嗜酸性粒细胞增多综合征1例并文献复习

正嗜酸性粒细胞增多综合征(Hypereosinophilic Syndrome,HES)是以血及骨髓嗜酸性粒细胞增多,组织中嗜酸性粒细胞浸润为特征的一类异质性疾病谱[1]。多累及皮肤、心血管、呼吸、消化及血液系统,并出现相关症状及体征。嗜酸性粒细胞增多性皮炎和慢性嗜酸性粒细胞性白血病分别为该疾病谱的良性端及恶性端,嗜酸性粒细胞增多性皮炎(Hypereosinophilic Dermatitis,HED),是一种仅侵犯皮肤而无系统性损害的亚型,皮疹多型、泛发伴剧烈瘙痒,预后尚可,该定义由Nir及Westfried     

嗜酸性粒细胞增多性皮炎1例

报告1例嗜酸性粒细胞增多性皮炎.患者男,77岁.全身红斑、斑块伴反复发热2年余,加重2个月入院.入院检查外周血和骨髓嗜酸性粒细胞明显增多,组织病理改变符合嗜酸性粒细胞改变.诊断:嗜酸性粒细胞增多性皮炎.给予糖皮质激素、抗感染及支持对症等治疗17天后出院.现随访中.     

嗜酸性粒细胞增多综合征并发肺栓塞

报告1例嗜酸性粒细胞增多综合征并发肺栓塞。患者男,35岁。以四肢反复皮疹伴瘙痒为主要表现,多次检查外周血嗜酸性粒细胞计数≥1.5×10~9/L,皮损组织病理及骨髓穿刺结果均显示嗜酸性粒细胞增多,诊断为嗜酸性粒细胞增多综合征。患者病程中在无常见高危因素情况下并发肺栓塞,考虑肺栓塞是患者嗜酸性粒细胞增多综合征的并发症之一。     

以皮肤损害为突出表现的嗜酸性粒细胞增多综合征1例

患者女,35岁,全身皮肤红斑、丘疹、肥厚伴瘙痒7年,加重6个月。外周血、骨髓涂片及活检、流式细胞术检测均提示嗜酸性粒细胞明显增多;皮损组织病理改变符合嗜酸性粒细胞增多综合征;淋巴结活检:淋巴结不典型增生,伴较多浆细胞及少量嗜酸性粒细胞浸润。IgE 7 100 IU/mL; HBsAg(+)、抗HBsAg(-)、HBeAg(+)、抗HBeAg(-)、抗HBcAg(+);乙肝病毒DNA定量:2. 04E+002。诊断:嗜酸性粒细胞增多综合征、慢性乙型肝炎。采用糖皮质激素联合抗乙肝病毒药物治疗,疗效显著。     

嗜酸性粒细胞增多综合征1例

患者女,53岁。反复咳嗽、咳痰1年,全身起疹伴瘙痒2个月入院。入院检查外周血和骨髓嗜酸性粒细胞明显增多,组织病理改变符合嗜酸性粒细胞改变。诊断:嗜酸性粒细胞增多综合征。给予糖皮质激素、抗感染和支持对症等治疗14d后出院。现随访中。     

嗜酸性粒细胞增多综合征1例

患者男,78岁。全身出现丘疹,伴瘙痒2年余,出现红斑,伴脱屑半年余,既往体健。外周血和骨髓嗜酸性粒细胞增多,组织病理改变符合嗜酸性粒细胞增多综合征。予糖皮质激素、抗感染和支持对症治疗20d,痊愈。     

网状青斑伴木村病1例并文献复习

患者男,56岁,双耳垂肿胀伴痒10余年.患者既往有网状青斑50余年.皮损组织病理示:真皮内淋巴细胞增生,见多量淋巴滤泡样结构,伴间质血管增生及大量嗜酸性粒细胞浸润.外周血示嗜酸性粒细胞增多,血清IgE水平明显升高.诊断:网状青斑伴木村病.     

并发嗜酸性粒细胞增多症的套细胞淋巴瘤

报告1例并发嗜酸性粒细胞增多症的套细胞淋巴瘤。患者男,57岁。颈部淋巴结增大3年,反复水肿性红斑、丘疹、结节伴瘙痒半年。外周血嗜酸性粒细胞增高。结合皮损组织病理、骨髓活检和颈部淋巴结组织病理,诊断为并发嗜酸性粒细胞增多症的套细胞淋巴瘤。     

误诊为血管瘤的嗜酸性粒细胞增多性血管淋巴样增生

报告1例误诊为血管瘤的嗜酸性粒细胞增多性血管淋巴样增生。患者男,40岁。左耳廓及左耳后多发结节伴瘙痒8个月。皮肤科检查:左耳廓及耳后散在多个黄豆至蚕豆大暗红色结节,表面光滑,质硬,孤立不融合,可推动,无压痛,部分皮损表面结痂。皮损组织病理检查:真皮内血管增生,内皮细胞肿胀,向管腔突出,血管周围及胶原纤维间淋巴组织细胞和嗜酸性粒细胞浸润。诊断:嗜酸性粒细胞增多性血管淋巴样增生。     

嗜酸性蜂窝织炎

嗜酸性蜂窝织炎(Eosinophilic Cellulitis)是一种少见的、有独特的临床(开始似蜂窝织炎样、随后变为硬斑样的单发或多发性皮损)和组织病理改变(真皮有明显的嗜酸性粒细胞浸润和有火焰样图形的炎症性肉芽肿)特征,并伴外周血嗜酸性粒细胞增多的复发性皮肤病。本病首先由Wells在1971年以“伴有嗜酸性粒细胞增多的复发性肉芽肿性皮炎”(Recurrent Gnanulomatous Derma—     

A comparison between one and two weeks' treatment with bifonazole in pityriasis versicolor

The mycologic and clinical efficacy and the local tolerance for 1 and 2 weeks of once-daily treatment of sixty cases of pityriasis versicolor with bifonazole 1% cream were studied in a biometrically planned, controlled, double-blind group comparison. The mycologic findings after 2 weeks were negative in all the patients, with the exception of one from the 1-week group. Two weeks later the findings were negative in each case. The evolution of the clinical symptoms was similarly good: after 2 weeks, only two patients in the 2-week group still exhibited scaling. In one case the pruritus, which had disappeared in the course of treatment, reappeared 2 weeks later. The mycosis began to improve within the first week, except in two patients in the 2-week group and one patient in the 1-week group.     

Recombinant interferon alfa-2b in plaque-phase mycosis fungoides. Intralesional and low-dose intramuscular therapy

A two-part clinical trial was conducted to determine the therapeutic efficacy of recombinant interferon alfa-2b in plaque-phase mycosis fungoides. In an initial randomized double-blind study, each of six patients had two representative plaques injected intralesionally with 1 X 10(6) U of recombinant interferon alfa-2b per site and two control plaques injected with placebo three times weekly for four consecutive weeks. Complete clinical regression of disease was observed at ten of 12 recombinant interferon alfa-2b sites compared with one of 12 placebo-treated sites four weeks after treatment with injections was stopped. Subsequently, in an open-labeled study, five of these patients were treated intramuscularly with 5 X 10(6) U of recombinant interferon alfa-2b three times weekly for four weeks and two patients were treated with a second, more extended course of therapy lasting 12 to 16 weeks. Three of the five patients treated systemically showed some improvement overall, but the responses were judged not to be clinically significant. The differential response observed from intralesional and intramuscular injections may be related to differences in concentration of recombinant interferon alfa-2b achieved in lesional skin by the two methods of administration.     

Treatment of dermatophyte infection of the finger- and toe-nails with terbinafine (SF 86-327, Lamisil), an orally active fungicidal agent

We report on the use of a new orally active fungicidal agent, terbinafine (SF 86-327, Lamisil) in the treatment of patients with dermatophyte onychomycosis. Twenty patients with toe-nail, and 10 with finger-nail infection received 250 mg of terbinafine daily: finger-nail infections were treated for 6 months and toe-nail infections for 12 months. All 24 patients who completed the course of therapy achieved mycological cure, as did two subjects who dropped out of the trial. All but two patients had clinically normal nails at the end of the study period. The mean time for mycological cure was 12.5 weeks for finger-nail infection, and 24 weeks for toe-nail infections. The time for a clinical cure with normal nails was 20.5 weeks for finger-nail infection, and 44 weeks for toe-nail infection. An exacerbation of pre-existing dyspepsia occurred in three of the six patients who did not complete the trial but there were no other significant adverse reactions.     

Itraconazole in the treatment of tinea corporis and tinea cruris

Forty-five patients with tinea corporis or tinea cruris were treated with oral itraconazole 100 mg daily for 15 days. At the end of the 15-day treatment, 80% of the patients were healed or had markedly improved. At the first follow-up visit, 2 weeks after stopping therapy, 80% of patients were considered responders. An additional follow-up visit another month later (i. e. 6 weeks post-treatment) showed that 32 of 41 patients had responded (78%). Overall, the mycological cure rate (culture and microscopy negative) was somewhat lower than the clinical response rate. Only three patients reported minor side effects (7%). Nausea was reported by two patients and an urticarial reaction was seen in one patient after 8 days treatment. This latter patient discontinued therapy because of the adverse experience. It is concluded that itraconazole, given at a daily dose of 100 mg for 15 days, is effective in the treatment of tinea corporis and tinea cruris. Response rates at the last visit (6 weeks post-therapy) remained at the same satisfactory levels as at the first follow-up visit (2 weeks post-therapy), even though treatment was stopped after 2 weeks. Itraconazole appears to be well tolerated by patients. These results, both in terms of efficacy and side effects, are in line with results reported by other investigators. The fact that the mycological cure rates were somewhat lower than the clinical response rates had apparently no influence on the relapse rate at 6 weeks follow-up post-therapy.     

Short-term etretinate therapy for prurigo chronica multiformis

Prurigo chronica multiformis is an intensely pruritic, chronic cutaneous disorder of unknown etiology without any effective treatment. This is a report on the results of using etretinate therapy to treat prurigo chronica multiformis. Thirty-seven patients (average age; 69.1+/-11.5 year-old) were treated with 30 mg/day etretinate along with topical steroids (very strong classes) and oral antihistamines. Etretinate was discontinued as soon as remission was achieved. Thirty-six patients were followed up for at least four weeks. The number of patients who achieved remission increased progressively after the initiation of etretinate therapy; 18 patients were totally and 14 were partially free of active skin lesions within four weeks. Eventually, 27 patients achieved remission with an average duration of 4.4+/-3.1 weeks etretinate treatment (range; 1-14 weeks), and five achieved partial remission. Four patients discontinued etretinate within two weeks because of the absence of clinical response (two cases) or exacerbation of the skin lesion (two cases). Among the 27 patients who had achieved remission, 23 had recurrence after the cessation of etretinate. The remission period ranged from 1 to 32 weeks with an average duration of 5.7+/-6.7 weeks. Combined treatment with topical steroids and oral antihistamines did not achieve remission in the recurrent cases but re-administration of 30 mg/day etretinate did. Our observation suggests that a moderate dose of etretinate is a safe and effective therapy for prurigo chronica multiformis, which is often resistant to conventional treatment using topical steroids and oral antihistamines.     

阿维A联合冷冻治疗多发性寻常疣35例

目的探讨阿维A胶囊联合冷冻治疗多发性寻常疣的安全性与临床疗效。方法治疗组35例,口服阿维A胶囊10mg/次,2次/d,2周后局部行冷冻治疗,服用3周后逐渐减量,共服8周。对照组30例,单用冷冻疗法治疗。结果治疗组有效率88.57%,对照组为56.67%,两组比较差异有统计学意义(P<0.05)。结论阿维A联合冷冻治疗多发性寻常疣效果满意。     

火针联合阿达帕林凝胶治疗轻中度痤疮疗效评价

目的评价火针联合阿达帕林凝胶治疗轻、中度痤疮的有效性和安全性。方法选取门诊就诊的89例轻、中度痤疮患者,随机分为2组,试验组45例,对照组44例。试验组给予火针治疗,每周1次;外用阿达帕林凝胶治疗,每晚1次,治疗4周;对照组给予外用阿达帕林凝胶,每晚1次,治疗4周,比较两组患者临床疗效。结果治疗4周后试验组总有效率为95.56%,高于对照组,差异有统计学意义(P0.05)。结论火针联合阿达帕林凝胶治疗轻、中度痤疮有明显的疗效。     

Clinical effects of undershirts coated with borage oil on children with atopic dermatitis: a double-blind, placebo-controlled clinical trial

It has been reported that gamma-linolenic acid contained in borage oil is effective against atopic dermatitis. The clinical effects of undershirts coated with borage oil rich in gamma-linolenic acid on atopic dermatitis were evaluated. Thirty-two children, aged 1-10 years, were involved in the clinical control study. Sixteen had worn undershirts coated with borage oil everyday for 2 weeks, and 16 had worn non-coated undershirts as a placebo. Their symptoms were assessed on a 4-point scale. Those children who had worn undershirts coated with borage oil for 2 weeks showed improvements in their erythema and itch, which were statistically significant. Transepidermal water loss from the back was decreased. In the placebo group, there were no statistically significant differences. The undershirts coated with borage oil were found to be statistically effective, and had no side-effects on children with mild atopic dermatitis.     

Calcipotriol versus coal tar: a prospective randomized study in stable plaque psoriasis

BACKGROUND: Topical therapies are the first line of treatment for patients with stable plaque psoriasis (SPP) affecting a limited body surface area. Very few trials comparing newer agents, such as 0.005% topical calcipotriol, with conventional modes of therapy, such as coal tar ointment, have been reported. METHODS: A prospective, right-left randomized, investigator-blinded study with a 12-week treatment period and an 8-week follow-up period was performed. Thirty-six patients with nearly bilaterally symmetrical SPP lesions on the limbs were instructed to apply 5% coal tar ointment overnight on one side once daily and 0.005% calcipotriol ointment on the other side twice a day. All patients were advised to expose both sides to the sun for 2 h every day. Psoriatic lesions and progress during treatment were evaluated using the severity (0-3) scale of erythema, scaling and induration (ESI score). Evaluation was carried out every 2 weeks during the treatment period and monthly during follow-up. At the end of 12 weeks, patients with > 75% reduction in the ESI score were considered to be markedly improved, those with 51-75% reduction to be moderately improved, those with 26-50% reduction to be minimally improved and those with < 25% to be non-responders. Self-assessment by the patients regarding the efficacy and acceptability of the two modalities was on a five-point scale. Serum calcium, serum phosphate, total and differential serum proteins, 24-h urinary calcium and phosphate were monitored both at baseline and after completion of therapy. RESULTS: Thirty of the 36 recruited patients completed the study. The difference in clinical response between the two sides was statistically significant at 4, 6 and 8 weeks, with the percentage reduction in ESI score with calcipotriol being 65.7 +/- 12.2% compared with 45.8 +/- 16.6% with coal tar at 8 weeks (P < 0.01, t = 6.4). However, the difference in clinical response at 10 and 12 weeks between the two sides was not significant, with a mean reduction of 71.9 +/- 13.3% in ESI score on the calcipotriol-treated side compared with 69.4 +/- 15.4% with coal tar ointment (P > 0.05). In the follow-up period of 8 weeks, recurrence of lesions was noted in 10% of patients treated with calcipotriol compared with 16.7% in those treated with coal tar after an average period of 6 +/- 1.2 and 5 +/- 1.3 weeks, respectively (P > 0.05). CONCLUSIONS: It was found that 0.005% calcipotriol ointment produced a faster initial response and had better cosmetic acceptability in patients, although after a long period of treatment, i.e. 12 weeks, 5% coal tar ointment had comparable efficacy. There was no statistically significant difference in the relapse rates between the two modalities.     

外用抗菌离子膜治疗细菌性毛囊炎的临床研究

目的:观察外用抗菌离子膜治疗细菌性毛囊炎的临床疗效。方法:从门诊筛选符合入选标准的28例细菌性毛囊炎患者,予抗菌离子膜外喷,每日2次,疗程2周,观察临床症状、体征和治疗前后病原学指标的变化。结果:治疗2周后,临床症状和体征评分及脓疱数较治疗前明显下降(P<0.05);细菌清除率达82.14%;临床疗效痊愈率、有效率分别为53.57%、92.86%;总体疗效痊愈率、有效率分别为46.43%、75.0%。结论:外用抗菌离子膜是一安全有效的非抗菌素抗菌剂,能有效地治疗细菌性毛囊炎。