颗粒状角化不全一例

患者女,31岁,左腋窝红斑、糜烂、痒23年.体检:左腋下可见近环形红色斑片,约8 cm×10 cm,皮损中央淡紫红色粟粒大棘状丘疹,不完全融合形成斑块,皮损外周红斑表面轻度糜烂、渗液,散在少量米粒大脓疱,部分区域可见瘢痕;全身其他间擦部位未见任何皮损.皮损表面分泌物真菌镜检阴性.组织病理:角质层增厚,角化过度并显著角化不全,角质层大多数细胞保留细胞核,包含大量嗜碱性颗粒.角化不全下方颗粒层仍然保留,其中少部分细胞胞质呈空泡状.表皮呈银屑病样增生,真皮内血管周围以淋巴细胞为主的混合炎症浸润,并可见明显血管扩张.诊断:颗粒状角化不全.     

对称性药物相关性间擦部及屈侧疹一例

48岁男性患者,左腋窝红斑、丘疹伴瘙痒3周.皮肤科情况:双侧腋窝、腹股沟可见对称性分布的粟粒至黄豆粒大小的红斑、丘疹,部分皮损表面可见黄褐色厚腻性鳞屑及浅溃疡,并拢双腿后皮损呈V形分布.肛周可见呈环形分布的米粒至绿豆粒大小的红色丘疹,部分丘疹表面可见黄褐色结痂.皮损组织病理示:角质层可见结痂、角化不全及角化过度,棘层灶...     

儿童腋窝颗粒状角化不全

报告1例儿童腋窝颗粒状角化不全.患儿女,12岁.左侧腋窝发生红斑、丘疹伴瘙痒10年.组织病理检查示角化过度伴角化不全,并可见透明角质颗粒,颗粒层轻度增厚,表皮突延长.诊断:腋窝颗粒状角化不全.     

儿童屈侧银屑病一例

男性10岁患儿,颈部、腋窝、腹股沟反复红斑、丘疹、鳞屑1年。皮肤科情况:颈周及腋窝散在鳞屑性红色斑丘疹,部分融合成片;双侧腹股沟区可见境界相对清楚的大片红斑,表面相对湿润,鳞屑不明显,其中腹股沟内侧皱褶处局部浸渍,腹股沟区红斑周围、股内侧散在鳞屑性红色丘疹;头皮、躯干及四肢无类似皮损;指(趾)甲未见异常。组织病理示:表皮角化过度伴角化不全,可见Munro微脓肿,棘层肥厚,表皮突向下延伸,真皮乳头处小血管增生,部分区域充血,真皮上部血管周围单一核细胞浸润。最后诊断:屈侧银屑病。     

毛囊角化病合并皮肤蝇蛆病1例

报告毛囊角化病合并皮肤蝇蛆病1例.患者女,68岁,头面颈部毛囊性丘疹60年余,左耳后皮肤破溃3d.皮肤科检查:头面部可见弥漫分布粟粒至黄豆大小丘疹,部分融合成斑块,上覆黄色及棕褐色痂;左侧耳廓后见一长约10 cm溃疡,表面脓血性分泌物渗出,溃疡深部可见大量坏死组织及蛆虫.左面部皮损组织病理学检查示表皮角化过度、角化不全...     

非典型幼年型毛发红糠疹1例

患儿男,13个月。双掌跖弥漫性红斑、角化过度10个月;面颈部、腋下、腹股沟、臀部红斑、鳞屑,伴瘙痒9个月。家族中有类似疾病患者。右臀部皮损组织病理示:表皮角化过度伴灶性角化不全,在水平方向和垂直方向可见交替的角化不全和角化过度;颗粒层及棘层肥厚,表皮突增宽;真皮乳头血管扩张,浅层血管周围少量淋巴细胞浸润。诊断:非典型幼年型毛发红糠疹。     

颗粒状角化不全

报告2例颗粒状角化不全.患者分别为22岁女性和39岁男性,左腋窝角化性丘疹伴瘙痒10余年和18年.组织病理检查示角质层角化过度及角化不全,伴有明显嗜碱性透明角质颗粒沉积.诊断:颗粒状角化不全.     

泛发性炎症性线状疣状表皮痣1例

患者女,46岁,面部及右侧颈部、躯干、下肢丘疹伴瘙痒40余年。皮肤科情况:左侧额部、眶周及右侧面颊、下颌、颈部、背部、乳房、下肢见多发红色绿豆至黄豆大小斑丘疹、丘疹,部分融合成斑块,呈线状排列,表面有少量鳞屑、结痂,右足底角化过度。皮损组织病理:角化过度伴部分区域角化不全,真皮浅层少量炎性细胞浸润。诊断:泛发性炎症性线状疣状表皮痣。     

泛发性汗孔角化症合并枕部巨大鳞癌一例

患者,女,46岁。全身角化性丘疹30年余,头皮破溃1年余。皮肤科情况：躯干四肢褐色斑块,部分中央萎缩;枕部可见18 cm×9 cm溃疡。枕部皮损组织病理检查示条索状异型肿瘤细胞;免疫组化示鳞癌。上肢皮损组织病理检查：多个角化不全柱。诊断：泛发性汗孔角化症合并枕部巨大鳞癌。给予放疗,效果可。     

巨大型疣状增生与显著角化过度型汗孔角化症1例

报告1例巨大型疣状增生与显著角化过度型汗孔角化症。患者女,48岁,臀部、双下肢丘疹、斑块伴剧痒5年余。体检：腰臀部见密集多发绿豆至蚕豆大小红色丘疹、斑块,双臀部皮疹融合成巨大型疣状增生;双大腿内、屈侧密集孤立粟米至黄豆大褐色角化性丘疹。皮损组织病理检查：表皮角化过度,可见角化不全的圆锥状板形成,棘层增厚。根据临床症状及皮肤组织病理学改变,诊断为汗孔角化症。     

SOLITARY TRUNCAL POROKERATOTIC ECCRINE OSTIAL AND DERMAL DUCT NEVUS IN A SIXTY-YEAR-OLD MAN

A sixty-year-old white man presented with a 2 × 1.5 cm lesion on his right buttock. The lesion had been present for several years, but had not been present when the patient was a child. No other family members reported having similar lesions. His past medical history was unremarkable. By history, the lesion was slowly growing, but was neither painful nor pruritic. On examination, a well defined pink nodule was noted on his right buttock. The surface of the lesion had a crateriform appearance with verrucous edges. A shave biopsy was performed.
Histopathology : The specimen was cut into four pieces and sections stained with hematoxylin and eosin were examined. A low power view (Fig. 1) shows an epidermis with considerable hyperkeratosis and several focal areas of parakeratosis that fill epidermal dilated eccrine ducts. Higher magnification (Fig. 2) reveals, that these foci of parakeratosis resemble the cornoid lamellae seen in porokeratosis of Mibelli. Figure 2 also reveals that the process originates within the eccrine duct. Higher magnification demonstrates the porokeratotic column arising from dyskeratotic keratinocytes that lack a granular layer (Fig. 3). An inflammatory infiltrate consisting of lymphocytes and histiocytes is present in the underlying dermis with accentuation directly under the cornoid lamellae.     

Incidental granular parakeratosis associated with dermatomyositis

A 43-year-old patient presented with a 4-month history of intermittently occurring symmetrical and slightly scaling erythematous plaques in his zygomatic regions. Because of polymyositis in the patient's history, the skin lesions were thought to be a manifestation of dermatomyositis. The skin biopsy revealed a sparse superficial perivascular infiltrate of lymphocytes, which was associated with telangiectases and both discrete vacuolar alteration and smudging of the dermal-epidermal junction. These findings were consonant with dermatomyositis. In addition to these features focal granular parakeratosis was present. The histopathologic presence of granular parakeratotic corneocytes above a zone of orthokeratosis and the absence of clinical features of granular parakeratosis indicate the granular parakeratosis is incidental.     

CHILD Syndrome: Analysis of Abnormal Keratinization and Ultrastructure

Abstract: A new patient with CHILD syndrome (congenital hemidysplasia, ichthyosiform erythroderma, and limb defects), the thirtieth in the literature, was observed for over three years. Initially, the right-sided lesion spared the breast area. At 10 months of age the trunk lesion extended to cover the entire area of the right chest At age 20 months the patient developed linear, bandlike, keratotic, brown-black lesions on her teft thigh that subsided within six weeks, leaving a slight hyperpigmentation. This patient was studied by routine histologic methods as well as with markers of keratinlzation and electron microscopy. In hematoxylin and eosinstained sections, parakeratosis and orthokeratosis atternated. In some parakeratotlc areas, targe granular cells, and in others, ghost granular cells, were present. The latter showed basophilic cytoplasm, and palestaining or vacuolated nucleus and were seen either above the normal granular layer or without it. Although regional variations existed, basat cell-type keratins as recognized by AE1 continued to be expressed in suprabasal layers. Filaggrin- and Involucrin-positive layers were expanded, particularly the latter, down to the lower prickle cell layer. Ultrastructurally, numerous lamellar or membranous structures were found in upper layers of the epidermis, both intracellulary and intercellularly. Normal cementsomes coexisted with these abnormal lamellar structures, and it was thought that the latter represent modified cementsomes because the discharge of those from the cell periphery was Often detected.     

Adult‐onset inflammatory linear verrucous epidermal nevus: Immunohistochemical studies and review of the literature

Adult‐onset inflammatory linear verrucous epidermal nevus (ILVEN) is an uncommon cutaneous disease compared to childhood‐onset ILVEN. The typical histopathologic features are alternating parakeratosis and orthokeratosis with an absent granular layer underneath parakeratosis, in contrast to a thickened granular layer below the foci of orthokeratosis in psoriasiform epidermal hyperplasia. Herein, we present a 49‐year‐old woman with typical clinical and histopathologic characteristics of adult‐onset ILVEN, including linear arrangement of thick scaly papules and plaques localized on the medial side of her right leg, ankle, and foot. Immunohistochemical studies included involucrin, Ki‐67, and keratin‐10. Compared to the staining pattern in psoriasis, the expression of involucrin in this case was of lower intensity and localized to upper epidermal layers with relatively less extensive staining beneath regions of parakeratosis as compared to orthokeratosis; Ki‐67 showed lower basal layer proliferative activity; and keratin‐10 showed a greater intensity of staining within suprabasal epidermis.     

Granular parakeratosis – a clinical‐pathological correlation of 10 cases

Background: Granular parakeratosis describes chronic skin lesions within the intertriginous areas that demonstrate microscopically parakeratosis together with retention of keratohyalin granules within a thickened stratum corneum. Granular parakeratosis is rarely diagnosed, since it is still relatively unknown within the differential diagnoses of intertriginous eruptions, and a skin biopsy is required for diagnosis. In order to gain insight into the clinical‐histopathologic correlation, we present 10 cases of granular parakeratosis. Methods: The files of the DermatoHistologisches Labor Dr. H. Laaff, Freiburg, were searched for the diagnosis of granular parakeratosis. Identified cases were evaluated for clinical information and histopathologic characteristics. Result: From 2004 to 2007 10 cases (7 women, 3 men) of granular parakeratosis were found corresponding to a frequency of 0.004%. The average age was 62 (33–82). In women lesions occurred in submammary region (4), axillae (2) and popliteal fossa; in men, groin (2) and genital region. Clinically two different patterns are recognized – lichen planus‐like red‐brown slightly hyperkeratotic or scaly papules, and larger plaques which are either bright red shiny or grey‐brown with lichenification. Histologically the typical granular parakeratosis was seen in a prominently thickened stratum corneum. It remains unclear whether granular parakeratosis is a disease entity or whether it reflects a reaction pattern to unknown stimuli.     

Incidental granular parakeratosis associated with molluscum contagiosum

A patient presented with a 4-month history of slowly progressive pruritic papules on her trunk and extremities. Biopsies from 2 of these lesions revealed molluscum contagiosum. One of the biopsies also showed several small foci of granular parakeratosis. Based on the clinical features and course of this patient, the granular parakeratosis seems to be an incidental finding.     

Incidental granular parakeratosis associated with molluscum contagiosum

A patient presented with a 4-month history of slowly progressive pruritic papules on her trunk and extremities. Biopsies from 2 of these lesions revealed molluscum contagiosum. One of the biopsies also showed several small foci of granular parakeratosis. Based on the clinical features and course of this patient, the granular parakeratosis seems to be an incidental finding.     

VP-16对鼠尾表皮颗粒层生成及血清IL-2水平的影响

目的：观察VP—16对小鼠尾部表皮颗粒层生成及血清IL一2水平的影响。方法：采用小鼠尾部鳞片表皮颗粒层形成模型，不同组别的小鼠以VP—16或甲氨蝶呤灌胃，观察其对鼠尾表皮颗粒细胞生成的调节作用。并用ELISA法测定各组小鼠血清IL一2水平的变化。结果：VP—16可显著促进小鼠尾部鳞片表皮颗粒层形成，并抑制血清IL一2的水平。结论：VP—16对银屑病的角化不全具有良好的治疗作用。     

表皮松解性角化过度鱼鳞病伴侏儒1例

报告1例表皮松解性角化过度鱼鳞病患者伴侏儒和骨骼畸形。患者女,15岁。全身皮肤红斑、表面覆灰棕色痂皮15年,伴体形矮小、四肢畸形12年。皮肤组织病理检查显示表皮角化过度伴角化不全,棘层肥厚,表皮颗粒层下见明显裂隙,裂隙内有较多角化不良细胞,表皮和真皮内有大量中性粒细胞浸润。