腋窝皱襞小切口治疗腋臭56例疗效观察

目的观察腋窝皱襞小切口治疗腋臭的疗效。方法切口设计在腋窝皱褶处,沿皮纹方向,根据腋毛范围设计(1~2)个长约(2~3)cm长的切口,沿皮下组织浅层分离术区皮肤组织,翻转皮瓣,剪除皮下脂肪组织、大汗腺及毛囊,再缝合切口并加压包扎。结果本组56例患者,其中55例患者切口均一期愈合,51例无皮下血肿、切口感染、皮肤坏死等并发症,4例及时清除血肿后,伤口仍然一期愈合,1例发生切口缘浅表坏死。术后随访6个月,55例痊愈;1例显效。结论小切口大汗腺剪除术治疗腋臭有效率高,此方法既能兼顾美容又能兼顾效果,值得推广。     

小切口潜行清除汗腺治疗腋臭

目的：寻求一种简便、有效治疗腋臭的外科于术方法。法：肿胀麻醉下通过1．0cm顺皮纹的小切口，于皮下脂肪层潜行分离一略大于腋毛边界的完整腔隙，用剪刀紧贴皮肤侧，剪除真皮下的脂肪浅层，清除其中的大汗腺及毛囊。果：78例患者均取得了较好的临床效果，无术后血肿、皮瓣坏死等并发症。腋部异味均消失，腋窝部仅留下1．0cm顺皮纹瘢痕。其中56例半年后随访，异味完全消失、瘢痕不明显：结论：小切口潜行清除汗腺术治疗腋臭是一种并发症少、瘢痕小、效果好的腋臭手术方法?     

“V”形切口皮下修剪术治疗腋臭临床分析

目的:探讨"V"形切口皮下修剪术治疗腋臭的效果及并发症。方法:236例腋臭患者采用"V"形切口皮下修剪术治疗,从腋窝后壁中央腋毛边缘行"V"形切口,向上及两侧分离腋毛区,剪除大汗腺层,闭合切口,弹力绷带包扎压迫。结果:切口愈合时间平均为(11±2.6)d,一期愈合211例(89.41%),二期愈合25例(10.59%)。局限性皮下血肿17例(7.20%),局限性切口感染13例(5.51%),轻度切口糜烂裂开12例(5.08%)。有效率96.71%,复发率3.29%;局部瘢痕不明显,上肢活动均不受影响。结论:"V"形切口皮下修剪术治疗腋臭效果良好,并发症少,是较为理想的根治腋臭的手术方法。     

汗腺疾病

20 0 12 596　 Z形皮瓣治疗腋臭 68例 /廖大杰 (重庆市潼南县医院 )…∥华西医学 .- 2 0 0 0 ,15( 4) .- 462沿腋毛区作 Z形切口 ,切开皮肤并翻开 ,剪除皮下组织 ,彻底去除大汗腺 ,创面用电凝彻底止血 ,用“3～ 0”尼龙线将两个皮瓣交替对位缝合。此超薄皮瓣不但彻底去除了大汗腺 ,而且无传统腋臭术中切除了部分皮肤而致的皮肤紧张及瘢痕挛缩。共治疗 68例全部根治。参 2　 (王建琴 )2 0 0 12 597　小切口皮下搔刮加修剪术治疗腋臭 /梁刘萍 (一军大南方医院皮肤科 )…∥岭南皮肤性病科杂志 .- 2 0 0 0 ,7( 3) .- 172 0 0 12 598　局部多汗…     

腋窝皱襞小切口皮下剥离术与双平行切口皮下修剪术治疗腋臭疗效比较

目的对比腋窝皱襞小切口皮下剥离术与双平行切口皮下修剪术治疗腋臭患者的应用效果。方法选取我院腋臭患者96例,随机数字表法分为剥离组与修剪组,每组各48例。修剪组行双平行切口皮下修剪术治疗,剥离组行腋窝皱襞小切口皮下剥离术。观察对比腋臭清除率、并发症发生率。结果术后剥离组腋臭清除率100.00%高于修剪组(83.33%,P <0.05);剥离组并发症发生率4.17%低于修剪组(18.75%,P <0.05)。结论相较于双平行切口皮下修剪术,腋窝皱襞小切口皮下剥离术应用于腋臭患者,可显著提高腋臭清除率,降低并发症发生率。     

小切口大汗腺清除术治疗腋臭的疗效评价

目的:观察小切口大汗腺清除术治疗腋臭的远期疗效和并发症.方法:对腋臭患者应用小切口大汗腺清除术治疗,随访3～23个月后评价疗效.结果:共67例完成随访,创面均Ⅰ期愈合,疤痕细小.臭味清除效果优者64例,良好者3例,没有患者无效或再次手术.并发症有皮下血肿7例,在早期清除血肿后均一期愈合,术后皮下小囊肿15例.所有患者术后都有色素沉着,均在6～ 12月内消失.21例早期出现不同程度皮肤挛缩,但随时间全部恢复.结论:小切口大汗腺清除术治疗腋臭疗效高,不需要特殊设备,术后出现的并发症也较轻,是理想的腋臭手术方法.     

三种不同切口下大汗腺修剪术治疗腋臭的疗效比较

目的评价三种不同切口下大汗腺修剪术治疗腋臭的临床疗效。方法将入选的182例腋臭患者随机分为3组,分别在腋后壁V形切口皮下修剪法、腋后壁W形切口皮下修剪法和腋皱襞切口皮下修剪法下行大汗腺清除术。结果腋后壁V形切口皮下修剪法、腋后壁W形切口皮下修剪法和腋皱襞切口皮下修剪法下行大汗腺清除术的有效率依次为98.33%,96.72%,85.08%,复发率依次为1.67%,3.28%,4.92%,差异均无统计学意义(P均0.05),但其并发症发生率(依次为8.33%,22.95%和37.70%)差异有统计学意义(P0.01),其中腋后壁V形切口皮下修剪法并发症发生率低于其他两种方法的并发症发生率。结论该三种不同切口下大汗腺清除术治疗腋臭的疗效相当,但腋后壁V形切口皮下修剪法治疗腋臭具有术后并发症少等优点。     

顺腋纹平行双切口保留真皮血管网切除顶泌汗腺治疗腋臭

目的：评价肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术根治腋臭的疗效.方法：手术顺腋纹做两个平行切口,于腋浅筋膜浅层向四周锐性分离皮下组织达腋毛边缘,翻转皮瓣直视下逐一修剪顶泌汗腺组织.结果：本组68例共136侧,所有病例切口均I期愈合,无1例发生皮瓣坏死,术后经6～12个月的随访,治愈122侧,治愈率89.71%,显效14侧,显效率10.29%,总有效率100%.术后瘢痕轻微、隐蔽,腋窝皮肤活动性好,上肢功能无影响.结论：肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术治疗腋臭总有效率高,并发症少,瘢痕小,为目前较理想的根治腋臭的手术治疗方法.     

小切口皮下修剪联合多孔引流治疗腋臭

目的探讨小切口皮下修剪联合多孔引流术治疗腋臭的疗效。方法 58例腋臭患者通过小切口皮下修剪术剪除汗腺和毛囊后,缝合伤口。在皮瓣上以1 cm为间距,沿皮肤纹理方向,用11号尖刀片戳数个3~5 mm的微引流孔,弹力绷带加压包扎。术后48 h换药观察伤口,弹力绷带包扎5~7 d,7~10 d拆线。术后3个月复查,12、24个月时电话随访。结果 50例患者痊愈,8例显效。所有患者均腋部汗臭消失,出汗明显减少,恢复正常社交。无瘢痕增生。结论小切口皮下修剪联合多孔引流治疗腋臭的疗效确切,多孔引流可作为皮下修剪术治疗腋臭的有效引流方法。     

改良“W”或“M”形切口在腋臭治疗中的应用

目的：探讨一种改良“W”或“M”形切口在腋臭外科手术治疗中的应用。方法：先沿腋窝腋毛分布区与正常皮肤交界处划线，再在上臂和侧胸腋毛分布区接近正常皮肤处做上下对称的“W”或“M”形切口设计手术切口线，切开皮肤后，剪除腋毛区域及周围约1CHI皮肤上的脂肪组织、顶泌汗腺及毛囊，修剪成仅含皮肤全层和真皮下血管网的超薄皮瓣，最后缝合切口。结果：2006～2008年5月笔者应用改良“W”或“M”形切口治疗23例腋臭患者（女17例，男6例），所有患者均获随访，最短时间为6个月，23例患者获得满意效果，无一例出现皮肤边缘坏死。结论：改良“W”或“M”形切口手术切口小，手术在直视下破坏顶泌汗腺，手术彻底，操作简单，术后切口瘢痕不明显，术区皮肤柔软，可达到患者美容要求。由于手术并不切除腋窝皮肤，术后患者上肢功能不受影响。本法缺点是术区部分毛囊破坏，腋毛脱落。     

A-T皮瓣修复颞部皮肤肿瘤切除后缺损32例

目的 介绍应用A-T皮瓣修复颞部皮肤肿瘤切除术后创面缺损的经验和体会。方法 在遵循皮肤肿瘤切除原则基础上彻底切除皮肤肿瘤,设计A-T皮瓣修复颞部皮肤缺损,A形两侧切口线顺应眼部鱼尾纹走向,T形底边为顺应或平行发际线和耳前轮廓线的曲线,形成上下两个推进皮瓣修复中间三角形缺损,术后的切口线隐蔽。结果 本组共32例患者,颞部皮肤缺损面积最大2.8cm×4.0cm,术后皮瓣全部成活,外形美观。随访2年,未见复发,效果满意。结论 应用A-T皮瓣修复颞部皮肤肿瘤切除术后创面缺损,术后可获得满意的美容修复效果。     

斑秃共聚焦激光扫描显微镜影像学特征分析

目的 通过在体共聚焦激光扫描显微镜（CLSM）采集斑秃的微解剖图像,研究斑秃的CLSM影像学特征。方法 2010年1月至2011年5月,临床诊断斑秃患者46例。选定患处皮损及31例皮损附近正常皮肤行CLSM检查,并与斑秃的组织病理象作比较。结果 CLSM显示,单位面积内毛囊数目斑秃进展期［（134.856 ± 18.301）/cm2］及静止期［（147.159 ± 17.536）/ cm2］均显著低于正常对照组［（301.613 ± 35.317）/cm2,P值均 < 0.05］,毛囊内毛干缺失,毛囊周围、毛囊及真皮浅层毛细血管周围可见炎细胞浸润,静止期炎细胞浸润程度较进展期减轻;恢复期［（227.778 ± 16.861）/cm2］毛囊数目较进展期增加,但仍少于正常对照（P < 0.05）,可见毳毛及终毛生长,炎细胞浸润进一步减少。结论 斑秃CLSM图像与常规组织病理表现相符合,CLSM描述斑秃细胞水平的成像特点,可用于斑秃的临床观察及动态随访。     

Tattoos and dermatological, plastic and visceral surgery

The estimated prevalence of tattooed individuals in Europe and in France is around 10%. The current "tattooed generation" was born mainly between 1975 and 1986, and according to a recent German study, the "typical tattooed" individual is a 30-year-old male or female with a mean tattooed area of 300 cm(2) or over in 61% of cases and more than one tattoo in 65% of cases. As this population gradually ages, physicians will be increasingly called on to treat tattooed areas, either for surgical removal of the tattoo itself or for excision of a suspect lesion or skin tumour, or for incision of the skin in a setting of either elective or emergency visceral surgery. This review focuses on the surgical situations potentially arising in tattooed patients.     

Phototrichogram. Adaptation, standardization and applications

Clinical investigation and hair plucking performed during trichogram, a traumatic technique for obtaining a hair formula, are the present means of evaluation in patients with alopecia or complaining of loss of hair. These means do not provide quantitative data valuable enough for a possible appreciation of the severity of hair loss, let alone for a reliable evaluation in therapeutical trials. Phototrichogram, a technique proposed by Saitoh (1970), Fiquet and Courtois (1979) and developed by Bouhanna (1982-1983), brings more satisfactory qualitative and quantitative means of studying hair growth and pilar cycles. Its standardisation had yet to be obtained so as to give results comparable from one study to another and reproducible in any given patient. We propose here a standardised optical equipment and particularly recommend a rigid frame allowing a fixed distance from the skin to the lens, and a superimposed glass window with millimetric graduations; the 0.50 square centimeter skin area to be analysed may easily be marked off by an 0.2 mm wide black microtatoo. This personal technical adaptation gives an easily obtainable definition of five quantitative parameters analysing the hair on a given area of the scalp: density of implantation, telogen percentage, growth rate, mean anagen diameter and percentage of fine hair less than 40 mu in diameter. In the normal male adult our measurements gave the following results on the vertex: density 204 +/- 10 hair per square centimeter, telogen percentage 17.8 +/- 2.8 p. 100, growth rate 0.35 +/- 0.03 mm p. day, mean anagen diameter 76 +/- 5 mu, percentage of fine hair 9.2 +/- 1.8 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)     

脂水肿性脱发1例

 报告1例脂水肿性头皮伴脂水肿性脱发。患者女,44岁,因头皮肿胀、增厚伴脱发5年余就诊。皮肤专科检查：患者头顶部可见一面积约9 cm×18 cm的梭形毛发稀疏区域,残留断发＜2 cm,脱发区头皮呈黄褐色,稍隆起,明显增厚,触之柔软,似海绵状;拉发试验阴性。头部MRI示头皮下脂肪层不均匀增厚。皮损组织病理示：毛囊数量减少,毛囊由增生的纤维组织替代,少许淋巴细胞浸润。诊断为脂水肿性头皮伴脂水肿性脱发。患者及家属拒绝治疗,随访半年余,病情未进展。     

青壮年隐匿阴茎手术矫形的体会

目的：探讨手术矫治青壮年隐匿阴茎的手术方法和疗效。方法：经冠状沟环形切开阴茎皮肤与筋膜,松解分离脱套至阴茎根部,切断阴茎背悬韧带,清除部分脂肪,再将皮肤及筋膜复位,间断环形缝合冠状沟切口,阴茎皮肤与白膜缝合固定。结果：38例青壮年患者手术矫形效果满意,阴茎体显露明显,平均延长3.7cm。结论：本矫形形式安全、有效,是目前治疗青壮年隐匿阴茎的一种满意整形术。     

Betacellulin regulates hair follicle development and hair cycle induction and enhances angiogenesis in wounded skin

Betacellulin (BTC) belongs to the EGF family, whose members play important roles in skin morphogenesis, homeostasis, and repair. However, the role of BTC in skin biology is still unknown. We employed transgenic mice overexpressing BTC ubiquitously to study its role in skin physiology. Immunohistochemistry revealed increased levels of BTC especially in the hair follicles and in the epidermis of transgenic animals. Expression of key markers of epithelial differentiation was unaltered, but keratinocyte proliferation was significantly increased. At post-natal day 1 (P1), transgenic mice displayed a significant retardation of hair follicle morphogenesis. At P17, when most follicles in control mice had initiated hair follicle cycling and had already entered into their first late catagen or telogen phase, all follicles of transgenic mice were still at the mid- to late catagen phases, indicating retarded initiation of hair follicle cycling. Healing of full-thickness excisional wounds and bursting strength of incisional wounds were similar in control and transgenic mice. However, an increase in the area covered by blood vessels at the wound site was detected in transgenic animals. These results provide evidence for a role of BTC in the regulation of epidermal homeostasis, hair follicle morphogenesis and cycling, and wound angiogenesis.     

自体单株毛囊移植术治疗眉部白癜风疗效观察

目的探讨自体单株毛囊移植术治疗眉部白癜风的治疗效果。方法回顾性分析我科2012年7月—2013年8月,采用自体单株毛囊移植术治疗21例眉部白癜风患者的临床资料。结果术后随访6个月~1年,18例患者(85.7%)在白斑区出现毛囊周围复色,发生在移植后的4~8周,6个月后复色的直径为3~12 mm。6例患者(21%)眉毛复色。结论自体单株毛囊移植术不仅能使眉毛周围皮肤复色,还能使眉毛复色,是一种有效的治疗眉部白癜风的方法。