白色纤维性丘疹病1例

报告1例白色纤维性丘疹病.患者女,28岁,双上肢及上背部丘疹1年,既往鱼鳞病病史20年.皮肤科检查:双上肢及上背部散在白色丘疹,直径2～3 mm,瓷白色,未有融合倾向.皮损组织病理检查示表皮网篮状角化过度,真皮浅层血管周围少量淋巴组织细胞,真皮中上层胶原纤维束增粗.弹性纤维染色显示真皮浅层弹性纤维减少.胶原纤维及弹性纤...     

20例白色萎缩临床及病理分析

目的:分析20例白色萎缩患者的临床、病理表现.方法:对我中心诊治的20例白色萎缩患者的临床资料进行回顾性分析,包括临床、病理、误诊及治疗情况.结果:多见于青年女性,皮损好发于下肢;11例患者血管腔内有透明血栓形成(占55%);小剂量阿司匹林、双嘧达莫及达那唑治疗效果较好,治疗有效率100%;早期误诊10例(占50%).结论:临床特点及组织病理学检查为诊断本病的依据,医务人员应加强对早期白色萎缩的认识.     

非色素型小汗腺汗孔瘤二例

例1 女,33岁,因左足跟部红色丘疹3年于2018年5月13日就诊.患者3年前无明显诱因左足跟出现米粒大红色丘疹,缓慢增大,触碰稍有疼痛.体检:系统检查无异常.皮肤科检查:左足跟腱外侧见0.5 cm×0.4 cm大小红色丘疹,有蒂,表面较光滑,上覆少量白色鳞屑(图1A).皮肤镜检查:粉红至白色无结构区,可见线状血管、分...     

皮肤镜辅助诊断小汗腺汗孔瘤1例

报告1例小汗腺汗孔瘤.患者男,58岁.左足跟部红色肿物10余年.皮肤科检查:左足跟腱部可见直径约1 cm的红黑色隆起性结节,质软,边界清楚,伴外周褐黑色色素沉着.皮肤镜下可见边界清晰的类圆形结节,皮损中央可见多个叶状血管,血管周围有白色晕.皮损组织病理检查:真皮内可见与表皮相连的肿瘤细胞团块,向下延展进入真皮,瘤细胞大...     

白色萎缩性血管炎的小量肝素疗法

白色萎缩性血管炎(青斑样血管炎)为下肢发生周期性疼痛性溃疡的一种慢性疾病,考虑是由于在真皮中部、浅部血管被纤维蛋白阻塞而引起,治疗十分困难.降糖灵及乙雌烯醇控制本病有效,推测     

A Clinical review of thirteen cases of atrophie blanche

目的:提高对白色萎缩的临床认识,探讨其诊治方法.方法:回顾分析13例白色萎缩患者的临床表现、实验室检查、治疗及随访情况.结果:患者以青年女性居多,病情夏重冬轻.主要表现为双下肢,尤其双踝关节及足背部对称性红色或紫红色斑疹、斑片、丘疹及水疱,逐渐出现溃疡、渗出物及结痂,愈后遗留象牙白色萎缩性瘢痕,周围有毛细血管扩张和(或)形成小血管球瘤样外观.部分患者双下肢还有网状青斑样改变.实验室检查无特异性,组织病理检查均符合青斑血管炎改变.口服达那唑、双嘧达莫(潘生丁)、小剂量阿司匹林、丹参滴丸,外用肝素钠乳膏或多磺酸黏多糖乳膏可获良好效果,但容易反复发作.结论:白色萎缩的诊断需结合临床特征及组织病理检查结果,药物治疗虽易控制症状,但容易反复发作.     

非色素性小汗腺汗孔瘤的皮肤镜及组织病理特征分析

目的 评价非色素性小汗腺汗孔瘤的皮肤镜特征以及组织病理学特征。方法 回顾性分析17例组织病理诊断明确的非色素性小汗腺汗孔瘤患者临床资料,分析其皮肤镜及组织病理特征。结果 非色素性小汗腺汗孔瘤的皮肤镜下特征包括血管结构、红色球状结构及白色无结构区。11例（64.7%）患者可见血管结构,2例（11.8%）患者表现为多形态血管模式,9例（52.9%）患者表现为单形态血管模式。16例（94.1%）患者可见红色球状结构;17例（100%）患者均可见白色无结构区;7例（41.2%）表面有糜烂,17例（100%）可见鳞屑。结论 血管结构、红色球状结构及白色无结构区是非色素性小汗腺汗孔瘤的常见皮肤镜特征,有助于提高临床诊断率。     

头皮银屑病和脂溢性皮炎的皮肤镜特征分析

目的确定皮肤镜下头皮银屑病和脂溢性皮炎的皮肤镜特征。方法共选取55例进展期或静止期头皮银屑病患者和45例头皮脂溢性皮炎患者。其研究指标为鳞屑颜色、血管形态、血管排列模式。结果头皮银屑病皮肤镜下主要特征为低倍镜下白色或类银白色鳞屑、点/球状血管、规则排列成线状/环状、高倍镜下肾小球状血管。其中,白色或类银白色鳞屑、规则排列、肾小球状血管同时存在时灵敏度为65%,特异度为98%。头皮脂溢性皮炎为黄色鳞屑、低倍下多种血管、高倍下细分支血管和不典型血管,不规则排列。结论皮肤镜下头皮部位银屑病和脂溢性皮炎的不同模式,可用于临床辅助诊断。某些皮肤镜特征同时存在有助于鉴别诊断银屑病。     

胸部淡红色斑——丹毒样癌

目的:提高对白色萎缩的组织病理和发病机制的认识,探讨有效的治疗方法.方法:对47例白色萎缩患者的临床和组织病理资料进行回顾性分析.结果:该病发病以青年女性居多,皮损表现为双小腿、踝部、足部散在的淡红色和紫红色斑疹、浅表溃疡,愈后形成象牙色萎缩斑,夏重冬轻.组织病理表现为真皮浅中层血管有透明血栓形成.部分患者有血管炎的改变.结论:该病的诊断主要依靠临床表现和组织病理检查,口服达那唑治疗有良好的疗效.     

有青斑样血管炎表现的系统性红斑狼疮

报告1例有青斑样血管炎表现的系统性红斑狼疮.患者男,3l岁.面部出现蝶形红斑,足背和踝关节周围皮肤出现疼痛性溃疡,以及町触性紫癜和萎缩性瓷白色搬痕2年.足背皮损组织病理榆查:真皮浅层血管扩张、弯曲,部分血管腔有大量纤维蛋白样物质和红细胞栓塞,血管周围散在淋巴细胞浸润.结合其他实验室榆查,诊断为系统性红斑狼疮.对患者采用糖皮质激素和雷公藤多苷进行治疗,同时给予抗凝和抗血小板活化治疗,皮损得到部分缓解.     

发疹性黄瘤1例

患者男,41岁。面部、躯干下部及双下肢泛发橘黄色丘疹3个月。面部、躯干下部及双下肢散在分布橘黄色丘疹,米粒至绿豆大小,质硬,部分基周红晕,有压痛。抠挤后破溃,结痂,遗留色素性或肥厚性瘢痕。患糖尿病和脂肪肝2年。诊断:发疹性黄瘤。嘱低脂饮食,继续治疗高脂血症,面部皮损予激光治疗,现随访中。     

Sweet syndrome (acute febrile neutrophilic dermatosis) and erythema nodosum in Crohn disease

We report on 2 patients who developed an acute febrile neutrophilic dermatosis (Sweet's syndrome) and erythema nodosum in association with Crohn's disease. The first patient showed symmetrical painful erythemas on her cheeks after hemicolectomy. Additionally, red painful nodules appeared on her lower legs. The second patient disclosed typical Sweet's syndrome-like lesions with pustules and plaques on her face, scalp and extremities after activation of Crohn's disease. Simultaneously, erythema nodosum-like lesions appeared on her lower legs.     

Granulomatous pigmented purpuric dermatoses: report of three cases and review of the literature

Purpuric pigmented dermatoses represent a form of chronic, recurrent capillaritis characterized by petechiae and purpuric macules over the lower limbs. We report three female cases who presented with clinical features of purpuric pigmented dermatosis with unusual histopathologic features. The first patient had golden-brown pigmented purpura over bilateral knees, shins and dorsal feet. The second patient showed purpuric papules on the medial aspects of the ankles. The third patient presented with numerous petechiae on her lower legs. All three patients demonstrated granulomatous inflammation in addition to the histologic features of pigmented purpuric dermatosis. A total of 11 patients have currently been reported in the literature. A review of the clinical details of the cases revealed a high incidence of hyperlipidemia (7/11) and hypertension (4/11) among these patients.     

2 basaliomas of the lower leg in a 60-year-old female--one of them simulating ulcus cruris

We report on a 60-year-old female patient with an ulcer on the left lower leg, which was treated for 2 years without success. Histologically, a biopsy specimen showed a partly fibrotic and partly solid basal cell epithelioma. When all of the patient's skin was examined, a small skin-colored nodule was found on her right lower leg that histologically also turned out to be a basal cell epithelioma. The patient had no history of predisposing factors like exposure to arsenic or actinic skin damage. Our case is compared with the literature and briefly discussed.     

Cutaneous manifestations in a patient with a long-term history of untreated ACTH-dependent Cushing's syndrome

Cushing's syndrome is accompanied by many different skin symptoms. A case of a 43-year-old female patient with unrecognized adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome is reported. Besides numerous skin lesions, the patient presented with a rapidly progressive leg ulcer due to venous thrombosis. The initial skin symptoms appeared on her lower leg one month prior to admission. The patient was treated with oral prednisone, however, rapid progression of the skin lesion was observed. On admission the patient presented with a large, very painful ulceration, partially covered with a crust, on the right lower leg with several satellite smaller ulcerations. The other leg showed no changes. Moreover, the patient had pronounced hirsutism and skin darkening on the face, and Muehrcke's lines were observed on all her nails. Microscopic findings of skin biopsy were uncharacteristic, with some signs of angiopathy and vasculitis. Based on the elevated serum levels of ACTH and cortisol, and the result of dexamethasone suppression test, ACTH-dependent Cushing syndrome was diagnosed. Sonography of leg veins revealed a recanalized thrombus of the right popliteal vein with reflux. The patient was transferred to surgical department where both suprarenal glands were removed. Upon suprarenal gland removal, significant improvement of the patient's general condition and rapid healing of the leg ulcer were observed. Briefly, this patient is presented to point out that a leg ulcer caused by venous insufficency may mimic fulminant purpura or some other type of vasculitis in patients with Cushing syndrome.     

Antineutrophil cytoplasmic antibody-associated vasculitis with oculomotor nerve palsy

We report a patient with antineutrophil cytoplasmic antibody-associated vasculitis with oculomotor nerve palsy. The patient presented with a high fever, diplopia, blepharoptosis and impairment of ocular movement of the left eye except for lateral gaze. Multiple erythematous and livedoid lesions were observed on the forehead, both cheeks and both legs. Laboratory examination showed positive results for myeloperoxidase antineutrophil cytoplasmic antibodies. Skin biopsy revealed leucocytoclastic vasculitis of the small arteries in the lower dermis. The patient was successfully treated with systemic corticosteroids.     

Quinidine-induced photodermatitis confirmed by photopatch testing

A patient with quinidine-induced photosensitivity confirmed by photopatch testing is presented. The action spectrum for the reaction appeared to be in the UVA range, and the patient's minimal erythema dose was lower than expected while the patient was on quinidine.     

Maffucci syndrome with the spindle cell hemangiomas in the mucosa of the lower lip: a rare case report and literature review

The presence of non‐cutaneous vascular lesions in the syndrome of multiple enchondromas and subcutaneous hemangiomas, also named Maffucci syndrome, is exceedingly rare. Until now, non‐cutaneous vascular lesions have been described in nine patients, while only three cases were present in the oral cavity; they were found in the tongue in two patients and in the lower lip in one patient. Herein, we report the second case of vascular lesions localized in the mucosa of lower lip in a patient with Maffucci syndrome. Histopathologic examination showed spindle cell hemangioma.     

Effect of early and late mobilisation on split skin graft outcome

Background: There is an increasing trend towards early mobilisation post‐split skin grafting of the lower limbs. This study was performed to determine if early mobilisation impacts negatively on graft healing and patient morbidity. Methods: A retrospective review of 48 cases of lower limb split skin grafts performed by the plastic surgery department at Royal Perth Hospital was undertaken. Patients were stratified into early and late mobilisation groups. Results: No difference in outcome was identified with early mobilisation, but an increased rate of deconditioning with increased length of stay was present with late mobilisation. Conclusion: These results suggest that early mobilisation post‐split skin grafting of the lower limb is beneficial to patient care and is associated with lower morbidity.     

巨大型嗜酸性脓疱性毛囊炎治愈1例

45岁男性患者，头面部丘疹、脓疱、肿块反复4年，双小腿褐色斑块1月，外周血嗜酸粒细胞计数增高，皮损组织病理显示表皮内毛囊内嗜酸性脓肿，皮质类固醇联合抗生素及抗组胺药治疗疗效显著。