus, Rhizopus, and Mucor spp. are the most common causes. We also describe the cutaneous manifestations of disseminated fungal infections (v). These infections usually occur in the setting of prolonged neutropenia. The most common causes are Candida, Aspergillus, and Fusarium spp. Therapy is with systemic antifungal therapy. The relative efficacies of amphotericin B, fluconazole, itraconazole, voriconazole, and caspofungin are discussed. Recovery from disseminated fungal infections is unlikely, however, unless the patient's neutropenia resolves.     

抗C_3ELISA法检测皮肤血管炎病人血清CIC

采用抗Ｃ３ＥＬＩＳＡ和ＤＩＦ技术分别检测了４８例皮肤血管炎病人血清内３种ＣＩＣ和皮损内３种ＴＩＣ。结果表明ＣＩＣ与ＴＩＣ有密切的关系；ＴＩＣ主要来源于血液，不同疾病血清ＣＩＣ的类型不一样。血清ＣＩＣ水平与病情活动性有一定的关系。     

Cutaneous infection due to acremonium

We report an immunocompromised patient who developed a cutaneous infection caused by acremonium which is a rare opportunistic fungi. With the increasing number of immunocompromised patients opportunistic fungal infection can cause serious diseases and early recognition is mandatory.     

Cutaneous Osteomas: A Clinical and Histopathologic Review

Summary In 20000 consecutive skin biopsies we found 35 cutaneous osteomas. Ten were primary while 25 appeared secondary to another abnormality. Associated with ossification were Malherbe's calcifying epithelioma, basal cell carcinoma, nevus cell nevus, appendageal and fibrous proliferations, inflammation, trauma, and calcification. Cutaneous bone formation appears to be either a hamartomatous or metaplastic phenomenon.Dedicated to Prof. Dr. Dr. med. h.c. Oscar Gans on his 90th birthday, in appreciation for his support of German-American cooperation in dermatologyDr. W. Burgdorf was a guest in the Department of Dermatology and Venerology, J. W. Goethe University, from 1 January through 30 June 1977Offprint requests to: Prof. Dr. Th. Nasemann (address see above)     

In Situ Hybridization is a Valuable Diagnostic Tool in Cutaneous Deep Fungal Infections

Dimorphic fungal infections (histoplasmosis, blastomycosis, coccidiomycosis, and cryptococcosis) can occur in immunocompromised and healthy individuals. Cutaneous involvement is often secondary and may be the presenting sign of systemic disease. These ominous infections are frequently clinically indistinct and their prognosis is influenced by their timely diagnosis and treatment. Morphological differentiation between these organisms is not definitive and tissue cultures represent the diagnostic gold standard in current day practice. However, not uncommonly tissue cultures are not obtained and merely represent an afterthought in seemingly unsuspecting cases. Furthermore, when performed, they may take several days to weeks for completion. In situ hybridization (ISH) utilizing oligonucleotide probes directed against fungal ribosomal RNA represents a rapid and accurate assay for the diagnosis of dimorphic fungi in paraffin‐embedded tissue sections. We present 7 patients in whom ISH both prospecitively and retrospectively confirmed the presence of a cutaneous infection (2 histoplasmosis, 2 blastomycosis, 1 coccidiomycosis, 2 cryptococcosis). In all of the skin sections analyzed, dimorphic fungi were morphologically apparent but not diagnostically discernable. In summary, ISH represents a valuable tool in the prompt diagnosis of cutaneous deep fungal infections.     

紫外线辐射的尿刊酸对小鼠迟发型超敏反应抑制的研究

建立了以小鼠耳厚的增加反映对ＤＮＰ６－ＯＶＡ抗原的迟发型超敏反应（ＤＴＨ）的动物模型，以观察经紫外线辐射的顺式尿刊酸（ｃｉｓ－ＵＣＡ）对小鼠ＤＴＨ的抑制程度。结果注射ｃｉｓ－ＵＣＡ的小鼠耳厚增加与对照组有显著性差异（尸＜０．０１），而注射反式尿刊酸（ｔｒａｎｓ－ＵＣＡ）的小鼠耳厚增加与对照无显著性差异（Ｐ＞０．０５）。表明在对ＤＮＰ６－ＯＶＡ的免疫应答中，ｃｉｓ－ＵＣＡ能够抑制细胞免疫反应。     

皮肤Rosai-Dorfman病的研究进展

【摘要】 Rosai?Dorfman病是一种罕见的组织细胞增生性疾病,病因及发病机制尚不明确,可能与感染和免疫功能紊乱引起的信号转导通路激活及炎症反应有关。仅有皮肤受累者称为皮肤Rosai?Dorfman病。皮损组织病理可见真皮大量组织细胞伴淋巴细胞、浆细胞浸润,在组织细胞的胞浆内可见吞噬的完整淋巴细胞,称为伸入运动。免疫组化示组织细胞阳性表达CD68和S100,不表达CD1a。CRDD的治疗可采用手术切除、局部治疗及系统治疗,部分患者皮疹可自行消退,预后较好。     

抗磷脂综合征的皮肤表现

抗磷脂综合征是一种以反复动静脉形成、流产、血小板减少及血抗磷脂抗体持续阳性为特征的系统性自身免疫性疾病。该综合征可以累及包括皮肤在内的全身任何器官。临床上皮肤表现可作为其首要症状,多见于网状青斑、Sneddon综合征、白色萎缩、皮肤溃疡坏死、斑状萎缩和Degos病等。掌握抗磷脂综合征的皮肤表现对其早期诊断、及时治疗极为关键。