发生在外阴部位的上皮样血管瘤

报告1例发生在外阴部位的上皮样血管瘤。患者女,55岁。外阴皮下结节反复破溃及渗出,伴瘙痒2年。皮肤科检查:左侧大阴唇触及一蚕豆大皮下结节,质硬,结节表面皮肤红肿,可见破溃及渗出。皮损组织病理检查:真皮层血管增生扩张,管腔不规则,内皮细胞肿胀,部分呈柱状突入管腔;真皮可见大量淋巴细胞和嗜酸性粒细胞浸润。诊断:上皮样血管瘤。治疗:予肌内注射复方倍他米松治疗,随访2年未复发。     

二期梅毒1例

临床资料 患者女,23岁.因外阴皮疹伴瘙痒2周于2004年1月就诊.2周前患者于外阴部左侧出现一枣样大小的肿物,轻触压痛,未处置.1周后外阴及大腿根部出现皮疹、瘙痒.体检:系统检查无异常,腹股沟淋巴结轻度肿大.皮肤科情况:躯干及上肢可见淡黄色黄豆至蚕豆大小圆形皮疹,其上可见少许鳞屑;外阴、大腿根部及肛周可见密集分布黄豆大小圆形紫红色浸润性斑;外阴部左侧见一枣样大小肿物,形状不规则,湿润,表面无破溃,无明显分泌物,轻压痛(图1).实验室检查:TPHA阳性,RPR1:128阳性,外阴部肿物分泌物暗视野镜检见梅毒螺旋体.诊断:二期梅毒.治疗:肌肉注射普鲁卡因青霉素80万u 1次/d,共2周.1周后外阴肿物消退,2周后躯干及上肢、外阴皮损基本消退,外阴部可见色素沉着.     

外阴部化脓性汗腺炎1例

<正>1临床资料患者女,21岁,学生。外阴肿痛、结节、破溃反复发作5年。5年前患者发现右侧小阴唇、阴蒂红肿,表面可见豆粒大丘疹,有脓头,走路不便,挤压痛,1个月后到当地医院就诊,给予"甲硝唑"口服治疗,并做开放式手术,术后1个月复发。脓液破溃后形成瘢痕,以后逐渐出现结节、破溃、瘢痕,皮损逐渐加重。否认性生活史。皮肤科情况:外阴部及大、小阴唇肥厚瘢痕,外阴部、肛周散在豆粒至花生米大小结节,形成核桃大小斑块、脓肿,表面可见脓头。间或有花生米大小溃疡,可见     

外用氮芥及糖皮质激素局部封闭治疗外阴朗格汉斯细胞组织细胞增生症

报告1例外阴朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)。患者女,42岁。外阴丘疹、结节2年。皮肤科检查:大阴唇内侧及小阴唇可见小米至绿豆大肤色丘疹、结节,表面光滑,散在溃疡面。皮损组织病理检查:表皮水肿,海绵形成,真皮浅层及深层弥漫组织细胞浸润,细胞质丰富,细胞核呈肾形,可见散在嗜酸性粒细胞。免疫组化:S-100蛋白(+),CD1a(+)。诊断:LCH。给予外用氮芥溶液及糖皮质激素局部封闭治疗,皮损消退,随访半年无局部复发及系统受累。     

先天性巨大色素痣伴黏液沉积

报告1例先天性巨大色素痣伴黏液沉积.患儿男,2月龄,躯干黑色斑块2个月.皮肤科检查:背部、腰部、双侧臀部、右侧外阴及右侧大腿近端可见黑色斑片,表面有稀疏毛发分布,边界清楚,部分皮损上分布黄豆至鸡蛋大结节.皮损组织病理检查:表皮大致正常,角质形成细胞间散在色素颗粒,真皮内可见痣细胞散在或成巢分布,并见成熟现象,部分痣细胞...     

外阴朗格汉斯细胞组织细胞增生症1例

报告1例外阴朗格汉斯细胞组织细胞增生症。患者女,44岁,外阴大片丘疹、结节、糜烂伴痛痒感1年余,渗液1周。皮损组织病理示:皮肤局部糜烂,底部一致性细胞组织样细胞增生,可见核仁与核沟,未见核分裂。瘤细胞内散在少量中性粒细胞浸润,周围可见簇集状淋巴细胞浸润,嗜酸性粒细胞浸润不明显。免疫组化:S-100(+)、CD1a(+)。诊断:外阴朗格汉斯细胞组织细胞增生症。     

外阴肛周汗管瘤

报告1例外阴肛周汗管瘤。患者女,35岁。因肛周、外阴褐色丘疹伴瘙痒3年余就诊。皮肤科检查:双侧大阴唇、阴阜及肛周密集分布肤色至黄褐色扁平小丘疹。皮损组织病理检查:表皮不规则增生,真皮浅层可见多数由嗜碱性上皮细胞聚集成圆形或卵圆形细胞团及管腔结构,腔管壁周围由两层立方形细胞组成,腔内有无定型嗜伊红物质。结合临床表现及组织病理改变诊断为汗管瘤。     

误诊为泛发性脓疱疮的青年寻常型天疱疮1例

患者男,24岁。鼻、口周水疱、脓疱、糜烂、结痂40d,泛发全身半个月。患者曾诊断为泛发性脓疱疮。皮肤科情况:面部、背部、外阴、双足散在分布大小不等水疱、脓疱,其上见糜烂面、少量脓性分泌物及黄色痂壳;双足趾表面皮肤发黑,趾间可见糜烂、浸渍,伴肿胀;口腔及外阴黏膜均可见大小不一的糜烂面。脓疱细菌培养无细菌等生长,糜烂面分泌物培养分别为大肠埃希菌及奇异变形杆菌;皮损病理检查示:表皮内基底层上大疱,疱腔内可见棘层松解细胞及混合炎细胞浸润。直接免疫荧光示:角质形成细胞间网状IgG(2+),C_3(+)沉积;血清桥粒芯蛋白抗体Dsg1,3均(+)。诊断:寻常型天疱疮。系统使用糖皮质激素,疗效佳,2周后好转出院。     

双下肢钙化防御

报告1例双下肢钙化防御。患者女,45岁。双下肢暗红斑及结节伴疼痛6个月。皮肤科检查:双侧大腿伸侧可见片状萎缩性紫罗兰色网状青斑,对称分布,红斑中央可见溃疡、结痂及色素沉着,周边散在分布数个黄豆至鸽蛋大溃疡;左大腿伸侧可扪及一鸽蛋大皮下结节,触痛明显。皮损组织病理检查:表皮基本正常,真皮层及脂肪层可见少许增生的血管,脂肪层深部可见血管钙化,小动脉中膜可见蓝紫色团块状颗粒沉积。Von Kossa染色阳性。诊断:钙化防御。     

外阴β-Catenin阳性皮肤颗粒细胞瘤1例

<正>患者女,38岁。左侧外阴结节12年。患者12年前无诱因发现左侧外阴出现黄豆大结节,无明显自觉症状,未治疗,结节缓慢增大至蚕豆大,遂于2017年1月11日就诊我科。患者既往体健,家族中无类似疾病患者。体格检查:系统检查无异常。皮肤科检查:左侧外阴一约2 cm×2 cm大肤色结节(图1),质地中等,活动     

Secondary syphilis in HIV infection - a diagnostic dilemma

A case of secondary syphilis in HIV infection is being reported. The patient presented with skin rash only. VDRL was found to be negative and HIV testing was positive. He was treated for secondary syphilis with clinical response. Blood VDRL test was subsequently reported as reactive.     

Manifestations and treatment of ocular syphilis during an epidemic in France

OBJECTIVES: To review cases of ocular syphilis presenting to a tertiary uveitis clinic during a syphilis epidemic in France between January 2001 and January 2004. STUDY DESIGN: Retrospective chart and patient database review. RESULTS: Ten patients who presented with symptoms and signs of uveitis tested positive for active syphilis. Some of the patients also presented with a rash or headache. Human immunodeficiency virus (HIV) antibody testing was positive in eight of the 10 patients, with CD4 cell counts >200 cells/mm3 in seven of the patients. Ocular inflammation resolved and visual acuity improved in all patients after treatment. CONCLUSIONS: A diagnosis of ocular syphilis should be considered in any patient with visual loss associated with a rash or headache, irrespective of the patient's CD4 cell count. Ocular syphilis in HIV-positive patients should be treated as neurosyphilis, whereas ocular syphilis in non-HIV patients can be treated as secondary syphilis.     

二期梅毒疹伴发下唇硬下疳1例

患者女,28岁。1月前下唇出现溃疡,1月后全身出现对称性丘疹性损害,梅毒特异性抗体检测(TPPA)(+),快速梅毒血清反应素(RPR)1∶128(+),诊断:二期梅毒疹伴发下唇硬下疳。予苄星青霉素240万U肌肉注射,1次/周,共3周。治疗结束后溃疡愈合,皮疹消退。     

早期梅毒215例临床特点及流行病学分析

目的　为了解贺州市梅毒病例的流行病学及临床特点。方法　对广西贺州市皮肤病防治院皮肤科 2 0 0 1年 1月～ 2 0 0 3年 12月确诊的 2 15例早期梅毒病例进行流行病学及临床分析。结果　二期梅毒占 5 5 .3 5 % ;多发年龄为2 0～ 3 9岁 ;职业以农民和个体居多 ,干部职员比例增高 ;文化程度以中学居多 ;传染来源以非婚性接触为主。一期梅毒皮疹以单一的溃疡为主 ;二期梅毒皮疹以斑疹型为主 ;同一患者可在不同部位出现多种皮疹 ,一期梅毒皮疹与二期梅毒皮疹可并存 ;治疗以长效青霉素加罗红霉素疗效较佳。结论　非婚性接触是贺州市梅毒流行的主要途径 ,早期梅毒皮疹可呈多形性、多部位出现 ,易误诊。     

Non-Hodgkin's lymphoma-like pseudolymphoma in syphilis II

We report on a patient suffering from early secondary syphilis associated with hepatitis and generalized papular rash which clinically and histologically appeared as non-Hodgkin lymphoma of the centrocytic-centroblastic type. The benign course and the response of the papular rash to penicillin therapy as well as repeated histological examination of many plasma cells and epithelioid cells, however, revealed pseudolymphoma.     

Corymbiform syphilis associated with three other sexually transmitted infections

Secondary syphilis can have different clinical presentations, with corymbiform rash as its rarest manifestation. The disease is characterized by a central papule surrounded by smaller ones. We report the case of a man who has sex with man with corymbiform syphilis. The patient was subsequently diagnosed with HIV infection, hepatitis B, non-gonococcal urethritis, as well as infection of the central nervous system by treponema. This case not only illustrates a rare presentation of secondary syphilis, but also demonstrates the importance of further investigation of sexually transmitted infections, particularly among at-risk patients.     

A case of adrenal insufficiency secondary to syphilis and difficulties in the diagnostic work‐up

We report a case of Addison's disease presumed to be secondary to syphilis. The patient presented with adrenal failure and a maculopapular rash on his trunk and palms. Syphilis was suspected but the non‐treponemal serological test used (the rapid plasma reagin test (RPR)) was falsely negative due to the prozone phenomenon. Treatment with benzathine penicillin resulted in normalization of adrenal function and resolution of the cutaneous findings. Repeat testing of the previously obtained serum sample showed the RPR to be positive on increasing dilutions of serum, consistent with the prozone effect.     

123例早期梅毒临床分析

目的观察早期梅毒的临床特点及疗效,为提高早期诊治水平提供科学依据。方法对123例早期梅毒患者的临床资料进行综合分析。结果本组病例中男性76例,女性47例。Ⅰ期梅毒53例,以外生殖器硬下疳为主;Ⅱ期梅毒67例,以掌跖暗红斑、扁平湿疣及玫瑰疹为主;潜伏梅毒3例,无皮疹。123例患者USR、Trust、TI'PA试验均为阳性(100%):使用苄星青霉素治疗梅毒血清试验阴转率达95.9%。结论早期梅毒临床表现多样性,易误诊。苄星青霉素是治疗早期梅毒的首选药物。     

发生在早期梅毒的脑部树胶肿一例

患者,女,50岁。梅毒病史17个月,阵发性头疼4个月。17个月前患者确诊“一期梅毒”,正规治疗并定期复查,快速血浆反应素试验(RPR)滴度下降4倍,皮疹消退。10个月前躯干、四肢出现鳞屑性红斑,掌跖部亦有类似皮疹,RPR滴度上升,梅毒复发,再次治疗后皮疹消退。4个月前出现阵发性头疼,后于外院神经外科住院,查头部核磁共振成像为右侧肿块,考虑为转移性肿瘤。给予手术治疗,术后组织病理为梅毒树胶肿,头痛症状消失,遂于我院性病科进行梅毒治疗及随访。     

Syphilitic periostitis of the skull and ribs in a HIV positive patient

We report the case of a HIV and syphilis co-infected patient who presented with headache and rash and was found to have syphilitic periostitis. Our case illustrates a rare manifestation of early syphilis and presents the diagnostic dilemmas that can arise in HIV and syphilis co-infected patients.