进行性血管淋巴管瘤1例及其皮肤镜、共聚焦显微镜特征

患者男,12岁,左股外侧簇集性暗红色丘疹2年余,逐渐增多。皮损组织病理示:轻度角化过度,棘层轻度肥厚,真皮浅层多发扩张血管和淋巴管,部分可见红细胞和蛋白样物质;皮肤镜下可见淡红色背景上界限清楚,大小不等的,圆形或椭圆形棕红色斑,散在黑褐色斑;共聚焦显微镜下可见真皮浅层多发大小不等低折光腔隙,腔隙内缘光滑平整,有些腔内一侧可见多数点状闪烁高折光小点。诊断:进行性血管淋巴管瘤。     

主要表现为臀部结节的疥疮误诊1例

患者男,21岁.臀部红斑、结节伴瘙痒15d.皮肤科情况:臀部可见弥漫分布的红斑,其上散在黄豆大小的红色结节,阴囊未见明显结节.手指缝散在针尖大小红色丘疹.疥虫镜检:阴性.皮肤镜检查:手部皮损可见白色隧道,顶端可见褐色三角形结构,即"三角翼喷气式飞机和凝结尾迹结构".诊断:疥疮.     

皮肤镜及反射式共聚焦显微镜辅助诊断儿童结缔组织增生性毛发上皮瘤1例

患儿女，11岁，下颌肿物5年。皮肤科情况：下颌黄豆大小丘疹，色黄、质硬，边界清楚，中央略凹陷，其上可见针尖大小粟丘疹样突起。皮损组织病理检查示：真皮浅层可见上皮样条索及角囊肿，间质胶原纤维致密、增生。反射式共聚焦显微镜(RCM)检查示：真皮浅层可见多个低折光圆形、长形瘤细胞团块，瘤团内可见大小、形态相似的低折光鱼子样细胞，中央可见中高折光均质团块，周围包绕明亮的胶原纤维束呈平行排列，部分瘤团内可见高折光多边形小团块结构。皮肤镜检查示：皮损区边界清楚，呈象牙白色背景，边缘见线状血管及黄白色圆形结构灶性分布，中央少量薄层鳞屑。诊断：结缔组织增生性毛发上皮瘤(desmoplastic trichoepithelioma, DTE)。RCM和皮肤镜对疑似DTE患者，能在无创诊断、鉴别诊断及病理取材定位方面提供较可靠的辅助诊断价值，尤其对儿童患者及面部皮损具有较高临床应用价值。     

经典型小汗腺汗孔瘤1例

患者男,30岁,左足外侧缘褐色丘疹20余年。皮肤科情况:左足外侧缘见一约黄豆大小褐色丘疹,边界清楚,表面粗糙,可见黄褐色痂屑,锯齿状裂隙,周围可见黄白色角化性鳞屑。皮肤镜示:红褐色类椭圆形结节,边界清晰,可见粉红色-红色不规则均质团块,部分周围可见白晕,可见不规则均质褐色色素沉着,表面可见黄白色痂屑,可见灶性分布的点状、不规则线状血管。组织病理示:表皮角化过度,可见境界清楚的从表皮向下延伸入真皮的瘤细胞团,相互交织呈宽带状,瘤体内可见囊腔及导管样结构,间质含有丰富的毛细血管及导管腔结构。诊断:经典型小汗腺汗孔瘤。     

皮肤镜辅助诊断皮肤结节病2例

例1,男,37岁。面颈、双上肢多发暗红色丘疹伴瘙痒5个月。皮肤科情况:面部、颈部、双上肢泛发孤立红色丘疹,粟粒至黄豆大小,质韧。例2,女,53岁。臀部红色丘疹2年。皮肤科情况:面部、颈部、肘部、臀部皮肤可见散在红色、暗紫色丘疹、斑块,约豆粒至钱币大小,有浸润感,质韧。两例患者皮肤镜下均可见橘黄色无结构区、白色线条及白色瘢痕样色素减退、线状血管及线状分支状血管;皮损组织病理检查:真皮可见大量上皮样细胞组成的"裸结节",结节周围少量淋巴细胞浸润,散在的多核巨细胞。诊断:皮肤结节病。     

吗替麦考酚酯成功治疗干燥综合征并发结节病一例

45岁女性患者,四肢、腰臀部多发皮下结节3个月。既往干燥综合征病史8年余。皮肤科情况:四肢、腰臀部可触及9处直径0.8～2.0 cm皮下结节,散在分布,部分结节表面淡红色,无压痛。结节组织病理示真皮内可见大小不等的、由上皮样细胞构成的肉芽肿性结节,其内有少量多核巨细胞;部分结节周围可见少量淋巴细胞及中性粒细胞浸润,部分结节间的胶原颗粒样变性。诊断:(1)结节病;(2)干燥综合征。给予吗替麦考酚酯胶囊0.75g口服,维持治疗5个月余,结节无复发。     

单纯性汗腺棘皮瘤

报告1例单纯性汗腺棘皮瘤。患者男,55岁。因右臀部、右大腿内侧斑块3年就诊。皮损组织病理检查示表皮内可见境界清楚的肿瘤团块,团块内可见汗腺导管结构。诊断:单纯性汗腺棘皮瘤。     

黑素瘤并发晕痣样色素减退斑

报告1例黑素瘤并发晕痣样色素减退斑.患者女,55岁.因左臀部黑色丘疹30余年,出现结节并逐渐增大和色素减退斑2年,破溃、结痂10个月就诊.皮肤科检查:左臀部-2 cm× 3 cm ×0.6 cm暗红色结节,表面破溃、结痂;结节周围绕以1-2 cm宽、边界清楚的色素脱失晕.皮损组织病理检查示真皮中上部境界清楚的肿瘤团块,由多数梭形细胞和部分上皮样细胞组成,免疫组化染色示S-100(+),HMB45(+).诊断为黑素瘤并发晕痣样色素减退斑.     

儿童管状顶泌汗腺腺瘤1例

患者男,8岁,臀部结节2年。皮肤科情况：左侧臀部一紫红色半球形结节,直径约0.6 cm,境界清楚,质地中等,表面糜烂、结痂,轻度压痛。皮损组织病理示：真皮内大量增生的形态不规则的管腔或囊腔样结构,部分与表皮相连,管腔衬以两层或多层上皮细胞,外层细胞扁平,内层细胞核圆形或类圆形,可见顶浆分泌。免疫组织化学：肿瘤细胞CK7(+),管腔内侧上皮细胞EMA、CEA(+),管腔外侧上皮细胞p63(+)。治疗：予手术完整切除,现在随访中。     

透明细胞汗腺瘤1例

患者女,34岁。左耳前皮下结节1月余。皮肤科情况:左耳前可见一皮下结节,肤色,表面光滑,质地中等,无压痛。皮损组织病理示:真皮内可见大小不等肿瘤细胞团块,境界清楚,和表皮不相连;肿瘤团块由两种细胞组成:透明细胞及嗜碱性细胞。诊断:透明细胞汗腺瘤。     

皮肤僵硬综合征1例

患儿男,9岁。出生后9个月时被发现双侧臀部皮肤坚硬如石,并逐渐累及双侧髋部、腰部及大小腿。双侧臀上部、臀外侧及股外侧皮肤毳毛增多、增粗。皮损组织阿新蓝染色显示真皮内有黏多糖沉积。诊断:皮肤僵硬综合征。     

IIb型家族性高胆固醇血症性黄瘤病一例

患儿,女,2岁。双侧臀横纹皮肤黄色丘疹半个月。父母及患儿血脂均升高。患儿皮损组织病理检查：真皮层见大量泡沫状细胞聚集。综上诊断为IIb型家族性高胆固醇血症性黄瘤病。给予口服烟酸及降血脂治疗。目前仍在随访中。     

巨细胞动脉炎1例

报告1例巨细胞动脉炎。患者男，80岁。因头面部皮下结节伴疼痛1个月余入院。皮肤科检查；前额，双侧额部有条索状皮下结节，有轻微触痛，双眼视物模糊。皮损组织病理检查符合巨细胞动脉炎改变，给予糖皮质激素治疗后病情好转。     

Tumoral Calcinosis: Report of a Case and Brief Review of the Literature

A patient with a 32-year history of tumoral calcinosis is described. The calcified lesions involved the soft tissues in the hips, shoulders, and ankles. Periodically, a chalky semifluid material extruded through several cutaneous sinuses. Laboratory tests including serum calcium concentration were normal, except for slight elevation of serum phosphorous levels. Ophthalmologic examination revealed the interesting finding of subretinal angioid streaks. The dental radiograms disclosed pathognomonic short bulbous roots and partial obliteration of pulp cavities, while the radiological evaluation of the tumoral masses revealed typical features of tumoral calcinosis.     

疣状皮肤结核继发糜烂溃疡一例

患者,男,60岁。臀部、腹股沟红斑丘疹、溃疡7个月余。多次在我科门诊就诊,诊断为湿疹、传染性湿疹样皮炎、皮肤溃疡等,治疗效果差。后收住院诊治,组织病理提示上皮样细胞肉芽肿及干酪样坏死,PPD试验阳性,TSPOT阳性,诊断：疣状皮肤结核继发细菌感染。给予异烟肼、利福平及盐酸乙胺丁醇三联口服治疗后皮疹消退。     

单纯性汗腺棘皮瘤1例

患者女,56岁。左臀部暗红色斑块8年。组织病理学显示:表皮内可见边界清楚的肿瘤组织团块,单个肿瘤细胞呈圆形或立方形,细胞大小一致,排列均匀,与周围角质形成细胞界限清楚。诊断:单纯性汗腺棘皮瘤。     

Squamous cell carcinoma of the penis in a man with a human papilloma virus 31 infection

We report a 51-year-old man with squamous cell carcinoma (SCC) on his penis. He was surgically treated for his phimosis when he was 20 years old. He presented with an indurated nodule on the tip of his penis. The tumor was treated with partial penectomy and standard inguinal lymphadenectomy. Histological examination revealed that the tumor was a well-differentiated type of SCC. A polymerase chain reaction was performed to detect human papilloma virus (HPV) DNA. The result revealed the presence of HPV in the SCC. The results of sequencing analysis showed that the DNA was HPV 31.     

Eruptive squamous cell carcinomas, keratoacanthoma type, arising in a multicolor tattoo

Permanent tattoos are formed through the injection of ink solids through the epidermis into the dermis and can cause multiple adverse reactions. We report a 38-year-old man who presented to our Dermatologic Surgery Unit with a diagnosis of a superficially invasive squamous cell carcinoma (SCC), keratoacanthoma (KA) type, of the left forearm in a 1-month-old tattoo. Since his initial biopsy, he developed four more similar lesions on his left forearm within his tattoo. On physical examination, the patient had a large, multicolor tattoo on his left forearm, a well-healed surgical biopsy site and four erythematous hyperkeratotic papules within differently pigmented areas of the patient's tattoo. Histopathological examination showed KA and tattoo pigment. Based on the eruptive nature of these lesions, their clinical presentation and the histopathological changes, we report this as the first case of eruptive KA arising in a multicolor tattoo.     

Jackson-Lawler综合征1例

报告1例Jackson-Lawler综合征。患儿男，10岁。自出生后3个月起双手、足指（趾）甲增厚，伴面部、躯干、四肢丘疹和结节。甲真菌检查阴性，皮肤组织病理检查证实为多发性脂囊瘤，临床诊断为Jackson-Lawler综合征。     

肉芽肿性口周皮炎一例

患者,男,49岁。10年前无明显诱因下颌出现红斑、丘疹,逐渐增多。皮肤科检查：下颌片状红斑,其上可见红色粟粒大丘疹,少许鳞屑,密集分布。组织病理检查：可见上皮样细胞肉芽肿及淋巴细胞浸润。 诊断：肉芽肿性口周皮炎。给予多西环素0.1 g,每日2次口服,0.1%他克莫司局部外用,治疗40天后皮疹完全消退。