足跟压力性疼痛性丘疹

1968年Shelley等首先描述本病,当时称“脂肪疝引起的足痛”(“Painful feet dueto herination of fat”),因本病表现为丘疹并与受压有关,以后则常用“足跟压力性疼痛性丘疹”[“Painful Piezogenic pedal(heel)papules”]这一名称。临床裹现皮损表现为丘疹,皮肤颜色,圆形,直径2～8mm不等。在以足跟着地站立时,丘疹出现在足跟的后、内或外侧,同时产生触痛和自觉痛。丘疹数目10～40不等,使足跟呈鹅卵石路面外观。久站、负重和行路多时疼痛加剧;当足跟部不承受压力时,如将足抬高、坐位,以及只以足趾站立时,丘疹消失,疼痛也缓解。从文献中收集的10例中,女性8例;男性2例。年龄20～56岁(平均32.4岁),除上     

足跟压力性丘疹

报告足跟压力性丘疹1例。患者女,39岁,双足跟部多发丘疹1年余,无明显自觉症状。皮肤科检查:双足跟可见数个淡红色半球形丘疹,约黄豆至蚕豆大,触之柔软,有弹性。皮损组织病理检查:表皮大致正常,真皮见较多增生的血管,脂肪团块上移至真皮中下部,皮下脂肪间隔内见团块状增生粗大的胶原,其内见可疑嗜碱性物质沉积,周围部分胶原纤维素样变性。诊断:足跟压力性丘疹。     

黏液性汗管化生

报告1例黏液性汗管化生。患者男,52岁。左足跟内侧外伤后出现丘疹10年。皮肤科检查:左足跟内侧一直经约0.8 cm的丘疹,表面有糜烂和轻度渗液。皮损组织病理检查:表皮不规则增生,局部可见腺腔样分化,并可见杯状细胞。PAS及阿新蓝染色示杯状细胞染色阳性。免疫组化染色结果示腺腔及杯状细胞Cam5.2、癌胚抗原(CEA)及上皮膜抗原(EMA)阳性。诊断:黏液性汗管化生。     

慢性苔藓样角化病的临床及组织病理特征

慢性苔藓样角化病临床罕见,属良性、慢性、进行性苔藓样角化性皮肤病。其病因和发病机制不明。临床典型表现为四肢、臀部无症状性、对称性并呈线状或网状分布的紫红色角化性苔藓样丘疹性结节性损害,颜面部及头皮常表现为玫瑰痤疮或脂溢性皮炎样丘疹。皮损组织病理示苔藓样界面皮炎改变,但棘层增厚和萎缩交替出现,胶质小体大而多,且炎症浸润较扁平苔藓更深和程度更重。本病无特效治疗方法,对激素等多种药物治疗的反应差,维甲酸类药物结合光疗(NB-UVB,PUVA)或为有效治疗手段。本文就该病相关临床及组织病理学特征做一综述。     

持久性隆起性红斑1例

<正>1临床资料患者女,51岁。因双侧手掌、肘部、膝部和足跟部紫红色隆起的结节、斑块,逐渐增大,病程约12年,于2014年7月来我科就诊。患者于12年前无明显诱因偶然发现上述肢体部位多处出现皮疹。双侧手掌、肘部、膝部和足跟部早期仅为小的红斑、丘疹,     

小汗腺汗孔瘤1例

<正>1临床资料患者男,47岁,因"右足跟外侧缘红色结节5月"就诊。5月前无明显诱因右足跟外侧缘出现一绿豆大小红色丘疹,不伴疼痛及瘙痒,不影响行走,未予重视。皮损逐渐增大至豌豆大,表面易破溃出血,遂来就诊。     

小汗腺汗孔瘤1例

1临床资料患者男，47岁，因“右足跟外侧缘红色结节5月”就诊。5月前无明显诱因右足跟外侧缘出现一绿豆大小红色丘疹，不伴疼痛及瘙痒，不影响行走，未予重视。皮损逐渐增大至豌豆大，表面易破溃出血，遂来就诊。     

鲍温样丘疹病的研究进展

鲍温样丘疹病(Bowenoid Papulosis简称BP)是发生在男女外生殖器部位的多发性丘疹性损害,临床良性经过,组织学上表现为原位鳞癌样改变。许多作者对本病的临床特征、组织病理、发病原因等方面作了不少研究。现复习国内外文献综述如下:     

带蒂腓肠神经筋膜皮瓣修复足跟部鳞状细胞癌一例

患者女,66岁.因左足跟部赘生物2年,于2008年5月14日就诊.患者于2006年5月,左足跟部碰伤后出现一绿豆大小丘疹,无自觉症状,并逐渐增大,1年前左足跟部出现溃疡,就诊当地医院并行皮肤病理检查,诊断为皮肤溃疡,先后外用抗生素、激素及光动力等治疗,效果差,溃疡表面出现脓性分泌物,有触痛.     

单侧线状型汗孔角化症1例

<正>1临床资料患者女,34岁。左侧颈部、左上肢及左下肢出现带状分布的丘疹和斑块26年。26年前,患者左侧颈部、左上肢屈侧、足跟内侧、前左内踝及左大腿内侧出现呈带状分布的红色丘疹及斑块,偶有瘙痒,部分皮损渐增厚,颜色变为浅棕红色。天气转凉后皮损自行缓解,颜色变淡和变薄。气温升高后     

A reappraisal of the histologic findings of pigmented pretibial patches of diabetes mellitus

BACKGROUND: Pigmented pretibial patches (PPPs) are the most common cutaneous alterations in diabetes mellitus, found in up to 50% of diabetic patients. They classically present as flat-topped, dull-red papules on the pretibial areas, later becoming hyperpigmented and atrophic. Little is known regarding the pathogenesis of these lesions, and the histopathologic findings have been regarded as non-specific. METHODS: We investigated the clinical and pathologic attributes of a series of 12 diabetic patients with PPP in an effort to discern any specific histologic attributes compared to normal skin removed from diabetic patients with cutaneous carcinoma. RESULTS: All cases of PPP showed hyaline microangiopathy, all patients showed extravasated erythrocytes and/or hemosiderin deposits, and 10 patients showed an appreciable number of perivascular plasma cells. The average number of plasma cells per vascular plexus was 2.2. Control specimens removed from five diabetic patients showed hyaline microangiopathy, and three showed extravasated erythrocytes and hemosiderin. One patient showed a single vascular plexus with two plasma cells, p = 0.01. CONCLUSION: The presence of increased dermal perivascular plasma cells in the appropriate clinical context might be an important and under-recognized clue for PPP. The pathogenic significance of this finding is unknown.     

Successful Treatment of Pearly Penile Papules with Carbon Dioxide Laser Resurfacing After Local Anesthesia in an Adolescent Patient

Pearly penile papules (PPP) can cause significant psychological morbidity. Herein we report the successful use of a macrofractionated carbon dioxide laser at full‐field ablative density settings for the treatment of PPP in a 17‐year‐old boy using local anesthetic alone. Our experience leads us to believe that PPP can be successfully treated in the pediatric and adolescent populations using this novel and relatively noninvasive technique.     

Painful Piezogenic Pedal Papules on a Child with Ehlers-Danlos Syndrome

A 5-year-old girl with Ehlers-Danlos syndrome developed painful piezogenic pedal papules. She had suffered from pain in her heels for the previous two years and had undergone extensive orthopedic examinations that revealed no abnormalities. On admission, she had typical signs associated with piezogenic pedal papules (PPP), with pain induced by standing and disappearance of the lesions and the pain on relief of pressure. These papules were due to herniation of subcutaneous fat into the dermis, possibly because of structural defects of the connective tissue. To the best of our knowledge, this is the first reported case of painful PPP occurring in childhood. We suggest that the herniation of subcutaneous fat in our patient was most probably due to the connective tissue defect that occurs in the Ehlers-Danlos syndrome.     

Pearly penile papules: still no reason for uneasiness

BACKGROUND: Penile lesions and pearly penile papules (PPP) are frequently found in male sexual partners of women with cervical intraepithelial neoplasia (CIN). The former have been associated with human papillomavirus (HPV). OBJECTIVES: We estimated the prevalence of PPP in male sexual partners of women with CIN, and investigated the association between PPP and flat and papular penile lesions found in these men. We further evaluated a possible association between PPP and HPV, age, and CIN grade of the female partner. METHODS: We evaluated by penoscopy the presence of HPV-associated penile lesions and PPP in 226 male sexual partners of women with CIN. HPV was tested by polymerase chain reaction-enzyme immunoassay and in situ hybridization. RESULTS: The prevalence of PPP was 34% and was not associated with the presence of penile lesions or a positive HPV test. Age and CIN grade of the female partner were not related to the presence of PPP. CONCLUSION: The prevalence of PPP in male sexual partners of women with CIN is comparable with the prevalence described in men of more diverse populations. Our data do not support a causative role for HPV in the genesis of PPP.     

司库奇尤单抗治疗13例难治性局限性脓疱型银屑病的临床疗效与安全性观察

目的观察司库奇尤单抗对常规治疗无效或不耐受的难治性局限性脓疱型银屑病的临床疗效和安全性。方法收集并分析2019年12月至2022年4月于西京皮肤医院门诊接受司库奇尤单抗治疗的13例难治性局限性脓疱型银屑病患者的资料, 评价掌跖脓疱病(PPP)患者治疗前后PPP皮损面积和严重程度指数(PPPASI)评分、临床医师整体评估(PGA)评分, 评价连续性肢端皮炎(ACH)患者临床疗效总体量表(CGI)评分, 记录治疗期间不良事件发生情况。结果 13例难治性局限性脓疱型银屑病患者中, PPP 6例, ACH 3例, PPP合并ACH 4例。男3例, 女10例, 年龄(33.2 ± 14.6)岁。治疗12周时, 存在PPP表现的10例患者PPPASI评分由基线(13.88 ± 3.62)分降至(6.81 ± 2.31)分, 4例达到PPPASI75, 5例达到PGA0/1;存在ACH表现的7例患者中6例CGI评分达到中度改善以上, 4例达到显著改善。2例PPP患者因应答不佳分别于治疗3周、5周停药, 1例ACH患者治疗12周CGI评分为轻度改善。随访期间未发生严重不良事件, 出现毛囊性炎性丘疹、湿...     

What do we know about palmoplantar pustulosis?

Palmoplantar pustulosis is characterized by a chronic eruption of sterile pustules on palms and soles. The disease affects mainly women in the sixth and seventh decade of life. Some authors consider palmoplantar pustulosis a separate entity, whereas others consider it a condition in the spectrum of psoriasis. Aim of this study was to summarize the most recent data about PPP which aimed at establishing the nosological position of palmoplantar pustulosis. A systematic search of published literature was carried out. General characteristics of patients with PPP in different populations were present. We reviewed histological, immunological and genetic studies, as well as treatment options for PPP. PPP presents with clinical features, which are not present in psoriasis; however, the common coexistence of psoriasis vulgaris and/or positive family history for psoriasis indicates at least a close relationship between PPP and psoriasis. At present, there are not sufficient data to exclude PPP from psoriasis group.     

The spectrum of nail involvement in palmoplantar pustulosis

Abnormalities of the nail are not a well recognized feature of palmoplantar pustulosis (PPP). However, in a group of 50 patients with PPP, we Found nail dystrophy in 15 (30%). The most frequent pattern was subungual pustulation. present in 10 patients, and progressing to nail destruction in two. Onycholysis and pilling of the nail were present in a few patients. In contrast to psoriasis vulgaris. the rate of linear nail growth in PPP was no greater than in matched normal controls. This is another clinical feature of PPP that separates it from psoriasis vulgaris.     

Palmoplantar pustular psoriasis: successful therapy with efalizumab after non-response to infliximab

Palmoplantar pustular psoriasis (PPP) is a chronic inflammatory skin condition mainly characterized by recurrent eruptions of sterile pustules on erythematous skin; hyperkeratosis and fissures on the palms and soles are additional clinical features. Treatment options for PPP are unsatisfactory. We present a patient with a typical course of PPP that had previously received a broad range of topical and systemic antipsoriatic therapies. They all had to be discontinued due to ineffectiveness or side effects. Being aware of the high efficacy of infliximab in generalized pustular psoriasis, we initiated this therapy. An initial improvement was followed by a substantial flare after 7 months, during which a combination treatment of infliximab with methotrexate was administered. Only subsequent monotherapy with efalizumab led to complete clearing up of PPP after 10 to 12 weeks of treatment without any adverse effects. This indicates that efalizumab is potentially effective in PPP.     

Primary cutaneous aggressive epidermotropic CD8(+) cytotoxic T-cell lymphoma with atypical presentation

Primary cutaneous aggressive epidermotropic CD8(+) cytotoxic T-cell lymphoma is characterized by a proliferation of epidermotropic CD8(+) cytotoxic T cells and an aggressive clinical behavior. Patients present with localized or disseminated eruptive papules, nodules and tumors. We report a case of primary cutaneous aggressive epidermotropic CD8(+) cytotoxic T-cell lymphoma with unusual clinical manifestation. The lesion occurred as multiple brownish macules and flat-topped papules on the hands, feet and face in a 25-year-old woman.     

Clinically occult cutaneous metastases

Cutaneous metastases present themselves in a variety of clinical patterns and tend to be manifested as indurated papules/nodules/tumors. Some of those clinical expressions are unique for certain types of metastases. This report describes an entirely different phenomenon of clinically incognito cutaneous metastases that were only apparent histopathologically as an incidental finding.