妊娠诱发结节性红斑4例

妊娠诱发结节性红斑４例张堂德，曹化琴，周冼苡，梁应权第一军医大学珠江医院皮肤科（邮政编码５１０２８２）４例年龄分别为２２、２８、２４、２５岁，分别于妊娠第６、８、６、１１周在小腿伸侧出现结节性红斑，例１、例４分别持续４、３周皮损消退，例２持续２周无好...     

变应性亚败血症性红斑2例

例１女，９岁。以反复发热，伴四肢关节痛，皮肤红斑１个月入院。皮疹随体温上升增多，体温下降减少，反复出现间歇热，曾用“氢化考的松”缓解，既往有慢性扁桃体炎史。体检：Ｔ３８．７℃，ＢＰ１２．０／６．０ｋＰａ，Ｐ９０次／ｍｉｎ，满月脸，心肺等系统无异常。面...     

温州地区尖锐湿疣组织人乳头瘤病毒检测及型别分析

用人乳头瘤病毒（ＨＰＶ）通用引物（ＧＰ）及型特异性引物（ＳＰ）６、１１、１６、１８对４２例尖锐湿疣（ＣＡ）组织和４８例对照组进行多聚酶链反应（ＰＣＲ）检测。结果：ＣＡ组织五组引物扩增阳性率分别为８５．７％（３６／４２）、７３．８％（３１／４２）、１９．１％（８／４２）、２．４％（１／４２）、４．８％（２／４２），多重型别阳性率为１１．９％（５／４２）；对照组ＨＰＶ阳性率为６．３％（３／４８）。表明本地区ＣＡ以ＨＰＶ６型感染为主     

皮肤血管炎患者血浆TXB26—Keto—PGF1α水平的检测

目的 探讨皮肤血管炎患者血浆ＴＸＢ２、６－Ｋｅｔｏ－ＰＧＦ１α水平的变化与病情的关系。方法 采用放免法对结节性红斑、慢性游走性结节性红斑、结节性血管炎患者治疗前后血浆ＴＸＢ２、６－Ｋｅｔｏ－ＰＧＦ１α含量进行了动态检测并与正常对照组进行对比。结果 皮肤血管炎患者血浆ＴＸＢ２水平在治疗前后与正常对照组差异无显著性意义,而６－Ｋｅｔｏ－ＰＧＦ１α在治疗前高于正常组,当皮损消退后其水平恢复正常。结论 地     

色素障碍性皮肤病

２０００１１８６ 手术合并药物治疗白癜风２８例／吴余乐（中国医科院皮研所）…／／中华皮肤科杂志．－１９９９，３２（４）．－２６９ 对进行期、稳定期白癜风患者实施手术合并药物治疗，取得较满意效果。总治愈率：薄刃厚皮片移植术稳定期９４．５％（５２／５５），进行期９１．７％（１１／１２），微小邮票皮片移植术进行期８３．３％（５／６）；单纯磨削术稳定期８９．４％（１７／１９），进行期７２．７％（８／１１）。术前准备：外用０．０５％卤美他松霜１个月以上。术后口服泼尼松１５～２０ｍｇ／ｄ１个月。拆线后继续外用…     

系统性红斑狼疮脑萎缩1例

患者女，１９岁。５个月来先后出现面部对称性红斑，光敏感，肩、肘、膝各关节游走性疼痛，于１９９６年４月４日入院。既往无癫痫史。家族中无癫痫及红斑狼疮患者。入院体检：Ｔ３６．３℃，Ｐ９６次／ｍｉｎ，Ｒ２４次／ｍｉｎ，ＢＰ１０／６ｋＰａ。系统检查未见异常。...     

胡萝卜素血症12例

１２例中，男６例，女６例；年龄８～１３岁，平均１１．５岁；１２例均为正常发育学龄儿童，一般情况良好，无先天性缺陷，既往无肝、胆疾病，未服阿的平及其它药物，系统检查无异常。１２例掌跖部位深度黄染，２例重者除巩膜、粘膜外全身皮肤均呈橘黄色。均无自觉症状。...     

麻风无痛性神经炎的早期发现及治疗

对２００例麻风现症和监测期病人进行３至３０个月的系统观察，发现无痛性神经为１２例（６．０％），涉及１４条神经，其中尺神经２条，腓总神经２条，面神经２条，胫神经８条。对所有病例用强的松标准方案治疗６个月，疗效按神经计为优７条（５０％），良２条（１４．３％），尚可４条（２８．６％），无效１条（７．１％）。感觉和运动功能的恢复率分别为６０％（６／１０）和６６．７％（４／６）（Ｐ＞０．０５）。本组所有接受     

麻风在FD MDT后复发的危险性

在１９８６－１９９５年间，于云贵川三省５９例共８，３０７名麻风病人完成了ＦＤ ＭＤＴ，之后每年进行监测得的平均复发率在ＭＢ是０．１５／１０００人，ＰＢ０．５５／１０００人年。ＦＤ ＭＤＴ前的未治组与经治组的复发率没有显著差异。ＭＢ中５名复发出现在监测的第４－７年；５名ＰＢ复发在ＦＤ ＭＤＴ后的４－５年，另有６名ＰＢ在５５年监测期后复发，未计算在复发率中。ＰＢ复发中，多数（６／１１）是原本应上ＭＢ廊     

粘膜疾病

２００１１０９８连理汤加味治疗口腔扁平苔藓临床观察／陈建灵（广东省中医院）／／湖北中医杂志．－２０００， ２２（８）．－２７ 党参２０ｇ，黄芪３０ｇ，干姜８ｇ，白术、茯苓、丹参各１５ｇ，桃仁１２ｇ，甘草 ６ｇ。水煎服，共服２次，１剂／ｄ。对照组用左旋咪唑５０ｍｇ，３次／ｄ，连服 ２天，停药 ５天。结果：治疗组４８例，痊愈５例，显效１２例，好转２５例，无效６例，总有效率为８７．５０％；对照组３０例，分别为２例、４例，１３例、１１例和６３．３３％。两组等级疗效比较差异有显著性（Ｐ＜０．０５）。表１参５（…     

Immunological evaluation of erythema nodosum in tularaemia

During two tularaemia outbreaks in the Bursa region of Turkey in 1991, a total of 98 patients were diagnosed and evaluated. Thirteen of these patients had erythema nodosum, which is accepted as a secondary skin manifestation. The patients with erythema nodosum, 21 patients without any skin lesions, and 20 healthy controls were studied. Comparable elevations of levels of IgG, IgA, and IgM were detected in the two tularaemia groups. There was no difference in complement C3c and C4 levels between the groups. All of the patients with erythema nodosum had elevated circulating immune complex (CIC) levels, when compared with the patients without skin lesions and the control group. The acute phase response (C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) of the erythema nodosum group was significantly higher than the patients with normal skin, and healthy controls (P> 0.001). Serum transferrin levels were significantly decreased in both of the tularaemia groups (P>0.001). Serum soluble interleukin-2 receptor levels (SIL-2R) were significantly elevated in both tularaemia groups (P>0.001), and the elevation was more marked in the erythema nodosum group (P> 0.05). Histopathologicai evaluation of biopsies from two patients with erythema nodosum showed dermal oedema, a perivascular lymphocytic infiltrate, and panniculitis. No immunoglobulin or complement deposits were detected on immunofluorescence. Erythema nodosum in the course of tularaemia is associated with many immunological changes, although it is not clear whether these findings are related to the increased tissue response, or whether they play a role in the pathogenesis of the erythema nodosum.     

Chronic recalcitrant erythema nodosum leprosum: therapeutic dilemma and role of mycobacterium indicus pranii vaccine

Erythema nodosum leprosum is a severe immune reaction that complicates the usual course of multibacillary leprosy. There is increased activation of T-cells in erythema nodosum leprosum. Treatment modalities available to date for the management are systemic steroids, thalidomide, methotrexate, cyclophosphamide, azathioprine, minocycline, and apremilast but none of them is promising and safe. Mycobacterium indicus pranii is an atypical mycobacterium possessing strong immunomodulatory properties. The vaccine for this mycobacterium has been shown to have both immunotherapeutic and immunoprophylactic effects in multibacillary leprosy patients. We report a case of chronic recalcitrant erythema nodosum Leprosum which responded to Mycobacterium indicus pranii vaccine without any adverse effects, thereby suggesting its role as a novel therapeutic option in this reaction.     

结节性红斑的病因学研究进展

结节性红斑是一种脂膜炎,常发生于双侧胫前,以红斑、痛性皮下结节为主要表现.青年女性好发.组织学表现为间隔性脂膜炎,伴多种炎症细胞浸润.确切的发病机制尚不明确,目前认为可能是一种迟发超敏反应,也有学者认为,是免疫复合物沉积在脂肪间隔的小静脉所致,引起嗜中性脂膜炎.病因复杂,与感染、系统性疾病、药物、激素水平、恶性肿瘤等因素相关.由于地区差异,病因可能有所不同.     

Septal granulomatous panniculitis: comparison of the pathology of erythema nodosum migrans (migratory panniculitis) and chronic erythema nodosum

Fifty-eight cases of septal granulomatous panniculitis were reviewed; 14 cases were diagnosed as erythema nodosum migrans (migratory panniculitis) and 36 as chronic erythema nodosum on the basis of clinical and histopathologic features. Erythema nodosum migrans was characterized by markedly thickened and fibrotic septae, marked capillary proliferation (like granulation tissue), and massive granulomatous reaction (with giant cells) along the borders of the widened septa. Hemorrhage was rare, and phlebitis was not seen. Chronic erythema nodosum showed mild septal change, little fibrosis, and lymphohistiocytic perivascular inflammation with only focal granulomatous formation. Phlebitis and hemorrhage were common. The condition termed erythema nodosum migrans has many of the same clinical features as chronic erythema nodosum, and we think this term is preferable to migratory panniculitis. We believe that there are sufficient clinical and histopathologic features to justify considering erythema nodosum migrans as a unique clinicopathologic entity.     

Propylthiouracil-induced ANCA-positive erythema nodosum treated with thalidomide

Background Propylthiouracil (PTU), one of the mainstays of antithyroid therapy drugs, can lead to antineutrophil cytoplasmic antibody (ANCA) positivity and skin lesions. PTU‐induced ANCA‐positive vasculitis is rare and even more rare is erythema nodosum. Objective To report a case of a 57‐year‐old woman with hyperthyroidism who developed myeloperoxidase (MPO)‐ANCA erythema nodosum after PTU treatment for 11 months. Methods Skin biopsy demonstrated septal panniculitis without vasculitis. PTU‐induced ANCA‐positive erythema nodosum was made. Results With discontinuation of PTU and initiation of thalidomide, skin lesions resolved completely in three weeks, and after three months, the titers of MPO‐ANCA and perinuclear‐ANCA (p‐ANCA) had decreased remarkably. At 14‐month follow‐up, the patient was asymptomatic, but low levels of ANCA titers persisted. Conclusions This report indicated that ANCA positive erythema nodosum could develop following PTU treatment. Thalidomide has been proven to be helpful and averted the adverse effects from systemic corticosteroids and other immunosuppressive drugs in this patient.     

流式细胞仪检测结节性红斑结节性血管炎患者T细胞亚群

目的　研究结节性红斑、结节性血管炎患者细胞免疫功能。方法　应用流式细胞仪技术 ,通过微量血直接免疫荧光染色法测定患者外周血T细胞亚群。结果　结节性红斑与结节性血管炎患者外周组CD3 + ,CD4+ 较对照组明显下降 (P <0 .0 5 ) ;CD8+ ,CD4+ /CD8+ 比值较对照组有所下降 ,但差异无显著性 (P >0 .0 5 )。结论　结节性红斑、结节性血管炎患者存在细胞免疫功能改变。     

Tumour necrosis factor-alpha promoter polymorphism in erythema nodosum.

Erythema nodosum is a common skin disease characterized by erythematous, tender subcutaneous nodules, mostly located on the lower extremities. Little is known about its pathogenesis, although a wide variety of aetiological factors (e.g. bacterial and viral infections, neoplastic diseases and drugs) have been described. Sarcoidosis, a typical granulomatous disease, often occurs in association with erythema nodosum (Loefgren syndrome). Since granulomatous diseases have been closely linked to a deregulated tumour necrosis factor (TNF)-alpha production, it was tempting to speculate whether TNF-alpha might play a role in the pathogenesis of erythema nodosum, at least in cases associated with sarcoidosis. A previously described nucleotide exchange, (G-A) at position -308 in the human TNF-alpha gene promoter, has been shown to be a major cause for enhanced TNF-alpha production. In the present report, we investigated the genomic TNF-alpha promoter region in patients suffering from EN with and without underlying sarcoidosis. Our results showed a strong correlation between the uncommon TNF A II allele and sarcoidosis-associated erythema nodosum. Patients with erythema nodosum without underlying sarcoidosis displayed a similar allele frequency compared with controls. Taken together, we provide evidence that erythema nodosum in association with sarcoidosis might be pathogenically linked to altered TNF-alpha production due to a genetic promoter polymorphism.     

Identification of herpes simplex virus DNA in lesions of erythema multiforme by the polymerase chain reaction.

An association between erythema multiforme and herpes simplex virus infection has been supported by clinical studies and by the detection by immunofluorescence of herpes viral antigen in sera and skin biopsy specimens of patients with erythema multiforme. In rare cases, the virus has also been isolated in cultures of skin biopsy specimens of erythema multiforme. To investigate further the association between erythema multiforme and herpes simplex virus, we used the polymerase chain reaction for herpes simplex virus to examine skin lesions from patients with erythema multiforme. In this study herpes simplex virus DNA was detected in 11 of 31 biopsy specimens of erythema multiforme; six additional cases showed equivocal amplification results, which is suggestive of low amounts of viral DNA. Seven skin and mucosal biopsy specimens with the histologic changes of herpes virus infection served as positive controls: all were positive for herpes simplex virus DNA. Viral DNA was not detected in control biopsy specimens from skin excised for unrelated conditions. These studies support the association of herpes simplex virus in the pathogenesis of some cases of erythema multiforme. The polymerase chain reaction provides a quick and effective method of detecting herpes simplex virus in lesions of herpes-associated erythema multiforme. Furthermore, the polymerase chain reaction may delineate those cases of erythema multiforme that are etiologically related to herpes virus infection and therefore might be treated with acyclovir to prevent recurrence.     

Non-bullous, erythema annulare-like pemphigus

A 25-year-old woman presented with a 1-month duration, mildly pruritic, erythema annulare-like rash involving the trunk and proximal aspects of the limbs, in the absence of any clinically obvious blister formation. Only discrete scaling and very sparse vesiculation were detected mainly at the periphery of the lesions. Biopsy specimens for histopathologic examination and direct immunofluorescence study showed typical pemphigus findings. Circulating anti-epidermal cell surface antibodies were also detected with indirect immunofluorescence tests. The erythema annulare-like pattern of presentation of pemphigus is exceedingly rare; nevertheless, this possibility should be considered in the differential diagnosis of persistent, annular and figurate erythematous eruptions.