以急性发热性嗜中性皮病皮疹为表现的白塞病1例

分析报告 1例以急性发热性嗜中性皮病皮疹为表现的白塞病。患者表现为急性发热性嗜中性皮病皮疹 ,伴口腔溃疡、关节疼痛 ,组织病理符合皮肤急性发热性嗜中性粒细胞增多性皮病 ,皮肤针刺反应阳性 ,诊断白塞病。     

具有水疱及脓疱的急性发热性嗜中性皮肤病

报告1例具有水疱及脓疱的急性发热性嗜中性皮肤病。患者女，41岁。全身出现红色丘疹、斑块、水疱及脓疱伴疼痛1d。皮损组织病理检查示表皮下水疱形成，真皮全层有以中性粒细胞为主的弥漫性炎性细胞浸润。诊断：急性发热性嗜中性皮肤病。     

Sweet综合征1例

Sweet综合征（Sweet’s Syndrome，SS）又称急性发热性嗜中性皮病（Acute febrile neutrophilic dermatosis），1964年由sweet首先报道，该病主要特点为发热、疼痛的红色丘疹、结节或斑块，中性粒细胞、白细胞升高和对真皮浅层的中性粒细胞浸润。本文报道1例无发热，白细胞及中性粒细胞均正常，误诊为单纯疱疹的患者。     

Sweet综合征与恶性肿瘤

Sweet于1964年首先以急性发热性嗜中性皮病报告的Sweet综合征(SS)有5个主要的特征:1.发热;2.嗜中性白细胞增多;3.多发性、高起的、不对称、红斑性、痛性皮肤斑块;4.由成熟的嗜中性细胞组成的浓密的皮肤浸润;5.对类固醇激素治疗迅速获效.本文复习了全世界有关伴有恶性肿瘤的急性发热性嗜中性皮病的文献,并进行了综述.SS与血液的恶性肿瘤最常发生于SS患者的肿瘤是急性髓细     

Sweet综合征1例

Sweet综合征(Sweet’sSyndrome,SS)又称急性发热性嗜中性皮病(Acute febrile neutrophilic dermatosis),1964年由sweet首先报道,1该病主要特点为发热、疼痛的红色丘疹、结节或斑块,中性粒细胞、白细胞升高和对真皮浅层的中性粒细胞浸润.     

Sweet综合征的诊治要点

Sweet综合征又名急性发热性嗜中性皮病,以发热,四肢、面、颈部有疼痛性红色丘疹、斑块或结节,组织病理见真皮有密集的中性粒细胞浸润,末梢血中中性粒细胞增多为最突出的特点,女性较为多发。     

大疱型急性发热性嗜中性皮病

报告1例大疱型急性发热性嗜中性皮病。患者男,51岁。面部及双上肢出现红色斑块及水疱伴发热10余天。实验室检查示外周血白细胞计数增高。皮损组织病理检查:表皮灶状水肿,真皮乳头高度水肿,局部真、表皮分离,真皮浅层致密团块状淋巴细胞及中性粒细胞浸润,局部红细胞溢出伴少许核尘,炎症累及中层血管周围。直接免疫荧光示Ig G、Ig M、Ig A及C3均(-)。诊断:大疱型急性发热性嗜中性皮病。     

利湿化浊法治疗急性发热性嗜中性皮病8例临床分析

目的分析急性发热性嗜中性皮病的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对8例确诊的急性发热性嗜中性皮病患者的临床表现、组织病理、中医证候、中医治则、方药、预后进行回顾性分析。结果 8例患者中男4例,女4例,平均年龄41.67岁,平均病程28.52 d。皮疹局限者3例(右上肢2例,左小腿1例),面、四肢、躯干泛发5例。发热6例,无发热2例。所有患者经过病理确诊,病理特征为组织病理见真皮内中性粒细胞浸润,而无白细胞碎裂性血管炎改变。8例患者均符合湿热蕴结证。中医治则均采用利湿化浊之法。方药均选用甘露消毒丹加减。8例患者皮损均完全消退。随访1年,除1例合并再生障碍性贫血患者出现重症感染死亡外,余均预后良好,6例单用中药患者无复发,1例合并系统性红斑狼疮患者目前仍在糖皮质激素维持治疗中。结论利湿化浊法在急性发热性嗜中性皮病治疗中疗效肯定,并能明显降低复发率,值得进一步研究。     

以急性发热性嗜中性皮病为首发症状的急性髓系白血病1例

 报告以急性发热性嗜中性皮病为首发症状的急性髓系白血病1例。患者女,50岁,反复全身红色斑块伴疼痛4个月,加重2 d。皮肤科检查：颈部及双上肢分布大小不等红色斑块,皮损边缘略隆起于皮面,呈环状,未见水疱及破溃,触痛阳性。上唇少许糜烂面。组织病理符合急性发热性嗜中性皮病改变。入院后查血液系统异常,诊断急性髓系白血病,以急性发热性嗜中性皮病为首发症状。予EA方案预化疗。三个月后患者因严重脑出血死亡     

Sweet病及其合并症

Sweet病是1964年英国人Sweet氏首先报告的疾病。讨论了8例具有同样症状的中年女性患者。具有如下特征:(1)发热,(2)以中性粒细胞增多为主的末梢血白细胞增多,(3)有好发于颜面、颈部、四肢的特征性皮疹(典型疹为痛性结节、丘疹或环状高起斑块,呈暗红色),(4)病理组织学:位于真皮层可见有密集的中性白细胞浸润等。所以被命名为急性发热性嗜中性皮肤病。被认     

降钙素基因相关肽在银屑病斑块型皮损的分泌与表达

为了解精神心理刺激诱发加重银屑病的原因,探讨神经肽在银屑病发病机理中的作用,研究了降钙素基因相关肽（ＣＧＲＰ）在银悄病皮损中的分泌与表达,并确定ＣＧＲＰ作用的靶细胞,应用特异性放射免疫反相法分析,测定３２例建党型银屑病慢性斑块型皮损组织提取液中ＣＧＲＰ的含量,用抗生物素蛋白－生物素－过氧化物酶复合法和兔抗人ＣＧＲＰ抗体进行免疫组化染色,观察ＣＧＲＰ分泌表达的部位和作用的靶细胞。结果建党型银屑病慢性     

0.1％他克莫司软膏对斑块状银屑病皮损MIF表达的影响

目的 探讨银屑病皮损中巨噬细胞移动抑制因子（Macrophage migration inhibition factor,MIF）的表达水平及其相关性,并比较他克莫司对银屑病皮损中MIF的影响,讨论其临床意义.方法 采用免疫组化法和染色评分半定量法对50例进行期斑块状银屑病皮损标本和42例正常皮肤组织标本（对照组）中的MIF的表达量进行检测,比较结果.同时,选取30例对他克莫司治疗有效的银屑病消退期皮损中MIF的表达量与曲安奈德治疗组、安慰剂治疗组各30例及未用药组50例进行比较.结果 斑块状银屑病皮损中MIF的表达量明显高于对照组,2组间差异有统计学意义（P＜0.05）.他克莫司和曲安奈德药物治疗组MIF的表达阳性率明显减低（P＜0.05）,安慰剂组与未用药组的MIF表达阳性率无统计学意义（P＞0.05）.结论 斑块状银屑病皮损中MIF的表达与疾病的严重程度相关,他克莫司可以明显抑制MIF在银屑病皮损中的表达,达到与糖皮质激素相当的治疗效果,他克莫司对银屑病的治疗作用可能与其抑制MIF的表达有关。     

斑块型银屑病与骨质疏松相关性的研究进展

关节病型银屑病引起患者骨量减少已得到广泛共识,但目前关于斑块型银屑病与骨质疏松之间的关系仍尚未完全明确。最近的一些研究表明,斑块型银屑病患者发生骨质疏松甚至病理性骨折的风险有所增加。本文回顾了斑块型银屑病和骨质疏松之间的相关性及可能的机制,包括炎症因子的参与、微量元素的变化、药物的使用及生活习惯的改变等,为斑块型银屑病患者骨质疏松和病理性骨折的防治提供理论依据。     

A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides

Parapsoriasis en plaque has been suggested to be an early manifestation of mycosis fungoides (cutaneous T-cell lymphoma). We explored the disease course of patients with small plaque or large plaque parapsoriasis in a 26-year retrospective cohort analysis of 105 parapsoriasis patients, who were clinically and histopathologically followed up in Helsinki and Tampere University Hospitals. Eventual later cancers of these patients were verified from the Finnish Cancer Registry. In the small plaque parapsoriasis group, 7 patients (10%) and in the large plaque parapsoriasis group 12 patients (35%), developed histologically confirmed mycosis fungoides during a median of 10 and 6 years, respectively. No significant differences were found regarding the risk of developing mycosis fungoides or the tendency to remission in patients treated with or without phototherapy. Our results show that not only large plaque parapsoriasis, but also small plaque parapsoriasis, as currently defined in textbooks, can progress to mycosis fungoides. The benefits of phototherapy are equivocal in parapsoriasis treatment as far as progression to cancer is concerned.     

Plaque variant of trichoblastic fibroma

BACKGROUND: Tricoblastic fibroma is a rare benign skin tumor originating in the hair follicle. There are two clinical presentations: nodular and plaque variants. The plaque variant is almost exclusively located on the face with deep tissue infiltration. CASE REPORT: A 38-year-old man presented with a 2 cm diameter cutaneous plaque located on the right cheek. It had first been noted by the patient 3 years earlier and had enlarged slowly. On examination, the plaque was well defined, yellowish and slightly indurated. The first clinical diagnosis was basal cell carcinoma and the plaque was removed. Histology provided the diagnosis of trichoblastic fibroma. The patient remains well, with no evidence of recurrence, 10 months after excision. DISCUSSION: Trichoblastoma is an inclusive term for all benign cutaneous neoplasms that are mostly composed of follicular germinative cells. According to Altman, the plaque variant of trichoblastic fibroma is a poorly circumscribed neoplasm, particularly at its lateral and deep margins. This author also states that mitotic figures are more numerous in the plaque variant of trichoblastic fibroma and considers this clinical variant as a low-grade follicular malignancy.     

Control of cutaneous blood vessels in psoriatic plaques.

The aim of this study was to compare local blood flow in psoriatic plaques before and after provocations known to alter cutaneous vascular resistance, in order to determine whether plaque hyperemia is caused by a failure of normal vascular control mechanisms. Cutaneous blood flow was recorded using a laser Doppler flowmeter over plaque skin (plaque site) and clinically normal skin (nonplaque site) on the opposite arm, at least 5 cm away from the nearest plaque. It is important to note that most of the laser Doppler signal comes from the subpapillary plexus of the skin and only a small portion (2%-10%) is produced by capillary blood flow. In the psoriatic plaques the basal flux was between nine and 13 times greater than nonplaque skin. The biologic zero (a signal independent of perfusion, which also persists after complete proximal arterial occlusion) was also significantly greater at plaque sites compared with nonplaque sites. Sympathetic and local vasoconstriction in psoriatic skin was shown to be intact and responses to vasodilator tests were likewise intact, i.e., there was no failure of response to normal vascular control mechanisms, albeit some quantitative differences. Tests of vasodilatation indicated that, although basal flux is high in plaque compared with nonplaque skin, arterioles supplying plaque skin can dilate further, i.e., lesional arterioles are not normally maximally dilated but have a basal constrictor tone. Interestingly, the red cell flux at maximum dilatation in nonplaque skin is less than even the basal flux in plaque skin. This means that in plaque skin either there are more arterioles than in nonplaque skin, or there is chronic, structural widening of the existing arterioles in plaque skin.     

毛囊漏斗部肿瘤

报告1例毛囊漏斗部肿瘤。患儿女,11岁。因左颞部斑块、结节11年就诊。患儿出生后左颢部即有一粉红色斑块．3个月前在斑块表面出现一小结节。皮损组织病理检查示真皮乳头层见呈水平盘状生长的肿瘤,与表皮多部位相连。肿瘤细胞染色偏淡,周围细胞呈栅栏样排列。诊断：毛囊漏斗部肿瘤。     

Lymphoplasmacytic plaque in children: a report of two new cases with review of the literature

Lymphoplasmacytic plaque in children has been proposed as a rare, emerging clinicopathologic entity characterized by solitary, extratruncal, asymptomatic papules and plaques that are typically found in healthy young Caucasian females. Biopsy of these lesions reveals a dermal lymphoplasmacytic infiltrate with or without epithelioid granulomas. Two unique patients with lymphoplasmacytic plaque in children are presented in this report, including a 26‐month‐old female with a lesion on her finger, who represents both the youngest described patient and the first documented with a finger lesion, as well as a 17‐year‐old young woman with a left thigh lesion, who represents the patient with the longest clinically and histopathologically observed lesion to date. These two additional patients corroborate the experience of lymphoplasmacytic plaque in children in the six previously reported cases and further expand the clinicopathologic spectrum of the disease. Recognition of lymphoplasmacytic plaque in children is important to facilitate distinction from potential differential considerations, including lymphoproliferative disorders and infectious conditions, particularly as the experience to date appears to suggest that lymphoplasmacytic plaque in children represent a reactive (pseudolymphomatous) condition.     

In vivo quantification of the structural abnormalities in psoriatic microvessels before and after pulsed dye laser treatment

BACKGROUND: Microvascular abnormalities (capillary elongation, widening and tortuosity) are a characteristic feature of psoriasis and form one of the pathological diagnostic criteria. These changes occur early in the progression of a psoriatic plaque, before there is clinical or histological evidence of epidermal hyperplasia. Treatment of psoriatic microvessels with a pulsed dye laser (PDL) has been associated with both clinical improvement and clearance of lesions. OBJECTIVES: To quantify the structural vascular abnormalities in plaque skin using noninvasive techniques in vivo. Investigations were carried out before and after PDL treatment to determine the nature of laser-induced microvascular changes and the relationship between these changes and clinical improvement. METHODS: Plaque microvessels were visualized using native capillaroscopy. Plaques were then treated three times with the PDL at 14-day intervals. Native capillaroscopy was repeated at 2 and 6 weeks after the final laser treatment. Images were analysed using a combination of nonstereological and stereological measurements. RESULTS: Whole body disease was stable. Treated plaques showed a 48% reduction in plaque severity score (P < 0.01). Native studies showed that the PDL significantly reduced plaque microvessel density (P < 0.05), image area fraction (P < 0.01), microvessel length density (P < 0.01) and vessel image width (P < 0.01). The reduction in plaque severity score (which denoted clinical improvement) was related quantitatively to the reduction in microvessel area per unit area of plaque skin, i.e. the image area fraction (correlation coefficient = 0.772, P < 0.01). The greatest response of plaque microvessels was within 2 weeks after the final laser treatment, while the greatest reduction in plaque severity score occurred between 2 and 6 weeks after the final laser treatment, i.e. clinical improvement was preceded by microvascular improvement. CONCLUSIONS: These findings indicate that there is a close correlation between the state of the superficial vasculature and the clinical status of psoriasis. The expanded superficial microvascular bed in plaque skin is a necessary component for maintaining clinical lesions and these blood vessels are thus a legitimate target for treatment.     

Milia en plaque

Milia plaque is an unusual and rare variant of milia. We now report a Chinese man with numerous milia within an erythematous plaque of the upper and lower eyelids; histology confirmed the diagnosis and showed pericystic inflammation. All but one of the previous 10 reported cases affected the ear or adjacent sites, and to our knowledge, this is the first reported case of milia en plaque affecting the eyelids.