中药治疗进行性色素性紫癜性皮肤病

进行性色素性紫癜性皮肤病（ｐｒｏｇｒｅｓｉｖｅｐｉｇｍｅｎｔｅｄｐｕｒｐｕｒｉｃｄｅｒｍａｔｏｓｉｓ,ＰＰＰＤ）病因尚不明了,慢性经过。１９９０年８月～１９９７年８月,我们用中药先后治疗８６例,现报告如下。临床资料８６例均经我院皮肤科门诊根据典型临床...     

三七通舒胶囊联合糖皮质激素治疗色素性紫癜性皮肤病临床观察

目的观察三七通舒胶囊联合糖皮质激素治疗色素性紫癜性皮肤病的疗效和安全性。方法采用随机、平行、开放对照的方法,对45例色素性紫癜性皮肤病患者,按1：1：l比例分成A、B、c3组,分别随机按A组：三七通舒胶囊、强的松治疗;B组：三七通舒胶囊治疗;C组：强的松治疗。观察第14天、28天的临床疗效及1年内复发率。结果治疗色素性紫癜性皮肤病第14天和28天的有效率分别为：A组80％和93-3％;B组66．6％和80．6％;C组73．3％和86．6％。3组之间差异无统计学意义（P〉0．05）。观察1年内复发率：A组8．3％,B组50％,C组22．2％。结论三七通舒胶囊联合糖皮质激素治疗色素性紫癜性皮肤病疗效好,治愈率较高,有减少复发的作用。     

进行性色素性紫癜性皮肤病1例

色素性紫癜性皮肤病是临床常见的毛细血管炎类疾病,经典表现为对称发生于小腿及踝之周围,一般无自觉症状。笔者门诊遇到1例患者皮损全身泛发,临床较为少见,现报道如下。临床资料　患者,女,5 3岁,家庭妇女。全身皮疹伴微痒4～5个月。病初先于双小腿及踝之周围出现紫红色瘀点,斑片,微痒。曾在外院按皮炎治疗(用药不详)效果不明显,以后皮损逐渐累及大腿躯干、双上肢、颈部。发疹前无服药史,否认化学品接触史,饮食无特殊;发疹前后无发热、咽痛、咳嗽,否认外伤,平素体健,既往无类似病史。体检:系统检查无异常,皮肤科情况:颈部、躯干、四肢均匀散…     

凉血五根汤治疗色素性紫癜性苔藓样皮肤病体会

色素性紫癜性苔藓样皮肤病,是一种较少见而又难治愈的皮肤病,此病与祖国医学里所说的"血疳"相类似.     

具有色素性紫癜性皮肤病等表现的未分化结缔组织病

患者男,44岁.因躯干和四肢出现红斑、丘疹、紫癜性皮损6年.于2006年12月来我院就诊.6年前无明显诱因患者躯干、四肢出现红斑、丘疹,无明显自觉症状.皮损逐渐增多,躯干和上肢皮损经历l至数月后可缓慢消退,但可反复发作,消退后不留瘢痕.小腿皮损逐渐转为紫癜性皮损,并融合成片,从未消退.在当地医院治疗效果欠佳.     

泛发性色素性紫癜性皮肤病1例

色素性紫癜性皮肤病是临床常见的毛细血管炎类疾病，经典表现为对称发生于小腿及踝之周围，一般无自觉症状。笔者门诊遇到1例患者皮损全身泛发临床较为少见，现报告如下：     

肝素钠软膏(海普林)治疗色素性紫癜性皮肤病疗效观察

目的观察肝素钠乳膏(海普林)治疗进行性色素性紫癜性皮病、色素性紫癜性苔藓样皮炎两种疾病疗效。方法采用随机对照观察方法对478例进行性色素性紫癜性皮病和207例色素性紫癜性苔藓样皮炎患者应用肝素钠乳膏外涂患处,同时配合内服药物治疗,并与单纯应用内服药物治疗对照。结果进行性色素性紫癜性皮病对照组有效率为43.91%,治疗组有效率为79.44%,差异有显著性;色素性紫癜性苔藓样皮炎对照组有效率为32.00%,治疗组为73.83%,差异有显著性。结论海普林乳膏可以作为糖皮质激素替代制剂治疗色素性紫癜性皮肤病。     

色素性紫癜性皮病

色素性紫癜性皮病(PPD)为一组病谱性疾病,以主要局限于双下肢的多种紫癜性损害为特征,虽然皮损形态各异,但有共同的组织病理学基础。PPD诊断并不困难,但治疗效果不佳,目前对PPD病因和治疗仍存在争议。     

加味桃红四物汤治疗白癜风的临床及实验室研究

目的 观察加味桃红四物汤治疗白癜风的效果并探讨其作用机制。方法 白癜风患者243例，用加味桃红四物汤口服液，每次10mL，3次／d，口服。体外培养的正常人黑素细胞以含药血清作用后测定细胞酪氨酸酶活性、黑素含量和细胞增殖。结果 临床观察显示243例白癜风患者服用加味桃红四物汤后，治愈26例(10．7％)，显效66例(27．2％)，有效76例(31．3％)，无效75例(30．8％)；实验结果显示加味桃红四物汤的含药血清能上调酪氨酸酶活性，提高黑素含量，促进黑素细胞增殖。结论加味桃红四物汤治疗白癜风有明显疗效，其作用可能与刺激黑素细胞黑素合成、上调酪氨酸酶活性、促进细胞增殖有关。     

Granulomatous variant of chronic pigmented purpuric dermatosis: report of two cases

Two patients presenting with chronic pigmented purpuric dermatosis (CPPD) on the dorsum of both feet were found to show granulomatous inflammation superimposed on the pathological changes of CPPD. Two similar cases have been reported from Japan. The unique clinicopathological features of this group of patients suggest that they have a rare granulomatous variant of CPPD.     

表现为进行性色素性紫癜性皮病的蕈样肉芽肿1例

患者,女,76岁。双下肢出现红色瘀点、进行性增多伴轻微瘙痒半年。组织病理示:表皮及真皮浅层单一核细胞浸润,表皮内可见Pautrier微脓肿。免疫组化:CD3(+)、CD4(+)、CD8(散在+)、CD45R0(+)、Ki-67(20%左右+)。诊断:蕈样肉芽肿。     

Two cases of unilateral pigmented purpuric dermatosis

Two cases of pigmented purpuric dermatosis showing unusual distribution are reported. Case 1: 35-year-old female. A group of three asymptomatic purpuric macules developed on the ulnar side of the elbow flexure of the left forear 3-6 months before presentation. Histopathological analysis revealed a band-like inflammatory infiltrate in the Uppermost dermis and extravasation of red blood cells just beneath the epidermis, but there was no evidence of lichefaction degeneration in the basal layer of the epidermis. Case 2: 26-year-old female. Asymptomatic purpuric pigmentations developed on the flexure side of the right lower extremity in a linear arrangement 2-3 months before presentation. Histopathological analysis revealed focally perivascular inflammatatory infiltrates consisting mainly of lymphocytes and conspicuous extravasation of red blood cells into the papillary dermis. There was no histological evidence of vasculitis in either case. Hemosiderin deposits were more limited than expected in both patients. Both cases are compatible with diagnoses of pigmented purpuric dermatosis. Case 1 on the left arm was compatible with lichen purpuricus. Case 2 occurred in a linear arrangement on the right leg and had a history of aspirin use for chronic headache. We therefore suspected that medication had been an etiological or contributing factor.     

持续性色素性紫癜性皮病样蕈样肉芽肿一例并文献复习

持续性色素性紫癜性皮病样蕈样肉芽肿是皮肤T细胞淋巴瘤中的罕见类型,具有特征性的临床表现、皮肤镜、病理及免疫组化特点。本文报道1例持续性色素性紫癜性皮病样蕈样肉芽肿病例并复习相关文献。     

Sarcoidosis with small syringotropic granulomas presenting clinically as a pigmented purpuric dermatosis: Inconspicuous clinical and histopathological clues to systemic illness

Sarcoidosis is a multisystem granulomatous disease with a myriad of clinical manifestations and a predilection to involve the lungs, eyes, lymph nodes, and skin. A 38-year-old man presented to dermatology with a history of progressive dyspnea, pulmonary consolidations on chest X-ray, and hilar adenopathy on computed tomography scan. Skin exam revealed asymptomatic, yellow to brown macules on the right lower extremity. Biopsy of a lesion showed diminutive syringotropic granulomas and perivascular hemosiderin; stains for bacteria, mycobacteria, and fungi were negative. Subsequent fine needle aspiration of a hilar mass revealed non-necrotizing epithelioid granulomas further supporting a diagnosis of sarcoidosis. The patient was placed on systemic steroids and had improvement of his pulmonary symptoms and stabilization of his hilar lymphadenopathy without resolution of his pigmented purpuric dermatosis (PPD) like lesions. Only three prior cases of syringotropic sarcoidosis have been reported; however, the biopsies had revealed conspicuously large granulomas in contrast with the small granulomas in our case, and none of the prior patients had clinical examination findings that mimicked PPD. Recognition of rare dermatologic and histopathological appearances of sarcoidosis is paramount as cutaneous sarcoidosis may be the harbinger of a systemic illness, which requires a timely diagnosis.     

Calcium dobesilate (Cd) in pigmented purpuric dermatosis (PPD): a pilot evaluation

Pigmented purpuric dermatosis (PPD) is a chronic disorder of unknown etiology. It is quite common, and no therapy is significantly effective. Calcium dobesilate (Cd) has been tried successfully in many vascular disorders. The aim of this study was to evaluate the usefulness and efficacy of Cd in PPD. Nine male patients (7 with Schamberg's and 1 each with lichenoid dermatosis of Gougerot and Blum and lichen aureus) were given Cd 500 mg twice daily for two initial weeks and then 500 mg once daily for a total period of three months. All the patients were followed up for one year after cessation of therapy. The improvement was moderate in 11.11% and mild in 66.67% of cases; 22.22% did not show any improvement. New lesions stopped appearing in two weeks in all patients, and itching also improved in symptomatic cases without any significant side effects. Based upon the results of this pilot study we recommend Cd as the first line therapy for PPD.     

Transitory pigmented purpuric dermatoses in a young Japanese female

We report a 23-year-old female patient with a 4-month history of transitory pigmented purpuric dermatoses (PPD). She was otherwise healthy and reported no history of previous medication intake and none of her family members had any disorders. Clinical examination revealed well-demarcated, brownish hyperpigmented, reticulated pigmentation with pinhead-sized purpura. The histopathological specimen was characterized by a mild epidermal hyperkeratosis, elongated rete ridges, papillomatosis and mild mononuclear cell infiltration in the superficial dermis with focal extravasations of red blood cells without siderophage. Despite prominent extravasations of red blood cells and edema both in the papillary dermis and the subpapillary layer, no definite capillaritis was seen. Based on these clinicohistopathological findings, the diagnosis of transitory PPD was considered to be most compatible. Clinicians should recognize the unique but rarely acknowledged disease as a subtype of pigmented purpuric dermatoses.     

Persistent pigmented purpuric eruption associated with mycosis fungoides: a case report and review of the literature

A purpuric eruption may be an unusual early manifestation of mycosis fungoides (MF). On the other hand, persistent pigmented purpuric dermatoses (PPPD) may, occasionally, evolve to cutaneous T-cell lymphoma. Coexistence of these two conditions has been reported, but it is extremely rare. We present the case of an elderly woman with a long-standing pruritic, pigmented purpuric eruption. On 1-year follow-up, histological features suggesting early MF were observed and molecular analysis of the rearrangement of T-cell receptor genes revealed clonality. Our patient may represent a case of PPPD evolving to MF, a case of MF clinically featuring PPPD, or an intermediate condition in a nosological continuity extending from PPPD to MF. A persistent pigmented purpuric eruption may rarely be a harbinger of cutaneous T-cell lymphoma. Therefore, vigilant long-term follow-up of PPPD is highly recommended.     

Granulomatous pigmented purpura: report of a case and review of the literature

The pigmented purpuric dermatoses (PPD) are a group of diseases characterized by petechiae and bronze discoloration of the skin on the lower extremities. Histopathologically, extravasation of erythrocytes with hemosiderin deposition, a perivascular lymphocytic infiltrate centered on the superficial capillaries and endothelial cell swelling are seen. The granulomatous variant of PPD (GPPD) was described in 1996 and only 10 cases have been reported since in the literature, almost exclusively in patients of East Asian descent only involving the extremities. We present a case of GPPD in a Caucasian, North American Ashkenazi Jewish woman involving the thighs, back, forearms and wrists with concomitant non-granulomatous PPD of the shins. She presented with an asymptomatic, spreading, cayenne pepper-like rash. This rash intermittently involved the lower extremities and back for 15 years, but now involves the thighs with accompanying pink papules on the back, wrists and forearms. Histopathology of the thigh and back lesions revealed superficial lichenoid granulomatous dermatitis with palisading lymphocytes and focal interface changes. Extravasated erythrocytes were seen, but vasculitis was absent. No lymphocytic atypicality was noted and T-cell gene rearrangement studies were non-clonal. This is the second reported case of GPPD in a non-Asian patient and the first case involving sites other than the extremities.