肉芽肿性酒渣鼻并发结节性红斑一例

患者,女,41岁。因面部丘疹半年,双下肢结节伴触痛20天余就诊。结合临床、病理等检查,面部诊断为肉芽肿性酒渣鼻,下肢诊断为结节性红斑。 给予盐酸米诺环素胶囊 100 mg 日2次 、维胺脂胶囊25 mg日3次,甘草酸二胺肠溶胶囊150 mg 日3次 ;外用他克莫司软膏。治疗2周后双下肢皮疹消退,疼痛消失,面部皮疹有所减轻,患者连续治疗2个月后停药。5个月后随访,面部皮损复发。     

发疹性黄瘤1例

患者男,41岁。面部、躯干下部及双下肢泛发橘黄色丘疹3个月。面部、躯干下部及双下肢散在分布橘黄色丘疹,米粒至绿豆大小,质硬,部分基周红晕,有压痛。抠挤后破溃,结痂,遗留色素性或肥厚性瘢痕。患糖尿病和脂肪肝2年。诊断:发疹性黄瘤。嘱低脂饮食,继续治疗高脂血症,面部皮损予激光治疗,现随访中。     

水光针注射美容致面部异物肉芽肿一例

患者,女,27岁。面部起丘疹伴痒1个月。4个月前在当地美容院给予水光针注射。临床表现结合组织病理诊断为面部异物肉芽肿。给予皮损内局部注射复方倍他米松注射液,皮损消退。     

恶性萎缩性丘疹病一例

患者，女，58岁。躯干四肢散在红斑丘疹4个月余。皮肤科检查：躯干四肢散在红斑丘疹，丘疹中央可见瓷白色萎缩性斑片，边缘隆起伴红晕，伴腹痛。皮损组织病理示：表皮萎缩变薄，真皮浅中层胶原变性，血管周围散在小片状的淋巴细胞及组织细胞浸润。诊断：恶性萎缩性丘疹病。给予阿司匹林、双嘧达莫、雷贝拉唑钠、美沙拉嗪、阿嗪米特口服治疗1个月后腹痛症状缓解，全身皮疹颜色变淡。2个月后患者腹痛加重诊断为肠穿孔，术后无明显改善。4个月后去世。     

Bloom综合征1例

患者,女,17岁。面部毛细血管扩张17年。出生40天出现面部多发粟粒大红色丘疹,伴毛细血管扩张。系统检查正常。组织病理改变符合Bloom综合征。     

Papular acantholytic dyskeratosis of the genitalia

A 32-year-old man presented with multiple papules on the pubic area for 5 months. There were no subjective symptoms. We could not find any clues for predisposing factors. Pathological examination of the excised papules revealed marked acantholysis and dyskeratosis in the epidermis. The lesions persisted for 5 months after the pathological examination. We consider the present case to be similar to that of Chorzelski et al., papular acantholytic dyskeratosis of the vulva, reported in 1984. We would like to propose this case as papular acantholytic dyskeratosis of the genitalia.     

Multiple trichoepitheliomas in a mother and daughter

A 38-year-old mother and her 8-year-old daughter presented with multiple facial papules. In both cases, the papules had started to develop at about the age of 4-5 years. Biopsy of one of the mother's papules revealed a trichoepithelioma. With time the lesions had become less obvious in the mother, so she and her daughter elected to have no treatment. Both mother and daughter were otherwise well. However, there have been rare reports of multiple trichoepitheliomas being associated with systemic conditions. Multiple trichoepitheliomas are inherited in an autosomal dominant manner and have been mapped to chromosome 9p21.     

Papular elastorrhexis in childhood improved by intralesional injections of triamcinolone.

Papular elastorrhexis is a rare disease developing asymptomatic skin-colored small papules in adolescence with histopathological loss of elastic fibers. There has been no established treatment for this disease. A 4-year-old Korean boy had multiple, hard, whitish papules on his chest and back for one year. Histopathologic examination revealed focal loss of elastic fibers in the dermis, and X-ray examination showed no bony abnormalities. His skin lesions were improved by intralesional injections of triamcinolone but recurred after four months.     

Birt-Hogg-Dubé syndrome and multinodular goitre

A 50-year-old woman presented with multiple skin-coloured facial papules. There was a family history of similar lesions. Histology of one of these papules was consistent with fibrofolliculoma. Multiple fibrofolliculomas together with flexural acrochordons suggested the diagnosis of Birt-Hogg-Dubé syndrome. Investigations to exclude associated disease revealed changes consistent with multinodular goitre on thyroid ultrasound. The literature regarding the association of Birt-Hogg-Dubé syndrome with internal disease is reviewed.     

线状扁平型尖锐湿疣1例

报告1例线状扁平型尖锐湿疣。患者男,27岁。3个月前包皮内侧出现肤色扁平丘疹成串排列,无自觉症状。5％醋酸白试验阳性。皮肤组织病理检查示：棘层肥厚,表皮上部可见典型的凹空细胞,基底层无色素增加,表皮细胞无异形性改变：皮损HPV 16 DNA检测阳性。给予2次冷冻治疗后皮损消退,随访2个月无复发。     

EFFICACY OF PULSED DYE LASER IN COSMETICALLY DISTRESSING FACIAL DERMATOSES IN SKIN TYPES IV AND V

Background:

Pulsed dye laser (PDL) has revolutionized treatment of vascular dermatoses. It has been successfully employed to treat several non-vascular conditions in fair skinned individuals without producing significant pigmentary and textural complications.

Aim:

A preliminary study was undertaken to assess its efficacy in cosmetically distressing facial, vascular and non-vascular dermatoses in Indian patients with skin types IV and V.

Materials and Methods:

Nine patients of ages 7 to 55 years, with facial verruca plana (VP- 4 cases), angiofibromas (AF- 4 cases) and multiple pyogenic granulomas (PG- one case) were recruited. They had no systemic complaints. Laser parameters used were (spot size/fluence/wavelength/pulse duration):VP- 5mm/5.5-7.5J/585nm/0.45ms; AF-5mm/6-8.5J/585nm/0.45ms;PG- 5mm/7J/585 and 595nm alternately/1.5ms. Response was assessed clinically and photographically.

Results and Conclusions:

All VP lesions completely resolved after 2-4 sessions (mean 3.25 sessions), AF showed 50% regression in all cases after 2-3 sessions (mean 2.5 sessions) and ≥75% subsidence after 3-7 sessions (mean 5.5 sessions) and in PG, after 3 sessions, there was complete subsidence of small satellite lesions with moderate shrinkage of larger papules and complete resolution after 5 sessions. Complications included transient hyperpigmentation/hypopigmentation only. There was no recurrence during next 6 months. PDL offers significant cosmetic improvement in facial dermatoses in Indian patients.     

Paraneoplastic pemphigus with fatal pulmonary involvement in a woman with a mesenteric Castleman tumour

A 42-year-old woman presented with oral and labial erosions, conjunctivitis, facial rash and lichenoid erythematous papules on the trunk. Paraneoplastic pemphigus (PNP) was suspected, and a search for a neoplasm revealed an intra-abdominal Castleman tumour sized 7 x 5 x 6 cm. After removal of the Castleman tumour, the skin and mucosal inflammation gradually subsided over the next 12 months. However, due to irreversible pulmonary involvement the patient died of intractable respiratory distress 2 years after the onset of the disease. Systemic corticosteroids, azathioprine, cyclophosphamide, high-dose intravenous immunoglobulins and thalidomide were ineffective. The diagnosis of PNP was confirmed by keratinocyte antigen immunoprecipitation with the patient's serum.     

Cowden Disease: Case Report and Review of the Literature

Cowden''s disease is a rare autosomal dominant, multiple hamartoma syndrome with characteristic mucocutaneous lesions. It is associated with abnormalities of the breast, thyroid, and gastrointestinal tract; and is characterized by multiple hamartomas in the gastrointestinal tract and mucocutaneous lesions such as trichilemmomas, oral papillomatosis, facial papules, and acral keratosis. A 21-year-old male patient presented with erythematous facial papules, oral mucosal papillomatosis, and punctate palmoplantar hyperkeratosis indicating a definite case of Cowden''s disease. This disease derives from variable expression resulting from a mutation in the PTEN gene. Gastrointestinal endoscopy and colonoscopy revealed multiple hamartomas in the stomach and colon. On thyroid ultrasonography, several probable benign nodules were noted in the right thyroid gland. He had no pertinent family history and no other systemic findings. Further regular laboratory and image studies will be planned for our patient, as well as his family members. Sporadic Cowden''s disease is rarely observed. Herein, we report a case of Cowden''s disease without known family history. Dermatologists should be aware of the possibility of Cowden syndrome based on its several dermatologic findings.     

Cutaneous and systemic plasmacytosis: a Chinese case

Cutaneous and systemic plasmacytosis (CSP) is an exceedingly rare condition arising primarily in patients of Japanese descent. Herein, we describe a patient of mainland Chinese origin suffering CSP. A 49-year-old Chinese male had asymptomatic brownish-red plaques and papules of the face and trunk for 6 years. Physical examination revealed innumerable symmetric red-brownish macules on face and trunk with fewer red-brownish papules scattered among the macules. Chemical analysis revealed hypergammaglobulinemia. Computerized tomography scan discovered some lymphadenopathy in the axillary, paratracheal and pulmonary regions. Histological examination showed focal perivascular and periadnexal infiltrate of mainly plasma cells in the superficial and deep dermis. Immunohistochemical study showed that a great number of the infiltrating cells were CD20-positive. The infiltrated polyclonal plasma cells expressed both kappa and lambda light chains. Topical therapy with tacrolimus 0.1% ointment for 2 months reduced the thickness and pigmentation of the facial skin lesions. The lesions resumed the original appearance 3 weeks after discontinuing the therapy. To the best of our knowledge, this is the first case of CSP from mainland China.     

阿达木单抗治疗坏疽性脓皮病一例并文献复习

报道阿达木单抗成功治疗一例坏疽性脓皮病,并进行文献复习。患者,男,53岁。左股内侧红斑、丘疹6个月,溃疡3个月。组织病理示：符合坏疽性脓皮病。给予雷公藤多苷片、沙利度胺片治疗3天,仍有新发红斑、丘疹,于第3天、第10天分别给予皮下注射阿达木单抗80 mg、40 mg,后每2周皮下注射阿达木单抗40 mg,注射第4剂阿达木单抗时溃疡已愈合。半年后随访,皮损未复发。     

外阴疣状黄瘤

报告1例外阴疣状黄瘤.患者女,47岁.外阴丘疹6个月.皮损组织病理学检查示:表皮呈乳头瘤样增生,真皮乳头较多泡沫细胞;免疫组化染色示CD68阳性.手术切除后随诊9个月无复发.     

儿童表皮痣综合征1例

 报告儿童表皮痣综合征1例。患儿女,6周岁,脚趾畸形6年,右侧下肢、腰部、肩部、项部及左侧脚背部散在红斑、丘疹5年余。患儿出生时右侧第2、3脚趾畸形,第3、4脚趾向内侧弯曲,右侧脚踝出现红色丘疹,丘疹逐渐增多并蔓延至整个右侧脚踝及脚背部;出生后2个月左右,右侧腰部、肩部、项部及左侧脚背开始出现红色丘疹,红色丘疹逐渐增多并融合,伴有明显的瘙痒感。皮肤科检查：右侧腰部、腹股沟、下肢及脚踝、脚背部红色疣状丘疹,伴有黄色鳞屑,部分融合成片状或线状;右侧肩部及项部肤色、棕色、红色丘疹;左侧脚背部线状红色斑块,皮疹沿Blaschko线分布。右侧第2、3脚趾畸形,第3、4脚趾向内侧弯曲。皮损组织病理示：表皮角化过度,表皮突下延,棘层肥厚,真皮浅层血管周围见少量炎性细胞浸润。诊断：表皮痣综合征。     

Extracellular signal‐regulated kinase activation of self‐healing Langerhans cell histiocytosis: A case report

A 3‐month‐old boy developed small papules on his trunk. After the papules increased in number, the patient was diagnosed with Langerhans cell histiocytosis based on the pathological findings. He was referred to our department for further examination. Upon initial examination, the papules and nodules were scattered on his back, abdomen and lumbar region. Because he did not present with any organ involvement except the skin, he was diagnosed with single‐system and skin‐limited Langerhans cell histiocytosis. Skin rashes were treated with a topical steroid and started regressing 3 months after onset. All papules disappeared 6 months after onset. In this boy, the Langerhans cell histiocytosis tumor cells expressed phosphorylated extracellular signal‐regulated kinases. In Langerhans cell histiocytosis, BRAF V600E and other genes are known to mutate to act as driver mutations in stem cells of the myeloid dendritic cell lineage. Consequently, extracellular signal‐regulated kinases are continuously activated, which contributes to Langerhans cell histiocytosis carcinogenesis.     

射频联合A型肉毒毒素改善下面部松弛的临床观察

 

目的:探讨射频联合A型肉毒毒素注射改善下面部松弛的临床疗效及安全性。方法：纳入40例要求改善下面部松弛的求美者,随机分为对照组和试验组各20例,对照组采用A型肉毒毒素颈阔肌注射治疗,试验组采用下面部射频治疗联合A型肉毒毒素颈阔肌注射治疗,分别于治疗前,治疗后1、3及6个月对求美者进行标准化摄影,采用Photoshop CS6测量两组治疗前后下面部提升的距离和角度,采用重复测量方差分析方法对数据进行统计学处理。结果：40例求美者均完成治疗。对照组与试验组相比,治疗1、3个月后下颌缘轮廓缩小及提升差异不明显;治疗后6个月下颌缘轮廓缩小及提升差异明显（P值均＜0.05）。结论：射频联合A型肉毒毒素注射可改善下面部松弛,提高远期疗效,且疗效可靠、安全,值得临床推广应用。

     

Lymphomatoid papulosis subtype C: A case report and literature review

Lymphomatoid papulosis (LyP) is a rare CD30⁺ lymphoproliferative primary skin disease with a benign clinical course and malignant histopathology. LyP is classified into seven subtypes based on histopathology: subtypes A through F and LyP with 6p25.3 chromosome rearrangement. We present here, a case report of a 51‐year‐old man, afflicted with multiple papules and nodules on his left arm for over 3 months and diagnosed with LyP subtype C. The patient refused treatment, and his lesions faded with no visible rash on the left arm 14 months after diagnosis.