皮肤镜观察尖锐湿疣1例

正患者男,49岁。主诉:阴茎赘生物10余天。现病史:患者10余天前发现阴茎赘生物,无自觉症状。院外未予特殊处理。既往史:既往健康。否认非婚性接触史,自诉其妻未见类似皮疹。家族史:家族中无类似疾病患者及其他遗传病史。体格检查:一般情况好,系统检查未见异常。皮肤科检查:阴茎远端可见0.5 cm×0.5 cm和0.1 cm×0.1 cm粉红色赘生物(图1),界限清楚,质地柔软。     

乳房外Paget病并发尖锐湿疣

报告1例乳房外Paget病(EMPD)并发尖锐湿疣(CA)。患者男,72岁。阴茎、阴囊浸润性红斑伴瘙痒4年,1个月前阴茎、阴囊、龟头及包皮出现多个疣状赘生物。皮损组织病理检查:(阴茎根部皮损)表皮棘层肥厚,表皮突延长,表皮内有不等量的Paget细胞,呈圆形或卵圆形,无细胞间桥,胞质丰富,淡染,细胞核较大,伴慢性炎症;(阴茎赘生物)鳞状上皮呈乳头样增生伴挖空样细胞。免疫组化示:CK7(+)、CerbB2(+)、CK5/6(+)、P53(+)、Ki-67约20%(+)、CK20(-)、s-100蛋白(-)及HMB45(-)。诊断:EMPD并发CA。     

增殖性红斑继发鳞状细胞癌1例

患者男,37岁。龟头红斑、溃烂和渗液半年余。皮肤科情况:龟头包皮系带处可见直径约2.5cm糜烂面,上有少许渗液,皮疹中央可见乳头瘤状增生。皮损组织病理示:鳞状细胞癌(中～高度分化)。诊断:增殖性红斑,鳞状细胞癌。予5%咪喹莫特软膏外用,ALA光动力疗法4次,无好转。予阴茎部分切除术,切除断端组织进行组织病理检查,未见癌细胞,术后切口愈合可。     

龟头疣状癌1例

报告1例龟头疣状癌。患者男,71岁,尿道口起疹伴疼痛1年余,包皮粘连30年。皮肤科情况:尿道口周围可见一钱币大小的色素减退斑,尿道口右侧可见一绿豆大小的近白色丘疹,表面粗糙,触痛明显,尿道口狭窄。双侧腹股沟淋巴结未触及肿大。组织病理学检查:鳞状上皮呈乳头瘤样增生,有角化过度和角化不全,棘层肥厚,真皮可见肿瘤团块,肿瘤细胞异形不明显。诊断为龟头疣状癌。行阴茎部分切除术,术后切口愈合良好。     

疣型外阴上皮内瘤变1例

患者女,64岁。左侧腹股沟赘生物6年。皮肤科情况:左侧腹股沟见一约4cm×3cm大小肉红色赘生物,呈菜花状隆起,边界清楚,有蒂,表面粗糙,湿润,质脆,赘生物周围有暗红色斑疹。皮损组织病理示:角化过度,伴角化不全,真皮乳头瘤样增生,表皮颗粒层及棘层上部见多量凹空细胞,棘层内见多量不典型增生的细胞,可见病理核分裂相。真皮浅层见少量淋巴细胞浸润。行HPV分型检查示:高危型HPV病毒51亚型。诊断:疣型外阴上皮内瘤变(VIN)。     

龟头皮角1例

患者男 ,10岁。因龟头赘生物 5年就诊。 5年前无诱因龟头背侧长出米粒大小黑褐色赘生物 ,无自觉症状 ,皮疹逐渐长大变长 ,曾在泌尿外科先后 3次手术切除 ,但不久后均复发。体检 :患者一般情况好 ,浅表淋巴结不肿大 ,系统检查无异常。皮肤科情况 :包皮上翻 ,龟头背部近冠状沟处见一 1ｃｍ长圆锥形黑褐色表面粗糙角化性赘生物 ,质硬 ,基底稍宽 ,无潮红、浸润、破溃 (图 1)。治疗 :手术切除 ,深达基底下正常组织 0 .2ｃｍ。病理检查 :表皮明显角化过度 ,乳头瘤样增生 ,真皮浅层无炎性细胞浸润。图 1　龟头皮角皮角属癌前期病变。多见于 40岁以…     

阴茎疣状癌1例

1临床资料患者男,60岁,农民。阴茎肿物渐增大1年余。患者1年前无明显原因出现阴茎肿物,无自觉症状,无疼痛、瘙痒和泌尿系感染,未予任何治疗。近来皮损逐渐增大。否认不洁性生活史,配偶无异常。体检:系统检查未见明显异常,未触及浅表淋巴结肿大。皮肤科情况:阴茎根部、阴茎近端及龟头可见巨大疣(菜花)状增生物,呈灰白或淡红色,质硬,上覆黄色或黑色痂皮、污秽,无分泌物,最大处直径约8 cm,伴有恶臭(图1),血、尿、粪常规、肝、肾功能、骨盆X线平片等检查均正常。皮损组织病理示:表皮乳头瘤样增生,可见角化不全、角化不良细胞及空泡细胞,真皮部…     

乳房外Paget病一例

患者男,54岁,阴囊及股部赘生物4个月.皮肤科检查:右侧腹股沟及阴囊见多个红色或皮色的结节和肿块,直径为0.5 cm×0.5 cm～8 cm×8 cm,呈疣状或圆顶状,部分表面糜烂,有少许脓性分泌物,伴恶臭.该患者在以往的皮损基础上出现新生物,伴有恶臭,根据患者的临床表现及病史考虑为鳞状细胞癌,给予进一步检查,经皮损组...     

阴茎分裂痣

<正>1病历摘要患者男,29岁。阴茎包皮、龟头出现黑斑5年,于2012年12月25日来我院皮肤科就诊。患者5年前无明显诱因于阴茎包皮及龟头处各出现一块黑斑,无疼痛及瘙痒等不适,皮损边界清楚,并以冠状沟为界分为大小、形态相似的两块黑斑,出现至今大小、颜色、数量无变化,也未用药治疗。体格检查:一般情况可,系统检查无异常。皮肤科检查:阴茎龟头处可见一约2.0 cm×1.7 cm黑斑,包皮内板近冠状沟处可见一约2.5 cm×2.0 cm黑斑,黑斑与周围组织分界清楚,局部皮肤无破溃、红肿及分泌物(图1A)。皮损组织病理检查:(阴茎)表皮内基底层可见数个痣细胞,大部分痣细胞团进入真皮内,形成真     

尖锐湿疣继发鳞癌1例

报告尖锐湿疣继发鳞癌1例.患者男,67岁,龟头反复出现赘生物并伴溃疡一年半,经组织病理学检查确诊为高分化鳞状细胞癌.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.