Cutaneous metastases of lung cancer.

The reported incidence of skin metastases from lung cancer varies from 2.8-7.5%. In the present study 8.7% of patients had skin metastases, with head and neck being the most common sites, nodular lesions the most common, and adenocarcinoma the most frequent histology. Although most patients develop these lesions during the course of a known progressive disease, they may be the presenting manifestation of a primary tumour in the lung. The occurrence of skin lesions in lung cancer announces an ominous prognosis. The response to chemotherapy is poor, possibly due to poor blood supply to the skin; monitoring response to chemotherapy, however, is easier when such lesions are present.     

Clinical manifestations, diagnosis and classification of leprosy

Mycobacterium leprae, the causative organism of leprosy is slow-growing and the reason is its long incubation period of 2-4 years. Males are predominantly affected and deformity is produced in less than 2% of people affected with the disease. The disease manifests in the skin as macules, papules, nodules, plaques or infiltration. Hypopigmented or erythematous skin patches with definite sensory deficit is one of the clinical cardinal signs by which one can make a definite diagnosis. Demonstration of bacilli in the slit skin smear is the bacteriological cardinal sign used to make definite diagnosis of leprosy. Involvement of common cutaneous nerves with thickening and/or tenderness with its dysfunction is the second clinical cardinal sign used to diagnose leprosy. Diagnosis can be made by eliciting definite sensory deficit in the skin lesions (other than nodules and infiltration). In the absence of two clinical cardinal signs and when there is a strong suspicion of leprosy, slit skin smear should be taken from both ear lobes and one of the lesions for demonstration of acid-test bacilli. Clinical classification is based on characteristics like number of lesions, their margin, sensory deficit, satellite lesions, symmetry of lesions, central healing and scaling. Up to 5 lesions are grouped under paucibacillary and six and more are grouped under multibacillary leprosy.     

浅析“善治者治皮毛”

皮部位居人体最表,通过十二经脉与脏腑相沟通,具有"审内"与"御外"的作用。治皮之理、浅刺之法,其意皆在激发体表皮肤的卫阳之气,进而通过皮部—经络—脏腑这一信息传输通道,达到疏通经络、调节脏腑及平衡阴阳之目的。因此,无论是未病先防,还是既病防变,都可从"皮"论治,使病邪由"皮"而解。时至今日,从"皮"论治已衍生出多种针法,如梅花针、浮针、皮内针等。     

Detection of Varicella Zoster Virus DNA within Lesions and Healed Skin Lesions of Herpes Zoster by PCR

ＤｅｔｅｃｔｉｏｎｏｆＶａｒｉｃｅｌａＺｏｓｔｅｒＶｉｒｕｓＤＮＡｗｉｔｈｉｎＬｅｓｉｏｎｓａｎｄＨｅａｌｅｄＳｋｉｎＬｅｓｉｏｎｓｏｆＨｅｒｐｅｓＺｏｓｔｅｒｂｙＰＣＲＺｈａｎｇＭｅｉｈｕａ（张美华）ＺｈｕＷｅｎｙｕａｎ（朱文元）ＸｕＭｅｉｐｉｎｇ...     

Gonococcaemia with arthritis, dermatitis and myocarditis

Six cases of gonococcaemia seen at the University Hospital of the West Indies are described. All presented with polyarthritis and all but one had skin lesions. They varied widely in severity and chronicity and included one case with rigors and myocarditis. Emphasis is placed on the diagnostic value of the scanty skin lesions, and the importance of repeated examination of cervical swabs.     

Versapulse激光治疗外源性皮肤色素性病变的临床应用

目的：观察Versapulse激光治疗外源性皮肤色素性病变的临床效果,方法：用Versapulse激光的三种不同Q开关激光激光分别治疗不同的外源性皮肤色素性病变。结果;此方法可明显去除或淡化外源色素性病变,无疤痕产生,结论：Versapulse激光对外源性皮肤色素性病变效果好,但个别病例如色素颗粒较大,色素较深,需多次治疗,才能达到效果,本方法明显优于传统的治疗方法,值得推广。     

上皮钙粘素、β-连环蛋白、细胞周期素D1在进行期寻常型银屑病皮损的表达

目的 通过检测银屑病患者皮损处上皮钙粘素、β-连环蛋白和细胞周期素D1的表达,探讨其在银屑病角质形成细胞高度增殖中的意义.方法 用免疫组化方法 检测正常组织及进行期银屑病皮损处上皮钙粘素、β-连环蛋白和细胞周期素D1蛋白的表达.结果 银屑病患者皮损增生的表皮细胞上皮钙粘素和β-连环蛋白在颗粒层和基底细胞层表达明显降低,与正常人相比有显著性差异(P<0.01).而细胞周期素D1在银屑病患者皮损基底细胞层表达显著升高,并与β-连环蛋白的异常表达相关.结论 上皮钙粘素和β-连环蛋白表达的下调可能与银屑病角质形成细胞高度增殖有关.Wnt信号转导系统异常可能参与银屑病的发病机制.     

CD 13/APN expression in peripheral blood lymphocytes and skin lesions in patients with advanced psoriasis vulgaris

Objective： To observe the expression of CD13/APN in peripheral blood lymphocytes and skin lesions of patients with advanced psoriasis vulgaris, and discuss its effect on the pathogenesis of psoriasis. Methods： CD 13 expression in peripheral blood lymphocytes and skin lesions was detected by flow cytometry and imrnunohistochemical technique, respectively. Results were compared with those of healthy controls. Results： CD 13 expression was significantly higher in peripheral blood lymphocytes of patients with advanced psoriasis vulgaris than in that of healthy controls, and in skin lesions than in healthy skin tissues. The expression was mainly in the suprabasal layers of skin lesions, and positively correlated to PASI （R 0.78029）. Conclusion： The significantly higher expression of CD13 in peripheral blood lymphocytes and skin lesions of the patients with advanced psoriasis vulgaris probably is related to immunological abnormality, blood vessel abnormality and proliferation of keratinocyte in the pathogenic course of psoriasis. It may be a novel and effective way to treat psoriasis with specific CD13 inhibitors.     

放射性皮肤损伤经不同护理措施干预的效果对比

目的 探讨医用射线防护剂(奥克喷)联合磺胺嘧啶银乳霜对放射性皮肤损伤(简称:放疗皮损)的防治效果。 方法 选取2017年1月—2018年12月浙江绿城心血管病医院接诊的鼻咽癌首诊患者,采用随机数字表法,将接受直线加速器放射治疗的150例鼻咽癌患者随机分成3组,每组50例。对3组分别施行不同的护理干预措施。观察Ⅰ组:放疗前,在照射区采用医用射线防护喷剂奥克喷,外用。观察Ⅱ组:放疗前,在照射区采用医用射线防护喷剂奥克喷,外用。放疗后,在照射区采用磺胺嘧啶银乳膏,外用。对照组:采用常规护理方法。至总疗程结束,比较3组放疗皮损的发生情况(发生率、发生时间、严重程度)及创面愈合情况(愈合时间、愈合率)。 结果 3组放疗皮损的发生率均为100%。3组放疗皮损出现的时间比较,差异有统计学意义(F=3.329,P<0.05),观察Ⅱ组的放疗皮损发生更晚。3组放疗皮损的程度比较,差异有统计学意义(P<0.05),观察Ⅱ组中严重放疗皮损(Ⅲ~Ⅳ级)的发生率更低。3组放疗皮损经治疗干预后的临床疗效比较差异有统计学意义(P<0.05),观察Ⅱ组的临床效果更好。3组放疗皮损愈合时间比较,差异有统计学意义(P<0.05),观察Ⅱ组的放疗皮损愈合时间更短。3组已愈合创面百分率比较,差异有统计学意义(P<0.05),观察Ⅱ组的已愈合创面百分率更高。 结论 对鼻咽癌患者的放射性皮肤损伤,采用奥克喷联合磺胺嘧啶银,可以更好地减轻放疗皮损,促进放疗皮损创面的愈合。      

An unusual cutaneous manifestation of ulcerative colitis: thrombotic skin gangrene.

Ulcerative colitis has a number of associated skin lesions. We report the case of a patient with active ulcerative disease presenting with rapidly progressive necrotic skin lesions, identified as thrombotic and requiring skin grafting. Thrombotic cutaneous gangrene is a rare but potentially serious manifestation of uncontrolled ulcerative colitis.     

Tyrosine-induced eye and skin lesions. A treatable genetic disease.

Tyrosine-induced eye and skin lesions in man are an autosomal, recessive, inherited syndrome associated with tyrosinemia, tyrosinuria, and increased urinary excretion of tyrosine metabolites. Patients have mild to severe keratitis and erosive and hyperkeratotic lesions on the palms and soles. The degree of involvement was variable in the small number of patients studied. Mental retardation is frequently a part of the syndrome. A low-tyrosine low-phenylalanine diet lowers blood tyrosine level and leads to healing of the skin and eye lesions. Early dietary treatment may prevent mental retardation.     

热休克蛋白60在银屑病、慢性湿疹中的表达研究

目的：观察银屑病患者及慢性湿疹患者皮损表皮细胞中热休克蛋白（HsP60）的表达情况。方法：通过免疫组织化学（SABC）方法及原位杂交技术检测了33例银屑病皮损及28例慢性湿疹皮损表皮组织中HSP60蛋白及其mRNA的表达,并与16例正常皮肤组织作对照。结果：HSP60蛋白在正常人及慢性湿疹患者皮损表皮细胞中表达很弱或无表达,两者问差异无统计学意义（P〉0．05）;在银屑病患者皮损表皮细胞中表达增强,与正常对照组及慢性湿疹患者皮损表皮相比,差异有统计学意义（P〈0．05,P〈0．01）。HSP60mRNA与HSP60蛋白表达部位较一致。结论：HSP60在不同皮肤疾病的发病机制中发挥着不同作用。     

β防御素-2和白细胞介素-1β在寻常型银屑病患者皮损中表达的研究

目的探讨β防御素-2（HBD-2）和白细胞介素-1β（IL-1β）在寻常型银屑病皮损中的表达及其共同作用对银屑病皮损形成的影响。方法采用实时荧光定量逆转录聚合酶链反应（RT-PCR）法检测45例银屑病患者皮损区、非皮损区及15例正常人皮肤中HBD-2和IL-1β的表达情况,对其在皮损中的表达情况进行相关性分析,并将其与PASI评分进行相关性分析。结果与正常人皮肤组织和银屑病患者非皮损区相比,银屑病患者皮损区HBD-2和IL-1β的表达明显上调,非皮损区HBD-2和IL-1β的表达也高于正常人皮肤组织,差异均有统计学意义（均P〈0.05）。银屑病患者皮损中HBD-2和IL-1β的表达水平与PASI评分之间均存在正相关关系（P〈0.05）。结论HBD-2和IL-1β在寻常型银屑病皮损中的表达均升高,可能共同参与银屑病的发病过程。     

高压氧联合音乐疗法治疗神经性皮炎的疗效观察

目的观察高压氧联合音乐疗法对神经性皮炎的治疗效果。方法高压氧联合音乐疗法治疗25例患者,观察皮损消退情况。结果本组患者获得满意疗效,皮损有不同程度的消退。结论高压氧联合音乐疗法治疗有利于皮损的愈合,值得推广应用。     

康惠尔贴应用于肝胆外科重症患者肛周皮肤损伤的疗效观察

目的探讨康惠尔透明贴用于肝胆外科重症患者腹泻或血便引起的肛周皮肤损伤护理中的应用效果。方法将我院肝胆外科ICU140例腹泻或血便患者随机分为观察组与对照组。观察组72例，其中40例采用康惠尔透明贴治疗肛周已经发生的皮肤损伤，32例用于预防皮肤损伤发生；对照组68例，其中37例采用常规疗法治疗肛周已经发生的皮肤损伤，31例用于预防皮肤损伤发生；比较两组患者治疗效果、皮肤损伤愈合时间及护理时间，比较两种方法在预防性应用时肛周皮损的发生率。结果观察组总有效率明显高于对照组（P〈0．05），愈合时间显著缩短（P〈0．05），护理时间显著缩短（P〈0．05）。预防性应用时观察组的肛周皮损发生率明显低于对照组（P〈0．05）。结论康惠尔透明贴对预防和治疗肝胆外科ICU患者肛周皮肤损伤方面疗效肯定，值得临床推广。     

A case of neonatal herpes simplex with pneumonia.

A case of neonatal herpes simplex infection is discussed that presented as pneumonia, with subsequent development of skin lesions. The virus was isolated from skin scrapings. In spite of treatment with vidarabine, skin lesions continued to develop, and central nervous system involvement occurred. Acyclovir therapy led to prompt resolution of symptoms.     

寻常痤疮皮肤人β防御素-2的表达及意义

目的：研究寻常痤疮患者皮肤B防御素-2（hBD-2）的表达情况及丹参酮治疗对其的影响。方法：用免疫组化方法检测40例寻常痤疮患者皮损及非皮损部位hBD-2的表达水平,观察其在丹参酮治疗前、后的变化,同时记录皮损情况及不良反应等,并与正常对照组进行比较。结果：丹参酮治疗寻常痤疮效果良好,副作用少。在寻常痤疮患者皮损处hBD-2的表达显著增强,与非皮损部位及正常对照组比较差异有统计学意义（P〈0．05）;丹参酮治疗后皮损好转,局部hBD-2表达减弱,但仍明显高于非皮损部位（P〈0．05）;治疗前、后非皮损部位hBD-2的表达水平没有明显变化,与正常对照组比较差异亦无统计学意义（P〉0．05）。结论：hBD-2在寻常痤疮皮损部位的表达显著增加,并随着炎症的减轻而下调,提示其参与痤疮的发病过程。     

Characterization of DNA antigens from immune complexes deposited in the skin of patients with systemic lupus erythematosus

Background Skin lesions are common manifestations in systemic lupus erythematosus (SLE). It is still unknown what the definite pathogenesis of skin involvement was and whether DNA participated in it. Our study was designed to explore the pathogenetic role and nature of nuclear antigen (DNA) deposited in the skin lesions of patients with SLE.Methods Thirty skin samples from patients with SLE and 2 normal skin samples were studied. Extracellular DNA was evaluated by indirect immunofluorescence methods. The deposited immune complexes were extracted by cryoprecipitation, and DNA was then isolated with phenol and chloroform. DNA fragment sizes were detected by agarose gel electrophoresis. Finally, 8 different probes were used to analyze the origin of these DNA molecules using Dot hybridization.Results Extracellular DNA staining was found only in skin lesions, mainly those located in the basement membrane zone, vascular wall, and hair follicle wall. Normal skin and non-lesion SLE skin showed no fluorescence at locations outside the nuclei. There were no differences in the rate and intensity of extracellular DNA staining when comparing active phase to remission phase patients. No relationship was found between extracellular DNA and circulating anti-dsDNA antibodies. Deposited DNA fragments clustered into four bands of somewhat discrete sizes: 20 000 bp, 1300 bp, 800-900 bp, 100-200 bp. Small sized fragments (100-200 bp) were positively correlated with disease activity (P&lt;0.05, r=0.407). Dot hybridization showed significant homology of the various extracellular DNA fragments examined with human genomic DNA, but not with DNA from the microorganisms and viruses we examined. There were also homologies between DNA samples from different individuals.Conclusions DNA and its immune complexes may contribute to the pathogenesis of skin lesions in SLE. These DNA molecules range in size from 100 bp to 20 kb and may be endogenous in origin.     

CD45RA和CD45RO在寻常型银屑病皮损中的表达的研究

目的：观察寻常型银屑病患者皮损中CD45RA和CD45RO的表达情况,探讨寻常型银屑病的发病机制。方法：免疫组化检测30例寻常型银屑病患者皮损中CD45RA和CD45RO的表达,取10例正常人的躯干皮肤做正常对照。结果：寻常型银屑病患者皮损中CD45RO的表达明显高于对照组（P〈0．01）,CD45RA的表达和对照组比较无统计学意义（P〉0．05）。结论：寻常型银屑病患者皮损真皮中浸润的淋巴细胞以记忆性T淋巴细胞为主,推测细胞免疫在寻常型银屑病的发病中起重要作用。     

Factors influencing the number needed to excise: excision rates of pigmented lesions by general practitioners

OBJECTIVE: To identify doctor and patient characteristics associated with excision of benign versus malignant pigmented skin lesions. DESIGN, SETTING AND PARTICIPANTS: Retrospective audit of data on 4741 pigmented skin lesions excised from November 1998 to February 2000 by 468 general practitioners (39% response rate) from 223 practices in Perth, WA. (The data used were from the baseline period of a randomised controlled trial of a diagnostic aid for pigmented skin lesions.) MAIN OUTCOME MEASURE: The number needed to treat (NNT), defined as the number of pigmented lesions needed to be excised to identify one melanoma, in relation to demographic characteristics of GPs and patients. RESULTS: Relatively more benign lesions were excised per melanoma (NNT = 83) in the youngest patients (aged 10-19 years) compared with the oldest (aged > or = 70) (NNT = 11) (P [trend] < 0.001), in females (NNT = 37) compared with males (NNT = 23) (P = 0.02), and in the most socioeconomically disadvantaged (NNT = 60) compared with the least disadvantaged group (NNT = 20) (P [trend] < 0.001). The most recently graduated GPs excised more benign lesions for each melanoma (NNT = 59) than the least recently graduated (NNT = 22) (P [trend] = 0.01). CONCLUSIONS: GPs could raise their threshold for excising pigmented lesions in patients who are young, female, or from areas of low socioeconomic status, or if the GPs themselves are recent graduates.