452例妇女外阴瘙病因调查分析

目的：对皮肤性病科门诊妇女外阴瘙患者进行病因调查分析。方法：对以外阴瘙为主诉的妇女患者进行皮肤性病科临床检查;取阴道分泌物进行pH值,胺试验及念珠菌,滴虫和线索细胞检查。取宫颈分泌物作淋球菌,解脲支原体培养和沙眼衣原体荧光抗原检查,可疑部位取材作HSV和HPV检测及梅毒血清学检查。结果：在452例入选患者中,外阴阴道念珠菌病,非淋菌性宫颈炎和细菌性阴道病分别占25．44％,20．79％和13．50％,外阴湿疹,滴虫性阴道炎和外阴瘙 症也较多见,结论：与性传播因素有关的病原体感染及外阴湿疹和瘙等是皮肤性病科就诊妇女外阴瘙的主要原因。     

452例妇女外阴瘙痒病因调查分析

目的 :　对皮肤性病科门诊妇女外阴瘙痒患者进行病因调查分析。方法 :　对以外阴瘙痒为主诉的妇女患者进行皮肤性病科临床检查 ;取阴道分泌物进行pH值、胺试验及念珠菌、滴虫和线索细胞检查 ;取宫颈分泌物作淋球菌、解脲支原体培养和沙眼衣原体荧光抗原检查 ;可疑部位取材作HSV和HPV检测及梅毒血清学检查。结果 :　在 45 2例入选患者中 ,外阴阴道念珠菌病、非淋菌性宫颈炎和细菌性阴道病分别占 2 5 .44 %、2 0 .79%和 13.5 0 % ,外阴湿疹、滴虫性阴道炎和外阴瘙痒症也较多见。结论 :　与性传播因素有关的病原体感染及外阴湿疹和瘙痒等是皮肤性病科就诊妇女外阴瘙痒的主要原因。     

性病患者阴道念珠菌感染情况分析

为了解性病患者阴道念珠菌感染情况，对性病门诊初诊女性病人同时进行各种性病检测。念珠菌培养采用沙氏氯霉素培养基。结果 369例性病患者念珠菌阳性率47．70％，369例对照组念珠菌阳性率23．30％，两组比较有显著性意义（P＜0．01）；尖锐湿疣合并念珠菌感染最高74．29％，滴虫病、细菌性阴道病较低，分别为30．76％、25．64％；分离菌种以白念珠菌为主，两组分别为93．75％和95．34％。提示性病患者阴道念珠菌分离阳性率和发病率高于非性病者。     

广州地区性病门诊细菌性阴道病的现状调查

为了解广州地区性病门诊女性患者细菌性阴道病（BV）的发病情况，用BV快速检测方法和诊断标准方法对2000年性病门诊725例女性患者进行检测；并对确诊的BV患者做淋球菌、衣原体、支原体、滴虫和念珠菌检测。结果725例病人确诊为BV者131例，患病率为18．07％（131／725）。131例BV患者中有113例合并其它病原菌感染。其合并感染率为86．26％（113／131）。其中解脲支原体(Uu)占首位（38．93％），其次为淋球菌（14．50％），第3为Uu、Mh混合感染（9．90％）。BV快速检测方法阳性预测价值不高（57．60％），不能用于确诊。     

细菌性阴道病并发性传播性疾病病原体检测

近来研究发现,细菌性阴道病（bacterial vaginosis,BV）与滴虫、衣原体感染、淋病等性传播性疾病（STD）有密切关系。为此,笔者对我院性病门诊2005年6月-2006年10月就诊的310例女性患者进行检测,现将结果报告如下。[第一段]     

对加德纳菌阴道炎的调查分析

细菌性阴道病是近年来被确定的与性传播有关的疾病。其病原体为阴道加德纳菌,随着性病病原体感染谱的变化,发病率有逐年增高的趋势。目前对加德纳菌的实验诊断,主要的还是直接涂片找线索细胞。我们对187名年龄在20～29岁的已婚妇女,均无不良性行为,夫妻性生活正常,对其宫颈分泌物检测。     

妊娠期阴道、宫颈微生态的评价

目的了解妊娠期阴道、宫颈感染状况,探讨妊娠期进行阴道分泌物检测及宫颈分泌物HPV、衣原体检测的临床意义。方法产前门诊常规围产保健孕妇980例（早孕期159例、中孕期612例、晚孕期209例）采集阴道分泌物,测定pH值、涂片常规检查及,宫颈分泌物行杂交捕获试验检测人乳头瘤病毒（HPV）及送微生物室行免疫层析法检测沙眼衣原体抗原。妇科门诊非阴道炎就诊的患者（年龄≤40岁）100例进行相同的检查作为非孕期对照。结果阴道pH值在妊娠期、非孕期分别为3．88±0．20及4．28±0．33,孕期低于非孕期（P〈0．01）。孕期细菌性阴道病（BV）、外阴阴道假丝酵母菌病（VVC）及沙眼衣原体（CT）感染率分别是23．9％、21．5％、22．0％,非孕期三项感染率分别为12．0％、11．0％、6．0％,孕期显著高于非孕期（P〈0．01）。孕期HPV感染率同非妊娠期。无症状体征孕妇中,仍有29．8％存在阴道微生态失调。在HPV阳性孕妇中BV、VVC、CT的患病率分别为48．7％、41．7％、45．2％,HPV阴性组中分别为20．6％、18．8％、19．0％,HPV阳性组BV、VVC、CT患病率明显高于阴性组（均P〈0．01）。结论妊娠期阴道微生态发生改变,表现为pH值降低,微生态失调比例升高,与HPV感染密切相关。     

计划生育门诊人工流产妇女生殖道感染流行状况及危险因素分析

目的：确定计划生育门诊人工流产妇女生殖道感染的流行状态及其危险因素,以建立简便筛查方法和预防治疗措施。方法：为横断面研究。在研究期内,对所有到两家计划生育门诊做人工流产的妇女进行体检和问卷调查,并取阴道和宫颈管标本进行病原体检测。同时取静脉血做梅毒血清和HIV检测。对危险因素应用单变量和逻辑回归方程进行多变量分析。结果：在2020名人工流产妇女的检测中,衣原体感染率为4．8％,淋球菌0．4％,阴道毛滴虫2．5％,细菌性阴道病3．4％,白念珠菌病6．5％,累计梅毒流行率为1％(TPPA阳性者),1例妇女HIV抗体阳性。虽然在多变量分析中发现一些与感染相关的危险因素,但阳性预测值较差。结论：人工流产妇女可作为性传播感染的干预人群,特别是衣原体感染。但由于多数感染妇女为无症状者,且无法建立选择性筛查标准,因此,必须探讨其它方法以检测该人群中生殖道性传播感染者。     

儿童泌尿生殖道沙眼衣原体、解脲脲原体的检测及其意义

目的 探讨儿童泌尿生殖道沙眼衣原体（Ct）、解脲脲原体（Uu）等病原体的感染情况。方法 对门诊就诊的155例儿童，取尿道分泌物、阴道分泌物检测炎症细胞、Ct、Uu、淋球菌（Ng）、念珠菌、阴道毛滴虫、蛲虫卵。结果 22例女童阴道分泌物检出白细胞（WBC）阳性，Q检出率6．45％（10／155），Uu检出率22．58％（35／155），检出淋球菌2例（1．29％），念珠菌2例（1．29％），蛲虫卵3例（1．94％）。结论 对儿童泌尿生殖道炎症，要注意查找性病因素。儿童泌尿生殖道内存在Ct、Uu健康携带或正常定植情况。     

180例外阴阴道念珠菌病临床分析

性病门诊中180例外阴阴道念珠菌病患进行了临床研究，发现发病诱因中妊娠、糖尿病、口服避孕药仅占小部分比例，而不洁性接触，性传播疾病、大量应用广谱抗生素，在性病门诊中占较大比例，性交频繁、较少应用保护性措施以及男性念珠菌性包皮龟头炎都是可能的危险因素；临床表现和体征与献报道无差异，常规做宫颈及阴道分泌物STD涂片检查，有助于发现念珠菌感染以外的病原体，以利于治疗；口服抗真菌药对治疗外阴阴道念珠菌病已显示高效、安全服用方便的特性。     

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.