以播散性带状疱疹为首发表现的血管免疫母细胞性T细胞淋巴瘤1例

患者男,68岁,右侧头部疱疹伴疼痛1周,躯干、四肢皮疹3 d。既往身体健康。体格检查:右侧头部可见成簇疱疹,部分破溃,部分已结痂。双侧颈部及双侧腋窝可触及肿大淋巴结。躯干及四肢散在红色丘疹,上有小水疱、周围绕以红晕,部分结痂。皮损组织病理示:淋巴结活检可见淋巴结结构破坏,未见明显淋巴滤泡,淋巴结内多形性细胞浸润,瘤细胞生长活跃,核分裂象易见。淋巴结免疫组织化学显示CD3广泛阳性;CD10片状阳性;BCL6片状阳性;CXCL13广泛阳性;Ki-67(70%~80%阳性);PD1广泛阳性;EBER散在阳性。     

类风湿性关节炎伴复发性带状疱疹1例

患者女,71岁。右侧腰腹部出现红斑、水疱、疼痛1周。患者10年前、6年前曾分别于左侧腰腹部、右侧腰腹部患带状疱疹,均予抗病毒、营养神经、止痛治疗后痊愈。入院前1周,患者右侧腰腹部再次出红斑、水疱,自觉疼痛。既往＂类风湿关节炎＂病史18年,一直服用泼尼松和甲氨蝶呤等治疗,病情控制尚可。诊断：1复发性带状疱疹;2类风湿性关节炎。     

A Case of Human Immunodeficiency Virus Infection Initially Presented with Disseminated Herpes Zoster

Herpes zoster is characterized by unilateral grouped vesicles along the distribution of a single dermatome. Disseminated herpes zoster usually is defined as a generalized eruption of more than 20 extra-dermatomal vesicles occurring within a week of the onset of classic dermatomal herpes zoster. It occurs chiefly in old or debilitated individuals, and especially in patients with underlying malignancy, immunosuppressive therapy, or human immunodeficiency virus (HIV) infection. A 51-year-old man presented with segmental grouped vesicles on the left upper trunk and arm, and a varicella-like eruption over the entire body. Tzanck smear preparation and punch biopsy done on the vesicles of the trunk indicated a herpetic infection. Later, he was found to be HIV-positive. We report a rare case of HIV infection initially presenting with disseminated herpes zoster.     

Milia Arising in Herpes Zoster Scars

Milia caused by proliferative tendencies of the epithelium after injury may occur in areas of bullous eruption (10). Even though the possibility of milia arising in herpes zoster scar is real, it has not been reported previously. We describe a case of milia arising in herpes zoster scars as an another example of milia occurring in traumatized skin.     

盐酸伐昔洛韦治疗带状疱疹临床疗效观察

目的:评价盐酸伐昔洛韦治疗带状疱疹的临床疗效。方法:将入选患者随机分为两组,治疗组患者给予盐酸伐昔洛韦0.3g,每日2次口服;对照组患者给予阿昔洛韦0.2g,每日5次口服。疗程均为10d,并于用药后观察记录临床症状和体征改善情况。结果:盐酸伐昔洛韦的平均止痛、止疱、结痂时间均比阿昔洛韦短,治疗组有效率为91.4%,对照组有效率为54.3%,两组有效率比较,差异有显著性意义(P0.01)。结论:盐酸伐昔洛韦治疗带状疱疹疗效好,不良反应少,是一个安全有效的药物。     

以带状疱疹为首诊症状的艾滋病1例

目的:报告1例以带状疱疹为首诊症状的艾滋病。方法:根据病史、临床表现及实验室检查结果进行诊断。结果:患者有不规则发热和进行性消瘦病史,血清HIV抗体阳性,血液CD4 细胞/CD8 细胞<1.0,并出现较严重的病毒感染和皮肤细菌感染,诊断为艾滋病合并带状疱疹。结论:临床遇到严重的感染性皮损,如排除了糖尿病等系统疾病导致的免疫功能低下,应警惕艾滋病。     

SLE伴发坏疽性带状疱疹1例

患者女 ,44岁。患SLE 2年 ,左侧颈胸肩背部红斑、水疱、结痂伴疼痛 2 0天来诊 ,体检见左侧颈、胸、肩背部大片界线清楚的红斑 ,周绕红晕 ,部分融合、破裂、糜烂、结痂。手足可见毛细血管扩张性红斑及多形红斑皮疹。诊断为系统性红斑狼疮伴发坏疽性带状疱疹 ,给抗病毒、抗炎、镇痛、激素疗法 ,带状疱疹病愈出院。     

不同年龄带状疱疹的临床特征及综合治疗研究

目的 探讨不同年龄和皮疹分布不同部位的不同综合治疗方法。方法 1999—2003年问，对546例患者进行了年龄与皮疹分布部位、疼痛程度、潜伏期的分析，并采取不同的综合治疗方法。结果 546例带状疱疹患者其年龄与发病率，疼痛程度和潜伏期成正比。面部三叉神经受累者，90岁以上组为33％，70～89岁组为14％，50～69岁组为7．8％，20～49岁组为3．5％。采取不同的综合治疗方法有效降低了带状疱疹后遗神经痛的发生。结论 综合治疗对降低带状疱疹后遗神经痛的发生有明显的疗效。     

以带状疱疹为首发症状的艾滋病8例临床分析

目的探讨合并有性病、多种皮肤病、嫖娼、多性伴史与以带状疱疹为首发表现的艾滋病患者的特点和关系。方法对2011年3月-2012年2月间诊治的8例以带状疱疹为首发表现的艾滋病患者临床资料进行分析。结果 8例患者中男3例,女5例,年龄26～38岁7例,81岁1例;未婚和丧偶5例,在婚3例。8例一般情况良好,带状疱疹于躯干四肢7例,额面部1例。皮损为大面积群簇性水疱、大疱、血疱,部分融合伴剧烈刺痛。合并非淋菌性尿道(宫颈)炎2例,淋病1例,尖锐湿疣1例,隐性梅毒1例,合并复发性生殖器疱疹和进展期肺结核1例。同时合并单纯疱疹、脂溢性皮炎1例;同时合并尖锐湿疣、非淋菌性宫颈炎及隐性梅毒1例。8例患者有多性伴或嫖娼史,无输血史、吸毒史,经过治疗后7例治愈,1例后遗神经痛3个月。结论对于带状疱疹患者,文化程度较低、不在婚者、有多性伴史、嫖娼史、过去和现时有性病史者,或多种反复发作的皮肤病、肺结核,特别是服务行业年轻女性、性活跃者,都应行HIV初筛检查,以免漏诊。     

万乃洛韦联合小剂量泼尼松治疗老年人带状疱疹的临床疗效观察

目的:了解盐酸万乃洛韦与小剂量泼尼松联合用药治疗老年人带状疱疹的临床疗效.方法:84例老年带状疱疹患者随机分为两组,研究组联用盐酸万乃洛韦与小剂量泼尼松,对照组单纯用盐酸万乃洛韦,用药后第3、7、14、30天观察记录治疗效果.结果:研究组发疹停止时间、疼痛缓解时间、痊愈时间及后遗神经痛发生率与对照组比较均有显著性差异,两组均无不良反应发生.结论:万乃洛韦联合小剂量泼尼松治疗老年人带状疱疹起效快、病程短并能减少后遗症神经痛的发生率.     

Evaluation of Acceleration Plethysmograms in Dermatology—Efficacy of Lipo PGE1 Preparations against Herpes Zoster and Neuralgia Following Herpes

Reports published in recent years indicate that administration of lipo PGE₁ is effective against herpes zoster and neuralgia following herpes. However, there are presently no standards to objectively assess efficacy. We therefore looked into the possibility of achieving this goal by using an acceleration plethysmograph. The results showed a significant difference in the rate of change of pulse waves after initiation of drip infusion as compared to before drip infusion among the effective group, the control group, and the non-effective group. This method appears to be useful to objectively assess both the analgesic effects of lipo PGE₁ and the efficacy of drugs in general, based on data analysis. Our results suggest that investigations using this method may be able to predict the therapeutic effects of vasodilators and analyze hemodynamic disorders of the skin.     

恶性淋巴瘤3次伴发带状疱疹1例

事状疱疹发病后一般获终身免疫，但偶有复发者。本文报告1例27岁患恶性淋巴瘤女性患者，在化疗后3次伴发带状疱疹。2次在同侧不同部位,1 次发生在三叉神经眼支。提示带状疱疹在机体免疫功能极度低下时，可以多次复发。     

两种剂量的伐昔洛韦分散片治疗带状疱疹临床疗效对照

目的比较两种剂量的伐昔洛韦分散片治疗带状疱疹的疗效。方法选择在本院门诊就诊符合诊断标准的带状疱疹患者为研究对象,采用随机、开放、对照的临床试验。治疗组患者采用伐昔洛韦分散片0.15g,2次/d口服,共服10天;对照组患者采用伐昔洛韦分散片0.3g2次/d口服,共服10天。用药后第3,6和10天观察疗效。结果共入组77例,治疗后第3,6和10天,治疗组的有效率分别是32.5%,42.5%,87.5%,对照组的有效率分别是35.1%,62.2%,89.2%,两组患者治疗指数比较差异无统计学意义(P>0.05);疼痛改变(VAS法分值)比较两组间差异无统计学意义(P>0.05)。结论伐昔洛韦分散片治疗带状疱疹0.15g2次/d口服疗效不低于0.3g2次/d口服。     

Case of herpes zoster duplex bilateralis

Non-contiguously simultaneous development of herpes zoster is very rare. It is named either herpes zoster duplex unilateralis or bilaterarlis, depending on whether one or both sides of the body are involved. Herein, we report a 21-year-old man, who had been treated for ulcerative colitis with prednisolone, and presented with painful grouped vesicles of the lower abdomen and back in a relatively symmetrical distribution. A Tzanck smear and punch biopsy were performed on the vesicles of the back. We report a rare case of symmetrical herpes zoster duplex bilateralis.     

Scanning and Transmission Electron Microscopic Studies of Lesional Epidermis in Herpes Zoster

The epidermal skin lesions of herpes zoster were studied by scanning (SEM) and transmission electron microscopy (TEM). When erythematous lesions were observed by TEM, many of the infected keratinocytes showed evidence of cell degeneration, being characterized by swollen nuclei, disappearance of desmosomes, and widening of intercellular spaces. Macrophages and/or lymphocytes migrated through the intercellular spaces between degenerated keratinocytes. In the vesicular lesions, SEM and TEM showed some infiltrating neutrophils, directly adhering to the virus-infected keratinocytes, with swollen nuclei and irregularly clumped chromatin. In some specimens, balloon-degenerated keratinocytes were observed in the cavity. In the pustular stage, ruptured keratinocytes and numerous neutrophils were observed in the reticular-degenerated epidermal tissue. These results suggest that, in herpes zoster, the epidermal damage may be due, at least in part, to cell-mediated host immunity as well as to the cytopathic effect of varicella-zoster virus.     

半导体激光联合阿昔洛韦口服治疗老年带状疱疹临床疗效观察

目的观察半导体激光照射结合阿昔洛韦口服治疗老年带状疱疹的临床疗效。方法122例老年带状疱疹患者随机分为两组,半导体激光照射结合阿昔洛韦口服治疗(治疗组),单一阿昔洛韦口服治疗(对照组),疗程均为10d。结果半导体激光照射结合阿昔洛韦口服治疗的疗效显著优于阿昔洛韦口服治疗,后遗神经痛明显减少,病程明显缩短。结论半导体激光照射结合阿昔洛韦口服治疗老年带状疱疹能明显提高疗效,是一种值得推广的方法。     

带状疱疹愈合部位发生银屑病-Wolf's同位反应1例

患者男,38岁。6周前左胸及背部出现带状疱疹皮损,2周后治愈。20d前,皮损愈合处出现簇集分布的鳞屑性红斑丘疹。皮损组织病理符合银屑病,提示为带状疱疹Wolf's同位反应。     

双侧带状疱疹1例

患者男,66岁。5天前感冒后,于右侧胸背3、4、5肋间前胸后背处,及右侧胸腹9、10肋间处,出现呈带状 分布的、较完整的两列簇集性丘疹、水疱。有针刺样抽痛。诊断为双侧带状疱疹。     

三种方法治疗带状疱疹疗效观察

目的寻找更安全、有效、经济的治疗带状疱疹及神经痛的方法。方法91例患者随机分为三组进行对比观察.分别于疗程第5,10天观察症状及体征的变化和不良反应。A组口服泛昔洛韦250mg,3次/d,复方甘草酸苷片75mg,3次/d;B组口服泛昔洛韦250mg,3次/d;C组口服复方甘草酸苷片75mg,3次/d。结果三组在结痂起始、止痛起效、疼痛消失时间上有显著性差异;有效率分别为96.77%,86.67%和73.33%;不良反应分别为3.2%,3.3%和0。结论泛昔洛韦和复方甘草酸苷联合应用是治疗带状疱疹和神经痛的一种安全、有效、也较为经济的方法。