生殖器疱疹合并感染的临床研究

目的:分析并探讨生殖器疱疹合并感染的临床特点,从而为临床诊断提供依据。方法:选取2010年1月至2016年1月期间在我院就诊的性病门诊患者574例。采用回顾性分析的方法,总结患者临床资料,分析临床特征。结果:574例患者中,生殖器疱疹372例,占64.81%,硬下疳占17.42%,淋菌性包皮龟头炎占1.74%,念珠菌性包皮龟头炎占3.66%,白塞病占1.22%,其他类型占11.15%。372例生殖器疱疹患者平均年龄为(36.35±6.34)岁,男性患者占78.23%,女性占21.77%。初次发病占30.11%,复发占69.89%。合并其他感染87例,占23.39%,其中以合并尖锐湿疣为主,占8.60%。HSV-1感染者24例(6.54%),HSV-2感染者348例(23.39%)。所有合并感染者均为HSV-2感染者。结论:生殖器疱疹是临床常见性病之一,容易合并其他性传播疾病,HSV-2型为易感其他疾病类型,临床上要早期诊断。     

生殖器疱疹合并其它性传播感染的临床研究

目的：探讨生殖器疱疹合并其它性传播感染的发生率及其临床特点。方法：对生殖器部位有疱疹性损害或可能由疱疹病毒引起损害的患者进行了临床资料采集和分析，并作了生殖器疱疹、梅毒、尖锐湿疣、生殖器 念珠菌病等性传播感染的病原学检测。结果：在287例入选病例中，确诊生殖器疱疹186例（64．8％），对其中68例（23．7％）患者作了HIV血清抗体检测，未发现HIV感染者。在186例生殖器疱疹病例中，43例（23．1％）合并有其它性传播感染，其中合并尖锐湿疣16例（8．6％）、活动性梅毒及潜伏梅毒13例（7．0％）（包括合并硬下疳6例）、生殖器念珠菌病12例（6．5％）。有合并性传播感染的生殖器疱疹均为HSV－2感染所致。结论：生殖器疱疹易合并其它性传播感染，且可引起其损害形态发生改变。     

男性与女性下体尖锐湿疣的临床特征及流行病学的差异性调查

目的:分析男、女性下体尖锐湿疣(CA)的临床特征与流行病学的差异性。方法:收集2010年12月至2015年1月北京市昌平区医院皮肤科收治的138例男性、114例女性下体尖锐湿疣患者的临床资料,总结其临床特点,调查其流行病学特征,总结男、女下体尖锐湿疣的差异性。结果:男性下体尖锐湿疣患者年龄普遍大于女性,且其发病时间较长(P0.05);男性下体尖锐湿疣患者职业多为干部、保健行业、商人,女性则以保健行业为首,其次为商人、茶艺师;男、女性下体尖锐湿疣患者婚姻状况对比差异无统计学意义(P0.05),男性下体尖锐湿疣患者文化程度较高,而女性尖锐湿疣患者初中及以下所占比例高于男性(P0.05);男性下体尖锐湿疣患者吸烟、饮酒者多于女性(P0.05),女性食辛辣所占比例多于男性(P0.05);男性感染途径多为一夜情,其次为同居,而女性感染首要途径为同居,其次为婚内性生活,不同性别尖锐湿疣感染途径对比差异有统计学意义(P0.05);女性近1年来有生殖系统感染史占23.68%,多于男性(P0.05);男性从不使用安全套比例低于女性(P0.05),每次性生活使用安全套比例多于女性(P0.05);男性高低危混合HPV感染比例低于女性(P0.05),其余各亚型对比差异无统计学意义(P0.05);男性疣体多分布于包皮、阴茎、尿道口、系带处,女性疣体主要分布于会阴、阴道口、舟状窝、宫颈及小阴唇处。结论:女性尖锐湿疣患者多为性活跃期人群,且发病时间短,既往多合并生殖系统感染史,保健行业人群多见;男性则以中年群体居多,发病时间长,文化程度高,职业以干部、商人等为主,交易性行为为其主要感染途径。     

2008-2017年中国生殖器疱疹流行特征分析北大核心CSCD

目的了解2008--2017年全国生殖器疱疹流行特征,为制定防控对策提供依据。方法应用描述性流行病学方法对2008--2017年全国105个国家性病监测点报告的生殖器疱疹病例资料进行“三间分布”分析。。结果生殖器疱疹报告发病率从2008年的8．30／10万下降到2017年的6．14／10万,年均下降3．29％。不同监测点报告发病率差异较大,最高可达113．51／10万,最低〈1／10万。高发地区主要为广东、广西、海南、浙江、福建、重庆和湖北,报告发病率较低的地区主要为华北和中部地区,少数农村监测点无病例报告。2016年女性报告发病率略高于男性,其他年份男性均高于女性,男女性别比由2008年的1．77：1下降至2017年的1．03：1。生殖器疱疹高发年龄段为20—39岁的性活跃人群,以25—34岁年龄组报告发病率最高（17．84／10万～26．89／10万）。综合医院报告病例数最多,占58．13％。76．52％,其次为皮肤性病专科医院、妇科医院和妇幼保健院。结论虽然中国生殖器疱疹报告发病率整体呈下降趋势,但在广东、广西、海南、浙江、福建、重庆和湖北发病率仍较高,应根据各地疾病流行特点有针对性地采取不同的防治措施。     

甘肃省庆阳市2010-2014年性病/艾滋病流行病学分析

目的分析庆阳市性病/艾滋病疫情资料,为"十三五"制定性病防控策略提供科学依据。方法对庆阳市2010-2014年网络直报的五种主要性病及艾滋病疫情资料进行流行病学描述性分析。结果 5年共报告2 869例性病病例,男女性别比为0.82∶1,女性发病率(28.07/10万)高于男性(22.28/10万),差异有统计学意义(P0.01);性病疫情年均发病率为28.56/10万,2014年发病率是2010年的2.07倍。疫情总体呈上升趋势(P0.01),除淋病外,梅毒、尖锐湿疣、HIV/AIDS病例数也呈现上升趋势(P0.01);年龄以20~39岁为主,占58.73%,50岁以上病例构成总体呈上升趋势;职业以农民为主,占70.93%;排前三位的性病为梅毒、淋病、尖锐湿疣,构成分别为56.71%,18.86%和17.32%,同时它们的发病率也居前三位。结论庆阳市性病疫情总体呈上升趋势,以梅毒、淋病、尖锐湿疣为主,HIV/AIDS发现人数也呈现增长趋势。     

梅毒合并其他性传播疾病和/或HIV感染情况的分析

目的探讨梅毒合并其他性传播疾病和/或HIV感染的发生率及其流行情况。方法对确诊梅毒的患者进行生殖器疱疹、非淋菌性尿道炎(宫颈炎)、淋病、生殖器念珠菌病等性传播疾病及HIV感染的实验室检测。结果在470例入选病例中,合并感染256例,占54.5%,其中男107例(占男性病例的36.1%),女149例(占女性病例的85.6%),女性合并感染率明显高于男性(P(0.001);在梅毒合并其他性传播疾病和/或HIV感染病例中,HIV感染8例(1.7%),生殖器疱疹77例(16.4%),沙眼衣原体41例(18.7%),解脲脲原体86例(18.3%),人型支原体19例(4.0%),淋球菌34例(7.2%)及念珠菌52例(11.1%);其中合并一种病原体201例(42.8%),合并两种病原体47例(10%),合并三种及3种以上病原体8例(1.7%)。结论梅毒易合并其他性传播疾病感染,促进HIV感染;梅毒患者应全面进行其他性病实验室项目及HIV抗体检查。     

生殖器疱疹临床流行病学研究

目的探讨生殖器疱疹患者的临床流行病学特点。方法总结2015年6月~2016年12月我科诊治的312例生殖器疱疹患者临床特点、复发诱因及观察口服盐酸伐昔洛韦(明竹欣)的抑制性治疗和肌注卡介菌多糖核酸注射液(斯奇康)的免疫调节治疗对部分生殖器疱疹复发的影响。结果 312例生殖器疱疹中,男性占76.92%,女性占23.08%;未婚者占15.06%;年龄(16~52)岁,平均25.4岁。88.78%在(21~40)岁;病程为3天~15年;初次发作患者占19.55%,复发患者占80.45,其中复发患者86.06%频繁复发(每年复发≥6次);复发的主要的诱因是劳累、饮酒和感冒或腹泻等;每(1~2)月发病作1次的患者,35例每天口服明竹欣1年,期间复发率降低83.33%,74例肌注(斯奇康)3个疗程,1年内复发率比预期降低62.92%。结论生殖器疱疹多见中青年男性患者,容易复发,应避免劳累、饮酒等诱发因素,每日口服明竹欣及肌注斯奇康可降低复发率。     

国家性病监测点广东省兴宁市2007-2014年间5种性病流行特征分析

目的:探讨广东省兴宁市成为国家性病监测点8年间的5种性病疫情流行病学特征,为今后制定防治对策提供依据。方法:采用描述性流行病学方法对全市19个街道办事处及乡镇5种性病报告病例的"三间分布"进行分析。结果:2007~2014年间兴宁市梅毒、生殖器疱疹及尖锐湿疣报病数逐年增加,生殖道沙眼衣原体报病数早年上升明显,近2年有下降趋势,淋病发病呈现下降趋势。兴田街道办事处(城区)发病率明显高于农村。男性、女性的淋病及生殖器疱疹报告发病率均较低,而梅毒、生殖道沙眼衣原体报告发病率均较高。结论:兴宁市成为国家性病监测点通过高质量监测数据可真实了解不同地区性病感染状况,疫情的变化较真实反映了性病流行情况,未来应进一步加强性病报病网络建设,并应采取综合措施控制性病在本地区的流行。     

中药黄白液联合阿昔洛韦治疗复发性生殖器疱疹疗效观察

我科应用中药黄白液和阿昔洛韦联合治疗复发性生殖器疱疹熏对其复发情况进行了观察熏收到令人满意的疗效熏现将结果报告如下。1资料和方法临床资料选择2004年7月—2005年6月期间在我科门诊就诊的复发性生殖器疱疹患者99例,男性67例,女性32例,年龄23～42岁,病程6个月～3年。每月     

生殖器尖锐湿疣与外阴阴道念珠菌病发病相关性临床探讨

为探讨生殖器尖锐湿疣（CA）与外阴阴道念珠菌病（VVC）临床发病相关性，选取女性生殖器CA患者142例为研究对象。治疗前进行了疣体组织活检和疣体组织液PCR检测人乳头瘤病毒的（HPV）11、6型及外阴阴道分泌物真菌培养和涂片。并随访3个月。结果发现141例CA患者中111例合并VVC，发病率78．72％；合并感染者CA复发明显高于单纯CA（P＜0．05）。提示女性生殖器CA与VVC有密切的联系。     

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.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.