多部位鲍温样丘疹病1例

目的报告1例少见的多部位鲍温样丘疹病。方法对其临床、血液免疫学检查、皮肤组织病理进行分析研究。结果RPR及TPPA皆(-);HPV-DNA原位杂交:16/18、31/33型皆(-)。组织病理示表皮角化不全,假上皮瘤样增生,棘层肥厚;棘层细胞大小不等、排列紊乱,细胞核异形、深染;可见核分裂象及角化不良细胞;真皮浅层少量淋巴细胞浸润;阴茎部皮损中棘细胞大小不等、排列紊乱明显,凹空细胞数量少,而肛周皮损中可见大量凹空细胞及较多的角化不良细胞。结论该病可能是HPV16、18、31、33以外型别致病,同时具有的尖锐湿疣病理改变,颇为特殊。     

恶性萎缩性丘疹病1例

患者男,23岁。躯干、四肢反复出现丘疹2年,丘疹中央可坏死,愈后遗留瓷白色萎缩性瘢痕,周围绕以水肿性红晕,无任何自觉症状。皮损组织病理示:角化过度,棘层萎缩变薄,皮突消失,真皮浅层见带状的胶原坏死区,其下少许黏蛋白沉积,未见明显的血管病变。诊断:恶性萎缩性丘疹病。     

A Case of Isolated Bowenoid Papulosis of the Nipple

Bowenoid papulosis (BP) is a disease that mainly occurs in sexually active young adults. The patients present with multiple pigmented papular lesions with a verrucous surface on the anogenital area. Although extragenital BP is usually associated with concomitant genital involvement, a few cases of isolated extragenital BP have been reported. However, to our knowledge, BP of the nipple has not yet been reported in the medical literature. We report the case of a 32-year-old woman who presented with isolated extragenital BP of the nipple caused by human papillomavirus-16.     

淋巴瘤样丘疹病1例

患者男,27岁。躯干、四肢反复发生暗红色丘疹、结节、坏死、结痂4月余,无痛,偶有瘙痒。皮肤科情况:躯干、臀部及四肢暗红色丘疹、结节,部分中央坏死、破溃,结黑褐色厚痂,留有萎缩性瘢痕或色素沉着。皮损组织病理示:真皮结节状淋巴及大组织样细胞浸润,可见多数异型细胞,约占30%,少数细胞呈双核或多核;免疫组化染色示:CD3(+),CD4(+),CD30(+),CD68(+),CD8个别(+),CD20个别(+),Ki-67约10%(+)。诊断:淋巴瘤样丘疹病。     

透明细胞丘疹病1例并文献复习

患儿女,1岁,下腹部、阴阜、双腹股沟、双腋下皮损渐增多1年。皮肤科情况:下腹部、阴阜、双腹股沟、双腋下见对称性散在分布的直径约2~5 mm的类圆形白色扁平丘疹,皮损边界清。皮损组织病理示:基底层可见数个细胞核圆形或卵圆形,胞浆丰富的透明细胞,胞体比相邻的角质形成细胞大。免疫组织化学示:透明细胞CK、CK7、CEA、EMA阳性,Melan-A阴性。诊断:透明细胞丘疹病。     

淋巴瘤样丘疹病继发蕈样肉芽肿:共同T细胞克隆增生一例报告

目的 报道一例淋巴瘤样丘疹病(LyP)继发蕈样肉芽肿(MF)，随访27年，并检测其克隆性是否与疾病相关。方法 比较不同时期的皮肤组织病理和免疫表型特点，同时应用聚合酶链反应(PCR)和Southern印迹杂交法，检测皮损组织和外周血标本的T细胞受体基因重排。结果 此例在不同时期各具临床病理学特征，增生的淋巴细胞为成熟的Th细胞，且示共同T细胞克隆。结论 LyP继发MF示相同T细胞克隆，克隆性T细胞与疾病的生物行为无关。     

淋巴瘤样丘疹病17例临床分析

目的分析淋巴瘤样丘疹病临床表现、组织病理及免疫组化特征。方法检索2000年1月-2010年12月中国知网和万方数据库中的国家级专业期中报道的淋巴瘤样丘疹病患者的文献资料,并进行分析和总结。结果淋巴瘤样丘疹病有以自限性红斑和口腔溃疡为首发症状的报道,组织病理见表皮角化不全、楔形坏死、水肿或正常,真皮内瘤细胞以楔形分布、团块状或结节状浸润为主,血管炎样表现较为常见。免疫组化染色见异型细胞表达T细胞免疫表型,多数CD3阳性表达,但CD68,CD4,CD45RO和LCA阳性率也比较高,几乎全部见CD30抗原表达。结论淋巴瘤样丘疹病临床表现多样,应加强对此病的认识,做到早诊断、早治疗并定期随访。     

鲍恩样丘疹病研究进展

鲍恩样丘疹病为外生殖器部位的多发扁平丘疹,组织病理为低度恶性原位癌表现。研究发现,人乳头瘤病毒与鲍恩样丘疹病关系密切。一些新的治疗方法,如局部免疫调节剂和光动力疗法有显著的优越性。少数皮损有癌变的可能,应终身随访。     

Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case

Fibroelastolytic papulosis is a rare, acquired fibroelastolytic disorder that presents clinically as white‐to‐yellow papules and plaques most commonly occurring on the neck of elderly patients. The term fibroelastolytic papulosis encompasses two closely related conditions previously described as pseudoxanthoma elasticum‐like papillary dermal elastolysis (PDE) and white fibrous papulosis of the neck (WFPN). Here we present a case of a 78‐year‐old white female with a several‐year history of numerous, asymptomatic 2–3 mm yellowish, non‐follicular papules distributed symmetrically over the posterior neck, axillae, arm and antecubital fossae. Histopathologic examination revealed thickened and clumped elastotic fibers admixed with thick, sclerotic appearing collagen bundles in the mid and deep reticular dermis. Rare melanophages, loss of vertically oriented elastic fibers and scattered elastotic globes were noted in the papillary dermis. Based on the shared clinicopathologic features showed in this case, strong consideration should be made for the additional inclusion of papillary dermal elastosis as existing along the disease continuum of fibroelastolytic papulosis. This occurrence of fibroelastolytic papulosis shows unique histopathologic findings of pseudoxanthoma elasticum‐like PDE, papillary dermal elastosis and WFPN, further supporting the theory that these entities exist as variants along the fibroelastolytic papulosis spectrum.     

Lymphomatoid Papulosis Followed by Anaplastic Large Cell Lymphoma in a Pediatric Patient

Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP. However, this transformation rarely occurs in patients younger than 20 years of age. Here, we present the first known pediatric patient in Korea, a 12-year-old boy who developed a subcutaneous nodule on the scrotum 13 months after papulonecrotic lesions of LyP were identified on both lower extremities and face. Histological and immunohistochemical examination of the subcutaneous nodule revealed anaplastic large cell lymphoma (ALCL). A T-cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in the two specimens, indicating that a common T-cell clone had proliferated over time in both the LyP and ALCL lesions.     

鲍温样丘疹病的临床及感染人乳头瘤病毒类型的研究

目的 研究鲍温样丘疹病(BP)的诊治及其感染人乳头瘤病毒(HPV)的类型。方法 对9例BP的临床表现、组织病理及治疗进行总结,用PCR法检测13例BP石蜡组织标本HPV16 L1基因。结果 BP表现为生殖器部位的褐色扁平丘疹,有线状排列趋势。病理表现为角化不全,棘层肥厚,角质形成细胞出现异型性并排列如伏麦状,基底膜完整。8例经疣体破坏、干扰素及免疫增强剂治疗,全部治愈;1例行手术局部扩大切除后复发,再经上述方案治疗而愈13例 BP标本有12例 HPV阳性,都为HPV16。结论 BP主要由HPV16感染引起,临床和病理表现特异,疣体玻坏结合干扰素及免疫增强剂治疗,疗效较好。     

淋巴瘤样丘疹病1例

患者女,60岁。躯干、四肢起红色水肿性丘疹2个月。组织病理检查示:真皮浅层、中层和血管周围致密淋巴细胞浸润,细胞大小不一,核形态不规则,染色深,部分细胞核呈脑回状。免疫组化染色结果:CD30(+)。诊断:淋巴瘤样丘疹病。     

淋巴瘤样丘疹病1例

报告1例淋巴瘤样丘疹病。患者女22岁,躯干、四肢出现结节、丘疹1月,可自愈。组织病理提示有异形性细胞浸润,伴混合性炎症细胞浸润,免疫组化标记:异形性细胞CD3(+)、CD30部分(+)。     

淋巴瘤样丘疹病1例

报告1例淋巴瘤样丘疹病。患者男,40岁,面、颈、躯干、双上臂多发丘疱疹、丘疹。组织病理示:真皮层见散在团块状异形细胞浸润,以异形组织细胞为主,伴有少量异形淋巴细胞及少数成熟中性及淋巴细胞。以阿维A、卡介苗素及雷公藤多甙联合治疗,取得较好疗效。     

炎症后弹性组织离解伴皮肤松垂1例

患儿女,4岁。全身反复出现疼痛性斑块、结节1年半,再发3月。皮损表现为大小不等的红色环状、半环状斑块,界清,可见假性水疱,触痛明显。组织病理示:真皮乳头高度水肿,真皮全层弥漫性炎性细胞浸润,以中性粒细胞浸润为主,有较多核尘,真皮血管扩张,内皮细胞肿胀,血管壁及周围中性粒细胞浸润,弹力纤维染色见真皮浅层、中层弹力纤维减少,部分断裂,呈现颗粒状。诊断:炎症后弹性组织离解伴皮肤松垂。     

淋巴瘤样丘疹病1例

报告1例全身泛发皮疹的淋巴瘤样丘疹病。本例临床上类似恶性淋巴瘤的表现,但组织学上符合淋巴瘤样丘疹病的诊断,治疗上采用维甲酸联合PUVA有一定效果。     

鲍温样丘疹病四种疗法回顾性分析

目的总结135例鲍温样丘疹病(BP)的治疗经验,以期为临床提供更佳治疗选择。方法回顾性分析四种不同方法治疗BP患者的临床资料,比较CO2激光、5-氨基酮戊酸光动力疗法(ALA-PDT)、外用咪喹莫特、咪喹莫特与ALA-PDT联合治疗四种疗法对BP的临床疗效和不良反应,对其治疗效果与随访结果进行总结。结果CO2激光组、ALA-PDT组、外用咪喹莫特组、联合组治愈率分别为82.86%,60.53%,48.15%,88.57%;复发率分别为62.07%,17.39%,7.69%,3.22%。激光组和联合组的疗效明显优于ALA-PDT组和外用咪喹莫特组(P均<0.01),ALA-PDT组、咪喹莫特组和联合组的复发率明显低于CO2激光组(P均<0.01),其余各组间差异无显著性(P均>0.05)。除激光组3例患者出现较明显的瘢痕修复以及外用咪喹莫特组1例患者出现用药部位色素减退外,余两组患者耐受性良好,最常见的副作用是治疗局部的红肿和糜烂。结论ALA-PDT联合咪喹莫特治疗BP,具有疗效好,复发率低的优势。对皮损较多和播散分布的BP患者,推荐采用光动力与咪喹莫特联合治疗。对于皮损较少的患者可直接选用CO2激光或直接外用咪喹莫特治疗。     

Lymphomatoid Papulosis Followed by Ki-1 Positive Anaplastic Large Cell Lymphoma: Proliferation of a Common T-Cell Clone

We report a case of lymphomatoid papulosis (LyP) followed by Ki-1 positive anaplastic large cell lymphoma (LCL). A 33-year-old man developed subcutaneous nodules in the left inguinal region and the left thigh after a seven-year-history of self-healing papulonecrotic lesions of LyP. Histological and immunohistochemical examination of the subcutaneous nodules revealed LCL. DNA was isolated from a nodule of the initial stage of LyP in 1988, a subcutaneous nodule of LCL in 1993, and a papule of LyP in 1993 which appeared after chemotherapy for LCL. T cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in all the three specimens, indicating that a common T cell clone proliferated throughout the course in both the LyP and LCL lesions.     

尖锐湿疣和鲍温样丘疹病中Livin,Caspase-3的表达及相关性分析

目的探讨尖锐湿疣(CA)和鲍温样丘疹病(BP)中凋亡抑制蛋白(Livin),半胱氨酸蛋白酶-3(Caspase-3)的表达,并进行相关性分析。方法选取CA,BP皮损和正常成年人包皮组织各30例,采用免疫组化法检测Livin,Caspase-3蛋白的表达。结果 Livin在BP组中阳性率(3.833±1.533)高于CA组(3.033±1.866)及正常对照组(2.733±1.112),Caspase-3在正常对照组中阳性率(3.833±1.556)高于CA组(1.733±1.856)及BP组(2.000±1.640),差异均有统计学意义(P均<0.05)。在CA,BP及正常对照组中Livin与Caspase-3的表达均无相关性(P均>0.05)。结论 Livin,Caspase-3可能在HPV感染相关的皮肤增殖性疾病中发挥一定作用。