不规则毛霉致皮肤型毛霉病一例

患者,女,65岁。反复左上肢结节、斑块、流脓伴疼痛7年,累及右上肢1年。2型糖尿病病史3年。左手背皮损组织病理示表皮棘层肥厚伴角化不全,真皮全层多灶肉芽肿形成伴淋巴细胞、浆细胞浸润,胶原纤维变性,并累及皮下脂肪;真菌培养示白色绒毛状菌落生长,镜下表现为粗大、无分隔菌丝,可见圆形孢子囊;宏基因组测序示不规则毛霉。诊断为不规则毛霉致皮肤型毛霉病。     

不规则毛霉致原发性皮肤毛霉病一例

患者女,39岁,右面部斑块、溃疡伴疼痛2个月。既往患急性髓系白血病1年,经治疗后缓解,半年前再次复发。皮肤科检查：右面颊5 cm × 5 cm紫红色斑块,中央糜烂溃疡,表面覆盖黄褐色痂皮,可见肉芽组织,剥去痂皮有黄色脓液溢出,皮损边界清晰,边缘稍隆起,触痛明显。实验室检查：白细胞28.75 × 109/L,中性粒细胞1.05 × 109/L,淋巴细胞27.17 × 109/L,红细胞2.20 × 1012/L,血红蛋白69 g/L,血小板84 × 109/L;肝肾功能、电解质及心电图检查未见异常。皮损组织病理HE及过碘酸希夫染色示真皮内大量淋巴细胞及组织细胞浸润,并见宽大无隔菌丝。真菌小培养见宽大透明无隔菌丝,并见假根、匍匐菌丝及球形孢子囊。分子生物学鉴定为不规则毛霉。诊断：①不规则毛霉致原发性皮肤毛霉病;②急性髓系白血病。给予口服羟基脲（0.5 g每日3次）、一次性静脉输注悬浮红细胞（4个单位）,静脉滴注两性霉素B（起始剂量5 mg/d,每天递增5 mg,最大增至25 mg/d,约0.5 mg·kg?1·d?1）,患者皮损逐渐变平、缩小。12 d后因故患者出院后失访。     

原发性皮肤毛霉病

报告1例原发性皮肤毛霉病.患者男,57岁.右前臂埋置静脉套管针17 d后局部出现红肿,迅速坏死并扩大.患者患2型糖尿病及慢性肾功能不全.皮肤科检查示右前臂大片坏死区,上覆黑色焦痂及渗出.取黑痂及渗液行真菌镜检,镜下可见大量粗大、无分隔、垂直分枝的菌丝,培养第2天即有棉花糖样菌落生长,初步诊断为皮肤毛霉病.皮损行组织病理检查,PAS染色示真皮及皮下组织可见较多粗大、无分隔菌丝,确诊为皮肤毛霉病.给予两性霉素B脂质体泵入、坏死组织清创术、术后外敷两性霉素B脂质体溶液及外用人成纤维细胞生长因子.患者伤口愈合良好,随访4个月无复发.     

皮肤垢着病1例

患者男,23岁。面部出现油腻性痂垢2年。发病前有面部柴油烧伤史。查体风面部及耳廓遍布密集褐黑色油腻性痂垢,与皮肤附着紧密。痂下分泌物细菌培养阴性,组织PAS染色未见真菌。诊断为皮肤垢着病。经中药口服并局部外敷痊愈。     

皮肤假性淋巴瘤一例

患者,男,13岁。右侧小腿红色丘疹5年,偶有瘙痒。组织病理示：表皮突萎缩变平,真皮浅层淋巴细胞、浆细胞团块状浸润,局部不典型淋巴滤泡形成,真皮中深部血管周围淋巴细胞、浆细胞浸润。免疫组化：真皮内浸润细胞CD3阳性,部分CD20阳性,浆细胞CD138阳性,kappa和Lambda散在阳性,呈多克隆表达,CD30阴性,Ki67阳性细胞约10%。符合假性淋巴瘤。治疗：外用丙酸氟替卡松乳膏。     

皮肤淋巴细胞瘤1例

患者女，23岁。上唇反复出现丘疹8年，两颊部丘疹半年。发病前有口唇单纯疱疹病史。组织病理检查示，真皮中淋巴滤泡形成；免疫组化示B、T淋巴细胞染色阳性，Bcl-2、CD30、Bcl-6和CD10均阴性。病理诊断为皮肤淋巴细胞瘤。     

皮肤浆细胞增多症

报告1例皮肤浆细胞增多症.患者男,51岁.右下肢股外侧浸润性红斑4年余,口周和腹部皮损1年.皮损组织病理检查:真皮深层及部分皮下组织可见以成熟浆细胞为主的大量炎性细胞浸润,其间有少量淋巴细胞及多核巨细胞.免疫组化染色示:浸润的浆细胞CD79a、CD138阳性.诊断:皮肤浆细胞增多症.     

Cutaneous anthrax: a case report

A case of cutaneous anthrax is reported and the need for clinical vigilance reiterated. The report emphasizes the importance of initialing treatment if bacteriological confirmation is likely to be delayed.     

皮肤子宫内膜异位1例

报告1例皮肤子宫内膜异位。患者女,47岁。脐部肿块半年余,无症状。脐窝下半部可见约1.0cm×0.8cm大隆起性肿块,表面呈棕褐色,质地中等,基底较硬,局部无红、肿、痛。皮损组织病理检查示:真皮中、下部可见管腔结构,管由单层柱状细胞构成,柱状细胞近腔面有纤毛,其间有透明细胞夹杂,腺体周围存在间质细胞。     

皮肤炭疽一例

患者,男,46岁,藏族,甘南某地牧民。右上肢红肿、水疱、黑色痂皮伴发热10天于2015年8月20日入院。2周前患者曾有宰杀病牛史。10天前患者右前臂出现数个黄豆大红色丘疹、斑疹,3天后右上肢肿胀,表面密布蚕豆大水疱、血疱,部分血疱破溃形成浅表溃疡,表面覆黑色干燥痂皮。恶心、呕吐、头痛,同时伴高热,体温最高达39.3℃。     

皮肤平滑肌瘤1例

报告1例多发性毛发平滑肌瘤。患者女，64岁。躯干出现皮疹3年，临床表现为躯干、四肢散在红褐色丘疹、结节。皮肤组织病理显示，真皮可见较多群集束关和团块状杂乱排列平滑肌束。免疫组化证实过度增生的纤维为平滑肌。     

Cutaneous mucormycosis

We report two cases of primary cutaneous mucormycosis in immunocompromised patients. Although their clinical presentation showed nonspecific necrotic ulcers, the histopathologic features were diagnostic. In both cases, broad, branching, nonseptate hyphae were found in the dermis and subcutaneous tissue. In one case the hyphae could be observed in the epidermis. To our knowledge, this is the only reported case of primary cutaneous mucormycosis with hyphae detectable in the epidermis.     

Cutaneous mucormycosis

The patient, a 59-year-old male, had been diagnosed as having alcoholic hepatopathy 20 years previously. He noticed localized swelling on his left leg after fishing in a river. The patient was diagnosed as having cutaneous mucormycosis upon histological and mycological examination of the skin. Gradual improvement of the symptoms was noted four weeks after administration of itraconazole and fruconazole; these were discontinued after five months.     

皮肤垢着病1例

报道1例皮肤垢着病，患者女，19岁，双面颊出现垢样物，无明显自觉症状2个月，皮肤科检查见双面颊不规则斑块，附黄褐色油腻性痂，取鳞屑真菌直接镜检发现圆形孢子，给予伊曲康唑治疗取得良效。     

皮肤动静脉性血管瘤

报告1例皮肤动静脉性血管瘤.患者男,55岁.左颧部蓝红色赘生物4年余.皮肤科检查:左颧部一黄豆大结节,表面光滑,呈蓝红色,质地中等.皮损组织病理检查:真皮内见由大量大的内皮细胞内衬的厚壁血管组成的团块,界限清楚,血管腔内可见红细胞.诊断:皮肤动静脉性血管瘤.     

经典皮肤纤毛囊肿一例

患者,女,17岁。左股内侧囊肿渐增大1个月。组织病理示：表皮正常,皮肤组织真皮层及皮下组织内见一囊肿,与表皮不相连,囊肿壁可见较多乳头状突起,囊壁覆以假复层纤毛柱状上皮。免疫组化染色示：上皮膜抗原（EMA）、CK 7、CK8/CK18、CK19、ER、PR、E-Cca均为阳性, S-100个别阳性,大囊肿病液体蛋白15（GCDFP-15）、癌胚抗原（CEA）、平滑肌肌动蛋白（SMA）均为阴性。诊断：皮肤纤毛囊肿。     

Cutaneous Rosai-Dorfman disease: a case report

Rosai-Dorfman disease, otherwise known as sinus histiocytosis with massive lymphadenopathy, is a non-Langerhans cell histiocytosis with a benign course and unknown etiology. It was described in 1969 as a painless cervical lymph node enlargement in association with fever, weight loss and sweating. Extranodal disease has been reported in 43% of cases, with involvement of multiple organs. Purely extranodal Rosai-Dorfman disease has been already reported, including forms restricted to the skin. This paper reports a case of purely cutaneous Rosai-Dorfman disease, which is of interest in view of the rarity of this condition.     

Cutaneous gonococcal abscess: a case report

A 29-year-old man was diagnosed as having a gonococcal abscess of the prepuce and urethritis. Such abscesses, caused by fetal monitoring during labor of a mother infected with Neisseria gonorrhoeae, have been observed on the scalp of newborns. If antibiotic treatment is to be effective, these abscesses must be excised and drained.     

Cutaneous mercury granuloma: a case report

Cutaneous mercury (Hg) granuloma is a rare disorder caused by the traumatic introduction of elemental Hg into skin or soft tissue. Typically, cutaneous elemental Hg deposits cause limited systemic effects. Prominent systemic toxicity may, however, occasionally occur. Herein we report a case of cutaneous Hg granuloma resulting in chronic painful local wounds and systemic toxicity in the form of abdominal pain, visual disturbances, and psychiatric abnormalities. The related literature also is reviewed.