迪维霜和复方维E霜治疗黄褐斑

我们从１９９７年１月～１９９８年１２月应用重庆华邦制药有限公司生产的迪维霜（０． ０２５％）及我院自制的复方维Ｅ霜联合治疗黄褐斑，取得了一定的效果，现报告如下。１资料与方法１．１临床资料门诊患者３２例，均为已婚女性，年龄２５～４５岁，病程半年～５年；伴有妇科疾病（附件炎、月经不调、卵巢囊肿）１０例，妊娠期发病６例，服避孕药及日晒后发病各３例，劣质化妆品及严重贫血引起各１例，原因不明８例。１．２治疗方法双氧水洁面后，在离子喷雾下应用等量迪维霜及复方维Ｅ霜，遵循一定的手法按摩面部及皮损部位，按摩沿皮…     

正红花油引起急性荨麻疹1例报告

正红花油引起急性荨麻疹１例报告苑贵毕（贵州省毕节地区医院皮肤科５５１７００）患者男，１５岁，学生。因前额及颈部被蚊虫叮咬后，外用正红花油，约１小时后，患儿全身皮肤出现瘙痒，潮红及少许散在大小不等的红色风团，约１个半小时后，全身皮疹增多，瘙痒加剧，同时...     

Reiter病1例

Ｒｅｉｔｅｒ病１例杨敬蓉①王惠富①李利②周光平②患者男，２７岁，因皮疹３月余、关节肿痛２月余入院。入院前４个月受凉后相继出现双眼红肿痒痛、尿频尿急及尿道口灼痛，半个月后“自愈”。１个月后，会阴及外生殖器出现红色丘疹，逐渐发展到全身。２个多月后出现右踝...     

浅部真菌性包皮炎1例

浅部真菌性包皮炎１例雷承意（山西吕梁卫校，离石县，０３３０００）患者男性，３０岁，已婚。１９９２年１月与其妻过性生活后包皮出现微小裂口，次日出现包皮及尿道奇痒、包皮潮红，数日后裂口处出现白色膜状分泌物，抗生素治疗无效。取分泌物直接涂片发现大量菌丝及孢...     

口服田七花粉液引起过敏性紫瘢1例

口服田七花粉液引起过敏性紫瘢１例华中理工大学医院皮肤科熊竞华患者男，５８岁，口服田七花粉液后３天，两下肢出现皮疹。伴关节痛及腹痛。检查：两下肢有米粒大紫红色瘀点。尿常规、血小板计数正常。予抗过敏治疗，１周后皮疹及上述症状消失。隔一段时间后，因饮用了含...     

自体免疫性溶血性贫血伴发寻常型天疱疮1例报告

自体免疫性溶血性贫血伴发寻常型天疱疮１例报告陈洁，赵启明，金茶芽患者女，１６岁。间歇性酱油色尿１年半，伴头晕乏力。１９９２年１月１６日拟＂自体免疫性溶血性贫血＂曾住内科治疗１月后好转出院。近因全身皮肤出现大小不等水疱、糜烂、奇痒，发热及酱油色尿。于１...     

小儿淋病误诊2例

小儿淋病误诊２例邓亚秋，蔡立智湖北省沙市第一人民医院儿科（邮政编码４３４０００）例１女，２个多月，生后１周因鼻塞、排尿哭闹２天，伴眼红及臀红，以新生儿上感、结膜炎、尿布疹住院治疗。静脉用青霉素、氨节青霉素４天及对症处理，临床症状消失出院。后因症状反复...     

转移因子及α_1—干扰素对尖锐湿疣患者T淋巴细胞亚群的影响

转移因子及α１—干扰素对尖锐湿疣患者Ｔ淋巴细胞亚群的影响刘广国梁雪冰任晓红（山东省泰安市中心医院皮肤性病科２７１０００）我们应用ＧＸ—Ⅱ型多功能电离子手术治疗机电灼尖锐湿疣、术后随机分组，甲组２０例，皮下注射转移因子３ｕ，隔日１次，疗程１个月，乙组１...     

伊曲康唑治疗马尔尼菲青霉菌感染指甲1例报告

患者女，３３岁，工人，４年前双手掌部外伤伴感染，给予大量抗生素治疗后，每年夏季双手脱屑，糜烂，冬季有所好转。２年前，右手食指及中指指甲变暗，甲板增厚，１年前左手中指、食指、小指受累；于２００１年９月来我科就诊，作病甲真菌学检查，发现菌丝及孢子；甲屑真菌培养，菌种鉴定为马尔尼菲青霉菌。为排除污染菌，每周１次，连续作３次，都系同一真菌，确诊为甲真菌病。治疗：采用伊曲康唑间歇疗法，每次２００mg，每日２次，午餐、晚饭后服，连服１周，停药３周，再服１周，停３周，再服１周。停药３个月后复诊，甲根部已有新甲长…     

泛发性带状疱疹1例报告

泛发性带状疱疹１例报告路永红，苏晓杰（成都市第二人民医院皮肤科１００３１）患者蒋某某，男，３９岁，无明显诱因右侧头皮及额部起红斑，绿豆到黄豆大小的水疱伴剧烈疼痛，继而右眼脸红肿、胀痛、流泪及睁眼困难而入院。入院后１天，面、颈、胸、背及四肢近端出现散在...     

Lower-face and neck antiaging treatment and prevention using onabotulinumtoxin A: the 2010 multidisciplinary French consensus--part 2

Background Onabotulinumtoxin A has been used for many years in the aging face treatment. A survey was organized to identify current practices in France. Objective To develop consensual recommendations for treating aging lower face and neck with onabotulinumtoxin A. Methods and materials Fifty‐seven participants to six regional surveys reviewed practices and techniques for each individual treatment indication. From conference summaries and data from a questionnaire, consensual recommendations were developed. Results General considerations, key treatment rules, injection specifics (dose, site, and techniques), associated procedures/treatments, and procedure follow‐up were defined by indication, i.e., nasolabial angle, nasal tip repositioning, dilated nostrils, lips and perioral area, Marionette lines and depressor anguli oris, gingival smile, risorius and zygomatic perioral muscles, masseters, chin, and platysma. For the consensus participants, current onabotulinumtoxin A use is a global preventive and corrective treatment. Overall, judicious treatment of multiple sites and adjunctive modalities, such as fillers, peels, and laser, leads to satisfactory results with a youthful, harmonious, animated, and natural‐looking face. Conclusion Years of experience using onabotulinumtoxin A result in sophisticated treatment approaches, more specific targeted injections, and better understanding of lower facial and neck aging, leading to satisfying therapeutic results for patients and clinicians.     

Late-onset Rothmund-Thomson syndrome

A 43-year-old woman presented with complaints of exfoliation of the skin and mottled pigmentation all over the body, intolerance to sunlight for the last 14 years, and swelling on the lower one-third of the neck for 15 years. She was apparently well until the age of 29 years when she noticed redness on her shins which later progressed to involve the upper limbs, chest, and face. Three months later, she observed multiple, small, brownish plaques over the erythematous areas, which gradually spread to the sun-exposed areas, namely the face, forearms, hands, and nape of the neck. The erythema disappeared within 5 months of onset. The patient experienced redness of the face, intolerance to the sun, and reduced sweating, particularly during the summer. There was no history of bullous eruption, difficulty during deglutition, tremors, or pedal edema. She suffered five miscarriages and, ultimately, was successful in delivering a normal boy who is now 16 years of age. She had menarche at the age of 14 years and her menstrual cycle was regular. There was no history of similar illness in the family. On cutaneous examination, the skin on the face, neck, trunk, buttocks, and limbs was found to be dry, lusterless, thin, and covered with fine scales. Mottled hyperpigmentation was observed all over the body. Atrophy and telangiectasia were seen over the neck (Fig. 1), face (Fig. 2), nape of the neck, upper and lower limbs, back, and chest. Mild erythema was observed over the face, nose, ears, and forearms. The hair on the scalp, eyebrows, axillae, and pubic area was sparse and thin. The teeth were loose and discolored due to caries, and a foul odor emanated from the mouth. The nails were lusterless and centrally depressed. The thyroid gland was enlarged, smooth, nontender, and moved with deglutition. No bruit was heard over it. No ocular abnormality was detected. The patient had a haemoglobin level of 7.6 g%, total serum iron binding capacity of 70 micromol/L (normal, 45-66 micromol/L), and serum ferritin level of 10 microg/L (normal, 15-200 microg/L). Peripheral blood smear showed hypochromic microcytic red blood cells. Total and differential leukocyte counts, erythrocyte sedimentation rate (ESR), blood glucose, serum electrolytes, total and differential serum proteins, liver function tests, blood urea, and microscopic examination of urine and stools were within normal limits. The thyroid profile and complement C3 and C4 levels were within normal limits. Rheumatoid factor, antinuclear factor and LE cells were absent. Abdominal ultrasonogram was normal. Fine needle aspiration cytology from the thyroid gland showed features suggestive of colloid goiter. Skin biopsy revealed thinning of the epidermis, flattening of the rete ridges, and hydropic degeneration of the basal cell layer. The dermis was edematous with dilated capillaries, melanophages, and a band-like mononuclear infiltrate. The sweat glands were reduced in number.     

罗格列酮对2型糖尿病患者血清脂联素、超敏C-反应蛋白水平的影响

目的探讨2型糖尿病（T2DM）患者及肥胖患者血清脂联素、超敏C-反应蛋白（hs—CRP）与胰岛素敏感性的相关性及罗格列酮对脂联素、hs—CRP水平的影响。方法测定30名2型糖尿病患者（A组）、30名T2DM合并肥胖患者（B组）、30名单纯性肥胖患者（C组）及30名正常对照者（D组）的空腹血糖（FPG）、空腹胰岛素（FINS）、脂联素及超敏C反应蛋白（hs—CRP），计算稳态模型评估法胰岛素抵抗指数（HOMA—IR）及胰岛素敏感指数（ISI）。前三组给予罗格列酮治疗8周后，重复测定，并对前后数据进行统计学比较。结果与D组相比，前三组FINS、hs—CRP、和HOMA—IR较高，脂联素、ISI较低；给予罗格列酮8周后，FINS、hs—CRP、HOMA—IR明显下降，脂联素、ISI明显升高f均P〈0、05）。在A组和B组，hs—CRP与FPG、FINS、HOMA—IR呈正相关，与脂联素、ISI呈负相关。结论血清标志物hs—CRP、脂联素检测对2型糖尿病早期诊断、治疗、预后、胰岛素抵抗及生理机制的研究具有重要意义。     

Lipoid proteinosis

A 21-year-old man presented with a complaint of hoarseness as well as lesions along the eyelids and on his knees, elbows, and fingers. Hoarseness had developed in childhood, followed by lesions along the eyelids and on the elbows and fingers. He had developed lesions on the knees, feet, scrotum, penis, and axilla over the last 2 years. His parents were relatives, but nobody in the family showed similar features. His physical examination was normal. On dermatologic examination, there were beaded papules along the eyelids and small, yellow-white infiltrations on the tongue, buccal mucosa, palate, scrotum, and penis (Fig. 1). His tongue was firm and its mobility was limited. He also had infiltration of the frenulum (Fig. 2) and warty and hyperkeratotic papular and nodular lesions on the hands, knees, elbows (Fig. 3), and axilla. The laboratory findings and laryngoscopic examination were normal. Ophthalmologic, neurologic, and psychiatric examinations were also normal. Electroencephalogram (EEG), electromyogram (EMG), craniography, and cranial computed tomography (CT) scanning revealed no abnormality. The histopathologic examination of the skin biopsy specimens obtained from the axilla, elbow, and dorsum of the hand showed hyperkeratosis and periodic acid-Schiff-positive (PAS(+)) staining hyaline material around the dermal capillaries and sweat glands, and confirmed the diagnosis of lipoid proteinosis.     

Smoking and the skin

Smoking is the main modifiable cause of disease and death in the developed world. Tobacco consumption is directly linked to cardiovascular disease, chronic bronchitis, and many malignant diseases. Tobacco also has many cutaneous effects, most of which are harmful. Smoking is closely associated with several dermatologic diseases such as psoriasis, pustulosis palmoplantaris, hidrosadenitis suppurativa, and systemic and discoid lupus erythematosus, as well as cancers such as those of the lip, oral cavity, and anogenital region. A more debatable relationship exists with melanoma, squamous cell carcinoma of the skin, basal cell carcinoma, and acne. In contrast, smoking seems to protect against mouth sores, rosacea, labial herpes simplex, pemphigus vulgaris, and dermatitis herpetiformis. In addition to the influence of smoking on dermatologic diseases, tobacco consumption is also directly responsible for certain dermatoses such as nicotine stomatitis, black hairy tongue, periodontal disease, and some types of urticaria and contact dermatitis. Furthermore, we should not forget that smoking has cosmetic repercussions such as yellow fingers and fingernails, changes in tooth color, taste and smell disorders, halitosis and hypersalivation, and early development of facial wrinkles.     

Complications of lasers and light treatments

Cutaneous lasers and lights, and also more novel cutaneous energy modalities like radiofrequency and ultrasound, are in general very safe interventions with an associated rapid healing time. Posttreatment sequelae are usually mild and spontaneously resolving, with erythema and edema lasting hours to days. More troublesome, less common short-term adverse events include urticaria, erosions, crusting, ecchymoses, blistering, and infection. Medium-term adverse events include hyperpigmentation, hypopigmentation, a line of demarcation, burns, textural imperfections, and delayed reepithelialization. Long-term to permanent adverse events, which are fortunately rare, include indentation, scar, and ocular damage. With few exceptions, there are management strategies for avoiding laser adverse events, and, if they do occur, for mitigating their impact.     

Nutritional and Metabolic Profile of Children with Epidermolysis Bullosa

The clinical features of epidermolysis bullosa (EB) include oral, pharyngeal, gastrointestinal, and total-body blistering. This results in the potential for decreased oral intake, malabsorption, anemia, and depressed visceral protein stores, and a multifactorial etiology for the development of malnutrition and growth retardation. Thus, it was the purpose of this study to document the nutritional and metabolic profile of seven children with junctional or recessive dystrophic EB as compared to seven age- and sex-matched controls. Each child underwent a comprehensive nutritional assessment, including evaluation of anthropometric, dietary, and biochemical values and determination of resting energy expenditures. This study demonstrated that subjects with EB are statistically different for all anthropometric values studied and represent a population suffering from the effects of acute and chronic malnutrition. Nutrient deficiencies were reported for zinc, magnesium, calcium, potassium, and iron; vitamines A, D, E, B1, B12, and B6; protein, and calories. Comparison of laboratory values revealed significantly lower values for hemoglobin, hematocrit, and zinc. This research illustrates the magnitude of the growth deficits, and nutrient and biochemical deficiencies present in children with EB. The results provide a strong argument for the value of nutritional assessment and intervention and their potential impact in this population. Optimizing nutritional status may be one viable method of improving the morbidity and mortality associated with the disease and ultimately improving the overall quality of life.     

Desmosomal dissolution in Grover's disease, Hailey-Hailey's disease and Darier's disease

Proteins involved in the formation of desmosomes and simpler adherens junctions were studied in three types of non-immune acantholytic diseases; specifically, four cases of Grover's disease (GD), one case of Hailey-Hailey's disease (HMD) and one case of Darier's disease (DD), and these were compared to two cases of immune-mediated acantholytic disease pemphigus vulgaris (PV). The proteins studied included: 1. The intracellular desmosomal proteins, desmoplakin I and II and plakoglobin; 2. The intercellular desmosomal proteins, desmoglein and CD44; and 3. vinculin, which is a major intracellular protein of the simpler aherens junctions. In GD, HHD and DD, immunostaining showed a loss of desmoplakin I and II and plakoglobin from the desmosomes, and a diffuse staining in the cytoplasm. In contrast, in pemphigus vulgaris, these proteins seemed intact and were localized to dot-like spots on the cell surface. Also, desmoglein, and CD44 were slightly affected in GD, and moderately affected in HHD and DD. Absence of desmosomal attachment plaques, the lack of labeling with desmoglein in the affected desmosomes and a diffusion of the labels into cytoplasm were demonstrated with electron microscopy using an immunogold technique. In PV, desmoglein III is one of the target antigens for the autoantibodies in this disease and was only partially preserved in a small number of lesional cells, while CD44 was mostly preserved. Vinculin was intact in GD, HHD and DD, but was lost in PV. This study, our previous work, and that of others, suggest that: 1. In GD, HHD and DD, the proteins of the desmosomal attachment plaque are primarily affected; 2. In PV, the intercellular glycoproteins are primarily involved; and 3. Simple adherens junctions are intact in GD, HHD and DD, but are damaged in PV.     

生殖道分泌物支原体培养、半定量与耐药率调查

近年来,泌尿生殖道支原体感染,越发引起重视。检出手段也不断创新,新药不断开发,而支原体的耐药谱也不断发生变化,为此,要了解目前北京地区泌尿生殖道支原体中解脲支原体(Uu)和人型支原体(Mh)的感染率和耐药性,笔者选用了IST与DM培养试剂盒,对170例生殖道标本进行了培养检测,又将前次培养阳性结果与耐药率一并统计,临床分析另文报道,现就实验部分报告如下: