丘疹性弹性纤维离解

报告1例丘疹性弹性纤维离解.患者女,32岁.颈部、枕部及下颌部无症状性白色丘疹3周.局部无痤疮及其他炎症性皮肤病史.皮肤科检查:下颌及颈、枕部见20余枚白色非毛囊性斑疹及丘疹,直径2～4 mm,呈圆形、星形或多角形.皮损组织病珲检查:真皮乳头层胶原轻度增生,弹性纤维断裂、减少,甚至局灶性消失.诊断为丘疹性弹性纤维离解.     

炎性线状疣状表皮痣3例

例1男,36岁,右足小趾、足背外缘沿小腿屈侧至腘窝出现暗红色角化性丘疹、斑块伴瘙痒32年.例2女,4岁,左下腹及腹股沟红色或红褐色丘疹、斑丘疹沿Blaschko线分布至外阴部,伴瘙痒3年半.例3男,26岁,右手背、手指、上肢至肩部暗红色丘疹、斑丘疹伴瘙痒3年.该3例皮损组织病理均示:表皮角化过度伴角化不全,棘层肥厚,呈...     

Cowden综合征1例

患者女,19岁,口腔、面、四肢丘疹15年,腹痛2周。皮肤科情况:口腔黏膜、舌部、面部及四肢可见散在皮色角化性丘疹,部分呈疣状或乳头瘤样,面部为甚。胃肠镜检查:消化道多发性息肉。组织病理学检查:(胃窦黏膜)增生性息肉伴中度慢性炎症,HP(+);(舌部)鳞状上皮乳头状瘤;(右前臂)表皮角化过度,局部棘层及颗粒层增生。诊断:Cowden综合征。     

肛周生殖器部位丘疹性棘层松解性角化不良1例

患者女,41岁。外阴、肛周出现丘疹伴瘙痒2年,无糜烂、疼痛不适。病理检查示:表皮角化过度,棘层肥厚,棘层松解,可见散在角化不良细胞,真皮浅层血管增生,少许淋巴细胞浸润。诊断为:肛周生殖器部位丘疹性棘层松解性角化不良。     

浅表性播散性汗孔角化症合并原发性皮肤淀粉样变1例

患者男,68岁,四肢、背部、面部褐色斑疹渐增多伴偶痒20年,双下肢褐色丘疹伴瘙痒半年。皮肤科情况：四肢、背部、面部散在环形斑片,边界清楚,表面呈褐色,边缘呈角化性堤状隆起,中央轻度萎缩,压之不痛;双下肢可见圆形或椭圆形褐色粟粒大小丘疹,密集分布,质地较硬,其间可见散在圆形环状斑片。左下肢皮损组织病理示：表皮显著角化过度,棘层肥厚,真皮乳头层增宽,可见淡红着色均匀团块状物质,中有裂隙及噬色素细胞;表皮层内存在角化不全柱,下方颗粒层消失,可见角化不良细胞,真皮浅层血管周围炎症细胞浸润。结晶紫染色(+)。诊断：浅表性播散性汗孔角化症合并原发性皮肤淀粉样变。     

外阴淋巴管瘤1例

患者女,53岁。外阴皮疹6月余。双侧大阴唇内、外侧散在分布粟粒至黄豆大红褐色群集性半透明蛙卵样丘疹,部分皮疹表面角化过度,似疣状。组织病理示:真皮浅层可见多数由单层内皮细胞组成的淋巴管囊样扩张。诊断:淋巴管瘤。     

误诊为Hailey-Hailey病的毛囊角化病

报告1例误诊为Hailey-Hailey病的毛囊角化病。患者女，31岁。乳房下红褐色丘疹19年，肛周红斑、糜烂4年。曾于外院多次诊断为湿疹、Hailey-Hailey病，因病情反复，近期有加重，遂至该院就诊。皮肤科检查：双侧乳房下多发红褐色丘疹，部分融合成斑块，肛周暗红色肥厚性斑块，伴皲裂，局部轻度糜烂。皮损组织病理检查：表皮部分糜烂，疣状增生，基底层上可见裂隙及棘层松解细胞，大量红染的角化不良细胞。基因检测：ATP2A2基因突变。结合患者基因检测结果，最终诊断为毛囊角化病。     

砷角化病并发鳞状细胞癌1例及文献复习

患者男,60岁,手足角化性丘疹40年,足部反复破溃4年。专科检查:双侧掌跖角化过度,其上可见多发淡黄色角化性丘疹,直径2～5 mm。左足底见两处溃疡面。躯干散在大小不等淡褐色色素沉着斑,其间夹杂点状或雨滴状色素减退斑。足部破溃处病理检查符合"鳞状细胞癌"。诊断:砷角化病并发鳞状细胞癌。治疗:予阿维A胶囊20 mg/次,1次/d,口服,硫代硫酸钠0.64 g静脉滴注驱砷治疗,足底破溃疡处行光动力治疗。     

头皮多发性寻常疣1例

患者男,21岁.右手拇指丘疹4个月,头皮丘疹1个月.皮肤科情况:右手拇指背侧见两颗丘疹,枕部头皮散在多个肤色丘疹,呈圆形,绿豆至黄豆大小,表面角化,无糜烂、渗出.头部皮损组织病理:表皮乳头状增生伴角化过度、角化不全,颗粒层增生,可见大量挖空细胞和不均匀嗜碱性颗粒.结合临床及病理检查诊断:多发性寻常疣.给予注射用人干扰素...     

伴有皮肤淀粉样变的播散性汗孔角化症

病史:男性,73岁,从67岁起他逐渐发生散在、少量、发痒的皮肤疹子。在两侧大腿及臀部布有多数棕红色扁平的角化过度的丘疹,在臀部为融合而带裂隙的角化过度斑。边缘隆起,境界清楚而稀疏存在的丘疹性损害。手掌、足跖是正常的。组织学:见棘层增厚,角化过度和多数角化不全柱(鸡眼样层板)。在这些柱状物的基底部颗粒层变薄和出现角化不良。真皮内主要在血管周围可以见到稀疏     

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.