阴囊淋巴管瘤1例

1临床资料患者,男,81岁,因阴囊水疱20年,加重伴渗液1月于2008年5月6日入院治疗。患者20年前无明显诱因于阴囊出现数个米粒大小水疱,无自觉症状,摩擦破溃后可有少量清亮渗液。曾自涂"皮炎平"等药膏但无明显好转,且进行性增多,数年后遍布整     

阴囊淋巴管瘤1例

正1临床资料患者,男,44岁,因"阴囊肿大、疼痛40年,加重伴渗液30年"于2015年9月15日入我院治疗。患者40年前无明显诱因自觉阴囊红肿、疼痛,曾自行外擦药水无明显好转,皮损处开始出现数个米粒大小水疱,表面光滑,自觉阴囊疼痛,未予诊治。阴囊水疱增多,部分水疱相互融合增大,逐渐蔓延至整个阴囊皮肤,30年前患者尿道口开始渗出白色清亮液体,疼痛加重,整个阴囊皮肤亦有白色清亮液体渗出,渗液量较大,每天需更换1     

阴囊单纯性获得性淋巴管瘤一例

临床资料患者,男,75岁,农民。因阴囊多发水疱伴乳糜样渗液4个月就诊。患者4个月前不明原因阴囊部出现散在米粒大水疱,无自觉症状,摩擦易破,可流出乳糜样液体,水疱逐渐增多,布满整个阴囊。患者曾在当地医院就诊,拟抗生素系统治疗无效。否认外伤、手术史,否认家族中有类似病史。体检：体温：37.4℃,脉搏：72次/分。     

水疱型毛母质瘤1例

报告水疱型毛母质瘤1例。患者男,26岁,右肘部屈侧皮肤肿物7年。皮肤科检查：右肘部屈侧可见一约3.0 cm×3.0 cm×1.0 cm大小类圆形松弛的淡红色水疱,隆起皮面,边界清楚,无破溃与渗液,触之有波动感,水疱基底部可扪及一约1.5 cm×1.0 cm×0.3 cm大小的质硬结节,活动度差,形状欠规则,触压痛不明显。皮损组织病理：表皮正常,肿瘤位于真皮内,肿瘤细胞团块周围可见扩张淋巴管,其中充满淋巴液,肿瘤团块由基底样细胞及影子细胞构成。诊断为水疱型毛母质瘤。予手术完整切除,创面愈合良好。目前随访未复发。     

限局性淋巴管瘤及二氧化碳激光气化治疗的评价

皮肤淋巴管瘤是淋巴管的畸形,在临床上表现为成群或散在的大小不等的水疱或血疱,一部分患者可无症状,但另一些患者可发生多种并发症,最常见的有复发性蜂窝组织炎、疼痛及大量渗液。在组织学上,表浅损害为真皮乳头层有囊性扩张的淋巴管,而深在损害则可累及整个真皮,皮下甚至肌层。对淋巴管瘤进行淋巴管造影术,无单独的输送淋巴管可见;当淋巴管瘤受外伤后,其淋巴液中含有的红细胞可存留数周;如将染料注入淋巴管附近无损害皮肤的真皮内,染料被正常的淋巴管摄取,而在淋巴管瘤中囊性扩张的淋巴管内无染料,这些情况表明淋巴管瘤是一封闭的系统,它与正常的淋巴系统相互不沟通。     

银屑病合并落叶型天疱疮一例

患者男,34岁,因全身红斑、水疱伴疼痛1周,于2016年11月24日于广东省中医院皮肤科就诊.诉11月17日左手大拇指因磁铁被夹伤,伤口0.4 cm × 0.2 cm,当时有渗血,自行外用创口贴贴敷,当天伤口处曾触及甲苯.18日双手及腋下散发透明小水疱,部分融合为大水疱,破溃后渗液明显,伴有疼痛,当时未予以重视,未行任何治疗.随后皮疹渐增多,双手臂、双侧腋下、胸腹部、背部多处片状红斑,水疱已破溃,局部可见痂皮,少许渗液;颜面部红肿,眼周、嘴唇等多处红斑、水疱,融合成片,破溃后渗液明显,局部可见黄褐色痂皮;双下肢小腿处片状鳞屑性暗红斑,瘙痒剧烈.患者自诉皮损处疼痛明显,有异味,精神状态尚可.既往有寻常性银屑病病史10余年,近1年来口服中药及中成药,银屑病病情控制尚可,否认药物食物过敏史.     

肛周淋巴管瘤1例

淋巴管瘤是一种良性肿瘤，属于先天性，由异常增生的淋巴管组成，为淋巴管的畸形或发育异常。现将１例肛周淋巴管瘤报告如下。１病历摘要患者女性，２８岁，１０年前发现肛周肿物，后逐渐增多、增大，无疼痛、流水和便血。１年前疑诊尖锐湿疣切除并活检，病理报告：肛周淋巴管瘤。检查：系统检查无异常。肛周情况：肛左前皮肤见簇集性疣状物，肛左、肛左后见皮肤不规则隆起，质软，界不清，无渗液。于腰俞穴局麻下行肿瘤切除术，创缘用电刀烧灼，切口开放，坐浴换药。术后病理报告：皮肤真皮层可见多数明显囊性扩张淋巴管，管腔内有均质、红…     

大疱性疥疮

报告1例大疱性疥疮。患者男,65岁。3个月前无明显诱因躯干、四肢出现散在红斑、水疱、糜烂、结痂,伴瘙痒。患者1个月前指缝间、阴囊处出现类似红斑、丘疹,瘙痒明显。皮肤科检查:躯干、四肢可见弥漫性红斑,部分红斑上可见紧张性水疱,疱壁紧张,疱液清亮,部分水疱破裂后糜烂,可见红色糜烂面,部分表面结痂;双手指缝间、阴囊散在红斑,苔藓样变,可见抓痕。皮损组织病理检查:(左股内侧皮损)角化不全,浆液渗出,可见表皮下疱,疱内可见浆液,大量嗜酸性粒细胞及红细胞,真皮浅层可见嗜酸性粒细胞及中性粒细胞浸润;直接免疫荧光:皮肤全层未见特异性荧光,间接免疫荧光:真皮与表皮交界处(-);镜检发现疥螨。诊断:大疱性疥疮。     

儿童白色萎缩1例

1临床资料患儿男,13岁。双下肢皮疹伴疼痛3个月。患者3个月前无明显诱因双小腿出现斑疹、斑片,呈淡红色或紫红色,直径0.5~2.0cm,散在分布,部分皮疹呈环状、半环状,无疼痛及瘙痒,未予治疗。2个月前因打球不慎摔伤后,双侧踝关节内、外侧出现皮肤溃疡,溃疡表面可见渗血,无水疱及血疱,当地医院以“毛细血管扩张性皮病”予以口服维生素C、火把花根、复方芦丁等(具体用法及用量不详)治疗20余天,皮损未见好转,逐渐蔓延至双足背,弥漫性分布,且出现少许绿豆至黄豆大小水疱,疱液清亮,破溃后可见渗液、结痂,无血疱,并伴有双小腿疼痛。1月前当地医院以…     

家族性良性天疱疮1例及其超微结构

1 病历摘要 患者男,43岁.因双侧腋窝出现绒毛样红斑、水疱、渗液及灼痛,反复发作2年,于2008年7月24日来院就诊.患者2年前无明显诱因双侧腋窝m现红斑、浸润、水疱、渗液及糜烂,曾用过多种药物治疗,效果不佳,病情反复,并出现双侧腋窝活动受限.家族成员中无类似疾病史.     

Sirt5 is dispensable for BrafV600E‐mediated cutaneous melanoma development and growth in vivo

Sirt5 is known to functionally regulate mitochondrial proteins by altering posttranslational modifications, including lysine desuccinylation. While roles for Sirt5 as either a tumor promoter or suppressor, or in chemoresistance, have been implicated in other cancers, the function of Sirt5 in cutaneous melanoma has not been well examined. Therefore, to determine whether Sirt5 is necessary for Braf^V600E‐mediated melanoma formation and/or disease progression, we crossed a genetically engineered murine melanoma model (Tyr^CreERT2/+; Braf^{LSL‐V600E/+}; Pten^flox/flox) to Sirt5^?/? knockout animals. In addition, we tested for synergism with a selective BRAF (V600E) inhibitor in Sirt5^?/? mouse melanoma cells. Taken together, this report demonstrates that, in these models, Sirt5 is dispensable for Braf^V600E‐mediated cutaneous melanoma formation and growth in vivo, and does not improve sensitivity to a selective BRAF inhibitor.     

Evaluation of monocyte to high-density lipoprotein ratio,lymphocytes, monocytes,and platelets in psoriasis

BackgroundPsoriasis is a chronic immune-mediated inflammatory skin disease that is associated with cardiovascular comorbidities.ObjectivesThe objective of this retrospective study is to assess the C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio as inflammatory markers in patients with psoriasis and to search for a relationship between these parameters and psoriasis severity, as defined by the psoriasis area and severity index.MethodsThere were 94 patients with psoriasis and 118 healthy controls enrolled in the study. The C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio values of two groups were retrospectively evaluated.ResultsStatistically significant differences were observed in terms of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio between the patient and control groups (p = 0.001, p = 0.003, p = 0.038, and p = 0.007, respectively). Positive correlations were found between the psoriasis area and severity index and the values of C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (r: 0.381; p < 0.01, r: 0.203; p < 0.05, r: 0.268; p < 0.01, r: 0.374; p < 0.01, r: 0.294; p < 0.01, respectively).Study limitationsThe small sample size and the retrospective design of the study are limitations.ConclusionElevated C-reactive protein, monocyte-to-high-density-lipoprotein ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were significantly associated with psoriasis. A positive correlation between C-reactive protein and monocyte-to-high-density-lipoprotein ratio leads to the suggestion that monocyte-to-high-density-lipoprotein ratio might be a reliable parameter in psoriasis during the follow-up. The relationship between the diasease and inflammatory parameters might provide early detection of cardiovascular morbidities in psoriasis patients.     

Dysplastischer melanozytärer Nävus

Zusammenfassung Trotz Einsatz modernster molekularbiologischer Methoden konnte bis in die heutige Zeit, d. h. rund 20 Jahre nach Formulierung des sequenziellen Progressionsmodells melanozytärer Tumoren vom Nävus zum malignen Melanom, noch kein abschließender Konsens in der Diskussion gefunden werden, ob es sich beim dysplastischen Nävus um eine eigene Entität, eine Vorläuferläsion maligner Melanome oder eine Verlegenheitsdiagnose handelt. Zusätzlich erschwerend kommt hinzu, dass der Begriff "melanozytäre Dysplasie" auf allen Ebenen der dermatologischen Diagnostik (klinisches Erscheinungsbild, Dermatoskopie, Dermatohistopathologie, Molekularbiologie) unterschiedlichen Definitionen unterliegt. Die Frage, ob eine starre, arbiträre Unterteilung pigmentierter Hautveränderungen in einzelne Entitäten sinnvoll ist, bleibt unbeantwortet. Unabhängig jeglicher semantischer Verwirrung über den Begriff Dysplasie sollte der praktisch tätige Dermatologe in dem Bewusstsein handeln, dass jede klinisch oder dermatoskopisch verdächtige melanozytäre Läsion ein initiales malignes Melanom darstellen könnte und somit adäquat, d. h. durch Exzision, zu behandeln ist. Fundierte dermatologische Kenntnisse und der jeweilige Erfahrungsschatz des Untersuchers spielen nach wie vor die entscheidende Rolle.

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The use of digital dermoscopy in the surveillance of melanocytic skin lesions: A real-life retrospective study comparing university hospital and private practices

BackgroundFew studies have evaluated the role of digital dermoscopy (DD) in the surveillance of pigmented lesions in real-life practice.Patients and methodsPatients followed with DD by 4 hospital dermatologists (group 1) and 4 private dermatologists (group 2) were retrospectively included if they had had at least 2 DD examinations for a minimum of 4 pigmented lesions. Their characteristics, risk factors, history of excision of benign nevi and melanomas prior to and during the DD follow-up, and characteristics of detected melanomas, were recorded.ResultsOne hundred and ninety-six patients were included in group 1 and 205 in groups 2. A family history of melanoma (25% vs. 12%, p < 0.01), a personal history of melanoma before DD follow-up (47% vs. 15%, p < 0.01), and a family (3% vs. 0%, p = 0.01) and personal (8% vs. 1%, p < 0.01) germline CDKN2a mutation were more frequent in group 1 than in group 2. In both groups, the number of excisions of benign lesions was higher before DD follow-up (380 and 347, respectively) than during DD follow-up (194 and 132). During follow-up, 29 melanomas were detected in group 1, with a median Breslow thickness of 0.4 mm, versus 1.3 mm for melanomas diagnosed before DD follow-up (p < 0.02). In group 2, 4 melanoma and 5 superficial atypical melanocytic proliferations of unknown significance were detected. The median Breslow thickness of newly diagnosed melanomas was 0.35 mm vs. 0.6 mm before DD follow-up (p = 0.1).ConclusionIn both populations in real-life practice, DD seemed to allow the detection of thin melanomas and to decrease the rate of “futile” resections.     

Methodische Probleme bei der exogenen und endogenen Beeinflussung der Hautoberfläche

Zusammenfassung Die Hautoberfläche, unter der funktionell der Wasser-Lipidmantel und die Hornschicht verstanden wird, stellt ein kombiniert hydrophilhydrophobes Abwehr- und Adaptationssystem für den Organismus dar, das proliferativ von der Epidermis sowie sekretorisch von Schweiß- und Talgdrüsen beeinflußt wird und auf diesen Wegen auch zentralen Steuerungen unterliegt.An den Adaptationsvorgängen, wie am Beispiel der pH-Messung über die Alkalineutralisation und die potentiometrische Titration gezeigt wird, sind von der Intensität des Insultes abhängig unterschiedliche Elemente der Haut beteiligt.Gegenseitige Beeinflussung und polare Wirkung des Oberflächensystems empfehlen stets die Anwendung verschiedener Methoden; Umwelteinflüsse lassen es zweckmäßig erscheinen, funktionelle Abläufe anstelle aktueller Reaktionen zu erfassen. Eine Ergänzung physikalischer Meßverfahren durch chemische oder biochemische, wie z.B. quantitative Talganalysen sind unerläßlich. Eine Auswahl möglicher Methoden zur Bestimmung der Reaktion der Hautoberfläche und ihrer Funktionstüchtigkeit beschließt das vorgelegte Referat.

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The relationship between history of hormonal contraceptive use and iron status among women in Tanzania: A population-based study

ObjectivesApproximately 30% of the Tanzanian women in the reproductive age group are iron deficient. At population-level, there is a dearth of research on the relationship between hormonal contraceptive use and iron deficiency. The study objective was to examine the relationship between history of hormonal contraceptive use and iron status among women in Tanzania.Study designWe conducted a cross-sectional study analysis including 4186 women who participated in the population-based 2010 Tanzania Demographic and Health Survey.Main outcome measureIron status determined by iron deficiency, anemia, and iron deficiency anemia.ResultsAlmost 19.0% women reported history of hormonal contraceptive use. Nearly, 30.0%, 39.5%, and 14.3% women had iron deficiency, anemia and iron deficiency anemia respectively. History of hormonal contraceptive use was negatively associated with iron deficiency, anemia and iron deficiency anemia, independent of potential confounders. Compared to non-users, the multivariable-adjusted odds ratio OR (95% CI) among hormonal contraceptive users was 0.73 (0.56–0.94, p < 0.05) for iron deficiency, 0.58 (0.46–0.72, p < 0.001) for anemia, and 0.53 (0.37–0.74; p < 0.001) for iron deficiency anemia. Longer duration of hormonal contraceptive use (>2 years) had lesser odds of iron deficiency 0.63 (0.43–0.91, p for trend 0.005), anemia 0.51 (0.36–0.73, p for trend <0.001) and iron deficiency anemia 0.35 (0.19–0.65, p for trend <0.001).ConclusionOur finding has important implications for educating healthcare providers and women about additional nutritional benefits of the use of hormonal contraceptives.     

A prospective comparative study on the effectiveness of two different non-adherent polyurethane dressings on split-thickness skin graft donor sites

AimTo analyze differences in re-epithelization, exudate absorbency, ease and pain on dressing removal between ALLEVYN? Non-Adhesive and Betaplast? N.MethodologyPatients admitted to the general ward undergoing split skin grafting were recruited. Allevyn and Betaplast were applied on the donor site. Exudate absorption was assessed daily using an absorbency grading chart. Dressing change was done on post-operative day five. Ease of dressing removal and pain score using the Wong-Baker Pain Scale was assessed. The percentage of re-epithelization for each dressing was assessed.Results30 patients were recruited. There was a statistically significant difference in exudate absorption on post-operative day 3 (z = ?2.006, p = 0.045, T = 236) and post-operative day 4 (z = ?2.026, p = 0.0143, T = 188), pain score (z = ?2.861, p = 0.004, T = 180), ease of removal (z = ?2.668, p = 0.008, T = 126) and re-epithelization (z = ?2.566, p = 0.009, T = 336) between Betaplast and Allevyn.ConclusionBetaplast may have faster re-epithelization, better exudate absorption, and is easier to remove while minimizing discomfort as compared to Allevyn.     

Intermediate hair follicles: a new more clinically relevant model for hair growth investigations

Background Alopecia causes widespread psychological distress, but is relatively poorly controlled. The development of new treatments is hampered by the lack of suitable human hair follicle models. Although intermediate and vellus hair follicles are the main clinical targets for pharmacological therapy, terminal hair follicles are more frequently studied as smaller hair follicles are more difficult to obtain. Objectives This investigation was designed to quantify in vivo morphological and in vitro behavioural differences in organ culture between matched intermediate and terminal hair follicles, in order to develop a new clinically relevant model system. Methods Microdissected terminal and intermediate hair follicles, from the same individuals, were analysed morphometrically (250 follicles; five individuals), or observed and measured over 9 days of organ culture (210 follicles; six individuals). Results Intermediate hair follicles were less pigmented and smaller, penetrating less below the skin surface (mean ± SEM) (2·59 ± 0·07 vs. 3·52 ± 0·10 mm; P = 0·02), with smaller fibre (0·03 ± 0·002 vs. 0·07 ± 0·002 mm), connective tissue sheath (0·24 ± 0·01 mm vs. 0·33 ± 0·01 mm), bulb (0·19 ± 0·01 vs. 0·31 ± 0·01 mm) and dermal papilla (0·06 ± 0·002 vs. 0·12 ± 0·01 mm) diameters (P < 0·001). Intermediate hair follicle bulbs appeared ‘tubular’, unlike their ‘bulbous’ terminal follicle counterparts. In organ culture they also grew more slowly (0·044 ± 0·002 vs. 0·067 ± 0·003 mm per day; P < 0·001), remained in anagen longer (84 ± 0·03% vs. 74 ± 0·03% at day 9; P = 0·012) and produced less hair fibre (0·36 ± 0·02 vs. 0·50 ± 0·03 mm; P < 0·001) than terminal follicles. Conclusions Smaller intermediate hair follicles showed major morphological differences from terminal follicles in vivo and retained significant, biologically relevant differences in vitro in organ culture. Therefore, intermediate hair follicles offer a novel, exciting, more clinically relevant, albeit technically difficult, model for future investigations into hair growth. This should be particularly important for developing new therapies.     

Assessment of collagen lattice thickness by B-scan echography

Background/aims: Collagen lattices are an in vitro dermal equivalent that has led to the development of an original model of dermal tissue. Fibroblasts cultured in three-dimensions in a collagen matrix differentiate similarly to in vivo. New technological performances in ultrasonic imaging can now provide precise measurements of tissue thickness with good resolution. The aim of this study was to assess, by B-scan echography, the correlation between collagen lattice thickness and various collagen and cell concentrations. Methods: Three concentrations of human dermal fibroblasts (F₁ = 8.10⁵ C/mL, F₂ = 16.10⁵ C/mL, F₃ = 32.10⁵ C/mL) and three concentrations of rat tail collagen (C₁ = 2 mg mL⁻¹, C₂ = 3 mg mL⁻¹, C₃ = 4 mg mL⁻¹) were prepared for five different kinds of collagen lattices: F₂C₁, F₂C₂, F₂C₃, F₁C₁ and F₃C₁ (n = 5 per case). Ultrasonic imaging was performed on day 0, 4, 6, 10, 12 and 14 using a Dermcup^® 2020 scanner. The scans measured thickness in the centre and periphery of the lattice. Results: The collagen lattice echogenicity was similar to a dermis in vivo. For each assessment, the collagen lattice thickness increased until day 12 and then stabilized. The lattice was thicker when the cellular concentration was higher, (at day 14: F_1C1 = 0.66 mm, F_2C1 = 0.86 mm, F_3C1 = 1.21 mm). The collagen concentration did not significantly influence lattice thickness. Conclusion: Collagen lattice thickness increased with retraction time and cellular concentration.     

Age‐related changes in skin mechanical properties: a quantitative evaluation of 120 female subjects

Background/purpose: The most commonly used method to determine the mechanical ability of skin is the creep test using suction chamber devices. Until now, there is no scientific consensus upon which skin deformation parameters and which body sites are particularly suitable to describe age‐related changes in human skin mechanics. The aim of this study was to find those mechanical skin parameters best representing influence of aging at five different body sites. Methods: A total of 120 healthy women aged 18–65, divided into four similar age groups, were included in this study. The biomechanical properties of the skin were measured using the Cutometer^® MPA 580 on five body sites: cheek, neck, cleavage, volar forearm and back of the hand. In order to analyze parameters referred to 1 mm skin thickness, we also used 20 MHz sonography (DUB 20). Results: A high average correlation with age was found for the parameters U_a/U_f, U_r/U_e, U_r, U_r/U_f and U_a. Only low correlation with age was found for the parameters U_v/U_e, U_f‐U_a, U_f5/U_f, U_d/U_f and U_a5. The localizations cheek, forearm and neck showed the highest correlation with age, while cleavage showed only low correlation. Conclusion: According to the results of our study, we recommend the parameter ratio of elastic recovery to distensibility (U_r/U_f) as well as the gross elasticity (U_a/U_f) for evaluation of aging effects on the mechanical properties of skin. Their high correlation with age makes them particularly applicable to represent the influence of aging onto skin mechanical properties. Most suitable localizations to evaluate skin aging are cheek, forearm and neck.