新生儿漂浮指1例

患儿男,出生3 d。患者出生时左手拇指桡侧即有肤色囊性赘生物。皮损组织病理示:角化过度,真表皮分离,真皮乳头层触觉小体,真皮网状层内见增多的神经纤维束。诊断为新生儿漂浮指。     

双氢克尿塞和氨苯喋啶合用引起亚急性皮肤红斑狼疮样药疹

例1.男性,75岁,服双氢克尿塞和氨苯喋啶后不久,双臂出现红斑性损害,日晒后加重。检查发现双臂伸侧及颈两侧有鳞屑性红色斑块。活检见真皮表皮连接处液化变性、角化不全及棘层肥厚。在一些部位真皮乳头层淋巴样细胞的围管性浸润已接近真表皮连接处,真皮内嗜黑素细胞散集,真皮乳头层增宽,纤维化伴血管扩张,部分钉突消失。化验检查:ANA 1:160阳性,均质型。抗SS-A     

肢端持续性丘疹性黏蛋白病1例

患者女,57岁,双手背及前臂伸侧多发丘疹2年余。皮损组织病理示:表皮正常,真皮乳头及真皮网状层上部黏蛋白沉积,阿辛蓝染色证实黏液样物质沉积增多。诊断为肢端持续性丘疹性黏蛋白病。     

界限类偏结核样型麻风病1例

患者男,38岁。右手腕皮疹伴麻木1年,加重1周。皮肤科检查见右手腕屈侧黄红色环形斑块。组织病理示真皮全层可见沿血管、神经和汗腺分布的类椭圆形结核样肉芽肿,以真皮下部为著。予氨苯砜和利福平联合化疗,现随访中。     

皮肤由表皮、真皮、皮下组织三部分组成合理吗?

<正> 一般人们均认为:皮肤由表皮、真皮、皮下组织三部分组成。表皮由里向外可分为基底层、棘层、颗粒层、透明层、角质层五部分。真皮由外向里可分为乳头层和网状层二部分。那么位于真皮和表皮之间的表皮下基底膜带(BMZ)又称表—真皮     

抗层黏连蛋白γ1类天疱疮一例研究

【摘要】 患者男,55岁。临床表现为四肢、躯干紧张性大疱,组织学表现为表皮下水疱,真皮浅层有淋巴细胞、嗜酸性粒细胞等浸润,初步诊断为大疱性类天疱疮（BP）。在血清学分析中,发现该患者血清中自身抗体与盐裂皮肤真皮侧结合,且酶联免疫吸附法未检测到BP180、BP230、Ⅶ型胶原抗体,从而排除了大疱性类天疱疮、获得性大疱性表皮松解症的诊断。通过免疫印迹、免疫沉淀检测,发现该患者血清存在与真皮侧200 000蛋白结合的抗体,综合这些特点,诊断该患者为抗P200类天疱疮,即抗层黏连蛋白γ1类天疱疮。     

脂溢性角化病并发日光性角化病及基底细胞癌1例

患者女,85岁。右前臂伸侧出现一花生米大暗红色结节2年。皮损组织病理示:(1)突起部分:表皮局部糜烂,真皮可见由基底细胞组成的巢状肿瘤团块,癌巢周边的基底细胞呈栅栏状排列;(2)蒂部周围:棘层下方细胞排列紊乱,有异型性,部分区域表皮全层异型,基底层非典型细胞呈芽蕾状增生,伸向真皮上部。真皮浅层胶原纤维嗜碱性变,并有较多的淋巴细胞浸润;(3)外围黑褐色斑块皮损:角化过度、棘层肥厚、基底细胞呈乳头瘤样增生,瘤边界平坦,下界与皮肤基底层相平。诊断:脂溢性角化病并发日光性角化病及基底细胞癌。     

单侧性真皮中层弹性组织溶解症一例

患者女,38岁,颈右侧黄色丘疹伴带状萎缩20年。皮损缓慢发展,无明显症状。否认有长期日晒及家族史。皮肤科检查：颈右前侧皮肤见沿皮纹方向、大小不一的黄色丘疹、斑块;颈右后侧见多数以毛囊为中心的针帽大丘疹;整个颈右侧皮肤呈境界较清楚的带状萎缩斑,表面为细皱纹样改变,似老年人皮肤外观。颈部左侧皮肤大致正常,黄色丘疹处组织病理检查：表皮大致正常;真皮浅层血管周稀疏淋巴组织细胞及少量噬黑素细胞浸润,未见日光性变性改变;真皮中层胶原纤维增粗,排列紧密,未见明显炎细胞浸润。弹力纤维染色示真皮网状层弹性组织几乎完全缺失,剩余的少量弹性纤维肿胀、断裂明显。Von Kossa染色阴性。诊断：单侧性真皮中层弹性组织溶解症。     

肾宝治疗寻常型银屑病1例

临床资料患者，男，36岁。全身反复起鳞屑性红斑10年，腰膝酸软1月。10年前患者因全身大量鳞屑性红斑来我院就诊。体检：系统检查无异常。皮肤科情况：全身大量红斑，上覆厚层银白色鳞屑，Auspitz征阳性，皮损以头部、背部，四肢伸侧为主，对称分布。临床诊断：寻常型银屑病。组织病理检查：表皮部分角化不全，颗粒层变薄，棘层增厚，表皮突呈杵状向下延伸；真皮乳头向上延伸，色细血管扩张、充血，真皮浅层血管周围有淋巴细胞及组织细胞浸润；     

角化性皮肤病

20100529局灶性肢端角化过度/周城(北京大学人民医院皮肤科),杜娟,张建中∥临床皮肤科杂志.-2009,38(11).-693～694女,45岁。双手淡黄色扁平丘疹10余年,无自觉症状。皮肤科检查:双手背、手指背、指间关节伸侧、大小鱼际及手腕屈侧见密集的圆或卵圆形淡黄色至肤色半透明角化性丘疹,栗粒至黄豆大,质较硬,表面光滑,部分皮损融合,少数丘疹呈脐状。组织病理示:表皮角化过度,颗粒层及棘层增厚,真皮浅层血管周围稀疏性细胞浸润;真皮弹性纤维及胶原纤维大致正常,未见明显弹性纤维断裂及减少。图2参7(刘昕)20100530线状汗孔角化病1例/黄莉宁(贵阳中医学院一附院皮肤科),贾敏,廖跃…∥     

High-performance liquid chromatography analysis of rubber allergens in protective gloves used in health care

A high-performance liquid chromatography (HPLC) method developed for analysis of zinc dithiocarbamates was validated and used to perform a survey of disposable medical gloves used in southern Sweden. The gloves were extracted with acetone at room temperature for 10 min by shaking. The extracts were injected into a polyether ether ketone lined HPLC column, and peaks were analysed by a diode-array detector. The survey shows that of 19 gloves analysed, 10 contained zinc diethyldithiocarbamate (0.070-3.5 mg/g), 3 contained zinc pentamethylenedithiocarbamate (1.0-4.3 mg/g), 4 contained zinc dibutyldithiocarbamate (0.9-1.1 mg/g), and 2 contained 2-mercaptobenzothiazole (0.005-0.008 mg/g). None of them contained thiurams.     

Atypical fibroxanthoma: two unusual variants

Two unusual fibroxanthomas were studied by light microscopy. The first case contained numerous osteoclast-like cells and resembled malignant giant cell tumour of soft tissues, a variant of malignant fibrous histiocytoma. Osteoclast-like giant cells were negative for lysozyme and alpha-1-antitrypsin. The second case contained areas of chondroid differentiation which resembled chondrosarcoma. Tumour cells within the cartilaginous areas were positive for S100 protein.     

Ultrastructural studies of the skin and cultured fibroblasts in I-cell disease

The skin and cultured fibroblasts from a patient with I-cell disease were examined by electron microscopy. Multiple vacuolations were seen in fibroblast and/or histiocyte-like cells, secretory cells of eccrine glands, and Schwann cells of the skin. Vacuolar inclusions were single membrane-limited, and contained a few reticulo-floccular and vesicular materials, endothelial cells of the dermal capillaries contained other types of inclusions, which were also membrane-limited, more electron dense, and multivesicular. The epidermis and pilosebaceous appendages seemed to be normal. Cultured skin fibroblasts contained prominent inclusions which varied in size and morphology. Acid phosphatase activity was seen in some of those inclusions, indicating their derivation from lysosomes. These findings suggest that the I-cell disease is a type of lysosomal storage disease and that electron microscopic examination of normal-appearing skin in this disease may contribute to the diagnosis.     

Hyperpigmentation of the skin associated with minocycline therapy

Skin biopsy specimens and discolored fingernails from minocycline-treated patients were examined by light and electron microscopy, histochemistry, and energy-dispersive x-ray analysis. Both hyperpigmented and adjacent normally pigmented skin samples contained pigment-laden macrophages in the dermis, although these cells were more numerous in the hyperpigmented skin samples. Elemental analysis showed that both pigment deposits and stratum corneum of hyperpigmented skin samples contained iron and calcium. Discolored areas of fingernails from a minocycline-treated patient also contained iron and calcium. Both skin and nail discoloration were possibly due to the presence of an iron chelate of minocycline and/or quinoid derivatives of minocycline. The presence of iron-containing pigment in normal as well as hyperpigmented skin may have predisposed to formation of minocycline-associated pigment in these patients.     

Connective tissue alterations in the skin of ultraviolet irradiated hairless mice

Connective tissue alterations were induced in hairless mouse skin by ultraviolet (UV) irradiation. Hairless mice were irradiated three times a week for 10 weeks with sunlamps (UVA and UVB) and the skin was examined using immunochemical and biochemical techniques. Indirect immunofluorescence was performed with antibodies directed against elastin, microfibrillar proteins, and fibronectin. Increased fluorescence was observed in the actinically damaged skin for elastin, microfibrillar proteins, and fibronectin. The elastic fiber components, elastin and microfibrillar proteins, were then isolated and quantified. Control skin contained approximately 0.1% by dry weight of elastic fiber components, whereas actinically damaged skin contained 0.2% by dry weight. These data are consistent with previous observations of elastic fiber hyperplasia in UV irradiated mice. In addition, irradiated mouse skin contained 1.12 mg of extracted fibronectin per gram wet weight as compared with 0.59 mg in control skin. Irradiated mouse skin contained increased quantities of hyaluronic acid and chondroitin sulfate (uronic acid content). These studies further support the validity of the UV irradiated hairless mouse as a model of human dermal photoaging.     

Benign cephalic histiocytosis

Benign cephalic histiocytosis is a self-healing non-X, nonlipid cutaneous histiocytosis of children, characterized by a papular eruption on the head. Mucous membranes and viscera are always spared. In the 13 cases reported herein, the children were otherwise in good general health. The disease appeared during the first three years of life, and spontaneous regression was complete by the age of nine years in the four cases healed to date. The histiocytic infiltrate was localized in the upper and middle dermis and contained no lipids at any stage of evolution. All the histiocytes contained coated vesicles, and 5% to 30% also contained comma-shaped bodies in their cytoplasm.     

Cartilaginous pseudocyst of the external auricle in children with atopic eczema

Four children with severe atopic eczema developed painless endochondral pseudocysts of the external auricle. The lesions were bilateral in two cases. In one case the lesion spontaneously resolved; of the remaining five lesions, one contained haematoma and the other four contained serous fluid. The aetiology of these lesions and their association with atopic eczema are unclear, but repeated minor trauma from rubbing may play a part.     

Errors in the Archives of Dermatology and the Journal of the American Academy of Dermatology from January through December 2003

OBJECTIVE: To assess the frequency of statistical errors in the dermatology literature. DESIGN: Original studies published in the Archives of Dermatology and the Journal of the American Academy of Dermatology from January through December 2003 were analyzed for correctness of statistical methods and reporting of the results. RESULTS: Of 364 studies published, 155 included statistical analysis. Of these, 59 (38.1%) contained errors in the methods or omissions in reporting of the statistical results. Fourteen percent of the articles with statistical analysis contained errors in the methods used (considered to be more significant errors), 26.5% contained errors in the presentation of the results, and 2.6% contained errors in both. CONCLUSIONS: The misuse of statistical methods is prevalent in the dermatology literature, and the appropriate use of these methods is an integral component of all studies. Readers should critically analyze the methods and results of studies published in the dermatology literature.     

Vasitis nodosa and spermatic granuloma of the skin: an histologic study of a rare complication of vasectomy

A 29-year-old man noticed localized painful swelling of the scrotal skin after elective vasectomy. The lesion was excised and its histologic examination revealed a diffuse inflammatory, partly granulomatous infiltrate with numerous tubular structures in the dermis and subcutaneous tissues. These ductules were lined by cuboidal epithelial cells and contained spermatozoa. The inflammatory infiltrate consisted of lymphocytes, plasma cells and histiocytes, but also contained spermatozoa and a few spermatic granulomas. These changes were the sequelae of a vasocutaneous adhesion and fistula; the ductules were the result of epithelial regeneration from the vas deferens and the inflammation with spermatic granulomas was due to extravasated spermatozoa.     

Congenital Hemangioma with Milialike Structures: A Case Report

Abstract: A 4-month-old infant had two 3 cm × 4 cm hemangiomatous lesions on the scalp and back, present since birth, which contained peculiar white-yellowish small nodules. Histologically the lesions proved to have a hemangiomatous (capillary-type) component together with small keratin-containing epidermal cysts (milialike) which progressively extruded their contents. The lesions also contained embryonic-like hair structures. The hemangiomas resolved spontaneously. We were unable to find any reference in the literature describing this peculiar combination of features.