单纯疱疹病毒DNA在多形红斑皮损中的表达

应用聚合酶链式反应方法，对26例多形红斑组织中的单纯疱疹病毒DNA进行检测。18例为阳性，阳性率为72％，对照组选择结节性红斑11例，固定性药疹8例，均为阴性。结果对研究单纯疱疹病毒在多形红斑发病中的意义和临床治疗有指导价值。     

皮肤平滑肌瘤27例临床病理分析

Aclinico－pathologicalanaiysisof27casesofleiomyoma皮肤平滑肌瘤是一种不太常见的良性肿瘤，临床表坎皮肤或皮下疼痛性结节，而往往被临床误诊为皮肤其它肿瘤或疾病。我们对27例皮肤平滑肌瘤进行临床病理分析报告如下。l材料和方法收集我院1980－1994年活检标本中诊断为皮肤平滑肌瘤的病例27例，年龄11－57岁，其中间例比较集中在25～45岁年龄组，占63％。男性问例，女性匕例。肿瘤发生部位：上肢3例，多位于肘部；下肢11例，多位于胜前或膝部；手部5例，多位于掌侧；足部5例，多位于踝部；耳廓、阴囊及会阻部各1例；以发生于下肢者最多…     

军事训练致多人中暑患者的护理

目的：为多人中暑的救治提供经验资料。方法总结一起15例因军事训练而中暑的15例患者的临床资料和护理体会；在护理方面主要采取以下措施：给予快速降温，加强呼吸道管理，注重心理护理和健康教育及基础护理。结果14例患者完全康复，1例重症患者留有神经功能障碍。结论快速地降温、维持内环境稳定和器官功能支持治疗是改善预后的重要方法。     

儿童毛母质瘤577例临床特点分析

目的：探讨儿童毛母质瘤的临床特点。方法：回顾性分析2015年1月—2019年12月北京儿童医院皮肤科经手术切除和术后组织病理确诊的577例毛母质瘤患儿临床资料。结果：577例患儿中，男女比例为1∶1.3，发病年龄为0～16岁，中位发病年龄为6.6岁，病程为1周～108个月，平均病程为9.2个月。616处肿瘤中，5.0%位于头部，63.8%位于面部，10.3%位于颈部，5.0%位于躯干部，15.9%位于四肢。随年龄增长，面部发病率下降，四肢发病率升高。577例患儿中，88.9%为经典型，5.0%为多发型，3.1%为水疱型，3.0%为穿通型。多发型患儿肿瘤数为2～5个，均无并发其他疾病。结论：儿童毛母质瘤男女发病相当，出生即可发病，好发于学龄期儿童，好发部位为面部，其次为四肢。经典型最多见，其次为多发型，肿瘤数≤5个的多发型患儿并发其他疾病风险较低。     

Nd:YAG激光仪治疗太田痣298例

目的：探讨多波长激光仪治疗太田痣的疗效。方法：我院应用多波长激光仪对298例太田痣患者进行皮损区的多次照射治疗。治疗间期3月～6月，对患者治疗次数、年龄、皮损面积、部位、颜色以及不良反应等进行了分组观察研究。结果：年龄小，皮损颜色浅者，随治疗次数增加疗效越显著，298例患者经过1次～7次左右的治疗，痊愈166例，显效76例，有效26例，无效30例。总显效率81．20％，总有效率89．92％。166例痊愈患者平均治疗次数为5．74次，其中小于6岁儿童为4．25次。一般治疗5次左右可以治愈，无遗留瘢痕。结论：多波长激光仪治疗太田痣安全有效。     

上海郊区隐翅虫皮炎34例临床分析

目的了解隐翅虫皮炎的临床特征方法对34例门诊就诊的隐翅虫皮炎患者进行回顾性临床分析结果患者均为郊区人士，男19例，女15例，平均年龄32岁，晨起发病14例，傍晚发病20倒结论隐翅虫皮炎发病有季节性，以暴露部位多见。     

甘利欣注射液联合雷公藤多苷片治疗寻常型银屑病疗效观察

目的：探讨甘利欣注射液联合雷公藤多苷片治疗寻常型银屑病的疗效。方法：将24例寻常型银屑病患者分为治疗组和对照组，每组各12例。两组均给与雷公藤多苷20mg，每日3次，维生素C200mg，每日3次口服，局部外涂0．05％氯倍他索霜（本院自制）。治疗组同时用甘利欣注射液150mg加入10％葡萄糖250ml中静脉滴注，每日1次，每周连续3日，两组患者均治疗1个月为1个疗程，连用2个疗程。结果：治疗组痊愈3例，显效6例，有效2例，无效1例，总有效率为75％（9／12）；对照组痊愈1例，显效3例，有效5例，无效3例，总有效率33．3％（4／12）。结论：甘利欣注射液与雷公藤多苷联合应用对寻常型银屑病起到较好的控制作用，有明显的近期疗效。     

98例麻风畸残者自我护理3年效果报告

根据中英麻风康复合作项目任务的要求，我县自１９９５年５月至１９９８年５月间共对１００例麻风畸残患者实施了眼手足自我护理训练，随访观察３年期间２例死亡。现将资料完整的９８例自我护理结果报告如下。资料和方法对象选择按Ｗａｔｓｏｎ所介绍的方法，对患者眼手足进行保护性感觉检查和肌力测定，凡确诊有神经损害者为自我护理的对象。９８例中男性７１例，女性２７例；院内６例，院外９２例；年龄１８～６９岁，其中５０岁以下者６２例，占６３．２６％；少菌型６６例、多菌型３２例；麻风畸残Ｉ级４例，Ⅱ级９４例。自护方法　按Ｗ…     

人工流产妇女衣原体普查和预防性治疗的成本效果分析

目的：评估人工流产妇女衣原体感染普查和阿奇霉素预防治疗的投入成本效果，确定不同并发症发生率对投入成本效果影响的敏感性。方法：建立决策树模型评价项目的效果，如预防衣原体感染的后遗症。在衣原体流行率为4．8％的基数上，从公共卫生角度评估普查和阿奇霉素预防治疗对无干预的成本效果。对后遗症和可预防性盆腔炎（PID）的发生率及贴现率进行了敏感性分析。结果：如感染率为4．8％，不干预将导致302例PID，并发症费用为296827元，阿奇霉素预防性治疗的费用为411525元，但可预防289例PID，与不干预相比，每预防1例PID需花费397元。应用PCR普查可预防253例PID，花费1018119元，与不干预相比，每预防1例PID需花费3049元。与普查相比，阿奇霉素预防治疗多预防36例PID，每多预防1例PID少花费18239元。结论：阿奇霉素预防治疗对人工流产妇女的衣原体感染具有成本效果。     

百多邦治疗感染性皮肤病疗效观察

百多邦治疗感染性皮肤病疗效观察梁成萍，陈南琴我科用中美史克必成公司研制的百多邦抗生素软膏，治疗原发性和继发性感染性皮肤病１４５例，收到非常满意效果，现报导如下。１材料与方法１．１临床资料：本文收治１４５例病人，男７８例，女６７例，年龄２～８５岁。原发...     

Neutral endopeptidase expression and distribution in human skin and wounds.

Cutaneous sensory nerves mediate inflammation and wound healing by the release of neuropeptides such as substance P. Neutral endopeptidase is a cell surface enzyme that degrades substance P and thereby terminates its biologic actions. The distribution of neutral endopeptidase in normal skin and wounded human skin, however, has not been examined. The objectives of this study were to evaluate neutral endopeptidase expression in wounded and unwounded skin as well as in cells derived from human skin. Neutral endopeptidase was strikingly localized in normal skin by immunohistochemistry to keratinocytes of the epidermal basal layer, to hair follicles, eccrine and sebaceous glands as well as to endothelium of blood vessels and to large nerves. Standard incisional human wounds were studied at several time points between 1 h and 28 d after wounding. Staining for neutral endopeptidase was noted in the wound bed 6 h after wounding. In contrast to normal skin, staining of all the epidermal cell layers was noted in the migrating tongue of epithelium in l d wounds. Similar full-thickness staining was noted in 3 d and 7 d wounds in all layers of the new wound epithelium and in a "transition epithelium" near the wound edge. By 28 d post wounding neutral endopeptidase staining again was detected only in the basal layer of the epidermis. Neutral endopeptidase mRNA was detected in normal skin and wounds as well as cultured keratinocytes, fibroblasts and endothelial cells. Neutral endopeptidase enzymatic bioactivity was demonstrated in cultured keratinocytes. While it is known that several metalloproteinases important to tissue repair are produced by keratinocytes, this is the first evidence that keratinocytes produce neutral endopeptidase. Neutral endopeptidase may terminate the proinflammatory and mitogenic actions of neuropeptides in normal skin and wounds.     

Derivation and clinical application of special imaging by means of digital cameras and Image J freeware for quantification of erythema and pigmentation.

BACKGROUND: Quantification of erythema and pigmentation is useful for analysis of skin tests and management of skin diseases. However, reflectance instruments for this purpose suffer from many technical and financial disadvantages. The aim of this study was to establish a method for evaluation of the amounts of haemoglobin and melanin using ordinary digital cameras and Image J freeware. METHODS: Based on the theories on the absorbance of a multilayered skin model, the erythema index (EI) and melanin index (MI) images were derived by image processing from digital colour images of the skin, which were obtained with four kinds of digital cameras. The specificity of these indices and the linearity between index values and the amounts of haemoglobin and melanin were determined by using images of various concentrations of haemoglobin and melanin solutions. The accuracy of both types of index images was also examined by comparing the index values of UV-induced erythema and pigmentation of various intensities with those measured with a reflectance spectrophotometer. RESULTS: The specificity of EI and MI images was good as little interference was noted with each other. The linearity between EI and haemoglobin concentration, as well as that between MI and melanin concentration was excellent. For UV-induced erythema and pigmentation, good linear correlation was confirmed between two types of EI obtained by the two methods, as well as between two types of MI. However, the index values derived from digital images depended on the camera used as well as on the circumstantial conditions, such as the distance from objects and illumination. CONCLUSION: EI and MI images are reliable and useful for quantifying erythema and pigmentation, if obtained under constant and consistent conditions. Apart from financial benefits, this method has many advantages and greater clinical utility in comparison with reflectance instruments.     

MMP-21 is expressed by macrophages and fibroblasts in vivo and in culture

Matrix metalloproteinase (MMP)-21 and MMP-26 (matrilysin-2) are two recently cloned epithelial metalloproteases. Here we examined their expression in various benign skin disorders, in which macrophages and fibroblasts have been implicated as well as in cultures of these cells. Expression of MMP-21 was detected by immunohistochemistry in a subset of macrophages of granulomatous skin lesions and in fibroblasts in dermatofibromas. MMP-21 mRNA was found in THP-1, U937, HEL 299 and Hs68 cells. Furthermore, MMP-21 protein was detected by immunohistochemistry in cultures of the same cell lines. In culture MMP-21 was upregulated by phorbol myristate acetate in THP-1 cells and by retinoic acid (RA) in U937 cells, and downregulated by transforming growth factor beta 1 (TGF-beta1) in HEL 299 as assessed by Taqman quantitative polymerase chain reaction (PCR). Expression of MMP-26 was detected by immunohistochemistry in granulomatous skin diseases and actinic elastosis. MMP-26 at both mRNA and protein levels was only found in HEL 299 cells. In culture it was downregulated by TGF-beta1, RA and IL-1beta as assessed by Taqman quantitative PCR. Our results suggest these two novel MMPs are not only associated with cancer but may be important in connective tissue remodelling and pathobiology of various benign skin disorders.     

Medical imaging and MRI in nail disorders: report of 119 cases and review of the literature

Radiographs remain the golden standard for exploration of the bony structures located beneath the nail plate, but they provide no information on the perionychium. Until a few years ago the nail apparatus was deprived of investigative medical imaging. Glomus tumor was the only condition that was explored using invasive techniques such as angiography or scintigraphy. High-frequency ultrasound rapidly came up against technical limits. High-resolution magnetic resonance imaging (MRI) offers a superior alternative in detection of distal lesions as well as their relationship with the adjacent structures. MRI provides an accurate analysis of the nail apparatus with detection of lesions as small as 1 mm. This noninvasive technique will allow us to better understand, diagnose, and treat pathologies of the distal phalanx.     

Diagnostic treatment and reporting criteria for gonorrhoea in sexually transmitted disease clinics in England and Wales. 2: treatment and reporting criteria

The current methods of treatment and reporting are described. The most common form of treatment for gonorrhoea in men and women was a single dose of oral ampicillin, usually 2 g. In proportionately more of the clinics treating women, treatment was given over several days. The wide use of ampicillin represents a marked change in treatment practice during the last decade. Procaine penicillin was the most commonly used parenteral preparation. The two dosages used most often for men were 1.2 and 2.4 megaunits. In women the commonest regimen was 2.4 megaunits and again there was a tendency for treatment to be given over several days. Epidemiology treatment was used widely and in one-third of clinics this occurred without confirmation that the patient was a true contact. Consultants used varying diagnoses on the quarterly returns for patients treated epidemiologically in whom the smears and/or cultures were negative. Most clinics classified these cases as 'other conditions requiring treatment' (D2) but as many as 19% of clinics designated these cases as being 'true' gonorrhoea. It is suggested that this results in an overestimate of the number of cases of 'real' gonorrhoea treated in England and Wales.     

Subcutaneous fat necrosis of the newborn following hypothermia and complicated by pain and hypercalcaemia

A female infant was delivered at term with complications of severe meconium aspiration and birth asphyxia. Surface cooling was performed in the first 24 hours as part of the management of her birth asphyxia. Woody erythema was noted at 24 hours, followed by the formation of red-purple nodules on the 6th day. Clinical findings in the first 24 hours were suggestive of cold panniculitis. However, clinical and histological findings progressed to be in keeping with the diagnosis of subcutaneous fat necrosis of the newborn (SCFN). Furthermore, the immediate postnatal period was complicated by pain resistant to treatment with opiates. Asymptomatic hypercalcaemia was noted on periodic testing at 7 weeks and treated by rehydration, diuretics, prednisolone, etidronate and a low-calcium and -vitamin D diet. A review of the clinical and histological findings of the relevant panniculitides occurring in the postnatal period is presented, as well as a review of the treatment of hypercalcaemia in SCFN.     

Malignant melanoma and granulomatosis

Summary Sarcoidosis or granulomatous reactions have rarely been reported in association with malignant melanoma (MM). We describe seven patients who presented with both granulomatous disease and MM, and discuss the physiopathoiogical and prognostic significance of this association. In three patients, the granulomatosis was diagnosed as true sarcoidosis and in one patient, as tumour-associated granuloma. In three cases, designated here as atypical tumour-associated granulomatoses, the presence of clear-cut pulmonary granulomatous nodules was typical neither for sarcoidosis nor for tumour-associated granuloma and was highly suggestive of melanoma metastases. Mediastinal lymphadenopathy was present in every patient, hi ail seven patients, the question of mediastinal or pulmonary involvement or relapse of the MM was raised, but could be confirmed in only one patient. MM can be associated with granulomatous disease. Knowledge of this association has implications in the management of patients with MM.     

Cyclin D1, B and A expression and cell turnover in psoriatic skin lesions before and after cyclosporin treatment

BACKGROUND: Cyclosporin induces a dramatic reversal to normality in psoriatic lesions, with a reduction of inflammatory infiltrate and epidermal proliferation. It is known that the cell cycle and cell proliferation are regulated by the sequential activation of cyclin-dependent kinase/cyclin complexes. AIM: We evaluated epidermal cell turnover and thickness, as well as the expression of cyclins D1, B and A in psoriatic skin before and after therapy with cyclosporin. METHODS: Epidermal thickness, mitotic and apoptotic indices (MI, AI), as well as the percentages of epidermal cell nuclei positive for Ki-67 and cyclins D1, B and A were calculated. Cytoplasmic positivity to cyclin B was also evaluated. RESULTS: After 6 weeks of therapy, we observed a clinical improvement of the disease and normalization of the epidermis. Epidermal thickness and Ki-67-, cyclins B- and A-positive nuclei percentage were significantly higher before therapy than after (0.52 +/- 0.05 mm vs. 0.21 +/- 0.03 mm, P < 0.001; 19 vs. 2.6, 19 vs. 3, and 12 vs. 1, respectively; P < 0.0005); cytoplasmic positivity to cyclin B was slightly higher before therapy (score 3 vs. 2-3). Cyclin D1 was negative or expressed in a low percentage of nuclei in psoriasis before therapy (0.78), whereas it was always negative after therapy. MI was 0.15 before therapy, whereas mitoses were almost absent afterwards. Apoptoses were undetectable before therapy, whereas a few apoptoses were observed after treatment (AI = 0.4). CONCLUSIONS: Overexpression of cyclins B and A, rather than D1 seems to characterize psoriasis. Their evaluation could provide further insights in understanding the development of this disorder and could be used to verify the efficacy of currently used therapies as well as future ones.     

Culture of uninvolved and involved psoriatic and normal epidermis with 3T3 feeder layers: morphological and biochemical comparison

Isolated cells of uninvolved and involved psoriatic and normal epidermis have been cultured with 3T3 feeder layers. The efficiency of colony formation in the involved psoriatic epidermal cells was 50% as high as that in the uninvolved. No differences were observed between the uninvolved and involved psoriatic epidermal cell growth assessed by measuring the size of the growing colonies. Histologically, the structure of psoriatic colonies as revealed by electron microscopy did not differ from that of healthy control skin, having several layers of stratified epidermal cells with incomplete keratinization. The cyclic AMP level stimulated by the addition of isoproterenol to the involved psoriatic cell culture was about 50% as high as that in the uninvolved.     

Dermoscopy and the experienced clinicians

For several decades, melanoma diagnosis was based on symptoms rather than clinical features. In fact, until the 1970s melanoma was widely not recognized and only diagnosed when presenting as a large, ulcerated, and bleeding nodule. Today it is well known that ulceration and bleeding are symptoms of an advanced stage; thus, it comes not as a surprise that the prognosis of melanoma at that time was very poor. This paper was developed to recognize dermoscopy as an integrative part of the clinical examination, bearing in mind that naked eye diagnosis can change after dermoscopy outcomes, and to help clinicians avoid the concept: “If in doubt, cut it out”.