肛周泛发性扁平湿疣1例

1临床资料患者男,38岁。肛周皮疹1月余。1个月前患者发现肛周有数个皮色丘疹,当地医院以"痔疮"治疗,无明显疗效,皮疹渐增大增多,伴疼痛和瘙痒。发病前有不洁性生活史,2个月前有外生殖器部位溃疡史。查体:体形矮胖,痛苦面容,右腹股沟皮下触及一蚕豆大淋巴结,无痛,与周围组织无粘连,其余无特殊。皮肤科情况:肛周可见20余个圆形及椭圆形红色肥厚斑块,质中,界清,表面潮湿,部分皮疹轻度糜烂,0.3cm×0.5cm～2.0cm×3.0cm大小,自觉瘙痒     

二期梅毒合并淋球菌性前庭大腺脓肿及衣原体性宫颈炎一例

患者女,21岁。因肛周起红色丘疹2周,外阴肿痛、发热5d而就诊。自诉2周前肛周出现暗红色丘疹伴轻度痒痛,拟诊为痔疮,外用马应龙软膏等药物治疗,皮疹无明显消退。5d前发现右侧大阴唇出现疼痛性肿块,约一粒花生米大小,曾口服头孢氨苄2d,肿块逐渐增大至拇指大小,疼痛加重伴发热(体温37.8℃);同时阴道口出现脓性白带。该患者承认半年内有多次非婚性接触史,最近1次为10d前。其性伴2个月前曾有阴茎破溃史。体检:体温37.6℃,痛苦貌,全身系统检查无异常。肛门周围可见暗红色浸润性扁平丘疹,表面轻度糜烂。右侧大阴唇有约3.0cm×1.0cm的触痛性囊性隆起…     

以环形疹和扁平湿疣共存为临床表现的二期梅毒1例

正1临床资料患者男,32岁。阴囊、大腿内侧环形皮疹,肛周扁平丘疹2周。2周前阴囊、大腿内侧出现红斑,肛周出现小丘疹,逐渐增大增多,皮疹伴轻度瘙痒及疼痛。就诊时否认有婚外性生活史,否认有外阴皮肤破溃史,无食物及药物过敏史。系统检查未见异常。皮肤科情况:阴囊皮肤见大小不等的浸润性环形红斑,中央呈暗红色,表面少许粘着性鳞屑,边缘稍堤状隆起;双     

多部位扁平湿疣1例

1.临床资料 患者男,50岁.肛周及外阴皮疹伴瘙痒1周.1周前因肛周和外阴部瘙痒发现有较多丘疹,以夜间为其.否认不洁性交史;无输血和同性恋史.2月前与妻有性接触.系统检查无异常.     

多发性硬下疳一例

患者女．45岁．因会阴、肛周破溃20d就诊。患者20d前小阴唇、肛周出现数个绿豆大小的丘疹,无自觉症状,数天后出现破溃并逐渐增大,形成数个大小不等的溃疡,有少许分泌物,并伴有轻微疼痛,在家用1：5000的高锰酸钾溶液外洗．涂红霉素软膏症状不减轻。患者既往无性病病史,无用药病史。起皮疹前15d,患者有非婚性接触史,     

增殖性脓性皮炎-脓性口炎一例

患者女,26岁,因头皮、眼结膜、牙龈、外阴及肛周脓疱、溃疡、增殖性斑块10 d就诊。10 d前无明显诱因双侧大阴唇侧出现溃疡,伴有黄色脓性分泌物,无明显疼痛。随后眼结膜、牙龈、头皮出现红斑,并在红斑上多发脓疱,脓疱易破,逐渐形成增殖性斑块。中度瘙痒,无明显疼痛及脱发。5 d 前右耳后出现钱币大小溃疡面,右侧腰肋部可见一甲盖大小破溃,表面结黄痂……     

儿童慢性苔藓样糠疹一例

患儿男,7岁10个月。因全身出现皮疹1个月就诊。1个月前患儿无明显诱因下腹部出现多个红色丘疹,3 ~ 4 d后皮疹延及胸背部,10 d后面部、四肢出现类似皮疹,1周前皮疹明显增多,表现为全身泛发的多数密集分布粟粒至绿豆大小红色、暗红色丘疹和斑丘疹,多数瘀点。无瘙痒感,无发热,无皮肤黄染,无鼻衄、牙龈出血,无头晕、乏力。曾在多家医院就诊,考虑病毒感染？皮肤过敏？予左西替利嗪、复方甘草酸苷口服,外用丙酸氟替卡松乳膏等疗效不佳……     

类天疱疮样扁平苔藓合并Turner综合征一例

患者女,28岁,无业。因全身起紫红色扁平丘疹伴痒2个月,四肢出现水疱3 d,于2013年10月14日收入院。该患者2个月前无明显诱因于四肢起粟粒至绿豆大小多角形、界清的紫红色扁平丘疹,表面蜡样薄膜,自觉瘙痒,搔抓后皮疹逐渐增多,波及躯干。在外院就诊,均诊断为湿疹,静脉滴注复方甘草酸苷60 ml日1次,连续7 d无好转,改为口服盐酸西替利嗪片,外用地奈德软膏,亦无好转,仍有新起皮疹,分布密集,躯干处部分皮疹融合成片……     

妊娠期发生Ksposi水痘样疹1例

<正>1 病历摘要患者女,20岁。因乳头、乳晕、外阴反复红斑、丘疹、糜烂伴瘙痒4年,局部水疱伴发热3 d就诊。患者4年来外阴、乳头、乳晕反复出现片状红斑、密集小丘疹,伴剧烈瘙痒,搔抓后局部出现糜烂、渗液及结痂。曾自行外用药(具体不详)治疗,瘙痒及皮疹可减轻。近3 d皮疹再发,瘙痒加剧,局部出现绿豆大水疱,触痛明显,并出现高热、寒战。既往体健,否认慢性病、传染病、遗传病及非婚性接触史;无药物及食物过敏史,孕5个月;入院前1周其配偶患生殖器疱疹。     

以瘙痒为主要表现的二期梅毒一例

患者女 40岁 ,外阴、躯干出现皮疹伴瘙痒1个月。患者就诊前1个月,无明显诱因大小阴唇、躯干出现丘疹伴瘙痒,随后躯干皮疹渐扩大呈环形、边缘伴有少许脱屑。在当地医院检查排除霉菌性或滴虫性阴道炎,诊断为皮炎,给予依匹斯汀片10 mg口服每天1次,外用糖皮质激素软膏（具体不详）,效果欠佳。因瘙痒剧烈,皮疹无明显消退,就诊于我院皮肤科。否认有发热和非婚性接触史。体检：各系统检查未见异常……     

Epidemiology and control and curable sexually transmitted diseases: opportunities and problems

BACKGROUND: Despite the availability of safe and effective treatment, infection with bacterial sexually transmitted diseases persists at a high prevalence in many populations. GOAL: To review the difficulties of parameter estimation when a cure is readily available and to explore the impact of different treatment and screening strategies that might maximize the benefits of using available treatments. STUDY DESIGN: A standard deterministic model for the spread of a bacterial sexually transmitted disease that causes symptomatic and asymptomatic infections, in which the population is stratified according to sex and sexual activity, is further stratified into two host groups to enable the modeling of different treatment and screening strategies. RESULTS: In the presence of a core group, if an infection has a high transmission probability, then screening for asymptomatic infections has a short-lived benefit. Repeated screening is slightly better if it is not restricted to a fraction of the at-risk population, but targeting of high-risk groups should be effective. Screening to treat asymptomatic infections in men could be beneficial if a substantial fraction of cases remain asymptomatic. CONCLUSIONS: After the initial gains achieved through treating symptomatic infections, further reductions in the prevalence of infections can be achieved by finding asymptomatic infections. However, these gains are difficult to achieve, especially in the case of gonorrhea. Because men are likely to have an asymptomatic chlamydial infection, screening of men for chlamydia should be worthwhile.     

皮肤激光与光子:进展与现状

1治疗理论1.1选择性光热作用原理选择性光热作用原理(theory of selective photothermolysis)是1983年Anderson等提出来的,其精